bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of erectile dysfunction in the ageing men using colour Doppler sonography
Authors: Aiyekomogbon J. O. , Itanyi D. U. , Atim T. , Igashi J. B.
Published: April 2021

Background

Erectile dysfunction (ED) is common among ageing men because of associated underlying risk factors which are peculiar to this category of patients. Endothelial dysfunction and replacement of cavernosal smooth muscles by collagen fibres are common in older men, making them prone to ED. It is either vasogenic, neurogenic, hormonal, cavernosal or psychogenic in origin, but vasogenic causes are the commonest. This study was aimed at establishing vasogenic causes among patients being evaluated for ED using Doppler ultrasound as this category of ED is amenable to either medical and/or surgical treatment.

Methods

The study was conducted from July 2015 to January, 2017 at Federal Medical Centre Abuja. Nineteen consecutive patients with clinical diagnosis of erectile dysfunction were evaluated with Doppler ultrasound scan using a high-frequency linear array transducer. The penile scan was done before and after intracavernosal injection of 20 µg of Prostaglandin E1 (PGE1). B-mode scan of the penis was done prior to intracavernosal injection of PGE1, and the spectral waveforms as well as peak systolic velocity (PSV) of the CA were recorded at 5 min interval, from 5 to 50 min post-intracavernosal injection of PGE1, using angle of insoation ≤ 60°.

Results

The age range of the patients was fifty to sixty-six years (mean: 57.4 ± 4.3 years), while the PSV of CA varied between 21.4 and 104.4 cm/s (mean: 46.2 ± 19.2) among the entire patients, between 21.4 and 22.3 cm/s (mean: 21.9 ± 0.7) among patients with arteriogenic ED, and between 25.0 and 74.9 cm/s (mean: 45.0 ± 15.5) among those with venogenic ED. Arteriogenic ED was found in two patients (10.6%), while venogenic ED was observed in seven patients, which constituted 36.8% of the entire research participants. None had Peyronie’s disease, penile fracture, penile tumour or mixed arteriogenic and venogenic ED.

Conclusion

47.4% of the patients had vasogenic ED and venogenic ED was more common than arterioegenic ED in the age range considered. This categorization of ED with Doppler study is imperative before initiating therapy as treatment protocol for vasogenic ED is aetiologic specific.
Imprints of independent allopolyploid formations on patterns of gene expression in two sibling yarrow species (Achillea, Asteraceae)
Authors: Chen Duo , Yan Peng-Cheng , Guo Yan-Ping
Published: April 2021

Background

Polyploid species often originate recurrently. While this is well known, there is little information on the extent to which distinct allotetraploid species formed from the same parent species differ in gene expression. The tetraploid yarrow speciesAchillea alpinaandA. wilsonianaarose independently from allopolyploidization between diploidA. acuminataandA. asiatica. The genetics and geography of these origins are clear from previous studies, providing a solid basis for comparing gene expression patterns of sibling allopolyploid species that arose independently.

Results

We conducted comparative RNA-sequencing analyses on the twoAchilleatetraploid species and their diploid progenitors to evaluate: 1) species-specific gene expression and coexpression across the four species; 2) patterns of inheritance of parental gene expression; 3) parental contributions to gene expression in the allotetraploid species, and homeolog expression bias. DiploidA. asiaticashowed a higher contribution than diploidA. acuminatato the transcriptomes of both tetraploids and also greater homeolog bias in these transcriptomes, possibly reflecting a maternal effect. Comparing expressed genes in the two allotetraploids, we found expression of ca. 30% genes were species-specific in each, which were most enriched for GO terms pertaining to “defense response”. Despite species-specific and differentially expressed genes between the two allotetraploids, they display similar transcriptome changes in comparison to their diploid progenitors.

Conclusion

Two independently originatedAchilleaallotetraploid species exhibited difference in gene expression, some of which must be related to differential adaptation during their post-speciation evolution. On the other hand, they showed similar expression profiles when compared to their progenitors. This similarity might be expected when pairs of merged diploid genomes in tetraploids are similar, as is the case in these two particular allotetraploids.
Multicentre cohort study of the impact of percutaneous coronary intervention on patients with concurrent cancer and ischaemic heart disease
Authors: Nishikawa Tatsuya , Morishima Toshitaka , Okawa Sumiyo , Fujii Yuki , Otsuka Tomoyuki , Kudo Toshihiro , Fujita Takeshi , Kamada Risa , Yasui Taku , Shioyama Wataru , Oka Toru , Tabuchi Takahiro , Fujita Masashi , Miyashiro Isao
Published: April 2021

Background

The incidence of concurrent cancer and ischaemic heart disease (IHD) is increasing; however, the long-term patient prognoses remain unclear.

Methods

Five-year all-cause mortality data pertaining to patients in the Osaka Cancer Registry, who were diagnosed with colorectal, lung, prostate, and gastric cancers between 2010 and 2015, were retrieved and analysed together with linked patient administrative data. Patient characteristics (cancer type, stage, and treatment; coronary risk factors; medications; and time from cancer diagnosis to index admission for percutaneous coronary intervention [PCI] or IHD diagnosis) were adjusted for propensity score matching. Three groups were identified: patients who underwent PCI within 3 years of cancer diagnosis (n = 564, PCI + group), patients diagnosed with IHD within 3 years of cancer diagnosis who did not undergo PCI (n = 3058, PCI-/IHD + group), and patients without IHD (n = 27,392, PCI-/IHD- group). Kaplan–Meier analysis was used for comparisons.

