bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychometric properties of the ethical conflict in nursing questionnaire critical care version among Chinese nurses: a cross-sectional study
Authors: Liu Yuanfei , Cui Nianqi , Zhang Yuping , Wang Xiyi , Zhang Hui , Chen Dandan , Sun Shunxia , Jin Jingfen
Published: July 2021

Background

Ethical conflicts are common in the critical care setting, and have compromised job satisfaction and nursing care quality. Using reliable and valid instruments to measure the ethical conflict is essential. This study aimed to translate the Ethical Conflict in Nursing Questionnaire — Critical Care Version into Chinese and determine the reliability and validity in the population of Chinese nurses.

Methods

Researchers obtained permission and followed the translation-backward method to develop the Chinese version of the Ethical Conflict in Nursing Questionnaire — Critical Care Version (ECNQ-CCV-C). Relevant psychometric properties were selected according to the Consensus-based standards for the selection of health status measurement instruments checklist. Critical care nurses were recruited from two tertiary public hospitals in Hangzhou, Zhejiang Province, and Kunming, Yunnan Province. Of the 264 nurses we approached, 248 gave their consent and completed the study.

Results

The ECNQ-CCV-C achieved Cronbach’s alphas 0.902 and McDonald’s omega coefficient 0.903. The test-retest reliability was satisfactory within a 2-week interval (intraclass correlation coefficient = 0.757). A unidimensional structure of the ECNQ-CCV-C was determined. Confirmatory factor analysis supported acceptable structure validity. Concurrent validity was confirmed by a moderate relation with a measure for hospital ethical climate (r = − 0.33,p < 0.01). The model structure was invariant across different gender groups, with no floor/ceiling effect.

Conclusions

The ECNQ-CCV-C demonstrated acceptable reliability and validity among Chinese nurses and had great clinical utility in critical care nursing.
Rabbit haemorrhagic disease virus Lagovirus europaeus/GI.1d strain: genome sequencing, in vivo virus replication kinetics, and viral dose effect
Authors: Droillard Clément , Lemaitre Evelyne , Amelot Michel , Blanchard Yannick , Keita Alassane , Eterradossi Nicolas , Le Gall-Reculé Ghislaine
Published: July 2021

Background

Rabbit haemorrhagic disease virus Lagovirus europaeus/GI.1d variant (GI.1d/RHDV) was identified in 1990 in France, and until the emergence of the new genotype GI.2, it was the main variant circulating in the country. The early stages of RHDV infection have been described in a few studies of rabbits experimentally infected with earlier strains, but no information was given on the minimum infective dose. We report the genomic and phenotypic characterisation of a GI.1d/RHDV strain collected in 2000 in France (GI.1d/00–21).

Results

We performed in vivo assays in rabbits to study virus replication kinetics in several tissues at the early stage of infection, and to estimate the minimum infective dose. Four tested doses, negligible (10− 1 viral genome copies), low (104), high (107) and very high (1011) were quantified using a method combining density gradient centrifugation of the viral particles and an RT-qPCR technique developed to quantify genomic RNA (gRNA). The GI.1d/00–21 genome showed the same genomic organisation as other lagoviruses; however, a substitution in the 5′ untranslated region and a change in the potential p23/2C-like helicase cleavage site were observed. We showed that the liver of one of the two rabbits inoculated via the oral route was infected at 16 h post-infection and all tissues at 39 h post-infection. GI.1d/00–21 induced classical RHD signs (depression) and lesions (haemorrhage and splenomegaly). Although infective dose estimation should be interpreted with caution, the minimum infective dose that infected an inoculated rabbit was lower or equal to 104 gRNA copies, whereas between 104 and 107 gRNA copies were required to also induce mortality.

Conclusions

These results provide a better understanding of GI.1d/RHDV infection in rabbits. The genome analysis showed a newly observed mutation in the 5′ untranslated region of a lagovirus, whose role remains unknown. The phenotypic analysis showed that the pathogenicity of GI.1d/00–21 and the replication kinetics in infected organs were close to those reported for the original GI.1 strains, and could not alone explain the observed selective advantage of the GI.1d strains. Determining the minimum dose of viral particles required to cause mortality in rabbits is an important input for in vivo studies.
Rare hereditary nonspherocytic hemolytic anemia caused by a novel homozygous mutation, c.301C > A, (Q101K), in the AK1 gene in an Indian family
Authors: Dongerdiye Rashmi , Sampagar Abhilasha , Devendra Rati , Warang Prashant , Kedar Prabhakar
Published: July 2021

Background

Adenylate kinase (AK) deficiency is a rare red cell enzymopathy associated with moderate to severe congenital nonspherocytic hemolytic anemia, along with mental and psychomotor retardation (in exceptional cases). Only ten mutations have been detected in the AK1 gene to date. In this study, we aimed to diagnose the unexplained issue of haemolytic anaemia and offer antenatal screening to the family.

Methods

Genomic DNA was isolated from whole blood by a standard protocol. Targeted next-generation sequencing (t-NGS) was performed to identify pathogenic variants in the patient and control samples. A chronic villus sample was collected at 11 weeks of gestation from the mother, and molecular testing was performed. Genetic confirmation was concluded by Sanger DNA sequencing. Bioinformatics tools predicted the pathogenicity of the variant.

