bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Semistructured Interview Based on Doctor-Patient Perspective in Constructing a Palliative Care Regimen for Patients with Advanced Heart Failure
Authors: Zhou Ting , Cai HaiQin , Xu ChunHui
Published: June 2022

Objective. The aim of this study is to explore the application of semistructured interview based on doctor-patient perspective in constructing a palliative care regimen for patients with advanced heart failure. Methods. 112 patients with advanced heart failure who were admitted to the hospital were selected between December 2019 and December 2020, and they were randomly divided into an interview group and a routine group, with 56 cases in each group. The routine group was given routine nursing for advanced heart failure while the interview group developed a palliative care regimen based on a semistructured interview from the doctor-patient perspective. The psychological states (Depression-Anxiety-Stress Scale (DASS-21)), symptoms (Memorial Symptom Assessment Scale-Heart Failure (MSAS-HF)), quality of life (Kansas City Cardiomyopathy Questionnaire (KCCQ)), and prognosis (readmission rate, mortality rate) were compared between the two groups before and after intervention. Results. Compared with before intervention, there were no significant differences in the scores of DASS-21, MSAS-HF, and KCCQ in the routine group after intervention (

P
>
0.05

), and the scores of DASS-21 and MSAS-HF in the interview group were decreased while KCCQ scores were increased (

P
<
0.05

). Scores of DASS-21 and MSAS-HF and readmission rate were lower while the KCCQ scores were higher in the interview group compared with those in the routine group (

P
<
0.05

). There was no significant difference in the mortality rate between the two groups (

P
>
0.05

). Conclusion. The application of a semistructured interview based on the doctor-patient perspective to construct the palliative care regimen for patients with advanced heart failure can eliminate the negative emotions, improve the psychological states, relieve the clinical symptoms, enhance the quality of life, and reduce the risk of readmission.
SPCABS: Signature-Policy Comparable Attribute-Based Signatures
Authors: Chen Hongying , Huang Zhenjie , Huang Hui , Guo Yafeng
Published: June 2022

Attribute-based signature is an attractive cryptographic primitive and finds broad applications in many fields. Existing attribute-based signature schemes deal with attributes in the way of “with” or “without,” and there is no attribute-based signature scheme that supports comparing attributes. Using the 0-encoding and 1-encoding, we propose an access structure algorithm and an attribute expansion algorithm, enabling the attribute-based signature scheme to effectively deal with the comparative attributes. Then, we propose a signature-policy comparable attribute-based signature scheme using the proposed expansion algorithms. The proposed scheme is existentially unforgeable under the computational Diffie–Hellman exponent (CDHE) assumption and achieves privacy in the sense of information theory. Theoretical analysis and simulation experiments show that our method is practical and has significant advantages in storage and computation overhead compared with the trivial way. Comparable attribute-based signature dramatically expands the application scenarios of attribute-based signature.
Comparison of Maximum Heat Generation during Implant Site Preparation between Single and Gradual Drilling Protocols in Artificial D1 Bone Blocks: An In Vitro Study
Authors: koutiech Tammam , Ahmad heshmeh Omar , Alkerdi Kamal , Toumi Johnny , Al sabek Laith
Published: June 2022

Aim. Two protocols for implant site preparation have been demonstrated in the literature: conventional gradual drilling and single drilling. Objectives. The purpose of this study is to assess the maximum temperature changes reached during and after implant site preparation of 4.2 implant diameter using the gradual drilling protocol and single drilling protocol. Material and Methods. The artificial bone block samples (#1522–23; Sawbones, Malmö, Sweden) with the density of d1 were divided into two groups. Twelve implant site preparations were performed with the use of only one drill in group A, and the same number of preparations was performed using five gradual drills in group B. The drilling speed was set for each group at 1500 rpm with the use of external irrigation with a constant of 50 ml/min at room temperature (25 ± 1°C). The maximum temperature changes were measured using an infrared camera (Fluke Ti55, USA). The data were gathered and analyzed using Student’s t-test for independent samples. Results. With the 95% confidence intervals (CIs) for the means of ∆T between groups A and B, group B showed a statistically significant higher temperature change (∆T) than group A. Conclusions. The current outcomes propose that the single drilling protocol, while preparing a bed for a 4.25 mm dental implant in d1 artificial bone blocks, generates less heat than the conventional gradual drilling protocol.
Mast Cell Activation Syndrome in COVID-19 and Female Reproductive Function: Theoretical Background vs. Accumulating Clinical Evidence
Authors: Szukiewicz Dariusz , Wojdasiewicz Piotr , Watroba Mateusz , Szewczyk Grzegorz
Published: June 2022

Coronavirus disease 2019 (COVID-19), a pandemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, can affect almost all systems and organs of the human body, including those responsible for reproductive function in women. The multisystem inflammatory response in COVID-19 shows many analogies with mast cell activation syndrome (MCAS), and MCAS may be an important component in the course of COVID-19. Of note, the female sex hormones estradiol (E2) and progesterone (P4) significantly influence mast cell (MC) behavior. This review presents the importance of MCs and the mediators from their granules in the female reproductive system, including pregnancy, and discusses the mechanism of potential disorders related to MCAS. Then, the available data on COVID-19 in the context of hormonal disorders, the course of endometriosis, female fertility, and the course of pregnancy were compiled to verify intuitively predicted threats. Surprisingly, although COVID-19 hyperinflammation and post-COVID-19 illness may be rooted in MCAS, the available clinical data do not provide grounds for treating this mechanism as significantly increasing the risk of abnormal female reproductive function, including pregnancy. Further studies in the context of post COVID-19 condition (long COVID), where inflammation and a procoagulative state resemble many aspects of MCAS, are needed.
A Cluster Analysis Model for PhD Dissertation Quality Based on the Depth Algorithm
Authors: Zheng Huanhuan
Published: June 2022

