bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of cancer clinical decision support systems on patient-reported outcomes: A systematic review
Authors: Pitt Erin , Bradford Natalie , Robertson Eden , Sansom-Daly Ursula , Alexander Kimberly
Published: May 2022

Background: The availability and implementation of high-quality decision-making support are integral to ensuring the delivery of quality cancer care and subsequently achieving positive patient outcomes and experiences. Decision Support Systems (DSS) are increasingly used to support decision-making in clinical practice. However, it is not known beyond supporting the decision-making process whether DSS are indeed effective in improving outcomes for people affected by cancer. The purpose of this review was to identify and synthesize the available literature regarding the effects of DSS on patient-reported outcomes in cancer, both during and after cancer treatment.Methods: We conducted a systematic search of four databases for empirical literature published between 2000 and July 2021, in the English language, that reported an evaluation of patient-reported outcomes. Key information was extracted from each article including study design, type of cancer, intervention elements, type of DSS intervention, measures, and key outcomes. We appraised study quality using the Mixed Methods Appraisal Tool (MMAT).Results: We included 14 studies, which we categorized as symptom assessment interventions or interactive educational interventions. Studies described a range of health-related and process-related patient-reported outcomes, as well as decisional complexities. Findings were mixed regarding the effectiveness of clinical DSS interventions in improving total symptom distress and severity, whereas the majority were effective in reducing mean scores for worst and usual pain. Interventions were not effective in improving other health-related patient-reported outcomes including quality of life, global distress, depression, or self-efficacy and there were mixed effects for reducing decisional conflict. Regarding process-related patient-reported outcomes, there was moderate to high patient adherence to the intervention as well as generally high satisfaction and acceptability. However, there was minimal evidence for the effect of clinical DSS interventions in clinician adherence to intervention recommendations. Conclusions: Inconsistencies in reporting of interventions may be a contributing factor to heterogeneous effects of clinical DSS regarding a broad range of patient-reported outcomes. There is a need to develop and implement evidence-based reporting guidelines to improve the reliability and validity of reporting clinical DSS interventions and enhance their timely translation into practice.Systematic review registration: PROSPERO (CRD42020190977)
Primary Hip and Knee Arthroplasty at District Level is Safe and May Reduce the Burden on Tertiary Care in a Low-income Setting
Authors: Laubscher Kim , Dey Roopam , Nortje Marc , Held Michael , Kauta Ntambue
Published: May 2022

Background: Arthroplasty procedures in low-income countries are mostly performed at tertiary centers, with waiting lists exceeding 12 to 24 months. Recently, this is further exacerbated by the impact of the Covid Pandemic on elective surgeries. Providing arthroplasty services at other levels of healthcare aims to offset this burden, however there is a marked paucity of literature regarding surgical outcomes. This study aims to provide evidence on the safety of arthroplasty at district level.Methods: Retrospective review of consecutive hip and knee primary arthroplasty cases performed at a District Hospital (DH), and a Tertiary Academic Hospital (TH) in Cape Town, South Africa between 1st January 2015 and 31st December 2018. Patient demographics, hospital length of stay, surgery related readmissions, reoperations, post-operative complications, and mortality rates were compared between cohorts. Results: Seven hundred and ninety-five primary arthroplasty surgeries were performed at TH level and 228 at DH level; of this Total Hip Replacements (THR) accounted for 50.6% (402) at TH and 39.9% (91) at DH level. The average hospital stay was 5.2±2.0 days at DH level and 7.6±7.1 days for TH (p<0.05). Readmissions within 3 months post-surgery of 1.75% (4 patients) for district and 4.40% (35) for tertiary level (p<0.05). Reoperation rate of 1 in every 100 patients at the DH and 8.3 in every 100 patients at the TH (p<0.05). Death rate was 0.4% vs 0.6% at district and tertiary hospitals respectively (p>0.05). Periprosthetic joint infection (PJI) rate was 0.43% at DH and 2.26% at TH. The percentage of hip dislocation requiring revision was 0% at district and 0.37% at tertiary level. During the study period, 228 patients received their arthroplasty surgery at the DH; these patients would otherwise have remained on the TH waiting list.Conclusions: Hip and Knee Arthroplasty at District health care level is safe and; for the reason that the DH feeds into the TH; providing arthroplasty at district level may help ease the pressure on arthroplasty services at tertiary care facilities in a Southern African context. Adequately trained surgeons should be encouraged to perform these procedures in district hospitals provided there is appropriate patient selection and adherence to strict theatre operating procedures.Level of Evidence: Level III Retrospective cohort study
Development and validation of a machine learning‐based stroke suicidal ideation prediction model : A retrospective study
Authors: Song Seung Il , Hong Hyeon Taek , Lee Changwoo , Lee Seung Bo
Published: May 2022

