bluuebunny/crossref_metadata_2025 huggingface dataset:
Decreased annual risk of tuberculosis infection in South Korean healthcare workers using interferon-gamma release assay between 1986 and 2005
Authors: Lee Eun Hye , Son Nak-Hoon , Kwak Se Hyun , Choi Ji Soo , Kim Min Chul , Seol Chang Hwan , Kim Sung-Ryeol , Park Byung Hoon , Kang Young Ae
Published: November 2021

Background

Tuberculosis (TB) has been a major public health problem in South Korea. Although TB notification rate in Korea is gradually decreasing, still highest among the member countries of the Organization for Economic Cooperation and Development. To effectively control TB, understanding the TB epidemiology such as prevalence of latent tuberculosis infection (LTBI) and annual risk of TB infection (ARI) are important. This study aimed to identify the prevalence of LTBI and ARI among South Korean health care workers (HCWs) based on their interferon-gamma release assays (IGRA).

Methods

This was single center, cross-sectional retrospective study in a tertiary hospital in South Korea. We performed IGRA in HCWs between May 2017 and March 2018. We estimated ARI based on IGRA results. Logistic regression model was used to identify factors affecting IGRA positivity.

Results

A total of 3233 HCWs were analyzed. Median age of participants was 38.0 and female was predominant (72.6%). Overall positive rate of IGRA was 24.1% and IGRA positive rates age-group wise were 6.6%, 14.4%, 34.3%, and around 50% in the age groups 20s, 30s, 40s, and 50s and 60s, respectively. The ARIs was 0.26–1.35% between 1986 and 2005; rate of TB infection has gradually decreased in the last two decades. Multivariable analysis indicated that older age, healed TB lesion in x-ray, and male gender were risk factors for IGRA positivity, whereas working in high-risk TB departments was not.

Conclusions

Results showed that ARI in South Korean HCWs gradually decreased over two decades, although LTBI remained prevalent. Our results suggest that the LTBI test result of HCWs might be greatly affected by age, rather than occupational exposure, in intermediate TB burden countries. Thus, careful interpretation considering the age structure is required.
Low cerebrospinal fluid Amyloid-βeta 1–42 in patients with tuberculous meningitis
Authors: Stroffolini Giacomo , Guastamacchia Giulia , Audagnotto Sabrina , Atzori Cristiana , Trunfio Mattia , Nigra Marco , Di Stefano Alessandro , Di Perri Giovanni , Calcagno Andrea
Published: November 2021

Background

Tuberculous meningitis (TBM) is an important disease leading to morbidity, disability and mortality that primarily affects children and immune-depressed patients. Specific neuromarkers predicting outcomes, severity and inflammatory response are still lacking. In recent years an increasing number of evidences show a possible role for infective agents in developing neurodegenerative diseases.

Methods

We retrospectively included 13 HIV-negative patients presenting with TBM and we compared them with two control groups: one of patients with a confirmed diagnosis of AD, and one of those with syphilis where lumbar punctures excluded central nervous system involvement. Lumbar punctures were performed for clinical reasons and CSF biomarkers were routinely available: we analyzed blood brain barrier permeability (CSF to serum albumin ratio, “CSAR”), intrathecal IgG synthesis, (CSF to serum IgG ratio), inflammation (neopterin), amyloid deposition (Aβ1–42), neuronal damage (T-tau, P-tau, 14.3.3) and astrocytosis (S-100 β).

Results

TBM patients were 83 % male and 67 % Caucasian with a median age of 51 years (24.5–63.5 IQR). Apart from altered CSAR (median value 18.4, 17.1–30.9 IQR), neopterin (14.3 ng/ml, 9.7–18.8) and IgG ratios (15.4, 7.9–24.9), patients showed very low levels of Aβ1–42 in their CSF (348.5 pg/mL,125-532.2), even lower compared to AD and controls [603 pg/mL (IQR 528–797) and 978 (IQR 789–1178)]. Protein 14.3.3 tested altered in 38.5 % cases. T-tau, P-tau and S100Beta were in the range of normality. Altered low level of Aβ1–42 correlated over time with classical TBM findings and altered neuromarkers.

Conclusions

CSF Biomarkers from patients with TBM were compatible with inflammation, blood brain barrier damage and impairment in amyloid-beta metabolism. Amyloid-beta could be tested as a prognostic markers, backing the routine use of available neuromarkers. To our knowledge this is the first case showing such low levels of Aβ1–42 in TBM; its accumulation, drove by neuroinflammation related to infections, can be central in understanding neurodegenerative diseases.
The effects of betamethasone on clinical outcome of the late preterm neonates born between 34 and 36 weeks of gestation
Authors: Arimi Yas , Zamani Narges , Shariat Mamak , Dalili Hossein
Published: November 2021

Background

Prenatal corticosteroid administration in preterm labor is one of the most important treatments available to improve neonatal outcomes; however, its beneficial effects on late preterm infants (after the 34th week of gestation) remained unknown. We aimed to assess the effects of betamethasone on the clinical condition of the late preterm infants born between 34 and 36 weeks of gestation.

Methods

This retrospective cohort study was performed on 100 consecutive infants born between 34 and 36 weeks of gestation and received betamethasone before delivery as the cases and 100 neonates with the same delivery conditions but without receiving betamethasone. All neonates were followed up within hospitalization to assess the neonatal outcome.

