bluuebunny/crossref_metadata_2025 huggingface dataset:
Dialysis decisions concerning cognitively impaired adults: a scoping literature review
Authors: Parsons Jordan A. , Ives Jonathan
Published: March 2021

Background

Chronic kidney disease is a significant cause of global deaths. Those who progress to end-stage kidney disease often commence dialysis as a life-extending treatment. For cognitively impaired patients, the decision as to whether they commence dialysis will fall to someone else. This scoping review was conducted to map existing literature pertaining to how decisions about dialysis are and should be made with, for, and on behalf of adult patients who lack decision-making capacity. In doing so, it forms the basis of a larger body of work that is exploring how these decisions ought to be made.

Methods

To identify relevant papers, searches were conducted on Ovid MEDLINE(R), Embase, PsychINFO, The Cochrane Library, and Web of Science. Inclusion criteria were then applied, requiring that papers: report on empirical studies about how decisions about dialysis are madeand/ordiscuss how decisions about dialysis should be made with, for, and on behalf of adult patients who lack decision-making capacity; be published from 1961 onwards; and be published in English. This resulted in 27 papers eligible for inclusion.

Results

Of note, the majority of papers originated in the United States. There was wide variation across the included papers. Extracted data were grouped under the following themes: involving various parties (patient involvement, family dominance, and wider communication); objectivity about care options (including difficulties with family detachment); cultural sensitivity; medical versus non-medical factors; managing nonadherent patients; and the role and prevalence of substituted judgement. The literature shows that there is inconsistency in the principles and processes surrounding decisions made about dialysis with, for, and on behalf of adult patients who lack decision-making capacity.

Conclusions

This scoping review demonstrates that there is significant variation in both the practice and theory of dialysis decision making with, for, and on behalf of cognitively impaired adult patients. Complexity arises in considering who should get a say, how influential their say should be in a decision, and what factors are most relevant to the decision. A lack of up-to-date literature exploring this issue is highlighted, with this scoping review providing a useful groundwork from which further research can be undertaken.
Sensitivity and specificity of the Bamberg Dementia Screening Test’s (BDST) full and short versions: brief screening instruments for geriatric patients that are suitable for infectious environments
Authors: Trapp Wolfgang , Röder Susanne , Heid Andreas , Billman Pia , Daiber Susanne , Hajak Göran
Published: March 2021

Background

Currently, many patients suffering from dementia do not have a diagnosis when admitted to geriatric hospitals. This is the case despite an increased risk of complications affecting the length of stay and outcome. Unfortunately, many dementia screening tests cannot be used on geriatric inpatients, who are often bedridden. Therefore, we aimed at evaluating the diagnostic accuracy of a small battery of bedside tasks that require minimal vision and fine motor skills in patients with suspected dementia.

Methods

In this prospective study, the Bamberg Dementia Screening Test (BDST) was administered to a consecutive series of 1295 patients referred for neuropsychological testing. The diagnosis of dementia was confirmed in 1159 and excluded in 136 patients.

Sensitivity and specificity for the first subtest (ultra-short form), the first two subtests (short form), and the total score of the BDST were obtained via receiver operating characteristic curves and compared with the sensitivity and specificity values of the Mini-Mental Status Examination (MMSE).

Results

The overall diagnostic quality of the BDST was superior to the MMSE for mild Alzheimer’s dementia (sensitivity and specificity = .94 (95% CI .92 to .96) and .82 (95% CI .75 to .88) vs. .79 (95% CI .76 to .83) and .88 (95% CI .82 to .93)) as well as for other subtypes of mild dementia (sensitivity and specificity = .91 (95% CI .88 to .94) and .82 (95% CI .75 to .88) vs. .72 (95% CI .67 to .76) and .88 (95% CI .82 to .93)). Even the short form of the BDST was comparable to the MMSE regarding sensitivity and specificity. For moderate dementia, it was possible to identify dementia cases with sufficient and excellent diagnostic quality by using the ultra-short and the short form.

Conclusions

The BDST is able to detect dementia in geriatric hospital settings. If the adaptive algorithm is used, administration time can be reduced to less than 2 min in most cases. Because no test materials have to be exchanged, this test is particularly suitable for infectious environments where contact between the examiner and the person being tested should be minimized.
When human guanylate-binding proteins meet viral infections
Authors: Zhang Rongzhao , Li Zhixin , Tang Yan-Dong , Su Chenhe , Zheng Chunfu
Published: March 2021

Innate immunity is the first line of host defense against viral infection. After invading into the cells, pathogen-associated-molecular-patterns derived from viruses are recognized by pattern recognition receptors to activate the downstream signaling pathways to induce the production of type I interferons (IFN-I) and inflammatory cytokines, which play critical functions in the host antiviral innate immune responses. Guanylate-binding proteins (GBPs) are IFN-inducible antiviral effectors belonging to the guanosine triphosphatases family. In addition to exerting direct antiviral functions against certain viruses, a few GBPs also exhibit regulatory roles on the host antiviral innate immunity. However, our understanding of the underlying molecular mechanisms of GBPs' roles in viral infection and host antiviral innate immune signaling is still very limited. Therefore, here we present an updated overview of the functions of GBPs during viral infection and in antiviral innate immunity, and highlight discrepancies in reported findings and current challenges for future studies, which will advance our understanding of the functions of GBPs and provide a scientific and theoretical basis for the regulation of antiviral innate immunity.
Cell-based high-throughput screening of polysaccharide biosynthesis hosts
Authors: Liu Zi-Xu , Huang Si-Ling , Hou Jin , Guo Xue-Ping , Wang Feng-Shan , Sheng Ju-Zheng
Published: March 2021

