bluuebunny/crossref_metadata_2025 huggingface dataset:
Path following of underactuated surface ships based on model predictive control with neural network
Authors: Li Ronghui , Huang Ji , Pan Xinxiang , Hu Qionglei , Huang Zhenkai
Published: August 2020

A model predictive control approach is proposed for path following of underactuated surface ships with input saturation, parameters uncertainties, and environmental disturbances. An Euler iterative algorithm is used to reduce the calculation amount of model predictive control. The matter of input saturation is addressed naturally and flexibly by taking advantage of model predictive control. The mathematical model group (MMG) model as the internal model improves the control accuracy. A radial basis function neural network is also applied to compensate the total unknowns including parameters uncertainties and environmental disturbances. The numerical simulation results show that the designed controller can force an underactuated ship to follow the desired path accurately in the case of input saturation and time-varying environmental disturbances including wind, current, and wave.
Effortful Emotion Regulation as a Unique Form of Cybernetic Control
Authors: Tamir Maya
Published: August 2020

Emotion regulation is important for psychological well-being, yet we know relatively little about why, when, and how hard people try to regulate emotions. This article seeks to address these motivational issues by considering effortful emotion regulation as a unique form of cybernetic control. In any domain of self-regulation, emotions serve as indices of progress in regulation and inform the expected value of regulation. In emotion regulation, however, emotions also serve as the very target of regulation. This interdependence gives rise to ironic processes that may render people less likely to exert effort in emotion regulation, precisely when they need it most. The proposed analysis complements and extends existing theories of emotion regulation, sheds new light on available findings, carries implications for psychopathology and well-being, and points to new hypotheses that could lead to theoretical and applied advances in the field.
Prioritization of critical risk influencing factors in quantitative risk analyses for offshore petroleum installations
Authors: Zhen Xingwei , Vinnem Jan Erik
Published: August 2020

Comprehensive and detailed investigations of various major offshore accidents have shown that multifarious risk influencing factors including technical, human, and organizational factors have a significant impact on the nonlinear accident sequences. Parallel efforts are being made to develop quantitative risk analysis models involving risk influencing factors. It is recognized that in order to keep quantitative risk analyses in a manageable size, it is essential to restrict the number of risk influencing factors for each failure event. This article describes an effort to prioritize critical risk influencing factors for offshore maintenance work. A prioritization index integrating the weight and the status of each risk influencing factor is developed to determine the most appropriate prioritization. A hierarchy tree is developed to structure the identified risk influencing factors. The unified fuzzy scoring criterion is established for evaluating the risk influencing factors status. The fuzzy analytic hierarchy process approach stressing the consistency of the fuzzy pairwise comparison is applied to evaluate the priority of each risk influencing factor. A sensitivity study is conducted to investigate the criticality of risk influencing factors. The case study demonstrates that the proposed method can be a practical tool for prioritizing critical risk influencing factors effectively for all failure events in the quantitative risk analysis model. The method can also be useful in handling uncertainties arising in quantitative risk analyses.
High dose PPI-amoxicillin dual therapy for the treatment of Helicobacter pylori infection: a systematic review with meta-analysis
Authors: Zhu Yang-Jie , Zhang Yi , Wang Ting-Yi , Zhao Jing-Tao , Zhao Zhe , Zhu Jian-Ru , Lan Chun-Hui
Published: August 2020

Background:

Helicobacter pylori resistance to amoxicillin remains rare in many regions. Proton pump inhibitor-amoxicillin-containing high dose dual therapy (HDDT) has been proposed to treat H. pylori infection. We aimed to assess the effectiveness and safety of PPI-amoxicillin HDDT for treatment of H. pylori infection in comparison with other regimens.

Methods:

Databases, including PubMed, Embase, and the Cochrane Register of Controlled Trials, were searched to find relevant publications. Randomized controlled trials comparing HDDT with control regimens for H. pylori eradication in adult patients were included. The primary outcome was eradication rate by intention-to-treat analysis. Adverse events were analyzed as second outcome.

Results:

A total of 15 trials with 3818 patients qualified for inclusion. The eradication rate of HDDT was neither significantly inferior nor superior to the recommended regimens such as triple therapy, bismuth quadruple therapy, and non-bismuth quadruple therapy [relative risk (RR): 1.00, 95% confidence interval (CI): 0.96–1.05, p = 0.870]. This finding was robust through subgroup analyses and sensitivity analyses. Trial sequential analysis showed that HDDT was equivalent to control regimens, and further similar trials were unlikely to alter the conclusions of this analysis. The frequency of adverse events was significantly lower in HDDT group (RR: 0.48, 95% CI: 0.37–0.64, p < 0.001).

Conclusion:

HDDT was equivalent to recommended first-line or rescue regimens with fewer adverse effects. The evidence from this meta-analysis supports the use of HDDT as first-line or rescue treatment for H. pylori infection.

