bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of bacterial uropathogens and their antimicrobial susceptibility patterns among pregnant women in Eastern Ethiopia: hospital-based cross-sectional study
Authors: Ejerssa Alemseged Workneh , Gadisa Diriba Alemayehu , Orjino Teferra Abula
Published: August 2021

Background

Urinary tract infection (UTI) is the commonest bacterial infections during pregnancy, leading to significant maternal and prenatal morbidity and mortality.

Method

This hospital-based cross-sectional study during November 2017 to January 2018 was aimed to determine hospital-based antibacterial susceptibility patterns of bacterial uropathogens among 200 pregnant women in Eastern Ethiopia. ~ 10–20 ml clean-catch midstream urine samples were collected by the study participants. The well-mixed urine samples standardized to 1 µl have inoculated onto Cystine Lactose Electrolyte-Deficient and MacConkey agar. The inoculum was cultured at 37 °C under aerobic conditions for 18–48 h and examined macroscopically to evaluate the colony appearance and size of colonies. The isolate on the plates with pure growth and colonies ≥ 105 CFU/ml were further subjected to biochemical identification and susceptibility testing according to the standard procedures explained in the Clinical and Laboratory Standards Institute guideline. SPSS version 25 was used for data analysis. Descriptive statistics such as frequency, percentage, and cross-tabulation were used to present the findings in the form of graphs and tables.

Results

The response rate for this study was 98.04%. Thirty-one bacteria were isolated among the 200 urine samples processed, which gave the overall UTI prevalence of 15.5%. The majority (90.3%) of the isolates were Gram-negative.Escherichia coli(45.2%) was the most frequent isolated uropathogen which followed byProteusspp. (22.6%),Klebsiella pneumoniae(16.1%),Staphylococcus aureus(9.7%), andPseudomonas aeruginosa(6.5%). Among the isolates, 96.4% of them were susceptible to amikacin and followed by nitrofurantoin (90.3%), and gentamicin (83.9%). However, high rates of resistance to ampicillin (58.1%), amoxicillin-clavulanate (51.6%), and cotrimoxazole (51.6%) were observed. Overall, 16(51.6%) of the bacterial isolates had developed multiple drug resistance to the selected antimicrobials.

Conclusion

In general, the overall prevalence of UTI was high, 15.5%. Most of isolated bacterial uropathogens were Gram-negative bacteria, andEscherichia coliwas the most frequent isolate. The majority of the isolates were susceptible to amikacin, nitrofurantoin, and gentamicin. However, a high rate of resistance was observed to ampicillin, amoxicillin-clavulanate, and cotrimoxazole. More than half of the isolated bacteria had multiple drug-resistant features. Therefore, periodic and continuous urine culture for screening and diagnosis is mandatory to reduce the consequence of UTI and multidrug resistance bacteria in pregnancy.
Evaluating the effect of interventions for strengthening non-physician anesthetists’ education in Ethiopia: a pre- and post-evaluation study
Authors: Asemu Yohannes Molla , Yigzaw Tegbar , Desta Firew Ayalew , Scheele Fedde , van den Akker Thomas
Published: August 2021

Background

Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In Ethiopia, non-physician anesthetists are the main anesthesia service providers. The Government of Ethiopia implemented a program intervention to improve the quality of non-physician anesthetists’ education, which included faculty development, curricula strengthening, student support, educational resources, improved infrastructure and upgraded regulations. This study aimed to assess changes following the implementation of this program.

Methods

A pre-and post-evaluation design was employed to evaluate improvement in the quality of non-physician anesthetists’ education. A 10-station objective structured clinical examination (OSCE) was administered to graduating class anesthetists of 2016 (n = 104) to assess changes in competence from a baseline study performed in 2013 (n = 122). Moreover, a self-administered questionnaire was used to collect data on students’ perceptions of the learning environment.

Results

The overall competence score of 2016 graduates was significantly higher than the 2013 class (65.7% vs. 61.5%, mean score difference = 4.2, 95% CI = 1.24–7.22, p < 0.05). Although we found increases in competence scores for 6 out of 10 stations, the improvement was statistically significant for three tasks only (pre-operative assessment, postoperative complication, and anesthesia machine check). Moreover, the competence score in neonatal resuscitation declined significantly from baseline (from 74.4 to 68.9%, mean score difference = − 5.5, 95% CI = -10.5 to − 0.5, p < 0.05). Initial gender-based performance differences disappeared (66.3% vs. 65.3%, mean score difference = − 1.0, 95% CI = − 6.11-3.9, p > 0.05 in favor of females), and female students scored better in some stations. Student perceptions of the learning environment improved significantly for almost all items, with the largest percentage point increase in the availability of instructors from 38.5 to 70.2% (OR = 3.76, 95% CI = 2.15–6.55, p < 0.05).

Conclusion

The results suggest that the quality of non-physician anesthetists’ education has improved. Stagnation in competence scores of some stations and student perceptions of the simulated learning environment require specific attention.
The application of rigid and flexible mediastinoscopy in esophagectomy: our experience and a new technology
Authors: Wu Chun-Li , Dong Bo , Wu Bin , Li Shi-Hao , Qi Yu
Published: August 2021

Background

To avoid the inconvenience of triangulation among various rigid operating instruments in mediastinoscopy-assisted esophagectomy, we invented a new technique: used a flexible endoscope to mobilize thoracic esophagus and dissected mediastinal lymph nodes through the left cervical incision. This technology has not been reported so far. In this study, we introduce our long-term experience and demonstrate this new technique.