Valuable polysaccharides are usually produced using wild-type or metabolically-engineered host microbial strains through fermentation. These hosts act as cell factories that convert carbohydrates, such as monosaccharides or starch, into bioactive polysaccharides. It is desirable to develop effective in vivo high-throughput approaches to screen cells that display high-level synthesis of the desired polysaccharides. Uses of single or dual fluorophore labeling, fluorescence quenching, or biosensors are effective strategies for cell sorting of a library that can be applied during the domestication of industrial engineered strains and metabolic pathway optimization of polysaccharide synthesis in engineered cells. Meanwhile, high-throughput screening strategies using each individual whole cell as a sorting section are playing growing roles in the discovery and directed evolution of enzymes involved in polysaccharide biosynthesis, such as glycosyltransferases. These enzymes and their mutants are in high demand as tool catalysts for synthesis of saccharides in vitro and in vivo. This review provides an introduction to the methodologies of using cell-based high-throughput screening for desired polysaccharide-biosynthesizing cells, followed by a brief discussion of potential applications of these approaches in glycoengineering.
Development of a chitosan‐modified PLGA nanoparticle vaccine for protection against Escherichia coli K1 caused meningitis in mice
Authors: Zhang Jin , Sun Hongwu , Gao Chen , Wang Ying , Cheng Xin , Yang Yun , Gou Qiang , Lei Langhuang , Chen Yanping , Wang Xingyong , Zou Quanming , Gu Jiang
Published: March 2021

Background

Escherichia coli K1 (E. coli K1) caused neonatal meningitis remains a problem, which rises the urgent need for an effective vaccine. Previously, we rationally designed and produced the recombinant protein OmpAVac (Vo), which elicited protective immunity against E. coli K1 infection. However, Vo has limited stability, which hinders its future industrial application.

Method

Chitosan-modified poly (lactic-co-glycolic acid) (PLGA) nanoparticles were prepared and used as carried for the recombinant Vo. And the safety, stability and immunogenicity of Vo delivered by chitosan-modified PLGA nanoparticles were tested in vitro and in a mouse model of bacteremia.

Results

We successfully generated chitosan-modified PLGA nanoparticles for the delivery of recombinant Vo (VoNP). In addition, we found that a freeze-drying procedure increases the stability of the VoNPs without changing the shape, size distribution and encapsulation of the Vo protein. Unlike aluminum adjuvant, the nanoparticles that delivered Vo were immunoprotective in mice even after storage for as long as 180 days.

Conclusions

We identified an effective strategy to improve the stability of Vo to maintain its immunogenicity, which will contribute to the future development of vaccines against E. coli K1.
Take home injectable opioids for opioid use disorder during and after the COVID-19 Pandemic is in urgent need: a case study
Authors: Oviedo-Joekes Eugenia , MacDonald Scott , Boissonneault Charles , Harper Kelli
Published: March 2021

Background

In North America the opioid poisoning crisis currently faces the unprecedented challenges brought by the COVID-19 pandemic, further straining people and communities already facing structural and individual vulnerabilities. People with opioid use disorder (OUD) are facing unique challenges in response to COVID-19, such as not being able to adopt best practices (e.g., physical distancing) if they’re financially insecure or living in shelters (or homeless). They also have other medical conditions that make them more likely to be immunocompromised and at risk of developing COVID-19. In response to the COVID-19 public health emergency, national and provincial regulatory bodies introduced guidance and exemptions to mitigate the spread of the virus. Among them, clinical guidance for prescribers were issued to allow take home opioid medications for opioid agonist treatment (OAT). Take Home for injectable opioid agonist treatment (iOAT) is only considered within a restrictive regulatory structure, specific to the pandemic. Nevertheless, this risk mitigation guidance allowed carries, mostly daily dispensed, to a population that would not have access to it prior to the pandemic. In this case it is presented and discussed that if a carry was possible during the pandemic, then the carry could continue post COVID-19 to address a gap in our approach to individualize care for people with OUD receiving iOAT.

Case presentation

Here we present the first case of a patient in Canada with long-term OUD that received take home injectable diacetylmorphine to self-isolate in an approved site after being diagnosed with COVID-19 during a visit to the emergency room where he was diagnosed with cellulitis and admitted to receive antibiotics.

Conclusion

In the present case we demonstrated that it is feasible to provide iOAT outside the community clinic with no apparent negative consequences. Improving upon and making permanent these recently introduced risk mitigating guidance during COVID-19, have the potential not just to protect during the pandemic, but also to address long-overdue barriers to access evidence-based care in addiction treatment.
A comprehensive comparison between cementless and cemented fixation in the total knee arthroplasty: an updated systematic review and meta-analysis
Authors: Liu Yuan , Zeng Yi , Wu Yuangang , Li Mingyang , Xie Huiqi , Shen Bin
Published: March 2021

Background

Whether the cement should be used in the total knee arthroplasty (TKA) was still in controversy. This meta-analysis was performed to compare the efficacy of two kinds of fixation.

