bluuebunny/crossref_metadata_2025 huggingface dataset:
Adverse Hemodynamic Effects of Dexmedetomidine in Critically Ill Elderly Adults
Authors: Ingebrigtson Megan , Miller James T.
Published: June 2022

Background: Dexmedetomidine is a currently recommended first-line sedative agent for critically ill patients requiring mechanical ventilation. Recent trials demonstrated no difference in clinical outcomes between patients treated with dexmedetomidine vs usual care, but significantly more hemodynamic adverse effects in the dexmedetomidine group. One subgroup analysis suggested a 90-day mortality benefit in elderly patients, but no distinction was made between groups regarding age when reporting adverse effects. Given potential decreased baroreceptor function in the elderly, adverse hemodynamic effects of dexmedetomidine may impact them more. Objective: To assess the incidence of adverse hemodynamic effects of dexmedetomidine in elderly ICU patients compared to other sedative agents to clarify the role of dexmedetomidine in this patient population. Methods: This was a single-center, retrospective study including mechanically ventilated elderly patients requiring sedative agents for ≥12 hours. The primary outcome evaluated was composite end point of incidence of bradycardia and hypotension. Secondary outcomes included incidence of each adverse event individually, hospital and ICU length of stay, and duration of mechanical ventilation. Results: There was no difference in adverse events between the two groups (58.7% vs 74.1% in the dexmedetomidine vs usual care groups, P =.074). There was no difference in hospital or ICU length of stay. Patients in the dexmedetomidine group were on the ventilator longer than patients in the usual care group with a median of 6 vs 3 days, respectively ( P = 0.004). Conclusion: In this single-center, retrospective study dexmedetomidine had a similar incidence of adverse events in elderly patients compare to the usual care group.
Preparation and gas separation performance of polyimide membranes endcapped with ionic liquid-type structures
Authors: Jia Hongge , Zhao Shijun , Jiang Pengfei , Jing Boyu , Yang Guoxing , Xu Shuangping , Zhang Mingyu , Qu Yanqing , Zou Yonglan
Published: June 2022

A set of ionic liquid capped polyimide membranes was prepared using 1-aminoethyl-3-methylimidazolium hexafluorophosphate (IL1) and 1-aminopropylimidazolium bis(trifluoromethylsulfonyl)imine (IL2) as the terminal groups. The products’ molecular weights, mechanical properties, and separation permeability (CO2/CH4) were investigated. For CO2/CH4 separation, the selectivity of the ionic liquid capped polyimide membranes was higher than that of noncapped ones. Among them, the membrane synthesized by 4.4′- diaminodiphenyl ether and 4.4′-(hexafluoroisopropyl) diphthalic anhydride (6FDA) as monomer, with IL1 as terminal group, displayed the best selectivity. Its permeability was 7.47 Barrer and selectivity 102.42, which exceeded the 1991 Robeson curve. Polyimide membranes capped by ionic liquid showed high gas selectivity and good gas permeability as well as good physical and chemical properties. Consequently, it can be concluded that introducing an ionic liquid structure to polyimide chains could make attractive membrane materials for various gas separation and related applications.
Numerical study of heat transport mechanism in hybrid nanofluid [(Cu-Al2O3)/water] over a stretching/shrinking porous wedge
Authors: Khan Umar , Abdul Wahab Hafiz , Syed Hosama , Ullah Basharat , Adnan
Published: June 2022

The numerical exploration of the dynamics of hybrid type nanofluid (Cu-Al2O3)/water over a fascinating domain of stretching/shrinking porous wedge is performed. The problem is designed and studied numerically by fluctuating the flow parameters. From the results, dominant behavior of stretching/shrining and suction/injection parameters observed on the velocity field. These are prominent at the wedge surface due to significant influence of suction/injection and stretchable characteristics of wedge. Further study revealed that (Cu-Al2O3)/water has better conductive characteristics than normal Cu/water due to optimum dominant thermophysical values of hybrid nanoparticles. The temperature drops prominently for [Formula: see text] with stretching of wedge. Further, injecting fluid from the wedge surface favors the temperature variations. Finally, the results aligned with published data under certain feasible conditions and found that the conducted study is valid.
Can raising trade barriers curb industrial pollution emissions?
Authors: Wang Shuhong , He Yuqing , Chen Hanxue
Published: June 2022

The development of foreign trade and industrial pollution control is an important theme of government governance today. Based on the institutional background of rising international trade protectionism, this study examines the impact of trade barriers on industrial pollution emissions by using different measurement methods and data from 16 industrial sectors in 10 major countries. The results show that lowering trade barriers can significantly reduce industrial pollution emissions, considering the impact of potential endogenous problems. Heterogeneity analysis shows that reducing trade barriers in developed countries can reduce industrial SO2-emission intensity, while the opposite is true in developing countries. Trade barriers have the greatest effect on the pollution-emission intensity of technology-intensive industries, followed by labor-intensive and capital-intensive industries. Mechanism analysis shows that trade barriers affect industrial pollution-emission intensity through both pollution emission and industrial output and that energy-use intensity and biased technological progress are important mechanisms. This study provides a useful reference for governments to promote foreign trade development and ecological and environmental protection.
A Study of Sick Newborn for Inborn Error of Metabolism by Tandem Mass Spectrometry
Authors: Bhautara Rahul , Agarwal Kamlesh Kumar , Gupta Ashok , Goyal Manisha , Kapoor Seema
Published: June 2022

Introduction:

Inborn errors of metabolism (IEM) form a large class of genetic diseases involving congenital disorders of metabolism. In most disorders, problems arise due to the accumulation of various toxic substances. Although some IEMs are harmless (benign), many can cause significant handicaps. Screening for IEMs among newborns not only prevents premature death and permanent neurological damage but also helps in planning prenatal diagnosis in future pregnancies. Tandem mass spectrometry (TMS) is an effective diagnostic technique and has been proposed as a means to realize this aim. Therefore, this study was planned to screen the sick newborns for inborn error of metabolism by TMS and to diagnose IEM as early as possible to minimize morbidity and mortality in sick/high-risk neonates.

