bluuebunny/crossref_metadata_2025 huggingface dataset:
The Vojvodina Gallery: Biographical Portraits of Four Jewish Cultural Workers
Authors: Ungar Olga
Published: January 2023

The article introduces four cultural workers of Jewish origin from Vojvodina, who were portrayed in the publication Vojvodina Gallery (1927). This unique biographical portrait gallery of influential people living at that time in the Vojvodina region, served as a starting point for this study. Vojvodina’s Jews were well represented in this publication; out of the three hundred and six individuals about sixty (or twenty percent of all entries) were of Jewish origin. Without the existence of the Vojvodina Gallery some of them would almost have been completely forgotten. Rediscovery of this publication is a reminder of the “lost generation” of Jews whose lives and careers were cut short by the Holocaust. The four personalities presented in this essay shed light on different aspects of Jewish cultural activities in Vojvodina: fine arts, literature, charitable work, and Jewish scholarship.
A new deep-sea eelpout of the genus Pyrolycus (Teleostei: Zoarcidae) associated with a hydrothermal seep on the Pacific margin of Costa Rica
Authors: FRABLE BENJAMIN W. , SEID CHARLOTTE A. , BRONSON ALLISON W. , MØLLER PETER RASK
Published: January 2023

A new species of the zoarcid genus Pyrolycus Machida & Hashimoto, 2002, Pyrolycus jaco sp. nov., is described from a hydrothermal seep environment named Jacó Scar in the eastern Pacific of Costa Rica. Four specimens were collected in 2018 between 1746–1795 m among tubeworm colonies around the seep. The new species is differentiated from its two western Pacific congeners by having a shorter head, snout, jaw, and pectoral fins. It is further diagnosed by having three postorbital pores and two occipital pores. Molecular sequences of the cytochrome c oxidase I gene are provided and are the first for the genus. The character states indicating miniaturization in this species are discussed. This is the first vertebrate species known from this composite reducing ecosystem and is the fourth hydrothermally-associated zoarcid from the eastern Pacific.
Quantum Computers for Weather and Climate Prediction: The Good, the Bad, and the Noisy
Authors: Tennie F. , Palmer T. N.
Published: January 2023

Over the past few years, quantum computers and quantum algorithms have attracted considerable interest and attention from numerous scientific disciplines. In this article, we aim to provide a nontechnical yet informative introduction to key aspects of quantum computing. We discuss whether quantum computers one day might become useful tools for numerical weather and climate prediction. Using a recently developed quantum algorithm for solving nonlinear differential equations, we integrate a simple nonlinear model. In addition to considering the advantages that quantum computers have to offer, we shall also discuss the challenges one faces when trying to use quantum computers for real-world problems involving “big data,” such as weather prediction.
Efficacy and safety of cyclosporine-based regimens for primary immune thrombocytopenia: a systematic review and meta-analysis
Authors: Li Xiaojing , Zhu Wenwei , Bao Jizhang , Li Jiekai , Zhou Yongming
Published: January 2023

Objective

To conduct a meta-analysis assessing the efficacy and safety of cyclosporine-based combinations for primary immune thrombocytopenia (ITP).

Methods

Randomized controlled clinical trials were collected by systematically searching databases (PubMed®, MEDLINE®, EMBASE, The Cochrane Library, China National Knowledge Infrastructure) from inception to June 2022. All studies included patients with ITP who received cyclosporine-based regimens. We performed comprehensive analyses of the overall response rate (ORR), complete response (CR) rate, partial response (PR) rate, relapse rate, platelet count, and adverse drug reaction (ADR) rate.

Results

Seven studies (n = 418) were ultimately included. According to a fixed-effects model, cyclosporine-based combinations improved the ORR and CR rate and reduced the relapse rate. The ADR rate was not increased in the cyclosporine-based combination group. Cyclosporine-based regimens effectively increased the platelet count. Subgroup analysis illustrated that cyclosporine-based combinations were linked to higher ORRs in both children (odds ratio [OR] = 5.74, 95% confidence interval [CI] = 1.79–18.41) and adults (OR = 5.46, 95% CI = 2.48–12.02) and a higher CR rate in adults (OR = 2.97, 95% CI = 1.56–5.63).

Conclusion

Cyclosporine exhibited efficacy in the treatment of ITP without increasing the risk of ADRs.
Spray-coating of graphene nanoplatelets on sisal fibers and its influence on electromechanical behavior of biocomposite laminates
Authors: Rodríguez-González Julio A , Renteria-Rodríguez Victoria , Rubio-González Carlos , Franco-Urquiza Edgar A
Published: January 2023

