bluuebunny/crossref_metadata_2025 huggingface dataset:
Urinmikroskopie
Authors: Haag Stefanie
Published: March 2021

Die Urinmikroskopie ist eine nichtinvasive Diagnostik, die sowohl stationär als auch ambulant verfügbar ist. Eine komplette Urinuntersuchung umfasst die makroskopische Beurteilung, den Urinteststreifen (Urinstixs) und die Urinmikroskopie. Für die Urinanalyse wird Mittelstrahlurin oder Katheterurin benötigt. Die Urinmikroskopie ist ein wichtiger Teil der Urinanalyse und erlaubt eine nähere Abklärung der ersten Befunde des Urinstixs und zeigt Strukturen auf, die im Urinstixs nicht detektiert werden können (z. B. Zylinder). Innerhalb von wenigen Minuten können die Ergebnisse Aufschluss über eine akute Erkrankung mit sofortigem Handlungsbedarf, wie z. B. bei der schnell progredienten Glomerulonephritis, geben. Sie dienen ebenfalls zur Verlaufsbeurteilung bei einer chronischen Nierenerkrankung oder zur weiteren Abklärung von Systemerkrankungen, die mit einer Niereninsuffizienz einhergehen können (z. B. bei arterieller Hypertonie, Diabetes mellitus, Vaskulitis).
Die New Nordic Diet — Frische, Regionalität und ein gesundheitsförderndes Potenzial
Authors: Karstens Vanessa , Bosy-Westphal Anja
Published: March 2021

Die „New Nordic Diet“ ist ein modernes Ernährungskonzept, das frische, regional und biologisch angebaute sowie unverarbeitete pflanzliche Lebensmittel miteinander kombiniert, ergänzt um Milchprodukte, Fisch, Meeresfrüchte und mageres Fleisch. Sie soll gut schmecken, gesundheitsfördernd wirken und in der heimischen Küche einfach umzusetzen sein.
Homöopathie bei chronischen Netzhauterkrankungen
Authors: Rehfueß Claudia
Published: March 2021

Vor dem Hintergrund detaillierter Leitlinientherapiekenntnis zeigt die Autorin als niedergelassene Augenärztin und Homöopathin an 3 Fällen unterschiedlicher, konventionell schwer zugänglicher Netzhauterkrankungen beeindruckende Heilverläufe bei rein homöopathischer Therapie. Mithilfe der optischen Schichtaufnahmetechnik (OCT) wird jeder Fall eingeführt und der nachhaltige Erfolg der Behandlungen über Monate dokumentiert. Begleitende positive Therapiewirkungen – für Homöopathen erwartbar, für zuvor konventionell therapierte Augenpatienten eher nicht – steigern die Lebensqualität der Patienten zusätzlich. Abschließend beleuchtet die Autorin das bedeutende Einsparpotenzial durch homöopathische Behandlung der feuchten Makuladegeneration gegenüber der leitliniengemäßen Injektionstherapie.
Behandlung einer psychogenen Sehstörung und rezidivierender Harnwegsinfekte
Authors: Schuldt Christian
Published: March 2021

Dargestellt wird der Therapieverlauf bei einem Kleinkind mit psychogener Sehstörung. Anschließend kommt es erneut zu einem Harnwegsinfekt, der mit einer in der Kinder- und Jugendheilkunde selten gebrauchten homöopathischen Arznei erfolgreich behandelt wird.
S2k-Leitlinie zur Diagnostik und Therapie von Patienten mit Asthma – Addendum 2020
Authors: Buhl R. , Bals R. , Baur X. , Berdel D. , Criée C.-P. , Gappa M. , Gillissen A. , Greulich T. , Haidl P. , Hamelmann E. , Horak F. , Kardos P. , Kenn K. , Klimek L. , Korn S. , Magnussen H. , Nowak D. , Pfaar O. , Rabe K. F. , Riedler J. , Ritz T. , Schultz K. , Schuster A. , Spindler T. , Taube C. , Vogelmeier C. , von Leupoldt A. , Wantke F. , Wildhaber J. , Worth H. , Zacharasiewicz A. , Lommatzsch M. ,   Unter Mitwirkung der folgenden Wissenschaftlichen Gesellschaften: Deutsche Gesellschaft für Arbeitsmedizin und Umweltmedizin e. V.,   Deutsche Gesellschaft für Rehabilitationswissenschaften e. V.,   Deutsche Gesellschaft für Gynäkologie und Geburtshilfe e. V.
Published: March 2021

Das vorliegende Addendum zur Leitlinie zur Diagnostik und Therapie von Patienten mit Asthma (2017) ergänzt wichtige neue Erkenntnisse zur Diagnostik und Therapie von Asthma sowie zu neu für die Therapie des Asthmas zugelassenen Medikamenten. Es werden sowohl für Kinder und Jugendliche als auch für Erwachsene mit Asthma die aktuellen, Evidenz-basierten diagnostischen und therapeutischen Empfehlungen dargelegt.
Feasibility study of a single-use balloon-assisted robotic colonoscope in healthy volunteers
Authors: Foo Chi-Chung , Leung Wai-Keung , Lui Thomas Ka-Luen , Cheung Jo Lai-Ken , Lam Kwok-Wai , Sreedhar Biji , Yeung Chung-Kwong
Published: March 2021

Background and study aims Despite its widespread adoption, colonoscope still has its limitations. Advancement is often limited by the looping of colon. The isolation of SARS-CoV-2 in stool raises concern for the risk of disease transmission. A single-use robotic colonoscope, the NISInspire-C System, that features a balloon-suction anchorage mechanism was developed to address these.

