bluuebunny/crossref_metadata_2025 huggingface dataset:
Dissolution and evolution effects on pressure fluctuations in a space micropump
Authors: Ren Zhipeng , Hao Honglei , Li Deyou , Wang Hongjie , Liu Jintao , Li Yong
Published: December 2022

The purpose of this paper is to reveal the dynamic mass transfer effects between gas and liquid on pressure fluctuations in a space micropump using our proposed computational model of gas–liquid mass transfer. Complex dissolution and evolution processes were applied to achieve accurate dynamic gas–liquid mass transfer predictions in the micropump. The validation of experiments was conducted by measuring the performance characteristics of the micropump, and the mass transfer model was verified by a dissolved oxygen concentration experiment in plug discharge flow. Based on this, four conditions including unsteady single-phase, two-phase without mass transfer, dissolution, and coexisting dissolved–released flows calculations are discussed to clarify the frequency contents, generation reasons, and propagation law. Combined with entropy production analysis, the pressure fluctuation influenced by the dissolution and evolution is illustrated. The results exhibit that the evolution of the gas is located on the head of the long blade suction surface in the impeller. When a unidirectional gas-to-liquid dissolution process occurs, the fluctuating amplitude of the characteristic dominant 5 fn is significantly weakened; otherwise, when dissolution and evolution coexist, the amplitude is significantly promoted as the released gas increase the flow instability. In addition, the distributions of local high entropy production induced by mean and fluctuating velocity gradients overlap that of large mass transfer rates and high amplitude of the mixing frequency in the volute, exhibiting the relationship between entropy production, mass transfer, and flow instability. The current study provides a guidance that the dissolved gases’ concentration must be controlled strictly to avoid the evolution of gas for the safety and stability of the space hydraulic system.
Meanings given to (super-)diversity in the Dutch national team by Dutch football commentators: A historical approach
Authors: van Campenhout Gijs , van Lienden Arne , van Sterkenburg Jacco
Published: December 2022

International football can be considered the main site for meaning-making processes related to national and racial/ethnic diversity. Various scholars have argued how international football, with the World Cup as its apex, can be seen as a barometer for understanding dominant attitudes towards societal diversity. A key domain where this diversity is interpreted and given meaning to is mediated football. To provide a wider overview of – often intersecting – meanings given to nationality and race/ethnicity over a longer period of time, this explorative study uses a historical approach to inquire how Dutch-mediated football – especially football commentary on television – has given meaning to a diversifying Dutch national team at three moments in time (the World Cups of 1974, 1998 and 2014). Further, it discusses how mediated football serves as a site for the (re)construction of discourses surrounding nationality and race/ethnicity in the Netherlands. Our findings show that meanings given to nationality and race/ethnicity are fluid, context-dependent and reconstructed in a particular temporal context. Further, it appears that key players have provided a significant role in meanings given to (super-)diversity of the Dutch national football team. Commentary on White Dutch key players was dominated by positive comments (in the World Cups of 1974 and 2014), while comments on Black Surinamese Dutch key players was relatively more negative (in the 1998 World Cup). Moreover, our results contrast with earlier studies in that Dutch commentators did not rely on stereotypical representations of Black Dutch footballers as ‘naturally’ athletic.
Music Mentor Preparation and Professional Development: A Program Review of the NAfME Music Mentorship Program Facilitator and Mentor Support Project (MMSP)
Authors: Vaughan-Marra Jessica , Baumgartner Christopher M.
Published: December 2022

The purpose of this program review was to provide an in-depth analysis of the National Association for Music Education Music Mentorship Program Facilitator and Mentor Support Project, led by members of Society for Music Teacher Education’s Supporting Beginning Music Teachers Area of Strategic Planning and Action. We used an illuminative evaluation process (Patton, 2015) to present (a) a rich description of the project, (b) perceptions of key stakeholders (organizers, session leaders, participating mentors/mentorship program facilitators), and (c) findings pertinent to developing new music teacher mentor programs. Along with a description of the program, the findings are organized into successes, opportunities, weaknesses, and challenges as outlined by a Strengths, Weaknesses, Opportunities, and Challenges analysis (Even Zahav & Hazzan, 2017). Within these areas, the unique design, workshop calendar and pace, as well as transferable content to state music education association (MEA) programs are presented. The review presents the program design as well as recommendations for making clearer connections to the needs of state-level MEA-sponsored mentoring programs.
Psychological Violence Within a Partner Relationship and Alcohol Abuse of Portuguese Women: The Mediating Role of Resilience
Authors: Fernandes Bárbara , Dias Paulo C. , Lopes Sílvia
Published: December 2022

In this study, we explored how psychological violence within a partner relationship relates to resilience and alcohol abuse of Portuguese women, particularly, testing the mediating role of resilience. A cross-sectional sample of 464 Portuguese women with a partner relationship was screened for psychological violence, alcohol abuse, and resilience. Results showed differences in terms of age, marital status, and current employment situation. Psychological violence was negatively related to resilience and positively related to alcohol consumption. Resilience also showed a negative relationship with alcohol consumption. A partial mediation was found between psychological violence and alcohol consumption through resilience, supporting the crucial role of resilience to break the negative “chain” between psychological violence and alcohol consumption.
A Narrative Inquiry into the Process of Inferential Identity upon Multiracial Children
Authors: Chin Philippa , Nambiar Aishwarya
Published: December 2022