Results

The neonates receiving betamethasone suffered more from respiratory distress syndrome (49% versus 31%,p = 0.008, RR = 1.59 95% CI (1.12–2.27)) and requiring more respiratory support (71% versus 50%,p = 0.002, RR = 1.43 95% CI (1.13–1.80)) as compared to the control group. There was no difference between the two groups in other neonatal adverse events or death.

Conclusion

the use of betamethasone in the late preterm period (after 34 weeks of gestation) has no beneficial effects on lung maturity or preventing neonatal adverse outcomes, even may lead to increase the risk for RDS and requiring respiratory support.
Comparison of the analgesic effect of ultrasound-guided paravertebral block and ultrasound-guided retrolaminar block in Uniportal video-assisted Thoracoscopic surgery: a prospective, randomized study
Authors: Wang Qiang , Wei Shijing , Li Shuai , Yu Jie , Zhang Guohua , Ni Cheng , Sun Li , Zheng Hui
Published: November 2021

Background

The optimal modality for postoperative analgesia after uniportal video-assisted thoracoscopic surgery (UVATS) for the treatment of lung cancer has not yet been determined. Both ultrasound-guided paravertebral block (PVB) and retrolaminar block (RLB) have been reported to be successful in providing analgesia after UVATS. However, which block technique provides superior analgesia after UVATS is still unclear. This randomized study was designed to compare the postoperative analgesic effects and adverse events associated with ultrasound-guided PVB and RLB after UVATS.

Methods

Sixty patients with lung cancer were randomized to undergo ultrasound-guided PVB (group P) or ultrasound-guided RLB (group R). In group P, 30 mL of 0.5% ropivacaine was injected at the T3 and T5 levels via ultrasound-guided PVB (15 mL at each level on the operative side). In group R, 30 mL of 0.5% ropivacaine was injected at the T3 and T5 levels via ultrasound-guided RLB (15 mL at each level on the operative side). The primary outcome was the numerical rating scale (NRS) score within 48 h after surgery. The secondary outcomes were total postoperative sufentanil consumption, time to first analgesic request and adverse events.

Results

At 3, 6, 12, 24, 36 and 48 h postoperatively, the NRS score at rest in group P was lower than that in group R (p < 0.05). At 3, 6, 12, 24 and 36 h postoperatively, the NRS score while coughing in group P was lower than that in group R (p < 0.05). The total postoperative sufentanil consumption in group P was significantly lower than that in group R (p < 0.001). Additionally, the time to first analgesic request was longer in group R than in group P (p < 0.0001). The incidence of nausea in group R was higher than that in group P (p < 0.05).

Conclusions

In patients with lung cancer undergoing UVATS, ultrasound-guided PVB with 0.5% ropivacaine provides better analgesia and results in less nausea than ultrasound-guided RLB. Compared with ultrasound-guided RLB, ultrasound-guided PVB seems to be a better technique for analgesia in UVATS.

Trial registration

The name of this study is the Effect And Mechanism Of Ultrasound-guided Multimodal Regional Nerve Block On Acute And Chronic Pain After Thoracic Surgery. This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100044060). The date of registration was March 9, 2021.
Association between physical limitations and depressive symptoms among Indian elderly: marital status as a moderator
Authors: Hossain Babul , Yadav Pawan Kumar , Nagargoje Varsha P. , Vinod Joseph K. J.
Published: November 2021

Background

Depression among the elderly is well-documented and associated with socio-economic factors, physical and mental health conditions. Few studies have focused on older adults’ physical limitations and depressive symptoms. However, very little is known about marital status’ role in such associations, especially in India. The present study examines the association between physical limitations and self-reported depressive symptoms and moderating role of marital status in such association separately for men and women.

Methods

The present study used data from the Longitudinal Ageing Study in India (LASI) wave 1, 2017–2018, a nationally and state representative longitudinal large-scale survey of ageing and health. For the present research, a total sample of 20,806 older adults aged 60+ years was selected after excluding missing values. Along with descriptive statistics, binary logistic regression analysis and interaction effect of marital status were applied to examine the association between physical limitations (functional limitations and mobility difficulty) with the depressive symptoms separately for men and women.

Results

About 58, 50, and 45% elderly reported having depressive symptoms and had difficulty in 2+ ADLs, 2+ IADLs, and 2+ mobility difficulties, respectively. By the marital status, the prevalence of depressive symptoms was higher among currently unmarried than currently married, irrespective of type and number of physical limitations. The unadjusted, marital and multivariate-adjusted association suggested that elderly with more than two ADLs, IADLs, and mobility difficulty had higher odds of depressive symptoms. The gender stratified interaction effect of marital status and physical limitations on depressive symptoms indicated that currently unmarried elderly, particularly unmarried older women with 2+ ADLs (OR = 2.85; CI 95% = 1.88–3.09), 2+ IADLs (OR = 2.01; CI 95% = 1.74–2.31) and 2+ mobility difficulty (OR = 2.20; CI 95% = 1.86–2.60) had higher odds of depressive symptoms. However, such association was only valid for unmarried men having mobility difficulty.

