bluuebunny/crossref_metadata_2025 huggingface dataset:
A postzygotic de novo NCDN mutation identified in a sporadic FTLD patient results in neurochondrin haploinsufficiency and altered FUS granule dynamics
Authors: Nicolas Gaël , Sévigny Myriam , Lecoquierre François , Marguet Florent , Deschênes Andréanne , del Pelaez Maria Carment , Feuillette Sébastien , Audebrand Anaïs , Lecourtois Magalie , Rousseau Stéphane , Richard Anne-Claire , Cassinari Kévin , Deramecourt Vincent , Duyckaerts Charles , Boland Anne , Deleuze Jean-François , Meyer Vincent , Clarimon Echavarria Jordi , Gelpi Ellen , Akiyama Haruhiko , Hasegawa Masato , Kawakami Ito , Wong Tsz H. , Van Rooij Jeroen G. J. , Van Swieten John C. , Campion Dominique , Dutchak Paul A. , Wallon David , Lavoie-Cardinal Flavie , Laquerrière Annie , Rovelet-Lecrux Anne , Sephton Chantelle F.
Published: February 2022

Frontotemporal dementia (FTD) is a heterogeneous clinical disorder characterized by progressive abnormalities in behavior, executive functions, personality, language and/or motricity. A neuropathological subtype of FTD, frontotemporal lobar degeneration (FTLD)-FET, is characterized by protein aggregates consisting of the RNA-binding protein fused in sarcoma (FUS). The cause of FTLD-FET is not well understood and there is a lack of genetic evidence to aid in the investigation of mechanisms of the disease. The goal of this study was to identify genetic variants contributing to FTLD-FET and to investigate their effects on FUS pathology. We performed whole-exome sequencing on a 50-year-old FTLD patient with ubiquitin and FUS-positive neuronal inclusions and unaffected parents, and identified a de novo postzygotic nonsense variant in the NCDN gene encoding Neurochondrin (NCDN), NM_014284.3:c.1206G > A, p.(Trp402*). The variant was associated with a ~ 31% reduction in full-length protein levels in the patient’s brain, suggesting that this mutation leads to NCDN haploinsufficiency. We examined the effects of NCDN haploinsufficiency on FUS and found that depleting primary cortical neurons of NCDN causes a reduction in the total number of FUS-positive cytoplasmic granules. Moreover, we found that these granules were significantly larger and more highly enriched with FUS. We then examined the effects of a loss of FUS function on NCDN in neurons and found that depleting cells of FUS leads to a decrease in NCDN protein and mRNA levels. Our study identifies the NCDN protein as a likely contributor of FTLD-FET pathophysiology. Moreover, we provide evidence for a negative feedback loop of toxicity between NCDN and FUS, where loss of NCDN alters FUS cytoplasmic dynamics, which in turn has an impact on NCDN expression.
Review of microplastic sources, transport pathways and correlations with other soil stressors: a journey from agricultural sites into the environment
Authors: Lwanga Esperanza Huerta , Beriot Nicolas , Corradini Fabio , Silva Vera , Yang Xiaomei , Baartman Jantiene , Rezaei Mahrooz , van Schaik Loes , Riksen Michel , Geissen Violette
Published: February 2022

This paper explores different interactions and processes involved in the transport of microplastics from agricultural systems to surrounding environments. We conducted an exhaustive review of the most recent scientific papers on microplastic transport in terrestrial systems, with an emphasis on agricultural systems. In the following sections, several aspects of this problem are discussed, namely (i) direct and indirect sources of microplastics, (ii) biotic and abiotic transportation of microplastics in and from the terrestrial environment, (iii) modelling of microplastics in the terrestrial environment and (iv) facilitated chemicals and pathogens in combination with plastic particles. There is very little information available concerning microplastic transport in the terrestrial environment; therefore, more research is needed to gain a better understanding of how these processes take place. The novelty of this review lies in assessing how microplastic transport occurs from the plastisphere (cellular) to the landscape level and from agricultural systems to the surrounding areas.

Graphical Abstract
Biocontrol of Fusarium root rot in squash using mycorrhizal fungi and antagonistic microorganisms
Authors: El-Sharkawy Eman E. S. , Abdelrazik Eman
Published: February 2022

Background

The study amid to investigate the influence ofTrichoderma album,T. harzianum, T.koningii,Bacillus subtilis(EF1) andPseudomonas fluorescensagainstFusarium solani, the causal agent of root rot in squash under in vitro conditions. Field experiment was conducted to evaluate the effects of arbuscular mycorrhizal fungii.e., (Glomus intraradices,G.monosporum,G.etunicatu,AMF) andT. harzianum(TZ) as well asB. subtilis(BS) either as individual or combined treatment againstFusariumroot rot of squash in two successive seasons of study 2020 and 2021 using New Eskandrani cultivar.

Results

Trichoderma harzianumcaused the greatest reduction in mycelial growth ofF. solani(75.17%), followed byT. albumandT.koningii. Amongst the tested 4 cultivars (Sakata, Galaxy, New Eskandrani H1 hybird, Hollr Queen F1 hybrid) in glasshouse, Hollr Queen was the most resistant to the infection ofF. solaniwith survival rate (84.92%), whereas New Eskandrani c.v was the most susceptible. Results of filed experiments proved that the combined inoculation of AMF + TZ + BS, AMF + BS, AMF + TZ, TZ + BS resulted in significant elevation of total chlorophyll, carotenoids, free phenolic compounds, free amino acids, total protein as well as the antioxidative enzyme activities (i.e.Superoxide dismutase, Peroxidase and Polyphenol-oxidase) and contents of macro and micro elements. Results further showed that the combined treatments caused a significant decrease in disease severity in both seasons with subsequent significant increase of plant growth parameters as well as total fruit yield/plant and total fruit yield/feddan.

