bluuebunny/crossref_metadata_2025 huggingface dataset:
Derivation and performance of an end-of-life practice score aimed at interpreting worldwide treatment-limiting decisions in the critically ill
Authors: Mentzelopoulos Spyros D. , Chen Su , Nates Joseph L. , Kruser Jacqueline M. , Hartog Christiane , Michalsen Andrej , Efstathiou Nikolaos , Joynt Gavin M. , Lobo Suzana , Avidan Alexander , Sprung Charles L. ,   the End-of-life Practice Score Study Group, Ely Wesley , Kompanje Erwin J. O. , Mer Mervyn , Feldman Charles , Metaxa Victoria , Shinall Myrick C. , Myburgh John , Vrettou Charikleia S.
Published: April 2022

Background

Limitations of life-sustaining interventions in intensive care units (ICUs) exhibit substantial changes over time, and large, contemporary variation across world regions. We sought to determine whether a weighted end-of-life practice score can explain a large, contemporary, worldwide variation in limitation decisions.

Methods

The 2015–2016 (Ethicus-2) vs. 1999–2000 (Ethicus-1) comparison study was a two-period, prospective observational study assessing the frequency of limitation decisions in 4952 patients from 22 European ICUs. The worldwide Ethicus-2 study was a single-period prospective observational study assessing the frequency of limitation decisions in 12,200 patients from 199 ICUs situated in 8 world regions. Binary end-of-life practice variable data (1 = presence; 0 = absence) were collected post hoc (comparison study, 22/22 ICUs, n = 4592; worldwide study, 186/199 ICUs, n = 11,574) for family meetings, daily deliberation for appropriate level of care, end-of-life discussions during weekly meetings, written triggers for limitations, written ICU end-of-life guidelines and protocols, palliative care and ethics consultations, ICU-staff taking communication or bioethics courses, and national end-of-life guidelines and legislation. Regarding the comparison study, generalized estimating equations (GEE) analysis was used to determine associations between the 12 end-of-life practice variables and treatment limitations. The weighted end-of-life practice score was then calculated using GEE-derived coefficients of the end-of-life practice variables. Subsequently, the weighted end-of-life practice score was validated in GEE analysis using the worldwide study dataset.

Results

In comparison study GEE analyses, end-of-life discussions during weekly meetings [odds ratio (OR) 0.55, 95% confidence interval (CI) 0.30–0.99], end-of-life guidelines [OR 0.52, (0.31–0.87)] and protocols [OR 15.08, (3.88–58.59)], palliative care consultations [OR 2.63, (1.23–5.60)] and end-of-life legislation [OR 3.24, 1.60–6.55)] were significantly associated with limitation decisions (all P < 0.05). In worldwide GEE analyses, the weighted end-of-life practice score was significantly associated with limitation decisions [OR 1.12 (1.03–1.22); P = 0.008].

Conclusions

Comparison study-derived, weighted end-of-life practice score partly explained the worldwide study’s variation in treatment limitations. The most important components of the weighted end-of-life practice score were ICU end-of-life protocols, palliative care consultations, and country end-of-life legislation.
25 years of experience with transjugular intrahepatic portosystemic shunt (TIPS): changes in patient selection and procedural aspects
Authors: Büttner Laura , Aigner Annette , Pick Lisa , Brittinger Josefine , Steib Christian J. , Böning Georg , Streitparth Florian
Published: April 2022

Background

TIPS is an established treatment for portal hypertension. The aim was to analyze how patient selection for TIPS implantation and procedural aspects have changed over 25 years. Routinely collected demographic, clinical, laboratory, and procedural data of 835 patients treated with TIPS in a single center were used. Time trends over the observational period from 1993 to 2018 were retrospectively analyzed. Descriptive statistical analysis was performed.

Results

The most common indication for TIPS implantation has changed significantly from secondary prevention of variceal hemorrhage in the early years to treatment of recurrent ascites. During the observation period, increasingly more severely ill patients became TIPS candidates. There was little change in MELD scores over this period (in total median 13.00; IQR 10.00–18.00). The proportion of patients with Child–Pugh C cirrhosis increased. The most frequent underlying diseases in total were alcohol-related liver disease (66.5%) and viral hepatitis (11.9%). However, shares of cryptogenic liver cirrhosis, autoimmune hepatitis, and NASH increased over time. The proportion of patients post liver transplant also increased. While bare metal stents were standard in the past, use of covered stents increased. The success rate of TIPS (defined by successful implantation and a decrease in the portosystemic pressure gradient ≤ 12 mmHg) increased significantly over time. The total success rate according to this definition was 84.9%.

Conclusion

The results of our analysis reflect technical developments in TIPS, especially in terms of stent material and gains in clinical experience, particularly regarding indications and patient selection for TIPS implantation.
Accidental ingestion of an endodontic file: a case report
Authors: Naderian Ashkun , Baghaie Hooman , Satchithanandha Vysheki
Published: April 2022

Background

Ingestion of dental instruments is rare during dental surgery but can result in serious complications. Here we describe a case in which an endodontic hand file was accidentally misplaced in situ during endodontic (root canal) therapy. Plain radiographs were used to identify its location, and serial imaging was used to monitor passage of the endodontic file through the gastrointestinal tract, and it ultimately passed without intervention. We conclude by describing methods for surveillance and management of ingested dental instruments.