Results

t-NGS revealed a homozygous variant (c.301C > A, p. Gln101Lys) in the AK1 gene in the patient and heterozygosity in the fetus and parental samples. The prediction tools SIFT, Polyphen2, Provean, PMUT, Mutation taster, and Mutation Assessor, confirmed the damaging effect of the variant on the AK1 protein structure

Conclusion

We have presented a novel mutation in the AK1 gene (p. Gln101Lys) associated with adenylate kinase deficiency. It is the first prenatal diagnosis of AK deficiency in India, where heterogeneity is exceptionally high.
Expression and prognostic significance of CBX2 in colorectal cancer: database mining for CBX family members in malignancies and vitro analyses
Authors: Zhou He , Xiong Yongfu , Liu Zuoliang , Hou Songlin , Zhou Tong
Published: July 2021

Background

The Chromobox (CBX) domain protein family, a core component of polycomb repressive complexes 1, is involved in transcriptional repression, cell differentiation, and program development by binding to methylated histone tails. Each CBX family member plays a distinct role in various biological processes through their own specific chromatin domains, due to differences in conserved sequences of the CBX proteins. It has been demonstrated that colorectal cancer (CRC) is a multiple-step biological evolutionary process, whereas the roles of the CBX family in CRC remain largely unclear.

Methods

In the present study, the expression and prognostic significance of the CBX family in CRC were systematically analyzed through a series of online databases, including Cancer Cell Line Encyclopedia (CCLE), Oncomine, Human Protein Atlas (HPA), and Gene Expression Profiling Interactive Analysis (GEPIA). For in vitro verification, we performed cell cloning, flow cytometry and transwell experiments to verify the proliferation and invasion ability of CRC cells after knocking down CBX2.

Results

Most CBX proteins were found to be highly expressed in CRC, but only the elevated expression of CBX2 could be associated with poor prognosis in patients with CRC. Further examination of the role of CBX2 in CRC was performed through several in vitro experiments. CBX2 was overexpressed in CRC cell lines via the CCLE database and the results were verified by RT-qPCR. Moreover, the knockdown of CBX2 significantly suppressed CRC cell proliferation and invasion. Furthermore, the downregulation of CBX2 was found to promote CRC cell apoptosis.

Conclusions

Based on these findings, CBX2 may function as an oncogene and potential prognostic biomarker. Thus, the association between the abnormal expression of CBX2 and the initiation of CRC deserves further exploration.
Classification of microcalcification clusters in digital breast tomosynthesis using ensemble convolutional neural network
Authors: Xiao Bingbing , Sun Haotian , Meng You , Peng Yunsong , Yang Xiaodong , Chen Shuangqing , Yan Zhuangzhi , Zheng Jian
Published: July 2021

Background

The classification of benign and malignant microcalcification clusters (MCs) is an important task for computer-aided diagnosis (CAD) of digital breast tomosynthesis (DBT) images. Influenced by imaging method, DBT has the characteristic of anisotropic resolution, in which the resolution of intra-slice and inter-slice is quite different. In addition, the sharpness of MCs in different slices of DBT is quite different, among which the clearest slice is called focus slice. These characteristics limit the performance of CAD algorithms based on standard 3D convolution neural network (CNN).

Methods

To make full use of the characteristics of the DBT, we proposed a new ensemble CNN, which consists of the 2D ResNet34 and the anisotropic 3D ResNet to extract the 2D focus slice features and 3D contextual features of MCs, respectively. Moreover, the anisotropic 3D convolution is used to build 3D ResNet to avoid the influence of DBT anisotropy.

Results

The proposed method was evaluated on 495 MCs in DBT images of 275 patients, which are collected from our collaborative hospital. The area under the curve (AUC) of receiver operating characteristic (ROC) and accuracy of classifying benign and malignant MCs using decision-level ensemble strategy were 0.8837 and 82.00%, which were significantly higher than the experimental results of 2D ResNet34 (AUC: 0.8264, ACC: 76.00%) and anisotropic 3D ResNet (AUC: 0.8455, ACC: 76.00%). Compared with the results of 3D features classification in the radiomics, the AUC of the deep learning method with decision-level ensemble strategy was improved by 0.0435, and the F1 score was improved from 79.37 to 85.71%. More importantly, the sensitivity increased from 78.13 to 84.38%, and the specificity increased from 66.67 to 77.78%, which effectively reduced the false positives of diagnosis

Conclusion

The results fully prove that the ensemble CNN can effectively integrate 2D features and 3D features, improve the classification performance of benign and malignant MCs in DBT, and reduce the false positives.
Mothers’ quality of life delivering kangaroo mother care at Malawian hospitals: a qualitative study
Authors: Nyondo-Mipando Alinane Linda , Kinshella Mai-Lei Woo , Hiwa Tamanda , Salimu Sangwani , Banda Mwai , Vidler Marianne , Molyneux Elizabeth , Dube Queen , Goldfarb David M. , Kawaza Kondwani
Published: July 2021

Introduction

Kangaroo mother care is known to help save the lives of preterm and low birthweight infants, particularly in resource-limited health settings, yet barriers to implementation have been documented. Mothers and their families are very involved in the process of providing kangaroo mother care and the impact on their well-being has not been well explored. The objective of this research was to investigate the perspectives and experiences of a mother’s quality of life while delivering facility-based kangaroo mother care.

