bluuebunny/crossref_metadata_2025 huggingface dataset:
Associação entre o estresse oxidativo e estado inflamatório com variáveis extrapulmonares em tabagistas
Authors: Lopes Helenize Veron , Félix Andressa Brum , Da Silva André Felipe Santos , Brancher Elizabeth Do Canto , Prestes Daniele , Steidl Eduardo Matias Dos Santos , Mancopes Renata , Pasqualoto Adriane Schmidt
Published: April 2020

Objetivo: Avaliar o estresse oxidativo e estado inflamatório de tabagistas e não tabagistas e analisar a associação com variáveis extrapulmonares. Métodos: Estudo transversal e descritivo, onde a amostra foi composta por 10 tabagistas (GT) e 10 não tabagistas. Após a espirometria, foram submetidos à análise do Hemograma, da Proteína C-Reativa us e TBARS e avaliação da força muscular respiratória, capacidade funcional e da qualidade de vida. A homogeneidade das variáveis foi testada pelo teste Levene, as diferenças entre os grupos foram analisadas pelo teste t de Student ou teste U de Mann-Whitney. Associações entre as variáveis foram avaliadas pelo teste de correlação de Pearson ou Spearman. Resultados: GT apresentou carga tabágica de 29,49±33,66 anos/maço e consumo diário de cigarros de 13,5±8,5. Foi encontrada diferença entre os grupos no nível de leucócitos 9750±2269 X 7320±1692 (p=0,028) entre os grupos. Houve associação entre PCR-us e carga tabágica (r= 0,806; p=0,007) e entre TBARS e PEmáx (r= 0,818; p= 0,006). Conclusão: houve presença de leucocitose no GT, bem como associação entre PCR-us e carga tabágica e entre PEmáx e TBARS. Não foram encontradas associações das demais variáveis com os níveis de TBARS e PCR-us.
Efficiency of fluid organomineral fertilizer with pig slurry in nitrogen and phosphorus availability
Authors: Grohskopf Marco André , Cruz Caio Vilela , Ferreira-Eloy Natália Rodrigues , Fernandes Dirceu Maximino , Büll Leonardo Teodoro , Corrêa Juliano Corulli
Published: April 2020

The use of pig slurry (PS) in fluid fertilizer formulation, for nitrogen (N) and phosphorus (P) supply, consists of an innovative technology due to this waste reuse in the environment. The objective of this study was to assess the agronomic efficiency of fluid organomineral fertilizers with PS concerning solid and fluid forms of soluble minerals as a source of N and P in a Typic Quartzipsamment (Entisol) and Typic Hapludox (Oxisol). Two experiments were carried out in a greenhouse, with three sequential cultivations in a completely randomized design. Experiment 1: was composed of N and presented the treatments Without-Nitrogen (N-W), solid mineral (N-SM), fluid mineral (N-FM), and fluid with PS (N-FO). Experiment 2: was composed of P and presented the treatments Without-Phosphorus (P-W), solid mineral (P-SM), fluid mineral (P-FM), and fluid with PS (P-FO). The fertilizer N-FO presented a lower N use efficiency by crops in Entisol when compared to the granular fertilizer N–SM, but a higher efficiency in Oxisol. For phosphorus, the fertilizer P-FO was more efficient concerning the solid mineral source P-SM in both Oxisol and Entisol soils. Fluid organomineral fertilizer with PS demonstrated to be a promising source of N and P for crop fertilization, especially in sandy soils, however, more studies are needed with this fertilizer type and its effect on plants and into acid soils of variable charges.
Effects of Risk Assessment, Control Environment and Control Activities on Performance of Listed Banks in Ghana
Authors: Ayimpoya Redruth Nyaaba , Akolgo David Amoah , Mbilla Simon Akumbo Eugene , Gbegble Michael Kwame
Published: April 2020

Globally, internal controls serve many important purposes for public private and public help organizations. There is however an increasing call for better and improved internal control systems especially in firms that are listed on public market. However, internal control systems, irrespective of how well conceived and implemented cannot provide absolute assurance of management and boards regarding the achievement of objectives. This research focused on the three components of internal control systems namely control environment, risk assessment, and control activities. This study therefore formulated four objectives and investigated how risk assessment, control activities, and control environment affects the performance of Ghanaian banks. In this quantitative study, representatives from twelve listed banks were engaged. Descriptive and regression analysis was performed on the field data. The study result shows while Risk assessment has a strong significant effect on financial performance, Control environment and Control activities, have a weak significant effect on financial performance. The practical implication of the study is that, when assessing the performance of banks, risk areas must be examined critically to reduce or eliminate their impacts on bank performance.
Assessment of Serum Zinc and Copper Levels among Sudanese Patients with Diabetes Mellitus Type 2 in Khartoum State-Sudan
Authors: Omer Thowyba Elhadi , Saeed Abdelwahab Abdien , Elmukashfi Salman Taha Ahmed
Published: April 2020

Background: Diabetes population in Sudan is around one million 90% have type 2 diabetes. In Sudan diabetes is as increasing problem, being responsible for 10% of hospital admission and mortality.

Measurement of zinc and copper is an important in decrease development of complication of DM, any disturbance in level of both zinc and copper have role in pathogenesis, prognosis of type 2 DM. This study aimed to assess the relationship between DM type 2 and trace elements by measured serum zinc and serum copper levels among Sudanese DM type 2 in Khartoum state.

