bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of Tissue Dissection Techniques for Diagnostic, Prognostic, and Theragnostic Analysis of Human Disease
Authors: Walsh Elise M. , Halushka Marc K.
Published: August 2022

Histopathology has historically been the critical technique for the diagnosis and treatment of human disease. Today, genomics, transcriptomics, and proteomics from specific cells, rather than bulk tissue, have become key to understanding underlying disease mechanisms and rendering useful diagnostic information. Extraction of desired analytes, i.e., nucleic acids or proteins, from easily accessible formalin-fixed paraffin-embedded tissues allows for clinically relevant activities, such as sequencing biomarker mutations or typing amyloidogenic proteins. Genetic profiling has become routine for cancers as varied as non-small cell lung cancer and prostatic carcinoma. The five main tissue dissection techniques that have been developed thus far include: bulk scraping, manual macrodissection, manual microdissection, laser-capture microdissection, and expression microdissection. In this review, we discuss the importance of tissue dissection in clinical practice and research, the basic methods, applications, as well as some advantages and disadvantages for each modality.
First Account of Psychological Changes Perceived by a Female with Congenital Leptin Deficiency upon Treatment with Metreleptin
Authors: Hebebrand Johannes , Zorn Stefanie , Antel Jochen , von Schnurbein Julia , Wabitsch Martin , Gradl-Dietsch Gertraud
Published: August 2022

Two psychiatric interviews of a 39-year old female with congenital leptin deficiency were conducted to define psychological changes 14 and 165 days after initiation of treatment with human recombinant leptin (metreleptin). The most pronounced initial experience related to the reduced preoccupation with food. An improved mood was reported by the patient, which she associated with this reduced preoccupation. Her mood remained elevated upon recontact, whereas she was no longer preoccupied with food. Overall, the interviews provide a vivid account of the subjective experiences upon the initiation of treatment. Some of the findings bear a resemblance to those reported recently in patients with anorexia nervosa who were treated with metreleptin for 1–3 weeks. This case report provides further evidence that metreleptin has strong psychopharmacological effects in patients with absolute or relative leptin deficiency. We strongly recommend profound psychological examinations of patients with congenital leptin deficiency at baseline and after intitiation of treatment with human recombinant leptin to gain further insight into the functions affected by this hormone.
Women Empowerment in Selected Fisheries-Related Livelihoods In Asid Gulf, Masbate, Philippines
Authors: Mahawan Alvin M. , Velza Jacob Frederick P. , Ibañez, Jr. Roger Y. , Dioneda, Sr. Ronnel R. , Belardo Sipronio B. , Agonos Emily M.
Published: August 2022

Women empowerment contributes to the coastal economy and dispositions to household income. This descriptive study aimed to establish women's empowerment and their roles in the overall performance of selected fisheries-related livelihood in coastal towns of Milagros, Cawayan, Placer, and Esperanza, Masbate. It was participated by 81 women beneficiaries. A structured survey questionnaire was utilized to collect information on the sociodemographic profile and adequacy level of empowerment aligned to WEAI-5DE. It was backed up with FGDs and KIIs. The data were treated through descriptive analysis techniques using frequencies and percentages. The respondents mainly belong to the reproductive age group (15-49 years old) and are married individuals (84%). They have resulted in the dismayed of occupation because respondents are mainly housewives. The present study reveals that women achieved an adequate level of control over using income and building relationships or groups within and outside the organization; hence, women are empowered. The study also focused on the need for women's empowerment along with agricultural production, access to and control of productive resources, leadership in the community, and time allocation. These gaps and impediments may be addressed when feasible vocational/TVET training programs are introduced to women, the establishment of collaboration among concerned government agencies to channel fishery products directly to the market, and the inclusion of gender sensitivity activities to lessen gender inequality in the fishery community.
The Effects of Different Fertilizer on the Resistance of Tomato in Tomato Yellow Leaf Curl Virus (TYLCV)
Authors: Barrera Janet , Fuentes Mariecel
Published: August 2022

The study aims to determine the resistance and evaluate the cost effectiveness of different organic fertilizer in tomato against Tomato Yellow Leaf Curl Virus (TYLCV).  Four types of treatments were used, namely: Canaan Organic Fertilizer, Idol Organic Fertilizer, Synthetic Fertilizer and no fertilizer applied as control group.   This study found that Treatment 4 (Synthetic Fertilizer) shows the highest height, least symptoms of TYLCV (yellowing and curling of leaves), and highest yield of tomatoes among the other treatments. Tomatoes applied with different fertilizers had no effect on the resistance against the Tomato yellow leaf curl virus. Once B. tabacci is present on the tomato host, there is a great chance of disease incidence.
Text Messaging and English Writing Proficiency of Grade Six Pupils
Authors: Biray Ersyl T. , Dalisay Ma. Teresa A.
Published: August 2022

