bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening novel genes by a comprehensive strategy to construct multiple stress-tolerant industrial Saccharomyces cerevisiae with prominent bioethanol production
Authors: Wang Li , Li Bo , Su Ran-Ran , Wang Shi-Peng , Xia Zi-Yuan , Xie Cai-Yun , Tang Yue-Qin
Published: January 2022

Background

Strong multiple stress-tolerance is a desirable characteristic for Saccharomyces cerevisiae when different feedstocks are used for economical industrial ethanol production. Random mutagenesis or genome shuffling has been applied for improving multiple stress-tolerance, however, these techniques are generally time-consuming and labor cost-intensive and their molecular mechanisms are unclear. Genetic engineering, as an efficient technology, is poorly applied to construct multiple stress-tolerant industrial S. cerevisiae due to lack of clear genetic targets. Therefore, constructing multiple stress-tolerant industrial S. cerevisiae is challenging. In this study, some target genes were mined by comparative transcriptomics analysis and applied for the construction of multiple stress-tolerant industrial S. cerevisiae strains with prominent bioethanol production.

Results

Twenty-eight shared differentially expressed genes (DEGs) were identified by comparative analysis of the transcriptomes of a multiple stress-tolerant strain E-158 and its original strain KF-7 under five stress conditions (high ethanol, high temperature, high glucose, high salt, etc.). Six of the shared DEGs which may have strong relationship with multiple stresses, including functional genes (ASP3, ENA5), genes of unknown function (YOL162W, YOR012W), and transcription factors (Crz1p, Tos8p), were selected by a comprehensive strategy from multiple aspects. Through genetic editing based on the CRISPR/Case9 technology, it was demonstrated that expression regulation of each of these six DEGs improved the multiple stress-tolerance and ethanol production of strain KF-7. In particular, the overexpression of ENA5 significantly enhanced the multiple stress-tolerance of not only KF-7 but also E-158. The resulting engineered strain, E-158-ENA5, achieved higher accumulation of ethanol. The ethanol concentrations were 101.67% and 27.31% higher than those of the E-158 when YPD media and industrial feedstocks (straw, molasses, cassava) were fermented, respectively, under stress conditions.

Conclusion

Six genes that could be used as the gene targets to improve multiple stress-tolerance and ethanol production capacities of S. cerevisiae were identified for the first time. Compared to the other five DEGs, ENA5 has a more vital function in regulating the multiple stress-tolerance of S. cerevisiae. These findings provide novel insights into the efficient construction of multiple stress-tolerant industrial S. cerevisiae suitable for the fermentation of different raw materials.

Graphical Abstract
Circular RNA circZNF532 facilitates angiogenesis and inflammation in diabetic retinopathy via regulating miR-1243/CARM1 axis
Authors: Wang Ting , Li Chaopeng , Shi Min , Zhou Shi , Chen Jiajing , Wang Fang
Published: January 2022

Background

Diabetic retinopathy (DR) is a serious complication of diabetes. Numerous reports have validated that circular RNAs (circRNAs) participate in DR progression. This study aimed to elucidate the role and potential mechanism of circRNA zinc finger protein 532 (circZNF532) in DR.

Methods

The levels of circZNF532, miR-1243, and coactivator associated arginine methyltransferase 1 (CARM1) in DR patients and human retinal microvascular endothelial cells (hRMECs) were determined by quantitative real-time PCR and western blot. Colony formation assay, transwell assay, tube formation assay and enzyme-linked immunosorbent assay were used to assess the biological function of hRMECs. The binding relationship between miR-1243 and circZNF532/CARM1 was verified by dual-luciferase reporter and RNA immunoprecipitation assays.

Results

circZNF532 and CARM1 levels were increased, while miR-1243 level was reduced in DR patients and high glucose (HG)-stimulated hRMECs. In terms of mechanism, miR-1243 competitively bound to circZNF532 and CARM1. Down-regulation of circZNF532 restrained HG-induced hRMECs proliferation, migration, invasion, angiogenesis and inflammation via regulating miR-1243. In addition, miR-1243 inhibited HG-triggered hRMECs progression via targeting CARM1.

Conclusion

circZNF532 facilitated HG-induced angiogenesis and inflammation in hRMECs via modulating the miR-1243/CARM1 pathway, suggesting that circZNF532 might be a potential biomarker for DR treatment.
Investigation of STEM fields motivation among female students in science education colleges
Authors: Dökme İlbilge , Açıksöz Arif , Koyunlu Ünlü Zeynep
Published: January 2022

Background

The expectancy-value theory that constitutes the theoretical background of this study on motivation provides a strong framework for cognitive development, as it includes most of the beliefs, values, and goal variables found in various theories on motivation. Besides, this theory focuses directly on how different socializers such as parents and teachers influence the students’ development of motivation. Strong motivation of teachers towards STEM fields is important both in terms of performing STEM activities in their own classrooms and motivating their students to STEM fields.

The context and purpose of the study

Our current research examines the motivation of female students in science education college towards their STEM fields according to certain demographic properties. Three-quarters of the students enrolled in science education colleges in Turkey are women who are under-represented in STEM fields. Determining the motivation of female science education college students towards STEM fields can be considered a long-term, sustainable, and pervasive effect, as they are the potential STEM educators of the future.

Results

As a result of the study, it was determined that the motivation of female science education college (university) students towards STEM fields did not differ according to grade level, type of high school they graduated from, and family income. However, motivation towards STEM fields did differ according to variables of “having received STEM training”, “having participated in STEM activities”, “having (or not having) a role model working in a STEM field” and, “father education-level”.