Methods

Twenty-nine patients with early esophageal cancer underwent mediastinoscopy-assisted esophagectomy in our hospital from June 2018 to September 2020. Among them, 12 patients used flexible mediastinoscopy, and 17 patients used conventional rigid mediastinoscopy and instruments to observe their therapeutic effect.

Results

There were no significant differences between the two groups in gender, average age, body mass index, incidence of adverse reactions, bleeding volume, and postoperative hospital stay. The operation time of flexible mediastinoscopy group was significantly shorter than that of rigid mediastinoscopy group (192.9 ± 13.0 vs 246.8 ± 6.9 min, p < 0.01). The number of lymph nodes removed by flexible endoscopy was significantly more than that of rigid endoscopy (8.5 ± 0.6 vs 6.0 ± 0.3, P < 0.01). Postoperative follow-up was completed for all patients, and the average follow-up time was 11.6 ± 7.2 months. During the follow-up period, no recurrence or death was observed.

Conclusions

Mediastinoscopy-assisted esophagectomy is an effective way to treat early esophageal cancer. The application of flexible mediastinoscopy provides more convenience and better stability. It can facilitate the operation of the surgeon and lymph node dissection, which proved to be a feasible technology.
Analysis of lncRNA-miRNA-mRNA expression pattern in heart tissue after total body radiation in a mouse model
Authors: Aryankalayil Molykutty J. , Martello Shannon , Bylicky Michelle A. , Chopra Sunita , May Jared M. , Shankardass Aman , MacMillan Laurel , Sun Landy , Sanjak Jaleal , Vanpouille-Box Claire , Eke Iris , Coleman C. Norman
Published: August 2021

Background

Radiation therapy is integral to effective thoracic cancer treatments, but its application is limited by sensitivity of critical organs such as the heart. The impacts of acute radiation-induced damage and its chronic effects on normal heart cells are highly relevant in radiotherapy with increasing lifespans of patients. Biomarkers for normal tissue damage after radiation exposure, whether accidental or therapeutic, are being studied as indicators of both acute and delayed effects. Recent research has highlighted the potential importance of RNAs, including messenger RNAs (mRNAs), microRNAs (miRNAs), and long non-coding RNAs (lncRNAs) as biomarkers to assess radiation damage. Understanding changes in mRNA and non-coding RNA expression will elucidate biological pathway changes after radiation.

Methods

To identify significant expression changes in mRNAs, lncRNAs, and miRNAs, we performed whole transcriptome microarray analysis of mouse heart tissue at 48 h after whole-body irradiation with 1, 2, 4, 8, and 12 Gray (Gy). We also validated changes in specific lncRNAs through RT-qPCR. Ingenuity Pathway Analysis (IPA) was used to identify pathways associated with gene expression changes.

Results

We observed sustained increases in lncRNAs and mRNAs, across all doses of radiation. Alas2, Aplnr, and Cxc3r1 were the most significantly downregulated mRNAs across all doses. Among the significantly upregulated mRNAs were cell-cycle arrest biomarkers Gdf15, Cdkn1a, and Ckap2. Additionally, IPA identified significant changes in gene expression relevant to senescence, apoptosis, hemoglobin synthesis, inflammation, and metabolism. LncRNAs Abhd11os, Pvt1, Trp53cor1, and Dino showed increased expression with increasing doses of radiation. We did not observe any miRNAs with sustained up- or downregulation across all doses, but miR-149-3p, miR-6538, miR-8101, miR-7118-5p, miR-211-3p, and miR-3960 were significantly upregulated after 12 Gy.

Conclusions

Radiation-induced RNA expression changes may be predictive of normal tissue toxicities and may indicate targetable pathways for radiation countermeasure development and improved radiotherapy treatment plans.
Flavonoids on diabetic nephropathy: advances and therapeutic opportunities
Authors: Hu Qichao , Qu Caiyan , Xiao Xiaolin , Zhang Wenwen , Jiang Yinxiao , Wu Zhao , Song Dan , Peng Xi , Ma Xiao , Zhao YanLing
Published: August 2021

With the advances in biomedical technologies, natural products have attracted substantial public attention in the area of drug discovery. Flavonoids are a class of active natural products with a wide range of pharmacological effects that are used for the treatment of several diseases, in particular chronic metabolic diseases. Diabetic nephropathy is a complication of diabetes with a particularly complicated pathological mechanism that affects at least 30% of diabetic patients and represents a great burden on public health. A large number of studies have shown that flavonoids can alleviate diabetic nephropathy. This review systematically summarizes the use of common flavonoids for the treatment of diabetic nephropathy. We found that flavonoids play a therapeutic role in diabetic nephropathy mainly by regulating oxidative stress and inflammation. Nrf-2/GSH, ROS production, HO-1, TGF-β1 and AGEs/RAGE are involved in the process of oxidative stress regulation. Quercetin, apigenin, baicalin, luteolin, hesperidin, genistein, proanthocyanidin and eriodictyol were found to be capable of alleviating oxidative stress related to the aforementioned factors. Regarding inflammatory responses, IL-1, IL-6β, TNF-α, SIRT1, NF-κB, and TGF-β1/smad are thought to be essential. Quercetin, kaempferol, myricetin, rutin, genistein, proanthocyanidin and eriodictyol were confirmed to influence the above targets. As a result, flavonoids promote podocyte autophagy and inhibit the overactivity of RAAS by suppressing the upstream oxidative stress and inflammatory pathways, ultimately alleviating DN. The above results indicate that flavonoids are promising drugs for the treatment of diabetic nephropathy. However, due to deficiencies in the effect of flavonoids on metabolic processes and their lack of structural stability in the body, further research is required to address these issues.
Empty spiracles homeobox genes EMX1 and EMX2 regulate WNT pathway activation in sarcomagenesis
Authors: Jimenez-García Manuel Pedro , Lucena-Cacace Antonio , Otero-Albiol Daniel , Carnero Amancio
Published: August 2021

