bluuebunny/crossref_metadata_2025 huggingface dataset:
Subacute Cardiac Tamponade Due to Tuberculous Pericarditis Diagnosed by Urine Lipoarabinomannan Assay in a Immunocompetent Patient in Oyam District, Uganda: A Case Report
Authors: De Vita Elda , Segala Francesco Vladimiro , Amone James , Samuel Kabuga , Marotta Claudia , Putoto Giovanni , Nassali Ritah , Lochoro Peter , Bavaro Davide Fiore , Ictho Jerry , Okori Samuel , Di Gennaro Francesco , Saracino Annalisa
Published: November 2022

Background: Uganda ranks among the countries with the highest burden of TB the world and tuberculous pericarditis (TBP) affects up to 2% of people diagnosed with pulmonary tuberculosis worldwide. In Africa, it represents the most common cause of pericardial disease. Here, we present the case of a 21-year-old male patient who was diagnosed of cardiac tamponade due to tuberculous pericarditis with a positive urine LF-LAM. Case report: We report a case of a 21-year-old male living in Oyam district, Uganda, who presented to the emergency department with difficulty in breathing, easy fatigability, general body weakness, and abdominal pain. A chest X-ray showed the presence of right pleural effusion and massive cardiomegaly. Thus, percutaneous pericardiocentesis was performed immediately and pericardial fluid resulted negative both for gram staining and real-time PCR test Xpert MTB/RIF. The following day’s urine LF-LAM test resulted positive, and antitubercular therapy started with gradual improvement. During the follow-up visits, the patient remained asymptomatic, reporting good compliance to the antitubercular therapy. Conclusion: Our case highlights the potential usefulness of a LF-LAM-based diagnostic approach, suggesting that, in low-resource settings, this test might be used as part of routine diagnostic workup in patients with pericardial disease or suspected extra-pulmonary tuberculosis.
Millennial Evolution of a Karst Socio-Ecological System: A Case Study of Guizhou Province, Southwest China
Authors: Li Yetong , Ke Qihua , Zhang Zhuodong
Published: November 2022

The dynamic changes in socio-ecological system (SES) have exerted increasing pressures on the natural environment, leading to observable changes in terrestrial surface structure. Therefore, understanding the historical evolution mechanism of social ecosystems is crucial for the future sustainable management of karst regions. However, detailed quantitative analyses of karst socio-ecological system at a long-term scale are lacking. Here, we applied a comprehensive research framework for the SES of karst region to visually analyze the evolution of karst SES over the past 1000 years in Guizhou Province, defining five evolution stages of the karst SES. Concurrently, we characterized the interactive effects of drivers on karst socio-ecological system during every evolutionary stage, and then assess major influences between these stages. Despite rocky desertification as the main effect of karst SES driven by many indicators, the quantitative analysis indicated that human-dominated land-use change explained the expansion of rocky desertification. Although effective implementation of relevant policies partly compensated for increased environmental pressures, continued structure and function shifts in local ecosystem can challenge progress towards sustainability in karst region. Our findings provide scientific references for managers and policymakers to assist them to identify how environmental issues emerged in karst areas and how they should be addressed.
An Empirical Framework for Assessing the Balanced Scorecard Impact on Sustainable Development in Healthcare Performance Measurement
Authors: Vărzaru Anca Antoaneta
Published: November 2022

Performance appraisal has become an essential tool for healthcare managers due to the frequent and rapid changes in the healthcare sector. Sustainable performance management implies increasing organizations’ efficiency and effectiveness while considering all vectors of sustainability. This study examines the impact of digital transformation, accounting information systems, and strategic human resource management improvements on organizational performance and sustainable development. The paper uses the balanced scorecard (BSC) for organizational performance assessment. The paper proposes a theoretical model that integrates the traditional and digital information systems and human resources engagement with the BSC dimensions for sustainable organizational development. The theoretical model is tested in an empirical study involving a questionnaire-based survey of 387 employees with management experience in the healthcare sector. Based on structural equation modeling, the research results showed that the efficiency and effectiveness of strategic human resources management and the accounting information system significantly positively affect the BSC dimensions. Furthermore, the use of BSC in measuring organizational performance has significant effects on sustainable development, with the internal process dimension being the most influential.
Site Selection of Natural Gas Emergency Response Team Centers in Istanbul Metropolitan Area Based on GIS and FAHP
Authors: Sarıkaya Mehmet Şerif , Yanalak Mustafa , Karaman Himmet
Published: November 2022

The location of natural gas emergency response team centers (NGERTCs) is critical in terms of addressing natural gas notifications that require a timely emergency response. The selection of NGERTCs in Istanbul has an important place in terms of providing better service, due to the necessity of responding to emergency natural gas notifications within 15 min, in addition to the over 200,000 natural gas notifications per year and heavy traffic conditions. Therefore, this study proposes a solution based on GIS and FAHP to determine suitable NGERTC locations in Istanbul Metropolitan Area. In the first stage of the study, the required 15-min coverage areas for emergency calls for 36 existing NGERTCs in Istanbul were extracted and the adequacy of their locations was analyzed. In the second stage of the study, the weights of seven criteria determined for new NGERTC site selection were calculated by the FAHP method. With spatial analysis made, 12 new NGERTC locations were proposed. Finally, re-coverage analysis was performed for proposed and existing NGERTCs, and changes in coverage area within a 15 min response time were analyzed. Natural gas network coverage increased from 70.04% to 83.86%, and natural gas subscriber coverage increased from 91.03% to 96.27%. The results show that GIS and FAHP are worth using in selecting suitable NGERTC locations.
Effect of CuO Loading on the Photocatalytic Activity of SrTiO3/MWCNTs Nanocomposites for Dye Degradation under Visible Light
Authors: Mai Xuan Truong , Bui Duc Nguyen , Pham Van Khang , Pham Thi Ha Thanh , Nguyen Thi To Loan , Chau Hung Dung , Tran Thi Kim Ngan
Published: November 2022

