bluuebunny/crossref_metadata_2025 huggingface dataset:
The ethical implications of preventing hospital delirium in older adults: A scoping review
Authors: Delgado Janet , Toledo Chávarri Ana , de Pascual y Medina Ana María , León Salas Beatriz , Trujillo Martín María del Mar , Serrano Aguilar Pedro
Published: April 2022

Introduction

Hospital delirium is a frequent, serious, costly, and underrecognized acute disorder of attention and cognition. Therefore, the prevention of hospital delirium is not only desirable for patients, caregivers, healthcare professionals, and the health system itself, but also a moral duty.

Objective

To identify and synthetize the main ethical aspects that arise related to the prevention of hospital delirium in patients 65 years and older.

Methods

A scoping review was carried out in Embase, Medline, and Web of Science (January 2009–January 2022). Articles published in English or Spanish analyzing any pharmacologic, non-pharmacologic, or multicomponent intervention for prevention of delirium in hospitalized patients aged 65 years and over were included.

Results

Twenty-seven studies were included. Based on the frequency of appearance and the relevance, our findings were organized into three main areas. The first one was related to the principle of nonmaleficence and collected findings about the iatrogenic causes of hospital delirium and the use of restraints systems. The second area analyzed the impact of delirium in patients, families, and healthcare professionals from a relational ethics perspective, and addressed the family presence as a factor to prevent delirium. Finally, the third area is related to the quality of care.

Conclusion

Prevention of delirium in hospitals is essential to avoid the discomfort and potential clinical complications of patients, as well as the suffering of their relatives, caregivers, and healthcare professionals. Policymakers and healthcare managers are encouraged to make the required efforts to prevent delirium in hospitalized older patients.
Theme Introduction to Special Issue: “Critical and Performative Reflections on Current Crises”
Authors: Alexander Bryant Keith , Weems Mary E.
Published: April 2022

The essays in this Special Issue respond in part to a call to acknowledge the multiple crises we now face: the global covid-19 virus pandemic; natural disasters caused by climate change and more. The essays call for a critical collaborative engagement over issues of trauma and survival, to build new templates of sociality towards progressive futures.
Walking Into the Unknown: A Research Journey Through Abuse, Trauma, Motherhood, Poverty, and the Covid Pandemic
Authors: Douglas Kitrina
Published: April 2022

Researching the lives of mothers with children under five from the most deprived areas of a major city in the United Kingdom during a pandemic was never going to be easy. In this performative reflection, I explore how walking and the side-be-sidedness of our interaction facilitated conversation and understanding, between one young mother and myself. I also consider in this performative text, the way a researcher’s thoughts whirl around and respond to what is being shared, although never voiced at the time.
Endovascular treatments of intracranial vertebral and internal carotid arteries dissections: An interactive systematic review and meta-analysis
Authors: Essibayi Muhammed Amir , Lanzino Giuseppe , Keser Zafer
Published: April 2022

Introduction

Management of intracranial artery dissection (IAD) remains elusive in medical practice. Intracranially, vertebral artery dissection (VAD) is more commonly encountered than internal carotid artery dissection (ICAD). Deconstructive (EVT-d) and reconstructive (EVT-r) endovascular techniques have been utilized to treat VAD and ICAD. This meta-analysis investigates the safety and efficacy of EVT-r and EVT-d in the management of VAD and ICAD.

Methods

The literature was searched for all studies with consecutive patient series evaluating EVT-d or EVT-r for VAD or ICAD management. Baseline characteristics and outcomes were compared between EVT-r and EVT-d groups using the random-effect model and meta-regression approaches.

Results

Overall, 1095 cases pooled from 56 studies were included. There was no statistically significant difference in baseline characteristics between VAD and ICAD. EVT-r was applied in 647 cases (59.1%) and EVT-d in the rest There was no statistical difference in the rate of procedural complications between EVT-r and EVT-d. Although EVT-d was significantly associated with higher rates of complete aneurysm occlusion (86.4%), lower rates of good clinical outcomes (72.1%) and higher mortality (15.1%) were achieved compared to EVT-r (70.2%, 83.3%, and 9.5%; respectively). The mortality rate was higher, and good clinical outcomes were less common in ruptured aneurysms. Ischemic presentation was statistically associated with poor outcomes (mRS 3-5) but low mortality. ICAD often tended to grow following treatment and resulted in poor neurological outcomes.

Conclusions

IAD has favorable outcomes when treated appropriately. Novel reconstructive endovascular techniques are promising and should be integrated well in endovascular practice. Further studies are warranted.
Entropy optimized flow of Jeffrey fluid with radiation effect over a stretched surface
Authors: Hayat Tasawar , Kainat Zobia , Khan Sohail A , Alsaedi Ahmed
Published: April 2022

The theme of this paper is to scrutinize hydromagnetic flow of Jeffrey fluid subject to stretched curved sheet. Heat expression is developed through dissipation, magnetic force and radiation. Entropy generation is also studied. First order isothermal reaction is examined. Nonlinear ordinary differential systems are found through adequate transformation. Here we have used the ND-based numerical solution method to develop numerical results. Impact of sundry variables on temperature, fluid flow, concentration and entropy rate are discussed. Performance of skin friction and heat transport rate via flow parameters are graphically studied. An increase in curvature variables lead to improve velocity and thermal field. Higher approximation of radiation enhances temperature. An intensification in drag force is seen versus Deborah number. Larger approximation of Brinkman number boosts up entropy analysis.
Recognition of rolling bearing running state based on genetic algorithm and convolutional neural network
Authors: Lu Wanjie , Mao Hongpeng , Lin Fanhao , Chen Zilin , Fu Hua , Xu Yaosong
Published: April 2022