Background

Sarcomas are a very heterogeneous group of tumors with intrinsic developmental programs derived from the cell of origin. This implies a functional hierarchy inside tumors governed by sarcoma stem cells. Therefore, genetic and/or epigenetic changes profoundly affect the biology of sarcoma tumor stem cells.EMXgenes are proposed to be transcription factors that are involved in the sarcomagenesis process, regardless of the neural or mesodermal embryological sarcoma origin. It has been shown thatEMX1orEMX2overexpression reduces tumorigenic properties, while reducing the levels of these genes enhances these properties. Furthermore, it has been shown thatEMXgenes decrease the expression of stem cell regulatory genes and the stem cell phenotype. Taken together, these results indicate that theEMX1andEMX2genes negatively regulate these tumor-remodeling populations or sarcoma stem cells, acting as tumor suppressors in sarcoma.

Methods

Bioinformatic analysis, quantitative mRNA and protein expression analysis, cell models of sarcoma by ectopic expression of EMX genes. By cell biology methods we measured tumorigenesis and populations enriched on stem cell phenotypes, either in vitro or in vivo.

Results

In this work, we showed that the canonical Wnt pathway is one of the mechanisms that explains the relationships ofEMX1/EMX2and stem cell genes in sarcoma. The Wnt-EMX1/EMX2relationship was validated in silico with sarcoma patient datasets, in vitro in primary derived sarcoma cell lines, and in vivo. EMX expression was found to negatively regulate the Wnt pathway. In addition, the constitutive activation of the Wnt pathway revers to a more aggressive phenotype with stem cell properties, and stemness gene transcription increased even in the presence ofEMX1and/orEMX2overexpression, establishing the relationship among the Wnt pathway, stem cell genes and theEMXtranscription factors.

Conclusions

Our data showed that Empty Spiracles Homeobox Genes EMX1 and EMX2 represses WNT signalling and activation of WNT pathway bypass EMX-dependent stemness repression and induces sarcomagenesis. These results also suggest the relevance of the Wnt/b-catenin/stemness axis as a therapeutic target in sarcoma.
Is tea consumption associated with reduction of risk of rheumatoid arthritis? A Swedish case-control study
Authors: Westerlind Helga , Palmqvist Ida , Saevarsdottir Saedis , Alfredsson Lars , Klareskog Lars , Di Giuseppe Daniela
Published: August 2021

Background

Tea is a popular beverage around the world and has properties that can affect the immune system. The association between tea consumption and the risk of rheumatoid arthritis (RA), a chronic autoimmune disease primarily affecting the joints, is not well studied and results are conflicting.

Methods

We collected data on tea consumption for 2237 incident RA cases diagnosed 2005–2018 and 4661 controls matched on age, sex, and residential area. Tea consumption was classified into no (0 cups/day), irregular (< 1 cup/day), regular (1–2 cups/day), and high (≥ 2 cups/day) consumption, and irregular consumption was used as the reference category. Missing data on tea consumption was classified as no consumers, and sensitivity analyses were performed to test this assumption. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression, adjusting for smoking, coffee, alcohol, educational level, and body mass index. We also performed stratified analysis on sex, anti-citrullinated autoantibody (ACPA) status, and smoking habits.

Results

Among the cases, we found 57.3% to be ever consumers of tea with 19.7 having a high tea consumption. Corresponding figures for the controls were 58.4% ever drinkers with 22.1% high tea consumers. High tea consumption had an inverse association to the risk of RA compared to irregular consumption [OR = 0.78 (95% CI 0.66–0.92)], but the association lost statistical significance in the adjusted model [adjusted OR (adjOR) = 0.85 (95% CI 0.71–1.01)]. Among non-tea consumers, a protective effect was also observed compared to irregular consumers [adjOR = 0.82 (95% CI 0.70–0.88)], but this association did not withstand sensitivity analysis, possibly due to bias. In the ACPA-positive group and among current smokers, a protective effect of tea consumption was observed among the high tea consumers [adjOR = 0.76 (95% CI 0.62–0.94) and adjOR = 0.60 (95% CI 0.38–0.95), respectively].

Conclusions

This study suggests a protective effect of high consumption of tea, among smokers and for ACPA-positive RA.

Trial registration

Not applicable
Use of intravenous tocilizumab in pregnancy for severe coronavirus disease 2019 pneumonia: two case reports
Authors: Abdullah Shazia , Bashir Nihal , Mahmood Nageena
Published: August 2021

Background

Tocilizumab, an interleukin-6 inhibitor is part of many international guidelines for the management of cytokine storm associated with severe coronavirus disease 2019 with observed improvements. However, this drug is not recommended during pregnancy owing to the lack of safety data. Restriction of such medication use makes the management of coronavirus disease 2019 in pregnant women more challenging. Pregnant women are more likely to deteriorate from respiratory infections because of the immunological changes during pregnancy and the hypoxic compromise. We report the use of tocilizumab in two pregnant patients who developed severe coronavirus disease 2019 with a successful outcome. To date, there have not been any published data on tocilizumab use in pregnancy for cytokine storm syndrome associated with coronavirus disease 2019.

