bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation of spunlaced viscose/PANI-ZnO/GO fiber membrane and its performance of photocatalytic decolorization
Authors: Liu Suo , Hu Jinyan , Wu Dingsheng , Zeng Haiao , Zhou Tang , Yang Maohuan , Feng Quan
Published: April 2022

In order to solve the increasingly serious problem of printing and dyeing wastewater pollution, a kind of novel, efficient, and reusable spunlaced viscose/polyaniline-ZnO/GO fibrous membrane was fabricated in this work. Specifically, spunlaced viscose/polyaniline conductive fibrous membrane was firstly prepared by in-situ growth method, followed with the growth of zinc oxide (ZnO) and graphene oxide (GO) via the hydrothermal route to obtain spunlaced viscose/PANI-ZnO/GO fibrous membrane (SV@PANI-ZnO/GO membrane). The results show that the decolorization rate of SV@PANI-ZnO/GO membrane for methylene blue (5.0 mg/L) was 97.4% within 120 min, and the decolorization rate remained above 76.7% after five cycles. Moreover, the reaction process conformed to a quasi-first order kinetic model with the apparent rate constant of 0.0209 min–1. Meanwhile, the free radical capture experiment revealed that the main reactive species in the decolorization process was .OH. This work may provide a new method for designing photocatalytic materials for environmental applications.
Dream Time With Dad: Autoethnography as Ritual in the Time of COVID-19
Authors: Collins Christopher C.
Published: April 2022

The following autoethnography is a death ritual for my father. The ritual enacts my father’s process of artmaking and his request to preserve his story through an act of poiesis. The text constellates themes of generational psychic inheritance, polytheism, and an orientation toward death. These subjects are framed by the larger context of a global pandemic and a health care system under duress. Autoethnography as ritual provides a method for transforming relationships, integrating experiences of death, and honoring the life of the individual.
Articulating Apostasy: Crisis-Driven Medical Misbehavior Inspires Disciplinary Interrogation
Authors: Scott D. Travers
Published: April 2022

In this essay I address insights gained during pandemic isolation in contrast to core assumptions of my professional discipline of communication. Drawing on perspectives from feminist studies of health and medicine, disability studies, and queer studies, I examine my increased health and productivity during social distancing. This is followed by a revised excerpt of an essay written to colleagues during our annual meeting, which had moved online. I conclude interrogating the ideology of beneficent connectedness.
Performing Queer of Color Joy Through Collective Crisis: Resistance, Social Science, and How I Learned to Dance Again
Authors: Tristano Michael
Published: April 2022

Through the use performative writing and autoethnography, this piece reflects on the current state of collective crises and social science to reinvigorate our approaches to building more equitable futures. More specifically, I push back on the politics of violent visibility for marginalized subjects both inside and outside the academy. I argue that texts and images of minoritarian trauma and violence reify the structures of power that created those material conditions to begin with. Utilizing the process of queer of color worldmaking, I suggest that centering minoritarian joy becomes a tool for speaking back toward our current climate of collective crisis. The piece concludes displaying the potential of experiencing and writing through collective joy.
PaxlovidTM Information From FDA and Guidance for AES Members
Authors: Cokley Jon A. , Gidal Barry E. , Keller Joy A. , Vossler David G. ,   Reviewed and approved by the AES Treatments Committee and Council on Clinical Activities
Published: April 2022

This American Epilepsy Society (AES) official statement provides information and preliminary guidance to Society members related to the U.S. Food & Drug Administration (FDA) December 22, 2021 Emergency Use Authorization for Paxlovid™ for the oral treatment of mild to moderate COVID-19 in adults and children (≥12 years and weighing ≥40 kg). Paxlovid is likely to be widely prescribed, and important considerations for patients on antiseizure medications (ASMs) include key contraindications and potential toxicity or dose adjustments while taking Paxlovid. This statement highlights concerns and provides information about their pharmacologic basis. Of particular concern, concomitant use of Paxlovid with the ASMs carbamazepine, phenobarbital, phenytoin, and primidone is contraindicated, because they are strong inducers of the CYP3A4 isozyme that metabolizes Paxlovid and thereby could cause loss of virologic response and development of resistance. Alternate oral or intravenous COVID-19 treatments should be considered. A second concern is that Paxlovid may increase the plasma concentrations of many ASMs, because it inhibits the CYP3A4 isozyme. ASMs that are metabolized, at least in part, by CYP3A4 include cannabidiol, carbamazepine, clobazam, clonazepam, diazepam, ethosuximide, everolimus, felbamate, lacosamide, midazolam, oxcarbazepine, perampanel, stiripentol, tiagabine, and zonisamide. Patients receiving these medications may warrant closer monitoring while being treated with Paxlovid.
Acceptability by End-users of a Standardized Structured Format for Reporting EEG
Authors: Guerrero-Aranda Alioth , Friman-Guillen Henry , González-Garrido Andrés Antonio
Published: April 2022