In this study, we report on the preparation of copper oxide/strontium titanate/multi-walled carbon nanotube (CuO/STO/MWCNTs) nanocomposites and their photocatalytic activity for degradation of dye under visible light. The crystalline structures of the nanocomposites were investigated by an X-ray diffraction (XRD) technique, which explored the successful fabrication of CuO/STO/MWCNTs nanocomposites, and the cubic STO phase was formed in all samples. For the morphological study, the transmission electron microscope (TEM) technique was used, which had proved the successful preparation of CuO and STO nanoparticles. The energy dispersive X-ray spectroscopy (EDX), dark field scanning transmission electron microscope (DF-STEM-EDX mapping), and X-ray photoelectron spectra (XPS) analysis were performed to evidence the elemental composition of CuO/STO/MWCNTs nanocomposites. The optical characteristics were explored via UV–Vis diffuse reflectance spectroscopy (DRS) and photoluminescence (PL) techniques. These studies clearly indicate the effect of the presence of CuO and MWCNTs on the visible absorption of the CuO/STO/MWCNTs nanocomposites. The photocatalytic activity of CuO/STO/MWCNTs nanocomposites was evaluated by the degradation of methylene blue (MB) dye under visible light irradiation, following first-order kinetics. Among the different x% CuO/STO/MWCNTs nanocomposites, the 5 wt.% CuO/STO/MWCNTs nanocomposites showed the highest photocatalytic efficiency for the degradation of MB dye. Moreover, the 5% CuO/STO/MWCNTs showed good stability and recyclability after three consecutive photocatalytic cycles. These results verified that the optimized nanocomposites can be used for photocatalytic applications, especially for dye degradation under visible light.
A New Approach for the Synthesis of Powder Zinc Oxide and Zinc Borates with Desired Properties
Authors: Kozerozhets Irina V. , Avdeeva Varvara V. , Buzanov Grigorii A. , Semenov Evgeniy A. , Ioni Yulia V. , Gubin Sergey P.
Published: November 2022

Zinc borates are widely used in industry due to their thermal stability as a flame retardant in the production of plastics, rubber, and other polymer compositions. We have developed a simple and effective approach for the synthesis of zinc borate powders with desired properties, including desired particle size, low bulk density, high reactivity, etc. Zinc borates were prepared by the thermal treatment of a concentrated water–carbohydrate solution of a zinc salt until finely dispersed ZnO was formed, followed by its hydrothermal treatment at 90–300 °C as part of a suspension based on a hot aqueous solution of H3BO3. According to X-ray powder diffraction, IR spectroscopy, and TG–DSC data, depending on the temperature of hydrothermal treatment, a decrease in the water content in the structure of synthesized zinc borate particles is observed. TEM and SEM data indicate the formation of isometrically shaped zinc borate particles in the nanometer range during hydrothermal treatment above 250 °C. Varying the temperature of the hydrothermal treatment affects the average size and fineness of the structure of the zinc borate particles.
Nesting Biology and Ecology of a Resin Bee, Megachile cephalotes (Megachilidae: Hymenoptera)
Authors: Akram Waseem , Sajjad Asif , Ghramh Hamed A. , Ali Mudssar , Khan Khalid Ali
Published: November 2022

We report the nesting biology and ecology of Megachile cephalotes Smith, 1853 for the first time in Pakistan. Wooden and bamboo trap nests were deployed at three different locations in Bahawalpur district, Pakistan, from January 2020 to May 2021. A total of 242 nests of M. cephalotes were occupied in all three locations with the maximum abundance in the Cholistan Institute of Desert Studies. Megachile cephalotes remained active from March to September (the spring and summer seasons). In a nest, females made 7–8 brood cells each having a length of 1.2–2.3 cm. Plant resin was used to construct cells and mud or animal dung to plug the nest entrance. A vestibular cell was also made between the outermost brood cell and the nest entrance that ranged from 1.4 to 2.5 cm in length. No intercalary cells were observed in the nests. The males took 65.3 days to become adults, while the females took 74.78 days. The sex ratio was significantly biased toward females in all three locations. Grewia asiatica was the predominant pollen grain species found in the brood cells. Megachile cephalotes were observed collecting resin from Acacia nilotica, Prosopis juliflora, and Moringa oleifera. Three cleptoparasites of this species were also recorded: Euaspis carbonaria, Coelioxys sp., and Anthrax sp. This study set up a background to encourage new studies on artificial nesting and provides tools for proper biodiversity management and conservation.
Laboratory Evaluation and Field Feasibility of Micro-Encapsulated Insecticide Effect on Rhodnius prolixus and Triatoma dimidiata Mortality in Rural Households in Boyacá, Colombia
Authors: Gual-Gonzalez Lídia , Medina Manuel , Valverde-Castro César , Beltrán Virgilio , Caro Rodrigo , Triana-Chávez Omar , Nolan Melissa S. , Cantillo-Barraza Omar
Published: November 2022

