bluuebunny/crossref_metadata_2025 huggingface dataset:
Genomic analysis of a functional haloacid-degrading gene of Bacillus megaterium strain BHS1 isolated from Blue Lake (Mavi Gölü, Turkey)
Authors: Wahhab Batool Hazim Abdul , Samsulrizal Nurul Hidayah , Edbeib Mohamed Faraj , Wahab Roswanira Ab. , Al-Nimer Marwan S. M. , Hamid Azzmer Azzar Abdul , Oyewusi Habeebat Adekilekun , Kaya Yilmaz , Notarte Kin Israel R. , Shariff Amir Husni Mohd , Huyop Fahrul
Published: February 2021

Purpose

Bacillus megaterium strain BHS1, isolated from an alkaline water sample taken from Mavi Gölü (Blue Lake, Turkey), can grow on minimal medium containing 2,2-dichloropropionic acid. We characterized this bacterium at the genomic level.

Methods

The HiSeq platform was used to carry out genome sequencing, de novo assembly, and scaffolding with strain BHS1. Next, genome data were analyzed to demarcate DNA regions containing protein-coding genes and determine the function of certain BHS1 genes. Finally, results from a colorimetric chloride ion–release assay demonstrated that strain BHS1 produces dehalogenase.

Results

De novo assembly of the BHS1 genomic sequence revealed a genome size of ~ 5.37 Mb with an average G+C content of 38%. The predicted nuclear genome harbors 5509 protein-coding genes, 1353 tRNA genes, 67 rRNA genes, and 6 non-coding (mRNA) genes. Genomic mapping of strain BHS1 revealed its amenability to synthesize two families of dehalogenases (Cof-type haloacid dehalogenase IIB family hydrolase and haloacid dehalogenase type II), suggesting that these enzymes can participate in the catabolism of halogenated organic acids. The mapping identified seven Na+/H+ antiporter subunits that are vital for adaptation of the bacterium to an alkaline environment. Apart from a pairwise analysis to the well-established L-2-haloacid dehalogenases, whole-cell analysis strongly suggested that the haloacid dehalogenase type II might act stereospecifically on L-2-chloropropionic acid, D,L-2-chloropropionic acid, and 2,2-dichloropropionic acid. Whole-cell studies confirmed the utilization of these three substrates and the gene’s role in dehalogenation.

Conclusions

To our knowledge, this is the first report of the full genome sequence for strain BHS1, which enabled the characterization of selected genes having specific metabolic activities and their roles in the biodegradation of halogenated compounds.
Non-association between low vitamin d levels and aeroallergen-positivity evaluated using multiple allergen simultaneous test in Korean adults
Authors: Wee Jee Hye , Cho Sung Woo , Kim Jeong-Whun , Rhee Chae-Seo
Published: February 2021

Background

Studies on the association between vitamin D levels and allergen sensitization have reported conflicting results. We aimed to evaluate the association between low vitamin D levels and sensitization to 59 aeroallergens in Korean adults.

Methods

We retrospectively reviewed serum 25-hydroxyvitamin D (25[OH]D) measurements of participants (n = 57,467) in a healthcare center between May 2003 and June 2020. Serum 25(OH)D levels were categorized as follows: severe deficiency (< 10 ng/mL), deficiency (10 to < 20 ng/mL), insufficiency (20 to < 30 ng/mL), and sufficiency (≥ 30 ng/mL). Among all subjects, 1277 simultaneously underwent the multiple allergen simultaneous test. Multiple linear and logistic regression analyses were used to estimate coefficients and odds ratios (ORs) with 95% confidence interval (CI) for the association between serum vitamin D deficiency and aeroallergen sensitization after adjustment for potential confounders. Subgroup analyses were conducted for the types of aeroallergen (house dust mites, pollens, animal dander, foods, cockroach, and fungus).

Results

Vitamin D deficiency, defined as serum 25(OH)D level < 20 ng/mL, was noted in 56.4% of participants. There were significant differences in serum 25(OH)D levels according to sex, age, season, and bone mineral density (all P < 0.001). In multiple linear regression analyses, serum 25(OH)D levels were significantly lower in young subjects (adjusted coefficient [95% CI], 0.188 [0.101, 0.275]) and during winter (− 4.114 [− 6.528, − 1.699]). However, no significant association was observed between serum 25(OH)D levels and allergen sensitization (adjusted coefficients [95% CI], − 0.211 [− 1.989, 1.567], P = 0.816). In multivariate logistic regression analyses, male sex, young age, and winter season were significant risk factors for vitamin D deficiency. However, allergen sensitization showed no significant association with 25(OD)D levels after adjusting for confounders (adjusted OR [95% CI], 1.037 [0.642, 1.674] in insufficiency; 0.910 [0.573, 1.445] in deficiency; 0.869 [0.298, 2.539] in severe deficiency groups, P for trend = 0.334). There were consistent findings across subgroups regarding type of aeroallergen sensitized.

Conclusion

Vitamin D deficiency was prevalent but was not significantly associated with aeroallergen sensitization in Korean adults. To the best of our knowledge, this is the first large-scale study to evaluate the association between vitamin D deficiency and sensitization to 59 different aeroallergens.
The antinuclear antibody HEp-2 indirect immunofluorescence assay: a survey of laboratory performance, pattern recognition and interpretation
Authors: Tebo Anne E. , Schmidt Robert L. , Kadkhoda Kamran , Peterson Lisa K. , Chan Edward K. L. , Fritzler Marvin J. , Wener Mark H.
Published: February 2021

Background

To evaluate the interpretation and reporting of antinuclear antibodies (ANA) by indirect immunofluorescence assay (IFA) using HEp-2 substrates based on common practice and guidance by the International Consensus on ANA patterns (ICAP).

