bluuebunny/crossref_metadata_2025 huggingface dataset:
Antitumor and Antibacterial Efficacy of Gallium Nanoparticles Coated by Ellagic Acid
Authors: El-sonbaty Sawsan M , Moawed Fatma SM , Kandil Eman I , M Tamamm Amira
Published: February 2022

Cancer is a mortality contributor worldwide, and breast cancer is the most common among women. Despite the numerous breast cancer therapeutic strategies, they either have limitations or sometimes are resisted by cancer, so new approaches are needed to tackle those restrictions. Nanotechnology offers exciting leaps in the diagnosis and treatment of cancer, especially breast cancer. The main objective of this study was to investigate the effect of the newly synthesized gallium nanoparticles coated by Ellagic acid (EA-GaNPs) on the induced mammary gland carcinogenesis in female rats and their antibacterial activities comparison with standard antibiotics (Ketoconazole (100 μg/ml) and Gentamycin (4 μg/ml)) by disc diffusion method using eight different microbial species. The antitumor efficacy of EA-GaNPs was conducted both in vitro and in in vivo. The result of antimicrobial activity of EA-Ga NPs (1 mg/1 mL) revealed moderate toxicity behavior against Gram-positive {Staphylococcus aureus, Bacillus subtilis, Bacillus cereus) and Gram-negative pathogenic bacteria {Escherichia coli, Proteus vulgarfs) also, antifungal activity was detected against {Aspergillus terreus). In vitro study showed that EA-GaNPs inhibited human breast cancer cell line (MCF-7) proliferation with IC50 of 2.86 μg/ml. Although in vivo; the administration of EA-GaNPs to DMBA-treated rats ameliorated the hyperplastic state of mammary gland carcinogenesis induced by DMBA. Additionally, EA-GaNPs administration significantly modulated the activities of ALT and AST, as well as the levels of urea and creatinine in serum. Also, EA-GaNPs administration improved the antioxidant state by increasing Superoxide dismutase activity and GSH content, and decreasing malondialdehyde content in the mammary tissue, besides enhancing the apoptotic activity through elevating the levels of caspase-3 and decreasing the protein intensities of protein kinase B & phosphatidyl inositide 3-kinases. Furthermore, a significant decrease in serum Total iron-binding capacity accompanied by a significant increase in the level of calcium was noted. So, it can be concluded that the newly synthesized nanoparticles EA-GaNPs have an efficient antitumor activity that was manifested by reduction of the viability on the human breast cancer cell line (MCF-7) in vitro. Also, in vivo against the chemically induced mammary gland carcinogenesis in a female rat model. Histopathological findings were in harmony with biochemical and molecular results showing the effectiveness of EA-GaNPs against mammary carcinogenesis. Therefore, EA-GaNPs could be a promising, potent anti-cancer compound.
Pregnancy following personalised aortic root support in Marfan syndrome
Authors: Coroyannakis Christina , Tome Maite , Watt-Coote Ingrid , Cauldwell Matthew
Published: February 2022

Marfan syndrome (MFS) is linked with adverse pregnancy events, one of the most significant being aortic dissection. We present a case of a woman with MFS with prior aortic root dilatation who opted for a Personalised External Aortic Root Support (PEARS). To date, she is only the fifth woman to have had this valve-sparing procedure prior to pregnancy. We outline her care in a tertiary centre with multidisciplinary expertise, from preconception through to the postpartum period.
Safety of cold snare polypectomy with periprocedural antithrombotic agents for colorectal polyps: a systematic review and meta-analysis
Authors: Yeh Jen-Hao , Wang Wen-Lun , Lin Chih-Wen , Lee Ching-Tai , Tseng Cheng-Hao , Hsiao Po-Jen , Liu Yu-Peng , Wang Jaw-Yuan
Published: February 2022

Background:

We aimed to study the safety of cold snare polypectomy (CSP) for colorectal polyps in patients administered periprocedural antithrombotic agents.

Methods:

We searched the PubMed, Embase, and Cochrane Library databases through June 2021. The primary outcomes were the rates of delayed and immediate bleeding (requiring endoscopic hemostasis). Secondary outcomes included thromboembolic events. Meta-analysis using odds ratios (ORs) and corresponding 95% confidence intervals (CIs) was performed to compare the outcomes.

Results:

Seventeen studies, including five randomized trials, were included. Over 96% of polyps were ⩽1 cm. The pooled rates of delayed and immediate bleeding for patients receiving CSP and periprocedural antithrombotic agents were 1.6% and 10.5%, respectively. Both the delayed (OR = 4.02, 95% CI = 1.98–8.17) and immediate bleeding (OR = 5.85, 95% CI = 3.84–8.89) rates were significantly higher in patients using periprocedural antithrombotic agents than in non-users. Although both antiplatelet agents and anticoagulants increased the risk of delayed bleeding, the risks associated with the use of direct oral anticoagulants (DOACs; 2.5%) or multiple agents (3.9%) were particularly high. Compared to their counterparts, diminutive polyps and uncomplicated lesions not requiring hemoclipping were associated with lower risks of delayed bleeding (pooled estimates of 0.4% and 0.18%, respectively). Thromboembolic risk was similar among patients using and not using periprocedural antithrombotic agents.