Trial registration:

PROSPERO CRD42019133002
Reduction in the procedure time of hybrid endoscopic submucosal dissection for early gastric neoplasms: a multi-center retrospective propensity score-matched analysis
Authors: Esaki Mitsuru , Suzuki Sho , Horii Toshiki , Ichijima Ryoji , Yamakawa Shun , Shibuya Hitoshi , Kusano Chika , Ikehara Hisatomo , Gotoda Takuji
Published: August 2020

Background:

Endoscopic submucosal dissection (ESD) for early gastric neoplasms is still a technically difficult and time-consuming procedure. Hybrid ESD (H-ESD) involves circumferential incision with partial submucosal dissection combined with subsequent mucosal resection by snaring, wherein the newly developed device allows us to perform H-ESD using a single device. This study aimed to determine the clinical outcomes of H-ESD compared with conventional ESD (C-ESD) for early gastric neoplasms.

Methods:

In this multi-center, retrospective study, using propensity score-matched analysis, we reviewed the charts of patients with early gastric neoplasms smaller than 20 mm treated with H-ESD or C-ESD at three hospitals between January 2017 and October 2018. The primary outcome was the procedure time, and the secondary outcomes were other factors, including the en bloc resection rate, complete resection rate, curative resection rate, and rate of adverse events.

Results:

Among 215 patients, 29 underwent H-ESD and 186 underwent C-ESD; 29 pairs were created by propensity score matching. In the H-ESD group, 82.8% of lesions met the absolute indication [mucosal lesions limited to 20-mm diameter, dominated by differentiated adenocarcinoma without ulcer (scar)] for endoscopic resection (ER). As a result, the procedure time of H-ESD was significantly shorter than that of C-ESD [20 (interquartile range, 12–27) min versus 40 (30–50) min; p < 0.001]. There was no significant difference in the secondary outcomes between the two groups.

Conclusion:

H-ESD contributed to reduced procedure time. Therefore, H-ESD could be an alternative endoscopic treatment for gastric neoplasms when the lesion fulfils the absolute indication for ER.
School Nurses on the Front Lines of Healthcare: Red Flags and Red Herrings: Improving the Recognition of Bruises and Burns Associated With Physical Abuse in School-Age Children
Authors: Lucas Christy , Crowell Kathryn R. , Olympia Robert P.
Published: August 2020

Through a series of case scenarios, this article describes the assessment and management of suspected physical child abuse presenting as bruises and burns. Although it is not uncommon for school-age children to have accidental injuries, recognizing patterns associated with physical child abuse and understanding red flags for abuse is vital. Failure to recognize injury patterns suspicious for physical child abuse, and thus failure to intervene appropriately, may leave children at risk for more serious injury or death.
The Role of Magnetic Resonance Imaging in Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: Analyzing MOCART 1 and 2.0
Authors: Casari Fabio A. , Germann Christoph , Weigelt Lizzy , Wirth Stephan , Viehöfer Arnd , Ackermann Jakob
Published: August 2020

Objective

To determine the role of magnetic resonance imaging (MRI) MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 1 and 2.0 scores in the assessment of postoperative outcome after autologous matrix-induced chondrogenesis (AMIC) for the treatment of osteochondral lesions of the talus (OLTs). It was hypothesized that preoperative patient factors or OLT morphology are associated with postoperative MOCART scores; yet postoperative clinical outcome is not.

Study Design

Cohort study; Level of evidence, 4. This study evaluated isolated AMIC that were implanted on the talus of 35 patients for the treatment of symptomatic OLT. Tegner and AOFAS (American Orthopaedic Foot and Ankle Society) scores were obtained at an average follow-up of 4.5 ± 1.8 years and postoperative MRI scored according to the MOCART 1 and 2.0.

Results

OLT size showed significant correlation with postoperative MRI scores (MOCART 1: P = 0.006; MOCART 2.0: P = 0.004). Bone grafting was significantly associated with a MOCART 1 subscale (signal intensity of repair tissue; P = 0.038). Age and defect size showed significant correlations with MOCART 2.0 subscales ( P < 0.05). Patients with shorter follow-up had a significantly higher MOCART 1 score and a trend toward better MOCART 2.0 scores than patients with longer follow-up (64.7 vs. 52.9 months, P = 0.02; 69.4 vs. 60.6 months, P = 0.058). No MOCART score was associated with postoperative patient-reported outcomes (n.s.).

Conclusion

Osteochondral lesion size is associated with postoperative MOCART scores in patients treated with AMIC for OLTs, with decreasing MOCART scores over time. Yet clinical outcome does not correlate with any MOCART score. Thus, MOCART assessment seems to have no significant role in the postoperative treatment of asymptomatic patients that underwent AMIC for OLTs.
Does Using Social Media Jeopardize Well-Being? The Importance of Separating Within- From Between-Person Effects
Authors: Stavrova Olga , Denissen Jaap
Published: August 2020

Social networking sites (SNS) are frequently criticized as a driving force behind rising depression rates. Yet empirical studies exploring the associations between SNS use and well-being have been predominantly cross-sectional, while the few existing longitudinal studies provided mixed results. We examined prospective associations between SNS use and multiple indicators of well-being in a nationally representative sample of Dutch adults ( N ∼ 10,000), comprising six waves of annual measures of SNS use and well-being. We used an analytic method that estimated prospective effects of SNS use and well-being while also estimating time-invariant between-person associations between these variables. Between individuals, SNS use was associated with lower well-being. However, within individuals, year-to-year changes in SNS use were not prospectively associated with changes in well-being (or vice versa). Overall, our analyses suggest that the conclusions about the causal impact of social media on rising mental health problems in the population might be premature.
Music Platforms and the Optimization of Culture
Authors: Morris Jeremy Wade
Published: August 2020