Conclusion

It could be concluded that the combined inoculations of the tested bioagents proved to have potentials in control ofFusariumroot rot but large scale field experiments should be conducted before any ultimate conclusion or recommendation was drawn.
Optical coherence tomography in patients with Parkinson’s disease
Authors: El-Kattan Manal Mahmoud , Esmat Soheir Mohammed , Esmail Eman Hasan , Deraz Heba Assem , Ismail Rania Shehata
Published: February 2022

Background

The changes in the different retinal layers in Parkinson’s disease (PD) patients can be easily assessed using optical coherence tomography (OCT). Our aim was to evaluate retinal structural changes in patients with PD using OCT. Structural measurements of the retinal nerve fiber layer (RNFL), macular and ganglion cell complex (GCC) thicknesses were obtained using spectral domain optical coherence tomography. Disease severity was assessed using Unified Parkinson Disease Rating Scale (UPDRS).

Results

Retinal nerve fiber layer parameters, except for the superonasal and inferonasal quadrants, were significantly reduced in PD patients compared to controls. All macular parameters and GCC thickness were also reduced in PD patients compared to controls. Hoehn and Yahr (HY) staging was inversely correlated with all macular parameters, GCC and temporal RNFL thicknesses. UPDRS score showed a significant negative correlation with macular volume, inferior and nasal parafoveal thicknesses, nasal and temporal RNFL thicknesses and GCC thickness. The disease duration was inversely correlated with macular volume, inferior and temporal parafoveal thicknesses and GCC thickness. Using the multivariate linear regression analysis, the HY scale was a significant predictor for both the average GCC thickness and the macular volume. The sensitivity and specificity of average GCC thickness and macular volume to detect disease severity were 58.8%, 86.7%, 64.7% and 86.7%, respectively.

Conclusion

Parkinson’s disease causes axonal damage in the RNFL along with retinal thinning that can be detected using SD-OCT. Patients with greater axonal damage tend to have longer duration of the disease and more severe PD symptoms.
The role of genetic mutation in alcoholic liver disease
Authors: Balakrishnan Ranjith , Mohammed Vajagathali , Veerabathiran Ramakrishnan
Published: February 2022

Background

Alcoholic liver disease (ALD) is the world’s most common type of liver disease caused due to overconsumption of alcohol. The liver supports the best level of tissue damage by hefty drinking since it is the binding site of ethanol digestion. This disease can progress to alcoholic steatohepatitis from alcoholic fatty liver, which implies steatosis has become the most punctual reaction to hefty drinking and is portrayed by the deposition of fat hepatocytes. In addition, steatosis can advance to steatohepatitis, a more extreme, provocative sort of liver damage described by hepatic inflammation. Constant and unnecessary liquor utilization delivers a wide range of hepatic sores, fibrosis and cirrhosis, and sometimes hepatocellular carcinoma. Most people consuming > 40 g of liquor each day create alcoholic fatty liver (AFL); notwithstanding, just a subset of people will grow further developed infection. Hereditary, epigenetic, and non-hereditary components may clarify the impressive interindividual variety in the ALD phenotype.

Main body

This systematic review is to classify new candidate genes associated with alcoholic liver disorders, such as RASGRF2, ALDH2, NFE2L2, ADH1B, PNPLA3, DRD2, MTHFR, TM6SF2, IL1B, and CYP2E1, MBOAT7 as well as to revise the functions of each gene in its polymorphic sequence. The information obtained from the previously published articles revealed the crucial relationship between the genes and ALD and discussed each selected gene’s mechanism.

Conclusion

The aim of this review is to highlight the candidate genes associated with the ALD, and the evidence of this study is to deliberate the part of genetic alterations and modifications that can serve as an excellent biological maker, risk predictors, and therapeutic targets for this disease.
Important alien and potential native invasive insect pests of key fruit trees in Sub-Saharan Africa: advances in sustainable pre- and post-harvest management approaches
Authors: Ndlela Shepard , Niassy Saliou , Mohamed Samira A.
Published: February 2022