Spray coating and vacuum-assisted resin infusion processes were implemented in this work to develop multifunctional biocomposite laminates. The biocomposites were fabricated using a bio-based epoxy resin reinforced with natural sisal fibers coated with graphene nanoplatelets (GNPs). A systematic characterization of material properties was performed to evaluate the mechanical, thermomechanical, electrical, and piezoresistive behavior of biocomposites with different GNPs contents (0, 1, 4, 6, and 8 wt.%). The mechanical tests revealed that adding GNPs to biocomposites has a slight positive effect on their flexural properties compared to the neat biocomposites (without GNPs). The electrical and thermomechanical tests showed that the electrical conductivity and glass transition temperature of biocomposites containing GNPs were enhanced significantly, achieving average values of 5.19 x 10-4 S/m and 63.29°C (26%), respectively. Regarding electromechanical tests, the biocomposites with 8 wt.% GNPs exhibited an excellent piezoresistive behavior under monotonic loading conditions, achieving a gage factor (strain sensitivity) of 3.56. Bending tests with cyclic loading were also performed, and cyclic reproducibility of the piezoresistive response of the biocomposites after 10 cycles was demonstrated, evidencing that the incorporation of GNPs onto sisal fibers by spray-coating produces an effective formation of conductive networks into biocomposites suitable for sensing applications.
‘Keeping an Eye on the Other Side’: RT, Sputnik, and Their Peculiar Appeal in Democratic Societies
Authors: Wagnsson Charlotte , Blad Torsten , Hoyle Aiden
Published: January 2023

The reach of illiberal international propaganda outlets rests on citizens in democratic countries as recipients and potential disseminators. However, little research has scrutinised the audiences for such platforms. Why do audiences in democratic states consume content from such outlets, and how far do they actually align with it ideologically? The present research seeks to address this gap. Building on and extending the recent research findings of a large-scale survey, interviews with Swedish media consumers were conducted between 23 March and 13 April 2022, providing a unique close-up on a group of media consumers who stated that they consumed, among other alternative media, the Russian state-sponsored media outlets RT and Sputnik as part of their media diet. The findings, elicited through interviews and the Q-sort method, challenge previous research that presents this audience in a one-dimensional way. First, we investigate their alignment with different political narratives, identifying three different profiles. Although only one profile generally aligned with the RT/Sputnik messaging, almost all the participants appreciate the content and share it on social media. Secondly, we examine their rationale for consumption, revealing a diverse array of motivations, and leading us to theorise four distinct consumption profiles: Distant Observers, Reluctant Consumers, Media Nihilists and Establishment Critics. We interpret these results and discuss their broader implications, before reflecting on the complexities of characterising audiences consuming authoritarian international broadcasting.
Illusory perception of visual patterns in pure noise is associated with COVID-19 conspiracy beliefs
Authors: Hartmann Matthias , Müller Petra
Published: January 2023

Just as perceptual heuristics can lead to visual illusions, cognitive heuristics can lead to biased judgements, such as “illusory pattern perception” (i.e., seeing patterns in unrelated events). Here we further investigated the common underlying mechanism behind irrational beliefs and illusory pattern perception in visual images. For trials in which no object was present in the noise, we found that the tendency to report seeing an object was positively correlated with the endorsement of both COVID-19 specific conspiracy theories and paranormal beliefs. The present results suggest that the cognitive bias to see meaningful connections in noise can have an impact on socio-political cognition as well as on perceptual decision making.
Unless Something Goes Wrong: Making Art to Understand and Mitigate the Risk of Therapeutic Inertia in the Treatment of Multiple Sclerosis
Authors: Byrne Libby
Published: January 2023

In the long-term management of a degenerative illness there is a risk that the approach we take to treatment can be characterized by therapeutic inertia (TI). With no evidence of disease progression clinicians can be reluctant to make a change to treatment regimes. This can lead to less choice and suboptimal outcomes for people with multiple sclerosis. The risk of TI is however greater when clinicians have an aversion to ambiguity and a low tolerance for uncertainty. (1) This article is an art-based inquiry into the possibility of TI in decision making when the advice from my neurologist was to stick with the treatment unless something goes wrong. (2) Through a unique process of rusting an existing canvas, the article reveals that the phrase, unless something goes wrong, is an expression of openness to uncertainty and ambiguity. (3) Art making offers the artist an opportunity to lean into and grow and capacity for tolerating uncertainty and ambiguity, thereby minimizing the risk of TI.
Cryopreservation of two species of the multicellular volvocine green algal genus Astrephomene
Authors: Nozaki Hisayoshi , Mori Fumi , Tanaka Yoko , Matsuzaki Ryo , Yamashita Shota , Yamaguchi Haruyo , Kawachi Masanobu
Published: January 2023

Background

Astrephomene is an interesting green algal genus that, together with Volvox, shows convergent evolution of spheroidal multicellular bodies with somatic cells of the colonial or multicellular volvocine lineage. A recent whole-genome analysis of A. gubernaculifera resolved the molecular-genetic basis of such convergent evolution, and two species of Astrephomene were described. However, maintenance of culture strains of Astrephomene requires rapid inoculation of living cultures, and cryopreserved culture strains have not been established in public culture collections.