This descriptive correlation study determined the influence of text messaging to the English writing proficiency of Grade Six pupils in Nagustan Elementary School in the District of Nabas, Aklan, Philippines during the School Year 2019 - 2020. Data about the participants’ profile and frequency of text messaging were gathered using a survey questionnaire to 41 Grade VI pupils. Results showed that majority of the pupils have Very Satisfactory grades in English during the 3rd grading period. A greater number of the pupils spend 2 to 3 hours in text messaging while only few spend less than 1 to 2 hours. Generally, the pupil participants have outstanding English writing performances in sentence structure, idea development, and understanding of literature/texts, and very satisfactory in organizational pattern, text support, transitional devices, word choice, and language mechanics. Only a few of them have satisfactory performance and a lesser number needs improvement in all criteria. A very high positive relationship was found between the grade in English and frequency of text messaging to the English writing proficiency of the participants. This implies that the higher the grade of a pupil in English and the more frequent they engage in text messaging, the more proficient they are in writing.
Food Safety Practices Among Street Food Vendors In The Twin Cities Of Zamboanga Del Norte
Authors: Solon Jan Jacob C.
Published: August 2022

This paper aimed to examine the food safety practices among street food vendors in the Twin Cities of Zamboanga del Norte. Food safety practices covered two indicators; Sanitation and Personal Hygiene practices. There were two types of respondents in the study. First, there were 50 owners and proprietors of street food vendors in the twin cities, breakdown into 25 respondents for each City. Second, there were 400 total respondents in the study, and these were customers of the street food vendors; 200 respondents were allocated for Dapitan, while another 200 respondents were from Dipolog City. The study revealed that the majority of street vendor owners are college graduates. However, 98% or 49 of the respondents have not attended any food safety seminars. Further, sanitation practices are often practiced. Moreover, personal hygiene practices were frequently and sometimes practiced. There was a significant difference in the personal hygiene practices of when group according to Age. It implies that the younger generation of street vendors are still learning and could eventually learn as they grow older. A strong reason why hygiene practices differ between young and old street food vendors in these two cities. Most street vendors are mature individuals but are still active in the street vending business. However, these street food vendors still have poor food safety practices for a lack of appropriate knowledge, and most did not attend any sanitation and personal hygiene seminars/ workshops. Street vendors may be subject to a regular sanitary inspection regarding how street food merchants sell their goods to prevent contamination and keep the food they serve from any health risks. The LGU of both Cities may organize a seminar/training related to sanitation and personal hygiene to improve the standard of their Food vending continuously. A policy/program to be developed by each LGU as their support for these street food vendors.
Significant Contributions of University Business Incubators in Enhancing the Business Graduates’ Employability and Technopreneurship
Authors: Valenzuela Renalee V.
Published: August 2022

This study determined the significant contributions of university business incubators (UBIs) in selected higher education institutions in Region II to the business graduates’ employability and technopreneurship. The study also highlights the present situation of the UBIs and the involvement of the business graduates. The method used in the study were mixed quantitative and qualitative analysis. Data were gathered through the administration of a researcher-made questionnaire, interviews, and focus group discussions. Moreover, descriptive statistics were used for the quantitative part, while thematic analysis using in-vivo and free coding was used for the qualitative part. Results revealed that the UBIs under study have adequate facilities and services, develop utility models and seek patents for innovations, assist technopreneurs, start-ups, and businesses, and develop products for different industries. Best practices and challenges were also identified. Involvement with UBIs by business students was self-perceived as high extent, while BI personnel perceived it as low extent. The results led to the development of the UBI's significant contribution model in enhancing the knowledge and skills of the business graduates' employability and technopreneurship. It is pinpointed that BIs can enhance the learning experience of business students through immersion, including it in the development or enhancement of curricula, and developing clear policies and guidelines will benefit business students and other stakeholders.
Exploring Digital Literacy Skills of Prospective Indonesian EFL Teachers
Authors: Christiani Natalia , Tungka Novalita Fransisca , Nainggolan Romauli
Published: August 2022

Understanding EFL students’ levels of digital literacy is a vital step to improve the quality of English teaching and learning. This paper explored the levels of digital literacy skills of prospective Indonesian EFL teachers in the matter of their readiness for the integration and implementation of digital tools in their language learning practices. The respondents were three hundred thirty-six students majoring in the English Language Education department across cultural regions in Indonesia. A questionnaire was distributed online to gather data. The data were then tabulated and interpreted descriptively. The analysis results reported that the prospective Indonesian EFL teachers’ level of digital literacy was moderate. The discussion in this paper focuses on their digital literacy skills in terms of creative, technological, personal security, internet safety, problem-solving, information, communication or netiquette, and navigation. The findings of this study will provide a useful reference to improve learning practices and the integration and implementation of digital tools in English teaching and learning contexts.
Positioning of Participants’ Mood on Watches’ Advertising as Multimodal Discourse
Authors: Harmayanthi Vera Yulia , Hardjanto Njaju Jenny Malik Tomi
Published: August 2022