Materials and Methods: This is a descriptive, case control study, was conducted in Khartoum state, Sudan. During the period from April to July 2018. Forty Sudanese patients with DM (20 controlled patients with DM and 20 uncontrolled patients with DM) Diabetes patients were divided into controlled and uncontrolled groups by measuring HbA1C. (Female 25% and male 15%), with different age. were selected as case and 30 apparently healthy individuals were selected as control group. Serum zinc and copper levels were analysis using Atomic Absorption Spectroscopy and ichroma for HbA1c, the obtained results were analyzed using social science software package.

Results: This study showed significant lower of serum zinc in diabetes type 2 patients comparison with control group and on another hand showed significant increase of serum copper in diabetes type 2 patients.

We concluded serum zinc significant lower in both diabetes group than healthy group, copper significant high in both diabetes group than healthy group, gender have significant effect in serum zinc and copper, weak positive correlation between zinc and HbA1C and weak negative correlation between copper and HbA1C.

Conclusion: This study concluded that the serum levels of Zinc significant lower in type 2 diabetes than healthy individuals. Serum levels of Copper significant increase in type 2 diabetes than healthy individuals as have been found in present study. Gender have significant effect in serum Zn and Cu in diabetic patients.

Weak Positive correlation between serum Zinc with HbA1c and weak negative correlation between copper with HbA1c.
Optimized incompressible smoothed particle hydrodynamics methods and validations
Authors: Ramos Ortega Melissa , Beaudoin Anthony , Huberson Serge
Published: April 2020

The solution of the Poisson's equation used by the incompressible smoothed particle hydrodynamics (ISPH) methods for estimating the pressure field is expensive in CPU time. The CPU time, consumed by the inversion of the operator ∇(1/ρ∇) and the estimation of the right hand side of the Poisson's equation, increases with the number N of particles used in a purely Lagrangian framework. In this work, this default of ISPH methods is overcome by solving the Poisson's equation on a Cartesian grid. This SPH‐mesh coupling is equivalent to the particle in cell method. In a first step, in order to analyze its efficiency, the optimized version of two ISPH methods (divergence free and density invariant) is compared with the standard weakly compressible SPH method through two benchmarks of incompressible bidimensional flows characterized by the Reynolds number Re, Lamb‐Oseen vortex (10 ≤Re≤ 100) and lid‐driven cavity flow (100 ≤Re≤ 1000). In a second step, the numerical results obtained by the three SPH methods are compared to laboratory experimental data of a dam break flow in order to show the performance of the SPH‐mesh coupling in a practical and complex flow problem. As in the configuration of the experimental setup, the numerical results are obtained for a Reynolds number Re = 3.8 106.
Development and functional analysis of an anticancer T‐cell medicine with immune checkpoint inhibitory ability
Authors: Fujiwara Kento , Shigematsu Kazuki , Tachibana Masashi , Okada Naoki
Published: April 2020

Adoptive cell therapy using patients' own T‐cells is expected to be an ideal cancer treatment strategy with excellent antitumor effects and low side effects. However, this therapy targeting solid tumors is unlikely to be effective because tumor tissues have an environment that suppresses T‐cell function. In particular, interaction between programmed death‐1 (PD‐1) and its ligand (PD‐L1) inhibits T‐cell activation by which T‐cells eliminate tumor cells. Here, we attempted to develop T‐cells that can exert potent antitumor activity even in tumor tissues by genetically modifying them to express the anti‐PD‐L1 membrane‐anchoring type single chain variable fragment (M‐scFv) that can inhibit PD‐L1/PD‐1 interaction. Anti‐PD‐L1 M‐scFv could be expressed on T‐cells while maintaining PD‐L1‐binding ability. Although T‐cell proliferation induced by CD3 stimulation was decreased depending on the PD‐L1 stimulation intensity, M‐scFv‐expressing T‐cells showed high proliferative activity even in the presence of PD‐L1 by avoiding the PD‐L1/PD‐1‐mediated suppression. Furthermore, M‐scFv‐expressing T‐cells showed higher cytotoxic activity against PD‐L1high tumor cells than that of mock T‐cells. The effect of PD‐L1/PD‐1 blockade was more pronounced when the therapeutic target was low‐antigenic tumor cells with low major histocompatibility complex expression, presenting only the shared antigen. These results indicated that anti‐PD‐L1 M‐scFv expression was functional in avoiding T‐cell dysfunction by PD‐L1/PD‐1 interaction. Our concept of anti‐PD‐L1 M‐scFv‐expressing T‐cells is thus expected to improve the efficacy of T‐cell therapy and contribute to simplify the treatment system and reduce treatment costs compared with the combination therapy of T‐cells and antibodies.
Total synthesis of Cinncassin A1
Authors: Nuriye Ahmed Y. , Craescu Cristina V.
Published: April 2020

In this communication, we report the first total synthesis of the phenolic natural product Cinncassin A1, which was recently isolated from the twigs of the cinnamon plant (Cinnamomum cassia). The novel and concise synthesis strategy involves a highly diastereoselective titanium enolate homocoupling and a permanganate‐mediated oxidative lactonization reaction as key steps. The structure of the compound was verified by single‐crystal X‐ray crystallography.
Synthesis, cytotoxic, and carbonic anhydrase inhibitory effects of new 2‐(3‐(4‐methoxyphenyl)‐5‐(aryl)‐4,5‐dihydro‐1H‐pyrazol‐1‐yl)benzo[d]thiazole derivatives
Authors: Tugrak Mehtap , Gul Halise Inci , Sakagami Hiroshi , Gulcin Ilhami
Published: April 2020

