bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Long Noncoding RNA H19 on Isoflurane-Induced Cognitive Dysregulation by Promoting Neuroinflammation
Authors: Ge Yanhu , Lin Duomao , Cui Boqun , Zhang Liang , Li Shurong , Wang Zhaoqi , Ma Jun
Published: December 2021

Introduction: Isoflurane (ISO) may cause neuronal apoptosis and synaptic disorder during development, and damage long-term learning and memory function. This observation aimed to study the function of H19 in vitro and in vivo tests and the further mechanism was identified. Methods: ISO cell models and rat models were established and reactive oxygen species (ROS) identified. The viability and apoptosis of HT22 cells were detected by the MTT and flow cytometer. Morris water maze test was conducted to analyze the neurotoxicity of ISO on spatial learning and memory ability. Quantitative PCR was the method to verify the expression of H19. The concentration of inflammatory indicators was identified by enzyme-linked immunosorbent assay. Results: 1.5% and 2% ISO led to the neurotoxicity of HT22 cells and increased expression of H19. Silenced H19 meliorated these adverse impacts of ISO. Interference of H19 exerted neuroprotective roles by repressing modified neurological severity score, inhibiting escape latency, elevating distance and time of target area, and controlling ROS and inflammation. MiR-17-5p might be a promising competing endogenous RNA of H19. The expression of miR-17-5p was reduced in the ISO group and reversed by the absence of H19. Conclusion: Our results of in vitro and in vivo assay indicated that the absence of HT22 is a neuroprotective regulator of cognition and inflammation by accumulating miR-17-5p.
Testosterone Therapy for Late-Onset Hypogonadism Improves Erectile Function: A Systematic Review and Meta-Analysis
Authors: Taniguchi Hisanori , Shimada Seiji , Kinoshita Hidefumi
Published: December 2021

Introduction: Randomized controlled trials (RCTs) of testosterone therapy (TTh) for late-onset hypogonadism are systematically reviewed and a meta-analysis to assess the efficacy of TTh in improving erectile function is performed. Methods: The PubMed, Cochrane Library, and Web of Science databases were searched to identify RCTs published from 2007. RCTs that assessed erectile function using the erectile function domain of the International Index of Erectile Function (IIEF-EFD) were included in the meta-analysis. Results: The systematic review included 18 RCTs and the meta-analysis included 6 studies that enrolled a total of 1,458 patients. The overall meta-analysis revealed that the IIEF-EFD score was significantly improved in the TTh group compared with the placebo group (mean difference 1.86; 95% confidence interval 1.01–2.72; p < 0.0001). Compared with patients receiving placebo, there was a significant improvement in the IIEF-EFD of patients who received TTh using testosterone gel, those who received TTh for over 30 weeks, and those without diabetes mellitus or metabolic syndrome. Conclusion: TTh achieved a significant improvement in the IIEF-EFD score of hypogonadal men compared with placebo, especially in those who received testosterone gel, were treated for over 30 weeks, and had no comorbidities.
10th Anniversary of the Asia Pacific Stroke Organization: State of Stroke Care and Stroke Research in the Asia-Pacific
Authors: Tan Kay-Sin , Yoon Byung-Woo , Lin Ruey-Tay , Mehndiratta Man Mohan , Suwanwela Nijasri C. , Venketasubramanian Narayanaswamy
Published: December 2021

The Asia Pacific Stroke Organization is the largest international and professional stroke group in the region. It has worked consistently over the last 10 years to gain visibility and consistency across the Asia-Pacific and beyond. The 10-year journey will be reviewed in the background of many internal and external developments including changes in Asia-Pacific stroke epidemiology, stroke care systems, and stroke service developments as well as major research studies in the Asia-Pacific.
Digital brain: Model-based framework for dependable electroencephalogram sensing and actuation in internet of things system
Authors: Kavitha R. J. , K. Saravanan K.
Published: December 2021

Real-time brain internet of thing (IoT) frameworks are expensive. But, creating a cheaper framework has been quickened incredibly by the superior investigation that's being done on virtual brain. The passing of an imperative individual on a mystery mission is considered delicate data and must be taken care of with as much security as conceivable. By guaranteeing this discreteness, the time taken for the message of their passing to reach the pertinent specialist is expanded to up to a few days. The time taken to provide the message is as well. These days, the advancements in equipment expanding the capacities of the virtual brain and of the wearable brain IoT sensors have made the advancement of various unused program systems conceivable for engineers to make valuable applications that combine the human brain with IoT. Different tactile pathways are too empowered for communications of the human brain with bigger measured data. The fundamental point of this extend is to transfer secret records onto the clouds safely.
Neural net implementation of steam properties on FPGA
Authors: Dutt R. V. S. Krishna , Ganesh R. , Premchand P.
Published: December 2021

