bluuebunny/crossref_metadata_2025 huggingface dataset:
Global assessment, cognitive profile, and characteristics of mild cognitive impairment in Parkinson's disease
Authors: Yang Jihyun , Pourzinal Dana , Byrne Gerard J. , McMahon Katie L. , Copland David A. , O’Sullivan John D. , Mitchell Leander , Dissanayaka Nadeeka N.
Published: June 2023

Background

Cognitive deficits are evident throughout the course of Parkinson's disease (PD), with 24% of patients experiencing subtle cognitive disturbances at the time of diagnosis, and with up to 80% of patients developing PD dementia (PDD) at advanced stages of the disease PD patients with mild cognitive impairment (MCI), an at‐risk phenotype of PDD, present with heterogeneous clinical characteristics that complicate the management of PD.

Objectives

This study aims to examine the characteristics of PD‐MCI by using the Movement Disorder Society (MDS) diagnostic criteria and evaluate the validity of global cognitive scales in identifying PD‐MCI.

Methods

Seventy‐nine (79) PD patients completed neuropsychological assessments and a comprehensive cognitive battery. PD‐MCI was classified according to the level 2 MDS task force criteria. Mini‐Mental State Examination (sMMSE), Montreal Cognitive Assessment (MoCA) and Parkinson's Disease Cognitive Rating Scale (PDCRS) were examined against a level 2 dichotomised PD‐MCI diagnosis. Characteristics of PD‐MCI were evaluated using logistic regression analysis.

Results

Twenty‐seven patients met criteria for PD‐MCI (34%). The MoCA and PDCRS demonstrated high validity to screen for PD‐MCI. Impairments in multiple cognitive domains were observed in 77.8% of PD‐MCI patients. There were significantly more males in the PD‐MCI group compared to PD patients without MCI (p < 0.01).

Conclusions

PD patients with MCI exhibited impairments in the attention/working memory, executive function and memory domains. Heterogeneous cognitive characteristics in PD warrant further investigation into specific cognitive subtypes to advance understanding and effective evaluation of PD‐MCI.
Assessment of risk perception and subjective norms related to Mpox (monkeypox) among adult males in Bangladesh: A cross‐sectional study
Authors: Nazmunnahar  , Haque Md. Anamul , Ahamed Bulbul , Tanbir Md. , Suhee Farhana Islam , Islam Md. Rabiul
Published: June 2023

Background and Aims

Monkeypox (Mpox) has become a concern worldwide after spreading into nonendemic countries. The World Health Organization (WHO) has declared this a public health emergency of international concern and recommended to get vaccinated first who are at the highest risk. Risk perception and subjective norms can influence the decision of vaccine uptake. Therefore, we intended to perform a cross‐sectional study on the male population in our country to assess their risk perception and subjective norms on Mpox.

Methods

We measured participants' risk perception and subjective norms using Google form. Demographic profile of participants was obtained using a structured questionnaire. We performed a χ2 test to compare the levels of risk perception and subjective norm perception and multiple logistic regression analysis to determine the association between the study parameters and the sociodemographic profile of the participants.

Results

Among the participants, 93 (23.72%), 288 (73.47%), and 11 (2.81%) had high, medium, and low‐risk perceptions, respectively. For subjective norms, we observed 288 (58.16%) participants had a medium, 117 (29.85%) had high, and 47 (11.99%) had low levels of subjective norms, respectively. Most participants possessed medium risk perception (73.47%) and subjective norms (58.16%). Moreover, we observed that moderate risk perception was prevalent in people with body mass index (BMI) level between 18.5 and 25 (73.3%), married (63.5%), low economic background (94.1%), living with a family (77.1%), smokers (68.4%), heterosexuals (99%), people with no/little impact of coronavirus disease 2019 (Covid‐19) on life (91%). Proportions of people with moderate subjective norms BMI level of 18.5–25 (73.2%), married (60.5%), low economic status (93.9%), rural (58.8%), living with family (77.2%), nonsmokers (71.1%), and people with no/little impact of Covid‐19 in their lives (91.2%).

Conclusion

The majority of participants perceived medium risk perception and subjective norms related to Mpox. Furthermore, we observed a significant association between the study parameters and the sociodemographic characteristics of our study participants. We recommend that further longitudinal studies to yield more accurate results.
A case of mucosal‐associated lymphoid tissue lymphoma of the urachus
Authors: Tsuboi Kazuma , Bekku Kensuke , Haisa Kohei , Kajihara Yuta , Tsugawa Takuji , Inoue Yosuke , Sako Tomoko , Murao Wataru , Ebara Shin
Published: June 2023

Introduction

Urachus carcinoma is a rare malignancy with an aggressive potential and a poor prognosis, and evidence is limited for its diagnosis and treatment.

Case presentation

A 75‐year‐old man underwent fluorodeoxyglucose positron emission tomography/computed tomography for staging prostate cancer, and a mass (standardized uptake value max 9.5) was observed on the outside of the urinary bladder dome. T2‐weighted magnetic resonance imaging showed the urachus and a low‐intensity tumor, which suggested a malignant tumor. We suspected urachal carcinoma and performed total resection of the urachus and partial cystectomy. Pathological examination revealed mucosa‐associated lymphoid tissue lymphoma with cells positive for CD20 and negative for CD3, CD5, and cyclin D1. After the surgery, no recurrence has been observed for more than 2 years.

