bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocean highways in the Western Mediterranean: Which are the areas with increased exposure to maritime traffic for loggerhead turtles?
Authors: Pasanisi Eugenia , Chimienti Marianna , Blasi Monica Francesca , Maffucci Fulvio , Hochscheid Sandra
Published: September 2022

Many marine megafauna taxa are tied to the sea surface for breathing which makes them vulnerable to vessel collisions. Sea turtles have developed efficient mechanisms to reduce surface time for breathing to a few seconds, but they can extend their surface periods to rest or to rewarm after diving into deep and colder waters. However, knowledge of collision occurrences is limited to data of turtles stranded along the coastline worldwide, whereas events occurring offshore go likely underestimated due to the sinking of carcasses. Here we performed a spatially explicit assessment to identify, for the first time, oceanic areas of higher exposure for sea turtles from maritime traffic in the Tyrrhenian Sea, Western Mediterranean. Satellite-tracking data were used to estimate utilization distributions of loggerhead turtles using Brownian bridge kernel density estimation. Maritime traffic density maps based on Automatic Identification System (AIS) data were extracted from open-access data layers, provided by the European Maritime Safety Agency, summarized, and used for the exposure analysis. Turtle occurrences were also investigated in response to vessel densities and seasonal patterns by fitting a generalized additive model to the data. Our results demonstrated that loggerhead turtles are potentially exposed to maritime traffic across the entire basin, especially in the easternmost part. The exposure varies among spring/summer and autumn/winter months. Highest turtle occurrences were found in regions primarily subjected to cargo, tanker, and passenger transportation. This study represents the first-ever effort to characterize the exposure of oceanic loggerhead turtles to maritime traffic and highlights oceanic areas of higher exposure where research and conservation efforts should be directed to understand the effective impact of this stressor on the species.
Plasticity of the Anemonia viridis microbiota in response to different levels of combined anthropogenic and environmental stresses
Authors: Palladino Giorgia , Rampelli Simone , Galià-Camps Carles , Scicchitano Daniel , Trapella Giulia , Nanetti Enrico , Angelini Valeria , Cleo Daniela , Turroni Silvia , Corinaldesi Cinzia , Candela Marco
Published: September 2022

Despite their recognized primary importance, marine coastal ecosystems around the globe are currently under threat, being subject to continuous local and global anthropogenic stressors. In this frame, understanding the response of coastal habitat-forming species to multiple stressors and their resilience is fundamental for the sustainable management of coastal ecosystems. In the present study, to provide some glimpses in this direction, we explored the response of theAnemonia viridis-associated microbiota to the combined anthropogenic stressors, which typically affect touristic hotspots at Mediterranean coastal sites. To this aim, two case studies have been carried out, the first in the Riccione coastal site (Italy, Center Mediterranean) and the second at Cap de Creus (Spain, North-western Mediterranean), where theA. viridismicrobiota was assessed under the conditions of both high and low anthropogenic pressure. According to our findings, theA. viridismicrobiota showed a relevant degree of plasticity in response to combined anthropogenic and environmental stressors, with changes that also mirrored variations in the surrounding seawater, thus indicating a close connection with the environment, from which potential symbiotic partners are selected. However, this potentially adaptive process also has a limitation, as observed in the highly anthropogenic impact site of Cap de Creus, whereA. viridis-associated microbiota appeared completely unstructured, as demonstrated by an increased dispersion according to the Anna Karenina principle. This raises the question about the resilience of theA. viridis-associated microbiota under combined climate and anthropogenic threats, as well as of the anthropogenic factors driving the observed dysbiosis changes.
Whitespotted eagle ray (Aetobatus narinari) age and growth in wild (in situ) versus aquarium-housed (ex situ) individuals: Implications for conservation and management
Authors: Boggio-Pasqua Atlantine , Bassos-Hull Kim , Aeberhard William H. , Hoopes Lisa A. , Swider Denise A. , Wilkinson Krystan A. , Dureuil Manuel
Published: September 2022