Material and Methods:

This hospital-based descriptive diagnostic study was conducted in the Department of Pediatrics, SPMCHI, SMS Medical College, Jaipur from June 2017 to May 2018. The study population included indoor 90 patients with age up to 28 days of life who were enrolled after applying exclusion criteria. All data were collected and analyzed with the help of suitable statistical parameters.

Results:

Out of 90 cases enrolled, 66 were of normal birth weight and 24 were of low-birth weight neonates and all positive subjects were low birth weight. Out of 90 neonates, 7 (7.8%) were positive for IEM and 83 (92.2%) were negative for IEM. Out of 7 positive, 3 (42.8%) had maple syrup urine disease, 2 (28.6%) had methylmalonic acidemia and 2 (28.6%) had carnitine palmitoyl transferase type 1 deficiency/mitochondrial myopathy. Out of 90, 26 (28.9%) were positive and 64 (71.1%) were negative for hypoglycemia. Out of 7 cases of IEM, 6 (85.7%) were positive and 1 (14.3%) was negative for hypoglycemia.

Conclusion:

Screening helps in early diagnosis and initiation of treatment. Early treatment and rehabilitation to the child with IEM prevent premature death and permanent neurological disability.
Political Economy of Trade in BIMSTEC: A Contemporary Perspective
Authors: Marwah Reena , Ramanayake Sanika Sulochani , Yasmin Lailufar
Published: June 2022

BIMSTEC has completed more than two decades of its existence, with 2022 marking the regional grouping’s 25th anniversary. In this article, we study the nature and evolution of BIMSTEC, as we discuss and analyse the nature of intra-regional trade, with a focus on BIMSTEC member countries’ trade with India and China. We also highlight the political challenges and hindrances to increasing intra-regional trade. The China factor and its expanding footprint among these countries is analysed. The article concludes with suggestions and unique pathways that BIMSTEC can emphasize in creating a common identity, that is, focusing on connectivity and improved logistics as well as establishing a BIMSTEC university for exchange of ideas and building trust. The article fills the existing gap in the literature by comparing India and China’s trade with BIMSTEC countries, emphasizing the creation of the soft power appeal of BIMSTEC to make it a more viable regional organization.
What kind of judicial review for the European Central Bank?
Authors: Baroncelli Stefania , Mooij Annelieke A.M.
Published: June 2022

This article examines the judicial review used by the CJEU in assessing the ECB's non-standard monetary policy measures and the dispute between the German Constitutional Court and the CJEU over the standard of review to be used. In addition, it discusses the possibility of a future clash between the two courts in the post Covid-19 era. It first analyses the type of judicial control carried out by the CJEU during the Euro crisis in the Gauweiler and Weiss cases. It then explores the reasons for criticism of the CJEU reasoning by the doctrine. During the pandemic period the ECB has taken unprecedented steps and increased its monetary policy instruments, such as the Pandemic Emergency Purchase Programme (PEPP). The potential confrontation between the GCC and the ECB over PEPP is, however, deemed limited. It concludes analysing the possibility to add a court-appointed expert to the CJEU's decision-making process. Indeed, the presence of an expert could improve judicial review and increase the depth of the judgments also against national courts that have asked for preliminary ruling. However, the independence of the ECB should not be affected.
Chasing Charms as Concept
Authors: Ward Amber
Published: June 2022

This lived approach to inquiry is situated in transcendental empiricism through, what Deleuze called, a sensibility of creating and becoming; the inquiry also chases charms as concept. I have invented the concept charms to help re-orient thought through a relational journey at the threshold of apprehension when naming it a concept. Nearly a dozen letters addressed to a Critical Studies scholar grapple with and question charms as concept—oftentimes in connection with other philosophical concepts. The inquiry lends itself to an immanent ontology when reading with poststructural philosophy, writing with and listening to the Critical Studies scholar, walking with a psychoanalytic scholar, and revising with two manuscript reviewers. It also invites readers to consider what and who they are entangled with/in and how those relations might encourage lived inquiry through a sensibility of creating and becoming.
The long-run tourism effect of historical celebrities: Evidence from one of the most influential literatus in China
Authors: Gao Yanyan , Su Wei
Published: June 2022

Do historical celebrities contribute to city tourism today? While the existing literature has widely examined the tourism effect of modern film celebrities, it has not yet explored the long-run impact of historical and cultural celebrities on tourism economies. We answer this question by tracing the places of residence of Su Shi, one of the greatest Chinese cultural celebrities in the Northern Song Dynasty (960–1127), and estimating the effect on average city tourism between 2002 and 2019. Our ordinary least square estimation finds that one more month of Su Shi’s residence increases domestic tourism revenue today by about 0.3%, leading to an average tourism value of around 118 million Chinese Yuan (about 18 million US dollars). We consolidate the long-run effect with several robustness checks. Channel analysis further shows that his residence facilitates tourism development today and increased cultural heritage in subsequent dynasties. These findings highlight the roles of historical celebrities in fostering cultural heritages and forming city tourism competitiveness.
Nordic research on health inequalities: A scoping review of empirical studies published in Scandinavian Journal of Public Health 2000–2021
Authors: Elstad Jon Ivar , Heggebø Kristian , Dahl Espen
Published: June 2022

Aims:

An important task for the Scandinavian Journal of Public Health is to address health inequality topics. This scoping review characterises Nordic empirical studies within this research field, published 2000–2021 by the Scandinavian Journal of Public Health.

