bluuebunny/crossref_metadata_2025 huggingface dataset:
Haemoptysis due to an atypical right bronchial artery branching from the left subclavian artery evaluated by four-dimensional CT and bronchial arteriography
Authors: Fukaya Takumi , Kasai Hajime , Nagata Jun , Sugiura Toshihiko
Published: March 2021

Haemoptysis can be a life-threatening condition, and bronchial artery embolisation (BAE) is the most effective treatment. A 19-year-old man who had been followed up for neutrophil migration failure and bronchiectasis since birth was admitted to our department with repeated haemoptysis. Contrast-enhanced CT revealed hyperplasia and tortuosity of the bronchial artery; however, it could not reveal the origin and running by the axial views. Three-dimensional (3D) and four-dimensional (4D) CT revealed branching of the right bronchial artery from the left subclavian artery and a bronchial artery–pulmonary artery shunt. Bronchial angiography confirmed these findings. Based on these findings, BAE was successfully performed. 3D and 4D CT can be useful for determining the cause of haemoptysis. Furthermore, evaluating the anatomy of bronchial arteries prior to BAE may be useful for performing safer procedures.
Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study
Authors: Challen Robert , Brooks-Pollock Ellen , Read Jonathan M , Dyson Louise , Tsaneva-Atanasova Krasimira , Danon Leon
Published: March 2021

Objective

To establish whether there is any change in mortality from infection with a new variant of SARS-CoV-2, designated a variant of concern (VOC-202012/1) in December 2020, compared with circulating SARS-CoV-2 variants.

Design

Matched cohort study.

Setting

Community based (pillar 2) covid-19 testing centres in the UK using the TaqPath assay (a proxy measure of VOC-202012/1 infection).

Participants

54 906 matched pairs of participants who tested positive for SARS-CoV-2 in pillar 2 between 1 October 2020 and 29 January 2021, followed-up until 12 February 2021. Participants were matched on age, sex, ethnicity, index of multiple deprivation, lower tier local authority region, and sample date of positive specimens, and differed only by detectability of the spike protein gene using the TaqPath assay.

Main outcome measure

Death within 28 days of the first positive SARS-CoV-2 test result.

Results

The mortality hazard ratio associated with infection with VOC-202012/1 compared with infection with previously circulating variants was 1.64 (95% confidence interval 1.32 to 2.04) in patients who tested positive for covid-19 in the community. In this comparatively low risk group, this represents an increase in deaths from 2.5 to 4.1 per 1000 detected cases.

Conclusions

The probability that the risk of mortality is increased by infection with VOC-202012/01 is high. If this finding is generalisable to other populations, infection with VOC-202012/1 has the potential to cause substantial additional mortality compared with previously circulating variants. Healthcare capacity planning and national and international control policies are all impacted by this finding, with increased mortality lending weight to the argument that further coordinated and stringent measures are justified to reduce deaths from SARS-CoV-2.
Severe malnutrition or famine exposure in childhood and cardiometabolic non-communicable disease later in life: a systematic review
Authors: Grey Kelsey , Gonzales Gerard Bryan , Abera Mubarek , Lelijveld Natasha , Thompson Debbie , Berhane Melkamu , Abdissa Alemseged , Girma Tsinuel , Kerac Marko
Published: March 2021

Introduction

Child malnutrition (undernutrition) and adult non-communicable diseases (NCDs) are major global public health problems. While convincing evidence links prenatal malnutrition with increased risk of NCDs, less is known about the long-term sequelae of malnutrition in childhood. We therefore examined evidence of associations between postnatal malnutrition, encompassing documented severe childhood malnutrition in low/middle-income countries (LMICs) or famine exposure, and later-life cardiometabolic NCDs.

Methods

Our peer-reviewed search strategy focused on ‘severe childhood malnutrition’, ‘LMICs’, ‘famine’, and ‘cardiometabolic NCDs’ to identify studies in Medline, Embase, Global Health, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. We synthesised results narratively and assessed study quality with the UK National Institute for Health and Care Excellence checklist.

Results

We identified 57 studies of cardiometabolic NCD outcomes in survivors of documented severe childhood malnutrition in LMICs (n=14) and historical famines (n=43). Exposure to severe malnutrition or famine in childhood was consistently associated with increased risk of cardiovascular disease (7/8 studies), hypertension (8/11), impaired glucose metabolism (15/24) and metabolic syndrome (6/6) in later life. Evidence for effects on lipid metabolism (6/11 null, 5/11 mixed findings), obesity (3/13 null, 5/13 increased risk, 5/13 decreased risk) and other outcomes was less consistent. Sex-specific differences were observed in some cohorts, with women consistently at higher risk of glucose metabolism disorders and metabolic syndrome.