In this study, the GA-CNN model is proposed to realize the automatic recognition of rolling bearing running state. Firstly, to avoid the over-fitting and gradient dispersion in the training process of the CNN model, the BN layer and Dropout technology are introduced into the LeNet-5 model. Secondly, to obtain the automatic selection of hyperparameters in CNN model, a method of hyperparameter selection combined with genetic algorithm (GA) is proposed. In the proposed method, each hyperparameter is encoded as a chromosome, and each hyperparameter has a mapping relationship with the corresponding gene position on the chromosome. After the process of chromosome selection, crossover and variation, the fitness value is calculated to present the superiority of the current chromosome. The chromosomes with high fitness values are more likely to be selected in the next genetic iteration, that is, the optimal hyperparameters of the CNN model are obtained. Then, vibration signals from CWRU are used for the time-frequency analysis, and the obtained time-frequency image set is used to train and test the proposed GA-CNN model, and the accuracy of the proposed model can reach 99.85% on average, and the training speed is four times faster than the model LeNet-5. Finally, the result of the experiment on the laboratory test platform The experimental results confirm the superiority of the method and the transplantability of the optimization model.
Complete coverage problem of multiple robots with different velocities
Authors: Li Lin , Shi Dianxi , Jin Songchang , Kang Ying , Xue Chao , Zhou Xing , Liu Hengzhu , Yu XiaoXiao
Published: April 2022

Complete coverage, which is integral to many robotic applications, aims to cover an area as quickly as possible. In such tasks, employing multiple robots can reduce the overall coverage time by appropriate task allocation. Several multi-robot coverage approaches divide the environment into balanced subareas and minimize the maximum subarea of all robots. However, balanced coverage in many situations, such as in the cases of robots with different velocities and heterogeneous multi-robot systems, may have inefficient results. This study addresses the unbalanced complete coverage problem of multiple robots with different velocities for a known environment. First, we propose a novel credit model to transform the unbalanced coverage problem into a set of single-objective optimization problems, which can find a combinational optimal solution by optimizing each separate objective function of the single-objective optimization problem to alleviate the computational complexity. Then, we propose a credit-based algorithm composed of a cyclic region growth algorithm and a region fine-tuning algorithm. The cyclic region growth algorithm finds an initial solution to the single-objective optimization problems set by a regional growth strategy with multiple restricts, whereas the region fine-tuning algorithm reallocates the tasks of the partitions with too many tasks to the partitions with too few tasks by constructing a search tree, thereby converging the initial solution to the optimal solution. Simulation results indicate that compared with conventional multi-robot complete coverage problem algorithms, the credit-based algorithm can obtain the optimal solution with the increased number of robots and enlarged size of the mission environment.
Facile synthesis of novel SrO 0.5:MnO 0.5 bimetallic oxide nanostructure as a high-performance electrode material for supercapacitors
Authors: Adimule Vinayak , Bhat Vinay S , Yallur Basappa C , Gowda Adarsha HJ , Padova Paola De , Hegde Gurumurthy , Toghan Arafat
Published: April 2022

Perovskite bimetallic oxides as electrode material blends can be an appropriate method to enhance the supercapacitor properties. In the present research, SrO 0.5:MnO 0.5 nanostructures (NS) were synthesized by a facile co-precipitation method and calcinated at 750–800°C. Crystal structure of SrO 0.5:MnO 0.5 NS were characterized by X-ray diffraction, surface chemical composition and chemical bond analysis, and dispersion of SrO into MnO was confirmed by X-ray photoelectron spectral studies. Structural morphology was analyzed from scanning electron microscopy. Optical properties of SrO 0.5:MnO 0.5 NS were studied using UV-Visible spectrophotometer and SrO 0.5 and MnO 0.5 NS showed ∼75 nm grain, ∼ 64 nm grain boundary distance, with two maxima at 261 nm and 345 nm as intensity of absorption patterns, respectively. The synthesized SrO 0.5:MnO 0.5 NS exhibited high specific capacitance of 392.8 F/g at a current density of 0.1 A/g. Electrochemical impedance spectroscopy results indicated low resistance and very low time constant of 0.2 s ∼73% of the capacitance was retained after 1000 galvanostatic charge-discharge (GCD) cycles. These findings indicate that SrO 0.5:MnO 0.5 bimetallic oxide material could be a promising electrode material for electrochemical energy storage systems.
Central Nervous System Involvement of Multiple Myeloma Presenting as Short-lasting Unilateral Neuralgiform Headache with Conjunctival Injection and Tearing: A Case Report
Authors: Wang Victor S. , Ahmad Ayesha , Mazuera Santiago , Lauritsen Clinton G.
Published: April 2022

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are part of the trigeminal autonomic cephalalgia (TAC) group of headache disorders. Attacks present with repeated, severe, sharp, stabbing, or throbbing pain. Patients may experience a single attack, recurrent attacks with pain-free interictal periods, or a sawtooth pattern background pain with superimposed stabs. 1 , 2

