bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutritional Status and Associated Factors among Primary Schoolchildren from Pastoral Communities, Mieso-Mulu District, Sitti Zone, Somali Regional State, Eastern Ethiopia: Institution-Based Cross-Sectional Study
Authors: Geletaw Alayou , Egata Gudina , Weldegebreal Fitsum , Kibr Gesessew , Semaw Mohammed
Published: September 2021

Background. Child undernourishment is the disturbance of body function arising from a dietary imbalance between body demand and supply, which is the most serious public health problem in developing countries. Objective. This study aimed to assess the magnitude of nutritional status and associated factors among full-cycle primary schoolchildren in pastoral communities in the Mieso-Mulu district, Sitti Zone, Somali Regional State of Ethiopia. Methods. An institution-based cross-sectional study design was used. Study participants were selected using two-stage sampling procedures. Data were collected using structured, translated, pretested, and interviewer-administered questionnaires. The weight and height were measured using a calibrated digital scale and a Seca Rod stadiometer, respectively. Microscopic identification of intestinal parasites was done. Multicollinearity was checked for independent variables. Height for age z scores (HAZ) and body mass index for age z scores (BAZ) were used to determine the nutritional status of children. Logistic regression with both bivariate analysis and multivariate analysis was applied to identify associated factors with the nutritional status of children. Adjusted odds ratios were reported and the level of statistical significance was declared at a

P

value <0.05. Results. The magnitudes of thinness and stunting were 13.1% [95% CI: 10.6%, 15.7%] and 24.6% [95% CI: 21.3%, 27.9%], respectively. Being male, not using a bed net, and the presence of intestinal parasitic infection were among the factors associated with thinness. Family size of less than five, household food insecurity, and unavailability of the latrine were among the factors associated with stunting. Conclusion. This study revealed that stunting and thinness are major health problems among schoolchildren. Household food insecurity, intestinal parasitic infection, bed net utilization, and the availability of latrine were some of the major factors significantly associated with undernutrition. Local policymakers, health programmers, nutritionists, health practitioners, and nongovernmental organizations should enhance the nutritional status of schoolchildren by using information dissemination interventions, particularly in improving waste disposal, sanitation/hygiene, latrine facilities, and school-based deworming. Furthermore, awareness creation using nutrition promotion and encouraging communities to attempt to diversify locally available and low-cost nutritionally effective food items to improve food consumption and distribution within a household is recommended to reduce the prevalence of undernutrition among schoolchildren.
Untargeted Metabolomic Profiling of Cuprizone‐Induced Demyelination in Mouse Corpus Callosum by UPLC‐Orbitrap/MS Reveals Potential Metabolic Biomarkers of CNS Demyelination Disorders
Authors: Zhao Zhijie , Li Tongqi , Dong Xiaohua , Wang Xiaojing , Zhang Zhongxiao , Zhao Changyi , Kang Xueran , Zheng Ruizhe , Li Xinyuan
Published: September 2021

Multiple sclerosis (MS) is a neurodegenerative disorder characterized by periodic neuronal demyelination, which leads to a range of symptoms and eventually to disability. The goal of this research was to use UPLC‐Orbitrap/MS to identify validated biomarkers and explore the metabolic mechanisms of MS in mice. Thirty‐two C57BL/6 male mice were randomized into two groups that were fed either normal food or 0.2% CPZ for 11 weeks. The mouse demyelination model was assessed by LFB and the expression of MBP by immunofluorescence and immunohistochemistry. The metabolites of the corpus callosum were quantified using UPLC‐Orbitrap/MS. The mouse pole climbing experiment was used to assess coordination ability. Multivariate statistical analysis was adopted for screening differential metabolites, and the ingenuity pathway analysis (IPA) was used to reveal the metabolite interaction network. We successfully established the demyelination model. The CPZ group slowly lost weight and showed an increased pole climbing time during feeding compared to the CON group. A total of 81 metabolites (VIP > 1 and P < 0.05) were determined to be enriched in 24 metabolic pathways; 41 metabolites were markedly increased, while 40 metabolites were markedly decreased in the CPZ group. The IPA results revealed that these 81 biomarker metabolites were associated with neuregulin signaling, PI3K‐AKT signaling, mTOR signaling, and ERK/MAPK signaling. KEGG pathway analysis showed that two significantly different metabolic pathways were enriched, namely, the glycerophospholipid and sphingolipid metabolic pathways, comprising a total of nine biomarkers. Receiver operating characteristic analysis showed that the metabolites (e.g., PE (16 : 0/22 : 6(4Z, 7Z, 10Z, 13Z, 16Z, 19Z)), PC (18 : 0/22 : 4(7Z, 10Z, 13Z, 16Z)), cytidine 5 ′‐diphosphocholine, PS (18 : 0/22 : 6(4Z, 7Z, 10Z, 13Z, 16Z, 19Z)), glycerol 3‐phosphate, SM (d18 : 0/16 : 1(9Z)), Cer (d18:1/18 : 0), galabiosylceramide (d18:1/18 : 0), and GlcCer (d18:1/18 : 0)) have good discrimination ability for the CPZ group. In conclusion, the differential metabolites have great potential to serve as biomarkers of demyelinating diseases. In addition, we identified metabolic pathways associated with CPZ‐induced demyelination pathogenesis, which provided a new perspective for understanding the relationship between metabolites and CNS demyelination pathogenesis.
A Comparative Performance Analysis between Serpentine-Flow Solar Water Heater and Photovoltaic Thermal Collector under Malaysian Climate Conditions
Authors: Hossain M. S. , Kumar Laveet , Nahar Afroza
Published: September 2021

