bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Androgen Deprivation Therapy on Extraocular Muscles, Retrobulbar Orbital Fat, and the Optic Nerve in Patients with Prostate Cancer
Authors: Sonmez Hatice Kubra , Sonmez Gokhan , Dogan Serap , Horozoglu Fatih , Demirtas Abdullah , Evereklioglu Cem
Published: October 2022

Introduction: The aim of this study was to evaluate radiologically the effects of long-term luteinizing hormone-releasing hormone (LHRH) agonist therapy on extraocular muscle thickness, retrobulbar orbital fat (ROF), and the optic nerve (ON) in prostate cancer (PCa) patients. Methods: The retrospective study included patients with primary or recurrent PCa who received androgen deprivation therapy (ADT) for at least 12 months. Each patient underwent gallium-68 prostate-specific membrane antigen positron emission tomography-computed tomography both before and at the end of the 12-month treatment. Thickness of the ON, lateral rectus muscle, medial rectus muscle, superior rectus muscle, and inferior rectus muscle were measured by using the coronal CT sections in soft tissue window. ROF, ocular protrusion, and ON length were measured in sagittal and coronal planes. Changes in these anatomical structures induced by LHRH analogs were investigated by comparing pre- and post-treatment measurements. Results: A total of 57 patients were included in the study. Median PSA and TT values ​​of the patients before treatment were 36.5 (range, 19.6–51.2) ng/mL and 614.0 (range, 472.0–743.0) ng/dL, respectively, and these values ​​decreased significantly after the treatment (10.6 [range, 5.2–14.2] ng/mL and 36.5 [range, 19.6–51.2] ng/dL, respectively, p < 0.001 for both). After the treatment, there was a statistically significant decrease in the areas of inferior rectus muscle, superior rectus muscle, lateral rectus muscle, and medial rectus muscle (p < 0.001 for all), while significant increases were observed in ROF (11.9%, p < 0.001) and ON thickness (14.3%, p = 0.004). The amount of ocular protrusion also showed a significant increase of approximately 14% after the treatment (14.0 [range, 12.0–16.0] mm vs. 16.0 [range, 14.0–17.2] mm, p < 0.001). Discussion/Conclusion: Our findings, for the first time in the literature, indicated that ADT causes a decrease in extraocular muscle mass and an increase in ROF with ocular protrusion. It can be asserted that these changes are similar to the changes in skeletal muscle and fat mass in other body parts. Further studies with a higher level of evidence are needed to clinically evaluate the increase in ocular protrusion and ON enlargement, which are likely to be caused by the increase in ROF.
IN SILICO SCREENING OF Syzygium myrtifolium FLAVONOID COMPOUNDS AS ANTI-BACTERIAL ACTIVITY
Authors:   Department of Food Technology, Politeknik Tonggak Equator, Pontianak, 78243, Indonesia, Permatasari Nelsy , Witoyo Jatmiko ,   Department of Agroindustrial Technology, Faculty of Agricultural Technology, Universitas Brawijaya, Malang, 65141, Indonesia, Masruri Masruri ,   Department of Chemistry, Faculty of Mathematics and Natural Science, Universitas Brawijaya, Malang, 65141, Indonesia, Yuwono Sudarminto ,   Department of Food Science and Biotechnology, Faculty of Agricultural Technology, Universitas Brawijaya, Malang, 65141, Indonesia, Widjanarko Simon ,   Porang Research Center, Universitas Brawijaya, Malang, 65141, Indonesia
Published: October 2022

Bacterial infection and antibiotic resistance are popular issues nowadays. Several previous reports performed antibacterial screening activities involving natural herbs and synthetic drugs. Alanine racemase and transglycosylase are essential proteins for peptidoglycan membrane synthesis in bacteria and an alternative target for antibacterial performance. This study identified six flavonoid compounds in Syzygium myrtifolium to perform the antibacterial activity. In silico study was conducted for modelling flavonoids – protein complexes. Five flavonoids from S. myrtifolium were taken out of the canonical smiles from the PubChem database and modelled three-dimensional structure using ChemDraw and molView. Targeted protein, alanine racemase and transglycosylase were downloaded from Protein Data Bank with ID 4WR3 and 1SLY. Ligands and proteins were interacted by Molegro virtual Docker 5.0 and visualized by Discovery studio version 21.1.1. Five flavonoids showed inhibition with alanine racemase and transglycosylase in the same active sites of control and sodium benzoate. According to the binding energy, calopiptin performed the lowest binding energy value in alanine racemase complexes, while 2-Propanone, 1,3-bis(5-nitro-2-furanyl) showed the lowest value of four other flavonoids at transglycosylase complexes. The type of interactions were electrostatic, hydrogen bonds, hydrophobic interactions and unfavorable ones. Low binding energy and varied interaction types indicated tight of ligand-protein interaction. In summary, five flavonoids inhibited alanine racemase and transglycosylase, and the peptidoglycane membrane synthesis in bacteria might be inferred. Keywords: Alanine racemase, Flavonoids, In silico, Transglycosylase
Censo Vizinhança USP: características domiciliares e socioculturais do Jardim Keralux e Vila Guaraciaba
Authors:   Associação Redes de Desenvolvimento da Maré
Published: October 2022