Method

Participants included two groups [16 clinical laboratories (CL) and 8 in vitro diagnostic manufacturers (IVD)] recruited via an email sent to the Association of Medical Laboratory Immunologists (AMLI) membership. Twelve (n = 12) pre-qualified specimens were distributed to participants for testing, interpretation and reporting HEp-2 IFA. Results obtained were analyzed for accuracy with the intended and consensus response for three main categorical patterns (nuclear, cytoplasmic and mitotic), common patterns and ICAP report nomenclatures. The distributions of antibody titers of specimens were also compared.

Results

Laboratories differed in the categorical patterns reported; 8 reporting all patterns, 3 reporting only nuclear patterns and 5 reporting nuclear patterns with various combinations of other patterns. For all participants, accuracy with the intended response for the categorical nuclear pattern was excellent at 99% [95% confidence interval (CI): 97–100%] compared to 78% [95% CI 67–88%] for the cytoplasmic, and 93% [95% CI 86%–100%] for mitotic patterns. The accuracy was 13% greater for the common nomenclature [87%, 95% CI 82–90%] compared to the ICAP nomenclature [74%, 95% CI 68–79%] for all participants. Participants reporting all three main categories demonstrated better performances compared to those reporting 2 or less categorical patterns. The average accuracies varied between participant groups, however, with the lowest and most variable performances for cytoplasmic pattern specimens. The reported titers for all specimens varied, with the least variability for nuclear patterns and most titer variability associated with cytoplasmic patterns.

Conclusions

Our study demonstrated significant accuracy for all participants in identifying the categorical nuclear staining as well as traditional pattern assignments for nuclear patterns. However, there was less consistency in reporting cytoplasmic and mitotic patterns, with implications for assigning competencies and training for clinical laboratory personnel.
$(r_{1},r_{2})$-Cesàro summable sequence space of non-absolute type and the involved pre-quasi ideal
Authors: Bakery Awad A. , Mohamed OM Kalthum S. K.
Published: February 2021

We suggest a sufficient setting on any linear space of sequences$\mathcal{V}$Vsuch that the class$\mathbb{B}^{s}_{\mathcal{V}}$BVsof all bounded linear mappings between two arbitrary Banach spaces with the sequence ofs-numbers in$\mathcal{V}$Vconstructs a map ideal. We define a new sequence space$(\mathit{ces}_{r_{1},r_{2}}^{t} )_{\upsilon }$(cesr1,r2t)υfor definite functionalυby the domain of$(r_{1},r_{2})$(r1,r2)-Cesàro matrix in$\ell _{t}$ℓt, where$r_{1},r_{2}\in (0,\infty )$r1,r2∈(0,∞)and$1\leq t<\infty $1≤t<∞. We examine some geometric and topological properties of the multiplication mappings on$(\mathit{ces}_{r_{1},r_{2}}^{t} )_{\upsilon }$(cesr1,r2t)υand the pre-quasi ideal$\mathbb{B}^{s}_{ (\mathit{ces}_{r_{1},r_{2}}^{t} )_{\upsilon }}$B(cesr1,r2t)υs.
A study on controllability of impulsive fractional evolution equations via resolvent operators
Authors: Gou Haide , Li Yongxiang
Published: February 2021

In this article, we study the controllability for impulsive fractional integro-differential evolution equation in a Banach space. The discussions are based on the Mönch fixed point theorem as well as the theory of fractional calculus and the$(\alpha ,\beta )$(α,β)-resolvent operator, we concern with the term$u'(\cdot )$u′(⋅)and finding a controlvsuch that the mild solution satisfies$u(b)=u_{b}$u(b)=uband$u'(b)=u'_{b}$u′(b)=ub′. Finally, we present an application to support the validity study.
On Chandrasekhar functional integral inclusion and Chandrasekhar quadratic integral equation via a nonlinear Urysohn–Stieltjes functional integral inclusion
Authors: El-Sayed Ahmed , Al-Issa Shorouk , Omar Yasmin
Published: February 2021

We investigate the existence of solutions for a nonlinear integral inclusion of Urysohn–Stieltjes type. As applications, we give a Chandrasekhar quadratic integral equation and a nonlinear Chandrasekhar integral inclusion.
Measles dynamics on network models with optimal control strategies
Authors: Xue Yuyi , Ruan Xiaoe , Xiao Yanni
Published: February 2021

To investigate the influences of heterogeneity and waning immunity on measles transmission, we formulate a network model with periodic transmission rate, and theoretically examine the threshold dynamics. We numerically find that the waning of immunity can lead to an increase in the basic reproduction number$R_{0}$R0and the density of infected individuals. Moreover, there exists a critical level for average degree above which$R_{0}$R0increases quicker in the scale-free network than in the random network. To design the effective control strategies for the subpopulations with different activities, we examine the optimal control problem of the heterogeneous model. Numerical studies suggest us no matter what the network is, we should implement control measures as soon as possible once the outbreak takes off, and particularly, the subpopulation with high connectivity should require high intensity of interventions. However, with delayed initiation of controls, relatively strong control measures should be given to groups with medium degrees. Furthermore, the allocation of costs (or resources) should coincide with their contact patterns.
Novel tools and methods for designing and wrangling multifunctional, machine-readable evidence synthesis databases
Authors: Haddaway Neal R. , Gray Charles T. , Grainger Matthew
Published: February 2021