The report of the electroencephalogram (EEG) results has traditionally been made using free-text formats with a huge variation in descriptions due to several factors. Recently, the International Federation of Clinical Neurophysiology (IFCN) endorsed the use of the Standardized Computer-based Organized Reporting of EEG (SCORE). This system has many advantages, but only some concerns have been investigated so far. This study aimed to assess the end-users acceptability of this proposed EEG report format. A 16-item electronic survey was sent to physicians who use EEG services of a medical diagnosis clinic. Physicians had been receiving the EEG reports in free-text formats from the same three board-certified electroencephalographers for the past three years. In January 2019, the report changed to the SCORE format. The survey assessed five main topics: physician information and historical use of EEG; personal preferences; comparative aspects of the formats; impact of the new format on clinical decision-making; and satisfaction. Thirty-two of 52 have responded to the survey (61%). On average, 81% of the responders have received enough reports with the new format to reliably complete the survey. Every responder prefers the standardized compared to the free-text format. Twenty-five responders like the inclusion of the head model, and interestingly, five suggest including another legend to differentiate “slow activity” from “other abnormal activity”. Virtually all responders would recommend the new format, but one-third read only the conclusion. Our findings suggest high acceptability of this standardized report format. Despite the limitations of this study, we hope these findings contribute to the improvement and expansion of standardized EEG reporting systems.
Should we adjudicate outcomes in stroke trials? A systematic review
Authors: Godolphin Peter J , Bath Philip M , Montgomery Alan A
Published: April 2022

Background:

Central adjudication of outcomes is common in randomized clinical trials in stroke. The rationale for adjudication is clear; centrally adjudicated outcomes should have less random and systematic errors than outcomes assessed locally by site investigators. However, adjudication brings added complexities to a clinical trial and can be costly.

Aim:

To assess the evidence for outcome adjudication in stroke trials.

Summary of review:

We identified 12 studies evaluating central adjudication in stroke trials. The majority of these were secondary analyses of trials, and the results of all of these would have remained unchanged had central adjudication not taken place, even for trials without sufficient blinding. The largest differences between site-assessed and adjudicator-assessed outcomes were between the most subjective outcomes, such as causality of serious adverse events. We found that the cost of adjudication could be upward of £100,000 for medium to large prevention trials. These findings suggest that the cost of central adjudication may outweigh the advantages it brings in many cases. However, through simulation, we found that only a small amount of bias is required in site investigators’ outcome assessments before adjudication becomes important.

Conclusion:

Central adjudication may not be necessary in stroke trials with blinded outcome assessment. However, for open-label studies, central adjudication may be more important.
Dietary patterns associated with stroke among West Africans: A case–control study
Authors: Okekunle Akinkunmi P , Asowata Osahon , Akpa Onoja M , Ovbiagele Bruce , Fakunle Adekunle , Komolafe Morenikeji , Arulogun Oyedunni , Sarfo Fred S , Akpalu Albert , Obiako Reginald , Wahab Kolawole , Osaigbovo Godwin , Owolabi Lukman , Ogbole Godwin , Akinyemi Joshua , Adeniyi Sunday , Calys-Tagoe Benedict , Aridegbe Mayowa , Adebowale Akintunde , Dambatta Hamisu , Agunloye Atinuke , Oyinloye Olalekan , Aderibigbe Adeniyi , Suleiman Isah , Adeoye Abiodun M , Akpalu Josephine , Agbogu-Ike Obiageli , Tiwari Hemant K , Arnett Donna , Akinyemi Rufus , Owolabi Mayowa O
Published: April 2022

Background:

The relationship of diet with stroke risk among Africans is not well understood.

Aim:

The aim of this study was to investigate the association between dietary patterns and stroke risk among West Africans.

Methods:

In this multi-center case–control study, 3684 stroke patients matched (for age and sex) with 3684 healthy controls were recruited from Nigeria and Ghana. Food consumption was assessed using a food frequency questionnaire, and dietary patterns were summarized using principal component analysis. Stroke was defined using predefined criteria primarily on clinical evaluation following standard guidelines. Conditional logistic regression was applied to compute odds ratio (OR) and 95% confidence interval (CI) for stroke risk by tertiles of dietary patterns adjusting for relevant confounders.

Results:

Overall, mean age was 59.0 ± 13.9 years, and 3992 (54.2%) were males. Seven dietary patterns were identified. Multivariable-adjusted OR (95% CI) for risk of stroke by second and third tertiles (using the lowest and first tertile as reference) of dietary patterns was 1.65 (1.43, 1.90) and 1.74 (1.51, 2.02), for “poultry product and organ meat”; 1.69 (1.47, 1.96) and 1.51 (1.31, 1.75) for “red meat”; 1.07 (0.92, 1.23) and 1.21 (1.04, 1.40) for “fried foods and sweetened drinks”; 0.69 (0.60, 0.80) and 0.45 (0.39, 0.53) for “vegetables”; 0.84 (0.72, 0.97) and 0.81 (0.70, 0.93) for “whole-grain and fruit drinks”; and 0.97 (0.84, 1.12) and 0.85 (0.73, 0.98) for “fruits” respectively ( p < 0.05).

Conclusion:

These data suggest that plant-based diets are associated with a lower risk of stroke and might be a beneficial dietary recommendation for the primary prevention of stroke among Africans.
European minimum wage: A Swedish perspective on EU’s competence in social policy in the wake of the proposed directive on adequate minimum wages in the EU
Authors: Sjödin Erik
Published: April 2022

The question of whether there can, may, and should be a lowest price for work performed by a human can be discussed from different perspectives. The President of the European Commission, Ursula von der Leyen, has unambiguously made it clear that the EU must take measures with regard to minimum wages. On October 28 2020, the Commission presented a proposal for a Directive on adequate minimum wages in the European Union.