Conclusions:

CSP with periprocedural antiplatelet agents and warfarin may be feasible, especially for diminutive polyps. However, drug discontinuation should be considered with the use of DOACs or multiple agents which entail higher bleeding risk even with hemoclipping.
Rotator cuff outcomes and mental health indices: Correlation or causation?
Authors: Sabo MT , Walker A , Elmi Assadzadeh G , Hildebrand KA
Published: February 2022

Background

Psychological factors such as catastrophizing, anxiety, and depression influence clinical outcomes in many conditions. Our purpose was to examine trends and associations between these and outcomes of rotator cuff surgery.

Methods

148 patients (76 W:72 M, 55.1 ± 8.2 years) with unilateral symptomatic rotator cuff syndrome were followed for 1 year after surgery. The Western Ontario Rotator Cuff Score (WORC), the Pain Catastrophizing Score (PCS), and the Hospital Anxiety and Depression Score (HADS) were administered. Evolution and associations of WORC, HADS and PCS scores were examined using uni- and multivariate analyzes.

Results

At 1 year, PCS, HADS-A, and HADS-D scores negatively correlated with WORC score ( R = −0.6, −0.61, −0.69). The strength of correlation was lower between baseline PCS, HADS-A, and HADS-D scores and 1-year WORC score ( R = −0.38, −0.43, −0.42). Prior anxiety diagnosis was associated with higher HADS-A scores at 2- and 6- weeks post-op ( p = 0.013, 0.011). 106 participants experienced an improving HADS-D over the year of follow-up. Worse pre-op pain, WORC, PCS, HADS-A, HADS-D, cardiovascular disease and current smoking were associated with non-improving HADS-D.

Discussion

Patient-reported outcomes of rotator cuff surgery are associated with patient-reported anxiety, depression, and pain catastrophizing. In many, all outcome scores improved over time suggesting a two-way association between shoulder condition and psychological parameters.

Level of evidence

II.
Survival Radiology: How a popular in-person interactive medical student radiology workshop pivoted online during the COVID-19 pandemic
Authors: Velaga Jyothirmayi , Lee Sonia Shu Yi , Tran Nguyen Tuan Anh , Vora Bimal Mayur Kumar , Cheng Lionel Tim-Ee
Published: February 2022

Background

Survival Radiology (SR) is a flagship annual full-day in-person radiology workshop targeted at final year medical students in Singapore to prepare them for internship. Previous in-person editions have consistently received positive reviews from 2014 to 2019. However, the COVID-19 pandemic necessitated a rapid online pivot for its sixth edition in 2020.

Objectives

This study aims to (a) identify key success factors of a traditional in-person medical student radiology workshop, (b) describe the rapid online pivot in 2020 and (c) to identify key success factors for online educational initiatives.

Methods

Post-workshop survey responses of SR from 2014 to 2020 were evaluated. Likert-scale data were quantitatively analysed, while free-text responses were qualitatively analysed.

Results

A total of 1248 post-workshop surveys (2014–2020 workshops) and 266 free-text responses (2020 workshop) were received from 2640 participants over the years. Progressive changes that sustained or improved participant feedback for in-person SR workshops included adoption of a case-based approach, utility of ‘live’ audience response systems and incorporation of quizzes with a favourable overall feedback rating of 4.42–4.89 from 2014 to 2019. The webinar version of SR in 2020 became the best-rated edition since inception with a rating of 4.9. Qualitative analysis of feedback from SR 2020 showed that the participants preferred the webinar model, online modes of engagement and interactivity.

Conclusion

Our experience shows that it is not only possible to successfully pivot online for such workshops, but that blended educational formats utilising online engagements supplemented by in-person activities will be well-received by ‘Generation Z’ learners even after the COVID-19 pandemic.
Video simulation to learn pediatric resuscitation skills tailored to a low resource setting: A pilot program in Iquitos, Peru
Authors: Shemwell Kristina , Jun-Ihn Esther , Pithia Neema , Strobel Katie M , Bacca Pinto Luis Angel , Chang Nadiuska Rosas , Seminario Juan R , Mitha Kiran
Published: February 2022

Introduction:

The Hospital Regional de Loreto in Peru partners with the University of California Los Angeles Global Health Program to enhance educational experiences for US and Peruvian trainees. University of California Los Angeles Pediatric faculty led intermittent in-person code simulation sessions for Peruvian residents, and there is a need for regular education on this topic.

Methods:

University of California Los Angeles residents created a video simulation of a patient in respiratory distress. The video was presented to Hospital Regional de Loreto trainees in pediatrics. Stakeholder interviews and reuse of the video after initial presentation assessed acceptability of this mode of education by the site. Pre- and post-surveys using numerical rating scales evaluated the educational utility of this specific simulation video. Paired t-tests compared the pre- and post-surveys in the effectiveness of increasing the trainees’ comfort of specific resuscitation skills.

Results:

Stakeholder interviews revealed the video simulation was integrated into formal intern orientation trainings as well as used for resident and physician trainings multiple times in the year after the introduction. Twenty trainees completed the pre-intervention survey and 19 completed the post-intervention survey. Trainee comfort with code team leadership (2.6 ± 0.9, 3.5 ± 0.09, p = 0.03) and arrhythmia recognition/automated external defibrillator (AED) management (2.4 ± 0.9, 3.1 ± 0.9, p = 0.03) increased significantly with the video intervention. There was no significant difference in comfort with other skills. Overall, trainees rated the helpfulness of the video as an average of 4.2 (±1.1) out of 5. The most common positive feedback included the utility of reviewing medication dosing and the skill of performing chest compressions. The most common suggestions for improvement were to review more pathophysiology and simulate available resources at Hospital Regional de Loreto more realistically.

