bluuebunny/crossref_metadata_2025 huggingface dataset:
A Video-Based Reflective Design to Prepare First Year Pharmacy Students for Their First Objective Structured Clinical Examination (OSCE)
Authors: Mak Vivienne , Malone Daniel , Karunaratne Nilushi , Yao Wendy , Randell Lauren , Vu Thao
Published: February 2022

We explored the use of a video-based reflective design in preparing first-year pharmacy students for their Objective Structured Clinical Examination (OSCE) in Victoria, Australia. This involved pre-workshop activities (a recording of themselves simulating the pharmacist responding to a simple primary care problem, written reflection, review of the OSCE video examples and pre-workshop survey); workshop activities (peer feedback on videos) and post-workshop activities (summative MCQ quiz and post-workshop survey). These activities took place three weeks before their OSCE. A mixed-method study design was employed with quantitative and qualitative analyses of the surveys and a focus group. A total of 137 students (77.4%) completed the pre- and post-workshop surveys, and ten students participated in the focus group. More student participants (54%) reported feeling prepared for the OSCE post-workshop than pre-workshop (13%). The majority (92%) agreed that filming, watching and reflecting on their video allowed them to learn and improve on their skills for the OSCE. The regression analysis found that video recording submissions and written reflections correlated positively with student OSCE performances, and the video-based reflective design learning experience was perceived to be beneficial in multiple ways. Thematic analysis of the focus group data revealed that students acquired metacognitive skills through the self-assessment of their video recordings, developed an awareness of their learning and were able to identify learning strategies to prepare for their first OSCE. Fostering students’ feedback literacy could be considered in future educational designs.
Profiles of Burnout, Job Demands and Personal Resources among Emergency Call-Takers and Dispatchers
Authors: Załuski Maciej , Makara-Studzińska Marta
Published: February 2022

According to scientific research, emergency call-takers and dispatchers are particularly vulnerable to burnout syndrome. There are no data describing specific burnout patterns or allowing for the definition of subgroups of workers who are particularly at risk. The aim of this research was to apply a person-oriented approach to characterize burnout profiles using job-related variables and personal resources. A cross-sectional survey study was conducted on 553 call-takers and dispatchers aged between 19 and 65, from 14 public safety answering points in Poland. The Link Burnout Questionnaire, the 10-item Perceived Stress Scale, the Generalized Self-Efficacy Scale, and an independent questionnaire were used to gather information. K-means cluster analysis was used, which allowed us to highlight three distinct burnout risk profiles: high risk of burnout, without full-blown pattern of burnout with high inefficacy, and no risk of burnout with an increased sense of disappointment. Several variables which coexisted with occupational burnout included work experience, weekly working hours, intensity of perceived stress, and self-efficacy level. The application of a person-oriented approach made it possible to identify groups of call takers characterized by a high risk of burnout syndrome, and to indicate the areas in which preventive measures, focused on each of their specific needs, should be taken.
Pharmacy Student Perceptions of a Virtual Pharmacogenomics Activity
Authors: Thomas Darrow , Soldner John A. , Cropp Cheryl D. , Beall Jennifer
Published: February 2022

Pharmacogenomics (PGx) utilizes a patient’s genome to guide drug treatment and dosing. The Accreditation Council for Pharmacy Education (ACPE) included PGx as a critical content area. Pharmacists are increasingly involved in providing this service, which necessitates training. Second-year pharmacy students at Samford University McWhorter School of Pharmacy have didactic training in the principles of PGx and managing drug therapy using PGx data. A clinical skills lab activity was developed to reinforce these principles and allow students to navigate resources to develop and communicate recommendations for drug therapy. The activity was initially planned as synchronous, but transitioned to asynchronous when students began remote learning in the spring of 2020 due to the COVID-19 pandemic. The investigators sought students’ perceptions of the PGx lab activity and the delivery of its content via a virtual format. This study gathered data from an anonymous, voluntary student survey through Samford University’s course management system, Canvas, in the spring of 2020 soon after completion of the virtual PGx learning activity. The investigators’ goal is to obtain the information and insights obtained from the students who participated in the PGx lab activity to provide guidance for the improvement of their PGx lab activity and for other schools of pharmacy to deliver a PGx lab activities using nontraditional teaching methodologies.
Triaged Out of Care: How Carceral Logics Complicate a ‘Course of Care’ in Solitary Confinement
Authors: Barragan Melissa , Gonzalez Gabriela , Strong Justin Donald , Augustine Dallas , Chesnut Kelsie , Reiter Keramet , Pifer Natalie A.
Published: February 2022

