bluuebunny/crossref_metadata_2025 huggingface dataset:
Colorectal sessile serrated lesion detection using linked-color imaging versus narrow-band imaging: a parallel randomized controlled trial
Authors: Li Jun , Chen Kan , Wei Yunlei , Zhang Di , Wang Yuxin , Hou Xiaojia , Wu Ruijin , Peng Kangsheng , Li Lei , Huang Chao , Wang Yilong , Xun Linjuan , Liu Feng
Published: December 2022

Background Previous studies have reported the effectiveness of narrow-band imaging (NBI) and linked-color imaging (LCI) in improving the detection of colorectal neoplasms. There has however been no direct comparison between LCI and NBI in the detection of colorectal sessile serrated lesions (SSLs). The present study aimed to compare the effectiveness of LCI and NBI in detecting colorectal SSLs.

Methods A prospective, parallel, randomized controlled trial was conducted. The participants were randomly assigned to the LCI or NBI arms. The primary end point was the SSL detection rate (SDR).

Results 406 patients were involved; 204 in the LCI arm and 202 in the NBI arm. The total polyp detection rate, adenoma detection rate, and SDR were 54.2 %, 38.7 %, and 10.8%, respectively. The SDR was not significantly different between the LCI and NBI arms (12.3 % vs. 9.4 %; P = 0.36). The differences in the detection rate and the per-patient number of polyps, adenomas, diminutive lesions, and flat lesions between LCI and NBI also were not statistically significant. Multivariate analysis showed that LCI and NBI were not independent factors associated with SDR, whereas Boston Bowel Preparation Scale score (odds ratio [OR] 1.35, 95 %CI 1.03–1.76; P = 0.03), withdrawal time (OR 1.13, 95 %CI 1.00–1.26; P = 0.04), and operator experience (OR 3.73, 95 %CI 1.67–8.32; P = 0.001) were independent factors associated with SDR.

Conclusions LCI and NBI are comparable for SSL detection, as well as for the detection of polyps and adenomas.
Development and Validation of a Survey to Measure Patients' Expectations of Wrist Arthritis Surgery
Authors: Wolff Aviva L. , Mancuso Carol A. , Lee Steve K. , Wolfe Scott W.
Published: December 2022

Background The purpose of this study was to develop and test a patient-derived expectations survey for wrist arthritis surgery. We hypothesized that preoperative patient expectations are higher in people with greater functional impairment and that postoperative fulfilment of patient expectations correlates with functional improvement.

Methods The study was conducted in four phases.

Development (n = 22) Preoperatively, patients were asked open-ended questions regarding expectations of surgery. A draft survey was then assembled.

Reliability (n = 35) The survey was administered twice preoperatively. Concordance was measured with weighted kappa values and intraclass correlations (ICC).

Validity (n = 58) Validity was assessed by comparing responses from the Expectations Survey to the patient-rated wrist evaluation (PRWE).

Responsiveness (n = 18) Responsiveness was calculated by comparing the proportion of expectations fulfilled to PRWE scores 1-year postoperatively.

Results Development Twenty-two distinct items representing the most frequent responses were utilized from the draft survey items of 1,244 expectations volunteered.

Reliability Patients had high preoperative expectations of surgery (mean = 76.8); 30% had scores ≥90. Test–retest reliability was high (Cronbach α coefficients = 0.91, 0.93, ICC = 0.86). Endorsement of items = 66 to 100%; and weighted kappa values = 0.39 to 0.96.

Validity Patients with greater preoperative expectations (≥63) had more pain, worse function, and worse PRWE scores than those with lower expectations.

Responsiveness The proportion of fulfilled expectations was high (mean 0.80, median 0.79), and greater fulfillment (proportion > 0.80, n = 8) was associated with better postoperative PRWE scores.

Conclusion The patient-derived expectations survey is reliable, valid, responsive, and addresses a spectrum of expectations for patients undergoing surgery for wrist arthritis.

Clinical relevance Understanding patient expectations can contribute to customized care given the range of surgical choices for the arthritic wrist.
Cr doped CeO2 nanoparticles as supercapacitor electrodes
Authors: Veena B. , Pavithra S. , Seetha M. , Sakunthala A. , Masuda Yoshitake
Published: December 2022

The consumption of electrical energy has greatly increased lately, and the requirement of portable charge storage devices has also increased. To fulfill this, a versatile rare earth element CeO2 in nanoparticle form is selected and synthesized through a cost effective precipitation method for supercapacitor application. To improve its efficiency, 2% and 4% of transition metal chromium were doped into the ceria lattice, and their electrochemical properties were studied. The cubic fluorite structure with an average crystallite size of all the samples was 16 nm, which was confirmed through x-ray diffraction analysis. Peculiar rice shaped clusters are observed for 2% Cr doped samples through field emission scanning electron microscopy analysis. The N2 adsorption desorption studies were performed to calculate the surface area of the prepared samples. A maximum specific capacitance of 42.6 F g−1 was obtained for the 2% Cr doped CeO2 sample at 5 mV s−1 in 2M KOH in cyclic voltammetric studies. The galvanostatic charge–discharge and electrochemical impedance spectroscopy measurements were also taken to analyze the charge–discharge cycles and stability of the samples.
ACCESS-S2: the upgraded Bureau of Meteorology multi-week to seasonal prediction system
Authors: Wedd Robin , Alves Oscar , de Burgh-Day Catherine , Down Christopher , Griffiths Morwenna , Hendon Harry H. , Hudson Debra , Li Shuhua , Lim Eun-Pa , Marshall Andrew G. , Shi Li , Smith Paul , Smith Grant , Spillman Claire M. , Wang Guomin , Wheeler Matthew C. , Yan Hailin , Yin Yonghong , Young Griffith , Zhao Mei , Xiao Yi , Zhou Xiaobing
Published: December 2022