Although SUNCT typically presents as a primary headache disorder, it may be secondary to an underlying pathology, such as pituitary tumors or posterior fossa lesions, both intra and extra-axial (vascular lesion, tumor, or bony abnormalities). Multiple Myeloma (MM) with central nervous system involvement (CNS MM) most commonly presents with visual changes (36%), radiculopathy (27%), headache (25%), confusion (21%), dizziness (7%) and seizures (6%). 3 , 4 Secondary SUNCT cases have been sparsely described (less than 60), and CNS MM presenting as SUNCT has not been previously described in the literature. 2 , 5

Our case describes a previously unreported clinical presentation of CNS MM. The report highlights the need for a timely and thorough diagnostic work-up of headache in patients with risk factors for a secondary etiology, which in this case included new-onset, autonomic features, older age, and history of malignancy. A misdiagnosis will preclude a potentially life-extending or saving targeted therapy for the underlying illness. We also aim to remind practitioners of the variability in the clinical symptoms of SUNCT, which are known to occur in a significant number of cases, including migrainous features and dull interictal pain.
Re-Conceptualizing the Drivers Toward mHealth Adoption in a Least Developing Country: A Qualitative Exploration
Authors: Hasan Najmul , Sultana Reajmin , Bao Yukun
Published: April 2022

Despite the recent proliferation of mHealth, the present research has not yet re-conceptualized on how mHealth can be used to promote healthcare over time. Researches have indicated that mHealth adoption and acceptance problems must be re-addressed to provide improved healthcare delivery. It is essential to explore the end-user centric factors for the complex implications process of mHealth before implementing it in practice. This research aims to re-conceptualize the contextual predictors of mHealth adoption in a least developing country. In-depth interviews with purposive and convenient sampling techniques were conducted with end-users ( n = 24) and healthcare professionals ( n = 15) in Bangladesh because qualitative research provides opportunities to explore end-user experiences and get detailed information about how they perceive user engagement in technology adoption. This study used grounded theory and thematic analysis to explain the state of mHealth adoption and to establish a theoretical basis for further investigations. Our findings indicate that traditional predictors for mHealth intention to use might not be enough. This study suggested four new predictors: “patients as a decision support unit,” “personal awareness building,” “health information exchange,” and “reward” to re-conceptualize the mHealth adoption. The study tried to clarify mHealth drivers from both end-users’ and healthcare professionals’ perspectives, which offered an alternative avenue that could provide the foundation for accepting mHealth widely.
Movement behavior patterns composition remains stable, but individuals change their movement behavior pattern over time in people with a first-ever stroke
Authors: van der Laag Patricia J. , Wondergem Roderick , Pisters Martijn F.
Published: April 2022

Background

Movement behaviors (i.e., physical activity levels, sedentary behavior) in people with stroke are not self-contained but cluster in patterns. Recent research identified three commonly distinct movement behavior patterns in people with stroke. However, it remains unknown if movement behavior patterns remain stable and if individuals change in movement behavior pattern over time.

Objectives

1) To investigate the stability of the composition of movement behavior patterns over time, and 2) determine if individuals change their movement behavior resulting in allocation to another movement behavior pattern within the first two years after discharge to home in people with a first-ever stroke.

Methods

Accelerometer data of 200 people with stroke of the RISE-cohort study were analyzed. Ten movement behavior variables were compressed using Principal Componence Analysis and K-means clustering was used to identify movement behavior patterns at three weeks, six months, one year, and two years after home discharge. The stability of the components within movement behavior patterns was investigated. Frequencies of individuals’ movement behavior pattern and changes in movement behavior pattern allocation were objectified.

Results

The composition of the movement behavior patterns at discharge did not change over time. At baseline, there were 22% sedentary exercisers (active/sedentary), 45% sedentary movers (inactive/sedentary) and 33% sedentary prolongers (inactive/highly sedentary). Thirty-five percent of the stroke survivors allocated to another movement behavior pattern within the first two years, of whom 63% deteriorated to a movement behavior pattern with higher health risks. After two years there were, 19% sedentary exercisers, 42% sedentary movers, and 39% sedentary prolongers.

Conclusions

The composition of movement behavior patterns remains stable over time. However, individuals change their movement behavior. Significantly more people allocated to a movement behavior pattern with higher health risks. The increase of people allocated to sedentary movers and sedentary prolongers is of great concern. It underlines the importance of improving or maintaining healthy movement behavior to prevent future health risks after stroke.
Transcriptome analysis of the growth-promoting effect of volatile organic compounds produced by Microbacterium aurantiacum GX14001 on tobacco (Nicotiana benthamiana)
Authors: Gao Yahui , Feng Jing , Wu Jiafa , Wang Kun , Wu Shuang , Liu Hongcun , Jiang Mingguo
Published: April 2022

Background

Plant growth-promoting rhizobacteria (PGPR) release volatile organic compounds (VOCs), which promote plant growth.

Results

A potential PGPR strain GX14001 was isolated from marine samples, and the VOCs produced by GX14001 significantly promoted tobacco (Nicotiana benthamiana) growth in a plate experiment. Based on 16S rRNA sequence alignment and physiological and biochemical characterization, GX14001 was identified as Microbacterium aurantiacum. Comparative transcriptome analysis was conducted between GX14001 VOCs-treated tobacco and the control; it was found that 1286 genes were upregulated and 1088 genes were downregulated. Gene ontology (GO) analysis showed that upregulated genes were involved in three biological processes: polysaccharide metabolic, polysaccharide catabolic and carbohydrate metabolic. The downregulated genes were involved in six biological processes, namely cell redox homeostasis, cellular homeostasis, carbohydrate metabolic process, homeostatic process, obsolete electron transport, and regulation of biological quality. Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis showed that 190 upregulated differentially expressed genes were mainly involved in plant hormone signal transduction, phenylpropyl biosynthesis, plant–pathogen interaction, and flavonoid biosynthesis. The 148 downregulated differentially expressed genes were mainly involved in plant hormone signal transduction and the metabolism of ascorbic, aldehyde, and pyruvate acids. Further analysis revealed that many genes were differentially expressed in the metabolic pathways of plant hormone signals, which were speculated to be the main reason why GX14001 VOCs promoted tobacco growth. To further study its regulatory mechanism, we found that GX14001 promoted plant growth through auxin, salicylic acid, and gibberellin in Arabidopsis mutant experiments.