Results

To establish cryopreserved culture strains of two species of Astrephomene, conditions for cryopreservation of the two species were investigated using immature and mature vegetative colonies and two cryoprotectants: N,N-dimethylformamide (DMF) and hydroxyacetone (HA). Rates of cell survival of the A. gubernaculifera or A. perforata strain after two-step cooling and freezing in liquid nitrogen were compared between different concentrations (3 and 6%) of DMF and HA and two types of colonies: immature colonies (small colonies newly released from the parent) and mature colonies (large colonies just before daughter colony formation). The highest rate of survival [11 ± 13% (0.36–33%) by the most probable number (MPN) method] of A. gubernaculifera strain NIES-4017 (established in 2014) was obtained when culture samples of immature colonies were subjected to cryogenic treatment with 6% DMF. In contrast, culture samples of mature colonies subjected to 3% HA cryogenic treatment showed the highest “MPN survival” [5.5 ± 5.9% (0.12–12%)] in A. perforata. Using the optimized cryopreservation conditions for each species, survival after freezing in liquid nitrogen was examined for six other strains of A. gubernaculifera (established from 1962 to 1981) and another A. perforata strain maintained in the Microbial Culture Collection at the National Institute for Environmental Studies (MCC-NIES). We obtained ≥0.1% MPN survival of the A. perforata strain. However, only two of the six strains of A. gubernaculifera showed ≥0.1% MPN survival. By using the optimal cryopreserved conditions obtained for each species, five cryopreserved strains of two species of Astrephomene were established and deposited in the MCC-NIES.

Conclusions

The optimal cryopreservation conditions differed between the two species of Astrephomene. Cryopreservation of long-term-maintained strains of A. gubernaculifera may be difficult; further studies of cryopreservation of these strains are needed.
The eye is a common site of granulomatosis with polyangiitis. A collaborative study
Authors: Dammacco Rosanna , Biswas Jyotirmay , Mohanan-Earatt Amanda , Lisch Walter , Zito Francesco Alfredo , Rubini Giuseppe , Manno Carlo , Cicco Sebastiano , Alessio Giovanni , Dammacco Franco
Published: January 2023

Background

Ocular manifestations of granulomatosis with polyangiitis (GPA) have been reported in a limited number of studies and with largely variable frequency. Here we report on the clinical, diagnostic, and therapeutic features of a cohort of 63 GPA patients, with particular regard to 22 of them with ophthalmic involvement (35%).

Methods

Clinical manifestations, results of immunological findings, histopathological pictures, imaging data, Birmingham Vasculitis Activity Score, therapeutic regimens, and outcomes were retrospectively analyzed. At diagnosis, in addition to a structured clinical assessment, all patients underwent a comprehensive ophthalmologic examination.

Results

The most frequently involved organs were kidneys, lungs, ear/nose/throat, and eyes. Ocular manifestations were bilateral in 32%. The three most commonly diagnosed ophthalmologic manifestations were scleritis (36%), retro-orbital pseudotumor or orbital mass (23%), and episcleritis (13%). Ocular and systemic involvement were simultaneously present at onset in 41% of the patients; systemic involvement was followed by ocular lesions in 36%; ocular inflammation was followed by systemic manifestations in 18%; and an orbital mass in the absence of systemic disease characterized 5%. Glucocorticoids plus cyclophosphamide and glucocorticoids plus rituximab were the combined therapies most frequently employed during remission induction and remission maintenance, respectively. Persistent ophthalmologic and extra-ocular remissions were achieved in 77 and 64% of the patients, respectively. One to three systemic relapses were diagnosed in 7 patients (31.8%). At the last follow-up, a visual outcome 20/40 or better in 31 (70%) of 44 eyes was determined.

Conclusions

The eye was involved in over one third of our patients with GPA. Increased awareness, early diagnosis, and multi-specialty collaboration are critical in achieving a favorable outcome of GPA.
Sex-specific percentiles for bodyweight and height in children born with esophageal atresia: a registry-based analysis 2001–2021
Authors: König Tatjana Tamara , Stefanescu Maria-Christina , Wildermuth Melanie , Frankenbach Luisa Maria , Muensterer Oliver J. , Gianicolo Emilio
Published: January 2023

Background

Esophageal atresia (EA) is a rare malformation with a wide range of co-morbidity and associated malformations impairing weight gain and growth. The aim of this study was to calculate specific percentiles for body weight and height for children born with esophageal atresia according to sex from birth to the age of 6 years, accounting for prematurity and presence of congenital heart disease (CHD).

Methods

Data was extracted from an anonymized voluntary national registry for patients born with esophageal atresia between 2001 and 2021, from birth until the age of six years. Missing values were imputed using a multiple imputation approach. In premature infants, chronological age was corrected for gestational week until the age of one year. The impact of sex and additional congenital heart disease on weight gain and growth was analysed using quartile regression models.

Results

In total, 1812 examinations of 485 patients were considered and 1232 examinations of 301 patients were finally included. Most data was available for children at birth and during the first year of life. Body weight was imputed for 3.3% and height for 12.5% of examinations. The mean body weight-for-age and length-for-age at birth according to gestational age was lower in EA patients and median body weight developed along the tenth percentile compared to the general population. Median height-for-age was at the 50th percentile during the first months of life, before crossing to lower percentiles before the age of one year. CHD had an additional negative impact on growth and weight gain, especially during the first year of life.