Conclusion:

E-learning is an acceptable mode of education in a resource-limited setting when tailored to the local context. This pilot project demonstrated short-term improvement in reported confidence and skills with some aspects of pediatric resuscitation.
Anti-HK antibody reveals critical roles of a 20-residue HK region for Aβ-induced plasma contact system activation
Authors: Chen Zu-Lin , Singh Pradeep Kumar , Horn Katharina , Strickland Sidney , Norris Erin H.
Published: February 2022

Alzheimer’s disease (AD) is a neurodegenerative disorder and the leading cause of dementia. Vascular abnormalities and neuroinflammation play roles in AD pathogenesis. Plasma contact activation, which leads to fibrin clot formation and bradykinin release, is elevated in many AD patients, likely due to the ability of AD’s pathogenic peptide β-amyloid (Aβ) to induce its activation. Since overactivation of this system may be deleterious to AD patients, the development of inhibitors could be beneficial. Here, we show that 3E8, an antibody against a 20-amino acid region in domain 6 of high molecular weight kininogen (HK), inhibits Aβ-induced intrinsic coagulation. Mechanistically, 3E8 inhibits contact system activation by blocking the binding of prekallikrein (PK) and factor XI (FXI) to HK, thereby preventing their activation and the continued activation of factor XII (FXII). The 3E8 antibody can also disassemble HK/PK and HK/FXI complexes in normal human plasma in the absence of a contact system activator due to its strong binding affinity for HK, indicating its prophylactic ability. Furthermore, the binding of Aβ to both FXII and HK is critical for Aβ-mediated contact system activation. These results suggest that a 20-amino acid region in domain 6 of HK plays a critical role in Aβ-induced contact system activation, and this region may provide an effective strategy to inhibit or prevent contact system activation in related disorders.
Prevalence, time trends and treatment practices of asthma in India: the Global Asthma Network study
Authors: Singh Sheetu , Salvi Sundeep , Mangal Daya Krishan , Singh Meenu , Awasthi Shally , Mahesh Padukudru Anand , Kabra Sushil K. , Mohammed Sabir , Sukumaran Thevaruparambil U. , Ghoshal Aloke G. , Barne Monica , Sinha Sanjeev , Kochar Sanjay K. , Singh Nishtha , Singh Udaiveer , Patel Kamalesh Kumar , Sharma Arvind Kumar , Girase Bhushan , Chauhan Anil , Sit Niranjan , Siddaiah Jayaraj B. , Singh Virendra
Published: February 2022

Objective

The objective of this subanalysis of data from centres across urban areas in India of the Global Asthma Network (GAN) was to study 1) the prevalence of symptoms of asthma in children and adults, 2) the change in prevalence of asthma and its trigger factors since the International Study of Asthma and Allergies in Childhood (ISAAC), and 3) current asthma treatment practice.

Methods

In this cross-sectional, multicentre, school-based and self-administered questionnaire, responses from children aged 6–7 years and 13–14 years, and their respective parents, were analysed.

Results

The GAN Phase I study included 20 084 children in the 6–7-year age group, 25 887 children in the 13–14-year age group and 81 296 parents. The prevalence of wheeze in the previous 12 months was 3.16%, 3.63% and 3.30% in the three groups, respectively. In comparison to the ISAAC studies, there was a significant reduction in the prevalence of current wheeze (p<0.001). Bivariate analysis revealed a significant reduction in the prevalence of trigger factors. Almost 82% of current wheezers and 70% of subjects with symptoms of severe asthma were not clinically diagnosed as having asthma. The daily use of inhaled corticosteroids (ICS) was less than 2.5% in subjects with current wheeze and those with symptoms of severe asthma but less than 1% used daily ICS when asthma remained undiagnosed.

Conclusion

The prevalence of current wheeze and its causal factors showed a significant reduction compared to previous ISAAC studies. Among subjects with current wheeze and symptoms of severe asthma, the problem of under-diagnosis and under-treatment was widespread.
Satisfaction with life, depression, anxiety, and stress among adolescent girls in Tehran: a cross sectional study
Authors: Hoseini-Esfidarjani Sara-Sadat , Tanha Kiarash , Negarandeh Reza
Published: February 2022

Objective and background

Mental health is a widespread field that entails variables such as the presence of positive feelings like satisfaction with life and lack of negative emotions like depression, anxiety, and stress. This research aimed to study the prevalence of depression, anxiety, stress, and satisfaction with life as dimensions of adolescent girls’ mental health in Tehran.

Methodology

The population considered in this cross-sectional study consisted of adolescent girls in the last grade of high school in Tehran. Research samples were selected using multi-stage sampling. The sample size in this study was 491 and the research tools used were standardized questionnaires. Descriptive and inferential statistics included Spearman, ANOVA, and regression tests were used.

Findings

More than half of the adolescents experienced common symptoms of depression, anxiety, and stress. About 30% of adolescents were dissatisfied with life to some extent. Satisfaction with life was negatively correlated with age, depression, anxiety, and stress. Age and depression were predictor variables of life satisfaction based on the regression model.