Fruit production in Sub-Saharan Africa is of paramount importance both socially and economically. Millions of farmers derive livelihoods from mango, avocado, citrus, cashew, and coconut farming, but native and alien invasive species constrain production The region’s capacity to contain invasives is weak due to the absence of national and institutional support systems for early detection, containment, eradication, or management of the pests. Climate change is expected to play a huge role in the influx of more alien invasive species and the shift of ecological requirements of some native species. Though a fair share of pre-and post-management pest management techniques for several insect pests has been developed, adoption and adaptation of the options are limited. Data on economic and social implications are largely lacking, making it challenging to implement informed policy decisions. The existence of the “Strategy for Managing Invasive Species in Africa 2021–2030” promises a paradigm shift in the management of invasives, from reactive thinking to coordinated proactive approaches. The uncoordinated deployment of management measures in the region and the lack of funding, play a negative role in managing the pests effectively. Prospects for enhanced future research are wide, and efforts are currently being channeled to Area-Wide-Integrated Pest Management in a bottom-up approach with stakeholders owning the process. Participatory development of technologies is also taking centre stage, paving the way for increased adoption and adaptation. Postharvest technologies promise to provide the adequate phytosanitary assurance required by countries importing fruit from Sub-Saharan Africa.
Recommendations for analgesia and sedation in critically ill children admitted to intensive care unit
Authors: Amigoni Angela , Conti Giorgio , Conio Alessandra , Corno Manuela , Fazio Paola Claudia , Ferrero Federica , Gentili Marta , Giugni Cristina , L’Erario Manuela , Masola Maristella , Moliterni Paola , Pagano Giuseppe , Ricci Zaccaria , Romagnoli Stefano , Vasile Beatrice , Vitale Francesca , Marinosci Geremia Zito , Mondardini Maria Cristina
Published: February 2022

We aim to develop evidence-based recommendations for intensivists caring for children admitted to intensive care units and requiring analgesia and sedation. A panel of national paediatric intensivists expert in the field of analgesia and sedation and other specialists (a paediatrician, a neuropsychiatrist, a psychologist, a neurologist, a pharmacologist, an anaesthesiologist, two critical care nurses, a methodologist) started in 2018, a 2-year process. Three meetings and one electronic-based discussion were dedicated to the development of the recommendations (presentation of the project, selection of research questions, overview of text related to the research questions, discussion of recommendations). A telematic anonymous consultation was adopted to reach the final agreement on recommendations. A formal conflict-of-interest declaration was obtained from all the authors. Eight areas of direct interest and one additional topic were considered to identify the best available evidence and to develop the recommendations using the Evidence-to-Decision framework according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. For each recommendation, the level of evidence, the strength of the recommendation, the benefits, the harms and the risks, the benefit/harm balance, the intentional vagueness, the values judgement, the exclusions, the difference of the opinions, the knowledge gaps, and the research opportunities were reported. The panel produced 17 recommendations. Nine were evaluated as strong, 3 as moderate, and 5 as weak. Conclusion: a panel of national experts achieved consensus regarding recommendations for the best care in terms of analgesia and sedation in critically ill children.
Lymphoedema and cancer: an overview
Authors: Bott Trevor
Published: February 2022

Secondary lymphoedema is a common concern for people with cancer. Trevor Bott, Clinical Trials Database Nurse, Cancer Research UK ( Trevor.Bott@cancer.org.uk ) discusses the links and its impact on quality of life
Developing pre-registration nurses' resilience to mass casualty situations through the pedagogy of simulation
Authors: Morgan Sara , Jones Bridie
Published: February 2022

Simulation has become a core component of nursing curricular worldwide. Within a three-year, pre-registration degree typically students would not be exposed to disaster type situations and it was believed that a well-coordinated simulation exercise could replicate this. It was hoped that the simulation would require students to think quickly on their feet and transfer acquired skills. Worldwide disasters including the current novel coronavirus have, heightened the need for well-prepared resilient health professionals capable of responding to many different types of emergencies including mass casualty situations. The simulated event involved 80 adult field student nurses, 19 probationer police officers, 6 photojournalism students, 2 Welsh Ambulance paramedics, 5 staff from 203 Field Hospital, 2 St John Cymru Wales Officers, 1 community first responder and 6 Fire and Rescue personnel. All these individuals came together to undertake a simulated emergency response to a mass casualty incident. Behaviours and clinical skills were observed throughout the event along with interprofessional interactions
Evaluating a psychological support service focused on the needs of critical care and theatres staff in the first wave of COVID-19
Authors: Herron Katie , Lonergan Grainne , Travis Susan , Rowan Patricia , Hutton Jane , Kelly Laura , Jordan Declan , Beattie Jane , Hampshire Peter , McCarthy Julia , Ryan Sue , Tsang Hoo Kee
Published: February 2022

Background:

In response to COVID-19, the authors used clinical psychology resources from their hospital's Pain Medicine Department to provide direct support to critical areas.

Aims:

The degree to which the service met the needs of staff and managers between March and August 2020 was evaluated.

Methods:

A total of 51 staff were referred. Most were nurses (43%), followed by theatre practitioners (36%), healthcare assistants (9%), consultants (8%), administrative (2%) and support staff (2%). Working status, reason for referral and presenting difficulties at first appointment and outcome were recorded. Staff were sent an anonymous survey following intervention.

Findings:

Staff reported high rates of burnout, anxiety and low mood, with 22% experiencing exacerbation of pre-existing mental health problems. All staff reported benefit from the intervention and managers provided positive feedback.

