bluuebunny/crossref_metadata_2025 huggingface dataset:
Determination of the activation parameters ∆H≠ and ∆S≠ via a kinetic study of d,l-mandelic acid oxidation by using chromic acid in the presence of 1,10-phenanthroline as a promoter in an aqueous micellar acid medium
Authors: Islam Monirul , Singha Swarnava , Bhattacharyya Anwesha , Roy Debraj
Published: October 2021

Chromic acid oxidation of d,l-mandelic acid in the presence and absence of 1,10-phenanthroline (Phen) is studied in an aqueous micellar medium under kinetic conditions, [d,l-mandelic acid] >> [Phen]T >> [Cr(VI)]T at different temperatures. From studies on the effect of temperature on the rate constant (k), the activation parameters ∆H≠ (enthalpy of activation) and ∆S≠ (entropy of activation) are evaluated by using the Eyring equation [−ln (kh/kBT) = ∆H≠/RT − ∆S≠/R]. The high value of ∆H≠ indicates that the phen-catalysed path is favoured mainly due to very high negative value of ∆S≠. The negative value of ∆S≠ and the composite rate constant kcat support the suggested cyclic transition state. Both the catalysed and uncatalysed paths show a first-order dependence on [H+], and both also show a first-order dependence on [d,l-mandelic acid]T and [Cr(VI)]T. The Phen-catalysed path is first order in [Phen]T. These observations remain unaltered in the presence of externally added surfactants. The cationic surfactant N-cetylpyridinium chloride is found to retard the rate of the reaction.
Raising Our Collective Voices: A Sing-Along for Our Collaborative Futures as Qualitative Inquiry (Introduction to a Song Panel From ICQI 2021)
Authors: Alexander Bryant Keith
Published: October 2021

The short essay serves as introduction to a partial Special Issue section that chronicles the 2021 ICQI panel “Raising Our Collective Voices.” The introduction outlines the purpose of the panel in relation to the congress theme and participant responses to the call. After the initial COVID year from which we will continue to reel, it seemed more important than ever to revisit the modality of song linked with the theme of the congress. And more importantly to revisit the power, potency, and possibility of music and how particular songs, old and emerging, stir and inspire something in all of us—tapping into our collective conscious, penetrating our sense of being fully alive, and giving voice and sound to the fury, desire, and resolve in our living.
Revisiting Early Sport Specialization: What’s the Problem?
Authors: Mosher Alexandra , Till Kevin , Fraser-Thomas Jessica , Baker Joseph
Published: October 2021

Context:

The assumed risks of early specialization in sport are well known, with several international consensus statements advising against specialization in early athlete development. However, there have been recent calls for more focused research in this area.

Evidence Acquisition:

Research evidence from several scientific disciplines (eg, sport psychology, sports medicine, human development) were synthesized to develop a framework for practitioners working with adolescent athletes.

Study Design:

Narrative review.

Level of Evidence:

Level 4.

Results:

There appear to be risks associated with a highly specialized approach to athlete training, but the mechanisms driving these effects are largely unknown. Greater attention to understanding these mechanisms would help mitigate risk and develop stronger policy for athlete development. Recommendations for program modifications are provided.

Conclusion:

Early specialization remains an important topic for researchers and practitioners working with youth and adolescent athletes. However, more work needs to be done to provide truly evidence-based recommendations for youth athlete training.
Ectopic gall bladder: A case report
Authors: Yadav Amitabh , Ray Samrat , Nundy Samiran
Published: October 2021

Ectopic gall bladder under the left lobe of liver is a rare congenital anomaly of the position of gall bladder, which is mostly detected during surgery and causes technical difficulty at the time of operation. We operated a 64-year-old male who presented with gall stone disease and pre-operative ultrasound did not report any abnormality in position. On laparoscopy, it was found to be attached on the left side of falciform ligament under segment III. It was a true ectopic gall bladder without situs inversus. Early division of the falciform ligament and a careful and complete dissection of the gall bladder are advocated before clipping the cystic artery and duct to avoid complications. The present case report discusses about this rare anomaly and the available literature on the subject.
Case study assessing the feasibility of using a wearable haptic device or humanoid robot to facilitate transitions in occupational therapy sessions for children with autism spectrum disorder
Authors: Beaudoin Audrée Jeanne , Pedneault Frédérique , Houle Marina , Bilodeau Cynthia , Gauvin Marie-Pier , Groleau Diane , Brochu Pascale , Couture Mélanie
Published: October 2021

Introduction

Some children with autism spectrum disorder (ASD) have difficulties with transitions that may lead to problem behaviours. Although the use of technologies with children with ASD is receiving increasing attention, no study has looked at their effect on transitions in activities of daily living. This study aimed to document the feasibility of (1) using two intervention technologies (NAO humanoid robot or wearable haptic device) separately to facilitate transitions in occupational therapy sessions for children with ASD and (2) the method used to document changes.

Methods

Using a single case reversal (ABA) design, two children with ASD were randomly assigned to one of the intervention technologies (humanoid robot or haptic bracelet). Each technology was used as an antecedent to stimulate the start of transitions in eight intervention sessions at a private occupational therapy clinic. Data concerning the time required for transitions, child’s behaviours during transitions at the clinic and mother’s perception of the child’s performance in transitions at home were analysed graphically.