Drawing on Mark Katz’s notion of phonographic effects—where musicians, during the advent of early recording technology, altered their style of play to be better captured by microphones—this article explores some of the “platform effects” that arise in the shift to platformization and how cultural goods and user practices are re-formatted in the process. In particular, I examine the case of the music streaming service Spotify to think through the variety of means, sonic, and otherwise, that artists, labels, and other platform stakeholders use to “optimize” music to respond to the pressures platformization creates. I develop a typology of strategies—sonic optimization, data optimization, and infrastructural optimization—to consider the creative and logistical challenges optimization poses for platforms, artists, and users alike. From creating playlist friendly songs to musical spam to artificial play counts, I use the blurry lines these cases create to explore the tensions between the competing needs of platform providers, content producers, and users. I argue that music, as data, adds pressure on musicians and producers to think and act like software developers and coders, treating their music not just as songs that need to reach listeners, but as an intermingling of sonic content and coded metadata that needs to be prepared and readied for discovery. This optimization of culture, and the pressures it creates, affects not just musicians, but content producers of all kinds (e.g., video, podcasts, apps, books, etc.) who are forced to negotiate their relationships digital culture and the platforms through which it circulates.
Curating and Exhibiting for the Pandemic: Participatory Virtual Art Practices During the COVID-19 Outbreak in China
Authors: Feng Xiaodan
Published: August 2020

Since China’s lockdown of major cities in response to COVID-19, different forms of online participatory initiatives led by self-organizing groups of volunteers have greatly contributed to information circulation, patient admission support, and other aspects of coping with the pandemic. Although often overlooked by those studying online cultural production during the pandemic, a massive spontaneous and participatory creative outpouring of individual and collaborative artworks related to “fight the pandemic” are being published through platforms including Kuaishou, TikTok, and WeChat public accounts. This article argues that while these participatory online exhibitions published through WeChat opened up a temporary space of expression that both offset the lack of information and enabled alternative ways of understanding of and expression about the crisis, they were not only subject to pervasive state surveillance, but also co-optation by state media.
Maxillo-mandibular osteoradionecrosis following C-ion radiotherapy: Clinical notes and review of literature
Authors: Dell’Era Valeria , Aluffi Valletti Paolo , Garzaro Giacomo , Garzaro Massimiliano
Published: August 2020

Osteoradionecrosis (ORN) is one of the most feared complications after head and neck radiotherapy. Among head and neck sites, the mandible is the most commonly involved bone. Heavy ion radiotherapy delivers high-dose distribution focused to the target while simultaneously sparing of the adjacent organs but there are anyway some reported cases of ORN. Cases in literature reported well-known risk factors for its developing (e.g. tobacco and alcohol abuse, diabetes), but other are still debated (e.g. teeth extraction during radiotherapy). Prevention is mandatory but multimodal care may be required, tailoring all treatments on the patient needs. This study, after a brief revision of the literature, reports and a case of maxillo-mandibular ORN following carbon-ion (C-ion) radiotherapy and its treatment.
Study on the Influence of Psychological Intervention on Mood State and Coping Styles for High-Level Athletes: A Case Study for Wushu Sport in China
Authors: Li Hua
Published: August 2020

Psychological intervention has a positive impact on the competitive psychological ability and performance of athletes, while there are few studies on this subject. To improve the psychological ability of athletes’ mood and coping styles and promote the smooth progress of the competition, a single-subject experimental design model is used carry out psychological intervention on four high-level athletes for 8 months. According to the characteristics of Wushu routines, the psychological measurement and social validity evaluation are combined to explore the effect of psychological intervention. The results show that the mood state of four athletes improved obviously with the same trend. The coping styles showed a positive upward trend after psychological intervention. The results of three athletes also improved in the City Games. In addition, the results of “social validation” obtained from the coaches and athletes support the effectiveness of the intervention. Psychological intervention can effectively improve the bad mood and negative coping style of Wushu routine athletes so as to improve the competition of athletes.
Analysis of Composition Change of Public Facility Care Users After the Universal Coverage Scheme in Thailand
Authors: Meemon Natthani , Paek Seung Chun
Published: August 2020

