bluuebunny/crossref_metadata_2025 huggingface dataset:
The interplay between intimacy and commodification: Queer agency and vulnerability amid neoliberalism with Chinese characteristics
Authors: Lo Iris Po Yee
Published: January 2023

This article examines the ways in which lesbians’ economic and intimate lives are closely intertwined amid neoliberal development in the urban landscape. Previous research on queer urban life has primarily drawn attention to commodified gay neighbourhoods and other sites for sexual consumption, which are often marketised as part of a liberal and queer-friendly urban landscape, in Euro-American contexts. Such a focus is not adequate, however, to capture the complex interplay between intimacy and commodification in contemporary societies. Drawing upon interviews with 35 lesbians in Beijing, this study shows how the market is experienced by lesbians as a site of queer agency and vulnerability under neoliberalism with Chinese characteristics. The findings reveal ‘commodified forms of intimacy’, through which lesbians actively engage in the labour market and (queer-targeted) pink market in order to develop their intimate relations. Meanwhile, ‘intimatised forms of commodification’ illustrate how women’s gendered and sexual expressions are closely policed and evaluated in the workplace as a site of both economic production and the reproduction of social norms. Participants were conscious of their vulnerable position as women and lesbians in the marketplace, but they were active in strategising ways to navigate urban landscapes of heteronormativity and gender inequalities. This article helps to develop a deeper understanding of the complicated and contradictory impacts of neoliberalism with Chinese characteristics on queer communities. It contributes to urban sociology and sexuality studies by mapping the multiple connections between commodified relations and intimate relations in the neoliberal city.
A Call for Black Superintendents to Document Their Experiences Through Autoethnography
Authors: Joseph Shawn
Published: January 2023

As a Black former superintendent of a U.S. urban school district, I understand the crucial need for Black superintendents to systematically document their experiences. Given the low number of Black school superintendents and the lack of research literature about them, Black superintendents need to describe and build knowledge about their experiences. In this article, I argue, autoethnographies allow Black superintendents to document their experiences, particularly focusing on how race and racism impact their work. On a broader scale, documenting and sharing experiences through autoethnography may lead to changes in the superintendent pipeline and social change. Future Black superintendents may use insights for strategic guidance and empowerment, increasing recruitment and retention in the superintendency. The article describes how Black superintendents can create an autoethnography and provides a brief personal example.
Predictive generalised active disturbance rejection for load frequency control with communication delay
Authors: Jain Shivam , Hote Yogesh V
Published: January 2023

This paper formulates a generalised active disturbance rejection control technique based on Smith predictor (SP-GADRC) for power systems with communication delay. The SP-GADRC technique employs essential plant information and uses the notion of Smith predictor to alleviate the deterioration of transient response that arises due to the presence of communication delay in a system. The generalised formulae for computation of controller and observer gains for various single and multi-area power systems are derived. Furthermore, the effect of parametric uncertainty, nonlinearities, model-plant mismatch, load disturbances as well as varying time delay is examined to validate the robustness of the SP-GADRC technique. An elaborate comparative analysis is conducted with various existing approaches to exhibit efficacy of the SP-GADRC technique. The simulation results reveal that SP-GADRC scheme demonstrates an improved disturbance rejection ability, better transient performance and is robust to the presence of nonlinearities and disturbances in system.
Performance Comparison of Break and Seat and Rubblization Rehabilitation Techniques for Reflection-Crack Mitigation: Case Study in Louisiana
Authors: Akentuna Moses , Chen Qiming , Zhang Zhongjie
Published: January 2023

Hot mix asphalt (HMA) overlays are constructed on Portland cement concrete (PCC) pavements to improve long-term performance. A significant disadvantage of using HMA overlays on PCC pavements is the development of reflection cracks. Reflection cracks are influenced by traffic loads and periodic temperature changes. The objective of the study was to compare field performance of two slab-fracturing (i.e., break and seat, and rubblization) techniques commonly used in Louisiana, U.S. Four PCC pavement rehabilitation projects with at least one slab-fracturing technique and a corresponding control section were evaluated. Field structural capacity and performance data were collected and analyzed to determine the effect of each reflection-crack mitigation technique on performance. Resilient modulus (Mr) of the existing subgrade was found to significantly influence the structural and functional performance of the pavement sections evaluated. Pavement sections with weaker subgrades were shown to be not suitable for slab-fracturing rehabilitation techniques. For the four field projects evaluated, rubblized test sections showed higher cracking resistance than the control sections. The break and seat technique did not consistently improve or reduce the crack resistance of pavement sections compared with their corresponding control sections because of variations in subgrade Mr values. Sections with smaller sized (i.e., 6 in. break pattern and rubblized particles) fractured particles exhibited higher cracking resistance. Rubblized and selected break and seat sections for the field projects evaluated exhibited lower overall performance compared with their corresponding control sections, which is attributed to other underlying subsurface conditions. Additional study is required to continuously monitor the pavement sections.
Multimodal imaging for the management of Lyme-associated uveitis: A case report from an Italian tertiary center
Authors: Ferro Desideri Lorenzo , Rosa Raffaella , Forte Paolo , Manocchio Riccardo , Vagge Aldo , Traverso Carlo Enrico , Nicolò Massimo
Published: January 2023

Introduction

Lyme borreliosis may present with different systemic manifestations and also the ocular involvement may be difficult to diagnose because of its multifaceted presentation. Considering the growing incidence of Lyme disease in European countries, ophthalmologist should be trained to distinguish ocular borreliosis.