Incarceration, along with its most restrictive iteration, solitary confinement, is an increasingly common experience in America. More than two million Americans are currently incarcerated, and at least one-fifth of incarcerated people will experience solitary confinement. Understanding the barriers to care people experience in prison, and especially in solitary confinement, is key to improving their access to care during and after incarceration. Drawing on in-depth qualitative interviews with a random sample of 106 people living in solitary confinement and a convenience sample of 77 people working in solitary confinement in Washington State, we identify two key barriers to care that people in solitary confinement face: cultural barriers (assumptions that incarcerated people do not need or do not deserve care) and structural barriers (physical spaces and policies that make contacting a healthcare provider difficult). While scholarship has documented both the negative health consequences of solitary confinement and correctional healthcare providers’ challenges navigating between the “dual loyalty” of patient care and security missions, especially within solitary confinement, few have documented the specific mechanisms by which people in solitary confinement are repeatedly triaged out of healthcare access. Understanding these barriers to care is critical not only to improving correctional healthcare delivery but also to improving healthcare access for millions of formerly incarcerated people who have likely had negative experiences seeking healthcare in prison, especially if they were in solitary confinement.
BnA.JAZ5 Attenuates Drought Tolerance in Rapeseed through Mediation of ABA–JA Crosstalk
Authors: Cao Biting , Bai Jinjuan , Wang Xuan , Zhang Yanfeng , Yu Xiang , Hu Shengwu , He Yuke
Published: February 2022

Drought stress reduces water availability in plant cells and influences rapeseed yield. Currently, key genetic regulators that contribute to rapeseed response to drought remain largely unexplored, which limits breeding of drought-resistant rapeseed. In this study, we found that Brassica napus JASMONATE ZIM-DOMAIN 5 (BnA.JAZ5), one of the transcriptional repressors functioning in the jasmonate (JA) signaling pathway, was triggered by drought treatment in rapeseed, and drought-susceptibility increased in BnA.JAZ5-overexpressing rapeseed plants as compared to wild-type plants, resulting in a lower survival rate after recovery from dehydration. After recovery for 3 days, 22–40% of p35S::BnA.JAZ5 transgenic plants survived, while approximately 61% of wild-type plants survived. Additionally, seed germination of BnA.JAZ5-overexpressing rapeseed was hyposensitive to abscisic acid (ABA). The germination rate of five transgenic lines was 32~42% under 9 µM ABA treatment, while the germination rate of wild-type plants was 14%. We also found that the average stomatal density of five overexpressing lines was 371~446/mm2, which is higher than that of wild-type (232/mm2) plants under normal conditions. These results indicate that BnA.JAZ5 regulated drought response in an ABA-dependent manner, possibly by affecting stomatal density. Interestingly, methyl jasmonate (MeJA) treatment rescued the ABA-hyposensitive seed germination, revealing crosstalk between JAZ5-meidated JA and the ABA signaling pathway. Taken together, our results suggest that BnA.JAZ5 attenuated drought resistance through the ABA-dependent pathway, which could represent important genetic loci for drought-resistant rapeseed breeding.
The Meaning of Social Support in Nature-Based Services for Young Adults with Mental Health Problems
Authors: Steigen Anne Mari , Eriksson Bengt G. , Kogstad Ragnfrid Eline , Bergh Daniel
Published: February 2022

In previous studies, social context and social support have been found to be important in nature-based services. However, no studies have previously focused on the meaning of different dimensions of social support in these contexts. The aim of this study is therefore to uncover dimensions of social support in relation to mental health among young adults with mental health problems participating in nature-based services in Norway. This study applies data from a survey of 93 young adults participating in nature-based services; in addition, qualitative interview data from 20 interviews are also used. The data are analysed using qualitative content analysis, descriptive statistics, and correlation analysis. The results indicate that participants in nature-based services experience emotional, esteem, informational, and instrumental support in addition to social integration and opportunities for nurturance in these services. The service leader, other participants, and the animals are important contributors to these dimensions of social support. Nature-based services may be a helpful intervention for young adults with mental health problems. The unique context of these services, including nature and animals, adds special qualities to mental health and social work practices.
A Study to Validate the Relevance of Semen F2-Isoprostanes on Human Male Infertility
Authors: Moretti Elena , Signorini Cinzia , Ferretti Fabio , Noto Daria , Collodel Giulia
Published: February 2022

F2-isoprostanes (F2-IsoPs), byproducts of arachidonic acid oxidation, are one of the most reliable indices for assessing lipid peroxidation in vivo. This study aimed at evaluating the seminal F2-IsoP level in 147 patients with different reproductive conditions (varicocele, urogenital infection, idiopathic infertility) and 45 fertile controls to establish a cut-off value discriminating physiological and pathological ranges. Semen analyses were performed following WHO guidelines; F2-IsoP levels were measured by gas chromatography/negative-ion chemical ionization tandem mass spectrometry. Considering the whole group of patients, F2-IsoPs correlated negatively with normal morphology (r = −0.283, p < 0.01), viability (r = −0.245, p < 0.01), total progressive motility (r = −0.309, p < 0.01) and rapid motility (r = −0.535, p < 0.01). The area under the ROC curve for F2-IsoP levels was 0.839, indicating a good performance of the test; the Youden index showed a cut-off value of 29.96 ng/mL. Fertile men (except one) were distributed in the group of patients with F2-IsoP level < 29.96 ng/mL. Varicocele and urogenital infection groups showed the highest levels of F2-IsoPs in semen. For the first time, a cut-off for F2-IsoPs is identified in human semen. It allows discriminating different male infertility conditions by the semen F2-IsoP amounts, as an additional parameter for clinical evaluation.
Evaluating the Effects of Built Environment on Street Vitality at the City Level: An Empirical Research Based on Spatial Panel Durbin Model
Authors: Wu Wanshu , Ma Ziying , Guo Jinhan , Niu Xinyi , Zhao Kai
Published: February 2022