The article is structured as follows. It begins with a brief description of the history of the proposal and a short presentation of its material content. This is followed by a discussion of the chosen legal basis in the Treaty and of whether the EU has the competence to adopt the proposal. I shall then analyse how it can be determined whether Sweden has transferred competence to the EU to adopt legislation regarding minimum wages. The article concludes with some comments on future developments as a result of the proposal for a Directive on adequate minimum wage in the European Union.
Renal inflammatory myofibroblastic tumour presenting with a large retroperitoneal abscess
Authors: Bandara Ginimal Bandaralage Kavinda Deshapriya , Jayarajah Umesh , Rodrigo Vitharanage Srimantha Dewsiri
Published: April 2022

Inflammatory myofibroblastic tumour arising from the kidney is a rare occurrence. In this case report, we present a rare case of inflammatory myofibroblastic tumour arising from the kidney diagnosed after the presentation with a large retroperitoneal abscess for the first time in literature. A 55-year-old woman with diabetes mellitus presented to us with painful lump in the left lumbar region of the back for 1-week duration. On examination, there was a firm, diffuse lump in the left lumbar region of the back. Her inflammatory markers were high, but the serum creatinine and blood urea were within the normal range. Abdominal ultrasonography showed a distorted left kidney with a heterogeneous mass consisting cystic and solid components measuring approximately 7 × 9 × 8 cm in size. A contrast-enhanced computed tomography scan showed an 11 × 9 × 9 cm-sized low-density mass posterior to the left kidney with multiple contrast-enhancing septations which appeared posterior to but separate from the left kidney within the left renal fascia. There was breeching of the Gerota’s fascia with extension posteriorly up to subcutaneous tissue. Since the radiological opinion was in favour of a complex perinephric abscess, open drainage of the abscess was performed after failed attempts of ultrasound-guided drainage. The biopsy of the abscess wall was suggestive of a renal cell carcinoma and radical nephrectomy was planned. Due to tumour invasion, the radical nephrectomy was combined with a splenectomy and the specimen sent for histology. It showed an inflammatory myofibroblastic tumour or pseudotumour with the periphery showing ulceration and abscess formation. The patient had an uneventful recovery following surgery. Thus, we report the first case of renal inflammatory myofibroblastic tumour presenting with a large retroperitoneal abscess extending to the subcutaneous tissue plane. Final diagnosis was made only after radical surgery which was curative.
Theoretical model and measurement of shared decision making in web-based pharmaceutical care consultation
Authors: Chen Haihong , Xiong Yuqi , Zhang Zinan , Zhou Qian , Wang Dan , Wang Xuemei , Zhang Xinping
Published: April 2022

Objectives

We aimed to construct a theoretical model and an observer-based measurement of shared decision making (SDM) in web-based pharmaceutical care consultation.

Methods

We first constructed a theoretical model through analysis of SDM models and interviews with 24 key informants. Then, the initial measurement was formulated, and the content was evaluated by 16 key informants alone. A cross-sectional study was executed, where 300 provider-patient encounters were collected at the online platform ‘Good Doctor Website’, for reliability and validity assessment. Content validity was evaluated by appropriateness score, that is the median of 7–9 and without disagreement. Interrater reliability was evaluated by Spearman correlation coefficient using 30 out of 300 samples. Single indicator validity was tested by Pearson correlation analysis, and convergent validity was evaluated by the Multiple Indicators Multiple Causes (MIMIC) model using 300 samples.

Results

Theoretical model constructed included four elements: ‘comprehensive understanding of the patient's condition’, ‘exchanging ideas on medication options’, ‘achieving a medication plan’, and ‘providing decision support’. Measurement constructed included four dimensions and 19 items, and four dimensions were in accordance with four elements of the theoretical model. We found median scores of these dimensions and items were 7–9 and without disagreement, indicating good content validity. Spearman correlation coefficients of 19 items were greater than 0.750, suggesting good interrater reliability. Pearson coefficients between 19 items and their external variables were significant ( p < 0.001), and MIMIC model results showed that the R2values of dimensions 1–4 were over 0.5, indicating good single indicator validity and convergent validity.

Conclusions

Characteristics of web-based pharmaceutical care consultation, highlighting the importance of medication history, medication regimen, and detailed medication plan, were observed in the theoretical model. Measurement constructed had good reliability and validity and may be used by health policymakers to improve the quality of pharmaceutical care consultation online.
Medial and Lateral Posterior Tibial Slope in the Skeletally Immature: A Cadaveric Study
Authors: Anchustegui Nicolas , Grimm Nathan L. , Milbrandt Todd A. , Rustad Audrey , Shea Cooper , Troyer Stockton , Dingel Aleksei B. , Ganley Theodore J. , Fabricant Peter D. , Shea Kevin G.
Published: April 2022

Background:

An increased posterior tibial slope (PTS) results in greater force on the anterior cruciate ligament (ACL) and is a risk factor for ACL injuries. Biomechanical studies have suggested that a reduction in the PTS angle may lower the risk of ACL injuries. However, the majority of these investigations have been in the adult population.

Purpose:

To assess the mean medial and lateral PTS on pediatric cadaveric specimens without known knee injuries.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 39 pediatric knee specimens with computed tomography scans were analyzed. Specimens analyzed were between the ages of 2 and 12 years. The PTS of each specimen was measured on sagittal computed tomography slices at 2 locations for the medial and lateral angles. The measurements were plotted graphically by age to account for the variability in development within age groups. The anterior medial and lateral tibial plateau widths were measured. The distance between the top of the tibial plateau and the physis was measured. The independent-samples t test and analysis of variance were used to analyze the measurements.