O livro traz e revela um conjunto de informações sobre o Jardim Keralux e a Vila Guaraciaba que agregam a diversidade de rostos, cores, idades e vivências nas muitas lutas estabelecidas ao longo de sua existência como favela na cidade de São Paulo. O tema foi desenvolvido a partir de uma articulação que reuniu professores, técnicos e alunos da universidade, instituições da sociedade civil, moradoras e moradores da região, além de parceiros que apoiaram essa relevante iniciativa. A proposta principal foi a de reunir e tornar compreensível uma série de dados que possam, a partir das demandas dos moradores do Jardim Keralux e da Vila Guaraciaba, servir a iniciativas e articulações intra e extracomunitárias de enfrentamento das desigualdades sociais e econômicas que separam, de forma estrutural, pessoas em uma mesma cidade.
Arginase-1 Deletion in Erythrocytes Promotes Vascular Calcification via Enhanced GSNOR (S-Nitrosoglutathione Reductase) Expression and NO Signaling in Smooth Muscle Cells
Authors: Gogiraju Rajinikanth , Renner Luisa , Bochenek Magdalena L. , Zifkos Konstantinos , Molitor Michael , Danckwardt Sven , Wenzel Philip , Münzel Thomas , Konstantinides Stavros , Schäfer Katrin
Published: October 2022

Background:

Erythrocytes (red blood cells) participate in the control of vascular NO bioavailability. The purpose of this study was to determine whether and how genetic deletion of ARG1 (arginase-1) affects vascular smooth muscle cell NO signaling, osteoblastic differentiation, and atherosclerotic lesion calcification.

Methods:

Atherosclerosis-prone mice with conditional, erythrocyte-restricted deletion of ARG1 (apoE
−/−
red blood cell.ARG1 knockout) were generated and vascular calcification studied using molecular imaging of the osteogenic activity agent OsteoSense, Alizarin staining or immunohistochemistry, qPCR of osteogenic markers and ex vivo assays.

Results:

Atherosclerotic lesion size at the aortic root did not differ, but calcification was significantly more pronounced in apoE
−/−
mice lacking erythrocyte ARG1. Incubation of murine and human VSMCs with lysed erythrocyte membranes from apoE
−/−
red blood cell. ARG1-knockout mice accelerated their osteogenic differentiation, and mRNA transcripts of osteogenic markers decreased following NO scavenging. In addition to NO signaling via sGC (soluble guanylyl cyclase), overexpression of GSNOR (S-nitrosoglutathione reductase) enhanced degradation of S-nitrosoglutathione to glutathione and reduced protein S-nitrosation of HSP (heat shock protein)-70 were identified as potential mechanisms of vascular smooth muscle cell calcification in mice lacking ARG1 in erythrocytes, and calcium phosphate deposition was enhanced by heat shock and prevented by GSNOR inhibition. Messenger RNA levels of enzymes metabolizing the arginase products L-ornithine and L-proline also were elevated in VSMCs, paralleled by increased proliferation, myofibroblast marker and collagen type 1 expression.

Conclusions:

Our findings support an important role of erythrocyte ARG1 for NO bioavailability and L-arginine metabolism in VSMCs, which controls atherosclerotic lesion composition and calcification.
Advancing Peripheral Artery Disease Quality of Care and Outcomes Through Patient-Reported Health Status Assessment: A Scientific Statement From the American Heart Association
Authors: Smolderen Kim G. , Alabi Olamide , Collins Tracie C. , Dennis Bernard , Goodney Philip P. , Mena-Hurtado Carlos , Spertus John A. , Decker Carole ,   on behalf of the American Heart Association Council on Peripheral Vascular Disease and Council on Lifestyle and Cardiometabolic Health
Published: October 2022

Peripheral artery disease (PAD) is chronic in nature, and individualized chronic disease management is a central focus of care. To accommodate this reality, tools to measure the impact and quality of the PAD care delivered are necessary. Patient-reported outcomes (PROs) and instruments to measure them, that is, PRO measures, have been well studied in the research and clinical trial context, but a shift toward integrating them into clinical practice has yet to take place. A framework to use PRO measures as indicators of the quality of PAD care delivered, that is, PRO performance measures (PRO-PMs), is provided in this scientific statement. Measurement goals to consider by PAD clinical phenotypes are provided, as well as an overview of potential benefits of adopting PRO-PMs in the clinical practice of PAD care, including reducing unwanted variability and promoting health equity. A central discussion with considerations for risk adjustment of PRO-PMs, individualized PAD care, and the need for patient engagement strategies is offered. Furthermore, necessary conditions in terms of required competencies and training to handle PRO-PM data are discussed because the interpretation and handling of these data come with great responsibility and consequences for designing care that adopts a broader framework of risk that goes beyond the inclusion of biomedical variables. To conclude, health system perspectives and an agenda to reach the next steps in the implementation of PRO-PMs in PAD care are offered.
Genetic Basis of Childhood Cardiomyopathy
Authors: Bagnall Richard D. , Singer Emma S. , Wacker Julie , Nowak Natalie , Ingles Jodie , King Ingrid , Macciocca Ivan , Crowe Joshua , Ronan Anne , Weintraub Robert G. , Semsarian Christopher
Published: October 2022

Background:

The causes of cardiomyopathy in children are less well described than in adults. We evaluated the clinical diagnoses and genetic causes of childhood cardiomyopathy and outcomes of cascade genetic testing in family members.