Solar energy has increasingly been employed for domestic and industrial water heating. Both conventional solar water heater (SWH) and photovoltaic thermal (PVT) systems suffer from the drawback of poor energy conversion efficiency. In this article, a unique parallel serpentine-flow thermal collector has been designed and developed that has been employed as an isolated SWH and also integrated with a 32-cell monocrystalline photovoltaic (PV) module. Simulation models of both SWH and PVT systems have been built in TRNSYS to study their thermal performance numerically. Thereafter, outdoor experimental investigations have been conducted under the composite climates of Malaysia. Experimental results show very good agreement with the simulation outcomes with disparity less than 2%. At the optimum flow rate, the maximum thermal efficiencies of SWH and PVT are 82.5% and 74.62%, respectively. Superior water outlet temperature was obtained with SWH. Although SWH exhibits superior thermal performance, PVT’s additional electrical output might make it preferable for several applications.
Dynamic Study of Intelligent Traffic Behaviour Based on Multiple Traffic Modes
Authors: Jing Hongwei , Li Xiaoming , Xu Guangquan , Zhu Mengli , Shen Li , Liu FangYuan , Peng Haoyang
Published: September 2021

With the rapid development of society, the traffic problem has become increasingly severe, and the traditional methods can no longer effectively solve the current social traffic behaviour problems. Although studies on the dynamics of human traffic behaviour based on traffic modes can effectively reveal the anomalies in traffic behaviour, few studies integrate intelligent traffic behaviour with multiple traffic modes. Based on the numerous traffic data of bike-sharing and ride-hailing in a Chinese city, this paper reveals the dynamic characteristics of various traffic behaviours in the city by combining spatiotemporal characteristics index and urban spatial structure with human traffic behaviour patterns. The experimental results show that the traffic behaviour of the town presents a double logarithmic power-law distribution in time characteristics, and there is a close interdependent dynamic relationship with the city’s spatial structure. The research in this paper can reveal the relationship between bimodal power-law distribution and spatial characteristics in complex systems and help solve social traffic problems effectively in social reality. Further research results can provide practical planning guidance for the behavioural integration of multiple traffic in smart cities.
Olaparib: A Clinically Applied PARP Inhibitor Protects from Experimental Crohn’s Disease and Maintains Barrier Integrity by Improving Bioenergetics through Rescuing Glycolysis in Colonic Epithelial Cells
Authors: Kovács Dominika , Vántus Viola Bagóné , Vámos Eszter , Kálmán Nikoletta , Schicho Rudolf , Gallyas Ferenc , Radnai Balázs
Published: September 2021

Crohn’s disease (CD) is an inflammatory disorder of the intestines characterized by epithelial barrier dysfunction and mucosal damage. The activity of poly(ADP‐ribose) polymerase‐1 (PARP‐1) is deeply involved in the pathomechanism of inflammation since it leads to energy depletion and mitochondrial failure in cells. Focusing on the epithelial barrier integrity and bioenergetics of epithelial cells, we investigated whether the clinically applied PARP inhibitor olaparib might improve experimental CD. We used the oral PARP inhibitor olaparib in the 2,4,6‐trinitrobenzene sulfonic acid‐ (TNBS‐) induced mouse colitis model. Inflammatory scoring, cytokine levels, colon histology, hematological analysis, and intestinal permeability were studied. Caco‐2 monolayer culture was utilized as an epithelial barrier model, on which we used qPCR and light microscopy imaging, and measured impedance‐based barrier integrity, FITC‐dextran permeability, apoptosis, mitochondrial oxygen consumption rate, and extracellular acidification rate. Olaparib reduced the inflammation score, the concentration of IL‐1β and IL‐6, enhanced the level of IL‐10, and decreased the intestinal permeability in TNBS‐colitis. Blood cell ratios, such as lymphocyte to monocyte ratio, platelet to lymphocyte ratio, and neutrophil to lymphocyte ratio were improved. In H2O2‐treated Caco‐2 monolayer, olaparib decreased morphological changes, barrier permeability, and preserved barrier integrity. In oxidative stress, olaparib enhanced glycolysis (extracellular acidification rate), and it improved mitochondrial function (mitochondrial coupling efficiency, maximal respiration, and spare respiratory capacity) in epithelial cells. Olaparib, a PARP inhibitor used in human cancer therapy, improved experimental CD and protected intestinal barrier integrity by preventing its energetic collapse; therefore, it could be repurposed for the therapy of Crohn’s disease.
Full‐Thickness Skin Graft according to Surrounding Relaxed Skin Tension Line Improves Scar Quality in Facial Defect Coverage: A Retrospective Comparative Study
Authors: Shin Jeonghwan , Jang Uk , Baek Sang Oon , Lee Jun Yong
Published: September 2021

A full‐thickness skin graft (FTSG) is useful for covering small skin and soft tissue defects. In this paper, we suggest FTSG in consideration of the relaxed skin tension line (RSTL) concept for scar quality improvement since FTSG has disadvantages, including contour irregularities and mismatches of color and texture. We conducted a retrospective chart review of twenty‐one patients with skin cancer on the face who underwent wide excision and FTSG by a single surgeon from October 2013 to July 2019. Twenty‐one patients with skin cancer on the face were divided into RSTL‐matched and RSTL‐unmatched groups, and FTSG was performed. Each group was subjected to scar assessment three months after surgery. Observer assessment was performed by five independent observers using the observer component of the patient and observer scar assessment scale (POSAS) and Vancouver scar scale (VSS). Our results indicate that there were significant differences between the RSTL‐matched and RSTL‐unmatched groups in the VSS and POSAS components. In addition, the RSTL‐matched group showed a natural appearance with surrounding tissue in the dynamic animation phase compared to the unmatched group. RSTL‐matched FTSG can be an attractive option for face skin and soft tissue defect coverage. (An earlier version of this paper has been presented at the International Conference on PRS Korea 2020.)
[Retracted] Characterization of Composite RFID Antennas Based on Thermal Properties: A Survey
Authors: Varadhan Chitra , Ashine Chamatu Fekadu , Arulselvi S.
Published: September 2021