Methods The NISInspire-C balloons are designed to provide anchorage for straightening of the colon during advancement. Angulation at the bending section is tendon-wire driven by servo mechanisms integrated into a robotic control console. This was a pilot, prospective trial to evaluate the safety and feasibility of this system. Healthy volunteers underwent examination with the NISInspire-C, followed by the conventional colonoscope. The procedure time, cecal intubation rates (CIR), complications, and level of pain were measured.

Results A total of 19 subjects underwent the examination. The cecal intubation rate was 89.5 % (17/19) and the overall time-to-cecum was 26.3 minutes (SD: 17.9 mins). There were no procedure-related complications. Polyps were detected in seven of 19 (36.8 %) subjects during the NISInspire-C procedure. Three more subjects were found to have adenomatous polyps with the conventional colonoscope. There was minimal variation in level of pain during the procedures with the two colonoscopes.

Conclusion The single-use robotic colonoscope NISInspire-C is a safe and feasible alternative to the conventional colonoscope. Further technical refinement is needed to improve the CIR. This study was limited by its small sample size.
Sprunggelenkorthesen bei neurologischen Krankheitsbildern
Authors: Böing Thorsten
Published: March 2021

In der orthopädietechnischen Versorgung von Patienten mit Fußheberschwäche ist die exakte medizinische Diagnose ein erster Wegweiser für die Auswahl möglicher Hilfsmitteloptionen. Denn von ihr hängt ab, ob Orthesen oder funktionelle Elektrostimulation die richtige Versorgungswahl sind.
Roboter in der Praxis – ein Interview
Authors: Mehrholz Jan , Zange Christian
Published: March 2021

Christian Zange ist Therapeutischer Leiter der VAMED Klinik Schloss Pulsnitz in Sachsen. In der stationären neurologischen Rehabilitation sind zurzeit große Herausforderungen zu bewältigen. Das Interview beleuchtet diese Situation und nimmt sich dann des Themenschwerpunkts „Technologien“ an.
A Catalytic, Oxidative Synthesis of Olivetol, Methyl Olivetolate and Orthogonally Protected Methyl Ether Derivatives
Authors: McNulty James , Hurem David , Macphail Benjamin J. , Carlini Rina , Lewis Jason
Published: March 2021

Olivetol, methyl olivetolate and a series of orthogonally protected methyl ether derivatives were synthesized from commonly available precursors using an atom-economical, catalytic oxidative aromatization process.
Acute Paradoxical Herniation: A Case Report
Authors: Denny Vanessa , Shalev Davina , Dastgir Jahannaz , Johnson Erin , Escobar Maria , Bernardita Gamallo Ma , Wynne Peter , Fried Arno
Published: March 2021

Decompressive craniectomy is used to relieve acute increased intracranial pressure (ICP) when medical therapy has failed. Paradoxical herniation is a rare complication that occurs when the pressure of the intracranial contents falls abnormally below the atmospheric pressure. Symptoms often include neurological deficits, the etiology of which is often mistaken for elevated ICP. This diagnosis requires quick recognition, and treatment requires a change from ICP reduction therapies to those that increase the ICP, and ultimately cranioplasty.
Granulocytes Acquire Antiapoptosis Activity and Promote Tumor Growth during Tumor Progress
Authors: Li Han , Shen Wenyan , Xu Yanjie , Wang Zien , Wang Linghao , Ding Zequn , Xie Zhiyuan , Zhang Yan
Published: March 2021

Granulocytes play important roles in cancer, and their apoptotic status is often changed by the influence of tumor environment. However, the changes and the function on granulocyte apoptosis in cancer are unclear. In this study, we used tumor-bearing mouse model and tumor patients to analyzed the apoptosis of granulocytes in different tissues by flow analysis and TUNEL fluorescence staining, and found that the percentage of apoptosis cells in granulocytes was significantly decreased in late-stage tumor-bearing mouse and patients. The in vitro co-culture experiment showed that these antiapoptotic granulocytes could significantly inhibit T cell proliferation, and RNA-seq proved that there was obvious difference on the transcriptome between these cells and control cells, particularly immune-related genes. What is important, adoptive transfer of these antiapoptotic granulocytes promoted tumor progress in mouse model. Conclusively, we found that granulocytes in late-stage tumor could delay the process of apoptosis, inhibit T cell proliferation, and acquire pro-tumor activity, which provides a new therapeutic target for tumor immunity.
The Cyborg Philharmonic: Synchronizing interactive musical performances between humans and machines
Authors: Chakraborty Sutirtha , Dutta Sourav , Timoney Joseph
Published: March 2021

Music offers a uniquely abstract way for the expression of human emotions and moods, wherein melodic harmony is achieved through a succinct blend of pitch, rhythm, tempo, texture, and other sonic qualities. The emerging field of “Robotic Musicianship” focuses on developing machine intelligence, in terms of algorithms and cognitive models, to capture the underlying principles of musical perception, composition, and performance. The capability of new-generation robots to manifest music in a human-like artistically expressive manner lies at the intersection of engineering, computers, music, and psychology; promising to offer new forms of creativity, sharing, and interpreting musical impulses. This manuscript explores how real-time collaborations between humans and machines might be achieved by the integration of technological and mathematical models from Synchronization and Learning, with precise configuration for the seamless generation of melody in tandem, towards the vision of human–robot symphonic orchestra. To explicitly capture the key ingredients of a good symphony—synchronization and anticipation—this work discusses a possible approach based on the joint strategy of: (i) Mapping— wherein mathematical models for oscillator coupling like Kuramoto could be used for establishing and maintaining synchronization, and (ii) Modelling—employing modern deep learning predictive models like Neural Network architectures to anticipate (or predict) future state changes in the sequence of music generation and pre-empt transitions in the coupled oscillator sequence. It is hoped that this discussion will foster new insights and research for better “real-time synchronized human-computer collaborative interfaces and interactions”.
Perspectives on advances in high-capacity, free-space communications using multiplexing of orbital-angular-momentum beams
Authors: Willner Alan E. , Zhao Zhe , Liu Cong , Zhang Runzhou , Song Haoqian , Pang Kai , Manukyan Karapet , Song Hao , Su Xinzhou , Xie Guodong , Ren Yongxiong , Yan Yan , Tur Moshe , Molisch Andreas F. , Boyd Robert W. , Zhou Huibin , Hu Nanzhe , Minoofar Amir , Huang Hao
Published: March 2021

