bluuebunny/crossref_metadata_2025 huggingface dataset:
Escalation of care in children at high risk of clinical deterioration in a tertiary care children’s hospital using the Bedside Pediatric Early Warning System
Authors: Gawronski Orsola , Latour Jos Maria , Cecchetti Corrado , Iula Angela , Ravà Lucilla , Ciofi degli Atti Marta Luisa , Dall’Oglio Immacolata , Tiozzo Emanuela , Raponi Massimiliano , Parshuram Christopher S.
Published: September 2022

Background

Escalation and de-escalation are a routine part of high-quality care that should be matched with clinical needs. The aim of this study was to describe escalation of care in relation to the occurrence and timing of Pediatric Intensive Care Unit (PICU) admission in a cohort of pediatric inpatients with acute worsening of their clinical condition.

Methods

A monocentric, observational cohort study was performed from January to December 2018. Eligible patients were children: 1) admitted to one of the inpatient wards other than ICU; 2) under the age of 18 years at the time of admission; 3) with two or more Bedside-Paediatric-Early-Warning-System (BedsidePEWS) scores ≥ 7 recorded at a distance of at least one hour and for a period of 4 h during admission. The main outcome -the 24-h disposition – was defined as admission to PICU within 24-h of enrolment or staying in the inpatient ward. Escalation of care was measured using an eight-point scale—the Escalation Index (EI), developed by the authors. The EI was calculated every 6 h, starting from the moment the patient was considered eligible. Analyses used multivariate quantile and logistic regression models.

Results

The 228 episodes included 574 EI calculated scores. The 24-h disposition was the ward in 129 (57%) and the PICU in 99 (43%) episodes. Patients who were admitted to PICU within 24-h had higher top EI scores [median (IQR) 6 (5–7) vs 4 (3–5), p < 0.001]; higher initial BedsidePEWS scores [median (IQR) 10(8–13) vs. 9 (8–11), p = 0.02], were less likely to have a chronic disease [n = 62 (63%) vs. n = 127 (98%), p < 0.0001], and were rated by physicians as being at a higher risk of having a cardiac arrest (p = 0.01) than patients remaining on the ward. The EI increased over 24 h before urgent admission to PICU or cardiac arrest by 0.53 every 6-h interval (CI 0.37–0.70, p < 0.001), while it decreased by 0.25 every 6-h interval (CI -0.36–0.15, p < 0.001) in patients who stayed on the wards.

Conclusion

Escalation of care was related to temporal changes in severity of illness, patient background and environmental factors. The EI index can improve responses to evolving critical illness.
What are the barriers and facilitators to seeking help for mental health in NHS doctors: a systematic review and qualitative study
Authors: Zaman Nadia , Mujahid Khadeejah , Ahmed Fahmid , Mahmud Simran , Naeem Hamza , Riaz Umar , Ullah Umayair , Cox Benita
Published: September 2022

Background

The mental health of healthcare professionals is reaching a breaking point, and the COVID-19 pandemic has exacerbated current mental health issues to unprecedented levels. Whilst some research has been carried out on the barriers that doctors face when seeking mental health help, there is little research into factors which may facilitate seeking help. We aimed to expand the research base on factors which act as barriers to seeking help, as well as gain insight into facilitators of help-seeking behaviour for mental health in NHS doctors.

Methods

We conducted a systematic literature review which identified the barriers and facilitators to seeking help for mental health in healthcare professionals. Following this, we conducted semi-structured interviews with 31 NHS doctors about their experiences with mental health services. Finally, through thematic analysis, key themes were synthesised from the data.

Results

Our systematic literature review uncovered barriers and facilitators from pre-existing literature, of which the barriers were: preventing actions, self-stigma, perceived stigma, costs of seeking treatment, lack of awareness and availability of support, negative career implications, confidentiality concerns and a lack of time to seek help. Only two facilitators were found in the pre-existing literature, a positive work environment and availability of support services.

Our qualitative study uncovered additional barriers and facilitators, of which the identified barriers include: a negative workplace culture, lack of openness, expectations of doctors and generational differences. The facilitators include positive views about mental health, external confidential service, better patient outcomes, protected time, greater awareness and accessibility, open culture and supportive supervisors.

Conclusion

Our study began by identifying barriers and facilitators to seeking mental health help in healthcare workers, through our systematic literature review. We contributed to these findings by identifying themes in qualitative data.. Our findings are crucial to identify factors preventing NHS doctors from seeking help for their mental health so that more can be done on a national, trust-wide and personal level to overcome these barriers. Likewise, further research into facilitators is key to encourage doctors to reach out and seek help for their mental health.
Variation in smoking attributable all-cause mortality across municipalities in Belgium, 2018: application of a Bayesian approach for small area estimations
Authors: Putrik Polina , Otavova Martina , Faes Christel , Devleesschauwer Brecht
Published: September 2022

Background

Smoking is one of the leading causes of preventable mortality and morbidity worldwide, with the European Region having the highest prevalence of tobacco smoking among adults compared to other WHO regions. The Belgian Health Interview Survey (BHIS) provides a reliable source of national and regional estimates of smoking prevalence; however, currently there are no estimates at a smaller geographical resolution such as the municipality scale in Belgium. This hinders the estimation of the spatial distribution of smoking attributable mortality at small geographical scale (i.e., number of deaths that can be attributed to tobacco). The objective of this study was to obtain estimates of smoking prevalence in each Belgian municipality using BHIS and calculate smoking attributable mortality at municipality level.