Advertising is an activity to advertise products or services as central creation into the wider meaning of their messages. Its messages have to be applied which refer to readers’ needs and interests in the current trends. Creating appropriated messages in multimodal discourse is a form of technological advances in advertising, such as the existence of multimodal discourse in newspapers. That print media still has a special place for its readers which consider some advantages in building messages. Producers produce some messages at multimodal discourse through newspapers that are used as one of media promotions. This makes producers have to provide extra funds for the promotions’ activities. It of course needs to create the messages of products or services in strategically position. Especially, it is during a pandemic situation to a new normal era where everything has to be done completely. Messages should be able to reach wide readers as their prospected customers. The position of message in multimodal discourse should be placed appropriately to build an active interaction with their prospected customers. It could be seen on watches’ advertising in newspapers. This research used data of 3 watches’ advertisings on Kompas as one of the popular daily newspapers in Indonesia. They were published in 2017 and 2018 where products are intended specifically for male and female consumers. Analyzing this research applied qualitative method through systemic functional of Halliday’s theories to show interpersonal view between participants. The results of this research appeared the positioning of participants’ mood as a description of the interpersonal situations in their roles. Participants’ positioning defined their activations in building interaction on multimodal discourse that be purposed for male and female as their prospected consumers.
Reducing Conversational Agents’ Overconfidence Through Linguistic Calibration
Authors: Mielke Sabrina J. , Szlam Arthur , Dinan Emily , Boureau Y-Lan
Published: August 2022

While improving neural dialogue agents’ factual accuracy is the object of much research, another important aspect of communication, less studied in the setting of neural dialogue, is transparency about ignorance. In this work, we analyze to what extent state-of-the-art chit-chat models are linguistically calibrated in the sense that their verbalized expression of doubt (or confidence) matches the likelihood that the model’s responses are factually incorrect (or correct). We find that these models are poorly calibrated, yet we show that likelihood of correctness can accurately be predicted. By incorporating such metacognitive features into the training of a controllable generation model, we obtain a dialogue agent with greatly improved linguistic calibration.
Embraces in Aeneid 8
Authors: Gramps Adrian
Published: August 2022

Venus and Vulcan, Venus and Aeneas, Pallas and Aeneas, Aeneas and Evander, Evander and Pallas: all of these pairs are seen embracing one another in Aeneid 8. Alongside these emotive scenes of embrace, the book is peppered with embrace-related vocabulary, imagery, and metaphor, often in surprising contexts. This article weaves together these embraces in Aeneid 8 in relation to the thematics of the book as a whole. It is proposed that, when read together, the embraces in Aeneid 8 tell a story about the possibilities of knowledge in relation to the senses. Vision is the supreme sense-modality of truth in epic, as embodied in the shield of Aeneas; and yet, in book 8, embrace emerges as a way of knowing that runs counter to optical discourses of knowledge. This leads to an exploratory reconsideration of hermeneutic principles in light of Aeneas’ much-puzzled-over response to the shield.
A Glass Half-Empty or Half-Full? An Assessment of the Labour Provisions in the CAI from Chinese and European Perspectives
Authors: Otteburn Kari , Marx Axel
Published: August 2022

The EU-China Comprehensive Agreement on Investment (CAI) presents a balancing act in labour rights protection. For the EU, labour rights protection constitutes an integral part of every trade and investment agreement it negotiates. China rarely includes labour provisions in trade and investment agreements. This article discusses current EU and Chinese approaches to integrating labour rights in trade and investment agreements, then introduces the provisions included in the proposed text of the CAI, and finally compares the proposed provisions in the CAI to the current approaches of the parties, focusing on five issues: international commitments, domestic labour regulation, dispute settlement, cooperation and stakeholder engagement. The article finds that from a European perspective, the CAI might represent a step back, while from a Chinese perspective, it might represent a step forward.
Obstacles, Opportunities, and Red Lines in the European Union: Past and Future of the CAI in Times of (Geo)-Politicisation
Authors: Burnay Matthieu , Raube Kolja
Published: August 2022

The conclusion and suspension of the Comprehensive Agreement on Investment (CAI) between the EU and China have been drawing substantial international academic attention over the last two years. To add to the ongoing debate, this article asks how one can best explain the conclusion and the suspension by the EU of the ratification of the CAI? And, secondly, the article focuses on the lessons which the EU can draw from the suspension of the CAI. By looking at the CAI background, negotiations and early ratification phase, the article sets out conceptually and empirically how a compartmentalisation and geo-politicisation of EU trade and investment policy contributed to the rise and fall of the CAI. Moreover, the article points to important lessons for future coherent and strategic investment policies. More specifically, it shows the need to bring together increasing investment flows with a sustained EU commitment to its very own founding values.
‘Day’ and ‘night’ in Latin
Authors: Nishimura Kanehiro
Published: August 2022

