bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased clearance of indoxyl sulphate in renal failure rats with the addition of water‐soluble poly‐β‐cyclodextrin to the dialysate
Authors: Liu Shuxin , Jia Lingyun , Xiao Jia , Li Jingyu , Mei Fangfang , Zhou Jianan , Han Lulu , Li Lin , Shan Jing
Published: November 2021

Aim

Indoxyl sulphate (IS), a protein‐bound uremic toxin that dramatically increases in the sera of patients with end‐stage renal disease (ESRD), is poorly removed by conventional haemodialysis (HD). The purpose of this study was to explore whether the addition of water‐soluble sorbent poly‐β‐cyclodextrins (PCDs) to dialysate can increase the clearance of IS in uremic rats in vivo.

Methods

Male SD rats (450‐550 g, n = 18) with nephrectomy plus IS injection (10‐mg/kg) were randomly divided into three groups: 1. The HD group (n = 6): conventional HD for 4 h; 2. the 2% PCD group: 2% PCD added to the dialysate, HD for 4 h; and 3. the 4% PCD group: 4% PCD added to the dialysate, HD for 4 h. The serum IS levels in model rats were similar to those of ESRD patients. A stable and safe rat HD treatment mode was established by adjusting the vascular access, blood flow rate, dialysate flow rate, dialysis pipe, dialysate configuration, temperature, treatment environment, and other aspects.

Results

Our study found that adding 2% PCD to dialysate significantly improved the clearance of IS approximately twofold compared with conventional HD. Further increasing the PCD concentration to 4% did not increase IS clearance.

Conclusion

Therefore, our study showed that adding water‐soluble sorbent PCDs to dialysate significantly improved the clearance of IS in uremic rats in vivo.
Resilience of seagrass populations to thermal stress does not reflect regional differences in ocean climate
Authors: Bennett Scott , Alcoverro Teresa , Kletou Demetris , Antoniou Charalampos , Boada Jordi , Buñuel Xavier , Cucala Lidia , Jorda Gabriel , Kleitou Periklis , Roca Guillem , Santana‐Garcon Julia , Savva Ioannis , Vergés Adriana , Marbà Núria
Published: November 2021

The prevalence of local adaptation and phenotypic plasticity among populations is critical to accurately predicting when and where climate change impacts will occur. Currently, comparisons of thermal performance between populations are untested for most marine species or overlooked by models predicting the thermal sensitivity of species to extirpation.

Here we compared the ecological response and recovery of seagrass populations (Posidonia oceanica) to thermal stress throughout a year‐long translocation experiment across a 2800‐km gradient in ocean climate. Transplants in central and warm‐edge locations experienced temperatures > 29°C, representing thermal anomalies > 5°C above long‐term maxima for cool‐edge populations, 1.5°C for central and < 1°C for warm‐edge populations.

Cool‐edge, central and warm‐edge populations differed in thermal performance when grown under common conditions, but patterns contrasted with expectations based on thermal geography. Cool‐edge populations did not differ from warm‐edge populations under common conditions and performed significantly better than central populations in growth and survival.

Our findings reveal that thermal performance does not necessarily reflect the thermal geography of a species. We demonstrate that warm‐edge populations can be less sensitive to thermal stress than cooler, central populations suggesting that Mediterranean seagrasses have greater resilience to warming than current paradigms suggest.
Risk Factors for Dysphagia after Anterior Cervical Discectomy and Fusion with the Zero‐P implant system: A Study with Minimum of 2 Years Follow‐up
Authors: Xue Rong , Ji Zhu‐yong , Cheng Xing‐dong , Zhang Zhu‐qiu , Zhang Feng
Published: November 2021

Objective

To evaluate the risk factors for dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero‐P Implant System by multidimensional analysis and investigated the predictive values of these risk factors for dysphagia.

Methods

A retrospective analysis of 260 patients who underwent ACDF with the Zero‐P Implant System and had at least 2 year of follow‐up were performed. All patients were divided into a non‐dysphagia group and a dysphagia group. Sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft‐tissue thickness, the levels of surgery, O‐C2 angle, C2–7 angle, T1 slope and segmental angle were analyzed. The Modified Japanese Orthopaedic Association (JOA) scoring system was used to determine functional status. NDI was used to evaluate neck pain and disability. The Bazaz grading system was chosen to evaluate dysphagia after surgery. Postoperative cerebrospinal fluid (CSF) leakage, infection, and dysphagia were recorded in both groups. An independent t‐test was used to compare quantitative variables, a chi‐square test was used to compare qualitative data between the two groups. To eliminate the influence of confounding factors, logistic regression was performed for multifactor regression of factors. The results were regarded as significant when the P‐values were less than 0.05 in this study.

Results

In total, the non‐dysphagia group comprised 70 patients and the dysphagia group comprised 190 patients, with an average age of 58.33 ± 4.68 years (ranging, 42–82 years). These patients were followed up for 28.5 ± 3.5 months (range, 24–32 months). For clinical outcomes, both groups demonstrated significant improvement in the NDI and JOA scores (P < 0.001). According to the Bazaz dysphagia grading system, mild, moderate, and severe dysphagia were found in 50, 17, and 3 patients, respectively. In total, 37.1% (n = 26) had resolved by 3 month, 38.6% (n = 27) by 6 months, and 17.1% (n = 12) by 12 months. Chi‐square test results indicated that number of operated levels, operation time dT1 slope, dO‐C2 angle, dC2–7 angle, segmental angle and dPSTT were associated with a high incidence of dysphagia. Multivariate logistic regression analysis showed that number of operated levels, operation time, dC2–7 angle and dPSTT were significantly associated with postoperative dysphagia.

