bluuebunny/crossref_metadata_2025 huggingface dataset:
Marine Mammal HiCUP: A High Current Underwater Platform for the Long-Term Monitoring of Fine-Scale Marine Mammal Behavior Around Tidal Turbines
Authors: Gillespie Douglas , Oswald Michael , Hastie Gordon , Sparling Carol
Published: March 2022

Arrays of tidal turbines are being considered for tidally energetic coastal sites which can be important habitat for many species of marine mammal. Understanding risks to marine mammals from collisions with moving turbine blades must be overcome before regulators can issue licenses for many developments. To understand these risks, it is necessary to understand how animals move around operational turbines and to document the rate at which interactions occur. We report on the design, and performance, of a seabed mounted sensor platform for monitoring the fine scale movements of cetaceans and pinnipeds around operational tidal turbines. The system comprises two high-frequency multibeam active sonars, which can accurately track animals in the horizontal plane. By offsetting the vertical angle of the sonars, the relative intensity of targets on the two sonars can also be used to resolve a vertical component of the animal location. For regularly vocalizing species, i.e., small cetaceans, a tetrahedral array of high frequency hydrophones mounted close to the sonars is used to measure both horizontal and vertical angles to cetacean echolocation clicks. This provides additional localization and tracking information for cetaceans and can also be used to distinguish between pinnipeds and cetaceans detected in the sonar data, based on the presence or absence of echolocation clicks. The system is cabled to shore for power, data transfer, and communications using turbine infrastructure. This allows for continuous operation over many months or years, which will be required to capture what may be rare interactions. The system was tested during a series of multi-week field tests, designed to test system integrity, carry out system calibrations, and test the efficiency of data collection, analyses, and archiving procedures. Overall, the system proved highly reliable, with the PAM system providing bearing accuracies to synthetic sounds of around 4.2 degrees for echolocation clicks with a signal to noise ratio above 15 dB. The system will be deployed close to an operational turbine in early 2022.
Impact of TOF on Brain PET With Short-Lived 11C-Labeled Tracers Among Suspected Patients With AD/PD: Using Hybrid PET/MRI
Authors: Wimalarathne D.D.N , Ruan Weiwei , Sun Xun , Liu Fang , Gai Yongkang , Liu Qingyao , Hu Fan , Lan Xiaoli
Published: March 2022

Objective

To explore the impact of the time-of-flight (TOF) reconstruction on brain PET with short-lived 11C-labeled tracers in PET magnetic resonance (PET/MR) brain images among suspected patients with Alzheimer's and Parkinson's disease (AD/PD).

Methods

Patients who underwent 11C-2-ß-carbomethoxy-3-b-(4-fluorophenyl) tropane (11C-CFT) and 2-(4-N-[11C] methylaminophenyl)-6-hydroxybenzothiazole (11C-PiB) PET/MRI were retrospectively included in the study. Each PET LIST mode data were reconstructed with and without the TOF reconstruction algorithm. Standard uptake values (SUVs) of Caudate Nucleus (CN), Putamen (PU), and Whole-brain (WB) were measured. TOF and non-TOF SUVs were assessed by using paired t-test. Standard formulas were applied to measure contrast, signal-to-noise ratio (SNR), and percentage relative average difference of SUVs (%RAD-SUVs).

Results

Total 75 patients were included with the median age (years) and body mass index (BMI-kg/m2) of 60.2 ± 10.9 years and 23.9 ± 3.7 kg/m2 in 11C-CFT (n = 41) and 62.2 ± 6.8 years and 24.7 ± 2.9 kg/m2 in 11C-PiB (n = 34), respectively. Higher average SUVs and positive %RAD-SUVs were observed in CN and PU in TOF compared with non-TOF reconstructions for the two 11C-labeled radiotracers. Differences of SUVmean were significant (p < 0.05) in CN and PU for both 11C-labeled radiotracers. SUVmax was enhanced significantly in CN and PU for 11C-CFT and CN for 11C-PiB, but not in PU. Significant contrast enhancement was observed in PU for both 11C-labeled radiotracers, whereas SNR gain was significant in PU, only for 11C-PiB in TOF reconstruction.

Conclusion

Time-of-flight leads to a better signal vs. noise trade-off than non-TOF in 11C-labeled tracers between CN and PU, improving the SUVs, contrast, and SNR, which were valuable for reducing injected radiation dose. Improved timing resolution aided the rapid decay rate of short-lived 11C-labeled tracers, and it shortened the scan time, increasing the patient comfort, and reducing the motion artifact among patients with AD/PD. However, one should adopt the combined TOF algorithm with caution for the quantitative analysis because it has different effects on the SUVmax, contrast, and SNR of different brain regions.
Exogenous Microorganisms Promote Moss Biocrust Growth by Regulating the Microbial Metabolic Pathway in Artificial Laboratory Cultivation
Authors: Tian Chang , Wang Heming , Wu Shufang , Bu Chongfeng , Bai Xueqiang , Li Yahong , Siddique Kadambot H. M.
Published: March 2022