Conclusion

A considerable percentage of adolescents suffered some form of depression, anxiety, and stress symptoms and were notably dissatisfied with life. Regarding the importance of satisfaction with life in having a joyful life and its role in initiating depression, anxiety, and stress, our findings highlight the need for interventions to prevent depression, anxiety, and stress and enhance life satisfaction among adolescents.
Association of public physical activity facilities and participation in community programs with leisure-time physical activity: does the association differ according to educational level and income?
Authors: Werneck André O. , Oyeyemi Adewale L. , Araújo Raphael H. O. , Barboza Luciana L. , Szwarcwald Célia L. , Silva Danilo R.
Published: February 2022

Background

Our aim was to analyze the association of the presence of public physical activity (PA) facilities and participation in public PA programs with leisure-time PA, with an emphasis on the moderating role of educational level and income.

Methods

We used data of 88,531 adults (46,869 women), with a mean age of 47.2 ± 17.1y, from the 2019 Brazilian National Health Survey. Leisure-time PA (dichotomized considering 150 min/week), the presence of a public PA facility near the household (yes or no), participation in public PA programs (yes or no), educational level (divided into quintiles) and per capita income (divided into quintiles) were all self-reported through interviews. Adjusted logistic regression models were used for the analyses.

Results

The presence of public PA facilities near the household and the participation in public PA programs were associated with higher leisure-time PA among all quintiles of income and educational level. However, multiplicative interactions revealed that participating in PA programs [Quintile (Q)1: OR: 13.99; 95%CI: 6.89–28.38 vs. Q5: OR: 3.48; 95%CI: 2.41–5.01] and the presence of public PA facilities near the household (Q1: OR: 3.07; 95%CI: 2.35–4.01 vs. Q5: OR: 1.38; 95%CI: 1.22–1.55) were more associated with higher odds of being active in the leisure-time among the lowest quintile of educational level.

Conclusions

The presence of public PA facilities and participation in public PA programs are environmental correlates that may be relevant for designing effective public health interventions to reduce social inequalities in leisure-time PA among adults in low-income areas.
Exploration the role of social, cultural and environmental factors in tendency of female adolescents to smoking based on the qualitative content analysis
Authors: Jafari Alireza , Mahdizadeh Mehrsadat , Peyman Nooshin , Gholian-Aval Mahdi , Tehrani Hadi
Published: February 2022

Background

The aim of this study was to explain the socio-cultural and environmental factors of smoking tendency in female adolescents.

Methods

This qualitative content analysis study was conducted among Iranian female adolescents in Mashhad, Iran. The data was collected through semi-structured interviews with 20 female smokers. The duration of each interview varies from 30 to 70 min. Data collection and management of data were done using MAXQADA software version 10.

Results

In exploration the effective socio-cultural and environmental factors in the tendency of female adolescents to smoking, six subcategories of role modeling of friends, membership in groups, parenting patterns, family modeling, the predisposing community, and the negative impact of the media were extracted.

Conclusions

The results obtained in this study indicated that there is a need to formulate policies and adopt environmental and social laws to reduce smoking. The results also showed the effective role of parents in improving personal skills, creating a stress-free environment in the family, and controlling adolescent behavior. Therefore, it is necessary to pay attention to all social and cultural aspects in order to make the smoking prevention programs.
Musculoskeletal healthcare at a Swiss university hospital chiropractic medicine outpatient clinic in 2019: a health services research study
Authors: Hofstetter Léonie , Häusler Melanie , Mühlemann Malin , Nyirö Luana , Mühlemann Daniel , Hincapié Cesar A.
Published: February 2022

Background

The Balgrist University Hospital in Zurich, Switzerland, is an academic hospital focused on musculoskeletal disorders. An integrated chiropractic medicine clinic provides chiropractic care to a broad patient population. This health services research study aims to advance understanding of chiropractic healthcare service for quality assurance and healthcare quality improvement.

Methods

We performed an observational clinical cohort study at the Balgrist chiropractic medicine outpatient clinic in 2019. The records of all patients with initial visits or returning initial visits (> 3 months since last visit) and their subsequent visits from January 1, 2019, to December 31, 2019, were used to create the study dataset. Data collected included demographic characteristics, diagnoses, imaging data, conservative treatments, surgeries, and other clinical care data. Descriptive statistics were used to summarize data.

Results

1844 distinct patients (52% female, mean age 48 ± 17 years) were eligible and included in the study. 1742 patients had a single initial visit, 101 had 2 initial visits, and 1 patient had 3 initial visits during the study period (total of 1947 initial visit records). The most common main diagnoses were low back pain (42%; 95% CI 40–46%), neck pain (22%; 20–24%), and thoracic pain (8%; 7–9%). 32% of patients presented with acute (< 4 weeks) symptoms, 11% subacute (4–12 weeks), and 57% chronic (> 12 weeks). Patients had a median of 5 chiropractic visits during their episode of care within a median of 28 days duration. Only 49% (95% CI 47–52%) of patient records had a clinical outcome that was extractable from routine clinical documentation in the hospital information system.