Case report

A 62-year-old Caucasian male presented to the Emergency Department approximately 2 hours after suspected ingestion or inhalation of an endodontic hand file. He had experienced two episodes of excessive coughing and dyspnea while undergoing endodontic therapy, and was promptly referred by his dentist for further investigation. On admission, plain abdominal radiographs confirmed the position of the file in the duodenum, and serial radiographs were used to monitor its transition and clearance through the gastrointestinal tract. During this time, the patient did not demonstrate any clinical signs of bowel perforation, nor was there any radiographic evidence of pneumoperitonium. The patient was discharged after a final radiograph confirmed the absence of the foreign body.

Conclusion

Ingestion and inhalation of dental instruments can be life threatening and should be managed cautiously, with early input from general surgeons, gastroenterologists, or respiratory physicians for possible endoscopic retrieval, emergent laparotomy, or surgical intervention. Imaging studies are useful for discerning the position of the foreign body and to determine whether retrieval is possible, and the management will ultimately depend on the position and characteristics of the foreign body, as well as risk factors from the patient which may increase the likelihood of perforation, obstruction, or impaction.
Coaching to develop leadership for healthcare managers: a mixed-method systematic review protocol
Authors: Hu Shuang , Chen Wenjun , Hu Huiping , Huang Wenqiu , Chen Jia , Hu Jiale
Published: April 2022

Background

An increasing number of interventions have focused on leadership development for healthcare managers, among which coaching is a common strategy. The purpose of the present systematic review is to synthesize evidence on the effect of coaching in developing leadership of healthcare managers.

Methods and analysis

A literature search will be conducted in six English databases (MEDLINE (Ovid), CINAHL, Embase, Cochrane library, Nursing & Allied Health Premium, and Scopus) and four Chinese databases (Wanfang, CNKI, SinoMed, and VIP) from inception to April 1st, 2022. The titles, abstracts, and full texts of the studies will be screened by two independent researchers to determine their eligibility. The RoB 2, ROBINS-I, CASP, and MMAT will be applied to assess the quality of randomized trials, non-randomized studies, qualitative studies, and mixed-method studies, respectively. We will then extract the study characteristics, participant characteristics, and study outcomes of the reviewed papers. The Aims, Ingredients, Mechanism, and Delivery framework will be used to extract the components of coaching strategies. For quantitative data, a meta-analysis will be performed if sufficient data are available; otherwise, we will conduct a narrative synthesis. Thematic synthesis methods will be used for qualitative data analysis.

Discussion

By conducting this systematic review, we expect to synthesize evidence regarding the components of coaching for leadership development among healthcare managers; the influence of coaching on leadership development among managers at the individual, unit-wide, or organizational level; and how managers view coaching as a leadership development strategy.

Trial registration

PROSPERO registration number:CRD42020194290.
COVID-19 contact tracing in Belgium: main indicators and performance, January – September 2021
Authors: Proesmans Kristiaan , Hancart Sharon , Braeye Toon , Klamer Sofieke , Robesyn Emmanuel , Djiena Achille , De Leeuw Frances , Mahieu Romain , Dreuw Alex , Hammami Naima , Wildemeersch Dirk , Cornelissen Laura , Van Cauteren Dieter
Published: April 2022

Background

Contact tracing is one of the main public health tools in the control of coronavirus disease 2019 (COVID-19). A centralized contact tracing system was developed in Belgium in 2020. We aim to evaluate the performance and describe the results, between January 01, 2021, and September 30, 2021. The characteristics of COVID-19 cases and the impact of COVID-19 vaccination on testing and tracing are also described.

Methods

We combined laboratory diagnostic test data (molecular and antigen test), vaccination data, and contact tracing data. A descriptive analysis was done to evaluate the performance of contact tracing and describe insights into the epidemiology of COVID-19 by contact tracing.

Results

Between January and September 2021, 555.181 COVID-19 cases were reported to the central contact center and 91% were contacted. The average delay between symptom onset and contact tracing initiation was around 5 days, of which 4 days corresponded to pre-testing delay. High-Risk Contacts (HRC) were reported by 49% of the contacted index cases. The mean number of reported HRC was 2.7. In total, 666.869 HRC were reported of which 91% were successfully contacted and 89% of these were tested at least once following the interview. The estimated average secondary attack rate (SAR) among the contacts of the COVID-19 cases who reported at least one contact, was 27% and was significantly higher among household HRC. The proportion of COVID-19 cases who were previously identified as HRC within the central system was 24%.

Conclusions

The contact-tracing system contacted more than 90% of the reported COVID-19 cases and their HRC. This proportion remained stable between January 1 2021 and September 30 2021 despite an increase in cases in March–April 2021. We report high SAR, indicating that through contact tracing a large number of infections were prospectively detected.

The system can be further improved by (1) reducing the delay between onset of illness and medical consultation (2) having more exhaustive reporting of HRC by the COVID-19 case.
Prevalence and genotype distribution of viral hepatitis B in Cambodia between 1990 and 2020: a systematic review and meta-analysis
Authors: E Bunthen , Ou Pichetra , Ouoba Serge , Hussain Md Razeen Ashraf , Ko Ko , Nagashima Shintaro , Sugiyama Aya , Akita Tomoyuki , Tanaka Junko
Published: April 2022

Background

Hepatitis B virus (HBV) infection is one of the major public health problems globally as well as in Cambodia. Continuous information on HBV infection burden is required to implement effective disease control strategies. This study aimed to determine the prevalence and genotype distribution of HBV infection in Cambodia through a systematic review with meta-analysis.