Real time applications like model predictive control, monitoring and data reconciliation of power plants and industrial processes employ nonlinear mathematical models and require thermodynamic properties and their derivatives of working fluids. Applications like super heater temperature control based on energy balance and real time data reconciliation, require an efficient and a compact method for simultaneous estimation of thermodynamic properties, and their partial derivatives suitable for implementation in field-programmable gate array (FPGA). However, the complex mathematical formulations of these properties prohibit direct implementations in FPGAs. Single artificial neural network (ANN) architecture is used to replace the entire code in higher level languages, running into a few thousand lines. FPGA implementation of a compact neural network for the entire range of thermodynamic properties is presented. Large arguments in sigmoid function are factored into a product of integer and a fractional part which is represented using series approximation with five terms only and the integers are represented in look up table (LUT). This ensures optimum storage and computational burden for the above applications. The ANN is implemented in IEEE 754 floating point with synthesis in Xilinx ISE design suite using Verilog HDL. The results are presented for a typical pressure versus saturation temperature.
FPGA based co-design of a speed fuzzy logic controller applied to an autonomous car
Authors: Aridhi Emna , Popescu Decebal , Mami Abdelkader
Published: December 2021

This paper invests in FPGA technology to control the speed of an autonomous car using fuzzy logic. For that purpose, we propose a co-design based on a novel fuzzy controller IP. It was developed using the hardware language VHDL and driven by the Zynq processor through an SDK software design written in C. The proposed IP acts according to the ambient temperature and the presence or absence of an obstacle and its distance from the car. The partitioning of the co-design tasks divides them into hardware and software parts. The simulation results of the fuzzy IP and those of the complete co-design implementation on a Xilinx Zynq board showed the effectiveness of the proposed controller to meet the target constraints and generate suitable PWM signals. The proposed hardware architecture based on 6-LUT blocks uses 11 times fewer logic resources than other previous similar designs. Also, it can be easily updated when new constraints on the system are to be considered, which makes it suitable for many related applications. Fuzzy computing was accelerated thanks to the use of digital signal processing blocks that ensure parallel processing. Indeed, a complete execution cycle takes only 7 us.
Image processing using a reconfigurable platform: Pre-processing block hardware architecture
Authors: N. Chiranjeevi G. , Kulkarni Subhash
Published: December 2021

Real time image processing is a challenging task in which fetching the sub image requires offset memory access apart from core processing needs. This paper aims at overcoming the offset needs for memory addressing in pre-processing blocks. Another feature of this present work is to appending the image data with customized algorithmic reequipments viz duplicating, zero padding. For KxK kernel size, the proposed hardware architecture can be programmed to fetch K pixels in one cycle, reducing the data access time. Results have been compared with software-based processing for KxK spatial filtering. performance indicates significant timing improvement using proposed pre-processing hardware block.
Anti-Cancer Assessment of a Ramie (Boehmeria nivea L. Gaud.) Leaf Extract Using Mcf-7 Cell Line and a Yeast-Based Bioassay
Authors: Peni Wulandari Asri , Qaromah Annisa Abdiwijaya , Lolowang Karen Kezia , Huspa Desi Harneti Putri , Zuhrotun Ade
Published: December 2021

Introduction: One strategy for molecular cancer therapy is to know the key mechanism of cytotoxic compounds that can kill cancer cells. Ramie (Boehmeria nivea L. Gaud.) leaves contain active compounds that have important effects on cancer chemoprevention. Objective: To obtain the active fraction of a Ramie leaf extract in inhibiting the proliferation of MCF-7 breast cancer cell lines and to determine the mechanism of apoptosis induction using MCF-7 and Saccharomyces cerevisiae strains 1140, 1353, and 1138. Method: Fractions were prepared using n-hexane, dichloromethane (CH2Cl2), ethyl acetate, and n-butanol as solvents. All fractions were tested qualitatively through phytochemical. The MTT-based cytotoxicity assay used MCF-7 (in vitro) to obtain the IC50 value, whereas the model system that targets the enzymatic (topoisomerase) used a yeast-based bioassay to obtain the IC12 value. Apoptotic induction of the active fraction in MCF-7 was performed using flow cytometry and qPCR (2-ΔΔCt method). Results: The phytochemical analysis indicated that the extract fraction consisted of alkaloids and steroids. The smallest IC50 value was obtained from the CH2Cl2 fraction as 3.79 g/mL, potentially act as an anticancer. A higher percentage of apoptosis than that of necrotizing cells and live cells was observed through flow cytometry. The CH2Cl2 fraction with an IC12 value < 8000 in strains 1140, 1353, and 1138 consistently showed the mechanism of apoptosis induction as topoisomerase I and II inhibitors. Also, another mechanism could be through the intrinsic pathway, indicated by the highest expression level in p53. Conclusions: The CH2Cl2 fraction of Ramie leaves can inhibits the proliferation of MCF-7 cells in the active and strong categories. The CH2Cl2 fraction induces apoptosis by increasing p53 gene expression and inhibiting topoisomerase I and II. Thus, it showed potential as an anticancer drug candidate.
Prevalence of otomycosis in patients with cerumen impaction due to ear-phone usage during COVID-19
Authors: Suresh Sunethra , Suresh Suraj , Sivasamy Sudha
Published: December 2021