Conclusion

We encountered an extremely rare case of mucosa‐associated lymphoid tissue lymphoma of the urachus. Surgical resection of the tumor provided an accurate diagnosis and good disease control.
Mechanistic Modeling of the Drug‐Drug Interaction Between Efavirenz and Dolutegravir: Is This Interaction Clinically Relevant When Switching From Efavirenz to Dolutegravir During Pregnancy?
Authors: Dallmann André , van den Anker John , Ahmadzia Homa K. , Rakhmanina Natella
Published: June 2023

Following the 2021 World Health Organization's updated recommendations on the management of HIV infection, millions of people living with HIV are currently switched from efavirenz‐based antiretroviral therapy to dolutegravir‐based antiretroviral therapy. Pregnant individuals transitioning from efavirenz to dolutegravir might be at increased risk of insufficient viral suppression in the immediate postswitch period because both efavirenz‐ and pregnancy‐related increases in hormone levels induce enzymes involved in dolutegravir metabolism, namely, cytochrome P450 3A4 and uridine 5′‐diphospho‐glucuronosyltransferase 1A1. This study aimed at developing physiologically based pharmacokinetic models to simulate the switch from efavirenz to dolutegravir in the late second and third trimester. To this end, the drug‐drug interaction between efavirenz and the uridine 5′‐diphospho‐glucuronosyltransferase 1A1 substrates dolutegravir and raltegravir was first simulated in nonpregnant subjects. After successful validation, the physiologically based pharmacokinetic models were translated to pregnancy and dolutegravir pharmacokinetics following efavirenz discontinuation were predicted. Modeling results indicated that, at the end of the second trimester, both efavirenz concentrations and dolutegravir trough concentrations fell below respective pharmacokinetic target thresholds (defined as reported thresholds producing 90%‐95% of the maximum effect) during the time interval from 9.75 to 11 days after dolutegravir initiation. At the end of the third trimester, this time interval spanned from 10.3 days to >4 weeks after dolutegravir initiation. These findings suggest that dolutegravir exposure in the immediate post‐efavirenz switch period during pregnancy may be suboptimal, leading to HIV viremia and, potentially, resistance. The clinical implications of these findings remain to be substantiated by future studies.
Pharmacokinetic Evaluation in Pregnancy—Current Status and Future Considerations: Workshop Summary
Authors: Guinn Daphne , Sahin Leyla , Fletcher Elimika Pfuma , Choi Su‐Young , Johnson Tamara , Dinatale Miriam , Baisden Kristie , Sun Wenjie , Pillai Venkateswaran C. , Morales Jose Pablo , Yao Lynne
Published: June 2023

As pregnant individuals have traditionally been excluded from clinical trials, there is a gap in knowledge at the time of drug approval regarding safety, efficacy, and appropriate dosing for most prescription medications used during pregnancy. Physiologic changes in pregnancy can result in changes in pharmacokinetics that can impact safety or efficacy. This highlights the need to foster further research and collection of pharmacokinetic data in pregnancy to ensure appropriate drug dosing in pregnant individuals. Therefore, the US Food and Drug Administration and the University of Maryland Center of Excellence in Regulatory Science and Innovation hosted a workshop on May 16 and 17, 2022, titled“Pharmacokinetic Evaluation in Pregnancy.” This is a summary of the workshop proceedings.
Design Considerations for Pharmacokinetic Studies During Pregnancy
Authors: Stika Catherine S. , Hebert Mary F.
Published: June 2023

Most of the interventions performed by obstetric providers involve the administration of drugs. Pregnant patients are pharmacologically and physiologically different from nonpregnant young adults. Therefore, dosages that are effective and safe for the general public may be inadequate or unsafe for the pregnant patient and her fetus. Establishing dosing regimens appropriate for pregnancy requires evidence generated from pharmacokinetic studies performed in pregnant people. However, performing these studies during pregnancy often requires special design considerations, evaluations of both maternal and fetal exposures, and recognition that pregnancy is a dynamic process that changes as gestational age advances. In this article, we address design challenges unique to pregnancy and discuss options for investigators, including timing of drug sampling during pregnancy, appropriate selection of control groups, pros and cons of dedicated and nested pharmacokinetic studies, single‐dose and multiple‐dose analyses, dose selection strategies, and the importance of integrating pharmacodynamic changes into these protocols. Examples of completed pharmacokinetic studies in pregnancy are provided for illustration.
MRI Assessment of Intrinsic Neural Timescale and Gray Matter Volume in Parkinson's Disease
Authors: Wei Yarui , Zhang Chunyan , Peng Yuanyuan , Chen Chen , Han Shaoqiang , Wang Weijian , Zhang Yong , Lu Hong , Cheng Jingliang
Published: June 2023

Background

Numerous studies have indicated altered temporal features of the brain function in Parkinson's disease (PD), and the autocorrelation magnitude of intrinsic neural signals, called intrinsic neural timescales, were often applied to estimate how long neural information stored in local brain areas. However, it is unclear whether PD patients at different disease stages exhibit abnormal timescales accompanied with abnormal gray matter volume (GMV).

Purpose

To assess the intrinsic timescale and GMV in PD.

Study Type

Prospective.

Population

74 idiopathic PD patients (44 early stage (PD‐ES) and 30 late stage (PD‐LS), as determined by the Hoehn and Yahr (HY) severity classification scale), and 73 healthy controls (HC).

Field Strength/Sequence

3.0 T MRI scanner; magnetization prepared rapid acquisition gradient echo and echo planar imaging sequences.

Assessment

The timescales were estimated by using the autocorrelation magnitude of neural signals. Voxel‐based morphometry was performed to calculate GMV in the whole brain. Severity of motor symptoms and cognitive impairments were assessed using the unified PD rating scale, the HY scale, the Montreal cognitive assessment, and the mini‐mental state examination.