Methods:

Original empirical research studies using data from Denmark, Finland, Iceland, Norway and/or Sweden, which linked differences in health or health-related aspects to socioeconomic positions, immigrant status, family structures and/or residential areas, were included in the review. The initial search in the Web of Science article database resulted in 294 possibly relevant articles, and 171 were judged to comply with our criteria.

Results:

Only one study was based on qualitative data, while all others used either surveys or register data, or both in combination. A wide variety of outcomes was addressed. Most studies had a social causation design, but 16 studies analysed health-related mobility processes and four reported intervention results. The most common statistical method was logistic regression. Poisson, Cox and ordinary least squares regression were less used. Few studies engaged explicitly with health inequality theories or with rigorous causality designs.

Conclusions:

The empirical health inequality studies published by the Scandinavian Journal of Public Health are rich sources for knowledge on a large array of health and health-related inequalities in Nordic countries. Drawbacks are underuse of qualitative data, few theoretical discussions and lack of studies assessing effects of interventions and policies.
Going against the interactional tide: The accomplishment of dialogic moments from a conversation analytic perspective
Authors: van Burgsteden Lotte , te Molder Hedwig , Raymond Geoffrey
Published: June 2022

This article addresses a vital concern in current society by showing what participants themselves may treat as ways to transcend their differences. Actors’ shared understanding has been of longstanding interest across the social sciences. Conversation analysis (CA) treats the procedural infrastructure of interaction as the basis for participants to manage intersubjectivity. The field of dialogue studies has made occasions in which people transform their relationship by discussing their differences, central to their research project, and called them “dialogic moments.” This study draws on CA to investigate “dialogic moments,” but now through the eyes of participants themselves. Using single-case analysis, we argue that such moments require participants to go against normative orientations in talk promoting social solidarity and progressivity, by soliciting differences to understand and transcend them. This “going against the interactional tide” may explain both why dialogue is difficult to achieve and why it is appreciated by participants as dialogue.
Sociocultural contexts and power dynamics in research interviews: Methodological considerations in Confucian society
Authors: Kim Geena
Published: June 2022

In this reflexive essay, I raise issues about power dynamics between interviewers and interviewees based on my experiences conducting research interviews in South Korea. I focus on the sociocultural contexts that drive social agents’ behaviors in the interview process, which in Korean Confucian contexts include respect for adults and educational fervor. A particular configuration of authority relationships was evident in each scenario, showing how sociocultural contexts underlie the complicated power dynamics of interview situations, which can be further complicated by topics that require participants to share their intellectual notions. Based on my interview experiences, I argue that acknowledging these social contexts and their impacts on power relations will serve to strengthen the depth of engagement in interviews and therefore the quality and potential impact of qualitative interview research.
Development of waste carpet (jute) and Multi-wall carbon nanotube incorporated epoxy composites for lightweight applications
Authors: Kumar Jogendra , Kumar Kaushlendra , Kumar Kuldeep , Jaiswal Balram , Verma Rajesh K
Published: June 2022

This work highlights the recycling of waste carpet (Jute) to develop epoxy composites using a modified vacuum-assisted environment. Incorporating Multi-wall carbon nanotube (MWCNT) into the epoxy matrix in different weight percentages improves the physio-mechanical properties. The MWCNT was supplemented at 0.25, 0.5, 0.75, and 1 wt% to investigate the mechanical aspects of composite samples. The nanofiller (MWCNT) dispersion in the epoxy matrix was simulated using X-ray diffraction (XRD) and Energy Dispersive X-Ray Analysis (EDX). The results were compared to the neat (pristine) sample to study the influence of nano-supplement. The Tensile, Flexural, and Impact tests were the selected experiments to assess the material characteristics. The findings show the feasibility of the developed samples for lightweight structural applications such as toy items, wall tiles, roof tiles, sound insulation, and roadside barriers. It could be endorsed as a feasible way to handle the waste issues generated by the carpet and textile sources.
Low Tumor Infiltrating Mast Cell Density Reveals Prognostic Benefit in Cervical Carcinoma
Authors: Guo Fan , Kong Wei-Na , Li De-Wei , Zhao Gang , Wu Hui-Li , Anwar Miyessar , Shang Xiao-Qian , Sun Qian-Nan , Ma Cai-Ling , Ma Xiu-Min
Published: June 2022