Conclusion

The VOCs produced by Microbacterium aurantiacum GX14001 may promote the growth of tobacco through the auxin, salicylic acid and gibberellin pathways.
Distribution and drug sensitivity of pathogenic bacteria in diabetic foot ulcer patients with necrotizing fasciitis at a diabetic foot center in China
Authors: Li Xuemei , Du Zhipeng , Tang Ziwei , Wen Qin , Cheng Qingfeng , Cui Yunhua
Published: April 2022

Background

Diabetic foot ulcer is one of the major complications for patients with diabetes, and has become an important cause of non-traumatic amputation. Necrotizing fasciitis is a life-threatening soft-tissue infection involving the fascia and subcutaneous tissue. When diabetic foot ulcers are complicated by necrotizing fasciitis (DNF), this increases the risk for amputation and mortality, making DNF treatment more complicated, and eventually leading to amputation and mortality. However, studies on pathogenic bacteria’s distribution and drug sensitivity in DNF patients remain lacking. This study investigated the distribution and susceptibility of pathogenic bacteria in DNF patients, and provided empirical antibacterial guidance for the clinic.

Methods

In a single diabetic foot center, the results from microbial cultures and drug susceptibility tests of patients with DNF from October 2013 to December 2020 were collected and analyzed.

Results

A total of 101 DNF patients were included in this study, of whom 94 had positive culture test results. A total of 124 pathogens were cultured, including 76 Gram-positive bacterial strains, 42 Gram-negative bacterial strains, and six fungal strains. Polymicrobial infections accounted for 26.7% and monomicrobial infections accounted for 66.3%. Staphylococcus aureus was the most common bacterium isolated, followed by Enterococcus faecalis and Streptococcus agalactiae. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Proteus mirabilis were the most common Gram-negative bacteria. Thirty-five strains of multi-drug resistant bacteria were isolated, representing 28.2% of the total isolates. Gram-positive bacteria were more sensitive to levofloxacin, moxifloxacin, vancomycin, teicoplanin, tigecycline, and linezolid, while Gram-negative bacteria were more sensitive to amikacin, piperacillin/tazobactam, cefoperazone/sulbactam, ceftazidime, cefepime, imipenem, and meropenem.

Conclusions

Gram-positive bacteria were the main bacteria isolated from DNF patients. The bacterial composition, the proportion of multi-drug resistant bacteria among the pathogens, and the high risk for amputation should be fully considered in the initial empirical medication, and broad-spectrum antibacterials are recommended.
Hyperuricemia and diabetes mellitus when occurred together have higher risks than alone on all-cause mortality and end-stage renal disease in patients with chronic kidney disease
Authors: Li Cheng-Hung , Lee Chia-Lin , Hsieh Yu-Cheng , Chen Cheng-Hsu , Wu Ming-Ju , Tsai Shang-Feng
Published: April 2022

Introduction

Hyperuricemia and diabetes mellitus (DM) are associated with increased mortality risk in patients with chronic kidney disease (CKD). Here we aimed to evaluate the independent and joint risks of these two conditions on mortality and end stage kidney disease (ESKD) in CKD-patients.

Methods

This retrospective cohort study enrolled 4380 outpatients (with CKD stage 3–5) with mortality and ESKD linkage during a 7-year period (from 2007 to 2013). All-causes mortality and ESKD risks were analyzed by multivariable-adjusted Cox proportional hazards models (adjusted for age, sex, smoke, previous coronary arterial disease, blood pressure, and medications for hyperlipidemia, hyperuricemia and renin–angiotensin system inhibitors).

Results

Overall, 40.5% of participants had DM and 66.4% had hyperuricemia. In total, 356 deaths and 932 ESKD events occurred during the 7 years follow-up. With the multivariate analysis, increased risks for all-cause mortality were: hyperuricemia alone, HR = 1.48 (1–2.19); DM alone, and HR = 1.52 (1.02–2.46); DM and hyperuricemia together, HR = 2.12 (1.41–3.19). Similar risks for ESKD were: hyperuricemia alone, HR = 1.34 (1.03–1.73); DM alone, HR = 1.59 (1.15–2.2); DM and hyperuricemia together, HR = 2.46 (1.87–3.22).

Conclusions

DM and hyperuricemia are strongly associated with higher all-cause mortality and ESKD risk in patients with CKD stage 3–5. Hyperuricemia is similar to DM in terms of risk for all-cause mortality and ESKD. DM and hyperuricemia when occurred together further increase both risks of all-cause mortality and ESKD.
Monoexponential, biexponential and diffusion kurtosis MR imaging models: quantitative biomarkers in the diagnosis of placenta accreta spectrum disorders
Authors: Lu Tao , Wang Yishuang , Guo Aiwen , Cui Wei , Chen Yazheng , Wang Shaoyu , Wang Guotai
Published: April 2022

Background

To investigate the diagnostic value of monoexponential, biexponential, and diffusion kurtosis MR imaging (MRI) in differentiating placenta accreta spectrum (PAS) disorders.

