bluuebunny/crossref_metadata_2025 huggingface dataset:
A pragmatic methodical framework for the user-centred development of an electronic process support for the sleep laboratory patients’ management
Authors: Zerlik Maria , Jung Ian-C. , Sehr Tony , Hennings Fabian , Kamann Christian , Brandt Moritz D. , Sedlmayr Martin , Sedlmayr Brita
Published: October 2022

Objective

Limited capacities and ineffective care pathways result in long waiting times for patients and sporadic treatment controls in sleep medicine. As one objective of the ‘Telesleep Medicine’ project, a portal should be developed, which supports sleep specialists in an efficient and resource-saving patient management. On account of the limited project timeframe, the ‘classical’ user-centred design and evaluation methods could not be comprehensively implemented. Therefore, a pragmatic methodical framework was developed.

Methods

For the iterative development of the portal, a combination of low-cost and quick-to-implement methods was used. In chronological order, these were: context interviews, personas, the development of an as-is model, a web search of design standards and good design aspects of similar systems, the development of a to-be model, the creation of an overarching mind map, and the iterative creation of mockups with simplified usability walkthroughs.

Results

The feasibility of the pragmatic methodological framework for the development of a prototype for the portal was demonstrated. The used method combination resulted in a prototype based on the needs and requirements of the sleep specialists, taking into account their specific workflow and the technical implementation conditions.

Conclusions

The presented pragmatic methodological framework can be a valuable resource for developers of comparable projects. The combination of methods worked well together regarding the limited timeframe and resources for concept development. For the future, we plan to implement and test the portal in the clinical field and thus enrich our framework with additional methods.
Closing the Equity Gap: An Intervention to Improve Chlamydia and Gonorrhea Testing for Adolescents and Young Adults in Primary Care
Authors: Tomcho Margaret M. , Lou Yingbo , O’Leary Sonja C. , Rinehart Deborah J. , Thomas-Gale Tara , Penny Lara , Frost Holly M.
Published: October 2022

Background:

Chlamydia trachomatis and Neisseria gonorrhea are the most reported sexually transmitted infections in the United States. Testing rates remain suboptimal and may be subject to implicit bias. We evaluated the effectiveness of an opt-out chlamydia and gonorrhea testing program for adolescents and young adults in improving testing rates and promoting equity.

Methods:

An opt-out testing program that standardized testing to once annually for 14 to 24-year-old patients was implemented across 28 federally qualified health centers spanning 4 specialties. A quasi-experimental design using interrupted time series analyses evaluated testing and infection rates between baseline, intervention, and pandemic-associated test shortage periods. Reduction in testing inequities based on sex, race, ethnicity, insurance, and language preference were also examined.

Results:

A total of 57 452 encounters during the baseline, 17 320 during the intervention, and 26 993 during the test supply shortage periods were included. Testing increased from 66.8% to 81.0% (14.2% absolute increase) between baseline and intervention periods. Pediatric clinics demonstrated the largest improvement compared to other settings (absolute increase 30.9%). We found significant reductions in testing inequities for language preference ( P < .001), and un-insured and public insured individuals ( P < .001). More cases of chlamydia and gonorrhea were detected in the intervention period (chlamydia-29.7; gonorrhea-7.4 per 1000 patients) than in the baseline period (chlamydia-20.7; gonorrhea-4.4 per 1000 patients; P < .001).

Conclusions:

An opt-out approach increased testing, reduced inequities between some groups and detected more infections than a risk-based approach. Opt-out testing should be considered as an approach to increase detection of chlamydia and gonorrhea and promote equity.
Neonatal Myxomas: Case Report and Literature Review
Authors: Pasternack Daniel M , Sharma Madhu , Colavito John , Ramirez Michelle M , Martinez Michael J , Chakravarti Sujata , Mosca Ralph , Susheel Kumar TK
Published: October 2022

Myxomas are rare tumors in neonates and tend to have a different presentation compared to adults. We present an infant with a left atrial myxoma presenting with episodic tachycardia who underwent successful surgical excision. In addition, we performed a review of the literature, identifying 17 cases of neonatal myxomas. Unlike adults, neonatal myxomas are more common in males and occur more often on the right side of the heart. Constitutional symptoms such as fever or embolism are rare among neonates. Most patients have favorable outcomes following surgical excision, refuting earlier claims that neonatal myxomas are associated with poor outcomes.
Axillary Lymphadenopathy as an Initial Presentation of Systemic Amyloidosis: A Case Report and Literature Review
Authors: Kumar Suneet , Grell Gilda-Rae , Joseph Gardith , Wang Jen C.
Published: October 2022

Amyloidosis rarely presents as localized lymphadenopathy. Various studies have elucidated the varied presentation and manifestations of this interesting disease. We reviewed the literature and found 36 cases of primary amyloidosis with lymph node enlargement as a presentation, and 17 of the 36 cases (47%) had systemic involvement on further work up. We describe a patient who presented with an isolated right axillary mass. Clinical examination and radiology were indicative of a lymph node enlargement with no evidence of malignancy in the breasts or lungs. Histopathological examination was indicative of amyloidosis. A further work up including serum, urine biochemistry, cardiac work up, bone marrow examination, and a kidney biopsy revealed systemic amyloidosis. Patient was treated with daratumumab and CyBorD (cyclophosphamide, bortezomib, and dexamethasone) followed by a stem cell transplantation. Patient is in remission for 1 year, at the time of submission of this report. Therefore, we conclude (1) systemic amyloidosis presenting as an isolated lymph node enlargement is rare, (2) a structured systemic work up is imperative for early diagnosis and proper management of amyloidosis, when there is an index of suspicion, and (3) use of novel therapeutic options such as CD38 + antibody (daratumumab) and stem cell transplant have positive impact on disease outcomes.
Characterization of clays from the Fez area (northern Morocco) for potential uses in the ceramics industry
Authors: El Halim Mouhssin , Daoudi Lahcen , El Ouahabi Meriam , Fagel Nathalie
Published: October 2022