Conclusions

More operated levels, more operation time, more dC2–7 angle and dPSTT were the risk factors for postoperative dysphagia. In additional, sufficient preoperative preparation, evaluation combined with proficient and precise surgical treatment were suggested to reduce the incidence of postoperative dysphagia when ACDF was performed.
Clinical Significance of Preoperative CT and MR Imaging Findings in the Prediction of Postoperative Recurrence of Spinal Giant Cell Tumor of Bone
Authors: Wang Qi‐zheng , Zhang En‐long , Xing Xiao‐ying , Su Min‐ying , Lang Ning
Published: November 2021

Objectives

To explore the predictive value of preoperative imaging in patients with spinal giant cell tumor of bone (GCTB) for postoperative recurrence and risk stratification.

Methods

Clinical data for 62 cases of spinal GCTB diagnosed and treated at our hospital from 2008 to 2018 were identified. All patients were followed up for more than 2 years according to the clinical guidelines after surgery. Medical history data including baseline demographic and clinical characteristics, computed tomography (CT) and magnetic resonance imaging (MRI) findings of recurrent and non‐recurrent patients were compared. Two musculoskeletal radiologists read the images and were blinded to the clinical data. The imaging features associated with postoperative recurrence were analyzed by multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff value of the largest lesion diameter predicting recurrence after surgery.

Results

According to whether the disease recurred within the follow‐up period, patients were divided into the recurrence group and the non‐recurrence group. Of 62 patients (29 males and 33 females), 17 had recurrence and 45 did not. The recurrence rate was 27.4%. The mean follow‐up time was 73.66 (± 32.92) months. The three major treatments were total en bloc spondylectomy (n = 26), intralesional spondylectomy (n = 20), and curettage(n = 16). A total of 16 CT and MRI features were analyzed. A univariate analysis showed no significant difference in age, sex, treatment, multi‐vertebral body involvement, location, boundary, expansile mass, residual bone crest, paravertebral soft tissue mass, CT value, and MRI signal on T1‐weighted imaging (WI), T2‐WI, and T2‐WI fat suppression (FS) sequences (P > 0.05). The largest lesion diameter [(4.68 ± 1.79) vs (5.92 ± 2.17) cm, t = 2.287, P = 0.026] and the vertebral compression fracture (51% vs 82%, χ2 = 5.005, P = 0.025) were significantly different between the non‐recurrence and recurrence groups. Logistic regression analysis showed that both largest lesion diameter (odds ratio [OR], 1.584; 95% confidence interval [CI], 1.108–2.264; P = 0.012) and compression fracture (OR, 8.073; 95%CI, 1.481–11.003; P = 0.016) were independent predictors of postoperative recurrence. When we set the cutoff value for the largest lesion diameter at 4.2 cm, the sensitivity and specificity for distinguishing the recurrence and non‐recurrence of GCTB were 94.1% and 42.2%, respectively, and the area under the curve (AUC) was 0.671. The combined model achieved a sensitivity, specificity and accuracy of 47.1%, 97.8% and 83.9%, respectively.

Conclusions

In spinal GCTB, maximum lesion diameter and the vertebral compression fracture are associated with tumor recurrence after surgery, which may provide helpful information for planning personalized treatment.
Increased food diversity in the first year of life is inversely associated with allergic outcomes in the second year
Authors: Zhong Chunrong , Guo Jinrong , Tan Tianqi , Wang Huanzhuo , Lin Lixia , Gao Duan , Li Qian , Sun Guoqiang , Xiong Guoping , Yang Xuefeng , Hao Liping , Yang Hongying , Yang Nianhong
Published: November 2021

Background

The evidence on the relationship between diet diversity in early life and allergic outcomes was few and inconsistent. We sought to determine the association of food diversity in the first year of life with allergic outcomes in the second year.

Methods

Two thousand two hundred fifty‐one mother‐infant pairs from Tongji Maternal and Child Health Cohort (TMCHC) were involved in the study. Information on complementary foods introduction was obtained by telephone interview at 6‐ and 12‐month postpartum follow‐up. Any doctor‐diagnosed allergic diseases in the second year were recorded at 2‐year postpartum follow‐up. Food allergies in infancy were assessed and self‐reported by mothers at each postpartum follow‐up. Multivariable logistic regression was used to examine the effect of food diversity at 6 and 12 months of age on later allergic diseases and food allergy.

Results

A total of 135 (6.0%) infants reported allergic diseases at between 1 and 2 years of age. Independent of food allergy history of infants and other potential confounders, less food diversity at 6 months of age was associated with increased risk of later allergic diseases (OR 2.17, 95% CI 1.04–4.50 for 0 vs. 3–6 food groups). By 12 months of age, significant inverse associations with later allergic diseases (OR 2.35, 95% CI 1.03–5.32 for 1–5 vs. 8–11 food groups, and OR 1.98, 95% CI 1.16–3.37 for 6–7 vs. 8–11 food groups) and food allergy (OR 2.10, 95% CI 1.29–3.42 for 1–5 vs. 8–11 food groups) were observed. Children with higher food diversity in both periods had the lowest risk of allergic diseases during the second year of life.