Methods

A total of 65 patients with PAS disorders and 27 patients with normal placentas undergoing conventional DWI, IVIM, and DKI were retrospectively reviewed. The mean, minimum, and maximum parameters including the apparent diffusion coefficient (ADC) and exponential ADC (eADC) from standard DWI, diffusion kurtosis (MK), and mean diffusion coefficient (MD) from DKI and pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) from IVIM were measured from the volumetric analysis and compared between patients with PAS disorders and patients with normal placentas. Univariate and multivariated logistic regression analyses were used to evaluate the value of the above parameters for differentiating PAS disorders. Receiver operating characteristics (ROC) curve analyses were used to evaluate the diagnostic efficiency of different diffusion parameters for predicting PAS disorders.

Results

Multivariate analysis demonstrated that only D mean and D max differed significantly among all the studied parameters for differentiating PAS disorders when comparisons between accreta lesions in patients with PAS (AP) and whole placentas in patients with normal placentas (WP-normal) were performed (all p < 0.05). For discriminating PAS disorders, a combined use of these two parameters yielded an AUC of 0.93 with sensitivity, specificity, and accuracy of 83.08, 88.89, and 83.70%, respectively.

Conclusion

The diagnostic performance of the parameters from accreta lesions was better than that of the whole placenta. D mean and D max were associated with PAS disorders.
Association of histological features with laryngeal squamous cell carcinoma recurrences: a population-based study of 1502 patients in the Netherlands
Authors: Ruiter Lilian N. , van Dijk Boukje A. C. , Bruggink Annette H. , Doornaert Patricia A. H. , Philippens Marielle E. P. , de Bree Remco , van Gils Carla H. , Willems Stefan M.
Published: April 2022

Background

Recurrences remain an important problem in laryngeal squamous cell carcinoma. Little has been described about histological characteristics of the primary laryngeal tumor that may be associated with recurrences. Identifying risk factors for recurrences might help in adapting treatment or follow-up. Using real-life population-based data, we aimed to identify histological features of the primary tumor associated with recurrences and overall survival.

Material and methods

Demographic, clinical and treatment information on all first primary invasive laryngeal tumors diagnosed in 2010–2014 (N = 3705) were extracted from the population-based nationwide Netherlands cancer registry (NCR) and linked to PALGA, the nationwide Dutch pathology registry, to obtain data on histological factors and recurrences. For a random 1502 patients histological information i.e., keratinization, perineural invasion (PNI+), vascular invasion (VI+), growth pattern, degree of differentiation, extracapsular spread (ECS+), cartilage- and bone invasion and extralaryngeal extension, was manually extracted from narrative pathology reports and analyzed for locoregional recurrence and overall survival using cox regression analysis.

Results

In total, 299 patients developed a locoregional recurrence and 555 patients died. Keratinization (HR = 0.96 (95%CI: 0.68–1.34) p = 0.79), two or three adverse characteristics (PNI+, VI+, non-cohesive growth) (HR = 1.38 (95% CI: 0.63–3.01) p = 0.42), and ECS+ (HR = 1.38 (95% CI: 0.48–4.02) p = 0.55) were not associated to recurrence. For death, also no significant association was found.

Conclusion

In this population-based real-life dataset on laryngeal carcinoma in the Netherlands, histological factors were not associated with locoregional recurrences or overall survival, but future studies should investigate the role of these features in treatment decisions.
Effects of intensive insulin therapy on the retinal microvasculature in patients with type 2 diabetes mellitus: a prospective observational study
Authors: Yang Ning , Li Ming-Xin , Peng Xiao-Yan
Published: April 2022

Background

We examined the retinal microvascular changes and associated factors in type 2 diabetes mellitus (T2DM) before and after intensive insulin therapy.

Methods

This prospective observational study recruited patients with T2DM and divided them into intensive insulin therapy and oral hypoglycemic agent groups. All patients enrolled in this study had diabetes without retinopathy or non-proliferative diabetic retinopathy. Optical coherence tomography angiography (OCTA) was used in all patients before treatment and at 1, 3, and 6 months after treatment. Vessel density (VD) and thickness changes in the macular and optic disc areas were assessed.

Results

The study included 36 eyes in the intensive insulin therapy group and 36 in the oral hypoglycemic agent group. One month after treatment, VD in the deep capillary plexus (DCP) and peripapillary capillary VD (ppVD) were significantly decreased by intensification (P = 0.009, 0.000). At three months after treatment, decreases in VD induced by intensification were found in the superficial capillary plexus (SCP), DCP, foveal density in a 300-μm-wide region around the foveal avascular area (FD-300), and ppVD (P = 0.032, 0.000, 0.039, 0.000). Six months after treatment, decreases in VD by intensification were observed in the DCP and ppVD groups (P = 0.000, 0.000). Vessel density showed no significant change in the oral hypoglycemic agent group after treatment. The amount of DCP-VD reduction was correlated with macular thickening (r = 0.348, P = 0.038; r = 0.693, P = 0.000 and r = 0.417, P = 0.011, respectively) after intensive insulin therapy.