Results

When using technology, both children’s behaviours were appropriate, quick and relatively stable. Also, both mothers reported improved perceptions of their child’s performance in transitions.

Conclusions

This exploratory study suggests no detrimental effect of using these technologies.
Treatment of 2-Part Proximal Humeral Fractures in Osteoporotic Patients With Medial Calcar Instability Using a PHILOS Plate Plus an Allogeneic Fibula Inserted Obliquely – A Retrospective Study
Authors: Cheng Huihui , Yu Jiali , Dong Zhirui , Lin Huanyi , Liu Qilong , Zhang Xinchao , Wu Jianguo , Zeng Xianshang , Yu Weiguang , Xu Bo
Published: October 2021

Introduction

To date, there is little research assessing the efficacy of a proximal humeral internal locking system (PHILOS) plate plus an allogeneic fibula inserted obliquely in the treatment of 2-part proximal humerus fractures (PHFs) with calcar comminution in patients >60 years old with severe osteoporosis. The aim of this study was to retrospectively evaluate the outcomes of elderly patients with osteoporotic 2-part PHFs combined with medial column (calcar) instability or disruption who experienced a PHILOS plate plus an allogeneic fibula inserted obliquely.

Materials and Methods

One hundred and twelve consecutive elderly patients with severe osteoporotic 2-part PHFs combined with calcar instability or disruption who were treated with a PHILOS plate plus an allogeneic fibula inserted obliquely were retrospectively identified from 3 tertiary medical centres during 2014–2019. The primary outcomes were the Constant scores and American Shoulder and Elbow Surgeons (ASES) scores; secondary outcome was the rate of key orthopaedic complications.

Results

Median follow-up was 24 (15.3–27.6) months. Significant improvements in the median Constant scores were observed (39 [26–58 points] prior to surgery vs 81 [67–95 points] at final follow-up). The median ASES scores improved from 43 (26–64 points) prior to surgery to 83 (65–96 points) at final follow-up. The percentage of key orthopaedic complications was 25.6% (22/86). Four (4.7%) cases had loss of reduction, 4 (4.7%) experienced aseptic loosening, 1 (.8%) had non-union, 4 (4.7%) suffered a periprosthetic fracture, 3 (3.5%) experienced a revision surgery, 1 (.8%) had a dislocation and 5 (5.8%) suffered an unbearable shoulder pain.

Conclusion

For elderly patients with osteoporotic 2-part PHFs combined with calcar instability or disruption, PHILOS plate combined with an allogeneic fibula inserted obliquely might have recognisable advantages in decreasing the loss of fixation and preventing medial calcar collapse.
Change in Household Environment Condition in India: Evidence From Panel Data
Authors: Brahmanandam N. , Nagarajan R. , Goli Srinivas
Published: October 2021

We examine the transition in household environment condition (HEC) in India during 2004–2012 by using panel data of the India Human Development Survey. In particular, this study documents the movement of households into and out of poor HEC. We found that a higher proportion of socially deprived classes, namely, Scheduled Tribes, Scheduled Castes, and Other Backward Castes, were continued to be in or fall into poor HEC than the General Castes. The movement out of poor HEC (to middle and better-off HEC) was least observed among the underprivileged Castes than the General Castes. Similarly, households in economically poor condition and those with illiterate and primary occupation household heads were entering into or remaining more in poor HEC than their counterparts. By regions, Central and Eastern regions were either continued to be more in poor HEC or experienced the least upward movement from poor HEC to the middle and better-off condition than other regions. Findings based on multivariate logistic regression models have reinforced the results from the bivariate analyses. From a policy perspective, the findings advance that socially disadvantaged population needs greater emphasis on ongoing programs to improve household living and environmental conditions in India.
Mitigation of liquefaction triggering due to bio-gas-induced desaturation using element tests and the strain energy approach
Authors: Baziar Mohammad Hassan , Eslami Amirabadi Omid
Published: October 2021

Currently, conventional remediation of liquefaction triggering may have many environmental effects, and this important issue has led researchers to look for more sustainable methods. In this research, one of the new bio-improvement methods (biogas) has been used to generate gas bubbles within a soil, susceptible to liquefaction. Using this method, two bio materials create ammonium ions and carbonate, in which ammonium ion is converted into nitrate due to the presence of bacteria in water, and they are eventually converted to nitrogen gas in an anaerobic condition. The nitrogen bubbles created in water reduce the soil’s degree of saturation, which in effect increases the soil’s resistance to liquefaction occurrence. In this study, two sources of urease enzyme were used to reduce the soil degree of saturation. The effects of various parameters, including the optimum concentration of each substance for optimum time to generate gas bubbles, as well as the effect of the oxygen amount in water were investigated using monotonic triaxial tests. The results illustrated that the addition of the mentioned two substances to the oxab (water with 60 ppm oxygen) or tap water decreased the pore water pressure due to desaturation. Finally, the energy approach was used to test the substance containing the amount of oxab with the highest decrease in pore water generation, here called “optimum selection,” in the cyclic triaxial device, and the results were analyzed to evaluate liquefaction occurrence. The outcome of these results revealed that compared with the strain energy of the non-treated sample, the treated sample had a much higher strain energy; in other words, the treated sample needed a larger amount of loading to trigger liquefaction.
Emotional distress in the early stages of the COVID-19 related lockdowns depending on the severity of the pandemic and emergency measures: a comparative online-survey in Germany, Austria and Italy
Authors: Eichenberg Christiane , Grossfurthner Martin , Kietaibl Sibylle , Riboli Greta , Borlimi Rosita , Holocher-Benetka Stefana
Published: October 2021

