bluuebunny/crossref_metadata_2025 huggingface dataset:
Tamarindus indica Leaf Extract Mediated Au NPs for Antimicrobial Treatment of Infectious Skin Wounds in Postoperative Wound Care Applications
Authors: Zheng Hui , Sun Shufeng , Ma Xueli , Hou Li
Published: October 2021

The main cause of delay in the wound healing process is usually the infection due to pathogens such as Pseudomonas aeruginosais. The current study reports the green fabrication of gold nanoparticles (Au NPs) using Tamarindus indica leaf extract. The prepared Au NPs have
displayed significant antimicrobial activities. Also, Au NPs activity alone and when combined with tetracycline was studied on the inoculated wounds with P. aeruginosain in mice. A total of 20 mice were anesthetized and deep skin wounds were made on the back of all the mice. Then, a
suspension containing bacteria was applied to wounds. The wound infection was studied by measuring the total microbial count as well as monitoring the wound healing macroscopically. Treatments were performed to all the groups on the wound bed topically using Au NPs alone, Au NPs with tetracycline
(Au NPs + tetracycline), tetracycline alone and normal saline in the control group. The Au NPs + Tetracycline group has attained 100% closure of the wound on the 9th day. The wound contraction percentage of animals treated with Au NPs (98%) was noticed to be almost similar with the percentages
of normal saline (79%) and tetracycline (99%) animal groups. In addition, all the groups treated with Au NPs + Tetracycline, tetracycline alone and Au NPs alone showed decreased bacterial concentration on the wound surface by the 9th day in comparison to the control group. Similarly, a significant
decrease (P < 0.001) was observed in the bacterial count of the groups treated with Au NPs+Tetracycline, tetracycline and Au NPs on comparison with the control group at all the time periods. Treatment with Au NPs + Tetracycline is highly effective than tetracycline and Au NPs alone
for the reduction of bacterial load with an increase in the wound macroscopic closure. Therefore, the above results support the application of Au NPs combined with an antimicrobial medicine for treating the skin wound infections.
Vasodilator therapy for pulmonary hypertension in children: a national study of patient characteristics and current treatment strategies
Authors: Jeremiasen Ida , Naumburg Estelle , Westöö Christian , G. Weismann Constance , Tran‐Lundmark Karin
Published: October 2021

Pulmonary vasodilator therapy is still often an off‐label treatment for pulmonary hypertension in children. The aim of this nationwide register‐based study was to assess patient characteristics and strategies for pulmonary vasodilator therapy in young Swedish children. Prescription information for all children below seven years of age at treatment initiation, between 2007 and 2017, was retrieved from the National Prescribed Drug Register, and medical information was obtained by linkage to other registers. All patients were categorized according to the WHO classification of pulmonary hypertension. In total, 233 patients had been prescribed pulmonary vasodilators. The treatment was initiated before one year of age in 61% (N = 143). Sildenafil was most common (N = 224 patients), followed by bosentan (N = 29), iloprost (N = 14), macitentan (N = 4), treprostinil (N = 2) and riociguat (N = 2). Over the study period, the prescription rate for sildenafil tripled. Monotherapy was most common, 87% (N = 203), while 13% (N = 20) had combination therapy. Bronchopulmonary dysplasia (N = 82, 35%) and/or congenital heart defects (N = 156, 67%) were the most common associated conditions. Eight percent (N = 18) of the patients had Down syndrome. Cardiac catheterization had been performed in 39% (N = 91). Overall mortality was 13% (N = 30) during the study period. This study provides an unbiased overview of national outpatient use of pulmonary vasodilator therapy in young children. Few cases of idiopathic pulmonary arterial hypertension were found, but a large proportion of pulmonary hypertension associated with congenital heart defects or bronchopulmonary dysplasia. Despite treatment, mortality was high, and additional pediatric studies are needed for a better understanding of underlying pathologies and evidence of treatment effects.
Super‐resolution Reconstruction MRI Application in Fetal Neck Masses and Congenital High Airway Obstruction Syndrome
Authors: Mufti Nada , Ebner Michael , Patel Premal , Aertsen Michael , Gaunt Trevor , Humphries Paul D. , Bredaki Fonteini Emmananouella , Hewitt Richard , Butler Colin , Sokolska Magdalena , Kendall Giles S. , Atkinson David , Vercauteren Tom , Ourselin Sebastien , Pandya Pranav P. , Deprest Jan , Melbourne Andrew , David Anna L.
Published: October 2021

Objective

Reliable airway patency diagnosis in fetal tracheolaryngeal obstruction is crucial to select and plan ex utero intrapartum treatment (EXIT) surgery. We compared the clinical utility of magnetic resonance imaging (MRI) super‐resolution reconstruction (SRR) of the trachea, which can mitigate unpredictable fetal motion effects, with standard 2‐dimensional (2D) MRI for airway patency diagnosis and assessment of fetal neck mass anatomy.

Study Design

A single‐center case series of 7 consecutive singleton pregnancies with complex upper airway obstruction (2013‐2019).

Setting

A tertiary fetal medicine unit performing EXIT surgery.

Methods

MRI SRR of the trachea was performed involving rigid motion correction of acquired 2D MRI slices combined with robust outlier detection to reconstruct an isotropic high‐resolution volume. SRR, 2D MRI, and paired data were blindly assessed by 3 radiologists in 3 experimental rounds.