Background: Otomycosis affects about 9% of patients with otitis externa. One of the predisposing factor is impacted cerumen.  Earphone usage causes cerumen impaction. In the light of the recent COVID-19 pandemic, people are housebound due to prolonged lockdown. Hence people are more technology dependent as working from home and studying online has become the norm. Therefore, usage of earphones has proportionately increased, and the impacted cerumen cases have increased. Methods: This cross-sectional study aimed to analyze data from questionnaire to assess the prevalence of otomycosis among patients with impacted cerumen due to excessive earphone usage, establish associations between otomycosis and symptoms such as pain and hearing loss as well as the correlation between fungal growth and the long hours of earphones usage. The relationship between the age of participants and the usage of earphones during the pandemic was also explored. The data was collected from 100 individuals aged 14 to 51 years who sought treatment for symptomatic impacted wax at an ENT clinic in Malaysia. Results: The mean age of participants was 25.9 years. There was a 31% prevalence of otomycosis among these patients. Otalgia was present in 60% of patients with otomycosis (t value 2.94, coefficient 0.27). Approximately 37% of patients had a large air-bone gap indicating conductive hearing loss. There was an insignificant correlation between otomycosis and the longer hours of earphones usage (t value 1.51, coefficient 0.00015). No correlation was found between age of participants and the total hours of earphone usage (t value 0.63, coefficient 0.0012). Conclusion: This study offers initial evidence that earphone usage could be a predisposing factor in developing otomycosis. However, there was no evidence of longer hours of earphones usage increasing the chances of developing otomycosis. Additionally, symptoms like otalgia and conductive hearing loss could be present in both earwax impaction and otomycosis.
Théâtres utopiques de Roland Barthes
Authors: Cohen Judith
Published: December 2021

L’œuvre de Roland Barthes oscille entre modernité et classicisme, pour autant, loin de considérer qu’il faille prendre parti et choisir sa propre conception de Roland Barthes, il s’agit de penser ce lien dans un rapport dynamique entre ces deux pôles au prisme de la notion d’utopie elle-même oscillant entre une forme de retour à un état antérieur et à la construction d’un programme idéal à venir. En effet, on peut penser avec Diana Knight dans son ouvrage Roland Barthes and Utopia : Space, Travel, Writting, que l’utopie est une thématique centrale au sein de l’œuvre de Roland Barthes ce qui rend son écriture ancrée dans sa propre modernité mais aussi dans la nôtre. L’utopie constitue un concept à deux jambes : l’une pratique et politique et l’autre théorique. À ce titre, on peut considérer que cette dualité propre à cette notion dès l’ouvrage de Thomas More construit en deux parties inséparables l’une de l’autre, explique en partie l’oscillation qui anime l’œuvre du critique français. On s’interrogera tout au long de cet article sur les liens que l’utopie noue entre le théâtre, la sexualité et l’amour au sein de l’œuvre de Roland Barthes en en suivant les « phases » tout en tentant d’en dégager des structures transversales et linéaires qui cherchent à remettre en question la dimension hétérogène et monolithique de ces « phases ».

 

utopie – théâtre – sexualité - amour.
Encenar um desejo, ensinar
Authors: Lima Natalie
Published: December 2021

O presente artigo busca mostrar como a teatralidade, em Roland Barthes, foi um dispositivo por ele utilizado ao longo de sua produção para encenar a si mesmo e construir sua figura de intelectual e escritor, bem como para ensaiar uma nova relação com a literatura e a crítica, cada vez mais cênica, a partir dos últimos anos de sua produção, sobretudo no curso A preparação do romance. Ali, o desejo de escrita, nomeado por Barthes como “Vouloir-Écrire”, se espacializa e traz consigo potências cênicas e romanescas. A sala de aula de A preparação do romance é então o palco para onde parte da produção barthesiana conflui, mas não se resolve.
Engajado, distanciado, deslocado, escritor: Roland Barthes por Mathieu Messager
Authors: Kaspar Katerina Blasques
Published: December 2021

Resenha do livro Roland Barthes (2019), por Mathieu Messager, publicado na coleção Que sais-je ?, da editora francesa Presses Universitaires de France. Aliando aspectos biográficos e bibliográficos, Messager logra oferecer aos leitores possibilidades de diálogo entre Barthes e a contemporaneidade.
Infinitas gamações: correspondências: Ana Cristina Cesar, Roland Barthes
Authors: Bastos Mariana Cobuci Schmidt
Published: December 2021

Este texto é um exercício de escrita com Roland Barthes e Ana Cristina Cesar, pensado e escrito a partir do curso “Roland Barthes: da pesquisa à sala de aula”, ministrado por Claudia Amigo Pino na Universidade de São Paulo no segundo semestre de 2020. Buscou-se, aqui, tal como faziam esses autores, sair da dinâmica do escrever sobre – trata-se, então, de uma produção a partir da leitura de diferentes textos de Barthes e Ana Cristina, uma tentativa de fazer ver e de promover em outros a paixão que reconheço neles, em suas escrituras.
Effect of Acute Exposure to Altitude on the Quality of Chest Compression‐Only Cardiopulmonary Resuscitation in Helicopter Emergency Medical Services Personnel: A Randomized, Controlled, Single‐Blind Crossover Trial
Authors: Vögele Anna , van Veelen Michiel Jan , Dal Cappello Tomas , Falla Marika , Nicoletto Giada , Dejaco Alexander , Palma Martin , Hüfner Katharina , Brugger Hermann , Strapazzon Giacomo
Published: December 2021

Background

Helicopter emergency medical services personnel operating in mountainous terrain are frequently exposed to rapid ascents and provide cardiopulmonary resuscitation (CPR) in the field. The aim of the present trial was to investigate the quality of chest compression only (CCO)‐CPR after acute exposure to altitude under repeatable and standardized conditions.