Case presentations

In 2020, two pregnant women of Asian origin in the last trimester of pregnancy were admitted to our hospital with severe coronavirus disease 2019. Their clinical condition progressed rapidly despite maximum supportive treatments. Blood testing in the second week of illness showed rising ferritin and interleukin-6 levels, indicating the possibility of cytokine storm syndrome. Both developed respiratory failure necessitating mechanical ventilation. Due to their critical clinical condition and lack of response to supportive treatment, a decision was made to use intravenous tocilizumab therapy. Both were treated with one intravenous infusion of tocilizumab and had a successful outcome. They were extubated later and gradually weaned off supplemental oxygen. The first patient continued with her pregnancy during the hospital stay with normal fetal scans. The second patient needed an emergency cesarean section and delivered a healthy infant.

Conclusion

In critical clinical situations, tocilizumab may have a role in managing coronavirus disease 2019 related cytokine storm during pregnancy.
Glycolaldehyde disrupts insulin signaling and glucose uptake through adipogenesis
Authors: Lee Hee-Weon , Gu Min ji , Hur Jinyoung , Park Ho-Young , Kim Yoonsook , Ha Sang Keun
Published: August 2021

The accumulation of advanced glycation end products (AGEs) plays critical roles in exacerbating obesity, arteriosclerosis, cardiovascular disease, diabetes, and their associated complications. Glycolaldehyde (GA) is the metabolic precursor of several AGEs, and its effects vary based on food and cooking methods. Here, 3T3-L1 adipocytes were used to examine the effects of GA on obesity and insulin resistance. We found that GA treatment did not increase lipid accumulation but increased the distribution of adipocyte differentiation. We also investigated the production of receptor for AGEs (RAGE) and reactive oxygen species (ROS) upon GA treatment, as well as the expression levels of peroxisome proliferator-activated receptors γ (PPARγ), CCAAT enhancer binding protein α (c/EBPα), and CCAAT enhancer binding protein β (c/EBPβ), which are transcription factors for adipogenesis, were significantly increased upon GA treatment in a concentration-dependent manner. GA arrested the cell cycle at the G0/G1 stage during the early phase of adipogenesis and suppressed the expression of p21 and p27. GA increased the expression of CDK2, phosphorylation of mitogen-activated protein kinases, and secretion of pro-inflammatory cytokines. Overall, these results suggest that GA can stimulate lipid metabolism, hence, we suggest that the stimulation of adipogenesis and insulin resistance by GA may be associated with the interaction between RAGE and adipogenic factors in adipocytes.
Can the Edinburgh Postnatal Depression Scale-3A be used to screen for anxiety?
Authors: Smith-Nielsen Johanne , Egmose Ida , Wendelboe Katrine Isabella , Steinmejer Pernille , Lange Theis , Vaever Mette Skovgaard
Published: August 2021

Background

Anxiety in the ante- and postnatal period is prevalent, often co-occurs with depression, and can have adverse consequences for the infant. Therefore, perinatal mental health screening programs should not only focus on depression but also on detecting anxiety. However, in many already implemented perinatal screening programs, adding extra screening instruments is not feasible. We examine the utility of a subscale of the Edinburgh Postnatal Depression Scale (EPDS) consisting of items 3, 4, and 5 (EPDS-3A) for detecting anxiety in new mothers.

Methods

We used confirmatory factor analysis (CFA) to confirm the presence of the EPDS-3A found in a previous study (n = 320) where exploratory factor analysis (EFA) was used. For the CFA we used a sample of new mothers (n = 442) with children aged 2–11 months recruited from the same population from which mothers for the previous study was recruited. Three models were tested and compared. Receiver operating characteristics of the EPDS-3A were investigated in relation to anxiety caseness status on the combined sample (N = 762). Sample weighing was used to match the dataset to the target population. Cross tabulation was used to investigate the proportion of anxiety cases identified by the EPDS-3A above those identified with the total EPDS.

Results

The presence of the EPDS-3A was confirmed. An EFA-driven, two-dimensional 7-item model showed the best data fit with one factor representing the anxiety subscale consisting of items 3, 4, and 5. An EPDS-3A score of ≥ 5 was the most optimal for identifying cases of anxiety (sensitivity: 70.9; specificity: 92.2; AUC: 0.926). Further, we found that the EPDS-3A identifies an additional 2.5% of anxiety cases that would not have been identified with the total EPDS.

Conclusions

The EPDS-3A can be used as a time-efficient screening for possible anxiety in ante- and postnatal mothers. However, adding the EPDS-3A to routine screening with the total EPDS does not lead to a substantial increase in the number of women identified. In line with previous studies, this study confirms that the EPDS identifies anxiety in addition to depression. Therefore, assessment and treatment adjusted to the specific emotional difficulties is imperative.
Use of paracetamol in sows around farrowing: effect on health and condition of the sow, piglet mortality, piglet weight and piglet weight gain
Authors: Kuller Wikke , Sietsma Steven , Hendriksen Susan , Sperling Daniel
Published: August 2021

Background

Pain and fever in the periparturient period can lead to prolonged farrowing and can slow down the recovery of the sow, which will have an effect on the vitality and survival of the piglets. This study investigated the use of orally administered Paracetamol (Pracetam- CEVA) in sows in the periparturient period.