Case Report

Several clinical presentations have been previously described, including uveitis, unilateral or bilateral chorioretinitis, keratitis, episcleritis, papillitis and ischemic optic neuropathy, retinal vasculitis and acute posterior multifocal placoid pigment epitheliopathy (APMPPE); however our case report showed a rare presentation with the presence of unilateral uveitis with vitreitis and multiple, patchy, yellowish lesions, in association with retinal vasculitis. This clinical picture was to be considered in differential diagnosis with ocular Toxoplasmosis.

Conclusions

The appropriate management of this patient was made possible by the combination of multimodal imaging and appropriate laboratory tests, representing the optimal process in the diagnostic and therapeutic pathway in high-risk patients for ocular Lyme disease.
Warp knitted spacer microfiber biomass carrier for wastewater treatment
Authors: Kolcavová Sirková Brigita , Lenfeldová Irena , Havlíček Karel , Ryvolová Martina , Vysanská Monika , Lederer Tomáš , Jirásková Petra
Published: January 2023

The development of novel biomass carriers is an option for increasing the efficiency of processes at wastewater treatment plants (WWTPs). Biomass carriers support the adhesion of specific bacteria and the subsequent biofilm formation. As part of this work, a new type of microfibrous biomass carrier with a unique sandwich structure was developed. Technologically, the structure of the biomass carrier is based on warp knitted spacer fabric created on a double-needle bar machine. Commercially available microfiber materials were used to achieve a large specific surface area (SSA) and internal porosity of the carrier to ensure high microorganism capture. A yarn combination was chosen to reach a final carrier density slightly lower than water to float in an aqueous environment. As the first, was developed and described a three-dimensional warp knitted microfiber biomass carrier. Next, were evaluated the properties of this carrier for post nitrification on WWTPs and compared with commercially available biomass carriers. Testing biofilm (using respirometry, real-time polymerase chain reaction, and next-generation sequencing) growing on the developed carrier in a post-nitrification laboratory reactor showed excellent adhesion, stability, and abundance of microorganisms. A high rate (more than 95%) of ammonia nitrogen removal was achieved in post-nitrification, and molecular genetics methods confirmed the high concentration of nitrifying bacteria in the biofilm. The developed three-dimensional microfiber biomass carriers have proven their functionality and can be considered an advance in biofilm processes.
Intravenous Lobular Capillary Hemangioma of the Neck: A Report of 2 Cases
Authors: Chen Ziwei , Zhang Jinyan , Wen Xiaorong , Wu Zhoupeng , Ma Yukui
Published: January 2023

Background: Intravenous lobular capillary hemangioma (IVLCH) of the neck is a kind of rare benign tumor of vein. Purpose: In this paper, we report two female patients who were hospitalized because of neck masses. Results: The tumors in the neck veins of our patients were white oval masses with pedicle, clearly defined and of different sizes. Their immunohistochemical staining results showed CD31 (+), CD34 (+), SMA (+), ERG (+). The pathological diagnosis was intravenous lobular capillary hemangioma. Conclusions: Due to the location, morphology and immunohistochemistry, This lesion needs to be distinguished from other intravascular lesions such as thrombus, hemangiosarcoma and papillary endothelial hyperplasia.
Thromboaspiration of Abdominal Aortic Mural Thrombus: A New Endovascular Approach
Authors: Bertolucci Leonardo H. , Donadello Martins Ana P. , Rockenbach Pereira Oscar , Schulte Alfredo A. , Perini Sílvio C.
Published: January 2023

Primary aortic mural thrombus (PAMT) is defined as a thrombus attached to the aortic wall in the absence of any atherosclerotic or aneurysmal disease in the aorta and a cardiac source of embolus. There is no consensus on the ideal treatment of PAMT. There are a few reports of thromboaspiration of aortic thrombus in literature. The objective of this article is to report a new endovascular approach of abdominal aortic mural thrombus. The use of Penumbra Thromboaspiration System is a feasible procedure to treat abdominal aortic thrombus and may be an option for patients unsuitable for open repair or conservative treatment.
Poly Lactic-Co-Glycolic Acid Nano-Carriers for Encapsulation and Controlled Release of Hydrophobic Drug to Enhance the Bioavailability and Antimicrobial Properties
Authors: Bukhari Attaullah , Fatima Zuha , Atta Madiha , Nazir Arif , Alshawwa Samar Z. , Alotaibi Hadil F. , Iqbal Munawar
Published: January 2023

