bluuebunny/crossref_metadata_2025 huggingface dataset:
Mortality of major cardiovascular emergencies among patients admitted to hospitals on weekends as compared with weekdays in Taiwan
Authors: Lai Chao-Lun , Kuo Raymond Nien-Chen , Wang Ting-Chuan , Chan K. Arnold
Published: July 2021

Background

Several studies have found a so-called weekend effect that patients admitted at the weekends had worse clinical outcomes than patients admitted at the weekdays. We performed this retrospective cohort study to explore the weekend effect in four major cardiovascular emergencies in Taiwan.

Methods

The Taiwan National Health Insurance (NHI) claims database between 2005 and 2015 was used. We extracted 3811 incident cases of ruptured aortic aneurysm, 184,769 incident cases of acute myocardial infarction, 492,127 incident cases of ischemic stroke, and 15,033 incident cases of pulmonary embolism from 9,529,049 patients having at least one record of hospitalization in the NHI claims database within 2006 ~ 2014. Patients were classified as weekends or weekdays admission groups. Dates of in-hospital mortality and one-year mortality were obtained from the Taiwan National Death Registry.

Results

We found no difference in in-hospital mortality between weekend group and weekday group in patients with ruptured aortic aneurysm (45.4% vs 45.3%, adjusted odds ratio [OR] 1.01, 95% confidence interval [CI] 0.87–1.17, p = 0.93), patients with acute myocardial infarction (15.8% vs 16.2%, adjusted OR 0.98, 95% CI 0.95–1.00, p = 0.10), patients with ischemic stroke (4.1% vs 4.2%, adjusted OR 0.99, 95% CI 0.96–1.03, p = 0.71), and patients with pulmonary embolism (14.6% vs 14.6%, adjusted OR 1.02, 95% CI 0.92–1.15, p = 0.66). The results remained for 1 year in all the four major cardiovascular emergencies.

Conclusions

We found no difference in either short-term or long-term mortality between patients admitted on weekends and patients admitted on weekdays in four major cardiovascular emergencies in Taiwan.
The impact of audit and feedback to support change behaviour in healthcare organisations - a cross-sectional qualitative study of primary care centre managers
Authors: Glenngård Anna H. , Anell Anders
Published: July 2021

Background

This article addresses the role of audit and feedback (A&F) to support change behaviour and quality improvement work in healthcare organisations. It contributes to the sparse literature on primary care centre (PCC) managers´ views on A&F practices, taking into account the broad scope of primary care. The purpose was to explore if and how different types of A&F support change behaviour by influencing different forms of motivation and learning, and what contextual facilitators and barriers enable or obstruct change behaviour in primary care.

Methods

A qualitative research approach was used. We explored views about the impact of A&F across managers of 27 PCCs, in five Swedish regions, through semi-structured interviews. A purposeful sampling was used to identify both regions and PCC managers, in order to explore multiple perspectives. We used the COM-B framework, which describes how Capability, Opportunity and Motivation interact and generate change behaviour and how different factors might act as facilitators or barriers, when collecting and analysing data.

Results

Existing forms of A&F were perceived as coercive top-down interventions to secure adherence to contractual obligations, financial targets and clinical guidelines. Support to bottom-up approaches and more complex change at team and organisational levels was perceived as limited. We identified five contextual factors that matter for the impact of A&F on change behaviour and quality improvement work: performance of organisations, continuity in staff, size of organisations, flexibility in leadership and management, and flexibility offered by the external environment.

Conclusions

External A&F, perceived as coercive by recipients of feedback, can have an impact on change behaviour through ‘know-what’ and ‘know-why’ types of knowledge and ‘have-to’ commitment but provide limited support to complex change. ‘Want-to’ commitment and bottom-up driven processes are important for more complex change. Similar to previous research, identified facilitators and barriers of change consisted of factors that are difficult to influence by A&F activities. Future research is needed on how to ensure co-development of A&F models that are perceived as legitimate by health care professionals and useful to support more complex change.
A model for measuring healthcare accessibility using the behavior of demand: a conditional logit model-based floating catchment area method
Authors: Jang Hoon
Published: July 2021

Background

Estimating realistic access to health services is essential for designing support policies for healthcare delivery systems. Many studies have proposed a metric to calculate accessibility. However, patients’ realistic willingness to use a hospital was not explicitly considered. This study aims to derive a new type of potential accessibility that incorporates a patient’s realistic preference in selecting a hospital.

Methods

This study proposes a floating catchment area (FCA)-type metric combined with a discrete choice model. Specifically, a new FCA-type metric (clmFCA) was proposed using a conditional logit model. Such a model estimates patients’ realistic willingness to use health services. The proposed metric was then applied to calculate the accessibility of obstetric care services in Korea.

Results

The clmFCA takes advantage of patients’ realistic preferences. Specifically, it can represent each patient’s heterogeneous characteristics regarding hospital choice. Such characteristics include bypassing behavior, which could not be considered using prior FCA metrics. Empirical analysis reveals that the clmFCA avoids the misestimation of accessibility to health services to an extent.