Conclusion:

Establishing a supportive service that included psychology benefited both staff and managers at the peak of the pandemic. Recommendations are provided.
Introducing nurse prescribing in Gibraltar: the impact on palliative care
Authors: Santos-Willshere Jamesina , Pizarro Nicole
Published: February 2022

This article critically explores the impact of the introduction of nurse prescribing on palliative care in Gibraltar. A preliminary audit review of the prescriptions issued by the two palliative independent nurse prescribers over their first full calendar year of prescribing (2020) revealed two primary areas of impact: facilitating end-of-life care at home and improving anticipatory prescribing for end-of-life symptom management. These initial findings will be discussed in the context of the challenges and facilitators encountered during the first year of prescribing practice. Challenges were primarily related to the introduction of an advanced nursing role into an existing medical paradigm. Identified facilitators included comprehensive record keeping, collaborative working and the development of local guidelines, as well as the support of management and peers. The article concludes with a recommendation for further audits of prescribing data as a way to measure the impact of the new role and to inform future palliative service development.
The clinical negligence system reform debate is heating up
Authors: Tingle John
Published: February 2022

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent developments on moves to reform our tort-based clinical negligence compensation system
Understanding those ‘future nurses’
Authors: Foster Sam
Published: February 2022

Sam Foster, Chief Nurse, Oxford University Hospitals, looks at the findings of a new report from UCAS and Health Education England into the mindset of the 2021 applicants to study nursing
Antimicrobial stewardship: wound treatment challenges
Authors: Fronzo Camila
Published: February 2022

The issues with silver resistance and the effectiveness of using DACC-coated dressings in wound treatment were discussed at an Essity-sponsored symposium. Camila Fronzo noted the key points presented by three speakers at the EWMA and Journées Cicatrisations conference 2021

This conference report presents an overview of the symposium ‘Being smart about wound infection: evaluating and treating wounds in the era of antimicrobial stewardship’, held in October 2021 as part of the joint European Wound Management Association (EWMA) and Journées Cicatrisations virtual conference. The first speaker, Hadar Lev-Tov, talked about the rising problem of silver resistance in wound care, and presented published data that show a general bacterial resistance against silver dressings. The next speaker, Cornelia Wiegand, explained the antimicrobial activity in Cutimed Sorbact dressings (Essity) against five top World Health Organization (WHO)-relevant pathogens, for which new antibiotics are urgently needed. The third and final speaker, Ewa Klara Stürmer, presented six case studies showing the use of Cutimed Sorbact to control bacteria and biofilm on hard-to-heal (a term which has replaced ‘chronic’) leg ulcers. These demonstrated the effectiveness of Sorbact when managing such wounds.
Skin tears: introducing best practice
Authors: Fronzo Camila
Published: February 2022

In an Essity-sponsored symposium, three key opinion leaders discussed the importance of developing, sharing and applying best practice in skin tear management. Camila Fronzo summarises the key points presented at the EWMA and Journées Cicatrisations conference 2021

This conference report offers an introduction to the symposium ‘Skin integrity: introducing best practice in skin tears’, held in October as part of the joint European Wound Management Association (EWMA) and Journées Cicatrisations virtual conference 2021. The first speaker, Karen Campbell, listed the individual and mediating factors that could affect skin tear development. She then summarised the three types of skin tears, and mentioned the dos and don'ts when treating these wounds. The next speaker, Wendy White, highlighted the importance of creating awareness, changing perceptions and implementing change around skin tear management. She shared the results on staff education from a recent quality improvement project, aimed at improving skin integrity and reducing skin tears in an aged care facility in Western Australia. The third and final speaker, Sitthichai Rees, presented further findings from the same project, focusing on the effects on skin tear incidence. His call to action can be followed by any health professional managing skin tears.
Medial plantar artery-based perforator and island flaps: a case series of applications in sole defects
Authors: Haq Ansarul , Singh Veena , Sharma Sarsij
Published: February 2022

Background:

Soft tissue defects of the plantar foot pose a challenge to the reconstructive surgeon. The plantar region of the foot has a unique skin structure, which helps in its paramount functions of weight-bearing and providing protective sensation. It is best replaced with tissue of its own kind. The medial plantar artery (MPA) flap fulfils all the requirements of an ideal replacement for small-to-medium-sized defects in the mid plantar and heel region. This study describes our experience with MPA-based flaps for small-to-medium-sized defects of the plantar foot.

Method:

The study was conducted in a tertiary referral hospital between April 2017 and March 2020 on patients who presented with defects on the mid plantar region and heel. MPA perforator (MPAP) flap or island flap were applied. The donor site was covered with split-thickness skin grafts.

Results:

The study included 21 patients. MPAP flap was applied in nine patients and the island flap was applied in 12 patients. The mean age of the patients was 37.95 years and the mean flap size was 36.6cm2. All flaps survived well. In two patients, venous congestion developed which resolved spontaneously, while three patients had small graft loss which also healed with conservative treatment. All patients regained protective sensation within five months of flap coverage.

Conclusion:

Based on the MPA, both perforator and island flaps can be raised due to the fairly constant position of the perforators. These flaps have the advantage of robust vascularity with the replacement of identical tissue for weight-bearing functions along with acceptable aesthetic outcomes. Since they also have the added advantage of conferring sensation, they can be used as a primary option in cases of small-to-medium-sized plantar foot defects.
Superabsorbent charcoal dressing versus silver foam dressing in wound area reduction: a randomised controlled trial
Authors: Probst Sebastian , Saini Camille , Rosset Chantal , Skinner Monika Buehrer
Published: February 2022

Aim:

This study aimed to compare the effect of a novel sterile polyacrylate wound pad with activated carbon cloth treatment with a standard non-adhesive hydrocellular foam dressing with silver in reducing wound area.

Method:

A multicentre randomised controlled open-label wound-dressing trial was conducted in two wound care outpatient clinics in western Switzerland from November 2018 to March 2020.