Although Latin is rich in vocabulary items for time, the history of their formation is not always clear. The adjectives and adverbs related to ‘day’ and ‘night’—diurnus ‘of the day’ / dius ‘by day’ and nocturnus ‘of the night’ / nox ‘by night’—are such cases and have not yet received fully satisfactory morphological explanations, particularly as to the -r- of the adjectives and the word-final sibilant of the adverbs, from either a Latin or an Indo-European perspective. Building upon traditional views, this paper offers a fresh approach to these forms. The results will then be applied to another temporal adjective, mēnstruus ‘of a month’, to clarify its phonological and morphological peculiarities.
Marshall on Salvation
Authors: Bock Darrell
Published: August 2022

This essay reviews I. Howard Marshall’s chapter on salvation as the core theological theme of Luke-Acts in Luke: Historian and Theologian. He contends for the idea of salvation being rooted in historical events and challenged Hans Conzelmann’s idea of the delay of the parousia. Jesus as Saviour and salvation in its broadest terms are at the center of Luke’s concerns. An assessment follows. Many have joined Marshall since in contending for a historically rooted portrait of the early church’s message. The idea of Jesus as Messiah-Lord may be a better central term for Luke’s Christology than Saviour. The theme of salvation as tied to reconciliation has brought focus to Luke’s emphasis on salvation. Also traced is the central role of geographical progression to point to the theme of Gentiles’ inclusion, as well as Paul’s career. The legacy of Marshall’s work still lives fifty years after this work.
Review of the New World genus Draeculacephala Ball (Hemiptera: Cicadellidae: Cicadellinae) from Mexico, with description of a new species
Authors: BLANCO-RODRÍGUEZ E. , PINEDO-ESCATEL J.A.
Published: August 2022

The taxonomy of the leafhopper genus Draeculacephala Ball in Mexico is revised. A new species, D. quetzalcoatli sp. nov., is described and illustrated from Chiapas state. In addition, D. albipicta Dietrich is recorded for first time occurring in the country. Eight species are recognized, and updated distribution data are provided. A key to all Mexican species is also given.
Numerical Study of Convective Heat Transfer Performance, Entropy Generation and Energy Efficiency of Al and Al2O3 Nanofluids in Minichannel
Authors: Ajeeb Wagd , Sohel Murshed S. M.
Published: August 2022

Due to their enhanced thermophysical properties, nanofluids are considered a promising cooling solution in many applications including energy systems and electronics. The convective heat transfer (CHT) characteristics and entropy generation of ethylene glycol (EG)/water-based Al and
Al2O3 nanofluids are numerically investigated for five nanoparticles concentrations (from 1.0 to 3.0 vol.%) and Reynolds number ranges between 400 and 2000 (laminar flow) under constant heat flux conditions in a minichannel. CFD tools are used to develop the numerical
approach which is validated using experimental data of the base fluid. The results show good enhancement in CHT for both nanofluids in comparison with the base fluid and the CHT rises with increasing nanoparticles concentration and reaches the maximum enhancements of 20.3% for Al nanoparticles
and 25.1% for Al2O3 nanoparticles at 3.0 vol.% concentration. The pressure drop also increases with increasing nanoparticles concentration and Re for both nanofluids, while friction factor is increased with increasing concentration of nanoparticles and reduced with the
increase of Reynolds number. The results of entropy generation showed a decrease with increasing the nanoparticles’ concentration with lower values for Al nanofluids than Al2O3 nanofluids. In another hand, the energy efficiency evaluation of the nanofluids performance
flow through the heat transfer system shows that there is no considerable change in the used energy of the overall system with nanofluids due to the increase in the pumping power.
Preparation, Characterization, Stability and Thermophysical Properties of Bio, Non-Bio (Metallic and Non-Metallic) and Hybrids Nanofluids: A Review
Authors: Okafor Anthony Amaechi , Mgbemena Chinedum Ogonna , Oreko Benjamin Ufuoma
Published: August 2022

Traditional heat transfer base fluids, such as ethylene glycol, ethanol, kerosene, oil, methanol, water etc. are normally used to enhance the heat transfer performance in many industrial applications. These traditional heat transfer fluids have many limitations. One of the limitations
is the poor thermophysical properties of each of the base fluids and this results in a lower heat transfer rate in Thermal Engineering systems. Nanofluids are considered a new generation heat transfer fluid with higher thermal conductivity. Nanofluids have enhanced thermophysical properties
compared to single-phase traditional heat transfer fluids. This paper highlights detailed reviews of the various methods of preparation, characterization, stability and thermophysical properties of bio, non-bio and hybrids nanofluids. Thermophysical properties such as density, viscosity, thermal
conductivity and specific heat capacity from different works of literature were summarized, discussed and presented. There are many different parameters to be considered while investigating the thermophysical properties of nanofluids. Density and specific heat capacity are strongly dependent
on the material type while the viscosity and thermal conductivity are highly affected by temperature and concentration. The most influential parameters on thermophysical properties of nanofluids are material type and temperature. The majority of the literature revealed that bio nanofluids
have low viscosity values and hybrids have high thermal conductivity values. The novelty of this review paper is the presentation of the various methods of synthesizing, characterization, stability and factors affecting the thermophysical properties of metallic, non-metallic and hybrid nanofluids.
The Shrinkage of Lake Lop Nur in the Twentieth Century: A Comprehensive Ecohydrological Analysis
Authors: Cai Danlu , Yu Lijun , Zhu Jianfeng , Fraedrich Klaus , Guan Yanning , Sielmann Frank , Zhang Chunyan , Yu Min
Published: August 2022