Results

Mortality did not differ in piglets during the first week, or during total lactation (P > 0.10). No difference was found in weight or weight gain of the piglets during lactation. The coefficient of variation of piglet weight was smaller in the Paracetamol (Pm) group at day 7, day 14 and at weaning, but not at birth. So, the variation within litters was smaller in the Pm- treated sows, in comparison with the Control (C) litters. No difference in mean IgG concentration was found between treatments, but the coefficient of variation was too high (> 40) in 50% of the C litters and not in Pm litters. The Pm- treated sows lost less backfat than the C- sows. No effect was found on the body temperature of the sows, but fever was rare in both groups.

Conclusion

Paracetamol results in less variation of body weight of piglets during lactation, seems to have a potential effect on the distribution of IgG within litters and has a positive effect on backfat loss. The effects of Paracetamol might be even more pronounced in farms with high piglet mortality (this farm only 8%) or with a high incidence of agalactia, fever after farrowing or piglet diarrhoea, which was not the case in this farm. Paracetamol is a promising product for increasing the welfare in lactating sows and optimising production in the farrowing stable.
Feasibility study of a digitalized nurse practitioner-led intervention to improve medication adherence in type 2 diabetes patients in Dutch primary care
Authors: Hogervorst Stijn , Adriaanse Marcel , Brandt Hella , Vervloet Marcia , van Dijk Liset , Hugtenburg Jacqueline
Published: August 2021

Purpose

The purpose of this feasibility study was to improve and implement an intervention aimed at enhancing medication adherence in sub-optimally controlled and non-adherent type 2 diabetes (T2DM) patients in primary care.

Methods

Four phases were completed: (1) context analysis, (2) collaboration protocol development, (3) digitalization, and (4) process evaluation. Two community pharmacies and seven general practices participated. In phase 1, two focus groups were conducted, of which one with healthcare providers (HCP, N = 5) and one with patients (N = 11). In phase 4, four semi-structured interviews and one focus group (N = 6) were conducted with healthcare providers. The goal of these focus groups and interviews was to obtain insights into current care to support medication adherence (phase 1), opportunities for collaboration (phase 2) and process evaluation (phase 4). Data were analyzed in Atlas.ti using thematic analyses.

Results

Both T2DM patients and HCPs considered medication adherence vital. Suboptimal collaboration between HCPs and unreliable ways to monitor medication non-adherence appeared important barriers for adequate care to support medication adherence (phase 1). The nurse practitioner (NP) was chosen as the interventionist with supportive roles for other HCPs (phase 2). All components of the intervention were digitalized (phase 3). The implementation of the digitalized intervention was reported to be suboptimal (phase 4). Main reasons were that pharmacy refill data were unreliable, NPs experienced difficulties addressing medication non-adherence adequately and collaboration between HCPs was suboptimal.

Conclusions

The medication adherence enhancing intervention was successfully digitalized, but implementation of the digitalized intervention appeared not feasible as of yet.
Low Levels of Serum Sclerostin in Adult Patients With Tumor-Induced Osteomalacia Compared With X-linked Hypophosphatemia
Authors: Ni Xiaolin , Zhang Qi , Li Xiang , Pang Qianqian , Gong Yiyi , Wang Ou , Li Mei , Xing Xiaoping , Jiang Yan , Xia Weibo
Published: August 2021

Context

Sclerostin inhibits Wnt-β-catenin signaling, regulating bone formation. Circulating sclerostin was reported to be elevated in X-linked hypophosphatemia (XLH) patients, and sclerostin antibody (Scl-Ab) increased bone mass and normalized circulating phosphate in Hyp mice. However, circulating sclerostin levels in patients with acquired hypophosphatemia due to tumor-induced osteomalacia (TIO) are rarely reported.

Objective

This study was designed to evaluate serum sclerostin levels in TIO patients compared with age- and sex-matched healthy controls and XLH patients to analyze correlations with bone mineral density (BMD) and laboratory parameters.

Methods

This cross-sectional study determined serum sclerostin levels in 190 individuals, comprising 83 adult TIO patients, 83 adult healthy controls and 24 adult XLH patients.

Results

TIO patients (43 male, 40 female) aged 44.3 ± 8.7 (mean ± SD) years had lower levels of circulating sclerostin than controls (94.2 ± 45.8 vs 108.4 ± 42.3 pg/mL, P = 0.01), adjusted for age, gender, BMI, and diabetes rate. Sclerostin levels were positively associated with age (r = 0.238, P = 0.030). Male patients had higher sclerostin than female patients (104.7 ± 47.3 vs 83.0 ± 41.8 pg/mL, P = 0.014). Sclerostin levels were positively associated with L1-4 BMD (r = 0.255, P = 0.028), femoral neck BMD (r = 0.242, P = 0.039), and serum calcium (r = 0.231, P = 0.043). Comparison of sclerostin levels in TIO patients (n = 24, age 35.9 ± 7.3 years) vs XLH patients vs healthy controls revealed significant differences (respectively, 68.4 ± 31.3, 132.0 ± 68.8, and 98.6 ± 41.1 pg/mL, P < 0.001).