Statistical Test

Analysis of variance; two‐sample t‐test; Spearman rank correlation analysis; Mann–Whitney U test; Kruskal‐Wallis' H test. A P value <0.05 was considered statistically significant.

Results

The PD group had significantly abnormal intrinsic timescales in the sensorimotor, visual, and cognitive‐related areas, which correlated with the symptom severity (ρ = −0.265, P = 0.022) and GMV (ρ = 0.254, P = 0.029). Compared to the HC group, the PD‐ES group had significantly longer timescales in anterior cortical regions, whereas the PD‐LS group had significantly shorter timescales in posterior cortical regions.

Conclusion

This study suggested that PD patients have abnormal timescales in multisystem and distinct patterns of timescales and GMV in cerebral cortex at different disease stages. This may provide new insights for the neural substrate of PD.

Level of Evidence

2

Technical Efficacy Stage

1
Editorial for “Altered Callosal Morphology and Connectivity in Asymptomatic Carotid Stenosis”
Authors: Sebök Martina , Fierstra Jorn
Published: June 2023

Level of Evidence

5

Technical Efficacy Stage

3
Physiologic Effects of Microneedle‐Mediated Intracochlear Dexamethasone Injection in the Guinea Pig
Authors: Feng Sharon J. , Leong Stephen , Aksit Aykut , Hébert Daniella , Olson Elizabeth S. , Kysar Jeffrey W. , Lalwani Anil K.
Published: June 2023

Objectives

Oral or intratympanic corticosteroids are commonly used to treat sudden sensorineural hearing loss (SSHL), tinnitus, and Meniere disease. Direct intracochlear delivery has been proposed to overcome the variability in bioavailability and efficacy of systemic or middle ear delivery. In this study, we aim to characterize the physiologic consequences of microneedle‐mediated direct intracochlear injection of dexamethasone through the round window membrane (RWM).

Methods

In Hartley guinea pigs (n = 5), a post‐auricular incision followed by bullostomy was made to access the round window membrane. Using 100 μm diameter hollow microneedles, 1.0 μl of 10 mg/ml dexamethasone was injected through the RWM over 1 min. Compound action potential (CAP) and distortion product otoacoustic action emissions (DPOAE) were measured before perforation, at 1 h, and at 5 h following injection. CAP hearing thresholds were measured from 0.5 to 40 kHz, and DPOAE f2 frequencies ranged from 1.0 and 32 kHz. Repeated measures ANOVA followed by pairwise t‐tests were used for statistical analysis.

Results

ANOVA identified significant CAP threshold shifts at four frequencies (4, 16, 36, and 40 kHz) and differences in DPOAE at 1 frequency (6 kHz). Paired t‐tests revealed differences between the pre‐perforation and 1 h time point. By 5 h post injection, both CAP hearing thresholds and DPOAE recover and are not significantly different from baseline thresholds.

Conclusion

Direct intracochlear delivery of dexamethasone via microneedles results in temporary shifts in hearing thresholds that resolve by 5 hours, thus supporting microneedle technology for the treatment of inner ear disorders.

Level of Evidence

NA Laryngoscope, 134:388–392, 2024
Classical solutions to the one‐dimensional logarithmic diffusion equation with nonlinear Robin boundary conditions
Authors: Cortissoz Jean C. , Reyes César
Published: June 2023

In this paper, we investigate the behavior of classical solutions to the one‐dimensional (1D) logarithmic diffusion equation with nonlinear Robin boundary conditions, namely,
where γ is a constant. Let u0 > 0 be a smooth function defined on [ − l, l], and which satisfies the compatibility condition
We show that for γ > 0, classical solutions to the logarithmic diffusion equation above with initial data u0 are global and blow‐up in infinite time, and that for p > 2 there is finite time blow‐up. Also, we show that in the case of γ < 0, , solutions to the logarithmic diffusion equation with initial data u0 are global and blow‐down in infinite time, but if p ⩽ 1 there is finite time blow‐down. For some of the cases mentioned above, and some particular families of examples, we provide blow‐up rates and blow‐down rates along sequences of times. Our approach is based on studying the Ricci flow on a cylinder endowed with a ‐symmetric metric, and some comparison arguments. Then, we bring our ideas full circle by proving a new long time existence result for the Ricci flow on a cylinder without any symmetry assumption. Finally, we show a blow‐down result for the logarithmic diffusion equation on a disc.
Adjusting for Underrepresentation Reveals Widespread Underestimation of Parkinson's Disease Symptom Burden
Authors: Hamedani Ali G. , Auinger Peggy , Willis Allison W. , Safarpour Delaram , Shprecher David , Stover Natividad , Subramanian Thyagarajan , Cloud Leslie
Published: June 2023

Background

Clinical research is limited by underrepresentation, but the impact of underrepresentation on patient‐reported outcomes in Parkinson's disease (PD) is unknown.

Objectives

To produce nationwide estimates of non‐motor symptom (NMS) prevalence and PD‐related quality of life (QOL) limitations while accounting for underrepresentation.

Methods

We performed a cross‐sectional analysis of data from the Fox Insight (FI) study, an ongoing prospective longitudinal study of persons with self‐reported PD. Using epidemiologic literature and United States (US) Census Bureau, Medicare, and National Health and Aging Trends Study data, we simulated a “virtual census” of the PD population. To compare the PD census to the FI cohort, we used logistic regression to model the odds of study participation and calculate predicted probabilities of participation for inverse probability weighting.