There is evidence that the built environment has an influence on street vitality. However, previous studies seldom assess the direct, indirect, and total effect of multiple environmental elements at the city level. In this study, the features of the street vitality on Xiamen Island are described based on the location-based service Big Data. Xiamen Island is the central urban area of Xiamen, one of the national central cities in China. With the help of multi-source data such as street view images, the condition of design that is difficult to effectively measure with traditional data can be better explored in detail on a macro scale. The built environment is measured through a 5D system at the city level, including Density, Diversity, Design, Destination accessibility, and Distance to transit. Spatial panel Durbin models are constructed to analyze the influence of the built environment on the street vitality on weekdays and weekends, and the direct, indirect, and total effects are evaluated. Results indicate that at the city level, the built environment plays a significant role in promoting street vitality. Functional density is not statistically significant. Most of the elements have spatial effects, except for several indicators in the condition of the design. Compared with the conclusions of previous studies, some indicators have different effects on different spatial scales. For instance, on the micro scale, greening can enhance the attractiveness of streets. However, on the macro scale, too much greening brings fewer functions along the street, which inhibits the street vitality. The condition of design has the greatest effect, followed by destination accessibility. The differences in the influences of weekdays and weekends are mainly caused by commuting behaviors. Most of the built environment elements have stronger effects on weekends, indicating that people interact with the environment more easily during this period.
Effect of Longitudinal and Transverse Foot Arch on the Position of the Hallux and Fifth Toe in Preschool Children in the Light of Regression Analysis
Authors: Puszczalowska-Lizis Ewa , Krawczyk Karolina , Omorczyk Jaroslaw
Published: February 2022

The aim of the study was to analyze the development of foot structure and the impact of longitudinal and transverse arching of the foot on the position of the hallux and fifth toe in preschool children. The study was carried out among 200 children aged 6 (100 G, 100 B). The research tool was the podoscope CQ-ST. The collected research results were analyzed with the use of the Mann–Whitney U test, Pearson Chi-square test and regression analysis. A statistically significant influence of the heel angle on the value of the varus angle of the fifth toe of the right (girls: p = 0.032; boys: p = 0.001) and left foot (girls: p = 0.004; boys: p = 0.005) was found. Boys’ feet are longer and wider than girls’ feet; moreover, they have a lower longitudinal arch. The frequency of longitudinal and transverse arch deformities of the feet, as well as valgus of the hallux and varus of the fifth toe do not depend on gender. In both sexes, decreasing the transverse arch of the foot has an influence on the severity of varus of the fifth toe. Changes in the height of the longitudinal foot arch does not affect the position of the hallux and fifth toe.
Neurological, Psychiatric, and Psychological Implications of the COVID-19 Pandemic: Protocol for a Large-Scale Umbrella Review of Observational Studies
Authors: Yeh Ta-Chuan , Liang Chih-Sung , Tsai Chia-Kuang , Solmi Marco , Lafer Beny , Tseng Ping-Tao , Hsu Chih-Wei , Lin Pao-Yen , Firth Joseph , Stubbs Brendon , Hassan Lamiece , Fornaro Michele , Vieta Eduard , Thompson Trevor , Shin Jaeil , Carvalho Andre F.
Published: February 2022

The severe acute respiratory syndrome coronavirus 2 disease (SARS-CoV-2) is the most severe manifestation of the coronavirus disease 2019 (COVID-19) pandemic. Accruing evidence indicates that the COVID-19 pandemic may have profound deleterious neurological, psychiatric, and psychological outcomes. The number of systematic reviews (SRs) and meta-analyses (MAs) on this topic has grown exponentially. This protocol aims to synthesize all evidence from SRs and MAs on the associations between the COVID-19 pandemic and neuropsychiatric outcomes. The following electronic databases will be systematically searched from inception up to 15 January 2022: PubMed, Embase, APA PsycINFO, and Cochrane Reviews. An umbrella review (UR) of SRs and MAs of observational studies will be conducted. SRs and/or MAs of observational studies examining any direct or indirect association of COVID-19 with the neuropsychiatric outcomes will be deemed eligible for potential inclusion in this UR. The direct associations include the impact on the (1) prognosis of COVID-19 and (2) neuropsychiatric sequelae after COVID-19 infection. The indirect associations include the influence of the COVID-19 pandemic on the (1) treatments and (2) outcomes of neurological and psychiatric conditions associated with the COVID-19 pandemic.
Adsorption Behavior of Magnetic Carbon-Supported Metal Nickel for the Efficient Dye Removal from Water
Authors: Lv Beifeng , Xu Jingjing , Kang Haibo , Liang Pengfei , Wang Wei , Tao Feifei
Published: February 2022