Elasmobranchs typically display slow growth, late maturity and low fecundity life history characteristics, making them vulnerable to fishing pressures and environmental perturbations. The whitespotted eagle ray (Aetobatus narinari), a large pelagic migratory ray with an endangered status on the IUCN Red List, fits this pattern based on available literature. Historically, age and growth parameters for this ray have been reported through vertebral ageing methods. However, the periodicity of vertebrate band pair formation, which is used for ageing, has not been validated for this species, making ageing accuracy and thus the resulting growth parameters uncertain. In this study, we used both a frequentist and Bayesian method of estimating sex-specific von Bertalanffy growth parameters (DW∞, k) in wild recaptured versus aquarium-housed rays. Additionally, we estimated growth from repeated measurement data collected from aquarium-housed rays, as an alternative approach to obtain growth parameters while allowing for individual variability. Between 2009 and 2020, 589 whitespotted eagle rays were caught, measured, tagged and released along the southwest coast of Florida. Of these rays, 34 were recaptured between 5–1413 days at liberty. Nineteen additional rays were collected during the same period, transported and maintained at Georgia Aquarium, Atlanta, where they were regularly weighted and measured. Data from Association of Zoos and Aquariums accredited facilities provided prior information on maximum size for the Bayesian estimations, and size at birth, size at maturity, and maximum life span. These data were used to plot and interpret von Bertalanffy growth curves. Wild whitespotted eagle rays were found to grow faster and mature earlier than previously thought, with Bayesian estimates of k = 0.28 year-1 in females, and k = 0.30 year-1 in males. Aquarium-housed individuals seemed to grow slower and reach smaller sizes, although data provided by the aquariums showed variable growth patterns depending on the facility. Longevity was estimated at 14-15 years in wild rays while maximum lifespan observed in aquariums was 19-20+ years. Life history parameters and growth trajectories generated from this study offer valuable information to aid with future conservation management strategies of this endangered species.
Climate warming-driven changes in the flux of dissolved organic matter and its effects on bacterial communities in the Arctic Ocean: A review
Authors: Nguyen Hien Thi , Lee Yung Mi , Hong Jong Kuk , Hong Seongjin , Chen Meilian , Hur Jin
Published: September 2022

The warming of the Arctic Ocean impacts the dissolved organic matter (DOM) imports into the Arctic region, which affects the local bacterial communities. This review addressed the current status of DOM inputs and their potential influences on bacteria data (e.g., population, production, and metabolic activity of bacteria), as well as the projected changes of DOM inputs and bacterial communities as a result of climate warming. Microbial communities are likely affected by the warming climate and the transport of DOM to the Arctic Ocean. Imported DOM can alter Arctic bacterial abundance, cell size, metabolism, and composition. DOM fluxes from Arctic River runoff and adjacent oceans have been enhanced, with warming increasing the contribution of many emerging DOM sources, such as phytoplankton production, melted sea ice, thawed permafrost soil, thawed subsea permafrost, melted glaciers/ice sheets, atmospheric deposition, groundwater discharge, and sediment efflux. Imported DOM contains both allochthonous and autochthonous components; a large quantity of labile DOM comes from emerging sources. As a result, the Arctic sea water DOM composition is transformed to include a wider range of various organic constituents such as carbohydrates (i.e., glucose), proteinaceous compounds (i.e., amino acid and protein-like components) and those with terrigenous origins (i.e., humic-like components). Changes to DOM imports can alter Arctic bacterial abundance, cell size, metabolism, and composition. Under current global warming projections, increased inflow of DOM and more diverse DOM composition would eventually lead to enhanced CO2 emissions and frequent emergence of replacement bacterial communities in the Arctic Ocean. Understanding the changes in DOM fluxes and responses of bacteria in the Arctic broadens our current knowledge of the Arctic Ocean’s responses to global warming.
Effect of Ganoderma lucidum polysaccharides as immunostimulants against Vibrio harveyi in pearl gentian grouper (♀Epinephelus fuscoguttatus × ♂Epinephelus lanceolatus)
Authors: Zhang Yilin , Zhong Jian , Huang Yucong , Jian Jichang , Cai Shuanghu
Published: September 2022