Conclusion

This health services study provides an initial understanding of patient characteristics and healthcare delivered in a Swiss academic hospital chiropractic outpatient setting and areas for improved clinical data quality assurance. A more concerted effort to systematically collect patient reported outcome measures would be a worthwhile healthcare quality improvement initiative.
Comparison of 68Ga-PSMA PET/CT and multiparametric MRI for the detection of low- and intermediate-risk prostate cancer
Authors: Zhou Chuanchi , Tang Yongxiang , Deng Zhihe , Yang Jinhui , Zhou Ming , Wang Long , Hu Shuo
Published: February 2022

Purpose

To assess 68Ga-PSMA PET/CT for detection of low- and intermediate-risk prostate cancer (PCa), high-risk PCa in comparison with mpMRI, respectively, and to determine which of low- and intermediate-risk PCa are more likely to be detected by 68Ga-PSMA PET/CT.

Methods

We conducted a retrospective analysis of patients who had undergone a prostate biopsy and/or radical prostatectomy and who were scanned with 68Ga-PSMA PET/CT and mpMRI between June 2019 and March 2021. The mpMRI images were scored with the Prostate Imaging-Reporting and Data System Version 2.1 (PI-RADS)
and were classified as either negative (PI-RADS 1–3) or positive (PI-RADS 4–5). Suspicious 68Ga-PSMA PET/CT lesions were reviewed for each relevant patient and classified by double-trained board-certified nuclear medicine physicians. The results were evaluated with the histopathological outcome. All patients were classified according to the D’Amico classification, and the clinical data were combined for stratified analysis.

Result

A total of 101 patients who were pathologically diagnosed with PCa were analyzed. Of the 101 patients, 88 (80.6%) patients presented with a pathologic mpMRI, and 85 (79.1%) with a pathologic 68Ga-PSMA PET/CT. In the high-risk PCa cohort, 68Ga-PSMA PET/CT was positive in 64/66 (97.0%) patients and yielded a higher detection rate than that for the mpMRI patients (58/66, 87.9%; p < 0.05). However, mpMRI provided superior diagnostic confidence in identifying low- and intermediate-risk PCa (30/35, 85.7% vs. 21/35, 60.0%; p < 0.05). When the age threshold exceeded 62.5 years and the serum prostate specific antigen (PSA) threshold exceeded 9.4 ng/ml, a higher uptake of PSMA was more likely to occur in the lesions of low- and intermediate-risk PCa.

Conclusion

The diagnostic performance of 68Ga-PSMA PET/CT was superior to that of mpMRI in the high-risk PCa cohort, which was consistent with prior studies. Furthermore, in the initial diagnosis of low- and intermediate-risk PCa, we found that mpMRI showed a higher diagnostic accuracy than 68Ga-PSMA PET/CT did. Low- and intermediate-risk PCa patients with a PSA ≥ 9.4 ng/ml and age ≥ 62.5 years were more likely to have a positive 68Ga-PSMA PET/CT result.
Evaluation of the real-time fluorescence loop-mediated isothermal amplification assay for the detection of Ureaplasma urealyticum
Authors: Shen Jie-Ni , Ye Jing-Yi , Lao Meng-Xiao , Wang Chu-Qiao , Wu Dong-Hong , Chen Xiao-Ying , Lin Li-Hong , Geng Wen-Yan , Guo Xu-Guang
Published: February 2022

Ureaplasma urealyticum (UU) is commonly present in human reproductive tract, which frequently leads to genital tract infection. Hence, there is an urgent need to develop a rapid detection method for UU. In our study, a real-time fluorescence loop-mediated isothermal amplification (LAMP) assay was developed and evaluated for the detection of UU. Two primers were specifically designed based on the highly conserved regions of ureaseB genes. The reaction was carried out for 60 min in a constant temperature system using Bst DNA polymerase, and the process was monitored by real-time fluorescence signal, while polymerase chain reaction (PCR) was performed simultaneously. In real-time fluorescence LAMP reaction system, positive result was only obtained for UU among 9 bacterial strains, with detection sensitivity of 42 pg/μL (4.2 × 105 CFU/mL), and all 16 clinical samples of UU could be detected. In conclusion, real-time fluorescence LAMP is a simple, sensitive, specific and effective method compared with conventional PCR, which shows great promise in the rapid detection of UU.
Transgender men's preferences when choosing obstetricians and gynecologists
Authors: Lifshitz Dror , Yaish Iris , Wagner-Kolasko Gal , Greenman Yona , Sofer Yael , Alpern Sharon , Groutz Asnat , Azem Foad , Amir Hadar
Published: February 2022

Background

Transgender men are a marginalized population with unique health care needs. However, their usage of health services is low because of considerable discrimination. A major factor in their avoidance is patient-provider interactions.

Methods

This cross-sectional study included 102 transgender men who anonymously completed a 55-item questionnaire in clinic, between 10/2017 and 01/2019. In addition, 92 transgender women filled out the part about family physician’s preferences. We examined which characteristics transgender men prefer in their obstetricians/gynecologists in order to promote their usage of healthcare services.