Doctoral education is an important part of higher education and plays an important role in cultivating  many higher talents for the country. In doctoral education, thesis writing is an indispensable teaching section. The quality of the doctoral thesis will directly affect the graduation of doctoral students. Therefore, the analysis of the quality of the doctoral thesis is a typical aspect of the evaluation of doctoral education work. This paper aims to study the quality clustering analysis of the doctoral dissertation based on the depth algorithm. This paper establishes a doctoral paper quality cluster analysis model based on the depth algorithm and carries out the doctoral paper quality cluster analysis experiment based on this model. After the experiment, the main factors affecting the quality of doctoral dissertation were also analyzed. The conclusion is the following: The accuracy rate of the doctoral paper quality cluster analysis model based on the depth algorithm has reached 88.5%.
Effect of Different Surface Treatments and Orthodontic Bracket Type on Shear Bond Strength of High-Translucent Zirconia: An In Vitro Study
Authors: Babaee Hemmati Yasamin , Neshandar Asli Hamid , Falahchai Mehran , Safary Sina
Published: June 2022

Objective. Considering the increasing number of adults seeking orthodontic treatment, and the possible need for bracket bonding to monolithic zirconia restorations, knowledge about the preferred type of bracket (metal/ceramic) and the most efficient surface treatment is imperative to achieve acceptable shear bond strength (SBS). This study aimed to assess the effect of different surface treatments and orthodontic bracket types on SBS of high-translucent zirconia. Materials and Methods. Totally, 248 disc-shaped zirconia specimens were assigned to two groups for bonding to metal and ceramic brackets. Each group was divided into four subgroups (n = 31) for the following surface treatments: no surface treatment (control group), airborne-particle abrasion (APA), tribochemical silica coating with CoJet, and CO2 laser irradiation. The mean surface roughness (Ra value) was measured. The SBS was measured after bracket bonding and thermocycling. Data were analyzed by two-way ANOVA, Tukey, Kruskal–Wallis, Mann–Whitney, and Fisher exact tests, and Bonferroni correction (

α
=
0.
05

). Results. The mean Ra value was significantly different among the surface treatment subgroups (

P
<
0.001

). The APA and CoJet subgroups were not significantly different regarding Ra (

P
=
0.754

). All other pairwise comparisons yielded significant differences (

P
<
0.001

). Bracket type, surface treatment, and their interaction significantly affected the SBS (

P
<
0.001

). Ceramic brackets bonded to zirconia surfaces treated with CoJet yielded the maximum SBS while ceramic brackets bonded to control and lased surfaces resulted in minimum SBS. No significant difference was noted in the SBS of different surface treatment groups when metal brackets were used (

P
>
0.05

). Conclusions. The use of ceramic brackets and CoJet surface treatment would be the most appropriate combination to achieve optimal bonding to high-translucent zirconia restorations.
Regulação do uso público e pesquisa em unidades de conservação estaduais do Amazonas: contexto, institucionalização e gerenciamento
Authors: Reis João Rodrigo Leitão dos , Brito Marco Antonio de Souza
Published: June 2022

A regulação do uso público é essencial para a gestão de unidades de conservação, garantindo segurança técnica e jurídica voltadas à implementação do princípio da sustentabilidade financeira. Este artigo analisa as atividades de uso público nas unidades de conservação estaduais do Amazonas, por meio do monitoramento realizado entre 2015 e 2019, sugerindo-se subsídios técnicos para uma nova regulação das ações. Para isso, utilizou-se o método exploratório, com pesquisa bibliográfica e documental. Constatou-se que somente a Reserva de Desenvolvimento Sustentável Uatumã possui plano de uso público. Apurou-se que foram emitidas 361 autorizações de visitas, atraindo 22.024 visitantes em 21 unidades de conservação. Identificaram-se também 538 autorizações de pesquisas, que abrangeram 3.107 pesquisadores em 42 unidades de conservação. Sugere-se que regramentos futuros foquem em requisitos operacionais para planejamento, controle, cobrança de ingressos, monitoramento, concessão e registro da visitação e pesquisa. Soma-se a isso a criação de um sistema de sistematização, diagnóstico, transparência e prestação de contas dos resultados.
Quantification of Cardiac Adipose Tissue in Failing and Nonfailing Human Myocardium
Authors: Peczkowski Kyra K. , Mashali Mohammed A. , Saad Nancy S. , Hare Austin , Campbell Courtney M. , Whitson Bryan A. , Mokadam Nahush A. , Janssen Paul M. L.
Published: June 2022

Background

Because body mass index (BMI) is generally used clinically to define obesity and to estimate body adiposity, BMI likely is positively correlated with epicardial adipose tissue (EAT) level. Based on echocardiography, previous outcomes on this matter have varied from almost absent to rather strong correlations between BMI and EAT. The purpose of our study was to unambiguously examine EAT content and determine if correlations exist between EAT content and BMI, cause of heart failure, or contractile force.