Methods

This study is a secondary analysis of the qualitative data collected within the “Integrating a neonatal healthcare package for Malawi” project. Twenty-seven health workers and 24 caregivers engaged with kangaroo mother care at four hospitals in southern Malawi were interviewed between May–August 2019. All interviews were face-to-face and followed a topic guide. Content analysis was conducted on NVivo 12 (QSR International, Melbourne, Australia) based on the six World Health Organization Quality of Life domains (physical, psychological, level of independence, social relationships, environment, spirituality).

Results

Fifty-one interviews were conducted with 24 caregivers and 14 health workers. Mothers experienced multidimensional challenges to their quality of life while delivering facility-based KMC. Though kangaroo mother care was considered a simple intervention, participants highlighted that continuous kangaroo mother care was difficult to practice. Kangaroo mother care was an exhausting experience for mothers due to being in one position for prolonged periods, compromised sleep, restricted movement, boredom, and isolation during their stay at the hospital as well as poor support for daily living needs such as food.

Discussion

A heavy burden is placed on mothers who become the key person responsible for care during kangaroo mother care, especially in resource-limited health settings. More focus is needed on supporting caregivers during the delivery of kangaroo mother care through staff support, family inclusion, and conducive infrastructure.
The additional use of methylene blue has a decatecholaminisation effect on cardiac vasoplegic syndrome after cardiac surgery
Authors: Petermichl Walter , Gruber Michael , Schoeller Ina , Allouch Kwahle , Graf Bernhard M. , Zausig York A.
Published: July 2021

Background

Postoperative vasoplegia with minimal responsiveness to vasopressors is common after cardiac surgery. Called cardiac vasoplegic syndrome (CVS), it is caused by multiple factors. Treating CVS involves a high dose of fluids and catecholamines, however high doses of catecholamines and fluids are associated with serious side effects. There is evidence that new therapeutic strategies can lead to a reduction in norepinephrine doses and mortality in CVS. Specifically, the use of non-adrenergic vasopressors such as methylene blue (MB) can be beneficial.

Methods

We retrospectively analyzed the electronic records of 8716 adult cardiac surgery patients from November 2008 to December 2016. Medication, hemodynamic and outcome parameter data were analyzed for CVS until discharge. We determined CVS according to the following parameters: a postoperative onset of ≤24 h, a reduced mean arterial pressure (MAP) of < 70 mmHg, a dose of norepinephrine ≥0.8 mg*h− 1 and a continuously increasing need for catecholamine, without ventricular dysfunction.

Results

We identified 513 patients with CVS. Perioperative risk factors were higher in patients treated with methylene blue (MB). Before MB administration patients had a significantly higher dose of norepinephrine, and MAP increased after MB administration. Norepinephrine could be reduced after MB administration and MAP remained stable at the same level even after the reduction of norepinephrine.

Conclusions

CVS patients have a severe systemic disease accompanied by significant operative stress and a high catecholamine requirement. The administration of MB in addition to standard treatment for CVS in the first 24 h was accompanied by an increase in MAP followed by a decrease in vasopressor requirement, indicating that early MB administration can be beneficial.
Conflict affected, parallel health systems: challenges to collaboration between ethnic and government health systems in Kayin State, Myanmar
Authors: Biesty Colette Pang , Brang Aung Ja , Munslow Barry
Published: July 2021

Background

Myanmar has had a long history of civil wars with its minority ethnic groups and is yet to see a sustainable peace accord. The conflicts have had a significant impact on health in Myanmar, with ethnic populations experiencing inequitable health outcomes. Consequently, to meet the health needs of ethnic people, Ethnic Health Organisations and Community-Based Health Organisations (EHO/CBHOs) created their own health system. The EHO/CBHO and Government health systems, provided by the Myanmar Ministry of Health and Sports (MoHS), remain parallel, despite both stakeholders discussing unification of the health systems within the context of ongoing but unresolved peace processes. EHO/CBHOs discuss the ‘convergence’ of health systems, whilst the MoHS discuss the integration of health providers under their National Health Plan.

Methods

A qualitative study design was used to explore the challenges to collaboration between EHO/CBHOs and the MoHS in Kayin state, Myanmar. Twelve health workers from different levels of the Karen EHO/CBHO health system were interviewed. Semi-structured, in-depth interviews were digitally recorded, transcribed, and coded. Data was analysed thematically using the Framework method. Topic guides evolved in an iterative process, as themes emerged inductively from the transcripts. A literature review and observation methods were also utilised to increase validity of the data.

Results

The challenges to collaboration were identified in the following five themes: (1) the current situation is not ‘post conflict’ (2) a lack of trust (3) centralised nature of the MoHS (4) lack of EHO/CBHO health worker accreditation (5) the NHP is not implemented in some ethnic areas.

Conclusions

Ultimately, all five challenges to collaboration stem from the lack of peace in Myanmar. The health systems cannot be ‘converged or ‘integrated’ until there is a peace accord which is acceptable to all actors. EHO/CBHOs want a federal political system, where the health system is devolved, equitable and accessible to all ethnic people. External donors should understand this context and remain neutral by supporting all health actors in a conflict sensitive manner.
Surgical caps displaying team members' names and roles improve effective communication in the operating room: a pilot study
Authors: Douglas Ned , Demeduik Sophie , Conlan Kate , Salmon Priscilla , Chee Brian , Sullivan Taylor , Heelan David , Ozcan John , Symons Gareth , Marane Candida
Published: July 2021

Background

Teamwork in the operating theatre is a complex emergent phenomenon and is driven by cooperative relationships between staff. A foundational requirement for teamwork is the ability to communicate effectively, and in particular, knowing each other’s name. Many operating theatre staff do not know each other’s name, even after formal team introductions. The use of theatre caps to display a staff member’s name and role has been suggested to improve communication and teamwork.