ACCESS-S2 is a major upgrade to the Australian Bureau of Meteorology’s multi-week to seasonal prediction system. It was made operational in October 2021, replacing ACCESS-S1. The focus of the upgrade is the addition of a new weakly coupled data assimilation system to provide initial conditions for atmosphere, ocean, land and ice fields. The model is based on the UK Met Office GloSea5-GC2 seasonal prediction system and is unchanged from ACCESS-S1, aside from minor corrections and enhancements. The performance of the assimilation system and the skill of the seasonal and multi-week forecasts have been assessed and compared to ACCESS-S1. There are improvements in the ACCESS-S2 initial conditions compared to ACCESS-S1, particularly for soil moisture and aspects of the ocean, notably the ocean currents. More realistic soil moisture initialisation has led to increased skill for forecasts over Australia, especially those of maximum temperature. The ACCESS-S2 system is shown to have increased skill of El Nino–Southern Oscillation forecasts over ACCESS-S1 during the challenging autumn forecast period. Analysis suggests that ACCESS-S2 will deliver improved operational forecast accuracy in comparison to ACCESS-S1. Assessments of the operational forecasts are underway. ACCESS-S2 represents another step forward in the development of seasonal forecast systems at the Bureau of Meteorology. However, key rainfall and sea surface temperature biases in ACCESS-S1 remain in ACCESS-S2, indicating where future efforts should be focused.
Marine planktonic dinophysoid dinoflagellates (order Dinophysales): 60 years of species-level distributions in Australian waters
Authors: Hallegraeff Gustaaf M. , Eriksen Ruth S. , Davies Claire H. , Uribe-Palomino Julian
Published: December 2022

We reviewed 9350 Australian species-level records and confirmed 64 species of the marine planktonic dinoflagellate genera Dinophysis Ehrenb. (17 species), Phalacroma F.Stein (12), Metaphalacroma L.S.Tai (1), Pseudophalacroma Jörg. (1), Ornithocercus F.Stein (7), Histioneis F.Stein (11 spp.), Parahistioneis Kof. & Skogsb. (4), Histiophysis (Kof. & Mich.) Kof. & Skogsb. (1), Citharistes F.Stein (2) and Amphisolenia F.Stein (8), from the period 1938–2019. The widespread D. acuminata Clap. & J.Lachm., D. acuta Ehrenb., D. caudata Kent, D. fortii Pavill., and D. tripos Gourret have attracted attention as causative organisms of diarrhetic shellfish poisoning in temperate Australian waters. We discriminate between Dinophysis and Phalacroma. We newly report from Australian waters O. assimilis Jörg., Metaphalacroma skogsbergii L.S.Tai, Parahistioneis pieltainii Osorio-Taffal, Amphisolenia extensa Kof., A. inflata G.Murr. & Whitt. and A. rectangulata Kof. We rediscovered Histiophysis rugosa (Kof. & Mich.) Kof. & Skogsb. here illustrated with two cells from the Coral Sea. The ornate tropical genera Ornithocercus and Histioneis are excellent warm-water indicators, reflecting the southward reach of the East Australian and Leeuwin currents, whereas D. truncata Cleve is a cold-water Subantarctic species.
Article use in Upper German – a ‘radical’ stage of grammaticalization?
Authors: Vergeiner Philip C. , Niehaus Konstantin
Published: December 2022

Despite an increasing interest in German dialect syntax, the study of article use in Upper German (Alemannic and
Bavarian) remains a desideratum. This is true in particular for Austrian varieties. The present study focusses on article
variation and change in Austrian Upper German and discusses the status of article grammaticalization. To that effect, ‘radical’
cases of article use in Upper German are analysed, i.e. cases considered incorrect in standard German: the use of indefinite
articles before mass nouns, of definite articles before proper nouns, and of indefinite articles in the plural. These phenomena
are investigated by means of a comprehensive dialect survey (3,599 dialect translations by 163 dialect speakers from 40 research
locations). The analysis examines inner-linguistic factors (lexis, semantics, syntax) as well as extra-linguistic factors (dialect
areas, age group). The findings reveal a surprisingly high variability and a relatively advanced stage of grammaticalization in
some areas, especially Central Bavarian dialects.
Reliance upon contextual information can impede visual anticipation
Authors: Müller Sean , Brenton John , O'Grady Mathew
Published: December 2022