Results

There are an estimated 849,488 persons living with PD in the US. Compared to 22,465 eligible FI participants, non‐participants are more likely to be older, female, and non‐White; live in rural regions; have more severe PD; and have lower levels of education. When these predictors were incorporated into a multivariable regression model, predicted probability of participation was much higher for FI participants than non‐participants, indicating a significant difference in the underlying populations (propensity score distance 2.62). Estimates of NMS prevalence and QOL limitation were greater when analyzed using inverse probability of participation weighting compared to unweighted means and frequencies.

Conclusions

PD‐related morbidity may be underestimated because of underrepresentation, and inverse probability of participation weighting can be used to give greater weight to underrepresented groups and produce more generalizable estimates. © 2023 International Parkinson and Movement Disorder Society.
High‐order schemes and their error analysis for generalized variable coefficients fractional reaction–diffusion equations
Authors: Singh Anshima , Kumar Sunil , Vigo‐Aguiar Jesus
Published: June 2023

In this manuscript, we develop and analyze two high‐order schemes, CFD
and PQS
, for generalized variable coefficients fractional reaction–diffusion equations. The generalized fractional derivative is characterized by a weight function and a scale function. We approximate it using generalized Alikhanov formula (
) of order
, where

denotes the order of the generalized fractional derivative. Moreover, for spatial discretization, we use a compact operator in CFD
scheme and parametric quintic splines in PQS
scheme. The stability and convergence analysis of both schemes are demonstrated thoroughly using the discrete energy method in the
‐norm. It is shown that the convergence orders of the CFD
and PQS
schemes are
and
, respectively, where
and
represent the mesh spacing in the time direction and
is the mesh spacing in the space direction. In addition, numerical results are obtained for three test problems to validate the theory and demonstrate the efficiency and superiority of the proposed schemes.
Generation of percentile curves for strength and functional abilities for boys with Duchenne muscular dystrophy
Authors: Leon Mariana Angélica De Souza , Roza Daiane Leite Da , Davoli Gabriela Barroso De Queiroz , Baptista Cyntia Rogean De Jesus Alves De , Sobreira Claudia Ferreira Da Rosa , Mattiello‐Sverzut Ana Claudia
Published: June 2023

Introduction/Aims

Considering the heterogeneity of the clinical manifestations of Duchenne muscular dystrophy (DMD), it is important to describe their various clinical profiles. Thus, in this study we aimed to develop percentile curves for DMD using a battery of measures to define the patterns of functional abilities, timed tests, muscle strength, and range of motion (ROM).

Methods

This retrospective data analysis was based on the records of patients with DMD using the Motor Function Measure (MFM) scale, isometric muscle strength (IS), dorsiflexion ROM, 10‐meter walk test (10 MWT), and 6‐minute walk test (6 MWT). Percentile curves (25th, 50th, and 75th percentiles) with MFM, IS, ROM, 10 MWT, and 6 MWT on the y axis and patient age on the x axis were constructed using the generalized additive model for location, scale, and shape, with Box‐Cox power exponential distribution.

Results

There were records of 329 assessments of patients between 4 and 18 years of age. The MFM percentiles showed a gradual reduction in all dimensions. Muscle strength and ROM percentiles showed that the knee extensors were the most affected from 4 years of age, and dorsiflexion ROM negative values were noted from the age of 8 years. The 10 MWT showed a gradual increase in performance time with age. For the 6 MWT, the distance curve remained stable until 8 years, with a subsequent progressive decline.

Discussion

In this study we generated percentile curves that can help health professionals and caregivers follow the trajectory of disease progression in DMD patients.
Toward vendor‐independent measurement of cerebral venous oxygenation: Comparison of TRUST MRI across three major MRI manufacturers and association with end‐tidal CO2
Authors: Eldirdiri Abubakr , Zhuo Jiachen , Lin Zixuan , Lu Hanzhang , Gullapalli Rao P. , Jiang Dengrong
Published: June 2023

Cerebral venous oxygenation (Yv) is a valuable biomarker for a variety of brain diseases. T2 relaxation under spin tagging (TRUST) MRI is a widely used method for Yv quantification. In this work, there were two main objectives. The first was to evaluate the reproducibility of TRUST Yv measurements across MRI scanners from different vendors. The second was to examine the correlation between Yv and end‐tidal CO2 (EtCO2) in a multisite, multivendor setting and determine the usefulness of this correlation to account for variations in Yv caused by normal variations and physiological fluctuations. Standardized TRUST pulse sequences were implemented on three scanners from major MRI vendors (GE, Siemens, Philips). These scanners were located at two research institutions. Ten healthy subjects were scanned. On each scanner, the subject underwent two scan sessions, each of which included three TRUST scans, to evaluate the intrasession and intersession reproducibility of Yv. Each scanner was also equipped with a capnograph device to record the EtCO2 of the subject during the MRI scan. We found no significant bias in Yv measurements across the three scanners (P = 0.18). The measured Yv values on the three scanners were also strongly correlated with each other (intraclass correlation coefficients > 0.85, P < 0.001). The intrasession and intersession coefficients of variation of Yv were less than 4% and showed no significant difference among the scanners. In addition, our results revealed that (1) within the same subject, Yv increased with EtCO2 at a rate of 1.24 ± 0.17%/mmHg (P < 0.0001), and (2) across different subjects, individuals with a higher EtCO2 had a higher Yv, at a rate of 0.94 ± 0.36%/mmHg (P = 0.01). These results suggest that (1) the standardized TRUST sequences had similar accuracies and reproducibilities for the quantification of Yv across the scanners, and (2) recording of EtCO2 may be a useful complement to Yv measurement to account for CO2‐related physiological fluctuations in Yv in multisite, multivendor studies.
Facilitators and inhibitors of traumatic brain injury transfers: A fieldwork investigation
Authors: Højbjerg Karin , Poulsen Ingrid , Egerod Ingrid
Published: June 2023

Aim

Intensified healthcare specialization has increased the need for patient transfers. We aimed to describe in‐hospital and interhospital patient transfer decisions during the traumatic brain injury (TBI) trajectory from a nursing perspective.