Objectives: Research on the role of mast cells (MCs) in cervical tumor immunity is more limited. Therefore, our study aimed to evaluate the prognostic value of MCs and their correlation with the immune microenvironment of cervical carcinoma (CC). Methods: The Cancer Genome Atlas (TCGA) data was utilized to obtain the degree of immune infiltration of MCs in CC. Meanwhile, this study retrospectively collected patient clinical characteristic data and tissue specimens to further verify the relevant conclusions. Mast cell density (MCD) was measured by the CIBERSORT algorithm in TCGA data and immunohistochemical staining of tryptase in CC tissues. Finally, differentially expressed genes (DEGs) of TCGA data were performed using “limma” packages and key gene modules were identified using the MCODE application in Cytoscape. Results: The results showed MCs were diffusely distributed in CC tissues. Moreover, we found that low tumor-infiltrating MCD was beneficial for overall survival (OS) in the TCGA cohort. Consistent conclusions were also obtained in a clinical cohort. In addition, a total of 305 DEGs were analyzed between the high tumor-infiltrating MCD and low tumor-infiltrating MCD group. Seven key modules, a total of 34 genes, were screened through the MCODE plug-in, which was mainly related to inflammatory response and immune response and closely correlated with cytokines including CSF2, CCL20, IL1A, IL1B, and CXCL8. Conclusion: In short, high tumor-infiltration MCs in CC tissue was associated with worse OS in patients. Furthermore, MCs were closely related to cytokines in the tumor microenvironment, suggesting that they collectively played a role in the immune response of the tumor. Therefore, MCD may be a potential prognostic indicator and immunotherapy target of CC.
Voxel-Level BED Corrected Dosimetric and Radiobiological Assessment of 2 Kinds of Hybrid Radiotherapy Planning Methods for Stage III NSCLC
Authors: Wang Hao , Huang Ying , Chen Hua , Shao Yan , Duan Yanhua , Feng Aihui , Gu Hengle , Ma Xiurui , Xu Zhiyong , Kong Qing , Zhou Yongkang
Published: June 2022

Background/purpose: To access the comparative dosimetric and radiobiological advantages of two methods of intensity-modulated radiation therapy (IMRT)-based hybrid radiotherapy planning for stage III nonsmall cell lung cancer (NSCLC). Methods: Two hybrid planning methods were respectively characterized by conventional fraction radiotherapy (CFRT) and stereotactic body radiotherapy (SBRT) and CFRT and simultaneous integrated boost (SIB) planning. All plans were retrospectively completed using the 2 methods for 20 patients with stage III NSCLC. CFRT and SBRT dose regimes 2 Gy  ×  30 f and 12.5 Gy  ×  4 f were, respectively, used for planning target volume of lymph node (PTVLN) and planning target volume of the primary tumor (PTVPT), while dose regimes 2 Gy  ×  26 f for PTVLN and sequential 2 Gy  ×  4 f for PTVLN combined with 12.5 Gy  ×  4 f for PTVPT were adopted for CFRT and SIB plans. SBRT and SIB EQD2 dose were calculated voxel by voxel, and then, respectively, superimposed with 30-fraction and 26-fraction CFRT plan dose to achieve biological equivalent dose (BED) dosimetric parameters of CFRT and SBRT and CFRT and SIB plans. Tumor control probability (TCP)/normal tissue complication probability (NTCP) was, respectively, calculated by equivalent uniform dose/Lyman–Kutcher–Burman models. BED plan parameters and TCP/NTCP were analyzed between 2 methods of hybrid planning. Primary tumor/lymph node (LN)/total TCP values were, respectively, evaluated as a function of the radiation dose needed to control 50% of tumor (TCD50) for 20 patients. Dosimetric errors were analyzed by nontransit electronic portal imaging device dosimetry measurement during hybrid plan delivery. Results: Statistically lower BED plan parameters of PTVLN D2 and homogeneity index resulted in slightly lower averaged LN/total TCP curves by CFRT and SIB planning. The gaps between Max and Min LN/total TCP curves were significantly closer for CFRT and SIB planning, which indicated better robustness of LN/total TCPs. A lower esophagus dose resulted in a lower esophagus NTCP by CFRT and SIB planning, which may be compromised by 1 week shorter overall treatment time by CFRT and SIB irradiation. Spinal cord Dmax was significantly reduced by CFRT and SIB plans. The dose verification results of the subplans involved in hybrid plans were acceptable, which showed that the 2 methods of hybrid planning could be delivered accurately in our center. Conclusion: CFRT and SIB plannings have more advantages on BED plan parameters and TCP/NTCP than CFRT and SBRT planning, and both methods of IMRT-based hybrid planning could be executed accurately for stage III NSCLC. The effectiveness of the results needs to be validated in the hybrid trial.
NTCP Change in Rats of Hilar Cholangiocarcinoma and Therapeutic Significance
Authors: Zhang Meng-yu , Luo Ming , He Kai , Xia Xian-ming , Wang Jie-ping
Published: June 2022