Conclusion

Severe malnutrition or famine during childhood is associated with increased risk of cardiometabolic NCDs, suggesting that developmental plasticity extends beyond prenatal life. Severe malnutrition in childhood thus has serious implications not only for acute morbidity and mortality but also for survivors’ long-term health. Heterogeneity across studies, confounding by prenatal malnutrition, and age effects in famine studies preclude firm conclusions on causality. Research to improve understanding of mechanisms linking postnatal malnutrition and NCDs is needed to inform policy and programming to improve the lifelong health of severe malnutrition survivors.
On the importance of primary and community healthcare in relation to global health and environmental threats: lessons from the COVID-19 crisis
Authors: Lauriola Paolo , Martín-Olmedo Piedad , Leonardi Giovanni S. , Bouland Catherine , Verheij Robert , Dückers Michel L A , van Tongeren Martie , Laghi Ferdinando , van den Hazel Peter , Gokdemir Ozden , Segredo Evelyn , Etzel Ruth A , Abelsohn Alan , Bianchi Fabrizio , Romizi Roberto , Miserotti Giuseppe , Romizi Francesco , Bortolotti Paolo , Vinci Emanuele , Giustetto Guido , Santamaria Mariagrazia , Serafini Alice , Pegoraro Samantha , Agius Raymond , Zeka Ariana
Published: March 2021

In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. The COVID-19 pandemic has shown the primary and community healthcare (P&CHC) system’s weaknesses worldwide. In many instances, P&CHC played only a minor role, the emphasis being on hospital and intensive care beds. This was compounded by political failures, in supporting local community resilience. Placing community building, social cohesion and resilience at the forefront of dealing with the COVID-19 crisis can help align solutions that provide a vision of ‘planetary health’. This can be achieved by involving local well-being and participation in the face of any pervasive health and environmental crisis, including other epidemics and large-scale ecological crises. This paper proposes that P&CHC should take on two critical roles: first, to support local problem-solving efforts and to serve as a partner in innovative approaches to safeguarding community well-being; and second, to understand the local environment and health risks in the context of the global health perspective. We see this as an opportunity of immediate value and broad consequence beyond the control of the COVID-19 pandemic.
Establishing and augmenting views on the acceptability of a paediatric critical care randomised controlled trial (the FEVER trial): a mixed methods study
Authors: Deja Elizabeth , Peters Mark J , Khan Imran , Mouncey Paul R , Agbeko Rachel , Fenn Blaise , Watkins Jason , Ramnarayan Padmanabhan , Tibby Shane M , Thorburn Kentigern , Tume Lyvonne N , Rowan Kathryn M , Woolfall Kerry
Published: March 2021

Objective

To explore parent and staff views on the acceptability of a randomised controlled trial investigating temperature thresholds for antipyretic intervention in critically ill children with fever and infection (the FEVER trial) during a multi-phase pilot study.

Design

Mixed methods study with data collected at three time points: (1) before, (2) during and (3) after a pilot trial.

Setting

English, Paediatric Intensive Care Units (PICUs).

Participants

(1) Pre-pilot trial focus groups with pilot site staff (n=56) and interviews with parents (n=25) whose child had been admitted to PICU in the last 3 years with a fever and suspected infection, (2) Questionnaires with parents of randomised children following pilot trial recruitment (n=48 from 47 families) and (3) post-pilot trial interviews with parents (n=19), focus groups (n=50) and a survey (n=48) with site staff. Analysis drew on Sekhon et al’s theoretical framework of acceptability.

Results

There was initial support for the trial, yet some held concerns regarding the proposed temperature thresholds and not using paracetamol for pain or discomfort. Pre-trial findings informed protocol changes and training, which influenced views on trial acceptability. Staff trained by the FEVER team found the trial more acceptable than those trained by colleagues. Parents and staff found the trial acceptable. Some concerns about pain or discomfort during weaning from ventilation remained.

Conclusions

Pre-trial findings and pilot trial experience influenced acceptability, providing insight into how challenges may be overcome. We present an adapted theoretical framework of acceptability to inform future trial feasibility studies.

Trial registration numbers

ISRCTN16022198 and NCT03028818.
The socialisation of the adolescent who carries out team sports: a transversal study of centrality with a social network analysis
Authors: Marqués-Sánchez Pilar , Benítez-Andrades José Alberto , Calvo Sánchez María Dolores , Arias Natalia
Published: March 2021

Objectives

To analyse the physical activity carried out by the adolescents in the study, its relationship to being overweight (overweight+obese) and to analyse the structure of the social network of friendship established in adolescents doing group sports, using different parameters indicative of centrality.

Setting

It was carried out in an educational environment, in 11 classrooms belonging to 5 Schools in Ponferrada (Spain).

Participants

235 adolescents were included in the study (49.4% female), who were classified as normal weight or overweight.

Primary and secondary outcome measures

Physical Activity Questionnaire for Adolescents (PAQ-A) was used to study the level of physical activity. A social network analysis was carried out to analyse structural variables of centrality in different degrees of contact.

Results

30.2% of the participants in our study were overweight. Relative to female participants in this study, males obtained significantly higher scores in the PAQ-A (OR: 2.11; 95% CI: 1.04 to 4.25; p value: 0.036) and were more likely to participate in group sport (OR: 4.59; 95% CI: 2.28 to 9.22; p value: 0.000). We found no significant relationship between physical activity and the weight status in the total sample, but among female participants, those with overweight status had higher odds of reporting high levels of physical exercise (OR: 4.50; 95% CI: 1.21 to 16.74; p value: 0.025). In terms of centrality, differentiating by gender, women who participated in group sports were more likely to be classified as having low values of centrality, while the opposite effect occurred for men, more likely to be classified as having high values of centrality.

Conclusions

Our findings, with limitations, underline the importance of two fundamental aspects to be taken into account in the design of future strategies: gender and the centrality within the social network depending on the intensity of contact they have with their peers.
Is there a role for physical activity interventions in the treatment pathway of bladder cancer? A scoping review of the literature
Authors: Bessa Agustina , Bosco Cecilia , Mehrotra Sneha , Rowland Megan , Zhang Hanyu , Russell Beth , Fox Louis , Beyer Katharina , Rammant Elke , Amery Suzanne , Chatterton Kathryn , Peat Nicola , Haggstrom Christel , Van Hemelrijck Mieke
Published: March 2021

Introduction

Physical activity (PA) interventions have been introduced in patients with cancer as they may contribute to better treatment outcomes and quality of life (QoL). However, little is known about the impact of PA on patients with bladder cancer (BC). This scoping review aimed to explore efficacy and feasibility of existing PA interventions in the BC care pathway.