Background: Currently, the identification of stroke patients with an increased suicide risk is mainly based on self‐report questionnaires, and this method suffers from a lack of objectivity. This study developed and validated a suicide ideation (SI) prediction model using clinical data and identified SI predictors.Method: Significant variables were selected through traditional statistical analysis based on retrospective data of 385 stroke patients; the data was collected from October 2012 to March 2014. The data was then applied to three boosting models (Xgboost, CatBoost, LGBM) to identify the comparative and best performing models.Results: Demographic variables that showed significant differences between the two groups were age, onset, type, socioeconomic, and education level. Additionally, functional variables also showed a significant difference with regard to ADL and emotion (p<0.05). The CatBoost model (0.900) showed higher performance than the other two models; and depression, anxiety, self-efficacy, and rehabilitation motivation (RM) were found to have high importance. Negative emotions such as depression and anxiety showed a positive relationship with SI and rehabilitation motivation and self-efficacy displayed an inverse relationship with SI.Conclusion: Machine learning-based SI models could augment SI prevention by helping rehabilitation and medical professionals identify high-risk stroke patients in need of SI prevention intervention.
Response of Inflation to the Climate Stress: Evidence from Azerbaijan
Authors: Yusifzada Tural
Published: May 2022

This research analyzes the climate change-related factors’ impact on inflation in Azerbaijan between 2005-2020 and forecasts for the 2021-2030 period. For this purpose, the chain impact of temperature on agricultural producer prices is analyzed by the BVAR model. In the second dimension, the transition requirements to green energy’s effects on inflation are examined through the exchange rate. According to the model results, climate changes’ contribution to inflation is expected to be 1.3 percentage points (pp) in the long run with the normal scenario. On the other hand, climate contribution to inflation is estimated to be 2.2 pp (surpasses half of the inflation target) in the worst scenario of climate change. In the light of these results, the paper highlights the importance of a well-developed climate action plan set by the government and the Central Bank of the Republic of Azerbaijan. JEL Codes: E31, Q54, E37, E58, C32
Text-based recommender system with explanatory capabilities
Authors: Pérez-Núñez Pablo , Díez Jorge , Bahamonde Antonio , Luaces Oscar
Published: May 2022

Recommender systems have proven their usefulness both for companies and customers. The former increase their sales and the latter get a more satisfying shopping experience. These systems can benefit from the advent of explainable artificial intelligence, since a well-explained recommendation will be more convincing and may broaden the customer’s purchasing options. Many approaches offer justifications for their recommendations based on the similarity (in some sense) between users, past purchases, etc., which require some knowledge of the users. In this paper we present a recommender system with explanatory capabilities which is able to deal with the so-called cold-start problem, since it does not require any previous knowledge of the user. Our method learns the relationship between the products and some relevant words appearing in the textual reviews written by previous customers for those products. Then, starting from the textual query of a user’s request for recommendation, our approach elaborates a list of products and explains each recommendation on the basis of the compatibility between the query’s words and the relevant terms for each product.
Congenital Orbital Teratoma: A case report with fetal presentation
Authors: Wheeler Matthew , Pergoretti Kelly , Gore Sri , D'Arco Felice , Merve Ashirward , Mankad Kshitij
Published: May 2022

Congenital orbital teratomas are rare entities with few case reports detailing their prenatal and perinatal imaging features. We present the case of a congenital orbital teratoma initially detected as cystic lesion on prenatal ultrasound, with fetal and postnatal imaging showing evolution of characteristic MRI appearances. Knowledge of these appearances and the ability to diagnose these rare entities in fetal life can aid management and operative planning in the immediate postnatal period.
Mapping and Assessing Spatial Extent of Floods from Multitemporal Synthetic Aperture Radar Images: A Case Study over Chennai City, India
Authors: Sundaram Sreechanth , Devaraj Suresh , Yarrakula Kiran
Published: May 2022

Urban floods are more concerned in recent days due to their substantial effect in loss of human lives and properties. Due to climate change, urban floods are frequently observed in many parts of the world. Flood events in Chennai city is a frequent scenario due to rapid increase in the density of population. Adyar river watershed and surrounding urban cover is focused in the present study. The present study aims at mapping flooded region using Sentinel 1 datasets over Chennai city. Series of Sentinel-1A image is collected before, during and after floods for mapping the extent of flood and mapping risk zones in Adyar watershed. Methodologies such as ISODATA Technique, Multi-Temporal Analysis, Thresholding Method, PCA and ICA Analysis and Grey Level Co-Occurrence Matrix are adopted for the extraction of flooded extent from the SAR datasets. Analysis performed over the Chennai city provided promising results in the extraction of flooded extent with Thresholding Method and Grey Level Co-Occurrence Matrix being the dominant of all the methods. Though higher accuracy is obtained in the extraction of flooded extent, limitation of layover, foreshortening and shadow is experienced in the built up region for the extraction of flooded pixels.
Association of Greenness Exposure with Asthma, Allergic rhinitis: A Systematic Review and Meta-analysis
Authors: Wu Birong , Guo Xianwei , Liang Mingming , Sun Chenyu , Gao Juan , Xie Peng , Feng Linya , Xia Weihang , Ma Shaodi , Liu Haixia , Sun Yehuan
Published: May 2022

Peer-reviewed literature was systematically searched before 23 December 2021 to summarize existed evidence on the relationship between greenness exposure (residential greenery/greenery around schools) and some allergic respiratory diseases, including asthma and allergic rhinitis (AR). A systematic review was conducted, together with a meta-analysis. Pooled odds ratio (OR) with 95% confidence interval (CI) was used to estimate the effect of Normalized Difference Vegetation Index (NDVI) on asthma and AR. Cochran's Q chi-square test and I2 statistics were used to assess heterogeneity and sensitivity analysis was performed for high heterogeneity. Publication bias was assessed by Egger's tests. This study finally included 26 articles with positive, negative or no correlation between greenness exposure and asthma and AR. Eight of these studies underwent finite meta-analysis in different groups. The results showed no relationship between NDVI and asthma or AR. Two articles with high heterogeneity were identified by sensitivity analysis. There was no publication bias. This study protocol was registered with PROSPERO, number CRD42022299861.
Cost Sensitivity, Partisan Cues, and Support for the Green New Deal
Authors: Benegal Salil , Green Jon
Published: May 2022