Conclusions

The results obtained from this study are valuable for the design of possible intervention studies in the future. For example, designing role model interventions, incorporating STEM training into education college programs, and organizing more STEM activities within education college programs are considered to be important steps to increase the motivation of female science education college students. Increasing the motivation of prospective science teacher candidates towards STEM fields with various interventions has indirect importance for them to motivate their students to consider STEM fields in their future professional lives.
The physical activity experience of prostate cancer patients: a multicentre peer motivation monitoring feasibility study. The Acti-Pair study
Authors: Baudot A. , Barth N. , Colas C. , Garros M. , Garcin A. , Oriol M. , Roche F. , Chauvin F. , Mottet N. , Hupin D. ,   on behalf the Acti-Pair investigators
Published: January 2022

Background

Although the benefits of physical activity (PA) on health are recognised, prostate cancer patients do not follow PA recommendations. The barriers to PA, whether physical, environmental or organisational, are known. Furthermore, even when such barriers are overcome, this achievement is not systematically accompanied by a change in lifestyle habits. The proposal of a programme enabling the integration of PA in the patient’s everyday life represents a new challenge in the personalized management of cancer patients. Peer-mentoring interventions have demonstrated their effectiveness in increasing adherence to PA by patients. This study aimed (1) to assess the feasibility of a peer-mentoring intervention: the Acti-Pair program in a local context and (2) to assess the effectiveness of the intervention in this context.

Methods and analysis

A pre-post  design pilot study will be used to evaluate feasibility, potential effectiveness and implementation outcomes overs in prostate cancer patients. We performed a mixed quantitative and qualitative prospective study to assess means and process indicators and the implementation of the Acti-Pair program. This study will be performed in cancer centres of Loire district and will be comprised of three successive stages (1) diagnosis of the target population, (2) recruitment and training of peers, and (3) implementation of this intervention in the Loire department.

Discussion

This study will allow us to extend the peer-mentoring intervention to other contexts and assess the effectiveness of this intervention and its generalisability.
Fit for Surgery—feasibility of short-course multimodal individualized prehabilitation in high-risk frail colon cancer patients prior to surgery
Authors: Bojesen R. D. , Jørgensen L. B. , Grube C. , Skou S. T. , Johansen C. , Dalton S. O. , Gögenur I.
Published: January 2022

Background

Prehabilitation is a promising modality for improving patient-related outcomes after major surgery; however, very little research has been done for those who may need it the most: the elderly and the frail. This study aimed to investigate the feasibility of a short course multimodal prehabilitation prior to primary surgery in high-risk, frail patients with colorectal cancer and WHO performance status I and II.

Methods

The study was conducted as a single-center, prospective one-arm feasibility study of eight patients with colon cancer between October 4, 2018, and January 14, 2019. The intervention consisted of a physical training program tailored to the patients with both high-intensity interval training and resistance training three times a week in sessions of approximately 1 h in length, for a duration of at least 4 weeks, nutritional support with protein and vitamins, a consultation with a dietician, and medical optimization prior to surgery. Feasibility was evaluated regarding recruitment, retention, compliance and adherence, acceptability, and safety. Retention was evaluated as the number of patients that completed the intervention, with a feasibility goal of 75% completing the intervention. Compliance with the high-intensity training was evaluated as the number of sessions in which the patient achieved a minimum of 4 min > 90% of their maximum heart rate and adherence as the attended out of the offered training sessions.

Results

During the study period, 64 patients were screened for eligibility, and out of nine eligible patients, eight patients were included and seven completed the intervention (mean age 80, range 66–88). Compliance to the high-intensity interval training using 90% of maximum heart rate as the monitor of intensity was difficult to measure in several patients; however, adherence to the training sessions was 87%. Compliance with nutritional support was 57%. Half the patients felt somewhat overwhelmed by the multiple appointments and six out of seven reported difficulties with the dosage of protein.

Conclusions

This one-arm feasibility study indicates that multimodal prehabilitation including high-intensity interval training can be performed by patients with colorectal cancer and WHO performance status I and II.

Trial registration

Clinicaltrials.gov: the study current feasibility study was conducted prior to the initiation of a full ongoing randomized trial registered by NCT04167436; date of registration: November 18, 2019. Retrospectively registered. No separate prospectively registration of the feasibility trial was conducted but outlined by the approved study protocol (Danish Scientific Ethical Committee SJ-607).
Fear of COVID-19 infection and its relation to depressive and anxiety symptoms among elderly population: online survey
Authors: Khalaf Ola Osama , Abdalgeleel Shaimaa Abdalaleem , Mostafa Nehal
Published: January 2022

Background

The pandemic of COVID-19 is considered as one of the major threats that affected all age groups all over the world. Old age group has been highly affected with increased risk of severe health complications that may result in several mental health problems such as anxiety symptoms, depressive symptoms, sleep problems, or any other mental health disorder. Thus the aim of this study is to investigate the fear of COVID-19 infection and its relation to depressive and anxiety symptoms among elderly population during COVID-19 outbreak. A survey was distributed online through social media via a link to people who are 60 years old or above (N= 161).

Results

The average score of fear of COVID-19 scale was 17.7 ± 5.4. There was a highly statistically significant correlation between anxiety subscale, depression subscale, and total score of hospital anxiety and depression scale with fear of COVID-19 score.