This study focusses on the fabrication of nano-carriers for delivery of ciprofloxacin through the nanoprecipitation process. This was done to examine the release of drug at the pH of stomach to find out the antibacterial action of ciprofloxacin loaded nanoparticles (NPs). Prepared NPs were characterized by Fourier Transform Infra-Red (FTIR) spectroscopy, Scanning Electron Microscopy (SEM), and particle size analyzer (PSA) techniques. Drug yield, loading, and sustained release was studied as function of time (up to 8 h). Antibacterial activity of ciprofloxacin loaded NPs were also determined against different gram-positive and gram-negative bacteria. Results revealed that nanoprecipitation is a suitable method for encapsulation of ciprofloxacin in poly(lactic-co-glycolic acid) PLGA NPs. The drug yield and drug loading were found to be 60%. The size range of NPs observed by PSA was in the range of 5.03–6.60 nm. It can be concluded that nanoformulation of ciprofloxacin loaded PLGA NPs can be used in stomach for longer period of time to enhance the bioavailability of the drug.
Pancreatic Beta-cell Dysfunction in Type 2 Diabetes
Authors: Khin Phyu Phyu , Lee Jong Han , Jun Hee-Sook
Published: January 2023

Pancreatic β-cells produce and secrete insulin to maintain blood glucose levels within a narrow range. Defects in the function and mass of β-cells play a significant role in the development and progression of diabetes. Increased β-cell deficiency and β-cell apoptosis are observed in the pancreatic islets of patients with type 2 diabetes. At an early stage, β-cells adapt to insulin resistance, and their insulin secretion increases, but they eventually become exhausted, and the β-cell mass decreases. Various causal factors, such as high glucose, free fatty acids, inflammatory cytokines, and islet amyloid polypeptides, contribute to the impairment of β-cell function. Therefore, the maintenance of β-cell function is a logical approach for the treatment and prevention of diabetes. In this review, we provide an overview of the role of these risk factors in pancreatic β-cell loss and the associated mechanisms. A better understanding of the molecular mechanisms underlying pancreatic β-cell loss will provide an opportunity to identify novel therapeutic targets for type 2 diabetes.
Analyzing the age-friendliness of the urban environment using computer vision methods
Authors: Moradi Fereshteh , Biloria Nimish , Prasad Mukesh
Published: January 2023

The accelerated growth of cities and urban populations over recent decades and the complexity and diversity of urban areas demands proficient spatial affordance assessment especially for the vulnerable sections of the society. Lately machine learning and computer vision models have become highly competent in analyzing urban images for assessing the built environment. This study harnesses the potential of computer vision techniques to assess the age-friendliness of urban areas. The developed machine learning model utilizes Google’s Street View images and is trained using lived experience-based image ratings provided by elderly participants. Newly assigned urban images are accordingly rated for their level of age-friendliness by the model with an accuracy of 85%. This paper elaborates upon the associated literature review, explains the data collection approach and the developed machine learning model. The success of the implementation is also demonstrated, confirming the validity of the proposed methodology.
The genome of sheep ked (Melophagus ovinus) reveals potential mechanisms underlying reproduction and narrower ecological niches
Authors: Zhang Qingxun , Zhou Qingsong , Han Shuyi , Li Ying , Wang Ye , He Hongxuan
Published: January 2023

Background

Melophagus ovinus is considered to be of great veterinary health significance. However, little is known about the information on genetic mechanisms of the specific biological characteristics and novel methods for controlling M. ovinus.

Results

In total, the de novo genome assembly of M. ovinus was 188.421 Mb in size (330 scaffolds, N50 Length: 10.666 Mb), with a mean GC content of 27.74%. A total of 13,372 protein-coding genes were functionally annotated. Phylogenetic analysis indicated that the diversification of M. ovinus and Glossina fuscipes took place 72.76 Mya within the Late Cretaceous. Gene family expansion and contraction analysis revealed that M. ovinus has 65 rapidly-evolving families (26 expansion and 39 contractions) mainly involved DNA metabolic activity, transposases activity, odorant receptor 59a/67d-like, IMD domain-containing protein, and cuticle protein, etc. The universal and tightly conserved list of milk protein orthologues has been assembled from the genome of M. ovinus. Contractions and losses of sensory receptors and vision-associated Rhodopsin genes were significant in M. ovinus, which indicate that the M. ovinus has narrower ecological niches.

Conclusions

We sequenced, assembled, and annotated the whole genome sequence of M. ovinus, and launches into the preliminary genetic mechanisms analysis of the adaptive evolution characteristics of M. ovinus. These resources will provide insights to understand the biological underpinnings of this parasite and the disease control strategies.
No need for a gold-standard test: on the mining of diagnostic test performance indices merely based on the distribution of the test value
Authors: Habibzadeh Farrokh , Roozbehi Hooman
Published: January 2023

Background

Diagnostic tests are important in clinical medicine. To determine the test performance indices — test sensitivity, specificity, likelihood ratio, predictive values, etc. — the test results should be compared against a gold-standard test. Herein, a technique is presented through which the aforementioned indices can be computed merely based on the shape of the probability distribution of the test results, presuming an educated guess.

Methods

We present the application of the technique to the probability distribution of hepatitis B surface antigen measured in a group of people in Shiraz, southern Iran. We assumed that the distribution had two latent subpopulations — one for those without the disease, and another for those with the disease. We used a nonlinear curve fitting technique to figure out the parameters of these two latent populations based on which we calculated the performance indices.

Results

The model could explain > 99% of the variance observed. The results were in good agreement with those obtained from other studies.