Magnetic carbon-supported metal nickel has been successfully synthesized by solvothermal method and heat treatment for highly effective adsorption of various reactive dyes. Structure characterization and composition analysis demonstrated that the metal nickel nanoparticles with the size of 1–2 nm were embedded into the pore of carbon spheres. It is helpful to prevent the agglomeration and falling off of metal nickel nanoparticles on the surface of carbon spheres. The adsorption performance of the carbon-supported metal nickel nanospheres for reactive brilliant yellow R-4GLN was studied by changing the pH value and initial concentration of the solution, adsorption time, adsorption temperature, and the amount of adsorbent. The carbon-supported metal nickel showed fast and efficient adsorption activity. After 5 min of adsorption, the removal efficiency of 10 mL 25 mg·mL−1 reactive brilliant yellow R-4GLN was close to 100%. The carbon-supported metal nickel composite was reused 20 times, and the removal efficiency of dye remained above 98%. It also showed good adsorption performance on various reactive dyes with wide universality, which has a certain adsorption effect on most dyes with a high utilization value in wastewater treatment.
Small Differences in Vitamin D Levels between Male Cardiac Patients in Different Stages of Coronary Artery Disease
Authors: Dziedzic Ewelina A. , Grant William B. , Sowińska Izabela , Dąbrowski Marek , Jankowski Piotr
Published: February 2022

Cardiovascular diseases are the main cause of mortality in males older than 65 years of age. The prevalent vitamin D deficiency in the worldwide population may have multiple effects on the cardiovascular system. This study sought to determine the association between serum levels of 25-hydroxyvitamin D (25(OH)D) and the stage of coronary artery disease (CAD) in Polish male subjects. Additionally, subjects with a history of myocardial infarction (MI) were analyzed for potential differences in 25(OH)D levels in comparison with those diagnosed with stable CAD. The study was conducted prospectively in a group of 669 male patients subjected to coronarography examination. CAD stage was defined using the Coronary Artery Surgery Study Score. Patients without significant coronary lesions had significantly higher 25(OH)D levels than patients with single-, double-, or triple-vessel disease (median, 17 vs. 15 ng/mL; p < 0.01). Significantly lower levels of 25(OH)D were apparent when MI was identified as the cause of the then-current hospitalization in comparison with stable CAD, as well as in patients with a history of MI; all of these cases had lower levels of 25(OH)D in comparison with patients with no such history. Male patients with single-, double-, or triple-vessel CAD, acute coronary syndrome, or a history of MI presented lower serum 25(OH)D.
Resistance to Antimalarial Monotherapy Is Cyclic
Authors: Weitzman Rachel , Calfon-Peretz Ortal , Saha Trishna , Bloch Naamah , Ben Zaken Karin , Rosenfeld Avi , Amitay Moshe , Samson Abraham O.
Published: February 2022

Malaria is a prevalent parasitic disease that is estimated to kill between one and two million people—mostly children—every year. Here, we query PubMed for malaria drug resistance and plot the yearly citations of 14 common antimalarials. Remarkably, most antimalarial drugs display cyclic resistance patterns, rising and falling over four decades. The antimalarial drugs that exhibit cyclic resistance are quinine, chloroquine, mefloquine, amodiaquine, artesunate, artemether, sulfadoxine, doxycycline, halofantrine, piperaquine, pyrimethamine, atovaquone, artemisinin, and dihydroartemisinin. Exceptionally, the resistance of the two latter drugs can also correlate with a linear rise. Our predicted antimalarial drug resistance is consistent with clinical data reported by the Worldwide Antimalarial Resistance Network (WWARN) and validates our methodology. Notably, the cyclical resistance suggests that most antimalarial drugs are sustainable in the end. Furthermore, cyclic resistance is clinically relevant and discourages routine monotherapy, in particular, while resistance is on the rise. Finally, cyclic resistance encourages the combination of antimalarial drugs at distinct phases of resistance.
Cause of Death in Heart Failure Based on Etiology: Long-Term Cohort Study of All-Cause and Cardiovascular Mortality
Authors: Spitaleri Giosafat , Zamora Elisabet , Cediel German , Codina Pau , Santiago-Vacas Evelyn , Domingo Mar , Lupón Josep , Santesmases Javier , Diez-Quevedo Crisanto , Troya Maria Isabel , Boldo Maria , Altimir Salvador , Alonso Núria , González Beatriz , Bayes-Genis Antoni
Published: February 2022

We assessed differences in long-term all-cause and cardiovascular (CV) mortality in heart failure (HF) outpatients based on the etiology of HF. Consecutive patients admitted to the HF Clinic from August 2001 to September 2019 (N = 2587) were considered for inclusion. HF etiology was divided into ischemic heart disease (IHD), dilated cardiomyopathy (DCM), hypertensive heart disease, alcoholic cardiomyopathy, drug-induced cardiomyopathy (DICM), valvular heart disease, and hypertrophic cardiomyopathy. All-cause death and CV death were the primary end points. Among 2387 patients included in the analysis (mean age 66.5 ± 12.5 years, 71.3% men), 1317 deaths were recorded (731 from CV cause) over a maximum follow-up of 18 years (median 4.1 years, interquartile range (IQR) 2–7.8). Considering IHD as the reference, only DCM had a lower risk of all-cause death (adjusted hazard ratio (aHR) 0.68, 95% confidence interval (CI) 0.56–0.83, p < 0.001), and only DICM had a higher risk of all-cause death (aHR 1.47, 95% CI 1.02–2.11, p = 0.04). However, almost all etiologies had a significantly lower risk of CV death than IHD. Among the studied HF etiologies, DCM and DICM have the lowest and highest risk of all-cause death, respectively, whereas IHD has the highest adjusted risk of CV death.
Two-Week Protocol Biopsy in Renal Allograft: Feasibility, Safety, and Outcomes
Authors: Lim Manuel , Park Byung Kwan , Lee Kyo Won , Park Jae Berm , Kim Kyeong Deok , Yang Jaehun , Kwon Jieun , Jeong Eun Sung , Lee Seunghwan
Published: February 2022