Results:

A total of 77 successive patients were randomised to receive either a sterile polyacrylate wound pad with activated carbon cloth treatment (n=38) or the standard non-adhesive hydrocellular foam dressing with silver (n=39). Reduction in wound area was the primary outcome, whereas the application period of the dressing, odour, maceration and pain were the secondary outcomes. Wound area was measured at baseline and during each wound dressing change until the dressings were no longer indicated. Wound area reduced faster in the intervention group than in the control group (0.45cm2 per day vs. 0.2cm2 per day), although the application period was longer in the intervention group compared with the control group (9.5 days vs. 8.1 days). Maceration reduction was more pronounced in the intervention group (-2.07cm2) than in the control group (-0.71cm2). Odour, pain and infection were similar in both groups.

Conclusion:

Sterile polyacrylate wound pad dressings with activated carbon cloth reduced the wound area, as well as the maceration area, faster than the non-adhesive hydrocellular foam dressing with silver.
Cost and clinical effectiveness of aggressive surgical debridement and delayed primary closure of infected cardiac surgical wounds
Authors: Yousafzai Sajjad Mohammad , Ugurlucan Murat , Awan Abid , Canver Charles C
Published: February 2022

Objective:

Postoperative wound infection in cardiac surgery remains a subject of significant concern due to associated morbidity, prolonged hospital stay and rise in treatment cost. A conservative management approach to postoperative wound infection with topical dressings and healing by secondary intention is not cost-effective and cosmetic results are less acceptable. We developed our institutional protocol for the treatment of infected postoperative cardiac surgical wounds to reduce hospital stay and improve cosmetic outcome. This study aims to compare our institutional protocol with the conservative management approach.

Methods:

Adult patients with postoperative superficial or deep sternal and/or leg wound infection were divided into two equal-sized groups and data collected from medical records. Group A was treated according to our institutional protocol of aggressive surgical debridement and delayed primary closure. Group B was treated according to conservative management with topical antiseptic wound dressings and healing by secondary intention. Data were analysed in retrospect with comparative statistics.

Results:

A total of 30 patients took part in the study. Group A (n=15, seven male, eight female) had a mean age of 55.34±12.84 years. Group B (n=15, eight male, seven female) had a mean age of 56.46±10.21 years. Mean length of hospital stay in Group A and Group B was 5.13±2.06 and 36.67±22.28 days, respectively (p<0.0001). Calculated mean hospital costs were 16,271.61±6815.50 Saudi Riyals (approximately equivalent to $4330±700 USD) in Group A and 116,212.2±26,311 Saudi Riyals (approximately equivalent to $30,932±1813 USD) in Group B (p<0.05). Patients in Group A had linear scars comparable with primary postoperative wound scars, whereas patients in Group B had excessive non-linear scarring.

Conclusion:

In this study, cost and clinical effectiveness of aggressive surgical debridement and delayed primary closure was superior to conservative management with topical antiseptic wound dressings and healing by secondary intention in terms of a shorter hospital stay and better cosmetic outcome.
Pressure injuries in surgical patients: a comparison of Norton, Braden and Waterlow risk assessment scales
Authors: Gurkan Aysel , Kirtil Inci , Aydin Yesim Dikmen , Kutuk Gamzegul
Published: February 2022

Objective:

This study aims to determine the predictive power of the Norton, Braden and Waterlow scales in determining risk of pressure injury (PI) in surgical patients.

Method:

This prospective study was carried out in the surgery clinic of a training and research hospital in Istanbul, Turkey between January and April 2017. The study sample consisted of adult patients aged ≥18 years and who did not have PI on admission to the clinic, had abdominal surgery under general anaesthesia and who stayed in the clinic for at least 48 hours. The data were collected using the Turkish versions of the Norton, Braden and Waterlow risk assessment scales. The predictive validity of PI risk assessment tools was assessed based on their sensitivity, specificity, positive and negative predictive values and the area under the receiver operating characteristic (ROC) curve. Predictive capacity was measured as relative risk (RR) with 95% confidence intervals (CI).

Results:

The study sample included 250 patients, and the incidence of PI was 12%. The sensitivity, specificity, positive predictive value and negative predictive value were: 83.3%, 45.4%, 17.2% and 95.2%, respectively, for the Norton scale (a cut-off point of 14); 100%, 40.4%, 18.6% and 100%, respectively, for the Braden scale (a cut-off point of 16); and 100%, 48.1%, 20.8% and 100%, respectively, for the Waterlow scale (a cut-off point of 10). The areas under the ROC curve were 0.749 for the Norton, 0.771 for the Braden and 0.971 for the Waterlow scales. This study's findings produced the following predictive capacity indicators: Norton (RR=3.62; 95%CI=1.43–9.14), Braden (RR=33.88; 95%CI=2.09–547.66); and Waterlow (RR=45.01; 95%CI=2.78–727.97).