Methods

Data of participants aged 15 + on smoking behavior, age, gender, educational level and municipality of residence were obtained from the BHIS 2018. A Bayesian hierarchical Besag-York-Mollie (BYM) model was used to model the logit transformation of the design-based Horvitz-Thompson direct prevalence estimates. Municipality-level variables obtained from Statbel, the Belgian statistical office, were used as auxiliary variables in the model. Model parameters were estimated using Integrated Nested Laplace Approximation (INLA). Deviance Information Criterion (DIC) and Conditional Predictive Ordinate (CPO) were computed to assess model fit.

Population attributable fractions (PAF) were computed using the estimated prevalence of smoking in each of the 589 Belgian municipalities and relative risks obtained from published meta-analyses. Smoking attributable mortality was calculated by multiplying PAF with age-gender standardized and stratified number of deaths in each municipality.

Results

BHIS 2018 data included 7,829 respondents from 154 municipalities. Smoothed estimates for current smoking ranged between 11% [Credible Interval 3;23] and 27% [21;34] per municipality, and for former smoking between 4% [0;14] and 34% [21;47]. Estimates of smoking attributable mortality constituted between 10% [7;15] and 47% [34;59] of total number of deaths per municipality.

Conclusions

Within-country variation in smoking and smoking attributable mortality was observed. Computed estimates should inform local public health prevention campaigns as well as contribute to explaining the regional differences in mortality.
The effect of micro-learning on learning and self-efficacy of nursing students: an interventional study
Authors: Zarshenas Ladan , Mehrabi Manoosh , karamdar Leila , Keshavarzi Mohammad Hasan , keshtkaran Zahra
Published: September 2022

Background

In the present age, e-learning has been playing a good role in educational and clinical settings along with face-to-face training. This study aimed to determine the effect of distance class using micro-learning contents on learning outcomes and self-efficacy in the clinical education of nursing students in 2021.

Methods

This research is a quasi-experimental pre-test-post-test study conducted at Shiraz University of Medical Sciences. The study population consisted of 46 nursing students who were recruited by the full census method. Students were randomly divided into two groups of intervention and control. Before and after educational interventions in both groups, students' learning and self-efficacy were evaluated using a questionnaire. Data Analysis was done using descriptive and analytical statistical methods and with SPSS software version 23.

Results

The results revealed a statistically significant difference in the mean score of clinical learning level of nursing students between the control and experimental groups after the intervention (p = 0.041). Also, the difference between the mean score of self-efficacy in the intervention group before and after the training was statistically significant (p = 0.001).

Conclusion

Micro-learning is an effective training method for raising learning outcomes and self-efficacy among nursing students, especially in internship units. This method is recommended since multimedia pays attention to all learning styles of learners and affects the learning outcomes and self-efficacy of learners.
Building leadership and managerial capacity for maternal and newborn health services
Authors: Tomblin Murphy Gail , Mtey Godfrey , Nyamtema Angelo , LeBlanc John , Rigby Janet , Abel Zabron , Mselle Lilian Teddy
Published: September 2022

Background

Strengthening leadership and management is important for building an effective and efficient health system. This paper presents the findings from a L&M capacity building initiative which was implemented as part of a larger study aimed at improving maternal and newborn outcomes within primary health facilities in the Morogoro, Tanzania.

Methods

The initiative, involving 30 stakeholders from 20 primary health facilities, 4 council health management teams and the regional health management team in the Morogoro region, provided leadership and managerial training through two 5-day in-person workshops, onsite mentoring, and e-learning modules. The initiative was evaluated using a pre-post design. Quantitative instruments included the ‘Big Results Now’ star-rating assessments and a team-developed survey for health providers/managers. The ‘Big Results Now’ star-rating assessments, conducted in 2018 (19 facilities) and 2021 (20 facilities), measured overall facility leadership and management capability, with comparisons of star-ratings from the two time-points providing indication of improvement. The survey was used to measure 3 key leadership indicators - team climate, role clarity/conflict and job satisfaction. The survey was completed by 97 respondents at baseline and 100 at follow up. Paired t-tests were used to examine mean score differences for each indicator. Triangulated findings from focus groups with 99 health providers and health management team members provided support and context for quantitative findings.

Results

Star-ratings increased in 15 (79%) of 19 facilities, with the number of facilities achieving the target of 3 plus stars increasing from 2 (10%) in 2018 to 10 (50%) in 2021, indicating improved organizational performance. From the survey, team climate, job satisfaction and role clarity improved across the facilities over the 3 project years. Focus group discussions related this improvement to the leadership and managerial capacity-building.