This study conducted a preliminary analysis to examine the impact of Thailand’s Universal Coverage Scheme (UCS) on health care use. In contrast with our expectation, no significant increase was found in the use of public facility care (i.e., use of the UCS services) after the UCS because the UCS increased the use of public facility care for the previously uninsured, but at the same time, it similarly decreased the previously insured who were previous public facility care users. Based on a view of this situation as a composition change of public facility care users, this study investigated where and discussed why the composition change occurred. By classifying health care use into four types (no care, informal care, public facility care, and private facility care), descriptive analysis and pooled logistic regression analysis were performed with data from the Health and Welfare Survey 2001 and 2003 to 2005. The study results showed that the UCS largely increased the use of public facility care for the previous uninsured people. In addition, the degree of the increase was relatively larger in lower income, older, younger, female, and rural people. Meanwhile, the UCS decreased the use of public facility care for previous public facility care users, especially those in higher income, middle-aged (mostly age 20–39 years), male, and urban people. This was probably due to an imbalance between the scaled-up UCS implementation and the resources allocated for improving the capacity of public facilities. This may have created circumstances that did not serve the needs of users (e.g., long waiting time) and pushed those previous users to the private sector.
Instagramming Social Presence: A Test of Social Presence Theory and Heuristic Cues on Instagram Sponsored Posts
Authors: Johnson Erika Katherine , Hong Seoyeon Celine
Published: August 2020

This study investigates social presence theory, using sponsored posts on Instagram. By testing a 3 (social presence) × 2 (heuristic cues) × 2 (source of sponsorship) mixed factorial experiment ( N = 378), the results showed significant main effects between social presence, heuristic cues, and sponsorship sources on social media outcomes. In sum, higher purchase intention and the intention to click “Like” generated higher social presence, higher “Likes” (heuristic), and official sponsorship sources. Our findings provide empirical evidence on how to effectively deliver sponsored content on Instagram.
Health Utility Estimates and Their Application to HIV Prevention in the United States: Implications for Cost-Effectiveness Modeling and Future Research Needs
Authors: Whitham Hilary K. , Hutchinson Angela B. , Shrestha Ram K. , Kuppermann Miriam , Grund Birgit , Shouse R. Luke , Sansom Stephanie L.
Published: August 2020

Objectives. Health utility estimates from the current era of HIV treatment, critical for cost-effectiveness analyses (CEA) informing HIV health policy, are limited. We examined peer-reviewed literature to assess the appropriateness of commonly referenced utilities, present previously unreported quality-of-life data from two studies, and discuss future implications for HIV-related CEA. Methods. We searched a database of cost-effectiveness analyses specific to HIV prevention efforts from 1999 to 2016 to identify the most commonly referenced sources for health utilities and to examine practices around using and reporting health utility data. Additionally, we present new utility estimates from the Centers of Disease Control and Prevention’s Medical Monitoring Project (MMP) and the INSIGHT Strategies for Management of Anti-Retroviral Therapy (SMART) trial. We compare data collection time frames, sample characteristics, assessment methods, and key estimates. Results. Data collection for the most frequently cited utility estimates ranged from 1985 to 1997, predating modern HIV treatment. Reporting practices around utility weights are poor and lack details on participant characteristics, which may be important stratifying factors for CEA. More recent utility estimates derived from MMP and SMART were similar across CD4+ count strata and had a narrower range than pre–antiretroviral therapy (ART) utilities. Conclusions. Despite the widespread use of ART, cost-effectiveness analysis of HIV prevention interventions frequently apply pre-ART health utility weights. Use of utility weights reflecting the current state of the US epidemic are needed to best inform HIV research and public policy decisions. Improved practices around the selection, application, and reporting of health utility data used in HIV prevention CEA are needed to improve transparency.
Research on the quality hospice care of elderly cancer patients in China under social work intervention
Authors: Wang Li , Wang Zhizhong
Published: August 2020

Background

Few studies have specifically addressed quality of life issues for elderly hospice patients. The purpose of this study is to explore various factors and service patterns of the quality of life of end-of-life care for the elderly.

Methods

We collect the data and make small-scale exploratory study via semi-structured individual interviews. Data were collected from the family of 2 elderly cancer patients receiving hospice services, and the data were analyzed qualitatively.

Results

After investigation, we found that elderly people in hospice care, regardless of age, are suffering from physical and psychological pain and do not want to spend the rest of their lives in the hospital, but want to die in their own homes.

Conclusions

Both hospitalization and in-home care can improve resource utilization, and the key is to find various factors affecting the quality of life. Improving the quality of life is what patients and their families need most.
Isolation and Quantification of Blood Apoptotic Bodies, a Non-invasive Tool to Evaluate Apoptosis in Patients with Ischemic Stroke and Neurodegenerative Diseases
Authors: Serrano-Heras Gemma , Díaz-Maroto Inmaculada , Castro-Robles Beatriz , Carrión Blanca , Perona-Moratalla Ana B. , Gracia Julia , Arteaga Sandra , Hernández-Fernández Francisco , García-García Jorge , Ayo-Martín Oscar , Segura Tomás
Published: August 2020

Background

Improper regulation of apoptosis has been postulated as one of the main factors that contributes to the etiology and/or progression of several prevalent diseases, including ischemic stroke and neurodegenerative pathologies. Consequently, in the last few years, there has been an ever-growing interest in the in vivo study of apoptosis. The clinical application of the tissue sampling and imaging approaches to analyze apoptosis in neurological diseases is, however, limited. Since apoptotic bodies are membrane vesicles that are released from fragmented apoptotic cells, it follows that the presence of these vesicles in the bloodstream is likely due to the apoptotic death of cells in tissues. We therefore propose to use circulating apoptotic bodies as biomarkers for measuring apoptotic death in patients with ischemic stroke and neurodegenerative diseases.