Background

The first wave of the COVID-19-pandemic hit different countries with varying degrees of severity, so that differences in the type and level of emergency measures were also necessary. It can be assumed that the psychological burden was higher in countries subjected to a more severe course of the pandemic (Italy) than in countries subjected to a less severe one (Germany, Austria).

Objective

To investigate and contrast the wellbeing of the population in Italy, Austria, and Germany in the early phase of the first lockdown.

Method

Online survey on N = 4289 individuals. The questionnaire comprised a self-administered section, exploring the dimensions: perceived severity of COVID-19, perceived risk of disease, concerns related to COVID-19, emergency measure acceptance and emotional distress due to emergency measures; and standardized scales to record emotional state and coping: Stress-Coping-Style Questionnaire, Positive and Negative Affect Schedule, State-Trait-Anxiety-Inventory.

Results

The three countries displayed significant differences in all investigated dimensions (p < .001). Italian participants assessed the COVID-19 virus as much more dangerous (p < .001), but despite the prevalence of the virus, the subjective risk of disease was perceived to be lower in Italy (p < .001). This could be a positive effect of the restrictive curfews set by the government in Italy. The emergency measures were generally perceived to be very effective in all three countries, but due to the duration and the severity of the measures, the fear and stress-reaction were the strongest among Italian participants (p < .001).

Conclusion

The stricter measures in Italy prevented an application of many positive stress processing strategies, which, in turn, fostered the perpetuation of stresses and fear.
The global prevalence of depression, suicide ideation, and attempts in the military forces: a systematic review and Meta-analysis of cross sectional studies
Authors: Moradi Yousef , Dowran Behnaz , Sepandi Mojtaba
Published: October 2021

Background

Given the wide range of depressive disorders, suicidal ideation and suicide attempts in various military studies around the world, determining the exact prevalence of these disorders in line with health planning as well as care and treatment service designing for military forces can be useful. The aim of the present meta-analysis was to determine the pooled prevalence of depressive disorders, suicide thoughts, and attempts in the military.

Methods

The present systematic review and meta-analysis study was performed based on PRISMA criteria in 5 steps of the search strategy, screening and selection of articles, data extraction, evaluation of article quality and meta-analysis. International databases (PubMed (Medline), Scopus, Web of science, Embase (Elsevier), PsycInfo (Ovid), Cochrane CENTRAL (Ovid)) were searched using related keywords extracted from Mesh and Emtree. After screening and final selection of articles, data were extracted and qualitative evaluation was performed using the NOS checklist.

Results

The results of meta-analysis showed that the prevalence of depression in active military forces and veterans was 23% (%95 CI: 20–26%) and 20% (%95 CI: 18–22%), respectively. In addition, the prevalence of suicidal ideation and attempts in the military was 11% (%95 CI: 10–13%) and 11% (%95 CI: 9–13%), respectively. The prevalence of suicide ideation and attempts in drug-using military was 18% (%95 CI: 7–33%) and 30% (%95 CI: 23–36%), respectively. The prevalence of suicidal ideation and attempts in military consuming alcohol were 9% (%95 CI: 4–13%) and 8% (%95 CI: 7–10%), respectively. In militaries with AIDS / HIV, the prevalence of suicide attempts was 5% (%95 CI: 4–8%).

Conclusion

Therefore, it is necessary to develop and design training and intervention programs in order to increase the awareness of the military, especially veterans, to prevent the occurrence of suicide and depression.
Influence of bone anatomical morphology of mandibular molars on dental implant based on CBCT
Authors: Kong Zhuo-lin , Wang Ge-ge , Liu Xue-ying , Ye Zhang-yan , Xu Dong-qian , Ding Xi
Published: October 2021

Background

To apply CBCT to investigate the anatomical relationship between the mandibular molar and alveolar bone, aimed to provide clinical guidelines for the design of implant restoration.

Methods

201 CBCT data were reevaluated to measure height of the alveolar process (EF), width of the alveolar process (GH), width of the basal bone (IJ), the angle between the long axis of the first molar and the alveolar bone (∠a) and the angle between the long axis of the alveolar bone and basal bone (∠b). The angle and width were measured to determine the implant-prosthodontic classification of the morphology in the left lower first molar (36) and right lower first molar (46). All measurements were performed on the improved cross-sectional images.