Methods and analysis

Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review guidelines and the Levac methodology framework were used; electronic databases were searched. Two independent reviewers screened all titles, abstracts and full-text publications for inclusion. The feasibility of integrating a PA intervention in the BC treatment pathway was discussed in a consultation phase with healthcare professionals and patient and public representatives.

Results

A total of 675 records were identified through database searching of which 14 studies were included in our scoping review. An additional 17 clinical trials were identified of which 12 were included for which no results have been published yet. The included studies looked at the feasibility of a PA intervention programme, the associations between PA, obesity and BC, but also the determinants of PA engagement for BC patients and the assessment of QoL.

Conclusion

This scoping review highlights that despite the general recognition on the role of PA in the BC treatment pathway, there is a gap regarding the understanding of the impact of PA interventions in BC care pathways as well as the limited understanding of factors underlying possible benefits of PA. No clear conclusions could be made regarding structure and processes of PA interventions that may lead to better outcomes. Further PA studies for patients with BC are needed to understand how to incorporate exercise guidelines recommendations.
N-cadherin inhibitor creates a microenvironment that protect TILs from immune checkpoints and Treg cells
Authors: Sun Yi , Jing Jun , Xu Huan , Xu Lingfan , Hu Hailiang , Tang Cai , Liu Shengzhuo , Wei Qiang , Duan Ruiqi , Guo Ju , Yang Lu
Published: March 2021

Background

Few patients with prostate cancer benefit from current immunotherapies. Therefore, we aimed to explore new strategies to change this paradigm.

Methods

Human tissues, cell lines and in vivo experiments were used to determine whether and how N-cadherin impacts the production of programmed death ligand-1 (PD-L1) and indole amine 2,3-dioxygenase (IDO-1) and whether N-cadherin can increase the production of effector (e)Treg cells. Then, we used PC3-bearing humanized non-obese diabetic/severe combined immunodeficiency IL2Rγnull (hNSG) mice with an intravenous injection of human CD34+ hematopoietic stem cells into the tail vein to evaluate whether the N-cadherin antagonist N-Ac-CHAVC-NH2 (designated ADH-1) could improve the therapeutic effect of tumor-infiltrating lymphocyte (TIL)-related treatment.

Results

N-cadherin dramatically upregulated the expression of PD-L1 and IDO-1 through IFN-γ (interferongamma) signaling and increasing the production of free fatty acids that could promote the generation of eTreg cells. In preclinical experiments, immune reconstitution mediated by TILs slowed tumor growth and extended the survival time; however, this effect disappeared after immune system suppression by PD-L1, IDO-1 and eTreg cells. Furthermore, ADH-1 effectively reduced immunosuppression and enhanced TIL-related therapy.

Conclusions

These data show that the N-cadherin antagonist ADH-1 promotes TIL antitumor responses. This important hurdle must be overcome for tumors to respond to immunotherapy.
General features of the linear crystalline morphology of accretion disks
Authors: Montani Giovanni , Tirozzi Brunello , Carlevaro Nakia
Published: March 2021

In this paper, we analyze the so-called Master Equation of the linear backreaction of a plasma disk in the central object magnetic field, when small scale ripples are considered. This study allows to single out two relevant physical properties of the linear disk backreaction: (i) the appearance of a vertical growth of the magnetic flux perturbations; (ii) the emergence of sequence of magnetic field O-points, crucial for the triggering of local plasma instabilities. We first analyze a general Fourier approach to the solution of the addressed linear partial differential problem. This technique allows to show how the vertical gradient of the backreaction is, in general, inverted with respect to the background one. Instead, the fundamental harmonic solution constitutes a specific exception for which the background and the perturbed profiles are both decaying. Then, we study the linear partial differential system from the point of view of a general variable separation method. The obtained profile describes the crystalline behavior of the disk. Using a simple rescaling, the governing equation is reduced to the second-order differential Whittaker equation. The zeros of the radial magnetic field are found by using the solution written in terms Kummer functions. The possible implications of the obtained morphology of the disk magnetic profile are then discussed in view of the jet formation.

GraphicAbstract
Optimisation of the Largest Annotated Tibetan Corpus Combining Rule-based, Memory-based, and Deep-learning Methods
Authors: Meelen Marieke , Roux Élie , Hill Nathan
Published: March 2021

This article presents a pipeline that converts collections of Tibetan documents in plain text or XML into a fully segmented and POS-tagged corpus. We apply the pipeline to the large extent collection of the Buddhist Digital Resource Center. The semi-supervised methods presented here not only result in a new and improved version of the largest annotated Tibetan corpus to date, the integration of rule-based, memory-based, and neural-network methods also serves as a good example of how to overcome challenges of under-researched languages. The end-to-end accuracy of our entire automatic pipeline of 91.99% is high enough to make the resulting corpus a useful resource for both linguists and scholars of Tibetan studies.
Topology and Symmetry of Quantum Materials via Nonlinear Optical Responses
Authors: Orenstein J. , Moore J.E. , Morimoto T. , Torchinsky D.H. , Harter J.W. , Hsieh D.
Published: March 2021