Methods

Four databases (PubMed, Web of Science, Scopus, and Google Scholar) were used to search published studies reporting either HBV prevalence or genotype distribution in Cambodia until August 21, 2020. Reviews, modeling studies, and studies conducted among Cambodian permanently living abroad were excluded. The Freeman–Tukey double arcsine transformation was implemented to achieve approximate normality. The DerSimonian and Laird method was used to compute pooled estimates based on the transformed values and their variance. Possible publication bias was assessed by the Egger test and the funnel plot.

Results

A total of 22 studies were included, covering 22,323 people. Ten studies reported HBV prevalence in the general population. The HBV infection prevalence was 4.73% (95%CI: 2.75–7.17%) in the general population and 19.87% (95%CI: 10.95–30.63%) in high-risk/co-infected groups. By sub-group analysis, the prevalence was 6.81% (95% CI: 4.43–9.66) in adults older than 15 years old, 2.37% (95% CI:0.04–7.05) in children 6–15 years old, and 2.47% (95% CI: 0.96–4.59) in children less than five years old. The prevalence of HBV infection decreased over time. Predominant HBV genotypes were genotypes C and B with 82.96% and 16.79%, respectively.

Conclusions

The decrease in HBV infection prevalence in Cambodia demonstrates the effects of national hepatitis B immunization, improved clinical hygiene, and the use of disposable devices. However, the estimated HBV prevalence among the general population indicates an intermediate endemicity level of HBV infection. Therefore, population screening and linkage to care, high vaccination coverage, health promotion, and HBV surveillance are essential to meet the WHO 2030 goal.
miR-199-5p regulates spermiogenesis at the posttranscriptional level via targeting Tekt1 in allotriploid crucian carp
Authors: Li Shengnan , Wang Qiubei , Huang Lu , Fan Siyu , Li Ting , Shu Yuqing , Zhang Chun , Zhou Yi , Liu Qingfeng , Luo Kaikun , Tao Min , Liu Shaojun
Published: April 2022

Background

Sperm abnormalities are one of the primary factors leading to male sterility, but their pathogenesis is still unclear. Although miRNAs are suggested to exert important roles in the regulation of spermatogenesis at both transcriptional and posttranscriptional levels, little is currently known regarding the regulation of sperm flagella assembly by microRNAs (miRNAs). The role of miRNAs in the development of sperm abnormalities in sterile triploid fish has not been studied.

Results

In this study, we found that miR-199-5p was widely expressed in all detected tissues of different-ploidy crucian carp. As one of the testis-specific candidate markers, Tekt1 was predominantly expressed in the testis. Quantitative real-time PCR (qRT-PCR) analyses showed that the expression trend of miR-199-5p was exactly opposite to that of Tekt1. Through bioinformatics analysis, we identified a putative miR-199-5p binding site in the Tekt1 mRNA. We further identified Tekt1 as a target of miR-199-5p using luciferase reporter assay. Finally, we confirmed that miR-199-5p was necessary for sperm flagellar assembly and spermatogenesis in vivo via intraperitoneal injection of miR-199-5p antagomir or agomir in diploid red crucian carp. Moreover, miR-199-5p gain-of-function could lead to spermatids apoptosis and abnormal spermatozoa structure, which is similar to that of allotriploid crucian carp.

Conclusions

Our studies suggested that abnormally elevated miR-199-5p inhibited the sperm flagella formation in spermiogenesis by negatively regulating the expression of Tekt1, thereby causing sperm abnormalities of male allotriploid crucian carp.
Changes of symptoms of eating disorders (ED) and their related psychological health issues during the COVID-19 pandemic: a systematic review and meta-analysis
Authors: Haghshomar Maryam , Shobeiri Parnian , Brand Serge , Rossell Susan L. , Akhavan Malayeri Ava , Rezaei Nima
Published: April 2022

Background

The COVID-19 pandemic and its related social restrictions have profoundly affected people’s mental health. It can be assumed that symptomatic behaviors and mental health of individuals with eating disorders (ED) deteriorated during this time. To get a thorough overview, we conducted a systematic review and meta-analysis with the following aims: First, to provide a comprehensive overview of symptoms of ED during the COVID-19-related confinement; second, to identify psychological mechanisms which impacted the emergence and maintenance of ED symptoms; third, to describe changes of daily routine and changes of access to healthcare in individuals with ED during confinement.

Methods

We searched Embase, PubMed, and Scopus databases for observational studies published between January 1st, 2020, to July 1st, 2021, which investigated the symptomatology of ED during the COVID-19 pandemic.