Results

After propensity score matching, the PCI + group had better prognosis (n = 489 in both groups, hazard ratio 0.64, 95% confidence interval 0.51–0.81, P < 0.001) than the PCI-/IHD + group. PCI + patients (n = 282) had significantly higher mortality than those without IHD (n = 280 in each group, hazard ratio 2.88, 95% confidence interval 1.90–4.38, P < 0.001).

Conclusions

PCI might improve the long-term prognosis in cancer patients with IHD. However, these patients could have significantly worse long-term prognosis than cancer patients without IHD. Since the present study has some limitations, further research will be needed on this important topic in cardio-oncology.
Prenatal diagnosis of coarctation of the aorta with a long and angled isthmus by two- and three-dimensional echocardiography: a case report
Authors: Wang Yu , Liu Caixia , Zhang Ying , Wang Meilian
Published: April 2021

Background

Prenatal diagnosis of coarctation of the aorta (CoA) is challenging for most examiners. The malformation often occurs at the aortic isthmus, which is a short segment between the origin of the left subclavian artery and the insertion of the ductus. We report herein a rare case of CoA with a long, angled, and hypoplastic isthmus. The echocardiographic characteristics and postmortem findings are presented to approach the skill of fetal diagnosis.

Case presentation

A pregnant women undergone fetal echocardiography at 26 + 3 gestational weeks in our center. Conventional two-dimensional echocardiography (2DE) showed that ascending aorta went straight upward branching three brachiocephalic arteries without the appearance of the arch, suggesting the possibility of an interrupted aortic arch. Three-dimensional echocardiography (3DE) using spatiotemporal image correlation (STIC) and high-definition flow imaging technique was performed to obtain the 3D rendered images, which clearly showed the arch and its angled junction with the slim isthmus in space. Intra-uterine fetal death occurred and an autopsy was performed. The gross findings showed the angled hypoplastic aortic isthmus in detail and thus confirmed the prenatal diagnosis.

Conclusions

Traditional 2DE may be limited in showing the angled hypoplastic aortic isthmus, while the 3DE STIC technique can provide additional spatial information to show great arteries in detail, help to find tiny vessels, and thus benefit the examiners to make an accurate diagnosis.
Convergent and discriminative validity of the Frail-VIG index with the EQ-5D-3L in people cared for in primary health care
Authors: Zamora-Sánchez Juan-José , Zabaleta-del-Olmo Edurne , Gea-Caballero Vicente , Julián-Rochina Iván , Pérez-Tortajada Gemma , Amblàs-Novellas Jordi
Published: April 2021

Background

The Frail-VIG frailty index has been developed recently. It is an instrument with a multidimensional approach and a pragmatic purpose that allows rapid and efficient assessment of the degree of frailty in the context of clinical practice. Our aim was to investigate the convergent and discriminative validity of the Frail-VIG frailty index with regard to EQ-5D-3L value.

Methods

We carried out a cross-sectional study in two Primary Health Care (PHC) centres of the Catalan Institute of Health (Institut Català de la Salut), Barcelona (Spain) from February 2017 to January 2019. Participants in the study were all people included under a home care programme during the study period. No exclusion criteria were applied. We used the EQ-5D-3L to measure Health-Related Quality of Life (HRQoL) and the Frail-VIG index to measure frailty. Trained PHC nurses administered both instruments during face-to-face assessments in a participant’s home during usual care. The relationships between both instruments were examined using Pearson’s correlation coefficient and multiple linear regression analyses.

Results

Four hundred and twelve participants were included in this study. Frail-VIG score and EQ-5D-3L value were negatively correlated (r = − 0.510; P < 0.001). Non-frail people reported a substantially better HRQoL than people with moderate and severe frailty. EQ-5D-3L value declined significantly as the Frail-VIG index score increased.

Conclusions

Frail-VIG index demonstrated a convergent validity with the EQ-5D-3L value. Its discriminative validity was optimal, as their scores showed an excellent capacity to differentiate between people with better and worse HRQoL. These findings provide additional pieces of evidence for construct validity of the Frail-VIG index.
Evaluation of muscle quality and quantity for the assessment of sarcopenia using mid-thigh computed tomography: a cohort study
Authors: Oba Hiroki , Matsui Yasumoto , Arai Hidenori , Watanabe Tsuyoshi , Iida Hiroki , Mizuno Takafumi , Yamashita Satoshi , Ishizuka Shinya , Suzuki Yasuo , Hiraiwa Hideki , Imagama Shiro
Published: April 2021

Background

For the diagnosis of Sarcopenia, European Working Group on Sarcopenia in Older People (EWGSOP) revised the algorisms in 2019, where they added computed tomography (CT) as an assessment tool not only for quantity but also for quality in research purpose. However, the evidence for clinical appreciation of CT has been lacking. Therefore, we investigated the correlation between CT and various motor function tests to assess the utility of CT as a potential diagnostic tool for sarcopenia.

