bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of the components for investigation of the psychological strength of nursing applicants: A qualitative study
Authors: Bagheriyeh Farzaneh , Ghahramanian Akram , Valizadeh Leila , Zamanzadeh Vahid , Dickens Geoffrey
Published: June 2021

Aim

There is a lack of clarity about the components which would signify appropriate psychological strengths among nursing student candidates. This study was conducted to identify such components from the viewpoint of the clinical nurses and nursing instructors.

Design

A qualitative study.

Methods

This study comprised qualitative research using a conventional content analysis approach. Participants were 25 nurses and nursing instructors. Data were collected in audio‐recorded and transcribed semi‐structured interviews and were analysed using MAXQDA10 software.

Results

Analysis revealed four main categories including "anger management," "Stress/distress management," "self‐belief" and "aptitude for hard work."

Conclusions

This study identified core components for future investigations into the psychological strengths of nursing applicants. This study provides specific testable hypotheses for future research endeavours. It is recommended that the researchers investigate the appropriateness of the components identified in this study to assess the psychological strength of the applicants in the longitudinal studies.
The generalizability of empirically derived syndromes of collateral‐reported elder psychopathology across 11 societies
Authors: Ivanova Masha Y. , Achenbach Thomas M. , Rescorla Leslie A. , Turner Lori V. , Dumas Julie A. , Almeida Vera , Anafarta‐Sendag Meltem , Carlos Caldas J. , Chen Yi‐Chuen , da Silva Oliveira Margareth , Erol Nese , Funabiki Yasuko , Guðmundsson Halldór S. , Kim Young A. , Leite Manuela , Liu Jianghong , Markovic Jasminka , Misiec Monika , Oh Kyung J. , Shi Shupeng , Sigurðardóttir Sigurveig H. , Sokoli Elvisa , Tomasevic Tanja , Zasępa Ewa
Published: June 2021

The purpose of this study was to test whether a syndrome model of elder psychopathology derived from collateral ratings, such as from spouses and adult children, in the United States would be generalizable in 11 other societies. Societies represented South America, Asia, and Europe. The Older Adult Behavior Checklist (OABCL) was completed by collateral informants for 6141 60‐ to 102‐year‐olds. The tested model comprised syndromes designated as Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited. The model was tested using confirmatory factor analyses in each society separately. The primary model fit index showed a good fit for all societies, while the secondary model fit indices showed acceptable to a good fit for all societies. The items loaded strongly on their respective factors, with a median item loading of 0.69 across the 11 societies. By syndrome, the overall median item loadings ranged from 0.47 for Worries to 0.77 for Functional Impairment. The OABCL syndrome structure was thus generalizable across the tested societies. The OABCL can be used for broad assessment of psychopathology for elders of diverse backgrounds in nursing services and research.
Diagnostic accuracy of image‐guided core needle biopsy of non‐central nervous system tumors in children
Authors: Bruinsma Rixt S. , Nievelstein Rutger A.J. , Littooij Annemieke S. , Vermeulen Marijn A. , van de Ven Cornelis P. , van Noesel Max M. , Wijnen Marc H.W.A. , van der Steeg Alida F.W. , de Krijger Ronald R.
Published: June 2021

Background and aims

Core needle biopsies (CNB) are less invasive, cause less morbidity, and have lower costs than open biopsies (OB). However, the number of studies reporting CNB accuracy in pediatric tumors is limited and series are small. The aim of this study is to investigate if CNB diagnosis is concordant with the final diagnosis in pediatric solid non‐central nervous system (CNS) tumors.

Methods

Data from all patients treated in a single center between November 2014 and December 2019 were collected from the national pathology database and from local medical records. Data collection included age, sex, CNB diagnosis, final diagnosis, number of cores obtained, number of cores used for histology, cumulative core length, greatest dimension of the lesion, lesion volume, and complications.

Results

Out of 361 CNB, 95.6% (345/361) provided a diagnosis. A resection or follow‐up biopsy was performed in 201 cases. The final diagnosis was concordant with the CNB in 100% (201/201) of cases. The age, number of cores used for histology, and the greatest dimension of the lesion did not significantly differ between diagnostic and nondiagnostic CNB. The cumulative core length of diagnostic CNB was significantly higher than in the nondiagnostic group (24.72 mm vs. 13.37 mm, p‐value .022). Complications occurred in 2.1% (7/337) of CNB procedures. Molecular analysis was successful in 228/233 (98%) of cases in which it was performed.

Conclusions

CNB diagnosis is highly concordant with the final diagnosis and the diagnostic rate is high. The complication rate in CNB is low.
Effects of zoledronic acid on osteonecrosis and acute lymphoblastic leukemia treatment efficacy in preclinical models
Authors: Janke Laura J. , Kim Jieun , Payton Monique A. , Jenkins David A. , Cai Xiangjun , Finch Emily R. , Liu Yiwei , Relling Mary V. , Karol Seth E.
Published: June 2021

Background

Osteonecrosis is a devastating side effect of acute lymphoblastic leukemia (ALL) therapy. Associations between bone density loss and osteonecrosis have sparked interest in using bisphosphonates to reduce this complication.

Procedure

We assessed the impact of zoledronic acid (ZA) on the development of osteonecrosis in murine models when used either throughout therapy (continuous administration) or late in therapy after vascular lesions have developed but before osteonecrosis has occurred. Effects on bone density were measured using microcomputed tomography (μCT)‐assessed tibial cortical thickness, while osteonecrosis was assessed histologically in the distal femur. Effects on antileukemic efficacy of chemotherapy were evaluated in both immunocompetent/syngeneic and patient‐derived xenograft (PDX) models.