We review recent progress in the study of photogalvanic effects and optical second-harmonic generation in topological and noncentrosymmetric metals.
Intention to be force efficient improves high-level anticipatory coordination of finger positions and forces in young and elderly adults
Authors: Schneider Thomas Rudolf , Hermsdörfer Joachim
Published: March 2021

Previous studies have shown that forces are covaried as a function of centers of pressure (CoPs) to exert adequate torques. Here, we demonstrate that force-efficient object manipulation requires the modulation of CoPs and show that providing the instruction to be force efficient and challenging surface conditions elicits a GF safety ratio reduction as well as an optimization of anticipatory CoP modulation and torques in the young and, to a lesser degree, in the elderly.
Advances in Endovascular Intervention Using Biomaterials: Study on Heat Efficiency of Scissor‐Type Ultrasonic Catheter Device
Authors: Morita Minoru , Yang Jingjing , Jiang Zhongwei
Published: March 2021

To improve the performance of the ultrasonic device during the endovascular operation, a scissor‐type ultrasonic catheter device with compound vibration was developed. The heat generated by friction between the target and the device affects its coagulation mechanism while the actuator contacts the tissue. The scissor‐type ultrasonic catheter device proposed in this study is expected to improve heat generation performance because it has the action of rubbing the object when it is pushed by combined vibration. In addition, since it is constructed by simple notch processing, it can be miniaturized and can be expected to be introduced into catheters. However, the observation of ultrasonic vibration during frictional heating is difficult, which is an issue for device design. In this paper, a thermal‐structure coupling analysis was done using the finite element method to calculate the heat generation efficiency and evaluate its coagulation performance.
Exploring a Design of Landslide Monitoring System
Authors: Khan Rahat , Yousaf Suhail , Haseeb Abdul , Uddin Muhammad Irfan
Published: March 2021

Landslide is a critical natural geological hazard that causes severe damage to property, infrastructure, and humans. In general, some location‐specific factors trigger a landslide. Wireless sensor network (WSN) is an enabling technology to monitor most of the parameters associated with these factors. A challenge in landslide monitoring through WSN is that each sensed data item might be critical whereas the underlying wireless communication is often unreliable. In case of landslides, the terrains have irregular shapes, providing harsh conditions for wireless communication thereby more data loss may be expected. This study focuses on the effect of lossy communication in WSN on the efficiency and accuracy of landslide monitoring systems. To this end, collaborative local data analysis is used to enable each node to decide locally whether its sensed data corresponds to a potential event‐of‐interest. Through extensive simulations, the performance of various landslide prediction and detection models has been evaluated. By and large, the study lets a significant insight into landslide monitoring before implementing a parameterized application for real‐world deployment.
Biomarkers of Joint Damage in Osteoarthritis: Current Status and Future Directions
Authors: Kumavat Rajkamal , Kumar Vijay , Malhotra Rajesh , Pandit Hemant , Jones Elena , Ponchel Frederique , Biswas Sagarika
Published: March 2021

Osteoarthritis (OA) is a disease of the whole joint organ, characterized by the loss of cartilage, and structural changes in bone including the formation of osteophytes, causing disability and loss of function. It is also associated with systemic mediators and low-grade inflammation. Currently, there is negligible/no availability of specific biomarkers that can be used to facilitate the diagnosis and treatment of OA. The most unmet clinical need is, however, related to the monitoring of disease progression over a short period that can be used in clinical trials. In this review, the value of biomarkers identified over the past decade has been highlighted. These biomarkers are associated with the synthesis and breakdown of cartilage, including collagenous and noncollagenous biomarkers, inflammatory and anti-inflammatory biomarkers, expressed in the biological fluid such as serum, synovial fluid, and urine. Broad validation of novel and clinically applicable biomarkers and their involvement in the pathways are particularly needed for early-stage diagnosis, monitoring disease progression, and severity and examining new drugs to mitigate the effects of this highly prevalent and debilitating condition.
Ultrasound-Guided Peripheral Nerve Blocks Performed by Orthopedic Surgeons: A Retrospective, Multicenter Study in Akita Prefecture, Japan
Authors: Tomioka Tatsuru , Senma Seietsu , Narita Yuichiro , Urayama Masakazu , Yumoto Satoshi , Ito Hiroki , Aizawa Toshiaki , Shirahata Tsuyoshi , Aonuma Hiroshi , Kaga Nozomi , Masutani Norimitsu , Yuasa Yusuke , Saito Hikaru , Ebata Kunio , Ouchi Kentaro , Miyakoshi Naohisa , Shimada Yoichi
Published: March 2021