Results:

The mean PTS angle for the medial and lateral tibial plateaus was 5.53° ± 4.17° and 5.95° ± 3.96°, respectively. The difference between the PTS angles of the medial and lateral tibial plateaus was not statistically significant ( P > .05). When plotted graphically by age, no trend between age and PTS was identified.

Conclusion:

This data set offers values for the PTS in skeletally immature specimens without a history of ACL injury and suggests that age may not be an accurate predictive factor for PTS.
The Impact of an Acute Medical Unit in Internal Medicine on Resident Education
Authors: Ibrahim Halah , Mohamad Mohamad Kasem , Adi Abd Al Kareem , Kamour Ashraf M. , Harhara Thana
Published: April 2022

Background

Medical trainees are expected to provide care for increasingly sick and treatment intensive patients. To improve patient care, hospitals worldwide have developed acute medical units (AMUs), dedicated medical wards that provide care for patients during the first 24 to 72 hours of an emergency medical hospital admission. A distinguishing feature of these units is that they are supervised by senior clinicians and offer multidisciplinary patient-centered care. Little is known about the impact of AMUs on trainee supervision and education.

Methods

In this educational case study, we describe the evolution, process and structure of our AMU service. We also provide resident and teaching faculty perceptions of the impact of this intervention on education and supervision.

Results

Questionnaire results showed that residents and teaching attendings believed that supervision and education were improved on the AMU, as compared to the traditional medical ward model. Residents also felt that their knowledge and clinical skills in managing acute patients improved. Procedure skills were less impacted by the intervention. A small number of residents believed that the AMU model worsened supervision and education.

Conclusion

Integrating medical trainees into an AMU allowed for early evaluation and input from senior clinicians and increased opportunities to work in and learn from multidisciplinary teams, contributing to improved resident supervision and education. Future studies are needed to assess the long-term impact of the AMU on educational outcomes.
Phenolic Compounds, Dyeing Potential, and Cytotoxic Activity ofAlkanna orientalisL. Boiss (Boraginaceae)
Authors: Yaglıoglu Ayse Sahin , Eser Ferda , Dolarslan Melda
Published: April 2022

Dyeing of cotton, viscose, wool, and polyester/viscose blended fabrics has been carried out with the aqueous extract of the roots of Alkanna orientalis plant. Fastness properties and color strength values were investigated in terms of users. Phenolic compounds and cytotoxic activities of ethanol (EtOH) and water extracts were determined. It was found that cotton fabric dyed with the aqueous extract of the roots of A. orientalis plant in the presence of alum mordant gave better depth of shade (K/S). The toxicity studies reveal that the EtOH and the water extracts of the root of A. orientalis exhibited 0% cytotoxicity while the standard cancer drug 5-fluorouracil exhibited 6% cytotoxicity. The overall results of this study show that the roots of A. orientalis can be used in the textile industry, especially for dyeing cotton fabrics.
Nummular headache in children: A case series and systematic literature review
Authors: Lax Daniel N , Hershey Andrew D , Kabbouche Marielle A , Kacperski Joanne
Published: April 2022

Background:

Nummular headache is a rare primary headache disorder potentially disabling and refractory to treatment. Of over 300 reported cases, only 9 are children.

Design/Methods:

We searched our institutional database and PubMed for “nummular headache” and synonyms and evaluated select articles from reference lists of substantial reviews.

Results:

Seven children were identified from our institution and nine from 107 unique publications. Mean age at onset was 9.7 and 11.9 years in our cohort and the literature, respectively, with a female:male ratio of 2:1. Location and quality varied, and allodynia was reported in five. Frequency ranged from every other week to continuous. Imaging was normal except in four cases. Migraine was often comorbid. Published cases were frequently refractory to treatment whereas four of our cohort improved with therapy for comorbid migraine.

Conclusions:

Nummular headache is rarely reported in children. We describe characteristics of seven new and nine previously published pediatric cases.
Up to 8-year follow-up from RESONATE-2: first-line ibrutinib treatment for patients with chronic lymphocytic leukemia
Authors: Barr Paul M. , Owen Carolyn , Robak Tadeusz , Tedeschi Alessandra , Bairey Osnat , Burger Jan A. , Hillmen Peter , Coutre Steve E. , Dearden Claire , Grosicki Sebastian , McCarthy Helen , Li Jian-Yong , Offner Fritz , Moreno Carol , Zhou Cathy , Hsu Emily , Szoke Anita , Kipps Thomas J. , Ghia Paolo
Published: April 2022