Results

Continuous administration of ZA with chemotherapy prevented chemotherapy‐associated bone loss (p < .001) and reduced osteonecrosis (p = .048). Late initiation of ZA diminished bone loss (p < .001) but had no impact on the development of osteonecrosis (p = .93). In the immunocompetent murine ALL model, mice treated with ZA and chemotherapy succumbed to leukemia sooner than mice treated with chemotherapy alone (p = .046). Analysis using PDX showed a nonsignificant decrease in survival with ZA (p = .17).

Conclusion

Our data indicate ZA may prevent osteonecrosis if begun with chemotherapy but showed no benefit when administered later in therapy. However, ZA may also reduce the antileukemic efficacy of chemotherapy.
Therapeutic effects of β‐caryophyllene on proliferative disorders and inflammation of the gerbil prostate
Authors: Castro Nayara Fernanda da Costa , Jubilato Fernanda Costa , Guerra Luiz Henrique Alves , Santos Fernanda Cristina Alcantara dos , Taboga Sebastião Roberto , Vilamaior Patrícia Simone Leite
Published: June 2021

Background

The prostate is susceptible to changes in androgen levels, which can play an important role in the development of Benign Prostatic Hyperplasia (BPH). Natural compounds have beneficial properties for organisms and can be an important therapeutic strategy in the treatment of diseases. β‐Caryophyllene (BCP) is a phytocannabinoid present in several medicinal and food plants species and has shown beneficial effects in different organs. However, little is known about its effects on the prostate. The present study seeks to evaluate the effects of exposure to BCP on the morphophysiology of the ventral prostate of adult gerbils supplemented with testosterone.

Methods

Animals were distributed into four groups (n = 8/group): Intact control (C); β‐Caryophyllene (BCP): β‐Caryophyllene (50 mg/kg/day); Testosterone (T): animals received subcutaneous injections of Testosterone Cypionate (3 mg/Kg), on alternate days, for one month and were euthanized 30 days supplementation ended; Testosterone and β‐Caryophyllene (TBCP): animals were exposed to testosterone cypionate (3 mg/Kg) to induce hyperplastic alterations followed by daily BCP (50 mg/kg). Morphological, biometric, immunohistochemical, and serological analyses were performed.

Results

Proliferative disorders and inflammatory foci were present in the ventral prostate of all experimental groups. An increase in the multiplicity of benign intraepithelial neoplasm and subepithelial inflammatory foci was observed in T group. The incidence of intraluminal inflammatory foci and microinvasive carcinoma was verified only in the T group. Cellular rearrangement and tissue remodeling occurred in the prostate of groups exposed to phytocannabinoids. A reduction was observed in the frequency of PHH3 and Cox2 markers in the prostatic epithelium of TBCP in comparison with T. A decrease in F4/80 and CD163 positive macrophages were also observed in the prostatic stroma of the TBCP group in comparison with T. The results suggest that BCP had favorable effects on BPH, reducing the proliferation and frequency of some inflammatory cells.

Conclusion

BCP impacts the tissue remodeling process in the premalignant prostate environment and that the use of this phytocannabinoid can have a promising effect in the handling of BPH.
Immune checkpoint B7‐H3 protein expression is associated with poor outcome and androgen receptor status in prostate cancer
Authors: Nunes‐Xavier Caroline E. , Kildal Wanja , Kleppe Andreas , Danielsen Håvard E. , Wæhre Håkon , Llarena Roberto , Mælandsmo Gunhild M. , Fodstad Øystein , Pulido Rafael , López José I.
Published: June 2021

Background

Novel immune checkpoint‐based immunotherapies may benefit specific groups of prostate cancer patients who are resistant to other treatments.

Methods

We analyzed by immunohistochemistry the expression of B7‐H3, PD‐L1/B7‐H1, and androgen receptor (AR) in tissue samples from 120 prostate adenocarcinoma patients treated with radical prostatectomy in Spain, and from 206 prostate adenocarcinoma patients treated with radical prostatectomy in Norway.

Results

B7‐H3 expression correlated positively with AR expression and was associated with biochemical recurrence in the Spanish cohort, but PD‐L1 expression correlated with neither of them. Findings for B7‐H3 were validated in the Norwegian cohort, where B7‐H3 expression correlated positively with Gleason grade, surgical margins, seminal vesicle invasion, and CAPRA‐S risk group, and was associated with clinical recurrence. High B7‐H3 expression in the Norwegian cohort was also consistent with positive AR expression.

Conclusion

These results suggest distinct clinical relevance of the two immune checkpoint proteins PD‐L1 and B7‐H3 in prostate cancer. Our findings highlight B7‐H3 as an actionable novel immune checkpoint protein in prostate cancer.
Isolation and characterization of fetal nucleated red blood cells from maternal blood as a target for single cell sequencing‐based non‐invasive genetic testing
Authors: Ito Noriko , Tsukamoto Kazuhiro , Taniguchi Kosuke , Takahashi Ken , Okamoto Aikou , Aoki Hiroaki , Otera‐Takahashi Yuka , Kitagawa Michihiro , Ogata‐Kawata Hiroko , Morita Hideaki , Hata Kenichiro , Nakabayashi Kazuhiko
Published: June 2021

Purpose

Although non‐invasive prenatal testing (NIPT) based on cell‐free DNA (cfDNA) in maternal plasma has been prevailing worldwide, low levels of fetal DNA fraction may lead to false‐negative results. Since fetal cells in maternal blood provide a pure source of fetal genomic DNA, we aimed to establish a workflow to isolate and sequence fetal nucleated red blood cells (fNRBCs) individually as a target for NIPT.