Background: Protocol biopsy in renal allograft helps to early detect subclinical rejection (SCR) in patients who have no abnormal clinical and laboratory findings. Still, there are rare reports about the techniques and outcomes of two-week protocol biopsy. The aim of this study was to assess two-week protocol biopsy regarding the technical feasibility, procedure safety, and clinical outcomes. Methods: A total of 894 protocol biopsies were performed in adult recipients between 2012 and 2019. Two-week and one-year protocol biopsies were guided with ultrasound in 842 and 399 patients by one of four radiologists with wide range of biopsy experience, respectively. These protocol biopsies were compared in terms of feasibility and safety. Standard references were clinico-laboratory findings and biopsy examinations. Results: The median period of two-week and one-year protocol biopsies were 12 days (10–20 days) and 383 days (302–420 days), respectively. All protocol biopsies were technically successful and there was no difference between radiologists regarding technical success and complications (p = 0.453). Major complication (Clavien–Dindo grading II–IV) rates of two-week and one-year protocol biopsies were 0.3% (3/842) and 0.2% (1/399), respectively (p = 1.000). However, univariate analysis demonstrated that platelet count < 100 K/mL and blood urea nitrogen ≥ 40 mg/dL were associated with major complications in two-week protocol biopsy. The SCRs of these protocol biopsies were 15.4% (130/842) and 33.6% (134/399), respectively (p < 0.001). Conclusion: Two-week protocol biopsy is technically feasible and safe. It contributes to early detecting a substantial number of SCRs. Prior to the biopsy, platelet count and blood urea nitrogen should be carefully checked to predict major complications.
Minimally Invasive Sympathicotomy for Palmar Hyperhidrosis and Facial Blushing: Current Status and the Hyperhidrosis Expert Center Approach
Authors: Kuijpers Michiel , van Zanden Judith E. , Harms Petra W. , Mungroop Hubert E. , Mariani Massimo A. , Klinkenberg Theo J. , Bouma Wobbe
Published: February 2022

Hyperhidrosis, the medical term for excessive sweating beyond physiological need, is a condition with serious emotional and social consequences for affected patients. Symptoms usually appear in focal areas such as the feet, hands, axillae and face. Non-surgical treatment options such as topical antiperspirants or systemic medications are usually offered as a first step of treatment, although these therapies are often ineffective, especially in severe and intolerable cases of hyperhidrosis. In the treatment algorithm for patients suffering from hyperhidrosis, surgical thoracoscopic sympathicotomy offers a permanent solution, which is particularly effective in the treatment of palmar hyperhidrosis and facial blushing. In this review, we describe the current status of thoracoscopic sympathicotomy for palmar hyperhidrosis and facial blushing. In addition, we share the specific treatment approach, technique and results of our Hyperhidrosis Expert Center. Last, we share recommendations to ensure an effective, reproducible and safe application of single-port thoracoscopic sympathicotomy for palmar hyperhidrosis and facial blushing, based on our extensive experience.
Temporal Changes in the Oxyhemoglobin Dissociation Curve of Critically Ill COVID-19 Patients
Authors: Ceruti Samuele , Minotti Bruno , Glotta Andrea , Biggiogero Maira , Bona Giovanni , Marzano Martino , Greco Pietro , Spagnoletti Marco , Garzoni Christian , Bendjelid Karim
Published: February 2022

Critical COVID-19 is a life-threatening disease characterized by severe hypoxemia with complex pathophysiological mechanisms that are not yet completely understood. A pathological shift in the oxyhemoglobin curve (ODC) was previously described through the analysis of p50, intended as the oxygen tension at which hemoglobin is saturated by oxygen at 50%. The aim of this study was to analyze Hb-O2 affinity features over time in a cohort of critically ill COVID-19 patients, through the analysis of ODC p50 behavior. A retrospective analysis was performed; through multiple arterial blood gas (ABG) analyses, each p50 was calculated and normalized according to PaCO2, pH and temperature; patients’ p50 evolution over time was reported, comparing the first 3 days (early p50s) with the last 3 days (late p50s) of ICU stay. A total of 3514 ABG analyses of 32 consecutive patients were analyzed. The majority of patients presented a left shift over time (p = 0.03). A difference between early p50s and late p50s was found (20.63 ± 2.1 vs. 18.68 ± 3.3 mmHg, p = 0.03); median p50 of deceased patients showed more right shifts than those of alive patients (24.1 vs. 18.45 mmHg, p = 0.01). One-way ANOVA revealed a p50 variance greater in the early p50s (σ2 = 8.6) than in the late p50s (σ2 = 3.84), associated with a reduction over time (p < 0.001). Comparing the Hb-O2 affinity in critically ill COVID-19 patients between ICU admission and ICU discharge, a temporal shift in the ODC was observed.
Complement Blockade Is a Promising Therapeutic Approach in a Subset of Critically Ill Adult Patients with Complement-Mediated Hemolytic Uremic Syndromes
Authors: Prével Renaud , Delmas Yahsou , Guillotin Vivien , Gruson Didier , Rivière Etienne
Published: February 2022