Methods:

We recruited children from a pediatric cardiology service or genetic heart diseases clinic. We performed Sanger, gene panel, exome or genome sequencing and classified variants for pathogenicity using American College of Molecular Genetics and Genomics guidelines.

Results:

Cardiomyopathy was diagnosed in 221 unrelated children aged ≤18 years. Children mostly had hypertrophic cardiomyopathy (n=98, 44%) or dilated cardiomyopathy (n=89, 40%). The highest genetic testing diagnostic yields were in restrictive cardiomyopathy (n=16, 80%) and hypertrophic cardiomyopathy (n=65, 66%), and lowest in dilated cardiomyopathy (n=26, 29%) and left ventricular noncompaction (n=3, 25%). Pathogenic variants were primarily found in genes encoding sarcomere proteins, with
TNNT2
and
TNNI3
variants associated with more severe clinical outcomes. Ten children (4.5%) had multiple pathogenic variants. Genetic test results prompted review of clinical diagnosis in 14 families with syndromic, mitochondrial or metabolic gene variants. Cascade genetic testing in 127 families confirmed 24 de novo variants, recessive inheritance in 8 families, and supported reclassification of 12 variants.

Conclusions:

Genetic testing of children with cardiomyopathy supports a precise clinical diagnosis, which may inform prognosis.
Recent Advances in Neuropsychological Outcomes and Intervention in Pediatric Stroke
Authors: Krivitzky Lauren S. , Westmacott Robyn , Boada Richard , Sepeta Leigh , Reppert Lauren , Mrakotsky Christine
Published: October 2022

Over the past 15 years, there have been significant advances in the treatment of acute and chronic medical consequences of stroke in childhood. Given high rates of survival in pediatric stroke, practitioners are tasked with treating the ongoing motor and neuropsychological sequelae in patients over the course of their development. This article provides a review of the current literature on neuropsychological outcomes in pediatric stroke, including intelligence, academics, language, visual-spatial skills, attention, executive functions, memory, and psychosocial function. Recent developments in functional neuroimaging are discussed, with a particular focus on language outcomes. We further review the current research on cognitive and behavioral rehabilitation and introduce intervention models in pediatric stroke. In the final section, we discuss future directions for clinical practice and research in pediatric stroke.
Revisiting the Passive Revolution
Authors: Sotiris Panagiotis
Published: October 2022

Passive revolution is one of the most debated notions to come out of the Prison Notebooks. It belongs to the notions that have been used as ‘established’ descriptions of historical and political sequences. However, a reading of Gramsci’s texts suggests that passive revolution is not a ‘historical phase’ and is not limited to the historical interpretation of a particular historical period. Nor is it part of an historical ‘canon’ that would suggest that, in the absence of a ‘proper’ Jacobin revolution, the only alternative is passive revolution. Rather it points to the experimental character of the Prison Notebooks and Gramsci’s confrontation with the profound changes in state apparatuses (and hegemonic apparatuses) and practices of politics and hegemony after WWI, in particular the new ‘mass’ forms of politics and ideological interpellation, and his attempt to elaborate a strategic–theoretical thinking suited to revolutionary politics in such a context.
The Godly “I Am” of Trans Identity
Authors: Sanchinel Sam
Published: October 2022

To many, reading trans identity through a Christian lens only makes sense if the goal is to deny trans people of rights. As such, trans persons have generally been understood through a secular lens, thus erasing the value held in Biblical texts on understanding humanity. In this paper the author reads trans identity as emerging from what they describe as “the Godly ‘I am.’ ” With a framework rooted in the works of Winnicott, de Certeau, and trans theological practice as well as referring to the Tower of Babel narrative and the various declarations of “I am” throughout the Bible, the author presents a view of trans embodiment as the expression of human possibility where one may truly “come into being” in the enunciation of “I am”.
A new species and three new records of Chloroperlidae (Plecoptera) from northeastern China
Authors: SHI WENJU , WANG HONGLIANG , LI WEIHAI
Published: October 2022

A new species of the genus Suwallia Ricker, 1943, S. kuandian sp. nov., from Liaoning Province of northeastern China is described, illustrated, and compared with similar species. Suwallia asiatica Zhiltzova & Levanidova, 1978 is reported for the first time from China. Additionally, Sweltsa illiesi Zhiltzova & Levanidova, 1978 and the chloroperlid genus Alaskaperla Stewart & DeWalt, 1991 are reported for the first time from China. The habitus and diagnostic features of these species are illustrated with color images.
First record of the genus Troglocollops (Coleoptera, Malachiidae) from China, with description of a new species
Authors: TONG JUNBO , TSHERNYSHEV SERGEI E. , LIU HAOYU , YANG YUXIA
Published: October 2022