Conclusions

Participants who were more worried about having the disease developed more symptoms of anxiety and depression during the COVID-19 pandemic. It is necessary to screen the older people for the COVID-19-related fear and accompanying psychological disorders.
Biomimetic sapphire windows enabled by inside-out femtosecond laser deep-scribing
Authors: Liu Xue-Qing , Zhang Yong-Lai , Li Qian-Kun , Zheng Jia-Xin , Lu Yi-Ming , Juodkazis Saulius , Chen Qi-Dai , Sun Hong-Bo
Published: January 2022

Femtosecond laser machining of biomimetic micro/nanostructures with high aspect ratio (larger than 10) on ultrahard materials, such as sapphire, is a challenging task, because the uncontrollable surface damage usually results in poor surface structures, especially for deep scribing. Here, we report an inside-out femtosecond laser deep scribing technology in combination with etching process for fabricating bio-inspired micro/nanostructures with high-aspect-ratio on sapphire. To effectively avoid the uncontrollable damage at the solid/air interface, a sacrificial layer of silicon oxide was employed for surface protection. High-quality microstructures with an aspect ratio as high as 80:1 have been fabricated on sapphire surface. As a proof-of-concept application, we produced a moth-eye inspired antireflective window with sub-wavelength pyramid arrays on sapphire surface, by which broadband (3–5 μm) and high transmittance (98% at 4 μm, the best results reported so far) have been achieved. The sacrificial layer assisted inside-out femtosecond laser deep scribing technology is effective and universal, holding great promise for producing micro/nanostructured optical devices.
Type IVA choledochal cyst: a rare cause of cirrhosis in adults
Authors: Razafindrazoto Chantelli Iamblaudiot , Rakotozafindrabe Andry Lalaina Rinà , Randrianambininjanahary Sakaiza Malala , Randriamifidy Nitah Harivony , Hasina Laingonirina Domoina Harivonjy , Maherison Sonny , Rajaonarison Lova Hasina Ny Ony Narindra , Rabenjanahary Tovo Harimanana , Razafimahefa Soloniaina Hélio , Ramanampamonjy Rado Manitrala
Published: January 2022

Background

Choledochal cysts (CDCs) are characterized by congenital cystic dilations of the intrahepatic or extrahepatic bile ducts or both. CDCs are very rarely reported in sub-Saharan Africa. This congenital anomaly of the bile ducts is rarely discovered at the stage of advanced chronic liver disease with portal hypertension. We report the first Malagasy case of a type IVA choledochal cyst discovered during an etiological work-up of cirrhosis.

Case presentation

A 23-year-old woman was hospitalized for jaundice and ascites. Biological and radiological investigations have led to the diagnosis of secondary biliary cirrhosis due to type IVA choledochal cyst. In view of the severity of the liver damage (Child-Pugh C score), a collegial decision (hepato-gastroenterologists and visceral surgeons) had rejected surgical intervention and opted only for the management of cirrhotic decompensation.

Conclusion

A type IVA choledochal cyst is a possible etiology of advanced chronic liver disease.
Plant carotenoids: recent advances and future perspectives
Authors: Sun Tianhu , Rao Sombir , Zhou Xuesong , Li Li
Published: January 2022

Carotenoids are isoprenoid metabolites synthesized de novo in all photosynthetic organisms. Carotenoids are essential for plants with diverse functions in photosynthesis, photoprotection, pigmentation, phytohormone synthesis, and signaling. They are also critically important for humans as precursors of vitamin A synthesis and as dietary antioxidants. The vital roles of carotenoids to plants and humans have prompted significant progress toward our understanding of carotenoid metabolism and regulation. New regulators and novel roles of carotenoid metabolites are continuously revealed. This review focuses on current status of carotenoid metabolism and highlights recent advances in comprehension of the intrinsic and multi-dimensional regulation of carotenoid accumulation. We also discuss the functional evolution of carotenoids, the agricultural and horticultural application, and some key areas for future research.
Outcome of Patients With an Ultralow-Risk 70-Gene Signature in the MINDACT Trial
Authors: Lopes Cardozo Josephine M.N. , Drukker Caroline A. , Rutgers Emiel J.T. , Schmidt Marjanka K. , Glas Annuska M. , Witteveen Anke , Cardoso Fatima , Piccart Martine , Esserman Laura J. , Poncet Coralie , van 't Veer Laura J.
Published: January 2022

PURPOSE

Patients with 70-gene signature ultralow-risk breast cancers have shown excellent survival in historic cohorts, including randomized trials. The ultralow-risk subgroup was characterized to help avoid overtreatment. We evaluated outcomes of ultralow-risk patients in the largest cohort to date.

METHODS

Of the 6,693 patients enrolled in the EORTC-10041/BIG-3-04 randomized phase III MINDACT trial, profiling revealed an ultralow-risk 70-gene signature in 1,000 patients (15%). Distant metastasis-free interval (DMFI) and breast cancer–specific survival (BCSS) were assessed in patients stratified by 70-gene signature result (high, low, and ultralow) by Kaplan-Meier analysis and hazard ratios with 95% CI from Cox regression.