Opponents of climate policy proposals frequently ground their objections in terms of costs. However, it is unclear whether these objections are persuasive to voters considering whether to support such programs. Not only do people have difficulties in understanding large numbers, partisans in particular may place more weight on the originator of a given proposal – supporting it if their own party proposed it, and opposing it otherwise. We test these dynamics using a survey experiment that varied the costs associated with real-world climate policy proposals attributed to each of the two major U.S. political parties, compared to a control group where no cost was made salient. We find little evidence that citizens are systematically sensitive to program cost, and that partisans tend to prefer policies proposed by their own party. The results provide reason for skepticism that cost-based objections to climate spending programs are persuasive at scale, after accounting for partisan cue-taking.
Preventive Strategies for Anthracyclines and Trastuzumab induced Cardiotoxicity: A systematic review and meta-analysis
Authors: Oliveira Cátia , Campos Rui , Flores Rui , Fontes Raquel , Pereira Vitor Hugo
Published: May 2022

Background
Despite the widespread use of anthracyclines (ANT) and anti-HER2 antibodies as trastuzumab (TZB) in chemotherapy schemes, it is known the potential cardiotoxic effects that can limit its use.
Aim
To study the benefit of drugs commonly used to treat heart failure with reduced ejection fraction or drugs known for an antioxidative effect on the prevention of ANT and TZB induced cardiotoxicity.
Methods
an extensive search was made in PubMed, Embase and Cochrane trials since inception to November 2020. Randomized controlled trials in which the drugs mentioned were given to adult patients treated with ANT and/or TZB were included. The outcomes of interest were left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), E/A ratio, E/e’ ratio, left atrium diameter, BNP/NT-pro-BNP and Troponin I levels. Subgroup analysis were made accounting for combinations of exposure to ANT and/or TZB
Results
24 randomized controlled trials were included with a total of 3159 participants (94% were women). A meta-analysis showed betablockers to lower E/A ratio (combined effect of 0,12 decrease (95% CI:[0,05; 0,19], I2 = 11%), and did not show any effect on LVEF, except perhaps for nebivolol, which in one study demonstrated a mean difference of 6,30% [3,32; 9,28] (p < 0,05) between groups. Angiotensin Conversion Enzyme Inhibitors and Angiotensin Receptor Antagonists did not show any protective effect. Dexrazoxane also showed to reduce the incidence of cardiac events with a combined risk ratio of 0,28 (95% CI: [0,16; 0,47], I2 = 9%). Rosuvastatin also showed to preserve LVEF and left atrium diameter and spironolactone showed to preserve LVEF, E/A and E/e’ ratio, however with only one trial each.
Conclusions
Prophylactic administration of either beta-blockers or dexrazoxane may prevent the development of ANT and TZB cardiotoxicity and therefore allow for fewer treatment interruptions and a better long-term prognosis of cancer patients.
Myricitrin promotes osteogenesis and prevents ovariectomy bone loss through PI3K/AKT signaling pathway
Authors: Li Jianliang , Mai JiaLe , Zhang Meng , He Qi , Ma YanHuai , Xiao Jiacong , Li Miao , Chen WeiJian , Li Zhen , Gong Dawei , Chen Shuai , Pan ZhaoFeng , Li Shaocong , Wang Haibin
Published: May 2022

Background: Osteoporosis is characterized by reduced bone mass and destruction of trabecular bone microstructure, increasing fracture risk. Newly marketed drugs have certain advantages in osteoporosis, but high health care expenditures and side effects limit their application. Therefore, it is urgent to explore new approaches to break the therapeutic deadlock in the current clinical condition. Myricitrin has many biological activities. However, the effect on antiosteoporosis has not fully been elucidated yet.Methods: The effect of myricitrin on the proliferation of immortalized bone marrow mesenchymal stem cells was evaluated using Cell Counting Kit-8 assays. Alizarin Red staining, Alkaline phosphatase staining, and activity were performed to elucidate osteogenesis. qRT-PCR and Western blot were performed to evaluate the expression of osteo-specific genes and proteins. To screen for candidate targets, sequencing of mRNA transcriptome genes was used through bioinformatics analysis. Western blot and Molecular docking analysis were used to examine target signaling markers. Rescue experiments were used to confirm myricitrin can enhance osteogenic differentiation of imBMSCs reversely. Moreover, ovariectomy mice were used to assess the effect of myricitrin on bone loss in vivo by Western blot, Micro-CT, Hematoxylin and Eosin staining, and immunochemistry.Results: Myricitrin can significantly enhance osteo-specific genes and proteins expression, alkaline phosphatase activity, and calcium deposition in imBMSCs in vitro. These phenomena were accompanied by an upregulation of the PI3K/AKT signaling pathway via bioinformatics analysis and Western blot. In addition, the improvement of osteogenesis due to myricitrin intervention was partially reversed by copanlisib, which is a PI3K inhibitor. Osteopontin (OPN), osteoprotegerin (OPG), p-PI3K, and p-AKT were significantly increased in the low dose and high dose myricitrin groups compared with the OVX group. Micro-CT, H&E staining, and immunochemistry showed that bone mass was significantly increased in low dose and high dose groups compared with the OVX group. Furthermore, myricitrin can attenuate bone loss in ovariectomy mice.Conclusion: These data suggest that myricitrin enhances the osteogenic differentiation of imBMSCs, partly via activation of the PI3K/AKT signaling pathway. Myricitrin may be a potential drug development for the treatment of postmenopausal osteoporosis.
Effect of patient position change during the colonoscopy withdrawal phase on increasing adenoma detection rate: a randomized controlled trial
Authors: Emami Abdolreza , Shirvani Javad Shokri , Alhooei Saman , Hosseini Akramasadat , Ahangar Hemmat Gholinia
Published: May 2022