Moss-dominated biocrusts (moss crusts) are a feasible approach for the ecological restoration of drylands, but difficulty obtaining inoculum severely limits the progress of large-scale field applications. Exogenous microorganisms could improve moss growth and be conducive to moss inoculum propagation. In this study, we investigated the growth-promoting effects and potential mechanisms of exogenous microorganism additives on moss crusts. We used an incubator study to examine the effects of inoculation by heterotrophic microorganisms (Streptomyces pactum, Bacillus megaterium) and autotrophic microorganisms (Chlorella vulgaris, Microcoleus vaginatus) combined with Artemisia sphaerocephala gum on the growth of Bryum argenteum, the dominant moss crusts species in sandy deserts. Amplicon sequencing (16S and 18S rRNA) and PICRUSt2 were used to illustrate the microbial community structure and potential function in the optimal treatment at different developmental stages. Our results showed that exogenous microorganisms significantly promoted moss growth and increased aboveground biomass. After 30 days of cultivation, the Streptomyces pactum (1 g kg–1 substrate) + Chlorella vulgaris (3.33 L m–2) treatment presented optimal moss coverage, height, and density of 97.14%, 28.31 mm, and 2.28 g cm–2, respectively. The best-performing treatment had a higher relative abundance of Streptophyta—involved in moss growth—than the control. The control had significantly higher soil organic carbon than the best-performing treatment on day 30. Exogenous microorganisms improved eukaryotic community diversity and richness and may enhance soil microbial functional and metabolic diversity, such as growth and reproduction, carbon fixation, and cellulose and lignin decomposition, based on functional predictions. In summary, we identified the growth-promoting mechanisms of exogenous additives, providing a valuable reference for optimizing propagation technology for moss inoculum.
Effectiveness of Physical Activity Interventions on Cognition, Neuropsychiatric Symptoms, and Quality of Life of Alzheimer’s Disease: An Update of a Systematic Review and Meta-Analysis
Authors: Liang Ya-Jing , Su Qing-Wen , Sheng Zhi-Ren , Weng Qiu-Yan , Niu Yan-Fang , Zhou Hong-Di , Liu Chun-Bo
Published: March 2022

The topic of physical activity interventions for the treatment of Alzheimer’s disease (AD) has been discussed for decades, but there are still inconsistent views on the effect of its intervention in different studies. With the increase in randomized controlled trials (RCTs), it is necessary to update newly published studies and systematically evaluate the effects of physical activity interventions. Scientific citation databases (e.g., PubMed, EMBASE, etc.) and registration databases (e.g., ISRCTN, CHICTR, etc.) were checked to screen RCTs and systematic reviews of physical activity interventions in AD. Then extract and review the intervention methods and their evaluation results in the included studies. Spearman correlation method was used to test the association between the mean difference (MD) of intervention results and activity time. The Hedges’g method was used to combine continuous data to analyze the standard MD (SMD) of different intervention types or time subgroups. The overall results show that physical activity intervention can improve the cognition, neuropsychiatric symptoms and quality of life (Qol) of AD patients, but the duration of the intervention significantly affected the outcome of the assessment. Subgroup analysis results showed that an intervention duration of 2–5 months had a significant advantage: cognitive function (Minimum Mental State Examination: SMD = 0.47, 95% CI = 0.33 ∼ 0.61, P < 0.01), neuropsychiatric symptoms (Neuropsychiatric Inventory: SMD = −0.48, 95% CI = −0.85 ∼−0.11, P < 0.01), and quality of life (Qol-AD: SMD = 0.47, 95% CI = 0.23 ∼ 0.71, P < 0.01). The systematic review and analysis results of updated RCTs suggested that short-term (2–5 months) physical activity interventions were more beneficial in improving cognitive function, neuropsychiatric symptoms and Qol in patients with AD. And there was no evidence of differences in the effectiveness of different physical activity interventions.
Enhancing Locomotor Learning With Transcutaneous Spinal Electrical Stimulation and Somatosensory Augmentation: A Pilot Randomized Controlled Trial in Older Adults
Authors: Clark David J. , Hawkins Kelly A. , Winesett Steven P. , Cox Brigette A. , Pesquera Sarah , Miles Jon W. , Fuller David D. , Fox Emily J.
Published: March 2022

This study investigated locomotor learning of a complex terrain walking task in older adults, when combined with two adjuvant interventions: transcutaneous spinal direct current stimulation (tsDCS) to increase lumbar spinal cord excitability, and textured shoe insoles to increase somatosensory feedback to the spinal cord. The spinal cord has a crucial contribution to control of walking, and is a novel therapeutic target for rehabilitation of older adults. The complex terrain task involved walking a 10-meter course consisting of nine obstacles and three sections of compliant (soft) walking surface. Twenty-three participants were randomly assigned to one of the following groups: sham tsDCS and smooth insoles (sham/smooth; control group), sham tsDCS and textured insoles (sham/textured), active tsDCS and smooth insoles (active/smooth), and active tsDCS and textured insoles (active/textured). The first objective was to assess the feasibility, tolerability, and safety of the interventions. The second objective was to assess preliminary efficacy for increasing locomotor learning, as defined by retention of gains in walking speed between a baseline visit of task practice, and a subsequent follow-up visit. Variability of the center of mass while walking over the course was also evaluated. The change in executive control of walking (prefrontal cortical activity) between the baseline and follow-up visits was measured with functional near infrared spectroscopy. The study results demonstrated feasibility based on enrollment and retention of participants, tolerability based on self-report, and safety based on absence of adverse events. Preliminary efficacy was supported based on trends showing larger gains in walking speed and more pronounced reductions in mediolateral center of mass variability at the follow-up visit in the groups randomized to active tsDCS or textured insoles. These data justify future larger studies to further assess dosing and efficacy of these intervention approaches. In conclusion, rehabilitation interventions that target spinal control of walking present a potential opportunity for enhancing walking function in older adults.
Delirium and Anxiety Outcomes Related to Visiting Policy Changes in the Intensive Care Unit During the COVID-19 Pandemic
Authors: Kim Bomi , Cho Jaehwa , Park Jin Young , Kim Hesun Erin , Oh Jooyoung
Published: March 2022

Objective

To evaluate the effect of intensive care unit (ICU) visit on the incidence of delirium, delirium subtype, and anxiety level in ICU patients.