Methods and Results

We qualitatively scored 150 human hearts ex vivo on EAT distribution. From each heart, multiple photographs of the heart were taken, and both atrial and ventricular adipose tissue levels were semiquantitatively scored. Main findings include a generally higher EAT content on nonfailing hearts compared with end‐stage failing hearts (atrial adipose tissue level 5.70±0.13 vs. 5.00±0.12,
P
<0.001; ventricular adipose tissue level 5.14±0.16 vs. 4.57±0.12,
P
=0.0048). The results also suggest that EAT quantity is not strongly correlated with BMI in nonfailing (atrial adipose tissue level
r
=0.069, ventricular adipose tissue level
r
=0.14) or failing (atrial adipose tissue level
r
=−0.022, ventricular adipose tissue level
r
=0.051) hearts. Atrial EAT is closely correlated with ventricular EAT in both nonfailing (
r
=0.92,
P
<0.001) and failing (
r
=0.87,
P
<0.001) hearts.

Conclusions

EAT volume appears to be inversely proportional to severity of or length of time with heart failure based on our findings. Based on a lack of correlation with BMI, it is incorrect to assume high EAT volume given high body fat percentage.
Revision of the genus Centrophorus (Squaliformes: Centrophoridae): Part 3—Redescription of Centrophorus uyato (Rafinesque) with a discussion of its complicated nomenclatural history
Authors: WHITE WILLIAM T. , GUALLART JAVIER , EBERT DAVID A. , NAYLOR GAVIN J.P. , VERÍSSIMO ANA , COTTON CHARLES F. , HARRIS MARK , SERENA FABRIZIO , IGLÉSIAS SAMUEL P.
Published: June 2022

Centrophorus uyato (Rafinesque, 1810) has a complicated nomenclatural history which has led to multiple scientific names being ascribed to this species. In the Mediterranean Sea, and elsewhere in its range, this species was previously referred to as C. granulosus (Bloch & Schneider, 1801). The first paper in this revision series clarified that C. granulosus refers to a much larger species of gulper shark which attains at least 1.7 m length and is absent from the Mediterranean Sea. Further complicating the nomenclature of this species is the fact that the original description clearly refers to a Squalus species, and not a Centrophorus species. In this third part of the revision of the genus Centrophorus, this problematic species is redescribed. A detailed synonymy is provided and it is confirmed that C. machiquensis, C. bragancae and C. zeehaani are junior synonyms of this species. To preserve nomenclatural stability within the genus, the name Centrophorus uyato is retained for this species with a neotype from close to the original type locality off Italy being designated. Intraspecific variation within Centrophorus uyato is also discussed, particularly relating to denticle morphology and body morphology.
A redescription of Hypogastrura gisini Strenzke, 1954 (Collembola: Hypogastruridae) and description of a new related species from Crete (Greece)
Authors: SKARŻYŃSKI DARIUSZ , GWIAZDOWICZ DARIUSZ J.
Published: June 2022

Hypogastrura gisini Strenzke, 1954 is redescribed based on paratypes and other available material. A description of similar new species from Crete‒‒H. cretensis sp. nov., formerly known as H. cf. gisini sensu Ellis (1976), is also provided. Both species belong to the manubrialis group and resemble H. breviempodialis (Stach, 1949), H. tianshanica Martynova, 1970 and H. ubsunurensis Babenko, 1999, which have a retinaculum with 3 + 3 teeth and a maxillary head of the H. vernalis type. H. gisini has a unique combination of morphological characters: claws without inner tooth, empodium shorter than half inner edge of claw, without basal lamella and setae m1 on abdominal tergum V usually absent. This species prefers sandy habitats on the shores of the Baltic Sea, Kattegat, North Sea, Black Sea and Mediterranean Sea. H. cretensis sp. nov. can be distinguished from its congeners by a combination of the following features: claws with small inner tooth, empodium with basal lamella equal to or slightly longer than half of the inner edge of claws and setae m1 on abdominal tergum V usually present. The new species seems to be associated with anthropogenic habitats mainly (e.g. roadsides, orchards, meadows) in the interior of Crete.
A new genus and two new species of the millipede family Chelodesmidae from Bahia state, northeastern Brazil, including a likely troglobiont (Diplopoda, Polydesmida)
Authors: GOLOVATCH SERGEI I. , BOUZAN RODRIGO S. , GALLO JÉSSICA S. , BICHUETTE MARIA E.
Published: June 2022

A new genus and two new species of Chelodesmidae are described from two caves of the João Rodrigues river system in Bahia state, northeastern Brazil: Strongylosomides troglobius sp. nov. and Rotundotergum elevatum gen. nov., sp. nov. The former species differs from congeners primarily by the gonopods showing the prefemoral process strongly fused caudally along its basal half to the acropodite and, in showing such troglomorphic traits as a nearly unpigmented and fragile body with thin tegument, it seems the first troglobiont to be documented in the genus. Moreover, this new species seems to be so remarkably similar to Leptodesmus stercoriarius Schubart, 1956, from Minas Gerais state, that the following new combination is warranted: Strongylosomides stercoriarius (Schubart, 1956), comb. nov. ex Leptodesmus de Saussure, 1859. The new genus, Rotundotergum gen. nov., seems to be especially similar to Eucampesmella Schubart, 1955, but differs clearly by the absence of a secondary process on the gonopodal prefemoral process, coupled with the latter being unusually long and strongly separated from the acropodite. The type species R. elevatum sp. nov., being partly clearly pigmented, seems to be only troglophilic. The region generally supports a typical dry tropical climate, whereas the caves represent sites with high humidity, this being essential for the survival of these and other species. However, these habitats remain unprotected by Brazilian law, while the João Rodrigues River system is threatened by irrigation projects, potential limestone exploitation, asphalt and road widening or construction that pass across the system and can collapse the rock, and pollution of the subterranean drainage. We hope that the new species described here could help us protect their type localities and the João Rodrigues River system as a whole.
Contribution to the knowledge of the genus Dendarus Dejean, 1821 (Coleoptera: Tenebrionidae: Blaptinae: Dendarini) from Iran, Turkmenistan and some adjacent territories
Authors: NABOZHENKO MAXIM V. , POGGI ROBERTO
Published: June 2022