One of the most important steps in the process of conducting a systematic review or map is data extraction and the production of a database of coding, metadata and study data. There are many ways to structure these data, but to date, no guidelines or standards have been produced for the evidence synthesis community to support their production. Furthermore, there is little adoption of easily machine-readable, readily reusable and adaptable databases: these databases would be easier to translate into different formats by review authors, for example for tabulation, visualisation and analysis, and also by readers of the review/map. As a result, it is common for systematic review and map authors to produce bespoke, complex data structures that, although typically provided digitally, require considerable efforts to understand, verify and reuse. Here, we report on an analysis of systematic reviews and maps published by the Collaboration for Environmental Evidence, and discuss major issues that hamper machine readability and data reuse or verification. We highlight different justifications for the alternative data formats found: condensed databases; long databases; and wide databases. We describe these challenges in the context of data science principles that can support curation and publication of machine-readable, Open Data. We then go on to make recommendations to review and map authors on how to plan and structure their data, and we provide a suite of novel R-based functions to support efficient and reliable translation of databases between formats that are useful for presentation (condensed, human readable tables), filtering and visualisation (wide databases), and analysis (long databases). We hope that our recommendations for adoption of standard practices in database formatting, and the tools necessary to rapidly move between formats will provide a step-change in transparency and replicability of Open Data in evidence synthesis.
Systematic screening on admission for SARS-CoV-2 to detect asymptomatic infections
Authors: Stadler Rahel N. , Maurer Laura , Aguilar-Bultet Lisandra , Franzeck Fabian , Ruchti Chantal , Kühl Richard , Widmer Andreas F. , Schindler Ruth , Bingisser Roland , Rentsch Katharina M. , Pargger Hans , Sutter Raoul , Steiner Luzius , Meier Christoph , Kübler Werner , Hirsch Hans H. , Egli Adrian , Battegay Manuel , Bassetti Stefano , Tschudin-Sutter Sarah
Published: February 2021

The proportion of asymptomatic carriers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains elusive and the potential benefit of systematic screening during the SARS-CoV-2-pandemic is controversial. We investigated the proportion of asymptomatic inpatients who were identified by systematic screening for SARS-CoV-2 upon hospital admission. Our analysis revealed that systematic screening of asymptomatic inpatients detects a low total number of SARS-CoV-2 infections (0.1%), questioning the cost–benefit ratio of this intervention. Even when the population-wide prevalence was low, the proportion of asymptomatic carriers remained stable, supporting the need for universal infection prevention and control strategies to avoid onward transmission by undetected SARS-CoV-2-carriers during the pandemic.
Navigating complexity to support justice-involved youth with FASD and other neurodevelopmental disabilities: needs and challenges of a regional workforce
Authors: Pedruzzi Rebecca Anne , Hamilton Olivia , Hodgson Helena H. A. , Connor Elizabeth , Johnson Elvira , Fitzpatrick James
Published: February 2021

Background

Young people with Fetal Alcohol Spectrum Disorder (FASD) can face significant challenges in their lives, including overrepresentation in the justice system from a young age. Police questioning and court proceedings can be difficult for these young people to navigate. Practice and policy responses are necessary to identify these individuals, provide appropriate support/rehabilitation, and upskill the justice workforce. The aim of this research was to determine the unmet workforce development needs of a regional workforce providing care and support to youth involved with the justice system. Interviews were conducted with 29 participants from 14 organisations to understand the support provided to youth, existence and uptake of referral pathways, and unmet needs.

Results

Results revealed a workforce that wants to see improvements to outcomes for young people with FASD and other neurodevelopmental disabilities who enter the youth justice system. However more support is required through training, ongoing funding, and assistance to develop FASD informed work practices.

Conclusions

The workforce supporting youth to navigate the justice system requires practical interventions to achieve best practice so that young people with FASD and other neurodevelopmental disabilities receive the support that they need. Following the interviews a model of care tool was developed and piloted in the sector. The tool includes current pathways through the justice system and provides resources to assist staff in achieving best practice care for young people with FASD and other neurodevelopmental disabilities.
Teachers’ experienced classroom demands and autonomic stress reactions: results of a pilot study and implications for process-oriented research in vocational education and training
Authors: Kärner Tobias , Höning Jana
Published: February 2021

Background

To examine relationships between teachers’ experienced classroom demands and autonomic stress reactions, we report the results of a pilot study. Based on an integrative literature review, we identified and described the following situational classroom demands: time and work pressure (including missing rest periods, time pressure, and pressure to get through the subject matter), vocal strain, uncertainty concerning the subject matter, uncertainty concerning didactical decisions, achievement-related diversity in class, lack of social appreciation, disquietude in class, classroom disturbances, behavioral problems of students, insufficient skills and concentration of students, and insufficient motivation of students.

Method

These identified categories of teachers’ situational classroom demands are the basis for the empirical item identification and selection (Study A). The identified items were used in a single-case, short-term longitudinal study in which we examined relationships between experienced classroom demands and autonomic stress reactions as well as between autonomic stress reactions and affective stress experience via first-order vector autoregressive modeling (Study B).