Methods

We hypothesized that the implementation of scrub hats with individual team members' names and roles would improve the perceived quality and effectiveness of communication in the operating theatre. A pilot project was designed as a pre-/post-implementation questionnaire sent to 236 operating room staff members at a general hospital in suburban Melbourne, Victoria, Australia, between November 6 to December 18, 2018. Participants included medical practitioners (anaesthetists, surgeons, obstetricians and gynaecologists), nurses (anaesthetic, scrub/scout and paediatric nurses), midwives and theatre technicians. The primary outcome was a change in perceived teamwork score, measured using a five position Likert scale.

Results

Of 236 enrolled participants, 107 (45%) completed both the pre and post intervention surveys. The median perceived teamwork response of four did not change after the intervention, though the number of low scores was reduced (p = 0.015). In a pre-planned subgroup analysis, the median perceived teamwork score rose for midwives from three to four (p < 0.001), while for other craft groups remained similar. The median number of staff members in theatre that a participant did not know the name of reduced from three to two (p < 0.001). Participants reported knowing the names of all staff members present in the theatre more frequently after the intervention (31% vs 15%, p < 0.001). The reported rate of formal team introductions was not significantly different after the intervention (34.7% vs 47.7% p = 0.058).

Conclusions

In this study, we found that wearing caps displaying name and role appeared to improve perceived teamwork and improve communication between staff members working in the operating theatre.
Simultaneous expression of steroid sulfatase and androgen receptor reduced overall survival of patients with epithelial ovarian tumors
Authors: Calvillo-Robledo Argelia , Pedernera Enrique , Morales-Vásquez Flavia , Pérez-Montiel Delia , Gómora María J. , Almaraz Miguel Ángel , de Alba Graue Paulina García , Rendón Elizabeth , López-Basave Horacio Noé , Quintanar-Stephano Andrés , Méndez Carmen
Published: July 2021

Background

Ovarian cancer is usually diagnosed at an advanced stage due to its early asymptomatic course and late-stage non-specific symptoms. This highlights the importance of researching the molecular mechanisms involved in ovarian carcinogenesis as well as the discovery of novel prognostic markers that could help improve the survival outcome of patients. The aim of this study was to evaluate the expression of the steroid sulfatase (STS) in 154 samples of primary ovarian tumors. This protein is crucial in the intracellular conversion of sulfated steroid hormones to active steroid hormones. The presence of STS, 3β-HSD, and 17β-HSD1 result in the production of testosterone which act through the androgen receptor (AR) in the tumor cell. The presence of STS and AR in epithelial ovarian tumors and their association to the overall survival of patients was evaluated using Kaplan–Meier and Cox regression analyses.

Results

Immunoreactivity for STS was detected in 65% of the tumors and no association was observed with histological subtypes and clinical stages of the tumor. The STS expression in the tumors exhibiting immunoreactive AR resulted in a reduced survival (log-rank test, p = 0.032) and a risk factor in univariate and multivariate analysis, HR = 3.46, CI95% 1.00–11.92, p = 0.049 and HR = 5.92, CI95% 1.34–26.09, p = 0.019, respectively.

Conclusions

These findings suggest that the intracellular synthesis of testosterone acting through its receptor can promote tumor growth and progression. Moreover, the simultaneous expression of STS and AR constitutes an independent predictor of poor prognosis in epithelial ovarian tumors.
Effect of GreenshellTM mussel on osteoarthritis biomarkers and inflammation in healthy postmenopausal women: a study protocol for a randomized double-blind placebo-controlled trial
Authors: Abshirini Maryam , Coad Jane , Wolber Frances M. , von Hurst Pamela , Miller Matthew R. , Tian Hong Sabrina , Kruger Marlena C.
Published: July 2021

Background

New Zealand Greenshell™ mussels (GSM; Perna canaliculus) have recently been shown to decrease cartilage degradation in a rat model of induced metabolic osteoarthritis (MetOA). However, this effect has not been investigated in human subjects. This study aims to determine the effect of GSM powder on biomarkers of cartilage metabolism, bone resorption, and inflammation in New Zealand healthy overweight/obese postmenopausal women who are at early stage or at high risk of OA.

Method

Fifty overweight or obese (BMI 25–35 kg/m2) postmenopausal women (aged 55–75 years) will be recruited by advertisement. Participants will be randomized based on a double-blind randomization schedule and stratified randomization based on BMI and age distribution. The participant will be assigned with a 1:1 allocation ratio to receive 3 g/d whole meat GSM powder or placebo (sunflower seed protein) for 12 weeks. Data on socio-demographics, physical activity, and dietary intake will be collected for each subject. Cartilage turnover biomarkers [(C-telopeptide of type II collagen (CTX-II), C-propeptide of type II procollagen (CPII), Cartilage oligomeric matrix protein (COMP)], and bone resorption marker (CTX-I) will be measured in blood and urine samples. Inflammatory status (hs-CRP and cytokine panel) will be assessed and iron status will be measured. Body composition including fat mass (FM), lean mass (LM), and fat percentage will be measured using dual-energy X-ray absorptiometry (DXA). Joint pain and knee function will be assessed using a 100-mm visual analog scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire, respectively.