The taxonomic review of the genus Dendarus Dejean, 1821 from Iran and Turkmenistan is given. In total, five species are distributed in Iran and four species in South Turkmenistan; three species occur in both countries. The new species D. matthewsi sp. n. is described from Iran and compared with D. simplex Seidlitz, 1893. One taxon is resurrected from a synonymy with D. transcaspicus: D. vagabundus sp. resurr. As a result, one Afghan subspecies of D. transcaspicus belongs to another species: D. vagabundus afghanicus Kaszab, 1973. The following new synonymy is proposed: Dendarus vagabundus vagabundus Reitter, 1904 = D. transcaspicus medvedevi Kaszab, 1973, syn. n. Lectotypes of Dendarus armeniacus Baudi di Selve, 1876 and D. leonhardi Schuster, 1940 are designated. The following erroneous interpretations of Iranian and Turkmenian species are indicated: D. vagabundus = D. armeniacus sensu G. Medvedev = D. transcaspicus sensu Kaszab; D. armeniacus = D. simplex sensu G. Medvedev. New distribution data are given: D. armeniacus—N Iran (excluded from faunistic lists of Armenia, Afghanistan, Turkmenistan and Turkey); D. crenulatus (Ménétriés, 1832)—Turkey, Transcaucasia, the North Caucasus (Russia: Dagestan, Chechen Republic), N Iran, Turkmenistan (new record for the country); D. leonhardi—NE Iran, S Turkmenistan; D. matthewsi Nabozhenko sp. n.—W Iran (Zagros); D. transcaspicus Brancsik, 1899—S Turkmenistan (Kopetdag); D. vagabundus vagabundus Reitter, 1904—N Iran, S Turkmenistan (Kopetdag). Two species must be excluded from Iranian faunistic list: D. simplex—Turkey, Syria, Iraq; D. extensus (Faldermann, 1837)—Georgia, Armenia, W Azerbaijan, Turkey (new record for the country). Well-illustrated keys to males and females of Iranian and Turkmenian species of the genus are given.
The genus Calligaster de Saussure (Hymenoptera: Vespidae: Zethinae) in the Philippine Islands
Authors: SELIS MARCO , FEMIA ARTURO
Published: June 2022

The Philippine species of the genus Calligaster de Saussure, 1852 are reviewed. Two species are recorded: C. ilocana Selis, sp. nov. and C. williamsi Bequaert, 1940. Calligaster zetteli Gusenleitner, 2006 is recognized as a synonym of Pseudozumia gracilis van der Vecht, 1963 syn. nov. New distributional records and a key to species are provided.
Morphological description of a new species of Capnia (Plecoptera: Capniidae) with DNA barcoding of genus members from the Russian Far East
Authors: TESLENKO VALENTINA A. , SEMENCHENKO ALEXANDER A.
Published: June 2022

Capnia yavorskayae, a new species of the stonefly family Capniidae, is described from the Low Amur River Basin, Khabarovskiy Kray of the Russian Far East, on the basis of female morphological features. Confirmation of the uniqueness of the new species was also molecularly compared to other Capnia, including a few Far Eastern species, C. aligera Zapekina-Dulkeit, C. bargusinica Zapekina-Dulkeit, C. khingana Teslenko, C. kurnakovi Zhiltzova, C. nearctica Banks, C. nigra (Pictet), and C. rara Zapekina-Dulkeit for which DNA barcodes were obtained. We support the distinctiveness of the new species with mitochondrial DNA sequences, comparing it to Capnia from the eastern Palaearctic and Nearctic realms and one Zwicknia species. The new species forms a common clade with C. khingana, C. kurnakovi from the Russian Far East, and an undetermined Capnia species from Honshu, Japan. Each species from the Russian Far East has high interspecific distances from other Capnia species except C. nearctica which was close to C. atra Morton.
New taxonomic data on Zodariinae (Araneae: Zodariidae) of Azerbaijan, Iran, Afghanistan and Pakistan
Authors: ZAMANI ALIREZA , MARUSIK YURI M.
Published: June 2022

New taxonomic considerations on several species of the zodariid spider subfamily Zodariinae Thorell, 1881 occurring in Azerbaijan, Iran, Afghanistan and Pakistan are presented. Three species, Trygetus cyrus sp. n. (♀; Fars, south-central Iran), T. nakhchivanicus sp. n. (♂; Nakhchivan, Azerbaijan) and Zodarion sharurensis sp. n. (♂♀; Nakhchivan, Azerbaijan) are described as new, and the hitherto unknown male of Trygetus susianus Zamani & Marusik, 2021 is described based on topotype material from Khuzestan, southwestern Iran. Indozodion Ovtchinnikov, 2006 stat. rev. is rediagnosed and removed from the synonymy of Tropizodium Jocqué & Churchill, 2005, and here considered to comprise I. inayatullahi Ovtchinnikov, 2006 comb. rev. (type species) and I. lindbergi (Roewer, 1960) comb. n. (ex. Zodarion Walckenaer, 1826); the latter species, previously known only from Afghanistan, is redescribed and reported from Pakistan. One of the paratypes of I. lindbergi, reported as a subadult female in the original description, is found to be an adult female of Parazodarion raddei (Simon, 1889). An error in a previous publication (attributing figures of Acanthinozodium elburzicum Zamani & Marusik, 2021 to P. raddei) is also corrected here.
Understanding the Role of Rainfall Intensity on Relative Car Crash Risk in the Carolinas
Authors: Eck Montana A. , Konrad Charles E. , Rayne Sandra , Black Alan W.
Published: June 2022