Methods

Using male‐bearing pregnancy cases, we isolated fNRBCs individually from maternal blood by FACS, and obtained their genomic sequence data through PCR screening with a Y‐chromosome marker and whole‐genome amplification (WGA)‐based whole‐genome sequencing.

Results

The PCR and WGA efficiencies of fNRBC candidates were consistently lower than those of control cells. Sequencing data analyses revealed that although the majority of the fNRBC candidates were confirmed to be of fetal origin, many of the WGA‐based genomic libraries from fNRBCs were considered to have been amplified from a portion of genomic DNA.

Conclusions

We established a workflow to isolate and sequence fNRBCs individually. However, our results demonstrated that, to make cell‐based NIPT targeting fNRBCs feasible, cell isolation procedures need to be further refined such that the nuclei of fNRBCs are kept intact.
The effect of stream shading on the inflow characteristics in a downstream reservoir
Authors: Ishikawa Mayra , Haag Ingo , Krumm Julia , Teltscher Katharina , Lorke Andreas
Published: June 2021

In thermally stratified reservoirs, inflows form density currents according to the interplay between inflow temperature and reservoir stratification. The temperature of inflowing water is affected by catchment properties, including shading by riparian vegetation. We hypothesize that the degree of shading in the catchment can affect the inflow dynamics in downstream reservoirs by changing inflow temperature and consequently the nature of the density current. We test it for a subtropical drinking water reservoir by combining catchment‐scale hydrological and stream temperature modeling with observations of reservoir stratification. We analyze the formation of density currents, defined as under, inter and overflow, for scenarios with contrasting shading conditions in the catchment. Inflow temperatures were simulated with the distributed water‐balance model LARSIM‐WT, which integrates heat‐balance and water temperature. River temperature measurements and simulations are in good agreement with a RMSE of 0.58°C. In simulations using the present state of shading, underflows are the most frequent flow path, 63% of the annual period. During the remaining time, river intrusion form interflows. In a scenario without stream shading, average inflow temperature increased by 2.2°C. Thus, interflows were the most frequent flow path (51%), followed by underflows (34%) and overflows (15%). With this change, we would expect a degradation of reservoir water quality, as overflows promote longer periods of anoxia and nutrient loads would be delivered to the photic zone, a potential trigger for algae blooms. This study revealed a potentially important, yet unexplored aspect of catchment management for controlling reservoir water quality.
Through the dam into troubled waters: Combined effects of stream fragmentation, habitat deterioration, and poor water quality on lowland stream fish distribution
Authors: van Puijenbroek Peter J.T.M. , Buijse Anthonie D. , Kraak Michiel H.S. , Verdonschot Piet F.M.
Published: June 2021

This study aimed to distinguish the contribution of stream fragmentation and poor habitat and water quality to the decline in riverine fish species. The species presence was related to the number of barriers between a specific lowland stream section and the main river and to the length of the stream section remaining between two barriers. To investigate the relationship between the absence of fish species and poor ecological water quality, the EQR and stream velocity indices were compared between accessible sites where the fish was either present or absent. 79% of the 1039 km lowland stream length was disconnected from the river Meuse by one or more barriers and 34% by more than 5 barriers, while 28% of all stream sections were shorter than 2.5 km. Only 2% of sites scored a very good water quality, while all study sites were characterized by (very) slow flowing waters (<0.15 m/s). As many fish passages are built to improve connectivity, fish passages do not improve habitat quality. Gudgeon and stone loach were hardly affected by stream fragmentation, and only slightly by too short stream sections. Ide was moderately affected, while the migratory species chub and dace were severely affected by stream fragmentation. Chub and dace were also sensitive to poor habitat and water quality. Distinguishing the effects of stream fragmentation, habitat deterioration, and poor water quality on lowland stream fish distribution increased the understanding of the reasons for the presence and absence of species and may aid effective management and restoration efforts.
The reciprocal Bayesian LASSO
Authors: Mallick Himel , Alhamzawi Rahim , Paul Erina , Svetnik Vladimir
Published: June 2021

A reciprocal LASSO (rLASSO) regularization employs a decreasing penalty function as opposed to conventional penalization approaches that use increasing penalties on the coefficients, leading to stronger parsimony and superior model selection relative to traditional shrinkage methods. Here we consider a fully Bayesian formulation of the rLASSO problem, which is based on the observation that the rLASSO estimate for linear regression parameters can be interpreted as a Bayesian posterior mode estimate when the regression parameters are assigned independent inverse Laplace priors. Bayesian inference from this posterior is possible using an expanded hierarchy motivated by a scale mixture of double Pareto or truncated normal distributions. On simulated and real datasets, we show that the Bayesian formulation outperforms its classical cousin in estimation, prediction, and variable selection across a wide range of scenarios while offering the advantage of posterior inference. Finally, we discuss other variants of this new approach and provide a unified framework for variable selection using flexible reciprocal penalties. All methods described in this article are publicly available as an R package at: https://github.com/himelmallick/BayesRecipe.
CLEC3B Identified as a Potential Lung Cancer Biomarker in Serum by Aptamer‐Capture Technology
Authors: Guo Yuanbin , Li Kun , Gao Yue , Zhao Shuhua , Shi Ming , Li Jian , Liu Zhiwei , Wang Zhaoxia , He Lei
Published: June 2021