Chagas disease is a neglected vector-borne zoonosis caused by the parasite Trypanosoma cruzi that is primarily transmitted by insects of the subfamily Triatominae. Although control efforts targeting domestic infestations of Rhodnius prolixus have been largely successful, with several regions in Boyacá department certified free of T. cruzi transmission by intradomicile R. prolixus, novel native species are emerging, increasing the risk of disease. Triatoma dimidiata is the second most important species in Colombia, and conventional control methods seem to be less effective. In this study we evaluated the efficacy and usefulness of micro-encapsulated insecticide paints in laboratory conditions and its applicability in rural communities to avoid triatomine domiciliation. Laboratory conditions measured mortality at 6 months and 12 months, with an average mortality between 93–100% for T. dimidiata and 100% for R. prolixus. Evaluation of triatomine infestation in rural households was measured after one year, with an overall perception of effectiveness in reducing household domiciliation. Although triatomines were still spotted inside and around the homes, our findings demonstrate the ability of micro-encapsulated insecticide to prevent colonization inside the households when comparing infestation rates from previous years. Current control measures suggest insecticide spraying every six months, which implies great economic cost and logistical effort. Complementary triatomine control measures with insecticide spraying and micro-encapsulated insecticide paint would make public health efforts more efficient and reduce the frequency of treatment.
Transient Analysis of a Finite Queueing System with Bulk Arrivals in IoT-Based Edge Computing Systems
Authors: Tang Shensheng
Published: November 2022

Queueing models can be used for making decisions about the resources required to provide high quality service. In this paper, a finite capacity single server queueing model with bulk arrivals is studied in IoT-based edge computing systems. The transient analysis of the model is carried out and the transient analytical solution to the system is derived with a group of recursive coefficients by using the ordinary differential equations (ODEs) technique. From which the steady-state probabilities are solved. Then, some performance metrics of interest are derived along with numerical results. Although the paper is initiated from the IoT based edge computing platform, the proposed system modeling and analysis method can be extended to more general situations such as telecommunication, manufacturing, transportation, and many other areas that are closely related to people’s daily lives.
Airway Bacterial Biodiversity in Exhaled Breath Condensates of Asthmatic Children—Does It Differ from the Healthy Ones?
Authors: Bar Kamil , Żebrowska Paulina , Łaczmański Łukasz , Sozańska Barbara
Published: November 2022

Asthma etiopathology is still not fully determined. One of its possible causes can be found in airway microbiome dysbiosis. The study’s purpose was to determine whether there are any significant differences in the bacterial microbiome diversity of lower airways microbiota of asthmatic children, since knowledge of this topic is very scarce. To the authors’ knowledge, this is the first research using exhaled breath condensates in children’s lower airways for bacterial assessment. Exhaled breath condensates (EBC) and oropharyngeal swabs were obtained from pediatric asthmatic patients and a healthy group (n = 38, 19 vs. 19). The microbial assessment was conducted through genetic material PCR amplification, followed by bacterial 16S rRNA amplicon sequencing. Collected data were analyzed, in terms of taxonomy and alpha and beta diversity between assessed groups. Swab samples are characterized by higher species richness compared to exhaled breath condensates (Shannon diversity index (mean 4.11 vs. 2.867, p = 9.108 × 10−8), observed features (mean 77.4 vs. 17.3, p = 5.572 × 10−11), and Faith’s phylogenetic diversity (mean 7.686 vs. 3.280 p = 1.296 × 10−10)). Asthmatic children had a higher abundance of bacterial species (Shannon diversity index, mean 3.029 vs. 2.642, p = 0.026) but more even distribution (Pielou’s evenness, mean 0.742 vs. 0.648, p = 0.002) in EBC than healthy ones; the same results were observed within pediatric patients born naturally within EBC samples. In children with a positive family history of allergic diseases, alpha diversity of lower airway material was increased (Shannon’s diversity index p = 0.026, Faith’s phylogenetic diversity p = 0.011, observed features p = 0.003). Class Gammaproteobacteria and Bacilli were less abundant among asthmatics in the exhaled breath samples. The most dominant bacteria on a phylum level in both sample types were Firmicutes, followed by Proteobacteria and Actinobacteriota. The obtained outcome of higher bacterial diversity of lower airways among asthmatic patients indicates a further need for future studies of microbiota connection with disease pathogenesis.
A Retrospective Assessment of Laboratory Findings and Cytokine Markers in Severe SARS-CoV-2 Infection among Patients of Roma Population
Authors: Mocanu Alexandra , Lazureanu Voichita Elena , Marinescu Adelina Raluca , Cut Talida Georgiana , Laza Ruxandra , Rusu Laura-Cristina , Marza Adina Maria , Nelson-Twakor Andreea , Negrean Rodica Anamaria , Popescu Irina-Maria , Mederle Alexandru Ovidiu
Published: November 2022