Background: Improvement in adenoma detection rate (ADR) reduces colorectal cancer incidence by increasing the colonoscopy quality. Using dynamic patient position changes during the withdrawal phase has shown promise in increasing ADR. We conducted this study to assess the effectiveness of the supine position on the improvement of ADR to improve its feasibility and avoid frequent patient position changes, particularly in sedated patients.Methods: This was a randomized, single-blind, parallel-group, single-center study implemented in the Mehregan private in Babol. Inclusion criteria were 40 to 85 years old, 4 L application of polyethylene glycol from the day before the procedure, no history of inflammatory bowel disease, bowel surgery, musculoskeletal problems, and negative familial history of colorectal cancer. Patients were allocated in a 1:1 ratio to the supine or left lateral positions during the withdrawal phase. All colonoscopies were performed by a single physician using a Fujifilm colonoscope. A P-value of <0.005 was considered statistically significant.Results: A total of 880 patients were assessed for eligibility, of which 472 patients were included in the final analysis; 53.4% were female, the mean age of participants was 55.86±10.30 years old, 95.1% of patients had adequate bowel preparation, and adenomatous polyps were the most common histopathologic type (63.7%). Despite the intervention group’s higher rate of ADR and PDR (19.5% vs. 17.7% for ADR and 27.2% vs. 26.5% for PDR), no statistically significant difference in ADR or PDR was detected (P=0.613 and 0.866). Conclusion: No statistical significance was observed despite the increase in ADR when the supine position was used exclusively during the withdrawal phase. As a result, we recommend that the dynamic position change method be used if a position change is required. Nonetheless, additional research is required to determine a more effective alternative to dynamic position change in obese or heavily sedated patients.Trial registration: IRCTID: IRCT20110721007080N5, registration date: 04/05/2020
Vortex dynamics downstream two-side lateral expansion in shallow open channel
Authors: Han Lei , Guo Chuanliang , Sun Erliang , Tan Heping
Published: May 2022

As an expansion existing in an open channel, a recirculation zone is formed downstream the expansion, and then a mixing layer is formed between the main flow zone, where vortex structures exist which dominate the material and momentum exchange process between the former two zones. This research focuses on the vortex dynamics downstream two-side lateral expansions in shallow open channels. First, the length of the recirculation zone is measured in a sudden lateral expansion channel by particle image velocimetry and also simulated by large eddy simulation. Second, to analyze the vortex dynamics, the flow fields are reconstructed based on proper orthogonal decomposition (POD). POD results indicate that the vortex energy decreases as S increases. Furthermore, the Reynolds stress and turbulent kinetic energy characteristics are compared among different S conditions that could be linked to the vortex energy dissipation process. Finally, a one-dimensional spectrum analysis is performed in the center of the mixing layer that reflects the vortex shedding frequency of the vortex. In summary, in the small S condition, the flow is significantly more confined by the free surface, the vortex energy peak frequency decays more slowly, and the vortex energy dissi-pation slows down.
Regolith at Chang'E-5 landing site: mature lunar soils from Fe-rich and young mare basalts
Authors: Lu Xuejin , Chen Jian , Ling Zongcheng , Liu Changqing , Fu Xiaohui , Qiao Le , Zhang Jiang , Cao Haijun , Liu Jianzhong
Published: May 2022

Space weathering process on airless bodies produces metallic iron (Fe0) particles widely existing in the rim and interior of mineral grains, which complicate visible and near-infrared spectra of surface materials. Although these space weathering products and their spectroscopic effects on the Moon have been extensively investigated based on returned Apollo samples and orbital datasets, the Chang’E-5 (CE-5) mission provides an unprecedent opportunity to couple information gained from newly returned CE-5 samples with in situ observations and investigate space weathering process on extremely Fe-rich basalts. The in situ detections, returned soils, and orbital measurements of soil maturity at CE-5 landing site are cross-validated and provide a new ground truth (Is/FeO value of 66.4) for lunar surface. The age of Xu Guangqi crater was determined to be 240 ~ 300 Ma and its ejecta is the main source of CE-5 soils. Further, abundant larger-sized Fe0 particles were observed in the regolith at CE-5 landing site, which indicates that the inherited Fe0 particles from late-stage mare basalts and dense clustering of oversaturated Fe0 in extremely FeO-rich (> 17 wt.%) basalts both contribute to observed Fe0 abundances. We suggest that space weathering of Fe-richer basalt generates Fe0 particles with larger grain size and faster production rate.
Evaluation of surface urban heat island intensity in arid environments (case study: Isfahan metropolitan area)
Authors: Montazeri Majid , Masoodian Seyed Abolfazl , Guo Xulin
Published: May 2022