The genus Troglocollops Wittmer, 1965 is reported from China for the first time. A new species is described and illustrated under the name Troglocollops (Troglocollopsoides) sinicus Tong & Yang, sp. nov. from Xinjiang, China. This new species can be easily distinguished from other species of Troglocollops by the body coloration (pronotum yellow with a black longitudinal stripe in the middle, elytra black with blue metallic lustre and yellow margination of apices), antennomere 1 somewhat smaller than 3, and endophallus with five strong spines and two groups of small spines near apex. An identification key to all known species of Troglocollops is updated.
A Self-Powered Flexible Sensor for Speed Skating Land Technology Monitoring
Authors: Deng Xuefeng , Fu Yanmin , Gao Jun
Published: October 2022

The Beijing Winter Olympics put forward the concept of scientific and technological Winter Olympics. Digital driving and precision training have become the main melody and high-frequency words in the field of sports training. In this context, the monitoring of athletes’ sports
technology is particularly important. Here, a selfpowered flexible sensor based on T-ZnO/PVDF, PAAM-LiCl hydrogel electrode and FEP is proposed to monitor athletes’ sports technology. Based on the piezoelectric effect, the outputting piezoelectric signal by the selfpowered flexible sensor
is not only the power supply energy of micro electronic device, but also the biosensor signal. In addition, the hydrogel electrode has the functions of anti-metal fatigue and stretchable flexibility, which can improve the adaptability of human motion machinery. The hybrid of polarized PVDF
and T-ZnO enhances the overall outputting piezoelectric performance of the sensor. This study provides a new application idea for human mechanical energy storage, motion technology monitoring and the application of flexible portable self-powered sensors.
Studies on the Preparation and Properties of Ni0.75Mn2.25O4 NTC Ceramic
Authors: Xu Puhao , Hou Haigang , Ding Yongkang , Shaheen Asma , Liu Guiwu , Qiao Guanjun
Published: October 2022

Ni0.75Mn2.25O4 NTC ceramics were synthesized by co-precipitation and solid-state method. Their phase, microstructure and electrical performances were analyzed by X-ray diffractometer (XRD), scanning electron microscopy (SEM) and Multifunctional digital
multimeter respectively. The Ni0.75Mn2.25O4 NTC ceramics synthesized by the co-precipitation method has a lower sintering temperature, higher bulk density, smaller grain size and higher ρ25 °C (4905 Ω cm) and B (4448 K) compared with the
samples fabricated by the solid-state method.
Research on Parameter Design and Simulation of Infrared Optical Fiber Imaging System Based on Error Theory
Authors: Zhao Wen-Jie , Li Jian-Ying , Du Xiao-Yan , Zhang Qian , Zhang Jian-Jun
Published: October 2022

As the microlens array is attached to the infrared optical fiber imaging bundle, forming a rigid assemble is a new method to optimize the imaging quality of the infrared optical fiber imaging system. The alignment accuracy of the assembly is essential to the overall imaging quality
of the system. To ensure that the assembly can still produce quality images under a certain alignment error, the imaging system model of assembly was established. Then introduced the concept of error margin and error margin coefficient to analyze the alignment error types and corresponding
error effects of the assembly. Based on these concepts, the parameter design of the optical fiber imaging system was started. The limiting alignment errors were calculated at the error margin factor ξ = 1.25: transverse δx = 9 μm, longitudinal dz
= 50 μm, and deflection angle γ = 1.5°. Lastly, a ZEMAX simulation study was carried out. The simulation results showed that: under a certain alignment error, the light did not leak but be completely coupled into the core of the fiber, which confirmed the accuracy
of error analysis and parameter design. And the assembly was realized in certain high-quality imaging under an alignment error. So the error analysis and parameters were designed correctly, and high imaging quality transfer of the system with a certain alignment error was achieved for the
assembly.
Analysis of Multiyear Blowing Snow Occurrences in the French Alps
Authors: Xie Zhipeng , Ma Yaoming , Ma Weiqiang , Hu Zeyong , Sun Genhou , Wang Yongjie
Published: October 2022

Wind-driven snow transport has important implications for spatial–temporal heterogeneity of snow distribution and snowpack evolution in mountainous areas, such as the French Alps. Due to the paucity of near-surface observations, our knowledge on the spatiotemporal variability of blowing snow occurrences is rather limited. Based on multiyear in situ observations, the spatial–temporal variability in the occurrence of blowing snow events in the French Alps was presented to investigate potential links with ambient meteorological conditions. Statistical analysis of the observations demonstrates that blowing snow events are frequently observed with substantial spatiotemporal variability. Most stations experienced snow transport one out of every five days throughout winter, and the corresponding cumulative hours with blowing snow occurrence accounted for 8% of the month in winter. Blowing snow events generally last 4–8 h in winter and early spring. The likelihood of blowing snow occurrences increases with wind speed but with divergent patterns across snow types. The frequency of blowing snow occurrences with concurrent snowfall is substantially higher than that without concurrent snowfall, although high spatiotemporal variability was found. The considerable variation in snow transport frequency can be explained by contrasting meteorological conditions, local climate, snowpack properties, and topography (elevation and aspect). The temperature-based empirical scheme failed to recognize individual occurrence of blowing snow events because of the significantly overestimated threshold wind speeds, highlighting the importance of validation using in situ observations. Our results contribute to the understanding of spatiotemporal occurrence of blowing snow events and facilitate the development of blowing snow models.
Online anomaly detection and remaining useful life prediction of rotating machinery based on cumulative summation features
Authors: Li Zhen , Xu Peihua , Wang Xian-Bo
Published: October 2022