Conclusions

A more diverse diet within the first year of life was associated with reduced risk of allergic diseases at 1–2 years of age. Introducing higher diversity of foods from 6 to 12 months of age might be an effective strategy to improve the allergy outcomes of infants in later life.
Public perceptions of ecological restoration within the context of Norwegian landscape management
Authors: Stange Erik , Hagen Dagmar , Junker‐Köhler Berit , Kaltenborn Bjørn P.
Published: November 2021

Ecological restoration is poised to become an increasingly important component of landscape management in the coming years as countries work to halt the rate of biodiversity loss. The success of future restoration projects will depend equally on both achieving biological objectives and on producing conditions that meet public expectations. Yet we often know very little about either how the public perceives the purpose or goals of ecological restoration, or how restoration might fit into public expectations for landscape management. We surveyed a representative sample of the Norwegian population (n = 4,077) to determine how familiar the Norwegian public is with ecological restoration, to explore their perceptions of restoration's purposes and goals, and to assess their preferences for types of common Norwegian landscapes. Survey participants generally had little familiarity with ecological restoration, yet they had a greater tendency to view restoration's purpose as enhancing naturalness than as providing benefits for humans. Public attitudes regarding landscape management were reasonably balanced between preserving cultural landscapes and promoting natural landscapes free from traces of human activity. While participants gave agricultural landscapes the highest scores for desirability, the survey did not reveal any conspicuous variation in landscape preferences among the Norwegian public. Policymakers, land managers, and ecological restoration practitioners should use insights from studies such as ours to help identify which future projects are most likely to enjoy widespread support, and to tailor their communication with stakeholders.
Expediting climate‐smart soils management
Authors: Hou Deyi
Published: November 2021

Soil represents the largest carbon pool in the terrestrial system, storing up to 5 times as much carbon as in the atmosphere. The number of annual publications pertaining to both soil and climate change has grown 18‐fold between 2001 and 2020, on average now accounting for 18.6% of all publications relating to climate change. Despite the significance of the soil system in combating climate change and a growing body of scientific knowledge, international negotiations, including COP26 that has just been held in Glasgow, UK, tend to overlook the role that soil must play in combating climate change. The importance of soil systems is multi‐faceted in a world of changing climate conditions. The most vulnerable population facing climate change tend to be smallholder farmers whose living depends on healthy and productive soil. Climate adaptation initiatives and financial assistance from developed countries to developing countries must put this as a high priority. On the other hand, soil renders high potential in carbon sequestration, and soil amendments like biochar are particularly promising as a carbon‐negative technology. However, the cost of producing biochar on a large scale must be significantly reduced in order to make it commercially viable. Soil also represents a significant source of greenhouse gases besides carbon dioxide. Technologies must be further developed to ensure food production and food security, while effectively reducing the emission of methane and nitrous oxide from agricultural soils. We conclude that expediting sustainable and climate‐smart soil management is an imperative in mitigating and adapting to global climate change.
Diversity, Equity, and Inclusion: Teaching Matters
Authors: Schweiger Franziska
Published: November 2021

This article examines the intersection of contingent faculty labor and institutional diversity on the student and faculty level of U.S. German Studies. Sara Ahmed's notion of “diversity as phenomenology” (2012, p. 173) provides a conceptual framework to show that active diversity work in the German classroom has a feedback effect and reveals how the contingentization of faculty labor undermines diversity on the student and faculty level. In three steps, the article draws on pertinent data to show how institutional superstructures become tangible through diversity work in the German classroom. Considering that German Studies continues to be the whitest world language in U.S. academia (Grawe, 2018; Hussar & Bailey, 2020; Murphy & Lee, 2019), the article proposes that German Studies ought to take a leading role in actively addressing the larger institutional structures that perpetuate white supremacy. It concludes with a proposal of four concrete steps for how German teachers and professional bodies can address systemic structures that exceed, yet directly impact German Studies.
A Systemic Functional Linguistics Approach to Instructional Design for L2 German: Connecting Language and Content
Authors: Kuhn‐Brown Kerstin
Published: November 2021

The creation of pedagogical activities in line with genre‐based approaches has substantially shaped world language curriculum design and instruction, as seen in Martin (2002a), Crane (2006), and Maxim (2004); however, an insignificant number of principled guidelines suggests exactly how to achieve these pedagogical goals (Kubota, 2016; Ryshina‐Pankova, 2016; Schleppegrell, 2019). To this end, this article demonstrates how a genre‐based textual analysis through the lens of Systemic Functional Linguistics (SFL) serves as a useful methodology for advanced learners of German at the university level. It introduces a unique online venue for exploring the GDR and selects Karin Bloth's narrative Stark und ohnmächtig zugleich (2004) from this website to conduct an SFL‐informed analysis regarding its generic structure, interpersonal meanings, and participant voices. The findings about the narrator's inner conflict as well as the social functions of language are directly applied to specific suggestions for pedagogical activities. The article concludes with a discussion of the benefits and implications of this methodology as a tool for world language educators to support their analyses of culturally relevant materials in order to develop content‐ and language‐integrated pedagogical activities.
Influenza‐associated thrombotic thrombocytopenic purpura: A report of two cases and a brief review of the literature
Authors: Onkarappa Mangala Yashvin , Sweeney Joseph D.
Published: November 2021

Background and Objectives

Thrombotic thrombocytopenic purpura (TTP) is often preceded by a recent history of an acute infection and influenza is the most implicated virus.