The authors highlight the experiences of monoracial parents of multiracial children in characterizing and inferring their child's ethnic and racial identity in the home. A review of existing research reveals the scarcity of frameworks that provide a model to help monoracial parents in this process. A narrative inquiry is utilized to explore how these parents racially and ethnically identify their multiracial children and the results are discussed. A detailed discussion inclusive of the limitations and implications for clinical practice and future research is noted.
Surgical goniolens for tag identification and removal in DMEK surgery
Authors: Vaccaro Sabrina , Bosio Lorenzo , Parekh Mohit , Gadhvi Kunal A , Giannaccare Giuseppe , Scorcia Vincenzo , Semeraro Francesco , Kaye Stephen B , Romano Vito
Published: December 2022

Introduction

We describe a novel technique for identifying endothelial Descemet membrane (DM) tags remaining after descemetorhexis in patients undergoing Descemet membrane endothelial keratoplasty (DMEK) surgery.

Methods

A surgical goniolens is applied to the corneal surface after descemetorhexis in order to visualize the peripheral inner corneal layer at 360° and identify endothelial-DM tags.

Results

A detailed visualization of the peripheral inner corneal layer is possible using goniolens, without using any staining in the anterior chamber.

Conclusion

The technique may be used to screen the posterior corneal surface for any retained endothelial-DM tags. It may to lower the risk of remaining tags and indirectly lower the incidence of DMEK graft detachment.
Engaging young people with disabilities in research about their experiences of physical education and sport: A scoping review of methodologies and methods
Authors: Clish Meg , Enright Eimear , Sperka Leigh , Tweedy Sean
Published: December 2022

Young people with disabilities (PWD) have increasingly become part of complex and important conversations surrounding their experiences and engagement in physical education (PE) and sport. Despite more young voices being heard, scant attention has been given to why we are listening, who we are listening to, and how we are listening. In this scoping review, we focus on the methodologies and methods used when researching the perspectives young PWD hold of PE and sport. Through searching Google Scholar, PE and sport journals, and citations and references of relevant research studies, we retrieved 52 empirical publications and information was extracted on their aims, country of origin, context and participants, research design, data sources, analytical, theoretical and conceptual frameworks, and key findings and recommendations. By reviewing methodologies and methods, we were able to identify that: authors often justified their work as ‘filling a gap’; varied, and often minimal, participant information was provided; and finally, data generation methods were at times exclusionary and/or not sensitive to disability research contexts. Moving forward, we first recommend that careful consideration is given to why research is being done beyond contributing knowledge to the field. Second, detailed information must be provided about participants to have a clearer picture about who has and has not been included in research so that findings can be contextualised. Finally, greater attention must be given to alternative and inclusive data generation methods to engage more diverse young people, specifically those with high support needs, in research about PE and youth sport.
Interpreting the CPASS Trial: Do Not Shift Motor Therapy to the Subacute Phase
Authors: Edwardson Matthew A. , Brady Kathaleen , Giannetti Margot L. , Geed Shashwati , Barth Jessica , Mitchell Abigail , Tan Ming T. , Zhou Yizhao , Bregman Barbara S. , Newport Elissa L. , Edwards Dorothy F. , Dromerick Alexander W.
Published: December 2022

The Critical Periods After Stroke Study (CPASS, n = 72) showed that, compared to controls, an additional 20 hours of intensive upper limb therapy led to variable gains on the Action Research Arm Test depending on when therapy was started post-stroke: the subacute group (2-3 months) improved beyond the minimal clinically important difference and the acute group (0-1 month) showed smaller but statistically significant improvement, but the chronic group (6-9 months) did not demonstrate improvement that reached significance. Some have misinterpreted CPASS results to indicate that all inpatient motor therapy should be shifted to outpatient therapy delivered 2 to 3 months post-stroke. Instead, however, CPASS argues for a large dose of motor therapy delivered continuously and cumulatively during the acute and subacute phases. When interpreting trials like CPASS, one must consider the substantial dose of early usual customary care (UCC) motor therapy that all participants received. CPASS participants averaged 27.9 hours of UCC occupational therapy (OT) during the first 2 months and 9.8 hours of UCC OT during the third and fourth months post-stroke. Any recovery experienced would therefore result not just from CPASS intensive motor therapy but the combined effects of experimental therapy plus UCC. Statistical limitations also did not allow direct comparisons of the acute and subacute group outcomes in CPASS. Instead of shifting inpatient therapy hours to the subacute phase, CPASS argues for preserving inpatient UCC. We also recommend conducting multi-site dosing trials to determine whether additional intensive motor therapy delivered in the first 2 to 3 months following inpatient rehabilitation can further improve outcomes.
Cerebral small vessel disease: Recent advances and future directions
Authors: Markus Hugh S , de Leeuw Frank Erik
Published: December 2022

Cerebral small vessel disease (SVD) causes lacunar stroke and intracerebral hemorrhage, and is the most common pathology underlying vascular cognitive impairment. Increasingly, the importance of other clinical features of SVD is being recognized including motor impairment, (vascular) parkinsonism, impaired balance, falls, and behavioral symptoms, such as depression, apathy, and personality change. Epidemiological data show a high prevalence of the characteristic magnetic resonance imaging (MRI) features of white matter hyperintensities and lacunar infarcts in community studies, and recent data suggest that it is also a major health burden in low- and middle-income countries. In this review, we cover advances in diagnosis, imaging, clinical presentations, pathogenesis, and treatment.