Conclusions

The clmFCA offers a new framework that more realistically estimates patients’ accessibility to health services. This is achieved by accurately estimating the potential demand for a service. The proposed method’s effectiveness was verified through a case study using nationwide data.
The association between polymorphisms near TMEM18 and the risk of obesity: a meta-analysis
Authors: Koj Natalia , Grochowalski Łukasz , Jarczak Justyna , Wójtowicz Weronika , Sobalska-Kwapis Marta , Słomka Marcin , Marciniak Błażej , Strapagiel Dominik
Published: July 2021

Background

Many studies have proposed that the pathogenesis of obesity has a genetic basis, with an important risk factor being the presence of polymorphisms in the region of theTMEM18gene, which plays a significant role in feeding behaviour; however, subsequent studies among different ethnic populations and age groups have shown inconsistent results. Therefore, this present meta-analysis examines the relationship betweenTMEM18polymorphisms with the risk of obesity with regard to age group and ethnic population.

Methods

A literature database search was conducted for available relevant studies investigating the association between obesity risk and the presence of rs6548238, rs4854344, rs11127485, rs2867125 and rs7561317 polymorphisms inTMEM18. Pooled odds ratio (OR) and 95% confidence intervals (95% CI) were calculated by either a fixed-effects model or random effect model based on a heterogeneity test. The meta-analysis of rs6548238 and its surrogates examined the relationships between 53 395 obesity cases and 123 972 healthy controls from 27 studies and published data from the POPULOUS collection (Poland).

Results

A significant association is observed between rs6548238 (and surrogate) and obesity risk, with OR = 1.25 (95% CI: 1.08–1.45). Regarding population type, a significant association was revealed among groups of Europeans with OR = 1.32 (1.10–1.59) and Mexicans with OR = 1.39 (1.13–1.73). However, a lack of statistical significance was noticed in groups in Asia with OR = 1.11 (95% CI: 0.86–1.42). Regarding age, a significant association was observed among children with OR = 1.28 (95% CI: 1.18–1.39) but not in adults OR = 1.21 (95% CI: 0.92–1.58).

Conclusions

The polymorphisms nearTMEM18appear to play a role in the development of obesity. Our findings indicate that differences exist between ethnic populations and age groups, supporting those of a previous study showing the various effects of genetic factors on age and ethnic groups.
Job preferences of undergraduate pharmacy students in China: a discrete choice experiment
Authors: Liu Ping , Liu Shimeng , Gong Tiantian , Li Quan , Chen Gang , Li Shunping
Published: July 2021

Background

Pharmacists are a crucial part of the health workforce and play an important role in achieving universal health coverage. In China, pharmaceutical human resources are in short supply, and the distribution is unequal. This study aimed to identify the key job characteristics that influence the job preferences of undergraduate pharmacy students and to elicit the relative importance of different job characteristics to shed light on future policy interventions.

Methods

A discrete choice experiment was conducted to assess the job preferences of undergraduate pharmacy students from 6 provinces in mainland China. A face-to-face interview was used to collect data. Conditional logit and mixed logit models were used to analyse data, and the final model was chosen according to the model fit statistics. A series of policy simulations was also conducted.

Results

In total, 581 respondents completed the questionnaire, and 500 respondents who passed the internal consistency test were analysed. All attributes were statistically significant except for open management. Monthly income and work location were most important to respondents, followed by work unit (which refers to the nature of the workplace) and years to promotion. There was preference heterogeneity among respondents, e.g., male students preferred open management, and female students preferred jobs in public institutions. Furthermore, students with an urban background or from a single-child family placed higher value on a job in the city compared to their counterparts.

Conclusion

The heterogeneity of attributes showed the complexity of job preferences. Both monetary and nonmonetary job characteristics significantly influenced the job preferences of pharmacy students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both incentives on the job itself and the background of pharmacy school graduates.
Muscle-strengthening activities and cancer incidence and mortality: a systematic review and meta-analysis of observational studies
Authors: Nascimento Wilson , Ferrari Gerson , Martins Camila Bertini , Rey-Lopez Juan Pablo , Izquierdo Mikel , Lee Dong Hoon , Giovannucci Edward L. , Rezende Leandro F. M.
Published: July 2021

Background

Physical activity has been associated with reduced risk of seven types of cancer. It remains unclear, however, whether muscle-strengthening activities also reduce cancer incidence and mortality.

Methods

PubMed, Embase, Web of Science and Scopus were searched from inception to March 2020. Summary hazard ratio (HR) and 95% confidence intervals (CI) were estimated using random-effects models.

Results

Twelve studies (11 cohorts; 1 case-control), 6 to 25 years of follow-up, including 1,297,620 participants, 32,196 cases and 31,939 deaths, met inclusion criteria. Muscle-strengthening activities were associated with a 26% lower incidence of kidney cancer (HR for high vs low levels of muscle-strengthening activities: 0.74; 95% CI 0.56 to 0.98; I2 0%; 2 studies), but not with incidence of other 12 types of cancer. Muscle-strengthening activities were associated with lower total cancer mortality: HRs for high vs low levels of muscle-strengthening activities was 0.87 (95% CI 0.73 to 1.02; I2 58%; 6 studies); and HR for ≥2 times/week vs < 2 times/week of muscle-strengthening activities was 0.81 (95% CI 0.74 to 0.87; I2 0%; 4 studies). Regarding the weekly duration of muscle-strengthening activities, HR for total cancer mortality were 0.91 (95% CI 0.82 to 1.01; I2 0%; 2 studies) for 1–59 min/week and 0.98 (95% CI 0.89 to 1.07; I2 0%) for ≥60 min/week vs none. Combined muscle-strengthening and aerobic activities (vs none) were associated with a 28% lower total cancer mortality (HR 0.72; 95% CI 0.53 to 0.98; I2 85%; 3 studies).

