bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of phenolic content of wrack debris on estuarine beaches: The effect on upper beach macrofauna
Authors: Gómez Marina , Barreiro Francisco , López Jesús , Lastra Mariano
Published: November 2021

Wrack supply represents the main organic input in sandy beaches ecosystems and is a common feature of beaches around the world. The chemical composition of the wrack is important in determining the extent and rate of the decay; in particular, phenolic compounds may affect consumption rates by wrack‐associated macrofauna and, consequently, modify the nutrient processing and recycling in sandy beaches. The aim of this research was to investigate the possible links between phenolic content of wrack supplies and the macrofaunal community inhabiting them. To achieve this, patches of wrack in three beaches of the NW coast of Spain were analysed and the phenolic contents and macrofaunal distribution, both at spatial and temporal scales, were assessed. Wrack and macrofaunal samples were collected along two shore‐parallel transects, coinciding with the wrack lines of previous tidal deposition. The results showed a general spatial distribution in the phenolic content of the beach‐cast according to their tidal position on the beach. Thus, two distinct zones were identified: the “spring‐tide deposited” zone located in the upper beach close to the base of the dunes and composed by wrack material with the lowest phenolic concentrations; and a “freshly deposited” zone with wrack deposits containing the highest concentrations of deterrent compounds. Nevertheless, only supratidal grazers, mostly linked to fresh deposits, have shown a slightly negative association between their abundance and the increasing phenolic contents of the stranded macroalgae. The lack of a consistent pattern in macrofaunal occupation of fresh and decayed drift lines detected suggests the species could be selecting habitats for reasons other than phenolic content.
Exploring power dynamics and their impact on intraprofessional learning
Authors: Looman Natasja , van Woezik Tamara , van Asselt Dieneke , Scherpbier‐de Haan Nynke , Fluit Cornelia , de Graaf Jacqueline
Published: November 2021

Background

During postgraduate training, considerable efforts for intraprofessional education are in place to prepare primary care residents (PC residents) and medical specialty residents (MS residents) for intraprofessional collaboration (intraPC). Power dynamics are inherently present in such hierarchical medical contexts. This affects intraPC (learning). Yet little attention has been paid to factors that impact power dynamics. This study aims to explore power dynamics and their impact on intraPC learning between PC residents and MS residents during hospital placements.

Methods

This study expands on previously published ethnographic research investigating opportunities and barriers for intraPC learning among residents in five Dutch hospitals. We analysed transcripts of observations and in‐depth interviews using template analysis. A critical theory paradigm was employed. Discourse analysis additionally informed the data.

Results

We defined five interrelated themes that describe characteristics of power dynamics in intraPC learning during hospital placements: beliefs; power distribution; interaction style; subjection; and fearless learning. Power dynamics operate both within and between the themes: power distribution between PC residents, MS residents and MS supervisors seemed to be an attribution affected by underlying beliefs about professional norms or about other professions; beliefs influenced the way PC residents, MS residents and MS supervisors interacted; power distribution based on inequity could lead to subjection of PC residents; power distribution based on equity could lead to fearless learning; and open interactions enabled fearless intraPC learning.

Conclusions

Power dynamics have an impact on intraPC learning among residents in hospitals. Constructive power dynamics occur when power distribution is based on equity, combined with sincere open interactions, actively inviting each other into discussions and enlisting the support of MS supervisors to foster fearless learning. This can be achieved by creating awareness of implicit beliefs and making them explicit, recognising interaction that encourages intraPC learning and creating policies that support fearless intraPC learning.
Real‐life applicability of the Euroarray dermatomycosis kit in the diagnosis of onychomycosis
Authors: Trave Ilaria , Cozzani Emanuele , Canepa Paola , Verdiani Simonetta , Parodi Aurora
Published: November 2021

Background

Traditionally, KOH microscopy and fungal culture are the two preferred tests as gold standard for diagnosis of onychomycosis. Recently, other diagnostic methods have been developed to improve the microbiological diagnosis. The EUROArray dermatomycosis kit is a PCR‐based microarray test system for the detection and direct identification of species that are most frequently involved in skin and nail infections.

Objectives

Our primary aim was to evaluate the real‐life applicability of the EUROArray dermatomycosis kit in the diagnosis of onychomycoses. In addition, we compared the aetiology of onychomycoses found in our patients with those described in the literature.

Patients/Methods

We prospectively studied consecutive 100 patients with suspected onychomycoses. Samples of suspect toenails were taken as part of routine medical management. Nail specimens were evaluated by means of three diagnostic methods: KOH preparation, culture and EUROArray dermatomycosis kit.

Results

Onychomycosis was diagnosed in 47/100 patients who proved positive on at least one reference diagnostic test and in 49/100 patients who proved positive on PCR. The combination of microscopy and PCR had better sensitivity than microscopy (p = .0397), fungal culture (p = .0061) and PCR alone (p = .0117). Moulds were more frequently positive in culture than in PCR (p = .033). Dermatophytes proved positive more frequent than moulds and yeasts in both culture and PCR; in particular, Trichophyton interdigitale was the most frequent pathogen.