Results

Airway patency was correctly diagnosed in 4 of 7 cases (57%) with 2D MRI as compared with 2 of 7 cases (29%) with SRR alone or paired 2D MRI and SRR. Radiologists were more confident (P =. 026) in airway patency diagnosis when using 2D MRI than SRR. Anatomic clarity was higher with SRR (P =. 027) or paired data (P =. 041) in comparison with 2D MRI alone. Radiologists detected further anatomic details by using paired images versus 2D MRI alone (P <. 001). Cognitive load, as assessed by the NASA Task Load Index, was increased with paired or SRR data in comparison with 2D MRI.

Conclusion

The addition of SRR to 2D MRI does not increase fetal airway patency diagnostic accuracy but does provide improved anatomic information, which may benefit surgical planning of EXIT procedures.
Genome-wide analysis of valine-glutamine motif-containing proteins related to abiotic stress response in cucumber (Cucumis sativus L.)
Authors: Shan Nan , Xiang Zijin , Sun Jingyu , Zhu Qianglong , Xiao Yao , Wang Putao , Chen Xin , Zhou Qinghong , Gan Zengyu
Published: October 2021

Background

Cucumber (Cucumis sativus L.) is one of the most important economic crops and is susceptible to various abiotic stresses. The valine-glutamine (VQ) motif-containing proteins are plant-specific proteins with a conserved “FxxhVQxhTG” amino acid sequence that regulates plant growth and development. However, little is known about the function of VQ proteins in cucumber.

Results

In this study, a total of 32 CsVQ proteins from cucumber were confirmed and characterized using comprehensive genome-wide analysis, and they all contain a conserved motif with 10 variations. Phylogenetic tree analysis revealed that these CsVQ proteins were classified into nine groups by comparing the CsVQ proteins with those of Arabidopsis thaliana, melon and rice. CsVQ genes were distributed on seven chromosomes. Most of these genes were predicted to be localized in the nucleus. In addition, cis-elements in response to different stresses and hormones were observed in the promoters of the CsVQ genes. A network of CsVQ proteins interacting with WRKY transcription factors (CsWRKYs) was proposed. Moreover, the transcripts of CsVQ gene were spatio-temporal specific and were induced by abiotic adversities. CsVQ4, CsVQ6, CsVQ16–2, CsVQ19, CsVQ24, CsVQ30, CsVQ32, CsVQ33, and CsVQ34 were expressed in the range of organs and tissues at higher levels and could respond to multiple hormones and different stresses, indicating that these genes were involved in the response to stimuli.

Conclusions

Together, our results reveal novel VQ resistance gene resources, and provide critical information on CsVQ genes and their encoded proteins, which supplies important genetic basis for VQ resistance breeding of cucumber plants.
Inspection plan for COVID-19 patients for Weibull distribution using repetitive sampling under indeterminacy
Authors: Rao G. Srinivasa , Aslam Muhammad
Published: October 2021

Background

This research work is elaborated investigation of COVID-19 data for Weibull distribution under indeterminacy using time truncated repetitive sampling plan. The proposed design parameters like sample size, acceptance sample number and rejection sample number are obtained for known indeterminacy parameter.

Methods

The plan parameters and corresponding tables are developed for specified indeterminacy parametric values. The conclusion from the outcome of the proposed design is that when indeterminacy values increase the average sample number (ASN) reduces.

Results

The proposed repetitive sampling plan methodology application is given using COVID-19 data belong to Italy. The efficiency of the proposed sampling plan is compared with the existing sampling plans.

Conclusions

Using the tables and COVID-19 data illustration, it is concluded that the proposed plan required a smaller sample size as examined with the available sampling plans in the literature.
Bayesian additional evidence for decision making under small sample uncertainty
Authors: Sondhi Arjun , Segal Brian , Snider Jeremy , Humblet Olivier , McCusker Margaret
Published: October 2021

Background

Statistical inference based on small datasets, commonly found in precision oncology, is subject to low power and high uncertainty. In these settings, drawing strong conclusions about future research utility is difficult when using standard inferential measures. It is therefore important to better quantify the uncertainty associated with both significant and non-significant results based on small sample sizes.

Methods

We developed a new method, Bayesian Additional Evidence (BAE), that determines (1) how much additional supportive evidence is needed for a non-significant result to reach Bayesian posterior credibility, or (2) how much additional opposing evidence is needed to render a significant result non-credible. Although based in Bayesian analysis, a prior distribution is not needed; instead, the tipping point output is compared to reasonable effect ranges to draw conclusions. We demonstrate our approach in a comparative effectiveness analysis comparing two treatments in a real world biomarker-defined cohort, and provide guidelines for how to apply BAE in practice.

Results

Our initial comparative effectiveness analysis results in a hazard ratio of 0.31 with 95% confidence interval (0.09, 1.1). Applying BAE to this result yields a tipping point of 0.54; thus, an observed hazard ratio of 0.54 or smaller in a replication study would result in posterior credibility for the treatment association. Given that effect sizes in this range are not extreme, and that supportive evidence exists from a similar published study, we conclude that this problem is worthy of further research.