Conclusions

Muscle-strengthening activities were associated with reduced incidence of kidney cancer and total cancer mortality. Combined muscle-strengthening and aerobic activities may provide a greater reduction in total cancer mortality.
High-intensity activity is more strongly associated with metabolic health in children compared to sedentary time: a cross-sectional study of the I.Family cohort
Authors: Fridolfsson Jonatan , Buck Christoph , Hunsberger Monica , Baran Joanna , Lauria Fabio , Molnar Denes , Moreno Luis A. , Börjesson Mats , Lissner Lauren , Arvidsson Daniel ,   on behalf of the I.Family consortium
Published: July 2021

Background

Physical activity (PA) during childhood is important for preventing future metabolic syndrome (MetS). To examine the relationship between PA and MetS in more detail, accurate measures of PA are needed. Previous studies have only utilized a small part of the information available from accelerometer measured PA. This study investigated the association between measured PA and MetS in children with a new method for data processing and analyses that enable more detailed interpretation of PA intensity level.

Methods

The association between PA pattern and risk factors related to MetS was investigated in a cross- sectional sample of children (n = 2592, mean age 10.9 years, 49.4% male) participating in the European multicenter I. Family study. The risk factors examined include body mass index, blood pressure, high-density lipoprotein cholesterol, insulin resistance and a combined risk factor score (MetS score). PA was measured by triaxial accelerometers and raw data was processed using the 10 Hz frequency extended method (FEM). The PA output was divided into an intensity spectrum and the association with MetS risk factors was analyzed by partial least squares regression.

Results

PA patterns differed between the European countries investigated, with Swedish children being most active and Italian children least active. Moderate intensity physical activity was associated with lower insulin resistance (R2 = 2.8%), while vigorous intensity physical activity was associated with lower body mass index (R2 = 3.6%), MetS score (R2 = 3.1%) and higher high-density lipoprotein cholesterol (R2 = 2.3%). PA of all intensities was associated with lower systolic- and diastolic blood pressure, although the associations were weaker than for the other risk factors (R2 = 1.5% and R2 = 1.4%). However, the multivariate analysis implies that the entire PA pattern must be considered. The main difference in PA was observed between normal weight and overweight children.

Conclusions

The present study suggests a greater importance of more PA corresponding to an intensity of at least brisk walking with inclusion of high-intense exercise, rather than a limited time spent sedentary, in the association to metabolic health in children. The methods of data processing and statistical analysis enabled accurate analysis and interpretation of the health benefits of high intensity PA that have not been shown previously.
The landscape of gene co-expression modules correlating with prognostic genetic abnormalities in AML
Authors: Guo Chao , Gao Ya-yue , Ju Qian-qian , Zhang Chun-xia , Gong Ming , Li Zhen-ling
Published: July 2021

Background

The heterogenous cytogenetic and molecular variations were harbored by AML patients, some of which are related with AML pathogenesis and clinical outcomes. We aimed to uncover the intrinsic expression profiles correlating with prognostic genetic abnormalities by WGCNA.

Methods

We downloaded the clinical and expression dataset from BeatAML, TCGA and GEO database. Using R (version 4.0.2) and ‘WGCNA’ package, the co-expression modules correlating with the ELN2017 prognostic markers were identified (R2 ≥ 0.4, p < 0.01). ORA detected the enriched pathways for the key co-expression modules. The patients in TCGA cohort were randomly assigned into the training set (50%) and testing set (50%). The LASSO penalized regression analysis was employed to build the prediction model, fitting OS to the expression level of hub genes by ‘glmnet’ package. Then the testing and 2 independent validation sets (GSE12417 and GSE37642) were used to validate the diagnostic utility and accuracy of the model.

Results

A total of 37 gene co-expression modules and 973 hub genes were identified for the BeatAML cohort. We found that 3 modules were significantly correlated with genetic markers (the ‘lightyellow’ module for NPM1 mutation, the ‘saddlebrown’ module for RUNX1 mutation, the ‘lightgreen’ module for TP53 mutation). ORA revealed that the ‘lightyellow’ module was mainly enriched in DNA-binding transcription factor activity and activation of HOX genes. The ‘saddlebrown’ module was enriched in immune response process. And the ‘lightgreen’ module was predominantly enriched in mitosis cell cycle process. The LASSO- regression analysis identified 6 genes (NFKB2, NEK9, HOXA7, APRC5L, FAM30A and LOC105371592) with non-zero coefficients. The risk score generated from the 6-gene model, was associated with ELN2017 risk stratification, relapsed disease, and prior MDS history. The 5-year AUC for the model was 0.822 and 0.824 in the training and testing sets, respectively. Moreover, the diagnostic utility of the model was robust when it was employed in 2 validation sets (5-year AUC 0.743–0.79).

Conclusions

We established the co-expression network signature correlated with the ELN2017 recommended prognostic genetic abnormalities in AML. The 6-gene prediction model for AML survival was developed and validated by multiple datasets.
Suicidal behaviour after first-episode psychosis: results from a 1-year longitudinal study in Portugal
Authors: Coentre Ricardo , Fonseca Alexandra , Mendes Tiago , Rebelo Ana , Fernandes Elisabete , Levy Pedro , Góis Carlos , Figueira Maria Luísa
Published: July 2021

Background

Suicide is one of the main causes of excess of premature death in psychotic patients. Published studies found that suicide risk begins in ultra-high risk of psychosis and continues in early years of the disease. Previous studies identifying predictive and risk factors associated with suicidality in first-episode psychosis (FEP) are highly inconsistent. Also, there are relatively few longitudinal studies on suicidal behaviour in FEP. The aim of this study was to examine prevalence, evolution and predictors of suicidal behaviour at baseline and the 12-month follow-up in patients presenting with FEP.