Conclusions

In conclusion, introducing EUROArray dermatomycosis kit into the diagnostic algorithm of onychomycosis increases the sensitivity of direct microscopy and yields more rapid results than culture.
Awareness, attitudes and the environmental engagement of young adults in New Zealand
Authors: Falloon Alice , Freeman Claire , van Heezik Yolanda
Published: November 2021

Young adults today will be at the forefront of future biodiversity actions and decision‐making, making it vital to understand their attitudes towards engagement in environmental initiatives. An online survey of 286 New Zealand young adults (age 18–25 years) revealed an awareness of relevant conservation issues and positive attitudes towards a range of conservation actions. However, only 25% belonged to more formal environmental groups. This low level of engagement demonstrated the need for adopting different modes of environmental engagement from those used currently. Conservationists need to develop ways to capitalise on this latent interest and translate it into more active engagement.
Assessment of automatic cephalometric landmark identification using artificial intelligence
Authors: Bulatova Galina , Kusnoto Budi , Grace Viana , Tsay T. Peter , Avenetti David M. , Sanchez Flavio Jose Castelli
Published: November 2021

Objective

To compare the accuracy of cephalometric landmark identification between artificial intelligence (AI) deep learning convolutional neural networks (CNN) You Only Look Once, Version 3 (YOLOv3) algorithm and the manually traced (MT) group.

Setting and sample population

The American Association of Orthodontists Federation (AAOF) Legacy Denver collection was used to obtain 110 cephalometric images for this study.

Materials and Methods

Lateral cephalograms were digitized and traced by a calibrated senior orthodontic resident using Dolphin Imaging. The same images were uploaded to AI software Ceppro DDH Inc The Cartesian system of coordinates with Sella as the reference landmark was used to extract x‐ and y‐coordinates for 16 cephalometric points: Nasion (Na), A point, B point, Menton (Me), Gonion (Go), Upper incisor tip, Lower incisor tip, Upper incisor apex, Lower incisor apex, Anterior Nasal Spine (ANS), Posterior Nasal Spine (PNS), Pogonion (Pg), Pterigomaxillary fissure point (Pt), Basion (Ba), Articulare (Art) and Orbitale (Or). The mean distances were assessed relative to the reference value of 2 mm. Student paired t‐tests at significance level of P < .05 were used to compare the mean differences in each of the x‐ and y‐components. SPSS (IBM‐vs. 27.0) software was used for the data analysis.

Results

There was no statistical difference for 12 out of 16 points when analysing absolute differences between MT and AI groups.

Conclusion

AI may increase efficiency without compromising accuracy with cephalometric tracings in routine clinical practice and in research settings.
The exceptional attachment ability of the ectoparasitic bee louse Braula coeca (Diptera, Braulidae) on the honeybee
Authors: Büscher Thies H. , Petersen Dennis S. , Bijma Nienke N. , Bäumler Fabian , Pirk Christian W. W. , Büsse Sebastian , Heepe Lars , Gorb Stanislav N.
Published: November 2021

Bee lice (Braulidae) are small parasitic flies, which are adapted to live on their bee host. As such, the wingless Braula coeca is a parasite of the common honey bee Apis mellifera and it is well adapted to attach to its hairy surface. The attachment system of B. coeca provides a secure grip on the fine setae of the bee. This is crucial for the parasite survival, as detachment from the host is fatal for the bee louse. The feet morphology of B. coeca is well adapted to the challenging bee surface, notably by strongly broadened claws, which are split into a high number of comb‐like teeth, perfectly matching the diameter of the bee hairs. Based on microscopy observations, both the morphology and material composition of the tarsi of B. coeca are characterized in detail. Using high‐speed video analysis, we combine the morphology data on the attachment system with a behavioural context. Furthermore, we directly measured the attachment forces generated by the bee lice in contact with the host. In particular, the claws are involved in attachment to the host, as the interstices between the teeth‐like spines allow for the collection of several hairs and generate strong friction, when the hairs slip to the narrow gap between the spines. The overall morphology of the tarsus produces strong attachment, with average safety factors (force per body weight) around 1130, and stabilizes the tarsal chain with lateral stoppers against overflexion, but also allows for the fast detachment by the tarsal chain torsion.
The Nutrition in Early Life and Asthma (NELA) birth cohort study: Rationale, design, and methods
Authors: Morales Eva , Alcantara‐Lopez Maria V. , Cabezas‐Herrera Juan , de Diego Teresa , Hernandez‐Caselles Trinidad , Jimenez‐Guerrero Pedro , Larque Elvira , Lopez‐Soler Concepción , Martinez‐Gracia Carmen , Martinez‐Torres Antonela , Martin‐Orozco Elena , Mendiola Jaime , Nieto‐Díaz Anibal , Noguera Jose A. , Perez‐Fernandez Virginia , Prieto‐Sánchez M. Teresa , Salvador‐Garcia Carme , Sanchez‐Solis Manuel , Santaella‐Pascual Marina , Sola‐Martinez Rosa A. , Torres‐Cantero Alberto , Yagüe‐Guirao Genoveva , Zornoza‐Moreno Matilde , Garcia‐Marcos Luis ,   the NELA Study Group
Published: November 2021

Background

Primary prevention strategies for asthma are lacking. Its inception probably starts in utero and/or during the early postnatal period as the developmental origins of health and disease (DOHaD) paradigm suggests.