Design

Ethnographic fieldwork.

Methods

We used participant observation and interviews at three sites representing the acute, subacute and stable stages of the TBI trajectory. Deductive analysis was applied supported by transition theory.

Results

During the acute stage (neurointensive care), transfer decisions were facilitated by physicians assisted by critical care nurses, in the subacute stage (highly specialized rehabilitation), transfer decisions were collaborative among in‐house healthcare professionals, community staff and family, and during the stable stage (municipal rehabilitation), transfer decisions were made by non‐clinical staff. Most of the resources allocated during the trajectory went towards highly specialized rehabilitation, whereas more resources are needed during the end of the trajectory.

No Patient or Public Contribution

Patients and the public were not involved in this study .
The psychometric properties of the Diabetes Self‐Efficacy Scale in Saudis with type 2 diabetes
Authors: Kerari Ali
Published: June 2023

Aim

To assess the psychometric properties of the Arabic version of the Diabetes Self‐Efficacy Scale (A‐DSES).

Design

This study used a cross‐sectional design.

Methods

This study recruited 154 Saudi adults with type 2 diabetes at two primary healthcare centres in Riyadh, Saudi Arabia. Its instruments were the Diabetes Self‐Efficacy Scale and the Diabetes Self‐Management Questionnaire. The psychometric properties of the A‐DSES were assessed for reliability, including internal consistency and validity using exploratory factor analysis, confirmatory factor analysis and criterion validity.

Results

The item‐total correlation coefficients were >0.30 for all items, ranging from 0.46 to 0.70. The Cronbach's alpha for internal consistency was 0.86. One factor was extracted from the exploratory factor analysis (self‐efficacy for diabetes self‐management), and the one‐factor model showed an acceptable fit to the data in the confirmatory factor analysis. Diabetes self‐efficacy levels were positively correlated with diabetes self‐management skills (r = 0.40, p < 0.001), indicating criterion validity.

Conclusions

The results indicate that the A‐DSES is a reliable and valid instrument for assessing self‐efficacy related to diabetes self‐management.

Relevance to Clinical Practice

The A‐DSES could be used in clinical practice and research to provide a reference for assessing self‐efficacy levels in areas of diabetes self‐management.

No Patient or Public Contribution

Participants were not involved in the design, conduct, reporting or dissemination plans of this research.
Evaluation of woman‐centred care status by Iranian midwives and providing strategies to improve women‐centred care: A sequential explanatory mixed method study protocol
Authors: Mashayekh‐Amiri Sepideh , Nourizadeh Roghaiyeh , Mohammad‐Alizadeh‐Charandabi Sakineh , Vaezi Maryam , Meedya Shahla , Mirghafourvand Mojgan
Published: June 2023

Aim

The present study aimed to evaluate the status of WCC provided by Iranian midwives.

Design

A sequential explanatory mixed method study protocol.

Methods

The present study was conducted in three phases: quantitative, qualitative and mixed. The first phase is a cross‐sectional study that will be performed on midwives working in health centres, public and private hospitals in Iranian. The second phase is a qualitative study, in which purposeful sampling will be used, meaning that the midwives who are part of the extreme cases according to the results of quantitative phase and are willing and able to express their own experiences regarding WCC will be selected. Also, pregnant and parturient women under their cover will also be interviewed. Finally, in the mixed phase, we will use a combination of two quantitative and qualitative studies, a literature review and expert opinion using a Delphi method to provide strategies to improve and promote WCC in midwives.

Results

Achieving this goal is expected to provide positive outcomes such as strengthening the midwives professional relationship with women and reducing health care costs.

No Patient or Public Contribution.
Mortality After Total Thyroidectomy for Amiodarone‐Induced Thyrotoxicosis According to Left Ventricular Ejection Fraction
Authors: Frey Samuel , Caillard Cécile , Mahot Pascale , Pattier Sabine , Volteau Christelle , Knipping Garance , Lande Gilles , Drui Delphine , Mirallié Eric
Published: June 2023

Objective

To report cardiac outcomes after total thyroidectomy for amiodarone‐induced thyrotoxicosis according to the baseline left ventricular ejection fraction in a tertiary referral center.

Study Design

Retrospective, monocentric.

Setting

The tertiary health care system.

Methods

Patients who underwent total thyroidectomy for amiodarone‐induced thyrotoxicosis between 2010 and 2020 with age >18 and available preoperative left ventricular ejection fraction were included in this study. Patients were dichotomized into: group 1 with left ventricular ejection fraction ≥40% (mildly reduced/normal ejection fraction), and group 2 with left ventricular ejection fraction <40% (reduced ejection fraction).