Materials and Methods

We identified two cases of TTP, which were preceded by influenza between 2010 and 2021. In one patient, we epitope mapped the binding specificity of antibodies using an overlapping peptide approach of the stalk protein of Influenza B and the cysteine‐rich spacer domain (CRSD) of ADAMTS13. A literature search was performed for reports of influenza‐associated TTP over the period 1980–2021.

Results

Two patients were identified in which TTP was preceded by influenza, one Influenza A and the other Influenza B. Epitope mapping of the latter's plasma identified target epitopes in both the stalk protein of Influenza B and CRSD of ADAMTS13. The literature review revealed only seven case reports, all but one from Europe or Asia and associated with Influenza A. Severe ADAMTS13 deficiency was demonstrated in only four cases.

Conclusion

We report the first small case series of influenza‐associated TTP. Moreover, it is the first case implicating Influenza B and a mechanism favouring polyclonal B‐cell proliferation rather than molecular mimicry as the stimulus to form anti‐ADAMTS13 auto‐antibodies is suggested.
Comparative assessment of dithiothreitol‐treated ABO isoagglutinin titres performed by two methods
Authors: Pandey Prashant , Setya Divya , Ranjan Shweta , Singh Mukesh Kumar
Published: November 2021

Background and aims

To determine actual concentration of clinically significant IgG antibodies, there is need to inactivate IgM antibodies. Aim of this study was to study effect of dithiothreitol (DTT) on ABO isoagglutinin titres performed by column agglutination technology (CAT) and conventional tube technique (CTT) and to compare results obtained by DTT treatment.

Materials and methods

This was a prospective, observational study conducted from October 2019 to March 2020. All consecutive A, B and O group donors were included. All samples were consecutively tested by CTT and CAT, before and after DTT treatment (pCTT, pCAT).

Results

A total of 300 donors were included, 100 each from group A, B and O. IgG titres were found to be more than IgM titres. For group O, IgG titre results were higher for both anti‐A and anti‐B compared with group A and B. Reduction in IgG titres was observed with DTT. With the use of DTT, one log reduction in group O IgG titres was observed and three log reduction in group A/B IgG titres was observed. When comparing anti‐A and anti‐B IgG results for group O individuals, results of CTT and pCAT were not found to be significant. IgG measurement of anti‐A and anti‐B of group O individuals showed strong to very strong correlation between CTT and CAT, before and after DTT treatment.

Conclusion

There is significant difference between antibody titres estimated using DTT‐treated and DTT‐untreated plasma. Use of DTT for ABO isoagglutinin titre estimation is recommended.
Multiple feedback sources in learning clinical history-taking skills: Developing evaluative judgement
Authors: Fitzgerald Kylie , Vaughan Brett , Tai Joanna Hong-Meng
Published: November 2021

Introduction: Contemporary feedback models emphasise the value of multiple feedback opportunities. Effective feedback participation requires evaluative judgement—the ability to discern the quality of one’s own and others’ work. Self and peer assessment may enable repeated practice and feedback for developing evaluative judgement. However, attitudes to self and peer assessment may present a barrier to effective implementation. This study explored whether congruence between marks from self and peer assessment improved with assessment task participation. Participants’ attitudes towards self and peer assessment and approaches to learning were also evaluated.Methods: Participants undertook simulated history-taking tasks in semester 2, 2018. Group 1 undertook formative and summative assessments and participated in self and peer assessment . Group 2 undertook formative and summative assessment. Group 3 undertook only summative assessment. All groups received faculty feedback for each submitted assessment. Participants completed the modified Study Process Questionnaire (mSPQ) and the Peer Perception of Assessment (PPA) before (T1) and after the formative task (T2) and after the summative task (T3).Results: Summative task scores improved for group 1 (n = 9, p < 0.01) and group 2 (n = 26, p < 0.01). Within-group (p = 0.02) and between-group differences (p = 0.01) were identified for surface learning approaches. All groups’ perceptions of peer assessment decreased significantly (p < 0.01) across all three time periods.Conclusions: Participants receiving self and peer assessment and faculty feedback improved performance and increased congruence of their self- and peer-assessment marks, potentially developing their evaluative judgment skills. Peer assessment perception became less positive, while surface learning approaches increased. Future research should assess the role of self and peer assessment in developing evaluative judgment.
Patient perceptions of allied health student communication and interpersonal skills: A cross-sectional study
Authors: Tripodi Nicholas , Cossar Sarah , Davidson Jessica , Farmer Ryan , Gorbonos Jessica , McDonald Amelia , Pierlot Melanie
Published: November 2021