Conclusion

We concluded that if we have an appropriate educated guess about the distributions of test results in the population with and without the disease, we may harvest the test performance indices merely based on the probability distribution of the test value without need for a gold standard. The method is particularly suitable for conditions where there is no gold standard or the gold standard is not readily available.
Clinical and genomic features in patients with second primary glioblastoma following first primary renal cell carcinoma
Authors: Zhang Guang-Tao , Liu Qi , Zuo Fu-Xing , Liu Hou-Jie , Wang Song-Quan , Yuan Qing , Liu Ang-Si , Hu Ke , Meng Xiao-Li , Wang Wei-Jia , Qian Hai-Peng , Wan Jing-Hai , Cai Hong-Qing
Published: January 2023

Purpose

To explore the potential pathogenesis and clinical features of second primary glioblastoma (spGBM) following first primary renal cell carcinoma (fpRCC).

Methods

Patients with spGBM after fpRCC were enrolled from our institution and the SEER dataset. Sanger sequencing, whole genome sequencing, and immunehistochemistry were used to detect molecular biomarkers.

Results

Four and 122 cases from our institution and the SEER dataset, respectively, were collected with an overall median age of 69 years at spGBM diagnosis following fpRCC. The median interval time between fpRCC and spGBM was 50.7 months and 4 years, for the four and 122 cases respectively. The median overall survival time was 11.2 and 6.0 months for the two datasets. In addition, spGBM patients of younger age (< 75 years) or shorter interval time (< 1 year) had favorable prognosis (p = 0.081 and 0.05, respectively). Moreover, the spGBM cases were molecularly classified as TERT only paired with TP53 mutation, PIK3CA mutation, EGFR alteration, low tumor mutation burden, and stable microsatellite status.

Conclusions

This is the first study to investigate the pathogenesis and clinical features of spGBM following spRCC. We found that spGBMs are old-age related, highly malignant, and have short survival time. Moreover, they might be misdiagnosed and treated as brain metastases from RCC. Thus, the incidence of spGBMs after fpRCC is underestimated. Further studies are needed to investigate the underlying molecular mechanisms and clinical biomarkers for the development of spGBM following fpRCC.
Prevalence of and factors associated with alexithymia among patients with chronic obstructive pulmonary disease in China: a cross-sectional study
Authors: Zhang Huaizhong , Wang Yixuan , Lou Heqing , Zhu Yanan , Dong Zongmei , Dong Dong , Chen Peipei , Zhu Xuan , Chen Bi , Zhang Pan
Published: January 2023

Background

Alexithymia is a common psychological disorder. However, few studies have investigated its prevalence and predictors in patients with chronic obstructive pulmonary disease (COPD). Therefore, we aimed to determine the prevalence and predictors of alexithymia in Chinese patients.

Methods

This cross-sectional study included 842 COPD patients to assess the prevalence and predictors of alexithymia using the 20-item Toronto Alexithymia Scale (TAS-20). We used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression, the modified British Medical Research Council dyspnea Rating Scale (mMRC) to assess dyspnea, St. George's Respiratory Questionnaire (SGRQ) to assess quality of life, and the age-adjusted Charlson comorbidity index (ACCI) to assess comorbidities. Alexithymia-related predictors were identified using univariate and multivariate logistic regression analyses.

Results

The prevalence of alexithymia in COPD patients was 23.6% (199/842). Multivariate analysis showed that age [odds ratio (OR) 0.886; 95% confidence interval (CI) 0.794–0.998], body mass index (OR 0.879; 95% CI 0.781–0.989), HADS-anxiety (OR 1.238; 95% CI 1.097–1.396), HADS-depression (OR 1.178; 95% CI 1.034–1.340), mMRC (OR 1.297; 95% CI 1.274–1.320), SGRQ (OR 1.627; 95% CI 1.401–1.890), ACCI (OR 1.165; 95% CI 1.051–1.280), and GOLD grade (OR 1.296; 95% CI 1.256–1.337) were independent predictors for alexithymia in patients with COPD.

Conclusions

The prevalence of alexithymia was high in Chinese COPD patients. Anxiety, depression, dyspnea, quality of life, comorbidities, and disease severity are independent risk factors, and age and BMI are predictive factors for alexithymia in COPD patients.
A novel nomogram to predict lymph node metastasis in cT1 non-small-cell lung cancer based on PET/CT and peripheral blood cell parameters
Authors: Wei Bohua , Jin Xin , Lu Gaojun , Zhao Teng , Xue Hanjiang , Zhang Yi
Published: January 2023

Background

Accurately evaluating the lymph node status preoperatively is critical in determining the appropriate treatment plan for non-small-cell lung cancer (NSCLC) patients. This study aimed to construct a novel nomogram to predict the probability of lymph node metastasis in clinical T1 stage patients based on non-invasive and easily accessible indicators.

Methods

From October 2019 to June 2022, the data of 84 consecutive cT1 NSCLC patients who had undergone PET/CT examination within 30 days before surgery were retrospectively collected. Univariate and multivariate logistic regression analyses were performed to identify the risk factors of lymph node metastasis. A nomogram based on these predictors was constructed. The area under the receiver operating characteristic (ROC) curve and the calibration curve was used for assessment. Besides, the model was confirmed by bootstrap resampling.