Results

There were 34 patients in group 1 and 17 to group 2. The latter were younger (median 58.4 [Q1‐Q3 48.0‐64.9] vs. 69.8 years in group 1 [59.8‐78.3], p = .0035) and they presented more cardiomyopathy (58.8 vs. 26.5%, p = .030). Overall, the median time until surgery referral was 3.1 [1.9‐7.1] months and 47.1% underwent surgery after restoration of euthyroidism. Surgical complications accounted for 7.8%. In group 2, the median left ventricular ejection fraction was significantly improved after surgery (22.5 [20.0‐25.0] vs. 29.0% [25.3‐45.5], p = .0078). Five‐year cardiac mortality was significantly higher in group 2 (p < .0001): 47.0% died of cardiac causes versus 2.9% in group 1. A baseline left ventricular ejection fraction <40% and a longer time until surgery referral were significantly associated with cardiac mortality (multivariable Cox regression analysis, p = .015 and .020, respectively).

Conclusion

These results reinforce the idea that surgery, if chosen, should be performed quickly in patients with left ventricular ejection fraction <40%.
Semitransparent Organic Position Sensitive Detector with Thin Ag Electrode Toward the Angle Detection of Incident Light Using Stacked‐Type Device
Authors: Takimoto Izuto , Kajii Hirotake , Takahashi Ryo , Nagakawa Ayumu , Miyazaki Takahiro , Kanazawa Keizo , Murakami Hiroshi , Fujita Suzuka , Morimune Taichiro
Published: June 2023

A semitransparent organic position sensitive detector (PSD) that takes advantage of the translucent feature of organic semiconductors is developed. It is fabricated by controlling the thickness of the Ag thin film used as the common electrode to create a translucent electrode. The linearity accuracy of the sensor is evaluated to be 2.7% for the incident light from the indium tin oxide side and 3.6% for the incident light from the Ag side. When two semitransparent devices are stacked and vertically incident, a linearity of about 6.0% is obtained, even for the device placed on the lower side. Furthermore, it is demonstrated that the incident angle of light can be detected by stacking two semitransparent devices. When the incident angle of light varies from 0° to 30°, the maximum difference from the actual incident angle is 6.5°. This work is anticipated to be useful for developing angular detection devices based on organic PSD.
Performance of Improvement of AlGaN‐Based Deep UV Light‐Emitting Diode with Two Parts Linearly Graded Barriers
Authors: Ren Peng-Peng , Lin Hao-Xiang , Cai Li-E , Xu Chao-Zhi , Chen Zhi-Chao , Lin Hong-Yi , Xiong Fei-Bing , Huang Jinman , Cai Linlin
Published: June 2023

Herein, a novel AlGaN‐based multiple quantum well (MQW) deep UV light‐emitting diode (DUV‐LED) structure with two parts linearly graded barriers is presented. The simulation result shows that at a current of 50 mA, the light output power of the DUV‐LED with two parts linearly graded barrier MQWs has significant improvement as compared to stationary barriers. The electroluminescence spectrum and radiative recombination rate of novel DUV‐LEDs are also larger more than twice that of the conventional QW structure. The reason is that the injection efficiency of holes is increased which helps improve the hole and electron concentration in the active area. Meanwhile, the electric field is also decreased by using two parts linearly graded quantum barriers, and according to reduce the electric field the quantum‐confined Stark effect and the bend of the energy band get relieved.
Robotic‐assisted versus laparoscopic redo antireflux surgery in children: A cost‐effectiveness study
Authors: Delgado‐Miguel Carlos , Camps Juan I.
Published: June 2023

Introduction

Robotic‐assisted redo fundoplication has some advantages compared to the laparoscopic approach in adults, although to date there are no studies in children.

Methods

A retrospective case‐control study was performed among consecutive children who underwent redo antireflux surgery between 2004 and 2020, divided into two groups: LAF group (laparoscopic redo‐fundoplication) and RAF group (robotic‐assisted redo‐fundoplication). Demographics, clinical, intraoperative, postoperative and economic data were compared.

Results

A total of 24 patients were included (10 LAF group; 14 RAF group) without demographic or clinical differences. The RAF group presented lower intraoperative blood loss (52 ± 19 vs. 145 ± 69 mL; p < 0.021), shorter surgery time (135 ± 39 vs. 179 ± 68 min; p = 0.009) and shorter length of hospital stay (median 3 days [2–4] vs. 5 days [3–7]; p = 0.002). The RAF group presented a higher rate of symptom improvement (85.7% vs. 60%; p = 0.192) and lower overall associated economic costs (25 800$ vs. 45 500$; p = 0.012).

Conclusion

Robotic‐assisted redo antireflux surgery may offer several benefits over the laparoscopic approach. Prospective studies are still needed.
Haar Frame Characterizations of Besov–Sobolev Spaces and Optimal Embeddings into Their Dyadic Counterparts
Authors: Garrigós Gustavo , Seeger Andreas , Ullrich Tino
Published: June 2023

We study the behavior of Haar coefficients in Besov and Triebel–Lizorkin spaces on $${\mathbb R}$$
R
, for a parameter range in which the Haar system is not an unconditional basis. First, we obtain a range of parameters, extending up to smoothness $$s<1$$

s
<
1

, in which the spaces $$F^s_{p,q}$$

F

p
,
q

s

and $$B^s_{p,q}$$

B

p
,
q

s

are characterized in terms of doubly oversampled Haar coefficients (Haar frames). Secondly, in the case that $$1/p<s<1$$