We report long-term follow-up from the RESONATE-2 phase 3 study of the once-daily Bruton’s tyrosine kinase inhibitor ibrutinib, which is the only targeted therapy with significant progression-free survival (PFS) and overall survival (OS) benefit in multiple randomized chronic lymphocytic leukemia (CLL) studies. Patients (≥65 years) with previously untreated CLL, without del(17p), were randomly assigned 1:1 to once-daily ibrutinib 420 mg until disease progression/unacceptable toxicity (n = 136) or chlorambucil 0.5-0.8 mg/kg ≤12 cycles (n = 133). With up to 8 years of follow-up (range, 0.1-96.6 months; median, 82.7 months), significant PFS benefit was sustained for ibrutinib vs chlorambucil (hazard ratio [HR], 0.154; 95% confidence interval [CI], 0.108-0.220). At 7 years, PFS was 59% for ibrutinib vs 9% for chlorambucil. PFS benefit was also observed for ibrutinib- vs chlorambucil-randomized patients with high-risk genomic features: del(11q) (HR, 0.033; 95% CI, 0.010-0.107) or unmutated immunoglobulin heavy chain variable region (HR, 0.112; 95% CI, 0.065-0.192). OS at 7 years was 78% with ibrutinib. Prevalence of adverse events (AEs) was consistent with previous 5-year follow-up. Ibrutinib dosing was held (≥7 days) for 79 patients and reduced for 31 patients because of AEs; these AEs resolved or improved in 85% (67 of 79) and 90% (28 of 31) of patients, respectively. With up to 8 years of follow-up, 42% of patients remain on ibrutinib. Long-term RESONATE-2 data demonstrate sustained benefit with first-line ibrutinib treatment for CLL, including for patients with high-risk genomic features. These trials were registered at www.clinicaltrials.gov as #NCT01722487 and #NCT01724346.
Impact of connected and autonomous vehicle dedicated lane on the freeway traffic efficiency
Authors: He Shanglu , Ding Fan , Lu Chaoru , Qi Yong
Published: April 2022

Background

The imminent emergence of connected and autonomous vehicles (CAVs) highlights the need for preparing the road infrastructure for traffic flows mixed with CAVs and human-driven vehicles. A dedicated lane (DL) for CAVs is one of the practical and potential ways to upgrade the road infrastructure for the mixed traffic.

Methods

This paper proposes a theoretical method to discuss the influence of implementing a CAV DL policy on the freeway traffic efficiency. In detail, the impact was measured by capacity and throughput. The calculation methods of these efficiency measurements under different CAV DL policies were proposed.

Experiments

Numerical experiments were conducted under various compositions of CAV DL policies and traffic conditions. More specifically, the relationship between the traffic conditions (i.e., traffic demand, market penetration rate (MPR) of CAVs, platoon intensity of CAVs, willingness of CAVs using the CAV DL) and the CAV DL policies (i.e., lane configuration, DL access control policy) were discussed.

Results and Conclusion

The results have led to some interesting findings, including the critical values of MPR that are valuable to guide an appropriate implementation of a CAV DL policy under a specific traffic condition.
Predicted coronavirus Nsp5 protease cleavage sites in the human proteome
Authors: Scott Benjamin M. , Lacasse Vincent , Blom Ditte G. , Tonner Peter D. , Blom Nikolaj S.
Published: April 2022

Background

The coronavirus nonstructural protein 5 (Nsp5) is a cysteine protease required for processing the viral polyprotein and is therefore crucial for viral replication. Nsp5 from several coronaviruses have also been found to cleave host proteins, disrupting molecular pathways involved in innate immunity. Nsp5 from the recently emerged SARS-CoV-2 virus interacts with and can cleave human proteins, which may be relevant to the pathogenesis of COVID-19. Based on the continuing global pandemic, and emerging understanding of coronavirus Nsp5-human protein interactions, we set out to predict what human proteins are cleaved by the coronavirus Nsp5 protease using a bioinformatics approach.

Results

Using a previously developed neural network trained on coronavirus Nsp5 cleavage sites (NetCorona), we made predictions of Nsp5 cleavage sites in all human proteins. Structures of human proteins in the Protein Data Bank containing a predicted Nsp5 cleavage site were then examined, generating a list of 92 human proteins with a highly predicted and accessible cleavage site. Of those, 48 are expected to be found in the same cellular compartment as Nsp5. Analysis of this targeted list of proteins revealed molecular pathways susceptible to Nsp5 cleavage and therefore relevant to coronavirus infection, including pathways involved in mRNA processing, cytokine response, cytoskeleton organization, and apoptosis.

Conclusions

This study combines predictions of Nsp5 cleavage sites in human proteins with protein structure information and protein network analysis. We predicted cleavage sites in proteins recently shown to be cleaved in vitro by SARS-CoV-2 Nsp5, and we discuss how other potentially cleaved proteins may be relevant to coronavirus mediated immune dysregulation. The data presented here will assist in the design of more targeted experiments, to determine the role of coronavirus Nsp5 cleavage of host proteins, which is relevant to understanding the molecular pathology of coronavirus infection.
Physiological adjustment of pomegranate pericarp responding to sunburn and its underlying molecular mechanisms
Authors: Liu Chunyan , Su Ying , Li Jiyu , Jia Botao , Cao Zhen , Qin Gaihua
Published: April 2022

Background

Sunburn is common in pomegranate, and sunburned fruits have poor appearance and low marketability. However, the physiological and metabolic responses to sunburn and their underlying molecular mechanisms in pomegranate fruit are little understood. Fruit of sunburn-sensitive cultivar ‘Hongyushizi’ was used to carry out physiological parameter detection and widely-targeted metabolomics and transcriptome study.

Results

Malondialdehyde and relative conductivity increased with the severity of sunburn, which indicated increased membrane injury. Meanwhile, the content of antioxidants (total phenols and flavonoids), which reduce and repair membrane damage, increased and were accompanied by increases in total antioxidant capacity. In sunburned fruits compared with controls, 129 metabolites changed (including naringenin, pelargonidin and kaempferol) and 447 differentially expressed genes including CHI (Pgr25966.1), F3′5′H (Pgr26644.1), and CHS (Pgr005566.1) may have contributed to these changes. Transcription factors, such as NAC 5 (Pgr008725.1), MYB 93 (Pgr001791.1), and MYB 111 (Pgr027973.1) may be involved in phenylpropanoid and flavonoid biosynthesis by regulating the CHI, F3′5′H, and CHS etc.