Conclusion

Improved leadership and managerial capacity in the participating health facilities and enhanced communication between the health facility, council and regional health management teams created a more supportive workplace environment, leading to enhanced teamwork, job satisfaction, productivity, and improved services for mothers and newborns. Leadership and managerial training at all levels is important for ensuring efficient and effective health service provision.
Experiences of family caregivers of patients with post-traumatic hydrocephalus from hospital to home: a qualitative study
Authors: Wang Jia-nan , Liu La-mei , Dela Rosa Ronnell , Sun Meng-jie , Qian Yu-meng , Sun Meng-yao Zhuan , Xu Tong-yao
Published: September 2022

Background

Post-traumatic hydrocephalus (PTH) is a complication of traumatic brain injury (TBI) that requires treatment and postoperative care. The shunt is one of the main treatments for PTH, which presents with dysfunction and infection. Considering brain injury, hydrocephalus shunt malfunction, and infection, family caregivers need to be responsible for caring for PTH patients, recognizing shunt malfunction and infection, and managing those patients accordingly from hospital to home. Understanding the experiences and needs of caregivers is beneficial for knowing their competency and quality of health care, ameliorating and ensuring future transition care. The study aimed to explore the feelings, experiences, and needs of family caregivers when caring for patients with TBI, PTH and shunts.

Methods

This was exploratory research of a purposive sample of 12 family caregivers of adult patients with TBI, PTH and shunts in five neurosurgery departments at a general hospital in Zhengzhou, Henan Province, China, using a semi-structured interview method. Data were collected from October 2021 to March 2022 before being analyzed by content analysis methods.

Results

Caregivers required professional and social knowledge and support in the areas of TBI, PTH and shunts, caregiving interventions, psychological care needs, and health insurance, just as caregivers do, but unlike other general caregivers, care for patients with TBI, PTH, and shunt is fraught with uncertainty and the need to manage shunt setting, and caregivers often experience 'complex emotional reaction' during the transitional period, where care needs and complex emotions may lead to a lack of caregiver confidence, which in turn may affect caregiving behaviors, and experiences that affect care may be mediated through caregiving confidence. The perceived availability of resources, particularly those that are still available to them when they return home, has a significant impact on participants' emotional response and sense of confidence.

Conclusions

The emotional response and the impact of stressor caregivers after TBI, PTH, and shunt was important, and sometimes confidence in care appeared to be an intermediate and useful factor that needed to be considered as health professionals prepared to develop care resources on how to manage and empower patients with TBI, PTH, and shunt. Meanwhile, there may be gaps and inequities in supportive care for patients diagnosed with TBI, PTH, and shunt in China.
Clinical management and acute exacerbations in patients with idiopathic pulmonary fibrosis in Spain: results from the OASIS study
Authors: Cano-Jiménez Esteban , Romero Ortiz Ana Dolores , Villar Ana , Rodríguez-Nieto María Jesús , Ramon Alba , Armengol Silvia
Published: September 2022

Background

Idiopathic pulmonary fibrosis (IPF) is a progressive disease associated with decline in lung function and poor prognosis entailing significant impairment in quality of life and high socioeconomic burden. The aim of this study was to characterize clinical management and resources utilization of patients with IPF in Spain, according to predicted forced vital capacity (FVC) % at baseline.

Methods

Prospective, non-interventional, multicentric real-world data study in patients with IPF in Spain with 12-months follow-up. Clinical management and resources utilization during study period were recorded and compared between groups. FVC decline and acute exacerbations occurrence and associated healthcare resource use were also analysed. FVC decline after 12 months was estimated as relative change.

Results

204 consecutive patients with IPF were included and divided according to baseline FVC % predicted value. At baseline, patients with FVC < 50% received significantly more pharmacological and non-pharmacological treatments, and more help from caregiver. During the 12-months follow-up, patients with FVC < 50% required more specialized care visits, emergency visits, hospitalizations, pulmonary functions tests, non-health resource use (special transportation), and pharmacological treatments (p < 0.05 for all comparisons). Moreover, patients with FVC < 50% at baseline experienced more AE-IPF (p < 0.05), requiring more health-related resources use (primary care visits, p < 0.05). FVC decline was observed in all groups over the 12 months. FVC decreased on average by 2.50% (95% CI: − 5.98 to 0.98) along the year. More patients experienced an FVC decline > 10% in the more preserved lung function groups than in the FVC < 50% group, because of their already deteriorated condition.

Conclusions

We observed a significantly higher annual IPF-related resource use in patients with more impaired lung function at baseline. Since FVC decreases irrespective of FVC% predicted at baseline, slowing IPF progression to maintain patients at early disease stages is relevant to improve IPF management and to optimize resource use.

Trial registration: EU PAS register number EUPAS19387 [June 01, 2017].
Primary melanoma of the bladder: case report and review of the literature
Authors: Dai Jin-Dong , He Ben , Liu Zhi-Hong , Shi Ming , Shen Peng-Fei
Published: September 2022

Background

Primary melanoma of the bladder is extremely rare and has been sporadically reported in case reports. Its incidence, diagnosis, treatment, and outcomes are still unclear.

Case presentation

We report a 67-year-old female patient who presented with hematuria and was diagnosed with primary melanoma of the bladder by transurethral resection. No distant metastasis was detected by fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT). After a multidisciplinary discussion, the patient received laparoscopic radical resection of the bladder tumor. There was no tumor recurrence or distant metastasis after 15 months of follow-up.