1
/
p
<
s
<
1

and $$f\in B^s_{p,q}$$

f
∈

B

p
,
q

s

, we actually prove that the usual Haar coefficient norm, $$\Vert \{2^j\langle f, h_{j,\mu }\rangle \}_{j,\mu }\Vert _{b^s_{p,q}}$$

‖

{

2
j

⟨
f
,

h

j
,
μ

⟩

}

j
,
μ

‖

b

p
,
q

s

remains equivalent to $$\Vert f\Vert _{B^s_{p,q}}$$

‖
f
‖

B

p
,
q

s

, i.e., the classical Besov space is a closed subset of its dyadic counterpart. At the endpoint case $$s=1$$

s
=
1

and $$q=\infty $$

q
=
∞

, we show that such an expression gives an equivalent norm for the Sobolev space $$W^{1}_p({\mathbb R})$$

W
p
1

(
R
)

, $$1<p<\infty $$

1
<
p
<
∞

, which is related to a classical result by Bočkarev. Finally, in several endpoint cases we give optimal inclusions between $$B^s_{p,q}$$

B

p
,
q

s

, $$F^s_{p,q}$$

F

p
,
q

s

, and their dyadic counterparts.
Optical properties of borate glasses containing chromium and erbium oxide
Authors: Kashif I. , Ratep A.
Published: June 2023

Borate glass samples containing chromium and erbium were prepared. According to the density and molar volume, the Cr2O3-free glass sample had an expanded glass structure. Cr has three distinct absorption bands, and according to the measured optical absorption characteristics, a band was observed at 688 nm due to the 4A2g(F) → 2Eg(G) transition, indicating the presence of Cr6+. Cr3+ was observed in the bands at 446 and 620 nm, which were attributed to 4A2g (F) → 4T2g (F) and 4A2g (F) → 4T1g (F). Using the absorption spectra of the glass samples, the Judd–Ofelt theory was used to calculate the three parameters for glass: Ω2, Ω4, and Ω6. The slow transformation of chromium ions in these glasses from Cr6+ to Cr3+ disturbs the local symmetry and adds coordinated bond defects, which affect the surroundings of Er3+ ions.
Interrelationships between Pre-processing and Subsequent Procedures in the Recycling of Spent Lithium-ion Batteries
Authors: Gerold E. , Anbauer A. , Kügele A. , Ebenauer K. , Antrekowitsch H.
Published: June 2023

The recycling of lithium-ion batteries (LIBs) is currently an important topic in the fields of research and industry. New developments for the recovery of valuable metals from spent LIBs show a clear trend towards hydrometallurgical concepts. In this context, pre-treatment in particular plays an essential role. If organic compounds remain in the material or if the cathode and anode materials are insufficiently separated from the conductor foils, this can lead to massive process complications in the subsequent hydrometallurgical processes. The chair of Non-ferrous Metallurgy is developing and testing the adaptation and improvement of the recycling possibilities of used lithium-ion batteries for subsequent hydrometallurgical processing. Particular attention is paid to the use of synergy effects and the interaction of treatment and metallurgical processes as this combination is the only way to find an efficient and economical way to recover valuable metals. For this purpose, the comparison of different aggregates for the optimal preparation of the active material from spent lithium-ion batteries for subsequent further processing is carried out. By improving the overall processes, the recovery rates for the valuable metals contained, such as cobalt, nickel, and lithium, can be significantly increased, the metallurgical processes be optimised and the raw material cycle be closed. This is a significant contribution to environmental and climate protection, especially in view of the criticality of the elements mentioned. Due to the demand for a holistic solution for the long-term supply of the European Union with critical raw materials through recycling, a significant optimisation in the field of recovering valuable metals from used lithium-ion batteries can be realised.
Mathematical model for force and energy of virion-cell interactions during full engulfment in HIV: Impact of virion maturation and host cell morphology
Authors: Kruse Elizabeth , Abdalrahman Tamer , Selhorst Philippe , Franz Thomas
Published: June 2023

Viral endocytosis involves elastic cell deformation, driven by chemical adhesion energy, and depends on physical interactions between the virion and cell membrane. These interactions are not easy to quantify experimentally. Hence, this study aimed to develop a mathematical model of the interactions of HIV particles with host cells and explore the effects of mechanical and morphological parameters during full virion engulfment. The invagination force and engulfment energy were described as viscoelastic and linear-elastic functions of radius and elastic modulus of virion and cell, ligand-receptor energy density and engulfment depth. The influence of changes in the virion-cell contact geometry representing different immune cells and ultrastructural membrane features and the decrease in virion radius and shedding of gp120 proteins during maturation on invagination force and engulfment energy was investigated. A low invagination force and high ligand-receptor energy are associated with high virion entry ability. The required invagination force was the same for immune cells of different sizes but lower for a local convex geometry of the cell membrane at the virion length scale. This suggests that localized membrane features of immune cells play a role in viral entry ability. The available engulfment energy decreased during virion maturation, indicating the involvement of additional biological or biochemical changes in viral entry. The developed mathematical model offers potential for the mechanobiological assessment of the invagination of enveloped viruses towards improving the prevention and treatment of viral infections.
Expression of PinX1 and hTERT in basal cell carcinoma and their implications
Authors: Qin Long , Ge Jing
Published: June 2023

Objective

This study aimed to investigate the expression and significance of PIN2/TERF1 interacting, telomerase inhibitor 1 (PinX1) and human telomerase reverse transcriptase (hTERT) in basal cell carcinoma (BCC).