Methods

Trained psychiatrists and nurses evaluated ICU patients for delirium, delirium subtypes, and anxiety. Propensity score matching (PSM) was used to retrospectively analyze the data. Then, we compared the differences in the incidence of delirium, delirium subtypes, and anxiety level before and after the ICU visit ban. Logistic regression was conducted to identify the risk factors for delirium subtypes and high anxiety levels.

Results

After PSM, there was no statistically significant difference in the incidence of delirium between the non-visiting and restrictive visiting groups (non-visiting 27.4% versus restrictive visiting 30.9%, p = 0.162). The proportion of hyperactive and mixed subtypes was higher in the non-visiting than in the restrictive visiting group (non-visiting 35.3 and 30.1% versus restrictive visiting 27.7 and 20.1%, p = 0.002). The anxiety level was higher in the non-visiting than in the restrictive visiting group (state-trait anxiety inventory score: non-visiting 53.46 ± 4.58 versus restrictive visiting 52.22 ± 6.50, p = 0.009). Patients who stayed in the ICU during the visit ban were more likely to have hyperactive (p = 0.005) and mixed subtype (p = 0.001) than those who did not. Moreover, patients who stayed in the ICU during the visit ban were more likely to experience high anxiety levels than those who did not (p < 0.001).

Conclusion

Prohibition of ICU visits during COVID-19 pandemic did not affect the incidence of delirium during COVID-19 but could change the delirium subtype and raise anxiety level. Moreover, visiting prohibition was a risk factor for non-hypoactive delirium subtype and high anxiety levels. Therefore, ICU visits are important in dealing with delirium subtypes and anxiety in ICU patients.
The Effects of Non-Invasive Brain Stimulation on Quantitative EEG in Patients With Parkinson's Disease: A Systematic Scoping Review
Authors: Costa Thaísa Dias de Carvalho , Godeiro Júnior Clécio , Silva Rodrigo Alencar e , dos Santos Silmara Freitas , Machado Daniel Gomes da Silva , Andrade Suellen Marinho
Published: March 2022

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms, aside from alterations in the electroencephalogram (EEG) already registered. Non-invasive brain stimulation (NIBS) techniques have been suggested as an alternative rehabilitative therapy, but the neurophysiological changes associated with these techniques are still unclear. We aimed to identify the nature and extent of research evidence on the effects of NIBS techniques in the cortical activity measured by EEG in patients with PD. A systematic scoping review was configured by gathering evidence on the following bases: PubMed (MEDLINE), PsycINFO, ScienceDirect, Web of Science, and cumulative index to nursing & allied health (CINAHL). We included clinical trials with patients with PD treated with NIBS and evaluated by EEG pre-intervention and post-intervention. We used the criteria of Downs and Black to evaluate the quality of the studies. Repetitive transcranial magnetic stimulation (TMS), transcranial electrical stimulation (tES), electrical vestibular stimulation, and binaural beats (BBs) are non-invasive stimulation techniques used to treat cognitive and motor impairment in PD. This systematic scoping review found that the current evidence suggests that NIBS could change quantitative EEG in patients with PD. However, considering that the quality of the studies varied from poor to excellent, the low number of studies, variability in NIBS intervention, and quantitative EEG measures, we are not yet able to use the EEG outcomes to predict the cognitive and motor treatment response after brain stimulation. Based on our findings, we recommend additional research efforts to validate EEG as a biomarker in non-invasive brain stimulation trials in PD.
Does the Brush-Sign Reflect Collateral Status and DWI-ASPECTS in Large Vessel Occlusion?
Authors: Rascle Lucie , Bani Sadr Alexandre , Amaz Camille , Mewton Nathan , Buisson Marielle , Hermier Marc , Ong Elodie , Fontaine Julia , Derex Laurent , Berthezène Yves , Eker Omer Faruk , Cho Tae-Hee , Nighoghossian Norbert , Mechtouff Laura
Published: March 2022

Introduction

The relevance of the brush-sign remained poorly documented in large vessel occlusion (LVO). We aimed to assess the relationship between the brush-sign and collateral status and its potential impact on baseline diffusion-weighted imaging–Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) in acute ischemic stroke (AIS) patients eligible to mechanical thrombectomy (MT).

Methods

Consecutive patients admitted in the Lyon Stroke Center with anterior circulation AIS due to intracranial internal carotid artery (ICA) and/or M1 or M2 segment of the middle cerebral artery (MCA) occlusion eligible for MT were included. The brush-sign was assessed on T2-gradient-echo MRI. Collateral status was assessed on digital subtraction angiography according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) score.

Results

In this study, 504 patients were included, among which 171 (33.9%) patients had a brush-sign. Patients with a brush-sign more frequently had a poor collateral status [72 (42.1%) vs. 103 (30.9%); p = 0.017]. In univariable analysis, a DWI-ASPECTS < 7 was associated with a brush sign. Following multivariable analysis, the brush-sign no longer affected DWI-ASPECTS < 7 while the latter remained associated with younger age [odds ratio (OR) 0.97, 95% CI.96–0.99], male sex (OR 1.79, 95% CI 1.08–2.99), a higher National Institutes of Health Stroke Scale (NIHSS) score (OR 1.16, 95% CI 1.1–1.21), a poor collateral status (OR 9.35, 95% CI 5.59-16.02), MCA segment (OR 2.54, 95% CI 1.25–5.38), and intracranial ICA (OR 3.01, 95% CI 1.16–8) occlusion.