RESULTS

Median follow-up was 8.7 years. Of the ultralow-risk patients (n = 1,000), 67% were > 50 years, 81% had tumors ≤ 2 cm, 80% were lymph node–negative, 96% had grade 1 or 2 tumors, and 99% were estrogen receptor (ER)-positive. Systemic therapy was received by 84% of patients (69% endocrine therapy, 14% endocrine therapy plus chemotherapy, 1% other) and 16% received no adjuvant systemic treatment. The 8-year DMFI for ultralow-risk patients was 97.0% (95% CI, 95.8 to 98.1), which was 2.5% higher than for patients with low-risk tumors (n = 3,295, 94.5% [95% CI, 93.6 to 95.3]). The hazard ratio for DMFI was 0.65 (95% CI, 0.45 to 0.94) for ultralow versus low risk, after adjusting for clinical-pathologic and treatment characteristics. The 8-year BCSS for ultralow-risk patients was 99.6% (95% CI, 99.1 to 100).

CONCLUSION

Patients with an ultralow-risk 70-gene signature have the best prognosis, distinctive from low risk, with 8-year BCSS above 99%, and very few patients developed distant metastases with an 8-year DMFI rate of 97%. These patients could be candidates for further de-escalation of treatment, to avoid overtreatment and the risk of side effects.
Validation of Continuous Noninvasive Blood Pressure Monitoring Using Error Grid Analysis
Authors: Juri Takashi , Suehiro Koichi , Kanematsu Rieko , Takahashi Kanae , Fujimoto Yohei , Tanaka Katsuaki , Mori Takashi
Published: January 2022

BACKGROUND:

Error grid analysis was recently proposed to compare blood pressure obtained by 2 measurement methods. This study aimed to compare continuous noninvasive blood pressure (CNBP) with invasive blood pressure (IBP) using the error grid analysis and investigate the confounding risk factors attributable to the differences between CNBP and IBP.

METHODS:

Sixty adult patients undergoing general anesthesia were prospectively enrolled. Simultaneous comparative data regarding CNBP and IBP were collected. The Bland-Altman analysis was conducted to compare CNBP and IBP for systolic blood pressure (SBP) and mean blood pressure (MBP; acceptable accuracy: mean bias <5 mm Hg; standard deviation <8 mm Hg). The clinical relevance of the discrepancies between CNBP and IBP was evaluated by the error grid analysis, which classifies the differences into 5 zones from “no risk” (A) to “dangerous risk” (E). Additionally, an ordinal logistic regression analysis was performed to evaluate the relationship between the risk zones for MBP, classified by the error grid analysis and covariates of interest.

RESULTS:

A total of 10,663 pairs of CNBP/IBP were finally analyzed. The Bland-Altman analysis showed an acceptable accuracy with a bias of −3.3 ± 5.6 mm Hg for MBP but a poor accuracy with a bias of 5.4 ± 10.5 mm Hg for SBP. The error grid analysis showed the proportions of zones A to E as 96.7%, 3.2%, 0.1%, 0%, and 0% for SBP, respectively, and 72.0%, 27.9%, 0.1%, 0%, and 0% for MBP, respectively. The finger cuff missed 23.9% of epochs when SBP <90 mm Hg and 55.3% of epochs when MBP <65 mm Hg. The ordinal logistic regression analysis revealed that older age (adjusted odds ratio for decade: 1.54, 95% confidence interval [CI], 1.15–2.08; P = .004) and length of time from the initiation of finger cuff inflation (adjusted odds ratio for 60 minutes: 1.40, 95% CI, 1.13–1.73; P = .002) were significant factors of being in a more dangerous zone of the error grid.

CONCLUSIONS:

The error grid analysis revealed the larger clinical discrepancy between CNBP and IBP in MBP compared with that in SBP. Old age and longer finger cuff inflation time were significant factors of being in a more dangerous zone of the error grid, which could affect the hemodynamic management during surgery.
A Comparison Between the Adductor Pollicis Muscle Using TOF-Watch SX and the Abductor Digiti Minimi Muscle Using TetraGraph in Rocuronium-Induced Neuromuscular Block: A Prospective Observational Study
Authors: Iwasaki Hajime , Yamamoto Mai , Sato Hanae , Doshu-Kajiura Akira , Kitajima Osamu , Takagi Shunichi , Luthe Sarah Kyuragi , Suzuki Takahiro
Published: January 2022

BACKGROUND:

The commonly used acceleromyography (AMG)-based neuromuscular monitor TOF-Watch SX is no longer manufactured. Recently, a new portable electromyography (EMG)-based neuromuscular monitor TetraGraph was introduced in clinical anesthesia. The aim of the study was to compare the responses obtained simultaneously from the abductor digiti minimi (ADM) muscle with TetraGraph and the adductor pollicis (AP) muscle with TOF-Watch SX during rocuronium-induced neuromuscular block.

METHODS:

Patients undergoing orthopedic surgery with general anesthesia were enrolled in this prospective, observational study. During total intravenous general anesthesia, train-of-four (TOF) responses following 0.9-mg·kg−1 rocuronium administration were monitored at the AP muscle with TOF-Watch SX and the ADM muscle with TetraGraph on the opposite arms. Sugammadex 2 mg·kg−1 was administered when both devices showed TOF counts (TOFCs) = 2. The primary outcome was time from rocuronium administration to first appearance of posttetanic count (PTC) response (first PTC). The secondary outcomes were baseline TOF ratios (TOFRs), onset time, time to first reappearance of TOFC = 1 (time to TOFC1), time to first reappearance of TOFC = 2 (time to TOFC2), and time from sugammadex administration to TOFR ≥0.9 with TetraGraph or to normalized TOFR ≥0.9 with TOF-Watch SX (recovery time). We used paired t test and Wilcoxon signed-rank test to analyze parametric and nonparametric data, respectively. P <.05 defined statistical significance.