Conclusions

Children with EA had a reduced bodyweight and -height compared to the general population. Therefore, specific percentile curves are helpful to evaluate growth and development. Especially during the first year of life, particular attention is necessary and complications leading to a reduced calorie intake should be treated without delay to promote timely development and growth. Cardiac co-morbidities may further compromise weight gain in these patients, implying that such patients should be under even closer surveillance.
Missed opportunity: low uptake of VMMC among men attending the OPD of a public health facility offering free VMMC services in Uganda
Authors: Kiyai Ruth Nyaiti , Ejalu David Livingstone , Kimuli Derrick
Published: January 2023

Background

Studies in various countries including Uganda and Kenya have shown a much lower incidence of the human immunodeficiency virus (HIV) among men that underwent voluntary medical male circumcision (VMMC) compared to uncircumcised men. Wakiso district, the district with the highest prevalence of HIV in Uganda (7%), has a very low estimated proportion of men who have undergone VMMC (30.5%). Within the district, various public health facilities provide free VMMC services. This study examined the prevalence and factors associated with the uptake of VMMC among men attending the outpatient department (OPD) of a public facility offering VMMC services.

Methods

We conducted a cross-sectional study between July to August 2021 using a sample of men attending the OPD at Kira Health Centre IV. We defined VMMC uptake as the removal of all or part of the foreskin of the penis by a trained healthcare professional. We determined factors independently associated with VMMC uptake using a modified Poisson regression analysis with robust standard errors at a 5% statistical significance level. Adjusted prevalence risk ratios (APRR) were reported as the measure of outcome.

Results

Overall, 389 participants were enrolled in the study. The mean age of the participants was 27.2 (standard deviation ± 9.02) years. The prevalence of VMMC uptake was 31.4% (95% Confidence Interval [CI] 26.8–36.2). In the adjusted analysis, the uptake of VMMC among men attending the OPD of Kira HC IV was less likely among married participants compared to unmarried participants (APRR 0.64, 95% CI 0.48–0.88), among participants from Western tribes (APRR 0.50, 95% CI 0.41–0.86) or Eastern tribes (APPR 0.31, 95% CI 0.13–0.72) compared to participants from the Central tribes and among participants who didn’t disclose their sexual partner number compared to those that had one or no sexual partner (APRR 0.62, 95% CI 0.40–0.97). On the other hand, the prevalence of uptake of VMMC was 7 times among participants who were aware of VMMC compared to those who were not aware of VMMC (APRR 7.85 95% CI 1.07–9.80) and 2.7 times among participants who knew their HIV status compared to those that didn’t know (APRR 2.75, 95% CI 1.85–4.0). Also, the uptake of VMMC was 85% more among participants who knew that Kira HC IV provided free VMMC services compared to those that didn’t (APRR 1.85, 95% CI 1.85–4.08).

Conclusion

VMMC among men attending the OPD at the largest public healthcare facility proving free VMMC services in Kira Municipality was low. The OPD may provide a quick win for improving VMMC uptake. Collaborative efforts among the administration of Kira HC IV, the Ministry of Health and VMMC implementation partners could work towards developing health-facility-based strategies that can improve VMMC awareness and uptake with emphasis on the OPD.
Investigating factors that influence the practice of exclusive breastfeeding among mothers in an urban general hospital in Ghana: a cross-sectional study
Authors: Dadzie Baaba , Bayor Fidelis , Doat Abdul-Razak , Kappiah Jamilatu B. , Akayuure Collins Adombire , Lamptey Aubrey A. , Yakong Vida Nyagre , Kampo Sylvanus
Published: January 2023

Background

In Ghana, only 52% of mothers exclusively breastfeed their babies and the rate of increase has been steadily slow across all geographical areas of Ghana. The purpose of this study was to determine the various factors that influence exclusive breastfeeding (EBF) among mothers who visited the child welfare clinic at the Tema General Hospital, Accra, Ghana.

Methodology

This descriptive cross-sectional study was carried out at the Child Welfare Clinic of the Tema General Hospital, Accra, Ghana. A random sampling technique was used to recruit mothers with children between the ages of 6 months and 24 months attending the Child Welfare Clinic. Mothers were interviewed with the aid of a structured questionnaire.

Results

Out of the 222 of mothers interviewed, 68.8% of them exclusively breastfed their infants up to 6 months. Mothers who have good knowledge were more than 3 times (AOR = 3.484, 95% CI 1.200, 10.122, P = 0.022) likely to breastfeed their children exclusively. Those who had positive attitudes towards EBF were about 4 times (COR: 4.018, 95% = 1.444, 11.181, P = 0.008) more likely to exclusively breastfeed than those who had poor attitudes towards EBF. Also, mothers whose spouses complained about EBF were about 3 times (AOR: 2.655, 95% CI 0.620, 11.365, P = 0.018) at increased odds of not exclusively breastfeeding their babies.

Conclusions

High rate of EBF among mothers who visited the child welfare clinic was found. The mothers' level of knowledge and attitude towards EBF significantly influenced the 6 months of EBF. Spouses also showed a high influence on whether or not mothers should exclusively breastfeed their babies.
Hysteroscopy for retained products of conception: a single-institution experience
Authors: Han Ling , Shi Gang , Zheng Ai , Ruan Jiaying
Published: January 2023

Background

Retained products of conception can occur with induced abortion during early-term pregnancy, induction of labor during mid-term pregnancy, drug-induced abortion, miscarriage, cesarean delivery, or full-term normal delivery. Compared with traditional dilation and curettage, hysteroscopy is a safer and more effective treatment method for retained products of conception. This study aimed to report the efficacy of hysteroscopy for treating retained products of conception and to share our new clinical perspectives.

