bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcatheter Arterial Infusion Combined With Radioactive Particles in the Treatment of Advanced Body/Tail Pancreatic Cancer
Authors: Han Shilong , Cao Chuanwu , Yuan Yifeng , Chen Jun , Yin Linan , Xu Huirong , Liu Jingzhou , Wang Wujie , Li Yuliang , Wang Lizhou , Zhou Shi , Li Fenqiang , Wang Wenhui , Ji Jiansong , Long Haideng , Yin Shiwu , Li Jue , Han Jianjun , Liu Ruibao , Li Maoquan , Zhang Xiaoping
Published: August 2021

Objectives

This retrospective cohort study investigated the efficacy of routine intravenous chemotherapy (the control group), transcatheter arterial infusion (TAI) chemotherapy, and TAI combined with radioactive particles as therapeutic methods for advanced body/tail pancreatic cancer by assessing the short-term and overall survival rates.

Methods

We screened our prospective database for patients with advanced body/tail pancreatic cancer, which tumor deemed unresectable, and no other confirmed malignant tumors, patients were assigned into 3 groups according to their treatment: routine intravenous chemotherapy, TAI, and TAI combined with radioactive particles.

Results

The median survival time was 6 months in the control group, 10 months in the TAI group, and 13 months in the TAI combined group. The Kaplan-Meier estimates of the overall survival among the 3 groups, indicating that there is significant difference among 3 groups (P < 0.000). The clinical remission rates were 17.5% in the control group, 41.5% in the TAI group, and 48.0% in the TAI combined group. Covariates analyzed showed that different treatment methods and times affected the results significantly (P < 0.002).

Conclusions

In the treatment of advanced body/tail pancreatic cancer, TAI and TAI combined with radioactive particles significantly improved the clinical outcomes in patients compared with routine intravenous chemotherapy.
Validation of the Modified Determinant-Based Classification for Patients With Acute Pancreatitis in Intensive Care Medicine
Authors: Zubia-Olaskoaga Felix , Maraví-Poma Enrique , Urreta-Barallobre Iratxe , Ramírez-Puerta María-Rosario , Mourelo-Fariña Mónica , Marcos-Neira María-Pilar ,   on behalf of the EPAMI study group
Published: August 2021

Objectives

To validate the Modified Determinant-Based Classification (MDBC) system, and compare it with the Revised Atlanta Classification (RAC) and the Determinant-Based Classification (DBC).

Methods

Prospective observational research was conducted in 35 international intensive care units, on patients with acute pancreatitis, and at least 1 organ failure (OF). Patient classification according to the MDBC was as follows: group 1 (transient OF, without local complications [LCs]), group 2 (transient OF and LC), group 3 (persistent OF, without LC), and group 4 (persistent OF and LC).

Results

A total of 316 patients were enrolled (mortality of 25.6%). In group 1, patients presented with low mortality (3.31%) and low morbidity (13.68%); in group 2, low mortality (5.26%) and moderate morbidity (55.56%); in group 3, high mortality (32.18%) and moderate morbidity (54.24%); and in group 4, high mortality (53.93%) and high morbidity (97.56%). The area under the receiver operator characteristic curve for mortality was 0.80 (95% confidence interval [CI], 0.75–0.84), with significant differences in comparison to RAC (0.76; 95% CI, 0.70–0.80) and DBC (0.79; 95% CI, 0.74–0.83) (P < 0.01).

Conclusions

The MDBC identified 4 groups with differentiated clinical evolutions. Its tiered mortality rating provided it with better discriminatory power than the DBC and the RAC.
Looking Back to Move Forward
Authors: Jennings Bonnie Mowinski
Published: August 2021

This article is based on an invited presentation delivered in celebration of the 50th anniversary of the Association of Leadership Science in Nursing. The article begins with framing the historical context of nursing administration/leadership. The look-back includes a glimpse at the evolution of the Council on Graduate Education for Administrative Nursing into the Association of Leadership Science in Nursing. Two present-day leadership issues are then considered—turbulence and interprofessional proficiency. Lastly, the concept of problematizing is proposed as a strategy for moving forward. Yesterday, today, and tomorrow though are not tidy packages with good boundaries. The chronology, therefore, is not always linear.
Group Prenatal Care and Maternal Outcomes
Authors: Tucker Curisa M. , Felder Tisha M. , Dail Robin B. , Lyndon Audrey , Allen Kari-Claudia
Published: August 2021

Purpose:

The objective of this study was to examine the current state of literature on group prenatal care and its impact on maternal outcomes and racial disparities in adverse maternal outcomes.

Design:

We conducted a scoping review of literature published between January 2010 and December 2020 using the PRISMA-ScR reporting checklist.

Methods:

Eligible studies were identified using key words and MeSH terms in PubMed, CINAHL, and Web of Science. Inclusion criteria were studies that were (a) conducted in the United States; (b) published between January 2010 and December 2020; (c) in English; (d) focused on the primary investigation of group prenatal care and reporting on maternal comorbidity outcomes; and (e) an observational study or clinical trial.

Results:

Nine studies met inclusion criteria. They reported on outcomes of preeclampsia, gestational hypertension, gestational diabetes mellitus, final A1C among patients with gestational diabetes mellitus, and postpartum hemorrhage. None reported on racial disparities for minoritized populations. Among all reported maternal outcomes, results were mixed, providing inconclusive evidence.