Methods

Randomized controlled trials (RCTs), prospective/retrospective observational studies from PubMed (on 2019 September), EMBASE (on 2019 September), and the Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science (on 2019 September) were searched. Only studies followed more than 2 years was included for the review. The PRISMA guidelines and Cochrane Handbook were adopted to assess the quality of the results reported in included studies to ensure that the results of our meta-analysis were reliable and veritable. The continuous and dichotomous outcomes were collected in a standard form, and the data were analyzed by Review Manager 5.3 software. Finally, the results were presented in the Forest plots.

Results

Twenty-six studies involving 2369 patients in cementless TKA and 2654 patients in cemented TKA were included. The rate of revision was not significantly different in two groups (p= 0.55). More than eight reasons caused revision were found in our study, the aseptic loosing was the most common, followed by the periprosthetic joint infection (PJI), neither was significantly different (p= 0.88 and 0.45, respectively). While significantly better long-term functional recovery was found in cementless TKA in terms of Knee Society Function Score (p= 0.004) and manipulation under anesthesia (p= 0.007).

Conclusion

Cementless fixation did not decrease the rate of revision after the total knee arthroplasty compared with the cemented fixation, while the long-term functional recovery was significantly better in the cementless group.
A thematic study: impact of COVID-19 pandemic on rare disease organisations and patients across ten jurisdictions in the Asia Pacific region
Authors: Chung Claudia Ching Yan , Ng Yvette Nga Chung , Jain Ritu , Chung Brian Hon Yin
Published: March 2021

Background

This study assesses the areas and extent of impact of the Coronavirus Disease of 2019 (COVID-19) pandemic on rare disease (RD) organisations in the Asia Pacific region. There is no existing literature that focuses on such impact on RD organisations in any jurisdictions, nor RD populations across multiple jurisdictions in the Asia Pacific region. A cross-sectional survey was distributed to RD organisations between April and May 2020. Quantitative and qualitative data on the impact of COVID-19 on RD organisations and patients were collected from the organisation representative’s perspective. Qualitative data was analysed using thematic analysis. A follow-up focus group meeting was conducted in August 2020 to validate the survey findings and to discuss specific needs, support and recommendations for sustainable healthcare systems during the pandemic.

Results

A total of 80 RD organisations from Australia, Hong Kong Special Administrative Region of China, India, Japan, mainland China, Malaysia, New Zealand, the Philippines, Singapore and Taiwan participated in the study. Of all, 89% were concerned about the impact of pandemic on their organisations. Results indicate that 63% of the organisations functioned at a reduced capacity and 42% stated a decrease in funding as their biggest challenge. Overall, 95% believed their patients were impacted, particularly in healthcare access, social lives, physical health, psychological health and financial impact. Specifically, 43% identified the reduced healthcare access as their top impact, followed by 26% about the impact on daily living and social life. Focus group meeting discussed differential impact across jurisdictions and point towards telemedicine and digitalisation as potential solutions.

Conclusions

This serves as the first study to assess the impact of COVID-19 on RD patients and organisations across multiple jurisdictions in the Asia Pacific region, identifying major themes on the impact on both RD patients and organisations. By including 80 organisations from ten jurisdictions, our study presents the most comprehensive assessment of the pandemic’s impact to date. It highlights the need for mental health support and sheds light on moving towards telemedicine and digitalisation of organisation operation, which constitutes a sustainable model in times of pandemics and beyond.
TP53 drives abscopal effect by secretion of senescence-associated molecular signals in non-small cell lung cancer
Authors: Tesei Anna , Arienti Chiara , Bossi Gianluca , Santi Spartaco , De Santis Ilaria , Bevilacqua Alessandro , Zanoni Michele , Pignatta Sara , Cortesi Michela , Zamagni Alice , Storci Gianluca , Bonafè Massimiliano , Sarnelli Anna , Romeo Antonino , Cavallo Carola , Bartolazzi Armando , Rossi Stefania , Soriani Antonella , Strigari Lidia
Published: March 2021

Background

Recent developments in abscopal effect strongly support the use of radiotherapy for the treatment of metastatic disease. However, deeper understanding of the molecular mechanisms underlying the abscopal effect are required to best benefit a larger proportion of patients with metastasis. Several groups including ours, reported the involvement of wild-type (wt) p53 in radiation-induced abscopal effects, however very little is known on the role of wtp53 dependent molecular mechanisms.

Methods

We investigated through in vivo and in vitro approaches how wtp53 orchestrates radiation-induced abscopal effects. Wtp53 bearing (A549) and p53-null (H1299) NSCLC lines were xenotransplanted in nude mice, and cultured in 2D monolayers and 3D tumor spheroids. Extracellular vesicles (EVs) were isolated from medium cell culture by ultracentrifugation protocol followed by Nanoparticle Tracking Analysis. Gene expression was evaluated by RT-Real Time, digital qRT-PCR, and dot blot technique. Protein levels were determined by immunohistochemistry, confocal anlysis, western blot techniques, and immunoassay.

Results

We demonstrated that single high-dose irradiation (20 Gy) induces significant tumor growth inhibition in contralateral non-irradiated (NIR) A549 xenograft tumors but not in NIR p53-null H1299 or p53-silenced A549 (A549sh/p53) xenografts. We further demonstrates that irradiation of A549 cells in vitro induces a senescence-associated secretory phenotype (SASP) producing extracellular vesicles (EVs) expressing CD63 and carrying DNA:RNA hybrids and LINE-1 retrotransposon. IR-A549 EVs also hamper the colony-forming capability of recipient NIR A549 cells, induce senescent phenotype, nuclear expression of DNA:RNA hybrids, and M1 macrophage polarization.