Results

EF, GH and IJ were measured as (10.83 ± 1.31) mm, (13.93 ± 2.00) mm and (12.68 ± 1.96) mm for 36, respectively; and (10.87 ± 1.24) mm, (13.86 ± 1.93) mm and (12.60 ± 1.90) mm for 46, respectively. No statistical significance was observed in EF, GH, IJ, ∠a and ∠b between 36 and 46 (all P > 0.05). The morphology was divided into three categories including the straight (68.7–69.2%), oblique (19.9–20.4%) and concave types (11%). Each type was consisted of two subcategories.

Conclusions

The proposed classification could provide evidence for appropriate selection and direction design of the mandibular molar implant in clinical. The concave type was the most difficult to implant with the highest risk of lingual perforation. The implant length, width, direction required more attention.
The influence of nursing home managers’ leadership on person-centred care and stress of conscience: A cross-sectional study
Authors: Backman Annica , Sjögren Karin , Lövheim Hugo , Lindkvist Marie , Edvardsson David
Published: October 2021

Background

Leadership and stress are common concepts in nursing, and this study explores empirically the connection between leadership and stress of conscience in the context of aged care practice. Previous literature has shown that when staff are unable to carry out their ethical liabilities towards the residents, feelings of guilt may occur among staff, which may be an expression of stress of conscience. Although leadership has been described as crucial for staff’s work perceptions of stress as well as for person-centred practices, the influence of nursing home managers’ leadership on stress of conscience among staff and person-centred practices is still not fully explored. This study attempts to address that knowledge gap by exploring the relationship between leadership, person-centred care, and stress of conscience.

Methods

This study was based on a cross-sectional national survey of 2985 staff and their managers in 190 nursing homes throughout Sweden. Descriptive statistics and regression modelling were used to explore associations.

Results

Leadership was associated with a higher degree of person-centred care and less stress of conscience. A higher degree of person-centred care was also associated with less stress of conscience. The results also showed that leadership as well as person-centred care were individually associated with lower levels of stress of conscience when adjusting for potential confounders.

Conclusion

Nursing home managers’ leadership was significantly associated with less staff stress of conscience and more person-centred care. This indicates that a leadership most prominently characterised by coaching and giving feedback, relying on staff and handling conflicts constructively, experimenting with new ideas, and controlling work individually can contribute to less staff stress as well as higher degree of person-centred care provision.
Burnout, lifestyle and relaxation among dentists in Lithuania: a cross-sectional study
Authors: Slabšinskienė Eglė , Gorelik Andrej , Kavaliauskienė Aistė , Zaborskis Apolinaras
Published: October 2021

Background

The aim of this study was to estimate the association of burnout level with lifestyle and relaxation among dentists in Lithuania. A better understanding of this association could help in the development of targeted interventions to prevent burnout among these professionals.

Methods

The survey was conducted among practising dentists (N = 380) using the Maslach Burnout Inventory (MBI) and an authors’ proposed scale to measure lifestyle and relaxation. Poisson regression was applied to examine the association between variables.

Results

Regular cigarette smoking among dentists in Lithuania was 16.8 % and alcohol consumption was 31.3 %. Some forms of active relaxation were also common: regular playing sports (57.9 %), and spending time in nature (61.4 %). Emotional exhaustion (EE) and depersonalization (DP) burnout dimensions were negatively related to the regular use of illegal substances, alcohol, medication and smoking, while personal achievement (PA) was negatively related to smoking only. Dentists who regularly exercised had significantly lower EE and DP sum scores, and better assessments of PA. There were also positive relationships of EE, DP and PA sum scores with the variables of relaxation (e.g., spending time with family or friends, visiting a theatre, engaging in art, listening to music).

Conclusions

It was concluded that the burnout dimensions are negatively associated with unhealthy lifestyle factors and positively associated with active relaxation among dentists in Lithuania. Therefore, burnout prevention should target specific lifestyle and relaxation improvement strategies.
Tracking distinct microglia subpopulations with photoconvertible Dendra2 in vivo
Authors: Miller Eric B. , Karlen Sarah J. , Ronning Kaitryn E. , Burns Marie E.
Published: October 2021

Background

The ability to track individual immune cells within the central nervous system has revolutionized our understanding of the roles that microglia and monocytes play in synaptic maintenance, plasticity, and neurodegenerative diseases. However, distinguishing between similar subpopulations of mobile immune cells over time during episodes of neuronal death and tissue remodeling has proven to be challenging.

Methods

We recombineered a photoconvertible fluorescent protein (Dendra2; D2) downstream of the Cx3cr1 promoter commonly used to drive expression of fluorescent markers in microglia and monocytes. Like the popular Cx3cr1–GFP line (Cx3cr1+/GFP), naïve microglia in Cx3cr1–Dendra2 mice (Cx3cr1+/D2) fluoresce green and can be noninvasively imaged in vivo throughout the CNS. In addition, individual D2-expressing cells can be photoconverted, resulting in red fluorescence, and tracked unambiguously within a field of green non-photoconverted cells for several days in vivo.