Results

After the screening, 13 studies with 7848 participants were included in the present systematic review and meta-analysis. The overall pooled prevalence of exacerbation of binge eating, food restriction, purging behaviors, and concerns about food intake in the pooled sample of 7848 was 59.65% (95% CI: 49.30%; 69.60%), and the overall prevalence of improved symptoms of ED in the pooled sample of 741 individuals was 9.37% (95% CI: 3.92%; 16.57%). Furthermore, COVID-19-related social restrictions negatively impacted the psychological health, daily routines, and physical activity of individuals with ED. More specifically, symptoms of anxiety and depression related to ED were increased significantly over time. However, there were also positive aspects to the COVID-19 pandemic. The main positive consequences included more emotional support from the family, less pressure to engage in social activities, and more flexible meal planning. Individuals with ED reported having difficulties getting access to healthcare centers and using telemedicine. They also found a hard time communicating via online sessions.

Conclusions

According to our interpretation, based on the data included in the systematic review and meta-analysis, the COVID-19 pandemic and its related social restrictions detrimentally impacted the mental health of majority of individuals with ED. Limited and impaired access to healthcare interventions appeared to have further exacerbated mental health issues of individuals with ED. Given this background, it seems that individuals with ED demand more attention during the COVID-19 crisis, and it is necessary to ensure that their course of treatment remains uninterrupted.
Multimedia learning principles in different learning environments: a systematic review
Authors: Çeken Burç , Taşkın Nazım
Published: April 2022

Current literature mainly focused on one or two multimedia learning principles in traditional learning environments. Studies on multimedia learning principles in AR and VR environments are also limited. To reveal the current situation and gaps of the multimedia learning principles in different learning environments, it is necessary to extend their boundaries. Thus, further studies may directly affect the investment in VR and AR technologies and their integration into the learning process by teachers. The current study presented a systematic review of multimedia learning principles in different learning environments, including traditional, virtual reality and augmented reality. In this study, 136 journal articles were identified based on PRISMA guidelines and reviewed regarding multimedia learning principles, learning environments, measurements, subject matters, learning outcomes, research methodologies, education programs, education fields, and years of publication. The results indicate that (1) there is an increasing interest in multimedia learning principles; (2) undergraduate students have been the target participant group in the review studies; (3) only five studies tested one of the multimedia learning principles in the VR environment, but no studies have been conducted in the AR learning environment; (4) most studies preferred subjective measurements (e.g., mental effort, difficulty) or indirect objective measurements (e.g., learning outcomes, eye-tracking, study time); (5) subject matters from STEM fields often preferred in investigations; and (6) modality was the most studied multimedia learning principle in the reviewed articles, followed by redundancy, multimedia, signaling, coherence, segmenting, personalization, spatial contiguity, temporal contiguity, image, pre-training, and voice, respectively. The results were discussed in detail. Specific gaps in the literature were identified, and suggestions and implications were provided for further research.
A mesh-based model of liver vasculature: implications for improved radiation dosimetry to liver parenchyma for radiopharmaceuticals
Authors: Correa-Alfonso Camilo M. , Withrow Julia D. , Domal Sean J. , Xing Shu , Shin Jungwook , Grassberger Clemens , Paganetti Harald , Bolch Wesley E.
Published: April 2022

Purpose

To develop a model of the internal vasculature of the adult liver and demonstrate its application to the differentiation of radiopharmaceutical decay sites within liver parenchyma from those within organ blood.

Method

Computer-generated models of hepatic arterial (HA), hepatic venous (HV), and hepatic portal venous (HPV) vascular trees were algorithmically created within individual lobes of the ICRP adult female and male livers (AFL/AML). For each iteration of the algorithm, pressure, blood flow, and vessel radii within each tree were updated as each new vessel was created and connected to a viable bifurcation site. The vascular networks created inside the AFL/AML were then tetrahedralized for coupling to the PHITS radiation transport code. Specific absorbed fractions (SAF) were computed for monoenergetic alpha particles, electrons, positrons, and photons. Dual-region liver models of the AFL/AML were proposed, and particle-specific SAF values were computed assuming radionuclide decays in blood within two locations: (1) sites within explicitly modeled hepatic vessels, and (2) sites within the hepatic blood pool residing outside these vessels to include the capillaries and blood sinuses. S values for 22 and 10 radionuclides commonly used in radiopharmaceutical therapy and imaging, respectively, were computed using the dual-region liver models and compared to those obtained in the existing single-region liver model.

Results

Liver models with virtual vasculatures of ~ 6000 non-intersecting straight cylinders representing the HA, HPV, and HV circulations were created for the ICRP reference. For alpha emitters and for beta and auger-electron emitters, S values using the single-region models were approximately 11% (AML) to 14% (AFL) and 11% (AML) to 13% (AFL) higher than the S values obtained using the dual-region models, respectively.

Conclusions

The methodology employed in this study has shown improvements in organ parenchymal dosimetry through explicit consideration of blood self-dose for alpha particles (all energies) and for electrons at energies below ~ 100 keV.
A serological biomarker of type I collagen degradation is related to a more severe, high neutrophilic, obese asthma subtype
Authors: Rønnow Sarah Rank , Sand Jannie Marie Bülow , Staunstrup Line Mærsk , Bahmer Thomas , Wegmann Michael , Lunding Lars , Burgess Janette , Rabe Klaus , Sorensen Grith Lykke , Fuchs Oliver , Mutius Erika V. , Hansen Gesine , Kopp Matthias Volkmar , Karsdal Morten , Leeming Diana Julie , Weckmann Markus ,   the ALLIANCE Study Group as part of the German Center of Lung Research (DZL)
Published: April 2022

Background

Asthma is a heterogeneous disease; therefore, biomarkers that can assist in the identification of subtypes and direct therapy are highly desirable. Asthma is a chronic inflammatory disease that leads to changes in the extracellular matrix (ECM) by matrix metalloproteinases (MMPs) degradation causing fragments of type I collagen that is released into circulation.