Conclusions

In our models, we demonstrate that high radiation dose in wtp53 tumors induce the onset of SASP and secretion of CD63+ EVs loaded with DNA:RNA hybrids and LINE-1 retrotransposons that convey senescence messages out of the irradiation field triggering abscopal effect in NIR tumors.
Pre-implantation exogenous progesterone and pregnancy in sheep: I. polyamines, nutrient transport, and progestamedins
Authors: Hoskins Emily C. , Halloran Katherine M. , Stenhouse Claire , Moses Robyn M. , Dunlap Kathrin A. , Satterfield Michael C. , Seo Heewon , Johnson Gregory A. , Wu Guoyao , Bazer Fuller W.
Published: March 2021

Background

Administration of exogenous progesterone (P4) to ewes during the pre-implantation period advances conceptus development and implantation. This study determined effects of exogenous P4 on transport of select nutrients and pathways that enhance conceptus development. Pregnant ewes (n = 38) were treated with either 25 mg P4 in 1 mL corn oil (P4, n = 18) or 1 mL corn oil alone (CO, n = 20) from day 1.5 through day 8 of pregnancy and hysterectomized on either day 9 or day 12 of pregnancy. Endometrial expression of genes encoding enzymes for synthesis of polyamines, transporters of glucose, arginine, and glycine, as well as progestamedins was determined by RT-qPCR.

Results

On day 12 of pregnancy, conceptuses from P4-treated ewes had elongated while those from CO-treated ewes were spherical. The mRNA expression of AZIN2, an arginine decarboxylase, was lower in endometria of P4-treated than CO-treated ewes on day 9 of pregnancy. Expression of FGF10, a progestamedin, was greater in endometria of CO and P4-treated ewes on day 12 of gestation in addition to P4-treated ewes necropsied on day 9 of gestation. Treatment with P4 down-regulated endometrial expression of amino acid transporter SLC1A4 on day 12 of pregnancy.

Conclusions

Results indicated that administration of exogenous P4 during the pre-implantation period advanced the expression of FGF10, which may accelerate proliferation of trophectoderm cells, but also was correlated with decreased expression of glycine and serine transporters and polyamine synthesis enzyme AZIN2. Further research with increased sample sizes may determine how differential expression affects endometrial functions and potentially embryonic loss.
The abrupt transition from face-to-face to online treatment for eating disorders: a pilot examination of patients’ perspectives during the COVID-19 lockdown
Authors: Lewis Yael Doreen , Elran-Barak Roni , Grundman-Shem Tov Rinat , Zubery Eynat
Published: March 2021

Background

Studies investigating patients’ perspectives towards an abrupt transition from face-to-face to online treatment in eating disorders (EDs) are scarce. The current study aimed to (1) conduct a preliminary assessment of patients’ perspectives regarding this transition, and (2) explore potential demographic, clinical, and treatment-related factors associated with these perspectives.

Methods

Sixty-three patients with EDs whose treatment was moved to an online format, were surveyed during the COVID-19 lockdown (April–May 2020). A 6-item measure was developed to examine their perspectives toward this transition. Exploratory factor analyses (EFAs) were conducted to confirm the rational-theoretical structure of the measure (Eigenvalue = 3.745, explaining 62.4% of variance). The Cronbach’s alpha value was excellent (α = 0.878). Validated questionnaires were used to measure ED symptoms, general psychopathology, therapeutic alliance, and pandemic anxiety, and their associations with our transition-focused scale and telemedicine satisfaction were examined.

Results

Mixed views were found regarding the transition, with the majority (68%) stating that they would not choose to continue online therapy given the option. Longer duration of treatment (r = 0.291,p = 0.022), stronger therapeutic alliance (r = 0.293,p = 0.028), and higher COVID-19 anxiety (r = 0.276,p = 0.029) were linked with more positive views towards the transition.

Conclusions

Analyses suggest that patients’ perspectives towards the transition can be measured using a Likert-type 6-item scale. Findings highlight the various responses to online treatment and indicate a need to identify patients who may face difficulties in the transition to this newly ubiquitous treatment mode. Clinicians should be cognizant of these potential difficulties and consider appropriate modes of treatment in the ongoing pandemic situation.
Diogene-CT: tools and methodologies for teaching and learning coding
Authors: Mecca Giansalvatore , Santoro Donatello , Sileno Nazzareno , Veltri Enzo
Published: March 2021