Conclusions and Relevance

The brush-sign may be a marker of poor collateral status but did not independently predict a lower DWI-ASPECTS.

Clinical Trial Registration

ClinicalTrials.gov, identifier: NCT04620642.
Intravoxel Incoherent Motion Magnetic Resonance Imaging Used in Preoperative Screening of High-Risk Patients With Moyamoya Disease Who May Develop Postoperative Cerebral Hyperperfusion Syndrome
Authors: Gao Feng , Zhao Wei , Zheng Yu , Duan Yu , Ji Ming , Lin Guangwu , Zhu Zhenfang
Published: March 2022

Objective

This study aimed to investigate the feasibility of preoperative intravoxel incoherent motion (IVIM) MRI for the screening of high-risk patients with moyamoya disease (MMD) who may develop postoperative cerebral hyperperfusion syndrome (CHS).

Methods

This study composed of two parts. In the first part 24 MMD patients and 24 control volunteers were enrolled. IVIM-MRI was performed. The relative pseudo-diffusion coefficient, perfusion fraction, apparent diffusion coefficient, and diffusion coefficient (rD*, rf, rADC, and rD) values of the IVIM sequence were compared according to hemispheres between MMD patient and healthy control groups. In the second part, 98 adult patients (124 operated hemispheres) with MMD who underwent surgery were included. Preoperative IVIM-MRI was performed. The rD*, rf, rADC, rD, and rfD* values of the IVIM sequence were calculated and analyzed. Operated hemispheres were divided into CHS and non-CHS groups. Patients’ age, sex, Matsushima type, Suzuki stage, and IVIM-MRI examination results were compared between CHS and non-CHS groups.

Results

Only the rf value was significantly higher in the healthy control group than in the MMD group (P < 0.05). Out of 124 operated hemispheres, 27 were assigned to the CHS group. Patients with clinical presentation of Matsushima types I–V were more likely to develop CHS after surgery (P < 0.05). The rf values of the ipsilateral hemisphere were significantly higher in the CHS group than in the non-CHS group (P < 0.05). The rfD* values of the ACA and MCA supply areas of the ipsilateral hemisphere were significantly higher in the CHS group than in the non-CHS group (P < 0.05). Only the rf value of the anterior cerebral artery supply area in the contralateral hemisphere was higher in the CHS group than in the non-CHS group (P < 0.05). The rf values of the middle and posterior cerebral artery supply areas and the rD, rD*, and rADC values of the both hemispheres were not significantly different between the CHS and non-CHS groups (P > 0.05).

Conclusion

Preoperative non-invasive IVIM-MRI analysis, particularly the f-value of the ipsilateral hemisphere, may be helpful in predicting CHS in adult patients with MMD after surgery. MMD patients with ischemic onset symptoms are more likely to develop CHS after surgery.
Spatial Heterogeneity of Household Food Consumption and Nutritional Characteristics of Grassland Transects in Inner Mongolia, China
Authors: Yang Wanni , Jia Haiwei , Wang Chao , Wang Haojia , Sun Chuanzhun
Published: March 2022

Household food consumption is the associative link between ecosystems and anthropogenic activities. In grassland areas, inappropriate food consumption patterns will cause irreversible damage to vulnerable local ecosystems. For this study, we selected three typical transitional grassland areas of Inner Mongolia, China (i.e., meadow steppe, typical steppe, and desert steppe), to analyze spatial heterogeneity in household food consumption and nutritional characteristics. Results showed that: (a) Food consumption structures exhibited zonal gradients from east to west alongside a reduction in grassland conditions. Additionally, the average food consumption quantity also decreased. Available food supplies altered household preferences for vegetables and fruits, meat, dairy products, and other food consumption category types. (b) The nutritional structure implied that grains provided the main source of energy, proteins, and fat for local rural households, while meat, dairy products, beans (including bean byproducts), and oils caused a fluctuation in the nutritional structure of residents. (c) Local food supplies affect short-term local food consumption patterns, while socioeconomic development affects long-term food consumption patterns. This study is intended to provide a reference for the development of sustainable strategies for regional resource management.
A Predictive Nomogram for Lymph Node Metastasis in Supraglottic Laryngeal Squamous Cell Carcinoma
Authors: Song Lulu , Heng Yu , Hsueh Chi-Yao , Huang Huiying , Tao Lei , Zhou Liang , Zhang Ming
Published: March 2022

Purpose

Lymph node metastasis (LNM) has a negative impact on the survival of patients with laryngeal squamous cell carcinoma (LSCC). Supraglottic LSCC is the most common cause of cervical lymph node metastases due to the extensive submucosal lymphatic plexus. The accurate evaluation of LNM before surgery can inform improved decisions in the clinic. In this study, we aimed to construct a nomogram to predict LNM in primary supraglottic LSCC patients.

Methods

The data from 314 patients with clinico-pathological confirmed supraglottic LSCC who underwent partial or total laryngectomy in our department from 2016 to 2020 were retrospectively analyzed (243 cases in the training set and 71 cases in the validation set). A multivariate logistic regression model was used to screen out independent risk factors and a nomogram was established. The accuracy and discrimination ability of the nomogram was evaluated using a consistency index and calibration curves.

Results

Tumor size, tumor differentiation degree and LMR (lymphocyte-monocyte ratio) were selected to construct the nomogram. The C-index was 0.731 in the training set and 0.707 in the validation set. The calibration curves of the training and validation group both exhibited close agreement between the predicted and the actual presence of LNM.