Results

Concerning our hypotheses, we found evidence that some of the experienced classroom demands (“I cannot respond to students’ different needs”; “There is disquietude in class”) had time-lagged associations with autonomic stress measures. Furthermore, we found that physiological arousal triggers affective stress experience due to a time-lagged effect.

Conclusion

The research approach and results of our pilot study can be the basis for further process-oriented research in vocational education and training (VET). From a practical point of view, our results on experienced classroom demands could be used in VET teacher education to prepare student teachers for specific skills to cope with such demands.
Comparison of miRNA expressions among benign, premalignant and malignant lesions of the larynx: Could they be transformation biomarkers?
Authors: Tuncturk Fatma Ruya , Akalin Ibrahim , Uzun Lokman , Zenginkinet Tulay
Published: February 2021

Background

The malignancy potential of the laryngeal lesions are one of the major concerns of the surgeons about choosing the treatment options, forming surgical margins, deciding the follow-up periods. Finding a biomarker to overcome these concerns are ongoing challenges and recently microRNAs (miRNAs) are attributed as possible candidates since they can regulate gene expressions in the human genome. The objective of our study was to investigate their capability as a transformation biomarker for malignant laryngeal lesions.

Materials and methods

We investigated mature miRNA expressions in paraffin-embedded surgical specimens of human laryngeal tissues grouped as benign, premalignant or malignant ( n = 10 in each). miRNA profiling was carried out by quantitative Real-Time polymerase chain reaction (RT-qPCR) and data were analyzed according to fold regulation.

Results

Our results demonstrated that 9 miRNAs were upregulated as the lesions become more malignant. Among them Hs_miR-183_5p, Hs_miR-155_5p, and Hs_miR-106b_3p expressions were significantly 4.16 ( p = 0.032), 2.72 ( p = 0.028) and 3.01 ( p = 0.022) fold upregulated respectively in premalignant lesions compared to the benign lesions. Moreover, their expressions were approximately 2.76 fold higher in the malignant group than in the premalignant group compared to the benign group. Besides them, significant 7.57 ( p = 0.036), 4.45 ( p = 0.045) and 5.98 ( p = 0.023) fold upregulations of Hs_miR-21_5p, Hs_miR-218_3p, and Hs_miR-210_3p were noticed in the malignant group but not in the premalignant group when compared to the benign group, respectively.

Conclusion

MiRNAs might have important value to help the clinicians for their concerns about the malignancy potentials of the laryngeal lesions. Hs_miR-183_5p, Hs_miR-155_5p, and Hs_miR-106b_3p might be followed as transformation marker, whereas Hs_miR-21_5p, Hs_miR-218_3p, and Hs_miR-210_3p might be a biomarker prone to malignancy.
Evaluation of NaCl and MgCl2 heat exchange fluids in a deep binary geothermal system in a sedimentary halite formation
Authors: Moore Kayla R. , Holländer Hartmut M.
Published: February 2021

Halite formations are attractive geothermal reservoirs due to their high heat conductivity, resulting in higher temperatures than other formations at similar depths. However, halite formations are highly reactive with undersaturated water. An understanding of the geochemical reactions that occur within halite-saturated formation waters can inform decision making regarding well construction, prevention of well clogging, formation dissolution, and thermal short-circuiting. Batch reaction and numerical 3-D flow and equilibrium reactive transport modeling were used to characterize the produced NaCl-brine in a well targeting a halite-saturated formation. The potential for inhibition of precipitation and dissolution using an MgCl2-brine and NaCl + MgCl2-brine were also investigated. Within the injection well, heating of an NaCl-brine from 70 to 120 °C caused the solubility of halite to decrease, resulting in the potential dissolution of 0.479 mol kg−1halite at the formation. Conversely, cooling from 120 to 100 °C in the production well resulted in potential precipitation of 0.196 mol kg−1halite. Concurrent precipitation of anhydrite is also expected. Introduction of MgCl2  into the heat exchange brine, which has a common Cl−ion, resulted in a decreased potential for dissolution by 0.290 mol kg−1halite within the formation, as well as decreased precipitation within the production well, compared to the NaCl-brine. The halite solubility was altered by changes in pressure up to 0.045 mol kg−1. This indicates that designing and monitoring the composition of heat exchange fluids in highly saline environments is an important component in geothermal project design.
Weights of evidence modeling for landslide susceptibility mapping of Kabi-Gebro locality, Gundomeskel area, Central Ethiopia
Authors: Getachew Nega , Meten Matebie
Published: February 2021