Methods

In total, 214 patients who were examined at our center during the study period (2016–2017) were included in the study. Single-slice CT scan of the mid-thigh region was performed, from which cross-sectional area (CSA) and CT attenuation value (CTV) of quadriceps femoris were evaluated for each subject. Other assessments included skeletal muscle mass index by DXA and BIA, muscle strength and physical performance. Furthermore, subjects were classified into four groups as per the Asia Working Group of Sarcopenia (AWGS) 2019 criteria as those with: normal, poor muscle function/strength (poor function), sarcopenia and severe sarcopenia.

Results

Knee muscle strength correlated with CSA (r = 0.60) and the correlation was significantly greater than that with DXA and BIA. For physical performance, standing-up test correlated with CSA (r = − 0.20) and CTV (r = − 0.40) and walking speed with CTV (r = 0.43), which was significantly greater than that with DXA and BIA. The CSA was significantly lower in women with sarcopenia group and in both men and women with severe sarcopenia (all p < 0.01). Furthermore, CTV was significantly lower in women with poor-function and in both men and women with severe sarcopenia group (all p < 0.01).

Conclusions

CSA mostly correlated with muscle strength, whereas CTV mostly correlated with physical performance. CT with measurements of CSA and CTV enables the evaluation of muscle mass and quality simultaneously. CT is believed to be useful in inferring evaluation of motor function and assessment of sarcopenia.
Automated detection and segmentation of thoracic lymph nodes from CT using 3D foveal fully convolutional neural networks
Authors: Iuga Andra-Iza , Carolus Heike , Höink Anna J. , Brosch Tom , Klinder Tobias , Maintz David , Persigehl Thorsten , Baeßler Bettina , Püsken Michael
Published: April 2021

Background

In oncology, the correct determination of nodal metastatic disease is essential for patient management, as patient treatment and prognosis are closely linked to the stage of the disease. The aim of the study was to develop a tool for automatic 3D detection and segmentation of lymph nodes (LNs) in computed tomography (CT) scans of the thorax using a fully convolutional neural network based on 3D foveal patches.

Methods

The training dataset was collected from the Computed Tomography Lymph Nodes Collection of the Cancer Imaging Archive, containing 89 contrast-enhanced CT scans of the thorax. A total number of 4275 LNs was segmented semi-automatically by a radiologist, assessing the entire 3D volume of the LNs. Using this data, a fully convolutional neuronal network based on 3D foveal patches was trained with fourfold cross-validation. Testing was performed on an unseen dataset containing 15 contrast-enhanced CT scans of patients who were referred upon suspicion or for staging of bronchial carcinoma.

Results

The algorithm achieved a good overall performance with a total detection rate of 76.9% for enlarged LNs during fourfold cross-validation in the training dataset with 10.3 false-positives per volume and of 69.9% in the unseen testing dataset. In the training dataset a better detection rate was observed for enlarged LNs compared to smaller LNs, the detection rate for LNs with a short-axis diameter (SAD) ≥ 20 mm and SAD 5–10 mm being 91.6% and 62.2% (p < 0.001), respectively. Best detection rates were obtained for LNs located in Level 4R (83.6%) and Level 7 (80.4%).

Conclusions

The proposed 3D deep learning approach achieves an overall good performance in the automatic detection and segmentation of thoracic LNs and shows reasonable generalizability, yielding the potential to facilitate detection during routine clinical work and to enable radiomics research without observer-bias.
Availability and affordability of children essential medicines in health facilities of southern nations, nationalities, and people region, Ethiopia: key determinants for access
Authors: Tadesse Tefera , Abuye Habtamu , Tilahun Gizachew
Published: April 2021

Background

Children in resource-limited countries are more likely to die from treatable conditions than those in higher resource settings due to a lack of the right essential medicine at the right time. Globally millions of children die every year from conditions that could be treatable with existing medicines before they reach their fifth birthday. This study aimed in assessing the availability and affordability of essential medicine for children in selected health facilities of southern nations, nationalities, and peoples’ regions (SNNPR), Ethiopia.

Method

A medicine outlets-based cross-sectional study was conducted to assess the availability, affordability, and prices of the 30 selected essential medicines (EMs) for children in 30 public and 30 private medicine outlets in SNNPR from March 29 to May 5, 2019, applying WHO and Health Action International (HAI) tools. Availability was expressed as the percentage of sampled medicine outlets per sector that the surveyed medicine was found on the day of data collection. The amount of daily wages required for the lowest-paid government unskilled worker (LPGW) to buy one standard treatment of an acute condition or treatment for a chronic condition for a month was used to measure affordability and median price ratio for the price of EMs.

The results

Availability varied by sector, type of medication, and level of health facilities. The average availability of EM was 57.67% for the public sector and 53.67% for the private sector. Ceftriaxone, SOR, zinc sulfate, and cotrimoxazole were the most widely available types of medications in the two sectors. The median price ratios (MPR) for the cheapest drugs LP were 1.26 and 2.24 times higher than their International Reference Price (IRP) in the public and private sectors respectively. Eighty-two percent of LP medicines in the public and 91 % of LP medicines in the private sectors used in the treatments of prevalent common conditions in the region were unaffordable as they cost a day’s or more wages for the LPGW.