The shortage of doctors is a societal problem, especially in rural areas such as Akita Prefecture, Japan. Therefore, it is not unusual in Akita for orthopedic surgeons to perform upper and lower limb surgeries under ultrasound-guided peripheral nerve blocks managed by the operators themselves. Multicenter studies of ultrasound-guided peripheral nerve blocks performed by orthopedic surgeons have not been reported. The purpose of this study was to clarify the safety and reliability of ultrasound-guided peripheral nerve blocks performed by orthopedic surgeons in Akita. A total of 1,674 upper extremity surgery cases operated under ultrasound-guided peripheral nerve blocks at 8 hospitals in Akita prefecture from April 2016 to April 2018 were investigated retrospectively. These blocks were performed by a total of 37 orthopedic surgeons, including senior surgeons and residents. In 321 of the 1,674 cases (19%), local anesthetics were added to the surgical field. Two cases with special factors were converted to general anesthesia. There were 2 cases of complications associated with the nerve block, but they were all transient and recovered promptly. The block site and the hospital where the block was performed showed a significant relationship with the addition of local anesthetics to the surgical site (P<0.001). Surgery time, age at surgery, and surgical site showed no significant relationships with the addition of local anesthetics. The volume of the anesthetic used for the nerve block showed a significant inverse relationship with the addition of local anesthetics (P=0.040). Many orthopedic surgeons in Akita prefecture began to perform ultrasound-guided peripheral nerve blocks, which had a reliable anesthesia effect with no noticeable complications, whether performed by residents or senior orthopedic surgeons, and this is a useful anesthetic technique for orthopedic surgeons.
A Rare Case of Eosinophilic Gastroenteritis and Ampullitis Leading to Benign Papillary Stenosis
Authors: Nyabera Akwe , Shah Keya , Nso Nso , Eskaros Saphwat , Niknam Negar
Published: March 2021

Eosinophilic gastroenteritis is characterized by eosinophilic infiltration of the gastrointestinal wall. There have been limited studies of eosinophilic infiltration involving the ampulla. We present a 70-year-old woman with a history of asthma, eosinophilic esophagitis, and eosinophilic sinusitis, who underwent work up for postprandial abdominal pain and abnormal liver function tests. The patient had various imaging studies done, including computed tomography (CT) scan, magnetic resonance imaging (MRI), and magnetic resonance cholangiopancreatography (MRCP). Dilated extrahepatic bile duct with distal tapering towards the ampulla was noted on MRCP and afterwards on endoscopic ultrasound (EUS). Endoscopic retrograde cholangiopancreatography (ERCP) revealed an inflamed major ampulla with benign papillary stenosis. The patient was treated with sphincterotomy, sphincteroplasty/dilation of distal common bile duct, and placement of an 11.5 Fr × 7 cm plastic stent into the bile duct. Additionally, she was started on prednisone, which was gradually tapered down. The patient demonstrated significant improvement with systemic steroid therapy. Liver function tests (LFTs) completely normalized after ERCP. Ampullitis leading to papillary stenosis secondary to eosinophilic infiltration of the major papilla is a rare manifestation of eosinophilic gastrointestinal disorders (EGIDs). Early diagnosis would lead to appropriate medical and endoscopic management.
Application of Magnetic Resonance Diffusion Tensor Imaging in the Clinical Diagnosis of Disc Herniation after Lumbar Spine Injury
Authors: Wu Penghuan , Huang Chengyan , Li Wenhu , Yuan Aidong , Jin Anmin
Published: March 2021

Magnetic resonance diffusion-weighted imaging (DTI) provides a unique perspective on the pathophysiological and microstructural changes during spinal cord injury, with high spatial specificity; meanwhile, NM reflects the conduction and integrity of neuroelectrical signals in spinal cord fiber tracts, with time-specific and dynamic evaluation effects. The fractional anisotropy (FA) value, SEP amplitude, and neurological function score or improvement rate are correlated. The combination of DTI and NM can more reliably quantify the spinal cord function, evaluate the effectiveness of treatment, and determine the patient's prognosis, which can provide reference for clinical decision making and future research for SCI patients. That is, the lower the preoperative FA value and the lower the SEP amplitude, the worse the preoperative and postoperative neurological function, the lower the improvement rate, and the worse the prognosis of patients. Therefore, we believe that spinal cord function can be graded according to JOA scores to find the corresponding FA and SEP amplitude ranges and that, by measuring FA and SEP amplitude in the future, we can reverse the assessment of spinal cord function, expected postoperative improvement, and long-term prognosis. At the same time, FA values can also help determine the nature of the lesion to some extent.
Rhabdomyolysis plus Hypocalcemia and Diabetic Ketoacidosis as Concurrent Rare COVID-19 Manifestations
Authors: Heidarpour Maryam , Vakhshoori Mehrbod , Haghighatpanah Mohammad Ali , Ashrafi Leila , Khorvash Farzin , Iraj Bijan
Published: March 2021

Background. Common manifestations of coronavirus disease 2019 (COVID-19) from its initial official introduction are mostly related to the respiratory system. However, other rarer presentations are reported nowadays. Case Presentations. We reported three cases of COVID-19-infected patients with rhabdomyolysis as well as two other rarer simultaneous signs, including hypocalcemia (Case 1) and diabetic ketoacidosis (DKA) (Case 2). Conclusion. Despite the fact that rhabdomyolysis is an infrequent manifestation of COVID-19, high clinical suspicion is required for proper diagnosis and management of this disease as well as other concurrent rarer presentations, including hypocalcemia and DKA for the prevention of further complications.
IoT‐Based Smart Alert System for Drowsy Driver Detection
Authors: Biswal Anil Kumar , Singh Debabrata , Pattanayak Binod Kumar , Samanta Debabrata , Yang Ming-Hour
Published: March 2021