In this paper, a comprehensive survey on thermal and geometric design parameters of composite materials utilized in the fabrication of modern RFID systems has been discussed mainly due to its advantages such as lightweight and high strength. Designing of RF antenna setup requires careful consideration of material, geometric and fabrication parameters. Polymer materials were chosen as the substrate and subjected to extensive studies to determine and predict the capability of the miniaturized RFID antenna. The effect of the polymer matrix composite (PMC) material on the antenna parameters such as gain, bandwidth, and return loss is analyzed and realized that improvement in bandwidth and perfection in impedance matching can be further accomplished by employing fractal structure. It is also discovered that the thermal properties affect the impedance and operating frequencies, thus enabling multilayer PMC deploying fractal structured RFID antennas to be used for many applications such as logistics, aerospace, biomedical, and mining.
The Accumulation Characteristics of the Paleozoic Reservoir in the Central-Southern Ordos Basin Recorded by Organic Inclusions
Authors: Zhu Ruijing , Li Rongxi , Wu Xiaoli , Qin Xiaoli , Zhao Bangsheng , Liu Futian , Zhao Di
Published: September 2021

The Permian tight clastic reservoir and Ordovician carbonate reservoir were developed in the central-southern Ordos Basin. This study investigated the fluid inclusion petrography, diagenetic fluid characteristics, formation process of natural gas reservoir, source rock characteristics, and reservoir accumulation characteristics of these Paleozoic strata by petrographic observations, scanning electron microscope imaging, fluid inclusion homogenization temperature, salinity, laser Raman spectrum, and gas chromatograph analyses. The results have suggested two phases of fluid inclusions in both the Permian sandstone and the Ordovician Majiagou Formation dolomite reservoirs, and the fluid inclusions recorded the history from the early thermal evolution of hydrocarbon generation to the formation, migration, and accumulation of natural gas. The early-phase inclusions show weak yellow fluorescence and recorded the early formation of liquid hydrocarbons, while the late-phase inclusions are nonfluorescent natural gas inclusions distributed in the late tectonic fractures and recorded the late accumulation of natural gas. The brine systems of the Permian and Ordovician fluid inclusions are, respectively, dominated by CaCl2-H2O and MgCl2-NaCl-H2O. The diagenetic fluids were in the ranges of medium-low temperature and moderate-low salinity. The natural gas hydrocarbon source rocks in the Ordos Basin include both the Permian coal-bearing rocks and the Ordovician carbonates. The process of the early-phase liquid hydrocarbon formation and migration into the reservoir corresponded to 220 Ma (Late Triassic). The late large-scale migration and accumulation of natural gas occurred at 100 Ma (early Late Cretaceous), which was close to the inclusion Rb/Sr isochron age of 89.18 Ma, indicating that the natural gas accumulation was related to the Yanshanian tectonic movement.
MHD Boundary Layer Flow over a Stretching Sheet: A New Stochastic Method
Authors: Ullah Hakeem , Khan Imran , Fiza Mehreen , Hamadneh Nawaf N. , Fayz-Al-Asad M. , Islam Saeed , Khan Ilyas , Raja Muhammad Asif Zahoor , Shoaib Muhammad
Published: September 2021

In this study, a new computing model is developed using the strength of feed-forward neural networks with the Levenberg–Marquardt scheme-based backpropagation technique (NN-BLMS). It is used to find a solution for the nonlinear system obtained from the governing equations of the magnetohydrodyanmic (MHD) boundary layer flow over a stretching sheet. Moreover, the partial differential equations (PDEs) for the MHD boundary layer flow over a stretching sheet are converting into ordinary differential equations (ODEs) with the help of similarity transformation. A dataset for the proposed NN-BLMM-based model is generated at different scenarios by a variation of various embedding parameters: Deborah number

β

and magnetic parameter (M). The training (TR), testing (TS), and validation (VD) of the NN-BLMS model are evaluated in the generated scenarios to compare the obtained results with the reference results. For the fluidic system convergence analysis, a number of metrics, such as the mean square error (MSE), error histogram (EH), and regression (RG) plots, are utilized for measuring the effectiveness and performance of the NN-BLMS infrastructure model. The experiments showed that comparisons between the results of proposed model and the reference results match in terms of convergence up to E-02 to E-10. This proves the validity of the NN-BLMS model. Furthermore, the results demonstrated that there is a decrease in the thickness of the boundary layer by increasing the Deborah number and magnetic parameter. The importance of the experiment can be seen due to its industrial applications such as MHD power generation, MHD generators, and MHD pumps.
Texture Analysis in the Assessment of Rectal Cancer: Comparison of T2WI and Diffusion-Weighted Imaging
Authors: Li Ming , Xu Xiaodan , Qian Pengjiang , Jiang Heng , Jiang Jianlong , Sun Jinbing , Lu Zhihua
Published: September 2021