2‐(3‐[4‐Methoxyphenyl]‐5‐aryl‐4,5‐dihydro‐1H‐pyrazol‐1‐yl)benzo[d]thiazoles (1b‐7b) were synthesized for the first time except 1b, and spectral methods such as 1H NMR, 13C NMR and HRMS were utilized to illuminate the chemical structures of the synthesized compounds. Phenyl (1b), 2‐methoxyphenyl (2b), 4‐methoxyphenyl (3b), 4‐methoxy‐3‐hydroxyphenyl (4b), 2,5‐dimethoxyphenyl (5b), 3,4,5‐trimethoxyphenyl (6b), or thiophene‐2‐yl (7b) was used as a aryl part. The inhibitory effects of the compounds were evaluated toward human carbonic anhydrase I and II enzymes (hCA I and hCA II). In vitro cytotoxic effects of the compounds against human oral squamous carcinomas and human normal oral cells were carried out via MTT. The compounds (1b‐7b) had Ki values of 36.87 ± 11.62‐66.24 ± 2.99 μM (hCA I) and 22.66 ± 1.41‐89.95 ± 6.25 μM (hCA II). Compounds 1b (Ki = 36.87 ± 11.62 μM) toward hCA I, 6b (Ki = 22.66 ± 1.41 μM) toward hCA II had significant enzyme inhibitory potency. Compound 6b had the highest tumor selectivity (TS = 29.3) and potency selectivity expression (PSE = 272.3) values. Therefore, compounds 1b and 6b with CAs inhibition effect and compound 6b with the cytotoxicity may be forwarded to further studies as potent compounds.
Editorial for “A Multiparametric MRI‐based Radiomics Nomogram for Predicting Lymphovascular Space Invasion in Endometrial Carcinoma”
Authors: Kido Aki , Nishio Mizuho
Published: April 2020

Level of Evidence

4

Technical Efficacy Stage

4 J. Magn. Reson. Imaging 2020;52:1263–1264.
Expedient Synthesis of Lupulones and Their Derivatization to 2,8‐7H‐Dihydrochromen‐7‐ones
Authors: Decuyper Lena , Kaur Gurkirat , Versyck Charlotte , Blondeel Eline , Depetter Yves , Van Hecke Kristof , D'hooghe Matthias
Published: April 2020

A convenient and improved method for the synthesis of beta acids or lupulones, which are known to possess e. g. anti‐cancer, anti‐inflammatory, anti‐oxidative and antimicrobial activity, has been developed successfully. Further derivatization of these complex structures to the corresponding dihydrochromen‐7‐ones, including the natural product machuone, was realized to simplify their analysis and to confirm their molecular structure. In addition to practical and safe laboratory procedures, the advantages associated with this new approach involve the use of water as a solvent and the direct crystallization of lupunones from acetonitrile, rendering our strategy more efficient and benign as compared to available methods.
Decentralization as a strategy of regime maintenance: The case of Yemen
Authors: Clausen Maria‐Louise
Published: April 2020

Proponents of decentralization often argue that decentralization makes governments more accountable and responsive to the governed. This is perhaps why the decentralization literature tends to overlook Middle Eastern regimes as these are among the most authoritarian and most centralized regimes in the world. However, many of these regimes have included decentralization in their legal framework. This article shows how a weak regime can use decentralization as a regime maintenance strategy when formal decentralization reforms strengthens external and internal legitimacy. The articles main argument builds on the literature on decentralization and elite capture to show how weak regimes can use formal decentralization reform to undermine local autonomy. The article uses the case of Yemen to make this argument. Yemen has a long tradition for local bottom‐up initiatives and there is widespread internal support for decentralization. Simultaneously, donors have seen decentralization as a way of strengthening the Yemeni state, leading to international support to the formulation of the Local Authority Law of 2000, Law 4/2000, an extensive legal decentralization framework.
New Developments for the Repair of Structural Engine Components with Laser Material Deposition
Authors: Müller Bernd
Published: April 2020

Driven by today's typical “power by the hour” type aftermarket support contracts (e.g. Corporate Care and Total Care) the demands for continuous operation of aircraft engines have increased significantly. For this reason, any disruption caused by heavy maintenance needs to be avoided. Where needed, repair operations should be as time, cost and material efficient as possible. However, service disruptions will still occur and wherever possible, the resulting maintenance intervention activities should take place either “on‐wing” or “near‐wing”. Consequently, it is the intention of Rolls‐Royce to introduce more and more in‐situ and minimal invasive maintenance capabilities, such as endoscopic laser material deposition (LMD), for the repair of structural engine components.
Testing the Potential of Regulatory Sigma Factor Mutants for Wastewater Purification or Bioreactor Run in High Light
Authors: Valev Dimitar , Kurkela Juha , Tyystjärvi Esa , Tyystjärvi Taina
Published: April 2020

It is shown that a freshly inoculated culture of the model cyanobacterium Synechocystis sp. PCC 6803 consumed almost all phosphate and 50% of nitrate within 6 days from the nutrient-rich BG-11 growth medium, indicating potential of cyanobacteria to purify wastewaters. Synechocystis sp. PCC 6803 control strain also collected nutrients efficiently from a landfill leachate wastewater KA2 (5.9–6.9 mM ammonium and 0.073–0.077 mM phosphate). Wastewaters might induce oxidative stress to microalgae, which prompted us to test growth of sigma factor inactivation strains, as ΔsigBCE and ΔsigCDE strains show superior growth in chemically induced oxidative stress. All cyanobacterial strains, including a stress-sensitive strain ΔsigBCDE, grew well in KA2 for four days, indicating that KA2 did not cause immediate oxidative stress. Completely arrested growth and bleaching of ΔsigBCDE cells after one week in KA2 wastewater point to the importance of group 2 sigma factor-mediated changes in gene expression during wastewater treatment. The growth of ΔsigBCD was arrested early in un-buffered and Hepes buffered (pH 7.5) KA2. In ΔsigBCD, all phosphate transporter genes are upregulated in standard conditions, and ΔsigBCD cells showed growth defects in low-phosphate BG-11 medium. ΔsigBCD cells removed phosphate slower from KA2 than the control strain, but phosphate supplementation of KA2 did not improve growth of ΔsigBCD. The ΔsigBCE strain showed superior growth in a laboratory-scale bioreactor in bright light and removed phosphate even slightly more efficiently than the control strain if KA2 was Hepes buffered although ΔsigBCE grew slowly in un-buffered KA2 and in low-phosphate BG-11 medium. The results indicate that engineering expression of regulatory group 2 sigma factor(s) might be useful for practical applications.
A negative correlation between RUV and αox in low-luminosity AGNs
Authors: Li Shuang-Liang
Published: April 2020