Conclusion

The study highlights that the elderly with physical limitations such as ADLs, IADLs, and mobility difficulty require attention and care. Although married elderly are less likely to have depressive symptoms even with all the mentioned physical limitations, unmarried women are more vulnerable to have depressive symptoms with physical limitations.
Factors contributing to the reduction in childhood stunting in Bangladesh: a pooled data analysis from the Bangladesh demographic and health surveys of 2004 and 2017–18
Authors: Kumar Pradeep , Rashmi Rashmi , Muhammad T. , Srivastava Shobhit
Published: November 2021

Background

Over the last two decades, Bangladesh has made progress in reducing the percentage of stunted children under age 5 years from 51% in 2004 to 31% in 2017. Such reduction has created a source for new research to understand its contributing factors. The present study aims to identify such crucial factors which contributed in reducing the percentage of under-five stunting status of children from 2004 to 2017–18.

Methods

The study used data from the Bangladesh Demographic and Health Surveys (BDHS), conducted in 2004 and in 2017–18, focused on children under-5-years of age (U5). The sample sizes were n = 6375 children included in the 2004 survey and n = 8312 children included in the 2017–18 survey. Descriptive analysis and bivariate analysis were conducted for a general characterization of the samples. Logistic regression was used to find out the significant factors contributing to the prevalence of stunting among U5 children. Furthermore, the Fairlie decomposition technique was used to identify the crucial factors that contributed to the reduction of stunting.

Results

The prevalence of stunting among U5 children has declined significantly, from 49.8 to 30.7% between the two survey periods (2004 and 2017–18). Estimates of decomposition analysis show that overall, the selected variables explained 50.6% of the decrease in the prevalence of stunting. Mother’s characteristics such as age at first birth, education level, working status and BMI (body mass index) status were the primary contributors of this change. Father’s characteristics, such as education explained 9% of this change.

Conclusion

The results of the study highlight the importance of increasing maternal education and reducing inter-household wealth inequality to improve nutritional status of U5 children. In order to achieve further reduction in stunting, among U5 children in Bangladesh, this paper calls for policymakers to develop effective programs to improve maternal education, raise parental awareness of parents regarding children’s height and weight, and aim to significantly reduce inter-household inequalities.
Enhancing implementation of a standardized initial assessment for demand management in outpatient emergency care in Germany: a quantitative process evaluation
Authors: Breckner Amanda , Roth Catharina , Szecsenyi Joachim , Wensing Michel
Published: November 2021

Background

Inadequate assessment of the severity and urgency of health problems is one of the factors contributing to unnecessary emergency department visits. A software-based instrument for standardized initial assessment (SmED) aims to support healthcare professionals and steer patients to the appropriate source of care. The aim of this study was to evaluate the implementation process of SmED based on the point of view of users in order to facilitate sustainable implementation.

Methods

A quantitative process evaluation on the basis of a paper-based questionnaire was carried out alongside the implementation of SmED in 26 outpatient emergency care services within 11 federal states in Germany. Healthcare professionals who worked with SmED either at the joint contact points of the outpatient emergency care service and the emergency departments of hospitals ("Joint Counter", German “Gemeinsamer Tresen”) or at the initial telephone contact points of the outpatient emergency care service (116117) were invited to participate in the survey.

Results

200 users of SmED completed the questionnaire comprising the five scales: Intervention effectiveness/efficacy, Interprofessional context/occupational Interest, Individual Context, Organisational Framework Conditions, and Medical Context. Several individual characteristics were related to the implementation process of SmED. Female and younger healthcare professionals and participants with less than five years of professional experience tended to evaluate the implementation process as more positive. Factors related to the Individual Context and to the Medical Context were associated with the reported use of SmED (p = 0.004 and 0.041, respectively).

Conclusion

The involvement of healthcare professionals, particularly more experienced professionals, in the implementation of SmED may help to facilitate sustainable implementation. In addition, training of potential user prior and during the implementation process and the adaption of Organisational Context factors are crucial.

Trial registration The study was registered at the German Clinical Trials Register prior to the start of the study (DRKS00017014).
Effects of Saccharomyces cerevisiae cell wall addition on feed digestibility, fecal fermentation and microbiota and immunological parameters in adult cats
Authors: de Oliveira Matheus Laura Fantucci , Risolia Larissa Wunsche , Ernandes Mariane Ceschin , de Souza Johnny Maciel , Oba Patrícia Massae , Vendramini Thiago Henrique Annibale , Pedrinelli Vivian , Henríquez Lucas Ben Fiuza , de Oliveira Massoco Cristina , Pontieri Cristiana Fonseca Ferreira , Brunetto Marcio Antonio
Published: November 2021

Background

This study aimed to evaluate the effects of increasing dosages of a commercial product composed bySaccharomyces cerevisiaeyeast (YAM), with active metabolites, which are beta glucans, nucleotides, organic acids, polyphenols, amino acids, vitamins and minerals (Original XPCtm, Diamond V, IOWA, USA) added to a commercially available dry cat food. Apparent digestibility of dietary nutrients, fecal microbiota, fecal fermentation products and immunological parameters were evaluated. Twenty-seven healthy cats of mixed sexes, with a mean body weight of 4.19 ± 0.83 kg and a mean age of 9.44 ± 5.35 years were distributed by age in an unbalanced randomized block design, consisting of three experimental treatments: CD (control diet), YAM 0.3 (control diet with 0.3% yeast with active metabolites) and YAM 0.6 (control diet with 0.6% yeast with active metabolites).