Texture analysis (TA) techniques derived from T2-weighted imaging (T2WI) and apparent diffusion coefficient (ADC) maps of rectal cancer can both achieve good diagnosis performance. This study was to compare TA from T2WI and ADC maps between different pathological T and N stages to confirm which TA analysis is better in diagnosis performance. 146 patients were enrolled in this study. Tumor TA was performed on every patient’s T2WI and ADC maps, respectively; then, skewness, kurtosis, uniformity, entropy, energy, inertia, and correlation were calculated. Our results demonstrated that those significant different parameters derived from T2WI had better diagnostic performance than those from ADC maps in differentiating pT3b-4 and pN1-2 stage tumors. In particular, the energy derived from T2WI was an optimal parameter for diagnostic efficiency. High-resolution T2WI plays a key point in the local stage of rectal cancer; thus, TA derived from T2WI may be a more useful tool to aid radiologists and surgeons in selecting treatment.
Market Concentration, Market Power, and Firm Growth of Construction Companies
Authors: Wang Yumou , Li Shilong
Published: September 2021

China’s economy has been transitioning from a phase of rapid growth to a stage of high‐quality development that is called “new normal,” and China’s construction industry plays a pillar part in China’s economy. Nevertheless, the industry is large but not strong. This labour‐intensive industry suffers from low concentration and fierce competition. Based on the organizational theory, which shows how market structure contributes to the growth of industry, this study aims to explore the impact of market concentration and market power on firm’s turnover and profit. Using statistical analysis and panel data of 37 China’s construction companies from 2009 to 2018, this study proposes and calculates the market concentration (CR) and the market power (MP) of China’s companies. Then the augmented Cobb–Douglas production function and OLS regression are used to explore the growth factors of China’s construction industry. The results show that the market concentration increases both the turnover and profit of construction firms. However, market power increases the profit of construction firms while decreases the turnover. In addition, the companies that are China’s non‐state‐owned have overseas income or are civil engineering and construction have more advantages in the growth of the construction industry in “quality”. This study provides a reference to understand the structures of the construction industries and the structural effect on the growth of different types of firms and could be replicated in other countries with the similar situation.
SLC5A3-Dependent Myo-inositol Auxotrophy in Acute Myeloid Leukemia
Authors: Wei Yiliang , Huang Yu-Han , Skopelitis Damianos S. , Iyer Shruti V. , Costa Ana S.H. , Yang Zhaolin , Kramer Melissa , Adelman Emmalee R. , Klingbeil Olaf , Demerdash Osama E. , Polyanskaya Sofya A. , Chang Kenneth , Goodwin Sara , Hodges Emily , McCombie W. Richard , Figueroa Maria E. , Vakoc Christopher R.
Published: September 2021

An enhanced requirement for nutrients is a hallmark property of cancer cells. Here, we optimized an in vivo genetic screening strategy in acute myeloid leukemia (AML), which led to the identification of the myo-inositol transporter SLC5A3 as a dependency in this disease. We demonstrate that SLC5A3 is essential to support a myo-inositol auxotrophy in AML. The commonality among SLC5A3-dependent AML lines is the transcriptional silencing of ISYNA1, which encodes the rate-limiting enzyme for myo-inositol biosynthesis, inositol-3-phosphate synthase 1. We use gain- and loss-of-function experiments to reveal a synthetic lethal genetic interaction between ISYNA1 and SLC5A3 in AML, which function redundantly to sustain intracellular myo-inositol. Transcriptional silencing and DNA hypermethylation of ISYNA1 occur in a recurrent manner in human AML patient samples, in association with IDH1/IDH2 and CEBPA mutations. Our findings reveal myo-inositol as a nutrient dependency in AML caused by the aberrant silencing of a biosynthetic enzyme.

Significance:

We show how epigenetic silencing can provoke a nutrient dependency in AML by exploiting a synthetic lethality relationship between biosynthesis and transport of myo-inositol. Blocking the function of this solute carrier may have therapeutic potential in an epigenetically defined subset of AML.

This article is highlighted in the In This Issue feature, p. 275
NOT-Gated CD93 CAR T Cells Effectively Target AML with Minimized Endothelial Cross-Reactivity
Authors: Richards Rebecca M. , Zhao Feifei , Freitas Katherine A. , Parker Kevin R. , Xu Peng , Fan Amy , Sotillo Elena , Daugaard Mads , Oo Htoo Zarni , Liu Jie , Hong Wan-Jen , Sorensen Poul H. , Chang Howard Y. , Satpathy Ansuman T. , Majzner Robbie G. , Majeti Ravindra , Mackall Crystal L.
Published: September 2021

Chimeric antigen receptor (CAR) T cells hold promise for the treatment of acute myeloid leukemia (AML), but optimal targets remain to be defined. We demonstrate that CD93 CAR T cells engineered from a novel humanized CD93-specific binder potently kill AML in vitro and in vivo but spare hematopoietic stem and progenitor cells (HSPC). No toxicity is seen in murine models, but CD93 is expressed on human endothelial cells, and CD93 CAR T cells recognize and kill endothelial cell lines. We identify other AML CAR T-cell targets with overlapping expression on endothelial cells, especially in the context of proinflammatory cytokines. To address the challenge of endothelial-specific cross-reactivity, we provide proof of concept for NOT-gated CD93 CAR T cells that circumvent endothelial cell toxicity in a relevant model system. We also identify candidates for combinatorial targeting by profiling the transcriptome of AML and endothelial cells at baseline and after exposure to proinflammatory cytokines.

Significance:

CD93 CAR T cells eliminate AML and spare HSPCs but exert on-target, off-tumor toxicity to endothelial cells. We show coexpression of other AML targets on endothelial cells, introduce a novel NOT-gated strategy to mitigate endothelial toxicity, and demonstrate use of high-dimensional transcriptomic profiling for rational design of combinatorial immunotherapies.