The two most common pathologies underlying SVD are arteriolosclerosis caused by aging, hypertension, and other conventional vascular risk factors, and cerebral amyloid angiopathy (CAA) caused by vascular deposition of β-amyloid. We discuss the revised Boston criteria of CAA based on MRI features, which have been recently validated. Imaging is providing important insights into pathogenesis, including improved detection of tissue damage using diffusion tensor imaging (DTI) leading to its use to monitor progression and surrogate endpoints in clinical trials. Advanced MRI techniques can demonstrate functional or dynamic abnormalities of the blood vessels, while the high spatial resolution provided by ultrahigh field MRI at 7 T allows imaging of individual perforating arteries for the first time, and the measurement of flow velocity and pulsatility within these arteries. DTI and structural network analysis have highlighted the importance of network disruption in mediating the effect of different SVD pathologies in causing a number of symptoms, including cognitive impairment, apathy, and gait disturbance.

Despite the public health importance of SVD, there are few proven treatments. We review the evidence for primary prevention, and recent data showing how intensive blood pressure lowering reduces white matter hyperintensities (WMH) progression and delays the onset of cognitive impairment. There are few treatments for secondary prevention, but a number of trials are currently evaluating novel treatment approaches. Recent advances have implicated molecular processes related to endothelial dysfunction, nitric oxide synthesis, blood–brain barrier integrity, maintenance and repair of the extracellular matrix, and inflammation. Novel treatment approaches are being developed to a number of these targets. Finally, we highlight the importance of large International collaborative initiatives in SVD to address important research questions and cover a number which have recently been established.
Resilience and mental health in UK urology trainees
Authors: Terry Tim R
Published: December 2022

In the absence of published quantitative data on resilience and mental health in the UK urology trainees, this paper analyses the 2018 and 2021 General Medical Council National Training Surveys with regard to the outcomes of seven work-related questions for all trainees and at all stages of training. The answers to these questions are used as a proxy for burnout levels in urology trainees and also to understand the effect of coronavirus disease 2019 (COVID-19) on training. In addition, the extrinsic and intrinsic factors that may influence a urological trainee’s performance are reviewed as these can act as negative drivers on personal and professional performance. The use of a trainee’s reflective practice and emotional intelligence are promoted to allow early diagnosis of burnout and prompt institution of viable treatment options.

Level of evidence: 2b
Preventing the Philippines from pivoting toward China: The role of the US–Japan security alliance
Authors: De Castro Renato Cruz
Published: December 2022

Shortly after becoming the Philippines’ 16th president in mid-2016, Rodrigo Roa Duterte had unraveled his predecessor's agenda of standing up to China's expansive claims in the South China Sea. He distanced his country from its long-time treaty ally and gravitated toward China which is resolute in reconfiguring the global commons in the Asia-Pacific region. He also set aside the 2016 UNCLOS decision on the South China Sea dispute favorable to the Philippines. His appeasement toward China contrasted sharply with the late President Benigno Aquino III's balancing strategy. President Duterte reoriented Philippine policy alarmed both the US and Japan. Consequently, Washington and Tokyo shored up their respective security ties with the Philippine military. The effort was aimed to prevent the Philippines from being pulled into China's orbit. Moreover, the US is the hub while Japan and the Philippines are spokes in the San Francisco System of alliances. This article concludes that the 1950 San Francisco Peace Conference not only established the series of US bilateral alliances in Asia, but also laid down the foundation of regional order and security which outlives the Cold War, and prevailed way beyond the second decade of the 21st century.
China's National Survey on Teaching-Research Officers and Institutions
Authors: Hu (胡惠闵) Huimin , Shen (沈伟) Wei
Published: December 2022

Highlights

A national survey of basic education teaching-research institutions was conducted as the first nationwide comprehensive survey that involved teaching-research officers and institutions in China. The structures and functions of the provincial, prefectural, and county teaching-research institutions, as well as their role differentiation, were analyzed. The future position and development of teaching-research institutions remain important for teachers’ professional development, as well as the development of teaching and research.
Interventions to reduce infections in patients with hematological malignancies: a systematic review and meta-analysis
Authors: Chai Khai Li , Wong Jonathan , Weinkove Robert , Keegan Anastazia , Crispin Philip , Stanworth Simon , Morrissey C. Orla , Wood Erica M. , McQuilten Zoe K.
Published: December 2022