Introduction: Effective patient–practitioner communication contributes to patient health outcomes by strengthening therapeutic relationships and, in the process, contributing to overall quality of patient care. Despite the growth of student-led university teaching clinics, little research has investigated communication skills within this context. Therefore, the aim of this study was to investigate the patient-perceived levels of communication and interpersonal skills within a student-led allied health clinic.Methods: The Communication Assessment Tool (CAT) was used to collect cross-sectional data on patients’ perceptions of student communication and interpersonal skills within an osteopathy teaching clinic. Data were analysed via descriptive and inferential statistics.Results: According to the CAT, patients perceived the students’ communication and interpersonal skills to be “excellent” overall (97.2%). No significant differences were found between percentage of “excellent” responses and gender (p = .600), number of consultations (p = .374) or pain duration (p = .741).Conclusions: Patients in this setting perceive student communication and interpersonal skills to be of a high standard. This can contribute positively to the patient–practitioner therapeutic alliance and may improve overall health outcomes. These findings have implications for communication training within student-led health professions clinics and tertiary curricula more broadly.
Near-peer teaching in paramedicine education: A cross-sectional study of student experiences
Authors: Whitfield Steve
Published: November 2021

Near-peer teaching (NPT) has been identified as a contemporary and valued pedagogical approach in higher education health programs, and it has recently gained momentum in paramedicine education. The objective of this study was to investigate the perceived experience of student paramedics involved in a near-peer teaching program over two academic trimesters. A cross-sectional study design was utilised in the form of an online questionnaire. The questionnaire contained a variety of questions that related to the experience of student paramedics involved in paramedicine near-peer programs. Of the 65 students enrolled, 34 completed the questionnaire (52.3% response rate). The results indicated that NPT was overwhelmingly considered a valuable and positive pedagogical method for use in paramedicine education.
Assessing the relationship between student learning characteristics and academic performance in chemical pathology in an undergraduate medical curriculum
Authors: Khine Wamono Aye Aye , Adefuye Anthonio Oladele , Busari Jamiu
Published: November 2021

Background: Teaching and learning chemical pathology requires that medical trainees interpret biochemical test results correctly (against the background of clinical information) to solve clinical problems, while being aware of factors that could affect results. To meet these competencies, students must possess certain learning characteristics. This study explored the relationship between student learning characteristics and academic performance in chemical pathology. It is expected that a better understanding of the relationship between students' learning characteristics and academic performance will help formulate strategies to enhance teaching and learning of this subject. Methods: This study was designed as an exploratory survey. Self-administered, validated questionnaires were used to obtain data on learning mode, learning style and learning approach from 250 fourth-year undergraduate medical students at a medical university in South Africa. One-way ANOVA and Pearson correlations were used to analyse the relationship between each learning characteristic and academic performance. Spearman’s rho was used to study the relationships between the three learning characteristics.  Results: A response rate of 72% was obtained. The largest number of participants (35%; n = 63) were visual learners, pragmatists (25%; n = 45) and learned using a superficial approach (44%; n = 79). Multimodal learning mode, balanced learning style and deep learning approach were found to correlate significantly with better academic performance in chemical pathology (r = 0.262, 0.307 and 0.467, respectively; p ≤ 0.0001).Conclusions: Our findings reveal that multimodal learners with a balanced learning style who have a deep approach to learning performed well in chemical pathology. This concurs with findings by studies that report a positive association between these learning characteristics and academic performance in other subjects in medicine. We propose that to achieve effective student learning, chemical pathology educators explore alternative teaching and learning activities to move students towards these positive learning characteristics.
Scoping Review of Antimalarial Drug Candidates in Phase I and II Drug Development
Authors: Abd-Rahman Azrin N. , Zaloumis Sophie , McCarthy James S. , Simpson Julie A. , Commons Robert J.
Published: November 2021

The emergence and spread of parasite resistance to currently available antimalarials has highlighted the importance of developing novel antimalarials. This scoping review provides an overview of antimalarial drug candidates undergoing phase I and II studies between 1 January 2016 and 28 April 2021.
Drown Them in Their Own Garbage: a New Strategy To Reverse Polymyxin Resistance?
Authors: May Kerrie L.
Published: November 2021

Purcell and colleagues offer new insights into a major mechanism of polymyxin resistance in Gram-negative bacteria. Inactivating a single lipid recycling enzyme causes accumulation of waste lipid by-products that inhibit a key factor responsible for polymyxin resistance.
Conditions for the Violation of Concentrational Homogeneity of Fe–Ni Invar Alloys
Authors: Sagaradze V. V. , Kataeva N. V. , Zavalishin V. A. , Shabashov V. A. , Kozlov K. A. , Klyukina M. F.
Published: November 2021

Conditions for the formation of microconcentration inhomogeneities in Fe–Ni alloys, which can decrease their invar characteristics, are determined. The nickel separation can be reached in the course of short-term annealing as a result of deformation-induced nickel segregation, nickel redistribution between martensite and austenite and between ferrite and austenite as well.
Comparison of the Methods for Determining Pyrogenically Modified Carbon Compounds
Authors: Dymov A. A. , Startsev V. V. , Gorbach N. M. , Pausova I. N. , Gabov D. N. , Donnerhack O.
Published: November 2021