Lung cancer is the first malignant tumor with morbidity and mortality in the world. To identify a novel lung cancer biomarker facilitating early detection lung cancer, we had obtained a nucleic acid aptamer (Apt‐5) that specifically recognized lung cancer serum. An affinity purification experiment by using magnetic nanoparticles was used to pull down the target proteins, protein CLEC3B was subsequently identified as the target of the aptamer Apt‐5 by MS analysis. The aptamer Apt‐5 displayed high affinity to the CLEC3B protein with a dissociation constant (KD) of 23.9±5.5 nM by SPR. The specificity and selectivity of the CLEC3B protein with the aptamer Apt‐5 were verified by EMSA. It was further confirmed by ELISA experiments that the average concentration of CLEC3B in lung cancer serum was higher than that in healthy human serum (3.272±0.1732 ng/mL vs. 2.104±0.1174 ng/mL, P<0.001.). Moreover, the sensitivity and specificity of ELISA assay in this study are 90 % and 80 %, respectively. So the protein CLEC3B might serve as a potential lung cancer biomarker for early diagnosis and therapy.
CO2 Electroreduction to Formate at a Partial Current Density up to 590 mA mg−1 via Micrometer‐Scale Lateral Structuring of Bismuth Nanosheets
Authors: Wang Dan , Liu Chuangwei , Zhang Yaning , Wang Yanying , Wang Zhenlin , Ding Ding , Cui Yi , Zhu Xiangmiao , Pan Chengsi , Lou Yang , Li Fengwang , Zhu Yongfa , Zhang Ying
Published: June 2021

2D bismuth nanosheets are a promising layered material for formate‐producing via electrocatalytic CO2 conversion. However, the commercial interest of bismuth nanosheets in CO2 electroreduction is still rare due to the undesirable current density for formate at moderate operation potentials (about 200 mA mg−1) and harsh synthesis conditions (high temperature and/or high pressure). This work reports the preparation of Bi nanosheets with a lateral size in micrometer‐scale via electrochemical cathodic exfoliation in aqueous solution at normal pressure and temperature. As‐prepared Bi LNSs (L indicates large lateral size) possess high Faradaic efficiencies over 90% within a broad potential window from −0.44 to −1.10 V versus RHE and a superior partial current density about 590 mA mg−1 for formate in comparison with state‐of‐the‐art results. Structure analysis, electrochemical results, and density functional theory calculations demonstrate that the increasing tensile lattice strain observed in Bi LNSs leads to less overlap of d orbitals and a narrower d‐band width, which tuning the intermediate binding energies, and therefore promotes the intrinsic activity.
3D‐Stretched Film Ni3S2 Nanosheet/Macromolecule Anthraquinone Derivative Polymers for Electrocatalytic Overall Water Splitting
Authors: Chen Yushan , Yu Zebin , Jiang Ronghua , Huang Jun , Hou Yanping , Chen Jianhua , Zhang Yongqing , Zhu Hongxiang , Wang Bing , Wang Mi
Published: June 2021

For the first time, a new polymer electrode AQS/S is prepared by compositing Ni3S2 nanosheets and macromolecular anthraquinone derivative (AQD) supported on nickel foam with flying colors. The AQS/S exhibits high crystalline structure and abundant S defects. Density of state calculation shows that AQD has stable internal bonding and easy external bonding with metals, conducive to the dispersion of metal reaction sites, ensuring excellent activity and high stability. Under 1.0 m KOH solution, ultralow overpotentials of 62 and 133 mV at 10 mA cm−2 on AQS/S for hydrogen evolution reaction and on activated AQS/S (A‐AQS/S) for oxygen evolution reaction, respectively, are achieved. 100 h chronopotentiometry and the cyclic voltammetry tests show that catalysts have high durability. The AQS/S‖A‐AQS/S two‐electrode system is also found to have good electrocatalytic activity for 1.43 V to get 10 mA cm−2 in overall water splitting, better than the state‐of‐the‐art 20% Pt/C‖RuO2 combination.
Stable and Efficient Blue‐Emitting CsPbBr3 Nanoplatelets with Potassium Bromide Surface Passivation
Authors: Lin Hao , Wei Qi , Ng Kar Wei , Dong Jia‐Yi , Li Jie‐Lei , Liu Wei‐Wei , Yan Shan‐Shan , Chen Shi , Xing Gui‐Chuan , Tang Xiao‐Sheng , Tang Zi‐Kang , Wang Shuang‐Peng
Published: June 2021

Colloidal all‐inorganic perovskites nanocrystals (NCs) have emerged as a promising material for display and lighting due to their excellent optical properties. However, blue emissive NCs usually suffer from low photoluminescence quantum yields (PLQYs) and poor stability, rendering them the bottleneck for full‐color all‐perovskite optoelectronic applications. Herein, a facile approach is reported to enhance the emission efficiency and stability of blue emissive perovskite nano‐structures via surface passivation with potassium bromide. By adding potassium oleate and excess PbBr2 to the perovskite precursor solutions, potassium bromide‐passivated (KBr‐passivated) blue‐emitting (≈450 nm) CsPbBr3 nanoplatelets (NPLs) is successfully synthesized with a respectably high PLQY of 87%. In sharp contrast to most reported perovskite NPLs, no shifting in emission wavelength is observed in these passivated NPLs even after prolonged exposures to intense irradiations and elevated temperature, clearly revealing their excellent photo‐ and thermal‐stabilities. The enhancements are attributed to the formation of K‐Br bonding on the surface which suppresses ion migration and formation of Br‐vacancies, thus improving both the PL emission and stability of CsPbBr3 NPLs. Furthermore, all‐perovskite white light‐emitting diodes (WLEDs) are successfully constructed, suggesting that the proposed KBr‐passivated strategy can promote the development of the perovskite family for a wider range of optoelectronic applications.
Work readiness attributes: Comparative views of clinical supervisors and final year sonography students
Authors: Kinnane Paula , Kennedy Narelle , Quinton Ann
Published: June 2021

Introduction

Graduate sonographers possess the necessary knowledge and practical skills for employment, but personal characteristics and behavioural skills can also affect employability prospects. There is a lack of research regarding important characteristic traits of graduate sonographers. This research aims to determine what personal, interpersonal, and professional attributes clinical supervisors think are important and compare these answers to final year student sonographers.