This study investigated whether skilled batsmen in a state cricket pathway could anticipate ball types when congruency of field‐placings was manipulated with a bowler's action. Twenty‐four male cricket batsmen were recruited who had played either first‐class cricket (n = 6), were part of under 17 (n = 8) or under 19 (n = 10) state cricket squads. Participants completed a video‐based temporal occlusion test where they were required to anticipate ball types from a swing bowler. In condition one, contextual field‐placing information was presented to be congruent with the delivery type and bowler's action, whilst in condition two it was incongruent. Results did not reveal skill level differences across conditions for anticipation. In the congruent condition, all skill groups predicted above the chance level at the beginning and end of the bowler's delivery stride. In the incongruent condition, first‐class players predicted above chance at the beginning of the bowler's delivery stride, and to a higher magnitude above chance compared to other skill groups at ball release. Under 17 and 19 players could not predict above chance at the start of the bowler's delivery stride with their magnitude of prediction lower than first‐class players at ball release. Results indicate skilled batsmen find it challenging to integrate contextual and kinematic information to anticipate. This is likely due to greater emphasis placed upon contextual information in part supplied by data analysts. Findings have theoretical and practical implications respectively for lower body positioning for bat‐ball interception and perceptual training to improve pick‐up of kinematic cues.
Capturing of non-hydrogenic Rydberg series of exciton binding energy in two-dimensional mono-layer WS2 using a modified Coulomb potential in fractional space
Authors: Ahmad Shahzad , Zubair Muhammad , Younis Usman
Published: December 2022

2D materials exhibit unique electronic states due to quantum confinement. Among the Group-VI chalcogenides, direct mono-layer WS2 is the most prominent where screening is non-localized, having strongly bound excitons with large binding energies and a pronounced deviation of the excitonic states from the hydrogenic series. State-of-the-art experimental and theoretical methods to determine excitonic Rydberg series employ optical spectroscopy and Bethe-Salpeter (BSE) equation, respectively, but incur high costs, paving the way to develop analytical approaches. We present a generalized hydrogenic model by employing a fractional version of the Coulomb-like potential to capture the excitonic Rydberg series of the fundamental optical transition in mono-layer WS2, based on the fractional scaling of the electron-hole pair interactions through the tuning of the fractional-space parameter β, benchmarked with experimental data and that of with numerical computation of the hydrogenic solution involving the Rytova-Keldysh (R-K) potential model. The enhanced electron-hole interactions lead to a strong dielectric contrast between the mono-layer WS2 and its surrounding environment and causes the deviation of the low-lying excitonic states from the hydrogenic series. The fractional Coulomb potential (FCP) model captures the first two non-hydrogenic states at β < 3, to fit a Coulomb-like to logarithmic change with respect to the excitonic radius and the higher hydrogenic states to have Coulombic interactions at β ≈ 3 in mono-layer WS2. A comparison of the proposed model with an existing model based on Wannier theory reveals a reduction in the relative mean square error of up to 30% for the excitonic series, with only the ground state captured as non-hydrogenic by the latter.
A flexible bilayer p-NiO/n-ZnO films with photodetecting properties in self power mode
Authors: Salunkhe Parashurama , Bhat Prashant , Kekuda Dhananjaya
Published: December 2022

We report highly efficient flexible p-NiO/n-ZnO heterojunction UV photodetectors. NiO and ZnO thin films were grown on plastic polyethylene terephthalate (PET) substrates by dc magnetron sputtering for constructing high quality interfaces. The diode has shown an excellent rectification ratio i.e. 106 under dark mode and observed more than 80% transparency in the visible region. Investigated structural, compositional, and optical properties of the film to correlate the UV photodetector transport characteristics. Further, UV illumination devices exhibit an excellent responsivity of 0.24 A W−1 with a detectivity of 1.25 × 1011 jones and the highest external quantum efficiency of 83.14% achieved at −5 V of bias. The device shows the fastest speed of response with rise/fall times of 86.10 ms/106.60 ms, accomplished at −1 V with the lowest optical power density. The photodiode has shown incredible characteristics that are mainly attributed to the built-in potential and the transport mechanism at the interface.
High anisotropic magnetoresistance, perfect spin-filtering effect, and negative differential resistance effect of Cr-doped anatase phase TiO2
Authors: Liu Sheng , Liu Bin , Wang Tongtong , Zhu Sicong , Li Yu
Published: December 2022

Anisotropy-based half-metallic materials are highly efficient in spintronic devices and have important applications in spintronics. Anatase phase TiO2 has attracted much attention because of its anisotropy, but its non-magnetism limits its applications in spintronics. We investigate the electronic structure of 3d transition metal-doped anatase phase TiO2 by first principles method to achieve spin injection of anatase. The calculation results exhibit that the Sc, Cr, Mn, Fe, and Ni-doped systems are half-metallic ferromagnets while other doped systems behave as magnetic metals except the V-doped system is a magnetic semiconductor. The calculated formation energy under O-rich condition are negative shows that all half-metals are thermodynamically stable, and we construct devices along the y-direction of the half-metal and find that the device based on the Cr-doped system has the best electronic transfer capacity under zero bias. Then we use the Cr-doped system as the electrode and the pure anatase unit cell as the central scattering region to construct devices in different directions. We find that the magnitude of the current along different transport directions varied greatly, and the calculated anisotropic magnetoresistance was as high as 300%. Furthermore, whether spin configurations (PC) or antiparallel configurations (APC), there is a 100% spin-filtering efficiency of the device, and we find a significant negative differential resistance effect of the device in PC. These results suggest that Cr-doped anatase phase TiO2 can be used in spintronics.
Laser processing of composite materials for acoustic applications
Authors: Singh Priyanka Priyadarsini , Nath Ganeswar
Published: December 2022