Objectives

The main objective of Nutrition in Early Life and Asthma (NELA) cohort study is to unravel whether the following factors contribute causally to the developmental origins of asthma: (1) maternal obesity/adiposity and foetal growth; (2) maternal and child nutrition; (3) outdoor air pollution; (4) endocrine disruptors; and (5) maternal psychological stress. Maternal and offspring biological samples are used to assess changes in offspring microbiome, immune system, epigenome and volatilome as potential mechanisms influencing disease susceptibility.

Population

Randomly selected pregnant women from three health areas of Murcia, a south‐eastern Mediterranean region of Spain, who fulfilled the inclusion criteria were invited to participate at the time of the follow‐up visit for routine foetal anatomy scan at 19–22 weeks of gestation, at the Maternal‐Fetal Medicine Unit of the “Virgen de la Arrixaca” University Clinical Hospital over a 36‐month period, from March 2015 to April 2018.

Design

Prospective, population‐based, maternal‐child, birth cohort study.

Methods

Questionnaires on exposures and outcome variables were administered to mothers at 20–24 gestation week; 32–36 gestation week; and delivery. Children were surveyed at birth, 3 and 18 months of age and currently at 5 years. Furthermore, physical examinations were performed; and different measurements and biological samples were obtained at these time points.

Preliminary results

Among the 1350 women invited to participate, 738 (54%) were finally enrolled in the study and 720 of their children were eligible at birth. The adherence was high with 612 children (83%) attending the 3 months’ visit and 532 children (72%) attending the 18 months’ visit.

Conclusion

The NELA cohort will add original and unique knowledge to the developmental origins of asthma.
Values and preferences for future end‐of‐life care among the indigenous Sámi
Authors: Kroik Lena , Eneslätt Malin , Tishelman Carol , Stoor Krister , Edin‐Liljegren Anette
Published: November 2021

Intoduction

Research with Indigenous peoples internationally indicates the importance of socio‐cultural contexts for end‐of‐life (EoL) preferences. However, knowledge about values and preferences for future EoL care among the Indigenous Sámi is limited.

Aim

We investigated if and how a Swedish adaptation of the English‐language GoWish cards, DöBra cards, supports reflection and discussion of values and preferences for future EoL care among the Sámi.

Methods

This qualitative study is based on interviews with 31 self‐defined Sámi adults who used DöBra cards at four events targeting the Sámi population, between August 2019 and February 2020. Using directed content analysis, we examined aspects of interviews addressing Sámi‐specific and Sámi‐relevant motivations for choices. Data about individuals’ card rankings were collated and compiled on group level to examine variation in card choices.

Findings

All 37 pre‐formulated card statements were ranked as a top 10 priority by at least one person. The cards most frequently ranked in the top 10 were a wild card used to formulate an individual preference and thus not representing the same statement, and the pre‐formulated card ‘to have those I am close to around me’. Reactions to interviews varied, with some participants commenting on the taboo‐laden nature of discussing EoL issues, although many commented positively about EoL conversations in general, and the benefit of using the DöBra cards in particular. We categorised reasoning about Sámi‐specific and Sámi‐relevant values and preferences under the themes: Attributes of contemporary Sámi culture, Spirituality, Setting for death, Maintaining identity, Preferences related to death, Dying and EoL care and After death.

Conclusions

The DöBra cards were found to be easy‐to‐use, understandable and a flexible tool for initiating and supporting conversations about EoL values and preferences. The open formulations of cards, with wild cards, enable discussions about individual values and preferences, with potential to reflect life as a Sámi in Sweden.
The Nexus Between Undergraduate and Graduate Reforms
Authors: Wurst Karin A.
Published: November 2021

Aimed at Ph.D. programs in German, this article offers a broad framework to discuss the urgent issues facing our programs to stem the tide of (possible or even likely) disinvestment in German in times of fiscal hardship. Many conversations on suitable reforms tend to be held separately by different stakeholders – teaching‐focused faculty or language directors and research‐focused faculty or graduate directors respectively. This article proposes to tackle reforms in undergraduate and graduate education in tandem, as we enhance undergraduate programs and socialize our graduate students in this student‐focused effort in the hope of stimulating more ideas and concrete individualized plans to strengthen programs within their specific institutional contexts. The focus for the readership of Die Unterrichtspraxis is on improving undergraduate education coupled with robust cocurricular activities and on educating graduate students by emphasizing graduate students' role as teachers within the institutional learning environment. The other dimension is to build strong competencies in (educational) technology and digital literacy for both undergraduate and graduate students. In their role as future faculty members, graduate students will be the stewards of ongoing holistic reform that dynamically and nimbly adjusts to changing geopolitical and market conditions facing German.
TeachingBabylon Berlin: Language and Culture Through a Hit TV Series
Authors: Sederberg Kathryn
Published: November 2021

Film courses are now standard offerings in collegiate world language programs, but instructors have only begun to consider the unique benefits of teaching a television series to engage language learners in meaningful communication. As series have become the entertainment of choice for today's students, educators should consider the opportunities in developing course materials around extensive viewing tasks. Following a literacy‐based approach, this article presents an intermediate language course designed around the hit German‐language TV seriesBabylon Berlin(Sky/ARD 2017‐present). Extensive viewing can help students develop critical interpretative skills and visual literacy while also addressing the need to target students' listening skills. This article situates this course within research on teaching with film and television and highlights how teaching with a series can provide rich cultural content as a backbone for course design that motivates intermediate learners to learn more about interwar history, culture, and politics. The article also offers reflections on the benefits and challenges of using television as a primary text and provides sample classroom activities, assignments, and assessments.
Closing the Loop: Sustainability Coursework in Collaboration with Local and German‐Speaking Partners
Authors: Nolan Daniel
Published: November 2021