Computational thinking is the capacity of undertaking a problem-solving process in various disciplines (including STEM, i.e. science, technology, engineering and mathematics) using distinctive techniques that are typical of computer science. It is nowadays considered a fundamental skill for students and citizens, that has the potential to affect future generations. At the roots of computational-thinking abilities stands the knowledge of computer programming, i.e. coding. With the goal of fostering computational thinking in young students, we address the challenging and open problem of using methods, tools and techniques to support teaching and learning of computer-programming skills in school curricula of the secondary grade and university courses. This problem is made complex by several factors. In fact, coding requires abstraction capabilities and complex cognitive skills such as procedural and conditional reasoning, planning, and analogical reasoning. In this paper, we introduce a new paradigm called ACME (“Code Animation by Evolved Metaphors”) that stands at the foundation of the Diogene-CT code visualization environment and methodology. We develop consistent visual metaphors for both procedural and object-oriented programming. Based on the metaphors, we introduce a playground architecture to support teaching and learning of the principles of coding. To the best of our knowledge, this is the first scalable code visualization tool using consistent metaphors in the field of the Computing Education Research (CER). It might be considered as a new kind of tools named as code visualization environments.
Thymol ameliorates ammonium toxicity via repressing polyamine oxidase-derived hydrogen peroxide and modulating ammonium transporters in rice root
Authors: Guo Kai , An Guangchi , Wang Ning , Pang Bingdong , Shi Zhiqi , Bai Hongwu , Zhang Li , Chen Jian , Xu Weimin
Published: March 2021

Background

Ammonium is an indispensable nutrient for crop growth, but anoxic conditions or inappropriate fertilizer usage result in the increase in ammonium content in soil. Excessive ammonium causes phytotoxicity. Thymol is a kind of natural phenolic compound with anti-microbial properties. However, little is known about the role of thymol in modulating plant physiology. Here we find the novel role of thymol in protecting rice from ammonium toxicity.

Results

Thymol remarkably rescued rice seedlings growth from ammonium stress, which may resulted from the attenuation of reactive oxygen species (ROS) accumulation, oxidative injury, and cell death in both shoots and roots. Polyamine oxidase (PAO) metabolizes polyamines to produce ROS in plants in response to stress conditions. Thymol blocked ammonium-induced upregulation of a set of rice PAOs, which contributed to the decrease in ROS content. In rice seedlings upon ammonium stress, thymol downregulate the expression of ammonium transporters (AMT1;1 and AMT1;2); thymol upregulated the expression of calcineurin B-like interacting protein kinase 23 (CIPK23) and calcineurin B-like binding protein 1 (CBL1), two negative regulators of AMTs. This may help rice avoid ammonium overload in excessive ammonium environment. Correlation analysis indicated that PAOs, AMTs, and CBL1 were the targets of thymol in the detoxification of excessive ammonium.

Conclusion

Thymol facilitates rice tolerance against ammonium toxicity by decreasing PAO-derived ROS and modulating ammonium transporters. Such findings may be applicable in the modulation of nutrient acquisition during crop production.

Graphical abstract
Designing reversible multi-level resistance states in a half-doped manganite
Authors: Banik Sanjib , Das Kalipada , Pradhan Kalpataru , Das Indranil
Published: March 2021

We design reversible multi-level resistance states in a half-doped charge-ordered manganite,

(SCSMO). By exploiting the electronic phase separation in SCSMO at 10 K, we show that the system can be stabilized into several metastable states, against thermal cycling, up to 62 K. The magnetization and the resistivity remain unaltered in each metastable states during the thermal cycling. Monte Carlo calculations using a two-band double-exchange model, including super-exchange, electron-phonon coupling, and quenched disorder, show that the system freezes into a phase-separated metastable state due to the disorder during the thermal cycling. We outline pathway to control the multi-level switching between four reversible metastable states. Our results may open the door for future investigations to engineer memory devices based on multi-level resistance switching using phase-separated transition metal oxides.
Evaluation of Drug Wastage in the Operating Rooms and Intensive Care Units of a Regional Health Service
Authors: Barbariol Federico , Deana Cristian , Lucchese Francesca , Cataldi Giuseppe , Bassi Flavio , Bove Tiziana , Vetrugno Luigi , De Monte Amato
Published: March 2021

BACKGROUND:

Pharmacological treatments for critical processes in patients need to be initiated as rapidly as possible; for this reason, it is a standard of care to prepare the main anesthesia and emergency drugs in advance. As a result, 20%–50% of the prepared drugs remain unused and are then discarded. Decreasing waste by optimizing drug use is an attractive strategy for meeting both cost containment and environmental sustainability. The primary end point of this study was to measure the actual amount of drug wastage in the operating rooms (ORs) and intensive care units (ICUs) of a Regional Health Service (RHS). The secondary end point was to analyze and estimate the economic implications of this waste for the Health Service and to suggest possible measures to reduce it.

METHODS:

This prospective observational multicenter study was conducted across 12 hospitals, all of which belong to the same RHS in the north-east of Italy. Data collection took place in March 2018 and included patients admitted to ICUs, emergency areas, and ORs of the participating hospitals. Data concerning drug preparation and administration were collected for all consecutive patients, independent of case types and of whether operations were scheduled or unscheduled. Drug wastage was defined as follows: drugs prepared in ready-to-use syringes but not administered at all and discarded untouched. We then estimated the costs of wasted drugs for a 1-year period using the data from this study and the yearly regional pharmacy orders of drugs provided to the ORs and ICUs. We also performed a sensitivity analysis to validate the robustness of our assumptions and qualitative conclusions.

RESULTS:

We collected data for a total of 13,078 prepared drug syringes. Drug wastage varied from 7.8% (Urapidil, an alpha-1 antagonist antihypertensive) to 85.7% (epinephrine) of prepared syringes, with an overall mean wastage rate of 38%. The estimated yearly waste was 139,531 syringes, for a total estimated financial cost of €78,060 ($92,569), and an additional quantity of medical waste amounting to 4968 kg per year. The total provider time dedicated to the preparation of unused drugs was predicted to be 1512 working hours per year.