Methods and Results

Forty‐eight helicopter emergency medical services personnel were divided into 12 groups of 4 participants; each group was assigned to perform 5 minutes of CCO‐CPR on manikins at 2 of 3 altitudes in a randomized controlled single‐blind crossover design (200, 3000, and 5000 m) in a hypobaric chamber. Physiological parameters were continuously monitored; participants rated their performance and effort on visual analog scales. Generalized estimating equations were performed for variables of CPR quality (depth, rate, recoil, and effective chest compressions) and effects of time, altitude, carryover, altitude sequence, sex, qualification, weight, preacclimatization, and interactions were analyzed. Our trial showed a time‐dependent decrease in chest compression depth (
P
=0.036) after 20 minutes at altitude; chest compression depth was below the recommended minimum of 50 mm after 60 to 90 seconds (49 [95% CI, 46–52] mm) of CCO‐CPR.

Conclusions

This trial showed a time‐dependent decrease in CCO‐CPR quality provided by helicopter emergency medical services personnel during acute exposure to altitude, which was not perceived by the providers. Our findings suggest a reevaluation of the CPR guidelines for providers practicing at altitudes of 3000 m and higher. Mechanical CPR devices could be of help in overcoming CCO‐CPR quality decrease in helicopter emergency medical services missions.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04138446.
Cardiac Arrest in Pigs With 48 hours of Post‐Resuscitation Care Induced by 2 Methods of Myocardial Infarction: A Methodological Description
Authors: Vammen Lauge , Munch Johannsen Cecilie , Magnussen Andreas , Povlsen Amalie , Riis Petersen Søren , Azizi Arezo , Løfgren Bo , Andersen Lars W. , Granfeldt Asger
Published: December 2021

Background

Systematic reviews have disclosed a lack of clinically relevant cardiac arrest animal models. The aim of this study was to develop a cardiac arrest model in pigs encompassing relevant cardiac arrest characteristics and clinically relevant post‐resuscitation care.

Methods and Results

We used 2 methods of myocardial infarction in conjunction with cardiac arrest. One group (n=7) had a continuous coronary occlusion, while another group (n=11) underwent balloon‐deflation during arrest and resuscitation with re‐inflation after return of spontaneous circulation. A sham group was included (n=6). All groups underwent 48 hours of intensive care including 24 hours of targeted temperature management. Pigs underwent invasive hemodynamic monitoring. Left ventricular function was assessed by pressure‐volume measurements. The proportion of pigs with return of spontaneous circulation was 43% in the continuous infarction group and 64% in the deflation‐reinflation group. In the continuous infarction group 29% survived the entire protocol while 55% survived in the deflation‐reinflation group. Both cardiac arrest groups needed vasopressor and inotropic support and pressure‐volume measurements showed cardiac dysfunction. During rewarming, systemic vascular resistance decreased in both cardiac arrest groups. Median [25%;75%] troponin‐I 48 hours after return of spontaneous circulation, was 88 973 ng/L [53 124;99 740] in the continuous infarction group, 19 661 ng/L [10 871;23 209] in the deflation‐reinflation group, and 1973 ng/L [1117;1995] in the sham group.

Conclusions

This article describes a cardiac arrest pig model with myocardial infarction, targeted temperature management, and clinically relevant post‐cardiac arrest care. We demonstrate 2 methods of inducing myocardial ischemia with cardiac arrest resulting in post‐cardiac arrest organ injury including cardiac dysfunction and cerebral injury.
National Minorities in the Post-Revolutionary Era
Authors: Haertel Kateryna
Published: December 2021

This study looks into Ukraine’s minority politics after the Revolution of Dignity of 2014. It analyses the inclusivity of minority politics against three key parameters – institutional framework, dialogue mechanisms, and non-discriminatory policies. The research is conducted through an in-depth comparison analysis of minority politics of two post-revolutionary presidents – Petro Poroshenko (full term) and Volodymyr Zelenskyi (first two years). The conclusion is made that the political elites failed to drive an inclusive course towards ethno-linguistic minorities. The inclusivity along the three criteria has been provided impetus either on ad-hoc basis or not at all. On the level of policies, a regression can be observed. The underlying cause for the state not succeeding in achieving an inclusive minority course is that the two administrations had predominantly divergent motives for addressing this topic. As a result, the implementation of some inclusivity-oriented measures suffered and the minority-related discourse became highly politicized.
Place Matters
Authors: Hedegaard Liselotte
Published: December 2021

This article positions place within a phenomenological framework. Current philosophical inquiry shows little interest in place, yet academic disciplines concerned with spatial properties look to philosophy—and in particular phenomenology—to provide important contributions to overcome the limitations of quantitative methodologies, particularly with respect to sentiments of attachment to and identification with places. Seemingly, however, philosophy offers little support in this field. Place disappears from philosophical investigations during the Middle Ages and is replaced by considerations on space. Keeping the employment of phenomenological approaches in other academic disciplines in mind, this article sets out to explore traces of a re-emerging interest in place among twentieth-century phenomenologists. It proposes a phenomenological approach to place in which there is a shift from regarding place in terms of a where to understanding what a place is in human experience.
A Taxonomy of Environmentally Scaffolded Affectivity
Authors: Coninx Sabrina , Stephan Achim
Published: December 2021