Objective

Here, we asked if MMP-generated type I collagen (C1M) was associated with subtypes of asthma.

Methods

C1M was serologically assessed at baseline in the adult participants of the All Age Asthma study (ALLIANCE) (n = 233), and in The Prospective Epidemiological Risk Factor study (PERF) (n = 283). In addition, C1M was assessed in mice sensitized to ovalbumin (OVA) and challenged with OVA aerosol. C1M was evaluated in mice with and without acute neutrophilic inflammation provoked by poly(cytidylic-inosinic) acid and mice treated with CP17, a peptide inhibiting neutrophil accumulation.

Results

Serum C1M was significantly increased in asthmatics compared to healthy controls (p = 0.0005). We found the increased C1M levels in asthmatics were related to blood neutrophil and body mass index (BMI) in the ALLIANCE cohort, which was validated in the PERF cohort. When patients were stratified into obese (BMI > 30) asthmatics with high neutrophil levels and uncontrolled asthma, this group had a significant increase in C1M compared to normal-weight (BMI < 25) asthmatics with low neutrophil levels and controlled asthma (p = 0.0277). C1M was significantly elevated in OVA mice with acute neutrophilic inflammation compared to controls (P = 0.0002) and decreased in mice treated with an inhibitor of neutrophil infiltration (p = 0.047).

Conclusion & clinical relevance

C1M holds the potential to identify a subtype of asthma that relates to severity, obesity, and high neutrophils. These data suggest that C1M is linked to a subtype of overall inflammation, not only derived from the lung. The link between C1M and neutrophils were further validated in in vivo model.

Trial registration

(ALLIANCE, NCT02419274).
A hierarchical coordinated control strategy based on multi-port energy router of urban rail transit
Authors: Chen Richeng , Yang Yaxi , Jin Tao
Published: April 2022

The multi-port energy router (ER) is an effective topology for integrating train traction load, AC load, the energy storage system and photovoltaic(PV) energy. The start and stop process of urban rail transit trains and the access of distributed energy sources to rail transit ER lead to serious fluctuations of DC bus power, so it is necessary to route energy between different ports, involving multi-operating modes, while seamless switching is a major challenge. In this paper, a hierarchical coordinated control strategy is proposed to enable the multi-port ER to operate in a coordinated fashion under the conditions of train parking, acceleration, constant power driving and deceleration, and to switch seamlessly under various working conditions. The energy central dispatching layer sends working condition instructions by sampling the state information of each port, while the microgrid control layer adopts centralized control, receiving upper working condition instructions and sending drive signals to the local control layers to maintain the balanced energy flow of each port. In the local control layers, the PV adopts the improved perturbation and observation method of power control (PC-P&O), while the ES system adopts voltage loop control with an SOC influence factor, voltage loop control with switching factor and power loop control according to the different working conditions, so as to transmit the required train load power accurately and maintain the stability of the DC bus voltage. Finally, the effectiveness of the proposed hierarchical coordination control is verified by MATLAB/Simulink simulations.
Identification of poor prognostic joint locations in an early rheumatoid arthritis cohort at risk of rapidly progressing disease: a post-hoc analysis of the Phase III AGREE study
Authors: Durez Patrick , Westhovens Rene , Baeke Femke , Elbez Yedid , Robert Sofie , Ahmad Harris A.
Published: April 2022

Background

Rheumatoid arthritis (RA) is a heterogeneous disease with established poor prognostic factors such as seropositivity, joint damage, and high disease activity at an early, treatment-naïve stage of disease. However, few studies have examined if specific joint locations are correlated with these factors in such a population. This analysis explored the potential correlation of individual swollen and erosive joints with other disease characteristics at baseline and with remission rates in a post-hoc analysis of the Phase III randomized AGREE study.

Methods

Methotrexate (MTX)-naïve, erosive, RF- and/or ACPA-positive early RA patients (N = 509) were retrospectively evaluated. Baseline joint swelling was analyzed for large and small joints. Baseline erosions were analyzed for wrist, MCP1–5, IP1, PIP2–5 and MTP1–5. Remission rates were assessed after 6 months of treatment with abatacept (ABA) + MTX (N = 256) or MTX (N = 253). The following statistical tests were used: Chi-Square or Fisher’s exact test (categorical variables); Student’s t-test or Wilcoxon rank-sum test (continuous variables); continuity-corrected Chi-square test (efficacy remission endpoints).

Results

Baseline swelling was most frequent in wrist (91.9%) and MCP2 joint (89.1%), while baseline erosion was most frequent in MTP5 joint (43.5%). Swollen shoulder was significantly correlated (p < 0.0001) with swelling of almost all other large or medium joints. Baseline swelling in the knee, temporomandibular joint (TMJ), wrist and elbow was highly correlated (p < 0.001) with higher tender and swollen joint counts, higher DAS28(CRP) and higher SDAI and CDAI. Baseline swelling was not correlated with erosion per joint, except for MCP2. The largest difference in mean Boolean remission rates at 6 months was in patients with baseline swollen wrist favoring ABA + MTX (14.0% vs 4.4%; p < 0.001).