Conclusion

Circulating sclerostin was decreased in TIO patients but increased in XLH patients, possibly due to histological abnormality and bone mass.
Topical treatments in dermatology
Authors: Rabindranathnambi Aswatha , Abid Maaz
Published: August 2021

Topical medications are key agents in treating a range of skin conditions, as they allow affected areas to be targeted while avoiding systemic side effects. Although there is a wide range of topical agents available, it is helpful to be familiar with a few commonly used formulations. This article describes how to select appropriate agents, prescribe appropriate quantities, and counsel patients on safe and effective treatment regimens.
Efficiency changes in orthopaedic trauma surgery and implications for resource allocation
Authors: Virani Siddharth , Faria Giles , Housden Philip
Published: August 2021

Background/Aims

The trauma and orthopaedic surgery department needed to modify practices as a result of the COVID-19 pandemic. This study quantitatively assessed the effects of changes in resource allocation on the efficiency of trauma, specifically the number of operations performed per defined trauma session.

Methods

Trauma lists were reviewed pre-COVID, at the peak and at the tail of the first wave of COVID-19 infections at a hospital in the UK. Efficiency was calculated before and after the reallocation of resources and this was defined as the number of cases per trauma session as well as turnaround times for each part of the surgical patient journey.

Results

The mean trauma list efficiency was 1.73 cases per session in February 2020 compared to 1.89 in February 2019. It reduced to 1.21 during the COVID peak in April 2020 compared to 1.90 in April 2019 and improved to 1.48 per session in June 2020 vs 1.82 in June 2019.

Conclusions

Measures introduced at the start of the pandemic are likely to continue for the foreseeable future. Increased allocation of resources would be needed to allow urgent trauma surgery to provide a timely and efficient service.
Management of the deteriorating adult patient: does simulation-based education improve patient safety?
Authors: Bennion Jacqueline , Mansell Stephanie K
Published: August 2021

Failure to recognise the deteriorating patient can cause severe harm and is related to preventable death. Human factors are often identified as contributing factors. Simulation-based education is used to develop clinicians' human factors skills. This article discusses the evidence concerning the efficacy of simulation-based education for improving the recognition and management of the acutely deteriorating adult patient, and the limitations of simulation-based education. Findings demonstrated simulation-based education was the most effective educational method identified for training staff in recognising unwell patients. The evidence demonstrating the impact of simulation-based education on patient outcomes was equivocal. The quality of the evidence was low grade regarding the efficacy of simulation-based education on human factors. Further research is required to confirm the efficacy of simulation-based education for human factors and patient outcomes.
Osmanlı Devleti’nde batı müziği ve keman ailesi enstrümanları üzerine inceleme
Authors: Dökmeci Sela Can
Published: August 2021

Osmanlı Devleti müzik kültüründe 19. yüzyıla kadar halk müziği ve Osmanlı sanat müziğinin var olduğu görülmektedir. Batı müziği ise, ilk temasları 16. yüzyıla dayansa da batılılaşma hareketleri ile paralellik göstererek 1826’dan sonra yoğun olarak Osmanlı müzik kültürü içerisine girmiştir. II. Mahmud yaptığı yenilikçi hamlelerin bir ürünü olarak kapatılan mehterin yerine Muzika-yı Hümayun adında batı tarzında askeri bir bando kurmuş ve bunu harbiye okuluna bağlamıştır. Bu sayede Osmanlı Devleti’nde Batı müziği kurumsallaşmıştır. Ardından sarayda da önemi artmıştır. Osmanlı hükümdarları, zevceleri ve çocukları batı müziği ve piyano eğitimi almaya başlamışlardır. İlk Batı müziği bestesi yapan padişah Sultan Abdülaziz’dir. Osmanlı döneminde müzik, usta çırak ilişkisi ile meşk edilerek öğrenilirken, batılılaşma süreci ve ardından Cumhuriyetin ilanıyla yerini nota, kitap ve bilimsel yöntemlere bırakmıştır.
Bu bilgiler neticesinde 18. yüzyıla gelindiğinde Osmanlı Devleti’nde keman ailesinden ilk olarak "Viola d'Amore" (halk arasında bilinen adıyla Sinekeman) isimli enstrüman kendini göstermiş olup, daha sonrasında keman da icra edilen yaylı sazlar arasına girmiştir. 19. yüzyılda imparatorluğun yüzünü tamamen Batı medeniyetine dönmesi neticesiyle keman ailesi enstrümanlarının diğer üyeleri olan viyola, viyolonsel ve kontrabas da saraya girmiştir. Bu çalışmada Osmanlı Devleti’nde Batı Müziğinin ne şekilde geliştiği ve bu müzik türünde kullanılan keman ailesi enstrümanlarının (keman, viyola, viyolonsel ve kontrabas) ne şekilde kullanılmaya başlandığı araştırılmıştır.
Preschool teachers’ view about the effect of musical games on musical talent and their development
Authors: Kryeziu Drıta
Published: August 2021

This study presents the results of a research work, which aims to highlight the impact that
the development of musical games during the learning process in preschool education has
on the emotional and social development of preschool children. The purpose of this study
is to investigate of the preschool teachers’ views about the impact you have on the overall
development of children in preschool age, ie the importance of applying these games in
preschool. The research approach applied in the study is a qualitative research approach.
The sampling of the study includes 4 teachers who teach in the preschool system, in the
kindergartens of the municipality of Gjilan, Kosova. The instruments applied in the study
include semi-structured interviews. The main results and conclusions of the study that
preschool teachers stated that the application of musical games during preschool lessons
has a positive effect on improving the emotional state of children, as well as improving
their social skills. Referring to the results of the study, it is suggested that teachers who
work with children in preschool educational institutions, in teaching practice, to apply
musical games in every lesson, not only to make the lesson as diverse as possible, but
above all to make children feel happy.
Online celebrity discourses on Facebook
Authors: Hegedűs Dániel
Published: August 2021