The consistency of machined components in terms of their final material surfaces is a fundamental aspect of manufacturing. Laser-based non-contact sensors that use non-destructive speckle imaging are challenging the surface profilometry technique as an alternative method for the analysis of surface quality. This paper presents research into the importance of laser techniques in analyzing the surface roughness of composite materials used in the fabrication of acoustic panels. Roughness analyses performed by both the designed laser sensor and the surface profilometry technique were both found to be efficient; however, the speckle imaging method produces better results for most materials. Enhancements in surface roughness were measured and found to be 20% greater than those observed by the stylus method; in addition, the laser technique has low costs for commercial applications while being a scientific-concept-based analytical technique that uses a novel approach. The surface roughness was measured under different conditions by varying the speckle contrast using different positions and laser source orientations. The interactions between photons and phonons were analyzed in depth for a fabricated biomaterial-based-composite to assess its suitability for acoustic applications in different smart devices.
Construction and Validation of a Geometry-based Mathematical Model for the Hard X-Ray Imager
Authors: Jiang Xian-Kai , Wu Jian , Chen Deng-Yi , Hu Yi-Ming , Wang Hao-Xiang , Liu Wei , Zhang Zhe
Published: December 2022

Quantitative and analytical analysis of the modulation process of the collimator is a great challenge, and is also of great value to the design and development of Fourier transform imaging telescopes. The Hard X-ray Imager (HXI), as one of the three payloads onboard the Advanced Space-based Solar Observatory (ASO-S) mission, adopts modulating Fourier-Transformation imaging technique and will be used to explore the mechanism of energy release and transmission in solar flare activities. As an important step to reconstruct the images of solar flares, accurate modulation functions of HXI are needed. In this paper, a mathematical model is developed to analyze the modulation function under a simplified condition first. Then its behavior under six degrees of freedom is calculated after adding the rotation matrix and translation change to the model. In addition, unparalleled light and extended sources are also considered so that our model can be used to analyze the X-ray beam experiment. Next, applied to the practical HXI conditions, the model has been confirmed not only by Geant4 simulations but also by some verification experiments. Furthermore, how this model helps to improve the image reconstruction process after the launch of ASO-S is also presented.
Solar Active Region Magnetogram Generation by Attention Generative Adversarial Networks
Authors: Sun Wenqing , Xu Long , Zhang Yin , Zhao Dong , Zhang Fengzhen
Published: December 2022

Learning the mapping of magnetograms and EUV images is important for understanding the solar eruption mechanism and space weather forecasting. Previous works are mainly based on the pix2pix model for full-disk magnetograms generation and obtain good performance. However, in general, we are more concerned with the magnetic field distribution in the active regions where various solar storms such as the solar flare and coronal mass ejection happen. In this paper, we fuse the self-attention mechanism with the pix2pix model which allows more computation resource and greater weight for strong magnetic regions. In addition, the attention features are concatenated by the Residual Hadamard Production (RHP) with the abstracted features after the encoder. We named our model as RHP-attention pix2pix. From the experiments, we can find that the proposed model can generate magnetograms with finer strong magnetic structures, such as sunspots. In addition, the polarity distribution of generated magnetograms at strong magnetic regions is more consistent with observed ones.
Magnetic sphincter augmentation: laparoscopic or robotic approach?
Authors: Maharsi Safa , Lipham John C , Houghton Caitlin C
Published: December 2022

Gastroesophageal reflux disease (GERD)—the pathologic reflux of gastric contents into the distal esophagus—is the most common benign disorder of the esophagus. Its incidence is at 10–20% of the Western population and it yearly cost of treatment in the USA in 9.3 billion dollars. Although first line treatment for the disorder is medical therapy with proton pump inhibitors, an estimated 30–40% of patients will continue to experience medically refractory GERD. In this population anti-reflux surgery can be offered. Traditional anti-reflux surgery is done via the Nissen fundoplication, a technically difficult surgery with uncomfortable side effects of bloating and inability to belch. Magnetic sphincter augmentation (MSA) of the lower esophagus via the LINX device was introduced a less technically challenging alternative to the Nissen. The LINX provides fewer side effects of bloating and inability to belch and has been adapted widely to the practice of anti-reflux surgery. In this paper we discuss the progression of surgical practices with the LINX, including an analysis of the laparoscopic and robotic approaches to MSA device implantation.
Circadian metabolism regulates the macrophage inflammatory response
Authors: Sun Yulong , Jiang Wenjiao , Horng Tiffany
Published: December 2022