The soil organic matter (SOM) is searched for the biomarkers and specific features associated with the effect of wildfires by the case study of peat soil, Rheic Hemic Histosol (Lignic), in the south of the middle taiga of the Komi Republic. It is shown that fires considerably influence the peat organic matter. Pyrogenic activity is assessed according to the content of charcoal particles. SOM is examined using solid-state 13C-NMR spectroscopy to determine the concentrations of polycyclic aromatic hydrocarbons (PAHs) and benzene polycarboxylic acids (BPCAs). The used methods allow for diagnosing the effects of wildfires on the SOM composition. In the horizons with the signs of pyrogenesis, the share of carbon represented by aromatic fragments increases as well as the PAH concentration, mainly at the expense of naphthalene, phenanthrene, and chrysene. The carbon stock of pyrogenically modified compounds, amounting to 4.4 kg/m2, is for the first time assessed in the European north based on the BPCA content. The characteristics of pyrogenically changed organic compounds and their fragments obtained by different methods correlate well: the Pearson coefficient for the correlation of the carbon content in aromatic compounds (Caryl) with total BPCA content is R = 0.84 (p < 0.05) and with individual BPCAs, R = 0.81–0.90 (p < 0.05).
Extraarticular joint ankylosis: a rare presentation
Authors: Kumar Saurabh , Charllu Arun Paul
Published: November 2021

Pseudoankylosis is a rare condition that causes inability to open the mouth due to condition related to outside of the temporomandibular joint. Most literature refers to this hypomobility disorder, a result of fusion of the zygomatic bone to the coronoid process, and very rarely is insidious coronoid hyperplasia causing mechanical interference with the posterior maxilla has been reported. We present a case of a 45-year-old woman, who presented with coronoid malformation and overgrowth resulting in progressive decrease in mouth opening. She was managed with coronoidectomy, following which good mouth opening was obtained. In this paper we discuss about the diagnosis and management of this rare disorder.
Diagnosing metastatic pheochromocytoma: Trick lies in attention to details!
Authors: Sharma Aditya , Ziauddin Shiraz Akif Mohammed , Chaudhary Kapil , Gupta Kirti , Dhanshekhar Venkatesh
Published: November 2021

Functional metastatic pheochromocytoma (PCC) is a very rare tumour and cytoreductive adrenalectomy with oligo metastatectomy is recommended in cases of low tumour burden. We report a rare case of metastatic PCC with an incidentally detected suspicious nodule seen on the anterior surface of the right lobe of the liver. The adrenal and the lesion were excised and sent for histopathology which was reported as a metastasis from PCC. This lesion was not visualised preoperatively on DOTA-PET-CT, highlighting the importance of keeping a low threshold for suspicion of metastasis in abnormal lesions and taking a biopsy during surgery. Inspection of the liver and rest of the abdomen for any abnormality should be done even when operating for any apparently benign lesions.
Adherence to antidiabetic treatment and impaired hypoglycemia awareness in type 2 diabetes mellitus assessed in Spanish community pharmacies: the ADHIFAC study
Authors: Gomez-Peralta Fernando , Fornos Pérez José A , Molinero Ana , Sánchez Barrancos Ignacio M , Arranz Martínez Ezequiel , Martínez-Pérez Pablo , Mera Gallego Inés , Andrés-Rodríguez N Floro
Published: November 2021

Introduction

Adherence to treatment and hypoglycemia awareness are strongly linked to glycemic control and hypoglycemia risk in people with type 2 diabetes mellitus (T2DM). Community pharmacies are suitable facilities to detect these conditions, and should be involved in the strategies to minimize the associated risks and burden.

Research design and methods

This cross-sectional study conducted at community pharmacies across Spain assessed the prevalence of low adherence to antidiabetic treatments, the frequency of impaired hypoglycemia awareness, and their predictive factors. Adherence was measured with the 8-item Morisky Medication Adherence Scale (MMAS-8) and electronic records of dispensed treatments. The Clarke questionnaire was used to assess impaired hypoglycemia awareness. Healthcare counseling provided in the pharmacy was collected.

Results

Seventy-nine pharmacists and 618 subjects with T2DM participated in the study. Mean age in the overall T2DM population was 67 years, being the majority (69%) pensioners. Adherence was high in 41% of participants, medium in 35%, and low in 24% according to the MMAS-8. Impaired hypoglycemia awareness was observed in 25% of participants. Main determinants of low adherence were the level of education, the number of treatments per patient, hypoglycemia awareness, and the type of pharmacy. Predictive factors of impaired hypoglycemia awareness were the level of education, information on diabetes-related complications, adherence levels, and the type of pharmacy. The proportion of participants who had healthcare counseling was 71% in the overall population and 100% in subjects with impaired hypoglycemia awareness and low adherence. Healthcare counseling comprised diabetes education (69%), pharmacotherapeutic assessment (20%), and physician referrals (11%).

Conclusion

Lack of adherence to antidiabetic treatments and impaired hypoglycemia awareness are frequent and correlate in T2DM. Community pharmacies can detect these conditions and should have an active role in the design of strategies to minimize them.
Long-term follow-up of a randomized clinical trial comparing glycemic excursion minimization (GEM) to weight loss (WL) in the management of type 2 diabetes
Authors: Cox Daniel J , Oser Tamara , Moncrief Matthew , Conaway Mark , McCall Anthony
Published: November 2021

Introduction

We previously reported the physical, psychological and behavioral 3-month post-treatment results of a randomized controlled trial comparing glycemic excursion minimization (GEM) versus conventional weight loss (WL) therapy in the management of type 2 diabetes (T2D). GEM is a paradigm shift in the lifestyle management of T2D that focuses on reducing postnutrient glucose excursions, rather than reducing weight. We now present the 13-month follow-up results.