Results

Dendra2-expressing retinal microglia were noninvasively photoconverted in both ex vivo and in vivo conditions. Local in vivo D2 photoconversion was sufficiently robust to quantify cell subpopulations by flow cytometry, and the protein was stable enough to survive tissue processing for immunohistochemistry. Simultaneous in vivo fluorescence imaging of Dendra2 and light scattering measurements (Optical Coherence Tomography, OCT) were used to assess responses of individual microglial cells to localized neuronal damage and to identify the infiltration of monocytes from the vasculature in response to large scale neurodegeneration.

Conclusions

The ability to noninvasively and unambiguously track D2-expressing microglia and monocytes in vivo through space and time makes the Cx3cr1–Dendra2 mouse model a powerful new tool for disentangling the roles of distinct immune cell subpopulations in neuroinflammation.
Inhibition of vascular adhesion protein 1 protects dopamine neurons from the effects of acute inflammation and restores habit learning in the striatum
Authors: Becchi Serena , Buson Alberto , Balleine Bernard W.
Published: October 2021

Background

Changes in dopaminergic neural function can be induced by an acute inflammatory state that, by altering the integrity of the neurovasculature, induces neuronal stress, cell death and causes functional deficits. Effectively blocking these effects of inflammation could, therefore, reduce both neuronal and functional decline. To test this hypothesis, we inhibited vascular adhesion protein 1 (VAP-1), a membrane-bound protein expressed on the endothelial cell surface, that mediates leukocyte extravasation and induces oxidative stress.

Method

We induced dopaminergic neuronal loss by infusing lipopolysaccharide (LPS) directly into the substantia nigra (SN) in rats and administered the VAP-1 inhibitor, PXS-4681A, daily.

Results

LPS produced: an acute inflammatory response, the loss of dopaminergic neurons in the SN, reduced the dopaminergic projection to SN target regions, particularly the dorsolateral striatum (DLS), and a deficit in habit learning, a key function of the DLS. In an attempt to protect SN neurons from this inflammatory response we found that VAP-1 inhibition not only reduced neutrophil infiltration in the SN and striatum, but also reduced the associated striatal microglia and astrocyte response. We found VAP-1 inhibition protected dopamine neurons in the SN, their projections to the striatum and promoted the functional recovery of habit learning. Thus, we reversed the loss of habitual actions, a function usually dependent on dopamine release in DLS and sensitive to striatal dysfunction.

Conclusions

We establish, therefore, that VAP-1 inhibition has an anti-inflammatory profile that may be beneficial in the treatment of dopamine neuron dysfunction caused by an acute inflammatory state in the brain.
Forearm compartment pressures and grip strength in elite motorbike racers with chronic exertional compartment syndrome
Authors: O’Dowd Dominic P. , Romer Heike , Hughes Richard , Harding Noel , Ball Samantha , Migliorini Filippo , Maffulli Nicola
Published: October 2021

Background

Remarkably little research has been published on chronic exertional compartment syndrome (CECS) of the forearm. This study investigated forearm flexor compartment pressure pre- and post-exercise in elite motorbike racers clinically diagnosed with CECS and assessed their grip strength before and after arm pump exercise.

Methods

Elite motorbike riders with a clinical diagnosis of CECS of the right forearm when racing were recruited during the opening rounds of a British Superbike season. Their grip strength and forearm flexor compartment pressures were measured before and after a set exercise programme.

Results

Of the 11 riders recruited to the study, 10 completed the full testing regime. The mean pre-exercise forearm compartment pressures [11.7 mmHg (range 7–17 mmHg)] significantly increased post-exercise [30.5 mmHg (range 15–45 mmHg)], with a mean increase of 18.80 mmHg (P < 0.0001). The mean pre-exercise grip strength [50.61 mmHg (range 37–66.7 mmHg)] decreased post-exercise to [35.62 mmHg (range 17.1–52.5 mmHg)], a mean decrease of 14.99 mmHg (P < 0.0001).

Conclusion

There is a statistically significant increase in the forearm flexor compartment pressures in elite motorbike racers with CECS, but with marked variability of these values. Grip strength decreases statistically significantly following onset of symptoms of CECS of the forearm.
Restoration of the immune function as a complementary strategy to treat Chronic Lymphocytic Leukemia effectively
Authors: Moreno Carol , Muñoz Cecilia , Terol María José , Hernández-Rivas José-Ángel , Villanueva Miguel
Published: October 2021

Chronic Lymphocytic Leukemia (CLL) is a hematological malignancy characterized by uncontrolled proliferation of B-cells and severe immune dysfunction. Chemo(immuno)therapies (CIT) have traditionally aimed to reduce tumor burden without fully understanding their effects on the immune system. As a consequence, CIT are usually associated with higher risk of infections, secondary neoplasms and autoimmune disorders. A better understanding of the biology of the disease has led to the development of therapeutic strategies which not only act against malignant B-cells but also reactivate and enhance the patient’s own anti-tumor immune response. Here, we review the current understanding of the underlying interplay between the malignant cells and non-malignant immune cells that may promote tumor survival and proliferation. In addition, we review the available evidence on how different treatment options for CLL including CIT regimens, small molecular inhibitors (i.e, BTK inhibitors, PI3K inhibitors, BCL-2 inhibitors) and T-cell therapies, affect the immune system and their clinical consequences. Finally, we propose that a dual therapeutic approach, acting directly against malignant B-cells and restoring the immune function is clinically relevant and should be considered when developing future strategies to treat patients with CLL.
Timing of antibiotic therapy in the ICU
Authors: Kollef Marin H. , Shorr Andrew F. , Bassetti Matteo , Timsit Jean-Francois , Micek Scott T. , Michelson Andrew P. , Garnacho-Montero Jose
Published: October 2021