Conclusions

A nomogram was established based on routinely measured pretreatment variables and the predicted results improved the management of patients with LNM.
Preliminary Clinical Application of RGD-Containing Peptides as PET Radiotracers for Imaging Tumors
Authors: Li Li , Chen Xiaoyuan , Yu Jinming , Yuan Shuanghu
Published: March 2022

Angiogenesis is a common feature of many physiological processes and pathological conditions. RGD-containing peptides can strongly bind to integrin αvβ3 expressed on endothelial cells in neovessels and several tumor cells with high specificity, making them promising molecular agents for imaging angiogenesis. Although studies of RGD-containing peptides combined with radionuclides, namely, 18F, 64Cu, and 68Ga for positron emission tomography (PET) imaging have shown high spatial resolution and accurate quantification of tracer uptake, only a few of these radiotracers have been successfully translated into clinical use. This review summarizes the RGD-based tracers in terms of accumulation in tumors and adjacent tissues, and comparison with traditional 18F-fluorodeoxyglucose (FDG) imaging. The value of RGD-based tracers for diagnosis, differential diagnosis, tumor subvolume delineation, and therapeutic response prediction is mainly discussed. Very low RGD accumulation, in contrast to high FDG metabolism, was found in normal brain tissue, indicating that RGD-based imaging provides an excellent tumor-to-background ratio for improved brain tumor imaging. However, the intensity of the RGD-based tracers is much higher than FDG in normal liver tissue, which could lead to underestimation of primary or metastatic lesions in liver. In multiple studies, RGD-based imaging successfully realized the diagnosis and differential diagnosis of solid tumors and also the prediction of chemoradiotherapy response, providing complementary rather than similar information relative to FDG imaging. Of most interest, baseline RGD uptake values can not only be used to predict the tumor efficacy of antiangiogenic therapy, but also to monitor the occurrence of adverse events in normal organs. This unique dual predictive value in antiangiogenic therapy may be better than that of FDG-based imaging.
Comparison Between Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) and Conventional Open Thyroidectomy for Patients Undergoing Total Thyroidectomy and Central Neck Dissection: A Propensity Score-Matching Analysis
Authors: Sun Haiqing , Wang Xiaojie , Zheng Guibin , Wu Guochang , Zeng Qingdong , Zheng Haitao
Published: March 2022

Background

Use of the novel transoral endoscopic thyroidectomy vestibular approach (TOETVA) is increasing worldwide. Although several studies have compared safety and efficacy of TOETVA and other approaches, most focused on comparisons in the context of unilateral thyroidectomy. Therefore, the present study aimed to compare the safety and surgical completeness of TOETVA with conventional open thyroidectomy (COT) in patients with papillary thyroid carcinoma (PTC) undergoing total thyroidectomy and central neck dissection.

Methods

The medical records of patients who underwent TOETVA or COT by a single surgeon between June 2017 and October 2021 were retrospectively reviewed. All patients were diagnosed with PTC and underwent total thyroidectomy with central neck dissection. Propensity score-matching (PSM) was used to reduce potential selection bias and to adjust for differences in baseline clinicopathological characteristics.

Results

After PSM, 84 (TOETVA: 28; COT: 56) patients remained in the study population. There were no significant differences in sex, mean age, combined thyroiditis, tumor size, capsule invasion, tumor multifocality in the same lobe, or tumor location between the groups. Operative time was longer (190.54 ± 28.26 vs. 123.93 ± 29.78 min, P<0.001), while postoperative drainage volume (161.07 ± 225.30 vs. 71.16 ± 28.56 ml, P=0.045) was greater, in the TOETVA group than in the COT group. The groups exhibited no significant differences in the mean number of central lymph nodes retrieved (9.39 ± 4.01 vs. 10.71 ± 5.17, P=0.202), mean number of metastatic central lymph nodes (1.36 ± 1.93 vs. 1.77 ± 2.31, P=0.421), postoperative mean thyroglobulin levels (0.08 ± 0.24 vs. 0.10 ± 0.27, P=0.686), rate of transient hypoparathyroidism (TOETVA: 67.9% vs. COT: 66.1%, P=0.870), rate of transient vocal cord palsy (TOETVA: 0% vs. COT: 1.8%, P=1.000), or other complications (TOETVA: 3.6% vs. COT: 0%, P=0.333).

Conclusions

TOETVA is a safe approach in select patients with PTC and exhibits similar efficacy to COT in terms of surgical completeness.
Case Report: Getting a Peek at the Angle of a Patient with Severe Keratoconus
Authors: Kawashima Rumi , Matsushita Kenji , Ohnuma Kazuhiko , Maeda Naoyuki , Koh Shizuka , Nishida Kohji
Published: March 2022

Visualization of the iridocorneal angle, which contains the aqueous humor circulatory system and controls intraocular pressure, is important for diagnosing and managing glaucoma; however, the presence of keratoconus, keratoglobus, or severe myopia may enable direct angle visualization without gonioscopy contact lenses or applying a coupling gel. We present the first report of a case in which the iridocorneal angle was viewed directly in an eye with keratoconus using the RetCam without applying gel to the cornea. This method overcame the inability to view the angle directly in a normal eye because of the total internal reflection.
Heart Involvement in Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children: The Retrospective Multicenter Cohort Data
Authors: Kostik Mikhail M. , Bregel Liudmila V. , Avrusin Ilia S. , Efremova Olesya S. , Belozerov Konstantin E. , Dondurei Elena A. , Kornishina Tatiana L. , Isupova Eugenia A. , Abramova Natalia N. , Felker Eugeniy Yu , Masalova Vera V. , Santimov Andrey V. , Kozlov Yuri A. , Barakin Alexander O. , Snegireva Ludmila S. , Konstantinova Julia , Vilnits Alla A. , Bekhtereva Maria K. , Argunova Vera M. , Matyunova Alla E. , Sleptsova Polina A. , Burtseva Tatyana E. , Shprakh Vladimir V. , Boyko Tatyana V. , Kalashnikova Olga V. , Chasnyk Vyacheslav G.
Published: March 2022

Objectives

Heart involvement in multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a new challenging problem, requiring fast and reliable diagnostics and appropriate treatment. The aim of this study is to describe heart involvement in patients with MIS-C.