The bearing is the core component of the gearbox transmission system. Once it is damaged during operation, it will cause the shutdown of the mechanical equipment for maintenance. It has important application significance to carry out fault detection and remaining useful life (RUL) prediction. Whereas, some bottlenecks, such as the noise interference of state characteristics, the excessive dependence of supervised learning on prior samples, and the practical RUL online calculation, restrict the industrial application of RUL prediction for rotating machinery equipment. To overcome the above problems, this paper introduces the discrete wavelet transform (DWT) to decrease the noise of the vibration acceleration signal obtained, and then uses the sliding average method to weaken the transient excitation. To make the state characteristics of the monitored bearing trendy, linear, and monotonic, this paper proposes a new set of state interpret indicators: energy and cumulative summation feature (CSF) to reflect the bearing health status. Based on the available bearing health information, the fault boundary threshold is established through the 3[Formula: see text] criteria, which serves as the basis for first predicting time (FPT) detection. Once the FPT point is determined, this paper applies CSF to replace the original vibration acceleration amplitude as the degradation indicator, which has better linearity and monotonicity than amplitude-based indicators, and which is conducive to the implementation of simple structure curve fitting to carry out the overall RUL prediction. Comparing with existing methods, such as relevance vector machine (RVM), deep belief network (DBN), and particle filtering (PF)-based methods, the experimental results demonstrate that the proposed method has the best RUL prediction efficiency and the fastest convergence.
Analysis and prediction of the joint strength of friction stir welded Aluminium 5754 to polyamide using response surface methodology and artificial neural network
Authors: S J Adarsh , Natarajan Arivazhagan
Published: October 2022

Lightweight hybrid structures are developing these days due to increased demand for fuel economy and lower emissions in the automotive and aerospace industries. This study aims to analyse and optimise the influence of friction stir welding (FSW) process parameters on the tensile shear strength of the aluminium-polyamide hybrid joint. The study on the influence of each parameter on the joint strength helps define the bonding mechanism while joining aluminium-polymer hybrid structures. Optical microscopy and scanning electron microscopy (SEM) were used for microstructural examination. A SEM image of the weld’s cross-sectional area shows micro and macro mechanical interlocks with a small interfacial gap which indicates better joint strength. An elemental area mapping investigation of the weld zone reveals fine polymer and aluminium mixing along the interaction region. In addition, FSW parameters have been optimized to maximize the tensile shear strength of aluminium-polyamide hybrid joints. A mathematical model for tensile shear strength in terms of FSW parameters is developed using response surface methodology (RSM). A predictive model was developed using an Artificial Neural Network (ANN) to validate RSM predicted results. The analysis of variance (ANOVA) shows that the actual and predicted values have a satisfactory correlation. ANN methods are better than regression models in predicting tensile shear strength within input welding parameter ranges. The process variables were optimised using the desirability function analysis. The maximum joint tensile shear strength of about 19.74 MPa and attained at optimal FSW parameters, i.e. rotational tool speed of 1421 r/min, welding speed of 27 mm/min, and tool tilt angle of 1°. The regression coefficient for the ANN model was 0.988 for the test data set, indicating that the developed model is appropriate for predicting tensile shear strength.
Patients with heat-related illness admitted to an intensive care unit in Hong Kong: A single-centre retrospective study (2009–2020)
Authors: Chan Carol Cheuk-Yan , Shum HP , Wu P , Leung NYW , Chang LL , Yan WW
Published: October 2022

Introduction:

In Hong Kong, heat-related illness (HRI) represents an important cause of morbidity and mortality among healthy adults engaging in outdoor activities during summer. It can result in intensive care unit (ICU) admission. This retrospective study aimed to profile critically ill patients with HRI and identify potential risk factors for mortality.

Methods:

This retrospective case series included adults with HRI from 1 January 2009 to 30 June 2020 admitted to the ICU of Pamela Youde Nethersole Eastern Hospital (PYNEH). Demographics, admission severity, co-morbidities, and laboratory investigations were analysed. Outcome data studied included mortality, ICU length of stay (LOS), ventilator days, and hospital LOS.

Results:

Among the 38 individuals included, 97% were hikers. About 92.1% of patients survived, while 7.9% expired. The median age of the patients was 48 years, and 78.9% were men. Hypertension was the most frequent concurrent disorder. Most cases were presented during the hot summer months of May (29%), July (24%) and August (18%). The localities’ median peak temperature and humidity were 33.2°C and 88%, respectively. Ninety-two percent of patients were airlifted to the hospital by helicopters. The median peak body temperature was 40.3°C. Central nervous system derangement (Glasgow Coma Scale (GCS) score ⩽ 8) was the top presenting feature (65.7%). About 57.9% of patients required vasopressor support, followed by mechanical ventilation (50%) and renal replacement therapy (31.6%).