Results

Four predictors (tumor SUVmax value, lymph node SUVmax value, consolidation tumor ratio and platelet to lymphocyte ratio) were identified and entered into the nomogram. The model indicated certain discrimination, with an area under ROC curve of 0.921(95%CI 0.866–0.977). The calibration curve showed good concordance between the predicted and actual possibility of lymph node metastasis.

Conclusions

This nomogram was practical and effective in predicting lymph node metastasis for patients with cT1 NSCLC. It could provide treatment recommendations to clinicians.
Utilization of dental care service and associated factors among pre-school children in northwest China over the past decade
Authors: Hu Xiao , Fan Xiaoyu , Tian Jiangang , Zhang Bin , Huang Ruizhe
Published: January 2023

Objective

The purpose of this study was to analyze the factors influencing the utilization of oral health care among 5 years old children.

Methods

We conducted two observational cross-sectional studies. The studies were conducted in 2005 and 2015 and included 5-year-old children who underwent dental examination by trained dentists and the caregivers of the children were requested to answer the questionnaire. Multi-level stratified sampling method was used. Chi-square tests were used to analyze the utilization of dental care and other socio-economic variables. Logistic regression models were employed to explore the primary factors influencing the use of dental care among pre-school children.

Results

In 2005, a total of 399 and in 2015, 492 child-caregiver pairs were included. The majority of the caregivers in both surveys were females, comprising 68.2% and 74.8% of the caregivers in 2005 and 2015, respectively. 75.2% and 87.0% (p < 0.05) of the respondents had an education level of lesser than 9 years. The prevalence of caries was higher in 2015 (63.2%) (p < 0.05) than in 2005 (53.4%). In 2005 and 2015, the utilization of dental care services was 20.8% and 20.0%, respectively. A statistically significant association was observed between caries and dental care use in 5-year-olds over the past decade. After adjusting for confounders, dental service usage among children in urban areas was 1.62 times higher than that of rural areas in 2005 (95% CI 0.069–0.571), and the self-assessment of caregivers regarding their child’s oral health significantly improved oral health use in 2015.

Conclusion

The utilization of dental care services over the past decade is insufficient among pre-school children in northwest China. Hence, with the decreasing gap about economic and health service resources, policymakers should place greater emphasis on raising awareness among caregivers about the oral health status of their children.
Evaluating the usability of a cancer registry system using Cognitive Walkthrough, and assessing user agreement with its problems
Authors: Bagheri Fatemeh , Abbasi Faezeh , Sadeghi Mojtaba , Khajouei Reza
Published: January 2023

Objective/aim

Good design of cancer registry systems makes them easy to use, while poor design of their user interfaces leads to user dissatisfaction and resistance. The objective of this study was to evaluate the usability of a cancer registry system using Cognitive Walkthrough (CW) and to assess users' agreement with its usability problems.

Methods

CW was used to evaluate the registry system. We developed a checklist to help evaluators speed up the evaluation process, a problems form to collect the usability issues identified by the evaluators, and a problems severity form to determine the severity of problems by the evaluators. The problems were classified into two categories according to the CW questions and the system tasks. The agreement of the users with the system problems was examined by an online questionnaire. Users' agreement with the problems was then analyzed using the Interclass Correlation Coefficient in the SPSS 22 (Statistical Package for Social Science).

Results

In this study, 114 problems were identified. In the categorization of problems based on the CW questions, 41% (n = 47) of the problems concerned the issue of “users do not know what to do at each stage of working with the system”, 24% (n = 27) were classified as “users cannot link what they intend to do with system controls”, and 22% (n = 25) were related to “user's lack of understanding of the system processes”. Based on user tasks, about 36% (n = 41) of the problems were related to “removing patient duplication” and 33% (n = 38) were related to “registration of patient identification information”. User agreement with the problems was high (CI 95% = 0.9 (0.96, 0.98)).

Conclusion

System problems often originate from user ignorance about what to do at each stage of using the system. Also, half of the system problems concern a mismatch between what users want to do and the system controls, or a lack of understanding about what the system does at different stages. Therefore, to avoid user confusion, designers should use clues and guides on the screen for users, design controls consistent with the user model of thinking, and provide appropriate feedback after each user action to help users understand what the system is doing. The high agreement of users with the problems showed that in the absence of users system designers can use CW to identify the problems that users face in the real environment.
COVID-19’s impact on care practice for alpha-1-antitrypsin deficiency patients
Authors: Calle Rubio Myriam , López-Campos José Luis , Miravitlles Marc , Michel de la Rosa Francisco Javier , Hernández Pérez José María , Montero Martínez Carmen , Montoro Ronsano José Bruno , Casas Maldonado Francisco , Rodríguez Hermosa Juan Luis , Tabernero Huguet Eva María , Martínez Sesmero José Manuel , Martínez Rivera Carlos , Callejas González Francisco Javier , Torres Durán María
Published: January 2023

Background

Patients with alpha-1 antitrypsin deficiency (AATD), commonly categorized as a rare disease, have been affected by the changes in healthcare management brought about by COVID-19. This study’s aim was to identify the changes that have taken place in AATD patient care as a result of the COVID-19 pandemic in Spain and to propose experts’ recommendations aimed at ensuring humanized and quality care for people with AATD in the post-pandemic situation.