Severe or life threatening infections are common among patients in the intensive care unit (ICU). Most infections in the ICU are bacterial or fungal in origin and require antimicrobial therapy for clinical resolution. Antibiotics are the cornerstone of therapy for infected critically ill patients. However, antibiotics are often not optimally administered resulting in less favorable patient outcomes including greater mortality. The timing of antibiotics in patients with life threatening infections including sepsis and septic shock is now recognized as one of the most important determinants of survival for this population. Individuals who have a delay in the administration of antibiotic therapy for serious infections can have a doubling or more in their mortality. Additionally, the timing of an appropriate antibiotic regimen, one that is active against the offending pathogens based on in vitro susceptibility, also influences survival. Thus not only is early empiric antibiotic administration important but the selection of those agents is crucial as well. The duration of antibiotic infusions, especially for β-lactams, can also influence antibiotic efficacy by increasing antimicrobial drug exposure for the offending pathogen. However, due to mounting antibiotic resistance, aggressive antimicrobial de-escalation based on microbiology results is necessary to counterbalance the pressures of early broad-spectrum antibiotic therapy. In this review, we examine time related variables impacting antibiotic optimization as it relates to the treatment of life threatening infections in the ICU. In addition to highlighting the importance of antibiotic timing in the ICU we hope to provide an approach to antimicrobials that also minimizes the unnecessary use of these agents. Such approaches will increasingly be linked to advances in molecular microbiology testing and artificial intelligence/machine learning. Such advances should help identify patients needing empiric antibiotic therapy at an earlier time point as well as the specific antibiotics required in order to avoid unnecessary administration of broad-spectrum antibiotics.
Gut bacterial metabolites modulate endoplasmic reticulum stress
Authors: Ke Xiaobo , You Kwontae , Pichaud Matthieu , Haiser Henry J. , Graham Daniel B. , Vlamakis Hera , Porter Jeffrey A. , Xavier Ramnik J.
Published: October 2021

Background

The endoplasmic reticulum (ER) is a membranous organelle that maintains proteostasis and cellular homeostasis, controlling the fine balance between health and disease. Dysregulation of the ER stress response has been implicated in intestinal inflammation associated with inflammatory bowel disease (IBD), a chronic condition characterized by changes to the mucosa and alteration of the gut microbiota. While the microbiota and microbially derived metabolites have also been implicated in ER stress, examples of this connection remain limited to a few observations from pathogenic bacteria. Furthermore, the mechanisms underlying the effects of bacterial metabolites on ER stress signaling have not been well established.

Results

Utilizing an XBP1s-GFP knock-in reporter colorectal epithelial cell line, we screened 399 microbiome-related metabolites for ER stress pathway modulation. We find both ER stress response inducers (acylated dipeptide aldehydes and bisindole methane derivatives) and suppressors (soraphen A) and characterize their activities on ER stress gene transcription and translation. We further demonstrate that these molecules modulate the ER stress pathway through protease inhibition or lipid metabolism interference.

Conclusions

Our study identified novel links between classes of gut microbe-derived metabolites and the ER stress response, suggesting the potential for these metabolites to contribute to gut ER homeostasis and providing insight into the molecular mechanisms by which gut microbes impact intestinal epithelial cell homeostasis.
The effect evaluation of Individual Placement and Support (IPS) for patients with substance use disorders: study protocol for a randomized controlled trial of IPS versus enhanced self-help
Authors: Rognli Eline Borger , Aas Erlend Marius , Drake Robert E. , Marsden John , Anders Paul , Bond Gary R. , Lystad June Ullevoldsæter , Reme Silje Endresen , Arnevik Espen Ajo
Published: October 2021

Background

Employment is associated with better outcomes of substance use treatment and protects against relapse after treatment completion. Unemployment rates are high for people with substance use disorders (SUD) who undergo treatment, with Norwegian estimates ranging from 81 to 91%. Evidence-based vocational models are lacking for patients in SUD treatment but exist for patients with psychosis in terms of Individual Placement and Support (IPS). The aim of the IPS for substance use disorders (IPS-SUD) trial is to investigate the effect of IPS in a SUD population.

Methods/design

The IPS-SUD trial is a randomized controlled trial (RCT) comparing IPS to an enhanced control intervention. The study is a seven-site, two-arm, pragmatic, parallel-group, superiority RCT. Participants are randomly assigned (1:1) to receive either IPS plus treatment as usual (TAU) or to receive a self-help guide book and 12-h workshop plus 1-h individual vocational guidance plus TAU. Aiming to recruit 200 participants, we will be able to detect a 20% difference in the main outcome of employment with 90% power. We will make assessments at inclusion and at 6- and 12-month follow-ups and obtain outcome data on employment from national mandatory registries. The primary outcome will be at least 1 day of competitive employment during the 18-month follow-up period. Secondary employment outcomes will capture the pattern and extent of employment in terms of total time worked (days/hours), time to first employment, number of different jobs, duration of the longest employment, and sustained employment. Secondary non-employment outcomes will be substance use, mental distress, and quality of life measured by validated instruments at 6, 12, and 18 months follow-up assessments. To be eligible, participants must be between 18 and 65 years, currently unemployed and in treatment for SUD.