Conclusions:

Most critically ill patients suffering from HRI were hikers and middle-aged adults. Mortality was 7.9% despite advanced life support in ICU. Raising public awareness of the associated risk with hiking in hot summer is essential for the prevention of HRI.
Prevalence, causes, and consequences of moral distress in healthcare providers caring for people living with dementia in long-term care during a pandemic
Authors: Haslam-Larmer Lynn , Grigorovich Alisa , Quirt Hannah , Engel Katia , Stewart Steven , Rodrigues Kevin , Kontos Pia , Astell Arlene , McMurray Josephine , Levy AnneMarie , Bingham Kathleen S , Flint Alastair J , Maxwell Colleen , Iaboni Andrea
Published: October 2022

Healthcare providers caring for people living with dementia may experience moral distress when faced with ethically challenging situations, such as the inability to provide care that is consistent with their values. The COVID-19 pandemic produced conditions in long-term care homes (hereafter referred to as ‘care homes’) that could potentially contribute to moral distress. We conducted an online survey to examine changes in moral distress during the pandemic, its contributing factors and correlates, and its impact on the well-being of care home staff. Survey participants (n = 227) working in care homes across Ontario, Canada were recruited through provincial care home organizations. Using a Bayesian approach, we examined the association between moral distress and staff demographics and roles, and characteristics of the long-term care home. We performed a qualitative analysis of the survey’s free-text responses. More than 80% of care home healthcare providers working with people with dementia reported an increase in moral distress since the start of the pandemic. There was no difference in the severity of distress by age, sex, role, or years of experience. The most common factors associated with moral distress were lack of activities and family visits, insufficient staffing and high turnover, and having to follow policies and procedures that were perceived to harm residents with dementia. At least two-thirds of respondents reported feelings of physical exhaustion, sadness/anxiety, frustration, powerlessness, and guilt due to the moral distress experienced during the pandemic. Respondents working in not-for-profit or municipal homes reported less sadness/anxiety and feelings of not wanting to go to work than those in for-profit homes. Front-line staff were more likely to report not wanting to work than those in management or administrative positions. Overall, we found that increases in moral distress during the pandemic negatively affected the well-being of healthcare providers in care homes, with preliminary evidence suggesting that individual and systemic factors may intensify the negative effect.
The failure of four bootstrap procedures for estimating confidence intervals for predicted-to-expected ratios for hospital profiling
Authors: Austin Peter C.
Published: October 2022

Background

Healthcare provider profiling involves the comparison of outcomes between patients cared for by different healthcare providers. An important component of provider profiling is risk-adjustment so that providers that care for sicker patients are not unfairly penalized. One method for provider profiling entails using random effects logistic regression models to compute provider-specific predicted-to-expected ratios. These ratios compare the predicted number of deaths at a given provider given the case-mix of its patients with the expected number of deaths had those patients been treated at an average provider. Despite the utility of this metric in provider profiling, methods have not been described to estimate confidence intervals for these ratios. The objective of the current study was to evaluate the performance of four bootstrap procedures for estimating 95% confidence intervals for predicted-to-expected ratios.

Methods

We used Monte Carlo simulations to evaluate four bootstrap procedures: the naïve bootstrap, a within cluster-bootstrap, the parametric multilevel bootstrap, and a novel cluster-specific parametric bootstrap. The parameters of the data-generating process were informed by empirical analyses of patients hospitalized with acute myocardial infarction. Three factors were varied in the simulations: the number of subjects per cluster, the intraclass correlation coefficient for the binary outcome, and the prevalence of the outcome. We examined coverage rates of both normal-theory bootstrap confidence intervals and bootstrap percentile intervals.

Results

In general, all four bootstrap procedures resulted in inaccurate estimates of the standard error of cluster-specific predicted-to-expected ratios. Similarly, all four bootstrap procedures resulted in 95% confidence intervals whose empirical coverage rates were different from the advertised rate. In many scenarios the empirical coverage rates were substantially lower than the advertised rate.

Conclusion

Existing bootstrap procedures should not be used to compute confidence intervals for predicted-to-expected ratios when conducting provider profiling.
Consultation of parents and healthcare professionals in end-of-life decision-making for neonates and infants: a population-level mortality follow-back physician survey
Authors: Dombrecht Laure , Cools Filip , Cohen Joachim , Deliens Luc , Goossens Linde , Naulaers Gunnar , Beernaert Kim , Chambaere Kenneth
Published: October 2022

Background

End-of-life decisions with potential life-shortening effect in neonates and infants are common. We aimed to evaluate how often and in what manner neonatologists consult with parents and other healthcare providers in these cases, and whether consultation is dependent on the type of end-of-life decision made.

Methods

Based on all deaths under the age of one that occurred between September 2016 and December 2017 in Flanders, Belgium, a nationwide mortality follow-back survey was performed. The survey asked about different types of end-of-life decisions, and whether and why parents and/or other healthcare providers had or had not been consulted.