Discussion

This trial will be the first to explore the effects of whole meat GSM powder on cartilage turnover, bone resorption, and inflammation biomarkers in overweight/obese postmenopausal women. The results from this trial will provide evidence on the efficacy of GSM in the prevention of OA.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000413921p. Registration on 27 March 2020.
Sensitivity of cohesin–chromatin association to high-salt treatment corroborates non-topological mode of loop extrusion
Authors: Golov Arkadiy K. , Golova Anastasia V. , Gavrilov Alexey A. , Razin Sergey V.
Published: July 2021

Cohesin is a key organizer of chromatin folding in eukaryotic cells. The two main activities of this ring-shaped protein complex are the maintenance of sister chromatid cohesion and the establishment of long-range DNA–DNA interactions through the process of loop extrusion. Although the basic principles of both cohesion and loop extrusion have been described, we still do not understand several crucial mechanistic details. One of such unresolved issues is the question of whether a cohesin ring topologically embraces DNA string(s) during loop extrusion. Here, we show that cohesin complexes residing on CTCF-occupied genomic sites in mammalian cells do not interact with DNA topologically. We assessed the stability of cohesin-dependent loops and cohesin association with chromatin in high-ionic-strength conditions in G1-synchronized HeLa cells. We found that increased salt concentration completely displaces cohesin from those genomic regions that correspond to CTCF-defined loop anchors. Unsurprisingly, CTCF-anchored cohesin loops also dissipate in these conditions. Because topologically engaged cohesin is considered to be salt resistant, our data corroborate a non-topological model of loop extrusion. We also propose a model of cohesin activity throughout the interphase, which essentially equates the termination of non-topological loop extrusion with topological loading of cohesin. This theoretical framework enables a parsimonious explanation of various seemingly contradictory experimental findings.
Coronavirus-disease-2019-induced antiphospholipid-like syndrome: a case report
Authors: Bahramnezhad Fatemeh , Ghorbani Banafsheh , Ghaedrahamt Meysam , Jamaati Hamidreza
Published: July 2021

Background

This paper describes a case of antiphospholipid syndrome-like condition caused by coronavirus disease 2019. The medical community still faces many diagnostic and therapeutic challenges vis-à-vis coronavirus disease 2019. Ultimately, coronavirus disease 2019 is diagnosed on the basis of laboratory and radiological findings. Considering the high rate of mortality due to coagulation abnormalities and thrombosis among coronavirus disease 2019 patients, it is important to pay attention to the differential diagnoses of coronavirus disease 2019 and other diseases following thrombotic events.

Case description

The patient was a 56-year-old Iranian man who underwent coronary artery bypass graft surgery and mitral valve repair. During hospitalization, the patient showed an elevated level of anticardiolipin antibody (immunoglobulin G isotype), antiphospholipid antibodies, and thrombosis in the brachial artery of the left hand, based on which a differential diagnosis of antiphospholipid syndrome was made. However, ultimately, the coronavirus disease 2019 polymerase chain reaction test and computed tomography scan of the lungs showed that the patient had coronavirus disease 2019.

Conclusion

According to the few studies performed on coronavirus disease 2019 patients, elevated levels of the isotypes of antiphospholipid antibodies in coronavirus disease 2019 patients create conditions similar to antiphospholipid syndrome, which, in the absence of reliable coronavirus disease 2019 testing, can lead to misdiagnosis and consequently delayed or improper treatment. Therefore, to provide timely and appropriate treatment, it is important to pay attention to differential diagnosis.
[18F]FDG PET/MRI enables early chemotherapy response prediction in pancreatic ductal adenocarcinoma
Authors: Harder Felix N. , Jungmann Friederike , Kaissis Georgios A. , Lohöfer Fabian K. , Ziegelmayer Sebastian , Havel Daniel , Quante Michael , Reichert Maximillian , Schmid Roland M. , Demir Ihsan Ekin , Friess Helmut , Wildgruber Moritz , Siveke Jens , Muckenhuber Alexander , Steiger Katja , Weichert Wilko , Rauscher Isabel , Eiber Matthias , Makowski Marcus R. , Braren Rickmer F.
Published: July 2021

Purpose

In this prospective exploratory study, we evaluated the feasibility of [18F]fluorodeoxyglucose ([18F]FDG) PET/MRI-based chemotherapy response prediction in pancreatic ductal adenocarcinoma at two weeks upon therapy onset.

Material and methods

In a mixed cohort, seventeen patients treated with chemotherapy in neoadjuvant or palliative intent were enrolled. All patients were imaged by [18F]FDG PET/MRI before and two weeks after onset of chemotherapy. Response per RECIST1.1 was then assessed at 3 months [18F]FDG PET/MRI-derived parameters (MTV50%, TLG50%, MTV2.5, TLG2.5, SUVmax, SUVpeak, ADCmax, ADCmean and ADCmin) were assessed, using multiple t-test, Man–Whitney-U test and Fisher’s exact test for binary features.

Results

At 72 ± 43 days, twelve patients were classified as responders and five patients as non-responders. An increase in ∆MTV50% and ∆ADC (≥ 20% and 15%, respectively) and a decrease in ∆TLG50% (≤ 20%) at 2 weeks after chemotherapy onset enabled prediction of responders and non-responders, respectively. Parameter combinations (∆TLG50% and ∆ADCmax or ∆MTV50% and ∆ADCmax) further improved discrimination.