Conclusions

Swelling in the large and medium joints (knee, TMJ, elbow and wrist) was highly correlated with severe disease activity while MCP2 swelling seemed to be correlated with joint damage. The correlation of joint locations at an early, treatment-naïve stage with poor prognostic factors, higher disease activity and joint damage, could establish a rapidly progressing anatomical pattern in early RA.

Trial registration: ClinicalTrials.gov NCT00122382, registered July 2005.
Biological control and field evaluation of the predatory mite, Typhlodromus setubali Dosse (Acari: Phytoseiidae) in apple orchards
Authors: Ouassat Said , Allam Latifa
Published: April 2022

Background

Typhlodromus setubaliDosse (Acari: Phytoseiidae) is an indigenous predatory mite in Morocco. This study aimed to evaluate its efficacy, through 3 release rates on 2 apple varieties, namely Skarlet and Golden delicious, with different initial densities of the European red spider mite,Panonychus ulmiKoch (Acari: Tetranychidae).

Results

The efficacy of the predator was significantly influenced by the initialP. ulmidensity. Furthermore, the release rate of 50 individuals/tree did not provide effective control ofP. ulmi.When it was released at 100 and 200 individuals per tree,T. setubalimaintained theP. ulmipopulation below the economic threshold of 5 motile stages per leaf.

Conclusions

When the initialP. ulmidensity is above the economic threshold, the lower release rate ofT. setubalimust be applied with high frequency or conciliated with a selective miticide treatment at a suitable dose for a successful biological control program. Further field-based studies are needed for perfect conclusions.
Molecular binding studies of anthocyanins with multiple antiviral activities against SARS-CoV-2
Authors: Akinnusi Precious Ayorinde , Olubode Samuel Olawale , Salaudeen Wasiu Adeboye
Published: April 2022

Background

The search for ideal drugs with absolute antiviral activity against SARS-CoV-2 is still in place, and attention has been recently drawn to natural products. Several molecular targets have been identified as points of therapeutic intervention. The targets used in this study include SARS-CoV-2 helicase, spike protein, RNA-dependent RNA polymerase, main protease, and human ACE-2. An integrative computer-aided approach, which includes molecular docking, pharmacophore modeling, and pharmacokinetic profiling, was employed to identify anthocyanins with robust multiple antiviral activities against these SARS-CoV-2 targets.

Result

Four anthocyanins (Delphinidin 3-O-glucosyl-glucoside, Cyanidin 3-O-glucosyl-rutinoside, Cyanidin 3-(p-coumaroyl)-diglucoside-5-glucoside), and Nasunin) with robust multiple inhibitory interactions were identified from a library of 118 anthocyanins using computer-aided techniques. These compounds exhibited very good binding affinity to the protein targets and moderate pharmacokinetic profiles. However, Cyanidin 3-O-glucosyl-rutinoside is reported to be the most suitable drug candidate with multiple antiviral effects against SARS-CoV-2 due to its good binding affinity to all five protein targets engaged in the study.

Conclusions

The anthocyanins reported in this study exhibit robust binding affinities and strong inhibitory molecular interactions with the target proteins and could be well exploited as potential drug candidates with potent multiple antiviral effects against COVID-19.
The varied experience of undergraduate students during the transition to mandatory online chem lab during the initial lockdown of the COVID-19 pandemic
Authors: Watts Joseph , Crippen Kent J. , Payne Corey , Imperial Lorelie , Veige Melanie
Published: April 2022

The radical global shift to online teaching that resulted from the initial lockdown of the COVID-19 pandemic forced many science educators into the predicament of translating courses, including teaching laboratories, that were based upon face-to-face or practical goals and conventions into ones that could be delivered online. We used this phenomenon at the scale of a research-intensive, land-grant public institution to understand the various ways that the switch was experienced by a large cohort of 702 undergraduate students taking General Chemistry Laboratory. Data was collected over 3 weeks with identical surveys involving four prompts for open-ended responses. Analysis involved sequential explanatory mixed methods where topic modeling, a machine learning technique, was used to identify 21 topics. As categories of experience, these topics were defined and further delineated into 52 dimensions by inductive coding with constant comparison. Reported strengths and positive implications tie predominantly to the topics of Time Management Across a Lab Activity and a Critique of Instruction. Consistent with other reports of teaching and learning during the pandemic, participants perceived Availability of the Teaching Assistant for Help as a positive implication. Perceptions of weakness were most associated with Having to Work Individually, the Hands On Experience, a Critique of Instruction, and Learning by Doing. Hands on Experience, which was interpreted as the lack thereof, was the only topic made up nearly entirely of weaknesses and negative implications. The topic of Learning by Doing was the topic of greatest occurrence, but was equally indicated as strengths, positive implication, weakness, and negative implication. Ramifications are drawn from the weaknesses indicated by students who identified as members of an underrepresented ethnic minority. The results serve as a reminder that the student experience must be the primary consideration for any educational endeavor and needs to continue as a principal point of emphasis for research and development for online science environments.
Becker congenital myotonia in black African with molecular findings
Authors: Azonbakin Simon , Adovoekpe Diane , Adjagba Marius , Alao Jules , Sagbo Gratien , Adjien Constant , Laleye Anatole
Published: April 2022

Background

Congenital myotonia is a congenital disorder that affects skeletal muscles with myotonia. Affected muscles show stiffness and pain sometimes. The two major types of myotonia congenita are known as Thomsen disease and Becker disease. These conditions are distinguished by the severity of their symptoms and their patterns of inheritance. The causative factor is mutations in CLCN1 gene. Myotonia congenita is rarely reported in black especially in black African.