Macrophages are an integral part of the innate immune system and coordinate host defense to microbial infections, as well as shaping the remodeling response after tissue injury. Metabolism is now appreciated to be a powerful and pervasive regulator of the identity and function of macrophages. Upon exposure to microbial ligands, macrophage inflammatory activation and the associated induction of phagocytosis, inflammatory responses, and other host defense activities are supported by dynamic changes to cellular metabolism. Of note, metabolic activity is robustly regulated in a circadian fashion, with many metabolic processes displaying peak activity in one phase of the circadian cycle and trough activity in an antiphase manner. Here, we review recent findings suggesting that circadian metabolism influences macrophage activities and particularly the inflammatory response. First, we summarize macrophage activities known to display time-of-day–dependent variation and their mechanistic basis. Second, we review metabolic processes that have been shown to be rhythmically regulated in macrophages and discuss how such circadian metabolism affects or is likely to affect macrophage activities. Third, we discuss the concept of entrainment of the macrophage clock, and consider how loss of rhythmic regulation of macrophage activities may contribute to pathophysiological conditions like shift work, obesity, and aging. Finally, we propose that circadian metabolism can be used to understand the rationale and mechanistic basis of dynamic regulation of inflammatory responses during infection.
Vaccination as an Equaliser? Evaluating COVID-19 Vaccine Prioritisation and Compensation
Authors: Günther Christian , Tonti Lauren , Domenici Irene
Published: December 2022

This article assesses the equity of COVID-19 vaccination programmes in three jurisdictions that have historically taken different approaches to the institutionalisation of equity considerations. The Sars-Cov-2 pandemic has thrown into sharp relief persistent societal inequalities and has added novel dimensions to these problems. Certain groups have proved particularly vulnerable, both in terms of infection risk and severity as well as the accompanying social fallout. Against this background the implementation of ‘objective’ vaccination programmes may seem like a great leveller, addressing the disparate risks that are tied to social determinants of health and the pandemic behemoth. However, implementing vaccination programmes in an equitable manner is itself essential for the realisation of such a vision. This article undertakes a comparative analysis of the English, Italian, and American jurisdictions and critically assesses two aspects of their vaccination frameworks: (i) the prioritisation of groups for vaccination and (ii) the nature of public compensation schemes for those who have suffered vaccine-related injuries. It examines whether and to what extent these measures address the inequalities raised by COVID-19 and the role of the law in this pursuit.
Factors associated with impaired physical function in elderly rheumatoid arthritis patients who had achieved low disease activity
Authors: Komiya Yoji , Sugihara Takahiko , Hirano Fumio , Matsumoto Takumi , Kamiya Mari , Sasaki Hirokazu , Hosoya Tadashi , Kimura Naoki , Ishizaki Tatsuro , Mori Masaaki , Tohma Shigeto , Yasuda Shinsuke , Matsui Toshihiro
Published: December 2022

Objectives

We aimed to investigate factors associated with impaired physical function [defined as Health Assessment Questionnaire Disability Index (HAQ-DI) >0.5] of old-old (aged 75–84 years) patients with rheumatoid arthritis.

Methods

Data from 15,185 rheumatoid arthritis patients in the National Database of Rheumatic Disease in Japan were extracted from 2017 to 2018. We enrolled 3708 patients aged 55–84 years in Simplified Disease Activity Index (SDAI) ≤11 and Steinbrocker Stage I/II. Factors associated with HAQ-DI >0.5 were analysed by multivariable logistic regression.

Results

About half of the old-old patients received methotrexate, which was lower than middle-aged (55–64 years) and young-old patients (65–74 years). The proportion of glucocorticoids in the old-old patients was highest among the three groups, and biological disease-modifying antirheumatic drugs were similarly used. The prevalence of HAQ-DI >0.5 was significantly higher in old-old patients with low disease activity than in those with remission. The same was true in the middle-aged and young-old patients. Multivariable analysis showed age, higher SDAI, glucocorticoid use, and methotrexate nonuse were significantly associated with HAQ-DI >0.5 in the old-old patients.

Conclusions

Achieving SDAI remission was an ideal goal for old-old patients in terms of physical function. Glucocorticoids and a low proportion of methotrexate use may influence the physical function of old-old patients.
Clinical and immunological effects of hydroxychloroquine in patients with active rheumatoid arthritis despite antirheumatic treatment
Authors: Takei Hiroshi , Takanashi Satoshi , Otomo Kotaro , Hanaoka Hironari , Kikuchi Jun , Yamaoka Kunihiro , Yoshimoto Keiko , Abe Takayuki , Takeuchi Tsutomu , Kaneko Yuko
Published: December 2022

Objectives

To investigate the efficacy and safety of hydroxychloroquine (HCQ) in patients with rheumatoid arthritis (RA).

Methods

Patients with active RA, despite conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), were recruited. HCQ was administered for 24 weeks, in addition to prior treatment. The primary end-point was the proportion of patients achieving American College of Rheumatology (ACR) 20 at Week 24, compared to that of a propensity score–matched historical control group.

Results

Sixty patients were enrolled and administered HCQ. We also identified 276 patients as candidates for the historical control group. Propensity score matching yielded 46 patients in each group. The proportion of patients achieving ACR20 at Week 24 was significantly higher in the HCQ group than in the control group (54.4% vs. 28.3%, P = .007). The proportion of patients achieving ACR50 and ACR70 at Week 24 were also higher in the HCQ group than in the control group (ACR50, 30.4% vs. 4.3%, P = .006; ACR70, 17.4% vs. 0%, P = .005). Neither HCQ retinopathy nor any new safety signal was observed during the study.