Conclusion

Multiparametric [18F]FDG PET/MRI-derived parameters, in particular indicators of a change in tumor glycolysis and cellularity, may enable very early chemotherapy response prediction. Further prospective studies in larger patient cohorts are recommended to their clinical impact.
Percutaneous dilatational tracheotomy in high-risk ICU patients
Authors: Lüsebrink Enzo , Krogmann Alexander , Tietz Franziska , Riebisch Matthias , Okrojek Rainer , Peltz Friedhelm , Skurk Carsten , Hullermann Carsten , Sackarnd Jan , Wassilowsky Dietmar , Toischer Karl , Scherer Clemens , Preusch Michael , Testori Christoph , Flierl Ulrike , Peterss Sven , Hoffmann Sabine , Kneidinger Nikolaus , Hagl Christian , Massberg Steffen , Zimmer Sebastian , Luedike Peter , Rassaf Tienush , Thiele Holger , Schäfer Andreas , Orban Martin ,   the P. D. T. Investigator Group, Kääb Stefan , Brunner Stefan , Orban Mathias , Petzold Tobias , Kehar Saliha , Würbel Sara , Stemmler Hans-Joachim , Binzenhöfer Leonhard , Kleeberger Jan , Kellnar Antonia
Published: July 2021

Background

Percutaneous dilatational tracheotomy (PDT) has become an established procedure in intensive care units (ICU). However, the safety of this method has been under debate given the growing number of critically ill patients with high bleeding risk receiving anticoagulation, dual antiplatelet therapy (DAPT) or even a combination of both, i.e. triple therapy. Therefore, the purpose of this study, including such a high proportion of patients on antithrombotic therapy, was to investigate whether PDT in high-risk ICU patients is associated with elevated procedural complications and to analyse the risk factors for bleeding occurring during and after PDT.

Methods

PDT interventions conducted in ICUs at 12 European sites between January 2016 and October 2019 were retrospectively analysed for procedural complications. For subgroup analyses, patient stratification into clinically relevant risk groups based on anticoagulation and antiplatelet treatment regimens was performed and the predictors of bleeding occurrence were analysed.

Results

In total, 671 patients receiving PDT were included and stratified into four clinically relevant antithrombotic treatment groups: (1) intravenous unfractionated heparin (iUFH, prophylactic dosage) (n = 101); (2) iUFH (therapeutic dosage) (n = 131); (3) antiplatelet therapy (aspirin and/or P2Y12 receptor inhibitor) with iUFH (prophylactic or therapeutic dosage) except for triple therapy (n = 290) and (4) triple therapy (DAPT with iUFH in therapeutic dosage) (n = 149). Within the whole cohort, 74 (11%) bleedings were reported to be procedure-related. Bleeding occurrence during and after PDT was independently associated with low platelet count (OR 0.73, 95% CI [0.56, 0.92], p = 0.009), chronic kidney disease (OR 1.75, 95% CI [1.01, 3.03], p = 0.047) and previous stroke (OR 2.13, 95% CI [1.1, 3.97], p = 0.02).

Conclusion

In this international, multicenter study bronchoscopy-guided PDT was a safe and low-complication airway management option, even in a cohort of high risk for bleeding on cardiovascular ICUs. Low platelet count, chronic kidney disease and previous stroke were identified as independent risk factors of bleeding during and after PDT but not triple therapy.
5G IoT-based geohazard monitoring and early warning system and its application
Authors: Li Zhaohua , Fang Linquan , Sun Xiaokun , Peng Wang
Published: July 2021

With the expansion of human production activities, geological disasters caused by slope instability are occurring more frequently. Hence, the research on effective monitoring and forecasting of the geotechnical stability of slopes is of great significance for the prevention and mitigation of slope geological disasters. In this study, a landslide monitoring and early warning system based on 5G Internet of Things (IoT) technology is introduced. The system monitors important indicators such as three-dimensional surface displacement, rainfall, and ground cracks using Global Navigation Satellite System equipment and various IoT sensors deployed on site. The key monitoring data are transmitted and displayed by 5G communication and advanced data visualization technologies. An early warning guideline is established by combining the surface deformation rate–time curve according to a four-level early warning method as well as embedded vector maps such as the topographic and geomorphological remote sensing map of the monitoring area, the geological section map, and the monitoring point distribution map. The system has the functions of accurate acquisition, rapid transmission, automatic search, and comprehensive analysis and is applied to the study of creep slopes of the Lianhe terraces in Youxi County, Fujian Province, with remarkable results.
Efficient task offloading using particle swarm optimization algorithm in edge computing for industrial internet of things
Authors: You Qian , Tang Bing
Published: July 2021