Results

The inclusion of the additive elevated the apparent digestibility of crude fiber (p = 0.013) and ash (p < 0.001) without interfering feed consumption, fecal production and fecal characteristics. Regarding fermentation products present in the feces, prebiotic inclusion increased lactic acid concentration (p = 0.004) while reducing isovaleric acid (p = 0.014), only in the treatment YAM 0.3. No differences were noticed on biogenic amines (BA), fecal pH, ammonia concentration, total and individuals short-chain fatty acids (SCFA) and total and individuals branched-chain fatty acids (BCFA) (except isovaleric acid in YAM 0.3). As regards to fecal microbiota, prebiotic inclusion has resulted in the reduction ofClostridium perfringens(p = 0.023). No differences were found in the immunological parameters evaluated.

Conclusion

It can be concluded that the additive, at the levels of inclusion assessed shows prebiotic potential and it has effects on fecal fermentation products and microbiota without interfering on crude protein and dry matter digestibility. More studies evaluating grater inclusion levels of the prebiotic are necessary to determine optimal concentration.
The longitudinal association between objectively measured physical activity and mental health among Norwegian adolescents
Authors: Barth Vedøy Ingeborg , Skulberg Knut Ragnvald , Anderssen Sigmund Alfred , Fagerland Morten Wang , Tjomsland Hege Eikeland , Thurston Miranda
Published: November 2021

Background

Mental health among young people in many countries, including Norway, seems to be deteriorating. Physical activity (PA) has been positively associated with mental health. However, methodological issues related to study design and measurement of PA and mental health outcomes currently limits our understanding of the relationship. The purpose of the present study is to explore the prospective relationship between objectively measured PA and mental health outcomes. More specifically, volume (total PA), intensity (moderate-to-vigorous PA [MVPA]) and sedentary behaviour (SED) were explored in relation to mental health problems (MHP) and mental wellbeing (MWB).

Methods

Data from 599 adolescents (54.4% female, mean age at baseline ±SD 13.3 ± 0.3 years) were collected annually during their 3 years (T1, T2 and T3) at lower secondary school. PA was measured using accelerometry. MWB was measured using the ‘Warwick-Edinburgh Mental Wellbeing Scale’ and MHP by the ‘Strengths and Difficulties Questionnaire’. Multiple linear regression was performed to explore relationships between changes in PA/SED (between T1-T3) and MWB/MHP (at T3). The term ‘movement categories’ was used to refer to components on the movement continuum and includes volume (total PA), intensity (MVPA) and SED.

Results

Among boys, any increase in SED was positively associated with MWB (β = 0.05, 95% CI: 0.01 to 0.10), whereas a small positive association between an increase in total PA (volume) and MWB was found among girls (β = 1.13, 95% CI: 0.05 to 2.21). There were no associations between changes in any movement categories [total PA (volume), MVPA, SED] and score on MHP at T3, neither for girls nor boys.

Conclusion

This study provided no clear evidence of any association between change in volume or intensity of PA and MHP among an overall healthy adolescent study sample. There was, however, evidence of a relationship between increased SED and MWB among boys and increased volume of PA and MWB among girls. The relationship between movement categories and mental health may depend on the measurement used to assess both PA/SED and variables of mental health. Future research would be strengthened by researchers clarifying what construct of mental health is being used and measured.
Focal adhesion kinase inhibitor TAE226 combined with Sorafenib slows down hepatocellular carcinoma by multiple epigenetic effects
Authors: Romito Ilaria , Porru Manuela , Braghini Maria Rita , Pompili Luca , Panera Nadia , Crudele Annalisa , Gnani Daniela , De Stefanis Cristiano , Scarsella Marco , Pomella Silvia , Levi Mortera Stefano , de Billy Emmanuel , Conti Adrian Libenzio , Marzano Valeria , Putignani Lorenza , Vinciguerra Manlio , Balsano Clara , Pastore Anna , Rota Rossella , Tartaglia Marco , Leonetti Carlo , Alisi Anna
Published: November 2021

Background

Hepatocellular carcinoma (HCC) is one of the most common and lethal malignant tumours worldwide. Sorafenib (SOR) is one of the most effective single-drug systemic therapy against advanced HCC, but the identification of novel combination regimens for a continued improvement in overall survival is a big challenge. Recent studies highlighted the crucial role of focal adhesion kinase (FAK) in HCC growth. The aim of this study was to investigate the antitumor effects of three different FAK inhibitors (FAKi), alone or in combination with SOR, using in vitro and in vivo models of HCC.

Methods

The effect of PND1186, PF431396, TAE226 on cell viability was compared to SOR. Among them TAE226, emerging as the most effective FAKi, was tested alone or in combination with SOR using 2D/3D human HCC cell line cultures and HCC xenograft murine models. The mechanisms of action were assessed by gene/protein expression and imaging approaches, combined with high-throughput methods.

Results

TAE226 was the more effective FAKi to be combined with SOR against HCC. Combined TAE226 and SOR treatment reduced HCC growth both in vitro and in vivo by affecting tumour-promoting gene expression and inducing epigenetic changes via dysregulation of FAK nuclear interactome. We characterized a novel nuclear functional interaction between FAK and the NuRD complex. TAE226-mediated FAK depletion and SOR-promoted MAPK down-modulation caused a decrease in the nuclear amount of HDAC1/2 and a consequent increase of the histone H3 lysine 27 acetylation, thus counteracting histone H3 lysine 27 trimethylation.