Clinical Implications:

Outcomes from group prenatal care focus more on neonatal outcomes than maternal outcomes. More studies are needed with stronger designs. Given pervasive racial disparities in U.S. maternal mortality, future studies should assess how group prenatal care participation may contribute to fewer experiences of racial discrimination and implicit bias for Black women in maternity care.
The Hepatitis C Clinical Exchange Network: A Local Health Department Partnership With Acute Care Hospitals to Promote Screening and Treatment of Hepatitis C Virus Infection
Authors: Kela-Murphy Nadine , Moore Miranda S. , Verma Charu M. , Bresnahan Marie P. , Harrison Emily , Schwartz Jessie , Winters Ann
Published: August 2021

Context:

As of 2015, an estimated 116000 New York City (NYC) residents had chronic hepatitis C, many of them undiagnosed. Although effective medications have been available since 2014 with the advent of direct-acting antivirals, provider-based barriers to treatment remain. The NYC Department of Health and Mental Hygiene (Health Department) coordinated the Hepatitis C Clinical Exchange Network (HepCX) from 2015 to 2019. The main goal of HepCX was to promote hepatitis C screening and treatment by hospital-based providers.

Program:

The Health Department recruited hepatitis C champions (Champions) from acute care hospitals (n = 40) to promote improved hepatitis C care at their institutions. The Health Department provided technical assistance for hospitals to improve electronic medical record (EMR) systems and implement reflex RNA testing, coordinated trainings to increase capacity to treat hepatitis C, and distributed dashboards containing facility-specific testing and treatment metrics.

Implementation:

By the end of the project period (2019), most hospitals (36/40; 90%) reported having a screening alert for baby boomers in their EMR system and 34 (85%) reported performing reflex RNA testing after a positive hepatitis C antibody test. The Health Department coordinated opportunities for Champions to share their work with providers from network hospitals at meetings and webinars and provided clinical education on hepatitis C treatment in partnership with a local nonprofit organization focused on liver health. Facility-specific dashboards were distributed annually to hospital leadership. RNA confirmation testing increased from an average of 57% in 2015 to 85% in 2018. Treatment initiation rates remained similar over 2 years, averaging 39% in 2017 and 38% in 2018.

Discussion:

HepCX was a multipronged initiative designed to promote hepatitis C testing and treatment initiation among providers at NYC acute care hospitals. Improvements were observed in confirmatory testing rates; however, treatment initiation rates did not change. Further efforts should be targeted to hospitals in need of additional resources for linkage to care and treatment of hepatitis C.
Reporting of Latent TB Infection Among Non–US-Born Persons Adjusting Their Immigration Status to Permanent Residents: An Opportunity to Enhance TB Prevention
Authors: Gustavson Gail , Narita Masahiro , Gardner Toren Katelynne
Published: August 2021

From October 15, 2019, to June 12, 2020, Public Health–Seattle & King County conducted phone outreach to individuals referred to the public health department by civil surgeons. The objective was to explore common barriers and facilitators to treatment of latent tuberculosis infection (LTBI) among this population. Civil surgeons are mandated to report cases of LTBI to the state or local health department. Outreach revealed a wide variation in patient understanding of LTBI and provider practices around discussing LTBI and recommending LTBI treatment. The results of this small-scale study can inform public health strategies to engage with civil surgeons and their patients to both improve reporting practices and increase rates of LTBI treatment completion in patients born in high TB burden countries. In addition, these findings provide insight into what challenges and opportunities may emerge when health jurisdictions mandate LTBI reporting at a state or county level.
Public Health and Health Care Partnerships for Improved Tobacco Cessation
Authors: Hilts Katy Ellis , Yeager Valerie A. , Kooreman Harold , Smith Regina , Busching Brian , Spitznagle Miranda
Published: August 2021

Context:

Tobacco use remains a leading cause of preventable death and disease. While most tobacco users are interested in quitting, few receive professional assistance.

Program:

This state health department–led project leveraged partnerships to build capacity and support 9 health care organizations in implementing system-level initiatives to improve delivery of tobacco cessation.

Implementation:

Participating organizations' initiatives targeted 3 focus areas: implementing best practices for tobacco cessation; quality improvement; and utilization of the electronic health record.

Evaluation:

A qualitative study was conducted to examine facilitators and barriers to tobacco cession systems change among participating health care organizations. Common barriers included time constraints, staffing issues, and organizational structure. These factors often differed by organization type (eg, large vs small). Facilitators included leadership buy-in, organizational priority, technical assistance, teams/teamwork, and IT support.

Discussion:

Initial findings suggest that this type of partnership model can be leveraged to gain organizational support, build capacity, address key barriers, and ensure that systems change strategies align with best practices for tobacco cessation across a diverse set of health care organizations. Findings presented in this report provide insights for other public health and health care organizations looking to implement similar initiatives.
Clinical Features, Laboratory, and Radiological Findings of Patients With Acute Inflammatory Myelopathy After COVID-19 Infection
Authors: Barman Apurba , Sahoo Jagannatha , Viswanath Amrutha , Roy Sankha Subhra , Swarnakar Raktim , Bhattacharjee Souvik
Published: August 2021