Beams carrying orbital-angular-momentum (OAM) have gained much interest due to their unique amplitude and phase structures. In terms of communication systems, each of the multiple independent data-carrying beams can have a different OAM value and be orthogonal to all other beams. This paper will describe the use of multiplexing and the simultaneous transmission of multiple OAM beams for enhancing the capacity of communication systems. We will highlight the key advances and technical challenges in the areas of (a) free-space and fiber communication links, (b) mitigation of modal coupling and channel crosstalk effects, (c) classical and quantum systems, and (d) optical and radio frequency beam multiplexing.
Origin of blue luminescence in Mg-doped GaN
Authors: Wang Jing , Wang Xiaodan , Shu Wanzhu , Zeng Xionghui , Chen Jiafan , Xu Ke
Published: March 2021

In this work, dual acceptor-bound exciton peaks are observed by low-temperature photoluminescence. The peaks correspond to the dual Mg-related acceptor levels in GaN based on the Haynes rule. By calibrating the energy-level structure, a mechanism for the origin of blue luminescence (BL) in Mg-doped GaN is proposed. The BL band is separated by thermal treatment at different temperatures, confirming the rationality of the dual-factor origin of the BL band. As the annealing temperature increases, the PL spectrum and the p-type conductivity of Mg-doped GaN also change. The experimental results indicate that there is not necessarily a relationship between the BL band and p-type conductivity in GaN grown by metalorganic chemical vapor deposition.
Mechanism of misfolding of the human prion protein revealed by a pathological mutation
Authors: Sanz-Hernández Máximo , Barritt Joseph D. , Sobek Jens , Hornemann Simone , Aguzzi Adriano , De Simone Alfonso
Published: March 2021

Significance

The misfolding and aggregation into amyloid fibrils of the prion protein (PrP) have been strongly linked with a group of neurodegenerative disorders that include the mad cow disease. Currently, the molecular origins of the prion diseases are unknown, including the underlying mechanisms of PrP misfolding and the regions promoting its aggregation. Here, we identified the structural basis by which the folded domain of the human PrP converts into amyloids. We showed that this process is promoted by intermediate species forming as a result of the pathological mutation T183A, and that POM antibodies are able to suppress completely the aggregation process by blocking the misfolding mechanism. This study thereby suggests possible molecular strategies to inhibit PrP aggregation into amyloids.
Acellular fish skin enhances wound healing by promoting angiogenesis and collagen deposition
Authors: Chen Hongchi , Yin Bohao , Hu Bin , Zhang Baokun , Liu Jingwen , Jing Yingzhe , Fan Zhiyuan , Tian Yuchen , Wei Xiaojuan , Zhang Wei
Published: March 2021

Acellular matrix is a type of promising biomaterial for wound healing promotion. Although acellular bovine and porcine tissues have proven effective, religious restrictions and risks of disease transmission remain barriers to their clinical use. Acellular fish skin (AFS), given its similarity to human skin structure and without the aforementioned disadvantages, is thus seen as an attractive alternative. This study aims to fabricate AFS from the skin of black carp (Mylopharyngodon piceus), evaluate its physical and mechanical properties and assess its impact on wound healing. The results showed that AFS has a highly porous structure, along with high levels of hydrophilicity, water-absorption property and permeability. Furthermore, physical characterization showed the high tensile strength of AFS in dry and wet states, and high stitch tear resistance, indicating great potential in clinical applications. Cell Counting Kit-8 was used to test the viability of L929 cells when culturing in the extracts of AFS. Compared with the control group, there is no significant difference in optical density value when culturing in the extracts of AFS at days 1, 3 and 7 (*p > 0.05). In vivo wound healing evaluation then highlighted its promotion of angiogenesis and collagen synthesis, its function in anti-inflammation and acceleration in wound healing. Therefore, this study suggests that AFS has potential as a promising alternative to mammal-derived or traditional wound dressing.
Triethanolamine–ethoxylate (TEA-EO) assisted hydrothermal synthesis of hierarchical β-MnO2 nanorods: effect of surface morphology on capacitive performance
Authors: Kumar Yogesh , Uke S J , Kumar Ashwani , Merdikar S P , Gupta Meenal , Thakur A K , Bocchetta P , Gupta Anshu , Kumar Vinay , Kumar Yogesh
Published: March 2021