In this paper, we argue that the concept of environmental scaffolding can contribute to a better understanding of our affective life and the complex manners in which it is shaped by environmental entities. In particular, the concept of environmental scaffolding offers a more comprehensive and less controversial framework than the notions of embeddedness and extendedness. We contribute to the literature on situated affectivity by embracing and systematizing the diversity of affective scaffolding. In doing so, we introduce several distinctions that provide classifications of different types of environmentally scaffolded affectivity. Furthermore, we differentiate eight dimensions (e.g., trust, individualization, or intent) that allow us to evaluate the quality and effectivity of scaffolds in particular applications. On that basis, we develop a taxonomy using paradigmatic examples of affective scaffolding. This taxonomy enriches the current debate by emphasizing distinctions that are often conflated and by identifying fields of application that are commonly overlooked.
Bodies-in-Relation: Fine-Tuning Group-Directed Empathy
Authors: Pawlett-Jackson Sarah
Published: December 2021

In this paper I analyze Alessandro Salice and Joona Taipale’s account of ‘group-directed empathy.’ I am highly sympathetic to Salice and Taipale’s account and intend this paper to be an endorsement of their project. However, I will argue that a more fine-grained account of group-directed empathy can be offered, and I seek to contribute to this discussion by outlining at least one way in which different types of group-directed empathy may be identified. I argue that while Salice and Taipale are right to claim that an account of group-directed empathy requires a corresponding account of ‘collective bodiliness,’ there is an important form of collective bodiliness that their account does not fully incorporate, namely embodied interaction between others. I argue that a closer look at the perceivability of interactions between others offers a richer and more complete account of how we can empathetically perceive shared emotions between groups of people.
A review of the Indian species of Apochinomma Pavesi, 1881 and Corinnomma Karsch, 1880, synonymy of Castianeira quadrimaculata Reimoser, 1934, and a catalogue of the Indian corinnid fauna (Arachnida: Araneae)
Authors: SANKARAN PRADEEP M.
Published: December 2021

Indian species of the genera Apochinomma Pavesi, 1881 and Corinnomma Karsch, 1880 are reviewed. Corinnomma rufofuscum Reimoser, 1934 syn. nov. is synonymised with A. nitidum (Thorell, 1895). Redescriptions of A. nitidum and C. severum (Thorell, 1877) are provided, and two colour morphs (brown and black) of A. nitidum are illustrated. Supplementary descriptions for A. dolosum Simon, 1897 and C. comulatum Thorell, 1891 are provided. The species Castianeira quadrimaculata Reimoser, 1934 syn. nov. is recognised as a junior synonym of Coenoptychus pulcher Simon, 1885. Images of all the examined type material are provided and a catalogue of Indian corinnid species is presented.
Three-dimensional SPACE MR with CAIPIRINHA fourfold acceleration for assessing long head of biceps tendon
Authors: Liu Liangjin , Wu Gang
Published: December 2021

Background

Data regarding controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) T2-weighted sampling perfection with application optimized contrast evolution (SPACE) with fourfold acceleration factor for assessing long head of biceps tendon (LHBT) disorder is lacking.

Purpose

To investigate the feasibility of 3D CAIPIRINHA SPACE with fourfold acceleration in assessing LHBT disorder.

Material and Methods

A total of 42 consecutive patients underwent shoulder magnetic resonance (MR) examinations including CAIPIRINHA SPACE with fourfold acceleration, and non-CAIPIRINHA SPACE with twofold acceleration, and 2D fast spin echo (FSE). A subjective score of depiction of LHBT was given to 3D sequence according to a 4-point scale (0–3, “poor” to “excellent”). The Wilcoxon signed rank test was used to compare depiction scores between 3D sequences. Three statuses of LHBT were defined in the study: normal, tendonitis, and tear. McNemar’s test was used compare diagnostic accuracy.

Results

LHBT was better depicted with CAIPIRINHA SPACE versus non-CAIPIRINHA SPACE (2.1 ± 0.4 vs. 1.5 ± 0.4; P < 0.001). Inter-modality agreement between CAIPIRINHA SPACE and 2D FSE was almost perfect (kappa = 0.884 ± 0.064). The sensitivity and specificity in detecting LHBT disorder were 95% (20/21) and 95% (20/21), respectively, for CAIPIRINHA SPACE, and 71% (15/21) and 76% (16/21), respectively, for non-CAIPIRINHA SPACE ( P = 0.039).

Conclusion

Fourfold acceleration CAIPIRINHA is feasible in reducing the acquisition time of SPACE MR in the shoulder. 3D CAIPIRINHA SPACE with fourfold acceleration is highly accurate in detecting LHBT disorder.
Single-cell RNA sequencing reveals thatBMPR2mutation regulates right ventricular functionvia IDgenes
Authors: Du Mingxia , Jiang Haibin , Liu Hongxian , Zhao Xin , Zhou Yu , Zhou Fang , Piao Chunmei , Xu Guoqiang , Ma Feng , Wang Jianan , Perros Frederic , Morrell Nicholas W. , Gu Hong , Yang Jun
Published: December 2021

Background

Mutations in bone morphogenetic protein type II receptor (BMPR2) have been found in patients with congenital heart disease-associated pulmonary arterial hypertension (CHD-PAH). Our study aimed to clarify whether deficient BMPR2 signalling acts through downstream effectors, inhibitors of DNA-binding proteins (IDs) during heart development to contribute to the progress of PAH in CHD patients.