It has been controversial for years that the accretion mode is different for bright active galactic nuclei (AGNs) and low-luminosity AGNs (LLAGNs). In this work, we compile from literature a sample of 32 LLAGNs, consisting 18 LINERs and 14 low Eddington ratio (λ) Seyfert galaxies. A strong negative correlation between the radio loudness RUV and the optical to X-ray spectral index αox is reported for the first time. We further demonstrate that this negative correlation can be understood consistently and comprehensively under the truncated accretion — jet model, a model that has been applied successfully to LLAGNs. We argue that the scatter in the observations is mainly due to the spread in the viscosity parameter α of a hot accretion flow, a parameter that can potentially serve as a diagnosis of the strength and/or configuration of magnetic fields in accretion flows.
AGN and Star Formation Feedback in Galaxy Outflows
Authors: de Gouveia Dal Pino Elisabete M. , Clavijo-Bohórquez William , Melioli Claudio
Published: April 2020

Large-scale, broad outflows are common in active galaxies. In systems where star formation coexists with an AGN, it is unclear yet the role that both play on driving the outflows. In this work we present three-dimensional radiative-cooling MHD simulations of the formation of these outflows, considering the feedback from both the AGN and supernovae-driven winds. We find that a large-opening-angle AGN wind develops fountain structures that make the expanding gas to fallback. Furthermore, it exhausts the gas near the nuclear region, extinguishing star formation and accretion within a few 100.000 yr, which establishes the duty cycle of these outflows. The AGN wind accounts for the highest speed features in the outflow with velocities around 10.000 km s−1 (as observed in UFOs), but these are not as cold and dense as required by observations of molecular outflows. The SNe-driven wind is the main responsible for the observed mass-loading of the outflows.
The correlation between the total jet power and the Poynting flux at the jet base
Authors: Nokhrina Elena E.
Published: April 2020

The magneto hydrodynamic models of relativistic jets from active galactic nuclei predict the jet power transported by the Poynting flux at the jet base, setting the correlation between the jet power and the total magnetic flux. For highly collimated jets taking the transversal structure into account allows to rewrite this correlation through the observed jet properties such as spectral flux and core shift. Applying this method we find that, for the sample of 48 sources, their jet power distribution is well peaked at the theoretically predicted level.
X-ray probing of NGC 1275 nuclear region with Hitomi, Swift, and Suzaku
Authors: Fukazawa Yasushi
Published: April 2020

NGC 1275 has been known as a ppint-like X-ray source with a continuum and a Fe-K line. Unlike radio and GeV/TeV gamma-ray emissions, origin of X-ray emission is not yet understood; is it a jet emission like blazars or an accretion corona emission like Seyfert galaxies. X-ray emission is important to determine the SED of jet emission to constrain jet parameters and also understand the relation between accretion and jet. Here we report a recent X-ray probing of NGC 1275 nuclear region with Hitomi/SXS, Swift/XRT, and Suzaku/XIS. Hitomi/SXS gave the first opportunity to measure a Fe-K line of AGNs with several eV resolution. The line center is consistent with the neutral iron emission, and the width is constrained to be 500-1600 km/s (FWHM). This ruled out the origin of broad line region and inner accretion disk. A low-covering-fraction molecular torus or a rotating molecular disk around pc scales, illuminated by accretion corona emission, is suggested as a possible origin. For the continuum emission, Suzaku/XIS monitor observations revealed that the X-ray flux has gradually increased as the GeV gamma-ray flux. Swift/XRT showed a several-days flux increase, associated with the GeV gamma-ray flare. These results on the continuum emission suggests a contribution of jet emission to the X-ray emission. Based on the combined results of Fe-K line and continuum, we discuss some scenarios for X-ray emitting region.
The wind production from black hole hot accretion flow
Authors: Bu De-Fu
Published: April 2020

Observations of low luminosity active galactic nuclei (LLAGNs) and the hard state of black hole X-ray binaries (BHBs) show that the wind exists. Black hole in LLAGNs and hard state of BHBs accretes gas in hot accretion mode. In this paper, we first use magnetohydrodynamic (MHD) simulations of hot accretion flow around a black hole to study the origin of the wind. We find that the wind is driven by the combination of gradients of gas and magnetic pressure and centrifugal forces. Second, we use simulations with focus on the region around Bondi radius to study whether the wind can be generated outside Bondi radius. In the simulation studying hot accretion flow around Bondi radius, in addition to the black hole gravity, we also take into account the gravity of nuclei stars. We find that the wind can not be generated outside Bondi radius. The absence of the wind is due to the change of gravity potential.
Numerical methods for General Relativistic particles
Authors: Bacchini Fabio , Ripperda Bart , Chen Alexander Y. , Sironi Lorenzo
Published: April 2020