Conclusion

The addition of HCQ to csDMARDs was effective, with no new safety signal in patients with RA.
EYE RADIATION DOSE SAVING IN HEAD CT EXAMINATIONS USING COPPER-BISMUTH RADIATION SHIELD
Authors: Keshtkar Mohammad , Blouri Basir , Mahmoudabadi Alireza , Alami Ali
Published: December 2022

The aim of the present study is to fabricate a new shield with an optimal combination of copper and bismuth to protect the eyes in the head computed tomography (CT) examinations without compromising image quality. Radiation shields with different compositions were constructed. Computed Tomography Dose Index phantom was used to evaluate the effectiveness of shields in dose reduction and their impact on image quality quantitatively. The shield that caused the least noise in the phantom study was selected for human study. The 10%Bi-90%Cu shield had the least effect on increasing the image noise, and also no remarkable artifact was seen in the CT image of the phantom. The patient study showed that only in 25% of the study group the artifact was observed so that it did not distort the interpretation of the image. It can be concluded that the 10%Bi-90%Cu shield is flexible and durable and would be safely used in the clinic to reduce the eye radiation dose in head CT imaging without compromising image quality.
Measuring Personalization, Embodiment, and Congruence in Online Learning: A Validation Study
Authors: Cook David A. , Skrupky Lee P.
Published: December 2022

Purpose

Instructional designs promoting personalization (conversational style and visible author), embodiment (human-like mannerisms and presence), and social and cognitive congruence have been shown to enhance learning. However, measurements of these instructional design features are lacking. The authors sought to develop and validate an instrument to measure personalization, embodiment, and congruence in an online course, collecting evidence of content, internal structure, and relationships with other variables.

Method

Through literature review, expert review, and pilot testing, the authors developed a 15-item, 5-domain instrument. Participants completed this instrument along with assessments of motivation (Instructional Materials Motivation Survey and Motivated Strategies for Learning Questionnaire), knowledge, and course satisfaction immediately after a 30-minute online multimedia learning module comprising slides with voiceover and (for some participants) short video clips, from January to April 2021. Participants included pharmacists, physicians, and advanced practice providers at academic and community hospitals. Confirmatory factor analysis (CFA) was used to examine model fit, followed by structural revisions guided by exploratory factor analysis (EFA) and tested in a new CFA using a split-sample approach. The authors evaluated associations between the revised instrument scores and motivation, knowledge, and satisfaction.

Results

There were 406 participants. CFA of the original 15-item instrument revealed poor model fit. EFA using 214 randomly selected participants suggested a 2-domain structure. CFA of the revised structure using the other 192 participants revealed good fit for a 9-item, 2-domain instrument: the Congruence–Personalization Questionnaire (CPQ). Linear regression confirmed positive, statistically significant associations for most hypothesized relationships (R2 ≥ 0.12 and P < .001 for 14 of 18 associations with motivation and satisfaction). Associations with knowledge were weak and nonsignificant (R2 ≤ 0.004, P > .23).

Conclusions

Evidence of content, internal structure, and relationships with other variables support the validity of CPQ scores for measuring personalization and congruence in an online module.
Are There Signs of Enthesitis in Nail Psoriasis? An Immunohistological Study of Nail Psoriasis With and Without Psoriatic Arthritis
Authors: Perrin Christophe
Published: December 2022

The concept of nail psoriasis as an entheseal-driven disease has essentially been formulated on the basis of radiological findings because it is usually not possible to obtain the tissue directly from the joints. The aim of this retrospective study was to evaluate the histological features of isolated nail psoriasis with and without distal interphalangeal psoriatic arthritis (PsA), focusing on the question as to whether the fascia and adipose tissue surrounding the apex of the nail unit genuinely show an inflammatory infiltrate. In support of the nail-enthesitis theory, an ongoing inflammatory infiltrate could be expected. An immunohistochemical study was performed to evaluate the distribution and phenotype of the inflammatory infiltrate in nail psoriasis with and without PsA. This study did not show an inflammatory infiltrate in the fascia connecting the nail to the extensor tendon. CD8 and CD4 subsets were present in equal number in the nail dermis of nail psoriasis with or without PsA, which is a similar distribution to that seen in psoriatic synovium while skin psoriasis is characterized by a dermal predominance of CD4 T lymphocytes. Because of this study and recent microanatomic studies of the normal nail unit, it is possible to move away from a purely anatomic explanation of the strong association between nail psoriasis and PsA and to propose immunological factors as contributory. This study provides support for the hypothesis that CD8+ T cells play a crucial role in the pathogenesis of nail psoriasis through a pathogenic pathway similar to that of PsA and contrasting with that of the skin.
Rosuvastatin alleviates renal injury in cardiorenal syndrome model rats through anti-inflammatory and antioxidant pathways
Authors: Zhou Biye , Ao Qiangguo , Zhao Hua , Ye Ping
Published: December 2022

Background

Cardiorenal syndrome is increasingly common and has been reported to be associated with inflammation and oxidative stress, and statins have anti-inflammatory and antioxidant effects. Therefore, we designed this experiment to study the preventive effect of statins on cardiorenal syndrome. The aim of the study is to investigate the effect of early rosuvastatin use on cardiorenal syndrome.