Conclusions

These findings provide insight into the sunburn mechanisms of pomegranate, and also into the genetic improvement of fruit sunburn.
The impact of COVID-19 on the number of active small primary care businesses by severity of the pandemic: evidence from South Korea
Authors: Son Kyung-Bok
Published: April 2022

Background

Health systems have become financially fragile owing to the economic recession caused by the COVID-19 pandemic. However, small primary care businesses have received less policy attention than public health and secondary care. We aimed to estimate the impact of COVID-19 on the number of active small primary care businesses in South Korea.

Methods

We selected clinics, dental clinics, oriental clinics, and pharmacies as primary care businesses. Our estimation took advantage of regional variations in COVID-19 cases in South Korea. We determined the number of active primary care businesses from 2019 1Q to 2021 1Q on a quarterly basis, and conducted interrupted time series analysis to estimate the effects of COVID-19 on this sector.

Results

This study found no significant increase or decrease in the number of clinics, dental clinics, and oriental clinics immediately after the pandemic began or in the time trends after the pandemic. However, there was a significant increase in the number of pharmacies immediately after the pandemic. The most affected area presented different trends in the number of pharmacies, dental clinics, and oriental clinics.

Conclusions

Impact of the pandemic on the number of active small primary care business were low in South Korea. However, the impact varied according to the type of primary care setting and severity of the pandemic. The additional public health role of primary care could be associated with the sustenance of primary care businesses.
The effectiveness of governmental nonpharmaceutical interventions against COVID-19 at controlling seasonal influenza transmission: an ecological study
Authors: Qiu Zekai , Cao Zicheng , Zou Min , Tang Kang , Zhang Chi , Tang Jing , Zeng Jinfeng , Wang Yaqi , Sun Qianru , Wang Daoze , Du Xiangjun
Published: April 2022

Background

A range of strict nonpharmaceutical interventions (NPIs) were implemented in many countries to combat the coronavirus 2019 (COVID-19) pandemic. These NPIs may also be effective at controlling seasonal influenza virus infections, as influenza viruses have the same transmission path as severe acute respiratory syndrome coronavirus 2. The aim of this study was to evaluate the effects of different NPIs on the control of seasonal influenza.

Methods

Data for 14 NPIs implemented in 33 countries and the corresponding influenza virological surveillance data were collected. The influenza suppression index was calculated as the difference between the influenza positivity rate during its period of decline from 2019 to 2020 and during the influenza epidemic seasons in the previous 9 years. A machine learning model was developed using an extreme gradient boosting tree regressor to fit the NPI and influenza suppression index data. The SHapley Additive exPlanations tool was used to characterize the NPIs that suppressed the transmission of influenza.

Results

Of all NPIs tested, gathering limitations had the greatest contribution (37.60%) to suppressing influenza transmission during the 2019–2020 influenza season. The three most effective NPIs were gathering limitations, international travel restrictions, and school closures. For these three NPIs, their intensity threshold required to generate an effect were restrictions on the size of gatherings less than 1000 people, ban of travel to all regions or total border closures, and closing only some categories of schools, respectively. There was a strong positive interaction effect between mask-wearing requirements and gathering limitations, whereas merely implementing a mask-wearing requirement, and not other NPIs, diluted the effectiveness of mask-wearing requirements at suppressing influenza transmission.

Conclusions

Gathering limitations, ban of travel to all regions or total border closures, and closing some levels of schools were found to be the most effective NPIs at suppressing influenza transmission. It is recommended that the mask-wearing requirement be combined with gathering limitations and other NPIs. Our findings could facilitate the precise control of future influenza epidemics and other potential pandemics.
18F-FDG-PET/CT in relapsed multiple myeloma: Are prognostic thresholds different from first-line therapy?
Authors: Zukovs Romans , Antke Christina , Mamlins Eduards , Sawicki Lino Morris , Mohring Annemarie , Lopez y Niedenhoff David , Boquoi Amelie , Kondakci Mustafa , Antoch Gerald , Müller Hans-Wilhelm , Fenk Roland , Haas Rainer
Published: April 2022

Purpose

While 18F-FDG PET/CT yields valuable prognostic information for patients in first-line therapy of multiple myeloma (MM), its prognostic relevance in relapse is not established. Available studies of relapsed MM describe prognostic thresholds for frequently used PET/CT parameters that are significantly higher than those identified in the first-line setting. The purpose of this study was to evaluate the prognostic role of PET/CT in relapsed MM, based on parameters used in the first-line setting.

Methods

Our retrospective study included 36 patients with MM who had received autologous or allogeneic stem cell transplantation, suffered at least one relapse, and underwent FDG-PET/CT at relapse. Number of focal bone lesions (FL), maximal standardised uptake value (SUVmax), and presence of PET-positive extramedullary lesions (EMD) were analysed.

Results

For the number of FLs, the prognostic value was demonstrated with a cut-off of > 3 (median OS 3.8 months vs. not reached, p = 0.003). Median OS of patients with SUVmax ≤ 4 was not reached, while it was 3.9 months in patients with SUVmax > 4 (p = 0.014). Presence of EMD was a significant prognostic parameter too, with median OS of 3.6 months versus not reached (p = 0.004). The above-mentioned parameters showed prognostic significance for PFS as well. Combination of higher ISS stage and PET/CT parameters identified patients with particularly short OS (3.7 months vs. not reached, p < 0.001) and PFS (3.6 vs. 11.7 months p < 0.001).