Conclusion

Primary melanoma of the bladder is easily confused with urothelium carcinoma in morphology. The immunohistochemical is crucial in diagnosis. Because of a lack of in-depth understanding of primary melanoma of the bladder, the “gold standard” treatment has not been set. We would like to provide some rare information about it and discuss the proper treatment strategy for this rare disease.
Enhanced photothermal heating and combination therapy of gold nanoparticles on a breast cell model
Authors: Faid Amna H. , Shouman Samia A. , Badr Yehia A. , Sharaky Marwa
Published: September 2022

Multi-drug resistance (MDR) in addition to the damage to non-malignant normal cells are the most difficult in cancer treatment. Drug delivery and Plasmonic photothermal therapy based on the use of resonant metallic nanoparticles have developed as promising techniques to destroy cancer cells selectively. In the present work, gold nanoparticles (AuNPs) were synthesized using trisodium citrate. The prepared AuNPs have a small size of 14 ± 4 nm and exhibit high stability with Zeta potential − 18 mV, AuNPs showed higher photothermal heating efficiency compared to irradiation with a 532 nm laser alone on the breast cancer cell line (MCF-7). Treatment of MCF-7 cells with 0.125 mM AuNPs coupled with laser irradiation for 6 min was found to significantly reduce (34%) the cell viability compared to 5% obtained with AuNPs in the same concentration and 26% with laser irradiation for 6 min without AuNPs. Moreover, the prepared AuNPs were used as an anticancer drug carrier for Doxorubicin (Dox), upon loading Dox to AuNPs there was a slight increase in the particle size to 16 ± 2 nm, FT-IR spectroscopic results showing the binding of Dox to AuNPs was through the –NH group. The potential cytotoxicity of the DOX@AuNPs nanocomposite was significantly increased compared to free DOX on the MCF7 cell line with a decrease in IC50. All these results suggested the potential use of AuNPs as therapeutic photothermal agents and drug carriers in cancer therapy.
Association of device-measured physical activity and sedentary behaviour with cardiovascular risk factors, health-related quality-of-life and exercise capacity over 12-months in cardiac rehabilitation attendees with coronary heart disease
Authors: Freene Nicole , McManus Margaret , Mair Tarryn , Tan Ren , Davey Rachel
Published: September 2022

Background

Few studies have considered the relationship between risk factors, physical activity and sedentary behaviour in people with heart disease. Here we examine the independent relationship of device-measured physical activity and sedentary behaviour on risk factors, quality-of-life and exercise capacity over 12-months in cardiac rehabilitation attendees.

Methods

Hospital-based phase II cardiac rehabilitation participants with coronary heart disease were assessed at the start and end of cardiac rehabilitation (6-weeks), 6 and 12-months. Physical activity (moderate-to-vigorous (MVPA), light-intensity (LIPA); min/day) and sedentary behaviour (min/day, bouts, breaks) were measured using an ActiGraph accelerometer. Risk factors included waist circumference, body mass index, systolic blood pressure (SBP), fasting blood lipid and glucose levels, anxiety and depression. Quality-of-life and exercise capacity were also collected. Associations were assessed with Generalized Estimating Equation modeling.

Results

Sixty-seven participants were included (mean age = 64 (SD 9) years; 81% male). An association was found between higher MVPA and lower high density lipoprotein (p ≤ 0.001). No significant (p ≤ 0.001) associations were found between sedentary behaviour variables and other outcomes. At p < 0.05 several associations were significant. Increased MVPA and LIPA were associated with decreased total cholesterol. Higher MVPA was associated with decreased SBP, whereas higher LIPA was associated with decreased waist circumference and body mass index. Higher sedentary behaviour bouts and breaks were associated with increased total cholesterol, anxiety and depression, and decreased SBP over time.

Conclusions

Any intensity of physical activity was associated with decreased total cholesterol. Increased LIPA was associated with improved measures of adiposity, while breaking up sedentary behaviour and increasing MVPA may decrease SBP over time. Further investigation of MVPA, LIPA and the distribution of sedentary behaviour is indicated in cardiac rehabilitation attendees to explore their relationship with risk factors.

Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12615000995572, http://www.ANZCTR.org.au/ACTRN12615000995572.aspx. Registered 22 September 2015.
Improving carboxymethyl cellulose edible coating using ZnO nanoparticles from irradiated Alternaria tenuissima
Authors: Anwar Mervat M. , Aly Sanaa S. H. , Nasr Essam H. , El-Sayed El-Sayed R.
Published: September 2022

In this paper, gamma-irradiation was successfully used to intensify the yield of Zinc oxide nanoparticles (ZnONPs) produced by the fungus Alternariatenuissima as a sustainable and green process. The obtained data showed that 500 Gy of gamma-irradiation increased ZnONPs’ yield to approximately four-fold. The synthesized ZnONPs were then exploited to develop active Carboxymethyl Cellulose films by casting method at two different concentration of ZnONPs 0.5% and 1.0%. The physicochemical, mechanical, antioxidant, and antimicrobial properties of the prepared films were evaluated. The incorporation of ZnONPs in the Carboxymethyl Cellulose films had significantly decreased solubility (from 78.31% to 66.04% and 59.72%), water vapor permeability (from 0.475 g m−2 to 0.093 g m−2 and 0.026 g m−2), and oxygen transfer rate (from 24.7 × 10–2 to 2.3 × 10–2 and 1.8 × 10–2) of the respective prepared films. Meanwhile, tensile strength (from 183.2 MPa to 203.34 MPa and 235.94 MPa), elongation (from 13.0% to 62.5% and 83.7%), and Yang's modulus (from 325.344 to 1410.0 and 1814.96 MPa) of these films were increased. Moreover, the antioxidant and antimicrobial activities against several human and plant pathogens the prepared of Carboxymethyl Cellulose-ZnONPs films were significantly increased. In conclusion, the prepared Carboxymethyl Cellulose-ZnONPs films showed enhanced activities in comparison with Carboxymethyl Cellulose film without NPs. With these advantages, the fabricated Carboxymethyl Cellulose-ZnONPs films in this study could be effectively utilized as protective edible coating films of food products.
Effect of modified Laprade technique on posterolateral ligament injury of knee
Authors: Fang Kaibin , Dai Zhangsheng , Lin Xiaocong
Published: September 2022