Acquired hypogammaglobulinemia is common in chronic lymphocytic leukemia (CLL), non-Hodgkin lymphoma (NHL), and multiple myeloma (MM). No previous systematic reviews (SRs) have compared different approaches to infection prevention. We sought to assess the efficacy and safety of prophylactic immunoglobulin, antibiotics, and vaccination in these patients. We performed an SR and meta-analysis of randomized controlled trials (RCTs) evaluating the efficacy and safety of prophylactic immunoglobulin, antibiotics, and vaccination in adult patients with hematological malignancies commonly associated with acquired hypogammaglobulinemia, specifically, CLL, NHL, and MM. We searched PubMed (MEDLINE), EMBASE, and Cochrane Registry up to 9 January 2021. Results for dichotomous data were expressed as relative risk (RR) with 95% confidence interval (CI) and pooled in a random-effects model. This review was registered with PROSPERO CRD42017070825. From 10 576 studies screened, there were 21 completed RCTs and 1 ongoing. Of these, 8 evaluated prophylactic immunoglobulin (n = 370; 7 published before 2000), 5 evaluated prophylactic antibiotics (n = 1587), 7 evaluated vaccination (n = 3996), and 1 compared immunoglobulin to antibiotics (n = 60). Prophylactic immunoglobulin reduced the risk of clinically documented infection (CDI) by 28% (n = 2 trials; RR, 0.72; 95% CI, 0.54-0.96), and vaccination reduced the risk by 63% (RR, 0.37; 95% CI, 0.30-0.45). Prophylactic antibiotics did not reduce the risk. No intervention reduced all-cause mortality. Prophylactic immunoglobulin and antibiotics increased the risk of adverse events. Findings should be interpreted with caution, given the high risk of bias in many studies. There is a clear need for high-quality contemporary trials to establish the effectiveness of different approaches to preventing infection.
Outcomes before and after providing interdisciplinary hematology and pulmonary care for children with sickle cell disease
Authors: Zeno Rachel N. , Stanek Joseph , Pugh Courtney , Gillespie Michelle , Kopp Benjamin T. , Creary Susan
Published: December 2022

People with sickle cell disease (pwSCD) are at risk of developing lung conditions that complicate their SCD but often face health care access barriers. An interdisciplinary clinic providing pulmonary care for pwSCD was created in 2014 at the Nationwide Children’s Hospital (NCH) to address access barriers that may prevent optimized treatment. We hypothesize that pwSCD and pulmonary disease would have fewer hospitalizations for acute chest syndrome (ACS), asthma, and vaso-occlusive episodes in the 2 years after their initial SCD-pulmonary clinic visit compared with the 2 years before. From 2014 to 2020, 119 pwSCD were evaluated in the SCD-pulmonary clinic and followed up at the NCH for at least 2 years before and after this initial visit. Acute care outcomes, pulmonary function, polysomnography, echocardiogram, laboratory, and medication prescribing data were collected and analyzed using the Wilcoxon signed ranked and McNemar tests. The median number of acute care visits for ACS (P < .001) and asthma (P = .006) were significantly lower during the 2 years after pwSCD’s initial SCD-pulmonary clinic evaluation compared with the 2 years before. Asthma and allergic rhinitis were more frequently diagnosed and prescriptions for hydroxyurea (P = .005) and inhaled corticosteroids (P = .005) were more common in the post–SCD-pulmonary clinic period. The median number of prescribed systemic corticosteroids was lower in the 2 years after SCD-pulmonary clinic evaluation (P < .0001). Lactate dehydrogenase and white blood cell counts also significantly decreased. Implementing a multidisciplinary SCD-pulmonary clinic is feasible and may allow improved management of pulmonary problems and lead to improvements in the usage of health and acute care.
Intraoperative measurement of the respiratory exchange ratio predicts postoperative complications after liver transplantation
Authors: Coeckelenbergh Sean , Desebbe Olivier , Carrier François Martin , Thepault Francois , De Oliveira Cécile , Pellerin Florian , Le Canne Cyril , Herboulier Laurence , Laukaityte Edita , Moussa Maya , Toubal Leila , Kato Hiromi , Pham Hung , Roullet Stephanie , Lanteri Minet Marc , Amara Youssef , Naili Salima , Ciacio Oriana , Cherqui Daniel , Duranteau Jacques , Vincent Jean-Louis , Van der Linden Philippe , Joosten Alexandre
Published: December 2022

Background

During surgery, any mismatch between oxygen delivery (DO2) and consumption (VO2) can promote the development of postoperative complications. The respiratory exchange ratio (RER), defined as the ratio of carbon dioxide (CO2) production (VCO2) to VO2, may be a useful noninvasive tool for detecting inadequate DO2. The primary objective of this study was to test the hypothesis that RER measured during liver transplantation may predict postoperative morbidity. Secondary objectives were to assess the ability of other variables used to assess the DO2/VO2 relationship, including arterial lactate, mixed venous oxygen saturation, and veno-arterial difference in the partial pressure of carbon dioxide (VAPCO2gap), to predict postoperative complications.

Methods

This retrospective study included consecutive adult patients who underwent liver transplantation for end stage liver disease from June 27th, 2020, to September 5th, 2021. Patients with acute liver failure were excluded. All patients were routinely equipped with a pulmonary artery catheter. The primary analysis was a receiver operating characteristic (ROC) curve constructed to investigate the discriminative ability of the mean RER measured during surgery to predict postoperative complications. RER was calculated at five standardized time points during the surgery, at the same time as measurement of blood lactate levels and arterial and mixed venous blood gases, which were compared as a secondary analysis.