The web 2.0 phenomenon and social media – without question – have reshaped our everyday experiences. These changes that they have generated affect how we consume, communicate and present ourselves, just to name a few aspects of life, and moreover, opened up new perspectives for sociology. Though many social practices persist in a somewhat altered form, brand new types of entities have emerged on different social media platforms: one of them is the video blogger. These actors have gained great visibility through so-called micro-celebrity practices and have become potential large-scale distributors of ideas, values and knowledge. Celebrities, in this case micro-celebrities (video bloggers), may disseminate such cognitive patterns through their constructed discourse which is objectified in the online space through a peculiar digital face (a social media profile) where fans can react, share and comment according to the affordances of the digital space. Most importantly, all of these interactions are accessible for scholars to examine the fan and celebrity practices of our era. This research attempts to reconstruct these discursive interactions on the Facebook pages of ten top Hungarian video bloggers. All findings are based on a large-scale data collection using the Netvizz application. As part of the interpretation of the results, a further consideration was that celebrity discourses may be a sort of disciplinary force in (post)modern society, which normalizes the individual to some extent by providing adequate schemas of attitude, mentality and ways of consumption.
Corporate fandom: Re-creating media fans as a public
Authors: Bay Jessica
Published: August 2021

Using Michael Warner’s () conception of publics and counterpublics, we can see that historically much of fandom was situated in the position of counterpublic as fans not only were placed on the outskirts by others but also actively participated in acts that ran counter to the mainstream reading and consumption of media content. Current media fans of popular American franchises, however, are often courted by corporations and those with the power to influence the mainstream. There is an interest in the types of transformative practices in which fans engage. In actively seeking these audience members and their practices, corporations are forcing these groups into a more public position while helping to shift the types of activities that are considered part of fandom. Essentially, by bringing ‘desirable’ and ‘affirmational’ media fans into the mainstream, corporations are reorganizing them as publics in terms of their position within society, and this shift could contribute to a change in what it means to be a media fan.
Prevalence and antimicrobial resistance phenotypes of Salmonella species recovered at various stages of broiler operations in Hathazari, Bangladesh
Authors: Ali Ferdausi , Silvy Tazriyan Noor , Hossain Tanim Jabid , Uddin Md. Kamal , Uddin Mohammad Seraj
Published: August 2021

Background and Aim: Dissemination of multidrug-resistant (MDR) Salmonella through food chains has serious health implications, with higher rates of morbidity and mortality. Broiler meat remains a major reservoir of Salmonella contamination. The lack of proper hygiene in local broiler operations has, therefore, prompted this research into the assessment of Salmonella contamination in local shops and associated antimicrobial resistance (AMR) phenotypes.

Materials and Methods: A total of 55 broiler samples including skin, meat, and swab samples from chopping and dressing sites were included in the study. The samples were collected from broiler shops in Hathazari, Bangladesh, and screened for the presence of Salmonella strains using culture-based methods. The isolates were biochemically characterized and further tested for AMR to eight common antibiotics using the disk diffusion technique.

Results: Salmonella contaminations were identified in 29% (16/55) of the broiler samples. Swab samples collected from the chopping sites appeared to be contaminated in higher proportions (33%) than those collected from the dressing areas (25%). On the other hand, the skin samples (50%) were detected with a higher percentage of contamination than the meat samples (25%). All Salmonella isolates showed resistance toward at least one of the eight antibiotics used. Although none of the isolates was resistant to all antibiotics, 18.75% showed resistance to a maximum of seven antibiotics. Resistance to nalidixic acid was most prevalent (87.5%), followed by sulfamethoxazole-trimethoprim (81.25%), erythromycin (81.25%), tetracycline (75%), streptomycin (56.25%), ampicillin-clavulanic acid (50%), chloramphenicol (43.75%), and cefotaxime (18.75%). The resistance patterns of the isolates were found to be highly diverse. The most frequently observed pattern was the following: Ampicillin-clavulanic acid-sulfamethoxazole-trimethoprim-nalidixic acid-tetracycline-chloramphenicol-streptomycin-erythromycin.

Conclusion: The relatively high prevalence of MDR strains in the samples underlies an urgent need for surveillance and control measures concerning hygiene and antibiotic use in local broiler operations.
ROLE STRESSORS AND ALIENATION FROM WORK DURING COVID-19 SETTING
Authors: Mitevska Mayiana
Published: August 2021

Summary: This study explores the interrelationships between work alienation and the role stressor dimensions of ambiguity and conflict. Diagnostics of role stressors in the workplace /Radoslavova, M. 2005/ and Assessment of alienation from work /Velichkov, A. 2005/. The data were collected with an online questionnaire, entered with Google Forms and processed with SPSS-21 using: descriptive statistics, and correlation analysis. The results are compared with similar previous studies conducted in Bulgaria and abroad. Respondents were 75 individuals, 72% of them were doctors working in a government hospital in a regional city. The results of the study showed that role ambiguity is a major workplace stressor in coping with the Covid-19 pandemic. Alienation from work is very high, which is also a significant antecedent for developing Burnout Syndrome.
Stationary sets of the mean curvature flow with a forcing term
Authors: Julin Vesa , Niinikoski Joonas
Published: August 2021

We consider the flat flow solution to the mean curvature equation with forcing in