Conclusions

Altogether, our findings provide the first evidence that TAE226 combined with SOR efficiently reduces HCC growth in vitro and in vivo. Also, our data highlight that deep analysis of FAK nuclear interactome may lead to the identification of new promising targets for HCC therapy.
Curcumin inhibits ovarian cancer progression by regulating circ-PLEKHM3/miR-320a/SMG1 axis
Authors: Sun Sifan , Fang Hailiang
Published: November 2021

Background

Curcumin has a potential therapeutic role in ovarian cancer. However, whether curcumin plays anti-cancer role in ovarian cancer by mediating the circular RNA (circRNA)/microRNA (miRNA)/mRNA network is still unclear.

Methods

The expression of circ-PLEKHM3, miR-320a, and suppressor of morphogenesis in genitalia 1 (SMG1) was detected via qRT-PCR. Cell viability, colony-formation ability and apoptosis were analyzed via cell counting kit-8 assay, colony formation analysis, and flow cytometry. Protein expression was measured using western blot. The in vivo experiments were performed using a xenograft model. Target association was evaluated via dual-luciferase reporter analysis and RIP assay.

Results

Curcumin suppressed ovarian cancer cell proliferation and promoted apoptosis. Circ-PLEKHM3 was downregulated in ovarian cancer, and its expression could be promoted by curcumin treatment. Circ-PLEKHM3 overexpression exacerbated the effect of curcumin on ovarian cancer cell proliferation and apoptosis, as well as anti-tumor effect. MiR-320a was targeted by circ-PLEKHM3. The inhibition effect of circ-PLEKHM3 overexpression on cell proliferation and the enhancing effect on cell apoptosis could be reversed by miR-320a mimic. SMG1 was targeted by miR-320a, and its knockdown also reversed the regulation of miR-320a inhibitor on the proliferation and apoptosis of ovarian cancer cells. In addition, circ-PLEKHM3 could upregulate SMG1 expression via sponging miR-320a.

Conclusion

Curcumin restrained proliferation and facilitated apoptosis in ovarian cancer by regulating the circ-PLEKHM3/miR-320a/SMG1 axis.
The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care
Authors: Jonas Daniel E. , Barclay Colleen , Grammer Debbie , Weathington Chris , Birken Sarah A. , DeWalt Darren A. , Shoenbill Kimberly A. , Boynton Marcella H. , Mackey Monique , Riley Sean , Cykert Samuel
Published: November 2021

Background

Unhealthy alcohol use is a leading cause of preventable deaths in the USA and is associated with many societal and health problems. Less than a third of people who visit primary care providers in the USA are asked about or ever discuss alcohol use with a health professional.

Methods/design

This study is an adaptive, randomized, controlled trial to evaluate the effect of primary care practice facilitation and telehealth services on evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use in small-to-medium-sized primary care practices. Study participants will include primary care practices in North Carolina with 10 or fewer providers. All enrolled practices will receive a practice facilitation intervention that includes quality improvement (QI) coaching, electronic health record (EHR) support, training, and expert consultation. After 6 months, practices in the lower 50th percentile (based on performance) will be randomized to continued practice facilitation or provision of telehealth services plus ongoing facilitation for the next 6 months. Practices in the upper 50th percentile after the initial 6 months of intervention will continue to receive practice facilitation alone. The main outcome measures include the number (and %) of patients in the target population who are screened for unhealthy alcohol use, screen positive, and receive brief counseling. Additional measures include the number (and %) of patients who receive pharmacotherapy for AUD or are referred for AUD services. Sample size calculations determined that 35 practices are needed to detect a 10% increase in the main outcome (percent screened for unhealthy alcohol use) over 6 months.

Discussion

A successful intervention would significantly reduce morbidity among adults from unhealthy alcohol use by increasing counseling and other treatment opportunities. The study will produce important evidence about the effect of practice facilitation on uptake of evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use when delivered on a large scale to small and medium-sized practices. It will also generate scientific knowledge about whether embedded telehealth services can improve the use of evidence-based screening and interventions for practices with slower uptake. The results of this rigorously conducted evaluation are expected to have a positive impact by accelerating the dissemination and implementation of evidence related to unhealthy alcohol use into primary care practices.

Trial registration

ClinicalTrials.govNCT04317989. Registered on March 23, 2020.
Comparing the effects of dexmedetomidine versus propofol on the treatment of emergence agitation in adult patients after general anesthesia: study protocol for a randomized, superiority, controlled trial (DP-TEA Trial)
Authors: Feng Zhaoyan , Shi Xiao , Yan Xue , Zhu Yamin , Gu Juan , Zhu Hao , Yu Weifeng , Zhang Song
Published: November 2021

Background

Emergence agitation (EA) after general anesthesia is a common complication in the post-anesthesia care unit (PACU). Once EA occurs, there are still no guidelines established for the treatment in adults. Propofol is excessively used in managing agitated patients in the PACU, but it lacks analgesia and can result in apnea. Intraoperative infusion of dexmedetomidine has been proven to have a preventive effect on EA, but the treatment effect of dexmedetomidine on EA remains unknown. This study aims to compare the effects between dexmedetomidine and propofol on relieving EA in adult patients after general anesthesia in the PACU.