Clays from the Saïss basin (northern Morocco) used traditionally in the ceramic industry in the Fez area were studied using mineralogical and physicochemical techniques to evaluate their potential suitability as raw materials for ceramics manufacture. X-ray diffraction was used to determine their mineralogical composition. The physical properties determined were particle-size distribution and consistency limits. The chemical composition was determined using X-ray fluorescence analysis and Fourier-transform infrared spectrometry. The structural changes of the mineral phases in the raw materials during firing were studied over a temperature range of 500–1000°C. In the pottery site from Fez, generally potters use a mixture of 25% fine clay (ARFS) from the upper part of the Miocene marls and 75% sandy clay (ARFR) from the lower part of the Miocene marls. The ARFS clay yielded very rigid specimens after firing that artisan potters would find difficult to handle so as to produce desired shapes and sizes. However, the specimens obtained from ARFR clay show signs of faltering. The mixture of these two clayey materials from this pottery site is therefore necessary to obtain the optimal paste for ceramics purposes. The chemical compositions indicated that SiO2, Al2O3, CaO and Fe2O3 are the major minerals, with trace amounts of K2O and MgO. Quartz, feldspars and clay minerals prevail in all samples. Kaolinite, illite and smectite are the dominant clay mineral phases, with traces of chlorite and interstratified illite–smectite. The classification of these samples using appropriate ternary diagrams showed that the proportions used in the mixture produce a new material with adequate characteristics for the production of traditional ceramics.
AROMA: real-world global registry of dupilumab for chronic rhinosinusitis with nasal polyps
Authors: Siddiqui Shahid , Bachert Claus , Chaker Adam M. , Han Joseph K. , Hellings Peter W. , Peters Anju T. , Heffler Enrico , Kamat Siddhesh , Zhang Haixin , Nash Scott , Khan Asif H. , De Prado Gomez Lucia , Jacob-Nara Juby A. , Rowe Paul J. , Deniz Yamo
Published: October 2022

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammatory disease of the nasal and paranasal sinuses. Dupilumab is a monoclonal antibody that blocks the shared receptor component for interleukin-4 and interleukin-13, which are key and central drivers of type 2 inflammation. In clinical trials, dupilumab significantly improved objective and patient-reported measures of CRSwNPversusplacebo and was well tolerated. Dupilumab is approved in the European Union, USA and Japan as add-on maintenance treatment for adults with inadequately controlled CRSwNP. There exists an important evidence gap between efficacy and effectiveness data for dupilumab in severe CRSwNP. In order to bridge this gap, the AROMA prospective global registry (ClinicalTrials.gov:NCT04959448) was established. AROMA will collect long-term data on the utilisation, effectiveness and safety of dupilumab for CRSwNP treatment in real-world clinical practice. AROMA will enrol approximately 1000 adults starting dupilumab for severe CRSwNP across 120 global sites. Baseline data will include patient demographics, medical/surgical history and presence of type 2 comorbidities. Effectiveness outcome assessments will include objective measures of CRSwNP assessed as part of routine clinical care and various patient-reported questionnaires. Treatment patterns, concomitant medications and long-term safety will also be recorded. Results from AROMA, the first prospective, real-world, global registry to characterise patients with severe CRSwNP starting dupilumab, will provide evidence on the real impact of dupilumab in patients with CRSwNP and complement the data from randomised clinical trials. The registry will also provide evidence on disease progression in patients with CRSwNP, including those with coexisting diseases.
Pulmonary Hypertension and Measurement of Exercise Capacity Remotely: Evaluation of the 1-min Sit-to-Stand Test (PERSPIRE) – a cohort study
Authors: Keen Carol , Smith Ian , Hashmi-Greenwood Molly , Sage Karen , Kiely David G.
Published: October 2022

Background

Multiparameter risk assessment is recommended to aid treatment decisions in patients with pulmonary arterial hypertension. The 1-min sit-to-stand test (1MSTS) has been validated for use in other respiratory illnesses. The aim of this study was to evaluate its safety in the hospital setting and potential utility in remote assessment in patients with pulmonary hypertension.

Methods

In a prospective cohort study design patients performed the 1MSTS and incremental shuttle walk test (ISWT) on the same day. The primary aim of the study was to assess safety signals and correlations with other metrics used in risk assessment.

Results

60 patients with pulmonary arterial hypertension and 15 with chronic thromboembolic pulmonary hypertension were enrolled. No adverse events were recorded. Post-test change in physiological parameters was lower for the 1MSTS than for the ISWT in heart rate (mean±sdchange +9.4±8.0versus+38.3±25.9 beats per min, p<0.001), oxygen saturation (−3.8±4.0%versus−8.9±7.3%, p<0.01) and systolic blood pressure (+10.1±10.5versus+17.7±19 mmHg, p<0.001). There were significant correlations between the 1MSTS and ISWT (r=0.702, p<0.01), World Health Organization functional class (r= −0.449, p<0.01), emPHAsis-10 (−0.436, p<0.001) and N-terminal pro-b-type natriuretic peptide (r= −0.270, p=0.022). 97% of patients were willing to perform the test at home.