As a significant detriment to physical and mental health, millions of motor vehicle crashes occur in the United States each year, with approximately 23% of these crashes linked to adverse weather conditions. This study builds upon a strong knowledge base to provide a deeper understanding of how rainfall intensity influences relative crash risk. Gridded precipitation and temperature data were aggregated to the county level and analyzed alongside motor vehicle crash data for all 146 counties in the Carolinas (North Carolina and South Carolina) for the period 2003–19. A matched-pair analysis routine linked unique time steps of rainfall (daily, 6-h, and hourly) to corresponding dry periods to evaluate relative crash risk across each state. Risk estimates were calculated on the basis of precipitation thresholds (light, moderate, heavy, and very heavy). Results indicate a statistically significant increase in crash risk during periods of rainfall in the Carolinas. As a baseline, the relative risk of experiencing a crash increases by 11.6% during days with accumulating rainfall and as much as 81.0% during heavy rainfall events over a 6-h period. In general, estimates of risk increase relative to the intensity of the rainfall event and the temporal delineation of the matched-pair routine. However, these relationships have unique spatiotemporal patterns indicating that, although hourly risk estimates may be beneficial for urban counties, daily relative risk estimates may be the only way to accurately capture risk in rural areas.

Significance Statement

Each year, more than 1 000 000 motor vehicle crashes in the United States are linked to adverse weather conditions in police reports, with rainfall events being among the largest contributors to increased crash risk. In this study, crash frequencies are evaluated to better understand how the intensity of rainfall events (light vs heavy) influences the risk of experiencing a collision on roadways in North Carolina and South Carolina. The results of statistical analyses revealed that risk increases significantly during rainfall events in both states and that the risk of experiencing a crash is highest during the heaviest rainfall events. However, even during light precipitation events, the risk of experiencing a crash is significantly higher than when driving during dry conditions. These results are helpful to transportation stakeholders and emergency responders in the hope of reducing crash risk in our changing climate.
Ischiofemoral impingement syndrome provoked by labor: An unusual case of complete sciatic mononeuropathy
Authors: Saw Jacqui-Lyn , Hale Jeremy , Madhavan Ajay , Ringler Michael D , Toledano Michel , Naddaf Elie
Published: June 2022

Peripheral neuropathies are a recognized complication of labor in the post-partum period. Herein, we describe an uncommon presentation of sciatic mononeuropathy due to ischiofemoral impingement during labor. A 29-year-old, gravida 4 para 2, female presented post-partum with acute left lower limb paresthesia and left foot drop, following spontaneous vaginal delivery of twins. Neurological examination demonstrated no activation of the left sciatic-innervated muscles and sensory loss in the same distribution. Electromyography (EMG) demonstrated an acute complete left sciatic mononeuropathy. MRI of the lumbosacral plexus and sciatic nerve showed a narrowed quadratus femoris space with mild edema of the muscle, consistent with ischiofemoral impingement syndrome. In addition, there was flattening of the sciatic nerve as it passed through the ischiofemoral space. She was treated conservatively, and at 7-month follow-up, there was marked improvement in muscle strength with ongoing sensory impairment. Repeat EMG demonstrated reinnervation in all sciatic-innervated muscles. This case highlights the risk of a sciatic mononeuropathy secondary to ischiofemoral impingement in the peripartum setting. Future studies are needed to determine if women with a narrow ischiofemoral space at baseline are at increased risk for peripheral nerve injury during labor.
The implementation and validation of the NoMAD during a complex primary care intervention
Authors: Lamarche Larkin , Clark Rebecca E. , Parascandalo Fiona , Mangin Dee
Published: June 2022

Background

Normalization process theory (NPT) has been widely used to better understand how new interventions are implemented and embedded. The NoMAD (Normalization Measurement Development questionnaire) is a 23-item NPT instrument based on NPT. As the NoMAD is a relatively new instrument, the objectives of this paper are: to describe the experience of implementing the NoMAD, to describe it being used as a feedback mechanism to gain insight into the normalization process of a complex health intervention, and to further explore the psychometric properties of the instrument.

Methods

Health TAPESTRY was implemented in six Family Health Teams (total of seven sites) across Ontario. Healthcare team members at each site were invited to complete the NoMAD, and three general questions about normalization, six times over a 12-month period. Each site was then provided a visual traffic light summary (TLS) reflecting the implementation of the Health TAPESTRY. The internal consistency of each sub-scale and validity of the NoMAD were assessed. Learnings from the implementation of the NoMAD and subsequent feedback mechanism (TLS) are reported descriptively.