The objective of this review was to analyze the existing data on acute inflammatory myelopathies associated with coronavirus disease 2019 infection, which were reported globally in 2020. PubMed, CENTRAL, MEDLINE, and online publication databases were searched. Thirty-three acute inflammatory myelopathy cases (among them, seven cases had associated brain lesions) associated with coronavirus disease 2019 infection were reported. Demyelinating change was seen in cervical and thoracic regions (27.3% each, separately). Simultaneous involvement of both regions, cervical and thoracic, was seen in 45.4% of the patients. Most acute inflammatory myelopathy disorders reported sensory motor and bowel bladder dysfunctions. On cerebrospinal fluid analysis, pleocytosis and increased protein were reported in 56.7% and 76.7% of the patients, respectively. Cerebrospinal fluid severe acute respiratory syndrome coronavirus 2 reverse transcriptase–polymerase chain reaction was positive in five patients. On T2-weighted imaging, longitudinally extensive transverse myelitis and short-segment demyelinating lesions were reported in 76% and 21%, respectively. Among the patients with longitudinally extensive transverse myelitis, 61% reported “moderate to significant” improvement and 26% demonstrated “no improvement” in the motor function of lower limbs. Demyelinating changes in the entire spinal cord were observed in three patients. Most of the patients with acute inflammatory myelopathy (including brain lesions) were treated with methylprednisolone (81.8%) and plasma-exchange therapy (42.4%). An early treatment, especially with intravenous methylprednisolone with or without immunoglobulin and plasma-exchange therapy, helped improve motor recovery in the patients with acute inflammatory myelopathy associated with coronavirus disease 2019.
Understanding Implications of Residual Limb Length, Strength, and Range-of-Motion Impairments of Veterans With Upper Limb Amputation
Authors: Resnik Linda , Borgia Matthew , Cancio Jill , Heckman Jeffrey , Highsmith M. Jason , Levy Charles , Phillips Samuel , Webster Joseph
Published: August 2021

Objective

The aim of the study was to describe and quantify the relationship between limb impairment variables to key functional outcomes.

Design

This was an observational study of 107 participants with unilateral above/at-elbow or below-elbow/wrist amputation. Demographics, prosthesis characteristics, residual limb length, and prevalence of passive range-of-motion restrictions, and strength impairments were described. Correlations between impairment variables were estimated. Linear regressions examined associations between impairment variables and activity performance, health-related quality of life, disability, and prosthesis satisfaction.

Results

Prevalence of short/very short below- and above-elbow residua was 25.7% and 12.5%, respectively. Shorter below-elbow/wrist residual limb length was correlated with elbow flexion weakness (r = 0.30) and prevalence of passive range of motion (r = 0.25). Shoulder prevalence of passive range-of-motion restrictions were correlated with shoulder (r = 0.27–0.51) and elbow weakness (r = 0.25–0.46). In regressions, activity performance was worse for those with shoulder flexion prevalence of passive range-of-motion restrictions (B = −5.0, P = 0.03) and better for those with flexion restrictions (B = 3.3, P = 0.04) compared with normal prevalence of passive range of motion. Prosthetic satisfaction was lower for those with limited elbow prevalence of passive range of motion.

Conclusions

Short below-elbow residual limb length was correlated with impairment of elbow flexion strength and prevalence of passive range of motion. Prevalence of passive range-of-motion restrictions were most prevalent at the shoulder and were strongly correlated with weakness in the same planes of motion. Few significant associations were found between impairment variables and outcomes.
Reducing Falls in Dementia Inpatients Using Vision-Based Technology
Authors: Wright Kay , Singh Swaran
Published: August 2021

Objectives

Falls have a significant negative impact on the health and well-being of people with dementia and increase service costs related to staff time, paramedic visits, and accident and emergency (A&E) admissions. We examined whether a remote digital vision-based monitoring and management system had an impact on the prevention of falls.

Methods

Our study was conducted within the Manor dementia inpatient wards at the Coventry and Warwickshire Partnership Trust. Data were retrieved from incident reports before and 22 months after installation of the system. We examined number of night time falls, severity of fall, number of paramedic visits and A&E admissions, and the number of enhanced observations during both time periods.

Results

There was a significant 48% reduction in the number of nighttime falls (P < 0.01), a 49% reduction in visits from paramedics (P < 0.2), and a 68% reduction in A&E admissions (P < 0.02). In addition, the data indicated an 82% reduction in the number of moderate severity falls and that enhanced one-to-one observation hours were reduced by 71%.

Conclusions

The study demonstrated that a contact-free, remote digital vision-based monitoring and management system reduced falls, fall-related injuries, emergency services time, clinician time, and disruptive night time observations. This benefits the clinicians by allowing them to undertake other clinical duties and promotes the health and safety of patients who might normally experience injury-related stress and disruption to sleep.
Percutaneous Transthoracic Lung Biopsy: Optimizing Yield and Mitigating Risk
Authors: Azour Lea , Liu Shu , Washer Sophie L. , Moore William H.
Published: August 2021

Percutaneous computed tomography–guided transthoracic lung biopsy is an effective and minimally invasive procedure to achieve tissue diagnosis. Radiologists are key in appropriate referral for further workup, with percutaneous computed tomography–guided transthoracic lung biopsy performed by both thoracic and general interventionalists. Percutaneous computed tomography–guided transthoracic lung biopsy is increasingly performed for both diagnostic and research purposes, including molecular analysis. Multiple patient, lesion, and technique-related variables influence diagnostic accuracy and complication rates. A comprehensive understanding of these factors aids in procedure planning and may serve to maximize diagnostic yield while minimizing complications, even in the most challenging scenarios.
Quantitative Histogram Analysis of T2-Weighted and Diffusion-Weighted Magnetic Resonance Images for Prediction of Malignant Thymic Epithelial Tumors
Authors: Morikawa Kazuhiko , Igarashi Takao , Shiraishi Megumi , Kano Rui , Misumi Shigeki , Ojiri Hiroya , Asano Hisatoshi
Published: August 2021

Purpose

To assess the value of histogram analysis for differentiating a high-risk thymic epithelial tumor (TET) from a low-risk TET using T2-weighted images and the apparent diffusion coefficient (ADC).