Background: The study aims to detect the expression of Na+/taurocholate cotransporter polypeptide in hilar cholangiocarcinoma of rat model, to provide a new therapeutic target for gene therapy of hilar cholangiocarcinoma. Methods: 60 male Wistar rats (weighing 190 ± 8 g) were randomly divided into 3 groups (experimental group, control group, and sham operation group; 20 rats in each group). The 3 groups were fed with standard diet. The QBC939 cell suspension of cholangiocarcinoma was injected into the hilar bile duct in the experimental group with a micro syringe. The control group was injected with normal saline, and the sham operation group was not injected with any drugs. Comprehensive behavior score and Basso Beattie Bresnahan were used to evaluate the mental state and exercise of rats every day. At 5 weeks, one rat in the experimental group was killed, and the changes in hilar bile duct were recorded. The procedure was repeated at one and half months. After one and half months, hilar cholangiocarcinoma only occurred in the experimental group. Pathological examination confirmed the formation of tumor, and hilar bile duct tissues were taken from the 3 groups. Na+/taurocholate cotransporter polypeptide expression in hilar bile duct was detected by real-time polymerase chain reaction and immunohistochemistry. Results: After 2 weeks, the rats in experimental group ate less, and their weight was significantly reduced compared with the other 2 groups. One and half months later, hilar cholangiocarcinoma was detected in 16 rats in the experimental group. The levels of alanine aminotransferase and aspartate transaminase in the experimental group were higher than those in the other 2 groups. The ratio of Na+/taurocholate cotransporter polypeptide/GAPDH mRNA in hilar cholangiocarcinoma, control group, and sham operation group was significantly different. Under the light microscope, Na+/taurocholate cotransporter polypeptide protein reacted with anti-Na+/taurocholate cotransporter polypeptide antibody and showed granular expression. Every pathological section included 4800 cells. 3823 positive cells were in the experimental group, 1765 positive cells were in the control group, and 1823 positive cells were in the sham operation group. Conclusions: Na+/taurocholate cotransporter polypeptide expression in hilar cholangiocarcinoma of rats was significantly higher than normal hilar bile duct tissues, suggesting that drugs targeting Na+/taurocholate cotransporter polypeptide may be a new strategy for the treatment of hilar cholangiocarcinoma.
Epidemiology of Diabetes Foot Amputation and its Risk Factors in the Middle East Region: A Systematic Review and Meta-Analysis
Authors: Bandarian Fatemeh , Qorbani Mostafa , Nasli-Esfahani Ensieh , Sanjari Mahnaz , Rambod Camelia , Larijani Bagher
Published: June 2022

This study aimed to review epidemiology of diabetic foot (DF) amputation and provide a pooled estimation of DF amputation rate in the region. A comprehensive search was performed in Web of Science, PubMed, Scopus and EMBASE databases using appropriate search term. Obtained records were entered endnote software and after removing duplicats were screened by title, abstract and full text. Data was extracted from the remained documents. Random effect meta-analysis was used to pool the estimated prevalence rate due to sever heterogeneity between studies. Finally 17 articles in diabetes, 20 in patients with DFU (diabetic foot ulcer) and two in both remained after screening and included in meta-analysis. Overall pooled amputation rate in diabetes was 2% (95% CI: 1%-3%) which was not significantly different between countries. The pooled prevalence of amputation rate in DFU patients was 33% (24%-43%) and the pooled prevalence in Saudi Arabia was significantly higher than in other countries. The estimated rate of foot amputation in diabetes patients and those with DFUs in the Middle East region is approximately high, which may indicate low quality of preventive foot care, low socioeconomics and low patients awareness or education in countries with high amputation rate.
A Critical Assessment of the Quality of Reporting of Ethical Protections in Medical Papers Published in Turkey
Authors: Temel M. Kemal
Published: June 2022

The Declaration of Helsinki (DoH), the International Committee of Medical Journal Editors (ICMJE) recommendations, and the Committee on Publication Ethics (COPE) guidelines outline the basic principles for ethical conduct and publication of human-subject research, most notably informed consent (IC) and research ethics committee (REC) approval. This retrospective observational study was a first study to investigate the quality of reporting of these protections in a selected sample of medical papers published in Turkey. A total of 573 research articles published in the official journals of six leading Turkish medical schools between January 2018 and December 2020 were searched for information on obtaining (i) REC approval, (ii) written IC from research subjects or their legal guardians/representatives, and (iii) an REC-granted IC waiver when it was found, as stated in the DoH, “impossible or impracticable to obtain consent” from research subjects. Similarly, a total of 166 case reports were searched for a statement about publication-specific IC, as was recommended by COPE. Despite a statistically significant improvement over the years, the overall rates were found to be unsatisfactory. The protections were particularly misused or underused in retrospective research, where the rates of reporting written IC (15.41% vs. 48.61%) and REC approval with date and reference number information (45.38% vs. 61.11%) were significantly lower than in prospective research ( p < .05). Both the practices of seeking and granting an IC waiver when no IC was obtained were extremely rare (n = 3). It was also found that the requirement of structured ethical information in research papers was associated with higher levels of ethics compliance, and that medical publishing in Turkey needed specific improvements, including better implementation of the protections already adopted in principle, clearer instructions for authors, more rigorous editorial scrutiny, and greater commitment to rejecting substandard submissions.
An Unusual Case of Bilateral Subperiosteal Orbital Hemorrhage
Authors: Uysal Sanem P. , Hassett Catherine E. , Dani Dhimant
Published: June 2022