Case presentation

This is a case report of Becker Congenital Myotonia in a 36-year-old male from Benin. The symptoms arose at the age of 7 years with regular and progressive course and muscles pains. Electromyogram, blood sampling, laboratory investigations and muscles biopsy confirm the diagnostic with molecular finding.

Conclusion

The authors report a case of Becker congenital myotonia in a black African with molecular confirmation.
Mexiletine was used as symptomatic agent with good results.
Multiple cardiac metastases from urothelial carcinoma case report
Authors: Grech Neil , Camilleri William , Borg Alexander
Published: April 2022

Background

Cardiac metastases are rare and frequently remain undiagnosed due to the absence of clinical signs in the majority of cases. Malignancies found to most commonly metastasise to the heart include lung carcinoma, breast carcinoma and lymphoma, while urothelial carcinoma is a rare cause of cardiac metastasis. The patient presented with pyrexia, a rare presentation of metastatic cardiac involvement. Single metastatic lesions are mainly reported in the literature, while multiple metastatic deposits such as in this case are less common.

Case presentation

A 74-year-old gentleman presented with frequent febrile spikes, a month after undergoing a nephroureterectomy for poorly differentiated urothelial carcinoma. No febrile source was identified, and a computed tomography identified two cardiac lesions. A transthoracic echocardiogram could not detect the cardiac lesions; therefore, cardiac magnetic resonance (CMR) imaging was performed. Three spherical intramyocardial masses were noted at the basal septum, LV apex and the anteromedial papillary muscle. The lesions demonstrated signal characteristics suggestive of cardiac metastases (high fluid content, absence of fat, presence of a surrounding rim of increased extravascular space, absence of deformation within the masses) from the previously resected urothelial carcinoma. The patient was palliated, and he shortly succumbed to his condition.

Conclusions

Urothelial carcinoma is an exceedingly rare cause of cardiac metastasis. CMR is an important imaging modality for localisation and characterisation of suspicious cardiac lesions, aiding in the diagnosis of cardiac metastasis.
Chronic activation of cardiac Atg-5 and pancreatic Atg-7 by intermittent fasting alleviates acute myocardial infarction in old rats
Authors: El Agaty Sahar Mohamed , Nassef Noha A. , Abou-Bakr Doaa A. , Hanafy Aya A.
Published: April 2022

Background

Aging is associated with cardiovascular and metabolic changes, increasing the susceptibility to acute myocardial infarction (AMI). Intermittent fasting (IF) has a beneficial effect on the age-associated cardiovascular diseases. The present study was planned to investigate the possible protective effect of IF against acute AMI induced by isoproterenol (ISO) in old rats and its possible underlying mechanisms mediated by heart and pancreatic autophagy. Thirty Male Wistar rats were divided into four groups: adult; old; Old-ISO (rats subjected to AMI by ISO) and Old-F-ISO groups (rats were subjected to IF for 4 weeks and AMI by ISO).

Results

IF significantly increased the mRNA expression of cardiac Atg-5 and pancreatic Atg-7 in Old-F-ISO versus old and adult groups. This was associated with a significant decrease in serum troponin-I, serum creatine kinase (CK-MB), cardiac malondialdehyde and cardiac TNF-α, fasting plasma glucose, and HOMA-IR in Old-F-ISO compared to Old-ISO group. Also, IF significantly decreased the age-related overall and visceral obesity in Old-F-ISO versus old and Old-ISO groups. Histological studies revealed attenuation of the local inflammatory response in Old-F-ISO versus Old-ISO group. Pancreatic Atg-7 and heart Atg-5 were significantly increased in Old-ISO versus old rats.

Conclusions

IF protects against acute AMI in old rats, possibly, via chronic activation of heart Atg-5 and pancreatic Atg-7, and alleviation of age-related overall and visceral obesity. Thus, IF could be a dietary lifestyle modification for attenuation of the susceptibility to acute AMI in aged population. On the other hand, acute activation of heart and pancreatic autophagy by ISO might augment cardiac injury.
Collaboration networks of the implementation science centers for cancer control: a social network analysis
Authors: Jacob Rebekah R. , Korn Ariella R. , Huang Grace C. , Easterling Douglas , Gundersen Daniel A. , Ramanadhan Shoba , Vu Thuy , Angier Heather , Brownson Ross C. , Haire-Joshu Debra , Oh April Y. , Schnoll Robert
Published: April 2022

Background

Multi-center research initiatives offer opportunities to develop and strengthen connections among researchers. These initiatives often have goals of increased scientific collaboration which can be examined using social network analysis.

Methods

The National Cancer Institute (NCI)-funded Implementation Science Centers in Cancer Control (ISC3) initiative conducted an online social network survey in its first year of funding (2020) to (1) establish baseline network measures including the extent of cross-center collaboration and (2) assess factors associated with a network member’s access to the network such as one’s implementation science (IS) expertise. Members of the seven funded centers and NCI program staff identified collaborations in planning/conducting research, capacity building, product development, scientific dissemination, and practice/policy dissemination.