Methods

A qualitative descriptive case study with a holistic single-case design was conducted, using focus groups with experts in AATD clinical management, including 15 health professionals with ties to the Spanish health system (12 pneumologists and 2 hospital pharmacists from 11 different hospitals in Spain) and 1 patient representative.

Results

COVID-19 has had a major impact on numerous aspects of AATD clinical patient management in Spain, including diagnostic, treatment, and follow-up phases. The experts concluded that there is a need to strengthen coordination between Primary Care and Hospital Care and improve the coordination processes across all the organizations and actors involved in the healthcare system. Regarding telemedicine and telecare, experts have concluded that it is necessary to promote this methodology and to develop protocols and training programs. Experts have recommended developing personalized and precision medicine, and patient participation in decision-making, promoting self-care and patient autonomy to optimize their healthcare and improve their quality of life. The possibility of monitoring and treating AATD patients from home has also been proposed by experts. Another result of the study was the recommendation of the need to ensure that plasma donations are made on a regular basis by a sufficient number of healthy individuals.

Conclusion

The study advances knowledge by highlighting the challenges faced by health professionals and changes in AATD patient management in the context of the COVID-19 pandemic. It also proposes experts’ recommendations aimed at ensuring humanized and quality care for people with AATD in the post-pandemic situation. This work could serve as a reference study for physicians on their daily clinical practice with AATD patients and may also provide guidance on the changes to be put in place for the post-pandemic situation.
Relationship between drug targets and drug-signature networks: a network-based genome-wide landscape
Authors: Lee Chae Won , Kim Sung Min , Sa Soonok , Hong Myunghee , Nam Sang-Min , Han Hyun Wook
Published: January 2023

Drugs produce pharmaceutical and adverse effects that arise from the complex relationship between drug targets and signatures; by considering such relationships, we can begin to understand the cellular mechanisms of drugs. In this study, we selected 463 genes from the DSigDB database corresponding to targets and signatures for 382 FDA-approved drugs with both protein binding information for a drug-target score (KDTN, i.e., the degree to which the protein encoded by the gene binds to a number of drugs) and microarray signature information for a drug-sensitive score (KDSN, i.e., the degree to which gene expression is stimulated by the drug). Accordingly, we constructed two drug–gene bipartite network models, a drug-target network and drug-signature network, which were merged into a multidimensional model. Analysis revealed that the KDTN and KDSN were in mutually exclusive and reciprocal relationships in terms of their biological network structure and gene function. A symmetric balance between the KDTN and KDSN of genes facilitates the possibility of therapeutic drug effects in whole genome. These results provide new insights into the relationship between drugs and genes, specifically drug targets and drug signatures.
Low dose ultra-slow infusion thrombolytic therapy (LDUSITT) as an alternative option in a COVID-19 patient with free-floating right atrial thrombus: a case report and review of literature
Authors: Mahjani Mahsa , Gohari Sepehr , Ahangar Hassan
Published: January 2023

The hyper-coagulopathy nature of COVID-19 is a prevalent consequence among patients. Free-floating right atrial thrombi are a relatively rare finding and the optimal therapy is a therapeutic dilemma.

We present a 37-year-old woman with acute dyspnea and fatigue. Several ground glass opacities were shown on computed tomography of chest that further proved to be associated with severe COVID-19 disease. A transthoracic echocardiography revealed a mobile right atrial mass with bilateral pulmonary embolism. She was considered high risk for surgical therapy by cardiovascular surgeons. She was then started on anticoagulation therapy for 5 days however the size regression of the thrombus remained unchanged. A regimen of low dose (24 mg) ultra-slow (24 h) intravenous infusion of alteplase, without bolus was initiated. Following the third day of thrombolytic therapy, the control echocardiography demonstrated complete resolution of the thrombus.

Prolonged infusion of low dose fibrinolytics can be an alternative treatment to surgery for right heart thrombi.
Description of recurrent headaches in 7–14-year-old children: Baseline data from a randomized clinical trial on effectiveness of chiropractic spinal manipulation in children with recurrent headaches
Authors: Dissing Kristina Boe , Vach Werner , Lynge Susanne , Christensen Henrik Wulff , Hestbaek Lise
Published: January 2023

Background

Headaches in children are poorly described and diagnosing can be challenging. Objectives are: (1) to describe headache characteristics and child characteristics, (2) to explore whether data can suggest a more diverse way to categorize headaches than traditionally.

Methods

Baseline data for a clinical trial included a questionnaire and a physical screening. Children's characteristics and detailed description of headache symptoms were provided. Children were classified for migraine or tension-type-headache based on questionnaire data reported by children and parents. This required to apply slightly modified classification criteria and a “non-classifiable” group was added. Severity and symptoms, related to the migraine versus tension type distinction, were investigated to define a migraine-tension-type-index.

Results

253 children were included. Mean pain intensity was 5.9/10. Over 2/3 of the children had headache for > 1 year, and > 50% for several days/week. Half of the children were non-classifiable, 22% were classified as migraine and 23% as tension-type headache. A migraine-tension-type-index was constructed and describes a continuous spectrum rather than two distinct groups.