Conclusion

The PET/CT parameters SUVmax > 4, nFL > 3, and presence of EMD identify patients with poor prognosis not only in the first-line setting but also in relapsed MM.
Downregulation of KRAB zinc finger proteins in 5-fluorouracil resistant colorectal cancer cells
Authors: Chauvin Anaïs , Bergeron Danny , Vencic Jean , Lévesque Dominique , Paquette Benoit , Scott Michelle S. , Boisvert François-Michel
Published: April 2022

Radio-chemotherapy with 5-flu orouracil (5-FU) is the standard of care treatment for patients with colorectal cancer, but it is only effective for a third of them. Despite our understanding of the mechanism of action of 5-FU, drug resistance remains a significant limitation to the clinical use of 5-FU, as both intrinsic and acquired chemoresistance represents the major obstacles for the success of 5-FU-based chemotherapy. In order to identify the mechanism of acquired resistance, 5-FU chemoresistance was induced in CRC cell lines by passaging cells with increasing concentrations of 5-FU. To study global molecular changes, quantitative proteomics and transcriptomics analyses were performed on these cell lines, comparing the resistant cells as well as the effect of chemo and radiotherapy. Interestingly, a very high proportion of downregulated genes were annotated as transcription factors coding for Krüppel-associated box (KRAB) domain-containing zinc-finger proteins (KZFPs), the largest family of transcriptional repressors. Among nearly 350 KRAB-ZFPs, almost a quarter were downregulated after the induction of a 5-FU-resistance including a common one between the three CRC cell lines, ZNF649, whose role is still unknown. To confirm the observations of the proteomic and transcriptomic approaches, the abundance of 20 different KZFPs and control mRNAs was validated by RT-qPCR. In fact, several KZFPs were no longer detectable using qPCR in cell lines resistant to 5-FU, and the KZFPs that were downregulated only in one or two cell lines showed similar pattern of expression as measured by the omics approaches. This proteomic, transcriptomic and genomic analysis of intrinsic and acquired resistance highlights a possible new mechanism involved in the cellular adaptation to 5-FU and therefore identifies potential new therapeutic targets to overcome this resistance.
Diagnostic value of mid-regional pro-Adrenomedullin as a biomarker of invasive bacterial infection in children: a systematic review
Authors: Corr Michael Paul , Fairley Derek , McKenna James P. , Shields Michael D. , Waterfield Thomas
Published: April 2022

Background

Invasive bacterial infections (IBI) in children present a difficult clinical challenge. They are often life-threatening, however in the early stages they can be hard to differentiate from benign viral infections. This leaves clinicians with the risk of missing a serious IBI diagnosis or inappropriately using antimicrobials in a child with a viral infection- contributing to the ongoing development of increased antimicrobial resistance. Hence, biomarkers which could aid in early detection of IBI and differentiation from viral infections are desirable. Mid-Regional pro-Adrenomedullin (MR-proADM) is a biomarker which has been associated with IBI. The aim of this systematic review was to determine its diagnostic accuracy in identifying children with IBI.

Methods

A strategy was devised to search online databases MEDLINE, Embase, Web of Science and Scopus for human clinical trials reporting the accuracy of MR-proADM in children. Against predesigned inclusion and exclusion criteria full texts were selected for inclusion and data extraction. True positives, false positives, true negatives and false negatives were extracted from each included study to fill 2 × 2 tables. Using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool methodological quality of each study was assessed.

Results

A total of 501 articles were initially identified. After the removal of duplicates and abstract screening 11 texts were fully reviewed and four texts (totaling 1404 patients) were included in the systematic analysis. Only one study was of a high quality and that study accounted for the vast majority of patients. A single study reported the diagnostic accuracy of MR-proADM for invasive bacterial infection reporting an Area under the Curve of 0.69. The paucity of available studies made meta-analysis and studies of heterogeneity impossible.

Conclusion

There is a paucity of research regarding the diagnostic accuracy of MR-proADM in the diagnosis of invasive bacterial infections in children. Initial results would suggest that MR-proADM testing alone is poor at identifying IBI in young children. It remains unclear if MR-proADM performs differently in older children or in children with signs and symptoms of IBI.

Trial registration

PROSPERO CRD42018096295.
Perspectives on barriers to treatment engagement of people with eating disorder symptoms who have not undergone treatment: a qualitative study
Authors: Liu Livia , Hay Phillipa , Conti Janet
Published: April 2022

Background

Many people with an eating disorder (ED) never engage with an evidence-based ED treatment. Of the few studies that have qualitatively explored barriers to receiving treatment, some do so in relation to mental health conditions in general, and others focus on participants who have already undergone treatment.

This study aims to address this gap in the literature by exploring the barriers to ED treatment engagement from the perspectives of individuals in the community with an ED (either self-identified or professionally diagnosed) and had not received ED treatment/s.

Method

Fifty-six of 772 participants in an online Eating Disorders Treatment Experience survey had self-identified as having symptoms consistent with an ED, or had received a diagnosis of an ED and indicated that they had never undergone treatment for an ED. They were asked to share the reasons for which they did not receive treatment with an open-ended question. Qualitative analysis of survey responses was completed using the Framework Method to generate overarching themes that encapsulated the diverse participant accounts.