Results

Since there is no scientific literature establishing the most appropriate method for collecting and enumerating apoptotic bodies from human blood samples. Authors, here, describe a reproducible centrifugation-based method combined with flow cytometry analysis to isolate and quantify plasma apoptotic bodies of patients with ischemic stroke, multiple sclerosis, Parkinson’s disease and also in healthy controls. Electron microscopy, dynamic light scattering and proteomic characterization in combination with flow cytometry studies revealed that our isolation method achieves notable recovery rates of highly-purified intact apoptotic bodies.

Conclusions

This easy, minimally time consuming and effective procedure for isolating and quantifying plasma apoptotic bodies could help physicians to implement the use of such vesicles as a non-invasive tool to monitor apoptosis in patients with cerebrovascular and neurodegenerative diseases for prognostic purposes and for monitoring disease activity.
RiboMiner: a toolset for mining multi-dimensional features of the translatome with ribosome profiling data
Authors: Li Fajin , Xing Xudong , Xiao Zhengtao , Xu Gang , Yang Xuerui
Published: August 2020

Background

Ribosome profiling has been widely used for studies of translation under a large variety of cellular and physiological contexts. Many of these studies have greatly benefitted from a series of data-mining tools designed for dissection of the translatome from different aspects. However, as the studies of translation advance quickly, the current toolbox still falls in short, and more specialized tools are in urgent need for deeper and more efficient mining of the important and new features of the translation landscapes.

Results

Here, we present RiboMiner, a bioinformatics toolset for mining of multi-dimensional features of the translatome with ribosome profiling data. RiboMiner performs extensive quality assessment of the data and integrates a spectrum of tools for various metagene analyses of the ribosome footprints and for detailed analyses of multiple features related to translation regulation. Visualizations of all the results are available. Many of these analyses have not been provided by previous methods. RiboMiner is highly flexible, as the pipeline could be easily adapted and customized for different scopes and targets of the studies.

Conclusions

Applications of RiboMiner on two published datasets did not only reproduced the main results reported before, but also generated novel insights into the translation regulation processes. Therefore, being complementary to the current tools, RiboMiner could be a valuable resource for dissections of the translation landscapes and the translation regulations by mining the ribosome profiling data more comprehensively and with higher resolution. RiboMiner is freely available athttps://github.com/xryanglab/RiboMinerandhttps://pypi.org/project/RiboMiner.
New insights into the Manila clam and PAMPs interaction based on RNA-seq analysis of clam through in vitro challenges with LPS, PGN, and poly(I:C)
Authors: Jiang Kunyin , Nie Hongtao , Li Dongdong , Yan Xiwu
Published: August 2020

Background

Manila clam (Ruditapes philippinarum) is a worldwide commercially important marine bivalve species. In recent years, however, microbial diseases caused high economic losses and have received increasing attention. To understand the molecular basis of the immune response to pathogen-associated molecular patterns (PAMPs) in R. philippinarum, transcriptome libraries of clam hepatopancreas were constructed at 24 h post-injection with Lipopolysaccharide (LPS), peptidoglycan (PGN), and polyinosinic-polycytidylic acid (poly(I:C)) and phosphate-buffered saline (PBS) control by using RNA sequencing technology (RNA-seq).

Results

A total of 832, 839, and 188 differentially expressed genes (DEGs) were found in LPS, PGN, and poly(I:C) challenge group compared with PBS control, respectively. Several immune-related genes and pathways were activated in response to the different PAMPs, suggesting these genes and pathways might specifically participate in the immune response to pathogens. Besides, the analyses provided useful complementary data to compare different PAMPs challenges in vivo. Functional enrichment analysis of DEGs demonstrated that PAMPs responsive signal pathways were related to apoptosis, signal transduction, immune system, and signaling molecules and interaction. Several shared or specific DEGs response to different PAMPs were revealed in R. philippinarum, including pattern recognition receptors (PRRs), antimicrobial peptides (AMPs), interferon-induced proteins (IFI), and some other immune-related genes were found in the present work.

Conclusions

This is the first study employing high throughput transcriptomic sequencing to provide valuable genomic resources and investigate Manila clam response to different PAMPs through in vivo challenges with LPS, PGN, and poly(I:C). The results obtained here provide new insights to understanding the immune characteristics of R. philippinarum response to different PAMPs. This information is critical to elucidate the molecular basis of R. philippinarum response to different pathogens invasion, which potentially can be used to develop effective control strategies for different pathogens.
Lung injury induced by short-term mechanical ventilation with hyperoxia and its mitigation by deferoxamine in rats
Authors: Wang Xiao-Xia , Sha Xiao-Lan , Li Yu-Lan , Li Chun-Lan , Chen Su-Heng , Wang Jing-Jing , Xia Zhengyuan
Published: August 2020

Background

Long-term mechanical ventilation with hyperoxia can induce lung injury. General anesthesia is associated with a very high incidence of hyperoxaemia, despite it usually lasts for a relatively short period of time. It remains unclear whether short-term mechanical ventilation with hyperoxia has an adverse impact on or cause injury to the lungs. The present study aimed to assess whether short-term mechanical ventilation with hyperoxia may cause lung injury in rats and whether deferoxamine (DFO), a ferrous ion chelator, could mitigate such injury to the lungs and explore the possible mechanism.