This article explores the intersection of international collaboration and community‐engaged learning in the context of a curriculum development project focused on sustainability in German‐speaking cultures. By closing the loop in international exchange between partners abroad and local community organizations, students in German Studies programs can streamline their engagement with sustainability and benefit from active use of their intercultural skill sets. However, significant difficulties arise when trying to simultaneously teach skills traditionally emphasized in German Studies programs, develop successful projects with local community practitioners, and collaborate effectively with international partners. This article discusses an upper‐division course, taught primarily in German, in which students develop group projects by working with peers at a partner institution in Germany. The article provides reflection on three key areas of focus: bolstering students' intercultural abilities to engage with partners abroad, training students to leverage their intercultural skills through virtual exchange, and articulating how cultural context is relevant for ongoing local sustainable development projects. Strengthening these skills allows German Studies students to demonstrate the value of interculturally sensitive collaborators while using their cultural knowledge to benefit local sustainable development work.
Educating university allied health students about gender-based violence: Report of a pilot study
Authors: Doran Frances , Orrock Paul
Published: November 2021

Introduction: Sexual harassment, bullying and discrimination occur across a range of healthcare settings, with frequent complaints made to health professional registration boards of Australia. Health professional education provides an ideal opportunity to ensure students understand the nature of gender-based violence (GBV) and how to prevent and address such behavior. However, there has been minimal health professional curricula that incorporates an integrated focus on gender. The aim of this study was to increase awareness and knowledge of pre-registration health students of the context of GBV and for participants to learn bystander approaches to effectively intervene to reduce violence.Methods: A violence prevention workshop incorporating a bystander approach was developed as a key component of the curriculum for a single discipline cohort of health students. Participants completed a survey pre and post workshop, where they provided responses, on a 5-point Likert scale, to statements exploring attitudes, knowledge and behaviours in relation to behaviours that constitute GBV. Within-subject pre- and post-intervention statistical analysis was completed.Results: The results demonstrated several significant positive changes to knowledge and attitude of the participants in relation to GBV.Conclusions: The findings of the project can inform the development of integrated gender-focused education as a core competency for preparing health professional students across a range of disciplines in clinical health and public health curricula.
Clinical characteristics of Australian osteopaths who teach: A national sample
Authors: Orrock Paul , Vaughan Brett , Fleischmann Michael , Fitzgerald Kylie
Published: November 2021

Background: Health professionals involved in teaching future practitioners have been studied to some extent, but our knowledge of their clinical characteristics is variable. Our study sought to profile the clinical characteristics of osteopaths who teach in the three Australian universities delivering pre-professional osteopathy education.Materials: This study is a secondary analysis of data collected via the Australian Osteopathy Research and Innovation Network (ORION) project. Descriptive statistics were generated for each of the 27-item questionnaire variables. For binary responses, unadjusted odds ratios were calculated, and for continuous variables, independent t-tests were used. Backward step-wise regression modelling was used to identify significant characteristics associated with university teaching in osteopathy. Results: The survey demonstrated 9.9% of Australian osteopaths reported being involved in university teaching. Compared to non-teaching survey respondents, the osteopaths involved in university teaching were more likely to be female (OR 1.56), older (p  0.01) and in clinical practice for longer (p  0.01) but report fewer patient care hours (p  0.01) and patient visits per week (p  0.01). Osteopaths involved in university teaching were also more likely to be involved in research (OR 18.54) and clinical supervision (OR 12.39). They also reported a broader range of patient presentations and therapeutic modalities than their counterparts.Conclusions: This nationally representative survey demonstrates a small percentage of the Australian osteopathy profession are engaged in university teaching. Our secondary analysis has highlighted several characteristics associated with involvement in university teaching that begin to shed light on the composition of the Australian osteopathy teaching workforce. This data may inform development of a skilled and experienced teaching workforce.
The Spectrum Power of Interstellar Plasma Inhomogeneities in the Direction of Eleven Radio Pulsars
Authors: Popov M. V. , Smirnova T. V.
Published: November 2021

We have analyzed two-dimensional correlation functions from the dynamic spectra of 11 pulsars using the archival data of the “Radioastron” project. The time-sections of these functions were approximated by exponential functions with a power $$\alpha $$. It is shown that this approximation describes the shape of the correlation function much better than the Gaussian. The temporal structure function $$D(\Delta t)$$ for small values of the delay $$\Delta t$$is a power law with an index $$\alpha $$. The spectrum power of spatial inhomogeneities of the interstellar plasma is related to the power of the structure function as $$n = \alpha + 2$$. We have determined the characteristic scintillation time and the power $$n$$ in the direction of 11 pulsars. In the direction of three pulsars (B0329+54, B0823+26, and B1929+10), the spectrum power of spatial inhomogeneities of the interstellar plasma turned out to be very close to the value for the Kolmogorov spectrum ($$n = 3.67$$). For other pulsars, it ranges from 3.18 to 3.86. It is shown that the measured scintillation parameters are significantly influenced by the duration of the observation session, expressed by its ratio to the characteristic scintillation time. If this parameter is less than 10, the parameter estimates may be biased: the values of $$\alpha $$ and the characteristic scintillation time $${{t}_{{{\text{scint}}}}}$$ may decrease.
Prolonged brachial plexus neuropathy: a rare complication following protracted endometriosis surgery in Lloyd-Davies position
Authors: Hay Anna Katrina , McDougall Anna , Hinstridge Peter , Rajakuldendran Sanjeev , Yoong Wai
Published: November 2021