ℝ
n

{\mathbb{R}^{n}}

.
Our main result states that tangential balls in

ℝ
n

{\mathbb{R}^{n}}

under a flat flow with a bounded forcing term will
experience fattening, which generalizes the result in
[N. Fusco, V. Julin and M. Morini,
Stationary sets and asymptotic behavior of the mean curvature flow with forcing in the plane,
preprint 2020, https://arxiv.org/abs/2004.07734]
from the planar case to higher dimensions. Then, as in the planar case, we characterize stationary sets in

ℝ
n

{\mathbb{R}^{n}}

for a constant forcing term as finite unions of equisize balls with mutually positive distance.
Convergence Theory for IETI-DP Solvers for Discontinuous Galerkin Isogeometric Analysis that is Explicit in ℎ and 𝑝
Authors: Schneckenleitner Rainer , Takacs Stefan
Published: August 2021

In this paper, we develop a convergence theory for Dual-Primal Isogeometric Tearing and Interconnecting (IETI-DP) solvers for isogeometric multi-patch discretizations of the Poisson problem, where the patches are coupled using discontinuous Galerkin. The presented theory provides condition number bounds that are explicit in the grid sizes ℎ and in the spline degrees 𝑝. We give an analysis that holds for various choices for the primal degrees of freedom: vertex values, edge averages, and a combination of both. If only the vertex values or both vertex values and edge averages are taken as primal degrees of freedom, the condition number bound is the same as for the conforming case. If only the edge averages are taken, both the convergence theory and the experiments show that the condition number of the preconditioned system grows with the ratio of the grid sizes on neighboring patches.
Pedagogy, Didactics, or Subject Matter? Exploring Pre-service Teachers’ Interest Profiles
Authors: Pozas Marcela , Letzel Verena
Published: August 2021

Interest has been considered an important determinant of teacher quality. However, research into teacher interest, and more specifically, pre-service teachers’ interest is limited. Hence, the current study tackled the current gaps in pre-service teachers’ interest and aimed to explore pre-service teachers’ interest profiles based on the multidimensional framework of teacher interest. A total of 225 pre-service teachers, enrolled in various initial teacher education programs of two universities in Germany, participated voluntarily in the study. The results revealed two distinct pre-service teachers’ profiles based on the three teacher interest factors. Interestingly, the two profiles did not significantly differ in their subject interest levels, but did vary in their didactic and educational interest. In addition, the findings also revealed gender and school track differences in pre-service teachers’ interests and profiles. Consequences for future research and teacher education are discussed in detail.
Applying design of experiments (DoE) on the properties of buccal film for nicotine delivery
Authors: Suksaeree Jirapornchai , Chaichawawut Benjarut , Srichan Muntira , Tanaboonsuthi Noppamon , Monton Chaowalit , Maneewattanapinyo Pattwat , Pichayakorn Wiwat
Published: August 2021

Design of experiments is used to optimize ratios between deproteinized natural rubber latex, Eudragit® NM 30 D, and pectin for nicotine buccal film with dependent variables as moisture content, moisture uptake, and swelling index in simulated saliva 3 and 5 h. Mathematical models were linear for moisture content and moisture uptake, while swelling index in simulated saliva 3 and 5 h was a quadratic model. Optimized polymer ratio was 0.319:0.362:0.319, respectively. Experimental values were 13.17 ± 0.92%, 3.96 ± 0.84%, 112.58 ± 22.63%, and 124.69 ± 8.01% for dependent variables, respectively. The buccal film showed high swelling at pH 7 and swelling–deswelling behaviors in a water/ethanol environment. The surface pH, weight, and thickness were 8.11, 63.28 ± 6.18 mg, and 219.87 ± 44.28 µm, respectively. Nicotine content was found as 10.22 ± 0.46 mg/4 cm2. Maximum cumulative nicotine release was 9.82 ± 0.94 mg/4 cm2. Kinetic model fitted to the Korsmeyer-Peppas model and release exponent was 0.36, representing that release mechanism was controlled by Fickian diffusion release.
Entrepreneurial Team Conflict and Cohesion: Meta-structural Equation Modeling
Authors: Yoo Sangok , Lee Jin , Lee Yunsoo
Published: August 2021

We explore the mediating effects that entrepreneurial team conflict and cohesion have on the relationship between team diversity and performance based on an inputs-mediators-outcomes framework. Using 56 samples from 54 empirical studies, we conducted a meta-analysis of the hypothesized relationships and used meta-analytic structural equation modeling (MASEM) to test the mediating models. Our findings reveal that team diversity was related to cognitive and affective conflict, and only affective conflict was associated with objective and subjective venture performance. Furthermore, entrepreneurial team cohesion had positive effects on venture performance. Our unique contributions to the entrepreneurial team literature and future research suggestions are also discussed.
Gross–Prasad periods for reducible representations
Authors: Loeffler David
Published: August 2021

We study

GL
2

⁡

(
F
)

{\operatorname{GL}_{2}(F)}

-invariant periods on representations of

GL
2

⁡

(
A
)

{\operatorname{GL}_{2}(A)}

, where F is a non-archimedean local field and

A
/
F

{A/F}

a product of field extensions of total degree 3. For irreducible representations, a theorem of Prasad shows that the space of such periods has dimension

⩽
1

{\leqslant 1}

, and is non-zero when a certain ε-factor condition holds. We give an extension of this result to a certain class of reducible representations (of Whittaker type), extending results of Harris–Scholl when A is the split algebra

F
×
F
×
F

{F\times F\times F}

.