Methods

Twenty-four SD rats were randomly divided into 3 groups (n = 8/group): mechanical ventilated with normoxia group (MV group, FiO2 = 21%), with hyperoxia group (HMV group, FiO2 = 90%), or with hyperoxia + DFO group (HMV + DFO group, FiO2 = 90%). Mechanical ventilation under different oxygen concentrations was given for 4 h, and ECG was monitored. The HMV + DFO group received continuous intravenous infusion of DFO at 50 mg•kg− 1•h− 1, while the MV and HMV groups received an equal volume of normal saline. Carotid artery cannulation was carried out to monitor the blood gas parameters under mechanical ventilation for 2 and 4 h, respectively, and the PaO2/FiO2 ratio was calculated. After 4 h ventilation, the right anterior lobe of the lung and bronchoalveolar lavage fluid from the right lung was sampled for pathological and biochemical assays.

Results

PaO2 in the HMV and HMV + DFO groups were significantly higher, but the PaO2/FiO2 ratio were significantly lower than those of the MV group (all p < 0.01), while PaO2 and PaO2/FiO2 ratio between HMV + DFO and HMV groups did not differ significantly. The lung pathological scores and the wet-to-dry weight ratio (W/D) in the HMV and HMV + DFO groups were significantly higher than those of the MV group, but the lung pathological score and the W/D ratio were reduced by DFO (p < 0.05, HMV + DFO vs. HMV). Biochemically, HMV resulted in significant reductions in Surfactant protein C (SP-C), Surfactant protein D (SP-D), and Glutathion reductase (GR) levels and elevation of xanthine oxidase (XOD) in both the Bronchoalveolar lavage fluid and the lung tissue homogenate, and all these changes were prevented or significantly reverted by DFO.

Conclusions

Mechanical ventilation with hyperoxia for 4 h induced oxidative injury of the lungs, accompanied by a dramatic reduction in the concentrations of SP-C and SP-D. DFO could mitigate such injury by lowering XOD activity and elevating GR activity.
Preoperative assessment of cognitive function and risk assessment of cognitive impairment in elderly patients with orthopedics: a cross-sectional study
Authors: Gan Shuyuan , Yu Yang , Wu Jiateng , Tang Xiaodong , Zheng Yueying , Wang Mingcang , Zhu Shengmei
Published: August 2020

Background

Preexisting cognitive impairment is emerging as a predictor of poor postoperative outcomes in seniors. Nevertheless, cognitive impairment in a large proportion of geriatric patients has not been well identified and diagnosed.

Methods

This is a cross-sectional study. Mini-mental state examination scale was used to assess the cognitive function of elderly patients aged ≥65 years undergoing orthopedic surgery preoperatively. The baseline, living habits and laboratory examination results of two groups were compared, and a multivariable logistic regression model was used to identify independent predictors of preoperative cognitive impairment.

Results

A total of 374 elderly patients with orthopedic surgery indications met the inclusion criteria, and 28.61% of them had preoperative cognitive impairment. Multivariable logistic regression analysis showed that age (OR = 1.089, P < 0.001), subjective sleep disorders (OR = 1.996, P = 0.021), atherosclerosis (OR = 2.367, P = 0.017), and high cholesterol level (OR = 1.373, P = 0.028) were independent risk factors for preoperative cognitive impairment, while high education level performed as a protective factor (compared with the illiterate group, primary school group: OR = 0.413, P = 0.009; middle school or above group: OR = 0.120, P < 0.001).

Conclusions

The prevalence of preoperative cognitive dysfunction in geriatric elective orthopedic surgical patients was high. Our study identified venerable age, low level of education, subjective sleep disorders, atherosclerosis, and high cholesterol level as risk factors for preoperative cognitive impairment in these patients. Understanding these risk factors contributes to assisting in prevention and directed interventions for the high-risk population.
Supine versus semi-Fowler’s positions for tracheal extubation in abdominal surgery-a randomized clinical trial
Authors: Zhu Qiongfang , Huang Zheyan , Ma Qiaomei , Wu Zehui , Kang Yubo , Zhang Miaoyin , Gan Tiantian , Wang Minxue , Huang Fei
Published: August 2020

Background

Tracheal extubation is commonly performed in the supine position. However, in patients undergoing abdominal surgery, the supine position increases abdominal wall tension, especially during coughing and deep breathing, which may aggravate pain and lead to abdominal wound dehiscence. The semi-Fowler’s position may reduce abdominal wall tension, but its safety and comfort in tracheal extubation have not been reported. We aimed to evaluate the safety and comfort of different extubation positions in patients undergoing abdominal surgery.

Methods

We enrolled 141 patients with an American Society of Anesthesiologists grade of I-III who underwent abdominal surgery. All patients were anesthetized with propofol, fentanyl, cisatracurium, and sevoflurane. After surgery, all patients were transferred to the post-anesthesia care unit (PACU). Patients were then randomly put into the semi-Fowler’s (n = 70) or supine (n = 71) position while 100% oxygen was administered. The endotracheal tube was removed after the patients opened their eyes and regained consciousness. Vital signs, coughing, and pain and comfort scores before and/or after extubation were recorded until the patients left the PACU.