Conclusion

This study has demonstrated the safety, sub-maximal characteristics of the 1MSTS in pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension in the hospital setting, its positive correlation with the ISWT and potential role in remote risk assessment. Further evaluation of this exercise test is now warranted.
Distribution of type 2 biomarkers and association with severity, clinical characteristics and comorbidities in the BREATHE real-life asthma population
Authors: Frøssing Laurits , Klein Ditte K. , Hvidtfeldt Morten , Obling Nicolai , Telg Gunilla , Erjefält Jonas S. , Bodtger Uffe , Porsbjerg Celeste
Published: October 2022

Background

Type 2 (T2) high asthma is recognised as a heterogenous entity consisting of several endotypes; however, the prevalence and distribution of the T2 biomarkers in the general asthma population, across asthma severity, and across compartments is largely unknown. The objective of the present study was to describe expression and overlaps of airway and systemic T2 biomarkers in a clinically representative asthma population.

Methods

Patients with asthma from the real-life BREATHE cohort referred to a specialist centre were included and grouped according to T2 biomarkers: blood and sputum eosinophilia (≥0.3×109 cells·L−1and 3% respectively), total IgE (≥150 U·mL−1), and fractional exhaled nitric oxide (≥25 ppb).

Results

Patients with mild-to-moderate asthma were younger (41versus49 years, p<0.001), had lower body mass index (25.9versus28.0 kg·m−2, p=0.002) and less atopy (47%versus58%, p=0.05), higher forced expiratory volume in 1 s (3.2versus2.8 L, p<0.001) and forced vital capacity (4.3versus3.9 L, p<0.001) compared with patients with severe asthma, who had higher blood (0.22×109versus0.17×109 cells·L−1, p=0.01) and sputum (3.0%versus1.5%, p=0.01) eosinophils. Co-expression of all T2 biomarkers was a particular characteristic of severe asthma (p<0.001). In patients with eosinophilia, sputum eosinophilia without blood eosinophilia was present in 45% of patients with mild-to-moderate asthma and 35% with severe asthma.

Conclusion

Severe asthma is more commonly associated with activation of several T2 pathways, indicating that treatments targeting severe asthma may need to act more broadly on T2 inflammatory pathways. Implementation of airway inflammometry in clinical care is of paramount importance, as the best treatable trait is otherwise is overlooked in a large proportion of patients irrespective of disease severity.
Proteome-wide analyses reveal diverse functions of protein acetylation and succinylation modifications in fast growing stolons of bermudagrass (Cynodon dactylon L.)
Authors: Zhang Bing , Chen Zhuoting , Sun Qixue , Liu Jianxiu
Published: October 2022

Background

Bermudagrass (Cynodon dactylon L.) is an important warm-season turfgrass species with well-developed stolons, which lay the foundation for the fast propagation of bermudagrass plants through asexual clonal growth. However, the growth and development of bermudagrass stolons are still poorly understood at the molecular level.

Results

In this study, we comprehensively analyzed the acetylation and succinylation modifications of proteins in fast-growing stolons of the bermudagrass cultivar Yangjiang. A total of 4657 lysine acetylation sites on 1914 proteins and 226 lysine succinylation sites on 128 proteins were successfully identified using liquid chromatography coupled to tandem mass spectrometry, respectively. Furthermore, 78 proteins and 81 lysine sites were found to be both acetylated and succinylated. Functional enrichment analysis revealed that acetylated proteins regulate diverse reactions of carbohydrate metabolism and protein turnover, whereas succinylated proteins mainly regulate the citrate cycle. These results partly explained the different growth disturbances of bermudagrass stolons under treatment with sodium butyrate and sodium malonate, which interfere with protein acetylation and succinylation, respectively. Moreover, 140 acetylated proteins and 42 succinylated proteins were further characterized having similarly modified orthologs in other grass species. Site-specific mutations combined with enzymatic activity assays indicated that the conserved acetylation of catalase and succinylation of malate dehydrogenase both inhibited their activities, further implying important regulatory roles of the two modifications.

Conclusion

In summary, our study implied that lysine acetylation and succinylation of proteins possibly play important regulatory roles in the fast growth of bermudagrass stolons. The results not only provide new insights into clonal growth of bermudagrass but also offer a rich resource for functional analyses of protein lysine acetylation and succinylation in plants.
Integrated physiological and transcriptional dissection reveals the core genes involving nutrient transport and osmoregulatory substance biosynthesis in allohexaploid wheat seedlings under salt stress
Authors: Chen Jun-fan , Liu Ying , Zhang Tian-yu , Zhou Zheng-fu , Huang Jin-yong , Zhou Ting , Hua Ying-peng
Published: October 2022

Background

Soil salinization has become a global problem restricting the seed yield and quality of crops, including wheat (Triticum aestivum L.). Salinity significantly alters plant morphology and severely disrupts physiological homeostasis. Salt tolerance of wheat has been widely studied whereas core ion transporters responsive to salt stress remain elusive.