As a new form of computing based on the core technology of cloud computing and built on edge infrastructure, edge computing can handle computing-intensive and delay-sensitive tasks. In mobile edge computing (MEC) assisted by 5G technology, offloading computing tasks of edge devices to the edge servers in edge network can effectively reduce delay. Designing a reasonable task offloading strategy in a resource-constrained multi-user and multi-MEC system to meet users’ needs is a challenge issue. In industrial internet of things (IIoT) environment, considering the rapid increase of industrial edge devices and the heterogenous edge servers, a particle swarm optimization (PSO)-based task offloading strategy is proposed to offload tasks from resource-constrained edge devices to edge servers with energy efficiency and low delay style. A multi-objective optimization problem that considers time delay, energy consumption and task execution cost is proposed. The fitness function of the particle represents the total cost of offloading all tasks to different MEC servers. The offloading strategy based on PSO is compared with the genetic algorithm (GA) and the simulated annealing algorithm (SA) through simulation experiments. The experimental results show that the task offloading strategy based on PSO can reduce the delay of the MEC server, balance the energy consumption of the MEC server, and effectively realize the reasonable resource allocation.
Utilization of Recycled Aggregate Concrete for Marine Site Based on 7-Year Field Monitoring
Authors: Chalee Wichian , Cheewaket Tieng , Jaturapitakkul Chai
Published: July 2021

This research aimed to create value of construction and demolition waste to be able used as a recycled coarse aggregate (RCA) in durable concrete, based on 7-year field investigation in marine site. Fly ash was used to substitute Portland cement type I in RCA concrete varied from 0 to 50% by weight of binder with three W/B ratios and comparing to natural aggregate (NA) concrete. Cubical concrete specimens were cast having round steel bars embedded with various concrete coverings to evaluate the durability performances. After 28-day curing, the specimens were placed at a tidal zone in the gulf of Thailand and investigated both mechanical and durability performances at 7-year exposed period. Based on site monitoring, 15–25% fly ash RCA concrete with W/B ratio of 0.40 would be advantaged to resist destruction due to the marine attack when compared with NA concrete with the same water-to-binder ratio.
Consistent estimation of strain-rate fields from GNSS velocity data using basis function expansion with ABIC
Authors: Okazaki Tomohisa , Fukahata Yukitoshi , Nishimura Takuya
Published: July 2021

Present day crustal displacement rates can be accurately observed at stations of global navigation satellite system (GNSS), and crustal deformation has been investigated by estimating strain-rate fields from discrete GNSS data. For this purpose, a modified least-square inversion method was proposed by Shen et al. (J Geophys Res 101:27957–27980, 1996). This method offers a simple formulation for simultaneously estimating smooth velocity and strain-rate fields from GNSS data, and it has contributed to clarify crustal deformation fields in many regions all over the world. However, we notice three theoretical points to be examined when we apply the method: mathematical inconsistency between estimated velocity and strain-rate fields, difficulty in objectively determining the optimal value of a hyperparameter that controls smoothness, and inappropriate estimation of uncertainty. In this study, we propose a method of basis function expansion with Akaike’s Bayesian information criterion (ABIC), which overcomes the above difficulties. Application of the two methods to GNSS data in Japan reveals that the inconsistency in the method of Shen et al. is generally insignificant, but could be clear in regions with sparser observation stations such as in islet areas. The method of basis function expansion with ABIC shows a significantly better performance than the method of Shen et al. in terms of the trade-off curve between the residual of fitting and the roughness of velocity field. The estimated strain-rate field with the basis function expansion clearly exhibits a low strain-rate zone in the forearc from the southern Tohoku district to central Japan. We also find that the Ou Backbone Range has several contractive spots around active volcanoes and that these locations well correspond to the subsidence areas detected by InSAR after the 2011 Tohoku-oki earthquake. Thus, the method of basis function expansion with ABIC would serve as an effective tool for estimating strain-rate fields from GNSS data.
Ground water-induced changes in velocities of P and S waves (Vp and Vs) measured using an accurately controlled seismic source
Authors: Suzuki Rina , Yamaoka Koshun , Tsuji Shuhei , Watanabe Toshiki
Published: July 2021

We analyze temporal variations in the travel times of both P and S waves (Vp and Vs) for 14 months at Toyohashi (central Japan) with a continuously operating vibration source that could efficiently produce both P and S waves. Seismic waves produced by the source, which is called the accurately controlled routinely operated signal system (ACROSS), are recorded by three nearby seismic stations, and the travel time variation at each station is estimated using the transfer function calculated from the recorded data. Long-term variations in Vp and Vs are observed and can be interpreted by the change in fluid saturation and crack density of the subsurface rocks. The variation in fluid saturation and crack density are consistent with that in the groundwater level, which is measured at the station nearest to the ACROSS. Short-term responses to rainfalls are observed at the station nearest to the ACROSS system; the interpretation of the changes in crack density and saturation is inconsistent with the ground water observation, partly owing to the initial response to rainfall. This can be interpreted as an air–water mixture within pores or cracks on a fine scale.
Best practices and opportunities for integrating nutrition specific into nutrition sensitive interventions in fragile contexts: a systematic review
Authors: Abdullahi Leila H. , Rithaa Gilbert K. , Muthomi Bonface , Kyallo Florence , Ngina Clementina , Hassan Mohamed A. , Farah Mohamed A.
Published: July 2021

Background

Annually, undernutrition contributes globally to 45% (3.1 million) of preventable deaths in children under 5. Effect following undernutrition i.e. physical growth & cognitive development etc. can be prevented during the first 1000 days also called window of opportunity. There is substantial evidence of positive nutrition outcomes resulting from integrating nutrition-specific interventions into nutrition specific program. However, there is paucity of knowledge on establishing and sustaining effective integration of nutrition intervention in fragile context. The objective of this review is to map and review the integration of nutrition-specific intervention to nutrition sensitive program and its impacts on nutrition outcomes.