Purpose

To investigate the effect of modified Laprade technique on the reconstruction of posterolateral structure of knee and anterolateral ligament of knee in the treatment of posterolateral injury of knee.

Methods

From December 2013 to June 2020, multiple ligament injury patients who received surgery in our hospital were collected in this research. These patients underwent a modified Laprade technique for posterolateral structural reconstruction of the knee. Lysholm scores of patients pre- and post-operation were recorded.

Result

The operations of the observation group or the control group patients were completed. There were no significant differences in gender, age, preoperative knee range of motion and preoperative Lysholm score. At the time of follow-up 1 month after operation, there was no significant difference in knee range of motion, dial-up test angle and Lysholm score between the observation and the control group. When followed up 1 year after operation, the Lysholm score of the observation group was higher than that of the control group. The difference was statistically significant. The same situation occurred in the range of motion of the knee in both groups. However, there was still no significant difference between the two groups in the dial-up test 1 year after operation, whether the knee flexion was 30° or 90°.

Conclusion

For patients with posterolateral structure injury of knee, the modified Laprade technique is a feasible surgical technique.
Iranian EFL teachers’ perceptions of writing assessment literacy: a countrywide study
Authors: Sohrabi Zohre , Ghanbari Nasim , Abbasi Abbas
Published: September 2022

Despite a surge of interest in language teacher assessment literacy, teachers’ writing assessment literacy (WAL) has received little attention. When considering the issue in the particular Iranian EFL context, it becomes more significant since exploring the context shows the lack of a countrywide and systematic study on EFL teachers’ WAL. Considering this gap, the present study sets out to investigate the Iranian EFL writing teachers’ knowledge, beliefs, and practices regarding writing assessment. To achieve this goal, an adapted version of Crusan’s et al (Assessing Writing 28:43-56, 2016) WAL questionnaire was sent out to writing teachers in ten major state universities in the country. Overall, the researchers received back 118 questionnaires. The analysis of the results illustrated that although writing instructors had a positive attitude toward writing assessment and were aware of some basic concepts of writing assessment, their level of assessment literacy was not reflected in their practice, particularly when it came to the use of assessment rubrics. The results further showed that the teachers need to develop sound and clear conceptual understanding of WAL as well as the ability to use the knowledge in practice in the actual context of their practice. Generally, it can be argued that in the absence of systematic pre-service and in-service writing assessment training programs, Iranian EFL writing teachers relied on their individual expertise developed throughout their years of practice. The study also provides several pedagogical implications for training writing teachers and improving EFL writing assessment in the long run.
Hygro-mechanical short-term behaviour of selected coatings: experiments and material modelling on vapour permeability and mechanical properties
Authors: Stöcklein Josef , Konopka Daniel , Grajcarek Gerald , Tietze Oliver , Oertel Silvia , Schulze Andreas , Kaliske Michael
Published: September 2022

Many pieces of fine art are made of wood that has been treated with coatings. Since wood is a very hygroscopic material, the moisture content strongly influences the deformation of wooden parts. Coatings often act as moisture barriers. Therefore, the moisture permeability of coatings must be considered for the evaluation of the structural behaviour. The mechanical properties are also relevant to evaluate the deformation of thin artwork like panel paintings as well as the damage of paintings and varnishes. Therefore, the mechanical properties and the permeability of selected coatings used for cultural wooden artwork are investigated and presented in the article at hand. In this study, coatings of three artworks are investigated: a Lusatian cupboard from the eighteenth century, an altarpiece by L. Cranach the Elder and a Russian icon from 1912. The coatings considered are white ground, colours, varnishes, glue and textile reinforced sizing. Mechanical tests are conducted to evaluate the stiffness and tensile strength of the Russian icon’s coating. Cup tests are made to identify the moisture permeability of the coatings. This test was conducted for single coatings as well as for coating systems consisting of different coatings to investigate both the moisture barrier of single coatings and the interaction of coatings. Exponential functions for the relative humidity-dependent permeability are fitted based on the experimental data. The results allow the quantification of permeability for all investigated coatings—from white ground with a high permeability to beeswax with a low permeability—and the magnitude of moisture dependency of the coating’s permeability. Furthermore, it is shown that the simple addition of the water vapour resistance of single coatings underrates the resistance of a total coating system. By the mechanical tests, the strength, ultimate strain and Young’s modulus are obtained. The permeability and the mechanical parameters are required as input for numerical simulations of the structural behaviour of coated wooden artwork. These results are a good step forward to assess the risk of damage of coated wooden artwork.
An exponential-interval sampling method for evaluating equilibrium climate sensitivity via reducing internal variability noise
Authors: Li Shufan , Huang Ping
Published: September 2022