Thrombotic microangiopathy (TMA) gathers consumptive thrombocytopenia, mechanical haemolytic anemia, and organ damage. Hemolytic uremic syndromes (HUS) are historically classified as primary or secondary to another disease once thrombotic thrombocytopenic purpura (TTP), Shiga-toxin HUS, and cobalamin C-related HUS have been ruled out. Complement genetics studies reinforced the link between complement dysregulation and primary HUS, contributing to reclassifying some pregnancy- and/or post-partum-associated HUS and to revealing complement involvement in severe and/or refractory hypertensive emergencies. By contrast, no firm evidence allows a plausible association to be drawn between complement dysregulation and Shiga-toxin HUS or other secondary HUS. Nevertheless, rare complement gene variants are prevalent in healthy individuals, thus providing an indication that an investigation into complement dysregulation should be carefully balanced and that the results should be cautiously interpreted with the help of a trained geneticist. Several authors have suggested reclassifying HUS in two entities, regardless of they are complement-mediated or not, since the use of eculizumab, an anti-C5 antibody, dramatically lowers the proportion of patients who die or suffer from end-stage renal disease within the year following diagnosis. Safety and the ideal timing of eculizumab discontinuation is currently under investigation, and the long-term consequences of HUS should be closely monitored over time once patients exit emergency departments.
Surgical Quality, Antihypertensive Therapy, and Electrolyte Balance: A Novel Trifecta to Assess Long-Term Outcomes of Adrenal Surgery for Unilateral Primary Aldosteronism
Authors: Anceschi Umberto , Mormando Marilda , Fiori Cristian , Zappalà Orazio , De Concilio Bernardino , Brassetti Aldo , Carrara Alessandro , Ferriero Maria Consiglia , Tuderti Gabriele , Misuraca Leonardo , Bove Alfredo Maria , Mastroianni Riccardo , Chiefari Alfonsina , Appetecchia Marialuisa , Tirone Giuseppe , Porpiglia Francesco , Celia Antonio , Gallucci Michele , Simone Giuseppe
Published: February 2022

Background: To propose a trifecta that summarizes endpoints and predicts their maintenance after adrenalectomy (n = 90) for unilateral primary aldosteronism (UPA). Methods: Trifecta was defined as coexistence of: ≥50% antihypertensive therapeutic intensity score reduction (∆TIS), no hypokalemia at 3 months, and no Clavien grade 2–5. Logistic regression was used to identify predictors of trifecta. Probability of clinical, biochemical, and simultaneous success according to trifecta were assessed by Kaplan–Meier. Cox regression was used to identify predictors of long-term clinical, biochemical, and simultaneous success. For all analyses, a two-sided p < 0.05 was considered significant. Results: Simultaneous success rate was 50%. On multivariable analysis, TIS was an independent predictor of trifecta achievement (HR 3.28; 95% CI 1.07–10.9; p = 0.03). At Kaplan–Meier, trifecta predicted higher success for all endpoints (each p < 0.03). On multivariable Cox analysis, adenoma size (AS) ≥6 cm and trifecta were independent predictors of biochemical (AS: HR 2.87; 95% CI 1.53–5.36; trifecta: HR 2.1; 95% CI 1.13–3.90; each p < 0.02) and simultaneous success (AS: HR 3.81; 95% CI 1.68–8.65; trifecta: HR 4.29; 95% CI 2.08–8.86; each p < 0.01), while trifecta was an independent predictor of complete clinical success (HR 2.84; 95% CI 1.45–5.58; p < 0.01). Conclusions: Trifecta and AS are independent predictors of either long-term complete clinical, biochemical, or combined success after adrenalectomy for UPA.
Effect of Gamma Irradiation on the Osteoinductivity of Demineralized Dentin Matrix for Allografts: A Preliminary Study
Authors: Ku Jeong-Kui , Kim Il-hyung , Um In-Woong , Kim Bo-Hyun , Yun Pil-Young
Published: February 2022

Demineralized dentin matrix (DDM) treated with gamma irradiation (GR) has shown promising results as an allograft without any adverse effects in in vivo and clinical studies. The purpose of this study was to evaluate the effects of 15 and 25 kGy GR on the osteoinductive properties of DDM at extra-skeletal sites. As a control group, non-irradiated DDM powder was implanted into the right subcutaneous tissues of the dorsal thigh muscles of 20 nude mice. DDM powder irradiated with 15 and 25 kGy was implanted into the left side. After two and four weeks, the bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry. After confirming osteoblast- and osteoclast-specific activities by alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP) staining, a histological analysis was performed to measure the new bone formation and the number of osteoblasts and osteoclast-like cells on the surface of the DDMs. Histomorphometry was used to calculate the new bone formation area on the surface of the DDM particles (DDMs). The BMD in all the groups increased from two and four weeks without statistically significant differences. The osteoblasts were dominantly activated on DDM without GR, and DDM treated with 25 kGy compared to DDM treated with 15 kGy. Among the groups, new bone formation was identified in all the groups at each time point. In conclusion, GR at doses of 15 and 25 kGy does not affect the osteoinductive properties of DDM powder.
Fixed Prosthetic Restorations and Periodontal Health: A Narrative Review
Authors: Srimaneepong Viritpon , Heboyan Artak , Zafar Muhammad Sohail , Khurshid Zohaib , Marya Anand , Fernandes Gustavo V. O. , Rokaya Dinesh
Published: February 2022