Heat island is formed due to the expansion of a city in a vast geographic area. The traditional index is used to describe the urban heat island based on the temperature difference between the urban and rural areas. Other indices have been suggested in the literature for this purpose. However, the heat island characteristics depend on the background climate of the place where the city is located. Therefore, an index was defined based on the background climate of the Isfahan metropolitan area in order to quantify the heat island intensity. This new index is based on the representative pixels of the urban and the non-urban areas. For this purpose, the MODIS land cover type product (MCD12Q1) data was used to distinguish between the urban and non-urban areas. Also, the data from the MODIS/Terra/Aqua land surface temperature product (MOD11A1/MYD11A1) from 2000 to 2016 was utilized for the day time and night time to study the heat island intensity. Then, the representative pixels of urban and the non-urban areas were identified using the spatial correlation method and the heat island index was calculated for the metropolitan area of Isfahan. The study showed that the frequency distribution for the nighttime heat island index in the metropolitan area of Isfahan follows a normal distribution and is often 3.5-4 K above the temperature of the surrounding areas at night. Investigating the temporal and spatial behavior of surface urban heat island in the metropolitan area of Isfahan showed that the intensity of the surface urban heat island is maximum in January and becomes weaker in summer. The 365-day floating mean of the surface urban heat island showed that this index has increased in recent years. The core of heat island in the metropolitan area of Isfahan is extended to downtown areas where the oldest part of the city is located.
Plant functional, biogeographical and phylogenetic diversity are related to native and non-native plant abundance in invaded Hawaiian forests
Authors: Hibit Joshua , Daehler Curtis C.
Published: May 2022

Numerous introduced species from cosmopolitan biogeographic origins have naturalized in the Hawaiian Islands and are spreading while native plant cover has declined. Phylogenetic, functional, and biogeographical diversity have been shown to influence invasion success, but relationships between these diversity measures and native plant abundance in invaded oceanic island forests has not been well established. Here we surveyed plant cover in 50 plots (400 m2) on the island of Oʻahu, Hawaiʻi. We measured four performance-related functional traits (specific leaf area, stem specific density, seed dry mass, and maximum plant height), and determined the growth form of each species. We calculated the differences between native and non-native community weighted mean trait values and assessed whether these differences, as well as measures of diversity, were associated with native and non-native cover. We found that average trait values were significantly higher for maximum height in natives, and significantly higher for specific leaf area and stem specific density in non-natives. The difference in maximum height of natives and non-natives was correlated with reduced non-native cover. Functional divergence and phylogenetic diversity of natives were positively correlated with native cover. Functional divergence and richness of non-natives were correlated with non-native cover. Biogeographical diversity was not significantly correlated with non-native cover but had indirect effects via its significant correlation with non-native functional richness, which was positively correlated with non-native cover. These findings suggest that diversity and competition for light may be important determinants of native and non-native species cover in invaded Hawaiian forests. An increasing number of distinct non-native plant introductions is thus likely to be associated with continued declines in native plant cover.
Time to Trimethoprim/Sulfamethoxazole Initiation among Patients with Rheumatic Disease Complicated by Pneumocystis jirovecii Pneumonia: Impact on 90-day Mortality
Authors: Song Siyang , Zhang Yang , Yu Jie , Xie Cuiying , Chen Yi , Zhang Xingyu
Published: May 2022

Background: Pneumocystis jirovecii pneumonia (PJP) is a life-threatening disease with increasing prevalence in patients with rheumatic disease. Trimethoprim/sulfamethoxazole (TMP/SMX) is an effective treatment for patients with rheumatic disease hospitalized for PJP. This study aimed to describe the 90-day mortality of patients with rheumatic disease complicated by PJP and investigate whether the administration of TMP/SMX after 7 days from initial symptoms correlates with 90-day mortality.Methods: We enrolled consecutive patients with rheumatic disease complicated with PJP in our center from August 2018 to August 2021. The participants were classified into two groups according to when TMP/SMX was initiated: early (within the first 7 days) and late (after 7 days). The primary outcome was 90-day PJP-related mortality. Multivariate cox regression and Kaplan–Meier survival analyses were conducted to identify the risk factors for mortality and examine differences in survival between early and late use of TMP/SMX.Results: Thirty-seven patients with rheumatic disease (median age 50.1 years, 24.3% male) complicated by PJP were enrolled in our study, and 15 (40.5%) patients died at or before 90 days of follow-up. The most common comorbidity was systemic lupus erythematosus (14, 37.8%), followed by inflammatory myopathy (11, 27.9%). Patients in the early group were less likely to require mechanical ventilation (29.6% vs. 90.0%, P = 0.002), and had lower mortality (25.9% vs. 80.0%, P = 0.006) than those in the late group. In the Kaplan–Meier analysis, the survivor probability of the early group was notably higher than that of the late group (P = 0.007). Multivariate cox regression analysis showed that initiation of TMP/SMX after 7 days from admission (hazard ratio [HR]: 5.9, 95% confidence interval [CI]: 1.1-30.4; P = 0.034) and a higher level of lactate dehydrogenase (LDH; HR: 6.0, 95% CI: 1.1-31.8; P = 0.035) were associated with 90-day mortality in patients with rheumatic disease complicated by PJP.Conclusion: Patients with rheumatic disease complicated by PJP had poor prognoses, with mortality rates as high as 40.5%. TMP/SMX initiation after 7 days from initial symptoms and a higher level of serum LDH were significantly associated with increased 90-day mortality.
Ischemic stroke in young patients (18-49 years) in Medellín, Colombia
Authors: Vargas-Murcia Juan Diego , Isaza-Jaramillo Sandra Patricia , Vallejo-Mesa Dionis Magnary , Carvajal-Muñoz Daniela
Published: May 2022