Conclusion:

In this study, the Waterlow scale demonstrated the best values of predictive validity among the three scales in the assessment of PI risk. However, all three scales had low specificity despite high sensitivity in terms of a good risk prediction. No definitive decision could be reached on the predictive capacities of the scales because of wide CIs.
Scar formation from the perspective of complexity science: a new look at the biological system as a whole
Authors: Korkmaz H Ibrahim , Niessen Frank B , Pijpe Anouk , Sheraton Vivek M , Vermolen Fred J , Krijnen Paul AJ , Niessen Hans WM , Sloot Peter MA , Middelkoop Esther , Gibbs Susan , van Zuijlen Paul PM
Published: February 2022

A burn wound is a complex systemic disease at multiple levels. Current knowledge of scar formation after burn injury has come from traditional biological and clinical studies. These are normally focused on just a small part of the entire process, which has limited our ability to sufficiently understand the underlying mechanisms and to predict systems behaviour. Scar formation after burn injury is a result of a complex biological system—wound healing. It is a part of a larger whole. In this self-organising system, many components form networks of interactions with each other. These networks of interactions are typically non-linear and change their states dynamically, responding to the environment and showing emergent long-term behaviour. How molecular and cellular data relate to clinical phenomena, especially regarding effective therapies of burn wounds to achieve minimal scarring, is difficult to unravel and comprehend. Complexity science can help bridge this gap by integrating small parts into a larger whole, such that relevant biological mechanisms and data are combined in a computational model to better understand the complexity of the entire biological system. A better understanding of the complex biological system of post-burn scar formation could bring research and treatment regimens to the next level. The aim of this review/position paper is to create more awareness of complexity in scar formation after burn injury by describing the basic principles of complexity science and its potential for burn care professionals.
Cost-effectiveness of dehydrated human amnion/chorion membrane allografts in lower extremity diabetic ulcer treatment
Authors: Tettelbach William H , Armstrong David G , Chang Thomas J , Jong Julie L De , Glat Paul M , Hsu Jeffrey H , Kelso Martha R , Niezgoda Jeffrey A , Labovitz Jonathan M , Hubbs Brandon , Forsyth R Allyn , Cohen Benjamin G , Reid Natalie M , Padula William V
Published: February 2022

Objective:

To evaluate the cost-effectiveness and budget impact of using standard care (no advanced treatment, NAT) compared with an advanced treatment (AT), dehydrated human amnion/chorion membrane (DHACM), when following parameters for use (FPFU) in treating lower extremity diabetic ulcers (LEDUs).

Method:

We analysed a retrospective cohort of Medicare patients (2015–2019) to generate four propensity-matched cohorts of LEDU episodes. Outcomes for DHACM and NAT, such as amputations, and healthcare utilisation were tracked from claims codes, analysed and used to build a hybrid economic model, combining a one-year decision tree and a four-year Markov model. The budget impact was evaluated in the difference in per member per month spending following completion of the decision tree. Likewise, the cost-effectiveness was analysed before and after the Markov model at a willingness to pay (WTP) threshold of $100,000 per quality adjusted life year (QALY). The analysis was conducted from the healthcare sector perspective.

Results:

There were 10,900,127 patients with a diagnosis of diabetes, of whom 1,213,614 had an LEDU. Propensity-matched Group 1 was generated from the 19,910 episodes that received AT. Only 9.2% of episodes were FPFU and DHACM was identified as the most widely used AT product among Medicare episodes. Propensity-matched Group 4 was limited by the 590 episodes that used DHACM FPFU. Episodes treated with DHACM FPFU had statistically fewer amputations and healthcare utilisation. In year one, DHACM FPFU provided an additional 0.013 QALYs, while saving $3,670 per patient. At a WTP of $100,000 per QALY, the five-year net monetary benefit was $5003.

Conclusion:

The findings of this study showed that DHACM FPFU reduced costs and improved clinical benefits compared with NAT for LEDU Medicare patients. DHACM FPFU provided better clinical outcomes than NAT by reducing major amputations, ED visits, inpatient admissions and readmissions. These clinical gains were achieved at a lower cost, in years 1–5, and were likely to be cost-effective at any WTP threshold. Adoption of best practices identified in this retrospective analysis is expected to generate clinically significant decreases in amputations and hospital utilisation while saving money.
Over-the-counter statins
Authors: Winter George
Published: February 2022

After the UK became the first country to make an over-the-counter statin available in 2004, George Winter delves into whether this precedent should be continued, and the various ongoing debates surrounding statin sales
Acalabrutinib in the management of chronic lymphocytic leukaemia
Authors: Dowling Maura , Kelly Mary B
Published: February 2022

Chronic lymphocytic leukaemia (CLL) is the most common leukaemia worldwide. This article explores the management of CLL with a particular focus on the role of acalabrutinib in managing patients with CLL under NICE guidelines. Acalabrutinib is a potent bruton tyrosine kinase (BTK) inhibitor. Its use requires careful assessment, monitoring and early intervention to minimise side effects and maintain patients on treatment. Continuity of patient care and promotion of adherence and compliance is essential, particularly in light of the indefinite treatment duration. Patient education is central to therapeutic adherence of oral anti-cancer drugs, and nurses are ideally positioned to educate and support patients with CLL in collaboration with pharmacy colleagues. The benefits of nurse/pharmacy-led oral therapy clinics include continuity of care, consistency in information provision, efficient use of time with patients and carers, improved therapeutic relationships and an enhanced patient experience.
A model of tax evasion and taxpayers’ perception about public goods provision
Authors: D’Agostino Elena , De Benedetto Marco Alberto , Sobbrio Giuseppe
Published: February 2022