A comprehensive ecohydrological analysis is designed to understand the formation and evolution of lake Lop Nur and the environmental change over the Tarim River basin. Three temporal scales from century-based climatological mean to decade-based quasi-steady state change and to annual-scale-based abrupt change test are included. Combining the Budyko and Tomer–Schilling framework, this research first analyzes hydroclimatic and ecohydrological resistance/resilience conditions, then attributes observed changes to external/climate impact or to internal/anthropogenic activities, and finally diagnoses the possible tipping point on ecohydrological dynamics. (i) The arid regions reveal less sensitivity in terms of low variabilities of excess water W and energy U and show high resilience, which will more likely stay the same pattern in the future. (ii) Present towns situated in the semiarid regions with a natural hydraulic linkage with the mainstream of the Tarim River show a higher sensitivity and likelihood to be affected if drier scenarios occurred in the future. (iii) The attribution from two subsequent quasi-steady states indicates increasing effects of the anthropogenic activities increase (1961–80 versus 1981–2000) and provides climatical evidence that the central Tarim River basin was getting wetter before 1960 and then kept drying afterward. (iv) In the Kongqi subcatchment, the excess water reveals a significant decrease-then-increase evolution, from which the years with abrupt changes are observed in the 1960s. Generally, both points iii and iv are in agreement with that the closed-basin lake Lop Nur desiccation until the 1970s and its connection with the eastern part of the Taklamakan Sand Sea.
Complicated Grief: The Lived Experiences of Those Bereaved By COVID-19
Authors: Ostadhashemi Leila , Alipour Fardin , Ahmadi Shokoufeh , Khoshnami Mohammad Sabzi , Arshi Maliheh , Hossein Javadi Seyed Mohammad
Published: August 2022

The morbidity and mortality rates of COVID-19 pandemic are increasing, and many families have lost their loved ones. This study explored the experiences of families living in Iran who lost a loved one to COVID-19. The researchers apply a descriptive phenomenological approach and draw on in-depth interviews with 18 family members who had lost at least one family member because of COVID-19. Data were analyzed using Colaizzi’s method. After reviewing and comparing the consistency of the codes, crisis in crisis, circumstances of death and its consequences, and lack of preservation of patient dignity were extracted as main categories. Neglecting grieving families and related issues can lead to delays and difficulties in the process of recovery and intensification of their psychosocial pressures. Acquiring more knowledge about different impacts of COVID-19 will be helpful for providing timely and better rehabilitation.
Influencers as ideological intermediaries: promotional politics and authenticity labour in influencer collaborations
Authors: Arnesson Johanna
Published: August 2022

Though politics and promotion have never been completely separate, the convergence between the two spheres is increasingly prominent in today’s digital culture. To broaden our understanding of such promotional politics in social media, this paper examines commercial collaborations between four Swedish influencers and two private companies that offer services enabled by specific neoliberal reforms during recent decades, and how they strive to present these services in a way that attracts an affluent but socially conscious middle-class. It argues that the political potential of influencers might not always be as spokespersons for a cause or party, but rather as ‘ideological intermediaries’ who promote a lifestyle to be inspired by, and aspire to. The analysis identifies the discourses that influencers draw on to achieve the promotional and ideological outcomes of commercial collaborations, as well as the authenticity labour that they perform in the texts. Further, the paper analyses how notions of authenticity also impact audiences’ interpretation and politicization of the collaborations, in the comment sections to the sponsored blogposts.
DRMM: A novel data mining-based emotion transfer detecting method for emotion prediction of social media
Authors: Shi Wei , Xue Guangcong , Yin Xicheng , He Shaoyi , Wang Hongwei
Published: August 2022

With the progress of the Internet and information technology, emotion analysis has been applied to analyse the emotional orientation and evolution trend of online public opinion of online tweets. At present, most of the existing methods use econometric model and machine learning algorithm to predict the trend of online public opinion. Although these methods have achieved good prediction results, they do not take into account the influence of internal factors on network public opinion prediction, such as mutual migration among emotion classes. The emotion may change dynamically because different events trigger it in the evolution process. In this view, this article proposes a novel method, called Deviation Rule Markov Model (DRMM), to predict the emotional change trend of Internet users in online public opinion by analysing the correlation between Internet users’ emotional categories. Structurally, the proposed DRMM involves various processes such as pre-processing, emotion classification, data mining and transfer prediction. For the processing of network comment data, the proposed model initially undergoes pre-processing to delete unnecessary data. Then, the extended fuzzy emotion ontology is used to annotate the emotion class of the comment data. Besides, an extended association rule mining algorithm is used in the emotion association analysis process to obtain the transfer probability between emotion classes. Moreover, Markov chain is used to construct an emotional state transition matrix to predict the transition probability of positive or negative emotions. According to the predicted single emotion transfer probability results, the analytic hierarchy process is used to assign values to different emotion classes, and finally, the transfer probability of the overall emotion in a certain period is obtained. Compared with the actual case, the mean absolute error (MAE) and root mean square error (RMSE) of the proposed model are 2.7119 and 3.7254, respectively, which has good prediction performance.
Predictive value of hemoglobin-to-red blood cell distribution width ratio for contrast-induced nephropathy after emergency percutaneous coronary intervention
Authors: Sun Xipeng , Zhang Ruixue , Fan Zhenxing , Liu Zhi , Hua Qi
Published: August 2022