Growing research data suggests that the severity of COVID-19 is linked with higher levels of inflammatory mediators, such as cytokines, chemokines, tumor necrosis factor, C-reactive protein, ferritin, and D-dimers. In addition, it was evident from the existing research data that the severity of SARS-CoV-2 infection differs according to independent risk factors such as race and ethnicity. Some scarce evidence shows that the European Roma community is likely to be at an elevated risk of illness and death during the pandemic due to their lifestyle, social factors, and economics. Assuming that precautions must be taken to protect this population from coronavirus infections and from widening existing disparities in comparison with the Romanian ethnic population, the current study aimed to observe the clinical evolution of the Roma patients with severe SARS-CoV-2 infection in correlation with the laboratory findings and inflammatory markers involved. After calculating the sample size requirements, we included 83 Roma patients admitted to the hospital with severe COVID-19 and 236 patients of Romanian ethnicity with the same inclusion criteria. Patients were selected from the period stretching from March 2020 to December 2021, before COVID-19 vaccines were introduced. Compared with the general population, the Roma patients with severe SARS-CoV-2 infection had a higher unemployment rate (39.8%), and most of them were residing in rural regions (65.4%). There were significantly more overweight patients in the Roma group than in the control group (57.8% vs. 40.7%), and it was also observed that high blood pressure and diabetes mellitus were significantly more prevalent in the Roma patients. They had significantly longer mean duration of hospitalization was significantly longer in the group of Roma patients (18.1 days vs. 16.3 days). IL-6 and CRP levels were significantly more elevated during admission in the group of Roma patients (43.4% vs. 28.4%); however, IL-6 levels normalized at discharge, but ESR remained high. Although ICU admissions were significantly more frequent in this group, the mortality rate was not significantly higher than in the general population. It is necessary to plan different healthcare strategies aimed at special populations, such as the Roma ethnicity to prevent disparities in negative outcomes reflected in this study. The results imply that community-health collaborations between organizations of minority groups and healthcare professionals can mitigate the disproportionate consequences of the pandemic on Roma.
Comparison of Prognostic Value of 10 Biochemical Indices at Admission for Prediction Postoperative Myocardial Injury and Hospital Mortality in Patients with Osteoporotic Hip Fracture
Authors: Fisher Alexander , Srikusalanukul Wichat , Fisher Leon , Smith Paul N.
Published: November 2022

Aim: To evaluate the prognostic impact at admission of 10 biochemical indices for prediction postoperative myocardial injury (PMI) and/or hospital death in hip fracture (HF) patients. Methods: In 1273 consecutive patients with HF (mean age 82.9 ± 8.7 years, 73.5% women), clinical and laboratory parameters were collected prospectively, and outcomes were recorded. Multiple logistic regression and receiver-operating characteristic analyses (the area under the curve, AUC) were preformed, the number needed to predict (NNP) outcome was calculated. Results: Age ≥ 80 years and IHD were the most prominent clinical factors associated with both PMI (with cardiac troponin I rise) and in-hospital death. PMI occurred in 555 (43.6%) patients and contributed to 80.3% (49/61) of all deaths (mortality rate 8.8% vs. 1.9% in non-PMI patients). The most accurate biochemical predictive markers were parathyroid hormone > 6.8 pmol/L, urea > 7.5 mmol/L, 25(OH)vitamin D < 25 nmol/L, albumin < 33 g/L, and ratios gamma-glutamyl transferase (GGT) to alanine aminotransferase > 2.5, urea/albumin ≥ 2.0 and GGT/albumin ≥ 7.0; the AUC for developing PMI ranged between 0.782 and 0.742 (NNP: 1.84–2.13), the AUC for fatal outcome ranged from 0.803 to 0.722, (NNP: 3.77–9.52). Conclusions: In HF patients, easily accessible biochemical indices at admission substantially improve prediction of hospital outcomes, especially in the aged >80 years with IHD.
Time-Averaged Hematuria as a Prognostic Indicator of Renal Outcome in Patients with IgA Nephropathy
Authors: Weng Mengjie , Lin Jiaqun , Chen Yumei , Zhang Xiaohong , Zou Zhenhuan , Chen Yi , Cui Jiong , Fu Binbin , Li Guifen , Chen Caiming , Wan Jianxin
Published: November 2022

We aim to investigate the association of time-averaged hematuria (TA-hematuria) with the progression of IgA nephropathy (IgAN). Based on TA-hematuria during follow-up, 152 patients with IgAN were divided into a hematuria remission group (≤28 red blood cells [RBCs]/μL) and a persistent hematuria group (>28 RBCs/μL). The persistent hematuria group had a higher percentage of patients with macroscopic hematuria, lower levels of hemoglobin and TA-serum albumin, and more severe renal pathologic lesions. The composite endpoint is defined as a doubling of the baseline SCr level (D-SCr), or the presence of ESRD. During the mean follow-up of 58.08 ± 23.51 months, 15 patients (9.9%) reached the primary outcome of ESRD and 19 patients (12.5%) reached the combined renal endpoint. Kaplan-Meier analysis showed that the persistent hematuria group had a lower renal survival rate. The persistent hematuria patients who were incorporated with proteinuria (≥1.0 g/day) and low TA-serum albumin (<40 g/L) had the worst renal outcomes. Multivariate Cox regression indicated that TA-hematuria (hazard ratio [HR] = 0.004, 95% CI: 0.001, 0.008; p = 0.010) was independently associated with the progression of IgAN. Receiver operating characteristic analysis indicated the optimal TA-hematuria cutoff value for predicting the progression of IgAN was 201.21 RBCs/μL in females and 37.25 RBCs/μL in males.
Differentiating Post–Digital Nannying Autism Syndrome from Autism Spectrum Disorders in Young Children: A Comparative Cross-Sectional Study
Authors: Pouretemad Hamid Reza , Sadeghi Saeid , Badv Reza Shervin , Brand Serge
Published: November 2022