RESULTS:

A total of 20 patients were analyzed. The baseline TOFRs were significantly higher with TOF-Watch SX than with TetraGraph (105 [96–110] vs 100 [98–101]; P = .0002). The time to first PTC (minutes) (31.7 ± 9.6 vs 41.1 ± 12.3; P < .001), time to TOFC1 (minutes) (48.0 ± 12.7 vs 58.8 ± 19.2; P < .001), time to TOFC2 (minutes) (56.2 ± 15.7 vs 74.2 ± 23.7; P < .001), and recovery time (seconds) (61.5 [32–148] vs 75.5 [94–102]); P = .043) were significantly faster with TOF-Watch SX than with TetraGraph. There were no significant differences in onset time.

CONCLUSIONS:

TOF-Watch SX overestimated recovery from rocuronium-induced neuromuscular block compared with TetraGraph.
Ultrasound-Guided Clavipectoral Fascial Plane Block With Intermediate Cervical Plexus Block for Midshaft Clavicular Surgery: A Prospective Randomized Controlled Trial
Authors: Zhuo Qian , Zheng Yanya , Hu Zixuan , Xiong Juncheng , Wu Yanqin , Zheng Yi , Wang Liangrong
Published: January 2022

BACKGROUND:

Regional anesthesia such as interscalene brachial plexus block (ISBPB) with intermediate cervical plexus block (ICPB) is generally a preferred choice for clavicular surgery. However, various studies have shown that these blocks, especially ISBPB, could cause phrenic nerve paralysis and decrease diaphragmatic motion. The study aimed to evaluate the efficacy of clavipectoral fascial plane block (CPB), an alternative technique to ISBPB, with ICPB, in reducing hemidiaphragmatic paralysis during midshaft clavicular surgery.

METHODS:

Forty patients scheduled for right midshaft clavicular surgery were randomized (1:1) into an ultrasound-guided ISBPB with ICPB (BC) group or ultrasound-guided CPB with ICPB (CC) group. Five milliliter of 0.375% ropivacaine was used for ICPB, another 20 mL for ISBPB or CPB, and no administration of additional sedative or general anesthetic was planned. Primary outcome was measured by the incidence of hemidiaphragmatic paralysis using M-mode ultrasonography, while secondary outcomes were measured by bedside pulmonary function test, the success rate of block, the time required for the block procedure and onset of block, and motor block score in right upper extremity.

RESULTS:

In comparison with BC group, the incidence of hemidiaphragmatic paralysis postblock was decreased in CC group (50% vs 0%; P < .001), and measurement of bedside pulmonary function was significantly improved. There was a 100% success rate for anesthetic block in both BC and CC groups, and CC group showed lower motor block score in upper extremity and less block procedure time than BC group (7.1 ± 1.2 vs 3.2 ± 0.6 minutes; P < .001). Moreover, no significant differences were found between time of onset of block and other anesthetic complications in the 2 groups.

CONCLUSIONS:

Ultrasound-guided CPB with ICPB could significantly reduce hemidiaphragmatic paralysis and provide an adequate surgical anesthesia with fewer complications such as motor block in upper extremity during right midshaft clavicular surgery.
Is Obesity Associated With Better Liver Transplant Outcomes? A Retrospective Study of Hospital Length of Stay and Mortality Following Liver Transplantation
Authors: Du Austin L. , Danforth Dennis J. , Waterman Ruth S. , Gabriel Rodney A.
Published: January 2022

BACKGROUND:

The rise in obesity in the United States, along with improvements in antiviral therapies, has led to an increase in the number of obese patients receiving liver transplants. Currently, obesity is a relative contraindication for liver transplant, although exact body mass index (BMI) limits continue to be debated. Studies conflict regarding outcomes in obese patients, while some argue that BMI should not be used as an exclusion criterion at all. Therefore, this retrospective study—utilizing a large national database—seeks to elucidate the association between recipient BMI and hospital length of stay and mortality following liver transplant.

METHODS:

A retrospective study was conducted using the United Network for Organ Sharing Standard Transplant Analysis and Research database. Fine-Gray competing risk regressions were used to explore the association between BMI and rate of discharge, which varies inversely with length of stay. In our model, subdistribution hazard ratio (SHR) represented the relative change in discharge rate compared to normal BMI, with in-hospital death was considered as a competing event for live discharge. Cox proportional hazard models were built to assess the association of BMI category on all-cause mortality after liver transplantation. Cluster-robust standard errors were used in all analyses to construct confidence intervals.

RESULTS:

Within the final sample (n = 47,038), overweight (≥25 and <30 kg/m2) patients comprised the largest BMI group (34.7%). The competing risk regression model showed an association for increased length of stay among underweight (SHR = 0.82, 95% confidence interval [CI], 0.77–0.89; P < .001) and class 3 obesity patients (SHR = 0.88, 95% CI, 0.83–0.94; P < .001), while overweight (SHR = 1.05, 95% CI, 1.03–1.08; P < .001) and class 1 obesity (SHR = 1.04, 95% CI, 1.01–1.07; P = .01) were associated with decreased length of stay. When the sample excluded patients with low pretransplant functional status, however, length of stay was not significantly shorter for overweight and obesity class 1 patients. Cox proportional hazard models demonstrated increased survival among overweight, class 1 and class 2 obesity patients and decreased survival among underweight patients.