Brachial plexus injury is a rare but potentially serious complication of laparoscopic surgery. Loss of motor and/or sensory innervation can have a significant impact on the patient’s quality of life following otherwise successful surgery. A 38-year-old underwent elective laparoscopic management of severe endometriosis during which she was placed in steep head-down tilt Lloyd-Davies position for a prolonged period. On awakening from anaesthesia, the patient had no sensation or movement of her dominant right arm. A total plexus brachialis injury was suspected. As advised by a neurologist, an MRI brachial plexus, nerve conduction study and electromyography were requested. She was managed conservatively and made a gradual recovery with a degree of residual musculocutaneous nerve neuropathy. The incidence of brachial plexus injury following laparoscopy is unknown but the brachial plexus is particularly susceptible to injury as a result of patient positioning and prolonged operative time. Patient positioning in relation to applied clinical anatomy is explored and risk reduction strategies described.
Spontaneous heparin-induced thrombocytopaenia with adrenal haemorrhage following orthopaedic surgery: a case report and literature review
Authors: Saengboon Supawee , Chinthammitr Yingyong , Kanitsap Nonglak
Published: November 2021

A 68-year-old woman was admitted to the hospital for elective total knee arthroplasty in both knees without preceding heparin exposure. She developed adrenal haemorrhage and thrombocytopaenia on postoperative day 12, followed by right leg arterial occlusion and multiple venous intra-abdominal sites thrombosis. After given unfractionated heparin to treat arterial occlusion, platelet count was gradually declined. Spontaneous heparin-induced thrombocytopaenia was diagnosed by heparin-induced platelet activation test with light transmission aggregometry. The patient was successfully treated with fondaparinux and intravenous immunoglobulin. Apixaban was given after recovery of platelet count. Resolution of both thrombus along aorta and adrenal haemorrhage were shown by CT of whole abdomen after 2 months of treatment. Our case demonstrates that this serious complication is important but seldom recognised early.
Cystic fibrosis: a diagnosis in an adolescent
Authors: Bennett Monica , Nogueira Andreia Filipa , Flores Maria Manuel , Reis Silva Teresa
Published: November 2021

Most patients with cystic fibrosis (CF) develop multisystemic clinical manifestations, the minority having mild or atypical symptoms. We describe an adolescent with chronic cough and purulent rhinorrhoea since the first year of life, with diagnoses of asthma, allergic rhinitis and chronic rhinosinusitis. Under therapy with long-acting bronchodilators, antihistamines, inhaled corticosteroids, antileukotrienes and several courses of empirical oral antibiotic therapy, there was no clinical improvement. There was no reference to gastrointestinal symptoms. Due to clinical worsening, extended investigations were initiated, which revealedPseudomonas aeruginosain sputum culture, sweat test with a positive result and heterozygosity for F508del and R334W mutations in genetic study which allowed to confirm the diagnosis of CF. In this case, heterozygosity with a class IV mutation can explain the atypical clinical presentation. It is very important to consider this diagnosis when chronic symptoms persist, despite optimised therapy for other respiratory pathologies and in case of isolation of atypical bacterial agents.
Anaesthetic challenges in the spine surgery of a young Asian man with lumbar amyloidosis
Authors: Jamil Jabraan , Tay Chong Yan , Bong Chin Pei , Yeap Tat Boon
Published: November 2021

Primary amyloidosis is a rare systemic disorder often associated with multiple organ dysfunction. The most common form, light chain amyloidosis, has an estimated age-adjusted incidence of 5.1–12.8 cases per million person-years. Spine involvement is extremely uncommon. We present the case of a young Asian man with newly diagnosed amyloidosis involving the lumbar spine among multiple organs with a pathological vertebral fracture that required urgent spine surgery. We believe this is the first reported case to discuss the perianaesthetic challenges in the management of lumbar spine amyloidosis.
Impacts of type 2 diabetes mellitus and hypertension on the incidence of cardiovascular diseases and stroke in China real-world setting: a retrospective cohort study
Authors: Liu Yan , Li Jie , Dou Ying , Ma Hongshan
Published: November 2021

Objective

The prevalence of type 2 diabetes mellitus (T2DM) and hypertension (HTN) has notably increased in recent years. However, there is little evidence from large-scale studies assessing the joint effect of T2DM and HTN on the risk of cardiovascular events in China. This study was performed to investigate the association of T2DM and HTN with the incidence of combined vascular events (VEs) and stroke in China.

Design

A retrospective cohort study.

Setting

Data were collected from the SuValue database which includes the electronic medical records of >90 million patients from 161 hospitals across 18 provinces in China.