Conclusions

Our proposed method provides a useful framework for interpreting analytic results from small datasets. This can assist researchers in deciding how to interpret and continue their investigations based on an initial analysis that has high uncertainty. Although we illustrated its use in estimating parameters based on time-to-event outcomes, BAE easily applies to any normally-distributed estimator, such as those used for analyzing binary or continuous outcomes.
Physicians’ knowledge, attitude, and prescribing behavior regarding stress ulcer prophylaxis in China: a multi-center study
Authors: Xing Xiao Xuan , Zhu Chen , Chu Yan Qi , Bai Xiang Rong , Wang Ke , Zhang Si Tao , Yan Su Ying
Published: October 2021

Background

Perioperative patients are at risk of developing stress ulcers (SU), which can cause clinically important bleeding. Stress ulcer prophylaxis (SUP) is widely applied to the patients in Intensive care unit (ICU) as well as the general ward, so it may lead to overmedication. However, there have been no surveys regarding SUP knowledge or prescribing habits.

Objective

Our study assessed the knowledge, attitudes, and prescribing behavior of the surgeons toward perioperative patients regarding SUP and determined factors associated with low knowledge and high level of prescribing behaviors.

Methods

We performed a cross-sectional survey using questionnaires, randomly sampling 1266 surgeons on their current SUP practices.

Results

Proton pump inhibitors for SUP were used the most (94%); 43% used lansoprazole. Guideline awareness was inconsistent; the most familiar guideline was the National Medical Journal of China, and 46% were unaware of any guidelines. The predictors of low knowledge score regarding SUP in multivariable analysis were the hospital grade (p = 0.000), the type of hospital (p = 0.044), attendance at continuing education programs (p = 0.037), the awareness of clinical practice guidelines (CPGs) for SUP (p = 0.000). Twenty-one percent of physicians were high prescribers. High prescribing behavior was associated with hospital grade(p = 0.000), education level(p = 0.010) and attendance at continuing education programs (p = 0.000).

Conclusion

We found that most surgeons used SUP, primarily proton pump inhibitors. However, surgeons knew little about the SUP guidelines, which may lead to insufficient SUP knowledge and overmedication. In addition, hospital grade, the type of hospital and attendance at continuing education programs may also affect the low knowledge of SUP. Hospital grade, education level and attendance at continuing education programs may affect high prescribing behavior.
Correction to: Vitrectomy for diabetic macular edema and the relevance of external limiting membrane
Authors: Ivastinovic Domagoj , Haas Anton , Weger Martin , Seidel Gerald , Mayer-Xanthaki Christoph , Lindner Ewald , Guttmann Andreas , Wedrich Andreas
Published: October 2021

An amendment to this paper has been published and can be accessed via the original article.
A process evaluation of a peer education project to improve mental health literacy in secondary school students: study protocol
Authors: Widnall Emily , Dodd Steve , Simmonds Ruth , Bohan Helen , Russell Abigail , Limmer Mark , Kidger Judi
Published: October 2021

Background

Emotional disorders in young people are increasing but studies have found that this age group do not always recognise the signs and symptoms of mental health problems in themselves or others. The Mental Health Foundation’s school-based Peer Education Project (PEP) has the potential to improve young people’s understanding of their own mental health at a critical developmental stage (early adolescence) using a peer teaching method. This study is a process evaluation to understand: the mechanisms through which PEP might improve young people’s mental health literacy, any challenges with delivery, how the project can be embedded within wider school life and how it can be improved to be of most benefit to the widest number of young people. We will also validate a bespoke mental health literacy questionnaire, and test the feasibility of using it to measure outcomes in preparation for a future study evaluating effectiveness.

Methods

All schools recruited to the study will receive the PEP intervention. The process evaluation will be informed by realist evaluation approaches to build understanding regarding key mechanisms of change and the impact of different school contexts. The evaluation will test and revise an existing intervention logic model which has been developed in partnership with the Mental Health Foundation. Process evaluation data will be collected from newly recruited schools (n = 4) as well as current PEP user schools (n = 2) including training and lesson delivery observations, staff interviews and student focus groups. Baseline and follow-up data will be collected in all newly recruited intervention schools (n = 4) from all students in Year 7/8 (who receive the PEP) and recruited peer educators in Year 12 via a self-report survey.

Discussion

This study will enable us to refine the logic model underpinning the peer education project and identify areas of the intervention that can be improved. Findings will also inform the design of a future effectiveness study which will test out the extent to which PEP improves mental health literacy.
Utilisation of community care services and self-rated health among elderly population in China: a survey-based analysis with propensity score matching method
Authors: Yang Liu , Wang Lijian , Di Xiaodong , Dai Xiuliang
Published: October 2021

Background

Elderly care and elderly health are the enormous challenges in such an aging society as China. Community care services have been developing rapidly in recent years in China as an increasingly mainstream care resource to promote elderly health. The purpose of this study is to examine the association between using community care services and self-rated health among Chinese elderly.

Methods

A cross-sectional survey was conducted in 2019 and 612 elderly people from China’s Shaanxi province were enrolled. The binary logistic regression was first employed to explore the association between community care services utilisation and elderly health. Given the potential selection bias issue, the propensity score matching method was hired to generate comparable samples between participants who used these services and participants who didn’t, and further examine the health benefits of using four types of services.

Results

The results of the binary logistic regression showed that the use of community care services predicted a better health status of elderly individuals. Overall, the results of the propensity score matching method showed the similar results. Specifically, with the nearest neighbors matching algorithm, using daily care services was significantly associated with a 0.246 increase in the self-rated health of the elderly (T = 1.83). For medical care services, the mean of self-rated health of elderly individuals who used these services was 3.542, significantly higher than those who didn’t (T = 2.15). For spiritual comfort services, elderly individuals using these services showed a significant increase by 0.280 in the self-rated health (T = 1.82). For social and recreational services, the result of the nearest neighbor matching method was not statistically significant, while the results of kernel matching method and the mahalanobis matching method showed a significant increase in the self-rated health among elderly individuals using these services (T = 2.03, T = 2.03, respectively). All the estimated results passed the Rosenbaum bounds analysis and were not sensitive to hidden bias.