Results

In this study, the wheat seedlings were subjected to salinity toxicity for morpho-physiological and transcriptomic analysis of wheat salt tolerance. There was a inversely proportional relationship between salt concentrations and morpho-physiological parameters. Under the condition of 100 mM NaCl, the H2O2, O2−, MDA content and membrane permeability were significantly increased whereas the chlorophyll content was markedly decreased. Under salt stress, a larger proportion of Na+ was partitioned in the roots than in the shoots, which had a lower Na+/K+ ratio and proline content. Salt stress also obviously affected the homeostasis of other cations. Genome-wide transcriptomic analysis showed that a total of 2,807 and 5,570 differentially expressed genes (DEGs) were identified in the shoots and roots, respectively. Functionality analysis showed that these DEGs were mainly enriched in the KEGG pathways related to carbon metabolism, phenylalanine, and amino acid biosynthesis, and were primarily enriched in the GO terms involving proline metabolism and redox processes. The Na+ transporter genes were upregulated under salt stress, which repressed the gene expression of the K+ transporters. Salt stress also significantly elevated the expression of the genes involved in osmoregulation substances biosynthesis, and obviously affected the expression profiling of other cation transporters. Co-expression network analysis identified TaNHX6-D5/TaNHX4-B7 and TaP5CS2-B3 potentially as core members regulating wheat salt tolerance.

Conclusions

These results might help us fully understand the morpho-physiological and molecular responses of wheat seedlings to salt stress, and provide elite genetic resources for the genetic modification of wheat salt tolerance.
Psychometric properties of the Internalized Stigma of Mental Illness (ISMI-10) scale in a Dutch sample of employees with mental illness
Authors: van Beukering I. E. , Bakker M. , Bogaers R. I. , Janssens K. M.E. , Gürbüz S. , Joosen M. C.W. , Brouwers E. P.M.
Published: October 2022

Background:

Internalized stigma can have numerous negative effects on the well-being and employment of people with mental illness. Brief, valid, and reliable measures are needed to get a better understanding of self-stigmatization. The aim of this study is to translate the brief version of the Internalized Stigma of Mental Illness (ISMI-10) scale into a Dutch version and to assess the reliability and validity of this Dutch version in a sample of employees with mental illness.

Methods:

The ISMI-10 was translated into Dutch using the forward-backward translation procedure. The sample consisted of 161 employees with mental illness. Internal consistency was evaluated and the retest reliability was tested with 68 respondents. The construct validity was evaluated by testing convergent and divergent validity.

Results:

The Dutch ISMI-10 showed good internal consistency (α = 0.83) and good test-retest reliability (r = 0.73). The Dutch ISMI-10 demonstrated excellent convergent validity; high correlations were found between the Dutch ISMI-10 and hope (r = -0.54), anxiety and depression (r = 0.59), self-esteem (r = -0.56), and empowerment (r = − 0.59). Acceptable divergent validity was indicated; small correlations were found between the Dutch ISMI-10 and the physical functioning subscale (r = -0.27) and the role limitation due to physical problems subscale (r = -0.21), and medium correlations were found between the Dutch ISMI-10 and the general health subscale (r = -0.36).

Conclusion:

The Dutch ISMI-10 demonstrated adequate psychometric properties for assessing internalized stigma and can be used by researchers in Dutch speaking countries to get a better understanding of self-stigmatization among people with mental illness.
Patient-reported outcomes following cemented versus cementless primary total knee arthroplasty: a comparative analysis based on propensity score matching
Authors: Ko Hyunkyu , Pelt Christopher E. , Martin Brook I. ,   The PEPPER Investigators, Browne James A. , Chen Antonia F. , Cohen Eric M. , Davis Charles M. , Fernando Navin D. , Fricka Kevin B. , Friedman Richard J. , Garvin Kevin L. , Iorio Richard , Kain Michael S. , Kates Stephen L. , Lanting Brent A. , Lindsey Brock A. , Maloney William J. , Molloy Robert M. , Mont Michael A. , Moschetti Wayne E. , Nace James , Nelson Charles L. , Perry Kevin I. , Slover James D. , Spangehl Mark J. , Specht Lawrence M. , Sporer Scott M. , Sterling Robert S. , Walton Zeke J. , Pellegrini Vincent D.
Published: October 2022

Background

Existing studies of patient-reported outcomes (PRO) following total knee arthroplasty (TKA) based on fixation methods (cemented vs cementless) are limited to single centers with small sample sizes. Using multicentered data,, we compared baseline and early post-operative global and condition-specific PROs between patients undergoing cemented versus cementless TKA.

Methods

With PROs prospectively collected through Comparative Effectiveness Pulmonary Embolism Prevention After Hip and Knee Replacement (PEPPER) trial (ClinicalTrials.gov: NCT02810704), we examined pre- and post-operative (1, 3, and 6-months) outcomes in 5,961 patients undergoing primary TKA enrolled by 28 medical centers between December 2016 and August 2021. Outcomes included the short-form of the Knee Injury and Osteoarthritis Outcome Score (KOOS-Jr.), the Patient-Reported Outcomes Measurement Information System Physical Health (PROMIS-PH), and the Numeric Pain Rating Scale (NPRS). To minimize selection bias, we performed a 1-to-1 propensity score matched analysis to assess relative pre- to post-operative change in outcomes within and between cemented and cementless TKA groups.

Results

With greater than 90% follow-up, significant pre to- post-operative improvements were observed in both groups. At 6 months, the cemented TKA group achieved a 3.3 point (55% of the Minimum Clinically Important Difference) greater improvement in the mean KOOS-Jr. (95%CI: 0.36, 6.30; P = 0.028) than did the cementless group with no significant between-group differences in PROMIS-PH and NPRS.