Methods

One hundred and eighteen patients presenting with FEP were recruited from two early psychosis units in Portugal. A comprehensive assessment examining socio-demographic and clinical characteristics was administered at baseline and the 12-month follow-up. Odds ratio were calculated using logistic regression analyses. McNemar test was used to evaluate the evolution of suicidal behaviour and depression prevalence from baseline to 12 months of follow-up.

Results

Follow-up data were available for 60 participants from the 118 recruited. Approximately 25.4% of the patients had suicidal behaviour at the baseline evaluation, with a significant reduction during the follow-up period to 13.3% (p = 0.035). A multivariate binary logistic regression showed that a history of suicidal behaviour and depression at baseline independently predicted suicidal behaviour at baseline, and a history of suicidal behaviour and low levels of total cholesterol predicted suicidal behaviour at the 12-month follow-up. A significant proportion of patients also had depression at the baseline evaluation (43.3%), with the last month of suicidal behaviour at baseline independently predicting depression at this time.

Conclusions

The findings of our study indicate that suicidal behaviour was prevalent on the year after FEP. Patients with a history of suicidal behaviour, depression at baseline and low levels of cholesterol should undergo close evaluation, monitoring and possible intervention in order to reduce suicide risk in the early phases of psychosis.
Methodology: non-invasive monitoring system based on standing wave ratio for detecting water content variations in plants
Authors: Yang Yunjeong , Kim Ji Eun , Song Hak Jin , Lee Eun Bin , Choi Yong-Keun , Jo Jeong Wook , Jeon Hyeon Jin , Kim Ho Hyun , Kim Kwang Jin , Kim Hyung Joo
Published: July 2021

Background

Water content variation during plant growth is one of the most important monitoring parameters in plant studies. Conventional parameters (such as dry weight) are unreliable; thus, the development of rapid, accurate methods that will allow the monitoring of water content variation in live plants is necessary. In this study, we aimed to develop a non-invasive, radiofrequency-based monitoring system to rapidly and accurately detect water content variation in live plants. The changes in standing wave ratio (SWR) caused by the presence of stem water and magnetic particles in the stem water flow were used as the basis of plant monitoring systems.

Results

The SWR of a coil probe was used to develop a non-invasive monitoring system to detect water content variation in live plants. When water was added to the live experimental plants with or without illumination under drought conditions, noticeable SWR changes at various frequencies were observed. When a fixed frequency (1.611 GHz) was applied to a single experimental plant (Radermachera sinica), a more comprehensive monitoring, such as water content variation within the plant and the effect of illumination on water content, was achieved.

Conclusions

Our study demonstrated that the SWR of a coil probe could be used as a real-time, non-invasive, non-destructive parameter for detecting water content variation and practical vital activity in live plants. Our non-invasive monitoring method based on SWR may also be applied to various plant studies.
A case report of primary pulmonary meningioma masquerading as lung metastasis in a patient with rectal carcinoma: role of 18F-FDG PET/CT
Authors: Jiang Maoqing , Chen Ping , Huang Rong , Zhang Jingfeng , Zheng Jianjun
Published: July 2021

Background

Primary pulmonary meningioma (PPM) is an extremely rare disease, which is often misdiagnosed as lung metastasis. Previous studies indicated that PPM usually showed homogeneous enhancement on enhanced CT and high uptake of 18F-fluorodeoxyglucose (18F-FDG) on positron emission tomography/CT (PET/CT). In this study, we report a case of PPM with atypical enhanced CT and 18F-FDG PET/CT features in a patient with rectal carcinoma.

Case presentation

A 70-year-old male was demonstrated to have rectal carcinoma by biopsy while a solitary pulmonary nodule (SPN) with well-defined edges measuring 13 × 13 × 15 mm was almost simultaneously found in the right lower robe on chest CT scan. Contrast-enhanced CT and PET/CT revealed mild centripetal enhancement of the nodule without accumulation of 18F-FDG. A thoracoscopic wedge resection of the right lower lobe was finally performed and histopathologic examinations and PET/CT imaging showed that the nodule was a PPM.

Conclusion

PPM is a rare disease with heterogeneity not only in blood supply but also in glucose metabolism. 18F-FDG PET/CT may be an effective method for differentiating benign and malignant SPNs. The diagnosis of PPM depends on pathological and radiological examinations.
Using infographics to improve trust in science: a randomized pilot test
Authors: Agley Jon , Xiao Yunyu , Thompson Esi E. , Golzarri-Arroyo Lilian
Published: July 2021

Objective

This study describes the iterative process of selecting an infographic for use in a large, randomized trial related to trust in science, COVID-19 misinformation, and behavioral intentions for non-pharmaceutical prevenive behaviors. Five separate concepts were developed based on underlying subcomponents of ‘trust in science and scientists’ and were turned into infographics by media experts and digital artists. Study participants (n = 100) were recruited from Amazon’s Mechanical Turk and randomized to five different arms. Each arm viewed a different infographic and provided both quantitative (narrative believability scale and trust in science and scientists inventory) and qualitative data to assist the research team in identifying the infographic most likely to be successful in a larger study.