Results

Of the 115 patients included, 57 developed at least one postoperative complication. The mean RER (median [25–75] percentiles) during surgery was significantly higher in patients with complications than in those without (1.04[0.96–1.12] vs 0.88[0.84–0.94]; p < 0.001). The area under the ROC curve was 0.87 (95%CI: 0.80–0.93; p < 0.001) with a RER value (Youden index) of 0.92 giving a sensitivity of 91% and a specificity of 74% for predicting the occurrence of postoperative complications. The RER outperformed all other measured variables assessing the DO2/VO2 relationship (arterial lactate, SvO2, and VAPCO2gap) in predicting postoperative complications.

Conclusion

During liver transplantation, the RER can reliably predict postoperative complications. Implementing this measure intraoperatively may provide a warning for physicians of impending complications and justify more aggressive optimization of oxygen delivery. Further studies are required to determine whether correcting the RER is feasible and could reduce the incidence of complications.
Coronary microcirculation dysfunction evaluated by myocardial contrast echocardiography predicts poor prognosis in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention
Authors: Wang Lan , Ma Yuliang , Jin Wenying , Zhu Tiangang , Wang Jing , Yu Chao , Zhang Feng , Jiang Bailin
Published: December 2022

Background

The mortality rate of acute ST-segment elevation myocardial infarction (STEMI) remains substantial, despite advances in treatment strategies. Coronary microcirculation dysfunction (CMD) persists after percutaneous coronary intervention (PCI) in a substantial proportion of STEMI patients. The association between CMD assessed using myocardial contrast echocardiography (MCE) and prognosis requires further elucidation. This study aimed to evaluate the impact of CMD after successful PCI on the prognosis of patients with STEMI.

Methods

We enrolled 167 patients with STEMI after PCI who underwent MCE during hospitalization between January 2018 and March 2022. Patients were classified into the CMD and non-CMD groups according to the results of MCE. The clinical data and MCE results of both groups were analyzed. Follow-up was conducted for major adverse cardiac events.

Results

MCE detected CMD in 105 patients (62.9%). The CMD group contained fewer hypertensive patients (55.2% versus 74.2%, P = 0.015). Patients with CMD exhibited significantly higher levels of plasma troponin I (TnI) [73.2 (23.0–124.0) versus 28.9 (12.7–80.2) ng/mL, P = 0.004], higher levels of plasma B-type natriuretic peptide [255 (99–641) versus 193 (59–389) pg/mL, P = 0.004], poorer Killip classification (P = 0.038), and different culprit vessels (P < 0.001) compared to the non-CMD group. Patients with CMD exhibited lower left ventricular ejection fraction [50 (43–58) versus 61 (54–67) %, P < 0.001], poorer wall motion score index values (1.68 ± 0.4 versus 1.31 ± 0.26, P < 0.001) and poorer left ventricular global longitudinal strain [–11.2 (–8.7 to –14.1) versus –13.9 (–11.0 to –17.2) %, P < 0.001] compared to the non-CMD group. Patients underwent follow-up for 13 (7–20) months. After adjusting for hypertension, peak TnI level, culprit vessel, and Killip classification, CMD was an independent predictor of total major adverse cardiac events at 13 months’ follow-up [adjusted odds ratio (OR), 2.457; 95% confidence interval (CI), 1.042–5.790; P = 0.040], and patients with CMD had a higher risk of hospitalization for heart failure (adjusted OR, 5.184; 95% CI, 1.044–25.747; P = 0.044) and repeat myocardial infarction (adjusted OR, 2.896; 95% CI, 1.109–7.565; P = 0.030).

Conclusions

MCE is a safe and effective method for detecting CMD in patients with STEMI. CMD detected by MCE after successful PCI in patients with STEMI is a common occurrence, which is associated with a significantly worse prognosis, especially hospitalization for heart failure and repeat myocardial infarction.
Association between AT1 receptor gene polymorphism and left ventricular hypertrophy and arterial stiffness in essential hypertension patients: a prospective cohort study
Authors: Ou Hangjun , Liu Danan , Zhao Guangjian , Gong Caiwei , Li Yunyun , Zhao Quanwei
Published: December 2022

Background

AT1 receptor gene (AGTR1) is related to essential hypertension (EH), and left ventricular hypertrophy (LVH) and arterial stiffness are common complications of EH. This study aimed to explore the association between AGTR1 genotype and LVH and arterial stiffness in EH patients.

Methods

A total of 179 EH patients were recruited in this study. Oral exfoliated cells were collected from each patient, and the genetic polymorphism of AGTR1(rs4524238) was assessed using a gene sequencing platform. The outcomes were LVH and arterial stiffness.