In this study we are presenting the synthesis of MnO2 nanorods using hydrothermal method assisted by facile tri-ethanolamine-ethoxylate. Structural (x-ray diffraction, Rietveld refinement), functional (Fourier Transform Infrared spectroscopy and x-ray Photoelectron Spectroscopy) and morphological (Field emission scanning electron microscope, Transmission electron microscopy) characterization conform the β-MnO2 nanostructure with a rod-like morphology and uniform thickness. The morphological variations of the nanorod thickness can be easily controlled by simply monitoring the reaction temperature. Comparative investigations of β-MnO2 samples synthesized at two different reaction temperatures (viz. 100 °C and 120 °C) used as a supercapacitive electrode material have been performed with the aid of different electrochemical techniques. With different electrolytes (Li2SO4 and Na2SO4), supercapacitor device is tested using Cyclic voltammetry, impedance spectroscopy and galvanostatic charge discharge. Interestingly, the low temperature synthesized β-MnO2 nanorods sample exhibit superior electrochemical performance in 1 mol l−1 Li2SO4 electrolyte in terms of high specific capacitance (462 Fg−1 at10 mVs−1), energy density (9.72 WhKg−1), and outstanding cyclic stability (90.26% over 2000 cycles).
Alcohol Hangover Across the Lifespan: Impact Of Sex and Age
Authors: Verster Joris C , Severeijns Noortje R , Sips Annabel S M , Saeed Hama M , Benson Sarah , Scholey Andrew , Bruce Gillian
Published: March 2021

Aim

To investigate the relationship between age and hangover frequency and severity.

Method

An online survey, generated through Facebook, collected self-report data relating to alcohol consumption from 761 Dutch alcohol consumers aged 18–94 years (61.6% female).

Results

Overall, young individuals consumed more alcohol than older drinkers, and men more than women. Significant interactions between age group and sex were found for both subjective intoxication and hangover severity, indicating that the sex differences in these variables were greatest in the younger age groups but became significantly smaller or absent in the older age groups. Partial correlations, correcting for estimated blood alcohol concentration (eBAC), revealed significant and negative partial correlations between age and subjective intoxication (r = −0.444, P < 0.0001), age and hangover severity (r = −0.327, P < 0.0001) and between age and hangover frequency (r = −0.195, P < 0.0001), i.e. subjective intoxication, hangover severity and hangover frequency decline with age. With regard to sex differences, the observed correlations with age for the past month heaviest drinking occasion were stronger in men for subjective intoxication, (z = −2.25, P = 0.024), hangover severity (z = −3.36, P = 0.0008) and hangover frequency (z = −3.63, P = 0.0003).

Conclusions

Hangover severity declines with age, even after controlling for eBAC or the amount of alcohol consumed. Sex differences were greatest in the younger age groups but became significantly smaller or absent in the older age groups. The relationship between age and hangover severity is strongly mediated by subjective intoxication. Pain sensitivity, lower with aging, might be a mediator.
Activation of Skeletal Muscle Satellite Cells by a Device Simultaneously Applying High-Intensity Focused Electromagnetic Technology and Novel RF Technology: Fluorescent Microscopy Facilitated Detection of NCAM/CD56
Authors: Halaas Yael , Duncan Diane , Bernardy Jan , Ondrackova Petra , Dinev Ivan
Published: March 2021

Background

Myosatellite cells are myogenic stem cells that can transform to provide nuclei for existing muscles or generate new muscle fibers as documented after extended exercise programs.

Objectives

The authors investigated whether the simultaneous application of High-Intensity Focused Electromagnetic (HIFEM) and Synchrode radiofrequency (RF) affects the levels of satellite cells similarly as the prolonged exercise does to achieve muscle growth.

Methods

Three 30-minute simultaneous HIFEM and Synchrode RF treatments (once a week) were administered over the abdominal area of 5 Large White swine aged approximately 6 months. All animals were anesthetized during the treatments and biopsy acquisition. Biopsies of muscle tissue were collected at baseline, 4 days, 2 weeks, and 1 month post-treatment. After binding the specific antibodies, the NCAM/CD56 levels, a marker of activated satellite cells, were quantified employing the immunofluorescence microscopy technique with a UV lamp.

Results

Examined slices showed a continuous increase in satellite cell levels throughout the study. Four days after the treatment, we observed a 26.1% increase in satellite cells, which increased to 30.2% at 2-week follow-up. Additional histological analysis revealed an increase in the cross-sectional area of muscle fibers and the signs of newly formed fibers of small diameters at 2 weeks after the treatment. No damage to muscle tissue and no adverse effects related to the treatment were observed.

Conclusions

The findings indicate that the simultaneous application of HIFEM and novel Synchrode RF treatment can initiate differentiation of satellite cells to support the growth of existing muscles and, presumably, even the formation of new myofibers.
ProDy 2.0: increased scale and scope after 10 years of protein dynamics modelling with Python
Authors: Zhang She , Krieger James M , Zhang Yan , Kaya Cihan , Kaynak Burak , Mikulska-Ruminska Karolina , Doruker Pemra , Li Hongchun , Bahar Ivet
Published: March 2021

ProDy, an integrated application programming interface developed for modelling and analysing protein dynamics, has significantly evolved in recent years in response to the growing data and needs of the computational biology community. We present major developments that led to ProDy 2.0: (i) improved interfacing with databases and parsing new file formats, (ii) SignDy for signature dynamics of protein families, (iii) CryoDy for collective dynamics of supramolecular systems using cryo-EM density maps and (iv) essential site scanning analysis for identifying sites essential to modulating global dynamics.

Availability and implementation

ProDy is open-source and freely available under MIT License from https://github.com/prody/ProDy.