Background

Although the relationship of either hemoglobin or red blood cell distribution width (RDW) with contrast-induced nephropathy (CIN) has been reported individually. To date, no studies have evaluated the predictive value of hemoglobin-to-red blood cell distribution width ratio (HRR) for CIN.

Methods

A total of 1658 elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) were retrospectively screened. Preoperative complete blood count was collected and the HRR was calculated as the ratio of hemoglobin to RDW. CIN was defined as an absolute ≥0.5 mg/dL (44.2 μmol/L) or a relative ≥25% increase in creatinine level at 72 h after contrast administration. Univariate and multivariate regression analysis were conducted to determine the effective predictors for CIN. The ROC curve analysis was plotted to determine the optimal cutoff value for HRR in predicting CIN.

Results

The overall incidence of CIN was 8.38%. The HRR was significantly lower in the CIN group compared with the non-CIN group (0.87 ± 0.15 vs 1.24 ± 0.23, p < 0.001). After multivariate regression analysis was performed, HRR was noted to be an effective predictor for the development of CIN (OR 1.617, 95% CI 1.439–2.706, p = 0.014), along with age, creatinine, eGFR, hs-CRP and contrast volume. An optimal cutoff value of 0.94 or lower for HRR was identified with 82.4% sensitivity and 63.5% specificity to predict CIN.

Conclusion

Lower HRR on admission was an effective predictor for CIN in elderly patients with STEMI undergoing emergency PCI. HRR may be a convenient, economical and reliable biomarker for risk stratification.
Characteristics and Outcomes of Young Adult Patients with Severe Sepsis Admitted to Pediatric Intensive Care Units Versus Medical/Surgical Intensive Care Units
Authors: Zakutansky Stephani K. , McCaffery Harlan , Viglianti Elizabeth M. , Carlton Erin F.
Published: August 2022

Purpose: Young adults receive severe sepsis treatment across pediatric and adult care settings. However, little is known about young adult sepsis outcome differences in pediatric versus adult hospital settings. Material and Methods: Using Truven MarketScan database from 2010-2015, we compared in-hospital mortality and hospital length of stay in young adults ages 18-26 treated for severe sepsis in Pediatric Intensive Care Units (PICUs) versus Medical ICUs (MICUs)/Surgical ICUs (SICUs) using logistic regression models and accelerated time failure models, respectively. Comorbidities were identified using Complex Chronic Conditions (CCC) and Charlson Comorbidity Index (CCI). Results: Of the 18 900 young adults hospitalized with severe sepsis, 163 (0.9%) were treated in the PICU and 952 (5.0%) in the MICU/SICU. PICU patients were more likely to have a comorbid condition compared to MICU/SICU patients. Compared to PICU patients, MICU/SICU patients had a lower odds of in-hospital mortality after adjusting for age, sex, Medicaid status, and comorbidities (adjusting for CCC, odds ratio [OR]: 0.50, 95% CI 0.29-0.89; adjusting for CCI, OR: 0.51, 95% CI 0.29-0.94). There was no difference in adjusted length of stay for young adults with severe sepsis (adjusting for CCC, Event Time Ratio [ETR]: 1.14, 95% CI 0.94-1.38; adjusting for CCI, ETR: 1.09, 95% CI 0.90-1.33). Conclusions: Young adults with severe sepsis experience higher adjusted odds of mortality when treated in PICUs versus MICU/SICUs. However, there was no difference in length of stay. Variation in mortality is likely due to significant differences in the patient populations, including comorbidity status.
Outcomes of distal radial endoprostheses for tumour reconstruction: a single centre experience over 15 years
Authors: Mahoney Rachel , Khan Zeeshan , Abudu Adesegun , Kurisunkal Vineet , Evans Scott , Jeys Lee M.
Published: August 2022

We report a retrospective study over a 15-year period, between 2005 and 2020, evaluating clinical and functional outcomes in patients who underwent reconstruction of the distal radius with an endoprosthetic replacement following excision of both malignant and aggressive benign bone tumours. Data was collected retrospectively from a prospectively maintained electronic database, and prospectively via telephone patient consultation. Musculoskeletal Tumour Society and patient-rated wrist evaluation scores were assessed at a minimum of 1 year postoperatively. Of nine implants, five were arthrodeses and four were arthroplasties. One patient required amputation within 6 months for proximal metastatic disease. At last follow-up, eight patients subjectively reported good function. Five patients returned to high functionally demanding jobs. Mean Musculoskeletal Tumour Society and patient-rated wrist evaluation scores were 72% and 50/100, respectively. We conclude that distal radius endoprosthetic replacements offer acceptable functional outcomes and remain a viable option when biological reconstruction is not possible.