Results

In comparison with the supine position, the semi-Fowler’s position significantly decreased the wound pain scores at all intervals after extubation (3.51 ± 2.50 vs. 4.58 ± 2.26, 2.23 ± 1.68 vs. 3.11 ± 2.00, 1.81 ± 1.32 vs. 2.59 ± 1.88, P = 0.009, 0.005 and 0.005, respectively), reduced severe coughing (8[11.43%] vs. 21[29.58%], P = 0.008) and bucking after extubation (3[4.29%] vs. 18[25.35%], P < 0.001), and improved the comfort scores 5 min after extubation (6.11 ± 2.30 vs. 5.17 ± 1.78, P = 0.007) and when leaving from post-anesthesia care unit (7.17 ± 2.27 vs. 6.44 ± 1.79, P = 0.034). The incidences of vomiting, emergence agitation, and respiratory complications were of no significant difference.

Conclusion

Tracheal extubation in the semi-Fowler’s position is associated with less coughing, sputum suction, and pain, and more comfort, without specific adverse effects when compared to the conventional supine position.

Trial registration

Chinese Clinical Trial Registry, ChiCTR1900025566. Registered on 1st September 2019.
General practitioners’ perspectives on barriers to depression care: development and validation of a questionnaire
Authors: Senchyna Arun , Abbiati Milena , Chambe Juliette , Haller Dagmar M. , Maisonneuve Hubert
Published: August 2020

Background

General practitioners (GPs) regularly feel challenged by the care of depressed patients and may encounter several barriers in providing best management. GPs’ perspectives on barriers to depression care are a subject of growing interest but there is a lack of validated assessment tools. The aim of this study was to develop and validate a questionnaire assessing barriers to depression care (BDC-Q) encountered by GPs in France and the French-speaking part of Switzerland.

Methods

The BDC-Q was constructed in five steps: Item development, content validation, pretesting, testing phase and test-retest reliability. The questionnaire items were generated through a literature search. An expert panel of GPs (n = 16) and psychiatrists (n = 3) validated the content and 20 GPs pretested the questionnaire to provide response process validity evidence. We then tested the questionnaire among 116 GPs and used principal component analysis and internal consistency testing (Cronbach’s alpha) to structure it into consistent dimensions. Test-retest reliability using Pearson correlation coefficient was assessed with 30 GPs who completed the questionnaire twice after an interval of at least 2 weeks.

Results

The 25 items BDC-Q was structured in five dimensions: (i) provision of care by the general practitioner, (ii) considering patients’ attitudes towards depression, (iii) guidance for care, (iv) collaboration with mental health specialists and (v) access to mental health care.

Conclusions

The BDC-Q displays evidence of validity and reliability to meaningfully assess GPs’ perspectives on barriers to depression care. It can be used both at a practice level within a quality improvement strategy, and at a broader level, to inform health planners and tailor appropriate strategies to improve depression care in the community.
Effects of a staff education programme about person-centred care and promotion of thriving on relatives’ satisfaction with quality of care in nursing homes: a multi-centre, non-equivalent controlled before-after trial
Authors: Lood Qarin , Sjögren Karin , Bergland Ådel , Lindkvist Marie , Kirkevold Marit , Sandman Per-Olof , Edvardsson David
Published: August 2020

Background

As part of a nursing home intervention study, the aim of this paper was 1) to evaluate the effects of a staff education programme about person-centred care and promotion of thriving on relatives’ satisfaction with quality of care and their perceptions of the person-centredness of the environment, and 2) to outline factors of importance to explain the variance in relatives’ satisfaction with quality of care. Relatives are often referred to as vital for the operationalisation of person-centredness in nursing homes, representing an important source of information for care planning and quality of care assessments. However, the evidence for effects of person-centredness in nursing homes on relatives’ experiences is sparse and little is known on what could explain their satisfaction with the quality of care.

Methods

A multi-centre, non-equivalent controlled group before-after design with study sites in Australia, Norway and Sweden. Staff in the intervention group participated in a 14-month education on person-centredness, person-centred care, thriving and caring environment. Staff in the control group received a one-hour lecture before the intervention period. Data were collected at baseline, after the intervention and six months after the end of the intervention, and analysed using descriptive statistics, a generalised linear model and hierarchical multiple regression.

Results

In general, relatives from both the intervention and control nursing homes were satisfied with the quality of care, and no statistically significant overall between-group-effects of the intervention were revealed on satisfaction with quality of care or perceptions of the person-centredness of environment. A person-centred environment in terms of safety and hospitality were identified as factors of prominent importance for the relatives’ satisfaction with the quality of care.

Conclusion

The findings of this paper provide a foundation for future research in terms of intervention design in nursing home contexts. Staff availability, approachability, competence and communication with relatives may be important factors to consider to improve quality of care from the perspective of relatives, but more research both with and for relatives to people living in nursing homes is necessary to identify the keys to success.