Immunostimulants are becoming one of the most effective models for healthy and sustainable development against vibriosis, which is a serious threat to the global aquaculture industry. This study evaluated the effects of different concentrations ofGanoderma lucidumpolysaccharides (GLPs) on the immunomodulation and disease resistance of pearl gentian groupers. The relative percent survival of the pearl gentian groupers challenged withVibrio harveyiZJ0603 by intraperitoneal injection reached 53.3, 60, 70, and 73.3% in the GLPs2, GLPs4, GLPs6, and GLPs8 groups, respectively, which are significantly higher than that of 33.3% in the control group. Meanwhile, the expression levels of immune-relative genes, includingIgM,MHC-Iα,MHC2,IL-1β, andTNF-α, were upregulated in the liver, spleen, head kidney, and thymus within 28 days after GLP injection. The total serum protein and the activities of catalase, superoxide dismutase, and lysozymes in serum were significantly upregulated in all GLP groups compared with those in the control. Moreover, the optimal immunity effect was observed with an injection of GLPs at concentrations of 6 or 8 mg/ml. The results demonstrate that GLPs were an effective immunostimulant, enhancing both specific and non-specific immunity as well as disease resistance in pearl gentian grouper.
Assessing the coral microbiome at the scale of tissue-specific habitats within the coral meta-organism
Authors: Bergman Jessica L. , Shaw Tayla , Egan Suhelen , Ainsworth Tracy D.
Published: September 2022

As sequencing techniques have advanced and become cheaper in recent years, there has been a rapid increase in the number of studies conducted into the role of the microbiome in coral health, physiology, and response to environmental change. However, there is substantial variation in the methodological approaches applied. For example, DNA extraction protocols and the types of tissues sampled from the coral meta-organism are known to influence the downstream analyses of the amplified microbial communities and subsequently the interpretation of the microbiome diversity, stability and role. Studies have generally focused on whole organisms, in which the coral sampling steps homogenize the meta-organism microhabitats, however other studies targeting specific microhabitats have identified sources of variation specific to distinct compartments of the coral’s microbial landscape. Here we present a comparative analysis of methodologies optimized for the generation of coral microbiome data from the coral tissues and whole coral fragments of two commonly studied branching coral genera with distinct tissue structure. We investigate the microbiome of the imperforate Pocillopora, where the coral tissue does not penetrate through the calcium carbonate matrix, and the perforate Acropora, where the coral tissues and skeleton are interwoven throughout the coral branch. Through comparing data generated from different DNA extraction protocols using fixed coral tissues isolated from the coral skeletal structure with fixed whole coral fragments, we identify sources of variation inherent to microbial data generated from different sample types, species, and extraction protocols.
Winter condition, physiology, and growth potential of juvenile Antarctic krill
Authors: Bernard Kim S. , Steinke Kirsten B. , Fontana Julia M.
Published: September 2022

In recent years, substantial efforts have been made to understand the implications of climate change on Antarctic krill, Euphausia superba, because of their pivotal role in the Southern Ocean food web and in biogeochemical cycling. Winter is one of the least studied seasons in Antarctica and we have limited understanding about the strategies Antarctic krill use to survive the winter. In particular, data on the winter physiology and condition of juvenile Antarctic krill are severely lacking. From May to September (the austral autumn-winter) of 2019, we maintained juvenile Antarctic krill in large (1,330 L) aquarium tanks at Palmer Station, Antarctica and, at monthly time intervals, measured their physiology and condition. Each tank served as a “food environment scenario”, representing possible food environments the krill may encounter during winter along the Western Antarctic Peninsula. We found that, unlike adults, juvenile krill maintain relatively high respiration rates through the winter and respond positively to increased food concentrations by increasing their ingestion rates. Unlike larval krill, juveniles use lipid stores accumulated during the summer and autumn to sustain themselves through periods of starvation in the winter. We used our empirically derived measurements of physiology and condition to estimate the energy budget and growth potential of juvenile krill during the winter. We found that, given their comparatively high respiration rates, small juvenile krill (20 mg dry weight) would need to encounter food at concentrations of ~ 0.15 mg C L-1 daily to avoid loss of body carbon. Without sufficient lipid reserves, this value increases to ~ 0.54 mg C L-1, daily. The health of juvenile krill in the wintertime is dependent on their ability to accumulate lipid stores in the summer and autumn and to find sufficient food during the winter. Changes in food availability to Antarctic krill throughout the year may become problematic to juvenile krill in the future. Understanding the variability in the winter energy budget of juvenile Antarctic krill will allow us to improve population models that make assumptions on seasonal growth patterns.
Creep characteristics of muddy submarine channel slope instability
Authors: Zhang Cunyong , Hou Jiankang
Published: September 2022