Participants

Patients aged ≥18 with a diagnosis of T2DM and/or HTN were included. Non-T2DM and non-HTN patients were included in this study as controls.

Outcomes

Incidence of combined VEs and stroke during the study.

Results

In the current study, 8012 patients with T2DM, 9653 patients with HTN, 3592 patients with both T2DM and HTN and 10 561 patients without T2DM or HTN were included. T2DM was significantly associated with combined VE and stroke risk (HR 1.332, 95% CI 1.134 to 1.565 and HR 1.584, 95% CI 1.246 to 2.014, respectively). HTN was significantly associated with combined VE and stroke risk (HR 3.244, 95% CI 2.946 to 3.572 and HR 4.543, 95% CI 3.918 to 5.268, respectively). T2DM combined with HTN was significantly associated with combined VE and stroke risk (HR 3.002, 95% CI 2.577 to 3.497 and HR 4.151, 95% CI 3.346 to 5.149, respectively). HTN was associated with a higher combined VE and stroke risk than T2DM (HR 2.435, 95% CI 2.113 to 2.805 and HR 2.868, 95% CI 2.341 to 3.513, respectively).

Conclusion

T2DM and HTN were strongly associated with combined VE and stroke risk; however, the HTN-only group had a higher combined VE and stroke risk than the T2DM-only group.
SARS-CoV-2 and influenza virus coinfection among patients with severe acute respiratory infection during the first wave of COVID-19 pandemic in Bangladesh: a hospital-based descriptive study
Authors: Akhtar Zubair , Islam Md Ariful , Aleem Mohammad Abdul , Mah-E-Muneer Syeda , Ahmmed M Kaousar , Ghosh Probir K , Rahman Mustafizur , Rahman Mohammed Ziaur , Sumiya Mariya Kibtiya , Rahman Md Mahfuzur , Shirin Tahmina , Alamgir A S M , Banu Sayera , Rahman Mahmudur , Chowdhury Fahmida
Published: November 2021

Objective

To estimate the proportion of SARS-CoV-2 and influenza virus coinfection among severe acute respiratory infection (SARI) cases-patients during the first wave of COVID-19 pandemic in Bangladesh.

Design

Descriptive study.

Setting

Nine tertiary level hospitals across Bangladesh.

Participants

Patients admitted as SARI (defined as cases with subjective or measured fever of ≥38 C° and cough with onset within the last 10 days and requiring hospital admission) case-patients.

Primary and secondary outcomes

Proportion of SARS-CoV-2 and influenza virus coinfection and proportion of mortality among SARI case-patients.

Results

We enrolled 1986 SARI case-patients with a median age: 28 years (IQR: 1.2–53 years), and 67.6% were male. Among them, 285 (14.3%) were infected with SARS-CoV-2; 175 (8.8%) were infected with the influenza virus, and five (0.3%) were coinfected with both viruses. There was a non-appearance of influenza during the usual peak season (May to July) in Bangladesh. SARS-CoV-2 infection was significantly more associated with diabetes (14.0% vs 5.9%, p<0.001) and hypertension (26.7% vs 11.5%, p<0.001). But influenza among SARI case-patients was significantly less associated with diabetes (4.0% vs 7.4%, p=0.047) and hypertension (5.7% vs 14.4%, p=0.001). The proportion of in-hospital deaths among SARS-CoV-2 infected SARI case-patients were higher (10.9% (n=31) vs 4.4% (n=75), p<0.001) than those without SARS-CoV-2 infection; the proportion of postdischarge deaths within 30 days was also higher (9.1% (n=25) vs 4.6% (n=74), p=0.001) among SARS-CoV-2 infected SARI case-patients than those without infection. No in-hospital mortality or postdischarge mortality was registered among the five coinfected SARI case-patients.

Conclusions

Our findings suggest that coinfection with SARS-CoV-2 and influenza virus was not very common and had less disease severity considering mortality in Bangladesh. There was no circulating influenza virus during the influenza peak season during the COVID-19 pandemic in 2020. Future studies are warranted for further exploration.
Live birth after additional tubal flushing with oil-based contrast versus no additional flushing: a randomised, multicentre, parallel-group pragmatic trial in infertile women with at least one patent tube at hysterosalpingo-foam sonography (HYFOIL study)
Authors: De Neubourg Diane , Janssens Lara , Verhaegen Iris , Smits Elke , Mol Ben W , Roelant Ella
Published: November 2021

Introduction

Tubal patency testing is an essential part in the fertility workup of many subfertile women. Hysterosalpingography (HSG) has long been the test of choice in many clinics. There is evidence from a large randomised multicentre trial and from a recent meta-analysis that women who had HSG using oil soluble contrast medium (OSCM) had higher rates of ongoing pregnancy compared with women who underwent this procedure using water contrast. However, the field is moving away from HSG and nowadays hysterosalpingo-foam sonography (Hyfosy) using ultrasound guidance is considered as the first line office tubal patency test. Therefore, a large multicentre randomised clinical trial (RCT) will be initiated to evaluate if flushing the fallopian tubes with OSCM after a normal Hyfosy showing at least one patent fallopian tube will increase the live birth rate as compared with no flushing.