Conclusions

In a large cohort of primary TKAs, patients with cemented fixation reported early incremental benefit in KOOS-Jr. over those with cementless TKA. Future studies are warranted to capture longer follow-up of PROs.
Development of a triple NanoPCR method for feline calicivirus, feline panleukopenia syndrome virus, and feline herpesvirus type I virus
Authors: Ye Jingfei , Li Zhijie , Sun Fei Yan , Guo Li , Feng Erkai , Bai Xue , Cheng Yuening
Published: October 2022

Background

Feline calicivirus (FCV), Feline panleukopenia virus (FPV), and Feline herpesvirus type I (FHV-1) are the three most common pathogens in cats, and also are the main pathogens leading to the death of kittens. Here, by a combination of gold nanoparticles and conventional PCR, we established a novel triple NanoPCR molecular detection method for clinical detection.

Results

The triple NanoPCR molecular detection is able to detect 2.97 × 101copies/μL FCV recombinant copies plasmid per reaction, 2.64 × 104copies/μL FPV recombinant copies plasmid per reaction, and 2.85copies/μL FHV-1 recombinant copies plasmid per reaction at the same time. The sensitivity of each plasmid is 100 times, 10 times, and 100 times higher than conventional PCR, respectively. The clinical results showed that among the 38 samples, the positive rates of FCV, FPV, and FHV-1 in a NanoPCR test were 63.16, 31.58, and 60.53%, while in a conventional PCR were 39.47, 18.42, and 34.21%.

Conclusions

In this report, it is the first time that NanoPCR assays are applied in the detection of FCV, FPV, and FHV-1 as well. This sensitive and specific NanoPCR assay can be widely used in clinical diagnosis and field monitoring of FCV, FPV, and FHV-1 infections.
PrEP-related stigma and PrEP use among gay, bisexual and other men who have sex with men in Ontario and British Columbia, Canada
Authors: Pico-Espinosa Oscar Javier , Hull Mark , MacPherson Paul , Grace Daniel , Gaspar Mark , Lachowsky Nathan , Mohammed Saira , Demers James , Kilduff Marshall , Truong Robinson , Tan Darrell H. S.
Published: October 2022

Background

We aimed to explore the association between PrEP-related stereotypes and perceived disapproval (hereafter PrEP-related stigma), and PrEP use.

Methods

We used data from a cross-sectional online survey among adult gay, bisexual, other men who have sex with men in Ontario and British Columbia, Canada. Participants were recruited 2019–2020 in-person from sexual health clinics and outreach programs, and online through dating mobile applications and websites. We used logistic regression models to explore the relationship between PrEP-related stigma and: 1-being a ‘never’ versus ‘current’ PrEP user, and 2-being a ‘former’ versus ‘current’ user.

Results

The median age of the sample was 32 (Q1-Q3 = 27–40), most were white born in Canada (48%), 45% had never used PrEP, 16% were former PrEP users and 39% were current PrEP users. Of 1527 individuals who started the survey, 1190 participants answered questions about PrEP-related stigma: 254 (21.3%) were classified as having low level of PrEP-related stigma, 776 (65.2%) intermediate, and 160 (13.5%) high. No significant association was found when never PrEP users and current PrEP users were compared: adjusted OR = 1.44 (95%-CI: 0.8–2.5). High PrEP-related stigma was positively associated with being a former PrEP user compared to being a current PrEP user: adjusted OR = 2.5 (95%-CI: 1.3–4.9).

Conclusion

PrEP-related stigma is associated with not using PrEP, particularly with PrEP discontinuation. Our findings indicate that stigma persists as a barrier to PrEP use.
New insights into the evolution of portunoid swimming crabs (Portunoidea, Heterotremata, Brachyura) and the brachyuran axial skeleton
Authors: Hazerli Dennis , Höpel Christoph Gert , Richter Stefan
Published: October 2022

Portunoidea (Heterotremata) is a morphologically disparate taxon of true crabs (Brachyura) best-known for many of its representatives being considered “swimming crabs”. The term “swimming crab”, however, sometimes refers to a distinct taxon (traditionally to Portunidae within Portunoidea), and sometimes to a certain morphotype in which the 5th pereiopod (P5) has a specific shape that facilitates swimming. We use the term “P5-swimming crab” or “P5-swimmer” herein, not only to restrict it to the morphotype, but also to distinguish the swimming in question from other kinds of swimming in Brachyura. The evolution of P5-swimming crabs has not yet been satisfactorily investigated. In particular, it is not known whether the morphotype evolved several times independently in different lineages of Portunoidea or whether it evolved only once and was lost in several lineages. Ours is the first approach combining molecular with morphological data to result in a new phylogenetic positioning of some members of Portunoidea. For the first time, data from the axial skeleton and extrinsic musculature are used. Morphological examinations reveal that the axial skeleton and extrinsic musculature in P5-swimming crabs are more diverse than previously thought, with the exception of the P5 anterior coxa muscle, which originates at the median plate in all P5-swimmers. Ancestral state reconstructions based on parsimony reveal that the stem species of Portunoidea already showed the morphotype of a P5-swimming crab, but with a long merus which probably resulted in less effective P5-swimming than in extant P5-swimming crab species with a short merus. Several other extant taxa represent a reversal of the P5-swimmer morphotype to varying degrees, with some extant species showing a complete reversal of unambiguous P5-swimming crab character states—one example being the well-known common shore crab Carcinus maenas. The absence of a connection between interosternite 7/8 and the sella turcica (the secondary loss of the “brachyuran sella turcica”) in the stem species of Heterotremata, resulting in a junction plate which forms a cavity that offers room and attachment sites for the P5 extrinsic musculature is uncovered as preadaptation to the P5-swimmer morphotype in Heterotremata. This preadaptation is missing in Podotremata and Thoracotremata, the other two traditional main taxa of Brachyura.
Alcohol use disorder and disability insurance in Switzerland: the attitudes and views of lawyers, insurance medical experts, and addiction-specialist therapists
Authors: Wyler Helen , Maisch Anja , Berger Thomas , Kieser Ueli , Schleifer Roman , Liebrenz Michael
Published: October 2022