Method

Forty-five Wistar rats were randomly divided into 3 groups. A unilateral nephrectomy group (Group 1), a unilateral nephrectomy + coronary ligation group (Group 2), and a unilateral nephrectomy + coronary ligation + rosuvastatin group (Group 3). Right kidney removal was performed on all rats during the first week, while Group 3 was given statin intragastric administration at 10 mg/kg/d. One month later, coronary ligation was performed on rats in Groups 2 and 3. Group 3 continued statin treatment. After feeding for 3 months and 2 days, the rats were killed; urine and blood were collected and sent to the laboratory for the determination of the urinary protein/creatinine ratio and blood lipid, creatinine, and urea nitrogen levels, respectively. Serum interleukin 1β, interleukin 6, malondialdehyde, glutathione peroxidase, angiotensin II, neutrophil gelatinase-associated lipocalin, cystatin C, and B natriuretic peptide levels were also determined. On the day before euthanasia, all rats were anesthetized and examined by cardiac ultrasound. Hematoxylin-eosin and periodic acid–Schiff staining were performed on heart and kidney sections.

Results

The ejection fraction in Group 2 was lower than that in Group 1 (P < 0.01). The ejection fraction value in Group 3 was lower than that in Group 1 (P < 0.01). Interleukin-1β levels in Group 2 were higher than those in Group 1 (P < 0.01). Interleukin-1β levels in Group 3 were lower than those in Group 2 (P < 0.01). The malondialdehyde value in Group 3 was lower than that in Group 2 (P < 0.05). Histopathology showed that Group 1 had slight renal damage, renal injury was aggravated in Group 2, and renal injury was still present in Group 3, but with alleviated morphology.

Conclusion

The interaction of the heart and kidneys in rats is related to inflammation and oxidation. Rosuvastatin can slow down the development of the heart-kidney interaction through anti-inflammatory and antioxidant effects.
Improving screening for major depressive disorder
Authors: Sharp Lauren K. , Montgomery Susan L. , Williams Russell W.
Published: December 2022

Background:

Depression affects up to 20% of primary care patients and negatively affects patients' mental and physical health.

Local Problem:

At a primary care clinic, a review of 291 patient records revealed that no patients were being screened for depression using a validated and reliable tool.

Methods:

The problem was addressed through the implementation of a depression screening and management protocol based on the U.S. Preventive Services Task Force guidelines. Processes used were recommended by the American College of Preventive Medicine and Institute for Clinical Systems Improvement.

Interventions:

This project implemented a protocol to screen, treat, and manage patients with depression at this primary care clinic. Analysis compared preimplementation and postimplementation metrics, including the number of patients screened for depression, newly diagnosed with depression, offered antidepressants, offered referral, and managed with follow-up.

Results:

Implementing a depression screening and management protocol in this clinic significantly increased depression screenings, the percent of patients newly diagnosed with depression, and the number of patients offered treatment.

Conclusion:

This quality improvement (QI) project improved screening, diagnosis, and management of patients with depression in this primary care clinic. A future QI project for this clinic should focus on measures to track improvements in patients with depression at this primary care clinic.
High incidence of newly diagnosed obstructive coronary artery disease regardless of chest pain detected on pre-procedural cardiac computed tomography angiography in patients undergoing atrial fibrillation ablation
Authors: Herczeg Szilvia , Simon Judit , Szegedi Nándor , Karády Júlia , Kolossváry Márton , Szilveszter Bálint , Balogi Bernadett , Nagy Vivien K. , Merkely Béla , Széplaki Gábor , Maurovich-Horvat Pál , Gellér László
Published: December 2022

Background

Cardiac computed tomography (CT) is often performed before catheter ablation of atrial fibrillation to map atrial and pulmonary anatomy. Incident coronary artery disease (CAD) may also be diagnosed during cardiac CT angiography (CTA). Our aim was to assess whether coronary CTA might be able to identify a significant proportion of patients with obstructive CAD prior to their catheter ablation procedure event, even in asymptomatic patients.

Methods

Consecutive patients undergoing pre-ablation coronary CTA for atrial fibrillation between 2013 and 2020 were retrospectively selected. Patients with previously diagnosed CAD were excluded. Obstructive CAD was defined as ≥50% luminal stenosis. We analyzed the relationship between obstructive CAD, any chest pain, and traditional risk factors.

Results

Overall, 2321 patients [median age 63.0 (54.4–69.2), 1052/2321 (45.3%) female] underwent coronary CTA and 488/2321 (21.0%) were diagnosed with obstructive CAD. There was no difference regarding the rate of obstructive CAD in patients with any chest pain compared to patients without any chest pain [91/404 (22.5%) vs. 397/1917 (20.7%), P = 0.416, respectively). The following parameters were associated with obstructive CAD: age > 65 years [odds ratio (OR) = 2.51; 95% confidence interval (CI), 2.02–3.13; P < 0.001), male sex (OR = 1.59; 95% CI, 1.28–1.98; P < 0.001), hypertension (OR = 1.40; 95% CI, 1.08–1.81; P = 0.012), diabetes (OR = 1.50; 95% CI, 1.13–1.99; P = 0.006), dyslipidaemia (OR = 1.33; 95% CI, 1.07–1.66; P = 0.011) and history of smoking (OR = 1.34; 95% CI, 1.07–1.68; P = 0.011).