Results

Data indicated that all infographics were perceived to be believable, with means ranging from 5.27 to 5.97 on a scale from one to seven. No iatrogenic outcomes were observed for within-group changes in trust in science. Given equivocal believability outcomes, and after examining confidence intervals for data on trust in science and then the qualitative responses, we selected infographic 3, which addressed issues of credibility and consensus by illustrating changing narratives on butter and margarine, as the best candidate for use in the full study.
FAIR chemical structures in the Journal of Cheminformatics
Authors: Schymanski Emma L. , Bolton Evan E.
Published: July 2021

The ability to access chemical information openly is an essential part of many scientific disciplines. The Journal of Cheminformatics is leading the way for rigorous, open cheminformatics in many ways, but there remains room for improvement in primary areas. This letter discusses how both authors and the journal alike can help increase the FAIRness (Findability, Accessibility, Interoperability, Reusability) of the chemical structural information in the journal. A proposed chemical structure template can serve as an interoperable Additional File format (already accessible), made more findable by linking the DOI of this data file to the article DOI metadata, supporting further reuse.
Borderline personality disorder (BPD) and attention deficit hyperactivity disorder (ADHD) revisited – a review-update on common grounds and subtle distinctions
Authors: Ditrich Ismene , Philipsen Alexandra , Matthies Swantje
Published: July 2021

Background

Overlap in symptom domains particularly in the field of impulsivity and emotional dysregulation in attention deficit hyperactivity disorder (ADHD) and borderline personality disorder (BPD) have stimulated further research activities since our last review from 2014.

Main body

Disentangling features of impulsivity in ADHD and BPD revealed that impulsivity is a feature of both disorders with patients suffering from both ADHD and BPD having highest impulsivity ratings. BPD individuals have more problems using context cues for inhibiting responses and their impulsivity is stress-dependent, whereas ADHD patients have more motor impulsivity and therefore difficulties interrupting ongoing responses. For emotion regulation difficulties the ranking order ranges from ADHD to BPD to the comorbid condition, again with the patients suffering from both, ADHD and BPD, having the most pronounced emotion regulation problems.

Environmental influences namely adverse childhood events were shown to be linked to both ADHD and BPD. Traumatic experiences seem independently linked to impulsivity features. Thus, some authors point to the risk of misdiagnosis during childhood and the necessity to screen for traumatic experiences in both patient groups.

Genetic research confirmed genetic overlap of BPD with bipolar disorder (BD) and schizophrenic disorders, as well as genetic overlap of BD and ADHD. A population-based study confirmed the high co-occurrence and familial co-aggregation of ADHD and BPD. Interesting questions in the field of gene-environment-interactions are currently dealt with by genetic and epigenetic research.

Few studies have investigated treatment strategies for the comorbid condition, though the issue is highly important for the management of patients suffering from both disorders and presenting with the highest symptom scores.

Conclusion

Research on the different impulsivity features might point to a necessity of disorder-specific treatment strategies in the field of impulse control. Future research is needed to base treatment decisions for the comorbid condition on an evidence basis.
Aeromagnetic survey in Kusatsu-Shirane volcano, central Japan, by using an unmanned helicopter
Authors: Koyama Takao , Kanda Wataru , Utsugi Mitsuru , Kaneko Takayuki , Ohminato Takao , Watanabe Atsushi , Tsuji Hiroshi , Nishimoto Taro , Kuvshinov Alexey , Honda Yoshiaki
Published: July 2021

Kusatsu-Shirane volcano is one of the active volcanoes in Japan. Phreatic explosions occurred in Mt. Shirane in 1983 and most recently, in 2018, in Mt. Motoshirane. Information on the subsurface structure is crucial for understanding the activity of volcanoes with well-developed hydrothermal systems where phreatic eruptions occur. Here, we report aeromagnetic surveys conducted at low altitudes using an unmanned helicopter. The survey aimed to obtain magnetic data at a high spatial resolution to map the magnetic anomaly and infer the magnetization intensity distribution in the region immediately after the 2018 Mt. Motoshirane eruption. The helicopter used in the survey was YAMAHA FAZER R G2, an autonomously driven model which can fly along a precisely programmed course. The flight height above the ground and a measurement line spacing were set to ~ 150 m and ~ 100 m, respectively, and the total flight distance was 191 km. The measured geomagnetic total intensity was found to vary by ~ 1000 nT peak-to-peak. The estimated magnetization intensity derived from measured data showed a 100 m thick magnetized surface layer with normal polarity, composed of volcanic deposits of recent activities. Underneath, a reverse-polarity magnetization was found, probably corresponding to the Takai lava flow in the Early Quaternary period (~ 1 Ma) mapped in the region. Our results demonstrate the cost-effectiveness and accuracy of using drone magnetometers for mapping the rugged terrain of volcanoes.
Mvda is required for zebrafish early development
Authors: Wong Wenghong , Huang Yike , Wu Zhuanbin , Kong Yu , Luan Jing , Zhang Qiaoan , Pan Jiewen , Yan Kexiang , Zhang Zhenghua
Published: July 2021

Background

TheMVDgene mutations are identified in porokeratosis, which is considered a skin-specific autoinflammatory keratinization disease. However, the biological function ofMVDgene remains largely unknown. Therefore, we analyzed the function of mvdagene, orthologous to the humanMVDgene, in developing zebrafish.