In current years, drowsy driver detection is the most necessary procedure to prevent any road accidents, probably worldwide. The aim of this study was to construct a smart alert technique for building intelligent vehicles that can automatically avoid drowsy driver impairment. But drowsiness is a natural phenomenon in the human body that happens due to different factors. Hence, it is required to design a robust alert system to avoid the cause of the mishap. In this proposed paper, we address a drowsy driver alert system that has been developed using such a technique in which the Video Stream Processing (VSP) is analyzed by eye blink concept through an Eye Aspect Ratio (EAR) and Euclidean distance of the eye. Face landmark algorithm is also used as a proper way to eye detection. When the driver’s fatigue is detected, the IoT module issues a warning message along with impact of collision and location information, thereby alerting with the help of a voice speaking through the Raspberry Pi monitoring system.
Adopting Building Information Modeling (BIM) for the Development of Smart Buildings: A Review of Enabling Applications and Challenges
Authors: Yang Ang , Han Mingzhe , Zeng Qingcheng , Sun Yuhui
Published: March 2021

The construction industry is undergoing a digital revolution due to the emergence of new technologies. A significant trend is that construction projects have been transformed and upgraded to the digital and smart mode in the whole life cycle. As a critical technology for the construction industry’s innovative development, building information modeling (BIM) is widely adopted in building design, construction, and operation. BIM has gained much interest in the research field of smart buildings in recent years. However, the dimensions of BIM and smart building applications have not been explored thoroughly so far. With an in‐depth review of related journal articles published from 1996 to July 2020 on the BIM applications for smart buildings, this paper provides a comprehensive understanding and critical thinking about the nexus of BIM and smart buildings. This paper proposes a framework with three dimensions for the nexus of BIM application in smart buildings, including BIM attributes, project phases, and smart attributes. According to the three dimensions, this paper elaborates on (1) the advantages of BIM for achieving various smartness; (2) applications of BIM in multiple phases of smart buildings; and (3) smart building functions that be achieved with BIM. Based on the analysis of the literature in three dimensions, this paper presents the cross‐analysis of the nexus of BIM and smart buildings. Lastly, this paper proposes the critical insights and implications about the research gaps and research trends: (1) enhancing the interoperability of BIM software; (2) further exploring the role of BIM in the operation and refurbishment phase of smart buildings; (3) paying attention to BIM technology in the field of transportation infrastructure; (4) clarifying the economic benefits of BIM projects; and (5) integrating BIM and other technologies.
Structural and Kinetic Characterization of Hyperthermophilic NADH-Dependent Persulfide Reductase from Archaeoglobus fulgidus
Authors: Shabdar Sherwin , Anaclet Bukuru , Castineiras Ana Garcia , Desir Neyissa , Choe Nicholas , Crane Edward J. , Sazinsky Matthew H.
Published: March 2021

NADH-dependent persulfide reductase (Npsr) has been proposed to facilitate dissimilatory sulfur respiration by reducing persulfide or sulfane sulfur-containing substrates to H2S. The presence of this gene in the sulfate and thiosulfate-reducing Archaeoglobus fulgidus DSM 4304 and other hyperthermophilic Archaeoglobales appears anomalous, as A. fulgidus is unable to respire S0 and grow in the presence of elemental sulfur. To assess the role of Npsr in the sulfur metabolism of A. fulgidus DSM 4304, the Npsr from A. fulgidus was characterized. AfNpsr is specific for persulfide and polysulfide as substrates in the oxidative half-reaction, exhibiting

k

cat

/

K

m

on the order of 104 M-1 s-1, which is similar to the kinetic parameters observed for hyperthermophilic CoA persulfide reductases. In contrast to the bacterial Npsr, AfNpsr exhibits low disulfide reductase activity with DTNB; however, similar to the bacterial enzymes, it does not show detectable activity with CoA-disulfide, oxidized glutathione, or cystine. The 3.1 Å X-ray structure of AfNpsr reveals access to the tightly bound catalytic CoA, and the active site Cys 42 is restricted by a flexible loop (residues 60-66) that is not seen in the bacterial homologs from Shewanella loihica PV-4 and Bacillus anthracis. Unlike the bacterial enzymes, AfNpsr exhibits NADH oxidase activity and also shows no detectable activity with NADPH. Models suggest steric and electrostatic repulsions of the NADPH 2

′

-phosphate account for the strong preference for NADH. The presence of Npsr in the nonsulfur-reducing A. fulgidus suggests that the enzyme may offer some protection against S0 or serve in another metabolic role that has yet to be identified.
Feeding Practices among Human Immunodeficiency Virus-Exposed Infants in Ethiopia: Systematic Review and Meta-Analysis
Authors: Temesgen Habtamu , Negesse Ayenew , Getaneh Temesgen , Bazezew Yibelu , Haile Dessalegn , Woyraw Wubetu , Desta Melaku , Aderaw Alamneh Alehegn
Published: March 2021

Background. Infant and young child feeding in the context of human immunodeficiency virus- (HIV-) infected mothers has significant challenges due to the risk of transmission of the virus via breastfeeding. In Ethiopia, a number of independent studies have been conducted to assess the feeding practice of HIV-exposed infants. But, there is no concrete evidence to show the national figure in Ethiopia. Hence, this review and meta-analysis aims to estimate the pooled prevalence of feeding practices among HIV exposed infants in Ethiopia. Methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. Articles were searched through search engines in PubMed, Cochrane Library, Google Scholar, and direct Google search. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument adapted for cross-sectional study design was used for quality assessment. The random effects model was used to estimate the pooled prevalence of infant feeding practices. Heterogeneity and publication bias were assessed. Trim and fill analysis was performed. Additionally, meta-regression was also performed. Results. In this review, a total of 26, 22, and 22 studies and 7413, 6224, and 6222 study participants for exclusive breastfeeding, replacement feeding, and mixed feelings were included, respectively. The overall pooled prevalence of exclusive breastfeeding, replacement feeding, and mixed feeding of HIV exposed infant was 63.99 % (95% Confidence Interval (CI): 52.32, 75.66), 16.13% (95% CI: 11.92, 20.32), and 20.95% (95% CI: 11.35, 30.58)) in Ethiopia, respectively. Conclusion and Recommendations. In Ethiopia, almost three in five HIV-exposed infants were exclusively breastfed. But still, mixed feeding during the period of first 6 months was practiced in almost one-fifth of the exposed infants in Ethiopia. Additionally, replacement feeding was also practiced even though not recommended for developing countries. Therefore, the government of Ethiopia should strengthen the health institutions to implement the existing infant feeding strategies and guidelines to increase exclusive breastfeeding for the first 6 months and to avoid mixed feeding during the periods of six months.
Personalized Nutrition for Depression: Impact on the Unholy Trinity
Authors: Duarte-Silva Eduardo , Clarke Gerard , Dinan Timothy G. , Peixoto Christina Alves
Published: March 2021