Excessive exposure of young children to digital devices has increased in recent years. Much research has shown that early excessive screentime is associated with autistic-like symptoms. This study aimed to differentiate children with Post–Digital Nannying Autism Syndrome (PDNAS) from children with autism spectrum disorders (ASD) and typically developing children (TDC), both behaviorally and cognitively. This study is comparative and cross-sectional and included three groups of children. The first group consisted of 15 young children with subthreshold autism symptoms. They had not received a formal diagnosis of ASD and had been exposed to digital devices for more than half of their waking time. The second group consisted of 15 young children with ASD, and the third group consisted of 15 young TDC. A lifestyle checklist, a modified checklist for autism in toddlers (M-CHAT), a behavioral flexibility rating scale-revised (BFRS-R), the Gilliam autism rating scale (GARS-2), and a behavior rating inventory of executive functioning-preschool version (BRIEF-P) were used to compare the three groups. The results showed that executive functions and behavioral flexibility were more impaired in children with ASD than in children with PDNAS and in TDC. Also, we found that there was no significant difference in the severity of autism symptoms between the children with ASD and the children with PDNAS. Early excessive exposure to digital devices may cause autism-like symptoms in children (PDNAS). Children with PDNAS are different from children with ASD in executive functions and behavioral flexibility. Further research is needed in this area.
Radiomics Combined with Multiple Machine Learning Algorithms in Differentiating Pancreatic Ductal Adenocarcinoma from Pancreatic Neuroendocrine Tumor: More Hands Produce a Stronger Flame
Authors: Zhang Tao , Xiang Yu , Wang Hang , Yun Hong , Liu Yichun , Wang Xing , Zhang Hao
Published: November 2022

The aim of this study was to assess the diagnostic ability of radiomics combined with multiple machine learning algorithms to differentiate pancreatic ductal adenocarcinoma (PDAC) from pancreatic neuroendocrine tumor (pNET). This retrospective study included a total of 238 patients diagnosed with PDAC or pNET. Using specialized software, radiologists manually mapped regions of interest (ROIs) from computed tomography images and automatically extracted radiomics features. A total of 45 discriminative models were built by five selection algorithms and nine classification algorithms. The performances of the discriminative models were assessed by sensitivity, specificity and the area under receiver operating characteristic curve (AUC) in the training and validation datasets. Using the combination of Gradient Boosting Decision Tree (GBDT) as the selection algorithm and Random Forest (RF) as the classification algorithm, the optimal diagnostic ability with the highest AUC was presented in the training and validation datasets. The sensitivity, specificity and AUC of the model were 0.804, 0.973 and 0.971 in the training dataset and 0.742, 0.934 and 0.930 in the validation dataset, respectively. The combination of radiomics and multiple machine learning algorithms showed the potential ability to discriminate PDAC from pNET. We suggest that multi-algorithm modeling should be considered for similar studies in the future rather than using a single algorithm empirically.
Impact of the COVID-19 Pandemic on Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Macular Edema in Japan
Authors: Komori Ryohei , Takamura Yoshihiro , Yamada Yutaka , Morioka Masakazu , Matsubara Hisashi , Hirano Takao , Mitamura Yoshinori , Shimizu Miho , Kusuhara Sentaro , Murakami Tomoya , Nihei Ryotaro , Ueda Tetsuo , Kunikata Hiroshi , Jujo Tatsuya , Terasaki Hiroto , Nagasato Daisuke , Noda Kousuke , Osaka Rie , Nagai Kazuki , Yoshida Shigeo , Nozaki Miho , Noma Hidetaka , Ishigooka Gaku , Takahashi Aya , Sawada Osamu , Kimura Kazuhiro , Inatani Masaru
Published: November 2022

Anti-vascular endothelial growth factor (VEGF) therapy for diabetic macular edema (DME) improves visual acuity. However, repeated injections during routine outpatient visits are required to maintain this effect. The recent sudden global outbreak of coronavirus disease 2019 (COVID-19) had a major impact on daily life, including medical care, such as the provision of VEGF therapy. We retrospectively investigated the relationship between the number of anti-VEGF injections for DME and the number of new COVID-19-positive patients at 23 centers in Japan. We also surveyed ophthalmologists regarding the impact of the COVID-19 pandemic on anti-VEGF therapy. In the third and fourth waves of the pandemic, when the number of infected patients increased, the number of injections significantly decreased. In the first, third, and fourth waves, the number of injections increased significantly during the last month of each wave. Approximately 60.9% of ophthalmologists reported that the number of injections decreased after the pandemic. Of the facilities, 52.2% extended the clinic visit intervals; however, there was no significant difference in the actual number of injections given between before and after the pandemic. Although the number of injections temporarily decreased, Japanese ophthalmologists maintained the total annual number of anti-VEGF injections for DME during the pandemic.
Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay
Authors: Serafim Rodrigo B. , Dal-Pizzol Felipe , Souza-Dantas Vicente , Soares Marcio , Bozza Fernando A. , Póvoa Pedro , Luiz Ronir Raggio , Lapa e Silva José R. , Salluh Jorge I. F.
Published: November 2022