Methods

An online questionnaire was designed and provided to clinical supervisors and final year sonography students from a single institution. Their anonymous responses were recorded, analysed, and compared.

Results

Reponses were obtained from 65 clinical supervisors and 39 final year students. There was a statistically significant difference in 10 of the 18 attributes, and these mainly trended from the personal characteristics and organisational acumen categories. Student results rated ‘works as a team’, ‘technical knowledge’, and ‘communication with a range of people’ to be of the highest importance whilst clinical supervisors felt ‘communication with a range of people’, ‘seeks support’, ‘technical knowledge’, and ‘clinical reasoning’ were vital for new graduates. Both groups agreed ‘communication with a range of people’ and ‘seeks support’ were important skills.

Conclusion

This research demonstrates both supervisors' and graduates' views of necessary work‐related traits for new sonography graduates. Overall, both groups had similar views regarding social intelligence and work competence attributes but diverged when it came to personal and organisational acumen categories. Education could be incorporated into the sonography student curriculum to ensure future students are aware of characteristics that might enhance their job prospects and career performance.
European guideline on indications, performance and clinical impact of 13C‐breath tests in adult and pediatric patients: An EAGEN, ESNM, and ESPGHAN consensus, supported by EPC
Authors: Keller Jutta , Hammer Heinz F. , Afolabi Paul R. , Benninga Marc , Borrelli Osvaldo , Dominguez‐Munoz Enrique , Dumitrascu Dan , Goetze Oliver , Haas Stephan L. , Hauser Bruno , Pohl Daniel , Salvatore Silvia , Sonyi Marc , Thapar Nikhil , Verbeke Kristin , Fox Mark R. ,   European 13C‐breath test group
Published: June 2021

Introduction

13C‐breath tests are valuable, noninvasive diagnostic tests that can be widely applied for the assessment of gastroenterological symptoms and diseases. Currently, the potential of these tests is compromised by a lack of standardization regarding performance and interpretation among expert centers.

Methods

This consensus‐based clinical practice guideline defines the clinical indications, performance, and interpretation of 13C‐breath tests in adult and pediatric patients. A balance between scientific evidence and clinical experience was achieved by a Delphi consensus that involved 43 experts from 18 European countries. Consensus on individual statements and recommendations was established if ≥ 80% of reviewers agreed and <10% disagreed.

Results

The guideline gives an overview over general methodology of 13C‐breath testing and provides recommendations for the use of 13C‐breath tests to diagnose Helicobacter pylori infection, measure gastric emptying time, and monitor pancreatic exocrine and liver function in adult and pediatric patients. Other potential applications of 13C‐breath testing are summarized briefly. The recommendations specifically detail when and how individual 13C‐breath tests should be performed including examples for well‐established test protocols, patient preparation, and reporting of test results.

Conclusion

This clinical practice guideline should improve pan‐European harmonization of diagnostic approaches to symptoms and disorders, which are very common in specialist and primary care gastroenterology practice, both in adult and pediatric patients. In addition, this guideline identifies areas of future clinical research involving the use of 13C‐breath tests.
Low torcular Herophili position and large brainstem–tentorium angle in fetuses with open spinal dysraphism at 11–13 weeks' gestation
Authors: Volpe P. , De Robertis R. , Fanelli T. , Boito S. , Volpe G. , Votino C. , Persico N. , Chaoui R.
Published: June 2021

Objective

To evaluate whether in fetuses with open spina bifida (OSB) the tentorium can be seen to be displaced downwards and vertically oriented by the time of the 11–13‐week scan and whether this is reflected in an alteration of the brainstem–tentorium (BST) angle.

Methods

The study population was recruited between 2015 and 2020 from three fetal medicine referral centers and comprised a control group and a study group of pregnancies with OSB. The control group was recruited prospectively and included singleton pregnancies with a normal sonographic examination after first‐trimester combined screening for chromosomal abnormalities and normal outcome. The study group was selected retrospectively and included all cases with OSB between 2015 and 2020. All cases underwent detailed ultrasound assessment at 11 + 0 to 13 + 6 weeks' gestation. The position of the torcular Herophili (TH) was identified in the midsagittal view of the fetal brain with the use of color Doppler and was considered as a proxy for the insertion of the tentorium on the fetal skull. The BST angle was calculated in the same view and was compared between the two groups.

Results

Sixty normal fetuses were included in the control group and 22 fetuses with OSB in the study group. In both groups, the BST angle was found to be independent of gestational age or crown–rump length (P = 0.8815, R2 = 0.0003861 in the controls, and P = 0.2665, R2 = 0.00978 in the OSB group). The mean BST angle was 48.7 ± 7.8° in controls and 88.1 ± 1.18°, i.e. close to 90°, in fetuses with OSB. Comparison of BST‐angle measurements between the control group and cases with OSB showed a statistically significant difference (P = 0.0153). In all fetuses with OSB, the downward displacement of the TH and tentorium was clearly visible at the 11–13‐week scan.