Major depressive disorder (MDD) is a chronic affective disorder that has a strong neuroinflammatory component underpinning its etiology. Recent studies indicate that MDD is also associated with changes in the gut microbiota and that the latter is mainly modulated by diet. Microbiota-based personalized nutrition aims to provide an individual-specific diet that will yield the maximum benefit from a given diet since the gut microbiota is accounted for the variations that individuals present in response to a given food. In this review, we present and discuss 5 possible outcomes of using microbiota-based personalized nutrition. Harnessing this approach is essential to design more accurate therapies to prevent and treat MDD or to even help in drug metabolism, especially in the case of antidepressants.
ВПЛИВ ВАЗОВАГАЛЬНИХ СИНКОПЕ ДИТЯЧОГО ВІКУ НА ПОКАЗНИКИ ЯКОСТІ ЖИТТЯ, ПОВ’ЯЗАНОЇ ЗІ ЗДОРОВ’ЯМ
Authors: Kovalchuk T. A. , Boyarchuk O. R.
Published: March 2021

Мета дослідження – вивчити вплив особливостей клінічного перебігу вазовагальних синкопе у дітей та підлітків на показники якості життя, пов’язаної зі здоров’ям.

Матеріали та методи. Було обстежено 81 дитину віком 8–17 років із діагнозом вазовагального синкопе. Контрольну групу склала 41 практично здорова дитина аналогічного віку. Оцінку якості життя здійснювали за допомогою української версії опитувальника PedsQL™ 4.0, яку самостійно заповнювали діти та їх батьки. Злагодженість батьківсько-дитячої оцінки якості життя визначали за допомогою коефіцієнта внутрішньокласової кореляції.

Результати дослідження та їх обговорення. За даними самозвіту дітей, у групі вазовагальних синкопе було встановлено нижчі показники фізичного здоров’я, психосоціального здоров’я та загального показника якості життя. У порівнянні з дитячим самозвітом, батьки дітей із вазовагальними синкопе відмітили лише погіршення їх фізичного функціонування, тоді як проблеми емоційного функціонування та функціонування у школі залишалися поза їхньою увагою. На показники якості життя впливають стать, тривалість хвороби з моменту першого синкопе, тригерні фактори (емоційна напруга), методи попередження повторних синкопе (необхідність переходу у горизонтальне положення, приймання їжі і/або води), особливості пресинкопального періоду (головокружіння, біль у животі, серцебиття і/або перебої в серці, відчуття нестачі повітря), тривалість постсинкопального періоду та його клінічні прояви (сонливість, головний біль, головокружіння, серцебиття і/або перебої в серці).

Висновки. Вазовагальні синкопе характеризуються зниженням якості життя у сферах фізичного функціонування, емоційного функціонування та функціонування у школі. За даними самозвіту дітей, порушення психосоціального здоров’я виступає на перший план порівняно з фізичним здоров’ям та адекватно не відображається у батьківських проксі-звітах. Усі шкали опитувальника PedsQL™ 4.0 характеризуються доброю злагодженістю батьківсько-дитячої оцінки, а тому рекомендованим є комбіноване використання самозвіту дітей та проксі-звіту батьків для оцінки якості життя серед пацієнтів із вазовагальними синкопе.
ПАТОГЕНЕТИЧНІ АСПЕКТИ ФОРМУВАННЯ АКУШЕРСЬКИХ УСКЛАДНЕНЬ У ВАГІТНИХ ІЗ НЕАЛКОГОЛЬНОЮ ЖИРОВОЮ ХВОРОБОЮ ПЕЧІНКИ ПРИ НАДЛИШКОВІЙ МАСІ ТІЛА (ОГЛЯД ЛІТЕРАТУРИ)
Authors: Bahnii L. V. , Heryak S. M. , Bahnii N. I.
Published: March 2021

Серед патологічних станів, які є факторами загрозливого перебігу вагітності, особливе місце посідають порушення ліпідного обміну, які на сьогодні прогресивно зростають. За даними ВООЗ, у 90 % жінок із надлишковою масою тіла вже у віці 20–25 років виявляють ранні прояви стеатозу печінки, який впродовж наступних п᾽яти років життя приводить до неалкогольного стеатогепатиту. Тому жінки із надлишковою масою тіла мають загрозу щодо розвитку акушерських та перинатальних ускладнень, у генезі яких значна роль належить метаболічним порушенням у печінці.