See related commentary by Velasquez and Gottschalk, p. 559.

This article is highlighted in the In This Issue feature, p. 549
Efficacy and Safety of Molidustat for Anemia in ESA-Naive Nondialysis Patients: A Randomized, Phase 3 Trial
Authors: Yamamoto Hiroyasu , Nobori Kiyoshi , Matsuda Yoshimi , Hayashi Yasuhiro , Hayasaki Takanori , Akizawa Tadao
Published: September 2021

Introduction: Molidustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor that predominantly induces renal production of erythropoietin (EPO). Molidustat was evaluated for the treatment of anemia associated with chronic kidney disease (CKD) in the “Molidustat Once Daily Improves Renal Anemia by Inducing EPO” (MIYABI) program, which comprises 5 phase 3 clinical trials. The present MIYABI Non-Dialysis Correction (ND-C) study investigated the efficacy and safety of molidustat in Japanese patients with renal anemia who were not undergoing dialysis and were not receiving erythropoiesis-stimulating agent (ESA) treatment. Methods: This was a 52-week, randomized (1:1), open-label, active-control, parallel-group, multicenter, phase 3 study in Japanese patients with renal anemia associated with CKD (stages 3–5). Molidustat or the ESA darbepoetin alfa (hereinafter referred to as darbepoetin) were initiated at 25 mg once daily or 30 μg every 2 weeks, respectively, and doses were regularly titrated to correct and to maintain hemoglobin (Hb) levels in the target range of ≥11.0 g/dL and <13.0 g/dL. The primary efficacy outcome was the mean Hb level and its change from baseline during the evaluation period (weeks 30–36). The safety outcomes included evaluation of all adverse events. Results: In total, 162 patients were randomized to receive molidustat (n = 82) or darbepoetin (n = 80). Baseline characteristics were generally well balanced between treatment groups. The mean (standard deviation) Hb levels at baseline were 9.84 (0.64) g/dL for molidustat and 10.00 (0.61) g/dL for darbepoetin. The mean (95% confidence interval [CI]) for mean Hb levels during the evaluation period for molidustat (11.28 [11.07, 11.50] g/dL) and darbepoetin (11.70 [11.50, 11.90] g/dL) was within the target range. Based on a noninferiority margin of 1.0 g/dL, molidustat was noninferior to darbepoetin in the change in mean Hb level during the evaluation period from baseline; the least-squares mean (95% CI) difference (molidustat-darbepoetin) was −0.38 (−0.67, −0.08) g/dL. The proportion of patients who reported at least 1 treatment-emergent adverse event (TEAE) was 93.9% for molidustat and 93.7% for darbepoetin. Most TEAEs were mild (54.9% for molidustat and 63.3% for darbepoetin) or moderate (22.0% for molidustat and 22.8% for darbepoetin) in intensity. There were 3 deaths in the molidustat group and 1 in the darbepoetin group. Discussion/Conclusion: In the MIYABI ND-C study, molidustat appeared to be an efficacious and generally well-tolerated alternative to darbepoetin for the treatment of renal anemia in Japanese patients who were not undergoing dialysis and were not receiving ESA treatment.
Occult Blood in Feces Is Associated with Increased Risk of Psoriasis
Authors: Lee Hyun Jung , Han Kyungdo , Soh Hosim , Koh Seong-Joon , Im Jong Pil , Kim Joo Sung , Park Hyo Eun , Kim Miri
Published: September 2021

Background: The fecal immunochemistry test (FIT) has been proposed as a surrogate marker of intestinal inflammation. Psoriasis is a chronic inflammatory skin disease that is linked to underlying systemic inflammatory conditions, including inflammatory bowel disease. Methods: We investigated the association between occult blood in feces and the risk of psoriasis using data from the National Health Insurance System. This study was conducted involving 1,395,147 individuals who underwent health examinations from January 2009 to December 2012 and were followed up until the end of 2017. Results: The incidence of psoriasis (per 1,000 person-years) was 3.76 versus 4.14 (FIT-negative versus FIT-positive group) during a median follow-up of 6.68 years. In the multivariable-adjusted model, the hazard ratios for psoriasis were 1.03 for one positive FIT result, 1.12 for two positive FIT results, and 1.34 for three positive FIT results compared with negative FIT results. Conclusion: The risk of psoriasis was significantly increased in patients with positive FIT results compared to the FIT-negative population.
Recurrent Fever due to Helicobacter cinaedi Infection during R-CHOP Chemotherapy in Diffuse Large B-Cell Lymphoma: Case Report and Literature Review
Authors: Takenaka Kei , Sugimoto Takeshi , Kawamura Kohei , Fukumoto Takeshi , Onuma Kenichiro , Naito Takuya , Oka Masahiro
Published: September 2021

Fever due to Helicobacter cinaedi bacteremia under chemotherapy has not been widely recognized among clinicians. We experienced a 72-year-old man with diffuse large B-cell lymphoma, who was complicated with H. cinaedi bacteremia-induced fever under R-CHOP chemotherapy. We summarized 6 cases including ours, suggesting that fever without neutropenia developing around day 6 from starting chemotherapy is a possible symptom caused by H. cinaedi bacteremia. We should discriminate fever due to H. cinaedi bacteremia if fever emerged before myelosuppression in the course of chemotherapy.
Inflammatory Bowel Disease Patients’ Perspectives during COVID-19 Pandemic: Results from a Portuguese Survey
Authors: Revés Joana Branco , Frias-Gomes Catarina , Morão Bárbara , Nascimento Catarina , Palmela Carolina , Fidalgo Catarina , Roque Ramos Lídia , Sampaio Ana , Glória Luísa , Cravo Marília , Torres Joana
Published: September 2021