Results

A small majority of the transgender men (54.1%) had no gender preference for their obstetrician/gynecologist, while 42.9% preferred a female obstetrician/gynecologist and 3.1% preferred a male obstetrician/gynecologist. Most transgender men with a same-gender preference preferred female obstetricians/gynecologists for both invasive procedures (e.g., pelvic examination, 97.4%) and non-invasive procedures (e.g., cesarean section, 60%). The reasons for preferences regarding invasive procedures were feeling comfortable, embarrassment and feeling that female obstetricians/gynecologists are gentler. Transgender men who preferred female obstetricians/gynecologists ranked ability (90.5%), sexual tolerance (92.9%) and gender identity tolerance (90.5%) as the top three desirable qualities of obstetricians/gynecologists, while the responders who did not prefer female ranked ability (94.6%), experience (92.9%) and knowledge (92.9%) as the top three qualities. Transgender men with female preferences considered female obstetricians/gynecologists to be more accepting of gender identity compared to the responders that did not prefer females (47.5% vs. 9.1%, P < .001)..

Conclusion

A small majority of the transgender men exhibited no gender preference when choosing an obstetrician/gynecologist, although 42.9% preferred females. The latter choice was associated with the assumption that female obstetricians/gynecologists are more tolerant towards their transgender men patients. Educating the medical staff about their special needs and establishing dedicated SGM centers staffed with high percentages of female healthcare providers are highly recommended.
Uncovering current pyroregions in Italy using wildfire metrics
Authors: Elia Mario , Giannico Vincenzo , Ascoli Davide , Argañaraz Juan Pablo , D’Este Marina , Spano Giuseppina , Lafortezza Raffaele , Sanesi Giovanni
Published: February 2022

Background

Pyrogeography is a major field of investigation in wildfire science because of its capacity to describe the spatial and temporal variations of fire disturbance. We propose a systematic pyrogeographic analytical approach to cluster regions on the basis of their pyrosimilarities. We employed the Affinity Propagation algorithm to cluster pyroregions using Italian landscape as a test bed and its current wildfire metrics in terms of density, seasonality and stand replacing fire ratio. A discussion follows on how pyrogeography varies according to differences in the human, biophysical, socioeconomic, and climatic spheres.

Results

The algorithm identified seven different pyroregion clusters. Two main gradients were identified that partly explain the variability of wildfire metrics observed in the current pyroregions. First, a gradient characterized by increasing temperatures and exposure to droughts, which coincides with a decreasing latitude, and second, a human pressure gradient displaying increasing population density in areas at lower elevation. These drivers exerted a major influence on wildfire density, burnt area over available fuels and stand replacing, which were associated to warm-dry climate and high human pressure. The study statistically highlighted the importance of a North–South gradient, which represents one of the most important drivers of wildfire regimes resulting from the variations in climatic conditions but showing collinearity with socioeconomic aspects as well.

Conclusion

Our fully replicable analytical approach can be applied at multiple scales and used for the entire European continent to uncover new and larger pyroregions. This could create a basis for the European Commission to promote innovative and collaborative funding programs between regions that demonstrate pyrosimilarities.
Selection of the high efficient sgRNA for CRISPR-Cas9 to edit herbicide related genes, PDS, ALS, and EPSPS in tomato
Authors: Yang So Hee , Kim Euyeon , Park Hyosun , Koo Yeonjong
Published: February 2022

Herbicide resistance is one of the main crop traits that improve farming methods and crop productivity. CRISPR-Cas9 can be applied to the development of herbicide-resistant crops based on a target site resistance mechanism, by editing genes encoding herbicide binding proteins. The sgRNAs capable of editing the target genes of herbicides, pds (phytoene desaturase), ALS (acetolactate synthase), and EPSPS (5-Enolpyruvylshikimate-3-phosphate synthase), were designed to use with the CRISPR-Cas9 system in tomato (Solanum lycopersicum cv. Micro-Tom). The efficiency of the sgRNAs was tested using Agrobacterium mediated transient expression in the tomato cotyledons. One sgRNA designed for editing the target site of PDS had no significant editing efficiency. However, three different sgRNAs designed for editing the target site of ALS had significant efficiency, and one of them, ALS2-P sgRNA, showed over 0.8% average efficiency in the cotyledon genome. The maximum efficiency of ALS2-P sgRNA was around 1.3%. An sgRNA for editing the target site of EPSPS had around 0.4% editing efficiency on average. The sgRNA efficiency testing provided confidence that editing of the target sites could be achieved in the transformation process. We confirmed that 19 independent transgenic tomatoes were successfully edited by ALS2_P or ALS1_W sgRNAs and two of them had three base deletion mutations, which are expected to have altered herbicide resistance. In this study, we demonstrated the usefulness of performing an sgRNA efficiency test before crop transformation, and confirmed that the CRISPR-Cas9 system is a valuable tool for breeding herbicide-resistant crops.
Charcoal or black stone? Reconstructions as a tool to study the behaviour of dry underdrawing materials within the paint structure of sixteenth century panel paintings
Authors: Melo H. P. , Valadas Sara , Cruz António João , Candeias António
Published: February 2022