Conclusions

The high prevalence of obstructive CAD even in patients without chest pain highlights the importance of additional coronary artery diagnostics in patients undergoing left atrial CTA awaiting catheter ablation for atrial fibrillation. These patients regardless of chest pain thus may require further risk modification to decrease their potential ischemic and thromboembolic risk.
Infusion Appointment Self‐Management Among Adolescents With Inflammatory Bowel Disease
Authors: Crume Bonnie , Mitchell Paul D. , Fishman Laurie N.
Published: December 2022

Objective:

Adolescents and young adults with inflammatory bowel disease (IBD) are in vulnerable positions for lapses in care as they transition from pediatric to adult practices. As biologic agents become a mainstay of treatment for these patients, it is important to ensure that responsibility for tasks related to scheduling, remembering, and transporting to infusion appointments for intravenous biologics are mastered prior to transition. This ensures preservation of therapy and disease control.

Methods:

We surveyed 236 adolescents and young adults with IBD aged 13–22 years receiving infusion‐based biologic therapy at outpatient infusion visits at Boston Children’s Hospital from February to May 2021. The questionnaire asked the ideal and actual ages that patients take responsibility for scheduling their infusion appointments, remembering their infusion appointments, and transporting to their infusion appointments.

Results:

We received 168 completed survey questionnaires. The ideal reported mean age for independence was 17.9 ± 1.7 years across all 3 tasks. Among 80 patients 18 years and older, 44 (55%) were independently scheduling their appointments, 63 (79%) were keeping track of their appointments, and 43 (54%) were getting to their appointments independently.

Conclusions:

Adolescent and young adult patients with IBD ideally would independently manage biologic infusion related tasks prior to the age of 18 years, as this is the natural age that many move away from the homes of their parents/guardians. Our study demonstrates that just over half of patients 18 years or older independently manage their infusion appointments. This is an educational opportunity that has implications for health outcomes of patients with IBD.
Enhancing Evidence-Based Practice Integration Into Clinical Practice
Authors: Snyder Megan D. , Campbell Tracy , DiGerolamo Kimberly A.
Published: December 2022

Purpose

This article describes how a large urban medical center was able to enhance the integration of evidence-based practice in the clinical environment by reconfiguring its approach to policy and procedures documentation.

Project Description

Leaders at a large urban medical center observed that numerous nursing practice documents lacked a base of evidence. No standard process existed for building staff awareness of the evidence-based underlying practice, and there was uneven knowledge of evidence-based practice in the milieu. To address the problem, a team of Clinical Nurse Specialists developed a novel policy establishing procedures for document review, formal structures for policy assignment, and rigorous standards for the development and sharing of evidence tables.

Outcome

The proportion of nursing guidance documents connected to evidence tables increased from 45% to 77% in the first year and a half following implementation. The change has enabled streamlining and consolidation of nursing practice guidance documents and has led to significant increases in engagement with clinical inquiry at the bedside.

Conclusion

A policy specifically requiring evidence to be incorporated into nursing practice guidance documents can help enhance the understanding and uptake of evidence-based practice in a complex clinical environment. Clinical Nurse Specialists played a vital role in facilitating this organizational culture change.
A comprehensive list of bacterial pathogens infecting humans
Authors: Bartlett Abigail , Padfield Daniel , Lear Luke , Bendall Richard , Vos Michiel
Published: December 2022

There exists an enormous diversity of bacteria capable of human infection, but no up-to-date, publicly accessible list is available. Combining a pragmatic definition of pathogenicity with an extensive search strategy, we report 1513 bacterial pathogens known to infect humans described pre-2021. Of these, 73 % were regarded as established (have infected at least three persons in three or more references) and 27 % as putative (fewer than three known cases). Pathogen species belong to 10 phyla and 24 classes scattered throughout the bacterial phylogeny. We show that new human pathogens are discovered at a rapid rate. Finally, we discuss how our results could be expanded to a database, which could provide a useful resource for microbiologists. Our list is freely available and archived on GitHub and Zenodo and we have provided walkthroughs to facilitate access and use.
New insights into the Germline Genes and CDR3 Repertoire of the TCRβ chain inChiroptera
Authors: Zhou Hao , Li Jun , Zhou Dewei , Wu Yingjie , Wang Xingliang , Zhou Jiang , Ma Qingqing , Yao Xinsheng , Ma Long
Published: December 2022

Bats are known to be natural reservoirs of many viruses, yet their unique immune system enables them to coexist with viruses without frequently exhibiting disease symptoms. The current understanding of the bat adaptive immune system is limited, as there is no database or tool capable of processing T-cell receptor (TCR) sequences for bats, and the diverse nature of the Chiroptera. We established a reference library of TCR-β germline genes by annotating three Chiroptera: The Greater Horseshoe Bat (Rhinolophus ferrumequinum, R. ferrumequinum), The Pale spear-nosed Bat (Phyllostomus discolor, P. discolor), and the Common Pipistrelle (Pipistrellus pipistrellus, P. pipistrellus). The distinct variations in the distribution of TRBV genes among the three types of bats could have a direct impact on the diversity of the TCR repertoire, as evidenced by the presence of conserved amino acids that indicate the T-cell recognition of antigens in bats is MHC-restricted. Furthermore, we conducted an analysis of the TCR-β repertoire in the Intermediate Horseshoe Bat (Rhinolophus affinis, R. affinis) using high-throughput sequencing (HTS). The bats’ TCR-β repertoire is formed through rearrangement of the V-D-J-C genes, with D-J/V-D deletions and insertion resulting a high diversity.