Creep is an important factor of muddy submarine channel slope instability. In this study, a sub-bottom profiler was used to monitor the continuous internal change of a muddy submarine channel slope in the laboratory to better understand the creep characteristics and mechanism of slope instability. The creep process was analyzed according to changes in the slope internal sound intensity. The results indicate a notable change of the creep characteristics during the slope instability process. Changes in the sound intensity time series decrease with increasing slope depth, and the fluctuation depth of the vertical sound intensity series varies during the slope creep process. The creep process of slope instability can be roughly divided into four stages based on the sub-bottom profile data: an expansion stage; an unstable expansion stage; a fracture stage; and a post-fracture development stage. An adjustment of the sediment microstructure in the slope is ascribed to slope creep deformation. This study highlights the prospects of high-resolution acoustic monitoring to detect and quantify the entire creep process of muddy submarine channel slope instability, which is of great significance for the evaluation and early warning prediction of channel slope instability.
Deterioration laws of concrete durability under the coupling action of salt erosion and drying–wetting cycles
Authors: Chen Shaojie , Ren Jianxi , Ren Xiang , Li Yugen
Published: September 2022

To investigate the deterioration laws of concrete durability under the coupling action of salt erosion and drying–wetting cycles, this study evaluated the macro–performance evolution of concrete under different environments (NaCl, Na2SO4, and MgSO4). Several measuring methods including nuclear magnetic resonance, computerized tomography tests, and microscopic morphology analysis are employed to investigate the damage mechanism of concrete. Experimental results show that with the action of salt erosion and drying–wetting cycles, the mass loss rate of concrete decreased first and then increased, and the relative dynamic modulus of elasticity and the compressive strength increased first and then decreased. The porosity and the pore quantity fluctuation increased. During the whole erosion process, needle-like attack products were formed in the pores, the crystals gradually filled the pores, and generated expansion pressure on the pore wall. As a result, concrete damage gradually occurred. Consequently, the damage degree was greater. The degrees of concrete damage under drying–wetting cycles induced were arranged as MgSO4>Na2SO4>NaCl.
Outcomes of patients with acute respiratory failure on veno-venous extracorporeal membrane oxygenation requiring additional circulatory support by veno-venoarterial extracorporeal membrane oxygenation
Authors: Erlebach Rolf , Wild Lennart C. , Seeliger Benjamin , Rath Ann-Kathrin , Andermatt Rea , Hofmaenner Daniel A. , Schewe Jens-Christian , Ganter Christoph C. , Müller Mattia , Putensen Christian , Natanov Ruslan , Kühn Christian , Bauersachs Johann , Welte Tobias , Hoeper Marius M. , Wendel-Garcia Pedro D. , David Sascha , Bode Christian , Stahl Klaus
Published: September 2022

Objective

Veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) is increasingly used to support patients with severe acute respiratory distress syndrome (ARDS). In case of additional cardio-circulatory failure, some experienced centers upgrade the V-V ECMO with an additional arterial return cannula (termed V-VA ECMO). Here we analyzed short- and long-term outcome together with potential predictors of mortality.

Design

Multicenter, retrospective analysis between January 2008 and September 2021.

Setting

Three tertiary care ECMO centers in Germany (Hannover, Bonn) and Switzerland (Zurich).

Patients

Seventy-three V-V ECMO patients with ARDS and additional acute cardio-circulatory deterioration required an upgrade to V-VA ECMO were included in this study.