Methods

Morpholino antisense oligonucleotide technique was used to generatemvdaloss-of-function phenotypes. Knockdown ofmvdawas confirmed by RT-PCR and Sanger sequencing. Scanning and transmission electron microscopy were performed to analyze the morphology of the epidermis. Angiogenesis study was presented using theTg(fli1a:EGFP)y1transgenic strain. In addition, acridine orange staining was used to examine the apoptotic cells in vivo.

Results

As expected, themvdamorphants showed abnormal morphology of the epidermis. Moreover, we observed ectopic sprouts in trunk angiogenesis and impaired formation of the caudal vein plexus in themvda-deficient zebrafish. Besides, increased apoptosis was found throughout the tail, heart, and eyes inmvdazebrafish morphants.

Conclusions

These findings indicated the essential role ofmvdain the early development of zebrafish. This was the first in vivo knockdown study of the zebrafishmvdagene, which might offer insight into the biological function of the humanMVDgene.
Cluster seizures and status epilepticus in new onset seizures among adult Egyptians
Authors: Mahmoud Mahmoud Hemeida , Awad Eman Mahmoud , Mohamed Ahmed Khalil , Shafik Mohamed Ahmed
Published: July 2021

Background

New onset seizure (NOS) is defined as the first seizure within a 24-h period ever experienced by the patient. Cluster seizures (CS) or status epilepticus (SE) can be the first manifestation of epilepsy or it may be a symptom of a brain tumor, a systemic disorder, an infection, or a syndrome. This study aims to determine the etiology of CS and SE in NOS among adult Egyptians. One hundred twenty adult Egyptian patients presented with NOS were enrolled in a hospital-based cross-sectional observational study within a time period of 6 months from March till September 2018. All patients were subjected to neurological examination including mini mental status examination, laboratory, neuroimaging, and electroencephalogram.

Results

Among 120 adult patients presented with NOS, males were prevalent (63%). Older adults (> 55 years) were prevalent (60%). Of the patients, 25% presented by CS, while 11% presented by SE. Post-stroke epilepsy (41%) was the predominant etiology of NOS. Cerebrovascular diseases (CVDs) were the prevalent etiology of SE in NOS (35%). NOS presented by CS were more prevalent among patients with brain tumors (29%) in comparison to CVDs (25%).

Conclusion

CS represented 25% of NOS in adult Egyptian patients. SE is prevalent among 11% of NOS. Despite CVDs being the most prevalent etiology of NOS in adult population (41%) including those presented with SE (35%), brain tumors are the most prevalent etiology of new onset CS (29%).
Socio-demographic status and 12 years trend of completed suicide in East Azerbaijan Province, Iran, during the period 2007–2018
Authors: Farahbakhsh Mostafa , Asgari Maryam Nejad , Aslrahimi Vahab , Hemmati Azam , Iranzad Ilnaz , Azizi Hosein
Published: July 2021

Background

The incidence rate of suicide has been increased in Iran over the past decades especially in East Azerbaijan Province which there are limited studies on suicide. We aimed to investigate the 12-year trend of suicide and demographic characteristics in East Azerbaijan Province during the period 2007–2018. We obtained the data on the suicide mortality and socio-demographic status from the Death Registry Information System (DRIS) and compared with legal medicine suicide statistics during the study period.

Results

A total of 2422 and 1783 suicide cases were reported by legal medicine and DRIS (average incidence rate 5.94 vs 4.4 per 100,000) in the 12-year period from 2007 to 2018, respectively. The suicide rate in males was more than two times that of females. The mean and median age of suicide was 34.07 and 31 years, respectively. The most common suicide method was hanging (51.9%). The incidence rate of suicide cases was decreasing between 2007 and 2014, however from 2015 to 2018 has been increased.

Conclusions

The incidence rate of suicide in this province has been increasing with a smooth slope. Community-based programs and measures should be taken to stop the growth rate of suicide.
COVID-19-associated rhino-orbital mucormycosis (CAROM)—a case report
Authors: Sethi Humsheer Singh , Sen Kamal Kumar , Mohanty Sudhansu Sekhar , Panda Sangram , Krishna Kolluru Radha , Mali Chayasmita
Published: July 2021

Background

There has been a rapid rise in the number of COVID-19-associated rhino-orbital mucormycosis (CAROM) cases especially in South Asian countries, to an extent that it has been considered an epidemic among the COVID-19 patients in India. As of May 13, 2021, 101 CAROM cases have been reported, of which 82 cases were from India and 19 from the rest of the world. On the other hand, pulmonary mucormycosis associated with COVID-19 has a much lesser reported incidence of only 7% of the total COVID-19-associated mucormycosis cases (Singh AK, Singh R, Joshi SR, Misra A, Diab Metab Syndr: Clin Res Rev, 2021). This case report attempts to familiarize the health care professionals and radiologists with the imaging findings that should alarm for follow-up and treatment in the lines of CAROM.

Case presentation

Rhino-orbital mucormycosis (ROM) is a manifestation of mucormycosis that is thought to be acquired by inhalation of fungal spores into the paranasal sinuses. Here, we describe a 55-year-old male, post COVID-19 status with long standing diabetes who received steroids and ventilator therapy for the management of the viral infection. Post discharge from the COVID-19 isolation ICU, the patient complained of grayish discharge from the right nostril and was readmitted to the hospital for the nasal discharge. After thorough radiological and pathological investigation, the patient was diagnosed with CAROM and managed.