Methods

To confirm that IDs are downstream effectors of BMPR2 signalling in cardiac mesoderm progenitors (CMPs) and contribute to PAH, we generated cardiomyocyte-specificId 1/3knockout mice (Ids cDKO), and 12 out of 25 developed mild PAH with altered haemodynamic indices and pulmonary vascular remodelling. Moreover, we generatedID1andID3double-knockout (IDs KO) human embryonic stem cells that recapitulated the BMPR2 signalling deficiency of CHD-PAH induced pluripotent stem cells (iPSCs).

Results

Cardiomyocytes differentiated from iPSCs derived from CHD-PAH patients with BMP receptor mutations exhibited dysfunctional cardiac differentiation and reduced calcium (Ca2+) transients, as evidenced by confocal microscopy experiments. Smad1/5 phosphorylation and ID1 and ID3 expression were reduced in CHD-PAH iPSCs and inBmpr2+/–rat right ventricles. Moreover, ultrasound revealed that 33% of Ids cDKO mice had detectable defects in their ventricular septum and pulmonary regurgitation. Cardiomyocytes isolated from mouse right ventricles also showed reduced Ca2+transients and shortened sarcomeres. Single-cell RNA sequencing analysis revealed impaired differentiation of CMPs and downregulated USP9X expression in IDs KO cells compared with wild-type cells.

Conclusion

We found that BMPR2 signals through IDs and USP9X to regulate cardiac differentiation, and the loss of ID1 and ID3 expression contributes to cardiomyocyte dysfunction in CHD-PAH patients withBMPR2mutations.
Effects of COVID-19 pandemics on urinary metabolites in kidney stone patients: our kidney stone prevention clinic experience
Authors: Tavasoli Sanaz , Borumandnia Nasrin , Basiri Abbas , Taheri Maryam
Published: December 2021

Background

The dietary habits and lifestyle changes during the COVID-19 pandemic could affect the urinary risk factors in kidney stone formers. In this study, we investigated the effects of the COVID-19 pandemic on 24-h urine metabolites, as a surrogate for dietary intake, in patients with kidney stones, in Tehran, Iran.

Methods

We evaluated the medical records of all patients with urolithiasis who visited in our stone prevention clinic from the beginning of COVID-19 in Iran to 1 year later (Feb 2020–Feb 2021) and compared it with the patients’ medical records in the same period a year before COVID-19 (Feb 2019–Feb 2020).

Results

The results of our stone prevention clinic showed a decrease in the number of visits during COVID-19. Twenty-four-hour urine urea, sodium, and potassium were significantly lower, and 24-h urine magnesium was significantly higher during COVID-19. Higher 24-h urine oxalate was only shown in patients with the first-time visit, whereas lower 24-h urine uric acid and citrate were only shown in patients with the follow-up visits.

Conclusions

COVID-19 pandemics may change some of the dietary habits of the patients, including lower salt, protein, and fruit and vegetable intake. Although economic issues, restricted access, or sanitation issues may be the reason for the undesirable dietary changes, the importance of a quality diet should be discussed with all patients, as possible. Since the number of patients visited in the stone clinic was lower during COVID-19, virtual visits could be an excellent alternative to motivate patients with kidney stones.
Treatment persistence to tolvaptan in patients with autosomal dominant polycystic kidney disease: a secondary use of data analysis of patients in the IMADJIN® dataset
Authors: Thomas Mark , Gois Pedro Henrique Franca , Butcher Belinda E. , Ta Michelle H. T. , Van Wyk Greg W.
Published: December 2021

Background

Tolvaptan is the only available disease-modifying treatment for autosomal dominant polycystic kidney disease (ADPKD). Prior to October 2020 access to tolvaptan in Australia was restricted by a controlled monitoring and distribution program called IMADJIN®. Focusing on hepatic safety, the IMADJIN® program collected real-world data on patients with ADPKD. A retrospective, secondary data analysis of the IMADJIN® dataset was undertaken to determine the time to all-cause discontinuation of tolvaptan in Australia.

Methods

Demographic and treatment data from 17 September 2018 to 30 September 2020 were extracted from the IMADJIN® dataset. Treatment persistence was analyzed using Kaplan-Meier methods, and Cox’s proportional hazard models were used to analyze differences in treatment persistence by age, sex and location.

Results

Four hundred seventy-nine patients with ADPKD were included in the analysis. After a median follow-up of 12.0 months (95% confidence interval [CI] 2.6, 23.4), the Kaplan-Meier estimation of 12-month persistence was 76.7% (95% CI 72.2, 80.5%). 114 (23.8%) patients discontinued treatment; sex, state, and remoteness did not significantly affect treatment persistence. Patients in the youngest tertile were more likely to discontinue compared to older ages (p = 0.049). Reasons for discontinuation included: aquaretic tolerability (4.2%), hepatic adverse events (abnormal liver function tests) (2.1%), disease progression (1.5%), and acute kidney injury (0.2%). Patients with a lack of aquaretic tolerance had shorter time to discontinuation. Hepatic toxicity events were initially observed 3 months after tolvaptan initiation and were less prevalent over time.