We present recent developments on numerical algorithms for computing photon and particle trajectories in the surrounding of compact objects. Strong gravity around neutron stars or black holes causes relativistic effects on the motion of massive particles and distorts light rays due to gravitational lensing. Efficient numerical methods are required for solving the equations of motion and compute i) the black hole shadow obtained by tracing light rays from the object to a distant observer, and ii) obtain information on the dynamics of the plasma at the microscopic scale. Here, we present generalized algorithms capable of simulating ensembles of photons or massive particles in any spacetime, with the option of including external forces. The coupling of these tools with GRMHD simulations is the key point for obtaining insight on the complex dynamics of accretion disks and jets and for comparing simulations with upcoming observational results from the Event Horizon Telescope.
High-dynamic-range 21 cm JVLA observations of the Perseus Cluster
Authors: Hull Charles L. H.
Published: April 2020

We present 21 cm (L-band) JVLA observations of the Perseus Cluster, comprising data from all four array configurations. The resulting images are nearly an order of magnitude deeper than any other image made of NGC 1275 and its environs at this frequency.
Mechanics of Electrical Transmission Line Robot Inspector: Pendulum as a Dynamic Vibration Absorber
Authors: Mohammad Reza Bahrami
Published: April 2020

The purpose of this article is to design a new dynamic vibration absorber (DVA) and create a mathematical model to analyze the electrical transmission lines inspection robot movement on the line. First, the vibration of the electrical line while the robot inspector moves along it has been modeled considering the conductor as a stretched string and the robot as a moving load. It follows by using a double pendulum as the dynamic vibration absorber. To better understanding the performance of the DVA, the results are compared with the model in which a robot inspector is considered as a pendulum with a suspension base (here the conductor). This example shows the possibility of usage of the double pendulum as the DVA in electrical transmission inspection robots.
Retour sur les Journées Annuelles de la SF2M 2019
Authors: Quantin Danièle
Published: April 2020

Les Journées Annuelles de la SF2M 2019 se sont déroulées à Paris (Chimie Paris Tech) du 21 au 23 octobre. Plus de 150
participants ont pu assister à 50 présentations scientifiques dont 3 plénières, 1 conférence plénière sur l’histoire des
matériaux et table ronde sur les carrières, organisée par le groupe « Jeunes » de la SF2M. Seize posters faisant l’objet d’un concours ont aussi été présentés. Les présentations scientifiques étaient regroupées en 3 thèmes génériques : Fabrication additive, de la fabrication de la matière première à la pièce fonctionnelle ; Ténacité et rupture brutale ; Mise
en forme, microstructure et propriétés d’usage des superalliages base nickel polycristallins.
Tierbissverletzungen durch heimische und wilde Tiere – eine retrospektive Analyse und Erstellung eines prognostischen Scores
Authors: Kuhbier Mara A. , Könneker Sören , Dastagir Khaled , Alawi Seyed A. , Vogt Peter M. , Kuhbier Jörn W.
Published: April 2020

Hintergrund Die aktuellen Richtlinien für Verletzungen durch Tierbisse empfehlen chirurgisches Debridement und Antibiotikatherapie. Im Allgemeinen führen Bisswunden zu Infektionen mit einem sehr hohen Risiko durch tief eindringende Hautläsionen. Bisswunden können sich jedoch durch die Eindringtiefe und die Beteiligung verschiedener anatomischer Strukturen drastisch unterscheiden. Eine prognostische Klassifikation über die Tiefe oder Schwere gibt es nur für Gesichtsverletzungen bei pädiatrischen Patienten – das ist der Score von Lackmann. In dieser Studie wurden prognostische Faktoren bewertet und ein prospektiver Score für allgemeine Tierbissverletzungen entwickelt.

Patienten und Methoden Eine retrospektive Einzelzentrumsanalyse wurde bei Verletzungen von Tierbissen zwischen 2007 und 2017 durchgeführt. Die Patienten wurden nach Tierart, Bissort, Behandlungsart und medizinischer Versorgung, Aufnahme, Verweildauer, Revisionsbedarf und Keimspektrum unterteilt. Es wurde ein Bewertungs-Score ermittelt und verifiziert, der von Grad I (oberflächlicher Kratzer) bis Grad Va (tiefe Wunde mit Knochenbeteiligung) und Grad Vb (tiefe Wunde mit Gelenkbeteiligung) reicht.

Ergebnisse 567 Patienten mit Tierbiss-Verletzungen wurden eingeschlossen, von denen 51,7 % von Hunden, 39,2 % von Katzen und 4,1 % von Wildtieren verursacht wurden. 75,7 % der Verletzungen befanden sich an den Händen, 12,9 % an den Armen, 5,1 % im Gesicht und 5,3 % an anderen Stellen. Der häufigste Keim war Pasteurella, gefolgt von Staphylokokken und anderen aeroben Arten. Die antibiotische Behandlung umfasste in 75 % der Fälle Sultamicillin, Cephalosporine in 10,2 %, Clindamycin in 7,6 % und andere Antibiotika in 5,1 %.

Es wurde eine signifikante Korrelation (p < 0,001) zwischen der Tierart und dem Vorliegen einer Infektion, der Art der medizinischen Versorgung, dem Bewertungs-Score und dem Keimspektrum festgestellt, ebenso wie zwischen dem Bewertungs-Score und der Notwendigkeit einer Revision, der Dauer der Antibiotikatherapie, der Art der Aufnahme, der Behandlung und der medizinischen Versorgung sowie der Dauer des Krankenhausaufenthaltes.