Conclusions

Insulin-intensive treatment caused a transient reduction in vessel density in the macular and optic disc areas. DCP-VD and ppVD were more susceptible at an earlier stage. Retinal microvasculature monitoring using OCTA is vital for patients with type 2 diabetes receiving intensive insulin therapy.
Is gas/air tamponade essential for eyes with small peripheral retinal breaks without detachment during vitrectomy?
Authors: Lee Kyung Ho , Chung Yoo-Ri , Yeo Suji , Lee Kihwang
Published: April 2022

Background

To investigate the safety of vitrectomy with laser photocoagulation in eyes with small peripheral retinal breaks without air or gas tamponade.

Methods

Among patients who underwent vitrectomy for various retinal disorders, those with small peripheral retinal breaks treated by laser photocoagulation without air or gas tamponade were included in this study. Their medical records were assessed retrospectively, and we investigated the characteristics of small peripheral retinal breaks and the incidence of postoperative retinal detachment (RD).

Results

Thirty-one eyes of 31 patients who presented with small peripheral retinal breaks requiring endolaser photocoagulation during vitrectomy were included in this analysis. There were two cases of iatrogenic retinal breaks that occurred during vitrectomy, while others were preexisting lesions, including retinal tears, atrophic retinal holes, and retinal holes with lattice degeneration. There were no cases of RD during the follow-up period of at least 6 months.

Conclusions

Adequate laser treatment without gas or air tamponade may be sufficient during vitrectomy in cases with small peripheral retinal breaks without concurrent RD, along with complete removal of vitreoretinal traction.
A coarse-grained approach to model the dynamics of the actomyosin cortex
Authors: Hernández-del-Valle Miguel , Valencia-Expósito Andrea , López-Izquierdo Antonio , Casanova-Ferrer Pau , Tarazona Pedro , Martín-Bermudo Maria D. , Míguez David G.
Published: April 2022

Background

The dynamics of the actomyosin machinery is at the core of many important biological processes. Several relevant cellular responses such as the rhythmic compression of the cell cortex are governed, at a mesoscopic level, by the nonlinear interaction between actin monomers, actin crosslinkers, and myosin motors. Coarse-grained models are an optimal tool to study actomyosin systems, since they can include processes that occur at long time and space scales, while maintaining the most relevant features of the molecular interactions.

Results

Here, we present a coarse-grained model of a two-dimensional actomyosin cortex, adjacent to a three-dimensional cytoplasm. Our simplified model incorporates only well-characterized interactions between actin monomers, actin crosslinkers and myosin, and it is able to reproduce many of the most important aspects of actin filament and actomyosin network formation, such as dynamics of polymerization and depolymerization, treadmilling, network formation, and the autonomous oscillatory dynamics of actomyosin.

Conclusions

We believe that the present model can be used to study the in vivo response of actomyosin networks to changes in key parameters of the system, such as alterations in the attachment of actin filaments to the cell cortex.
NKX2-5 variants screening in patients with atrial septal defect in Indonesia
Authors: Rozqie Royhan , Satwiko Muhammad Gahan , Anggrahini Dyah Wulan , Sadewa Ahmad Hamim , Gunadi  , Hartopo Anggoro Budi , Mumpuni Hasanah , Dinarti Lucia Kris
Published: April 2022

Background

NKX2-5 variant in atrial septal defect patients has been reported. However, it is not yet been described in the Southeast Asian population. Here, we screened the NKX2-5 variants in patients with atrial septal defect (ASD) in the Indonesian population.

Method

We recruited 97 patients with ASD for genetic screening of the NKX2-5 variant using Sanger sequencing.

Results

We identified three variants of NKX2-5: NM_004387.4:c.63A>G at exon 1, NM_004387.4:c.413G>A, and NM_004387.4:c.561G>C at exon 2. The first variant is commonly found (85.6%) and benign. The last two variants are heterozygous at the same locus. These variants are rare (3.1%) and novel. Interestingly, these variants were discovered in familial atrial septal defects with a spectrum of arrhythmia and severe pulmonary hypertension.

Conclusion

Our study is the first report of the NKX2-5 variant in ASD patients in the Southeast Asian population, including a novel heterozygous variant: NM_004387.4:c.413G>A and NM_004387.4:c.561G>C. These variants might contribute to familial ASD risk with arrhythmia and severe pulmonary hypertension. Functional studies are necessary to prove our findings.
Identifying health care access barriers in southern rural Ecuador
Authors: Brusnahan Anthony , Carrasco-Tenezaca Majo , Bates Benjamin R. , Roche Rosellen , Grijalva Mario J.
Published: April 2022

Background

Access to professional health care providers in Loja Province, Ecuador can be difficult for many citizens. The Health Care Access Barrier Model (HCAB) was established to provide a framework for classification, analysis, and reporting of modifiable health care access barriers. This study uses the HCAB Model to identify barriers and themes impacting access to health care access in southern rural Ecuador.

Methods

The research team interviewed 22 participants and completed 15 participant observation studies in the study area. Interviews and a single focus group session of artisans were recorded and transcribed from Spanish to English, and thematic analysis was performed.

Results

The thematic analysis found financial, structural, and cognitive health care access barriers. Cost of medications, transportation, missed responsibilities at work and home, difficulty scheduling appointments, and misconceptions in health literacy were the predominant themes contributing to health care access. These pressure points provide insight on where actions may be taken to alleviate access barriers.