Kabi-Gebro locality of Gundomeskel area is located within the Abay Basin at Dera District of North Shewa Zone in the Central highland of Ethiopia and it is about 320Km from Addis Ababa. This is characterized by undulating topography, intense rainfall, active erosion and highly cultivated area. Geologically, it comprises weathered sedimentary and volcanic rocks. Active landslides damaged the gravel road, houses and agricultural land. The main objective of this research is to prepare the landslide susceptibility map using GIS-based Weights of Evidence model. Based on detailed field assessment and Google Earth image interpretation, 514 landslides were identified and classified randomly into training landslides (80%) and validation landslides (20%). The most common types of landslides in the study area include earth slide (rotational and translational slide), debris slide, debris flow, rock fall, topple, rock slide, creep and complex. Nine landslide causative factors such as lithology, slope, aspect, curvature, land use/land cover, distance to stream, distance to lineament, distance to spring and rainfall were used to prepare a landslide susceptibility map of the study area by adding the weights of contrast values of these causative factors using a rater calculator of the spatial analyst tool in ArcGIS. The final landslide susceptibility map was reclassified as very low, low, moderate, high and very high susceptibility classes. This susceptibility map was validated using landslide density index and area under the curve (AUC). The result from this model validation showed a success rate and a validation rate accuracy of 82.4% and 83.4% respectively. Finally, implementing afforestation strategies on bare land, constructing surface drainage channels & ditches, providing engineering reinforcements such as gabion walls, retaining walls, anchors and bolts whenever necessary and prohibiting hazardous zones can be recommended in order to lessen the impact of landslides in this area.
Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study
Authors: Klingberg Sonja , van Sluijs Esther M. F. , Jong Stephanie T. , Draper Catherine E.
Published: February 2021

Background

Nurturing care interventions have the potential to promote health and development in early childhood. Amagugu Asakhula was designed to promote developmentally important dietary and movement behaviours among children of preschool age (3–5 years) in South Africa. An initial formative study in Cape Town found the intervention to be feasible and acceptable when delivered by community health workers (CHWs) linked to a community-based organisation. This study evaluated the delivery of the Amagugu Asakhula intervention by CHWs linked to a public sector primary health care facility in Soweto, as this mode of delivery could have more potential for sustainability and scalability.

Methods

A qualitative design was utilised to assess feasibility, acceptability, adoption, appropriateness, implementation, fidelity and context. CHWs (n = 14) delivered the intervention to caregivers (n = 23) of preschool-age children in Soweto over 6 weeks. Following the completion of the intervention, focus group discussions were held with CHWs and caregivers. Further data were obtained through observations, study records and key informant interviews (n = 5). Data were analysed using deductive thematic analysis guided by a process evaluation framework.

Results

The delivery of the Amagugu Asakhula intervention through CHWs linked to a primary health care facility in Soweto was not found to be feasible due to contextual challenges such as late payment of salaries influencing CHW performance and willingness to deliver the intervention. CHWs expressed dissatisfaction with their general working conditions and were thus reluctant to take on new tasks. Despite barriers to successful delivery, the intervention was well received by both CHWs and caregivers and was considered a good fit with the CHWs’ scope of work.

Conclusions

Based on these findings, delivery of the Amagugu Asakhula intervention is not recommended through public sector CHWs in South Africa. This feasibility study informs the optimisation of implementation and supports further testing of the intervention’s effectiveness when delivered by CHWs linked to community-based organisations. The present study further demonstrates how implementation challenges can be identified through qualitative feasibility studies and subsequently addressed prior to large-scale trials, avoiding the wasting of research and resources.
Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure—a case report
Authors: Doshu-Kajiura Akira , Suzuki Junko , Suzuki Takahiro
Published: February 2021

Background

Drugs administered subcutaneously have delayed onset and prolonged duration of action versus those given intravenously. Since the duration of action of rocuronium is prolonged in patients with renal dysfunction, subcutaneous administration of rocuronium to such patients might significantly prolong its effect.

Case presentation

A 51-year-old female with chronic renal failure was accidentally administered 1.04 mg/kg rocuronium subcutaneously. Marked prolongation of onset and duration of action of rocuronium were detected on acceleromyography. Slow development of the neuromuscular block was still observed at 100 min after injection. Administration of 4.5 mg/kg sugammadex at 140 min after rocuronium injection facilitated recovery from a train-of-four (TOF) count of 2 to a TOF ratio of 100% within 5 min. No symptoms of postoperative recurarization and upper airway obstruction were observed.

Conclusion

Neuromuscular monitoring is necessary to evaluate the progress and depth of neuromuscular block, particularly when rocuronium is inadvertently administered subcutaneously.
Research and application of online SPOC teaching mode in analog circuit course
Authors: Jia Yuchen , Zhang Limei
Published: February 2021

With the development of information technology and the advent of Massive Open Online Course (MOOC) and Small Private Online Course (SPOC), various online courses which include a lot of new resources and new teaching methods have appeared. The application of advanced teaching resources and educational concepts can improve students' learning experiences. This paper proposes a hybrid closed-loop teaching model of analog circuit SPOC based on online live. The course design is centered on the improvement of students' abilities. An online course resources construction mode of self-built platform with excellent courses introduction is expounded. It enriches the number of online course resources and increases the forms of resource expression. In teaching design, here present the target classification method based on Bloom, the indicators of the Bloom model corresponding to the knowledge, process arrangement, and tests of analog circuits. It also discusses the rules and presentation methods of learning goals, and online experiment teaching based on simulation. Taking the analog circuit course as an example, the implementation methods of resource construction, goal setting, live class schedule, PBL summary, course test, experimental teaching are described. Finally, it summarizes the methods of teaching data collection and the idea of optimizing teaching design applying feedback data. The current data shows that online SPOC teaching mode is conducive to improving students' interest in learning and cultivating their comprehensive ability.
Does scrolling affect measurement equivalence of electronic patient-reported outcome measures (ePROM)? Results of a quantitative equivalence study
Authors: Shahraz Saeid , Pham Tan P. , Gibson Marc , De La Cruz Marie , Baara Munther , Karnik Sachin , Dell Christopher , Pease Sheryl , Nigam Suyash , Cappelleri Joseph C. , Lipset Craig , Zornow Patrick , Lee Jeff , Byrom Bill
Published: February 2021

Background

Scrolling is a perceived barrier in the use of bring your own device (BYOD) to capture electronic patient reported outcomes (ePROs). This study explored the impact of scrolling on the measurement equivalence of electronic patient-reported outcome measures (ePROMs) in the presence and absence of scrolling.