Schlussfolgerung Der prognostische Wert des ermittelten Bewertungs-Scores konnte verifiziert werden. Darüber hinaus wurde die Bedeutung der Tierarten für die Behandlung aufgezeigt. Sultamicillin mit einer Wirksamkeit gegen die meisten der identifizierten Keime sollte als ermittelte Erstlinien-Antibiotikatherapie verwendet werden.
Schmerzfrei durch konservatives Vorgehen – Handtherapie bei SL-Band-Ruptur
Authors: Dopfer Barbara
Published: April 2020

Es liegt zwischen Kahn- und Mondbein und spielt für die Stabilität des Handgelenks eine große Rolle: das skapholunäre Band (SL-Band). Reißt das Band, kann ein neues konservatives Trainingsprogramm dem Klienten helfen, die Hand wieder schmerzfrei und im gewohnten Ausmaß zu bewegen.
Kompetenzen der pflegerischen Primärversorgung in unterversorgten Kommunen
Authors: Marks Frank
Published: April 2020

Die Engpässe in unserem Gesundheitssystem in puncto medizinischer und pflegerischer Versorgung der Bevölkerung machten ein Umdenken erforderlich: Nach internationalem Vorbild werden Pflegenden voraussichtlich auch in Deutschland neue Möglichkeiten in der kommunalen Primärversorgung, dem Community Health Nursing, eröffnet.
Krisen in der Kinder- und Jugendpsychiatrie
Authors: Dißmann Steffen
Published: April 2020

Schon im Säuglingsalter können Kinder ihre erste Krise erleben – wenn der Fokus der Eltern sich auf andere Dinge als das eigene Kind richtet. Jede weitere Lebensphase birgt auch weiteres Krisenpotenzial. Autor Steffen Dißmann stellt die verschiedenen Lebensphasen und deren spezifische Krisen vor und zeigt anhand von fiktiven Fallbeispielen deren Relevanz in der Kinder- und Jugendpsychiatrie.
Endothelial function in cardiovascular medicine: a consensus paper of the European Society of Cardiology Working Groups on Atherosclerosis and Vascular Biology, Aorta and Peripheral Vascular Diseases, Coronary Pathophysiology and Microcirculation, and Thrombosis
Authors: Alexander Yvonne , Osto Elena , Schmidt-Trucksäss Arno , Shechter Michael , Trifunovic Danijela , Duncker Dirk J , Aboyans Victor , Bäck Magnus , Badimon Lina , Cosentino Francesco , De Carlo Marco , Dorobantu Maria , Harrison David G , Guzik Tomasz J , Hoefer Imo , Morris Paul D , Norata Giuseppe D , Suades Rosa , Taddei Stefano , Vilahur Gemma , Waltenberger Johannes , Weber Christian , Wilkinson Fiona , Bochaton-Piallat Marie-Luce , Evans Paul C
Published: April 2020

Endothelial cells (ECs) are sentinels of cardiovascular health. Their function is reduced by the presence of cardiovascular risk factors, and is regained once pathological stimuli are removed. In this European Society for Cardiology Position Paper, we describe endothelial dysfunction as a spectrum of phenotypic states and advocate further studies to determine the role of EC subtypes in cardiovascular disease. We conclude that there is no single ideal method for measurement of endothelial function. Techniques to measure coronary epicardial and micro-vascular function are well established but they are invasive, time-consuming, and expensive. Flow-mediated dilatation (FMD) of the brachial arteries provides a non-invasive alternative but is technically challenging and requires extensive training and standardization. We, therefore, propose that a consensus methodology for FMD is universally adopted to minimize technical variation between studies, and that reference FMD values are established for different populations of healthy individuals and patient groups. Newer techniques to measure endothelial function that are relatively easy to perform, such as finger plethysmography and the retinal flicker test, have the potential for increased clinical use provided a consensus is achieved on the measurement protocol used. We recommend further clinical studies to establish reference values for these techniques and to assess their ability to improve cardiovascular risk stratification. We advocate future studies to determine whether integration of endothelial function measurements with patient-specific epigenetic data and other biomarkers can enhance the stratification of patients for differential diagnosis, disease progression, and responses to therapy.
Coronavirus Disease 2019 in Critically Ill Children: A Narrative Review of the Literature*
Authors: Ong Jacqueline S. M. , Tosoni Alvise , Kim YaeJean , Kissoon Niranjan , Murthy Srinivas
Published: April 2020

Coronavirus disease 2019 has spread around the world. In the 3 months since its emergence, we have learned a great deal about its clinical management and its relevance to the pediatric critical care provider. In this article, we review the available literature and provide valuable insight into the clinical management of this disease, as well as information on preparedness activities that every PICU should perform.
India’s Civil Registration System: a potentially viable data source for reliable subnational mortality measurement
Authors: Rao Chalapati , Kansal Mamta
Published: April 2020

Introduction

The Indian national Civil Registration System (CRS) is the optimal data source for mortality measurement, but is yet under development. As an alternative, data from the Sample Registration System (SRS) which covers less than 1% of the national population is used. This article presents a comparative analysis of mortality measures from the SRS and CRS in 2017, and explores the potential of the CRS to meet these subnational data needs.

Methods

Data on population and deaths by age and sex for 2017 from each source were used to compute national and state level life tables. Sex specific ratios of death probabilities in five age categories (0-4, 5-14, 15-29, 30-69, 70 -84, 85+) were used to evaluate CRS data completeness, using SRS probabilities as reference values. The quality of medically certified causes of death was assessed through hospital reporting coverage and proportions of deaths registered with ill-defined causes from each state.