Methods

This retrospective, single-center study was conducted at a tertiary hospital in Chengdu, China. We included 36 patients with retained products of conception who underwent hysteroscopy at our hospital.

Results

Our study reported a complete removal rate of 80.5% (29/36) with one procedure. The normal menstruation recovery rate during 1 year of follow-up was 91.6% (33/36). A low rate of postoperative intrauterine adhesions (2.8% [1/36]) was also reported.

Conclusion

Our retrospective study elucidated the use of hysteroscopy for retained products of conception. We also shared new perspectives regarding hysteroscopy and optimal surgical methods for treating retained products of conception as well as our experience treating residual products with hysteroscopy. To our knowledge, no other study has shared similar experiences.
Factors influencing future career interests of pharmacy interns in Saudi Arabia: a survey from 25 colleges of pharmacy
Authors: Thabit Abrar K. , Alghamdi Doaa I. , Alaqi Reem O. , Alsufyani Muath A. , Bagalagel Alaa A.
Published: January 2023

Background

Hundreds of pharmacists graduate from pharmacy colleges in Saudi Arabia, and various factors influence their choice of career pathway. Very few single-institution studies assessed career choices of pharmacy students with or without evaluating the influencing factors. Therefore, this study aimed to evaluate career choices and the associating factors of pharmacy interns from multiple colleges in Saudi Arabia.

Methods

This was a cross-sectional study that surveyed pharmacy interns from 25 pharmacy colleges in Saudi Arabia using an online questionnaire. The survey was sent during the last rotation month in the internship year (May–June 2022).

Results

Of 454 participants, 411 (90.5%) were enrolled in Doctor of Pharmacy programs. While most participants were interested in becoming clinical pharmacists (n = 183; 40.3%), a considerable number were also interested in working in different sectors of pharmaceutical companies and industry (n = 127; 28%). Internship training significantly correlated with selecting clinical pharmacy specialist career (r = 0.19; P = 0.0001), whereas salary/financial incentives significantly influenced the choice of working as sales and marketing representatives and pharmacy product specialists in pharmaceutical companies (r = 0.29 and 0.24; P < 0.0001 for both). College courses correlated with choosing academia in pharmaceutical sciences (r = 0.20; P < 0.0001), whereas summer training correlated with the community pharmacy career (r = 0.11; P = 0.02).

Conclusion

Pharmacy colleges should utilize results from this study to enhance the exposure of pharmacy students during their academic years to different pharmacy career pathways by allowing the opportunity to shadow pharmacists from different sectors as part of college courses, inviting previous graduates, and activating the role of academic advisors in career orientation.
Tolerability, safety and survival in patients with severe pulmonary arterial hypertension treated with intravenous epoprostenol (Veletri®): a prospective, 6-months, open label, observational, non-interventional study
Authors: Degering Julia , Egenlauf Benjamin , Harutyunova Satenik , Benjamin Nicola , Salkić Amina , Xanthouli Panagiota , Eichstaedt Christina A. , Seeger Rebekka , Sitbon Olivier , Grünig Ekkehard
Published: January 2023

Background

Epoprostenol AS (Veletri®), a thermostable epoprostenol formulation, provides better drug stability and improved clinical use compared to previous epoprostenol formulations. This study aims to expand clinical experience in the use of Veletri®, especially regarding tolerability, safety and survival.

Methods

Pulmonary arterial hypertension (PAH) patients at high risk despite pretreatment with at least double oral combination therapy and with clinical indication for epoprostenol (Veletri®) treatment were consecutively included in this prospective, open label, observational, non-interventional study. Clinical data were assessed at baseline, after 3 and 6 months. Adverse events (AEs) and serious adverse events (SAEs) were documented. Survival from initiation of Veletri® was assessed at last patient out.

Results

Fifteen patients (60 ± 13.7 years, WHO functional class III (n = 10) or IV (n = 5), severely impaired right ventricular function, mean pulmonary arterial pressure 54.8 ± 8.9 mmHg, mean pulmonary vascular resistance 4.4 ± 0.7 (median 3.8) Wood Units) were enrolled and treated with a mean dosage of 7.9 ± 3.9 (median 7.5) ng/kg/min. Eleven patients completed the study (treatment withdrawal n = 1, death n = 3). After a mean follow-up of 19.1 ± 13.5 (median 18.0) months, seven patients died and three were listed for lung transplantation. Seven AEs (nausea n = 3, diarrhea n = 1, flushing n = 2, headaches n = 1) and three SAEs (catheter infection n = 2, catheter occlusion n = 1) were related to Veletri®. The 1- and 2-year survival rates were 73.3% and 52.4%, respectively.

Conclusions

The study showed that safety and tolerability of epoprostenol AS (Veletri®) was comparable to previous prostacyclin formulations and was feasible for most patients. The maximum tolerable dosage was lower than dosages reported in the literature. In future applications/trials the up-titration process should be pushing for higher dosages of epoprostenol in the occurrence of side effects, as the achievement of a high and effective dosage is crucial for the clinical benefit of the patients. Survival was as expected in these prevalent severely impaired patients.