Trial registration

ClinicalTrials.gov-NCT02714452. Registered on March 19, 2016.
Mapping the situation of research on coronavirus disease-19 (COVID-19): a preliminary bibliometric analysis during the early stage of the outbreak
Authors: Zyoud Sa’ed H. , Al-Jabi Samah W.
Published: August 2020

Background

The novel coronavirus, named as 2019-nCoV or coronavirus disease 2019 (COVID-19), has recently appeared in China and has spread worldwide, presenting a health threat to the global community. Therefore, it is important to understand the global scientific output of COVID-19 research during the early stage of the outbreak. Thus, to track the current hotspots, and highlight future directions, we performed a bibliometric analysis to obtain an approximate scenario of COVID-19 to date.

Methods

Relevant studies to COVID-19 were obtained from the Scopus database during the early stage of the outbreak. We then analysed the data by using well-established bibliometric indices: document type, country, collaboration patterns, affiliation, journal name, and citation patterns. VOSviewer was applied to map and determine hot topics in this field.

Results

The bibliometric analysis indicated that there were 19,044 publications on Scopus published on COVID-19 during the early stage of the outbreak (December 2019 up until June 19, 2020). Of all these publications, 9140 (48.0%) were articles; 4192 (22.0%) were letters; 1797 (9.4%) were reviews; 1754 (9.2%) were editorials; 1728 (9.1%) were notes; and 433 (2.3%) were others. The USA published the largest number of publications on COVID-19 (4479; 23.4%), followed by China (3310; 17.4%), Italy, (2314; 12.2%), and the UK (1981; 10.4%). British Medical Journal was the most productive. The Huazhong University of Science and Technology, Tongji Medical, and Harvard Medical School were the institutions that published the largest number of COVID-19 research. The most prevalent topics of research in COVID-19 include “clinical features studies”, “pathological findings and therapeutic design”, “care facilities preparation and infection control”, and “maternal, perinatal and neonatal outcomes”.

Conclusions

This bibliometric study may reflect rapidly emerging topics on COVID-19 research, where substantial research activity has already begun extensively during the early stage of the outbreak. The findings reported here shed new light on the major progress in the near future for hot topics on COVID-19 research including clinical features studies, pathological findings and therapeutic design, care facilities preparation and infection control, and maternal, perinatal and neonatal outcomes.
Subcutaneous phaeohyphomycosis caused by Hongkongmyces snookiorum in a kidney transplant patient: a case report
Authors: Linqiang Deng , Yiguo Chen , Heping Xu , Dongke Chen , Longhua Hu , Xiaomei Gui , Xia Zou
Published: August 2020

Background

Morbidity and mortality in transplant patients is increased by infection caused mainly by rare opportunistic pathogens. The present study reports a case where Hongkongmyces snookiorum caused subcutaneous phaeohyphomycosis in a kidney transplant patient.

Case presentation

A 47-year old Chinese woman with chronic kidney disease 5 underwent kidney transplantation 3 years ago. Her regular medications included Tacrolimus (1 mg, two times daily), Mycophenolate Mofetil (two times 250 mg, twice daily) and Prednisone acetate tablets (5 mg daily). Eighteen months ago, her proximal right index finger was red, painful and swollen. After admission, a hard and fluctuating 1 cm × 1 cm abscess was found on the dorsal side of the right index finger. Gram and fluorescence staining of a direct smear of a syringe extraction from the abscess revealed presence of filamentous fungi. White velvet colonies (2–3 mm) were found on blood plate and Sabouraud glucose agar (SGA) after 1 week, and grey aerial hyphae were observed. After 15 days, a 26 mm gray colony was also observed on SGA. The homology between this filamentous fungus and Hongkongmyces snookiorum ILLS00125755 (Genbank Sequence ID: MH161189.1) was 99.66%. An in vitro antifungal susceptibility test showed that this filamentous fungus was sensitive to azoles such as itraconazole and voriconazole.

Conclusions

We report an opportunistic fungus infection caused by Hongkongmyces snookiorum in a transplant patient. Our finding shows that prevention of subcutaneous fungal infection is necessary for kidney transplantation patients.
The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence
Authors: Monaghesh Elham , Hajizadeh Alireza
Published: August 2020

Background

The outbreak of coronavirus disease-19 (COVID-19) is a public health emergency of international concern. Telehealth is an effective option to fight the outbreak of COVID-19. The aim of this systematic review was to identify the role of telehealth services in preventing, diagnosing, treating, and controlling diseases during COVID-19 outbreak.

Methods

This systematic review was conducted through searching five databases including PubMed, Scopus, Embase, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth services in all aspects of health care during COVID-19 outbreak, published from December 31, 2019, written in English language and published in peer reviewed journals. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies. Quality assessment was based on the Critical Appraisal Skills Program (CASP) checklist. Narrative synthesis was undertaken to summarize and report the findings.

Results

Eight studies met the inclusion out of the 142 search results. Currently, healthcare providers and patients who are self-isolating, telehealth is certainly appropriate in minimizing the risk of COVID-19 transmission. This solution has the potential to prevent any sort of direct physical contact, provide continuous care to the community, and finally reduce morbidity and mortality in COVID-19 outbreak.

Conclusions

The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe during COVID-19 outbreak.