Conclusions

Using community care services improved the self-rated health of the elderly. More effective measures may be implemented to increase access to care resources for senior citizens, and further improve their health status.
Weight-bearing MRI with a knee flexion angle of 20°: a study on additional MRI investigation modalities to support a more accurate understanding of patellofemoral instability
Authors: Leiprecht J. , Mauch F. , Huth J. , Ambros L. P. , Best R.
Published: October 2021

Background

Diagnosing patellofemoral instability disorders correctly, weight-bearing MRI (WB-MRI) has become an option. Aiming for a best possible accuracy in displaying potentially underlying causes, the named MRI modalities were sporadically even investigated in different knee flexion angles. However, despite confirmed MRI-outcome-differences between WB-MRI and non-WB-MRI, none of the described MRI modalities have so far established themselves. Mainly this is due to an unfeasibility in daily clinical routine in regard to time and economic aspects. Thus, we intended to evaluate an additional but reduced patellofemoral MR-imaging solely in a relevant 20° of knee flexion under WB- and non-WB-MRI conditions.

Methods

Seventy-three subjects with and without patellofemoral instability were investigated under supine as well as under WB-MRI conditions in a 20° of knee flexion angle. Patellofemoral risk indices in the sagittal plane (Insall-Salvati-Index, Caton-Deschamps-Index, Patellotrochlear Index) and the axial plane (Patella tilt of Fulkerson and Sasaki) were detected and compared between the different MRI conditions. Significance, reliability and Cohen’s effect size was calculated.

Results

Nearly all assessed indices showed significant differences between patients and controls in the different MRI positions. Comparing pairwise, all measured indices failed to show significant differences between the two MRI positions. However, patella tilt angles of the patient group showed an elevation from supine to WB-MRI (14.00 ± 7.54° to 15.97 ± 9.10° and 16.34 ± 7.84° to 18.54 ± 9.43°). Here, Cohen’s d showed small to medium effects between supine and WB-MRI.

Conclusion

In comparison to standard MRI in supine position, axial risk indices seem to be accentuated under WB-MRI and a knee flexion angle of 20°. In particular, symptomatic cases with inconspicuous conventional MRI imaging, additional MRI imaging only in the axial plane in a 20° of knee flexion could be beneficious and useful in clinical daily routine.
The effects of virtual reality training on clinical indices and brain mapping of women with patellofemoral pain: a randomized clinical trial
Authors: Ebrahimi Naghmeh , Rojhani-Shirazi Zahra , Yoosefinejad Amin Kordi , Nami Mohammad
Published: October 2021

Background

Virtual reality training (VRT) is a new method for the rehabilitation of musculoskeletal impairments. However, the clinical and central effects of VRT have not been investigated in patients with patellofemoral pain (PFP). To comprehensively assess the effects of VRT on clinical indices and brain function, we used a randomized clinical trial based on clinical and brain mapping assessment.

Methods

Twenty-six women with PFP for more than 6 months were randomly allocated to 2 groups: intervention and control. The intervention consisted of lifestyle education + 8 weeks VRT, in 24 sessions each lasting 40 min of training, whereas the control group just received lifestyle education. The balance was the primary outcome and was measured by the modified star excursion balance test. Secondary outcomes included pain, function, quality of life, and brain function which were assessed by visual analogue scale, step down test and Kujala questionnaire, SF-36, and EEG, respectively. Pre-intervention, post-intervention and follow-up (1 month after the end of the intervention) measurements were taken for all outcome measures except EEG, which was evaluated only at pre-intervention and post-intervention). Analyses of variance was used to compare the clinical outcomes between the two groups. The independent t-test also was used for between group EEG analyses.

Results

Balance score (P < 0.001), function (P < 0.001), and quality of life (P = 0.001) improved significantly at post-intervention and 1 month follow-up in the VRT group compared with the control group. VRT group showed a significantly decreased pain score (P = 0.004). Alpha (P < 0.05) and theta (P = 0.01) power activity also increased in the brain of the VRT group.

Conclusion

This study demonstrated that long term VRT was capable of improving both clinical impairments and brain function in patients with PFP. Therefore, therapists and clinicians can use this method as a more holistic approach in the rehabilitation of PFP.

Trial registration

IRCT, IRCT20090831002391N40. Registered 23 / 10 / 2019.
Risk factors for surgical site infections following open versus laparoscopic colectomies: a cohort study
Authors: Hoffman Tomer , Shitrit Pnina , Chowers Michal
Published: October 2021

Background

Surgical site infections (SSIs) are among the most common healthcare-associated infections. Evaluating risk factors for SSIs among patients undergoing laparoscopic and open colorectal resections can aid in selecting appropriate candidates for each modality.

Methods

A cohort of all consecutive patients undergoing elective colorectal resections during 2008–2017 in a single center was analyzed. SSIs were prospectively assessed by infection control personnel. Patient data were collected from electronic medical records. Risk factors for SSIs were compared between patients who underwent laparoscopic and open surgeries. A multivariate analysis was performed for significant variables.