Background

According to a landmark decision by the Swiss Federal Supreme Court, people with a substance use disorder (SUD) are now eligible for disability benefits if their disorder impairs their ability to work. Alcohol use disorder (AUD) is one of the most common SUDs in Switzerland and is associated with high societal and economic costs. This study aimed to gain an in-depth understanding of the views of professional stakeholder groups regarding AUD and their opinions on the new legal precedent.

Methods

Swiss social insurance lawyers, insurance medical experts, and addiction-specialist therapists (N = 79) answered an online questionnaire. Due to violations of the assumption of normality, non-parametric tests are reported in most cases.

Results

Therapists held significantly higher regard for patients with AUD than both lawyers and insurance medical experts. All three groups strongly supported a disease view of AUD but agreed significantly less that it was a disease like cancer, suggesting that AUDs might be seen as at least partially self-inflicted. Overall, moralist views of AUD received considerably less support than the disease view, with lawyers agreeing with moralist views more than therapists. All groups were well-informed and largely supportive about the new legal precedent. When asked about stipulating participation in medical treatment to mitigate damages associated with a claim, attending therapy was supported the most amongst the groups (80% of participants felt this was somewhat or fully appropriate), followed by a reduction in drinking quantity (58%), and abstinence (18%). In all three groups, we identified associations between certain views and opinions on AUD and support for the new legal precedent.

Conclusions

Whilst there were differences between the stakeholder groups in their regard for and views of AUD, all three adopted a clear harm-reduction approach with respect to measures to mitigate damages associated with the insurance disability claim. A possible connection of this stance with the Swiss national drug policy in recent years is discussed together with limitations of the study and practical implications of the findings.
Strategies for de-implementation of low-value care—a scoping review
Authors: Ingvarsson Sara , Hasson Henna , von Thiele Schwarz Ulrica , Nilsen Per , Powell Byron J. , Lindberg Clara , Augustsson Hanna
Published: October 2022

Background

The use of low-value care (LVC) is a persistent problem that calls for knowledge about strategies for de-implementation. However, studies are dispersed across many clinical fields, and there is no overview of strategies that can be used to support the de-implementation of LVC. The extent to which strategies used for implementation are also used in de-implementing LVC is unknown. The aim of this scoping review is to (1) identify strategies for the de-implementation of LVC described in the scientific literature and (2) compare de-implementation strategies to implementation strategies as specified in the Expert Recommendation for Implementing Change (ERIC) and strategies added by Perry et al.

Method

A scoping review was conducted according to recommendations outlined by Arksey and O’Malley. Four scientific databases were searched, relevant articles were snowball searched, and the journal Implementation Science was searched manually for peer-reviewed journal articles in English. Articles were included if they were empirical studies of strategies designed to reduce the use of LVC. Two reviewers conducted all abstract and full-text reviews, and conflicting decisions were discussed until consensus was reached. Data were charted using a piloted data-charting form. The strategies were first coded inductively and then mapped onto the ERIC compilation of implementation strategies.

Results

The scoping review identified a total of 71 unique de-implementation strategies described in the literature. Of these, 62 strategies could be mapped onto ERIC strategies, and four strategies onto one added category. Half (50%) of the 73 ERIC implementation strategies were used for de-implementation purposes. Five identified de-implementation strategies could not be mapped onto any of the existing strategies in ERIC.

Conclusions

Similar strategies are used for de-implementation and implementation. However, only a half of the implementation strategies included in the ERIC compilation were represented in the de-implementation studies, which may imply that some strategies are being underused or that they are not applicable for de-implementation purposes. The strategies assess and redesign workflow (a strategy previously suggested to be added to ERIC), accountability tool, and communication tool (unique new strategies for de-implementation) could complement the existing ERIC compilation when used for de-implementation purposes.
Hybrid approach for long-standing persistent atrial fibrillation: immediate versus staged treatment
Authors: Nasso Giuseppe , Lorusso Roberto , Di Bari Nicola , Condello Ignazio , Agró Felice Eugenio , Fiore Flavio , Bonifazi Raffaele , Santarpino Giuseppe , Speziale Giuseppe
Published: October 2022

Background

The hybrid approach has become the most effective treatment option for restoring sinus rhythm and reducing the risk of atrial fibrillation (AF) recurrence. However, several issues remain to be clearly defined, including the appropriate timing of the staged procedure and the most effective strategy.

Methods

Over a 12-year period of activity, we performed 609 AF ablation procedures via a right mini-thoracotomy. From this general population, 60 patients underwent a hybrid procedure with catheter ablation performed at least 4 weeks after the surgical procedure to confirm if effective complete electrical isolation of pulmonary veins was achieved. In 20 patients, the second stage procedure was performed during the same hospitalization due to patient’s electrical instability. The results obtained in immediate versus staged patients were compared.