Measurements and main results

Fifty-three patients required an upgrade from V-V to V-VA and 20 patients were directly triple cannulated. Median (Interquartile Range) age was 49 (28–57) years and SOFA score was 14 (12–17) at V-VA ECMO upgrade. Vasoactive-inotropic score decreased from 53 (12–123) at V-VA ECMO upgrade to 9 (3–37) after 24 h of V-VA ECMO support. Weaning from V-VA and V-V ECMO was successful in 47 (64%) and 40 (55%) patients, respectively. Duration of ECMO support was 12 (6–22) days and ICU length of stay was 32 (16–46) days. Overall ICU mortality was 48% and hospital mortality 51%. Two additional patients died after hospital discharge while the remaining patients survived up to two years (with six patients being lost to follow-up). The vast majority of patients was free from higher degree persistent organ dysfunction at follow-up. A SOFA score > 14 and higher lactate concentrations at the day of V-VA upgrade were independent predictors of mortality in the multivariate regression analysis.

Conclusion

In this analysis, the use of V-VA ECMO in patients with ARDS and concomitant cardiocirculatory failure was associated with a hospital survival of about 50%, and most of these patients survived up to 2 years. A SOFA score > 14 and elevated lactate levels at the day of V-VA upgrade predict unfavorable outcome.
Cholecystectomy promotes the development of colorectal cancer by the alternation of bile acid metabolism and the gut microbiota
Authors: Jiang Xi , Jiang Zhongxiu , Cheng Qi , Sun Wei , Jiang Min , Sun Yan
Published: September 2022

The incidence and mortality of colorectal cancer (CRC) have been markedly increasing worldwide, causing a tremendous burden to the healthcare system. Therefore, it is crucial to investigate the risk factors and pathogenesis of CRC. Cholecystectomy is a gold standard procedure for treating symptomatic cholelithiasis and gallstone diseases. The rhythm of bile acids entering the intestine is altered after cholecystectomy, which leads to metabolic disorders. Nonetheless, emerging evidence suggests that cholecystectomy might be associated with the development of CRC. It has been reported that alterations in bile acid metabolism and gut microbiota are the two main reasons. However, the potential mechanisms still need to be elucidated. In this review, we mainly discussed how bile acid metabolism, gut microbiota, and the interaction between the two factors influence the development of CRC. Subsequently, we summarized the underlying mechanisms of the alterations in bile acid metabolism after cholecystectomy including cellular level, molecular level, and signaling pathways. The potential mechanisms of the alterations on gut microbiota contain an imbalance of bile acid metabolism, cellular immune abnormality, acid-base imbalance, activation of cancer-related pathways, and induction of toxin, inflammation, and oxidative stress.
Can next-generation humanized mice that reconstituted with both functional human immune system and hepatocytes model the progression of viral hepatitis to hepatocarcinogenesis?
Authors: Guo Jinglong , Wang Siyue , Gao Qi
Published: September 2022

Hepatitis B virus (HBV) and Hepatitis C virus (HCV) chronic infections cause liver immunopathological diseases such as hepatitis, fibrosis, cirrhosis, and hepatocellular carcinomas, which are difficult to treat and continue to be major health problems globally. Due to the species-specific hepato-tropism of HBV and HCV, conventional rodent models are limited in their utility for studying the infection and associated liver immunopathogenesis. Humanized mice reconstituted with both functional human immune system and hepatocytes (HIS-HuHEP mice) have been extremely instrumental forin vivostudies of HBV or HCV infection and human-specific aspects of the progression of liver immunopathogenesis. However, none of the current HIS-HuHEP mice can model the progression of viral hepatitis to hepatocarcinogenesis which may be a notorious result of HBV or HCV chronic infection in patients, suggesting that they were functionally compromised and that there is still significant space to improve and establish next-generation of HIS-HuHEP mice with more sophisticated functions. In this review, we first summarize the principal requirements to establish HIS-HuHEP mice. We then discuss the respective protocols for current HIS-HuHEP mice and their applications, as well as their advantages and disadvantages. We also raise perspectives for further improving and establishing next-generation HIS-HuHEP mice.
Ocular manifestations of recent viral pandemics: A literature review
Authors: Taha Mohammad J. J. , Abuawwad Mohammad T. , Alrubasy Warda A. , Sameer Shams Khalid , Alsafi Taleb , Al-Bustanji Yaqeen , Abu-Ismail Luai , Nashwan Abdulqadir J.
Published: September 2022