Introduction: Patients with inflammatory bowel disease (IBD) do not seem to be at increased risk of infection by SARS-CoV-2, but there is a concern whether immunosuppressive therapy may be associated with more severe disease. Several clinical practice recommendations have been published to help guide IBD care during the COVID-19 pandemic. Nonetheless, few studies have addressed patients’ perspectives and fears. We aimed to evaluate Portuguese IBD patients’ perspectives on the clinical management of their disease during the SARS-CoV-2 pandemic as well as the impact on their professional life. Methods: An anonymous electronic survey was created using REDCap and was distributed by the Portuguese Association of Inflammatory Bowel Disease (APDI) between May and August 2020. Patients’ perspectives on immunosuppressive therapy, disease management, interaction with gastroenterology departments, and the impact of the pandemic in their professional life were assessed. Patients’ proposals to improve medical care were also evaluated. Descriptive analysis and logistic regression were performed. Results: A total of 137 participants answered the survey (79.6% females, mean age 41.7 ± 12.1 years). Although having IBD and receiving treatment with immunosuppressors (thiopurines, steroids, or biologics) were considered promotors of anxiety, most patients (85.4%) agreed that disease remission was a priority and only a minority of patients interrupted their treatment during the pandemic. In multivariate analysis, active disease, biologic treatment, and use of corticosteroids in the last 3 months were perceived by the patients as high-risk features for increased risk of SARS-Cov-2 infection and more severe disease. Fifty-nine patients (44%) believed that their follow-up was influenced by the pandemic and only 58.8% felt that they had the opportunity to discuss their therapeutic options with their doctor. Sixty-three patients (46.0%) were working from home during the pandemic, although this decision was related to IBD and immunosuppressive therapy in only 36.5 and 39.7% of the cases, respectively. Areas where care could have been improved during the pandemic were identified by patients, namely enhancement of the communication with IBD professionals, conciliation of telemedicine with face-to-face appointments, and facilitation of the interaction between patients and employers. Conclusion: Most patients agreed that maintaining IBD remission is crucial, and only a minority of the patients stopped their treatment as per their own initiative. IBD status only had a small influence on patients’ professional activity during the COVID-19 outbreak, with most changes being related to the pandemic itself.
Development and Evaluation of the Behavioral and Psychological Symptoms of Dementia Questionnaire 13-Item Version (BPSD13Q)
Authors: Fuju Taiga , Yamagami Tetsuya , Ito Mio , Naito Noriko , Yamaguchi Haruyasu
Published: September 2021

Introduction: Most behavioral and psychological symptoms of dementia (BPSD) scales have copyright issues and are difficult for care staff to use in daily care settings because they were primarily designed for physicians. Therefore, an easier tool for care staff is required. This study aimed to develop and validate the BPSD questionnaire 13-item version (BPSD13Q). Methods: We obtained data from 444 people with dementia living in group homes in Japan using the BPSD plus questionnaire (BPSD + Q; 27-item version) and Neuropsychiatric Inventory Nursing Home version (NPI-NH). We selected appropriate items to make a short-form version of the BPSD + Q and examined the construct validity, internal consistency, and criterion-related validity of the questionnaire. Results: By the pilot review, research on correlations with similar items from comparable scales, and factor analysis, we reduced 27 items to 13 items (BPSD13Q). The BPSD13Q and BPSD13Q-distress (BPSD13Q-D) showed good internal consistency (Cronbach’s α = 0.76 and 0.80, respectively). Moreover, the BPSD13Q was positively correlated with the NPI-NH (r = 0.72, p < 0.001) and BPSD + Q (r = 0.95, p < 0.001). The BPSD13Q-D was positively correlated with the NPI-NH-caregiver distress (r = 0.74, p < 0.001) and BPSD + Q-distress (r = 0.96, p < 0.001). Conclusion: We developed and validated the BPSD13Q, which is a short-form version of the BPSD + Q and is downloadable. The BPSD13Q may make BPSD evaluations easier for the care staff.
Taiwanese Clinical Experience with Noninvasive Prenatal Testing for DiGeorge Syndrome
Authors: Lin Tzu-Yi , Hsieh T’sang-T’ang , Cheng Po-Jen , Hung Tai-Ho , Chan Kok-Seong , Tsai Chris , Shaw Steven W.
Published: September 2021

Objective: DiGeorge syndrome (DGS) is associated with microdeletions of chromosome 22q11. It is the second most common cause of congenital heart disease and is an important consideration whenever a conotruncal cardiac anomaly is identified. The availability of noninvasive prenatal testing (NIPT) is altering the practice of prenatal genetics and maternal-fetal medicine, resulting in a decline in invasive testing. Antenatal ultrasound and other biomarkers have their own limitation. NIPT was proposed to screen DGS with cell-free DNA in Taiwan. Here, we present our experience of prenatal diagnosis of DGS in our center. Methods: This was a retrospective study between November 1, 2019, and August 31, 2020, in Taiwan. Data were collected from 7,826 pregnant women self-referred for DGS screening with massive parallel shotgun sequencing-based NIPT. High-risk cases subsequently received amniocentesis for array comparative genomic hybridization (aCGH) to confirm the diagnosis. Characteristics of pregnancies were documented when participants received the test. Report of NIPT was completed 2 weeks after the test. Follow-up on high-risk cases was completed by telephone interview on January 30, 2021. Results: Thirteen cases showed high risk by NIPT, and 7 cases were confirmed by aCGH. The sensitivity and specificity were 100% (95% confidence interval [CI] 64.57–100.00%) and 99.92% (95% CI 99.83–99.96%). The prevalence of DGS was 1 in 1,118 pregnancies. The positive predictive rate was 53.85% (95% CI 29.14–76.79%). One true positive (TP) showed US anomaly, and 5 TPs selected termination. Discussion/Conclusion: NIPT demonstrated good performance in DGS screening. Detection of 22q11.2 deletion could be combined with routine screening to facilitate proper intervention.
Exosomes Derived from Mouse Adipose-Derived Mesenchymal Stem Cells Alleviate Benzalkonium Chloride-Induced Mouse Dry Eye Model via Inhibiting NLRP3 Inflammasome
Authors: Wang Guifang , Li Honghui , Long Hongmei , Gong Xileyuan , Hu Shufang , Gong Can
Published: September 2021