Research design and methods

The initial study sample of 172 were 30–80 years old, had T2D for ≤10 years, an HbA1c ≥6.8% (51 mmol/mol), and were not using insulin. Participants were randomized to 6 hours of group treatment, either to WL or one of three versions of GEM. GEM groups differed in degree of blood glucose (BG) feedback provided during treatment: no recommended feedback, systematic capillary BG feedback before and after nutrient intake and physical activity, or continuous glucose monitoring. Since these GEM groups did not differ in pre-post improvement they were combined for initial and current analyses. Of those who completed the 3-month postassessment, 100% and 96% of the WL and GEM participants completed the 13-month follow-up assessment.

Results

Pre to follow-up within-group comparisons indicated WL participants sustained improvement in body mass index (BMI) (−0.9±1.4, p=0.001). GEM participants continued to benefit in their HbA1c (−0.5±1.4, p<0.001), BMI (−1±1, p<0.001), high-density lipoprotein (p<0.001), reduction of carbohydrate ingestion (p<0.001), self-monitoring of blood glucose satisfaction (p<0.001) and frequency (p<0.001), diabetes knowledge (p<0.001), diabetes empowerment (p<0.001), and both diabetes distress emotional (p=0.009) and regimen (p=0.001) subscales. Forty-two percent and 52% of WL and GEM participants, respectively, were classified as responders (individuals whose A1c dropped by at least −0.5%), with a mean HbA1c reduction of −1.2% and −1.5%. Neither WL nor GEM responders differed from non-responders in baseline demographics, psychological or disease severity variables. While WL responders could not be predicted, 73% of GEM responders were predicted by post minus pretreatment reductions of HbA1c, diabetes medication and BMI.

Conclusions

While WL sustained improvement in BMI, GEM sustained benefits across a broad range of physical, behavioral and psychological parameters, beneficial for clinicians and adults with T2D. This may be especially relevant for primary care physicians who manage about 90% of patients with T2D.

Trial registration number

NCT03196895.
Hemoglobin A1c in combination with fasting plasma glucose trumps fasting plasma glucose alone as predictive indicators for diabetes mellitus: an ambidirectional cohort study of Thai people with impaired fasting glucose
Authors: Thamakaison Sangsulee , Anothaisintawee Thunyarat , Sukhato Kanokporn , Unwanatham Nattawut , Rattanasiri Sasivimol , Reutrakul Sirimon , Thakkinstian Ammarin
Published: November 2021

Introduction

This ambidirectional cohort study aimed to assess the performance of combining hemoglobin A1c (HbA1c) to fasting plasma glucose (FPG) for estimation of progression rate to diabetes mellitus (DM) and to explore the risk factors of DM in patients with impaired fasting glucose (IFG).

Research design and methods

Patients with IFG were eligible for this study. IFG was defined as FPG of 100–125 mg/dL. Progression rates to DM were estimated using Kaplan-Meier analysis. Risk factors of DM were explored by Cox regression analysis.

Results

3011 patients were enrolled with median follow-up time of 8 years (range: 6 months–29 years). Progression rates to DM in patients with FPG 100–109 mg/dL and 110–125 mg/dL were 2.64 and 4.79 per 100 person-years. After adjusting covariables, compared with patients with FPG 100–109 mg/dL plus normal HbA1c (<5.7%), hazard ratios (95% CI) of patients with FPG 110–125 plus normal HbA1c, FBG 100–109 plus abnormal HbA1c (5.7%–6.49%), and FPG 110–125 plus abnormal HbA1c were 5.89 (2.37 to 14.63), 16.30 (8.59 to 30.92), and 33.84 (16.41 to 69.78), respectively. Body mass index ≥27.5 kg/m2, serum triglyceride level ≥150 mg/dL, family history of DM, and low level of high-density lipoprotein-cholesterol were independently associated with risk of DM in patients with IFG.

Conclusions

Patients with both IFG and abnormal HbA1c had higher risk of DM than patients with IFG alone. Therefore, performing HbA1c in combination with FPG helps to identify subgroups of people with IFG at highest risk of DM. These patients should have the highest priority in diabetes prevention programs, especially in countries with low and limited resources.
Association between ambulance prehospital time and maternal and perinatal outcomes in Sierra Leone: a countrywide study
Authors: Caviglia Marta , Putoto Giovanni , Conti Andrea , Tognon Francesca , Jambai Amara , Vandy Matthew Jusu , Youkee Daniel , Buson Riccardo , Pini Sara , Rosi Paolo , Hubloue Ives , Della Corte Francesco , Ragazzoni Luca , Barone-Adesi Francesco
Published: November 2021

Introduction

Sierra Leone, one of the countries with the highest maternal and perinatal mortality in the world, launched its first National Emergency Medical Service (NEMS) in 2018. We carried out a countrywide assessment to analyse NEMS operational times for obstetric emergencies in respect the access to timely essential surgery within 2 hours. Moreover, we evaluated the relationship between operational times and maternal and perinatal mortality.

Methods

We collected prehospital data of 6387 obstetric emergencies referrals from primary health units to hospital facilities between June 2019 and May 2020 and we estimated the proportion of referrals with a prehospital time (PT) within 2 hours. The association between PT and mortality was investigated using Poisson regression models for binary data.