Subperiosteal orbital hemorrhage usually occurs in the setting of facial or orbital trauma. Non-traumatic subperiosteal orbital hemorrhage (NTSOH) has rarely been reported in literature. The proposed mechanism of NTSOH is the transmission of sudden increase in cranial venous pressure to the orbital veins, which are valveless. We present a case of a 37 year old right-handed woman with a past medical history significant for type 1 diabetes, end-stage renal disease, peripheral artery disease and hypertension who developed NTSOH following an elective revision of a clotted right upper extremity arteriovenous fistula. During this procedure, she had acute eye pain, bilateral complete vision loss and emesis. CT of the orbits revealed large heterogeneously hyperdense lesions in the bilateral orbital apex extending anteriorly along the roof of the orbit, concerning for hemorrhage. Cultures obtained through nasal endoscopy were negative for a bacterial or fungal infection involving the sinuses. Ophthalmology was consulted and she underwent bilateral canthotomy and lateral cantholysis. Postoperatively, she was started on systemic and topical ocular antihypertensives, as well as prophylactic antibiotics. Visual acuity remained poor with finger counting on the right eye and lack of consistent response to light on the left eye. This case highlights periprocedural increase in systemic venous pressure secondary to a fistula repair procedure as a potential cause of NTSOH.
A gamified app for supporting undergraduate students’ mental health: A feasibility and usability study
Authors: Nicolaidou Iolie , Aristeidis Loizos , Lambrinos Lambros
Published: June 2022

Resilience, a person's mental ability to deal with challenging situations adaptively, is an important life skill. Supporting students in building psychological resilience and coping during crises (with the COVID-19 pandemic being a prime example) is crucial. Very few mobile applications (apps) for mental health explicitly report behavioral change techniques. Moreover, only a handful of the apps that support resilience are gamified, or use smartphone sensors readily available in modern smartphones for health self-management, or were designed for use by a nonclinical population. This study describes the design of a prototype for a gamified, theory-based mobile app that utilizes the Internet of Things to provide personalized data and enhance undergraduate students’ resilience. A total of 74 participants evaluated the prototype and completed an online questionnaire during the COVID-19 lockdowns. The questionnaire included questions examining the design's feasibility for supporting resilience and questions on the System Usability Scale evaluating its usability. Regarding the evaluation of the prototype on improving psychological resilience, positive responses ( M = 3.76 out of 5, SD = 0.82) were received for all functions (goal setting for studying, socializing and physical exercise, progress monitoring using sensors or self-reporting, reflection, motivational badges). The System Usability Scale returned an evaluation score of 72.9, indicating a satisfactory degree of usability. The resilience app is a promising proof of concept. Combining Internet of Things capabilities with active user interaction while incorporating behavior change techniques in a gamified environment was well accepted by students. Implications for the design of gamified environments for well-being are drawn. Future research will empirically validate its design using quasi-experimental methods.
Association Between Anesthetics and Postoperative Delirium in Elderly Patients Undergoing Spine Surgery: Propofol Versus Sevoflurane
Authors: Chang Jee-Eun , Min Seong-Won , Kim Hyerim , Won Dongwook , Lee Jung-Man , Kim Tae Kyong , Kim Chanho , Hwang Jin-Young
Published: June 2022

Study designs

Retrospective Observational Study Objectives: To compare the incidence of POD after propofol- and sevoflurane-based anesthesia in elderly patients undergoing spine surgery.

Methods

In this study, the medical records of elderly patients ≥ 65 years of age who underwent spine surgery under total intravenous anesthesia with propofol or inhalational anesthesia with sevoflurane were reviewed. The primary outcome was the incidence of POD after propofol- and sevoflurane-based anesthesia. Secondary outcomes included postoperative 30-day complications, length of postoperative hospital stay, associations of patient characteristics, and surgery- and anesthesia-related data with the development of POD, and associations of anesthetics with clinical outcomes such as postoperative 30-day complications, and length of postoperative hospital stay.

Results

Of the 281 patients, POD occurred in 29 patients (10.3%). POD occurred more frequently in the sevoflurane group than in the propofol group (15.7% vs. 5.0%, respectively; P=.003). The multivariable logistic regression analysis showed that sevoflurane-based anesthesia was associated with an increased risk of POD compared with propofol-based anesthesia (odds ratio [OR], 4.120; 95% confidence interval [CI], 1.549−10.954; P = .005), whereas anesthetics were not associated with postoperative 30-day complications and the length of postoperative hospital stay. Older age (OR, 1.242 CI, 1.130−1.366; P < .001) and higher mean pain score at postoperative day 1 (OR, 1.338 CI, 1.056−1.696; P = .016) were also associated with an increased risk of POD.

Conclusions

Propofol-based anesthesia was associated with a lower incidence of POD than sevoflurane-based anesthesia in elderly patients after spine surgery.
Applying Charismatic Leadership to Support Learner Engagement in Virtual Environments: Teaching and Learning in a Time of Crisis
Authors: Queen Courtney
Published: June 2022

The institutional spaces of education and health were transformed as a result of COVID-19. The shift to emergency remote education can occur in many contexts, more than once, and with differing degrees of severity. During these periods of disruption, educators are affected and are met with professional challenges. These challenges include maintaining curriculum flexibility in response to rapidly change teaching modalities while maintaining effective delivery of educational programing. Whether in a traditional setting or online classroom, evidence from classical leadership theory can ease this transition allowing the educator to keep the learner engaged, especially in virtual learning environments.
COVID-19-Related Knowledge and Anxiety Among Health-Care Workers in a Tertiary Care Centre in Kerala
Authors: K. P. Lakshmi , Prasanna Preetha , Chandra Subash , G. Krishnan Arya , Babu Abhinandh , Babu Binil , Moni Merlin , Sathyapalan Dipu T.
Published: June 2022

Introduction

The COVID-19 pandemic has posed an immense threat to both physical as well as mental health globally. The outbreak is immeasurably affecting all the communities worldwide. The pandemic fatigue has led to inadequate addressing of the impact of COVID-19 on mental health especially among the health-care workers (HCWs), mainly due to the fear of disease contraction, mortality of the condition, raised work stress, as well as the saturation of news on media and other social platforms. Prolonged confinement at home may also adversely impact mental health.