Discussion

The IPS-SUD trial will provide evidence for the use of IPS in a SUD population. Findings from the study will have implications for service delivery.

Trial registration

ClinicalTrials.gov NCT04289415. Registered on February 28, 2020
Multiomic study of skin, peripheral blood, and serum: is serum proteome a reflection of disease process at the end-organ level in systemic sclerosis?
Authors: Farutin Victor , Kurtagic Elma , Pradines Joël R. , Capila Ishan , Mayes Maureen D. , Wu Minghua , Manning Anthony M. , Assassi Shervin
Published: October 2021

Background

Serum proteins can be readily assessed during routine clinical care. However, it is unclear to what extent serum proteins reflect the molecular dysregulations of peripheral blood cells (PBCs) or affected end-organs in systemic sclerosis (SSc). We conducted a multiomic comparative analysis of SSc serum profile, PBC, and skin gene expression in concurrently collected samples.

Methods

Global gene expression profiling was carried out in skin and PBC samples obtained from 49 SSc patients enrolled in the GENISOS observational cohort and 25 unaffected controls. Levels of 911 proteins were determined by Olink Proximity Extension Assay in concurrently collected serum samples.

Results

Both SSc PBC and skin transcriptomes showed a prominent type I interferon signature. The examination of SSc serum profile revealed an upregulation of proteins involved in pro-fibrotic homing and extravasation, as well as extracellular matrix components/modulators. Notably, several soluble receptor proteins such as EGFR, ERBB2, ERBB3, VEGFR2, TGFBR3, and PDGF-Rα were downregulated. Thirty-nine proteins correlated with severity of SSc skin disease. The differential expression of serum protein in SSc vs. control comparison significantly correlated with the differential expression of corresponding transcripts in skin but not in PBCs. Moreover, the differentially expressed serum proteins were significantly more connected to the Well-Associated-Proteins in the skin than PBC gene expression dataset. The assessment of the concordance of between-sample similarities revealed that the molecular profile of serum proteins and skin gene expression data were significantly concordant in patients with SSc but not in healthy controls.

Conclusions

SSc serum protein profile shows an upregulation of profibrotic cytokines and a downregulation of soluble EGF and other key receptors. Our multilevel comparative analysis indicates that the serum protein profile in SSc correlates more closely with molecular dysregulations of skin than PBCs and might serve as a reflection of disease severity at the end-organ level.
Predicting the nature of pleural effusion in patients with lung adenocarcinoma based on 18F-FDG PET/CT
Authors: Li Yi , Mu Wei , Li Yuan , Song Xiao , Huang Yan , Jiang Lei
Published: October 2021

Background

This study aims to establish a predictive model on the basis of 18F-FDG PET/CT for diagnosing the nature of pleural effusion (PE) in patients with lung adenocarcinoma.

Methods

Lung adenocarcinoma patients with PE who underwent 18F-FDG PET/CT were collected and divided into training and test cohorts. PET/CT parameters and clinical information in the training cohort were collected to estimate the independent predictive factors of malignant pleural effusion (MPE) and to establish a predictive model. This model was then applied to the test cohort to evaluate the diagnostic efficacy.

Results

A total of 413 lung adenocarcinoma patients with PE were enrolled in this study, including 245 patients with MPE and 168 patients with benign PE (BPE). The patients were divided into training (289 patients) and test (124 patients) cohorts. CEA, SUVmax of tumor and attachment to the pleura, obstructive atelectasis or pneumonia, SUVmax of pleura, and SUVmax of PE were identified as independent significant factors of MPE and were used to construct a predictive model, which was graphically represented as a nomogram. This predictive model showed good discrimination with the area under the curve (AUC) of 0.970 (95% CI 0.954–0.986) and good calibration. Application of the nomogram in the test cohort still gave good discrimination with AUC of 0.979 (95% CI 0.961–0.998) and good calibration. Decision curve analysis demonstrated that this nomogram was clinically useful.

Conclusions

Our predictive model based on 18F-FDG PET/CT showed good diagnostic performance for PE, which was helpful to differentiate MPE from BPE in patients with lung adenocarcinoma.
Evidence on respectful maternity care for adolescents: a systematic review protocol
Authors: Habib Helen H. , Mwaisaka Jefferson , Torpey Kwasi , Maya Ernest Tei , Ankomah Augustine
Published: October 2021

Background

Intrapartum mistreatment of women is an ubiquitous public health and human rights challenge. The issue reportedly has severe maternal and neonatal outcomes including mortality, and generally leads to a decreased satisfaction with maternity care. Intrapartum mistreatment, despite being ubiquitous, indicates higher incidence amongst adolescent parturients who are simultaneously at a higher risk of maternal morbidity and mortality. Studies have suggested that Respectful Maternity Care interventions reduce intrapartum mistreatment and improve clinical outcomes for women and neonates in general. However, evidence on the effect of RMC on adolescents is unclear. Hence, the specific aim of this study is to synthesise the available evidence relating to the provision of RMC for adolescents during childbirth.