Methods

Adult participants with a chronic condition involving daily pain completed ePROMs on four devices with different scrolling properties: a large provisioned device not requiring scrolling; two provisioned devices requiring scrolling – one with a “smart-scrolling” feature that disabled the “next” button until all information was viewed, and a second without this feature; and BYOD with smart-scrolling. The ePROMs included were the SF-12, EQ-5D-5L, and three pain measures: a visual analogue scale, a numeric response scale and a Likert scale. Participants completed English or Spanish versions according to their first language. Associations between ePROM scores were assessed using intraclass correlation coefficients (ICCs), with lower bound of 95% confidence interval (CI) > 0.7 indicating comparability.

Results

One hundred fifteen English- or Spanish-speaking participants (21-75y) completed all four administrations. High associations between scrolling and non-scrolling were observed (ICCs: 0.71–0.96). The equivalence threshold was met for all but one SF-12 domain score (bodily pain; lower 95% CI: 0.65) and two EQ-5D-5L item scores (pain/discomfort, usual activities; lower 95% CI: 0.64/0.67). Age, language, and device size produced insignificant differences in scores.

Conclusions

The measurement properties of PROMs are preserved even in the presence of scrolling on a handheld device. Further studies that assess scrolling impact over long-term, repeated use are recommended.
Leucine-rich glioma-inactivated protein 1 antibody-mediated autoimmune encephalitis in a 4-year-old girl: a case report
Authors: Luo Junxia , Shi Jianguo , Chen Yehong , Hu Wandong , Guo Yujie , Hou Guangshun , Gao Zaifen
Published: February 2021

Background

Leucine-rich glioma-inactivated protein 1 (LGI1) antibody-mediated encephalitis is a rare subtype of autoimmune encephalopathy, which is associated with autoimmunity against the neuronal plasma membrane proteins. The characteristic symptoms of this disease are memory dysfunction, seizures, faciobrachial dystonic seizures, cognitive deficits, neuropsychiatric disturbances, and intractable hyponatremia. The diagnosis of this disease mainly depends on the presence of anti-LGI1 antibody in serum or cerebrospinal fluid of patients. LGI1 antibody encephalitis has been reported mostly in adults, with rare occurrences in children.

Case presentation

In this report, we described a 4-year-old girl with typical seizures. Seizure types included focal seizures and generalized tonic-clonic seizures. The electroencephalogram findings showed focal discharges. Brain magnetic resonance imaging (MRI) showed normal. The cerebrospinal fluid (CSF) levels of cells, glucose, and chloride were within the normal range, and the culture did not reveal growth of any pathogen. Test of serum LGI1-Ab was positive, while the tests for autoimmune encephalitis antibody series in CSF were negative. The seizures of the patient were completely controlled after the therapy of immunoglobulin, methylprednisolone and antiepileptic drugs (AEDs), and the mental state almost returned to normal.

Conclusion

To our knowledge, the patient described here may be the youngest case of LGI1 antibody encephalitis reported to date. Children with the LGI1 antibody-associated encephalitis may present only with single symptoms such as epileptic seizures and have good response to the therapy of immunoglobulin, methylprednisolone and antiepileptic drugs. Our case report will provide hints for pediatricians in the diagnosis and treatment of LGI1-antibody encephalitis.
An efficient algorithm to solve damped forced oscillator problems by Bernoulli operational matrix of integration
Authors: Singh Mithilesh , Sharma Seema , Rawan Sunil
Published: February 2021

An asymptotic perturbation solution for a linear oscillator of free damped vibrations in fractal medium described by local fractional derivatives was obtained in Yang and Srivastava (Commun Nonlinear Sci Numer Simul 29(1–3):499–504, 2015). In this paper, we obtain the numerical solution of damped forced oscillator problems by employing the operational matrix of integration of Bernoulli orthonormal polynomials. The operational matrix of integration is determined with the help of the integral operator on Bernoulli orthonormal polynomials. Numerical examples of two different problems of spring are given to delineate the performance and perfection of this approach and compared the results with the exact solution.
Addressing Insulin Access and Affordability: An Endocrine Society Position Statement
Authors:   The Endocrine Society
Published: February 2021

Rising costs have made access to affordable insulin far more difficult for people with diabetes, especially low-income individuals, those on high deductible health plans, beneficiaries using Medicare Part B to cover insulin delivered via pump, Medicare beneficiaries in the Part D donut hole, and those who turn 26 and must transition from their parents’ insurance, to manage their diabetes and avoid unnecessary complications and hospitalizations. For many patients with diabetes, insulin is a life-saving medication. Policymakers should immediately address drivers of rising insulin prices and implement solutions that would reduce high out-of-pocket expenditures for patients. The Endocrine Society recommends policy options to expand access to lower cost insulin in this paper.
Postoperative Hypotension and Adverse Clinical Outcomes in Patients Without Intraoperative Hypotension, After Noncardiac Surgery
Authors: Khanna Ashish K. , Shaw Andrew D. , Stapelfeldt Wolf H. , Boero Isabel J. , Chen Qinyu , Stevens Mitali , Gregory Anne , Smischney Nathan J.
Published: February 2021

BACKGROUND:

Postoperative hypotension (POH) is associated with major adverse events. However, little is known about the association of blood pressure thresholds and outcomes in postoperative patients without intraoperative hypotension (IOH) on the general-care ward. We evaluated the association of POH with major adverse cardiac or cerebrovascular events (MACCE) in patients without IOH.