Results

During the study period, 865 patients underwent elective colorectal resection: 596 laparoscopic and 269 open surgeries. Mean age was 68.2 ± 15.1 years, weight 72.5 ± 18.3 kg and 441 (51%) were men. The most common indication for surgery was malignancy, in 767 patients (88.7%) with inflammatory bowel diseases and diverticulitis following (4.5% and 3.9%, respectively). Patients undergoing laparoscopic surgery were younger, had fewer comorbidities, shorter pre-operative hospitalizations, lower risk index scores, and lower rates of SSI, compared with open surgery. Independent risk factors for SSI following laparoscopic surgery were chronic obstructive pulmonary disease [odds ratio (OR) 2.655 95% CI (1.267, 5.565)], risk index ≥ 2 [OR 2.079, 95% CI (1.041,4.153)] and conversion of laparoscopic to open surgery [OR 2.056 95%CI (1.212, 3.486)]. Independent risk factors for SSI following open surgery were immunosuppression [OR 3.378 95% CI (1.071, 10.655)], chronic kidney disease [OR 2.643 95% CI (1.008, 6.933)], and need for a second dose of prophylactic antibiotics [OR 2.519 95%CI (1.074, 5.905)].

Conclusions

Risk factors for SSIs differ between laparoscopic and open colorectal resections. Knowledge of specific risk factors may inform patient selection for these modalities.
Hsa_circ_0004296 inhibits metastasis of prostate cancer by interacting with EIF4A3 to prevent nuclear export of ETS1 mRNA
Authors: Mao Shiyu , Zhang Wentao , Yang Fuhan , Guo Yadong , Wang Hong , Wu Yuan , Wang Ruiliang , Maskey Niraj , Zheng Zongtai , Li Cheng , Ma Wenchao , Zhang Junfeng , Yan Yang , Yao Xudong
Published: October 2021

Background

Circular RNAs (circRNAs) have been shown to play vital biological functions in various tumors, including prostate cancer (PCa). However, the roles of circRNAs in the metastasis of PCa remain unclear. In the present study, differentially expressed circRNAs associated with PCa metastasis were screened using high-throughput RNA sequencing, from which hsa_circ_0004296 was identified.

Methods

Quantitative real-time PCR (qRT-PCR) was used to detect the expression of circ_0004296 in PCa tissues and adjacent normal tissues as well as in blood and urine. Gain and loss of function experiments were performed to investigate the function of circ_0004296 in PCa. Bioinformatics analyses, RNA pull-down assay, and mass spectrometry were conducted to identify RNA-binding proteins. RNA immunoprecipitation and RNA and protein nuclear-cytoplasmic fractionation were performed to investigate the underlying mechanism. A xenograft mouse model was used to analyze the effect of circ_0004296 on PCa growth and metastasis in vivo.

Results

The expression of circ_0004296 was decreased in PCa tissues, blood, and urine, which was negatively associated with metastasis. Furthermore, gain and loss of function experiments in vitro and in vivo showed that circ_0004296 inhibited the proliferation, migration, invasion, and epithelial-mesenchymal transition of PCa cells. Mechanistically, circ_0004296 regulated host gene ETS1 expression at the post-transcriptional level. EIF4A3 was identified and confirmed as the downstream binding protein of circ_0004296. EIF4A3 expression was significantly upregulated in PCa tissues and associated with PCa metastasis. Silencing EIF4A3 suppressed PCa cell proliferation, migration, invasion, and EMT.

Conclusions

Circ_0004296 overexpression efficiently inhibited ETS1 mRNA nuclear export by promoting EIF4A3 retention in the nucleus, leading to the downregulation of ETS1 expression and suppression of PCa metastasis; thus, circ_0004296 might be a potential biomarker and therapeutic target for patients with PCa.
Prevention of recurrent respiratory infections
Authors: Chiappini Elena , Santamaria Francesca , Marseglia Gian Luigi , Marchisio Paola , Galli Luisa , Cutrera Renato , de Martino Maurizio , Antonini Sara , Becherucci Paolo , Biasci Paolo , Bortone Barbara , Bottero Sergio , Caldarelli Valeria , Cardinale Fabio , Gattinara Guido Castelli , Ciarcià Martina , Ciofi Daniele , D’Elios Sofia , Di Mauro Giuseppe , Doria Mattia , Indinnimeo Luciana , Lo Vecchio Andrea , Macrì Francesco , Mattina Roberto , Miniello Vito Leonardo , del Giudice Michele Miraglia , Morbin Guido , Motisi Marco Antonio , Novelli Andrea , Palamara Anna Teresa , Panatta Maria Laura , Pasinato Angela , Peroni Diego , Perruccio Katia , Piacentini Giorgio , Pifferi Massimo , Pignataro Lorenzo , Sitzia Emanuela , Tersigni Chiara , Torretta Sara , Trambusti Irene , Trippella Giulia , Valentini Diletta , Valentini Sandro , Varricchio Attilio , Verga Maria Carmen , Vicini Claudio , Zecca Marco , Villani Alberto
Published: October 2021

Recurrent respiratory infections (RRIs) are a common clinical condition in children, in fact about 25% of children under 1 year and 6% of children during the first 6 years of life have RRIs. In most cases, infections occur with mild clinical manifestations and the frequency of episodes tends to decrease over time with a complete resolution by 12 years of age. However, RRIs significantly reduce child and family quality of life and lead to significant medical and social costs.