Purpose: The objective of the study was to investigate efficacy and mechanisms of mouse adipose-derived mesenchymal stem cell-derived exosomes (mADSC-Exos) in the benzalkonium chloride (BAC)-induced mouse dry eye model. Methods: Exosomes in the mADSC culture supernatant were isolated by ultracentrifugation. Western blotting, nanoparticle tracking analysis, and transmission electron microscopy were used to characterize mADSC-Exos. An experimental mouse model of dry eye was established by instillation of 0.2% BAC. mADSC-Exos were administered following BAC treatment. The positive control group was treated with commercial eye drops (0.1% pranoprofen). Corneal fluorescein staining, tear secretion, and tear film break-up time (BUT) were evaluated, and histologic analysis of the cornea and conjunctiva was performed by hematoxylin and eosin and periodic acid-Schiff staining. Apoptosis in the corneal epithelium was detected with the terminal deoxynucleotidyl transferase dUTP nick-end labeling assay and by Western blotting. Levels of pro-inflammatory cytokines in the cornea and conjunctiva were evaluated by flow cytometry, and mRNA and protein levels of NLR family pyrin domain-containing 3 (NLRP3) pathway components were assessed by quantitative real-time PCR and Western blotting, respectively. Results: mADSC-Exos were characterized as vesicles with a bilayer membrane. The particle size distribution peak was at 134 nm. mADSC-Exos specifically expressed cluster of differentiation (CD)9, CD63, and CD81. mADSC-Exos treatment repaired ocular surface damage. Additionally, mADSC-Exos inhibited cell apoptosis, decreased the levels of interleukin (IL)-1β, IL-6, IL-1α, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α, and increased levels of the anti-inflammatory cytokine IL-10. Meanwhile, NLRP3 inflammasome activation and upregulation of caspase-1, IL-1β, and IL-18 were reversed by mADSC-Exos. Conclusions: mADSC-Exos alleviate ocular surface inflammation, suggesting that it is a promising treatment for dry eye.
Speech and Language Therapists’ Perspectives of an E-Learning Course on Providing Feedback in the Clinical Learning Environment
Authors: Quigley Duana , Gilheaney Órla , O’Neill Mary , Davis Siobhan
Published: September 2021

Background: A fundamental component of supervising a student speech and language therapist (SLT) on placement is the provision of feedback. There are numerous identified challenges to ensure the delivery of high-quality feedback to optimise student learning and student success. Supervisors can help overcome these challenges and engage in evidence-based feedback processes if they are supported to develop the necessary knowledge and skills. E-learning is one possible means to provide this professional development to a large number of practising SLTs who are geographically dispersed and have conflicting schedules. Aims: This study aimed to capture and evaluate the perspectives of SLTs who completed an e-learning course on providing feedback in the clinical learning environment, including the suitability and effectiveness of the e-learning tool used. Methods and Procedures: An innovative e-learning course was designed to provide asynchronous video and interactive content on evidence-based theories and practices for effective feedback processes. Clinical scenarios relevant to the discipline of speech and language therapy were included. Participants were invited to complete optional, anonymous pre- and post-evaluation surveys. Data were analysed quantitively (descriptive and inferential statistics) and qualitatively (thematic analysis). Outcomes and Results: Participants indicated that the e-learning course supported them to enhance their feedback processes in the clinical learning environment through identified changes to their practices. The increases in confidence providing feedback they reported were statistically significant. In addition, the e-learning course was rated highly on numerous variables related to quality. Recommendations for adaptations and additions were also highlighted. Conclusions and Implications: An e-learning course on effective and evidence-based feedback processes provides an opportunity to provide professional development to a large number of geographically dispersed practitioners in a cost-effective and flexible way. This could ensure more SLTs are confident and competent in their role as supervisor of students, which requires distinct knowledge and skills from that of a practitioner. Ultimately, this will help maximise educator and student success in the feedback process and consequently improve clinical performance and healthcare delivery.
Small Choroidal Melanoma: Correlation between Clinical Characteristics and Metastatic Potential
Authors: Luo Shiming , Raval Vishal , Zabor Emily C. , Singh Arun D.
Published: September 2021