Trial registration The study was registered in the EUPAS registry (EUPAS32492).
Characterising spinal cerebrospinal fluid flow in the pig with phase-contrast magnetic resonance imaging
Authors: Bessen Madeleine Amy , Gayen Christine Diana , Quarrington Ryan David , Walls Angela Catherine , Leonard Anna Victoria , Kurtcuoglu Vartan , Jones Claire Frances
Published: January 2023

Background

Detecting changes in pulsatile cerebrospinal fluid (CSF) flow may assist clinical management decisions, but spinal CSF flow is relatively understudied. Traumatic spinal cord injuries (SCI) often cause spinal cord swelling and subarachnoid space (SAS) obstruction, potentially causing pulsatile CSF flow changes. Pigs are emerging as a favoured large animal SCI model; therefore, the aim of this study was to characterise CSF flow along the healthy pig spine.

Methods

Phase-contrast magnetic resonance images (PC-MRI), retrospectively cardiac gated, were acquired for fourteen laterally recumbent, anaesthetised and ventilated, female domestic pigs (22–29 kg). Axial images were obtained at C2/C3, T8/T9, T11/T12 and L1/L2. Dorsal and ventral SAS regions of interest (ROI) were manually segmented. CSF flow and velocity were determined throughout a cardiac cycle. Linear mixed-effects models, with post-hoc comparisons, were used to identify differences in peak systolic/diastolic flow, and maximum velocity (cranial/caudal), across spinal levels and dorsal/ventral SAS. Velocity wave speed from C2/C3 to L1/L2 was calculated.

Results

PC-MRI data were obtained for 11/14 animals. Pulsatile CSF flow was observed at all spinal levels. Peak systolic flow was greater at C2/C3 (dorsal: − 0.32 ± 0.14 mL/s, ventral: − 0.15 ± 0.13 mL/s) than T8/T9 dorsally (− 0.04 ± 0.03 mL/s; p < 0.001), but not different ventrally (− 0.08 ± 0.08 mL/s; p = 0.275), and no difference between thoracolumbar levels (p > 0.05). Peak diastolic flow was greater at C2/C3 (0.29 ± 0.08 mL/s) compared to T8/T9 (0.03 ± 0.03 mL/s, p < 0.001) dorsally, but not different ventrally (p = 1.000). Cranial and caudal maximum velocity at C2/C3 were greater than thoracolumbar levels dorsally (p < 0.001), and T8/T9 and L1/L2 ventrally (p = 0.022). Diastolic velocity wave speed was 1.41 ± 0.39 m/s dorsally and 1.22 ± 0.21 m/s ventrally, and systolic velocity wave speed was 1.02 ± 0.25 m/s dorsally and 0.91 ± 0.22 m/s ventrally.

Conclusions

In anaesthetised and ventilated domestic pigs, spinal CSF has lower pulsatile flow and slower velocity wave propagation, compared to humans. This study provides baseline CSF flow at spinal levels relevant for future SCI research in this animal model.
Early and mid-term outcomes after aortic valve intervention in patients with previous stentless or stented bioprostheses
Authors: Fukunaga Naoto , Al-Sarraf Ali , Jawad Khalil , Lafreniere-Roula Myriam , Rao Vivek
Published: January 2023

Background

Limited data are available concerning comparative outcomes of redo aortic valve interventions, including surgery after aortic valve replacement (AVR) with either stented or stentless bioprostheses. We investigated the comparative outcomes of redo aortic valve interventions, including surgery after AVR with either stented or stentless bioprostheses.

Methods

The cohort consisted of 112 patients who underwent aortic valve intervention for infective endocarditis or structural valve deterioration between 2001 and 2020. One hundred patients received a stented valve (stented group) and 12 patients received a stentless valve (stentless group) during the initial surgery. Early and late outcomes were evaluated.

Results

The mean [IQR] ages during the current interventions were 66 [54, 77] years in the stented group and 74 [67, 79] years in the stentless group (P = 0.13). In the stented group, aortic valve interventions included redo AVRs with stented valves (n = 54), mechanical valves (n = 26), stentless valves (n = 16), and transcatheter aortic valve implantations (n = 4). In the stentless group, redo AVRs were performed with stented valves (n = 4), mechanical valves (n = 2), stentless valves (n = 1), and transcatheter valve implantations (n = 5). Hospital mortality was observed in 2 (2%) patients in the stented group and 1 (8%) patients in the stentless group (P = 0.29). The 5-year survival was 80.8% [66.8, 88.5] in the stented group and 91.7% [53.9, 98.8] in stentless group. Statistically significant differences in thromboembolisms were observed between the groups.

Conclusions

No significant differences in early and mid-term outcomes (except thromboembolism) after aortic valve interventions were detected between patients with stented and stentless AVRs.
Minimization of ragweed allergy immunotherapy costs through use of the sublingual immunotherapy tablet in Canadian children with allergic rhinoconjunctivitis
Authors: Ellis Anne K. , Mack Douglas P. , Gagnon Rémi , Hammerby Eva , Gosain Sheena
Published: January 2023

Background

Allergy immunotherapy (AIT), in the form of subcutaneous immunotherapy (SCIT) with alum-precipitated aqueous extracts, SCIT with a modified ragweed pollen allergen tyrosine adsorbate (MRPATA; Pollinex®-R), or a sublingual immunotherapy (SLIT)-tablet are options for the treatment of ragweed pollen allergic rhinoconjunctivitis (ARC) in Canadian children. A cost minimization analysis evaluated the economic implications of the use of the ragweed SLIT-tablet vs SCIT in Canadian children with ragweed ARC.