Results

At the national level, the proportion of emergency obstetric referrals with a PT within 2 hours was 58.5% (95% CI 56.9% to 60.1%) during the rainy season and 61.4% (95% CI 59.5% to 63.2%) during the dry season. Results were substantially different between districts, with the capital city of Freetown reporting more than 90% of referrals within the benchmark and some rural districts less than 40%. Risk of maternal death at 60, 120 and 180 min of PT was 1.8%, 3.8% and 4.3%, respectively. Corresponding figures for perinatal mortality were 16%, 18% and 25%.

Conclusion

NEMS operational times for obstetric emergencies in Sierra Leone vary greatly and referral transports in rural areas struggle to reach essential surgery within 2 hours. Maternal and perinatal risk of death increased concurrently with operational times, even beyond the 2-hour target, therefore, any reduction of the time to reach the hospital, may translate into improved patient outcomes.
Double-masked, sham and placebo-controlled trial of corneal cross-linking and topical difluprednate in the treatment of bacterial keratitis: Steroids and Cross-linking for Ulcer Treatment Trial (SCUT II) study protocol
Authors: Radhakrishnan Naveen , Prajna Venkatesh N , Prajna Lalitha S , Venugopal Anitha , Narayana Shivanandha , Rajaraman Revathi , Amescua Guillermo , Porco Travis C , Lietman Thomas M , Rose-Nussbaumer Jennifer
Published: November 2021

Introduction

Although antibiotics are successful at achieving microbiological cure in infectious keratitis, outcomes are often poor due to corneal scarring. Ideal treatment of corneal ulcers would address both the infection and the inflammation. Adjunctive topical steroid treatment may improve outcomes by reducing inflammation. Corneal cross-linking (CXL) is a novel prospective therapy that may simultaneously reduce both inflammatory cells and bacterial pathogens. The purpose of this study is to determine differences in 6-month visual acuity between standard medical therapy with antibiotics versus antibiotics with adjunctive early topical steroid therapy versus antibiotic treatment plus CXL and early topical steroids.

Methods and analysis

This international, randomised, sham and placebo-controlled, three-arm clinical trial randomises patients with smear positive bacterial ulcers in a 1:1:1 fashion to one of three treatment arms: (1) topical 0.5% moxifloxacin plus topical placebo plus sham CXL; (2) topical 0.5% moxifloxacin plus difluprednate 0.05% plus sham CXL; or (3) the CXL group: topical 0.5% moxifloxacin plus difluprednate 0.05% plus CXL.

Ethics and dissemination

We anticipate that both adjunctive topical steroids and CXL will improved best spectacle corrected visual acuity and also reduce complications such as corneal perforation and the need for therapeutic penetrating keratoplasty. This study will comply with the NIH Data Sharing Policy and Policy on the Dissemination of NIH-Funded Clinical Trial Information and the Clinical Trials Registration and Results Information Submission rule. Our results will be disseminated via ClinicalTrials.gov website, meetings and journal publications. Our data will also be available on reasonable request.

Trial registration number

NCT04097730.
Parametrizations of the Poisson–Schrödinger equations in spherical symmetry
Authors: Parry Alan R.
Published: November 2021

We consider the asymptotically flat standing wave solutions to the Poisson–Schrödinger system of equations. These equations are also known as the Schrödinger–Newton equations and are the Newtonian limit of the Einstein–Klein–Gordon equations. The asymptotically flat standing wave solutions to the Poisson–Schrödinger equations are known as static states. These solutions can be parametrized using a variety of choices of two continuous parameters and one discrete parameter, each having a useful physical-geometrical interpretation. The values of the discrete variable determines the number of nodes (zeros) in the solution. We use numerical inversion techniques to analyze transformations between various informative choices of parametrization by relating each of them to a standard set of three parameters. Based on our computations, we propose explicit formulas for these relationships. Our computations also show that for the standard choice of continuous variables, the zero-node ground state yields a minimum value of a geometrically natural discrete variable. We give an explicit formula for this minimum value. We use these results to confirm two related observations from previous work by the author and others, and suggest additional applications and approaches to understand these phenomena analytically.
A generalized integrable hierarchy related to the relativistic Toda lattice: Hamiltonian structure, Darboux transformation, soliton solution and conservation law
Authors: Xu Zhiguo
Published: November 2021

Starting from a more generalized discrete [Formula: see text] matrix spectral problem and using the Tu scheme, some integrable lattice hierarchies (ILHs) are presented which include the well-known relativistic Toda lattice hierarchy and some new three-field ILHs. Taking one of the hierarchies as example, the corresponding Hamiltonian structure is constructed and the Liouville integrability is illustrated. For the first nontrivial lattice equation in the hierarchy, the [Formula: see text]-fold Darboux transformation (DT) of the system is established basing on its Lax pair. By using the obtained DT, we generate the discrete [Formula: see text]-soliton solutions in determinant form and plot their figures with proper parameters, from which we get some interesting soliton structures such as kink and anti-bell-shaped two-soliton, kink and anti-kink-shaped two-soliton and so on. These soliton solutions are much stable during the propagation, the solitary waves pass through without change of shapes, amplitudes, wave-lengths and directions. Finally, we derive infinitely many conservation laws of the system and give the corresponding conserved density and associated flux formulaically.