Background: there is scarce information about ischemic stroke in young patients in Colombia. The incidence is increasing. To describe the etiologies and risk factors of ischemic stroke in young patients in a third level complexity referral hospital in Medellin, Colombia. Methods: An observational cross-sectional study was carried out, retrospectively reviewing the medical records of patients between 18 and 49 years old admitted for the first time for ischemic stroke, from January 2009 to December 2019. The sociodemographic characteristics, risk factors and etiological classification of ischemic stroke according to the TOAST (Trial of Org 10172 in Acute Stroke Treatment) were described.Results: 237 cases were found. The most frequent risk factors were arterial hypertension (31.7%), smoking (29.6%) and alcohol intake (23.2%). There was a greater number of traditional cardiovascular risk factors at older ages. The TOAST classification was: large-artery atherosclerosis (6.8%), cardioembolism (17.7%), small-vessel disease (7.6%), other determined etiology (25.7%) and undetermined (42.2 %). Within cardioembolism, the most common high risk source was valvular exchange, and moderate risk was permeable foramen ovale. Craniocervical arterial dissection (11.4%) and substance abuse (2.9%) were the two most frequent entities within other determined etiologies. The most common compromised vascular territory was the anterior (55.7%).Conclusions: the high frequency of traditional risk factors in young patients highlights the need to optimize primary and secondary prevention plans. Illicit substances and infectious causes are particular causes in this study. It is necessary to investigate the reasons for the high proportion of undetermined causes.
Time-dependent measurement of plasmon-induced charge separation on a gold nanoparticle/TiO2 interface by electrostatic force microscopy
Authors: Misaka Tomoki , Ohoyama Hiroshi , Matsumoto Takuya
Published: May 2022

Plasmon-induced charge separation (PICS) is an efficient way to use the hot carriers generated by localized surface plasmon resonance. Although the ultrafast dynamics of hot carrier generation and annihilation itself are well understood, the slow dynamics of PICS are not, despite their importance for the use of hot carriers in chemical reactions. In this work, we directly observed the slow dynamics of PICS on an Au nanoparticle (NP)/TiO2 interface by using electrostatic force microscopy with time-resolved measurements obtained by sideband signal of frequency shift. The change in contact potential difference induced by PICS had a bias voltage dependence, indicating that the number of holes in the Au NPs ([h+AuNP]) accumulated by laser irradiation depended on bias voltage. The decay constant for the annihilation of the separated charge on the Au NPs at the Au NP/TiO2 interface was directly determined to be ca. 150 ms, and the annihilation process was discussed in a simple model based on the transient Schottky barrier.
Visible-light assisted surface plasmon resonance triggered Ag/ZnO nanocomposites: synthesis and performance towards degradation of indigo carmine dye
Authors: Kumar Rahul , Janbandhu Shaileshkumar Y. , Sukhadeve Gaurav K. , Gedam Rupesh S.
Published: May 2022

Water pollution caused by organic compounds, generated from different industries has gained attention worldwide today. In this regard, significant efforts have been made for suitable dye degradation technology. Zinc oxide (ZnO) based photocatalysts are considered novel materials to degrade organic effluents in contaminated water. The facile synthesis of Ag/ZnO nanocomposites and its application for the enhanced degradation of Indigo carmine (IC) dye under visible light irradiation is reported in this paper. The prepared photocatalysts were characterized using various analytical techniques such as X-ray diffraction (XRD), scanning electron microscopy (SEM), high-resolution transmission electron microscopy (HRTEM), FTIR, Raman, Impedance study, UV-Vis, and photoluminescence (PL). Prepared Ag/ZnO nanocomposites were tested for degradation of IC dye in visible light. The degradation efficiency of IC dye was found to be 95.71% in 120 min, with a rate constant of 0.01957 min− 1. This improved photocatalytic activity of Ag/ZnO nanocomposites was mainly due to the absorption of visible light caused by surface plasmon resonance (SPR) derived from Ag nanoparticles (NPs) and electron-hole separation. Radical trapping experiments suggest that holes (h+), and superoxide radical (O2•−) are the key factors in photocatalytic IC dye degradation.
The prevalence of early age-related macular generation and its relationship with dietary pattern in China: a cross-section study
Authors: Lin Yanhui , Peng Ting , Li Ying , Liu Yu
Published: May 2022