Results

Among 179 patients, 114 were with AGTR1 genotype of GG (57 males, aged 59.54 ± 13.49 years) and 65 were with AGTR1 genotype of GA or AA (36 males, aged 61.28 ± 12.79 years). Patients with AGTR1 genotype of GG were more likely to have LVH (47 [41.23%] vs. 14 [21.54%], P = 0.006) and arterial stiffness (30 [26.32%] vs. 8 [12.31%], P = 0.036). The AGTR1 polymorphism frequency was in accordance with Hardy–Weinberg equilibrium (P = 0.291). The multivariate logistic regression showed that AGTR1 genotype of GA or AA was independently associated with lower risk of LVH (OR = 0.344, 95%CI 160~0.696, P = 0.003) and arterial stiffness (OR = 0.371, 95%CI 0.155~0.885, P = 0.025) after adjusting for gender, age, and diabetes.

Conclusion

EH patients with the AGTR1 genotype of GA or AA were at lower risk for LVH and arterial stiffness than those with the GG genotype.
MetaAnalyst: a user-friendly tool for metagenomic biomarker detection and phenotype classification
Authors: Alshawaqfeh Mustafa , Rababah Salahelden , Hayajneh Abdullah , Gharaibeh Ammar , Serpedin Erchin
Published: December 2022

Background

Many metagenomic studies have linked the imbalance in microbial abundance profiles to a wide range of diseases. These studies suggest utilizing the microbial abundance profiles as potential markers for metagenomic-associated conditions. Due to the inevitable importance of biomarkers in understanding the disease progression and the development of possible therapies, various computational tools have been proposed for metagenomic biomarker detection. However, most existing tools require prior scripting knowledge and lack user friendly interfaces, causing considerable time and effort to install, configure, and run these tools. Besides, there is no available all-in-one solution for running and comparing various metagenomic biomarker detection simultaneously. In addition, most of these tools just present the suggested biomarkers without any statistical evaluation for their quality.

Results

To overcome these limitations, this work presents MetaAnalyst, a software package with a simple graphical user interface (GUI) that (i) automates the installation and configuration of 28 state-of-the-art tools, (ii) supports flexible study design to enable studying the dataset under different scenarios smoothly, iii) runs and evaluates several algorithms simultaneously iv) supports different input formats and provides the user with several preprocessing capabilities, v) provides a variety of metrics to evaluate the quality of the suggested markers, and vi) presents the outcomes in the form of publication quality plots with various formatting capabilities as well as Excel sheets.

Conclusions

The utility of this tool has been verified through studying a metagenomic dataset under four scenarios. The executable file for MetaAnalyst along with its user manual are made available athttps://github.com/mshawaqfeh/MetaAnalyst.
Contrast-enhanced CT findings-based model to predict MVI in patients with hepatocellular carcinoma
Authors: Yue Qi , Zhou Zheyu , Zhang Xudong , Xu Xiaoliang , Liu Yang , Wang Kun , Liu Qiaoyu , Wang Jincheng , Zhao Yu , Yin Yin
Published: December 2022

Background

Microvascular invasion (MVI) is important in early recurrence and leads to poor overall survival (OS) in hepatocellular carcinoma (HCC). A number of studies have reported independent risk factors for MVI. In this retrospective study, we designed to develop a preoperative model for predicting the presence of MVI in HCC patients to help surgeons in their surgical decision-making and improve patient management.

Patients and Methods

We developed a predictive model based on a nomogram in a training cohort of 225 HCC patients. We analyzed patients’ clinical information, laboratory examinations, and imaging features from contrast-enhanced CT. Mann–Whitney U test and multiple logistic regression analysis were used to confirm independent risk factors and develop the predictive model. Internal and external validation was performed on 75 and 77 HCC patients, respectively. Moreover, the diagnostic performance of our model was evaluated using receiver operating characteristic (ROC) curves.

Results

In the training cohort, maximum tumor diameter (> 50 mm), tumor margin, direct bilirubin (> 2.7 µmol/L), and AFP (> 360.7 ng/mL) were confirmed as independent risk factors for MVI. In the internal and external validation cohort, the developed nomogram model demonstrated good diagnostic ability for MVI with an area under the curve (AUC) of 0.723 and 0.829, respectively.

Conclusion

Based on routine clinical examinations, which may be helpful for clinical decision-making, we have developed a nomogram model that can successfully assess the risk of MVI in HCC patients preoperatively. When predicting HCC patients with a high risk of MVI, the surgeons may perform an anatomical or wide-margin hepatectomy on the patient.
Urinary tract infection caused by Edwardsiella tarda: a report of the first case in Iran
Authors: Gilani Abolfazl , Sarmadian Roham , Kahbazi Manijeh , Yousefichaijan Parsa
Published: December 2022

Bckground

Edwardsiella tarda, an Enterobacteriaceae family member, is prevalent in different aquatic settings and rarely infects humans. As a result of eating raw or undercooked seafood, humans become infected through their intestinal tracts. Extraintestinal infections have been reported infrequently, mostly in immunocompromised and chronically ill patients.

Case presentation

Our report describes a case of urinary tract infection caused by E. tarda in a 4-year-old female patient with a history of urinary tract infection and a complaint of fever, dysuria, and frequency. E. tarda was identified as the pathogen isolated from the urine culture. The patient's symptoms were alleviated after receiving ceftriaxone and then nitrofurantoin.