Methods

A cost minimization analysis was conducted comparing the short ragweed SLIT-tablet, 12 Amb a 1-U, preseasonally with preseasonal ragweed SCIT, annual ragweed SCIT, or MRPATA. The analysis was conducted over a time horizon of 3 years from a public payer perspective in Ontario and Quebec. Resources and costs associated with medication and services of healthcare professionals were considered for each treatment. The resource and cost input values for the model were obtained from published literature and validated by Canadian clinical experts in active allergy practice. A discount rate of 1.5% was applied. Several scenario analyses were conducted to determine the impact of many of the key base case assumptions on the outcomes.

Results

Over the total 3-year time horizon, the ragweed SLIT-tablet had a potential cost savings of $900.14 in Ontario and $1023.14 in Quebec when compared with preseasonal ragweed SCIT, of $6613.22 in Ontario and $8750.64 in Quebec when compared with annual ragweed SCIT, and $79.62 in Ontario and $429.49 in Quebec when compared with MRPATA. The ragweed SLIT-tablet had higher drug costs compared with the other AIT options, but lower costs for healthcare professional services. The lower costs for healthcare professional services with the ragweed SLIT-tablet were driven by the need for fewer office visits than SCIT. Scenario analysis indicated that costs were most impacted by including societal costs (e.g., costs associated with patient/caregiver travel and time lost). The potential cost savings of the ragweed SLIT-tablet versus SCIT and MRPATA was maintained in most scenarios.

Conclusions

In this cost minimization analysis, the ragweed SLIT-tablet provided estimated cost savings from a public payer perspective for the treatment of ragweed ARC in Canadian children compared with SCIT or MRPATA.
Cow’s milk allergy skin tests: fresh milk, commercial extracts, or both?
Authors: Lachover-Roth Idit , Giorno Nadav , Hornik-Lurie Tzipi , Cohen-Engler Anat , Rosman Yossi , Meir-Shafrir Keren , Confino-Cohen Ronit
Published: January 2023

Background

The diagnosis of food allergy is based on a history of immediate allergic reaction following food ingestion, and skin prick test (SPT) demonstrating sensitization with commercial extracts (CE) or fresh food (FF). For most food allergens, the SPT with FF is considered more accurate and predictive. Regarding cow’s milk, the results are inconclusive. This retrospective study aimed to evaluate the accuracy of SPT with fresh milk compared to CE (cow’s milk and casein) for evaluation of cow’s milk allergy (CMA).

Methods

This study summarized the medical records of children, diagnosed with CMA. The data include demographics, skin tests and oral food challenge results, as well as atopic comorbidities.

Results

Records of 698 patients with the diagnosis of CMA were reviewed, 388 fulfilled the inclusion criteria. Overall, 134 patients (34.54%) had an additional atopic disease. The SPT wheal size with fresh milk was significantly larger than with CE (cow's milk and casein) at first evaluation or before oral food challenge (OFC). Combination of SPT results (CE and FF) gave the maximal odds ratio for reaction during OFC and SPT with fresh milk alone gave the minimal OR (34.18 and 4.74, respectively).

Conclusions

SPT with CE for CMA evaluation is more reliable than SPT performed with fresh milk. In patients suspected of having IgE-mediated CMA, before deciding on performing OFC, it is advised to perform SPT with at least two different extracts, and always include casein. Fresh milk can serve as a backup if commercial extracts are not available. In cases that the SPT with fresh milk is 3 mm or less, there is 93.3% chance that the OFC will pass without reaction.

Trial registration This study protocol was reviewed and approved by the Ethics Committee of Meir Medical Center, IRB Number 0083-18 MMC.
MRI anatomy of the rectum: key concepts important for rectal cancer staging and treatment planning
Authors: Bogveradze Nino , Snaebjornsson Petur , Grotenhuis Brechtje A. , van Triest Baukelien , Lahaye Max J. , Maas Monique , Beets Geerard L. , Beets-Tan Regina G. H. , Lambregts Doenja M. J.
Published: January 2023

A good understanding of the MRI anatomy of the rectum and its surroundings is pivotal to ensure high-quality diagnostic evaluation and reporting of rectal cancer. With this pictorial review, we aim to provide an image-based overview of key anatomical concepts essential for treatment planning, response evaluation and post-operative assessment. These concepts include the cross-sectional anatomy of the rectal wall in relation to T-staging; differences in staging and treatment between anal and rectal cancer; landmarks used to define the upper and lower boundaries of the rectum; the anatomy of the pelvic floor and anal canal, the mesorectal fascia, peritoneum and peritoneal reflection; and guides to help discern different pelvic lymph node stations on MRI to properly stage regional and non-regional rectal lymph node metastases. Finally, this review will highlight key aspects of post-treatment anatomy, including the assessment of radiation-induced changes and the evaluation of the post-operative pelvis after different surgical resection and reconstruction techniques.
Study results from journals with a higher impact factor are closer to “truth”: a meta-epidemiological study
Authors: Heidenreich Andreas , Eisemann Nora , Katalinic Alexander , Hübner Joachim
Published: January 2023

Background

Scientists, physicians, and the general public legitimately expect scholarly publications to give true answers to study questions raised. We investigated whether findings from studies published in journals with higher Journal Impact Factors (JIFs) are closer to truth than findings from studies in less-cited journals via a meta-epidemiological approach.