Conclusions

In fetuses with OSB, the BST angle is significantly larger than in normal controls, with the tentorium being almost perpendicular to the brainstem. This sign confirms the inferior displacement of the tentorium cerebelli with respect to its normal insertion on the occipital clivus as early as the first trimester of pregnancy and is useful in the diagnosis of Chiari‐II malformation at this early stage. In fetuses with OSB, the low position of the tentorium and TH is clearly visible, even subjectively, at the 11–13‐week scan. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
Structure and concept of ICU rounds: the VIS-ITS survey
Authors: Hillmann Bastian , Schwarzkopf Daniel , Manser Tanja , Waydhas Christian , Riessen Reimer
Published: June 2021

Objective

To gather data about structural and procedural characteristics of patient rounds in the intensive care unit (ICU) setting.

Design

A structured online survey was offered to members of two German intensive care medicine societies.

Measurements and main results

Intensivists representing 390 German ICUs participated in this study (university hospitals 25%, tertiary hospitals 23%, secondary hospitals 36%, primary hospitals 16%). In 90% of participating ICUs, rounds were reported to take place in the morning and cover an average of 12 intensive care beds and 6 intermediate care beds within 60 min. With an estimated bed occupancy of 80%, this averaged to 4.3 min spent per patient during rounds. In 96% of ICUs, rounds were stated to include a bedside visit. On weekdays, 86% of the respondents reported holding a second ICU round with the attendance of a qualified decision-maker (e.g. board-certified intensivist). On weekends, 79% of the ICUs performed at least one round with a decision-maker per day. In 18%, only one ICU round per weekend was reported, mostly on Sundays. The highest-qualified decision-maker present during rounds on most ICUs was an ICU attending (57%). Residents (96%) and intensive care nurses (87%) were stated to be always or usually present during rounds. In contrast, physiotherapists, respiratory therapists or medical specialists such as pharmacists or microbiologist were not regular members of the rounding team on most ICUs. In the majority of cases, the participants reported examining the medical chart directly before or during the bedside visit (84%). An electronic patient data management system (PDMS) was available on 31% of ICUs. Daily goals were always (55%) or usually (39%) set during rounds.

Conclusion

This survey gives a broad overview of the structure and processes of ICU rounds in different sized hospitals in Germany. Compared to other mostly Anglo-American studies, German ICU rounds appear to be shorter and less interdisciplinary.
Vergleich der Anwendung verschiedener extraglottischer Atemwegshilfen durch Laien am Phantom
Authors: Jänig Christoph , Balogh Oliver , Krappitz Stephanie , Willms Arnulf , Schmidbauer Willi , Piepho Tim
Published: June 2021

Hintergrund

Supraglottische Atemwege (SGA) sind eine etablierte Methode der Atemwegssicherung sowohl in der prähospitalen Medizin als auch im klinischen Umfeld. Die endotracheale Intubation ist der Goldstandard, jedoch bieten SGA Vorteile in Bezug auf die schnellere Erlernbarkeit der Anwendung.

Ziele

In der vorliegenden Studie wurde untersucht, ob sich die Zeit bis zur ersten suffizienten Beatmung bei 3 untersuchten supraglottischen Atemwegen, angewendet durch medizinische Laien an einem Phantom, signifikant unterscheidet.

Material und Methoden

Besucher eines Einkaufszentrums (n = 160) wurden nach permutierender Blockrandomisierung einer der 3 SGA zugeordnet. Primärer Endpunkt der vorliegenden Studie war die benötigte Platzierungszeit bis zur ersten suffizienten Beatmung.

Ergebnisse

Die Platzierung der i‑gel-Larynxmaske (Intersurgical Beatmungsprodukte GmbH, Sankt Augustin, Deutschland) gelang den Teilnehmern im Median nach 11 s, wohingegen die Zeitspanne bis zur ersten suffizienten Beatmung mittels klassischer Larynxmaske (LMA; 26 s), respektive Larynxtubus (LT; 28 s) im Median deutlich länger war. Damit war die Zeitersparnis bei der Anwendung der i‑gel im Vergleich zu LT und LMA jeweils signifikant größer (p < 0,001), wohingegen sich die Zeiten zwischen LT und LMA nicht signifikant unterschieden (p 0,65).

Schlussfolgerung

Die Ergebnisse zeigen, dass Laien in der Lage sind, verschiedene supraglottische Atemwege nach einer kurzen Lernphase erfolgreich am Phantom anzuwenden. Die i‑gel-Larynxmaske konnte in unserem Setting mit der höchsten Erfolgsrate und höchsten Geschwindigkeit platziert werden.
Patientenindividuelle glenoidale Implantate in der Schulterendoprothetik
Authors: Petermann M. , Agneskirchner J.
Published: June 2021

Die Behandlung ausgeprägter glenoidaler Knochendefekte ist herausfordernd. Patientenindividuelle glenoidale Implantate stellen diesbezüglich ein neues Verfahren dar, welches mit enormen potenziellen Vorteilen behaftet ist. Die eigenen Erfahrungen zeigen, dass mit dieser Technologie einerseits der glenoidale Knochendefekt reproduzierbar wiederherzustellen ist und andererseits eine stabile Verankerung und eine hochpräzise Implantatpositionierung entsprechend der präoperativen Planung erzielt werden kann. Dies stellt sich besonders im Vergleich zu Alternativverfahren, wie der knöchernen Glenoidaugmentation, als substanzieller Vorteil der Technik für diese häufig hochdefizitären und anspruchsvollen Situationen dar. Nach Durchführung einer Computertomographie (CT) der Schulter wird präoperativ das individuelle Implantatdesign dreidimensional detailliert computergestützt geplant. Von zentraler Bedeutung für die korrekte und planungsgetreue Positionierung des definitiven Implantats während der Operation ist eine präzise Einbringung eines Kirschner-Drahts mittels PSI(„patient specific instrumentation“)-Guide.. Nach Fixation der glenoidalen Komponente kann diese mit Standardimplantaten des jeweiligen Systems kombiniert werden. Die aktuell vorhandene Literatur ist ermutigend und zeigt, dass kurzfristig signifikante klinische Erfolge mit dem Verfahren erzielbar sind. Weitere Forschung im Sinne von biomechanischen Untersuchungen und längeren Nachuntersuchungszeiträumen ist wünschenswert, um die Wertigkeit des Verfahrens weiter zu präzisieren.
Quantitative Regularity for the Navier–Stokes Equations Via Spatial Concentration
Authors: Barker Tobias , Prange Christophe
Published: June 2021