Conclusion

Uncontrolled diabetes and imprudent use of steroids are both contributing factors in the increased number of CAROM cases. Our report emphasizes on the radiological aspect of CAROM and reinforces the importance of follow-up imaging in post COVID-19 infection cases with a strong suspicion of opportunistic infections.
Implementation for Sustained Impact in Teleophthalmology (I-SITE): applying the NIATx Model for tailored implementation of diabetic retinopathy screening in primary care
Authors: Torres Diaz Alejandra , Lock Loren J. , Molfenter Todd D. , Mahoney Jane E. , Boss Deanne , Bjelland Timothy D. , Liu Yao
Published: July 2021

Background

Teleophthalmology provides evidence-based, telehealth diabetic retinopathy screening that is underused even when readily available in primary care clinics. There is an urgent need to increase teleophthalmology use in the US primary care clinics. In this study, we describe the development of a tailored teleophthalmology implementation program and report outcomes related to primary care provider (PCP) adoption.

Methods

We applied the 5 principles and 10 steps of the NIATx healthcare process improvement model to develop and test I-SITE (Implementation for Sustained Impact in Teleophthalmology) in a rural, the US multi-payer health system. This implementation program allows patients and clinical stakeholders to systematically tailor teleophthalmology implementation to their local context. We aligned I-SITE components and implementation strategies to an updated ERIC (Expert Recommendations for Implementing Change) framework. We compared teleophthalmology adoption between PCPs who did or did not participate in various components of I-SITE. We surveyed PCPs and clinical staff to identify the strategies they believed to have the highest impact on teleophthalmology use.

Results

To test I-SITE, we initiated a year-long series of 14 meetings with clinical stakeholders (n=22) and met quarterly with patient stakeholders (n=9) in 2017. Clinical and patient stakeholder groups had 90.9% and 88.9% participant retention at 1 year, respectively. The increase in teleophthalmology use was greater among PCPs participating in the I-SITE implementation team than among other PCPs (p < 0.006). The proportion of all PCPs who used the implementation strategy of electing diabetic eye screening for their annual performance-based financial incentive increased from 0% (n=0) at baseline to 56% (n=14) following I-SITE implementation (p = 0.004). PCPs and clinical staff reported the following implementation strategies as having the highest impact on teleophthalmology use: reminders to ask patients about diabetic eye screening during clinic visits, improving electronic health record (EHR) documentation, and patient outreach.

Conclusions

We applied the NIATx Model to develop and test a teleophthalmology implementation program for tailored integration into primary care clinics. The NIATx Model provides a systematic approach to engaging key stakeholders for tailoring implementation of evidence-based telehealth interventions into their local context.
Are NCCN Resource-Stratified Guidelines for Breast Cancer Systemic Therapy Achievable? A Population-Based Study of Global Need and Economic Impact
Authors: Wilson Brooke E. , Jacob Susannah , Do Viet , Amir Eitan , Bray Freddie , Ferlay Jacques , Knaul Felicia M. , Elawawy Ahmed , Pearson Sallie-Anne , Barton Michael B.
Published: July 2021

PURPOSE

Resource-stratified guidelines (RSG) for cancer provide a hierarchy of interventions, based on resource availability. We quantify treatment need and cost if National Comprehensive Cancer Network (NCCN) RSGs for breast cancer (BC) are adopted globally.

METHODS

We developed decision trees for first-course systemic therapy, merged with SEER and Global Cancer Observatory 2018 incidence data to estimate treatment need and cost if NCCN RSG are implemented globally based on country-level income. Simulations were used to quantify need and cost of globally scaling up services to Maximal.

RESULTS

Based on NCCN RSG, first-course chemotherapy is indicated in 0% (Basic), 87% (Core), and 86% (Enhanced) but declined to 50% (Maximal) because of incorporation of genomic profiling. First-course endocrine therapy (ET) is indicated in 80% in all settings. In 2018, treatment need was 1.4 million people for chemotherapy, 183,943 for human epidermal growth factor receptor 2 (HER2) therapies and 1.6 million for ET. The cost per person for chemotherapy or HER2 or immunotherapy increased by 17-fold from Core to Maximal ($1,278-$22,313 Australian dollars [AUD]). The cost of ET per person rose eight-fold from Basic to Maximal ($1,236-$9,809 AUD). If all patients with BC globally were treated with Maximal resources, the need for chemotherapy would decline by 28%, whereas cost of first-course treatment would rise by 1.8-fold ($21-$37 billion AUD) because of more costly therapies.

CONCLUSION

NCCN RSGs for BC could result in chemotherapy overtreatment in Core and Enhanced settings. The absence of chemotherapy in Basic settings should be reconsidered, and future iterations of RSG should perform cross-tumor comparisons to ensure equitable resource distribution and maximize population-level outcomes. Our model is flexible and can be tailored to the costs, population attributes, and resource availability of any institution or country for health-services planning.
Health Care Utilization and Costs Associated With Systemic First-Line Metastatic Melanoma Therapies in the United States
Authors: van Boemmel-Wegmann Sascha , Brown Joshua D. , Diaby Vakaramoko , Huo Jinhai , Silver Natalie , Park Haesuk
Published: July 2021

PURPOSE:

US Food and Drug Administration approvals of immune checkpoint inhibitors and targeted therapies revolutionized the treatment of metastatic melanoma. Our aim was to assess health care resource utilization and costs for patients with metastatic melanoma treated with systemic therapies in first line between January 2012 and December 2017.