Conclusion

This case demonstrates that even in immunocompetent patients, E. tarda can infect extraintestinal organs, including urinary tract. Our patient represents the first case of E. tarda infection in Iran and due to the fact that this pathogen is transmitted by aquatic animals, there is a possibility of infecting more aquatic animals and humans in Iran; therefore, the necessary precautions should be taken.
Input, process, and output factors contributing to quality of antenatal care services: a scoping review of evidence
Authors: Khatri Resham B , Mengistu Tesfaye S , Assefa Yibeltal
Published: December 2022

Background

High-quality antenatal care (ANC) provides a lifesaving opportunity for women and their newborns through providing health promotion, disease prevention, and early diagnosis and treatment of pregnancy-related health issues. However, systematically synthesised evidence on factors influencing the quality of ANC services is lacking. This scoping review aims to systematically synthesize the factors influencing in provision and utilisation of quality ANC services.

Methods

We conducted a scoping review of published evidence on the quality of ANC services. We searched records on four databases (PubMed, Scopus, Embase, and Google scholar) and grey literature from 1 to 2011 to 30 August 2021. We analysed data using Braun and Clarke’s thematic analysis approach. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline for the review. We explained themes using the Donabedian healthcare quality assessment model (input-process-output).

Results

Several inputs- and process-related factors contributed to suboptimal quality of ANC in many low and lower- or middle-income countries. Input factors included facility readiness (e.g., lack of infrastructure, provision of commodities and supplies, health workforce, structural and intermediary characteristics of pregnant women, and service delivery approaches). Processes-related factors included technical quality of care (e.g., lack of skilled adequate and timely care, and poor adherence to the guidelines) and social quality (lack of effective communication and poor client satisfaction). These input and process factors have also contributed to equity gaps in utilisation of quality ANC services.

Conclusion

Several input and process factors influenced the provision and utilization of optimum quality ANC services. Better health system inputs (e.g., availability of trained workforces, commodities, guidelines, context-specific programs) are essential to creating enabling facility environment for quality ANC services. Care processes can be improved by ensuring capacity-building activities for workforces (training, technical support visits), and mentoring staff working at peripheral facilities. Identifying coverage of quality ANC services among disadvantaged groups could be the initial step in designing and implementing targeted program approaches.
The utility of IMP3 immunohistochemical staining in differentiating nodular lymphocyte predominant Hodgkin Lymphoma from T-Cell/Histiocyte-Rich large B-Cell lymphoma
Authors: Kosari Farid , Bakhshi Trifeh , Ameli Fereshteh , Mokhtari Maral
Published: December 2022

Introduction

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) and T cell/histiocyte-rich large B-cell lymphoma (THRLBCL) have overlapping histological features that make their diagnosis challenging. Insulin-like growth factor II mRNA-binding protein 3 (IMP3) is a recently proposed diagnostic marker for Hodgkin’s lymphoma. The aim of this study was to determine the ability of IMP3 in differentiating NLPHL from THRLBCL.

Methods

In this retrospective study, the formalin-fixed paraffin-embedded blocks from 56 patients (28 NLPHL and 28 large B cell lymphoma (LBCL, including 16 THRLBCL and 12 DLBCL, NOS) cases based on immunohistochemistry (IHC) were included. Sample sections were stained for IMP3 using IHC method. Moderate to strong staining in at least 10% of tumor cells was considered positive IMP3 expression.

Results

The mean age of the patients was 41.25 ± 16.08 years old. The majority of the patients were male. There was a significant age difference between NLPHL (34.61 ± 16.44 years old) and LBCL (47.89 ± 12.85 years) groups (p = 0.001). No significant difference was seen in gender and site between NLPHL and LBCL groups. The expression of IMP3 was mainly strong in LBCL group, while it was heterogeneously distributed among NLPHL samples ranging from weak to strong (p < 0.001). It was determined that strong IMP3 expression at 55.00% can differentiate LBCL from NLPHL with 71.4% sensitivity and 71.4% specificity.

Conclusion

Our findings showed that IMP3 may be a good complement in differentiating NLPHL cases from THRLBCL.
Detecting eyes with high risk of angle closure among apparently normal eyes by anterior segment OCT: a health examination center-based model
Authors: Lin Sigeng , Hu Ying , Ye Cong , Congdon Nathan , You Ruirong , Liu Shanshan , Liu Chi , Lv Fan , Zhang Shaodan
Published: December 2022

Background

The main barriers keeping individuals with high-risk of angle closure from seeking eye-care service are the absence of both disease awareness and convenient and low-cost access to the ocular health care system. Present study described the efficacy of a health examination center-based screening model designed to detect eyes with high risk of angle closure (HRAC) among healthy individuals using anterior segment optical coherence tomography (AS-OCT).

Methods

From March 1 to April 30, 2017, consecutive individuals aged ≥ 40 years undergoing routine physical examinations at a health examination center were invited to enroll. Presenting visual acuity (PVA), intraocular pressure (IOP) measurement, non-mydriatic fundus photography and AS-OCT were performed by three trained nurses. Participants with PVA < 6/12 in the better-seeing eye, IOP ≥ 24 mmHg, or abnormal fundus photography in either eye were referred to the outpatient clinic, but not included in the analysis. Eyes with HRAC were defined as having trabecular-iris angle < 12 degrees in ≥ 3 quadrants. Configuration of the iris was classified into flat, bowing, bombe, thick peripheral iris and mixed mechanism.