This paper is concerned with quantitative estimates for the Navier–Stokes equations. First we investigate the relation of quantitative bounds to the behavior of critical norms near a potential singularity with Type I bound $$\Vert u\Vert _{L^{\infty }_{t}L^{3,\infty }_{x}}\le M$$

‖
u
‖

L
t
∞

L
x

3
,
∞

≤
M

. Namely, we show that if $$T^*$$

T
∗

is a first blow-up time and $$(0,T^*)$$

(
0
,

T
∗

)

is a singular point then $$\begin{aligned} \Vert u(\cdot ,t)\Vert _{L^{3}(B_{0}(R))}\ge C(M)\log \Big (\frac{1}{T^*-t}\Big ),\,\,\,\,\,\,R=O((T^*-t)^{\frac{1}{2}-}). \end{aligned}$$

‖
u

(
·
,
t
)

‖

L
3

(

B
0

(
R
)

)

≥
C

(
M
)

log

(

1

T
∗

-
t

)

,

R
=
O

(

(

T
∗

-
t
)

1
2

-

)

.

We demonstrate that this potential blow-up rate is optimal for a certain class of potential non-zero backward discretely self-similar solutions. Second, we quantify the result of Seregin (Commun Math Phys 312(3):833–845, 2012), which says that if u is a smooth finite-energy solution to the Navier–Stokes equations on $${\mathbb {R}}^3\times (0,1)$$

R

3

×

(
0
,
1
)

with $$\begin{aligned} \sup _{n}\Vert u(\cdot ,t_{(n)})\Vert _{L^{3}({\mathbb {R}}^3)}<\infty \,\,\,\text {and}\,\,\,t_{(n)}\uparrow 1, \end{aligned}$$

sup
n

‖
u

(
·
,

t

(
n
)

)

‖

L
3

(

R

3

)

<
∞

and

t

(
n
)

↑

1
,

then u does not blow-up at $$t=1$$

t
=
1

. To prove our results we develop a new strategy for proving quantitative bounds for the Navier–Stokes equations. This hinges on local-in-space smoothing results (near the initial time) established by Jia and Šverák (2014), together with quantitative arguments using Carleman inequalities given by Tao (2019). Moreover, the technology developed here enables us in particular to give a quantitative bound for the number of singular points in a Type I blow-up scenario.
Rise and fall of total mesorectal excision with lateral pelvic lymphadenectomy for rectal cancer: an updated systematic review and meta-analysis of 11,366 patients
Authors: Anania Gabriele , Davies Richard Justin , Arezzo Alberto , Bagolini Francesco , D’Andrea Vito , Graziosi Luigina , Di Saverio Salomone , Popivanov Georgi , Cheruiyot Isaac , Cirocchi Roberto , Donini Annibale
Published: June 2021

The role of lateral lymph node dissection (LLND) during total mesorectal excision (TME) for rectal cancer is still controversial. Many reviews were published on prophylactic LLND in rectal cancer surgery, some biased by heterogeneity of overall associated treatments. The aim of this systematic review and meta-analysis is to perform a timeline analysis of different treatments associated to prophylactic LLND vs no-LLND during TME for rectal cancer.

Methods

A literature search was performed in PubMed, SCOPUS and WOS for publications up to 1 September 2020. We considered RCTs and CCTs comparing oncologic and functional outcomes of TME with or without LLND in patients with rectal cancer.

Results

Thirty-four included articles and 29 studies enrolled 11,606 patients. No difference in 5-year local recurrence (in every subgroup analysis including preoperative neoadjuvant chemoradiotherapy), 5-year distant and overall recurrence, 5-year overall survival and 5-year disease-free survival was found between LLND group and non LLND group. The analysis of post-operative functional outcomes reported hindered quality of life (urinary, evacuatory and sexual dysfunction) in LLND patients when compared to non LLND.

Conclusion

Our publication does not demonstrate that TME with LLND has any oncological advantage when compared to TME alone, showing that with the advent of neoadjuvant therapy, the advantage of LLND is lost. In this review, the most important bias is the heterogeneous characteristics of patients, cancer staging, different neoadjuvant therapy, different radiotherapy techniques and fractionation used in different studies. Higher rate of functional post-operative complications does not support routinely use of LLND.
R1441G but not G2019S mutation enhances LRRK2 mediated Rab10 phosphorylation in human peripheral blood neutrophils
Authors: Fan Ying , Nirujogi Raja S. , Garrido Alicia , Ruiz-Martínez Javier , Bergareche-Yarza Alberto , Mondragón-Rezola Elisabet , Vinagre-Aragón Ana , Croitoru Ioana , Gorostidi Pagola Ana , Paternain Markinez Laura , Alcalay Roy , Hickman Richard A. , Düring Jonas , Gomes Sara , Pratuseviciute Neringa , Padmanabhan Shalini , Valldeoriola Francesc , Pérez Sisqués Leticia , Malagelada Cristina , Ximelis Teresa , Molina Porcel Laura , Martí Maria José , Tolosa Eduardo , Alessi Dario R. , Sammler Esther M.
Published: June 2021