Results

In total, 56 diverse health care team members from six implementation sites completed the NoMAD. Each used it at least once during the 12-month study period. The implementation of the NoMAD and TLS was time consuming to do with multiple collection (and feedback) points. Most (60%) internal consistency values of the four subscales (pooled across site) across each collection point were satisfactory. All correlations were positive, and most (86%) were statistically significant among NoMAD subscales. All but one correlation between the NoMAD subscales and the general questions were positive, and most (72%) were significant. Generally, scores on the subscales were higher at 12-month than baseline, albeit did not follow a linear pattern of change across implementation. Generally, scores were higher for experienced sites compared to first-time implementors.

Conclusion

Our experience would suggest fewer collection points; three timepoints spaced out by several months are adequate, if repeated administration of the NoMAD is used for feedback loops. We provide additional evidence of the psychometric properties of the NoMAD.

Trial Registration

Registered at ClinicalTrials.gov: NCT03397836.
Genetics education in primary care residency training: satisfaction and current barriers
Authors: Falah Nadia , Umer Amna , Warnick Emilea , Vallejo Manuel , Lefeber Timothy
Published: June 2022

Background

Genetics education can be integrated into general care medicine through primary care residency programs. A study of primary care residents was done to evaluate quality, satisfaction, and barriers in genetics education in residency training programs. Thus, providing more evidence for the necessity for its development and progress.

Methods

A cross-sectional descriptive self-administered questionnaire survey was delivered to four primary care West Virginia University (WVU) residency training programs in 2020–2021. The anonymous 14-item survey included the following questionnaire domains: general data, genetics training satisfaction, and genetics education barriers.

Results

The survey response rate was 52% (70/123) and 59 participants completed the survey. Overall, respondents viewed genetic education as critical to their chosen specialty (90%). Trainees at all educational levels obtained their education mostly from class based educational curricula (77% from lectures, 65% from didactic and 49% from grand rounds). The majority of survey respondents indicated insufficient experience with genetic patient care (34% ward genetic consultation, 5% clinic experience, 0% genetic department rotation). The percentage of residents who were satisfied with genetic topics were as follows: basic genetics (57%), capturing family history (82%), initiating basic genetic workup (15%), a basic understanding of the genetic report (23%), basic management surveillance in the genetic patient (18%), understanding the genetic referral and explaining it to a patient (47%).

Residents reported barriers to genetic interest included complexity of the field (87%), followed by limited utility of genetics testing (41%). The most common suggestions for improving the genetic education component were to provide more lectures (61%), followed by enhanced advertisement of genetic education resources specifically rotations in the genetics department (22%). Other suggestions include the integration of genetic education in inpatient learning (20%) and providing research experience (7%).

Conclusion

Primary care residents were satisfied with their genetic knowledge in the classroom and stated a clear need for enhanced hands-on clinical skills and research experience in their current residency training. The survey suggestions for improvement can enhance primary care residents’ genetic training that can lead to advances in rare disease recognition, precision medicine, and improve access to genetics testing.
Investigation of target sequencing of SARS-CoV-2 and immunogenic GWAS profiling in host cells of COVID-19 in Vietnam
Authors: Hoang Tham H. , Vu Giang M. , Tran Mai H. , Tran Trang T. H. , Le Quang D. , Tran Khanh V. , Nguyen Tue T. , Nguyen Lan T. N. , Tran Thinh H. , Ta Van T. , Vo Nam S.
Published: June 2022

Background

A global pandemic has been declared for coronavirus disease 2019 (COVID-19), which has serious impacts on human health and healthcare systems in the affected areas, including Vietnam. None of the previous studies have a framework to provide summary statistics of the virus variants and assess the severity associated with virus proteins and host cells in COVID-19 patients in Vietnam.

Method

In this paper, we comprehensively investigated SARS-CoV-2 variants and immune responses in COVID-19 patients. We provided summary statistics of target sequences of SARS-CoV-2 in Vietnam and other countries for data scientists to use in downstream analysis for therapeutic targets. For host cells, we proposed a predictive model of the severity of COVID-19 based on public datasets of hospitalization status in Vietnam, incorporating a polygenic risk score. This score uses immunogenic SNP biomarkers as indicators of COVID-19 severity.

Result

We identified that the Delta variant of SARS-CoV-2 is most prevalent in southern areas of Vietnam and it is different from other areas in the world using various data sources. Our predictive models of COVID-19 severity had high accuracy (Random Forest AUC = 0.81, Elastic Net AUC = 0.7, and SVM AUC = 0.69) and showed that the use of polygenic risk scores increased the models’ predictive capabilities.

Conclusion

We provided a comprehensive analysis for COVID-19 severity in Vietnam. This investigation is not only helpful for COVID-19 treatment in therapeutic target studies, but also could influence further research on the disease progression and personalized clinical outcomes.
Postoperative complications after gastrointestinal pediatric surgical procedures: outcomes and socio-demographic risk factors
Authors: Brock Robert , Chu Angel , Lu Shengjie , Brindle Mary Elizabeth , Somayaji Ranjani
Published: June 2022

Background

Several socio-demographic characteristics are associated with complications following certain pediatric surgical procedures. In this comprehensive study, we sought to determine socio-demographic risk factors and resource utilization of children with complications after common pediatric surgical procedures.

Methods

We performed a population-based cohort study utilizing the 2016 Healthcare Cost and Use Project Kids’ Inpatient Database (KID) to identify and characterize pediatric patients (age 0–21 years) in the United States with common inpatient pediatric gastrointestinal surgical procedures: appendectomy, cholecystectomy, colonic resection, pyloromyotomy and small bowel resection. Multivariable logistic regression modeling was used to identify socio-demographic predictors of postoperative complications. Length of stay and hospitalization costs for patients with and without postoperative complications were compared.