Conclusions

Persistence to tolvaptan in the real-world IMADJIN® dataset was 76%. Discontinuation due to hepatic events was low. Prescribers should take extra care when initiating treatment in younger patients as they are more likely to discontinue tolvaptan compared to older individuals. Nevertheless, the precise reason for this observation remains to be elucidated.
Prevalence and characteristics of patients with heart failure needing palliative care
Authors: Arenas Ochoa Luisa Fernanda , González-Jaramillo Valentina , Saldarriaga Clara , Lemos Mariantonia , Krikorian Alicia , Vargas John Jairo , Gómez-Batiste Xavier , Gonzalez-Jaramillo Nathalia , Eychmüller Steffen
Published: December 2021

Background

Few hospitals and heart failure (HF) clinics offer concurrent palliative care (PC) together with life-prolonging therapies. To know the prevalence of patients in HF clinics needing PC and useful tools to recognize them are the first steps to extending PC in those settings. However, it is still unknown whether tools commonly used to identify patients with HF needing PC can correctly distinguish them. Two systematic reviews found that the NECesidades PALiativas (NECPAL) tool was one of the two most commonly used tools to asses PC needs in HF patients. Therefore, we assessed 1) the prevalence of PC needs in HF clinics according to the NECPAL tool, and 2) the characteristics of the patients identified as having PC; mainly, their quality of life (QoL), symptom burden, and psychosocial problems.

Methods

This cross-sectional study was conducted at two HF clinics in Colombia. We assessed the prevalence of PC in the overall sample and in subgroups according to clinical and demographic variables. We assessed QoL, symptom burden, and psychosocial problems using the 12-Item Short-Form Health Survey (SF-12), the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Edmonton Symptom Assessment System (ESAS). We compared the results of these tools between patients identified as having PC needs (+NECPAL) and patients identified as not having PC needs (–NECPAL).

Results

Among the 178 patients, 78 (44%) had PC needs. The prevalence of PC needs was twice as nigh in patients NYHA III/IV as in patients NYHA I/II and almost twice as high in patients older than 70 years as in patients younger than 70 years. Compared to –NECPAL patients, +NECPAL patients had worse QoL, more severe shortness of breath, tiredness, drowsiness, and pain, and more psychosocial problems.

Conclusion

The prevalence of PC needs in outpatient HF clinics is high and is even higher in older patients and in patients at more advanced NYHA stages. Compared to patients identified as not having PC needs, patients identified as having PC needs have worse QoL, more severe symptoms, and greater psychosocial problems. Including a PC provider in the multidisciplinary team of HF clinics may help to assess and cover these needs.
A seven-year analysis of the role and impact of a free community eye clinic
Authors: Rowe Lucas W. , Scheive Melanie , Tso Hanna L. , Wurster Patrick , Kalafatis Nicholas E. , Camp David A. , Thau Avrey , Yung Chi Wah Rudy
Published: December 2021

Background

The Indiana University Student Outreach Clinic (IUSOC) Eye Clinic is a monthly student-run eye clinic that provides free visual screening to the Near East Side community of Indianapolis, IN, USA. Screening includes assessments of visual acuity, intraocular pressure, peripheral visual fields, refraction, and non-mydriatic fundus photography.

Methods

This is a retrospective chart review of 875 patients seen at the IUSOC Eye Clinic from October 2013 to February 2020. Data on demographics, insurance coverage, ocular history, physical examination, suspected diagnosis, referral status, and glasses provided were collected and analyzed.

Results

875 patients were seen at the IUSOC Eye Clinic from October 2013 to February 2020. 39.2% of the patients seen at the clinic reported being uninsured. 61.4% of patients were found to have visual acuity of 20/40 or worse, while 51.3% of patients were found to have a near visual acuity of 20/40 or worse. 20.3% of patients were referred to the local county hospital for further evaluation by an ophthalmologist, 14.4% of patients received free glasses prescriptions, and 27.9% of patients received free reading glasses. Common reasons for referral for further ophthalmology evaluation included glaucoma, decreased visual acuity, and diabetic retinopathy. An estimated value of services provided over the seven years of the clinic was 1271 relative value units.

Conclusion

The IUSOC Eye Clinic fills an important role in advancing ocular health and preventing irreversible blindness in an underserved Indianapolis community. Additionally, the clinic demonstrates an educational model for involving medical student volunteers.
Effects of COVID-19 pandemic on ART Service delivery: perspectives of healthcare workers in a Teaching Hospital in Ghana
Authors: Abraham Susanna Aba , Berchie Gifty Osei , Doe Patience Fakornam , Agyare Elizabeth , Addo Stephen Ayisi , Obiri-Yeboah Dorcas
Published: December 2021

Background

Ghana has a generalized HIV epidemic and efforts have been made to curb the spread and reverse its effects on the general population. In the wake of COVID-19 pandemic, the health system was unsettled and antiretroviral therapy (ART) care has been impacted in diverse ways. The study sought to explore the effects of COVID-19 on ART service provision in Ghana from the perspectives of the healthcare workers.

Methods

An exploratory-descriptive qualitative approach was employed in this study. Using maximum variation sampling method, fifteen healthcare workers; nurses, data managers and pharmacists were recruited from an ART clinic in a Teaching Hospital in Ghana. In-depth interviews were conducted and analysed using Braun and Clarke thematic approach.