Periodontal health plays an important role in the longevity of prosthodontic restorations. The issues of comparative assessment of prosthetic constructions are complicated and not fully understood. The aim of this article is to review and present the current knowledge regarding the various technical, clinical, and molecular aspects of different prosthetic biomaterials and highlight the interactions between periodontal health and prosthetic restorations. Articles on periodontal health and fixed dental prostheses were searched using the keywords “zirconium”, “CAD/CAM”, “dental ceramics”, “metal–ceramics”, “margin fit”, “crown”, “fixed dental prostheses”, “periodontium”, and “margin gap” in PubMed/Medline, Scopus, Google Scholar, and Science Direct. Further search criteria included being published in English, and between January 1981 and September 2021. Then, relevant articles were selected, included, and critically analyzed in this review. The margin of discrepancy results in the enhanced accumulation of dental biofilm, microleakage, hypersensitivity, margin discoloration, increased gingival crevicular fluid flow (GCF), recurrent caries, pulp infection and, lastly, periodontal lesion and bone loss, which can lead to the failure of prosthetic treatment. Before starting prosthetic treatment, the condition of the periodontal tissues should be assessed for their oral hygiene status, and gingival and periodontal conditions. Zirconium-based restorations made from computer-aided design and computer-aided manufacturing (CAD/CAM) technology provide better results, in terms of marginal fit, inflammation reduction, maintenance, and the restoration of periodontal health and oral hygiene, compared to constructions made by conventional methods, and from other alloys. Compared to subgingival margins, supragingival margins offer better oral hygiene, which can be maintained and does not lead to secondary caries or periodontal disease.
A Novel Visual-Range Sea Image Dataset for Sea Horizon Line Detection in Changing Maritime Scenes
Authors: Hashmani Manzoor Ahmed , Umair Muhammad
Published: February 2022

Sea horizon line (SHL) detection plays a pivotal role in the computational performance improvement of computer applications for the maritime environment by dividing the image into sea and sky regions. This division isolates the region of interest and reduces the computational cost of further processing. Testing and performance evaluation of SHL detection methods require a robust image dataset covering the maritime environment’s features at different geographical, seasonal, and maritime conditions. However, publicly available maritime image datasets are developed under a limited environment with slight-to-moderate variations in maritime features. This article proposes a novel sea image dataset that fills this gap by incorporating various geographical, seasonal, and maritime features. Across West Malaysia, one offshore and four geographically separated onshore locations were selected. On ten different occasions, field observations were recorded using a visual-range optical sensor and weather station. The data collection experiments were conducted between February 2020 until April 2021. The collected data were preprocessed and SHL images were selected based on their high feature diversity. Manual SHL annotation was applied on images, and a ground truth matrix was generated, which serves as a performance benchmark for SHL detection methods. As a result, the dataset presents 2673 high-definition (1920 × 1080 pixels) RGB images having a combination of 36 different geographical, seasonal, and maritime features to test and evaluate computer vision-based SHL detection methods.
Marine Power Systems
Authors: Poljak Igor
Published: February 2022

The international seaborne trade by volume is divided into 60% loaded and 70% discharged trade, which means that the marine industry today is still the number one means of transportation for the human kind [...]
Progressive Sensorineural Hearing Loss in Vibrant Soundbridge Users Requiring Cochlear Implantation
Authors: Brkic Faris F. , Baumgartner Wolf-Dieter , Riss Dominik , Thurner Thomas , Liu David T. , Gstöttner Wolfgang , Vyskocil Erich
Published: February 2022

Less than 20% of patients with sensorineural hearing loss (HL) provided with the Vibrant Soundbridge (VSB) experience a progressive HL and warrant cochlear implantation (CI). The aim of this study was to identify possible predictors of progressive HL prior to VSB implantation. This retrospective study included all consecutive ears with sensorineural HL provided with the VSB between 1998 and 2016. The patient cohort was divided in a study group comprising patients who underwent CI (CI group) after years of VSB usage and those who did not require VSB replacement during the observational time (control group). Pre- and postoperative pure-tone audiometry thresholds were compared among the two groups. Fifteen out of 81 VSB devices (18.5%) required a CI. The CI group had higher preoperative air-conduction (AC) thresholds than the control group (64.3 ± 8.9 dB vs. 56.3 ± 12.9 dB; p = 0.007) at the time of the VSB implantation. On average, the CI group was significantly younger (39.1 ± 12.3 years vs. 52.6 ± 16.2 years; p = 0.003). In conclusion, VSB users with higher preoperative AC thresholds and younger age at the time of VSB implantation might be at risk for progressive HL within the upcoming eight years and need a further CI surgery. Preoperative counseling is particularly advisable in this patient group.
The Impact of Total Knee Replacement with a Customized Cruciate-Retaining Implant Design on Patient-Reported and Functional Outcomes
Authors: Steinert Andre F. , Schröder Lennart , Sefrin Lukas , Janßen Björn , Arnholdt Jörg , Rudert Maximilian
Published: February 2022