Methods

We screened intervention reviews from the Cochrane Database of Systematic Reviews (CDSR) and sought well-appraised meta-analyses. We used the individual RCT study estimates’ relative deviation from the pooled effect estimate as a proxy for the deviation of the study results from the truth. The effect of the JIF on the relative deviation was estimated with linear regression and with local polynomial regression, both with adjustment for the relative size of studies. Several sensitivity analyses for various sub-group analyses and for alternative impact metrics were conducted.

Results

In 2459 results from 446 meta-analyses, results with a higher JIF were on average closer to “truth” than the results with a lower JIF. The relative deviation decreased on average by −0.023 per JIF (95% CI −0.32 to −0.21). A decrease was consistently found in all sensitivity analyses.

Conclusions

Our results indicate that study results published in higher-impact journals are on average closer to truth. However, the JIF is only one weak and impractical indicator among many that determine a studies’ accuracy.
An improvement of a nonuniform bound for unbounded exchangeable pairs
Authors: Sumritnorrapong Patcharee , Suntornchost Jiraphan
Published: January 2023

In this paper, we obtain a nonuniform Berry–Esseen bound for a normal approximation via the Stein method and the exchangeable-pair coupling technique where the boundedness condition of the difference between the exchangeable pair is not required. As applications of the result, we obtain nonuniform bounds for the normal approximations in two well-known applications that are the independence test and the quadratic form. Our results suggest that the obtained bounds for the two applications are sharper than other existing bounds.
Essential medicines for mental disorders: comparison of 121 national lists with WHO recommendations
Authors: Todesco Beatrice , Ostuzzi Giovanni , Gastaldon Chiara , Papola Davide , Barbui Corrado
Published: January 2023

Background

To compare the medicines for mental disorders included in national essential medicines lists with the World Health Organization (WHO) essential medicines list and assess the extent to which economic status and WHO Region account for the differences.

Methods

We searched WHO repository and government sites for national essential medicines lists and we abstracted medicines for mental disorders. We calculated the proportion of WHO essential medicines included, the total number of differences (counting both additions and deletions) between national and WHO model list and the proportion of lists including one second-generation oral antipsychotic plus one new-generation antidepressant. Non-parametric statistics was used to investigate whether these indicators were dependent on economic status and WHO Region.

Results

Amongst the 121 identified national lists, the total number of medicines for mental disorders ranged from 2 to 63 (median: 18; IQR: 14 to 25). The median proportion of WHO essential medicines for mental disorders included was 86% (IQR: 71–93%), with 16 countries (13%, 95% CI 7.75–20.5%) including all WHO essential medicines, while the median number of differences with the WHO EML was 11 (IQR: 7 to 15). Country economic level was positively associated with both the proportion of WHO essential medicines included (Spearman's rho = 0.417, p < 0.001) and the number of differences (Spearman's rho = 0.345, p < 0.001), implying that countries with higher income level included more WHO essential medicines, but also more additional medicines. Significant differences were observed in relation to WHO Region, with the African and Western Pacific Region showing the lowest proportions of WHO essential medicines, and the European Region showing the highest median number of differences. Overall, 88 national lists (73%, 95% CI 63–80%) included at least one second-generation oral antipsychotic and new-generation antidepressant, with differences by income level and WHO Region.

Conclusions

The degree of alignment of national lists with the WHO model list is substantial, but there are considerable differences in relation to economic status and WHO Region. These findings may help decision-makers to identify opportunities to improve national lists, aiming to increase access to essential medicines for mental disorders.
Association between central venous pressure measurement and outcomes in critically ill patients with severe coma
Authors: Tong Xin , Feng Xin , Duan Chuanzhi , Liu Aihua
Published: January 2023

Background

The use of central venous pressure (CVP) measurements among (intensive care unit) ICU patients with severe coma has been questioned. This study aimed to investigate the application value of CVP in this population.

Methods

Data stored in the ICU Collaborative Research Database (eICU-CRD) and Medical Information Mart for Intensive Care III (MIMIC-III) database were reviewed. Critically ill patients with a Glasgow Coma Scale (GCS) score of 3–8 were included. The primary outcome was the in-hospital mortality rate. The statistical approaches used included multivariable Cox regression, propensity score matching (PSM), inverse probability treatment weighting (IPTW), stabilized IPTW, and restricted cubic splines (RCS) to ensure the robustness of our findings.

Results

In total, 7386 patients were included in the study. Early CVP measurement was independently associated with in-hospital mortality [hazard ratio, 0.63; p < 0.001] in patients with severe-to-moderate coma. This result was robust in the PSM, sIPTW, and IPTW cohorts. For all patients with CVP measurements, the RCS curves showed that the risk of in-hospital mortality increased as the initial CVP time was delayed. In addition, early CVP measurement was significantly associated with lower ICU mortality, 28-day mortality, and 365-day mortality and a significantly higher number of ventilator-free days.

Conclusion

Early CVP measurement could improve clinical outcomes in critically ill patients with severe coma