Method

An online survey was conducted using a developed questionnaire to evaluate the knowledge and anxiety among 118 HCWs regarding the COVID-19 pandemic in a tertiary care hospital. Since the study was conducted during the period in which no standard questionnaires were available, an online questionnaire was developed based on a few articles published in indexed journals on the similar topic which was further approved by 5 experts in the field. The questionnaire along with an informed consent was sent to all the HCWs employed in the hospital to assess their knowledge and anxiety related to COVID-19.

Result

A total of 92.47% of participants were strongly aware that the major mechanism in COVID spread is droplet infection. An equal percentage of participants had good knowledge that the infection can always be prevented by maintaining social distance, appropriate hand washing, hand sanitizing, and using a mask. However, around 40.67% of participants avoided large meetings even in hospitals due to fear of the pandemic.

Conclusion

It is important to study the mental health impacts of HCWs during the pandemic. There is a need to intensify the awareness program and address the mental health issues of HCWs during this COVID-19 pandemic.
Human lungs show limited permissiveness for SARS-CoV-2 due to scarce ACE2 levels but virus-induced expansion of inflammatory macrophages
Authors: Hönzke Katja , Obermayer Benedikt , Mache Christin , Fatykhova Diana , Kessler Mirjana , Dökel Simon , Wyler Emanuel , Baumgardt Morris , Löwa Anna , Hoffmann Karen , Graff Patrick , Schulze Jessica , Mieth Maren , Hellwig Katharina , Demir Zeynep , Biere Barbara , Brunotte Linda , Mecate-Zambrano Angeles , Bushe Judith , Dohmen Melanie , Hinze Christian , Elezkurtaj Sefer , Tönnies Mario , Bauer Torsten T. , Eggeling Stephan , Tran Hong-Linh , Schneider Paul , Neudecker Jens , Rückert Jens C. , Schmidt-Ott Kai M. , Busch Jonas , Klauschen Frederick , Horst David , Radbruch Helena , Radke Josefine , Heppner Frank , Corman Victor M. , Niemeyer Daniela , Müller Marcel A. , Goffinet Christine , Mothes Ronja , Pascual-Reguant Anna , Hauser Anja Erika , Beule Dieter , Landthaler Markus , Ludwig Stephan , Suttorp Norbert , Witzenrath Martin , Gruber Achim D. , Drosten Christian , Sander Leif-Erik , Wolff Thorsten , Hippenstiel Stefan , Hocke Andreas C.
Published: June 2022

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) utilises the angiotensin-converting enzyme 2 (ACE2) transmembrane peptidase as cellular entry receptor. However, whether SARS-CoV-2 in the alveolar compartment is strictly ACE2-dependent and to what extent virus-induced tissue damage and/or direct immune activation determines early pathogenesis is still elusive.

Methods

Spectral microscopy, single-cell/-nucleus RNA sequencing or ACE2 “gain-of-function” experiments were applied to infected human lung explants and adult stem cell derived human lung organoids to correlate ACE2 and related host factors with SARS-CoV-2 tropism, propagation, virulence and immune activation compared to SARS-CoV, influenza and Middle East respiratory syndrome coronavirus (MERS-CoV). Coronavirus disease 2019 (COVID-19) autopsy material was used to validateex vivoresults.

Results

We provide evidence that alveolar ACE2 expression must be considered scarce, thereby limiting SARS-CoV-2 propagation and virus-induced tissue damage in the human alveolus. Instead,ex vivoinfected human lungs and COVID-19 autopsy samples showed that alveolar macrophages were frequently positive for SARS-CoV-2. Single-cell/-nucleus transcriptomics further revealed nonproductive virus uptake and a related inflammatory and anti-viral activation, especially in “inflammatory alveolar macrophages”, comparable to those induced by SARS-CoV and MERS-CoV, but different from NL63 or influenza virus infection.

Conclusions

Collectively, our findings indicate that severe lung injury in COVID-19 probably results from a macrophage-triggered immune activation rather than direct viral damage of the alveolar compartment.
Identification of pan-kinase-family inhibitors using graph convolutional networks to reveal family-sensitive pre-moieties
Authors: Lin Xiang-Yu , Huang Yu-Wei , Fan You-Wei , Chen Yun-Ti , Pathak Nikhil , Hsu Yen-Chao , Yang Jinn-Moon
Published: June 2022

Background

Human protein kinases, the key players in phosphoryl signal transduction, have been actively investigated as drug targets for complex diseases such as cancer, immune disorders, and Alzheimer’s disease, with more than 60 successful drugs developed in the past 30 years. However, many of these single-kinase inhibitors show low efficacy and drug resistance has become an issue. Owing to the occurrence of highly conserved catalytic sites and shared signaling pathways within a kinase family, multi-target kinase inhibitors have attracted attention.

Results

To design and identify such pan-kinase family inhibitors (PKFIs), we proposed PKFI sets for eight families using 200,000 experimental bioactivity data points and applied a graph convolutional network (GCN) to build classification models. Furthermore, we identified and extracted family-sensitive (only present in a family) pre-moieties (parts of complete moieties) by utilizing a visualized explanation (i.e., where the model focuses on each input) method for deep learning, gradient-weighted class activation mapping (Grad-CAM).