Viral pandemics often take the world by storm, urging the medical community to prioritize the most evident systemic manifestations, often causing ocular manifestations to go unnoticed. This literature review highlights the ocular complications of the Monkeypox, SARS-CoV-2, MERS, Ebola, H1N1, and Zika viruses as the most recent viral pandemics. Research into the effects of these pandemics began immediately. Moreover, it also discusses the ocular complications of the vaccines and treatments that were used in the scope of the viral pandemics. Additionally, this review discusses the role of the eye as an important route of viral transmission, and thereafter, the International recommendations to reduce the incidence of viral transmission were mentioned. Lastly, this paper wants to lay out a platform for researchers who want to learn more about how viruses show up in the eye.
Kimura disease, a rare cause of inguinal lymphadenopathy: A case report
Authors: Hu Xianwen , Li Xue , Yang Changwei , Li Dandan , Cai Jiong , Wang Pan
Published: September 2022

Kimura’s disease (KD) is a rare chronic granulomatous disease of unknown etiology that mainly involves damage to lymph nodes, soft tissues, and salivary glands. The clinical symptoms are mainly painless subcutaneous soft tissue masses, often involving head and neck lymph nodes and salivary glands, and are mainly characterized by diffuse eosinophilic infiltration, lymphocyte, and vascular proliferation. There are few reports in the literature that KD affects only inguinal lymph nodes. We report in this study a 41-year-old male patient who presented to the hospital for medical help with soft tissue masses in the groin. Magnetic resonance imaging (MRI) showed multiple abnormal soft tissue nodules around the iliac vessels in the left groin, and a contrast-enhanced scan showed obvious homogeneous enhancement. Diffusion-weighted imaging showed limited movement of water molecules and showed an obvious high signal. Fluoro18-labeled deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) was recommended for further evaluation of the patient’s general condition, and the results showed that except for the radioactive uptake in the lesions in the left groin region, no obvious abnormality was found in the rest of the body. Based on these imaging findings, the patient was first suspected to have malignant lesions, and then the patient underwent histopathological examination, which was confirmed to be KD. Our case study suggests that KD affects only the inguinal lymph nodes is rare and should be considered as one of the imaging differential diagnoses for lymphadenopathy such as lymphoma, metastases, and Castleman’s disease.
Parents' Perceptions and Intention to Vaccinate Their Children Against COVID-19: Results From a Cross-Sectional National Survey in India
Authors: Padhi Bijaya Kumar , Satapathy Prakasini , Rajagopal Vineeth , Rustagi Neeti , Vij Jatina , Jain Lovely , Chakrapani Venkatesan , Patro Binod Kumar , Kar Sitanshu Sekhar , Singh Ritesh , Pala Star , Sankhe Lalit , Modi Bhavesh , Bali Surya , Kiran Tanvi , Goel Kapil , Aggarwal Arun Kumar , Gupta Madhu
Published: September 2022

Background

Despite the success of adult vaccination against COVID-19, providing vaccines to children remains a challenge for policymakers globally. As parents are primary decision-makers for their children, we aimed to assess parents' perceptions and intentions regarding COVID-19 vaccination in India.

Methods

A cross-sectional web-based study was designed, parents or caregivers (N = 770) were recruited through snowball sampling using Google form. Cross-tabulation was performed by parents' intention to vaccinate their children against COVID-19 virus with sociodemographic characteristics and their risk perception toward COVID-19, trust in the healthcare system, and their history of vaccine hesitancy behavior. Multivariable logistic regression analysis was performed to compute the predictors of child vaccination intention among Indian parents.

Results

Seven hundred and seventy parents across the country have completed the survey. Of the 770 participants, 258 (33.5%) have shown intent to vaccinate their children. The stated likelihood of child vaccination was greater among parents who had a bachelor's degree or higher education (aOR: 1.98, 95% CI: 1.15–3.51); as well as among parents who intended to vaccinate themselves (aOR: 2.35, 95% CI: 1.30–4.67). Parental concerns centered around vaccine safety and side effects.