Methods

The methodology of the proposed systematic review follows the procedural guideline depicted in the preferred reporting items for systematic review protocol. The review will include published studies and gray literature from January 1, 1990, to June 30, 2021. Electronic databases including MEDLINE, PubMed, ScienceDirect, Cochrane, CINAHL, PsycINFO, Scopus, Google Scholar and Web of Science will be searched to retrieve available studies using the appropriate search strings. Studies included in the review will be appraised for quality using tools tailored to each study design. If appropriate, we will conduct random effects meta-analysis of data to summarise the pooled estimates of respectful maternity care prevalence and outcomes. The selection of relevant studies, data extraction and quality assessment of individual studies will be carried out by two independent authors.

Results

Summaries of the findings will be compiled and synthesised in a narrative summary. In addition to the narrative synthesis, where sufficient data are available, a random-effects meta-analysis will be conducted to obtain a pooled estimate value for respectful maternity care prevalence and outcomes.

Discussion

Respectful Maternity Care for adolescents holds great promise for improved maternal and neonatal care. However, there is a gap in knowledge on the interventions that work and the extent of their effectiveness. Findings from this study will be beneficial in improving Adolescents Sexual and Reproductive Health and Rights and reducing maternal mortality, especially for adolescents.

Systematic review registration

PROSPERO CRD42020183440
An inverse problem of reconstructing the time-dependent coefficient in a one-dimensional hyperbolic equation
Authors: Huntul M. J. , Abbas Muhammad , Baleanu Dumitru
Published: October 2021

In this paper, for the first time the inverse problem of reconstructing the time-dependent potential (TDP) and displacement distribution in the hyperbolic problem with periodic boundary conditions (BCs) and nonlocal initial supplemented by over-determination measurement is numerically investigated. Though the inverse problem under consideration is ill-posed by being unstable to noise in the input data, it has a unique solution. The Crank–Nicolson-finite difference method (CN-FDM) along with the Tikhonov regularization (TR) is applied for calculating an accurate and stable numerical solution. The programming language MATLAB built-in lsqnonlin is used to solve the obtained nonlinear minimization problem. The simulated noisy input data can be inverted by both analytical and numerically simulated. The obtained results show that they are accurate and stable. The stability analysis is performed by using Fourier series.
An inertial parallel algorithm for a finite family of G-nonexpansive mappings with application to the diffusion problem
Authors: Charoensawan Phakdi , Yambangwai Damrongsak , Cholamjiak Watcharaporn , Suparatulatorn Raweerote
Published: October 2021

For finding a common fixed point of a finite family of G-nonexpansive mappings, we implement a new parallel algorithm based on the Ishikawa iteration process with the inertial technique. We obtain the weak convergence theorem of this algorithm in Hilbert spaces endowed with a directed graph by assuming certain control conditions. Furthermore, numerical experiments on the diffusion problem demonstrate that the proposed approach outperforms well-known approaches.
COVID-19 vaccination program in the mainland of China: a subnational descriptive analysis on target population size and current progress
Authors: Zheng Wen , Yan Xuemei , Zhao Zeyao , Yang Juan , Yu Hongjie
Published: October 2021

Background

China is facing substantial risks of imported coronavirus disease 2019 (COVID-19) cases and a domestic resurgence in the long run, and COVID-19 vaccination is expected to be the long-lasting solution to end the pandemic. We aim to estimate the size of the target population for COVID-19 vaccination at the provincial level in the mainland of China, and summarize the current progress of vaccination programs, which could support local governments in the timely determination and adjustment of vaccination policies and promotional measures.

Methods

We conducted a descriptive study of the entire population in the mainland of China, between December 2020 and August 2021. By extracting provincial-stratified data from publicly available sources, we estimated the size of priority target groups for vaccination programs, and further characterized the ongoing vaccination program at the provincial level, including the total doses administered, the coverage rate, and the vaccination capacity needed to achieve the target coverage of 80% by the end of 2021. We used R (version 4.1.0) to complete the descriptive statistics.

Results

The size of the target population shows large differences among provinces, ranging from 3.4 million to 108.4 million. As of 31 August, 2021, the speed of vaccine roll-out differs considerably as well, with the highest coverage occurring in Beijing and Shanghai, where 88.5% and 79.1% of the population has been fully vaccinated, respectively. In 22 of 31 provincial-level administrative divisions (PLADs), more than 70% of the population was administered at least one dose by August. With the current vaccination capacity, the target of 80% coverage could be achieved by 2021 in 28 PLADs.

Conclusions

Disparities exist in the target population size and vaccination progress across provinces in the mainland of China. China has made great strides in the vaccination speed since roll-out, and could basically achieve the targeted vaccine coverage.

Graphic Abstract