Conclusions

This study is the first to propose the PKFI sets, and our results point out and validate the power of GCN models in understanding the pre-moieties of PKFIs within and across different kinase families. Moreover, we highlight the discoverability of family-sensitive pre-moieties in PKFI identification and drug design.
Testing alternative hypotheses on the origin and speciation of Hawaiian katydids
Authors: Rakesh Mohan , Aris-Brosou Stephane , Xia X.
Published: June 2022

Background

Hawaiian Islands offer a unique and dynamic evolutionary theatre for studying origin and speciation as the islands themselves sequentially formed by erupting undersea volcanos, which would subsequently become dormant and extinct. Such dynamics have not been used to resolve the controversy surrounding the origin and speciation of Hawaiian katydids in the genusBanza, whose ancestor could be from either the Old-World generaRuspoliaandEuconocephalus, or the New WorldNeoconocephalus.To address this question, we performed a chronophylogeographic analysis ofBanzaspecies together with close relatives from the Old and New Worlds.

Results

Based on extensive dated phylogeographic analyses of two mitochondrial genes (COX1andCYTB), we show that our data are consistent with the interpretation that extantBanzaspecies resulted from two colonization events, both by katydids from the Old World rather than from the New World. The first event was by an ancestral lineage ofEuconocephalusabout 6 million years ago (mya) after the formation of Nihoa about 7.3 mya, giving rise toB. nihoa.The second colonization event was by a sister lineage ofRuspolia dubia.The dating result suggests that this ancestral lineage first colonized an older island in the Hawaiian–Emperor seamount chain before the emergence of Hawaii Islands, but colonized Kauai after its emergence in 5.8 mya. This second colonization gave rise to the rest of theBanzaspecies in two major lineages, one on the older northwestern islands, and the other on the newer southwestern islands.

Conclusion

Chronophylogeographic analyses with well-sampled taxa proved crucial for resolving phylogeographic controversies on the origin and evolution of species colonizing a new environment.
Caenorhabditis elegans DAF-16 regulates lifespan and immune responses to Cryptococcus neoformans and Cryptococcus gattii infections
Authors: Kitisin Thitinan , Muangkaew Watcharamat , Sukphopetch Passanesh
Published: June 2022

Background

Cryptococcosis is a life-threatening infection is primarily caused by two sibling species Cryptococcus neoformans and Cryptococcus gattii. Several virulence-related factors of these cryptococci have been widely investigated in Caenorhabditis elegans, representing a facile in vivo model of host–pathogen interaction. While recent studies elucidated cryptococcal virulence factors, intrinsic host factors that affect susceptibility to infections by cryptococci remain unclear and poorly investigated.

Results

Here, we showed that defects in C. elegans insulin/insulin-like growth factor-1 (IGF-1) signaling (IIS) pathway influenced animal lifespan and mechanisms of host resistance in cryptococcal infections, which required the activation of aging regulator DAF-16/Forkhead box O transcription factor. Moreover, accumulation of lipofuscin, DAF-16 nuclear localization, and expression of superoxide dismutase (SOD-3) were elevated in C. elegans due to host defenses during cryptococcal infections.

Conclusion

The present study demonstrated the relationship between longevity and immunity, which may provide a possibility for novel therapeutic intervention to improve host resistance against cryptococcal infections.
Systematic analysis of the sugar accumulation mechanism in sucrose- and hexose- accumulating cherry tomato fruits
Authors: Sun Lulu , Wang Jianli , Lian Liqiang , Song Jian , Du Xueni , Liu Wenke , Zhao Wenchao , Yang Liu , Li Changbao , Qin Yong , Yang Rui
Published: June 2022

Background

Sugar content is an important indicator of fruit quality. Except for a few wild tomato species that accumulate sucrose in the fruits, most cultivated tomato species accumulate hexose. Although several studies have focused on wild sucrose-accumulating tomato, the sucrose accumulation mechanism is still unclear.

Results

Here, two homozygous inbred cherry tomato lines (‘TB0023’ and ‘TB0278’, which accumulated sucrose and hexose, respectively) were selected to analyze the sugar accumulation mechanism. Carbohydrate analysis, cytological observation, gene expression and enzyme activity analysis and proteomics methods were used in this study. The results indicated that glucose and fructose were absolutely dominant in the soluble sugar content of hexose-accumulating cherry tomato fruit, while sucrose and a certain proportion of hexose were the main forms of soluble sugar in sucrose-accumulating cherry tomato fruit. The phloem unloading pathway of the hexose-accumulating cherry tomato fruit switched from symplastic to apoplastic during fruit development, and the sucrose-accumulating cherry tomato probably had a mixed unloading pathway involving the symplastic and apoplastic. High activity of acid invertase (AI), sucrose phosphate synthase (SPS), sucrose synthase (SS) and sugar transporters LeSUT1, SlSWEET2a and SlSWEET12c were important factors for hexose accumulation in the hexose-accumulating cherry tomato fruit, while LeSUT2, SPS, SS, SlSWEET1b, SlSWEET5b, SlSWEET11b, SlSWEET7a, SlSWEET14 were responsible for solute sugar accumulation in the sucrose-accumulating cherry tomato.

Conclusions

This study provides detailed evidence for elucidation of the tomato sugar accumulation mechanism from the perspective of cell structure, physiology and molecular biology, providing a theoretical basis for the improvement of tomato quality and aiding the utilization of tomato genetic resources.