Methods

Forty-nine patients with histopathologically proven TET after thymectomy were enrolled in this study and retrospectively classified as having low-risk TET (low-risk thymoma) or high-risk TET (high-risk thymoma or thymic carcinoma). Twelve parameters were obtained from the quantitative histogram analysis. The histogram parameters were compared using the Mann-Whitney U test. Diagnostic efficacy was estimated by receiver-operating characteristic curve analysis.

Results

Twenty-five patients were classified as having low-risk TET and 24 as having high-risk TET. The mean ADC value showed diagnostic efficacy for differentiating high-risk TET from low-risk TET, with an area under the curve of 0.7, and was better than when using conventional methods alone.

Conclusion

The ADC-based histogram analysis could help to differentiate between high-risk and low-risk TETs.
Texture Analysis of Computed Tomography Images in the Lung of Patients With Breast Cancer
Authors: Han Meng , Qi Yana , Cui Xiaoxiao , Li Ranran , Hou Ruigang , Dun Aishe
Published: August 2021

Objective

The aim of this study was to investigate whether the texture features of lung computed tomography images were altered by primary breast cancer without pulmonary metastasis.

Methods

Texture analysis was performed on the regions of interest of lung computed tomography images from 36 patients with breast cancer and 36 healthy controls. Texture parameters between subjects with different clinical stages and hormone receptor (HR) statuses in patients with breast cancer were analyzed.

Results

Three texture parameters (mean, SD, and variance) were significantly different between patients with breast cancer and healthy controls and between preoperative and postoperative stages in patients with breast cancer. All 3 parameters showed an increasing trend under the tumor-bearing state. These parameters were significantly higher in the stage III + IV group than in the stage I + II group. The variance parameter was significantly higher in the HR-negative group than in the HR-positive group.

Conclusions

Texture analysis may serve as a novel additional tool for discovering conventionally invisible changes in the lung tissue of patients with breast cancer.
Ordinal Scoring of Coronary Artery Calcification by Computed Tomography Pulmonary Angiography in Acute Pulmonary Embolism
Authors: Aybay Muhsin Nuh , Peker Ahmet , Keskin Muhammed , Durmaz Mehmet Sedat , Tolu İsmet
Published: August 2021

Objective

To assess coronary artery calcification (CAC) in patients with acute pulmonary embolism and determine whether this correlates with right ventricular dilation (RVD) and mortality.

Methods

Computed tomography pulmonary angiography scans of 330 patients were used to perform retrospective assessment of the pulmonary artery computed tomography obstruction index (PACTOI), the right/left ventricle diameter ratio, the diameter of the pulmonary trunk, and the ordinal CAC score.

Results

Age (P < 0.001), urea level (P < 0.001), D-dimer level (P = 0.006), diameter of the pulmonary trunk (P < 0.001), and PACTOI (P < 0.001) were significantly higher in the RVD-positive patient group. We found a significant relation between increased CAC score and increased mortality (P = 0.038). Left-sided CAC was detected much more often in RVD-positive patients (P = 0.008).

Conclusions

Coronary artery calcification is common in patients with acute pulmonary embolism, especially when those patients are also RVD-positive. A significant relation was found between RVD and left-sided CAC.
Structured Reporting of Computed Tomography Examinations in Post–Lung Transplantation Patients
Authors: Spiro Judith Eva , Ceelen Felix , Kneidinger Nikolaus , Sommer Wieland Heinrich , Schinner Regina , Dinkel Julien , Hesse Nina
Published: August 2021

Objective

The aim of this study was to evaluate the benefits and potential of structured reports (SR) for chest computed tomography after lung transplantation.

Methods

Free-text reports (FTR) and SR were generated for 49 computed tomography scans. Clinical routine reports were used as FTR. Two pulmonologists rated formal aspects, completeness, clinical utility, and overall quality. Wilcoxon and McNemar tests were used for statistical analysis.

Results

Structured reports received significantly higher ratings for all formals aspects (P < 0.001, respectively). Completeness was higher in SR with regard to evaluation of bronchiectases, bronchial anastomoses, bronchiolitic and fibrotic changes (P < 0.001, respectively), and air trapping (P = 0.012), but not signs of pneumonia (P = 0.5). Clinical utility and overall quality were rated significantly higher for SR than FTR (P < 0.001, respectively). However, report type did not influence initiation of further diagnostic or therapeutic measures (P = 0.307 and 1.0).

Conclusions

Structured reports are superior to FTR with regard to formal aspects, completeness, clinical utility, and overall satisfaction of referring pulmonologists.
CT Radiomics for the Prediction of Synchronous Distant Metastasis in Clear Cell Renal Cell Carcinoma
Authors: Wen Rong , Huang Jing , Gao Rui-zhi , Wan Da , Qin Hui , Peng Yu-ting , Liang Yi-qiong , Li Xin , Wang Xin-rong , He Yun , Yang Hong
Published: August 2021

Purpose

The aim of this study was to construct and verify a computed tomography (CT) radiomics model for preoperative prediction of synchronous distant metastasis (SDM) in clear cell renal cell carcinoma (ccRCC) patients.