METHODS:

This retrospective analysis included 67,968 noncardiac patient-procedures (2008–2017) for patients discharged to the ward with postoperative mean arterial pressure (MAP) readings, managed for ≥48 hours postsurgery, with no evidence of IOH. The primary outcome was 30-day MACCE evaluated by postoperative MAP thresholds: ≤75, ≤65, and ≤55 mm Hg (POH defined as a single measurement below threshold). Secondary outcomes included all-cause mortality (30-/90-day), 30-day acute myocardial infarction, 30-day acute ischemic stroke, 30-day readmission, 7-day acute kidney injury, and 30-day readmission. Associations between POH and adverse events were also evaluated in a cohort (#2) of 16,034 patient-procedures with IOH (intraoperative MAP ≤65 mm Hg).

RESULTS:

In patients without IOH, exposure to POH was not associated with MACCE at any investigated MAP threshold (P < .016 was considered significant: ≤75 mm Hg, hazard ratio [HR] 1.18 [98.4% confidence interval {CI} 0.99-1.39], P = .023; ≤65 mm Hg, HR 1.18 [0.99–1.41], P = .028; ≤55 mm Hg, HR 1.23 [0.90–1.71], P = .121); however, associations were observed at all MAP thresholds for secondary outcomes of acute kidney injury and 30-day readmission, for 30-/90-day mortality for MAP ≤65 mm Hg, and 90-day mortality for MAP ≤55 mm Hg, compared to those without POH. No associations were detected between POH and secondary outcomes of acute ischemic stroke or acute myocardial infarction at any MAP threshold. No interaction between POH and IOH was found when we evaluated the association of POH on outcomes in the data set including all patients, regardless of IOH status (P values for interaction terms nonsignificant). When the interaction term was utilized, the association between POH without IOH and MACCE was significant for MAP ≤75 mm Hg (HR 1.20 [1.01–1.41]) and MAP ≤65 mm Hg (HR 1.21 [1.02-1.45]), but not MAP ≤55 mm Hg. Cohort #2 (POH with IOH) showed largely similar results for MACCE: not significant for MAP ≤75 and ≤65 mm Hg, but significant for MAP ≤55 mm Hg (HR 1.53 [1.05–2.22], P = .006).

CONCLUSIONS:

POH in patients without IOH was not associated with MACCE at any MAP investigated. No interaction was identified between POH and IOH. Large prospective randomized trials are necessary to develop better evidence and inform clinicians the value of postoperative blood pressure management.
Subcostal Anterior Quadratus Lumborum Block Versus Epidural Block for Analgesia in Open Nephrectomy: A Randomized Clinical Trial
Authors: Elsharkawy Hesham , Ahuja Sanchit , Sessler Daniel I. , Maheshwari Kamal , Mao Guangmei , Sakr Esa Wael Ali , Soliman Loran Mounir , Ayad Sabry , Khoshknabi Dilara , Khan Mohammad Zafeer , Raza Syed , DeGrande Sean , Turan Alparslan
Published: February 2021

BACKGROUND:

Epidural block are often used for analgesia after open nephrectomy surgery. Subcostal anterior quadratus lumborum block may be an alternative. We therefore tested the hypothesis that the continuous subcostal anterior quadratus lumborum block is noninferior to epidural block for analgesia in patients having open partial nephrectomies.

METHODS:

Adults having open partial nephrectomies were randomly allocated to epidural or unilateral subcostal anterior quadratus lumborum block. The joint primary outcomes were opioid consumption measured in morphine equivalents and pain measured on a numeric rating scale (0–10) from postanesthesia care unit (PACU) until 72 hours after surgery. The noninferiority deltas were 30% for opioid consumption and 1 point on a 0–10 scale for pain. Secondary outcomes included patient global assessment of pain management on the third postoperative day, the number of antiemetic medication doses through the third postoperative day, duration of PACU stay, and postoperative duration of hospitalization.

RESULTS:

Twenty-six patients were randomized to anterior quadratus lumborum block and 29 to epidural analgesia. Neither pain scores nor opioid consumption in the quadratus lumborum patients were noninferior to epidural analgesia. At 72 hours, mean ± standard deviation pain scores in subcoastal anterior quadratus lumborum block and epidural group were 4.7 ± 1.8 and 4.1 ± 1.7, with an estimated difference in pain scores of 0.62 (95% confidence interval [CI], 0.74-1.99; noninferiority P = .21). The median [Q1, Q3] opioid consumption was more than doubled in quadratus lumborum patients at 70 mg [43, 125] versus 30 mg [18, 75] in the epidural group with an estimated ratio of geometric means of 1.69 (95% CI, 0.66-4.33; noninferiority P = .80). Patient global assessment and duration of PACU and hospital stays did not differ significantly in the 2 groups.