Heterozygous gain-of-kinase function variants in LRRK2 (leucine-rich repeat kinase 2) cause 1–2% of all cases of Parkinson’s disease (PD) albeit with incomplete and age-dependent penetrance. All pathogenic LRRK2 mutations reside within the two catalytic domains of LRRK2—either in its kinase domain (e.g. G2019S) with modest effect or its ROC-COR GTPase domain (e.g. R1441G/H) with large effect on LRRK2 kinase activity. We have previously reported assays to interrogate LRRK2 kinase pathway activity in human bio-samples measuring phosphorylation of its endogenous substrate Rab10, that mirrors LRRK2 kinase activation status. Here, we isolated neutrophils from fresh peripheral blood from 101 participants including 42 LRRK2 mutation carriers (21 with the G2019S and 21 with the R1441G mutations), 27 patients with idiopathic PD, and 32 controls. Using a dual approach, LRRK2 dependent Rab10 phosphorylation at Threonine 73 (pRab10Thr73) was measured by quantitative multiplexed immunoblotting for pRab10Thr73/total Rab10 as well as targeted mass-spectrometry for absolute pRab10Thr73 occupancy. We found a significant over fourfold increase in pRab10Thr73 phosphorylation in carriers of the LRRK2 R1441G mutation irrespective of clinical disease status. The effect of the LRRK2 G2019S mutation did not reach statistical significance. Furthermore, we show that LRRK2 phosphorylation at Serine 935 is not a marker for LRRK2 kinase activity in human neutrophils. When analysing pRab10Thr73 phosphorylation in post-mortem brain samples, we observed overall high variability irrespective of clinical and LRRK2 mutation status and attributed this mainly to the adverse effect of the peri- and post-mortem period on the stability of posttranslational modifications such as protein phosphorylation. Overall, in vivo LRRK2 dependent pRab10Thr73 phosphorylation in human peripheral blood neutrophils is a specific, robust and promising biomarker for significant LRRK2 kinase hyperactivation, as with the LRRK2 R1441G mutation. Additional readouts and/or assays may be needed to increase sensitivity to detect modest LRRK2 kinase activation, as with the LRRK2 G2019S mutation. Our assays could be useful for patient stratification and target engagement studies for LRRK2 kinase inhibitors.
Efficacy of an optimal ovarian cancer screening: a best-case scenario study based on real-world data
Authors: Steinkasserer Lena , Irmgard Delmarko , Weiss Tatjana , Dirschlmayer Walter , Mossig Michael , Zeimet Alain G. , Marth Christian
Published: June 2021

Purpose

To date, ovarian cancer screening in asymptomatic women has not shown a mortality benefit. The aim of this simulation study was to outline the impact of different histological subtypes on a potential stage-shift, achieved by screening.

Methods

Real-world data were derived in the period of 2000–2017 from the Klinischen Tumorregister Austria. We estimated five-year overall survival (OS) of patients with ovarian cancer regarding different histological subtypes and FIGO stages. A theoretical model was generated predicting the trend of OS mediated by an eventual down-shifting of ovarian cancer from FIGO stage III/IV to FIGO stage I/II by screening, considering the influence of different histological subtypes.

Results

3458 ovarian cancer patients were subdivided according to histological subtypes and FIGO classification. Major difference in distribution of histological types was found between FIGO stage I/II and III/IV. A theoretical down-shift of tumors from high to low FIGO stages based on our registry calculations showed that the five-year OS would increase from 50% to nearly 80% by perfect screening.

Conclusion

In our simulation study, we showed that down-shifting ovarian cancers by successful screening might increase OS by 30 percentage point. Our results underscore the importance to recognize ovarian cancer as a heterogenous disease with distinct epidemiologic, molecular and clinical features. The individual characteristic of each histotype is of utmost impact on the definition of screening aims and may influence early detection and stage-shift. Efficacy of screening is mainly dependent on detection of high-risk cancer types and not the slow growing low-grade types.
Targeting hepatocyte growth factor in epithelial–stromal interactions in an in vitro experimental model of human periodontitis
Authors: Yamaguchi Yoko , Saito Akira , Horie Masafumi , Aoki Akira , Micke Patrick , Ohshima Mitsuhiro , Kappert Kai
Published: June 2021

Periodontitis is a chronic inflammatory disease leading to progressive connective tissue degradation and loss of the tooth-supporting bone. Clinical and experimental studies suggest that hepatocyte growth factor (HGF) is involved in the dysregulated fibroblast–epithelial cell interactions in periodontitis. The aim of this study was to explore effects of HGF to impact fibroblast-induced collagen degradation. A patient-derived experimental cell culture model of periodontitis was applied. Primary human epithelial cells and fibroblasts isolated from periodontitis-affected gingiva were co-cultured in a three-dimensional collagen gel. The effects of HGF neutralizing antibody on collagen gel degradation were tested and transcriptome analyses were performed. HGF neutralizing antibody attenuated collagen degradation and elicited expression changes of genes related to extracellular matrix (ECM) and cell adhesion, indicating that HGF signaling inhibition leads to extensive impact on cell–cell and cell–ECM interactions. Our study highlights a potential role of HGF in periodontitis. Antagonizing HGF signaling by a neutralizing antibody may represent a novel approach for periodontitis treatment.