CONCLUSIONS:

Our results provide evidence that overweight and obesity class 1 are associated with decreased length of stay and mortality following liver transplant, while underweight and obesity class 3 are associated with prolonged length of stay. Pretransplant functional status may contribute to outcomes for overweight and class 1 obese patients, which necessitates continued investigation of the isolated impact of BMI in those who have had a liver transplant.
Effect of flurbiprofen axetil combined with “Cocktail” therapy on opioid dosage in patients after total knee arthroplasty
Authors: Wang Lu , Wu Li-xin , Han Zhe , Ma Wen-hai , Geng Zhi-hui
Published: January 2022

Objectives: To investigate the effect of flurbiprofen axetil combined with “cocktail” therapy on opioid dosage in patients after total knee arthroplasty (TKA).

Methods: The clinical data of 200 patients who underwent TKA in Baoding No.1 Central Hospital hospital from March 2019 to March 2021 were collected for retrospective analysis. All 200 patients were divided into two groups according to their intraoperative anesthesia methods: the control group (100 cases) and the experimental group (100 cases). Patients in the control group were treated with “cocktail” therapy intraoperatively, while those in the experimental group were treated with flurbiprofen axetil combined with “cocktail” therapy intraoperatively. The hip pain scores in resting state and motion state were compared between the two groups at different postoperative time points, and postoperative pain relief, adverse reactions, and patient satisfaction with analgesia were statistically analyzed to evaluate the postoperative quality of life of the patients.

Results: A statistically significant difference was observed in the intergroup and temporal effects of pain scores in resting state and motion state between the two groups (p<0.05). By comparison at each time point, the pain scores in the experimental group were significantly lower than those in the control group at the time point T1-T6 in resting and motion states, with a statistically significant difference (p<0.05). The frequency and dosage of remedial medication per capita in the experimental group were significantly lower than those in the control group, with a statistical significance (p<0.05). There was no significant difference in the scores of life quality items between the two groups preoperatively (p>0.05), while the scores of each item in the experimental group were significantly higher than those in the control group postoperatively (p<0.05). The satisfaction degree of the experimental group was significantly higher than that of the control group, showing a statistically significant difference (p<0.05).

Conclusions: Flurbiprofen axetil combined with “cocktail” therapy is a safe treatment regimen that can improve the quality of life and safety of patients. With such a regimen, postoperative pain of patients undergoing TKA can be effectively relieved, and the use of opioids can be reduced.

doi: https://doi.org/10.12669/pjms.38.3.4735

How to cite this:Wang L, Wu L, Han Z, Ma W, Geng Z. Effect of flurbiprofen axetil combined with “Cocktail” therapy on opioid dosage in patients after total knee arthroplasty. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4735

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Υπερηχογραφική εκτίμηση της μέγιστης ταχύτητας χάλασης του διαφράγματος σε ασθενείς της ΜΕΘ υπό μηχανικό αερισμό
Authors: Κώτσο Εντέλα
Published: January 2022

Σκοπός: Η μελέτη είχε ως σκοπό να αξιολογήσει, σε μηχανικά αεριζόμενους ασθενείς στη ΜΕΘ και σε φάση αποδέσμευσης τους από τον μηχανικό αερισμό, εάν οι πληροφορίες που παρέχονται από τη διαφραγματική πίεση (Pdi) και την οισοφάγεια πίεση (Pes) θα μπορούσαν να ληφθούν μη επεμβατικά από την αντίστοιχη λήψη της κυματομορφής της διαφραγματικής μετατόπισης σε M-mode. Παρεμβάσεις: Σε 14 διαδοχικούς διασωληνωμένους ασθενείς που υποβλήθηκαν σε δοκιμασία αποδέσμευσης από τον μηχανικό αερισμό με δοκιμασία αυτόματης αναπνοής, μελετήθηκαν οι ταυτόχρονες καταγραφές των πιέσεων Pes και Pdi και της μετατόπισης του διαφράγματος και κατά τη διάρκεια ενός sniff like ελιγμού. Επιπλέον, η κλίση της καμπύλης διαφραγματικής μετατόπισης κατά τη διάρκεια της χάλασης συγκρίθηκε με τη μέγιστη ταχύτητα χάλασης (MRR) που λαμβάνεται από την κυματομορφή της Pdi. Αποτελέσματα: Περισσότερες από 200 αναπνοές αναλύθηκαν σε ζεύγη. Η διαφραγματική μετατόπιση συσχετίστηκε στατιστικα σημαντικά με τη Pdi (R2 = 0.33, p < 0.001) και την Pes (R2 = 0.44, p < 0.001), και αυτός ο συσχετισμός βελτιώθηκε περαιτέρω κατά τη διάρκεια του sniff like ελιγμού (R2 = 0.47, p < 0.001) και (R2 = 0.64, p < 0,001), αντίστοιχα. Επιπλέον, βρέθηκε μια σημαντική συσχέτιση μεταξύ της κλίσης της χάλασης από την κυματομορφή της διαφραγματικής μετατόπισης και της MRR από την κυματομορφή της Pdi, τόσο σε ήρεμη αναπνοή (R2 = 0,379, p < 0,001) όσο και κατά τη διάρκεια του sniff like ελιγμού (R2 = 0,71, p < 0,001).Συμπέρασμα: Οι παράμετροι που λαμβάνονται από την κυματομοφρή της μετατόπισης του διαφράγματος σε M-mode συσχετίζονται καλά με εκείνες που λαμβάνονται από την Pes και το Pdi, ιδιαίτερα κατά τη διάρκεια των sniff like ελιγμών . Η αξιολόγηση της διαφραγματικής μετατόπισης φαίνεται να προσφέρει μια εναλλακτική μη επεμβατική λύση για την κατανόηση και την κλινική παρακολούθηση των συσταλτικών ιδιοτήτων του διαφράγματος και την αποτυχία της αποδέσμευσης από τον μηχανικό αερισμό λόγω διαφραγματικής κόπωσης.
Complex psychiatric comorbidities in Thai trans women: A case series
Authors: Wainipitapong Sorawit , Burakitpachai Soravit , Bumphenkiatikul Thanapob
Published: January 2022