Level of evidence: IV
The Role of Maternal and Environmental Factors During Pregnancy on the Risk of Hypospadias Occurrence
Authors: Siregar Safendra , Sibarani Jupiter , Saputra Daniel
Published: August 2022

Introduction and Objectives

Hypospadias is a congenital disorder in boys in which the urethral meatus is located on the ventral penis. The incidence rate of hypospadias is increasing, however, there is still no literature regarding how significant is the role of maternal and environmental factors to the risk of hypospadias, especially in Indonesia. This study aims to analyze the maternal and environmental factors during pregnancy to the risk of hypospadias.

Materials and Methods

This study was an analytical observational study with a case control design. The subjects were mothers who gave birth to children with hypospadias, compared to normal, who visited the urology, pediatric-surgery, plastic-surgery, and pediatric clinic at Hasan Sadikin General Hospital.

Results

A total of 120 samples (60 cases and 60 control) were included in this study. There were 14 maternal factors, which 5 of them found significantly correlated with hypospadias, including maternal occupation as an industrial worker ( P = .003; OR:4.789), pregnancy-enhancing drugs usage ( P = .004; OR: 5.783), smoking consumption ( P = .034; OR: 2.294), mosquito-repellant usage ( P = .0001; OR: 82.600), and preterm birth ( P = .013; OR: 2.895). There were 2 environmental factors, and one of them was significant, which was the distance from home to industrial/rice fields/waste areas, approximately 780 m ( P = .0001; OR: 6.102). Based on multivariate analysis, we found that maternal occupation, mosquito repellent usage, and the distance from home to industrial area had a strong relationship in predicting hypospadias occurrence.

Conclusion

Several maternal and environmental factors were found significantly correlated to hypospadias occurrence. Among these, mosquito-repellant usage was found to be the most significant factor.
Applying a biopsychosocial model to migraine: rationale and clinical implications
Authors: Rosignoli Chiara , Ornello Raffaele , Onofri Agnese , Caponnetto Valeria , Grazzi Licia , Raggi Alberto , Leonardi Matilde , Sacco Simona
Published: August 2022

Migraine is a complex condition in which genetic predisposition interacts with other biological and environmental factors determining its course. A hyperresponsive brain cortex, peripheral and central alterations in pain processing, and comorbidities play a role from an individual biological standpoint. Besides, dysfunctional psychological mechanisms, social and lifestyle factors may intervene and impact on the clinical phenotype of the disease, promote its transformation from episodic into chronic migraine and may increase migraine-related disability.

Thus, given the multifactorial origin of the condition, the application of a biopsychosocial approach in the management of migraine could favor therapeutic success. While in chronic pain conditions the biopsychosocial approach is already a mainstay of treatment, in migraine the biomedical approach is still dominant. It is instead advisable to carefully consider the individual with migraine as a whole, in order to plan a tailored treatment. In this review, we first reported an analytical and critical discussion of the biological, psychological, and social factors involved in migraine. Then, we addressed the management implications of the application of a biopsychosocial model discussing how the integration between non-pharmacological management and conventional biomedical treatment may provide advantages to migraine care.
Diversity and dynamics of the CRISPR-Cas systems associated with Bacteroides fragilis in human population
Authors: Lam Tony J. , Mortensen Kate , Ye Yuzhen
Published: August 2022

Background

CRISPR-Cas (clustered regularly interspaced short palindromic repeats—CRISPR-associated proteins) systems are adaptive immune systems commonly found in prokaryotes that provide sequence-specific defense against invading mobile genetic elements (MGEs). The memory of these immunological encounters are stored in CRISPR arrays, where spacer sequences record the identity and history of past invaders. Analyzing such CRISPR arrays provide insights into the dynamics of CRISPR-Cas systems and the adaptation of their host bacteria to rapidly changing environments such as the human gut.

Results

In this study, we utilized 601 publicly available Bacteroides fragilis genome isolates from 12 healthy individuals, 6 of which include longitudinal observations, and 222 available B. fragilis reference genomes to update the understanding of B. fragilis CRISPR-Cas dynamics and their differential activities. Analysis of longitudinal genomic data showed that some CRISPR array structures remained relatively stable over time whereas others involved radical spacer acquisition during some periods, and diverse CRISPR arrays (associated with multiple isolates) co-existed in the same individuals with some persisted over time. Furthermore, features of CRISPR adaptation, evolution, and microdynamics were highlighted through an analysis of host-MGE network, such as modules of multiple MGEs and hosts, reflecting complex interactions between B. fragilis and its invaders mediated through the CRISPR-Cas systems.