Results

All patients were discharged after the first stage procedure in sinus rhythm. The 20 immediate patients had a shorter hospital stay compared with the staged patients, in whom the two hospitalizations resulted in a longer hospital stay (immediate 5.5 ± 1.6 days versus staged 8.7 ± 1.4, P < 0.001). A significantly higher number of immediate patients had an associated ablation of the Bachmann’s bundle (n = 16 in the immediate group [80%] versus n = 14 in the staged group [45%]; P = 0.001). After a mean follow-up of 74 months, there was no significant difference in the risk of AF relapse between groups (immediate 1/20 [5%] versus staged 7/40 [17.5%]; P = 0.18).

Conclusion

The hybrid approach for the treatment of AF was safe and effective in immediate restoring sinus rhythm and in its maintenance at follow-up. Our preliminary results show that both immediate and staged procedures show similar efficacy but this result is strongly influenced by the concomitant ablation of the Bachmann’s bundle, which appears to be the most important component of the treatment strategy in order to reduce the risk of recurrent AF.
Mutation analysis of SUOX in isolated sulfite oxidase deficiency with ectopia lentis as the presenting feature: insights into genotype–phenotype correlation
Authors: Li Jia-Tong , Chen Ze-Xu , Chen Xiang-Jun , Jiang Yong-Xiang
Published: October 2022

Background

Isolated sulfite oxidase deficiency (ISOD) caused by sulfite oxidase gene (SUOX) mutations is a rare neurometabolic disease associated with ectopia lentis (EL). However, few genotype–phenotype correlations have been established yet.

Methods

Potentially pathogenic SUOX mutations were screened from a Chinese cohort of congenital EL using panel-based next-generation sequencing and analyzed with multiple bioinformatics tools. The genotype–phenotype correlations were evaluated via a systematic review of SUOX mutations within our data and from the literature.

Results

A novel paternal missense mutation, c.205G > C (p.A69P), and a recurrent maternal nonsense mutation, c.1200 C > G (p.Y400*), of SUOX were identified in a 4-year-old boy from 312 probands. The biochemical assays manifested elevated urine sulfite and S-sulfocysteine accompanied by decreased homocysteine in the blood. The patient had bilateral EL and normal fundus, yet minimal neurological involvement and normal brain structure. Molecular modeling simulation revealed the p.A69P mutant had an unstable structure but an unchanged affinity for sulfite, while the truncated p.Y400* mutant showed decreased binding capacity. Genotype–phenotype analysis demonstrated patients with biallelic missense mutations had milder symptoms (P = 0.023), later age of onset (P < 0.001), and a higher incidence of regression (P = 0.017) than other genotypes. No correlations were found regarding EL and other neurological symptoms.

Conclusion

The data from this study not only enrich the known mutation spectrum of SUOX but also suggest that missense mutations are associated with mild and atypical symptoms.
Continuous glucose monitoring for detection of glycemic variability, hypoglycemia, and hyperglycemia in women with eating disorders
Authors: Uotani Nao , Noma Shun’ichi , Akamine Momoko , Miyawaki Takashi
Published: October 2022

Background

The aim of this study was to investigate the relationships between hypoglycemia, hyperglycemia, glycemic variability (GV), and eating behavior by measuring daily glucose levels through an intermittently scanned continuous glucose monitoring (isCGM) system in outpatients classified according to eating disorder subtypes.

Methods

We analyzed data for 18 patients (four ANR, nine ANBP, and five BN cases). A FreeStyle Libre Pro® device was attached to the posterior aspect of the upper arm for glucose monitoring. This device conducted measurements every 15 min for five consecutive days. We estimated the mean amplitude of glycemic excursions (MAGE), hypoglycemia, and hyperglycemia.

Results

The mean glucose levels were 91.1 ± 2.2 mg/dL in the ANR group, 94.8 ± 7.5 mg/dL in the ANBP group, and 87.1 ± 8.0 mg/dL in the BN group (P = 0.174). The overall mean MAGE index was 52.8 ± 20.5 mg/dL. The mean MAGE values according to the subtypes were 42.2 ± 5.6 mg/dL in the ANR group, 57.4 ± 23.7 mg/dL in the ANBP group, and 53.0 ± 21.8 mg/dL in the BN group (P = 0.496). Over the course of five days, the frequency of hypoglycemia was as follows: three occurrences in the ANBP group, five occurrences in the BN group, and no occurrences in the ANR group (P = 0.016). Moreover, the occurrence of hypoglycemia was statistically significantly higher in the BN group than in the ANR group (P = 0.013). In the BN group, the frequency of hypoglycemia was highest between 2 and 6 AM, while hypoglycemia was observed throughout the day in the ANBP group. The frequency of hyperglycemia was one occurrence in the ANR group, one occurrence in the BN group, and zero occurrences in the ANBP group (P = 0.641).