CONCLUSIONS:

We were unable to show that subcostal anterior quadratus lumborum block are noninferior to epidural analgesia in terms of pain scores and opioid consumption for open partial nephrectomies. Effectiveness of novel blocks should be rigorously tested in specific surgical setting before widespread adoption.
Comparison of Liposomal Bupivacaine and Conventional Local Anesthetic Agents in Regional Anesthesia: A Systematic Review
Authors: Jin Zhaosheng , Ding Olivia , Islam Ali , Li Ru , Lin Jun
Published: February 2021

BACKGROUND:

Pain is one of the most common adverse events after surgery. Regional anesthesia techniques are effective for pain control but have limited duration of action. Liposomal bupivacaine is a long-acting formulation of bupivacaine. We conduct this systematic review to assess whether liposomal bupivacaine may prolong the analgesic duration of regional anesthesia compared to conventional local anesthetic agents.

METHODS:

We systematically searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar, Web of Science citation index, US clinical trials register, and recent conference abstracts for relevant studies.

RESULTS:

We identified 13 randomized controlled trials that compared the use of liposomal bupivacaine to conventional local anesthetics in regional anesthesia. There were 5 studies on transversus abdominis plane (TAP) block, 3 of which reported longer duration of analgesia with liposomal bupivacaine. One study reported comparable analgesia with liposomal bupivacaine TAP block compared to TAP block catheter. There were 3 studies on brachial plexus block, 2 of which reported that liposomal bupivacaine may provide longer analgesia. Studies on other techniques did not report significantly longer analgesia with liposomal bupivacaine.

CONCLUSIONS:

Currently, there is limited evidence suggesting that liposomal bupivacaine provides longer analgesia than conventional local anesthetics when used in regional anesthesia. The analyses of multiple studies on liposomal bupivacaine for TAP blocks and brachial plexus blocks have yielded conflicting results. As a result, no definitive conclusions can be drawn about its efficacy compared to plain bupivacaine.
Perioperative Ulnar Neuropathy: A Contemporary Estimate of Incidence and Risk Factors
Authors: Pulos Bridget P. , Johnson Rebecca L. , Laughlin Ruple S. , Njathi-Ori Catherine W. , Kor Todd M. , Schroeder Darrell R. , Warner Mary E. , Habermann Elizabeth B. , Warner Mark A.
Published: February 2021

BACKGROUND:

Retrospective and prospective studies 2 decades ago from the authors’ institution reported the incidence of perioperative ulnar neuropathy persisting for at least several months in a noncardiac adult surgical population to be between 30 and 40 per 100,000 cases. The aim of this project was to assess the incidence and explore risk factors for perioperative ulnar neuropathy in a recent cohort of patients from the same institution using a similar definition for ulnar neuropathy.

METHODS:

We performed a retrospective incidence and case-control study of all adults (≥18 years) undergoing noncardiac procedures with anesthesia services between 2011 and 2015. Each incident case of persistent ulnar neuropathy within 6 months of surgery was matched by age, sex, procedure date, and procedure type to 5 surgical patient controls. For the case-control study, separate conditional logistic regression analyses were performed to assess specific risk factors including the patient’s body position and arm position, as well as body mass index (BMI), surgical duration, and selected patient comorbidities.

RESULTS:

Persistent ulnar neuropathy of at least 2 months duration was found in 22 of 324,124 anesthetics for patients who underwent these procedures during the study period for an incidence rate of 6.8 (95% confidence interval [CI], 4.3-10.3) per 100,000 anesthetics. The incidence of ulnar neuropathy was higher in men compared to women (10.7 vs 3.0 per 100,000; P = .016). From the matched case-control study, the odds of ulnar neuropathy increased with higher BMI (odds ratio [OR] = 1.67 [1.16-2.42] per 5 kg/m2 increase in BMI; P = .006), history of cancer (OR = 6.46 [1.64-25.49]; P = .008), longer procedures (OR = 1.53 [1.18-1.99] per hour; P = .001), and when 1 or both arms were tucked during surgery (OR = 6.16 [1.85-20.59]; P = .003).

CONCLUSIONS:

The incidence of persistent perioperative ulnar neuropathy observed in this study was lower than the incidence reported 2 decades ago from the same institution and using a similar definition for ulnar neuropathy. Several of the previously reported risk factors continue to be associated with the development of persistent perioperative ulnar neuropathy, providing ongoing targets for practice changes that might further decrease the incidence of this problem.
Liver and Biliary Disease of Pregnancy and Anesthetic Implications: A Review
Authors: Hansen Jennette D. , Perri Roman E. , Riess Matthias L.
Published: February 2021

Liver and biliary disease complicates pregnancy in varying degrees of severity to the mother and fetus, and anesthesiologists may be asked to assist in caring for these patients before, during, and after birth of the fetus. Therefore, it is important to be familiar with how different liver diseases impact the pregnancy state. In addition, knowing symptoms, signs, and laboratory markers in the context of a pregnant patient will lead to faster diagnosis and treatment of such patients. This review article discusses changes in physiology of parturients, patients with liver disease, and parturients with liver disease. Next, general treatment of parturients with acute and chronic liver dysfunction is presented. The article progresses to specific liver diseases with treatments as they relate to pregnancy. And finally, important aspects to consider when anesthetizing parturients with liver disease are discussed.