Methods

In this randomized, superiority, controlled clinical study, a total of 120 adult patients aged 18–65 years of both genders, with American Society of Anesthesiologists (ASA) classification I or II developing EA in the PACU after general anesthesia, will be enrolled. Patients will be randomized at a 1:1 ratio into two groups, receiving either a single dose of dexmedetomidine (0.7μg/kg) or propofol (0.5 mg/kg). The primary outcome is the proportion of patients having a recurrent EA within 15 min after intervention in the PACU.

Discussion

Previous studies have focused on premedication for preventing EA, while therapeutics for reliving EA have rarely been reported. To our knowledge, this study is the first randomized, superiority, controlled trial to compare a bolus of dexmedetomidine with the current routine care for this indication.

Trial registration

ClinicalTrials.govNCT04142840. Registered on October 26, 2019
Successful induction treatment of bullous pemphigoid using reslizumab: a case report
Authors: Rhyou Hyo-In , Han Song-Hee , Nam Young-Hee
Published: November 2021

Background

Bullous pemphigoid (BP) is a potentially life-threatening autoimmune blistering disease which is characterized by autoantibodies against hemidesmosomal proteins of the skin and mucous membranes. In recent years, the role of eosinophil and immunoglobulin E autoantibodies have been further elucidated in BP, and have been considered potential therapeutic targets.

Case presentations

A 67-year-old male presented with erythematous bullous eruption. The skin eruption was located on whole body, and suggested BP. Peripheral blood eosinophil count and total immunoglobulin E markedly elevated in initial laboratory findings. Topical and systemic steroid (methylprednisolone 2 mg/kg/day) treatment was started, and his skin symptoms worsened repeatedly, whenever systemic steroid were reduced. On admission day 29, reslizumab (anti-interleukin-5) 3.5 mg/kg was administered intravenously to the patients. The bullous skin lesion began to improve rapidly, and methylprednisolone (8 mg/day) was reduced without any worsening of symptoms during two doses of reslizumab.

Conclusions

We report a case of successful treatment response to reslizumab administration in a patient with BP. Further studies are needed to confirm the role of anti-interleukin-5 as a treatment for BP in the future.
Classification of nonnegative solutions to static Schrödinger–Hartree–Maxwell system involving the fractional Laplacian
Authors: Li Yunting , Liu Yaqiong , Yi Yunhui
Published: November 2021

This paper is mainly concerned with the following semi-linear system involving the fractional Laplacian: $$ \textstyle\begin{cases} (-\Delta )^{\frac{\alpha }{2}}u(x)= (\frac{1}{ \vert \cdot \vert ^{\sigma }} \ast v^{p_{1}} )v^{p_{2}}(x), \quad x\in \mathbb{R}^{n}, \\ (-\Delta )^{\frac{\alpha }{2}}v(x)= (\frac{1}{ \vert \cdot \vert ^{\sigma }} \ast u^{q_{1}} )u^{q_{2}}(x), \quad x\in \mathbb{R}^{n}, \\ u(x)\geq 0,\quad\quad v(x)\geq 0, \quad x\in \mathbb{R}^{n}, \end{cases} $$

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Impacts of weaning age on dietary needs of whey permeate for pigs at 7 to 11 kg body weight
Authors: Jang Ki Beom , Duarte Marcos Elias , Purvis Jerry M. , Kim Sung Woo
Published: November 2021

Background

Whey permeate is an effective lactose source for nursery pigs and the most benefits are obtained when pigs are at 7 to 11 kg BW. Altering weaning ages could cause different length of early-weaner phases until 7 kg BW and thus it would influence the dietary need of whey permeate during 7 to 11 kg BW of pigs. This study aimed to evaluate if weaning ages would affect the dietary needs of whey permeate for optimum growth performance of pigs at 7 to 11 kg BW.

Methods

A total of 1,632 pigs were weaned at d 21 (d 21.2 ± 1.3) or d 25 (d 24.6 ± 1.1) after birth. All pigs had a common early-weaner feeds until they reached 7 kg BW. When pigs reached 7 kg BW within a weaning age group, they were allotted in a randomized complete block design (2 × 4 factorial). Two factors were weaning age groups (21 and 25 d of age) and varying whey permeate levels (7.50%, 11.25%, 15.00%, and 18.75%). Data were analyzed using the GLM and NLIN procedures of SAS for slope-ratio and broken-line analyses to determine the growth response to whey permeate and optimal daily whey permeate intake for the growth of the pigs weaned at different ages.

Results

Pigs weaned at 21 d of age had a common diet for 11 d to reach 7 kg BW whereas pigs weaned at 25 d of age needed 2 d. The G:F of pigs weaned at 25 d of age responded to increased daily whey permeate intake greater (P < 0.05) than pigs weaned at 21 d of age. Breakpoints were obtained (P < 0.05) at 88 and 60 g/d daily whey permeate intake or 17.0% and 14.4% of whey permeate for G:F of pigs weaned at 21 and 25 d of age, respectively.