Despite recent advances in the field, the association between subsyndromal delirium (SSD) in the ICU and poor outcomes is not entirely clear. We performed a retrospective multicentric observational study analyzing mental status during the first 72 h of ICU stay. Of the 681 patients included, SSD occurred in 22.7%. Considering the worst cognitive assessment during the first 72 h, 233 (34%) patients had normal mental status, 124 (18%) patients had SSD and 324 (48%) patients had delirium or coma. SSD was not independently associated with an increased risk of death when compared with normal mental status (OR 95%IC 1.0 vs. 1.35 [0.73–1.49], p = 0.340), but was associated with a longer ICU LOS (7.0 (4–12) vs. 4 (3–8) days, p < 0.001). SSD patients who deteriorated to delirium or coma (21%) had a longer ICU LOS in comparison with those who improved or maintained mental status (8 (5–11) vs. 6 (4–8) days, p = 0.025), but did not have an increase in mortality. The main factors associated with the progression from SSD to delirium or coma were the use of mechanical ventilation, the use of intravenous benzodiazepines and a baseline APACHE II score > 23 points. Our findings support the association of SSD with increased ICU LOS, but not with ICU mortality. Monitoring the trajectory of SSD early at ICU admission can help to identify patients with increased risk of conversion from SSD to delirium or coma.
e-Estesia: A Serious Game for Reducing Arousal, Improving Emotional Regulation and Increasing Wellbeing in Individuals with Gambling Disorder
Authors: Mena-Moreno Teresa , Munguía Lucero , Granero Roser , Lucas Ignacio , Fernández-Aranda Fernando , Gómez-Peña Mónica , Moragas Laura , Verdejo-García Antonio , Menchón José M. , Jiménez-Murcia Susana
Published: November 2022

Gambling disorder (GD) is associated with deficits in emotion regulation and impulsivity-related personality traits. In recent years there has been an increase in the use of serious games (SG) to address these factors with positive results. The aim of this study was to analyze the efficacy of the intervention with a new SG (e-Estesia), as an adjunct to a CBT intervention for GD. The sample comprised two groups (experimental group (n = 40) and control group (n = 64)) of patients with GD diagnosis. Both groups received 16 weekly CBT sessions and, concurrently, only the experimental group received 15 additional sessions with e-Estesia. Pre-post treatment with e-Estesia administered in both groups were: DSM-5 Criteria, South Oaks Gambling Screen, Symptom Checklist-Revised and measure of relapses, dropout and compliance of treatment. As regards the experimental group were also administered: Difficulties in Emotion Regulation Scale, Emotion Regulation Questionnaire, and Impulsive Behavior Scale. No statistically significant differences in the general psychopathological state, emotion regulation or impulsivity were found when comparing the groups. However, patients enrolled in the e-Estesia intervention had significantly less relapses and better indicators of treatment compliance than the control group. Considering these results, the use of complementary tools such as SG are useful for addressing GD.
Concentrations of Soluble Angiotensin Converting Enzyme 2 (sACE2) in Children and Adults with and without COVID-19
Authors: Wissing Sarah Isabella , Obeid Rima , Rädle-Hurst Tanja , Rohrer Tilman , Herr Christian , Schöpe Jakob , Geisel Jürgen , Bals Robert , Abdul-Khaliq Hashim
Published: November 2022

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing the coronavirus disease 2019 (COVID-19) pandemic, leads to illness and death. Various risk factors for a severe course, such as higher age, male gender and pre-existing illnesses are known. However, pathophysiological risk factors are largely unclear. Notably, the mild course of disease in children is conspicuous. Angiotensin converting enzyme 2 (ACE2) serves as a receptor for SARS-CoV-2 and is a key enzyme in infection. Differences in the distribution of ACE2 can provide insights into different courses of COVID-19. Our aim was to elucidate the role of ACE2 as a pathophysiological risk factor by measuring soluble ACE2 (sACE2) via ELISA in blood samples (lithium-heparin-plasma or serum) of 367 individuals including children and adults with and without COVID-19. sACE2-levels were compared between the groups according to age and sex. In adults and children with COVID-19, sACE2-concentrations are significantly higher compared to healthy individuals. sACE2-levels increase with age and are lower in children compared to adults with COVID-19. Sex doesn’t significantly influence sACE2-concentration. It remains unclear whether sACE2 concentrations increase because of the infection and what factors could influence this response. In conclusion, the increase of sACE2-concentration with age could indicate that ACE2 concentrations mirror increased COVID-19 severity.
Inhibition of Demineralization of Dentin by Fluoride-Containing Hydrogel Desensitizers: An In Vitro Study
Authors: Matsuda Yasuhiro , Altankhishig Bayarchimeg , Okuyama Katsushi , Yamamoto Hiroko , Naito Katsuaki , Hayashi Mikako , Sano Hidehiko , Sidhu Sharanbir K. , Saito Takashi
Published: November 2022

Several desensitizers routinely used clinically for dentin hypersensitivity are expected to inhibit demineralization. This study aimed to evaluate the effectiveness of sealing materials in inhibiting demineralization and increasing fluorine (F) uptake by acid-treated root surfaces. Five noncarious extracted human teeth were used to produce specimens. Three different fluoride-containing materials, namely “MS Coat F” (MS), “MS Coat Hys Block Gel” (HS), and CTX2 Varnish (FV), were used herein. Each material was applied to the demineralized root surface. Single sections were obtained from each specimen. All surfaces of each specimen, except the polished surface, were covered with wax and immersed in an automatic pH cycling system for 2 weeks. Fluorine and calcium distributions in the carious lesions of each specimen were evaluated using proton-induced gamma emission (PIGE) and X-ray (PIXE) techniques, respectively. Dentin demineralization was analyzed using transverse microradiography (TMR) before and after pH cycling. µPIXE/PIGE analysis demonstrated that all sample groups showed increased fluoride uptake on the root surface. TMR analysis revealed that both HS and FV showed significantly lower integrated mineral loss values than the control group. All three samples demonstrated a tendency towards increased fluoride uptake from fluoride-containing hypersensitivity desensitizers and a demineralization inhibition effect on root dentin.
Training Specificity for Athletes: Emphasis on Strength-Power Training: A Narrative Review
Authors: Stone Michael H. , Hornsby W. Guy , Suarez Dylan G. , Duca Marco , Pierce Kyle C.
Published: November 2022