Methods

Real-time polymerase chain reaction and immunohistochemistry were performed to quantify the mRNA expressions and integrated optical density (IOD), respectively, of PinX1 and hTERT in BCC specimens (n = 30), as well as in normal skin specimens (n = 15). Results The mRNA expression level and IOD of PinX1 in the BCC samples were both significantly lower than those in the control specimens (P < 0.05). Conversely, the mRNA expression level and IOD of hTERT in BCC were both significantly higher than that in the control samples (P < 0.05). The correlation between the expression levels of PinX1 and hTERT showed no statistical significance (P > 0.05).

Conclusion

Downregulation of PinX1 and upregulation of hTERT expression may be associated with the activation and maintenance of telomerases in the induction of BCC.
Damage to Wistar rat livers after hypo-fractionated radiation and oxaliplatin
Authors: Chen Mingxuan , An Yongheng , Yu Hongsheng , Li Yifan , Chen Xiaoman
Published: June 2023

Objective

The purpose of this study was to clarify whether hypo-fractionated radiation therapy combined with oxaliplatin can aggravate liver damage, in order to determine its safety for clinical application.

Methods

Eighty Wistar rats were randomly divided into four groups: the control group, the chemotherapy treatment group, the radiation treatment group, and the concurrent chemoradiotherapy group. The rats’ liver tissues were then collected for histological evaluation at the first, second, fourth, sixth, and eight week after irradiation. The tissues were histologically evaluated using hematoxylin and eosin staining, and immunohistochemistry to analyze the expression of Bcl-2 and Bax.

Results

Histological examination revealed swollen hepatocellular cells in the experimental groups, with visible liver degeneration and necrosis. Alanine aminotransferase and aspartate aminotransferase levels were significantly different between the groups (F = 85.869 and 214.663; P < 0.001). The intra-group expressions of Bcl-2 and Bax were also significantly different between each time point (F = 6.047 and 43.344; P < 0.05). Bax expression was significantly different between each group (F = 8.122; P < 0.05), although no inter-group differences were observed for Bcl-2 expression (F = 0.808; P > 0.05).

Conclusion

Chemoradiotherapy may aggravate liver injury, possible via overexpression of Bcl-2 and reduced expression of Bax. Therefore, this treatment should be used carefully in the clinic.
A clinical study of thoracic esophageal carcinoma metastasis into abdominal lymph nodes
Authors: Yang Qingjie , Zhong Li , Guo Ming
Published: June 2023

Objective

The aim of this study was to analyze the potential of thoracic esophageal carcinoma to metastasize into abdominal lymph nodes.

Methods

The data on abdominal lymph node metastasis in 164 patients who had undergone resection of thoracic esophageal carcinoma were analyzed retrospectively and grouped according to tumor position in the upper, middle, or lower thoracic esophagus. The difference in tumor infiltration depth, differentiation degree, pathological type, pathological stage, and the metastasis rate in abdominal lymph nodes among the three groups was evaluated and the correlation of abdominal lymph node metastasis with tumor infiltration depth, differentiation degree, and pathological type was analyzed.

Results

Clinical characteristics such as tumor infiltration depth, differentiation degree, pathological type, and pathological stage were not significantly different between the patients with upper, middle, and lower thoracic esophageal carcinomas. Although there was a difference in the metastasis rate in abdominal lymph nodes between the three groups (6.9%, 27.4%, and 39.6% for the upper, middle, and lower thoracic esophageal carcinomas, respectively), it was not statistically significant. There was also no association between the rate of abdominal lymph node metastasis and tumor infiltration depth, differentiation degree, and pathological type.

Conclusion

Esophageal carcinoma specifically metastasizes into lymph nodes. If the tumor infiltrates the upper thoracic submucosa, it could metastasize down to abdominal lymph nodes via the lymphatic capillary net. The majority of esophageal carcinomas were of T1b or higher pathological stage at the diagnosis, indicating infiltration of the submucosa. Thus, tumors of the early stage, high degree of differentiation, or position in the upper thoracic esophagus were not less prone to metastasis into abdominal lymph nodes. Therefore, routine abdominal lymph node dissection during radical surgery for esophageal carcinoma is necessary.
Expression and clinical significance of serum lipoprotein (a) in patients with gastric cancer
Authors: Meng Lingjun , Shen Fangzhen
Published: June 2023

Objective

This study aimed to investigate the expression and clinical significance of serum lipoprotein (a) [LP (a)] in patients with gastric cancer.

Methods

Two hundred and twenty-two patients with gastric cancer (gastric cancer group) were selected from 2015 to 2017 [mean age (58.40 ± 10.40) years], as were 101 healthy persons [normal age group, mean age (58.18 ± 11.42) years]. Fasting blood samples were collected and evaluated by immunoturbidimetry with a biochemical analyzer. LP (a) concentration was observed and its difference was compared.

Results

There was no significant correlation between LP (a) and tumor stage (P > 0.05). Compared with the control group, the level of LP (a) in the male gastric cancer group was significantly higher than that in the control group (P < 0.05). In the subgroup analysis, the level of LP (a) and abnormal rate showed an increasing trend among patients with stages I-IV gastric cancer. The level of LP (a) in poorly differentiated gastric cancer patients was higher than that in the high middle differentiation group (P < 0.05). There was no significant difference in LP (a) levels among patients with different pathological types of gastric cancer (P > 0.05).

Conclusion

LP (a) was correlated with the occurrence, development and differentiation of gastric cancer, but not with the pathological classification of gastric cancer. Serum LP (a) concentration may be used as an indicator for the staging and prognosis of gastric cancer, but the specific underlying mechanism remains to be further studied.