Purpose
To estimate the prevalence of age-related macular generation (AMD) among people who underwent health examination in Hunan, China and to determine the relationship between dietary pattern and the risk of AMD.
Methods
The Questionnaire was used to collect dietary data from 56,775 subjects of ≥ 50 years old who underwent health examination at the Department of Health Management, the Third Xiangya Hospital of Central South University between January 2017 and December 2019. The diagnosis of AMD was based on the results of fundus examination and medical history taking. After excluding subjects with incomplete records or other oculopathies that may affect the results of fundus examination, a total of 43,672 subjects were included. The univariate and multivariate logistic regression analyses were used to determine the relationship between dietary pattern and the prevalence of AMD.
Results
Among the 43,672 subjects, 1080 (2.5%) had early AMD: the prevalences were 2.6% (n = 674) in males and 2.3% (n = 406) in females; the prevalences were 1.0% (n = 289), 3.6% (n = 401), 9.1% (n = 390) in 50–59, 60–69, ≥ 70 years old, respectively. The high-salt intake increased the risk of early AMD [odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.53–1.67], whereas the intake of meat decreased the risk (OR = 0.89, 95% CI = 0.80–0.99).
Conclusion
Our data indicate that high-salt intake increases the risk of early AMD, whereas intake of meat decreases the risk. Modulating the dietary pattern as an AMD prevention strategy warrants further study.
An Objective Analysis of the Flow of Patients Undergoing Mastectomy Through the Use of Length Of Stay: the case of “San Giovanni di Dio e Ruggi D’Aragona” University Hospital
Authors: Trunfio Teresa Angela , Scala Arianna , Borrelli Anna , Improta Giovanni
Published: May 2022

Background
Malignant breast cancer is the most common cancer affecting women worldwide. In Italy there are over 50,000 new diagnoses each year and the COVID-19 pandemic seems to have slowed this process. Mastectomy is a breast cancer surgery technique that involves the removal of the entire breast. Although the conservative approach is always preferred, some factors such as case complexity or patient decision lead to this invasive approach. The expected complexity of delayed diagnosis in the COVID-19 era pushes towards an objective analysis of the flow of patients undergoing mastectomy through the use of measurable quality indicators such as Length Of Stay (LOS).
Methods
In this work several regression models (Multiple Linear Regression Decision Tree, Random Forest, Linear Support Vector Machine and Narrow Neural Network) have been implemented in order to analyze the total LOS as functions of a set of independent variables of patients who underwent mastectomy at University Hospital "San Giovanni di Dio e Ruggi d'Aragona" of Salerno (Italy) in the years 2011–2018.
Results
The results obtained show in general the excellent performance of regression models in characterizing the particular case study. Among the models, the best was Random Forest with a R2 value higher than 0.8. Statistical analysis also showed that, among the independent variables, Pre-Operative LOS (p < 0.001) and Discharge Ward (p < 0.001) had a greater impact on total LOS.
Conclusion
Through this study it was possible to validate the use of regression models to characterize the total LOS of patients undergoing mastectomy. The LOS is confirmed to be an excellent indicator of performance and, also through the study of the impact of the other variables included, its evaluation is fundamental in guiding the strategies of healthcare management.
Mesenchymal Stromal Cells showed an alteration of differentiation potential under Environmental Micro and Nanoplastics Exposure
Authors: Najahi Hana , Alessio Nicola , Squillaro Tiziana , Conti Gea Oliveri , Ferrante Margherita , Bernardo Giovanni Di , Galderisi Umberto , Messaoudi Imed , Minucci Sergio , Banni Mohamed
Published: May 2022

Background: Humans are exposed to environmental microplastic (MPs) that can be frequent in water and food. The mesenchymal stromal cells are a heterogeneous population, which contain fibroblasts and stromal cells, progenitor cells and stem cells. They are part of the stromal component of most tissue and organs in our organisms. Any injury to their functions may impair tissue renewal and homeostasis. Methods: We evaluated the effects of different size MPs that could be present in water bottles on human bone marrow mesenchymal stromal cells (BMMSCs) and adipose mesenchymal stromal cells (AMSCs). MPs of polyethylene terephthalate (PET) (<1 µm and <2.6 µm) were tested in this study. Results: PET treatments induced a reduction in proliferating cells associated either with the onset of senescence or increase in apoptosis. The AMSCs and BMMSCs exposed to PET showed an alteration of differentiation potential. AMSCs remained in an early stage of adipocyte differentiation as shown by high levels of mRNA for PPARG and reduction in LPL mRNA levels. A loss of differentiation capacity was also observed for the osteocyte phenotype in BMMSCs.Conclusions: This pioneering mesenchymal cell response survey demonstrated that environmental plastic particles are bioavailable for uptake into cells and thus may lead to irreversible diseases.
Access to quality maternal healthcare services in Ethiopia: A multilevel analysis
Authors: Negero Melese Girmaye , Sibbritt David , Dawson Angela
Published: May 2022