Study Design

In this retrospective, multicenter cohort study, data of 122 patients were included. All patients met WHO and CDC criteria of MIS-C.

Results

Various types of heart involvement in MIS-C patients were observed. Patients with solely coronary artery lesions (CAL, n = 10, 8.2%) had typical features of Kawasaki disease: younger age, thrombocytosis and normal ferritin level, without giant CA aneurysms, thrombosis, myocardial infarction, shock, and ICU admission. Patients with solely myocardial involvement (MI, n = 30, 24.6%) had an older onset age, elevated ferritin, LDH, the highest D-dimer, H score, and thrombocytopenia level. The following clinical signs were associated with MI: gastrointestinal and central nervous system disorder, sore throat, swelling face, splenomegaly, shock, and treatment in the intensive care unit required. Patients with a combination of CAL and MI (n = 10, 8.2%) had symptoms similar to patients with solely MI, except for impressive thrombocytopenia. Shock and ICU admission were found in 34.7% of patients without heart involvement (n = 72, 59%). One major criterion [troponin > 32 pg/ml (52 points)] or at least two minor criteria [face swelling (32 points) and D-Dimer > 1,300 ng/ml (29 points)] were associated with MI (>32 points) with a sensitivity of 67.5% and a specificity of 88.9%.

Conclusion

The above-suggested criteria can be added to routine diagnostic procedures to confirm MI in MIS-C patients.
Pharmacometric Analysis of Intranasal and Intravenous Nalbuphine to Optimize Pain Management in Infants
Authors: Pfiffner Miriam , Berger-Olah Eva , Vonbach Priska , Pfister Marc , Gotta Verena
Published: March 2022

Objectives

The objective of this pharmacometric (PMX) study was to (i) characterize population pharmacokinetics (PPK) and exposure-pain response associations following intranasal (0.1 mg/kg) or intravenous (IV, 0.05 mg/kg) administration of nalbuphine, with the goal to (ii) evaluate strategies for optimized dosing and timing of painful interventions in infants 1–3 months old.

Methods

PPK analysis of nalbuphine serum concentrations, prospectively collected 15, 30, and between 120 and 180 min post-dose, utilizing the software package Monolix. The final PPK model was applied to derive individual time-matched concentration predictions for each pain assessment (Neonatal Infant Pain Score, NIPS) after establishment of venous access and urinary catheterization or lumbar puncture. Drug exposure-pain response simulations were performed to evaluate potential benefits of higher doses with respect to a previously proposed target concentration of 12 mcg/L (efficacy threshold).

Results

Thirty-eight of 52 study subjects receiving nalbuphine had at least one concentration measurement and were included in the pharmacometric analysis. A two-compartment model with allometric scaling was applied to describe population PK data, with intranasal bioavailability estimated to be 41% (95%CI: 26–56%). Model-based simulations showed that the proposed efficacy threshold (12 mcg/L) is expected to be exceeded with an IV dose of 0.05 mg/kg for 6 min, with 0.1 mg/kg for 30 min and with 0.2 mg/kg for 80 min. This efficacy threshold is not achieved with intranasal doses of 0.1 and 0.2 mg/kg, whereas an intranasal dose of 0.4 mg/kg is expected to exceed such threshold for 30 to 100 min.

Conclusion

This PMX study confirmed that bioavailability of intranasal nalbuphine is close to 50%. Exposure-pain response simulations indicated that an intranasal dose of 0.4 mg/kg is required to provide a comparable pain control as achieved with an IV dose of 0.1–0.2 mg/kg. The optimal time window for painful procedures appears to be within the first 30 min after IV administration of 0.1 mg/kg nalbuphine, whereas such procedures should be scheduled 30 min after an intranasal dose of 0.4 mg/kg nalbuphine. Additional clinical studies are warranted to confirm these PMX based recommendations and to further optimize pain management in this vulnerable infant population.
Docetaxel-Loaded Novel Nano-Platform for Synergistic Therapy of Non-Small Cell Lung Cancer
Authors: Feng Xing , Xiong Xiaoling , Ma Shenglin
Published: March 2022