Methods

Overall, 172 patients with ccRCC were enrolled in the present research. Contrast-enhanced CT images were manually sketched, and 2994 quantitative radiomic features were extracted. The radiomic features were then normalized and subjected to hypothesis testing. Least absolute shrinkage and selection operator (LASSO) was applied to dimension reduction, feature selection, and model construction. The performance of the predictive model was validated through analysis of the receiver operating characteristic curve. Multivariate and subgroup analyses were performed to verify the radiomic score as an independent predictor of SDM.

Results

The patients randomized into a training (n = 104) and a validation (n = 68) cohort in a 6:4 ratio. Through dimension reduction using LASSO regression, 9 radiomic features were used for the construction of the SDM prediction model. The model yielded moderate performance in both the training (area under the curve, 0.89; 95% confidence interval, 0.81–0.97) and the validation cohort (area under the curve, 0.83; 95% confidence interval, 0.69–0.95). Multivariate analysis showed that the CT radiomic signature was an independent risk factor for clinical parameters of ccRCC. Subgroup analysis revealed a significant connection between the SDM and radiomic signature, except for the lower pole of the kidney subgroup.

Conclusions

The CT-based radiomics model could be used as a noninvasive, personalized approach for SDM prediction in patients with ccRCC.
Posttransplant Lymphoproliferative Disorder Status Post–Solid Organ Transplant Presenting to the Emergency Department: Single Institute Experience
Authors: Rao Sanjay , Smith Daniel A. , Kikano Elias George , Tirumani Sree Harsha , Beck Rose , Ramaiya Nikhil H.
Published: August 2021

Objective

The objective of this study was to evaluate the clinical, laboratory, imaging, and pathology findings associated with emergency department presentations of posttransplant lymphoproliferative disorder (PTLD) after solid organ transplant (SOT).

Methods

Fifteen patients presenting to a single tertiary care center between 2004 and 2019 with PTLD after SOT were identified from a pathology database. Twelve patients presenting through the emergency department were included in the study. Demographic, clinical, imaging, pathology, treatment, and outcome data were reviewed.

Results

Among this 12 patient cohort (7 men; mean age, 44.2 years), transplant history included 4 combined kidney/pancreas, 4 kidney, 2 liver, 1 cardiac, and 1 lung. Mean time from transplant to diagnosis was 7.6 years. Posttransplant lymphoproliferative disorder was identified on initial computed tomography scans in 10 of 12 patients. The most common sites for PTLD development were the gastrointestinal tract (4/12) and liver (3/12). Outcomes included resolution of PTLD in 9 of 12 patients, with 3 patients dying within 6 months of diagnosis.

Conclusions

Posttransplant lymphoproliferative disorder is a serious consequence of solid organ transplantation that can present in various locations and with varied symptomatology in the emergency setting. Other posttransplant complications may present similarly including chronic rejection and infection. Posttransplant lymphoproliferative disorder should be considered in SOT patients presenting with worsening abdominal pain or constitutional symptoms, even with normal laboratory workup.
Open Preperitoneal Inguinal Hernia Repair, TREPP Versus TIPP in a Randomized Clinical Trial
Authors: Bökkerink Willem J. V. , Koning Giel G. , Vriens Patrick W. H. E. , Mollen Roland M. H. G. , Harker Mitchell J. R. , Noordhof Robin K. , Akkersdijk Willem L. , van Laarhoven Cees J. H. M.
Published: August 2021

Objective:

The aim of this study was to compare chronic postoperative inguinal pain (CPIP) in patients with an inguinal hernia after the TransREctus Sheath PrePeritoneal (TREPP) and the TransInguinal PrePeritoneal Technique (TIPP).

Background:

The preperitoneal mesh position for inguinal hernia repair showed beneficial results regarding CPIP with low recurrence rates. Two open preperitoneal techniques, TREPP and TIPP, were compared in a randomized clinical trial with the hypothesis of fewer patients with CPIP after TREPP due to complete avoidance of nerve contact.

Methods:

Adult patients with a primary unilateral inguinal hernia were randomized to either TREPP or TIPP in four hospitals. Before the trial's start the study protocol was ethically approved and published. Outcomes included CPIP after 1 year (primary outcome) and recurrence rates, adverse events, and health-related quality of life (secondary outcomes). Follow-up was performed at 2 weeks, 6 months, and 1 year.

Results:

Baseline characteristics were comparable in both groups. Pain was less often present after TREPP at 2 weeks and 6 months, but CPIP at rest at 1 year was comparable: 1.9% after TREPP vs 1.4% after TIPP,P= 0.535). The overall recurrence rate was higher in the TREPP group, 8.9% vs 4.6%,P= 0.022). Corrected for a learning curve for TREPP, no significant difference could be assessed (TREPP 5.7% and TIPP 4.8%,P= 0.591).

Conclusion:

Both the TREPP and TIPP technique resulted in a low incidence of CPIP after 1-year follow-up. The TREPP method can be considered a solid method for inguinal hernia repair if expertise is present. The learning curve of the TREPP techniques needs further evaluation.