Methods and analysis

We plan a multicentre two arm, 1:1 randomised, open-label pragmatic comparative trial in 12 Belgian centres. After informed consent, we will randomise infertile women between 18 and 40 years of age, undergoing Hyfosy as part of the fertility workup to Hyfosy with additional tubal flushing with OSCM versus Hyfosy without additional flushing. Infertility is defined as lack of conception despite 12 months of unprotected intercourse, or three cycles of donor insemination without pregnancy or three ovulatory ovulation induction cycles without pregnancy, all three in combination with at least one patent tube on Hyfosy. Primary endpoint will be live birth with conception within 6 months after randomisation.

Ethics and dissemination

Approval on 11 May 2021 by the Ethics Committee from ZNA Hospital Antwerp who was the central Ethics Committee for the Clinical Trial Regulation Pilot (Pilot 412) in the 12 centres. The findings from this RCT will be disseminated in peer-reviewed publications and presentations at scientific international meetings.

Trial registration numbers

EudraCT number: 2020-002135-30 andNCT04379973.
Rapid Assay for Sick Children with Acute Lung infection Study (RASCALS): diagnostic cohort study protocol
Authors: Clark John Alexander , Kean Iain Robert Louis , Curran Martin D , Khokhar Fahad , White Deborah , Daubney Esther , Conway Morris Andrew , Navapurkar Vilas , Bartholdson Scott Josefin , Maes Mailis , Bousfield Rachel , Gouliouris Theodore , Agrawal Shruti , Inwald David , Zhang Zhenguang , Török M Estée , Baker Stephen , Pathan Nazima
Published: November 2021

Introduction

Lower respiratory tract infection (LRTI) is the most commonly treated infection in critically ill children. Pathogens are infrequently identified on routine respiratory culture, and this is a time-consuming process. A syndromic approach to rapid molecular testing that includes a wide range of bacterial and fungal targets has the potential to aid clinical decision making and reduce unnecessary broad spectrum antimicrobial prescribing. Here, we describe a single-centre prospective cohort study investigating the use of a 52-pathogen TaqMan array card (TAC) for LRTI in the paediatric intensive care unit (PICU).

Methods and analysis

Critically ill children with suspected LRTI will be enrolled to this 100 patient single-centre prospective observational study in a PICU in the East of England. Samples will be obtained via routine non-bronchoscopic bronchoalveolar lavage which will be sent for standard microbiology culture in addition to TAC. A blood draw will be obtained via any existing vascular access device. The primary outcomes of the study will be (1) concordance of TAC result with routine culture and 16S rRNA gene sequencing and (2) time of diagnostic result from TAC versus routine culture. Secondary outcomes will include impact of the test on total antimicrobial prescriptions, a description of the inflammatory profile of the lung and blood in response to pneumonia and a description of the clinical experience of medical and nursing staff using TAC.

Ethics and dissemination

This study has been approved by the Yorkshire and the Humber-Bradford Leeds Research Ethics Committee (REC reference 20/YH/0089). Informed consent will be obtained from all participants. Results will be published in peer-reviewed publications and international conferences.

Trial registration number

NCT04233268.
Pain mechanisms and management in corneal cross-linking: a review
Authors: van der Valk Bouman Emilie Sophie , Pump Heather , Borsook David , Severinsky Boris , Wisse Robert PL , Saeed Hajirah N , Moulton Eric A
Published: November 2021

Though corneal collagen cross-linking (CXL) is an increasingly available and effective treatment for keratoconus, few reports have considered its impact on pain-related physiology in depth. This comprehensive narrative review summarises mechanisms underlying pain in CXL and clinical care possibilities, with the goal of future improvement in management of CXL-related pain. Postoperative pain associated with CXL is largely due to primary afferent nerve injury and, to a smaller extent, inflammation. Chronification of pain after CXL has not been reported, even as long-term nerve damage without regeneration following standard CXL treatment is frequently observed. The lack of pain chronification may be due to the minimally invasive nature of the procedure, with its rapidly recovering superficial corneal wound, and to the positive anti-inflammatory changes of the tear film that have been described after CXL. Different CXL approaches have been developed, with the transepithelial epithelial-on technique (epi-on) associated with less postsurgical pain than the gold standard, epithelial-off technique (epi-off). After the first few days, however, the difference in pain scores and need for analgesics between epi-on and epi-off disappear. Patients experience relatively high-intensity pain the first few days post-CXL, and many strategies for acute pain control following CXL have been studied. Currently, no method of pain management is considered superior or universally accepted. Acute pain following CXL is a recognised and clinically significant side effect, but few CXL studies have systematically investigated postoperative pain and its management. This review aims to improve patient pain outcomes following this increasingly common procedure.
Trajectory of inhaled cadmium ultrafine particles in smokers
Authors: Fireman Klein Einat , Klein Ilan , Ephrat Omer , Dekel Yoram , Kessel Aharon , Adir Yochai
Published: November 2021

Introduction

Tobacco smoking is a significant source of cadmium exposure among smokers. Most of inhaled heavy metals, including cadmium, are attached to ultrafine particles (UFPs) surface. A low inhaled UFP content in exhaled breath condensate reflects a high inflammatory status of airways. Increased respiratory epithelial permeability and translocation to the circulation is the proposed mechanism. UFP recovered from smokers’ airways have high levels of cadmium compared with the airways of non-smokers.