Despite the importance of this condition, there is currently no agreed definition of the term RRIs in the literature, especially concerning the frequency and type of infectious episodes to be considered. The aim of this consensus document is to propose an updated definition and provide recommendations with the intent of guiding the physician in the complex process of diagnosis, management and prevention of RRIs.
The impact of artificial intelligence on learner–instructor interaction in online learning
Authors: Seo Kyoungwon , Tang Joice , Roll Ido , Fels Sidney , Yoon Dongwook
Published: October 2021

Artificial intelligence (AI) systems offer effective support for online learning and teaching, including personalizing learning for students, automating instructors’ routine tasks, and powering adaptive assessments. However, while the opportunities for AI are promising, the impact of AI systems on the culture of, norms in, and expectations about interactions between students and instructors are still elusive. In online learning, learner–instructor interaction (inter alia, communication, support, and presence) has a profound impact on students’ satisfaction and learning outcomes. Thus, identifying how students and instructors perceive the impact of AI systems on their interaction is important to identify any gaps, challenges, or barriers preventing AI systems from achieving their intended potential and risking the safety of these interactions. To address this need for forward-looking decisions, we used Speed Dating with storyboards to analyze the authentic voices of 12 students and 11 instructors on diverse use cases of possible AI systems in online learning. Findings show that participants envision adopting AI systems in online learning can enable personalized learner–instructor interaction at scale but at the risk of violating social boundaries. Although AI systems have been positively recognized for improving the quantity and quality of communication, for providing just-in-time, personalized support for large-scale settings, and for improving the feeling of connection, there were concerns about responsibility, agency, and surveillance issues. These findings have implications for the design of AI systems to ensure explainability, human-in-the-loop, and careful data collection and presentation. Overall, contributions of this study include the design of AI system storyboards which are technically feasible and positively support learner–instructor interaction, capturing students’ and instructors’ concerns of AI systems through Speed Dating, and suggesting practical implications for maximizing the positive impact of AI systems while minimizing the negative ones.
Understanding parental self-medication with antibiotics among parents of different nationalities: a cross-sectional study
Authors: Zhou Zhongliang , Zhao Dantong , Zhang Huarui , Shen Chi , Cao Dan , Liu Guanping , Zhu Liang , Fang Yu
Published: October 2021

Background

There is an increasing trend on the practices of parental self-medication with antibiotics (PSMA) around world, accelerating the antibiotic abuse. This study aims to examine the nationality differences in the practices of PSMA and knowledge, attitudes and practices (KAP) toward antibiotic use, and understand the practices of PSMA among parents of various nationalities in China.

Methods

A cross-sectional study based on a structured questionnaire survey was conducted in Xi’an, Shaanxi Province, China, from September 2018 to October 2018. A total of 299 respondents participated in. The practices of PSMA (a dichotomous variable) and KAP toward antibiotic use (a continuous variable) served as dependent variables. Participant’s nationality was regarded as the independent variable. Binary logistic regression and ordinary least square regression were employed to examine the association between parent’s nationality and the practices of PSMA, and KAP toward antibiotic use, respectively.

Results

121 (40.88%) Chinese, 100 (33.76%) other Asians and 75 (25.34%) Occidentals were included in final analysis, with a sample size of 296. Chinese were more likely to practice PSMA (OR = 7.070; 95% CI 1.315, 38.01), with worse knowledge (Coef. = − 0.549; 95% CI − 1.021, − 0.078), attitudes (Coef. = − 3.069; 95% CI − 4.182, − 1.956) and practices (Coef. = − 1.976; 95% CI − 3.162, − 0.790) toward antibiotic use, compared to their Occidental counterparts. The main reasons for the practices of PSMA were enough previous medication experience (80.49%) and same ailments with no need to see a doctor (39.02%), with common symptoms such as fever (60.98%) and cough (58.54%). Purchasing antibiotics at pharmacies (92.08%) and using leftover antibiotics (26.83%) were usual approaches.

Conclusions

The study highlights the gaps in the practices of PSMA and KAP toward antibiotic use among parents of different nationalities. The access to obtain antibiotics from pharmacies reflects the pharmacists’ unaware of laws on prescription of antibiotics, fierce competition in the pharmacy market, and the government’s lax supervision in China. It suggests the need to improve pharmacists’ training, enforce current legislations on pharmacy market regarding the sale of antibiotics, and provide practical and effective educational interventions for residents about antibiotic use.
Diagnosis and Management of a Retained Local Anesthetic Needle Fragment in a Patient Who Underwent Scheduled Elective Cesarean Delivery: A Case Report
Authors: Black Kevin , Wright G. Andrew , Birkholtz Christopher , Dollar Bradley , Hofkamp Michael P.
Published: October 2021

Cesarean deliveries are often performed with a neuraxial anesthetic technique. Fracture of needles used for local anesthetic infiltration is rare. During subcutaneous infiltration of local anesthetic for a combined spinal epidural (CSE) anesthetic technique performed for elective cesarean delivery, a fragment from a fractured 27-gauge local anesthetic needle was retained in the lumbar subcutaneous tissue. CSE anesthesia was then successfully performed at a different spinal interspace, and the patient had an uneventful cesarean delivery. The patient had the needle fragment removed on the first postoperative day by an interventional radiologist who used fluoroscopy to identify the needle location.
Voices Carry
Authors: Morgan Cheryl A.
Published: October 2021