Conclusions

Varying GV, hypoglycemia, and hyperglycemia were observed in all subtypes of eating disorders. Our findings suggest that eating behaviors such as binge eating and purging are associated with GV and hypoglycemia. We showed the importance of developing different nutritional approaches tailored to the subtype of eating disorder to prevent hypoglycemia. Additional studies are needed to explore the relationship between glucose levels and eating behaviors in patients with eating disorders.
A practical guide to implementing a successful social media recruitment strategy: lessons from the Eczema Monitoring Online trial
Authors: Baker Arabella , Mitchell Eleanor J. , Thomas Kim S.
Published: October 2022

Background

Participant recruitment into clinical trials remains challenging. The global increase in the number of social media users has accelerated the use of social media as a modality of recruitment, particularly during the COVID-19 pandemic when traditional recruitment methods were reduced. However, there is limited evidence on the performance of social media recruitment strategies into eczema clinical trials.

Methods

From September 2021 to January 2022, we recruited participants with eczema into an online randomised controlled trial using free advertising on Twitter, Facebook, Instagram and Reddit (unpaid methods), followed by paid Facebook advertisements (paid method). Unpaid methods were used periodically for 63 days, whilst the paid method for 16 days. Interested individuals who clicked on the advertisement link were directed to the study website, where they could sign up to participate. Consenting, randomisation and data collection occurred exclusively online, using a database management web platform. Evaluation of the social media recruitment methods was performed, including the number of expression of interests, enrolment yield, cost, baseline characteristics and retention.

Results

Our multi-platform based social media recruitment strategy resulted in 400 expressions of interests, leading to 296 participants. Unpaid methods accounted for 136 (45.9%) of participants, incurring no financial cost. Paid Facebook adverts reached 154,370 individuals, resulting in 123 (41.6%) trial participants for a total cost of £259.93 (£2.11 per participant) and other recruitment methods resulted in 37 (12.5%) enrolments. Paid advertisements predominantly attracted younger participants below the age of 20, whereas unpaid methods mainly drew in participants between 20–29 years of age. The social media platforms recruited an ethnically diverse participant population. Completion rate of follow-up was slightly higher for the paid method (n = 103, 83.7%) compared with the unpaid methods (n = 111, 81.6%).

Conclusions

Unpaid social media posts recruited the most participants; however, it was time consuming for the researcher. Paid Facebook adverts rapidly recruited a large number of participants for a low cost and provided flexibility to target specific audiences. Our findings indicate that social media is an efficient tool that can potentially support recruitment to clinical trials.

Trial registration

ISRCTN45167024. Registered on 29 June 2021.
Indigenous weather forecasting among Gujii pastoralists in southern Ethiopia: Towards monitoring drought
Authors: Guye Mekuria , Legesse Abiyot , Mohammed Yimer
Published: October 2022

Indigenous weather forecasting (IWF) is practised by various communities around the world. Access to meteorological weather forecasting is limited in eastern Africa’s pastoral regions. As a result, pastoralists frequently rely on indigenous weather forecasting indicators. This paper investigates the use of IWF in drought forecasting among Gujii pastoralists in southern Ethiopia. To collect data, household surveys, focus group discussions, and key informant interviews were used. Furthermore, meteorological data were used to determine the frequency of drought events in the area. A comparison was made between IWF and data from the Ethiopian National Metrological Service Agency to ensure consistency of the results of IWF and climatic data. For quantitative data analysis, descriptive statistics was used, while hermeneutic and narrative analyses were used for qualitative data analysis. Pastoralists have used a variety of weather forecasting indicators, such as reading livestock intestines, observing animal and insect behaviours, and interpreting the star and moon alignment. Both the indigenous drought event forecasting result and the drought history result from the meteorological agency indicate the presence of drought in the area. However, several internal and external factors are contributing to IWF’s gradual decline. Religious teachings, technology, and education were identified as external factors, while the growing generation gap was identified as an internal factor. Thus, to increase the accuracy of forecasting of weather events and improve pastoralist’s prediction capacity, the integration of this knowledge is highly appreciated.
The prevalence of insufficient iodine intake in pregnancy in Africa: a systematic review and meta-analysis
Authors: Businge Charles Bitamazire , Musarurwa Hannibal Tafadzwa , Longo-Mbenza Benjamin , Kengne Andre Pascal
Published: October 2022

Background

Fortification of foodstuffs with iodine, mainly through iodization of salt, which commenced in several African countries after 1995 is the main method for mitigating iodine deficiency in Africa. We assessed the degree of iodine nutrition in pregnancy across Africa before and after the implementation of national iodine fortification programs (CRD42018099434).

Methods

Electronic databases and gray literature were searched for baseline data before implementation of population-based iodine supplementation and for follow-up data up to September 2020. R-metamedian and metamean packages were used to pool country-specific median urinary iodine concentration (UIC) estimates and derived mean UIC from studies with similar features.

Results

Of 54 African countries, 23 had data on iodine nutrition in pregnancy mostly from subnational samples. Data before 1995 showed that severe iodine deficiency was prevalent in pregnancy with a pooled pregnancy median UIC of 28.6 μg/L (95% CI 7.6–49.5). By 2005, five studies revealed a trend towards improvement in iodine nutrition state in pregnancy with a pooled pregnancy median UIC of 174.1 μg/L (95% CI 90.4–257.7). Between 2005 and 2020 increased numbers of national and subnational studies revealed that few African countries had sufficient, while most had mildly inadequate, and some severely inadequate iodine nutrition in pregnancy. The pooled pregnancy median UIC was 145 μg/L (95% CI 126–172).

Conclusion

Improvement in iodine nutrition status in pregnancy following the introduction of fortification of foodstuffs with iodine in Africa is sub-optimal, exposing a large proportion of pregnant women to the risk of iodine deficiency and associated disorders.

Systematic review registration

PROSPERO CRD42018099434