Мета дослідження – проаналізувати дані сучасної літератури щодо показників ліпідного профілю, функції ендотелію, біохімічних маркерів, ролі печінки у регуляції ліпідного обміну та ключові фактори ризику розвитку стеатозу в молодому віці, які можуть погіршити перебіг вагітності й пологів у вагітних із неалкогольною жировою хворобою печінки (НАЖХП) та ожирінням. Визначити оптимальні методи діагностики, профілактики та лікування акушерських та перинатальних ускладнень у вагітних із надлишковою масою тіла при НАЖХП.

Висновок. Поєднання НАЖХП та ожиріння має вагомий вплив на розвиток акушерських та перинатальних ускладнень.
ПОРІВНЯННЯ ЛАПАРОСКОПІЧНОЇ МІОМЕКТОМІЇ ТА ЕМБОЛІЗАЦІЇ МАТКОВИХ АРТЕРІЙ У ЖІНОК ІЗ СИМПТОМНОЮ ЛЕЙОМІОМОЮ МАТКИ
Authors: Boychuk A. V. , Koptiukh V. I. , Isniuk N. O.
Published: March 2021

Мета дослідження – порівняння ефективності, безпеки захворюваності та репродуктивних наслідків лікування лейоміоми тіла матки (ЛТМ), виконаних лапароскопічним доступом і технікою емболізації маткових артерій (ЕМА).

Матеріали та методи. Дослідження проводили на базі гінекологічного відділення КНП «ТКМЛ № 2». За період із 2018 до 2020 р. було проведено 112 лапароскопічних втручань і 52 методики емболізації маткових артерій. Із метою діагностики ЛТМ проводили ультразвукове обстеження органів малого таза, для виконання ЕМА обов’язковою умовою було проведення цитологічного аспірату із порожнини матки. ЕМА проводили в умовах операційної, обладнаної ангіографічним апаратом.

Результати дослідження та їх обговорення. Середній вік жінок, яким проводили лапароскопічне втручання, перебував у межах 38–42 років, індекс маси тіла – від 25,0 до 31,0, середня кількість видалених вузлів – від 2 до 5. Середній діаметр вузлів коливався в межах від 4 до 6 см. Крововтрата під час операції склала 100–150 мл із застосуванням біполярної діатермії, середня тривалість операції склала 50–60 хв. Післяопераційні ускладнення було відмічено у 30 % жінок.

У групі жінок, яким проводили ЕМА, середній вік перебував у межах 36–45 років. Індекс маси тіла становов 34,2. Середня кількість вузлів, які піддавали емболізації (склерозуванню), складала в основному 2–3 вузли. Крововтрата під час проведення операції емболізації маткових артерій була відсутня. Середня тривалість операції – 50–60 хв. Тривалість перебування в стаціонарі – 3–4 ліжко-дні.

Жінки, які планували вагітність, – це 26,7 % – 30 пацієнток після лапароскопії, і 38,4 % – 20 пацієнток після ЕМА. Змогли виконати дітородну функцію у першій групі 40 % – 12 жінок, у другій групі 25 % – 5 жінок.

Висновки. Підсумовуючи результати обох методів лікування лейоміоми матки, ми не отримали даних, які б свідчили про переваги того чи іншого методу. Втім, слід сказати, що ЕМА може бути альтернативою лапароскопії, особливо у групі жінок, які хотіли б виконати репродуктивну функцію в плані дітонародження.
ОЦІНКА ОВАРІАЛЬНОГО РЕЗЕРВУ В ЖІНОК ІЗ БЕЗПЛІДДЯМ НА ФОНІ ЛЕЙОМІОМИ МАТКИ В ПРОГРАМАХ ДОПОМІЖНИХ РЕПРОДУКТИВНИХ ТЕХНОЛОГІЙ
Authors: Drozdovska Yu. B.
Published: March 2021

Мета дослідження – підвищити частоту настання вагітності у безплідних жінок із лейоміомою матки (ЛМ) шляхом аналізу основних факторів розвитку даної патології та оптимізації лікувально-профілактичного комплексу.

Матеріали та методи. Рандомізоване проспективне клінічне дослідження проведено серед 175 (29,0 %) жінок репродуктивного віку, в яких діагностовано ЛМ, та в контрольній групі (КГ) із 32 соматично здорових жінок із нормальною менструальною та репродуктивною функціями, яких було поділено на такі групи: основна (ОГ) А група – 137 жінок із ЛМ із запропонованим лікуванням; порівняння (ПГ) Б група – 38 жінок із ЛМ та загальноприйнятим лікуванням.

Результати дослідження та їх обговорення. Проведено оцінку стану репродуктивної системи за допомогою ультразвукового, гормонального моніторингу для прогнозування ймовірної відповіді яєчників на стимуляцію. Детально з практичної точки зору оцінено отримані результати ультразвукового, гормонального моніторингу в жінок із безпліддям на фоні лейоміоми матки для подальшого лікування. Адекватний кровообіг – важливий фактор для функціонування яєчників. У випадку прогнозування «бідної» відповіді яєчників на їх контрольовану стимуляцію середня пікова систолічна швидкість (ПСШ) стромальних артерій була в 1,68 раза нижча, ніж у жінок контрольної групи. Виявлено позитивну кореляцію між кількістю введених гонадотропінів, рівнем ФСГ та пульсаційним індексом (0ПІ в стромальних артеріях яєчників склав 1,43±0,3).

Висновок. Проведення ретельної оцінки оваріальної відповіді дає змогу правильно вибрати тактику лікування та дозу препаратів, а також відстежити результати, врахувавши отримані дані.