Conclusion

Indian parents reported high knowledge of the COVID-19 virus and were aware of the development of a vaccine. However, about one-third of parents intended to vaccinate their children, and about half of them were not sure whether to vaccinate their children or not against the COVID-19 virus. The study highlighted the need for health promotion strategies that promote vaccine uptake among parents.
High-Intensity Use of Smartphone Can Significantly Increase the Diagnostic Rate and Severity of Dry Eye
Authors: Wang Chunyang , Yuan Kelan , Mou Yujie , Wu Yaying , Wang Xin , Hu Renjian , Min Jinjin , Huang Xiaodan , Jin Xiuming
Published: September 2022

Purpose

To investigate the effects of high-intensity use of smartphones on ocular surface homeostasis and to explore whether high-intensity use of handheld digital devices can cause false increase of dry eye diagnostic rate.

Methods

In this prospective self-control study, 60 subjects (120 eyes) were recruited and asked to read on smartphones provided by the same manufacturer for two consecutive hours. This study was conducted during 8:00 – 10:00 AM to eliminate the influence of digital equipment used the previous day. Ophthalmological examinations [non-invasive tear breakup time (NIBUT), fluorescein breakup time (FBUT), Schirmer I test, corneal fluorescein staining (CFS), bulbar conjunctival redness and meibomian gland (MG) assessment] and a questionnaire survey were conducted before and after the reading test. Based on the collected data, the changes in ocular surface damage and subjective symptoms of the subjects were evaluated, and the differences in the diagnostic rate of dry eye before and after high-intensity use of smartphones were compared.

Results

The diagnostic rate of dry eye was sharply increased (61.7% vs. 74.2%). The severity of dry eye also changed significantly, and the moderate and severe degree increased after reading (10% vs. 15%; 5% vs. 10.8%). The aggravated severity subjects had lower MG expressibility and more evident bulbar conjunctival redness compared to the non-aggravated severity subjects. After 2 h of continuous reading, NIBUT-First, NIBUT-Average and FBUT-Average were significantly decreased, while the proportion of BUT ≤ 5 s increased significantly. Non-invasive keratograph tear meniscus height(NIKTMH) decreased significantly compared to the baseline level, while the proportion of NIKTMH<0.20 mm increased significantly. No significant difference was observed in the Schirmer I test and CFS score between the two groups. Compared to the baseline, evident aggravation was observed in bulbar conjunctival redness. The Ocular Surface Disease Index (OSDI) was significantly higher than the baseline after the reading test.

Conclusion

Diagnostic indicators related to dry eye are rapidly deteriorating after high-intensity smartphone use, especially those with lower MG expressibility and ocular redness. High-intensity smartphone use can increase the false positive rate of dry eye diagnosis by disturbing ocular surface homeostasis.
Case Report: Rare Systemic and Aggressive ALK-Positive Histiocytosis With Recurrent Pancreatitis Treating by Alectinib
Authors: Li Yanchu , Shi Changle , Wu Yu , He Mingmin , Xia Xueming , Liu Jie , Jiang Yu
Published: September 2022

ALK-positive histiocytosis (APH) is a rare and recently described, solitary or generalized, histiocytic proliferative disorder with a characteristic gene translocation involving the fusion of the ALK gene at chromosome 2p23. To date, only 25 cases of APH have been reported. The patient presented with multiple nodules in the lung, liver, gallbladder, pancreas, kidney, and skin rashes, along with recurrent pancreatitis and cholecystitis. The histiocytes from the lesion were positive for CD68 and ALK and negative for S100 and CD1α. A reduced dose of the ALK inhibitor alectinib was administered rather than the standard dose of alectinib or chemotherapy because of recurrent pancreatitis, which has not been previously reported in APH cases. After 18 months of follow-up, the patient was maintained on alectinib, and a partial response (PR) was achieved.
The Apparent Asymmetrical Relationship Between Small Bowel Bacterial Overgrowth, Endotoxemia, and Liver Steatosis and Fibrosis in Cirrhotic and Non-Cirrhotic Patients: A Single-Center Pilot Study
Authors: Scarpellini E. , Abenavoli L. , Cassano V. , Rinninella E. , Sorge M. , Capretti F. , Rasetti C. , Svegliati Baroni G. , Luzza F. , Santori P. , Sciacqua A.
Published: September 2022

Introduction

Gut microbiota are a complex ecosystem harboring our intestine. They maintain human body equilibrium, while their derangement, namely, “dysbiosis“, has been associated with several gastrointestinal diseases, such as liver steatosis (NAFLD) and liver cirrhosis. Small intestinal bacterial overgrowth (SIBO) is an example of dysbiosis of the upper gastrointestinal (GI) tract.