Trans women (TW) have a high prevalence of poor mental health. Gender-affirming treatments could reduce distress regarding their gender incongruity. However, psychiatric comorbidities might complicate the management or even confirmation of being transgender. We reported three TW with complex mental illnesses, including anxiety disorder with cultural explanation, neurodevelopmental disorders with cross-dressing, and severe personality disorder accompanied by major depression. All cases received both psychiatric and gender-affirming treatments, which demonstrated promising outcomes. Along with gender dysphoria (GD), psychiatric comorbidities also altered these TW’s identity and manifestations. Recognition of such conditions would be beneficial in providing care for all TW, both with and without GD.
Quality care metrics for nurses working in general practice, mapping the evidence: a scoping review protocol
Authors: Loftus Moran Orla , Casey Mary , O'Connor Laserina , Cullen Walter
Published: January 2022

Background: Irish general practice nursing roles have developed and grown exponentially in response to changing policy, clinical and workforce demands over the past three decades. However, as nursing care in general practice advances at pace, comprehensive evaluation of the general practice nurse (GPN) role has not been undertaken. Therefore, processes which enable robust data collection to carefully assess the role and facilitate development of services are required. Nursing quality care metrics (QCM) are an established mechanism which measure nursing care process, evaluate quality, and impact of care, and inform service development. The use of nursing QCM has been adopted within seven distinct healthcare settings in Ireland but not general practice. This scoping review is the first stage of a project which aims to inform development of QCM within Irish GPN settings.

Aim: To explore and map the literature regarding the use, application, and impact of nursing quality care metrics within a general practice, primary care setting.

Methods: The following five-stage methodological framework for scoping reviews proposed by Arksey and O’Malley will be used: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting/mapping the data and (5) collating, summarizing, and reporting results. The review will be conducted and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR).

Conclusions: The focus of this scoping review relates to QCM which specifically measure the work of general practice nurses. It is envisioned that synthesis of international literature will give a broad perspective about QCM, their use in general practice or primary care settings, and enrich understanding of their development. It is anticipated that findings will provide key information to policy makers and health professionals interested in planning, strengthening, and delivering  primary care in Ireland.
First steps towards the detection of contact layers in Bangime: a multi-disciplinary, computer-assisted approach
Authors: Hantgan Abbie , Babiker Hiba , List Johann-Mattis
Published: January 2022

Bangime is a language isolate, which has not been proven to be genealogically related to any other language family, spoken in Central-Eastern Mali. Its speakers, the Bangande, claim affiliation with the Dogon languages and speakers that surround them throughout a cliff range known as the Bandiagara Escarpment.  However, recent genetic research has shown that the Bangande are genetically distant from the Dogon and other groups. Furthermore, the Bangande people represent a genetic isolate.  Despite the geographic isolation of the Bangande people, evidence of language contact is apparent in the Bangime language. We find a plethora of shared vocabulary with neighboring Atlantic, Dogon, Mande, and Songhai language groups. To address the problem of when and whence this vocabulary emerged in the language, we use a computer-assisted, multidisciplinary approach to investigate layers of contact and inheritance in Bangime. We start from an automated comparison of lexical data from languages belonging to different language families in order to obtain a first account on potential borrowing candidates in our sample. In a second step, we use specific interfaces to refine and correct the computational findings. The revised sample is then investigated quantitatively and qualitatively by focusing on vocabularies shared exclusively between specific languages. We couch our results within archeological and historical research from Central-Eastern Mali more generally and propose a scenario in which the Bangande formed part of the expansive Mali Empire that encompassed most of West Africa from the 13th to the 16th centuries. We consider our methods to represent a novel approach to the investigation of a language and population isolate from multiple perspectives using innovative computer-assisted technologies.
Improving national strategic foresight with the use of forecasting tournaments and its implications for the study of international relations
Authors: Kleňha Jan
Published: January 2022

Improving national strategic foresight can help the formation of more robust and informed policies, including foreign policy. Predicated upon the theory behind peer-prediction elicitation methods such as Reciprocal Scoring, we combined two foresight methods - Forecasting tournaments and a Delphi method - into a design in which a forecasting tournament predicted the results of a Delphi. Experts in a Delphi could take into account the arguments of participants from a prior forecasting tournament and thus make better-informed decisions. This methodological article aims to validate the feasibility of this design. It describes how we implemented it for identifying and prioritizing global megatrends as part of a strategic foresight project for the Czech government. We found this design practically applicable, while the forecasting tournament also seems to improve the ability of participants to predict a group consensus. Similar combinations of foresight methods could be used to enhance the study of international relations.
La Republicanismo e Independência do Brasil na “Conspiração Socialista na Bahia em 1798” de Francisco Adolpho de Varnhagen.
Authors: Valim Patrícia
Published: January 2022