Results

A total of 66,157 pediatric surgical hospitalizations were identified. Of these patients, 2,009 had postoperative complications. Male sex, young age, African American and Native American race and treatment in a rural hospital were associated with significantly greater odds of postoperative complications. Mean length of stay was 4.58 days greater and mean total costs were $11,151 (US dollars) higher in the complication cohort compared with patients without complications.

Conclusions

Postoperative complications following inpatient pediatric gastrointestinal surgery were linked to elevated healthcare-related expenditure. The identified socio-demographic risk factors should be considered in the risk stratification before pediatric surgical procedures. Targeted interventions are required to reduce preventable complications and surgical disparities.
Novel copy number variations within SYCE1 caused meiotic arrest and non-obstructive azoospermia
Authors: Huang Yuhua , Tian Ruhui , Xu Junwei , Ji Zhiyong , Zhang Yuxiang , Zhao Liangyu , Yang Chao , Li Peng , Zhi Erlei , Bai Haowei , Han Sha , Luo Jiaqiang , Zhao Jingpeng , Zhang Jing , Zhou Zhi , Li Zheng , Yao Chencheng
Published: June 2022

Background

Non-obstructive azoospermia (NOA) is the most severe disease in male infertility, but the genetic causes for majority of NOA remain unknown.

Methods

Two Chinese NOA-affected patients were recruited to identify the genetic causal factor of infertility. Whole-exome sequencing (WES) was conducted in the two patients with NOA. Sanger sequencing and CNV array were used to ascertain the WES results. Hematoxylin and eosin (H&E) staining and immunofluorescence (IF) were carried out to evaluate the stage of spermatogenesis arrested in the affected cases.

Results

Novel heterozygous deletion (LOH) within SYCE1 (seq[GRCh37] del(10)(10q26.3)chr10:g.135111754_135427143del) and heterozygous loss of function (LoF) variant in SYCE1 (NM_001143763: c.689_690 del:p.F230fs) were identified in one NOA-affected patient. While homozygous deletion within SYCE1 (seq[GRCh37] del(10)(10q26.3)chr10:g.135340247_135379115del) was detected in the other patient with meiotic arrest. H&E and IF staining demonstrated that the spermatogenesis was arrested at pachytene stage in the two patients with NOA, suggesting these two novel CNVs within SYCE1 could lead to meiotic defect and NOA.

Conclusions

We identified that two novel CNVs within SYCE1 are associated with meiotic arrest and male infertility. Thus, our study expands the knowledge of variants in SYCE1 and provides a new insight to understand the genetic etiologies of NOA.
Metabolomics of bronchoalveolar lavage in children with persistent wheezing
Authors: Liang Lingfang , Hu Minfei , Chen Yuanling , Liu Lingke , Wu Lei , Hang Chengcheng , Luo Xiaofei , Xu Xuefeng
Published: June 2022

Background

Recent studies have demonstrated the important role of metabolomics in the pathogenesis of asthma. However, the role of lung metabolomics in childhood persistent wheezing (PW) or wheezing recurrence remains poorly understood.

Methods

In this prospective observational study, we performed a liquid chromatography/mass spectrometry-based metabolomic survey on bronchoalveolar lavage samples collected from 30 children with PW and 30 age-matched infants (control group). A 2-year follow-up study on these PW children was conducted.

Results

Children with PW showed a distinct characterization of respiratory metabolome compared with control group. Children with PW had higher abundances of choline, oleamide, nepetalactam, butyrylcarnitine, l-palmitoylcarnitine, palmitoylethanolamide, and various phosphatidylcholines. The glycerophospholipid metabolism pathway was the most relevant pathway involving in PW pathophysiologic process. Additionally, different gender, prematurity, and systemic corticoids use demonstrated a greater impact in airway metabolite compositions. Furthermore, for PW children with recurrence during the follow-up period, children who were born prematurely had an increased abundance of butyrylcarnitine relative to those who were carried to term.

Conclusions

This study suggests that the alterations of lung metabolites could be associated with the development of wheezing, and this early alteration could also be correlated with wheezing recurrence later in life.
Overexpressed VDAC1 in breast cancer as a novel prognostic biomarker and correlates with immune infiltrates
Authors: Fang Yutong , Liu Junpeng , Zhang Qunchen , She Chuanghong , Zheng Rongji , Zhang Rendong , Chen Zexiao , Chen Chunfa , Wu Jundong
Published: June 2022

Background

More and more evidence suggests that cancer is a mitochondrial metabolic disease recently and mitochondria dysfunction is critical to tumorigenesis. As a gatekeeper of mitochondria, the voltage-dependent anion channel 1 (VDAC1) is associated with the development of breast cancer (BC). However, its potential mechanism and clinical significance remain unclear; thus, in this research, we aimed to explore it.

Methods

VDAC1 expression in BC tissues and normal tissues was obtained from The Cancer Genome Atlas (TCGA) and validated by datasets from the gene expression omnibus (GEO) database. Then, the relationships between VDAC1 expression and clinicopathological features were analyzed. Receiver operating characteristics (ROC) curves were used to identify the diagnostic value of VDAC1. The prognostic value was evaluated by Kaplan-Meier survival curves and Cox regression analysis. VDAC1 with its co-expression genes were subjected to enrichment analysis to explore potential mechanisms in BC and the protein-protein interaction (PPI) network was constructed. At last, the association between VDAC1 expression and infiltration levels of immune cell infiltration by various methods, as well as their corresponding markers, was analyzed. We also analyzed the correction between VDAC1 expression and eight immune checkpoint genes and the tumor immune dysfunction and exclusion (TIDE) scores of each BC sample in TCGA were calculated and the differences between high and low VDAC1 expression groups were analyzed.