We analyse the impact of public spending on tax evasion using a two-period model in which the government and taxpayers make their decisions in terms of level and quality of expenditures to set and taxes to pay. Results predict that tax evasion increases with government inefficiency.
Unexpected hyperechoic lesions of the breast and their correlations with pathology: a pictorial essay
Authors: Park Seo Young , Park Jee Young , Park Ji Won , Kim Won Hwa , Park Ji Young , Kim Hye Jung
Published: February 2022

Hyperechoic lesions of the breast encompass a wide range of conditions that are occasionally encountered during breast ultrasonography. Although typical hyperechoic lesions with a distinct fat component on imaging are well known, some hyperechoic lesions are diagnosed as unexpected pathology, making the radiology-pathology correlation difficult. Therefore, understanding the pathology of these lesions and how it correlates with imaging findings can help radiologists accurately diagnose and properly manage a range of related conditions. This article presents a pictorial review of unexpected hyperechoic benign and malignant breast lesions, with a focus on the pathological conditions that give rise to the hyperechoic pattern.
Numerical Study of The Effect of Penstock Dimensions on a Micro-hydro System using a Computational Fluid Dynamics Approach
Authors: Putra Yoga Satria , Noviani Evi , Muhardi Muhardi
Published: February 2022

The performance of a micro-hydro system needs always to be improved so that the electrical power produced can be more optimal. This article aims to study numerically the effect of penstock dimensions on the potential of electrical energy in a micro-hydro system using a computational fluid dynamics (CFD) approach. The study of the effect of dimensions on the performance of a hydropower system is still quite rare. In this paper, the impact of dimensions on the micro-hydro system has been analysed by constructing thirty simulations of water flow in the penstock consisting of five variations of penstock slope ( and ) for six penstock diameter variations (  m,  m,  m,  m,  m, and  m). The simulation was built using the open-source CFD software OpenFOAM which applies the finite volume method to solve the Navier-Stokes equation as a flow model. The simulated water velocity profile is then validated against the velocity profile of the analytical solution (power-law) for turbulent flow in the pipe. Energy loss analysis on the penstock has been carried out to determine the cause of the energy loss in the penstock characterised by loss coefficient . An enormous  value will impact the decrease in the electric power potential of a micro-hydro system. The total length of the penstock  induces the variation of the   which affects the changes in the electrical power of the micro-hydro system. The shorter  will increase the electric power potential of a micro-hydro system. With a high flow velocity of water in the penstock (  m/s), the electric power increases linearly with increasing the diameter value of the penstock. The analysis results show that the penstock dimensions can affect the changes in the electric power of the micro-hydro system. In addition, the work presented in this article has shown that the CFD approach can be used as a low-cost initial step in building an actual micro-hydro system
Runoff Coefficient Analysis After Regional Development in Tambakbayan Watershed, Yogyakarta, Indonesia
Authors: Suprayogi Slamet , Widyastuti M , Hadi M Pramono , Christanto Nugroho , Tivianton Tommy Andryan , Fadhilah Gita Oktaviani , Rahmawati Laelina , Fadlillah Lintang Nur
Published: February 2022

The Tambakbayan Watershed has experienced changes in its land utilization. Based on land-use data from 2006 and 2017, built-up land was found to have encroached on vegetated areas and showed a substantial increase in area. Such conversion can alter and modify runoff coefficients, as a measure of watershed response. This research aimed to evaluate land-use change in the watershed from 2006 through 2017 and its effects on runoff coefficients. It used descriptive quantitative methods combining literature study and data calculation. The secondary data were obtained from digital land-use maps (RBI) in 2006 and 2017, SRTM images, soil types, and the drainage network of the watershed. Runoff coefficient analysis confirmed that the land-use change between 2006 and 2017 caused by regional development increased the runoff coefficients of the watershed observed.ABSTRAKDaerah Aliran Sungai Tambakbayan telah terjadi perubahan, berdasarkan data penggunaan lahan tahun 2006 dan tahun 2017. Perubahan yang terjadi berupa meningkatnya lahan terbangun dan berkurangnya lahan bervegetasi. Perubahan penggunaan lahan yang terjadi dapat mengakibatkan perubahan respon DAS yang dikuantifikasikan dalam bentuk koefisien aliran. Tujuan penelitian adalah mengevaluasi perubahan penggunaan lahan daerah penelitian dari tahun 2006 dan 2017, kaitannya dengan koefisien aliran. Metode yang digunakan adalah deskriptif kuantitatif berdasarkan studi pustaka dan perhitungan. Data sekunder yang digunakan adalah Peta Rupa Bumi Digital Indonesia Tahun 2006 dan 2017, Citra SRTM DAS Tambakbayan, Jenis Tanah DAS Tambakbayan, dan Jaringan Drainase DAS Tambakbayan. Perubahan penggunaan lahan akibat perkembangan wilayah, mengakibatkan peningkatan koefisien aliran pada tahun 2017 apabila dibandingkan dengan koefisien aliran pada tahun 2006.
Adverse effects of the toxic industrial dye malachite green on the antioxidant and antimicrobial properties of Allium cepa L.
Authors: Biswas Shreya , Banerjee Nisha , Basak Piyali
Published: February 2022