As lutas pela independência política do Brasil nas várias províncias e o intenso debate político da época explicitaram que um projeto de nação republicana era uma forte e constante possibilidade histórica, de maneira que os republicanismos mobilizados em vários movimentos sociais desde o final do século XVIII foram constantemente criminalizados em várias esferas pela política d. Pedro I e d. Pedro II. O objetivo deste artigo é demonstrar a maneira pela qual essa criminalização ocorreu no processo de escrita da história de Francisco Adolpho de Varnhagen sobre a Conjuração Baiana de 1798, explicitando que apenas homens dos mais baixos setores daquela sociedade eram adeptos ao projeto de uma nação republicana, razão pela qual o autor enalteceu em sua obra como a coroa portuguesa afastou esses setores do universo da político com a punição exemplar dos réus da Conjuração Baiana, enforcados e esquartejados em praça pública em 1799.
Utopia jest sprzedawana oddzielnie: Polityczność sience fiction w recepcji fanowskiej (na przykładzie Star Treka)
Authors: Urbańczyk Agnieszka
Published: January 2022

UTOPIA IS SOLD SEPARATELY. THE POLITICS OF THE SCIENCE FICTION GENRE IN FAN RECEPTION (AS ILLUSTRATED BY STAR TREK) The subject of Agnieszka Urbańczyk’s monograph is fan reception of political content in works of science fiction and the way of shaping subsequent texts in official circulation by the reception. Since the discussed genre presents – just like utopias do – the possibility of a change and exposes elements which are conditioned and arbitrary in our social reality, theoreticians have often described it as political by definition. The formalist tradition of science fiction studies treats the genre as counter-hegemonic and sometimes leftist by nature. The monograph focuses on the popular, politically engaged and utopian Star Trek series, which has been a carrier of socially progressive content since the 1960s and – at least since 1980s – anticapitalist messages. In the centre of the author’s argument, there are political metaphors. Each of them requires interpretation, but they have been established via elements named and described on the literal level of the text and thus they may be completely missed by the audience. In her analysis of the text itself, conducted from the perspective of transmedia narratology, biopolitics and political theology, the author stresses points where the literal level opens to interpretation incompatible with the intent of series creators, facilitating the recuperation of potentially subversive messages. The multi-billion dollar franchise, albeit critical towards capitalism, functions thanks to capitalism and, by engaging fans, facilitates its growth.
The Social Divide of Social Distancing: Shelter-in-Place Behavior in Santiago During the Covid-19 Pandemic
Authors: Carranza Aldo , Goic Marcel , Lara Eduardo , Olivares Marcelo , Weintraub Gabriel Y. , Covarrubia Julio , Escobedo Cristian , Jara Natalia , Basso Leonardo J.
Published: January 2022

Voluntary shelter-in-place directives and lockdowns are the main nonpharmaceutical interventions that governments around the globe have used to contain the Covid-19 pandemic. In this paper, we study the impact of such interventions in the capital of a developing country, Santiago, Chile, that exhibits large socioeconomic inequality. A distinctive feature of our study is that we use granular geolocated mobile phone data to construct mobility measures that capture (1) shelter-in-place behavior and (2) trips within the city to destinations with potentially different risk profiles. Using panel data linear regression models, we first show that the impact of social distancing measures and lockdowns on mobility is highly heterogeneous and dependent on socioeconomic levels. More specifically, our estimates indicate that, although zones of high socioeconomic levels can exhibit reductions in mobility of around 50%–90% depending on the specific mobility metric used, these reductions are only 20%–50% for lower income communities. The large reductions in higher income communities are significantly driven by voluntary shelter-in-place behavior. Second, also using panel data methods, we show that our mobility measures are important predictors of infections: roughly, a 10% increase in mobility correlates with a 5% increase in the rate of infection. Our results suggest that mobility is an important factor explaining differences in infection rates between high- and low-incomes areas within the city. Further, they confirm the challenges of reducing mobility in lower income communities, where people generate their income from their daily work. To be effective, shelter-in-place restrictions in municipalities of low socioeconomic levels may need to be complemented by other supporting measures that enable their inhabitants to increase compliance.

This paper was accepted by David Simchi Levi, healthcare management.
Shapley Meets Uniform: An Axiomatic Framework for Attribution in Online Advertising
Authors: Singal Raghav , Besbes Omar , Desir Antoine , Goyal Vineet , Iyengar Garud
Published: January 2022

One of the central challenges in online advertising is attribution, namely, assessing the contribution of individual advertiser actions such as emails, display ads, and search ads to eventual conversion. Several heuristics are used for attribution in practice; however, most do not have any formal justification. The main contribution in this work is to propose an axiomatic framework for attribution in online advertising. We show that the most common heuristics can be cast under the framework and illustrate how these may fail. We propose a novel attribution metric, which we refer to as counterfactual adjusted Shapley value (CASV), which inherits the desirable properties of the traditional Shapley value while overcoming its shortcomings in the online advertising context. We also propose a Markovian model for the user journey through the conversion funnel, in which ad actions may have disparate impacts at different stages. We use the Markovian model to compare our metric with commonly used metrics. Furthermore, under the Markovian model, we establish that the CASV metric coincides with an adjusted “unique-uniform” attribution scheme. This scheme is efficiently implementable and can be interpreted as a correction to the commonly used uniform attribution scheme. We supplement our theoretical developments with numerical experiments using a real-world large-scale data set.

This paper was accepted by David Simchi-Levi, revenue management and market analytics.