Trial Registration:

ISRCTN18591339
Comparison of Visual Evoked Potentials in Patients Affected by Optic Neuritis From Multiple Sclerosis or Neuromyelitis Optica Spectrum Disorder
Authors: Filgueiras Thiago G. , Oyamada Maria K. , Hokazono Kenzo , Cunha Leonardo P. , Apóstolos-Pereira Samira L. , Callegaro Dagoberto , Monteiro Mário L. R.
Published: August 2021

Purpose:

To compare the visual evoked potentials (VEPs) of optic neuritis (ON) patients with multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and controls. To evaluate correlations between VEP and optical coherence tomography (OCT), contrast sensitivity (CS), and automated perimetry.

Methods:

Fifty-five eyes with ON from 29 patients (MS = 14 and NMOSD = 15) and 57 eyes from 29 controls were evaluated using VEP, automated perimetry, CS, and optical coherence tomography. Three groups were analyzed: 1) MS eyes with history of ON (ON-MS), 2) NMOSD eyes with ON (ON-NMOSD), and 3) healthy controls. Groups were compared and associations between the parameters were tested.

Results:

Compared to controls, ON-MS eyes showed significantly delayed N75 and P100 latencies when using a medium-sized stimulus (30′), and delayed P100 latency when using a large stimulus (1.5°), but similar amplitudes. Compared to controls, ON-NMOSD eyes showed significantly lower N75/P100 amplitudes (both stimulus sizes) and P100/N135 amplitudes (with the 30′ stimulus), but latencies did not differ, except for a delayed P100 latency with the 30′ stimulus. When comparing the 2 ON groups using the 1.5° stimulus, there was significant delay in P100 latency in ON-MS eyes and a reduction in N75/P100 amplitude in ON-NMOSD eyes. Peripapillary retinal nerve fiber layer, macular inner retinal layers, and CS measurements were significantly smaller in ON patients than in controls. A strong correlation was found between VEP parameters and inner retinal layer thickness in ON-NMOSD eyes.

Conclusions:

ON-MS eyes had normal amplitude and delayed VEP latency, whereas ON-NMOSD eyes displayed reduced amplitude and preserved latency when elicited by checkerboard stimulus with large 1.5° checks. Under such conditions, VEP may help distinguish resolved MS-related ON from resolved NMOSD-related ON.
Towards the development of cavitation technology for gas hydrate prevention
Authors: Wang Mingbo , Qiu Junjie , Chen Weiqing
Published: August 2021

In offshore gas well drilling and production, methane hydrate may block the tubing, resulting in the stoppage of gas production. Conventional methods such as injection of thermal hydrate inhibitors, thermal insulating or heating, gas dehydration and reducing pressure are time-consuming and expensive, and sometimes, they are not realistic in production conditions. New methods are needed to lower the cost of gas hydrate prevention and to overcome these limitations. The thermal effect of cavitation was applied to the prevention of gas hydrate in this study. The thermal impact of cavitation, supposed to heat the fluids and prevent the formation of gas hydrate, was evaluated. Numerical simulation was performed to study the thermal performance of cavitation. Furthermore, experimental studies of the influence of initial temperature, flow rate, fluid volume and fluid viscosity on the thermal effect of cavitation were performed, and the results were analysed.
Green and sensitive spectrofluorimetric method for the determination of two cephalosporins in dosage forms
Authors: Abdel-Aziz Heba , Tolba M. M. , El-Enany N. , Aly F. A. , Fathy M. E.
Published: August 2021

Using two green and sensitive spectrofluorimetric methods, we quantified two cephalosporins, cefepime (CFM) and cefazolin (CFZ), in raw and pharmaceutical formulations. The first method is based on the reaction between CFM and fluorescamine (borate buffer, pH 8), which yields a highly fluorescent product. After excitation at 384 nm, the fluorescent product emits light at 484 nm. At concentration ranges from 12.0 to 120.0 ng ml
−1
, the relative fluorescence intensity/concentration curve was linear with a limit of quantification (LOQ) of 2.46 ng ml
−1
. The second method relied on measuring the CFZ quenching action on acriflavine fluorescence through formation of an ion-associate complex using Britton–Robinson buffer at pH 8. We measured acriflavine fluorescence at 505 nm after excitation at 265 nm. The decrease in acriflavine fluorescence intensity was CFZ concentration-dependent. Using this method, we quantified CFZ in concentrations ranging from 1 to 10 µg ml
−1
with a LOQ of 0.48 µg ml
−1
. We studied and optimized the factors influencing reaction product formation. Moreover, we adapted our methods to the investigation of the mentioned drugs in raw and pharmaceutical formulations with greatly satisfying results. We statistically validated our methods according to International Council on Harmonisation Guidelines. The obtained results were consistent with those obtained with the official high-performance liquid chromatography methods.
Effective removal of tetracycline antibiotics from wastewater using practically applicable iron(III)-loaded cellulose nanofibres
Authors: Lu Lanxin , Liu Min , Chen Ying , Luo Ying
Published: August 2021