Equilibrium climate sensitivity (ECS) refers to the total global warming caused by an instantaneous doubling of CO2 from the preindustrial level. It is mainly estimated through the linear fit between the changes in global-mean surface temperature and top-of-atmosphere net radiative flux, due to the high costs of millennial-length simulations for reaching a stable climate. However, the accuracy can be influenced by the response’s nonlinearity and the internal noise, especially when using a limited-length simulation. Here, we propose a new method that derives a new series using an exponential-interval sampling (EIS) method for the original simulation to reduce the noise and estimate the ECS more accurately. Utilizing the millennial-length simulations of LongRunMIP, we prove that the EIS method can effectively reduce the influence of internal variability, and the estimated ECS based on the first 150 years of simulation is closer to the final ECS in the millennial-length simulations than previous estimations with the deviation rate decreased by around 1/3. The ECS in CMIP6 models estimated by the EIS method ranges from 1.93 to 6.78 K, and suggests that the multimodel mean ECS derived from the original series with previous methods could be underestimated.
Exploration of spatial and temporal variability of rainfall and their impact on rice production in Burma in 1901–1939 during the colonial period
Authors: Shrestha Badri Bhakta , Kawasaki Akiyuki , Inoue Tomoshige , Matsumoto Jun , Shiroyama Tomoko
Published: September 2022

Climate is one of the main factors for rice crop growth. Understanding the relationship between climate variability and rice production during the period from 1901 to 1939 in Burma can give a clear picture of the impact of climate variability on rice yield since there were fewer human interventions on the catchment and almost no use of chemical fertilizer or high-yielding rice varieties at that time. However, the quantitative analysis of climate variability and its impact on rice production has not yet been paid sufficient scientific attention for the historic period. First, the changing trends of rainfall and rice yield between 1901 and 1939 were analyzed, including the effect of rainfall variability on rice production from multiple perspectives regarding rainfall characteristics, such as seasonal rainfall, various rainfall indices, rainfall anomalies, and monthly rainfall variability. Then, the relationship between rice yield and rainfall was investigated using multiple regression analysis to show how rainfall spatial and temporal variabilities have influenced rice yield and production, including essential factors that affected rice yield in each Burma district. The historical development of rice production in Burma during the period was also explored. Our findings indicate that not only the annual variability of rainfall, but also its monthly variability within a particular year likely influenced rice production. Excessive rainfall in the early or middle stage of crop growth or less during the early-middle or latter half of crop growth possibly caused the rice yield reduction in Burma during the colonial period. Furthermore, the results indicated that although rainfall anomalies widely differed from period to period, rice yield anomalies clearly showed the distinction of periods with higher or lower rice yields than average rice yield. Mostly higher than average rice yield was observed before 1910 in the Coastal Zone and before 1918 in the Delta, Dry, and Hilly Zones. The results of this study imply that selected rainfall indices could affect rice yield, positively or negatively, including the varied magnitude of their effects from one district to another, depending on climatic zones and agricultural ecosystems.
Does 3-dimensional facial attractiveness relate to golden ratio, neoclassical canons, ‘ideal’ ratios and ‘ideal’ angles?
Authors: Zwahlen Roger A. , Tang Alexander T. H. , Leung Wai Keung , Tan Su Keng
Published: September 2022

Background

The established recommendations and guidelines regarding ideal measurements for an attractive face are mostly based on data gathered among Caucasian population. The aim of this study was to examine the relationship between perception of 3-dimensional facial attractiveness and golden ratio, neoclassical canons, ‘ideal’ ratios and ‘ideal’ angles in Hong Kong Chinese.

Methods

Thirty 3-D photographs (15 males and 15 females) were shown to 101 laypersons and 60 patients seeking orthognathic treatment. The photographs were rated based on a 100 mm visual analogue scale (VAS) from 0 (very unattractive) to 100 (very attractive).

Results

More than half of the measurements (42/77) in females and thirty-two measurements in males were found to be significantly different from the ideal target value (p < 0.05) upon the comparison of the attractive faces with golden ratio, neoclassical canons, ‘ideal’ ratios and ‘ideal’ angles. Meanwhile, correlation tests between VAS scores and the parameters detected significant results (p < 0.05) in only six ratios, eight angles, one neoclassical canon and one proportion.

Conclusions

Despite several renowned ‘ideal’ parameters of attractive faces that have been recommended in the literature, only a few of them were found to be significantly correlated with attractive faces in Hong Kong Chinese.
Unpredicted clinical manifestation of COVID-19: a unique case report and review of literature
Authors: Al-Ani Raid M. , Rashid Rasheed Ali
Published: September 2022

Background

Cervical lymphadenopathy in children is a common problem in daily clinical practice. Many cases of cervical lymphadenopathy after the COVID-19 vaccine were reported. However, there is no yet reporting a case of supraclavicular cervical lymphadenopathy due to COVID-19. 