Results

Response rate was 83% of the total population. End-of-life decisions in neonates and infants were consulted both with parents (92%) and other healthcare providers (90%), and agreement was reached between parents and healthcare providers in most cases (96%). When medication with an explicit life-shortening intent was administered parents were always consulted prior to the decision; however when medication without explicit life-shortening intention was administered parents were not consulted in 25% of the cases.

Conclusions

Shared decision-making between parents and physicians in case of neonatal or infant end-of-life decision-making is the norm in daily practice. All cases without parental consultation concerned non-treatment decisions or comfort medication without explicit life-shortening intention where physicians deemed the medical situation clear and unambiguous. However, we recommend to at least inform parents of medical options, and to explore other possibilities to engage parents in reaching a shared decision. Physicians consult other healthcare providers before making an end-of-life decision in most cases.
Health-Related Quality of Life and mental health of families with children and adolescents affected by rare diseases and high disease burden: the perspective of affected children and their siblings
Authors: Wiegand-Grefe Silke , Liedtke Anna , Morgenstern Lydia , Hoff Antonia , Csengoe-Norris Anikó , Johannsen Jessika , Denecke Jonas , Barkmann Claus , Grolle Benjamin , Daubmann Anne , Wegscheider Karl , Boettcher Johannes
Published: October 2022

Background

Advances in genetic and pharmaceutical technology and pediatric care have enabled treatment options for an increasing number of rare diseases in affected children. However, as current treatment options are primarily of palliative nature, the Health-Related Quality of Life (HRQoL) and mental health of this impaired population and their siblings are of increasing importance. Among children and adolescents with rare diseases, those who are technology-dependent carry a high disease burden and are selected as the target population in our study. In a cross-sectional observational design, the children’s HRQoL was assessed with the DISABKIDS (DCGM-37) as well as KIDSCREEN-27, while mental health was assessed with the Strengths and Difficulties Questionnaire (SDQ) by both the affected children, their parents, and siblings.

Results

Results of the study sample were compared to normative data. Affected children scored significantly lower than the norm on almost all HRQoL subscales as reported by parent and child. From the parental perspective, more mental health subscales were significantly impaired compared to the child’s perspective. Siblings showed no impairment in HRQoL as well as significantly fewer behavioral problems and higher prosocial behavior regarding their mental health compared to the norm.

Conclusion

Children and adolescents with rare diseases seem particularly impaired in social and emotional aspects of HRQoL and mental health. Interventions may focus primarily on promoting social skills, fostering prosocial behavior and peer relationships.
Type, density, and healthiness of food-outlets in a university foodscape: a geographical mapping and characterisation of food resources in a Ghanaian university campus
Authors: Mensah Daniel O. , Yeboah Godwin , Batame Michael , Lillywhite Rob , Oyebode Oyinlola
Published: October 2022

Introduction

Food environments are viewed as the interface where individuals interact with the wider food system to procure and/or consume food. Institutional food environment characteristics have been associated with health outcomes including obesity and nutrition-related non-communicable diseases (NR-NCDs) in studies from high-income countries. The objectives of this study were (1) to map and characterise the food-outlets within a Ghanaian university campus; and (2) to assess the healthiness of the food outlets.

Methods

Data collection was undertaken based on geospatial open-source technologies and the collaborative mapping platform OpenStreetMap using a systematic approach involving three phases: remote mapping, ground-truthing, and food-outlet survey. Spatial analyses were performed using Quantum Geographical Information System (QGIS) and comprised kernel density, buffer, and average nearest neighbour analyses to assess outlet distribution, density, and proximity. A classification system was developed to assess the healthiness of food-outlets within the University foodscape.

Results

Food-outlets were unevenly distributed over the University foodscape, with many outlets clustered closer to student residencies. Informal food-outlets were the most frequent food-outlet type. Compared to NCD-healthy food-outlets, NCD-unhealthy food-outlets dominated the foodscape (50.7% vs 39.9%) with 9.4% being NCD-intermediate, suggesting a less-healthy university foodscape. More NCD-unhealthy food outlets than NCD-healthy food outlets clustered around student residences. This difference was statistically significant for food outlets within a 100-m buffer (p < 0.001) of student residence and those within 100 and 500 m from departmental buildings/lecture halls (at 5% level of significance).

Conclusion

Further action, including research to ascertain how the features of the University’s food environment have or are influencing students’ dietary behaviours are needed to inform interventions aimed at creating healthier foodscapes in the study University and other campuses and to lead the way towards the creation of healthy food environments at the home, work, and community levels.
Evaluation of biofilm formation on acrylic resins used to fabricate dental temporary restorations with the use of 3D printing technology
Authors: Mazurek-Popczyk Justyna , Nowicki Adam , Arkusz Katarzyna , Pałka Łukasz , Zimoch-Korzycka Anna , Baldy-Chudzik Katarzyna
Published: October 2022

Background

Temporary implant-retained restorations are required to support function and esthetics of the masticatory system until the final restoration is completed and delivered. Acrylic resins are commonly used in prosthetic dentistry and lately they have been used in three-dimensional (3D) printing technology. Since this technology it is fairly new, the number of studies on their susceptibility to microbial adhesion is low. Restorations placed even for a short period of time may become the reservoir for microorganisms that may affect the peri-implant tissues and trigger inflammation endangering further procedures. The aim of the study was to test the biofilm formation on acrylamide resins used to fabricate temporary restorations in 3D printing technology and to assess if the post-processing impacts microbial adhesion.