Reconstructions were used as a tool to investigate the use of charcoal and black stone as underdrawing materials in sixteenth century panel paintings with white or off-white preparatory layers. Research was based on the examination of a group of sixteenth century panel paintings by the Portuguese Mannerist painter Francisco João (doc. 1558–1595) and his workshop. Analysis of the original underdrawing material in cross-sections, using microscopic and spectroscopic techniques was not always conclusive. Based on materials thought to be employed by Francisco João and on data collected from sixteenth and seventeenth century European technical treatises along with published analytical studies of panel paintings with white or off-white preparatory layers from this period, reconstructions were performed using charcoal (untreated and oiled—as described in contemporary literature) and natural black stone over different preparatory surfaces. Microscopic analyses of cross-sections from reconstructions were made to assist the discussion of the behaviour of the dry underdrawing media within the paint structure. Results revealed that whereas charcoal could be easily removed if drawn directly over gesso, it would remain fixed when drawn over a ground treated with an oil-based intermediate layer, even when the latter was completely dry to the touch. The persistence of a charcoal drawing when applied over oil challenged the widely disseminated assumption that naturally occurring black stone, which makes a permanent mark, had been employed more frequently than charcoal since the latter appeared to be easily disturbed and hence transitory. The very lengthy curing time for a drying oil could be responsible for fixing the friable media. Reconstructions further showed that oiled charcoal is easily prepared and agreeable to use on any type of surface, where it remains without smudging. Finally, research suggests that the painter’s choice of underdrawing material is closely dependent on the nature of the binder of intermediate layers and on the position of the underdrawing layout within the paint structure.
Data agreement analysis and correction of comparative geomagnetic vector observations
Authors: He Zhaobo , Hu Xingxing , Teng Yuntian , Zhang Xiuxia , Shen Xiaoyu
Published: February 2022

Geomagnetism, similar to other areas of geophysics, is an observation-based science. Data agreement between comparative geomagnetic vector observations is one of the most important evaluation criteria for high-quality geomagnetic data. The main influencing factors affecting the agreement between comparative observational data are the attitude angle, scale factor, long-term time drift, and temperature. In this paper, we propose a method based on a genetic algorithm and linear regression to correct for these effects and use the distribution pattern of points in Bland–Altman plots with a 95% confidence interval length to qualitatively and quantitatively evaluate the agreement between the comparative observational data. In Bland–Altman plots with better agreement, that is, with the corrected data, more than 95% of the points are distributed within the 95% confidence interval and there is no obvious pattern in the distribution of the points. Meanwhile, the length of 95% confidence interval decreased significantly after the correction. The method presented here has positive effects on the vector instrumentation detection and would enhance the robustness of geomagnetic observatory by bringing the data quality of the backup variometer data in line with the primary variometer.

Graphical Abstract
Seismic reflection imaging of deep crustal structures via reverse time migration using offshore wide-angle seismic data on the eastern margin of the Sea of Japan
Authors: Shiraishi Kazuya , No Tetsuo , Fujie Gou
Published: February 2022

We applied reverse time migration (RTM) to offshore wide-angle seismic data acquired with airgun shots and sparsely deployed ocean bottom seismographs (OBSs) for reflection imaging of the Moho discontinuity in the eastern margin of the Sea of Japan. While seismic tomography is generally applied to wide-angle seismic data for estimating regional velocity, reflection imaging is uncommon due to the low folds from wide-spacing OBS deployment. The long offset reflection data obtained by airgun-OBS surveys are promising for profiling deep crustal structures, which may be able to add constraints on the velocity structures estimated by tomographic inversion. Furthermore, reflection imaging from wide-angle seismic data is useful when only airgun-OBS data are acquired without any MCS data due to weather conditions or restrictions of using streamer cables. In this study, we validated the feasibility of RTM, which is an effective reflection imaging method based on wavefield modelling with the two-way wave equation, using offshore wide-angle seismic data acquired along two crossing survey lines off Niigata–Yamagata. Airgun shot intervals were 200 m in both surveys, and the OBS spacings were 5 km along a 297-km-long line and 8 km or 16 km along a 366-km-long line, except for OBSs near the coast. By applying RTM with velocity models estimated by traveltime tomography of the same OBS data, we successfully imaged clear reflections around depths of 20–30 km. We confirmed that reflections observed in the long offset range were effective in imaging the deep structures that were not imaged by the MCS survey in this region. The depths of reflectors were traced from approximately 20 km in the offshore area to approximately 30 km near the coast, which corresponds to the Moho discontinuity. The depth variation is consistent with the crustal classification that was inferred based on tomography analyses: thick oceanic crust in the Yamato Basin and rifted continental or island arc crust beneath the areas from the Sado Ridge to the coast. Our results from two surveys with different OBS spacings suggested the high potential of the application to a wide variety of wide-angle seismic data for crustal-scale seismic exploration.

Graphic Abstract
High levels of monocytic myeloid-derived suppressor cells are associated with favorable outcome in patients with pneumonia and sepsis with multi-organ failure
Authors: Schrijver Irene T. , Karakike Eleni , Théroude Charlotte , Baumgartner Pétra , Harari Alexandre , Giamarellos-Bourboulis Evangelos J. , Calandra Thierry , Roger Thierry
Published: February 2022

Background

Myeloid-derived suppressor cells (MDSCs) are immature myeloid cells with immunosuppressive functions sub-classified into monocytic and polymorphonuclear MDSCs (M-MDSCs and PMN-MDSCs). Clinical studies reported increased levels of MDSCs that were associated with poor outcome in sepsis patients. Since sepsis patients exhibit signs of inflammation and immunosuppression, MDSCs may provide benefit by dampening deleterious inflammation in some patients. To test this hypothesis, we measured MDSCs in critically ill sepsis patients with pneumonia and multi-organ dysfunctions and a high likelihood of death.