Conclusions

Children with recurrent headaches are often severely affected. A questionnaire-based classification appeared feasible to distinguish between migraine and tension-type headaches in children but leaving many children unclassified. A migraine-tension-type-index can be generated allowing to regard the traditional distinction as a continuum (including mixed headache), and potentially serving as an instrument to improve headache management.

Trial registration ClinicalTrials.gov, identifier NCT02684916.
Screening of Q-markers for the wine-steamed Schisandra chinensis decoction pieces in improving allergic asthma
Authors: Qu Zhongyuan , Bing Yifan , Zhang Tianlei , Zheng Yan , Wu Shuang , Ji Chenfeng , Li Wenlan , Zou Xiang
Published: January 2023

Background

Traditional Chinese medicine (TCM) posits that Chinese medicinal materials can only be clinically used after being processed and prepared into decoction pieces. Schisandra Chinensis Fructus (derived from the dried and mature fruits of Schisandra chinensis (Turcz.) Baill.) has been used as a traditional antiasthmatic, kidney strengthening, and hepatoprotective agent for 2000 years. The results of previous research show that decoction pieces of wine-steamed Schisandra chinensis (WSC) are more effective than raw decoction pieces of Schisandra chinensis (RSC) for treating cough and asthma. Steaming with wine was demonstrated to promote the dissolution of ingredients. However, the relationship between the changes in the components of the decoction pieces of WSC and the therapeutic effect remains unclear.

Methods

The efficacies of decoctions of RSC and WSC were compared using allergic asthma rats. The potential bioactive components in the serum of the WSC treatment group and the changes in the chemical composition of the RSC decoction pieces before and after wine steaming were determined by ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS/MS) and ultra-high-performance liquid chromatography tandem mass spectrometry (UPLC H-CLASS XEVO TQD) to speculate quality markers (Q-markers) related to the efficacy of WSC, which were subsequently verified based on a zebrafish inflammation model.

Results

Steaming RSC decoction pieces with wine was found to promote improvement of allergic asthma. Reverse tracing of 22 components detected in the serum of the high dose group of WSC (WSC-H) resulted in 12 ingredients being finally designated as potential effective components. Among these ingredients, 5 components, Schisandrin, Schisandrol B, Schisandrin A, Schisandrin B, and Gomisin D, had higher dissolution rates than RSC after steaming with wine. Validation by an inflammatory zebrafish model showed that these 5 ingredients had a dose-dependent effect and were therefore Q-markers for WSC in the treatment of allergic asthma.

Conclusion

In this study, changes in the components of decoction pieces of RSC and WSC and Q-markers related to WSC efficacy were identified, providing valuable information for expanding the application of WSC and establishing a specific quality standard for WSC.
Changes in the tumor oxygenation but not in the tumor volume and tumor vascularization reflect early response of breast cancer to neoadjuvant chemotherapy
Authors: Pavlov Mikhail V. , Bavrina Anna P. , Plekhanov Vladimir I. , Golubyatnikov German Yu. , Orlova Anna G. , Subochev Pavel V. , Davydova Diana A. , Turchin Ilya V. , Maslennikova Anna V.
Published: January 2023

Background

Breast cancer neoadjuvant chemotherapy (NACT) allows for assessing tumor sensitivity to systemic treatment, planning adjuvant treatment and follow-up. However, a sufficiently large number of patients fail to achieve the desired level of pathological tumor response while optimal early response assessment methods have not been established now. In our study, we simultaneously assessed the early chemotherapy-induced changes in the tumor volume by ultrasound (US), the tumor oxygenation by diffuse optical spectroscopy imaging (DOSI), and the state of the tumor vascular bed by Doppler US to elaborate the predictive criteria of breast tumor response to treatment.

Methods

A total of 133 patients with a confirmed diagnosis of invasive breast cancer stage II to III admitted to NACT following definitive breast surgery were enrolled, of those 103 were included in the final analysis. Tumor oxygenation by DOSI, tumor volume by US, and tumor vascularization by Doppler US were determined before the first and second cycle of NACT. After NACT completion, patients underwent surgery followed by pathological examination and assessment of the pathological tumor response. On the basis of these, data regression predictive models were created.

Results

We observed changes in all three parameters 3 weeks after the start of the treatment. However, a high predictive potential for early assessment of tumor sensitivity to NACT demonstrated only the level of oxygenation, ΔStO2, (ρ = 0.802, p ≤ 0.01). The regression model predicts the tumor response with a high probability of a correct conclusion (89.3%). The “Tumor volume” model and the “Vascularization index” model did not accurately predict the absence of a pathological tumor response to treatment (60.9% and 58.7%, respectively), while predicting a positive response to treatment was relatively better (78.9% and 75.4%, respectively).

Conclusions

Diffuse optical spectroscopy imaging appeared to be a robust tool for early predicting breast cancer response to chemotherapy. It may help identify patients who need additional molecular genetic study of the tumor in order to find the source of resistance to treatment, as well as to correct the treatment regimen.
Non-linear dose response effect of cathodal transcranial direct current stimulation on muscle strength in young healthy adults: a randomized controlled study
Authors: Vimolratana Oranich , Lackmy-Vallee Alexandra , Aneksan Benchaporn , Hiengkaew Vimonwan , Klomjai Wanalee
Published: January 2023

Background

Transcranial direct current stimulation (tDCS) is a technique that modulates brain excitability in humans. Increasing the stimulation intensity or duration within certain limits could enhance tDCS efficacy with a polarity-dependent effect; anodal stimulation increases cortical excitability, whereas cathodal stimulation decreases excitability. However, recent studies have reported a non-linear effect of cathodal tDCS on neuronal excitability in humans, and there is no conclusive result regarding the effect of cathodal tDCS on muscle performance.