Conclusion

Availability, affordability, and price are determinant pre-requisite for EMs access. According to the current work, although fair availability was achieved, the observed high price affected affordability and hence access to EMs.
Association between elevated serum bilirubin levels with preserved lung function under conditions of exposure to air pollution
Authors: Shapira Udi , Brezinski Rafael Y. , Rogowski Ori , Zeltser David , Berliner Shlomo , Shapira Itzhak , Shenhar-Tsarfaty Shani , Fireman Elizabeth
Published: April 2021

Background

High serum bilirubin levels have been shown to be associated with an improved pulmonary function test results. Their potential ability to similarly benefit pulmonary function in an environment of polluted air has not been tested. We retrospectively analyzed data of 15,605 apparently healthy individuals in order to evaluate the effect of serum bilirubin levels on forced expiratory volume in 1 s (FEV1).

Methods

Individuals attended the Tel-Aviv Medical Center Inflammatory Survey for a routine annual health check between February, 2002 and June, 2009 and were divided into low, medium and high serum bilirubin levels. Their FEV1 results were compared under various levels of air pollution. Air pollution and weather data were obtained from air pollution monitoring stations of the Israeli Ministry of Environmental Protection.

Results

The elevated serum bilirubin concentrations on FEV1 were evaluated under moderate and high pollution levels FEV1 and were significantly higher in participants with high blood bilirubin levels compared to medium or low levels (p < 0.001 and p = 0.018, respectively). Participants with high levels of bilirubin had preserved FEV1 under exposure to high and medium pollution levels of both Nitrogen Oxide (NOx) and Carbon Monoxide (CO) pollutants (p = 0.003 and p = 0.022, respectively). The multivariate regression analysis revealed that the influence of bilirubin under conditions of air pollution remained significant even after adjustment for FEV1 confounders, but the interaction was not significant.

Conclusions

Elevated serum bilirubin concentrations are associated with preserved lung function in healthy individuals in Israel exposed to high levels of air pollution.
Current antibiotic resistance patterns of rare uropathogens: survey from Central European Urology Department 2011–2019
Authors: Hrbacek Jan , Cermak Pavel , Zachoval Roman
Published: April 2021

Background

While the resistance rates of commonly detected uropathogens are well described, those of less frequent Gram-negative uropathogenic bacteria have seldom been reported. The aim of this study was to examine the resistance rates of less frequent uropathogenic Gram-negatives in a population of patients treated in a Department of Urology of a tertiary referral centre in Central Europe over a period of 9 years.

Methods

Data on all positive urine samples from urological in- and out-patients were extracted form the Department of Clinical Microbiology database from 2011 to 2019. Numbers of susceptible and resistant isolates per year were calculated for these uropathogens:Acinetobacterspp. (n = 74),Citrobacterspp. (n = 60),Enterobacterspp. (n = 250),Morganella morganii(n = 194),Providenciaspp. (n = 53),Serratiaspp. (n = 82) andStenotrophomonas maltophilia(n = 27). Antimicrobial agents selected for the survey included: ampicillin, amoxicillin/clavulanic acid, piperacillin/tazobactam; cefuroxime, cefotaxime, ceftazidime and cefepime; ciprofloxacin and ofloxacin; gentamicin and amikacin; ertapenem, meropenem and imipenem; trimethoprim-sulfamethoxazole (co-trimoxazole), nitrofurantoin and colistin.

Results

Penicillin derivatives have generally poor effect except piperacillin/tazobactam. Cefuroxime is not efficient unlike cefotaxime (except againstAcinetobacterspp. andS. maltophilia). Susceptibility to fluoroquinolones is limited. Amikacin is somewhat more efficient than gentamicine but susceptibilities for both safely exceed 80%. Nitrofurantoin shows virtually no efficiency. Cotrimoxazole acts well againstCitrobacterspp.,Serratiaspp. and it is the treatment of choice forS. maltophiliaUTIs. Among carbapenems, ertapenem was less efficient than meropenem and imipenem except forS. maltophiliawhose isolates were mostly not suceptible to any carbapenems.

Conclusions

Uropathogenic microorganisms covered in this report are noteworthy for their frequently multi-drug resistant phenotypes. Knowledge of resistance patterns helps clinicians choose the right empirical antibiotic treatment when the taxonomical assignment of the isolate is known but sensitivity results are pending.
The effect of oat bran consumption on gestational diabetes: a randomized controlled clinical trial
Authors: Barati Zahra , Iravani Mina , Karandish Majid , Haghighizadeh Mohammad Hosein , Masihi Sara
Published: April 2021

Background

Gestational diabetes is the most common medical complication in pregnancy, and it has many side effects for the mother and the fetus. The aim of this study was to evaluate the effect of oat bran consumption on gestational diabetes.