Conclusion

Modifiable health care access barriers outlined in the HCAB are evident in the study area. Further research and implementation of programs to resolve these barriers, such as the creation of health care subcenters and/or mobile clinic, insurance coverage of specialized care, increasing availability and accessibility to affordable transportation, improving roadways, introduction of a 24/7 call center to schedule medical visits, monetary incentive for primary care physicians to practice in rural and underserved areas, provision of affordable work equipment, and emphasizing the improvement of health care literacy through education, may diminish current barriers, identify additional barriers, and improve overall health in the rural area of Loja, Ecuador and similar rural regions around the world.
Antibody-mediated delivery of a viral MHC-I epitope into the cytosol of target tumor cells repurposes virus-specific CD8+ T cells for cancer immunotherapy
Authors: Jung Keunok , Son Min-Jeong , Lee Se-Young , Kim Jeong-Ah , Ko Deok-Han , Yoo Sojung , Kim Chul-Ho , Kim Yong-Sung
Published: April 2022

Background

Redirecting pre-existing virus-specific cytotoxic CD8+T lymphocytes (CTLs) to tumors by simulating a viral infection of the tumor cells has great potential for cancer immunotherapy. However, this strategy is limited by lack of amenable method for viral antigen delivery into the cytosol of target tumors. Here, we addressed the limit by developing a CD8+Tcellepitope-delivering antibody, termed a TEDbody, which was engineered to deliver a viral MHC-I epitope peptide into the cytosol of target tumor cells by fusion with a tumor-specific cytosol-penetrating antibody.

Methods

To direct human cytomegalovirus (CMV)-specific CTLs against tumors, we designed a series of TEDbodies carrying various CMV pp65 antigen-derived peptides. CMV-specific CTLs from blood of CMV-seropositive healthy donors were expanded for use in in vitro and in vivo experiments. Comprehensive cellular assays were performed to determine the presentation mechanism of TEDbody-mediated CMV peptide-MHC-I complex (CMV-pMHCI) on the surface of target tumor cells and the recognition and lysis by CMV-specific CTLs. In vivo CMV-pMHCI presentation and antitumor efficacy of TEDbody were evaluated in immunodeficient mice bearing human tumors.

Results

TEDbody delivered the fused epitope peptides into target tumor cells to be intracellularly processed and surface displayed in the form of CMV-pMHCI, leading to disguise target tumor cells as virally infected cells for recognition and lysis by CMV-specific CTLs. When systemically injected into tumor-bearing immunodeficient mice, TEDbody efficiently marked tumor cells with CMV-pMHCI to augment the proliferation and cytotoxic property of tumor-infiltrated CMV-specific CTLs, resulting in significant inhibition of the in vivo tumor growth by redirecting adoptively transferred CMV-specific CTLs. Further, combination of TEDbody with anti-OX40 agonistic antibody substantially enhanced the in vivo antitumor activity.

Conclusion

Our study offers an effective technology for MHC-I antigen cytosolic delivery. TEDbody may thus have utility as a therapeutic cancer vaccine to redirect pre-existing anti-viral CTLs arising from previously exposed viral infections to attack tumors.
In a large Juvenile Idiopathic Arthritis (JIA) cohort, concomitant celiac disease is associated with family history of autoimmunity and a more severe JIA course: a retrospective study
Authors: Naddei Roberta , Di Gennaro Simona , Guarino Alfredo , Troncone Riccardo , Alessio Maria , Discepolo Valentina
Published: April 2022

Background

A higher prevalence of celiac disease (CD) has been reported in patients with juvenile idiopathic arthritis (JIA) compared to the general population. Factors related to the increased risk of co-occurrence and associated disease course have not been fully elucidated. Aims of this study were to determine the prevalence of CD in a large Southern Italian cohort of children with JIA, describe their clinical features and disease course and investigate risk factors associated with their co-occurrence.

Findings

Demographic, clinical and laboratory data of all patients with JIA admitted to our Pediatric Rheumatology Unit from January 2001 to June 2019, who underwent CD screening, were retrospectively extracted from clinical charts and analyzed. Eight of 329 JIA patients were diagnosed with CD, resulting in a prevalence higher than the general Italian population (2.4% vs 0.93%, p < 0.05). Familiarity for autoimmunity was reported by 87.5% patients with JIA and CD compared to 45.8% of those without CD (p < 0.05). 87.5% patients with JIA and CD required both a conventional Disease Modifying Anti-Rheumatic Drug (DMARD) and a biological DMARD over time compared to 36.4% of those without CD (p < 0.05).

Conclusion

A higher CD prevalence was found in a large JIA cohort, supporting the need for CD screening in all JIA children, especially those with a family history of autoimmunity, found to be associated with the co-occurrence of the two diseases. This is clinically relevant since patients with CD and JIA more often required a step-up therapy, suggesting a more severe JIA clinical course.
A novel cocktail therapy based on quintuplet combination of oncolytic herpes simplex virus-2 vectors armed with interleukin-12, interleukin-15, GM-CSF, PD1v, and IL-7 × CCL19 results in enhanced antitumor efficacy
Authors: Hu Han , Zhang Siqi , Cai Linkang , Duan Haixiao , Li Yuying , Yang Junhan , Wang Yang , Liu Biao , Dong Shuang , Fang Zhizheng , Liu Binlei
Published: April 2022

Background

Selectively replicating herpes simplex virus-2 (HSV-2) vector is a promising treatment for cancer therapy. The insertion of multiple transgenes into the viral genome has been performed to improve its oncolytic activity.