Results

The CRS operates through an extensive infrastructure with high reporting coverage, but child deaths are uniformly under reported, as well as female deaths in some states. However, at ages 30 to 69 years, CRS death probabilities are higher than the SRS values in 15 states in males and 10 states in females. SRS death probabilities are of limited precision for measuring mortality trends and differentials. Medical certification of cause of death is affected by low hospital reporting coverage.

Conclusions

The Indian CRS is more reliable than the SRS for measuring adult mortality in several states. Targeted initiatives to improve the recording of child and female deaths, to strengthen the quality of medical certification of cause of death, and to promote use of verbal autopsy methods are necessary to establish the CRS as a reliable source of sub national mortality statistics in the near future.

KEY MESSAGES

The Sample Registration System (SRS) is currently the main source of mortality statistics in India, since the Civil Registration System (CRS) is yet under development

Limitations in sample size as well as problems with quality of causes of death result in considerable uncertainty in population level mortality estimates from the SRS

This research evaluated the quality of the sex and age specific mortality risks from the CRS, using the SRS values in each state as reference values

The CRS has high levels of reporting coverage for death registration, and also measures higher levels of mortality at ages 30 to 69 years in several states, with high precision

Interventions are required to improve child death registration, strengthen medical certification of cause of death in hospitals, and introduce verbal autopsy for home deaths

These interventions will establish the CRS as a routine and reliable source for national and subnational mortality measurement in India in the near future
Hormone replacement therapy and elevated breast cancer risk: An artifact of growth acceleration?
Authors: Engel Jutta , Schubert-Fritschle Gabriele , Hölzel Dieter
Published: April 2020

Background

Available data on accelerated proliferation and increased breast cancer risk due to hormone replacement therapy (HT) are inconsistent. Data on long-term effects of HT are limited. The interaction between several key factors was examined using a model-based approach.

Methods

Cohorts of 50 year old women, BCs were randomly generated for 30 years based on the age-specific incidence. A control group received a HT that increased the growth of occult BCs. In a 3rd cohort BCs were additionally induced by HT. This model illustrates the interrelationship of important parameters and allows the simulation and comparison of previously published clinical studies.

Results

Using plausible parameters for BC growth factor (GF) and HT-related effects it was demonstrated that HT caused accelerated growth of occult BCs with an apparent increase in incidence and shortened time to diagnosis. The Women’s Health Initiative (WHI) study was reconstructed assuming a GF of 1.43 induced by HT. The decision of millions of women to discontinue or forego HT based on the published risks of the WHI-study in 2002 could explain the marked jump of 6.7% in incidence within a few months. If additional BCs were induced by HT, then these BCs may become apparent after 10 or more years together with those appearing according to the normal incidence. At this time conclusive data on type, timing, and molecular characteristics of HT induced BCs are not yet available.

Conclusion

The acceleration in growth of occult BC has been underestimated. Initially HTs can cause an apparent increase in BC incidence thereby explaining the WHI-dependent decrease in 2003. A HT associated BC risk should only be detectable with a delay of ten and more years.
Improving the quality of venous blood sampling procedure (phlebotomy): avoiding tourniquet use
Authors: Freitas Francisco , Alves Mónica
Published: April 2020

Background

Guidelines for venous blood sampling procedure (phlebotomy) discourage tourniquet use whenever possible. Here, we aimed to assess the Biomedical Scientists capability of not using the tourniquet in phlebotomy, which we hypothesized to be equal to 50% of the patients attended, and identifying the most frequent venipuncture site.

Materials and Methods

We selected and assigned two (BMS) with the same age (41 years) and experience (20 years) to record ten phlebotomy days, the first with prioritized and the latter with non-prioritized patients. In a simple record form, each acquired daily data for the number of attended patients, age and gender, the frequency of non-tourniquet usage and the punctured vein. To test our work hypothesis we used the two-tailed single sample t-test (p < 0.05). Differences between age-group means and non-tourniquet use means by each BMS were tested by two-tailed t-test for independent means (p < 0.05).

Results

In 10 phlebotomy days 683 patients were attended, with males representing 43,2% of the population. We found no statistically difference between age-group means. The combined capability of non-tourniquet use was 50,5%, which did not differ from our null hypothesis, but the individual group-means were statistically different, being 33% and 66.9% in the prioritized vs non-prioritized group. The medial cubital vein was the most prone to be punctured (77,7%).

Conclusions

We have shown that performing phlebotomies without tourniquet use is possible and desirable in at least half of the attended patients, though being more limited in specific group populations. Our results provide room for quality improvement in the laboratory pre-analytical phase.

Key points summary

We assessed the capability of Biomedical Scientists not using the tourniquet in real life blood sampling procedures for diagnostic purposes.

Blood was collected from at least half of the attended patients without tourniquet use.

Biomedical Scientists were able to prioritize the antecubital veins without tourniquet application (medial cubital vein the most prone to be punctured - 78% of attempts).
Microscopic Review of Nasopharyngeal Swabs as a Means of Benchside Quality Assurance
Authors: Matelski AT. , Siddique N. , Mead P. , Raimondi T. , Jorgenson L. , Calderon O. , Harman K. , Farrell JJ.
Published: April 2020