Methods

This study is a randomized clinical trial that was performed on 112 women with gestational diabetes treated with diet. Participants were randomly divided into two groups of 56. Participants in both groups were given a diet for gestational diabetes. In addition to the diet, the intervention group received 30 g of oat bran daily for 4 weeks at lunch and dinner. Tests of fasting blood glucose and two-hour postprandial (2hpp) glucose were taken from both groups: before the intervention, and 2 and 4 weeks after the start of the intervention. Data analysis was performed using SPSS statistical software (version 22) using independent t-test, as well as Chi-square and Mann-Whitney tests. P values less than 0.05 were considered statistically significant.

Results

There was no statistically significant difference between the two groups in terms of mean blood glucose before the intervention, while 2 and 4 weeks after the intervention, mean fasting blood glucose and two-hour postprandial (2hpp) glucose decreased significantly in the intervention group compared with the control group (P < 0.001).

Conclusion

Based on the results of this study, the addition of oat bran to the standard diet for pregnant women with gestational diabetes reduced fasting blood glucose and two-hour postprandial (2hpp) glucose. More detailed studies with higher sample sizes are recommended to prove the effectiveness of this valuable dietary supplement.

Trial registration

IRCT registration number:IRCT20191220045828N1.

Registration date: 2020-04-18. Registered while recruiting.
The impact of uncertainty on bereaved family’s experiences of care at the end of life: a thematic analysis of free text survey data
Authors: Robinson Jackie , Pilbeam Caitlin , Goodwin Hetty , Raphael Deborah , Waterworth Susan , Gott Merryn
Published: April 2021

Background

Inequities in the provision of palliative care for people with cardiac disease have been well documented in the literature. Despite experiencing significant palliative care needs, those with cardiac disease are less likely to be referred to specialist palliative care services and more likely to die in a hospital when compared to those with cancer. The unpredictable trajectory of heart failure has been identified as a key barrier to providing palliative care with many people experiencing a long period of stability with appropriate medical treatment. However, as the disease progresses and cardiac function deteriorates, exacerbations of acute decompensation can lead to what is often perceived to be ‘sudden’ death. The aim of this study is to explore the impact of uncertainty on how death is remembered by bereaved family members of people with heart disease.

Methods

Thematic analysis of free text collected during a postal survey of bereaved family’s experiences of healthcare services in the last 3 months of life using the New Zealand version of the VOICES questionnaire was undertaken. Data was analysed using a three-dimensional conceptual framework of “scientific uncertainty”.

Results

Eight hundred and twenty-seven completed questionnaires were received of which 12.6% (n = 105) indicated that they had cared for someone at the end of life with cardiac disease. Experiences of uncertainty were found to have a significant impact upon bereaved family. Four key themes were identified; distrust in healthcare professionals, stories left incomplete, loss, regret and missed opportunity and disempowerment.

Conclusions

This study highlights the ongoing impact on bereaved family when uncertainty is not made explicit in conversations regarding end of life for people with heart disease. Timely and sensitive conversations regarding the uncertainty of when death may occur is an important factor in ensuring that bereaved family are not left with unresolved narratives. Reframing how we think and talk about uncertainty in end of life care is important, as clinicians’ uncertainties may not always reflect or match up with families’ uncertainties. Being explicit about our inability to be certain about the timing of death may thus lead to a more positive and complete experience for bereaved family.
Inter-physician variability in strategies linked to treatment limitations after severe traumatic brain injury; proactivity or wait-and-see
Authors: Robertsen Annette , Helseth Eirik , Førde Reidun
Published: April 2021

Background

Prognostic uncertainty is a challenge for physicians in the neuro intensive care field. Questions about whether continued life-sustaining treatment is in a patient’s best interests arise in different phases after a severe traumatic brain injury. In-depth information about how physicians deal with ethical issues in different contexts is lacking. The purpose of this study was to seek insight into clinicians’ strategies concerning unresolved prognostic uncertainty and their ethical reasoning on the issue of limitation of life-sustaining treatment in patients with minimal or no signs of neurological improvement after severe traumatic brain injury in the later trauma hospital phase.

Methods

Interviews with 18 physicians working in a neurointensive care unit in a large Norwegian trauma hospital, followed by a qualitative thematic analysis focused on physicians’ strategies related to treatment-limiting decision-making.

Results

A divide between proactive and wait-and-see strategies emerged. Notwithstanding the hospital’s strong team culture, inter-physician variability with regard to ethical reasoning and preferred strategies was exposed. All the physicians emphasized the importance of team—family interactions. Nevertheless, their strategies differed: (1) The proactive physicians were open to consider limitations of life-sustaining treatment when the prognosis was grim. They initiated ethical discussions, took leadership in clarification and deliberation processes regarding goals and options, saw themselves as guides for the families and believed in the necessity to prepare families for both best-case and worst-case scenarios. (2) The “wait-and-see” physicians preferred open-ended treatment (no limitations). Neurologically injured patients need time to uncover their true recovery potential, they argued. They often avoided talking to the family about dying or other worst-case scenarios during this phase.