Case presentation

A 12-year-old girl presented with fever, cough, fatigue, anosmia, and ageusia. COVID-19 was confirmed by real-time PCR. The symptoms were resolved within 10 days. Seven days later, she complained of supraclavicular swelling. Physical examination revealed painless, multiple, and mobile supraclavicular lymph nodes. Ultrasound and fine-needle aspiration cytology were suspicious. Therefore, an excisional biopsy of the largest node was performed. The specimen was sent for histopathology and immunohistochemistry evaluation which confirmed the benign nature of the lymph node.

Conclusion

To our best knowledge, this is the first case of supraclavicular lymphadenopathy in a child with COVID-19. It is essential to put COVID-19 in the differential diagnosis of cervical lymphadenopathy.
Targeting Accuracy and Clinical Outcomes of Awake versus Asleep Interventional Magnetic Resonance Imaging-Guided Deep Brain Stimulation for Parkinson's Disease: The University of California, San Francisco Experience
Authors: Lee Anthony T. , Han Kasey J. , Nichols Noah , Sudhakar Vivek R. , Burke John F. , Wozny Thomas A. , Chung Jason E. , Volz Monica M. , Ostrem Jill L. , Martin Alastair J. , Larson Paul S. , Starr Philip A. , Wang Doris D.
Published: September 2022

BACKGROUND:

Interventional MRI (iMRI)-guided implantation of deep brain stimulator (DBS) leads has been developed to treat patients with Parkinson's disease (PD) without the need for awake testing.

OBJECTIVE:

Direct comparisons of targeting accuracy and clinical outcomes for awake stereotactic with asleep iMRI-DBS for PD are limited.

METHODS:

We performed a retrospective review of patients with PD who underwent awake or iMRI-guided DBS surgery targeting the subthalamic nucleus or globus pallidus interna between 2013 and 2019 at our institution. Outcome measures included Unified Parkinson's Disease Rating Scale Part III scores, levodopa equivalent daily dose, radial error between intended and actual lead locations, stimulation parameters, and complications.

RESULTS:

Of the 218 patients included in the study, the iMRI cohort had smaller radial errors (iMRI: 1.27 ± 0.72 mm, awake: 1.59 ± 0.96 mm, P < .01) and fewer lead passes (iMRI: 1.0 ± 0.16, awake: 1.2 ± 0.41, P < .01). Changes in Unified Parkinson's Disease Rating Scale were similar between modalities, but awake cases had a greater reduction in levodopa equivalent daily dose than iMRI cases (P < .01), which was attributed to the greater number of awake subthalamic nucleus cases on multivariate analysis. Effective clinical contacts used for stimulation, side effect thresholds, and complication rates were similar between modalities.

CONCLUSION:

Although iMRI-DBS may result in more accurate lead placement for intended target compared with awake-DBS, clinical outcomes were similar between surgical approaches. Ultimately, patient preference and surgeon experience with a given DBS technique should be the main factors when determining the “best” method for DBS implantation.
Patlak plot based on the first 30 minutes post-injection dynamic 18F-florbetaben positron emission tomography scan separates amyloid-β positive from negative studies
Authors: Oliveira Francisco PM , Ferreira Sara MF , Silva Mariana GG , Castanheira Joana C , Teixeira Ricardo JV , Costa Durval C
Published: September 2022

Objective:

This work aims to search for the shortest duration of an early 18F-florbetaben positron emission tomography (PET) dynamic acquisition to obtain reliable information on the brain amyloid-β (Aβ) deposition and perfusion.

Methods:

25 patients that underwent an early 18F-florbetaben PET dynamic acquisition starting immediately post-injection (maximum of 60 min duration) were retrospectively included. Reference region-based Patlak plot [Formula: see text] (transference rate to the irreversible compartment) and [Formula: see text] (distribution volume) were computed. Shorter early dynamic acquisitions were simulated to a minimum of 15 min duration. Three nuclear medicine physicians evaluated qualitatively the [Formula: see text] parametric images obtained in comparison with those obtained from the standard clinical protocol defined by a late acquisition of 20 min duration starting 90 min post-injection.

Results:

All the [Formula: see text] parametric images obtained with at least an early 30-min dynamic acquisitions were suitable for visual classification. Shorter early acquisitions originated images with too much noise, making qualitative assessment difficult. Aβ deposition visual classification based on the [Formula: see text] images were highly concordant with the evaluation of standard late acquisitions (readers consensus agreement of 92%). [Formula: see text] images obtained from the different early dynamic acquisition’s duration were visually indistinguishable from each other (voxelwise r ≥ 0.98).

Conclusion:

Patlak plot method applied to early 30-min 18F-florbetaben PET dynamic acquisition may be an alternative to the dual acquisition protocol sometimes used in clinics. This improves patients’ comfort, service logistics and reduces radiation exposure.