This article examines the urban fiction of Jeanne Marni’s 1898 Fiacres, a collection of twenty-five stories that first appeared in the daily newspaper Le Temps. The stories are presented in the form of dialogues transcribed by an invisible spectator from within the horse drawn carriages for hire, the fiacres, the fin de siècle taxi cabs. Training her eye on and lending her ear to Belle Époque Paris, Marni registers the conversations of Parisians as they move about the city. In these feminocentric, and by turns humorous or ironic texts, Marni hones an “urban comic” that merges two nineteenth-century figures: the “invisible” flâneuse and the “inaudible” rieuse, or funny woman. Focusing on the intersection of the representation of urban experience and the humorous in Fiacres, this article situates Marni’s sound bites within a genealogy of women writers and the city that looks back to Delphine Gay de Girardin’s witty chronicles of July Monarchy Paris, the “Courrier de Paris” (1836–1848), and ahead to Annie Ernaux’s ironic journal of urban selfhood in transit, Journal du dehors (1993).
Οι ΤΠΕ και η εξ αποστάσεως μέθοδοι στις παραμεθόριες περιοχές
Authors: Αλασώνα Νίκη
Published: October 2021

Το συνεχώς μεταβαλλόμενο και αβέβαιο περιβάλλον μέσα στο οποίο καλούνται να λειτουργήσουν τα σύγχρονα σχολεία έχει επιφέρει σημαντικές αλλαγές στον ρόλο του εκπαιδευτικού αλλά και στις μεθοδολογίες που εφαρμόζονται στη μάθηση.Οι εξελίξεις παγκοσμίως σε συνδυασμό με τη ραγδαία ανάπτυξη της τεχνολογίας και τους περιορισμούς της τυπικής εκπαίδευσης δημιουργούν την ανάγκη για μια εκπαίδευση με πιο ευέλικτη μορφή που να ανταποκρίνεται σε όλα τα επίπεδα, την εξ αποστάσεως εκπαίδευση που ενσωματώνει διάφορα εργαλεία των Τεχνολογιών Πληροφορίας και Επικοινωνίας (ΤΠΕ). Σκοπός της παρούσας έρευνας είναι η διερεύνηση των επιπτώσεων των ΤΠΕ και της εξ αποστάσεως μεθοδολογίας σε Δημοτικά σχολεία στις παραμεθόριες περιοχές στους μαθητές με μαθησικές δυσκολίες. Η μεθοδολογία που ακουλουθήθηκε στην εργασία είναι τριγωνοποίηση με ποσοστική και ποιοτική έρευνα για την όσο το δυνατόν αξιοπιστία της έρευνας. Δόθηκε ένα ερωτηματολόγιο σε 200 δασκάλους με τυχαία δειγματοληψία που υπηρετούσαν στην πρωτοβάθμια εκπαίδευση σε παραμεθόριες περιοχές της χώρας και επίσης πραγματοποιήθηκαν δέκα συνεντεύξεις σε εκπαιδευτικούς που δίδασκαν σε δημοτικά σχολεία σε παραμεθόριες περιοχές με βολική δειγματοληψία. Τα εργαλεία που χρησιμοποιήθηκαν για την ανάλυση ήταν το λογισμικό spss 24 και το excel.Τα αποτελέσματα έδειξαν τα εργαλεία των ΤΠΕ που βοηθούν σε μεγαλύτερο βαθμό στην εξ αποστάσεως εκπαίδευση είναι τα εκπαιδευτικά λογισμικά και τα Βίντεο καθώς και οι διαδραστικές εφαρμογές και τα παιχνίδια.Για την αντιμετώπιση των μαθησιακών δυσκολιών θεωρήθηκε η χρήση των ΤΠΕ, τα Προγράμματα ψυχοπαιδαγωγικής ανάπτυξης, η χρήση έντονων χρωμάτων και εικόνων και τα Προγράμματα συναισθηματικής νοημοσύνης, θεωρώντας ότι η εξ αποστάσεως εκπαίδευση θα μπορούσε να βοηθήσει στην αντιμετώπιση των μαθησιακών δυσκολιών.Οι εκπαιδευτικοί αναφερόμενοι στον τρόπο που βοηθούν οι ΤΠΕ τα παιδιά με μαθησιακές δυσκολίες τόνισαν την οπτικοακουστική προσέγγιση της διδασκαλίας με τη χρήση εικόνας και ήχου, την ευκαιρία για πολλαπλές επαναλήψεις και την παιγνιώδη μορφή στο γνωστικό αντικείμενο αλλά και στη δυνατότητα παρουσίασης της διδακτικής ύλης με διάφορους τρόπους.Οι εφαρμογές των ΤΠΕ που βοηθούν τους μαθητές με μαθησιακές δυσκολίες περιλάμβαναν τον διαδραστικό πίνακα, τα διάφορα είδη αλληλεπιδραστικών λογισμικών και τα Προγράμματα προσαρμοσμένα στις μαθησιακές δυσκολίες.Επιπλέον, η εκπαίδευσή τους στις ΤΠΕ και τις μαθησιακές δυσκολίες δεν ήταν σε ικανοποιητικό επίπεδο παρόλο που είχαν επιμορφωθεί δείχνοντας ότι ίσως η επιμόρφωση πρέπει να είναι περισσότερο εξειδικευμένη ή/και με μεγαλύτερη διάρκεια.
The genome sequence of the speckled wood butterfly, Pararge aegeria (Linnaeus, 1758)
Authors: Lohse Konrad , Taylor-Cox Evelyn ,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: October 2021