Results

Altogether, 991 participants (77.3%) with readable OCT images (mean age 55.5 ± 9.0 years; 58.4% men) were included. HRAC was diagnosed in 78 eyes (7.9%, 61.3 ± 8.2 years, 41.0% men). The prevalence of HRAC increased with age (p < 0.001) and was much higher among women (11.2%) than men (5.5%) (p = 0.001). The mixed mechanism iris configuration was most common among eyes with HRAC (37/78, 47.4%).

Conclusion

HRAC is prevalent among asymptomatic Chinese adults undergoing routine health screening. Health examination center-based eye screening with AS-OCT administered by non-specialists may be a good model to screen narrow angles in the population at large.
The impact of early-life antibiotics and probiotics on gut microbial ecology and infant health outcomes: a Pregnancy and Birth Cohort in Northwest China (PBCC) study protocol
Authors: Qi Qi , Wang Liang , Gebremedhin Mitslal Abrha , Li Shaoru , Wang Xueyao , Shen Jiali , Zhu Yingze , Andegiorgish Amanuel Kidane , Cheng Yue , Shi Lu , Zhou Jing , Yang Ying , Kang Yijun , Yang Wenfang , Zhu Zhonghai , Zeng Lingxia
Published: December 2022

Background

Unreasonable use of antibiotics and probiotics can alter the gut ecology, leading to antibiotic resistance and suboptimal health outcomes during early life. Our study aims are to clarify the association among antibiotic and probiotic exposure in early life, the microecology of the gut microbiota, and the development of antibiotic resistance; to investigate the long-term impact of antibiotics and probiotics on the health outcomes of infants and young children; and to provide a theoretical basis for the rational use of antibiotics and probiotics from a life course perspective.

Methods

The study is a prospective, longitudinal birth cohort study conducted in Shaanxi Province, China from 2018 to 2024. A total of 3,000 eligible mother–child pairs will be enrolled from rural, suburban, and urban areas. The recruitment of the participants begins at pregnancy, and the newborns will be followed up for 2 years at successive timepoints: within 3 days after birth, 42 days after birth, and at 3, 6, 12, 18, and 24 months of age. Sociodemographic data, environmental exposures, dietary patterns, psychological conditions, and medical and drug histories are collected. Cognitive and behavioural development among infants and young children and questionnaires on antibiotic knowledge and behaviour among caregivers will be collected at 12 and 24 months of age. The faecal samples are collected and analysed by 16S rRNA high-throughput sequencing and quantitative PCR (qPCR) for antibiotic resistance genes.

Discussion

The findings will inform antibiotic and probiotic use for pregnant women and infants and contribute to establishing rational use strategies of antibiotics and probiotics for paediatricians, health practitioners, and drug administration policy-makers.

Trial registration

The study was registered on the Chinese Clinical Trial Registry (ChiCTR) platform, http://www.chictr.org.cn (Record ID: ChiCTR2100047531, June 20, 2021).
Education and Socio-economic status are key factors influencing use of insecticides and malaria knowledge in rural farmers in Southern Côte d’Ivoire
Authors: Kouamé Ruth M. A. , Guglielmo Federica , Abo Kouabénan , Ouattara Allassane F. , Chabi Joseph , Sedda Luigi , Donnelly Martin J. , Edi Constant
Published: December 2022

Background

Insecticides play a key role in rural farming; however, their over- or misuse has been linked with a negative impact on malaria vector control policies. This study was conducted amongst agricultural communities in Southern Côte d’Ivoire to identify which insecticides are used by local farmers and how it relates to the perception of farmers on malaria. Understanding the use of insecticides may help in designing awareness programme on mosquito control and pesticides management.

Methods

A questionnaire was administered to 1399 farming households across ten villages. Farmers were interviewed on their education, farming practices (e.g. crops cultivated, insecticides use), perception of malaria, and the different domestic strategies of mosquito control they use. Based on some pre-defined household assets, the socioeconomic status (SES) of each household was estimated. Statistical associations were calculated between different variables, showing significant risk factors.

Results

The educational level of farmers was significantly associated with their SES (p < 0.0001). Most of the householders (88.82%) identified mosquitoes as the principal cause of malaria, with good knowledge of malaria resulting as positively related to high educational level (OR = 2.04; 95%CI: 1.35, 3.10). The use of indoor chemical compounds was strongly associated to the SES of the households, their education level, their use of ITNs and insecticide in agricultural (p < 0.0001). Indoor application of pyrethroid insecticides was found to be widespread among farmers as well as the use of such insecticide for crops protection.

Conclusion

Our study shows that the education level remains the key factor influencing the use of insecticides by farmers and their awareness of malaria control. We suggest that better communication tailored to education level and including SES, controlled availability and access to chemical products, should be considered when designing campaigns on use of pesticides and vector borne disease control for local communities.