Purpose: To treat patients with tricompartimental knee osteoarthritis (OA), a customized cruciate-retaining total knee arthroplasty (CCR-TKA) system can be used, including both individualized instrumentation and implants. The objective of this monocentric cohort study was to analyze patient-reported and functional outcomes in a series of patients implanted with the second generation of this customized implant. Methods: At our arthroplasty center, we prospectively recruited a cohort of patients with tricompartmental gonarthrosis to be treated with total knee replacement (TKA) using a customized cruciate-retaining (CCR) implant design. Inclusion criteria for patients comprised the presence of intact posterior cruciate and collateral ligaments and a knee deformity that was restricted to <15° varus, valgus, or flexion contracture. Patients were assessed for their range of motion (ROM), Knee Society Score (KSS), Western Ontario and McMaster University osteoarthritis index (WOMAC), and short form (SF)-12 physical and mental scores, preoperatively, at 3 and 6 months, as well as at 1, 2, 3, and 5 years of follow-up (FU) postoperatively. Results: The average age of the patient population was 64 years (range: 40–81), the average BMI was 31 (range: 23–42), and in total, 28 female and 45 male patients were included. Implant survivorship was 97.5% (one septic loosening) at an average follow-up of 2.5 years. The KSS knee and function scores improved significantly (p < 0.001) from, respectively, 41 and 53 at the pre-operative visit, to 92 and 86, respectively, at the 5-year post-operative time point. The SF-12 Physical and Mental scores significantly (p < 0.001) improved from the pre-operative values of 28 and 50, to 50 and 53 at the 5-year FU, respectively. Patients experienced significant improvements in their overall knee range of motion, from 106° at the preoperative visit to 122°, on average, 5 years postoperatively. The total WOMAC score significantly (p < 0.001) improved from 49.1 preoperatively to 11.4 postoperatively at 5-year FU. Conclusions: Although there was no comparison to other implants within this study, patients reported high overall satisfaction and improvement in functional outcomes within the first year from surgery, which continued over the following years. These mid-term results are excellent compared with those reported in the current literature. Comparative long-term studies with this device are needed. Level of evidence 3b (individual case–control study).
Personalized Prediction of Postconcussive Working Memory Decline: A Feasibility Study
Authors: Chen Yung-Chieh , Chen Yung-Li , Kuo Duen-Pang , Li Yi-Tien , Chiang Yung-Hsiao , Chang Jyh-Jong , Tseng Sung-Hui , Chen Cheng-Yu
Published: February 2022

Concussion, also known as mild traumatic brain injury (mTBI), commonly causes transient neurocognitive symptoms, but in some cases, it causes cognitive impairment, including working memory (WM) deficit, which can be long-lasting and impede a patient’s return to work. The predictors of long-term cognitive outcomes following mTBI remain unclear, because abnormality is often absent in structural imaging findings. Previous studies have demonstrated that WM functional activity estimated from functional magnetic resonance imaging (fMRI) has a high sensitivity to postconcussion WM deficits and may be used to not only evaluate but guide treatment strategies, especially targeting brain areas involved in postconcussion cognitive decline. The purpose of the study was to determine whether machine learning-based models using fMRI biomarkers and demographic or neuropsychological measures at the baseline could effectively predict the 1-year cognitive outcomes of concussion. We conducted a prospective, observational study of patients with mTBI who were compared with demographically matched healthy controls enrolled between September 2015 and August 2020. Baseline assessments were collected within the first week of injury, and follow-ups were conducted at 6 weeks, 3 months, 6 months, and 1 year. Potential demographic, neuropsychological, and fMRI features were selected according to their significance of correlation with the estimated changes in WM ability. The support vector machine classifier was trained using these potential features and estimated changes in WM between the predefined time periods. Patients demonstrated significant cognitive recovery at the third month, followed by worsened performance after 6 months, which persisted until 1 year after a concussion. Approximately half of the patients experienced prolonged cognitive impairment at the 1-year follow up. Satisfactory predictions were achieved for patients whose WM function did not recover at 3 months (accuracy = 87.5%), 6 months (accuracy = 83.3%), and 1 year (accuracy = 83.3%) and performed worse at the 1-year follow-up compared to the baseline assessment (accuracy = 83.3%). This study demonstrated the feasibility of personalized prediction for long-term postconcussive WM outcomes based on baseline fMRI and demographic features, opening a new avenue for early rehabilitation intervention in selected individuals with possible poor long-term cognitive outcomes.
Breakdown of Government Debt into Components in Euro Area Countries
Authors: László Török
Published: February 2022

The pandemic that erupted in 2020 generated a significant increase in public debt, which is likely to draw the attention of economic policy and the economic profession to the evolution and sustainability of debt. This study first shows how the gross sovereign nominal consolidated government debt of the euro area member states developed between 2011 and 2019. Using conventional breakdown and correlation calculation methods, the study analyzes how closely the three components are related to the government debt ratio. The three components are: budget balance, economic growth, and real interest rates. The study then groups the member states into groups using the hierarchical cluster analysis of the SPSS program. The “composite” rankings formed on the basis of the correlation coefficients proved to be well-understood, and the examined countries were given a clear position within the cluster. Finally, a verbal macroeconomic analysis of the member states in the same group follows in terms of the relevance of each component in the evolution of their public debt. The analysis shows that each independent variable had a significantly different effect on the change in the government debt ratio of each member state. The results and the correlations established can also be used later to examine the sustainability of public debt in the euro area.