Supplementary information

Supplementary data are available at Bioinformatics online.
The NRGTEN Python package: an extensible toolkit for coarse-grained normal mode analysis of proteins, nucleic acids, small molecules and their complexes
Authors: Mailhot Olivier , Najmanovich Rafael
Published: March 2021

The Najmanovich Research Group Toolkit for Elastic Networks (NRGTEN) is a Python toolkit that implements four different NMA models in addition to popular and novel metrics to benchmark and measure properties from these models. Furthermore, the toolkit is available as a public Python package and is easily extensible for the development or implementation of additional normal mode analysis models. The inclusion of the Elastic Network Contact Model developed in our group within NRGTEN is noteworthy, owing to its account for the specific chemical nature of atomic interactions.

Availability and implementation

https://github.com/gregorpatof/nrgten_package/.
Leucocyte count and C-reactive protein cannot be relied upon in the diagnosis of acute appendicitis in HIV-infected patients
Authors: Truter M , Karusseit V O L , Montwedi D , Becker P , Mokoena T
Published: March 2021

Background

South Africa has the highest prevalence of human immunodeficiency virus (HIV) infection in the world, and is commonly found in association with appendicitis. Atypical presentation of appendicitis in the presence of HIV infection makes clinical diagnosis of appendicitis unreliable, and inflammatory markers are commonly used as adjuncts. The aim of this study was ascertain the value of inflammatory markers in the diagnosis of appendicitis in patients with and without HIV infection.

Methods

Patients with acute appendicitis were studied and divided into HIV-infected and HIV-uninfected groups. Symptoms, and systemic and local signs were recorded. Appendiceal pathology was classified as simple or as complicated by abscess, phlegmon or perforation. Total white cell count (WCC) and C-reactive protein (CRP) were chosen as inflammatory markers. Findings were compared between the two groups.

Results

The study population consisted of 125 patients, of whom 26 (20.8 per cent) had HIV infection. Clinical manifestations did not differ statistically, and there was no difference in the incidence of simple or complicated appendicitis between the two groups. The mean CRP level was significantly higher in HIV-infected patients (194.9 mg/l versus 138.9 mg/l in HIV-uninfected patients; P = 0.049), and mean WCC (x109/L) was significantly lower (11.07 versus 14.17×109/l respectively; P = 0.010)

Conclusion

Clinical manifestations and pathology did not differ between HIV-infected and HIV-uninfected patients with appendicitis, except that the WCC response was significantly attenuated and CRP levels were generally higher in the presence of HIV infection.
Suture rectopexy versus ventral mesh rectopexy for complete full-thickness rectal prolapse and intussusception: systematic review and meta-analysis
Authors: Lobb H S , Kearsey C C , Ahmed S , Rajaganeshan R
Published: March 2021

Background

This systematic review and meta-analysis aimed to compare recurrence rates of rectal prolapse following ventral mesh rectopexy (VMR) and suture rectopexy (SR).

Methods

MEDLINE, Embase, and the Cochrane Library were searched for studies reporting on the recurrence rates of complete rectal prolapse (CRP) or intussusception (IS) after SR and VMR. Results were pooled and procedures compared; a subgroup analysis was performed comparing patients with CRP and IS who underwent VMR using biological versus synthetic meshes. A meta-analysis of studies comparing SR and VMR was undertaken. The Methodological Items for Non-Randomized Studies score, the Newcastle–Ottawa Scale, and the Cochrane Collaboration tool were used to assess the quality of studies.

Results

Twenty-two studies with 976 patients were included in the SR group and 31 studies with 1605 patients in the VMR group; among these studies, five were eligible for meta-analysis. Overall, in patients with CRP, the recurrence rate was 8.6 per cent after SR and 3.7 per cent after VMR (P < 0.001). However, in patients with IS treated using VMR, the recurrence rate was 9.7 per cent. Recurrence rates after VMR did not differ with use of biological or synthetic mesh in patients treated for CRP (4.1 versus 3.6 per cent; P = 0.789) and or IS (11.4 versus 11.0 per cent; P = 0.902). Results from the meta-analysis showed high heterogeneity, and the difference in recurrence rates between SR and VMR groups was not statistically significant (P = 0.76).

Conclusion

Although the systematic review showed a higher recurrence rate after SR than VMR for treatment of CRP, this result was not confirmed by meta-analysis. Therefore, robust RCTs comparing SR and biological VMR are required.
Psychological distress and health-related quality of life up to 2 years after oesophageal cancer surgery: nationwide population-based study
Authors: Liu Y J , Schandl A , Markar S , Johar A , Lagergren P
Published: March 2021

Background

Patients are at higher risk of suffering from psychological distress and reduced health-related quality of life (HRQoL) after oesophageal cancer surgery. This Swedish nationwide population-based longitudinal study aimed to evaluate the association between psychological distress and HRQoL up to 2 years after oesophageal cancer surgery.

Methods

The study included patients with oesophageal cancer who had survived for 1 year after oesophageal cancer surgery. The exposure was psychological distress measured using the Hospital Anxiety and Depression Scale. Patients scoring at least 8 on either the anxiety or the depression subscale were classified as having psychological distress. The outcome was HRQoL assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire generic and disease-specific questionnaires (EORTC QLQ-C30 and QLQ-OG25). Exposure and outcome were measured at 1, 1.5, and 2 years after operation. Fixed-effects models with adjustment for all time-invariant confounding and potential time-varying confounders were used to examine the mean score difference in HRQoL between patients with and without psychological distress.

Results

In total, 180 patients were analysed. Clinically relevant, statistically significant and time-constant mean score differences were found in emotional function, social function, dyspnoea, anxiety, eating difficulty, eating in front of others, and weight loss (mean score difference range 10–29). Mean score differences for global quality of life, cognitive function, appetite loss, EORTC QLQ-C30 summary score, and trouble with taste increased over time, and reached clinical and statistical significance at 1.5 and/or 2 years after surgery. For body image, there was a clinically relevant decrease in mean score difference over time.