Conclusions

Depending on the individual physician in charge, ethical issues may rest unresolved or not addressed in the later trauma hospital phase. Nevertheless, team collaboration serves to mitigate inter-physician variability. There are problems and pitfalls to be aware of related to both proactive and wait-and-see approaches. The timing of best-interest discussions and treatment-limiting decisions remain challenging after severe traumatic brain injury. Routines for timely and open discussions with families about the range of ethically reasonable options need to be strengthened.
Longitudinal analysis of sinus microbiota post endoscopic surgery in patients with cystic fibrosis and chronic rhinosinusitis: a pilot study
Authors: Wagner Mackenzie Brett , Dassi Camila , Vivekanandan Anitha , Zoing Melissa , Douglas Richard G. , Biswas Kristi
Published: April 2021

Background

Cystic fibrosis is a debilitating, autosomal recessive disease which results in chronic upper and lower airway infection and inflammation. In this study, four adult patients presenting with cystic fibrosis and chronic rhinosinusitis were recruited. Culture and molecular techniques were employed to evaluate changes in microbial profiles, host gene expression and antimicrobial resistance (AMR) in the upper respiratory tract over time.

Methods

Swab samples from the sinonasal cavity were collected at the time of surgery and at follow-up clinics at regular time intervals for up to 18 months. Nucleic acids were extracted, and DNA amplicon sequencing was applied to describe bacterial and fungal composition. In parallel, RNA was used to evaluate the expression of 17 AMR genes and two inflammatory markers (interleukins 6 and 8) using custom qPCR array cards. Molecular results were compared with routine sinus and sputum culture reports within each patient.

Results

Bacterial amplicon sequencing and swab culture reports from the sinonasal cavity were mostly congruent and relatively stable for each patient across time. The predominant species detected in patients P02 and P04 were Pseudomonas aeruginosa, Staphylococcus aureus in patient P03, and a mixture of Enterobacter and S. aureus in patient P01. Fungal profiles were variable and less subject specific than bacterial communities. Increased expressions of interleukins 6 and 8 were observed in all patients throughout the sampling period compared with other measured genes. The most prevalent AMR gene detected was ampC. However, the prevalence of AMR gene expression was low in all patient samples across varying time-points.

Conclusions

We observed a surprising degree of stability of sinonasal microbial composition, and inflammatory and AMR gene expression across all patients post sinus surgery.
How metformin affects various malignancies by means of microRNAs: a brief review
Authors: Alimoradi Nahid , Firouzabadi Negar , Fatehi Reihaneh
Published: April 2021

Metformin known as the first-line orally prescribed drug for lowering blood glucose in type II diabetes (T2DM) has recently found various therapeutic applications including in cancer. Metformin has been studied for its influences in prevention and treatment of cancer through multiple mechanisms such as microRNA (miR) regulation. Alteration in the expression of miRs by metformin may play an important role in the treatment of various cancers. MiRs are single-stranded RNAs that are involved in gene regulation. By binding to the 3′UTR of target mRNAs, miRs influence protein levels. Irregularities in the expression of miRs that control the expression of oncogenes and tumor suppressor genes are associated with the onset and progression of cancer. Metformin may possess an effect on tumor prevention and progression by modifying miR expression and downstream pathways. Here, we summarize the effect of metformin on different types of cancer by regulating the expression of various miRs and the associated downstream molecules.
Selenium nanoparticles produce a beneficial effect in psoriasis by reducing epidermal hyperproliferation and inflammation
Authors: Gangadevi Vinod , Thatikonda Sowjanya , Pooladanda Venkatesh , Devabattula Geetanjali , Godugu Chandraiah
Published: April 2021

Background

Psoriasis is a chronic autoimmune skin disease characterized by hyperproliferation of keratinocytes. Wide treatment options used to treat psoriasis is associated with various adverse effects. To overcome this nanoformulation is prepared. Selenium is an essential trace element and plays major role in oxidation reduction system. Toxicity and stability limits the applications of selenium. Toxicity can be reduced and stabilized upon preparation into nanoparticles.

Results

Selenium nanoparticles (SeNPs) exhibit potent apoptosis through the generation of reactive oxygen species (ROS) with cell cycle arrest. SeNPs topical gel application produced significant attenuation of psoriatic severity with the abrogation of acanthosis and splenomegaly. SeNPs reduced the phosphorylation and expressions of MAPKs, STAT3, GSK-3β, Akt along with PCNA, Ki67, and cyclin-D1.

Conclusion

SeNPs inhibit various inflammation and proliferation mediated pathways and could be an ideal candidate for psoriasis therapy.

Materials and methods

SeNPs were characterized and various techniques were used to determine apoptosis and other molecular mechanisms. In vivo studies were performed by inducing psoriasis with imiquimod (IMQ). SeNPs were administered via topical route.

Graphic Abstract
A device for the controlled cooling and freezing of excised plant specimens during magnetic resonance imaging
Authors: Villouta Camilo , Cox Benjamin L. , Rauch Beth , Workmaster Beth Ann A. , Eliceiri Kevin W. , Atucha Amaya
Published: April 2021

Background

Investigating plant mechanisms to tolerate freezing temperatures is critical to developing crops with superior cold hardiness. However, the lack of imaging methods that allow the visualization of freezing events in complex plant tissues remains a key limitation. Magnetic resonance imaging (MRI) has been successfully used to study many different plant models, including the study of in vivo changes during freezing. However, despite its benefits and past successes, the use of MRI in plant sciences remains low, likely due to limited access, high costs, and associated engineering challenges, such as keeping samples frozen for cold hardiness studies. To address this latter need, a novel device for keeping plant specimens at freezing temperatures during MRI is described.