CONCLUSIONS:

The overall extent of drug wastage in ORs and ICUs is concerning. Interventions aimed at minimizing waste-related costs and improving the environmental sustainability of our practice are paramount. Effort should be put into designing a more efficient workflow that reduces this waste while providing for the emergency availability of these medications in the OR and ICU.
MFN2 interacts with nuage-associated proteins and is essential for male germ cell development by controlling mRNA fate during spermatogenesis
Authors: Wang Xiaoli , Wen Yujiao , Zhang Jin , Swanson Grace , Guo Shuangshuang , Cao Congcong , Krawetz Stephen A. , Zhang Zhibing , Yuan Shuiqiao
Published: March 2021

Mitochondria play a crucial role in spermatogenesis and are regulated by several mitochondrial fusion proteins. However, their functional importance associated with their structure formation and mRNA fate regulation during spermatogenesis remains unclear. Here, we show that mitofusin 2 (MFN2), a mitochondrial fusion protein, interacts with nuage-associated proteins (including MIWI, DDX4, TDRKH and GASZ) in mice. Conditional mutation of Mfn2 in postnatal germ cells results in male sterility due to germ cell developmental defects. Moreover, MFN2 interacts with MFN1, another mitochondrial fusion protein with a high-sequence similarity to MFN2, in testes to facilitate spermatogenesis. Simultaneous mutation of Mfn1 and Mfn2 in testes causes very severe infertile phenotypes. Importantly, we show that MFN2 is enriched in polysome fractions of testes and interacts with MSY2, a germ cell-specific DNA/RNA-binding protein, to control gamete-specific mRNA (such as Spata19) translational activity during spermatogenesis. Collectively, our findings demonstrate that MFN2 interacts with nuage-associated proteins and MSY2 to regulate male germ cell development by controlling several gamete-specific mRNA fates.
Selective axonal translation of the mRNA isoform encoding prenylated Cdc42 supports axon growth
Authors: Lee Seung Joon , Zdradzinski Matthew D. , Sahoo Pabitra K. , Kar Amar N. , Patel Priyanka , Kawaguchi Riki , Aguilar Byron J. , Lantz Kelsey D. , McCain Caylee R. , Coppola Giovanni , Lu Qun , Twiss Jeffery L.
Published: March 2021

The small Rho-family GTPase Cdc42 has long been known to have a role in cell motility and axon growth. The eukaryotic Ccd42 gene is alternatively spliced to generate mRNAs with two different 3′ untranslated regions (UTRs) that encode proteins with distinct C-termini. The C-termini of these Cdc42 proteins include CaaX and CCaX motifs for post-translational prenylation and palmitoylation, respectively. Palmitoyl-Cdc42 protein was previously shown to contribute to dendrite maturation, while the prenyl-Cdc42 protein contributes to axon specification and its mRNA was detected in neurites. Here, we show that the mRNA encoding prenyl-Cdc42 isoform preferentially localizes into PNS axons and this localization selectively increases in vivo during peripheral nervous system (PNS) axon regeneration. Functional studies indicate that prenyl-Cdc42 increases axon length in a manner that requires axonal targeting of its mRNA, which, in turn, needs an intact C-terminal CaaX motif that can drive prenylation of the encoded protein. In contrast, palmitoyl-Cdc42 has no effect on axon growth but selectively increases dendrite length. Together, these data show that alternative splicing of the Cdc42 gene product generates an axon growth promoting, locally synthesized prenyl-Cdc42 protein.

This article has an associated First Person interview with one of the co-first authors of the paper.
Jaw kinematics and tongue protraction–retraction during chewing and drinking in the pig
Authors: Olson Rachel A. , Montuelle Stéphane J. , Chadwell Brad A. , Curtis Hannah , Williams Susan H.
Published: March 2021

Mastication and drinking are rhythmic and cyclic oral behaviors that require interactions between the tongue, jaw and a food or liquid bolus, respectively. During mastication, the tongue transports and positions the bolus for breakdown between the teeth. During drinking, the tongue aids in ingestion and then transports the bolus to the oropharynx. The objective of this study was to compare jaw and tongue kinematics during chewing and drinking in pigs. We hypothesized there would be differences in jaw gape cycle dynamics and tongue protraction–retraction between behaviors. Mastication cycles had an extended slow-close phase, reflecting tooth–food–tooth contact, whereas drinking cycles had an extended slow-open phase, corresponding to tongue protrusion into the liquid. Compared with chewing, drinking jaw movements were of lower magnitude for all degrees of freedom examined (jaw protraction, yaw and pitch), and were bilaterally symmetrical with virtually no yaw. The magnitude of tongue protraction–retraction (Txt), relative to a mandibular coordinate system, was greater during mastication than during drinking, but there were minimal differences in the timing of maximum and minimum Txt relative to the jaw gape cycle between behaviors. However, during drinking, the tongue tip is often located outside the oral cavity for the entire cycle, leading to differences between behaviors in the timing of anterior marker maximum Txt. This demonstrates that there is variation in tongue–jaw coordination between behaviors. These results show that jaw and tongue movements vary significantly between mastication and drinking, which hints at differences in the central control of these behaviors.
OTTER, a new method for quantifying absolute amounts of tRNAs
Authors: Nagai Akihisa , Mori Kohei , Shiomi Yuma , Yoshihisa Tohru
Published: March 2021