We present a genome assembly from an individual female Pararge aegeria (the speckled wood butterfly; Arthropoda; Insecta; Lepidoptera; Nymphalidae). The genome sequence is 517 megabases in span. The majority of the assembly (99.68%) is scaffolded into 29 chromosomal pseudomolecules, with the W and Z sex chromosome assembled. Gene annotation of this assembly on Ensembl has identified 12,288 protein coding genes.
Anterolateral Thigh Free Flap to Cover Diabetic Foot Defect by Using Reverse Flow of Severely Calcified Dorsalis Pedis Artery
Authors: Kim BumSik , Yoon JungSoo , Lim SooA , Han Yea Sik , Eo SuRak
Published: October 2021

Low blood flow in the distal part of the diabetic foot aggravates the wound to an ischemic state, which eventually leads to amputation. However, major advancements in microvascular surgery have shown the ability to salvage the limb even in the presence of poor perfusion. Since a foot is constituted of a complex network of angiosomes, each separate territory of the foot is supplied by interconnected vessels. We report the successful salvage of a severe diabetic foot injury of a 72-year-old male patient with a heavily calcified dorsalis pedis artery (DPA). Although the proximal end of the DPA was clogged to prevent the flow of blood and was insufficient to use as a recipient vessel, reverse flow from the distal end was restored after removing multiple calcification fragments. As a result, a large soft-tissue defect on the third and fourth toe region was successfully covered by a contralateral anterolateral thigh free flap.
Building and experimenting with an agent-based model to study the population-level impact of CommunityRx, a clinic-based community resource referral intervention
Authors: Lindau Stacy Tessler , Makelarski Jennifer A. , Kaligotla Chaitanya , Abramsohn Emily M. , Beiser David G. , Chou Chiahung , Collier Nicholson , Huang Elbert S. , Macal Charles M. , Ozik Jonathan , Tung Elizabeth L.
Published: October 2021

CommunityRx (CRx), an information technology intervention, provides patients with a personalized list of healthful community resources (HealtheRx). In repeated clinical studies, nearly half of those who received clinical “doses” of the HealtheRx shared their information with others (“social doses”). Clinical trial design cannot fully capture the impact of information diffusion, which can act as a force multiplier for the intervention. Furthermore, experimentation is needed to understand how intervention delivery can optimize social spread under varying circumstances. To study information diffusion from CRx under varying conditions, we built an agent-based model (ABM). This study describes the model building process and illustrates how an ABM provides insight about information diffusion throughin silicoexperimentation. To build the ABM, we constructed a synthetic population (“agents”) using publicly-available data sources. Using clinical trial data, we developed empirically-informed processes simulating agent activities, resource knowledge evolution and information sharing. Using RepastHPC and chiSIM software, we replicated the interventionin silico, simulated information diffusion processes, and generated emergent information diffusion networks. The CRx ABM was calibrated using empirical data to replicate the CRx interventionin silico. We used the ABM to quantify information spread via social versus clinical dosing then conducted information diffusion experiments, comparing the social dosing effect of the intervention when delivered by physicians, nurses or clinical clerks. The synthetic population (N = 802,191) exhibited diverse behavioral characteristics, including activity and knowledge evolution patterns.In silicodelivery of the intervention was replicated with high fidelity. Large-scale information diffusion networks emerged among agents exchanging resource information. Varying the propensity for information exchange resulted in networks with different topological characteristics. Community resource information spread via social dosing was nearly 4 fold that from clinical dosing alone and did not vary by delivery mode. This study, using CRx as an example, demonstrates the process of building and experimenting with an ABM to study information diffusion from, and the population-level impact of, a clinical information-based intervention. While the focus of the CRx ABM is to recreate the CRx interventionin silico, the general process of model building, and computational experimentation presented is generalizable to other large-scale ABMs of information diffusion.
Development of a novel real-time polymerase chain reaction assay for the sensitive detection of Schistosoma japonicum in human stool
Authors: Halili Sara , Grant Jessica R. , Pilotte Nils , Gordon Catherine A. , Williams Steven A.
Published: October 2021

Background

Elimination and control of Schistosoma japonicum, the most virulent of the schistosomiasis-causing blood flukes, requires the development of sensitive and specific diagnostic tools capable of providing an accurate measurement of the infection prevalence in endemic areas. Typically, detection of S. japonicum has occurred using the Kato-Katz technique, but this methodology, which requires skilled microscopists, has been shown to radically underestimate levels of infection. With the ever-improving capabilities of next-generation sequencing and bioinformatic analysis tools, identification of satellite sequences and other highly repetitive genomic elements for use as real-time PCR diagnostic targets is becoming increasingly common. Assays developed using these targets have the ability to improve the sensitivity and specificity of results for epidemiological studies that can in turn be used to inform mass drug administration and programmatic decision making.

Methodology/Principal findings

Utilizing Tandem Repeat Analyzer (TAREAN) and RepeatExplorer2, a cluster-based analysis of the S. japonicum genome was performed and a tandemly arranged genomic repeat, which we named SjTR1 (Schistosoma japonicum Tandem Repeat 1), was selected as the target for a real-time PCR diagnostic assay. Based on these analyses, a primer/probe set was designed and the assay was optimized. The resulting real-time PCR test was shown to reliably detect as little as 200 ag of S. japonicum genomic DNA and as little as 1 egg per gram of human stool. Based on these results, the index assay reported in this manuscript is more sensitive than previously published real-time PCR assays for the detection of S. japonicum.

Conclusions/Significance

The extremely sensitive and specific diagnostic assay described in this manuscript will facilitate the accurate detection of S. japonicum, particularly in regions with low levels of endemicity. This assay will be useful in providing data to inform programmatic decision makers, aiding disease control and elimination efforts.