Specificity has two major components: A strength-endurance continuum (S-EC) and adherence to principles of Dynamic Correspondence. Available evidence indicates the existence of the S-EC continuum from two aspects. Indeed, the S-EC exists, particularly if work is equated as a high load low repetition scheme at one end (strength stimulus) and high volume (HIEE stimulus) at the other. Furthermore, some evidence also indicates that the continuum as a repetition paradigm with high-load, low repetition at one end (strength stimulus) and a high repetition, low load at the other end. The second paradigm is most apparent under three conditions: (1) ecological validity—in the real world, work is not equated, (2) use of absolute loads in testing and (3) a substantial difference in the repetitions used in training (for example 2–5 repetitions versus ≥10 repetitions). Additionally, adherence to the principles and criteria of dynamic correspondence allows for greater “transfer of training” to performance measures. Typically, and logically, in order to optimize transfer, training athletes requires a reasonable development of capacities (i.e., structure, metabolism, neural aspects, etc.) before more specific training takes place.
Effects of Dietary Vegetable Oils Replacing Fish Oil on Fatty Acid Composition, Lipid Metabolism and Inflammatory Response in Adipose Tissue of Large Yellow Croaker (Larimichthys crocea)
Authors: Xu Dan , Xiang Xiaojun , Li Xueshan , Xu Ning , Zhang Wencong , Mai Kangsen , Ai Qinghui
Published: November 2022

The present study was conducted to investigate the effects of dietary vegetable oils (VOs) replacing fish oil (FO) on fatty acid composition, lipid metabolism and inflammatory response in adipose tissue (AT) of large yellow croaker (Larimichthys crocea). The initial body weight of a large yellow croaker was 10.07 ± 0.13 g. Three iso-nitrogenous and iso-lipidic diets were formulated by replacing FO with 0% (the control group), 100% soybean oil (SO) and 100% linseed oil (LO). Results showed that the contents of C18:2n-6 and C18:3n-3 were significantly increased in AT of fish fed the SO and LO diets compared with the FO diet, respectively. The proportion of n-6 polyunsaturated fatty acid (PUFA) was increased in SO and LO diets, while the proportions of saturated fatty acid and n-3 LC-PUFA were decreased. Moreover, dietary SO and LO significantly induced excess fat accumulation of AT by increasing the triglyceride content and the hypertrophy of adipocytes. Dietary SO and LO significantly increased lipogenesis-related gene expressions (dagt2, fabp10, srebp1, cebpα and pparγ), while decreasing the gene expression of lpl. Meanwhile, dietary SO increased the expression of genes related to fatty acid β-oxidation (cpt1 and aco), while LO showed no differences. Furthermore, dietary SO and LO increased the pro-inflammatory gene expressions and decreased the anti-inflammatory gene il10 expression. The phosphorylation levels of p38 MAPK and NF-κB were significantly upregulated by dietary SO and LO. In addition, there was a significant increase in macrophage infiltration and M1 polarization in AT of fish fed SO and LO diets. In conclusion, the present study revealed that dietary SO and LO replacing FO affected fatty acid composition and induced lipid dysmetabolism and inflammatory response in the adipose tissue of large yellow croaker.
Fungal Strains with Identical Genomes Were Found at a Distance of 2000 Kilometers after 40 Years
Authors: Zhu Qili , Lin Yang , Lyu Xueliang , Qu Zheng , Lu Ziyang , Fu Yanping , Cheng Jiasen , Xie Jiatao , Chen Tao , Li Bo , Cheng Hui , Chen Weidong , Jiang Daohong
Published: November 2022

Heredity and variation are inherent characteristics of species and are mainly reflected in the stability and variation of the genome; the former is relative, while the latter is continuous. However, whether life has both stable genomes and extremely diverse genomes at the same time is unknown. In this study, we isolated Sclerotinia sclerotiorum strains from sclerotium samples in Quincy, Washington State, USA, and found that four single-sclerotium-isolation strains (PB4, PB273, PB615, and PB623) had almost identical genomes to the reference strain 1980 isolated in the west of Nebraska 40 years ago. The genome of strain PB4 sequenced by the next-generation sequencing (NGS) and Pacific Biosciences (PacBio) sequencing carried only 135 single nucleotide polymorphisms (SNPs) and 18 structural variations (SVs) compared with the genome of strain 1980 and 48 SNPs were distributed on Contig_20. Based on data generated by NGS, three other strains, PB273, PB615, and PB623, had 256, 275, and 262 SNPs, respectively, against strain 1980, which were much less than in strain PB4 (532 SNPs) and none of them occurred on Contig_20, suggesting much closer genomes to strain 1980 than to strain PB4. All other strains from America and China are rich in SNPs with a range of 34,391–77,618 when compared with strain 1980. We also found that there were 39–79 SNPs between strain PB4 and its sexual offspring, 53.1% of which also occurred on Contig_20. Our discoveries show that there are two types of genomes in S. sclerotiorum, one is very stable and the other tends to change constantly. Investigating the mechanism of such genome stability will enhance our understanding of heredity and variation.
Comparison of Glucose Lowering Efficacy of Human GLP-1 Agonist in Taiwan Type 2 Diabetes Patients after Switching from DPP-4 Inhibitor Use or Non-Use
Authors: Tsai Chia-Jen , Tsao Cheng-Feng
Published: November 2022