The non-toxic and completely biodegradable cellulose within bamboo is one of the most abundant agricultural polysaccharide wastes worldwide, and can be processed into cellulose nanofibres (CNFs). Iron(III)-loaded CNFs (Fe(III)@CNFs) derived from bamboo were prepared to improve the adsorption of tetracycline (TC), chlortetracycline (CTC) and oxytetracycline (OTC) from an aqueous solution. The preparation conditions of Fe(III)@CNFs suitable for the simultaneous adsorption of three tetracycline antibiotics (TCs) were investigated. Various analyses proved the abundance of oxygen-containing functional groups and the existence of Fe(III) active metal sites in Fe(III)@CNFs. In batch experiments, Fe(III)@CNFs were applied under a wide pH range and the maximum adsorption capacities were 294.12, 232.56 and 500.00 mg g−1(for TC, CTC and OTC, respectively). In addition, different concentrations and types of coexisting anions have a weak effect on TCs adsorption. The original TCs adsorption capacities of Fe(III)@CNFs remained stable (greater than 92%) after five cycles when UV + H2O2was used as the regeneration method. Four adsorption mechanisms (surface complexation, hydrogen bonding, electrostatic interaction and van der Waals force) were obtained for the endothermic adsorption of TCs, among which surface complexation between Fe(III) and TCs always dominates. The practically applicable Fe(III)@CNFs adsorbents are promising for TCs enrichment and remediation in engineering applications.
Behavioural red-light sensitivity in fish according to the optomotor response
Authors: Matsuo Megumi , Kamei Yasuhiro , Fukamachi Shoji
Published: August 2021

Various procedures have been adopted to investigate spectral sensitivity of animals, e.g. absorption spectra of visual pigments, electroretinography, optokinetic response, optomotor response (OMR) and phototaxis. The use of these techniques has led to various conclusions about animal vision. However, visual sensitivity should be evaluated consistently for a reliable comparison. In this study, we retrieved behavioural data of several fish species using a single OMR procedure and compared their sensitivities to near-infrared light. Besides cavefish that lack eyes, some species were not appropriate for the OMR test because they either stayed still or changed swimming direction frequently. Eight of 13 fish species tested were OMR positive. Detailed analyses using medaka, goldfish, zebrafish, guppy, stickleback and cichlid revealed that all the fish were sensitive to light at a wavelength greater than or equal to 750 nm, where the threshold wavelengths varied from 750 to 880 nm. Fish opsin repertoire affected the perception of red light. By contrast, the copy number of long-wavelength-sensitive (
LWS
) genes did not necessarily improve red-light sensitivity. While the duplication of
LWS
and other
cone opsin
genes that has occurred extensively during fish evolution might not aid increasing spectral sensitivity, it may provide some other advantageous ophthalmic function, such as enhanced spectral discrimination.
Application of alternating trilinear decomposition-assisted multivariate curve resolution to gas chromatography-mass spectrometric data for the quantification of polycyclic aromatic hydrocarbons in aerosols
Authors: Qing Xiangdong , Zhou Xiaohong , Xu Ling , Zhang Jin , Huang Yi , Lin Li , Liu Zhi , Zhang Xiaohua
Published: August 2021

For the first time, alternating trilinear decomposition-assisted multivariate curve resolution (ATLD-MCR) was applied to analyse complex gas chromatography–mass spectrometric (GC-MS) data with severe baseline drifts, serious co-elution peaks and slight retention time shifts for the simultaneous identification and quantification of polycyclic aromatic hydrocarbons (PAHs) in aerosols. It was also compared with the classic multivariate curve resolution-alternating least-squares (MCR-ALS) and the GC-MS-based external standard method. In validation samples, average recoveries of five PAHs were within the range from (96.2 ± 6.8)% to (106.5 ± 4.1)% for ATLD-MCR, near to the results of MCR-ALS ((98.0 ± 1.5)% to (106.7 ± 4.3)%). In aerosol samples, the concentrations of pyrene provided by ATLD-MCR were not significantly different from those of MCR-ALS. The other four PAHs including chrysene, benzo[a]anthracene, fluoranthene and benzo[b]fluoranthene were not detected by ATLD-MCR and the GC-MS-based external standard method. The results of figures of merit further demonstrated that ATLD-MCR achieved high sensitivities (8.9 × 10
4
to 1.7 × 10
6
mAU ml µg
−1
) and low limits of detection (0.003 to 0.087 µg ml
−1
), which were better than or similar to MCR-ALS, presenting a great choice to deal with complex GC-MS data for the simultaneous determination of targeted PAHs in aerosols.
Ancient DNA reveals multiple origins and migration waves of extinct Japanese brown bear lineages
Authors: Segawa Takahiro , Yonezawa Takahiro , Mori Hiroshi , Akiyoshi Ayumi , Allentoft Morten E. , Kohno Ayako , Tokanai Fuyuki , Willerslev Eske , Kohno Naoki , Nishihara Hidenori
Published: August 2021

Little is known about how mammalian biogeography on islands was affected by sea-level fluctuations. In the Japanese Archipelago, brown bears (
Ursus arctos
) currently inhabit only Hokkaido, the northern island, but Pleistocene fossils indicate a past distribution throughout Honshu, Japan's largest island. However, the difficulty of recovering ancient DNA from fossils in temperate East Asia has limited our understanding of their evolutionary history. Here, we analysed mitochondrial DNA from a 32 500-year-old brown bear fossil from Honshu. Our results show that this individual belonged to a previously unknown lineage that split approximately 160 Ka from its sister lineage, the southern Hokkaido clade. This divergence time and fossil record suggest that brown bears migrated from the Eurasian continent to Honshu at least twice; the first population was an early-diverging lineage (greater than 340 Ka), and the second migrated via Hokkaido after approximately 160 Ka, during the ice age. Thus, glacial-age sea-level falls might have facilitated migrations of large mammals more frequently than previously thought, which may have had a substantial impact on ecosystem dynamics in these isolated islands.
Structural modulation of π-conjugated linkers in D–π–A dyes based on triphenylamine dicyanovinylene framework to explore the NLO properties
Authors: Khalid Muhammad , Khan Muhammad Usman , Shafiq Iqra , Hussain Riaz , Ali Akbar , Imran Muhammad , Braga Ataualpa A. C. , Fayyaz ur Rehman Muhammad , Akram Muhammad Safwan
Published: August 2021