Importance: Diagnosis of small choroidal melanoma is based upon clinical features and presence of factors predictive of local malignant growth. Prognostic biopsy quantifies risk of metastasis. Objective: The aim of this study is to explore relationship between clinical characteristics and metastatic potential of a small choroidal melanoma. Design: Retrospective review of 53 patients with small choroidal melanoma treated in a tertiary oncology clinic. Patients were derived from 3 cohorts, with pathologic confirmation, with growth confirmation, and those treated only on clinical basis. Based upon prognostic biopsy outcomes, each case was classified into low or high metastatic potential groups. Distribution of clinical characteristics such as age, laterality, symptoms, tumor dimensions, tumor distance from optic nerve and fovea, presence of surface orange pigment, drusen, retinal pigment epithelial atrophy, and subretinal fluid was analyzed between metastatic groups. Main Outcome Measures: Distribution of clinical characteristics between low or high metastatic potential groups was analyzed. Results: A total of 53 patients [mean age, 61 years (range, 27–81 years); 32 (60%) men and 21 (40%) women] were classified into pathology confirmed group (n = 13), growth confirmed group (n = 26), and with clinical group (n = 14). Prognostic biopsy in the growth, pathology, and clinical groups revealed low metastatic potential in 23, 10, and 11 patients, respectively, and high metastatic potential in 3 patients in each group. Distribution of clinical characteristics between low or high metastatic potential groups was not statistically significantly different. Conclusion: Clinical characteristics do not identify metastatic potential of a small choroidal melanoma.
First record of Scinax centralis (Anura, Hylidae) in the Triângulo Mineiro region, state of Minas Gerais, southeastern Brazil, with further data on its vocalization
Authors: Bang Davi Lee , Pie Marcio , Giaretta Ariovaldo Antonio
Published: September 2021

Scinax comprises more than 120 species which are split in two clades, the S. ruber and the S. catharinae clades. A few species within the S. catharinae clade occur in gallery forests of the Brazilian Cerrado. We here extend the distribution of S. centralis southwards based on new populations sampled in the banks of the Rio Paranaíba, in the borders of Minas Gerais (MG) and Goiás (GO) states, southeastern Brazil. We also provide further data on the species vocalization. Variation was seen among our population and topotypes regarding SVL and call dominant frequency, both likely representing a clinal variation. Our new population of S. centralis represents the first record of the species for the state of Minas Gerais.
Phenotypes of Chronic Covert Brain Infarction in Patients With First-Ever Ischemic Stroke: A Cohort Study
Authors: Vynckier Jan , Kaesmacher Johannes , Wardlaw Joanna Marguerite , Roten Laurent , Beyeler Morin , Belachew Nebiyat Filate , Grunder Lorenz , Seiffge David Julian , Jung Simon , Gralla Jan , Dobrocky Tomas , Heldner Mirjam Rachel , Prange Ulrike , Goeldlin Martina Béatrice , Arnold Marcel , Fischer Urs , Meinel Thomas Raphael
Published: September 2021

Background and Purpose:

The aim of this study was to assess the rate of chronic covert brain infarctions (CBIs) in patients with acute ischemic stroke (AIS) and to describe their phenotypes and diagnostic value.

Methods:

This is a single-center cohort study including 1546 consecutive patients with first-ever AIS on magnetic resonance imaging imaging from January 2015 to December 2017. The main study outcomes were CBI phenotypes, their relative frequencies, location, and association with vascular risk factors.

Results:

Any CBI was present in 574/1546 (37% [95% CI, 35%–40%]) of patients with a total of 950 CBI lesions. The most frequent locations of CBI were cerebellar in 295/950 (31%), subcortical supratentorial in 292/950 (31%), and cortical in 213/950 (24%). CBI phenotypes included lacunes (49%), combined gray and white matter lesions (30%), gray matter lesions (13%), and large subcortical infarcts (7%). Vascular risk profile and white matter hyperintensities severity (19% if no white matter hyperintensity, 63% in severe white matter hyperintensity,
P
<0.001) were associated with presence of any CBI. Atrial fibrillation was associated with cortical lesions (adjusted odds ratio, 2.032 [95% CI, 1.041–3.967]). Median National Institutes of Health Stroke Scale scores on admission were higher in patients with an embolic CBI phenotype (median National Institutes of Health Stroke Scale, 5 [2–10],
P
=0.025).

Conclusions:

CBIs were present in more than a third of patients with first AIS. Their location and phenotypes as determined by MRI were different from previous studies using computed tomography imaging. Among patients suffering from AIS, those with additional CBI represent a vascular high-risk subgroup and the association of different phenotypes of CBIs with differing risk factor profiles potentially points toward discriminative AIS etiologies.
Imitating the Traditional Gods
Authors: Bartninkas Vilius
Published: September 2021

This paper examines moral virtues and cult practice in Plato’s Laws. It explores the symposium and the chorus and their potential to provide a recognisable cultural setting, in which the Magnesian citizens can test their responses to pleasurable and painful experiences and thus train their moral virtues. The challenge to this reading is to explain what additional input to moral habituation is provided by the religious aspect of these institutions. This paper draws attention to the relationship between the people and the patron gods of the respective institutions. It argues that the cult practices are designed to reflect the virtuous character of the traditional gods, who serve as the ethical role models for the worshipers. In this way, the worship of the traditional gods not only facilitates moral progress by exemplifying the objective of virtuous life, but also gives an egalitarian version of the ideal of godlikeness to its citizens.
Two new species of Thermosbaenacea (Peracarida, Halosbaenidae and Monodellidae) from southern France
Authors: Wagner H. P. , Bou C.
Published: September 2021

Two new species of Thermosbaenacea are described from various locations in southern France. One species is Limnosbaena occidentalis n. sp., a species that has been known since 1967 and has long been awaiting a formal description, the other is Tethysbaena exigua n. sp., a very small species that represents a new species-group within the genus and has more morphological affinities with the Caribbean Tethysbaena sanctaecrucis species-group than with any other group. Furthermore, some considerations about the origin and ecology of these species are given. Three species distributed over the families of Halosbaenidae and Monodellidae are now known in France within a radius of 80 km around Marseille, one of which has also been identified in the alluvial aquifer of the Dordogne river.