Conclusion

Pigs weaned at an older age with a short early-weaner phase had a greater growth response to whey permeate intake compared with pigs weaned at a younger age with a long early-weaner phase. Altering weaning ages affected dietary needs of whey permeate for optimum growth performance of pigs from 7 to 11 kg BW.
Online residency training during the COVID-19 pandemic: A national survey of otolaryngology head and neck surgery program directors
Authors: Chénard-Roy Jade , Guitton Matthieu J. , Thuot François
Published: November 2021

Background

The COVID-19 pandemic has deeply impacted healthcare and education systems, including resident education. The impact of the pandemic on the different types of pedagogical activities, and the displacement of pedagogical activities to online modalities have not yet been quantified. We sought to evaluate the impact of the COVID-19 pandemic on formal pedagogic components of otorhinolaryngology–head and neck surgery (ORL–HNS) residency, the switch to distance learning and program director's perceptions of the future of teaching and learning.

Methods

A nationwide online survey was conducted on Canadian ORL–HNS program directors. The use of standard didactic activities in-person and online, before and during the pandemic was rated with Likert scales. Perceptions of the pandemic were described with open-ended questions.

Results

A total of 11 of the 13 program directors contacted responded. The analysis were conducted using nonparametric statistics. There was a significant drop in overall didactic activities during the pandemic, regardless of the teaching format (3.5 ± 0.2 to 3.1 ± 0.3, p < 0.05). The most affected activities were simulation and in-house lectures. Online activities increased dramatically (0.5 ± 0.2 to 5.0 ± 0.5, p < 0.001), including attendance to lectures made by other programs (0.5 ± 0.3 to 4.0 ± 0.8, p < 0.05). Respondents stated their intention to maintain the hybrid online and in-person teaching model.

Conclusions

These findings suggest that hybrid online and in-person teaching is likely to persist in the post-pandemic setting. A balanced residency curriculum requires diversity in academic activities. The pandemic can have positive consequences if higher education institutions work to better support distance teaching and learning.

Graphical Abstract
The effects of soil temperature from soil mulching and harvest age on phenol, flavonoid and antioxidant contents of Java tea (Orthosiphon aristatus B.)
Authors: Komariah  , Pitaloka Diora Diah Ayu , Batubara Irmanida , Nurcholis Waras , Sandrawati Apong , Setyawati Andriyana , Syamsiyah Jauhari , Dewi Widyatmani Sih
Published: November 2021

Background

The environmental conditions resulted by the agronomic management practices may govern the secondary metabolite contents of medicinal plants, including Java tea (Orthosiphon aristatusB). Abiotic factors such as temperatures have been known to determine the secondary metabolite contents of Java tea. This study aimed at evaluating the effects of soil temperature resulting from soil mulching and harvest age on total phenol, flavonoid and antioxidant contents of Java tea.

Methods

The research was arranged using nested (hierarchy design) with completely randomized design under a screen house at Karanganyar, Indonesia, from July to December 2019. The main factor was soil mulching (control; black plastic mulch, transparent plastic mulch, biodegradable mulch and rice straw mulch) with three replicates. The main factor was nested in the temporal hierarchy factor, namely harvest age which consisted of two levels, i.e., 80 and 100 days. The observation parameters were soil temperature of 10 min (maximum; mean; minimum and soil temperature-based Growing Degree Days, GDD) with sensors and logger; plant growth (plant height, number of leaves, fresh and dry weight); and secondary metabolites including phenol, flavonoids and antioxidant.

Results

The results confirmed the order of the highest to the lowest mean soil temperature was resulted under the transparent plastic mulch > straw > black plastic mulch > control > biodegradable plastic mulch (26.69 > 26.29 > 26.10 > 26.07 > 25.68 °C, respectively). Overall, the harvest age 100 days resulted in higher plant growth, indicated by the higher fresh and dry weight of biomass, higher phenol and antioxidant contents than 80 days. Soil mulching, especially with plastic and biodegradable plastic mulches with long harvest age (100 days) effected into lower fresh and dry weight of plants. On the other hand, soil mulching indirectly resulted in lower phenol but higher flavonoid contents through higher soil temperature, while antioxidant contents were higher under the big soil temperature-based Growing Degree Day (GDD). The total phenol, flavonoids and antioxidant produced ranging from 193.75 to 412.50 mg GAE/ 100 g DW; 81.13 to 141.47 mg QE/ 100 g DW; and 1875.5–2144.4 µmol TE/g DW.

Conclusion

Higher maximum soil temperature resulted in lower phenol content, while higher minimum soil temperature and shorter harvest age increased total flavonoid. Longer harvest age produced more total phenol and antioxidant due to bigger soil temperature-based Growing Degree Day (GDD).

Graphical Abstract
Determinants of species assemblages of insect pests in alpine forest ecosystems of western China
Authors: Wang Chun-Jing , Wang Rong , Yu Chun-Mei , Pubu Yongcuo , Sun Wan-Gui , Dang Xiao-Feng , Li Qiang-Feng , Wan Ji-Zhong
Published: November 2021

Background

Insect pests are a significant threat to natural resources and social development. Modeling species assemblages of insect pests can predict spatiotemporal pest dynamics. However, research gaps remain regarding the mechanism for determining species assemblages of insect pests in alpine forest ecosystems. Here, we explored these determinants using a field investigation conducted for insect pests in a region of the Qinghai-Tibet Plateau. We assessed the species assemblages of insect pests in alpine forest ecosystems based on species co-occurrence patterns and species diversity (i.e., observed diversity, dark diversity, community completeness, and species pool). A probabilistic model was used to test for statistically significant pairwise patterns of species co-occurrence using the presence-absence matrix of pest species based on species interactions. We used ordinary least squares regression modeling to explore relationships between abiotic factors (i.e., climate factors and human influence) and species diversity.