A donor–π–acceptor type series of Triphenylamine–dicyanovinylene-based chromophores (DPMN1–DPMN11) was designed theoretically by the structural tailoring of π-linkers of experimentally synthesized moleculesDTThandDTTzto exploit changes in the optical properties and their nonlinear optical materials (NLO) behaviour. Density functional theory (DFT) computations were employed to understand the electronic structures, absorption spectra, charge transfer phenomena and the influence of these structural modifications on NLO properties. Interestingly, all investigated chromophores exhibited lower band gap (2.22–2.60 eV) with broad absorption spectra in the visible region, reflecting the remarkable NLO response. Furthermore, natural bond orbital (NBO) findings revealed a strong push–pull mechanism inDPMN1–DPMN11as donor and π-conjugates exhibited positive, while all acceptors showed negative values. Examination of electronic transitions from donor to acceptor moieties via π-conjugated linkers revealed greater linear (〈α〉 = 526.536–641.756 a.u.) and nonlinear (βtot= 51 313.8–314 412.661 a.u.) response. It was noted that the chromophores containing imidazole in the second p-linker expressed greater hyperpolarizability when compared with the ones containing pyrrole. This study reveals that by controlling the type of π-spacers, interesting metal-free NLO materials can be designed, which can be valuable for the hi-tech NLO applications.
Adjustable positive and negative hygrothermal expansion metamaterial inspired by the Maltese cross
Authors: Lim Teik-Cheng
Published: August 2021

A metamaterial that can manifest both positive and negative coefficients of moisture and thermal expansion is presented herein, based on inspiration from the Maltese cross. Each unit of the metamaterial consists of a pair of equal-armed crosses pin-joined at their junctions to permit rotation, but elastically restrained by a bimaterial spiral spring, and four pairs of hinge rods to translate the relative rotational motion of the pair of equal-armed crosses into translational motion of the connecting rods. The effective coefficients of moisture and thermal expansion models were developed for small and large changes in the hygrothermal conditions using infinitesimal (approximate) and finite (exact) motion analyses, respectively, with the former giving constant effective coefficients with respect to environmental changes. Results indicate that the approximate method underestimates the magnitude of both the effective expansion coefficients under cooling and drying but overestimates magnitudes of both coefficients during heating and moistening, and that the change in both expansion coefficients is more drastic during cooling and drying than during heating and moistening. In addition to providing another micro-lattice geometry for effecting expansion coefficients of either signs, this metamaterial exhibits auxetic property.
Why don't all animals avoid inbreeding?
Authors: Pike Victoria L. , Cornwallis Charlie K. , Griffin Ashleigh S.
Published: August 2021

Individuals are expected to avoid mating with relatives as inbreeding can reduce offspring fitness, a phenomenon known as inbreeding depression. This has led to the widespread assumption that selection will favour individuals that avoid mating with relatives. However, the strength of inbreeding avoidance is variable across species and there are numerous cases where related mates are not avoided. Here we test if the frequency that related males and females encounter each other explains variation in inbreeding avoidance using phylogenetic meta-analysis of 41 different species from six classes across the animal kingdom. In species reported to mate randomly with respect to relatedness, individuals were either unlikely to encounter relatives, or inbreeding had negligible effects on offspring fitness. Mechanisms for avoiding inbreeding, including active mate choice, post-copulatory processes and sex-biased dispersal, were only found in species with inbreeding depression. These results help explain why some species seem to care more about inbreeding than others: inbreeding avoidance through mate choice only evolves when there is both a risk of inbreeding depression and related sexual partners frequently encounter each other.
The genome of a daddy-long-legs (Opiliones) illuminates the evolution of arachnid appendages
Authors: Gainett Guilherme , González Vanessa L. , Ballesteros Jesús A. , Setton Emily V. W. , Baker Caitlin M. , Barolo Gargiulo Leonardo , Santibáñez-López Carlos E. , Coddington Jonathan A. , Sharma Prashant P.
Published: August 2021

Chelicerate arthropods exhibit dynamic genome evolution, with ancient whole-genome duplication (WGD) events affecting several orders. Yet, genomes remain unavailable for a number of poorly studied orders, such as Opiliones (daddy-long-legs), which has hindered comparative study. We assembled the first harvestman draft genome for the species
Phalangium opilio
, which bears elongate, prehensile appendages, made possible by numerous distal articles called tarsomeres. Here, we show that the genome of
P. opilio
exhibits a single Hox cluster and no evidence of WGD. To investigate the developmental genetic basis for the quintessential trait of this group—the elongate legs—we interrogated the function of the Hox genes
Deformed
(
Dfd
) and
Sex combs reduced
(
Scr
), and a homologue of
Epidermal growth factor receptor
(
Egfr
). Knockdown of
Dfd
incurred homeotic transformation of two pairs of legs into pedipalps, with dramatic shortening of leg segments in the longest leg pair, whereas homeosis in L3 is only achieved upon double
Dfd + Scr
knockdown. Knockdown of
Egfr
incurred shortened appendages and the loss of tarsomeres. The similarity of
Egfr
loss-of-function phenotypic spectra in insects and this arachnid suggest that repeated cooption of EGFR signalling underlies the independent gains of supernumerary tarsomeres across the arthropod tree of life.