To determine the efficacy of glucose control in type 2 diabetes patients who switch from dipeptidyl peptidase-4 (DPP-4) inhibitors use or non-use to GLP-1 receptor agonists (GLP-1 RAs). We conducted a cohort study using data from the Chang Gung Research Database. Patients aged ≥18 years using newly initiated GLP-1 RAs between 1 January 2009, and 31 December 2016, were included. Cox proportional hazards models were used to adjust for treatment selection bias. The primary outcome was changes in the glycated hemoglobin (HbA1c) level. The HbA1c level fell substantially after initiating GLP-1 RAs in DPP-4 inhibitor users and nonusers. A mean HbA1c reduction of −0.42% was found in patients who received DPP-4 inhibitors. Those who were DPP-4 inhibitor nonusers had a reduction in HbA1c of −0.99%. The degree of reduction in HbA1c was significantly greater in patients who were DPP-4 inhibitor nonusers (p value < 0.01), compared to the DPP-4 inhibitor users. In routine care, DPP-4 inhibitor nonusers had better efficacy in glucose control than DPP-4 inhibitor users after switching to a GLP-1 agonist.
Perception about Health Applications (Apps) in Smartphones towards Telemedicine during COVID-19: A Cross-Sectional Study
Authors: Reddy Lingala Kalyan Viswanath , Madithati Pallavi , Narapureddy Bayapa Reddy , Ravula Sahithya Ravali , Vaddamanu Sunil Kumar , Alhamoudi Fahad Hussain , Minervini Giuseppe , Chaturvedi Saurabh
Published: November 2022

Background: The use of health applications (apps) in smartphones increased exponentially during COVID-19. This study was conducted the with the aim to understand the factors that determine the consumer’s perception of health apps in smartphones towards telemedicine during COVID-19 and to test any relation between these factors and consumers towards Telemedicine in India. Methods: This questionnaire-based cross-sectional study was conducted from July 2021 to December 2021 in India. Out of 600 selected participants, 594 responded and in that 535 valid questionnaires were measured. The questionnaire consists of close-ended responses, with the first part consisting of demographic information, the second part consisting of questions associated with consumers’ perceptions and the third part kept for suggestions and complaints. The questionnaire was distributed using digital platforms via WhatsApp or email. A 5-point Likert scale, ranging from strongly agree’ (5) to strongly disagree (1) was used to record responses. Results: Results revealed a high response rate of 90%. The highest score was obtained for the question assessing the satisfaction of the users towards health apps [1175 = 500 (agree-4) + 675 (Strongly agree-5)]. The interface of the app scored very low, showing disagreement (514) with app functionality, and was the most common disadvantage as perceived by patients. The mean scores of reliabilities and vicinity of health services; efficacy and comprehensive health information; development and improvement of health apps and telemedicine (3.24, 3.18, 3.62, 3.49), respectively, show the difference in attraction existing between groups. There is a strong positive correlation between the variables except for efficacy and comprehensive information about health and Telemedicine (−0.249), development and improvement of health apps, and reliability and vicinity of health services (−0.344) which have a negative correlation. Conclusions: The findings of this survey reveal a positive outlook of health apps toward telemedicine. This research also found a strong forecaster of the consumer’s perception of health apps in smartphones towards telemedicine. In the broad spectrum, the future of health app affiliates for telemedicine is better affected by the consumer’s perception of health app efficacy. This study suggests that health app marketers develop more innovative apps to increase usage and help consumers.
Prolonged Maternal Separation Reduces Anxiety State and Increases Compulsive Burying Activity in the Offspring of BALB/c Mice
Authors: Jarrar Qais , Ayoub Rami , Alhussine Kawther , Goh Khang Wen , Moshawih Said , Ardianto Chrismawan , Goh Bey Hing , Ming Long Chiau
Published: November 2022

Background: The elevated plus maze (EPM) and the marble burying (MB) tests are common behavioral tests used for behavioral phenotyping in mouse models for neurodevelopmental disorders. However, the behavioral effects of maternal separation (MS), a standard paradigm for early life stress in animals, in both the EPM and MB tests remain incompletely known. Objectives: This study aimed to investigate the behavioral effects of prolonged MS in the offspring of mice using the EPM and MB tests. Methods: Male BALB/c mice were isolated from their mothers for 4 h each day during the first 30 days after birth. On day 50 postnatal, groups of separated and non-separated mice (n = 18/each group) were subjected to the EPM and MB tests for comparative behavioral evaluations. In addition, the locomotor activity of mice was evaluated using the actophotometer test. Results: The findings of the EPM test revealed that separated mice exhibited anxiolytic-like behaviors, as evidenced by a significant increase in the latency to closed arms and the time spent in the open arms compared with non-separated mice. Separated mice also showed compulsive burying activity in the MB test, as determined by a significant increase in the number of buried marbles. The results of the actophotometer test did not show any significant change in locomotor activity. Conclusions: Prolonged MS caused the adult offspring of mice to exhibit a decrease in anxiety state and increased compulsive burying activity, which were not associated with a change in locomotor activity. Further investigations with validated tests are needed to support these findings.