Advances in knowledge:

This work shows, for the first time, that early (0–30 min post-injection) 18F-florbetaben dynamic PET scans with reference region-based Patlak plot method could replace the dual acquisition protocol and the 90–110 min standard acquisition.
Us versus them mentality in football fans: Significant social defeat engages the mentalization network and disengages cognitive control areas
Authors: Zamorano Francisco , Carvajal-Paredes Patricio , Soto-Icaza Patricia , Stecher Ximena , Salinas César , Muñoz-Reyes José Antonio , López Vladimir , Méndez Waldemar , Barrera Joel , Aragón-Caqueo Gonzalo , Billeke Pablo
Published: September 2022

Background: Social affiliation is one of the building blocks that shapes cultures and communities. This motivation contributes to the development of social bonding among individuals within a group, enjoying rights, assuming obligations, and strengthening its identity. Evidence has shown that social affiliation has inspired different social phenomena, such as wars, political movements, social struggles, among others, based on two human motivations: the ingroup love and the outgroup hate. One contemporary group to study as a proxy of social affiliation, and ingroup and outgroup motivations is the sports competition. However, this affiliation model has been poorly considered in social neuroscience research. This research aimed to shed light on the neurobiological networks that are related to social affiliation in football fans of two of the most popular Chilean football teams.

Methods: To this end, 43 male fans of two football rival teams watched videos of winning and losing goals of their favorite team while their brain activity was measured with functional magnetic resonance imaging (fMRI).

Results: The results showed that while the activation of the reward system was observed in fans when their team scores goals against the rival, both the activation of the mentalization network and the inhibition of the dorsal anterior cingulate cortex were associated with the emotional correlates of defeat in football fans.

Conclusions: Taking these findings together could contribute to a deeper understanding of social affiliation, and more importantly, of extreme affiliation phenomena, and fanaticism.
Development of liquid culture media mimicking the conditions of sinuses and lungs in cystic fibrosis and health
Authors: Ruhluel Dilem , O'Brien Siobhan , Fothergill Joanne L , Neill Daniel R
Published: September 2022

The respiratory tract is a compartmentalised and heterogenous environment. The nasopharynx and sinuses of the upper airways have distinct properties from the lungs and these differences may shape bacterial adaptation and evolution. Upper airway niches act as early colonisation sites for respiratory bacterial pathogens, including those, such as Pseudomonas aeruginosa, that can go on to establish chronic infection of the lungs in people with cystic fibrosis (CF). Despite the importance of upper airway environments in facilitating early adaptation to host environments, currently available in vitro models for study of respiratory infection in CF focus exclusively on the lungs. Furthermore, animal models, widely used to bridge the gap between in vitro systems and the clinical scenario, do not allow the upper and lower airways to be studied in isolation. We have developed a suite of culture media reproducing key features of the upper and lower airways, for the study of bacterial adaptation and evolution in different respiratory environments. For both upper and lower airway-mimicking media, we have developed formulations that reflect airway conditions in health and those that reflect the altered environment of the CF respiratory tract. Here, we describe the development and validation of these media and their use for study of genetic and phenotypic adaptations in P. aeruginosa during growth under upper or lower airway conditions in health and in CF.
Soluble FMS-Like Tyrosine Kinase-1: Role in placenta accreta spectrum disorder
Authors: Lumbanraja Sarma , Yaznil M Rizki , Siahaan Andre M , Berry Eka Parda Bancin
Published: September 2022

Background: Placenta accreta is a pregnancy condition where the placenta's blood vessels attach too deeply to the uterine wall. Incidence of placenta accreta  is increasingly seen today as the rate of cesarean section increases, however, the exact pathophysiology of this condition is still not fully understood. Soluble fms-like tyrosine kinase-1  (sflt-1) as a protein produced by the placenta was found to be decreased in placenta accreta, Therefore we aim  to see if  sfltsFlt-1 has a role in the development of placenta accreta.

Methods: This study involved 40 samples from patients that had been diagnosed with placenta accreta spectrum disorder (case group), and 40 samples from patients with normal pregnancies (control group)  at Rumah Skit Umum Pusat H.Adam Malik (RSUP) Haji Adam Malik Medan, in Indonesia.  Diagnosis of placenta accreta syndrome was based on Placenta Accreta Spectrum  Score (PAS), and International Federation of Gynecology and Obstetrics  (FIGO) classification of placenta accreta spectrum disorder.Analyses  were performed by independent t-test, man Mann-Whitney U test, and Kruskal-Wallis analysis test, with a P-value <0.05  considered as statistically significant (95%CI).

Results: Based on this study, we found that the sFlt-1 level in the case group was lower than the control group. Data analysis using the Kruskal-Wallis test showed that there was a difference in sFlt-1 levels in this study group (p = 0.02), which was further evaluated  with post hoc analysis using Mann. -Whitney U test. The results indicated that there were significant differences between the control and PAS 0, PAS1, and PAS 2 (p = 0.043; p = 0.002; p = 0.03).

Conclusion: sFlt-1 levels decreased in placental invasive pregnancies compared to normal pregnancies, however, this still needs to be investigated further in a multi-center study, considering that sFlt-1 levels are also influenced by ethnicity and other conditions that cannot be excluded in this study.
BREAST CANCER TREATMENT
Authors: Guseynov Arif , Guseynov T. , Bobkov M. , Blincov V. , Odincov V.
Published: September 2022

The article presents up-to-date information for doctors of various specialties: oncologists, surgeons, mammologists, obstetricians and gynecologists, general practitioners on the problems of modern treatment of breast cancer. The issues of treatment tactics, indications and contraindications for surgical, radiation and drug treatment of breast cancer patients are highlighted.