Methods

Urine was collected from 22 smokers subjects and 43 non-smokers. Samples were analysed for UFP and cadmium content. UFP were measured in urine samples by means of the NanoSight LM20 system (NanoSight, UK). A Niton XL3 X-ray fluorescence spectrometer analyzer (Thermo Fischer Scientific, Germany) quantified heavy metal contents in the urine samples.

Results

Smokers had elevated UFP and cadmium content in urine compared with non-smokers (4.6 E8/mL and 20.6 ppm vs 3.4 E8/mL and 18.5 ppm, p=0.05 and p=0.05, respectively). Smokers had elevated levels of lead and rubidium compared with non-smokers (8.9 ppm and 27 ppm vs 7.8 ppm and 2 ppm, p=0.05 and p=0.04, respectively)

Discussion

We suggest that the trajectory of cadmium-related UFP in smokers begins by its inhalation into the airways. The UFPs induce inflammation and oxidative stress in the small airways, are subsequently translocated from the interstitium to the circulation and are finally detected and secreted in urine
Rogue and lump waves for the (3+1)-dimensional Yu-Toda-Sasa-Fukuyama equation in a liquid or lattice
Authors: Hu Cong-Cong , Tian Bo , Zhao Xin
Published: November 2021

Two-layer fluid models are used to depict some nonlinear phenomena in fluid mechanics, medical science and thermodynamics. In this paper, we investigate a (3[Formula: see text]1)-dimensional Yu-Toda-Sasa-Fukuyama equation for the interfacial waves in a two-layer liquid or elastic quasiplane waves in a lattice. Via the Kadomtsev-Petviashvili hierarchy reduction, we derive the rational solutions in the determinant forms and semi-rational solutions. The [Formula: see text]th-order lump waves and multi-lump waves are obtained, where [Formula: see text] is a positive integer. We observe the second-order lump waves: Two-lump waves interact with each other and separate into two new lump waves. Two-lump waves are observed: Overtaking interaction takes place between the two-lump waves; After the interaction, the two-lump waves propagate with their original velocities and amplitudes. Studying the semi-rational solutions, we show the fusion between a lump wave and a bell-type soliton and fission of a bell-type soliton. Interaction between a line rogue wave and a bell-type soliton is shown.
Simulation of optical triode based on PT symmetric structure under electro-optic modulation
Authors: Liu Jia-Chen , Fang Qian-Xiao , Wu Yu , Xia Zheng-Ya , Fang Yun-Tuan
Published: November 2021

In modern microwave and optical communication systems, it is urgent to develop optical components with the same performance as electronic components. In this paper, a PT-symmetric structure including electro-optical medium is designed to construct optical triode. It is found that the structure has a pole effect of amplification under certain parameters. The frequency of the incident wave at the pole is taken as the carrier frequency, and the electrical signal is modulated into an optical signal. By setting the bias electric field, the modulated optical signal can be amplified in phase and out phase, and even by doubling frequency, and a new optical triode model is obtained. The designed model will play an important role in the design of optical integrated devices.
Solitary wave solutions along with Painleve analysis for the Ablowitz–Kaup–Newell–Segur water waves equation
Authors: Rizvi Syed T. R. , Seadawy Aly R. , Akram U. , Younis M. , Althobaiti Ali
Published: November 2021

This study focuses on the Ablowitz–Kaup–Newell–Segur (AKNS) water waves equation. Painleve test (P-test) will be implemented to check the integrability of AKNS equation and an extended modified auxiliary equation mapping (EMAEM) architectonic is implemented to get a new set of traveling wave solutions like periodic and doubly periodic, bell type, kink, singular kink, anti-kink, trigonometric, singular, rational, combined soliton like solutions and hyperbolic solutions. Furthermore, it is analyzed that the implemented algorithm is efficient and accurate for solving nonlinear evolution equations (NLEEs). Finally, graphical simulations (2D, 3D and contours) are also provided to illustrate the detailed behavior of the solution and effectiveness of the proposed method.
STRUCTURAL CHARACTERIZATION OF BRASS BY Au-ION IMPLANTATION: SURFACE ANALYSIS
Authors: SHAHNAWAZ MUHAMMAD , MUHAMMAD NAWAZ
Published: November 2021

Brass has been tested for the modification in its structural, electrical properties as well as hardness using Au-ion implantation. Four ion doses were devised as follows: [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text] ions/cm2. SRIM/TRIM software helped to predict Au-ion distribution inside the brass. The alloy was then characterized using X-ray diffraction (XRD), microhardness, four-point probe testing and scanning electron microscopy (SEM) analysis. The microstructure parameters from XRD analysis were determined and used for the calculation of lattice parameter, crystallite size, microstrain and dislocation density. The microhardness value was observed to be changed from 106[Formula: see text]HV to 119[Formula: see text]HV with the maximum increase as 12.26%. A noticeable decrease occurred in the crystallite size from 44[Formula: see text]nm to 34[Formula: see text]nm for the plane (2 2 0) due to increase in dislocation density, and the corresponding change in ([Formula: see text]/[Formula: see text] is also noted. The electrical conductivity is overall found to be decreased, whereas the [Formula: see text]-spacing values fluctuated with ion dose. SEM analysis helped observing the microstructural changes, which occurred in the form of particulates and defects, namely pores, voids, cavities and craters. The relationships between microstructure and these properties are important for developing new materials for future prospects.