Results

Three themes emerged from the data; “… And the pandemic struck”, “Impact of the pandemic on ART service delivery”; “Effecting the needed change”. The healthcare workers’ initial reactions to the pandemic and their show of commitment in ensuring continued ART service was evident. COVID-19 impacted service delivery in three main ways; (1) clients’ clinic attendance was erratic at various stages of the pandemic, (2) irregular resource availability as shortage was reported due to affected last mile delivery as a result of the lockdown in Accra, and (3) the health worker-patient interaction became less engaging because of established COVID-19 protocols. The healthcare workers however instituted strategies such as adjusting the patient appointment schedule, health professionals’ work schedule, establishing several work stations, task-shifting, and ensuring the implementation of all the COVID-19 protocols within the ART unit to ensure consistent service delivery as well as patient and staff safety. The study also found a decline in the implementation of several strategies established in the ART clinic during the initial phases of the pandemic such as a decline in the supply of Personal Protective Equipment (PPEs) by hospital management.

Conclusions

Although several strategies were implemented to manage the effects of the pandemic on ART care, there is a need to establish pathways of support for healthcare workers within the ART clinic and to consolidate as well as institutionalise the changes that ensured continuous but safe service delivery.
Impact of global budget combined with pay-for-performance on the quality of care in county hospitals: a difference-in-differences study design with a propensity-score-matched control group using data from Guizhou province, China
Authors: Zhou Wuping , Jian Weiyan , Wang Zhifan , Pan Jay , Hu Min , Yip Winnie
Published: December 2021

Background

Provider payment system has a profound impact on health system performance. In 2016, a number of counties in rural Guizhou, China, implemented global budget (GB) for county hospitals with quality control measures. The aim of this study is to measure the impact of GB combined with pay-for-performance on the quality of care of inpatients in county-level hospitals in China.

Methods

Inpatient cases of four diseases, including pneumonia, chronic asthma, acute myocardial infarction and stroke, from 16 county-level hospitals in Guizhou province that implemented GB in 2016 were selected as the intervention group, and similar inpatient cases from 10 county-level hospitals that still implemented fee-for-services were used as the control group. Propensity matching score (PSM) was used for data matching to control for age factors, and difference-in-differences (DID) models were constructed using the matched samples to perform regression analysis on quality of care for the four diseases.

Results

After the implementation of GB, rate of sputum culture in patients with pneumonia, rate of aspirin at discharge, rate of discharge with β-blocker and rate of smoking cessation advice in patients with acute myocardial infarction increased. Rate of oxygenation index assessment in patient with chronic asthma decreased 20.3%. There are no significant changes in other indicators of process quality.

Conclusions

The inclusion of pay-for-performance in the global budget payment system will help to reduce the quality risks associated with the reform of the payment system and improve the quality of care. Future reform should also consider the inclusion of the pay-for-performance mechanism.
Maternal lithium use and the risk of adverse pregnancy and neonatal outcomes: a Swedish population-based cohort study
Authors: Hastie Roxanne , Tong Stephen , Hiscock Richard , Lindquist Anthea , Lindström Linda , Wikström Anna-Karin , Sundström-Poromaa Inger
Published: December 2021

Background

Lithium is prescribed during pregnancy, but there is limited information about pregnancy and neonatal outcomes following in utero exposure. Thus, this study aimed to investigate the associations between lithium use and adverse pregnancy and neonatal outcomes.

Methods

This population-based cohort study examined associations between maternal lithium use and major adverse pregnancy and neonatal outcomes via inverse probability weighted propensity score regression models.

Results

Of 854,017 women included in this study, 434 (0.05%) used lithium during pregnancy. Among pre-specified primary outcomes, lithium use during pregnancy was associated with an increased risk of spontaneous preterm birth (8.7% vs 3.0%; adjusted relative risk [aRR] 2.64 95% CI 1.82, 3.82) and birth of a large for gestational age infant (9.0% vs 3.5%; aRR 2.64 95% CI 1.91, 3.66), but not preeclampsia nor birth of a small for gestational age infant. Among secondary outcomes, lithium use was associated with an increased risk of cardiac malformations (2.1% vs 0.8%; aRR 3.17 95% CI 1.64, 6.13). In an analysis restricted to pregnant women with a diagnosed psychiatric illness (n=9552), associations remained between lithium and spontaneous preterm birth, birth of a large for gestational age infant, and cardiovascular malformations; and a positive association with neonatal hypoglycaemia was also found. These associations were also apparent in a further analysis comparing women who continued lithium treatment during pregnancy to those who discontinued prior to pregnancy.

Conclusions

Lithium use during pregnancy is associated with an increased risk of spontaneous preterm birth and other adverse neonatal outcomes. These potential risks must be balanced against the important benefit of treatment and should be used to guide shared decision-making.
Dopamine, behavior, and addiction
Authors: Wise Roy A. , Jordan Chloe J.
Published: December 2021

Addictive drugs are habit-forming. Addiction is a learned behavior; repeated exposure to addictive drugs can stamp in learning. Dopamine-depleted or dopamine-deleted animals have only unlearned reflexes; they lack learned seeking and learned avoidance. Burst-firing of dopamine neurons enables learning—long-term potentiation (LTP)—of search and avoidance responses. It sets the stage for learning that occurs between glutamatergic sensory inputs and GABAergic motor-related outputs of the striatum; this learning establishes the ability to search and avoid. Independent of burst-firing, the rate of single-spiking—or “pacemaker firing”—of dopaminergic neurons mediates motivational arousal. Motivational arousal increases during need states and its level determines the responsiveness of the animal to established predictive stimuli. Addictive drugs, while usually not serving as an external stimulus, have varying abilities to activate the dopamine system; the comparative abilities of different addictive drugs to facilitate LTP is something that might be studied in the future.