Results

The device consists of commercial and custom parts. All custom parts were 3D printed and made available as open source to increase accessibility to research groups who wish to reproduce or iterate on this work. Calibration tests documented that, upon temperature equilibration for a given experimental temperature, conditions between the circulating coolant bath and inside the device seated within the bore of the magnet varied by less than 0.1 °C. The device was tested on plant material by imaging buds from Vaccinium macrocarpon in a small animal MRI system, at four temperatures, 20 °C, − 7 °C, − 14 °C, and −  21 °C. Results were compared to those obtained by independent controlled freezing test (CFT) evaluations. Non-damaging freezing events in inner bud structures were detected from the imaging data collected using this device, phenomena that are undetectable using CFT.

Conclusions

The use of this novel cooling and freezing device in conjunction with MRI facilitated the detection of freezing events in intact plant tissues through the observation of the presence and absence of water in liquid state. The device represents an important addition to plant imaging tools currently available to researchers. Furthermore, its open-source and customizable design ensures that it will be accessible to a wide range of researchers and applications.
Correction to: CXCL10 could drive longer duration of mechanical ventilation during COVID-19 ARDS
Authors:   Pneumochondrie Study Group, Blot Mathieu , Jacquier Marine , Glele Ludwig-Serge Aho , Beltramo Guillaume , Nguyen Maxime , Bonniaud Philippe , Prin Sebastien , Andreu Pascal , Bouhemad Belaid , Bour Jean-Baptiste , Binquet Christine , Piroth Lionel , de Barros Jean-Paul Pais , Masson David , Quenot Jean-Pierre , Charles Pierre-Emmanuel
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Impact of a shared decision-making mHealth tool on caregivers’ team situational awareness, communication effectiveness, and performance during pediatric cardiopulmonary resuscitation: study protocol of a cluster randomized controlled trial
Authors: Ehrler Frédéric , Sahyoun Cyril , Manzano Sergio , Sanchez Oliver , Gervaix Alain , Lovis Christian , Courvoisier Delphine S. , Lacroix Laurence , Siebert Johan N.
Published: April 2021

Background

Effective team communication, coordination, and situational awareness (SA) by team members are critical components to deliver optimal cardiopulmonary resuscitation (CPR). Complexity of care during CPR, involvement of numerous providers, miscommunication, and other exogenous factors can all contribute to negatively influencing patient care, thus jeopardizing survival. We aim to investigate whether an mHealth supportive tool (the Interconnected and Focused Mobile Apps on patient Care Environment [InterFACE]) developed as a collaborative platform to support CPR providers in real-time and share patient-centered information would increase SA during pediatric CPR.

Methods

We will conduct a prospective, cluster randomized controlled trial by groups of 6 participants in a tertiary pediatric emergency department (33,000 consultations/year) with pediatric physicians and nurses. We will compare the impact of the InterFACE tool with conventional communication methods on SA and effective team communication during a standardized pediatric in-hospital cardiac arrest and a polytrauma high-fidelity simulations. Forty-eight participants will be randomized (1:1) to consecutively perform two 20-min video-recorded scenarios using either the mHealth tool or conventional methods. The primary endpoint is the SA score, measured with the Situation Awareness Global Assessment Technique (SAGAT) instrument. Enrollment will start in late 2020 and data analysis in early 2021. We anticipate that the intervention will be completed by early 2021 and study results will be submitted in mid 2021 for publication.

Discussion

This clinical trial will assess the impact of a collaborative mHealth tool on increasing situational awareness and effective team communication during in-hospital pediatric resuscitation. As research in this area is scarce, the results generated by this study may become of paramount importance in improving the care of children receiving in-hospital CPR, in the era of increasing communication technology.

Trial registration

ClinicalTrials.govNCT04464603. Registered on 9 July 2020.
ROSE in Rosai–Dorfman–Destombes (RDD) disease: a cytological diagnosis
Authors: Tummidi Santosh , Singh Hemant Kumar , Reddy Prudhvinath A , Sindhura Manda , Kosaraju Navya , Shankaralingappa Arundhathi , Kumar Naresh P
Published: April 2021

Background

Rosai–Dorfman–Destombes (RDD) is also known as sinus histiocytosis with massive lymphadenopathy (SHML). It is a benign proliferative disorder of histiocytes, affecting lymph nodes, rarely with extra-nodal involvement. Rapid on-site evaluation (ROSE) with fine-needle aspiration cytology (FNAC) can be utilized as a minimally invasive investigation to avoid unnecessary surgery of this self-limiting disease.

Case presentation

A 65-year-old female presented with complaints of bilateral cervical lymphadenopathy since 1 year. Rapid on-site stain with FNAC from bilateral cervical lymph nodes revealed features of Rosai–Dorfman–Destombes (RDD) disease.