Results

Of the 192 invitees, 182 network members completed the survey (95%). The most prevalent roles were faculty (60%) and research staff (24%). Almost one-quarter (23%) of members reported advanced expertise in IS, 42% intermediate, and 35% beginner. Most members were female (69%) and white (79%). One-third (33%) of collaboration ties were among members from different centers. Across all collaboration activities, the network had a density of 14%, suggesting moderate cohesion. Degree centralization (0.33) and betweenness centralization (0.07) measures suggest a fairly dispersed network (no single or few central member(s) holding all connections). The most prevalent and densely connected collaboration was in planning/conducting research (1470 ties; 8% density). Practice/policy dissemination had the fewest collaboration, lowest density (284 ties’ 3% density), and the largest number of non-connected members (n=43). Access to the ISC3 network varied significantly depending on members’ level of IS expertise, role within the network, and racial/ethnic background. Across all collaboration activities, most connected members included those with advanced IS expertise, faculty and NCI staff, and Hispanic or Latino and white members.

Conclusions

Results establish a baseline for assessing the growth of cross-center collaborations, highlighting specific areas in need of particular growth in network collaborations such as increasing engagement of racial and ethnic minorities and trainees or those with less expertise in IS.
Pentacam versus anterior segment OCT in measuring intended versus achieved ablation depth post-myopic LASIK correction
Authors: Khalil Hossam-Eldin Mohammed Ahmad , Abd-Elhafiz Khaled Abd-Elaziz , Ibrahim Abdulaziz Kamal
Published: April 2022

Background

Accurate quantitative measurements of central corneal thickness (CCT) provide valuable, clinical information for preoperative assessment, surgical planning, and follow-up in myopic patients who have undergone LASIK correction. Typically, an ultrasound is used to measure such parameters. However, noncontact devices such as the Visante anterior segment optical coherence tomographer [AS-optical coherence tomography (OCT)] and Pentacam are becoming more popular to measure ocular parameters. It is important to assess the level of similarity between these two optical devices to compare between the intended and achieved ablation depth after LASIK procedures in cases of myopia and myopic astigmatism.

Methods

This cross-sectional, prospective study included 80 eyes of 40 patients attending Beni-Suef University Hospital between November 2018 and November 2019. All patients underwent LASIK surgery for the correction of myopia with or without myopic astigmatism with spherical equivalent ranging from − 1.5 to − 12 diopters.

Results

No statistically significant difference was observed between the intended ablation depth and the clinically measured ablation depth calculated by Pentacam and AS-OCT 3 months after surgery (P > 0.05).

Conclusion

When planning corneal refraction surgery, ablation depth readouts calculated by the computer software of the excimer laser used in this study are reliable. Both Pentacam and AS-OCT are accurate, sensitive, and specific in measuring the CCT and calculating ablation depth. Pentacam provides slightly higher accuracy and sensitivity compared with AS-OCT. LASIK is a safe, predictable, and effective procedure in the treatment of simple myopia and myopic astigmatism.
Communal Imagination and the Problem of Allegory in Tomás Rivera’s . . . y no se lo tragó la tierra
Authors: Robles Francisco E.
Published: April 2022

This essay argues that Tomás Rivera’s seminal Chicano text . . . y no se lo tragó la tierra is a polyvocal and deeply communal work whose formal inventiveness illuminates the imaginative lives of migrant workers. Contesting the dominant critical reading of the book as an allegorical treatment of political consciousness and its development, the essay contends that a close reading of the novel’s narrative framework, as well as its emphasis on listening and memory, suggests that important aesthetic and political considerations need not be precisely tied to allegory in order to create a communal text. Ultimately, the essay argues that the literary can help illuminate the workings of ethnic identity by exploring new forms for imagining community belonging.
Generic model for biological regulation
Authors: Vihinen Mauno
Published: April 2022

A substantial portion of molecules in an organism are involved in regulation of a wide spectrum of biological processes. Several models have been presented for various forms of biological regulation, including gene expression regulation and physiological regulation; however, a generic model is missing. Recently a new unifying theory in biology, poikilosis, was presented.  Poikilosis indicates that all systems display intrinsic heterogeneity, which is a normal state. The concept of poikilosis allowed development of a model for biological regulation applicable to all types of regulated systems. The perturbation-lagom-TATAR countermeasures-regulator (PLTR) model combines the effects of perturbation and lagom (allowed and sufficient extent of heterogeneity) in a system with tolerance, avoidance, repair, attenuation and resistance (TARAR) countermeasures, and possible regulators. There are three modes of regulation, two of which are lagom-related. In the first scenario, lagom is maintained, both intrinsic (passive) and active TARAR countermeasures can be involved. In the second mode, there is a shift from one lagom to another. In the third mode, reguland regulation, the regulated entity is the target of a regulatory shift, which is often irreversible or requires action of another regulator to return to original state. After the shift, the system enters to lagom maintenance mode, but at new lagom extent. The model is described and elaborated with examples and applications, including medicine and systems biology. Consequences of non-lagom extent of heterogeneity are introduced, along with a novel idea for therapy by reconstituting biological processes to lagom extent, even when the primary effect cannot be treated.