Nowadays, non-small cell lung cancer (NSCLC) is threatening the health of all mankind. Although many progresses on treatment of lung cancer have been achieved in the past few decades, the current treatment methods are still traditional surgery, radiotherapy, and chemotherapy, which had poor selectivity and side effects. Lower-toxicity and more efficient treatments are in sore need. In this paper, a smart nanodelivery platform based on photothermal therapy, chemotherapy, and immunotherapy was constructed. The nanoparticles are composed of novel photothermal agents, Mn-modified phthalocyanine derivative (MnIIIPC), docetaxel (DTX), and an effective targeting molecule, hyaluronic acid. The nanoplatform could release Mn2+ from MnIIIPC@DTX@PLGA@Mn2+@HA(MDPMH) and probably activate tumor immunity through cGAS-STING and chemotherapy, respectively. Furthermore, DTX could be released in the process for removal of tumor cells. The “one-for-all” nanomaterial may shed some light on treating NSCLC in multiple methods.
Antidiabetic Activity of Elephant Grass (Cenchrus Purpureus (Schumach.) Morrone) via Activation of PI3K/AkT Signaling Pathway, Oxidative Stress Inhibition, and Apoptosis in Wistar Rats
Authors: Ojo Oluwafemi Adeleke , Oni Abosede Itunuoluwa , Grant Susan , Amanze Jennifer , Ojo Adebola Busola , Taiwo Odunayo Anthonia , Maimako Rotdelmwa Filibus , Evbuomwan Ikponmwosa Owen , Iyobhebhe Matthew , Nwonuma Charles Obiora , Osemwegie Omorefosa , Agboola Anthonia Oluyemi , Akintayo Christopher , Asogwa Nnaemeka Tobechukwu , Aljarba Nada H. , Alkahtani Saad , Mostafa-Hedeab Gomaa , Batiha Gaber El-Saber , Adeyemi Oluyomi Stephen
Published: March 2022

Ethnopharmacological Relevance: The management of diabetes over the years has involved the use of herbal plants, which are now attracting interest. We assessed the antidiabetic properties of aqueous extract of C. purpureus shoots (AECPS) and the mechanism of action on pancreatic ß-cell dysfunction.

Methods: This study was conducted using Thirty-six 36) male Wistar rats. The animals were divided into six equal groups (n = 6) and treatment was performed over 14 days. To induce diabetes in the rats, a single dose of 65 mg/kg body weight of alloxan was administered intraperitoneal along with 5% glucose. HPLC analysis was carried out to identified potential compounds in the extract. In vitro tests α-amylase, and α-glucosidase were analyzed. Body weight and fasting blood glucose (FBG) were measured. Biochemical parameters, such as serum insulin, liver glycogen, hexokinase, glucose-6-phosphate (G6P), fructose-1,6-bisphosphatase (F-1,6-BP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and nuclear factor kappa B (NF-ĸB), were analyzed. Additionally, mRNA expressions of phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT), B-cell lymphoma 2 (Bcl-2), and proliferating cell nuclear antigen (PCNA) were each evaluated.

Results: This in vitro study showed inhibitory potency of Cenchrus purpureus extract (AECPS) as compared with the positive controls. AECPS showed a gradual decrease in alloxan-induced increases in FBG, total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL-c), G6P, F-1,6-BP, malondialdehyde (MDA), IL-6, TNF-α, and NF-ĸB and increased alloxan-induced decreases in liver glycogen, hexokinase, and high density lipoprotein (HDL-c). The diabetic control group exhibited pancreatic dysfunction as evidenced by the reduction in serum insulin, homeostasis model assessment of ß-cell function (HOMA-β), expressions of PI3K/AKT, Bcl-2, and PCNA combined with an elevation in homeostatic model assessment of insulin resistance (HOMA-IR). High performance liquid chromatography (HPLC) revealed 3-O-rutinoside, ellagic acid, catechin, rutin, and kaempferol in AECPS.

Conclusion: AECPS showed efficient ameliorative actions against alloxan-induced pancreatic dysfunction, oxidative stress suppression as well as, inflammation, and apoptosis via the activation of PI3K/AKT signaling pathways.
Differentiate Responses of Soil Microbial Community and Enzyme Activities to Nitrogen and Phosphorus Addition Rates in an Alpine Meadow
Authors: Zi Hongbiao , Hu Lei , Wang Changting
Published: March 2022

Nitrogen (N) and phosphorus (P) are the dominant limiting nutrients in alpine meadows, but it is relatively unclear how they affect the soil microbial community and whether their effects are rate dependent. Here, N and P addition rates (0, 10, 20, and 30 g m–2 year–1) were evaluated in an alpine meadow and variables related to plants and soils were measured to determine the processes affecting soil microbial community and enzyme activities. Our results showed that soil microbial biomass, including bacteria, fungi, gramme-negative bacteria, and actinomycetes, decreased along with N addition rates, but they first decreased at low P addition rates (10 g m–2 year–1) and then significantly increased at high P addition rates (30 g m–2 year–1). Both the N and P addition stimulated soil invertase activity, while urease and phosphatase activities were inhibited at low N addition rate and then increased at high N addition rate. P addition generally inhibited peroxidase and urease activities, but increased phosphatase activity. N addition decreased soil pH and, thus, inhibited soil microbial microorganisms, while P addition effects were unimodal with addition rates, achieved through altering sedge, and available P in the soil. In conclusion, our studies indicated that soil microbial communities and enzyme activities are sensitive to short-term N and P addition and are also significantly influenced by their addition rates.
Changes in Cannabis Consumption During the Global COVID-19 Lockdown: The International COVISTRESS Study
Authors: Salles Juliette , Yrondi Antoine , Marhar Fouad , Andant Nicolas , Dorlhiac Raimundo Avilés , Quach Binh , Jiao Jiao , Antunes Samuel , Ugbolue Ukadike Chris , Guegan Julien , Rouffiac Karine , Pereira Bruno ,   The COVISTRESS Network
Published: March 2022

Introduction: COVID-19 lockdown measures have been sources of both potential stress and possible psychological and addiction complications. A lack of activity and isolation during lockdown are among the factors thought to be behind the growth in the use of psychoactive substances and worsening addictive behaviors. Previous studies on the pandemic have attested to an increase in alcohol consumption during lockdowns. Likewise, data suggest there has also been a rise in the use of cannabis, although it is unclear how this is affected by external factors. Our study used quantitative data collected from an international population to evaluate changes in cannabis consumption during the lockdown period between March and October, 2020. We also compared users and non-users of the drug in relation to: (1) socio-demographic differences, (2) emotional experiences, and (3) the information available and the degree of approval of lockdown measures.