To maintain an optimal proteome, both codon choice of each mRNA and supply of aminoacyl-tRNAs are two principal factors in translation. Recent reports have revealed that the amounts of tRNAs in cells are more dynamic than we had expected. High-throughput methods such as RNA-seq and microarrays are versatile for comprehensive detection of changes in individual tRNA amounts, but they suffer from inability to assess signal production efficiencies of individual tRNA species. Thus, they are not the perfect choice to measure absolute amounts of tRNAs. Here, we introduce a novel method for this purpose, termed oligonucleotide-directed three-prime terminal extension of RNA (OTTER), which uses fluorescence-labeling at the 3′ terminus of a tRNA by optimized reverse primer extension and an assessment step of each labeling efficiency by northern blotting. Using this method, we quantified the absolute amounts of the 34 individual and four pairs of isoacceptor tRNAs out of the total 42 nuclear-encoded isoacceptors in the yeast Saccharomyces cerevisiae. We found that the amounts of tRNAs in log phase yeast cells grown in a rich glucose medium range from 0.030 to 0.73 pmol/µg RNA. The tRNA amounts seem to be altered at the isoacceptor level by a few folds in response to physiological growing conditions. The data obtained by OTTER are poorly correlated with those by simple RNA-seq, marginally with those by microarrays and by microscale thermophoresis. However, the OTTER data showed good agreement with the data obtained by 2D-gel analysis of in vivo radiolabeled RNAs. Thus, OTTER is a suitable method for quantifying absolute amounts of tRNAs at the level of isoacceptor resolution.
In vitro inhibitory effects of commercial antiseptics and disinfectants on foodborne and environmental bacterial strains
Authors: Isawumi Abiola , Donkor Jacob K. , Mosi Lydia
Published: March 2021

Background: Antibacterial agents, including disinfectants and antiseptics are commonly used to reduce bacterial loads. As they have a broad-spectrum of activity against bacteria, function either as bactericidal or bacteriostatic agents. While bacterial antimicrobial resistance is increasing, disinfectants and antiseptics are still relevant antibacterial agents.  

Methods:  This study investigated the in vitro inhibitory effects of commonly used antiseptics and disinfectants. Using standard disc diffusion methods, selected common household antibacterial agents were tested on resistant Staphylococcus aureus isolated from hospital environment and foodborne Escherichia coli and Bacillus species.

Results: The study showed that the selected antibacterial agents were effective against the antibiotic resistant bacteria with appreciable zone of inhibition relative to the standard controls used.

Conclusions: Though bacteria are consistently developing resistance to available antibiotics, disinfectants still inhibit bacterial growth and survival with considerable public health importance.
Current concepts in diagnosis and management of common upper limb nerve injuries in children
Authors: Catena Nunzio , Gennaro Giovanni Luigi Di , Jester Andrea , Martínez-Alvarez Sergio , Pontén Eva , Soldado Francisco , Steiger Christina , Choong Jiahui , Zarantonello Paola , Farr Sebastian ,   EPOS Upper Limb Study Group
Published: March 2021

Peripheral nerve injuries (PNI) of the upper limb are a common event in the paediatric population, following both fractures and soft tissues injuries. Open injuries should in theory be easier to identify and the repair of injured structures performed as soon as possible in order to obtain a satisfying outcome. Conversely, due to the reduced compliance of younger children during clinical assessment, the diagnosis of a closed nerve injury may sometimes be delayed. As the compliance of patients is influenced by pain, anxiety and stress, the execution of the clinical manoeuvres intended to identify a loss of motor function or sensibility, can be impaired. Although the majority of PNI are neuroapraxias resulting in spontaneous recovery, there are open questions regarding certain aspects of closed PNI, e.g. when to ask for electrophysiological exams, when and how long to wait for a spontaneous recovery and when a surgical approach becomes mandatory. The aim of the article is therefore to analyse the main aspects of the different closed PNI of the upper limb in order to provide recommendations for timely and correct management, and to determine differences in the PNI treatment between children and adults.
Exotic light dynamics around an exceptional point of order four associated with three connecting second-order exceptional points
Authors: Dey Sibnath , Laha Arnab , Ghosh Somnath
Published: March 2021

The physics of exceptional point (EP) singularities has been a key to a wide range of unique physical applications in open systems. In this context, the mutual interactions among four coupled states around a fourth-order EP (EP4) in a physical system is yet to be explored. Here we investigate the unique features of an EP4 in a fabrication feasible planar optical waveguide with a multilayer gain-loss profile based on only two tunable parameters. Following a quasistatic gain-loss around the embedded EP4, a unique fourth-order successive switching phenomenon among the propagation constants (

β

values) of four coupled modes has been explored. An exclusive chiral light dynamic following the dynamical variation of the gain-loss profile has been reported for the first time, which enables a special type of asymmetric higher-order mode conversion scheme. Here all the coupled modes associated with an EP4 are fully converted into different specific higher-order modes based on the choice of encirclement directions. The proposed scheme would present EP4 as a new light manipulation tool for integrated photonic devices.
Reconstruction of atomic resonances with attosecond streaking
Authors: Borrego-Varillas Rocío , Lucchini Matteo
Published: March 2021