Results

Positive pest species interactions and many association links can occur widely across different investigation sites and parts of plant hosts in alpine forest ecosystems. We detected high dark diversity and low community completeness of insect pests in alpine forest ecosystems. High temperature and precipitation could promote pest species diversity, particularly dark diversity and species pools. Human influence could drive high levels of pest species diversity and lead to dark diversity and species pools. Community completeness could be an effective indicator for insect pest risk assessment.

Conclusions

Our study provides new evidence for the determinants of insect pest species assemblages in alpine forest ecosystems from the perspectives of pest species interactions and abiotic factors. The findings of our study could reveal the mechanism for shaping species assemblages and support the prevention and control of insect pests in alpine forest ecosystems.
Object detection for automotive radar point clouds – a comparison
Authors: Scheiner Nicolas , Kraus Florian , Appenrodt Nils , Dickmann Jürgen , Sick Bernhard
Published: November 2021

Automotive radar perception is an integral part of automated driving systems. Radar sensors benefit from their excellent robustness against adverse weather conditions such as snow, fog, or heavy rain. Despite the fact that machine-learning-based object detection is traditionally a camera-based domain, vast progress has been made for lidar sensors, and radar is also catching up. Recently, several new techniques for using machine learning algorithms towards the correct detection and classification of moving road users in automotive radar data have been introduced. However, most of them have not been compared to other methods or require next generation radar sensors which are far more advanced than current conventional automotive sensors. This article makes a thorough comparison of existing and novel radar object detection algorithms with some of the most successful candidates from the image and lidar domain. All experiments are conducted using a conventional automotive radar system. In addition to introducing all architectures, special attention is paid to the necessary point cloud preprocessing for all methods. By assessing all methods on a large and open real world data set, this evaluation provides the first representative algorithm comparison in this domain and outlines future research directions.
Double-objective optimization-based firefly algorithm of a stand-alone photovoltaic/water pumping system for water supply in rural and remote areas: a case study
Authors: Zieba Falama Ruben , Bakari Hamadou , Dumbrava Virgil
Published: November 2021

A techno-economic study of a stand-alone PV water pumping system for water supply is done in this paper. An optimal design of the system is realized thanks to a double-objective optimization based on a proposed operational strategy of the system and on firefly algorithm (FA). The two objective functions simulated simultaneously using FA are: the function defining the cost of water (COW) and the function which defines the loss of water supply probability (LWSP). The system is designed to supply water to around 328 households in Cameroon, each composed by an average of six (06) persons. For different LWSP, the double-objective simulation determines the optimal configurations of the system with their related cost. The optimal and reliable (LWSP of 0%) system configuration obtained is composed by a number of 7 PV modules, a reservoir volume of 98.4 m3 with 2 days autonomy, a total dynamic head of 40 m, and a pump power of around 1 kW. The related COW corresponding to this configuration is 0.1185 $/m3, and the total investment cost is 27,506 $. The sensitivity analysis of the system revealed that the PV size, the volume of reservoir storage, and the efficiency of the pump influence the system both technically and economically, whereas the total dynamic head only influences the system economically. The validation of the optimized system has been done by comparison with manufacturer datasheets. It is demonstrated in this paper that the techno-economic analysis of energy systems based on multi-objective optimization using firefly algorithm is a powerful tool for decision-making.
Prevalence of lower limb deformities among primary school students
Authors: Ganeb Sahar Saad , Egaila Sami El-Said , Younis Abdelmoniem Abdelfattah , El-Aziz Asmaa Moheiy Abd , Hashaad Nashwa Ismail
Published: November 2021

Background

Lower limb deformities could affect child's quality of life and may worsen with time. This work aims to study the prevalence of lower limb deformities among primary school students in our governorate.

Methods

This cross-sectional descriptive study was carried out on 4689 students attending 12 public primary schools during the academic year 2019–2020.Complete clinical examination was done for picking of cases of genu varum, genu valgum, genu recurvatum, flat foot, pes cavus, hallux valgus, in-toeing, and lower limb discrepancy, and x-ray on both feet, pelvis, and full-length lower limb was requested.

Results

This cross-sectional descriptive study included 4689 students. The prevalence of lower limb (LL) deformities was 16.61%. One hundred twenty-three (2.62%) children had a positive history of musculoskeletal pain, 0.09% had genu varum, 0.11% had genu valgum, 0.75% had Genu recurvatum, 0.03% had LL discrepancy, 13.86% had flexible flat foot, 1.22% had rigid flat foot, 0.23% had pes cavus, 1.04 % had in-toeing, 0.06% had hallux varus, and 0.11% had hallux valgus.

Conclusions

Lower limb deformities are a considerable problem in primary school students that need early diagnosis because it could affect child’s future, health, and career. Further studies are needed to investigate spinal deformity, vit D level, calcium level, foot wear, and school bag weight as hidden factors.