Conclusion

Psychological distress was associated with several aspects of poor HRQoL up to 2 years after surgery for oesophageal cancer.
Consensus exercise identifying priorities for research in the field of general surgery of childhood in the UK
Authors: Hall N J , Rees C M , Rhodes H , Williams A , Vipond M , Gordon A , Evans D A , Wood R J , Bytheway J , Sutcliffe J ,   on behalf of the British Association of Paediatric Surgeons research committee
Published: March 2021

Background

The evidence base underlying clinical practice in children’s general surgery is poor and high-quality collaborative clinical research is required to address current treatment uncertainties. The aim of this study was, through a consensus process, to identify research priorities for clinical research in this field amongst surgeons who treat children.

Methods

Questions were invited in a scoping survey amongst general surgeons and specialist paediatric surgeons. These were refined by the study team and subsequently prioritized in a two-stage modified Delphi process.

Results

In the scoping survey, a total of 226 questions covering a broad scope of children’s elective and emergency general surgery were submitted by 76 different clinicians. These were refined to 71 research questions for prioritization. A total of 168 clinicians took part in stage one of the prioritization process, and 157 in stage two. A ‘top 10’ list of priority research questions was generated for both elective and emergency general surgery of childhood. These cover a range of conditions and concepts, including inguinal hernia, undescended testis, appendicitis, abdominal trauma and enhanced recovery pathways.

Conclusion

Through consensus amongst surgeons who treat children, 10 priority research questions for each of the elective and emergency fields have been identified. These should provide a basis for the development of high-quality multicentre research projects to address these questions, and ultimately improve outcomes for children requiring surgical care.
Incidence, drivers and global health implications of the 2019/2020 yellow fever sporadic outbreaks in Sub-Saharan Africa
Authors: Uchenna Emeribe Anthony , Nasir Abdullahi Idris , O. R. Ajagbe Odunayo , Egede Ugwu Charles , Oloche Onoja Solomon , Dahiru Abubakar Sharafudeen , Modesta Umeozuru Chikodi , Sunday Animasaun Olawale , Omoruyi Omosigho Pius , Mukhtar Danmusa Umar , Alhaji Baba Mallam Mala , Saidu Aminu Maijiddah , Yahaya Hadiza , Oyewusi Silifat
Published: March 2021

The 2019 and 2020 sporadic outbreaks of yellow fever (YF) in Sub-Saharan African countries had raised a lot of global health concerns. This article aims to narratively review the vector biology, YF vaccination program, environmental factors and climatic changes, and to understand how they could facilitate the reemergence of YF. This study comprehensively reviewed articles that focused on the interplay and complexity of YF virus (YFV) vector diversity/competence, YF vaccine immunodynamics and climatic change impacts on YFV transmission as they influence the 2019/2020 sporadic outbreaks in Sub-Saharan Africa (SSA). Based on available reports, vectorial migration, climatic changes and YF immunization level could be reasons for the re-mergence of YF at the community and national levels. Essentially, the drivers of YFV infection due to spillover are moderately constant. However, changes in land use and landscape have been shown to influence sylvan-to-urban spillover. Furthermore, increased precipitation and warmer temperatures due to climate change are likely to broaden the range of mosquitoes' habitat. The 2019/2020 YF outbreaks in SSA is basically a result of inadequate vaccination campaigns, YF surveillance and vector control. Consequently, and most importantly, adequate immunization coverage must be implemented and properly achieved under the responsibility of the public health stakeholders.
Candidate genes involved in cuticular hydrocarbon differentiation between cryptic, parabiotic ant species
Authors: Sprenger Philipp P , Hartke Juliane , Schmitt Thomas , Menzel Florian , Feldmeyer Barbara
Published: March 2021

Insect cuticular hydrocarbons (CHCs) are highly diverse and have multiple functions, including communication and waterproofing. CHC profiles form species-specific, complex blends of up to 150 compounds. Especially in ants, even closely related species can have largely different profiles, raising the question how CHC differences are mirrored in the regulation of biosynthetic pathways. The neotropical ants Crematogaster levior and Camponotus femoratus both consist of two cryptic species each that are morphologically similar, but express strongly different CHC profiles. This is ideal to study the molecular basis of CHC differences. We thus investigated gene expression differences in fat-body transcriptomes of these ants. Despite common garden conditions, we found several thousand differentially expressed transcripts within each cryptic species pair. Many of these were related to metabolic processes, probably accounting for physiological differences. Moreover, we identified candidate genes from five gene families involved in CHC biosynthesis. By assigning candidate transcripts to orthologs in Drosophila, we inferred which CHCs might be influenced by differential gene expression. Expression of these candidate genes was often mirrored in the CHC profiles. For example, Cr. levior A, which has longer CHCs than its cryptic sister species, had a higher expression of elongases and a lower expression of fatty acyl- CoA reductases. This study is one of the first to identify CHC candidate genes in ants and will provide a basis for further research on the genetic basis of CHC biosynthesis.
DNA replication, transcription, and H3K56 acetylation regulate copy number and stability at tandem repeats
Authors: Salim Devika , Bradford William D , Rubinstein Boris , Gerton Jennifer L
Published: March 2021