The therapeutic importance of Allium cepa L. has been well established through ethnobotanical studies. Malachite Green is a highly toxic dye that finds extensive use in the textile industry as a fabric colorant. A. cepa was treated with malachite green solutions (20mg/l and 40mg/l) for 45 days. The roots actively take up malachite green and impede the plant's growth in root length, shoot length and fresh weight. A. cepa is rich in bioactive compounds, which have superior antioxidant and antimicrobial properties. We observe that the antimicrobial activities decrease by 36% for Staphylococcus aureus and 31% for Escherichia coli on the treatment of A. cepa bulbs with 40 mg/l malachite green. Antioxidant activity was similarly lowered by 61% under the toxic effects of the dye. Reduction in the efficacy of A. cepa in terms of the critical medicinal properties and general retardation in growth is a cause of concern. This article reports a previously unknown aspect of malachite green toxicity and presents the effect of any dye on the medicinal properties of A. cepa for the first time.
The Rising Electoral Role of Polarization & Implications for Policymaking in the United States Senate: Assessing the Consequences of Polarization in the Senate from 1914–2020
Authors: Algara Carlos , Johnston Savannah
Published: February 2022

The dramatic Democratic victories in the 2021 Georgia U.S. Senate runoffs handed Democrats their first majority since 2015 and, with this, unified Democratic control of Washington for the first time since 2011. While Democratic Leaders and President Joe Biden crafted their agenda, any hope of policy passage rested on complete unity in a 50–50 Senate and a narrow majority in the U.S. House. Against this backdrop, the 117th Senate is the most polarized since direct-election began in 1914 and, by popular accounts, the least deliberative in a generation. In this article, we examine the implications of partisan polarization for policymaking in the U.S. Senate throughout the direct-election era. First, we show that greater polarization coincides with more partisan Senate election outcomes, congruent with recent trends in the House. Today, over 90% of Senators represent states carried by their party’s presidential nominee. Secondly, we show that polarization coincides with higher levels of observable obstruction, conflict, partisan unity, and narrower majorities. Lastly, we show that this polarization coincides with lower levels of deliberation in the form of consideration of floor amendments and committee meetings. Taken together, we paint a picture of a polarized Senate that is more partisan, more obstructionist, and less deliberative.
Get Out of the Way: Joe Biden, the U.S. Congress, and Executive-Centered Partisanship During the President’s First Year in Office
Authors: Jacobs Nicholas F. , Milkis Sidney M.
Published: February 2022

On the campaign trail and at his inauguration, Joe Biden pledged, above all else, to be a uniter to restore the soul of America. At the end of his first year in office, many campaign promises have been met, but unity has not been one. Far from transcending partisanship as promised, Biden has embraced the levers of presidential discretion and power inherent within the modern executive office to advance partisan objectives. He is not just a victim of polarization, but actively contributes to it. This is not unexpected. Rather it is the culmination of a decades-long reorientation within both major parties: the rise of an executive-centered party-system, with Democrats and Republicans alike relying on presidents and presidential candidates to pronounce party doctrine, raise campaign funds, campaign on behalf of their partisan brethren, mobilize grass roots support, and advance party programs. Like Barack Obama and Donald Trump before him, Biden has aggressively used executive power to cut the Gordian knot of partisan gridlock in Congress. Even pandemic politics is not immune to presidential partisanship; in fact, it has accentuated the United States’ presidency-centered democracy, which weakens the public resolve to confront and solve national problems.
Design of a miniaturized branch line microstrip coupler with a simple structure using artificial neural network
Authors: Roshani Saeed , Azizian Javad , Roshani Sobhan , Jamshidi Mohammad (Behdad) , Parandin Fariborz
Published: February 2022

In this paper, a compact branch microstrip coupler with the simple structure using T-shaped resonators and open-ended stubs at 1.8 GHz is designed and fabricated. The proposed coupler creates two transmission zeros at 3.4 and 3.87 GHz, with more than 50 dB attenuation level, which resulted in a good harmonic suppression at 2nd harmonic. Artificial neural network (ANN) has been utilized to extract the transfer function of the proposed coupler resonator for the first time, so the values of the transmission zeros can be located in the desired frequency. This technique can also be used for the other electrical devices. The designed device has a small size of 28 mm × 30 mm (0.9 λ × 0.95 λ), which shows more than 35% size reduction compared to the typical branch-line coupler with λ/4 branch lines. The proposed coupler is simulated using Advanced Design System (ADS) software and fabricated on Rogers Duroid 5880 substrate (ε
r = 2.2, h = 31 mil). The simulation and measurement results verify the correct performance of the designed coupler.
Entropy, Transformations and Sustainability of Industrial Life Cycles
Authors: Hornbogen Erhard
Published: February 2022

Life cycles of materials are analysed in a systematic manner as a six-stage process. It starts with primary or secondary raw materials and ends with recycling or deposition of waste. The purpose of the industrial process is the transformation of matter into materials from which useful goods are produced. The complete cycle can be described as a sequence of man-made transformations with defined changes in entropy and energy. Entropy is the measure for any type of disorder. Changes in entropy are due to separation (mining, purification: negative entropy), ordering (consolidation, construction: negative entropy) or disordering (mixing, crushing: positive entropy).

Sustainability comprises undesired, irreversible changes of our environment. It can be regarded as an inverse function of the raise in entropy. We have to distinguish entropy with respect to matter, energy and information. In our context, entropy changes due to different distributions of matter are of primary importance. Sustainability implies that increases in entropy due to industrial activities must be balanced, as much as possible, by extraterrestrial negative entropy. This requires the evaluation and comparison of entropy efficiency for the production of goods with defined useful properties.