Methods

Our study aimed to investigate the immediate effects of different intensities (i.e., 1, 1.5, and 2 mA and sham tDCS) of cathodal tDCS on muscle strength in healthy participants. All participants [mean age 23.17 (3.90) years] were recruited and randomly allocated into four groups (1, 1.5, and 2 mA cathodal tDCS and sham tDCS). Muscle strength in bilateral upper and lower extremities was measured before and immediately after tDCS using a handheld dynamometer.

Results

Our results showed that cathodal tDCS at 1 and 1.5 mA reduced muscle strength bilaterally in upper and lower extremity muscles, whereas stimulation at 2 mA tended to increase muscle strength on the dominant limb.

Conclusion

These findings support the non-linear effects of cathodal tDCS on muscle strength, which should be considered for the clinical use of tDCS in motor rehabilitation.

Trial registration: NCT04672122, date of first registration 17/12/2020.
Resilience in the face of adversity: classes of positive adaptation in trauma-exposed children and adolescents in residential care
Authors: Sölva Katharina , Haselgruber Alexander , Lueger-Schuster Brigitte
Published: January 2023

Children and adolescents in residential care often face multiple traumatic experiences. However, some individuals show resilient adaptation. To depict this heterogeneity, the person-centered examination of different classes of adaptation is a powerful tool. Up to date, resilience was insufficiently addressed in this population. Data from 141 children and adolescents in residential care institutions in Austria regarding trauma history, psychopathology, behavioral adjustment, and protective factors were assessed with standardized self-report questionnaires. Distinct classes of adaptation after traumatic experiences were examined with Latent Class Analysis. Class differences regarding traumatic experiences and protective factors were analyzed with χ2 testing. Three classes were identified [resilience (66.18%), mixed psychopathology (13.97%, mixed), high psychopathology (19.85%, high)]. Only males were classified into the resilient class and only females into the high class. The high class differed significantly from the resilient class regarding cumulative trauma history and protective factors. The mixed class did not differ from the resilient class regarding trauma history, however, they differed significantly regarding protective factors. The resilient class was associated with protective factors. Strong gender differences show the relevance of a differentiated evaluation of gender-specific protective factors and resilience indicators. Fostering protective factors may be a suitable approach for tailored intervention measures.
The AMADEUS score is not a sufficient predictor for functional outcome after high tibial osteotomy
Authors: Heinz Tizian , Meller Felix , Luetkens Karsten Sebastian , Anderson Philip Mark , Stratos Ioannis , Horas Konstantin , Rudert Maximilian , Reppenhagen Stephan , Weißenberger Manuel
Published: January 2023

Purpose

The Area Measurement And Depth Underlying Structures (AMADEUS) classification system has been proposed as a valuable tool for magnetic resonance (MR)‐based grading of preoperatively encountered chondral defects of the knee joint. However, the potential relationship of this novel score with clinical data was yet to determine. It was the primary intention of this study to assess the correlative relationship of the AMADEUS with patient reported outcome scores in patients undergoing medial open‐wedge high tibial valgus osteotomy (HTO). Furthermore, the arthroscopic ICRS (International Cartilage Repair Society) grade evaluation was tested for correlation with the AMADEUS classification system.

Methods

This retrospective, monocentric study found a total of 70 individuals that were indicated for HTO due to degenerative chondral defects of the medial compartment between 2008 and 2019. A preoperative MR image as well as a pre‐osteotomy diagnostic arthroscopy for ICRS grade evaluation was mandatory for all patients. The Knee Osteoarthritis Outcome Score (KOOS) including its five subscale scores (KOOS‐ADL, KOOS‐QOL, KOOS‐Sports, KOOS‐Pain, KOOS‐Symptoms) was obtained preoperatively and at a mean follow‐up of 41.2 ± 26.3 months. Preoperative chondral defects were evaluated using the AMADEUS classification system and the final AMADEUS scores were correlated with the pre‐ and postoperative KOOS subscale sores. Furthermore, arthroscopic ICRS defect severity was correlated with the AMADEUS classification system.

Results

There was a statistically significant correlation between the AMADEUS BME (bone marrow edema) subscore and the KOOS Symptoms subscore at the preoperative visit (r = 0.25, p = 0.04). No statistically significant monotonic association between the AMADEUS total score and the AMADEUS grade with pre‐ and postoperative KOOS subscale scores were found. Intraoperatively obtained ICRS grade did reveal a moderate correlative relation with the AMADEUS total score and the AMADEUS grade (r = 0.28, p = 0.02).

Conclusions

The novel AMADEUS classification system largely lacks correlative capacity with patient reported outcome measures in patients undergoing HTO. The MR tomographic appearance of bone marrow edema is the only parameter predictive of the clinical outcome at the preoperative visit.