Methods

Herein, we simultaneously constructed five “armed” oncolytic viruses (OVs), designated oHSV2-IL12, -IL15, GM-CSF, -PD1v, and IL7 × CCL19. These OVs delete theICP34.5andICP47genes with the insertion of transgenes into the deletedICP34.5locus. The anti-tumor efficacy in vivo was tested in the syngeneic 4T1 and CT26 tumor-bearing mice model.

Results

The OVs showed comparable oncolytic capability in vitro. The combination therapy of oHSV2-IL12, -IL15, GM-CSF, -PD1v, and IL7 × CCL19 exhibited the highest tumor inhibition efficacy compared with the treatment of single OV or two OVs combination.

Conclusions

The OVs armed with different transgenes combination therapy also named 5-valent oHSV2 (also called cocktail therapy) might be an effective therapeutic strategy for solid tumors.
A severe case of human rhinovirus A45 with central nervous system involvement and viral sepsis
Authors: Liu Jun , Zhao Hongwei , Feng Ziheng , Liu Yingchao , Feng Qianyu , Qian Suyun , Xu Lili , Gao Hengmiao , Xie Zhengde
Published: April 2022

Background

Rhinovirus is a common viral aetiology of upper respiratory infection and is mostly associated with common cold or flu-like illness. Although rhinovirus has been recognized as a pathogen for lower respiratory infections in severe cases credited to advances in molecular detection, central nervous system involvement and multiorgan dysfunction are extremely rare.

Case presentation

A previously healthy 10-year-old girl developed fever, sore throat and conjunctive injection after contact with an upper respiratory infection patient, followed by seizures, haematuria, and severe diarrhoea. She experienced viral sepsis and multiorgan dysfunction after admission. Cerebral computed tomography showed significant diffuse encephaledema. Cerebrospinal fluid analysis showed significantly elevated protein levels. After her consciousness disturbance improved, she still took a long time to recover from haematuria and diarrhoea. We identified a rarely reported rhinovirus A45 in her oropharyngeal and anal swabs by metagenomic next-generation sequencing, and bacterial culture of blood specimens yielded negative results.

Conclusions

This case presents a patient with severe rhinovirus infection, which was very likely responsible for her central nervous system symptoms and viral sepsis.
On a viscous fourth-order parabolic equation with boundary degeneracy
Authors: Liang Bo , Su Caiyue , Wang Ying , Li Xiumei , Zhang Zhenyu
Published: April 2022

A viscous fourth-order parabolic equation with boundary degeneracy is studied. By using the variational method, the existence of a time-discrete fourth-order elliptic equation with homogeneous boundary conditions is solved. Moreover, the existence and uniqueness for the corresponding parabolic problem with nondegenerate coefficient is shown by several asymptotic limit processes. Finally, by applying the regularization method, the existence and uniqueness for the problem with degenerate boundary coefficient is obtained by applying the energy method and a small parameter limit process.
Anisotropic magnetoresistance and possible weak antilocalization in Mg3Bi2 single crystal
Authors: Ma Yuzhe , Wang Yulong , Wang Gang
Published: April 2022

Kagome compound Mg3Bi2 has recently been proposed as a type-II nodal-line semimetal, which may exhibit novel transport phenomena. We grew Mg3Bi2 single crystals by a Bi flux method and systematically investigated the magneto-transport properties. A large transverse magnetoresistance anisotropy around 20 was observed for I // (00l) at 2 K under a magnetic field of 5 T. The gourd-shaped out-plane angle-dependent magnetoresistance indicates that the Fermi surface has a two-fold symmetry and strong anisotropy. The cusp-like magnetoresistance for I // (0kl) (k = integer,

) at low temperature and low magnetic field shows evidence of weak antilocalization. The magnetoconductance measured at different angle merges together when plotted as a function of

at

, showing that the domination of topological surface states when

.
Analysis of baryon to entropy ratio in Ricci inverse gravity
Authors: Jawad Abdul , Sultan Abdul Malik
Published: April 2022

This letter is devoted to investigate the matter-antimatter asymmetry through baryogenesis (and generalized gravitational baryogenesis interaction) in the realm of f(R, A) theory of gravity also known as Ricci inverse gravity, where R is the curvature scalar and A is the anti-curvature scalar. Baryogensis (baryon to entropy ratio

) is a theoretical process that took place in the early history of the universe producing supremacy of matter over anti-matter, where S is entropy of universe and

is the baryon (anti-baryon) number. In this article, we inspect the consequences of

interactions proportional to

and

. We take

as specific model to analyze the phenomenon of baryogenesis and generalized gravitational baryogenesis. Our outcomes show that f(R, A) gravity can come up consistently and significantly to the phenomenon of gravitational baryogenesis. We compare our results with latest astrophysical data of baryon to entropy ratio, which exhibits outstanding compatibility with the observational bounds.
Milestones in dosimetry for nuclear medicine therapy
Authors: Gear Jonathan
Published: April 2022

Nuclear Medicine therapy has reached a critical juncture with an unprecedented number of patients being treated and an extensive list of new radiopharmaceuticals under development. Since the early applications of these treatments dosimetry has played a vital role in their development, in both aiding optimisation and enhancing safety and efficacy. To inform the future direction of this field, it is useful to reflect on the scientific and technological advances that have occurred since those early uses. In this review, we explore how dosimetry has evolved over the years and discuss why such initiatives were conceived and the importance of maintaining standards within our practise. Specific milestones and landmark publications are highlighted and a thematic review and significant outcomes during each decade are presented.