METHODS:

We conducted a retrospective cohort study of patients with metastatic melanoma using MarketScan data. We included patients diagnosed with melanoma and secondary malignant neoplasm who used pembrolizumab, nivolumab, ipilimumab, ipilimumab plus nivolumab, BRAF-inhibitor (BRAF-i) plus MEK inhibitor (MEK-i), BRAF-i or MEK-i monotherapy, or chemotherapy in first line. We compared health care utilization and costs per patient per month (PPPM) using two-part and generalized linear models.

RESULTS:

We identified 1,870 patients, including 185 pembrolizumab, 103 nivolumab, 689 ipilimumab, 185 nivolumab plus ipilimumab, 214 BRAF-i plus MEK-i, 240 BRAF-i or MEK-i monotherapy, and 254 chemotherapy users. Highest PPPM rates of hospitalizations, emergency room visits, and outpatient visits were observed in patients with ipilimumab plus nivolumab therapy (adjusted difference v pembrolizumab [aDiff], 0.18, 0.12, and 0.88, respectively; all P < .001). Ipilimumab monotherapy users (aDiff, 0.07 and 0.93; all P < .001) and chemotherapy users (aDiff, 0.10 and 2.63; all P < .001) showed higher PPPM rates of hospitalizations and outpatient visits compared with pembrolizumab users, respectively. Utilization rates in nivolumab, BRAF-i plus MEK-i, and BRAF-i or MEK-i groups were similar to the pembrolizumab group. Highest PPPM total costs and drug-related costs were observed in the ipilimumab group ($80,139 US dollars [USD] and $70,051 USD; all P < .001), followed by the ipilimumab plus nivolumab ($71,689 USD and $56,217 USD; all P < .001) and the BRAF-i plus MEK-i group ($31,184 USD and $19,648 USD; all P < .001). PPPM costs in the nivolumab group were similar to the pembrolizumab group.

CONCLUSION:

Significant differences in health care resource utilization and costs were found across first-line metastatic melanoma regimens. Utilization rates were highest in patients using ipilimumab-containing therapies. High drug costs constituted a major fraction of total PPPM health care costs.
Mammalian tracheal development and reconstruction: insights from in vivo and in vitro studies
Authors: Kishimoto Keishi , Morimoto Mitsuru
Published: July 2021

The trachea delivers inhaled air into the lungs for gas exchange. Anomalies in tracheal development can result in life-threatening malformations, such as tracheoesophageal fistula and tracheomalacia. Given the limitations of current therapeutic approaches, development of technologies for the reconstitution of a three-dimensional trachea from stem cells is urgently required. Recently, single-cell sequencing technologies and quantitative analyses from cell to tissue scale have been employed to decipher the cellular basis of tracheal morphogenesis. In this Review, recent advances in mammalian tracheal development and the generation of tracheal tissues from pluripotent stem cells are summarized.
Yorkie ensures robust tissue growth in Drosophila ribosomal protein mutants
Authors: Wada Yayoi , Ohsawa Shizue , Igaki Tatsushi
Published: July 2021

Heterozygosity of ribosomal protein genes causes a variety of developmental abnormalities in humans, which are collectively known as ribosomopathies, yet the underlying mechanisms remain elusive. Here, we analyzed Drosophila Minute (M)/+ mutants, a group of mutants heterozygous for ribosomal protein genes that exhibit a characteristic thin-bristle phenotype. We found that, although M/+ flies develop essentially normal wings, simultaneous deletion of one copy of the Hippo pathway effector yki resulted in severe wing growth defects. These defects were caused by JNK-mediated cell death in the wing pouch via Eiger/TNF signaling. The JNK activation in M/+, yki/+ wing discs required the caspase Dronc, which is normally blocked by DIAP1. Notably, heterozygosity of yki reduced DIAP1 expression in the wing pouch, leading to elevation of Dronc activity. Dronc and JNK formed a positive-feedback loop that amplifies Dronc activation, leading to apoptosis. Our observations suggest a mechanism of robust tissue growth whereby tissues with reduced ribosomal protein prevent ectopic apoptosis via Yki activity.
The energetics of social signaling during roost location in Spix's disc-winged bats
Authors: Chaverri Gloriana , Sandoval-Herrera Natalia Ivone , Iturralde-Pólit Paula , Romero-Vásquez Adarli , Chaves-Ramírez Silvia , Sagot Maria
Published: July 2021

Long-term social aggregations are maintained by multiple mechanisms, including the use of acoustic signals, which may nonetheless entail significant energetic costs. To date, however, no studies have gauged whether there are significant energetic costs to social call production in bats, which heavily rely on acoustic communication for a diversity of social tasks. We measured energetic expenditure during acoustic signaling in Spix's disc-winged bats (Thyroptera tricolor), a species that commonly uses contact calls to locate the ephemeral furled leaves that they use for roosting. To determine the cost of sound production, we measured oxygen consumption using intermittent-flow respirometry methods, with and without social signaling. Our results show that the emission of contact calls significantly increases oxygen consumption; vocal individuals spent, on average, 12.42 kJ more during social signaling trials than they spent during silent trials. We also found that as resting metabolic rate increased in males, there was a decreasing probability that they would emit response calls. These results provide support to the ‘allocation model’, which predicts that only individuals with lower self-maintenance costs can afford to spend energy in additional activities. Our results provide a step forward in our understanding of how physiology modulates behavior, specifically how the costs of call production and resting metabolic rate may explain the differences in vocal behavior among individuals.