BackgroundThe quality of care a woman receives during antenatal care (ANC), intrapartum care, and postnatal care (PNC) affects the health of the woman and her child and her likelihood of seeking care in the future. This study aimed to assess the recommended interventions received by a mother and/or her newborn during ANC, intrapartum care and PNC, and their determinants in Ethiopia using data from the nationally representative 2019 Mini Demographic and Health Survey. MethodsWe defined quality ANC as having: blood pressure measurement, urine and blood tests, informed of danger signs, iron supplementation, and nutritional counselling; quality intrapartum care as having: a health facility birth, skilled birth assistance, and newborn put to the breast within one hour; and quality PNC as having: PNC within two days; cord examination; temperature measurement, and counselling on danger signs and breastfeeding of the newborn; and healthcare provider's observation of breastfeeding. We used multilevel mixed-effects logistic regression analyses specifying three-level models: a woman/household, a cluster, and an administrative region to determine predictors of each care quality. The analyses employed sampling weights and were adjusted for sampling design.ResultsThirty-six percent (n=1,048), 43% (n=1,485), and 21% (n=374) women received quality ANC, intrapartum, and PNC, respectively. Private health facilities provided higher-quality ANC and PNC but poor intrapartum care quality, compared to public health facilities. Receiving ≥4 ANC contacts and commencing this during the first trimester, higher levels of women's education and household wealth were positive predictors of quality ANC. Government health posts were less likely to provide quality ANC. Richer, urban residing women with education and ≥4 ANC contacts were more likely to receive quality intrapartum care. Women who received quality ANC and skilled birth assistance were more likely to receive quality PNC. Adolescent mothers were more likely to receive quality intrapartum care, but were less likely to receive quality PNC than mothers aged 20-49. ConclusionsWe recommend standardizing the components of maternal healthcare provided in all health facilities; and promoting early and ≥4 ANC contacts, effectiveness, sensitivity, and vigilance of care provided to adolescent mothers, digital clinical decision support tools, and women's education and economic empowerment.
Spatial variability of Methane and Carbon dioxide emissions from an active municipal solid waste dumpsite under various surface physicochemical conditions
Authors: Herath Priyantha Lakmini , Jayawardana Daham , Bandara Nilanthi
Published: May 2022

Surface methane (CH4) and carbon dioxide (CO2) emissions were studied from an open, active municipal solid waste (MSW) dumpsite, which has been functioning for over 30 years by filling MSW in Colombo Sri Lanka. Based on the surface physical conditions and waste disposal history, multiple samplings were done from eight identified cells using a standard static closed flux chamber. Results showed that the superficial average emission rates of CH4 and CO2 were 10,672 mg m-2 h-1 and 40,827 mg m-2 h-1, respectively. The highest average flux rate is reported from trenches that leachate flows and the lowest from the old mixed waste covered by compacted soil layer. Further, the highest fractions are observed from an area of old mixed waste covered with water, and the values are CH4; 26% and CO2; 35%, from the total emission (CH4; 7,436 kg d-1 and CO2; 21,653 kg d-1). Significantly, the results revealed that leachate provides an ideal pathway for the transmission of landfill gases. In contrast, moisture content and organic matter content have a positive relationship with the rate of CH4 flux. The CH4 oxidation capacity of the surface layer depends on its physical conditions and revealed vegetation enhancing CH4 oxidation. The results show that adequate water drainage and leachate treatment are essential to control the migration of landfill gases from MSW disposal sites.
Flexible iontronics based on 2D nanofluidic material
Authors: Wei Di , Yang Feiyao , Jiang Zhuoheng , Wang Zhong Lin
Published: May 2022

Iontronics focuses on the interactions between electrons and ions, playing essential roles in most processes across physics, chemistry and life science. Osmotic power source as an example of iontronics, could transform ion gradient into electrical energy, however, it generates low power, sensitive to humidity and can’t operate under freezing point. Herein, based on 2D nanofluidic graphene oxide (GO) material, we demonstrated an ultrathin (~ 10 µm) osmotic power source with voltage of 1.5 V, volumetric specific energy density of 6 mWh cm− 3 and power density of 28 mW cm− 3, achieving the highest values so far. Coupled with triboelectric nanogenerator, it could form a self-charged conformable triboiontronic device. Furthermore, a Lego-like design scaled up areal power density up to 1.3 mW cm− 2 purely from ion gradient based on nanoconfined enhancement from GO that can operate under − 40°C and overcome humidity limitations, enabling to power the future implantable electronics in human-machine interface.
Effect of silymarin on Interleukin-6 level and size of endometrioma lesions in women with ovarian endometriosis: a randomized, double-blind placebo-controlled trial
Authors: mirzaei negin , Sadatmahalleh shahideh Jahanian , Rouholamin Safoura , Nasiri Malihe
Published: May 2022

Objective: To study the effect of silymarin on interleukin-6 (IL-6) level, size of endometrioma lesion, pain, sexual function, and quality of life (QoL) in women diagnosed with endometriosis.Materials and methods: This randomized, double-blind placebo-controlled clinical trial was performed on 70 women with endometriosis which was divided into two groups of intervention and control. The intervention was 140 mg silymarin (or matching placebo) administered twice daily for 12 weeks. The volume of endometrioma lesions, IL-6, pain, sexual function, and QoL were analyzed before and after the intervention.Results: The means of endometrioma volume (P =0.04), interleukin-6 (P = 0.002), and pain (P<0.001) were reduced significantly in the silymarin group after intervention. However, the QoL, FSFI did not improve substantially in the two groups (P > 0.05).Conclusion: Silymarin significantly reduced interleukin-6 levels, sizes of endometrioma lesions, and pain-related symptoms.The trial has been registered in the Iranian Registry of Clinical Trials (IRCT20150905023897N5) on 4th February 2020 (04/02/2020) (https://en.irct.ir/trial/42215) and the date of initial participant enrollment was 2nd March 2020 (02/03/2020).