Nasopharygneal swabs (NPS) are the collection modality recommended by the Centers for Disease Control and Prevention (CDC) for reverse-transcription polymerase chain reaction (RT-PCR) testing for SARS-CoV2. NPS gather both extracellular material and human respiratory epithelial cells and, when used with RT-PCR, have reliable sensitivity for detection of viral infection. However, at our institution, we identified a 1.7% re-order rate within 7-days for NPS for respiratory pathogen RT-PCR, which we hypothesize may be due to low confidence in adequate sample collection. We sought to identify an inexpensive and accessible strategy for benchside quality assurance of NPS adequacy by observing microscopic content of viral transport media. For 801 NPS samples collected in November 2019, we air-dried and safranin-stained aliquots of viral transport media on glass slides. We then counted morphologically distinct ciliated columnar epithelial cells (CCEs). 19% of samples negative by RT-PCR for respiratory pathogens had no CCEs, while just 6% of positive samples exhibited the same. Pearson’s Chi-squared test was used to compare presence of CCEs between samples that were positive and negative for respiratory pathogens by RT-PCR (p=3.3×10-38). The negative predictive value (NPV) of finding no identifiable CCEs on microscopy was 85%. We posit that samples without identifiable CCEs may have been inadequately collected. The basic, benchside protocol using inexpensive laboratory reagents that we describe here could help improve accuracy and accessibility of NPS and RT-PCR testing for SARS-CoV2 and other respiratory pathogens while conserving limited resources in the face of a pandemic.
Alcohol and Parasomnias: The Statistical Evaluation of the Parasomnia Defense in Sexual Assault, Where Alcohol is Involved
Authors: Munro Neil A.
Published: April 2020

Sleep sex may be a defense for alleged sexual assault. The International Classification of Sleep Disorders (ICSD3) states: “Disorders of arousal should not be diagnosed in the presence of alcohol intoxication… The former [alcohol blackouts] are exponentially more prevalent.” A panel member of ICSD3, quoting ICSD3 asserts: “alcohol intoxication should rule out a sleep‐walking defense”. This implies extremely strong support for a prosecution hypothesis (Hp) over a defense hypothesis (Hd). I use Bayesian methodology to evaluate the evidential probity of alcohol intoxication. The likelihood ratio, LR, measures the amplification of prior odds of guilt,

. By Bayes' theorem,

. I use data from cross‐sectional studies of sexual assault and prevalence of alcohol use, in college students, with data from longitudinal studies, and data from the epidemiology of parasomnias to evaluate LR (alcohol). LR ~1.5 or 5, depending whether alcohol does, or does not, increase the risk of parasomnias. The proposition of extremely strong support for Hp implies a LR ~1,000,000, so the proposition in ICSD3 is not supported by formal analysis. The statistical reasoning in ICSD3 is unclear. There appears to be inversion of the Bayesian conditional (confusing intoxication given assault, and assault given intoxication) and failure to evaluate alcohol intoxication in Hd. Similar statistical errors in R. v Sally Clark are discussed. The American Academy of Sleep Medicine should review the statistical methodology in ICSD3.
The use of short‐acting beta‐2 adrenergic receptor agonists for asthma increased among Finnish and Swedish children from 2006 to 2017
Authors: Kivistö Juho E. , Karjalainen Jussi , Huhtala Heini , Protudjer Jennifer L. P.
Published: April 2020

Aim

Paediatric asthma hospitalisation has decreased in Finland, but has remained stable in Sweden. The reasons for these intercountry differences are unclear. The aim of this study was to explore the trend of dispensed asthma medication, including inhaled corticosteroids (ICS), among paediatric populations in the two countries.

Methods

We explored trends in dispensed asthma medication among paediatric populations aged 0‐19 in Finland and Sweden from 2006 to 2017. The Finnish Statistics on Reimbursements for Prescription Medicines and The Swedish Prescribed Drug Register provided data on all dispensed asthma prescriptions.

Results

During the study period, the prevalence of dispensed ICS in paediatric populations was fairly stable in Finland and Sweden. Among children aged 0‐4, ICS were 1.5 times more commonly dispensed in Sweden than in Finland. The prevalence of children dispensed short‐acting beta‐2 adrenergic receptor agonists (SABA) increased in both countries, but rose more in Finland (51%) than in Sweden (27%).

Conclusion

Inhaled corticosteroids were more commonly dispensed for children aged 0‐4 in Sweden than in Finland during the study period. This study showed an increasing prevalence of children dispensed SABA in Finland and Sweden, particularly in Finland. Differences and trends in asthma medication may effect asthma hospitalisation and asthma deaths.
Mindin deficiency alleviates renal fibrosis through inhibiting NF‐κB and TGF‐β/Smad pathways
Authors: Yang Kang , Li Wei , Bai Tao , Xiao Yusha , Yu Weimin , Luo Pengcheng , Cheng Fan
Published: April 2020

Renal fibrosis acts as a clinical predictor in patients with chronic kidney disease and is characterized by excessive extracellular matrix (ECM) accumulation. Our previous study suggested that mindin can function as a mediator for liver steatosis pathogenesis. However, the role of mindin in renal fibrosis remains obscure. Here, tumour necrosis factor (TGF)‐β‐treated HK‐2 cells and global mindin knockout mouse were induced with renal ischaemia reperfusion injury (IRI) to test the relationship between mindin and renal fibrosis. In vitro, mindin overexpression promoted p65—the hub subunit of the NF‐κB signalling pathway—translocation from the cytoplasm into the nucleus, resulting in NF‐κB pathway activation in TGF‐β‐treated HK‐2 cells. Meanwhile, mindin activated the TGF‐β/Smad pathway, thereby causing fibrotic‐related protein expression in vitro. Mindin−/− mice exhibited less kidney lesions than controls, with small renal tubular expansion, inflammatory cell infiltration, as well as collagen accumulation, following renal IRI. Mechanistically, mindin−/− mice suppressed p65 translocation and deactivated NF‐κB pathway. Simultaneously, mindin disruption inhibited the TGF‐β/Smad pathway, alleviating the expression of ECM‐related proteins. Hence, mindin may be a novel target of renal IRI in the treatment of renal fibrogenesis.