Recent development of spectroscopic techniques based on attosecond radiation has given the community the right tools to study the timing of the photoelectron process. In this work we investigate the effect of Fano resonances in attosecond streaking spectrograms and the application of standard phase-reconstruction algorithms. We show that while the existence of the infrared coupling (ac-Stark shift) hinders the applicability of FROG-like methods, under certain conditions it is still possible to use standard reconstruction algorithms to retrieve the photoemission delay of the bare resonance. Finally, we propose two strategies to study the strength of IR coupling using the attosecond streaking technique.
Broadband emission Gd3Sc2Al3O12:Ce3+ transparent ceramics with a high color rendering index for high-power white LEDs/LDs
Authors: Ma Yuelong , Zhang Le , Huang Jin , Wang Rui , Li Tao , Zhou Tianyuan , Shi Zedi , Li JunWei , Li Yanbin , Huang Guocan , Wang Zhongying , Selim Farida A. , Li Ming , Wang Yun , Chen Hao
Published: March 2021

The discovery of single structure Ce3+ doped garnet transparent ceramics (TCs) with a broad full width at half maximum (FWHM) is essential to realize a high CRI for high-power white light emitting diodes (LEDs) and laser diodes (LDs). In this work, by utilizing the ion substitution engineering strategy, pure phase Gd3Sc2Al3O12:Ce3+ (GSAG:Ce) TC with a broad FWHM of 132.4 nm and a high CRI value of 80.7 was fabricated through the vacuum sintering technique for the first time. The optimized in-line transmittance of TCs was 58.4% @ 800 nm. Notably, the GSAG:Ce TCs exhibited a remarkable red shift from 546 nm to 582 nm, with a high internal quantum efficiency (IQE) of 46.91%. The degraded thermal stability in Ce:GSAG TCs was observed compared with that of Ce:YAG TC, owing to the narrowed band gap of GSAG. Additionally, remote excitation white LEDs/LDs were constructed by combining GSAG:Ce TCs with blue LED chips or laser sources. A tunable color hue from yellow to shinning white was achieved in white LEDs, whereas the acquired CRI and CCT of the white LDs were 69.5 and 7766 K, respectively. This work provides a new perspective to develop TCs with high CRI for their real applications in high-power white LEDs/LDs.
Thickness dependent photocurrent spectra and current-voltage characteristics of P3HT:PCBM photovoltaic devices
Authors: Vlahović J. , Stanojević M. , Gojanović J. , Melancon J. , Sharma A. , Živanović S.
Published: March 2021

P3HT:PCBM based photovoltaic devices with different active layer thicknesses (ALTs) were examined in photodetector and solar cell operation modes. The photodetector photocurrent spectra and solar cell current density-voltage characteristics were measured. All experimental results were reproduced by the unique drift-diffusion model which excludes the optical interference and allows the parameters of photogeneration, transport, and recombination to be ALT dependent. The active layer optical characterization indicated a thickness dependence of optical parameters too. A conclusion was drawn that the P3HT:PCBM film thickness and morphology are strongly correlated which leads to a non-monotonic change of film parameters with its thickness.
Shifted band-extended angular spectrum method for off-axis diffraction calculation
Authors: Zhang Wenhui , Zhang Hao , Matsushima Kyoji , Jin Guofan
Published: March 2021

The shifted band-extended angular spectrum method (Shift-BEASM) is proposed to calculate free-space diffraction between two parallel planes with an off-axis offset. Off-axis numerical propagation is useful for simulating non-paraxial and large-scale fields. The proposed Shift-BEASM allow us to calculate the off-axis diffraction in a wide propagation range by extending the effective bandwidth using the nonuniform fast Fourier transform. The calculation accuracy is higher than that of existing techniques, such as the shifted-Fresnel method and shifted band-limited angular spectrum method, not only in the near field but also in the far field. Numerical examples and accuracy as well as theoretical formulation are presented to confirm validity of the proposed method.
Large-area all-dielectric metasurface fabricated by an anodized aluminum oxide template
Authors: Du Bintao , Wu Zhihai , Xia Jun , Wu Jun , Tong Guodong , Zhang Hao
Published: March 2021

Transmissive metasurfaces formed by high-index dielectric materials have received great attention due to its potential in holograms, deflectors, beam converters, and flat lenses. However, a key challenge of all-dielectric metasurfaces is the limited scale and high cost in fabrication, such as electron beam lithography (EBL) and focused ion beam (FIB) lithography. In this paper, for the first time to our knowledge, an anodized aluminum oxide (AAO) template is combined with titanium dioxide (TiO2) metasurface fabrication with advantages of large area (>2cm2) and low cost. Using the ordered anodized aluminum oxide (AAO) as an evaporation mask, a TiO2 nanocylinder array is deposited through the AAO mask onto the SiO2 substrate. Electric and magnetic dipole resonances of TiO2 metasurface appear in the visible spectrum. Furthermore, we demonstrate the interaction of the CsPbBr1.5I1.5 quantum dot (QD) emission with magnetic dipole (MD) resonance of TiO2 metasurface. Our results reveal that the metasurface exhibits remarkable photoluminescence (PL) enhancement of 25%. Up to now, a TiO2 metasurface with 2.25-cm2-large area using AAO template method has never been attempted. Different from the metasurfaces fabricated by FIB and EBL, our method offers great ease for large-area metasurface fabrication, which is convenient for metasurface researchers and avoids costly facilities.