Methods: An online self-report questionnaire concerning the lockdown was widely disseminated around the globe. Data was collected on sociodemographics and how the rules imposed had influenced the use of cannabis and concerns about health, the economic impact of the measures and the approach taken by government(s).

Results: One hundred eighty two respondents consumed cannabis before the lockdown vs. 199 thereafter. The mean cannabis consumption fell from 13 joints per week pre-lockdown to 9.75 after it (p < 0.001). Forty-nine respondents stopped using cannabis at all and 66 admitted to starting to do so. The cannabis users were: less satisfied with government measures; less worried about their health; more concerned about the impact of COVID-19 on the economy and their career; and more frightened of becoming infected in public areas. The risk factors for cannabis use were: age (OR = 0.96); concern for physical health (OR = 0.98); tobacco (OR = 1.1) and alcohol consumption during lockdown (OR = 1.1); the pre-lockdown anger level (OR = 1.01); and feelings of boredom during the restrictions (OR = 1.1).

Conclusion: In a specific sub-population, the COVID-19 lockdown brought about either an end to the consumption of cannabis or new use of the drug. The main risk factors for cannabis use were: a lower age, co-addictions and high levels of emotions.
Neuropsychological Symptom Identification and Classification in the Hospitalized COVID-19 Patients During the First Wave of the Pandemic in a Front-Line Spanish Tertiary Hospital
Authors: Molina Juan D. , Rodrigo Holgado Irene , Juanes González Alba , Combarro Ripoll Carolina Elisa , Lora Pablos David , Rubio Gabriel , Alonso Jordi , Rivas-Clemente Francisco P. J.
Published: March 2022

Studies specifically designed to determine the profile of psychiatric symptoms among COVID-19 patients are limited and based on case series, self-report questionnaires, and surveys. The objective of the study was to identify and classify the neuropsychological symptoms of hospitalized COVID-19 patients during the first wave of the pandemic in one of the most important front-line tertiary hospitals from Spain, and to analyze its correlation with diagnosed mental disorders, as well as to explore potential risk factors associated with mental health problems. This observational, cohort study involved data from COVID-19 patients at the University Hospital 12 de Octubre (Madrid, Spain) from February to May 2020. First, patients underwent a semistructured phone interview (screening phase), based on the Mini International Neuropsychiatric Interview (MINI). Then the confirmation of the diagnosis (confirmation phase) was performed in patients who reported a mental disorder development or worsening. A factorial analysis was performed to identify groups of symptoms. A tetrachoric matrix was created, and factorial analysis, by a principal component analysis, was employed upon it. Factors showing values >1.0 were selected, and a varimax rotation was applied to these factors. Symptoms most frequently identified in patients were anosmia/ageusia (54.6%), cognitive complaints (50.3%), worry/nervousness (43.8%), slowing down (36.2%), and sadness (35.4%). Four factors were identified after the screening phase. The first (“anxiety/depression”) and second (“executive dysfunction”) factors explained 45.4 and 11.5% of the variance, respectively. Women, age between 50 and 60 years, duration in the hospital (more than 13 days), and psychiatric history showed significant higher levels (number of symptoms) in the factors. This study reports the factor structure of the psychiatric symptoms developed by patients with a confirmed diagnosis of SARS-CoV2 during the first wave of the COVID-19. Three item domains (anxiety, depression, and posttraumatic stress disorder symptoms) were loaded together on one factor, whereas sleep disturbance stood up as a separate factor. Interestingly, the item anosmia/ageusia was not captured by any factor. In conclusion, an increase in neuropsychiatric morbidity is expected in the upcoming months and years. Therefore, screening for early symptoms is the first step to prevent mental health problems associated with this pandemic.
Causes and Consequences of Not Having a Personal Healthcare Provider Among American Indian Elders: A Mixed-Method Study
Authors: Jaramillo Elise Trott , Sommerfeld David H. , Haozous Emily A. , Brunner Amy , Willging Cathleen E.
Published: March 2022

Having a regular relationship with a healthcare provider contributes to better health outcomes and greater satisfaction with care for older adults. Although members of federally recognized American Indian tribes have a legal right to healthcare, American Indian Elders experience inequities in healthcare access that may compromise their ability to establish a relationship with a healthcare provider. This multi-year, community-driven, mixed-method study examines the potential causes and consequences of not having a personal healthcare provider among American Indian Elders. Quantitative surveys and qualitative interviews were conducted with 96 American Indian Elders (age 55 and over) in two states in the Southwestern United States. Quantitative and qualitative data were analyzed separately and then triangulated to identify convergences and divergences in data. Findings confirmed that having a consistent healthcare provider correlated significantly with self-rated measures of health, confidence in getting needed care, access to overall healthcare, and satisfaction with care. Lack of a regular healthcare provider was related to interconnected experiences of self-reliance, bureaucratic and contextual barriers to care, and sentiments of fear and mistrust based in previous interactions with medical care. Increasing health equity for American Indian Elders will thus require tailored outreach and system change efforts to increase continuity of care and provider longevity within health systems and build Elders' trust and confidence in healthcare providers.