Tandem repeats are inherently unstable and exhibit extensive copy number polymorphisms. Despite mounting evidence for their adaptive potential, the mechanisms associated with regulation of the stability and copy number of tandem repeats remain largely unclear. To study copy number variation at tandem repeats, we used two well-studied repetitive arrays in the budding yeast genome, the ribosomal DNA (rDNA) locus, and the copper-inducible CUP1 gene array. We developed powerful, highly sensitive, and quantitative assays to measure repeat instability and copy number and used them in multiple high-throughput genetic screens to define pathways involved in regulating copy number variation. These screens revealed that rDNA stability and copy number are regulated by DNA replication, transcription, and histone acetylation. Through parallel studies of both arrays, we demonstrate that instability can be induced by DNA replication stress and transcription. Importantly, while changes in stability in response to stress are observed within a few cell divisions, a change in steady state repeat copy number requires selection over time. Further, H3K56 acetylation is required for regulating transcription and transcription-induced instability at the CUP1 array, and restricts transcription-induced amplification. Our work suggests that the modulation of replication and transcription is a direct, reversible strategy to alter stability at tandem repeats in response to environmental stimuli, which provides cells rapid adaptability through copy number variation. Additionally, histone acetylation may function to promote the normal adaptive program in response to transcriptional stress. Given the omnipresence of DNA replication, transcription, and chromatin marks like histone acetylation, the fundamental mechanisms we have uncovered significantly advance our understanding of the plasticity of tandem repeats more generally.
Cuttlefish and squid egg deposition patterns on artificial devices and trap-like gears: implications for offspring survival and population management
Authors: Ganias Konstantinos , Perri Rozalia , Moditsis Anastasios
Published: March 2021

We investigated the effect of trap-like gear deployment on the survival of European squid Loligo vulgaris and common cuttlefish Sepia officinalis eggs laid on various surfaces of these gears. In parallel, a detailed assessment of the two species’ egg deposition patterns on such gears was performed with respect to both the fishing season and their preferences for artificial spawning substrates. Hemp ropes with floats were the most preferred spawning substrate for squid, whereas cuttlefish mostly deposited their egg clusters on the plastic mesh of rectangular pots. Almost no egg laying was observed on traps where netting frame was coated with antifouling paints (copper oxide or zinc pyrithione). A high proportion of squid egg mops and cuttlefish egg clusters were shown to either be lost or to die after a period of continuous operation (i.e. hauling and retrieval at frequent intervals), which exceeded egg incubation periods. It is thus advised that coastal fishers either completely avoid operating static gears, which act as artificial spawning substrates on the spawning fields or use gears with materials that are repellent for these animals to approach and lay their eggs, such as nets coated with antifouling substances.
Open wounds and rifampicin therapy are associated with rifampicin resistance among staphylococcal vascular graft/endograft infections
Authors: Leung Yau Kei Stefan , Ledergerber Bruno , Eberhard Nadia , Mestres Carlos A , Rancic Zoran , Zimmermann Alexander , Zbinden Reinhard , Brugger Silvio D , Zinkernagel Annelies S , Hasse Barbara ,   Vascular Graft Cohort Study, Anagnostopoulos Alexia , Eberhard Nadia , Hasse (PI) Barbara , Husmann Lars , Ledergerber Bruno , Mayer Dieter O , Mestres Carlos A , Rancic Zoran , Zbinden Reinhard , Zimmermann Alexander , Zinkernagel Annelies S
Published: March 2021

Background

Optimal timing for rifampicin combination therapy in patients with staphylococcal vascular graft/endograft infection (S-VGEI) is unknown. Experts recommend adding rifampicin after lowering bacterial load by surgery and wound closure.

Objectives

To assess predictors of rifampicin resistance among staphylococci isolated from patients in the Vascular Graft Infection Cohort Study.

Methods

We included prospective patients with S-VGEI diagnosis from 1 January 2002 to 30 June 2020. We retrospectively assessed determinants of rifampicin resistance using exact logistic regression and described survival with Kaplan–Meier curves.

Results

We analysed 513 Staphylococcus spp. among 143 predominantly male (82%) patients with a median age of 68 years (IQR 60–75). Thereof, 82 (57%) received a rifampicin combination therapy and 61 (43%) received an antimicrobial therapy without rifampicin. Among 82 patients with rifampicin, 26/26 patients with any rifampicin resistance had open wounds with a strong association of rifampicin resistance with rifampicin treatment while having open wounds (OR 37, 95% CI 6.1 to ∞). Among 75 patients with a rifampicin combination therapy and rifampicin-susceptible staphylococci at S-VGEI diagnosis, 12/12 patients with a secondary rifampicin-resistant isolate had an open wound (OR 14, 95% CI 2.1 to ∞).

Conclusions

Rifampicin should be started after wound closure due to increased risk of rifampicin resistance observed while having open wounds or second-look surgeries among patients with S-VGEI.
A multicentre point prevalence survey of patterns and quality of antibiotic prescribing in Indonesian hospitals
Authors: Limato Ralalicia , Nelwan Erni J , Mudia Manzilina , de Brabander Justin , Guterres Helio , Enty Enty , Mauleti Ifael Y , Mayasari Maria , Firmansyah Iman , Hizrani May , Hamers Raph L
Published: March 2021

Background

The global emergence of antimicrobial resistance is driven by antibiotic misuse and overuse. However, systematic data in Indonesian hospitals to adequately inform policy are scarce.

Objectives

To evaluate patterns and quality indicators of antibiotic prescribing in six general hospitals in Jakarta, Indonesia.

Methods

We conducted a hospital-wide point prevalence survey (PPS) between March and August 2019, using Global-PPS and WHO-PPS protocols. The analysis focused on antibacterials (antibiotics) for systemic use.