Conclusions

We made available of all annotated CRISPR-Cas systems and their target MGEs, and their interaction network as a web resource at https://omics.informatics.indiana.edu/CRISPRone/Bfragilis. We anticipate it will become an important resource for studying of B. fragilis, its CRISPR-Cas systems, and its interaction with mobile genetic elements providing insights into evolutionary dynamics that may shape the species virulence and lead to its pathogenicity.
Inappropriate and potentially avoidable emergency department visits of Swiss nursing home residents and their resource use: a retrospective chart-review
Authors: Zúñiga Franziska , Gaertner Katharina , Weber-Schuh Sabine K. , Löw Barbara , Simon Michael , Müller Martin
Published: August 2022

Background

Emergency department (ED) visits for nursing home residents lead to higher morbidity and mortality. Therefore, inappropriate visits (for conditions treatable elsewhere) or potentially avoidable visits (those avoidable through adequate chronic care management) must be minimized. This study aimed to investigate factors and resource consumption patterns associated with inappropriate and potentially avoidable visits in a Swiss tertiary hospital.

Methods

This is a single-center retrospective chart review in an urban Swiss university hospital ED. A consecutive sample of 1276 visits by nursing home residents (≥ 65 years old), recorded between January 1, 2015 and December 31, 2017 (three calendar years) were included. Case characteristics were extracted from ED electronic documentation. Appropriateness was assessed via a structured Appropriateness Evaluation Protocol; potentially avoidable visits—measured as ambulatory-care sensitive conditions (ACSCs)—were analyzed separately. Inter-group differences concerning ED resource use were tested respectively with chi-square or Wilcoxon rank sum tests. To identify predictors of inappropriate or potentially-avoidable visits, we used multivariable logistic regression analysis.

Results

Six percent of visits were rated as inappropriate: they had lower triage levels (OR 0.55 [95%-CI 0.33-0.92], p=0.024) and, compared to ambulance calls, they had higher odds of initiation via either patient-initiated walk-in (OR 3.42 [95%-CI 1.79-6.55], p≤0.001) or GP referrals (OR 2.13 [95%-CI 1.16-3.90], p=0.015). For inappropriate visits, overall ED resource use was significantly lower (median 568 vs. 1403 tax points, p≤0.001). Of all visits included, 29% were due to (often potentially-avoidable) ACSCs. In those cases, compared to ambulance initiation, odds of being potentially-avoidable were considerably lower for walk-in patients (OR 0.46 [95%-CI 0.27-0.77], p=0.004) but higher for GP referrals (OR 1.40 [95%-CI 1.00-1.94], p=0.048). Nurse work (93 tax points vs. 64, p≤0.001) and laboratory resource use (334 tax points vs. 214, p≤0.001) were higher for potentially-avoidable ED visits.

Conclusions

We revealed substantial differences between the investigated groups. While nearly one third of ED visits from nursing homes were potentially avoidable, inappropriate visits were lower in numbers and not resource-intensive. Further research is required to differentiate potentially avoidable visits from inappropriate ones and to determine these findings’ public health implications.
Prognostic significance of AKR1C4 and the advantage of combining EBV DNA to stratify patients at high risk of locoregional recurrence of nasopharyngeal carcinoma
Authors: Guo Shan-Shan , Chen Yan-Zhou , Liu Li-Ting , Liu Rong-Ping , Liang Yu-Jing , Wen Dong-Xiang , Jin Jing , Tang Lin-Quan , Mai Hai-Qiang , Chen Qiu-Yan
Published: August 2022

Background

Distinguishing patients at a greater risk of recurrence is essential for treating locoregional advanced nasopharyngeal carcinoma (NPC). This study aimed to explore the potential of aldo–keto reductase 1C4 (AKR1C4) in stratifying patients at high risk of locoregional relapse.

Methods

A total of 179 patients with locoregionally advanced NPC were grouped by different strategies; they were: (a) divided into two groups according to AKR1C4 expression level, and (b) classified into three clusters by integrating AKR1C4 and Epstein-Barr virus (EBV) DNA. The Kaplan–Meier method was used to calculate locoregional relapse-free survival (LRFS), overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). The Cox proportional hazards model was used to determine potential prognostic factors, and a nomogram was generated to predict 3-year and 5-year LRFS.

Results

A significant difference in the 5-year LRFS was observed between the high and low AKR1C4 expression groups (83.3% vs. 92.7%, respectively; p = 0.009). After integrating AKR1C4 expression and EBV DNA, the LRFS (84.7%, 84.5%, 96.9%, p = 0.014) of high-, intermediate-, and low- AKR1C4 and EBV DNA was also significant. Multivariate analysis indicated that AKR1C4 expression (p = 0.006) was an independent prognostic factor for LRFS. The prognostic factors incorporated into the nomogram were AKR1C4 expression, T stage, and EBV DNA, and the concordance index of the nomogram for locoregional relapse was 0.718.

Conclusions

In conclusion, high AKR1C4 expression was associated with a high possibility of relapse in NPC patients, and integrating EBV DNA and AKR1C4 can stratify high-risk patients with locoregional recurrence.