Results

VDAC1 expression was remarkably elevated in BC (p < 0.001), and high expression of VDAC1 was associated with the positive expression of ER (p = 0.004), PR (p = 0.033), and HER2 (p = 0.001). ROC analysis suggested that VDAC1 had diagnosed value in BC. The Kaplan-Meier analysis suggested that higher expression of VDAC1 was associated with shorter overall survival (OS), and further Cox regression analysis revealed that VDAC1 was an independent factor of unfavorable prognosis in BC patients. Enrichment analysis of VDAC1 and its co-expression suggested that VDAC1 was related to the regulation of mitochondrial energy metabolism and protein modification, and the HIF-1 singing pathway might be the potential mechanism in BC. Notably, we found that VDAC1 expression was infiltration levels of most types of immune cells, as well as the expression of marker genes of immune cells. The ICGs PDCD1, CTLA4, LAG3, SIGLEC15, and TIGIT were negatively corrected with VDAC1 expression in BC. TIDE scores between the low and high expression groups showed no difference.

Conclusion

Overexpressed VDAC1 in BC could be severed as a novel biomarker for diagnosis and VDAC1 was an independent factor for adverse prognosis prediction. Our study revealed that VDAC1 might inhibit tumor immunity and might be a novel therapeutic target in BC.
Cellular inhibitor of apoptosis 2 (cIAP2) restricts neuroinflammation during experimental autoimmune encephalomyelitis
Authors: Biswas Debolina D. , Martin Rebecca K. , Brown LaShardai N. , Mockenhaupt Karli , Gupta Angela S. , Surace Michael J. , Tharakan Anuj , Yester Jessie W. , Bhardwaj Reetika , Conrad Daniel H. , Kordula Tomasz
Published: June 2022

Background

Immune activation, neuroinflammation, and cell death are the hallmarks of multiple sclerosis (MS), which is an autoimmune demyelinating disease of the central nervous system (CNS). It is well-documented that the cellular inhibitor of apoptosis 2 (cIAP2) is induced by inflammatory stimuli and regulates adaptive and innate immune responses, cell death, and the production of inflammatory mediators. However, the impact of cIAP2 on neuroinflammation associated with MS and disease severity remains unknown.

Methods

We used experimental autoimmune encephalomyelitis (EAE), a widely used mouse model of MS, to assess the effect of cIAP2 deletion on disease outcomes. We performed a detailed analysis on the histological, cellular, and molecular levels. We generated and examined bone-marrow chimeras to identify the cIAP2-deficient cells that are critical to the disease outcomes.

Results

cIAP2−/−mice exhibited increased EAE severity, increased CD4+T cell infiltration, enhanced proinflammatory cytokine/chemokine expression, and augmented demyelination. This phenotype was driven by cIAP2-deficient non-hematopoietic cells. cIAP2 protected oligodendrocytes from cell death during EAE by limiting proliferation and activation of brain microglia. This protective role was likely exerted by cIAP2-mediated inhibition of the non-canonical NLRP3/caspase-8-dependent myeloid cell activation during EAE.

Conclusions

Our findings suggest that cIAP2 is needed to modulate neuroinflammation, cell death, and survival during EAE. Significantly, our data demonstrate the critical role of cIAP2 in limiting the activation of microglia during EAE, which could be explored for developing MS therapeutics in the future.
ALK rearrangement-associated renal cell carcinoma morphologically mimicking mucinous tubular and spindle cell carcinoma: a case report
Authors: Kai Keita , Tobu Shohei , Kido Shinichi , Mikami Shuji , Takeuchi Kengo , Dobashi Akito , Togashi Yuki , Noguchi Mitsuru , Aishima Shinichi
Published: June 2022

Background

Anaplastic lymphoma kinase rearrangement-associated renal cell carcinoma (ALK-RCC) is an extremely rare tumor and ALK-RCC that mimics mucinous tubular and spindle cell carcinoma (MTSCC) has been very reported only in one instance.

Case presentation

A 42-year-old Japanese woman was admitted to our hospital for the treatment of a left renal tumor measuring 5 cm in maximum dimension. She underwent a laparoscopic left nephrectomy. Histologically, the tumor formed tubular or focally papillary structures with a small amount of spindle-shaped tumor cells against the background of prominent extracellular mucin. Although the tumor cells were negative for immunohistochemistry (IHC) of alpha-methylacyl-CoA racemase (AMACR) and lymph node metastasis was presented (these are atypical findings for MTSCC), we initially diagnosed the tumor as MTSCC based on its morphological characteristics with mucin deposition. However, an additional IHC analysis revealed that the tumor cells were diffusely positive for ALK-IHC. In addition, TPM3 exon 8 – ALK exon 20 fusion gene was detected by RNA sequencing. The tumor was thus correctly diagnosed as ALK rearrangement-associated renal cell carcinoma (ALK-RCC).

Conclusions

Since the use of molecular targeted therapy with an ALK inhibitor for ALK-RCC is promising, the correct pathological diagnosis of ALK-RCC is quite important. We strongly recommend that ALK-IHC be routinely performed for renal tumors with negative AMACR staining that mimic MTSCC.