Methods

In the study, we systematically searched the literature on integrated nutrition intervention into multi-sectoral programme in PUBMED, Google’s Scholar, the Cochrane Library, World Health Organisation (WHO), United Nations Children’s Fund (UNICEF), World Bank and trial registers from their inception until Oct 30, 2020 for up-to-date published and grey resources. We screened records, extracted data, and assessed risk of bias in duplicates. This study is registered with PROSPERO (CRD42020209730).

Result

Forty-four studies were included in this review, outlining the integration of nutrition-specific interventions among children 0–59 months with various existing programme. Most common integration platform in the study included integrated community case management and Integrated Management of Childhood Illness, Child Health Days, immunization, early child development, and cash transfers. Limited quantitative data were suggestive of some positive impact on nutrition and non-nutrition outcomes with a number of model of integration which varies according to the context and demands of the particular setting in which integration occurs.

Conclusion

Overall, existing evidence for nutrition sensitive and specific interventions is not robust and remains limited. It’s worthwhile to note, for future studies/interventions should be based on the context key criteria like relevance, political support, effectiveness, feasibility, expected contribution to health system strengthening, local capacities, ease of integration and targeting for sustainability, cost effectiveness and financial availability.
Ultrasonographic and resistance index evaluation of nails in psoriatic arthritis, psoriasis, and control groups: a cross-sectional study
Authors: De Rossi Samanta Daiana , Mendonça José Alexandre , Palominos Penelope Ester , Kohem Charles Lubianca , Cestari Tania Ferreira , da Silva Chakr Rafael Mendonça
Published: July 2021

Background

Nail psoriasis occurs frequently in patients with psoriatic disease, it can lead to functional impairment, pain, discomfort, decreased quality of life and can also be a predictor for the development of arthritis. Early recognition of this condition can provide early and effective treatment and prevent structural impairment. This study aims to identify nail ultrasonographic characteristics in three groups: psoriasis (PsO), psoriatic arthritis (PsA) and controls patients, to determine if the ultrasonography (US) can identify early signs of nail psoriatic impairment or local inflammation. We conducted nail US to determine nail matrix resistance index (NMRI), nail bed resistance index (NBRI), and power Doppler (PD) and grayscale (GS) parameters in these 3 groups.

Methods

Single-center, cross-sectional study. GS, PD, and spectral doppler images of bilateral 2nd and 3rd fingernails were acquired from 35 PsO, 31 PsA, and 35 controls patients. An US equipment with an 18 MHz linear transducer for GS and 8.0 MHz for PD was used. PD, NMRI, NBRI, nail plate thickness (NPT), nail bed thickness (NBT), nail matrix thickness (NMT), and morphostructural characteristics of the trilaminar structure (TS) were evaluated in saved images, blind.

Results

Mean NMRI and NBRI did not differ between groups. Linear regression analysis detected no relationships between PsO or PsA and NMRI or NBRI. Nail PD grade did not differ between groups. Type I and IV TS changes were more frequent in PsO; types II and III changes were more frequent in PsA (p < 0.001). NPT was greater in PsA and PsO groups than controls: PsA 0.73 ± 0.14 mm, PsO 0.72 ± 0.15 mm, Controls 0.67 ± 0.10 mm (p = 0.001).

Conclusion

Echographic TS characteristics of the nail plate and NPT evaluated by GS are useful and can distinguish PsO and PsA nails from controls. NMRI, NBRI, and US nail microcirculation parameters could not distinguish psoriatic nails.

Trial registration

72762317.4.0000.5327 (Certificate of Presentation of Ethical Appreciation – CAAE - Plataforma Brasil) Avaiable in https://plataformabrasil.saude.gov.br/login.jsf.
The genetic diversity of “papillomavirome” in bovine teat papilloma lesions
Authors: Sauthier Jéssica Tatiane , Daudt Cíntia , da Silva Flavio Roberto Chaves , Alves Christian Diniz Beduschi Travassos , Mayer Fabiana Quoos , Bianchi Ronaldo Michel , Driemeier David , Streit Rodrigo Silva Araujo , Staats Charley Christian , Canal Cláudio Wageck , Weber Matheus Nunes
Published: July 2021

Background

Papillomaviruses are small nonenveloped, circular double-stranded DNA viruses that belong to thePapillomaviridaefamily. To date, 29Bos taurus papillomavirus(BPV) types have been described. Studies involving mixed BPV infections have rarely been reported in contrast to human papillomavirus (HPV), which is commonly described in numerous studies showing coinfections. Moreover, previous studies had shown that HPV coinfections increase the risk of carcinogenesis. In the present study, we used rolling-circle amplification followed by a high-throughput sequencing (RCA-HTS) approach in 23 teat papillomas from southern Brazil.

Results

Eleven well-characterized BPV types and 14 putative new BPV types were genetically characterized into theXi,EpsilonandDyoxipapillomavirusgenera according to phylogenetic analysis of the L1 gene, which expands the previous 29 BPV types to 43. Moreover, BPV coinfections were detected in the majority (56.3%) of the papilloma lesions analyzed, suggesting a genetic diverse “papillomavirome” in bovine teat warts.

Conclusions

The data generated in this study support the possibility that a wide range of BPV is probably underdetected by conventional molecular detection tools, and that BPV coinfections are underestimated and probably genetic diverse. Additionally, 14 new BPV types were characterized, increasing the knowledge regarding BPV genetic diversity.