Conclusion

FNAC with rapid on-site evaluation can provide a simple and cost-effective method for looking at the unique cytological features of the disease and act as a first-line investigation.
The transition process between child and adolescent mental services and adult mental health services for patients with anorexia nervosa: a qualitative study of the parents’ experiences
Authors: Lockertsen Veronica , Holm Lill Ann Wellhaven , Nilsen Liv , Rø Øyvind , Burger Linn May , Røssberg Jan Ivar
Published: April 2021

Background

Patients with Anorexia Nervosa (AN) often experience the transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) as challenging. This period tends to have a negative influence on the continuity of care for the adolescents and represents a demanding and difficult period for the parents. To our knowledge, no previous study has explored the parents’ experience with the transition from CAMHS to AMHS. Therefore, this qualitative study examines how parents experience the transition process from CAMHS to AMHS.

Methods

In collaboration with a service user with carer experience, qualitative interviews were conducted with 10 parents who had experienced the transition from CAMHS to AMHS, some from outpatient care and others from both in- and outpatient mental care units in Norway. All had some experience with specialized eating disorder units. The interviews were analyzed with a Systematic Text Condensation (STC) approach. Service users’ perspectives were involved in all steps of the research process.

Results

Six categories represent the parents’ experiences of the transition: (1) the discharge when the child turns 18 years old is sudden; (2) the lack of continuity is often followed by deterioration and relapses in the patient; (3) the lack of involvement and information causes distress; (4) knowledge – an important factor for developing a trusting relationship between parents` and clinicians`; (5) parents have overwhelming multifaceted responsibilities; and (6) parents need professional support.

Conclusion

Improving the transition by including parents and adolescents and preparing them for the transition period could ease parental caregiving distress and improve adolescents’ compliance with treatment. Clinicians should increase their focus on the important role of parents in the transition process. The system should implement routines and guidelines to offer caregivers support and guidance during the transition process.
Virtual Care in Rhinology
Authors: Smith Kristine A. , Thamboo Andrew , Chan Yvonne , Chin Christopher J. , Werger Megan , Rotenberg Brian
Published: April 2021

Background

The SARS-CoV-2 (COVID) pandemic has resulted in an increase in virtual care. While some specialties are well suited to virtual care, Otolaryngology – Head and Neck Surgery could be limited due to reliance on physical examination and nasal endoscopy, including Rhinology. It is likely virtual care will remain integrated for the foreseeable future and it is important to determine the strengths and weaknesses of this treatment modality for rhinology.

Methods

A survey on virtual care in rhinology was distributed to 61 Canadian rhinologists. The primary objective was to determine how virtual care compared to in-person care in each area of a typical appointment. Other areas focused on platforms used to deliver virtual care and which patients could be appropriately assessed by virtual visits.

Results

43 participants responded (response rate 70.5%). The majority of participants use the telephone as their primary platform. History taking and reviewing results (lab work, imaging) were reported to be equivalent in virtual care. Non-urgent follow up and new patients were thought to be the most appropriate for virtual care. The inability to perform exams and nasal endoscopy were reported to be significant limitations.

Conclusion

It is important to understand the strengths and limitations of virtual care. These results identify the perceived strengths and weaknesses of virtual care in rhinology, and will help rhinologists understand the role of virtual care in their practices.

Graphical Abstract
Students’ implicit epistemologies when working at the intersection of engineering and the arts
Authors: Cruz Joshua , Bruhis Noa , Kellam Nadia , Jayasuriya Suren
Published: April 2021

Background

This paper explores the epistemologies and discourse of undergraduate students at the transdisciplinary intersection of engineering and the arts. Our research questions focus on the kinds of knowledge that students value, use, and identify within an interdisciplinary digital media program, as well as how they talk about using these epistemologies while navigating this transdisciplinary intersection. Six interviews were conducted with students pursuing a semester-long senior capstone project in the digital culture undergraduate degree program in the School of Arts, Media and Engineering at Arizona State University that emphasizes the intersection between arts, media, and engineering.

Results

Using deductive coding followed by discourse analysis, a variety of student epistemologies including positivism, constructionism, and pragmatism were observed. “Border epistemologies” are introduced as a way to think and/or construct knowledge with differing value across disciplines. Further, discourse analysis highlighted students’ identifications with being either an artist or an engineer and revealed linguistic choice in how students use knowledge and problem-solve in these situations.

Conclusions

Students in a digital media program use fluid, changing epistemological viewpoints when working on their projects, partly driven by orientations with arts and/or engineering. The findings from this study can lead to implications for the design and teaching of transdisciplinary capstones in the future.
Correction to: Influence of dosimetry method on bone lesion absorbed dose estimates in PSMA therapy: application to mCRPC patients receiving Lu-177-PSMA-I&T
Authors: Brosch-Lenz Julia , Uribe Carlos , Gosewisch Astrid , Kaiser Lena , Todica Andrei , Ilhan Harun , Gildehaus Franz Josef , Bartenstein Peter , Rahmim Arman , Celler Anna , Ziegler Sibylle , Böning Guido
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.