Results

The thematic analysis generated two main themes, each with two subthemes. The first theme was the negotiation of the need for treatment within oneself (intrapersonal factors; theme 1). The second theme explored interpersonal contexts that shaped the participant’s decision not to seek treatment (interpersonal/external factors; theme 2). Two cross-cutting subthemes of fear and health literacy were also generated that demonstrated a high degree of overlap with the aforementioned main themes.

Conclusions

The process by which individuals decide whether or not to engage with ED treatment services is complex and involves intra- and interpersonal negotiations intertwined with health literacy and fear. A factor not prominent in previous research was negative self-perceptions and the belief of being undeserving of treatment. These factors have implications for ongoing community and clinical interventions to further address barriers to ED treatment engagement.
The effect of BMI on long-term outcomes after operatively treated ankle fractures: a study with up to 16 years of follow-up
Authors: Cardoso Diogo Vieira , Paccaud Joris , Dubois-Ferrière Victor , Barea Christophe , Hannouche Didier , Veljkovic Andrea , Lübbeke Anne
Published: April 2022

Background

Ankle fractures are a common injury and the main cause of post-traumatic ankle arthritis. The prevalence of obesity is increasing worldwide, and this population is known to have poorer short and midterm outcomes after ankle fractures. Our objective is to assess long-term patient-reported outcomes in patients with operatively treated ankle fractures, and the effect of BMI on these results using the new and validated patient-reported outcome questionnaire, the Manchester Oxford foot and ankle questionnaire (MOXFQ).

Methods

We performed a retrospective review of all ankle fractures treated operatively in a ten-year period from 2002–2012. The MOXFQ and SF-12 were sent to all patients and were obtained, on average, 11.1 years after surgery (range 5.3–16.2 years).

Results

Two thousand fifty-five ankle fractures were reviewed, of which 478 (34%) patients completed the questionnaires. The mean age was 48.1 ± 15.5 years, 52% were men and the mean BMI was 26.1 ± 4.5 kg/m2. Of the 478, 47% were of normal weight, 36% were overweight, and 17% were obese. Overall, 2.1% were type A, 69.9% B, and 24.9% type C fractures. There were no significant differences in the type of fracture between the BMI groups. Comparing obese and non-obese patients, there were large differences in MOXFQ pain (33 ± 29 vs. 18.7 ± 22.1, effect size 0.55), and function scores (27.3 ± 29 vs. 12.5 ± 21.1, effect size 0.58). No differences in complications and reoperations rates were observed. The BMI value at surgery correlated more strongly with the MOXFQ pain score than the BMI at follow-up (Spearman’s Rho 0.283 vs. 0.185, respectively).

Conclusion

These findings reveal that obese patients have significant worse long-term outcomes, namely increased pain, poorer function, and greater impairment in everyday life after an operatively treated ankle fracture. Moreover, pain and function linearly declined with increasing BMI. Our findings appear to indicate that increased BMI at surgery is an important contributor to adverse outcome in the operative management of rotational ankle fractures.

Level of evidence

III.
Robot-assisted radical prostatectomy in the treatment of patients with clinically high-risk localized and locally advanced prostate cancer: single surgeons functional and oncologic outcomes
Authors: Shin Tae Young , Lee Yong Seong
Published: April 2022

Background

Optimal treatment approaches for high-risk localized and locally advanced prostate cancer remain controversial and there are currently no standard treatments. These patients with high-risk localized and locally advanced prostate cancer are usually offered radiotherapy in combination with hormonal therapy. We report functional and oncologic outcomes of patients who underwent primary robot-assisted radical prostatectomy (RARP) and assess the role of RARP in patients with high-risk localized and locally advanced prostate cancer.

Methods

This study included 188 patients with high-risk localized (clinical stage T2c or a pretreatment prostate-specific antigen level > 20 ng/mL or a biopsy Gleason score ≥ 8) and/or locally advanced (any PSA, cT3-4 or cN+) prostate cancer who underwent RARP between July 2013 and May 2020. Functional outcomes including postoperative continence and potency were assessed at 1, 3, 6, and 12 months after RARP. Oncologic outcomes comprised positive surgical margins (PSMs), biochemical recurrence (BCR), BCR-free survival, and clinical recurrence (CR)-free survival rates at 1 and 3 years.

Results

The median operative time was 185 (interquartile range [IQR] 130–260) minutes. Based on postoperative pathology, the rates of PSMs in the entire cohort and in those with stage pT2 disease were 26.6% and 8.5%, respectively. The continence and potency rates at 12 months were 88.3% and 56.4%, respectively. The BCR rate was 22.3%, and the median time to BCR was 10.5 (IQR 3.5–26.9) months. The 1- and 3-year BCR-free survival rates were 87.6% and 78.7%, respectively, and the 1- and 3-year CR-free survival rates were 97.5% and 90.8%, respectively.

Conclusions

Most patients with clinically high-risk localized and locally advanced prostate cancer treated with primary RARP remained BCR-free and CR-free during the 1- and 3-year follow-up, demonstrating the good functional outcomes with RARP. RARP was a safe and feasible minimally invasive surgical alternative to radiotherapy or hormonal therapy in select patients with high-risk localized and locally advanced prostate cancer. These results should be validated to assure the reproducibility of measurements in prospective randomized-controlled studies on primary RARP.