Results

Of 1602 inpatients, 993 (62.0%) received ≥1 antimicrobial. Of 1666 antimicrobial prescriptions, 1273 (76.4%) were antibiotics. Indications comprised community-acquired infections (42.6%), surgical prophylaxis (22.6%), hospital-acquired infections (18.5%), medical prophylaxis (9.6%), unknown (4.6%) and other (2.1%). The most common reasons for antibiotic prescribing were pneumonia (27.7%), skin and soft tissue infections (8.3%), and gastrointestinal prophylaxis (7.9%). The most prescribed antibiotic classes were third-generation cephalosporins (44.3%), fluoroquinolones (13.5%), carbapenems (7.4%), and penicillins with β-lactamase inhibitor (6.8%). According to the WHO AWaRe classification, Watch antibiotics accounted for 67.4%, followed by 28.0% Access and 2.4% Reserve. Hospital antibiotic guidelines were not available for 28.1% of prescriptions, and, where available, guideline compliance was 52.2%. Reason for the antibiotic prescription, stop/review date and planned duration were poorly documented. Culture-guided prescriptions comprised 8.1% of community-acquired infections and 26.8% of hospital-acquired infections.

Conclusions

Our data indicate a high rate of empirical use of broad-spectrum antibiotics in Indonesian hospitals, coupled with poor documentation and guideline adherence. The findings suggest important areas for antimicrobial stewardship interventions.
International Child Sponsorship Improves School Performance: Evidence from Goma (DRC)
Authors: Rossignoli Domenico , Balestri Sara , Beretta Simona , Maggioni Mario A
Published: March 2021

This paper provides new evidence on the impact on educational attainment of an international child support (ICS) program, implemented in ten primary schools located in the peri-urban districts of the city of Goma (Democratic Republic of Congo). Using original micro data from a sample of 309 children (treated, 121; control, 188), we explore, through a difference-in-differences approach, whether the ICS program, which reduces the structural uncertainty faced by the targeted pupils and their families, impacts on a broad set of alternative educational outcomes—namely, performance scores in four different subjects (civic education and religion, French languages, national languages and mathematics), total score, failure and school drop-out rates. The results show that sponsored children report lower drop-out and failure rates in comparison to their control peers and that they succeed in catching up in all subjects in two school years. Results are robust to the implementation of a coarsened exact matching procedure, exploiting the data structure to produce unbiased estimates along with bounded ex-post balancing.
Natural language processing and machine learning of electronic health records for prediction of first-time suicide attempts
Authors: Tsui Fuchiang R , Shi Lingyun , Ruiz Victor , Ryan Neal D , Biernesser Candice , Iyengar Satish , Walsh Colin G , Brent David A
Published: March 2021

Objective

Limited research exists in predicting first-time suicide attempts that account for two-thirds of suicide decedents. We aimed to predict first-time suicide attempts using a large data-driven approach that applies natural language processing (NLP) and machine learning (ML) to unstructured (narrative) clinical notes and structured electronic health record (EHR) data.

Methods

This case-control study included patients aged 10–75 years who were seen between 2007 and 2016 from emergency departments and inpatient units. Cases were first-time suicide attempts from coded diagnosis; controls were randomly selected without suicide attempts regardless of demographics, following a ratio of nine controls per case. Four data-driven ML models were evaluated using 2-year historical EHR data prior to suicide attempt or control index visits, with prediction windows from 7 to 730 days. Patients without any historical notes were excluded. Model evaluation on accuracy and robustness was performed on a blind dataset (30% cohort).

Results

The study cohort included 45 238 patients (5099 cases, 40 139 controls) comprising 54 651 variables from 5.7 million structured records and 798 665 notes. Using both unstructured and structured data resulted in significantly greater accuracy compared to structured data alone (area-under-the-curve [AUC]: 0.932 vs. 0.901 P < .001). The best-predicting model utilized 1726 variables with AUC = 0.932 (95% CI, 0.922–0.941). The model was robust across multiple prediction windows and subgroups by demographics, points of historical most recent clinical contact, and depression diagnosis history.

Conclusions

Our large data-driven approach using both structured and unstructured EHR data demonstrated accurate and robust first-time suicide attempt prediction, and has the potential to be deployed across various populations and clinical settings.
Prevalence of Five Commonly Analyzed Cannabinoids in Forensic Toxicology Casework from Orange County CA, USA, from 2016 to 2019
Authors: Meneses Vanessa M , Mata Dani C
Published: March 2021

Over the last 25 years, marijuana laws have been changing throughout the USA. California started legalizing medicinal marijuana in 1996 and has since continued to relax laws. Compared to Washington and Colorado, there are little data on how the changing laws have affected the cannabinoid detection rate in California. This paper looks at the prevalence of five cannabinoids (Δ9-tetrahydrocannabinol (THC), 11-hydroxy-tetrahydrocannabinol (hydroxy-THC), 11-nor-9-carboxy-tetrahydrocannabinol (carboxy-THC), cannabinol and cannabidiol) in Orange County, CA, from 2016 to 2019. From 2016 to 2017, after legalizing recreational marijuana, there was an increase in the presence of THC, carboxy-THC and hydroxy-THC in postmortem and major crime cases, consisting mostly of sexual assaults. However, driving under the influence of drugs (DUID) saw a slight decrease. In 2018, when shops could be licensed to sell marijuana to anyone over 21 years old, there was an increase seen in all five cannabinoids for DUID and postmortem cases. The age group from 21 to 30 years showed the most prevalent cannabinoid use in all case types for all years except in major crime cases in 2019, where <21 year-old age group was the most prevalent. Surprisingly, the >50-year-old group in death investigation cases was a close second in prevalence in all years, which differs from DUID and major crime cases.