Methods

This was a prospective multicenter observational cohort study performed in eight ICUs in Athens and Thessaloniki, Greece, enrolling critically ill patients with pneumonia and sepsis with multi-organ dysfunctions. A flow cytometry approach using blood collected at study inclusion in tubes containing lyophilized antibodies combined to unsupervised clustering was developed to quantify M-MDSCs and PMN-MDSCs.

Results

Forty-eight patients were included, of whom 34 died within 90 days. At study inclusion, M-MDSCs and PMN-MDSCs were increased in sepsis patients when compared to healthy subjects (3.07% vs 0.96% and 22% vs 2.1% of leukocytes, respectively; p < 10–4). Increased PMN-MDSCs were associated with secondary infections (p = 0.024) and new sepsis episodes (p = 0.036). M-MDSCs were more abundant in survivors than in patients who died within 28 days (p = 0.028). Stratification of patients according to M-MDSC levels revealed that high levels of M-MDSC were associated with reduced 90-day mortality (high vs low M-MDSCs: 47% vs 84% mortality, p = 0.003, hazard ratio [HR] = 3.2, 95% CI 1.4–7.2). Combining high M-MDSC levels with low Acute Physiology and Chronic Health Evaluation (APACHE) II score improved patient stratification (M-MDSCshigh/APACHE IIlow vs M-MDSCslow/APACHE IIlow: 20% vs 80% 90-day mortality, p = 0.0096, HR = 7.2, 95% CI 1.6–32). In multivariate analyses high M-MDSCs remained correlated with improved survival in patients with low APACHE II score (p = 0.05, HR = 5.26, 95% CI 1.0–27.8).

Conclusion

This is the first study to associate high levels of M-MDSCs with improved survival in sepsis patients.
Wave-shaped microfluidic chip assisted point-of-care testing for accurate and rapid diagnosis of infections
Authors: Yin Bin-Feng , Wan Xin-Hua , Yang Ming-Zhu , Qian Chang-Cheng , Sohan A. S. M. Muhtasim Fuad
Published: February 2022

Background

Early diagnosis and classification of infections increase the cure rate while decreasing complications, which is significant for severe infections, especially for war surgery. However, traditional methods rely on laborious operations and bulky devices. On the other hand, point-of-care (POC) methods suffer from limited robustness and accuracy. Therefore, it is of urgent demand to develop POC devices for rapid and accurate diagnosis of infections to fulfill on-site militarized requirements.

Methods

We developed a wave-shaped microfluidic chip (WMC) assisted multiplexed detection platform (WMC-MDP). WMC-MDP reduces detection time and improves repeatability through premixing of the samples and reaction of the reagents. We further combined the detection platform with the streptavidin–biotin (SA-B) amplified system to enhance the sensitivity while using chemiluminescence (CL) intensity as signal readout. We realized simultaneous detection of C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) on the detection platform and evaluated the sensitivity, linear range, selectivity, and repeatability. Finally, we finished detecting 15 samples from volunteers and compared the results with commercial ELISA kits.

Results

Detection of CRP, PCT, and IL-6 exhibited good linear relationships between CL intensities and concentrations in the range of 1.25–40 μg/ml, 0.4–12.8 ng/ml, and 50–1600 pg/ml, respectively. The limit of detection of CRP, PCT, and IL-6 were 0.54 μg/ml, 0.11 ng/ml, and 16.25 pg/ml, respectively. WMC-MDP is capable of good adequate selectivity and repeatability. The whole detection procedure takes only 22 min that meets the requirements of a POC device. Results of 15 samples from volunteers were consistent with the results detected by commercial ELISA kits.

Conclusions

WMC-MDP allows simultaneous, rapid, and sensitive detection of CRP, PCT, and IL-6 with satisfactory selectivity and repeatability, requiring minimal manipulation. However, WMC-MDP takes advantage of being a microfluidic device showing the coefficients of variation less than 10% enabling WMC-MDP to be a type of point-of-care testing (POCT). Therefore, WMC-MDP provides a promising alternative to POCT of multiple biomarkers. We believe the practical application of WMC-MDP in militarized fields will revolutionize infection diagnosis for soldiers.
A help or hindrance? Highly educated refugees’ perceptions of the role of civic integration programmes in accessing the labour market in Oslo, Malmö and Munich
Authors: Mozetič Katarina
Published: February 2022

Research often focuses on individual-level factors shaping refugee labour market participation. Less research has been conducted on the implications of the roles of employers, integration programmes, migrant support organisations and similar. This article contributes to the literature by seeking to understand highly educated refugees’ perceptions of how civic integration programmes shape opportunity structures for their labour market participation. It is particularly concerned with how the programmes’ characteristics of malleability and comprehensiveness inform integration processes. Accordingly, the article analyses identification contestations that transpire within civic integration programmes, as perceived by the participants, and compares how these unfold in three different contexts. A total of 41 semi-structured interviews with highly educated refugees in Oslo, Malmö, and Munich were analysed. The findings suggest that the civic integration programmes were thought to either foster or hinder the participants’ employment pathways depending on whether the participants were perceived as highly educated individuals or reduced to the general category of ‘refugee’. The differences were traced back to each civic integration programme’s capacity to provide malleable integration support, calling attention to the importance of the programmes’ acknowledgment of refugees’ heterogeneous needs and the pitfalls associated with undifferentiated refugee categorisation.