Methods

Disk-shaped samples were manufactured using the 3D printing technique from three commercially available UV-curable resins consisting of acrylate and methacrylate oligomers with various time and inhibitors of polymerization (NextDent MFH bleach, NextDent 3D Plus, MazicD Temp). The tested samples were raw, polished and glazed. The ability to create biofilm by oral streptococci (S. mutans, S. sanguinis, S. oralis, S. mitis) was tested, as well as species with higher pathogenic potential: Staphylococcus aureus, Staphylococcus epidermidis and Candida albicans. The roughness of the materials was measured by an atomic force microscope. Biofilm formation was assessed after 72 h of incubation by crystal violet staining with absorbance measurement, quantification of viable microorganisms, and imaging with a scanning electron microscope (SEM).

Results

Each tested species formed the biofilm on the samples of all three resins. Post-production processing resulted in reduced roughness parameters and biofilm abundance. Polishing and glazing reduced roughness parameters significantly in the NextDent resin group, while glazing alone caused significant surface smoothing in Mazic Temp. A thin layer of microbial biofilm covered glazed resin surfaces with a small number of microorganisms for all tested strains except S. oralis and S. epidermidis, while raw and polished surfaces were covered with a dense biofilm, rich in microorganisms.

Conclusions

UV-curing acrylic resins used for fabricating temporary restorations in the 3D technology are the interim solution, but are susceptible to adhesion and biofilm formation by oral streptococci, staphylococci and Candida. Post-processing and particularly glazing process significantly reduce bacterial biofilm formation and the risk of failure of final restoration.
When cultural values meets professional values: a qualitative study of chinese nurses’ attitudes and experiences concerning death
Authors: Tu Jiong , Shen Manxuan , Li Ziying
Published: October 2022

Background

In China, there is a culture of death-avoidance and death-denying. Influenced by this distinctive socio-cultural views surrounding death, nurses often find it challenging to handle death and care for dying patients. This study explores the nurses’ attitudes and coping strategies concerning death and caring for dying patients in a cultural context of death taboo.

Methods

This research is a qualitative study that employs in-depth, semi-structured interviews with nurses from two major hospitals in Guangzhou, China. Overall, 28 nurses from four departments with high patient death rate were recruited and interviewed. All of the interviews were analyzed thematically.

Results

The nurses who participated in this study expressed attitudes toward death and caring for dying patients from both a personal dimension and a professional dimension. The personal dimension is influenced by traditional culture and societal attitudes towards death and dying, while their professional dimension is congruent with the nursing and palliative care values concerning death and dying. With an obvious discrepancy between these two dimensions, Chinese nurses adopt three strategies in their practice to solve this tension: boundary-drawing to separate their personal and professional life, complying with the existing cultural values at work, and constructing positive meanings for end-of-life care.

Conclusion

In a society that traditionally avoids making any reference to death, it is useful to reduce cultural taboo and construct positive meanings in end-of-life care, death education and the development of palliative care. Meanwhile, nurses also need institutional support, education and training to transition smoothly from a novice to a mature professional when handling patient death.
Exploration of biomedical knowledge for recurrent glioblastoma using natural language processing deep learning models
Authors: Jang Bum-Sup , Park Andrew J. , Kim In Ah
Published: October 2022

Background

Efficient exploration of knowledge for the treatment of recurrent glioblastoma (GBM) is critical for both clinicians and researchers. However, due to the large number of clinical trials and published articles, searching for this knowledge is very labor-intensive. In the current study, using natural language processing (NLP), we analyzed medical research corpora related to recurrent glioblastoma to find potential targets and treatments.

Methods

We fine-tuned the ‘SAPBERT’, which was pretrained on biomedical ontologies, to perform question/answering (QA) and name entity recognition (NER) tasks for medical corpora. The model was fine-tuned with the SQUAD2 dataset and multiple NER datasets designed for QA task and NER task, respectively. Corpora were collected by searching the terms “recurrent glioblastoma” and “drug target”, published from 2000 to 2020 in the Web of science (N = 288 articles). Also, clinical trial corpora were collected from ‘clinicaltrial.gov’ using the searching term of ‘recurrent glioblastoma” (N = 587 studies).

Results

For the QA task, the model showed an F1 score of 0.79. For the NER task, the model showed F1 scores of 0.90 and 0.76 for drug and gene name recognition, respectively. When asked what the molecular targets were promising for recurrent glioblastoma, the model answered that RTK inhibitors or LPA-1 antagonists were promising. From collected clinical trials, the model summarized them in the order of bevacizumab, temozolomide, lomustine, and nivolumab. Based on published articles, the model found the many drug-gene pairs with the NER task, and we presented them with a circus plot and related summarization (https://github.com/bigwiz83/NLP_rGBM).

Conclusion

Using NLP deep learning models, we could explore potential targets and treatments based on medical research and clinical trial corpora. The knowledge found by the models may be used for treating recurrent glioblastoma.