Aim

The aim of this study is to evaluate the relationship between SIBO and levels of endotoxemia and grade of liver steatosis (LS) and liver fibrosis (LF) in hepatologic patients.

Materials and Methods

Consecutive outpatients referred to our hepatology clinic were tested for SIBO by the lactulose breath test (LBT) and peripheral blood levels of endotoxemia; LS grading and LF were assessed by abdominal ultrasound and transient elastography, respectively.

Results

Fifty-two consecutive patients (17 with alcohol abuse (4.5 ± 0.8 alcohol units per day), 4 with HCV and 2 with HBV infection, 24 of metabolic origin, 2 of autoimmune origin, and 3 with cholangiopathies; mean age 54.7 ± 8.3 years, 31 F, BMI 24.1 ± 1.1 Kg/m2) and 14 healthy volunteers (HV) (mean age 50.1 ± 4.3 years, 9 F, BMI 23.3 ± 1.1 Kg/m2) were enrolled. SIBO prevalence was significantly higher in cirrhotic (LC) vs. non-cirrhotic (LNC) patients and vs. HV (all, p < 0.05), with a significant positive trend according to Child-Pugh status (all, p < 0.05). SIBO prevalence was not correlated with LS stages (all, p = NS). Consensually, endotoxin levels were significantly higher in LC vs. LNC and vs. HV (all, p < 0.05) and significantly correlated with LF in patients with LC, according to Child-Pugh status (all, p < 0.05).

Conclusion

This study shows that SIBO prevalence and relative endotoxin blood levels seem to be significantly associated with the grade of LF vs. LS in LC. SIBO is also present under pre-cirrhotic conditions, but its prevalence seems to correlate with liver disease irreversible derangement.
The Optimal Dose of Intraoperative Dexmedetomidine for Antiemetic Effects of Post-operative Nausea and Vomiting in Patients Undergoing Elective Thoracic Surgery: A Retrospective Cohort Study
Authors: Li Bing , Zhao Ying , Liu Xinmin , Liu Yao , Zhang Jiaqiang , Zhang Wei
Published: September 2022

Background

Dexmedetomidine (DEX) administration decreases post-operative nausea and vomiting (PONV), but it is a lack of large-scale retrospective cohort study and is unclear whether there is a dose-relationship and optimal dose for antiemetic effects between DEX and PONV. We performed a large-scale retrospective cohort study to explore the optimal dose of intraoperative DEX for antiemetic effects of PONV.

Methods

A total of 5,310 patients aged ≥18 who underwent elective thoracic surgery from January 2016 to March 2020 under total intravenous anesthesia (TIVA) or combined intravenous and inhalation anesthesia in Henan Provincial People's Hospital. Patients were divided into two groups, those who received DEX intraoperatively and those who did not receive DEX. Patients who received DEX after surgery were excluded. Our primary outcomes were the association, the dose-response relationship, and the optimal dose for antiemetic effects between intraoperative DEX and PONV.

Results

Among the 3,878 patients enrolled, 2,553 patients received DEX and 1,325 patients did not receive DEX. The incidence of PONV in patients who received DEX was 21.3%, and the incidence of PONV in patients who did not receive DEX was 46.5% (P = 0.001). After the matched-pairs cohort consisted of 1,325 patients, the incidence of PONV in patients who received DEX was 23.6%, and the incidence of PONV in patients who did not receive DEX was 46.5% (P = 0.001). We analyzed three different models after propensity matching to validate the stability of the prediction model between intraoperative DEX and PONV. A dose-response relationship between intraoperative DEX and PONV was observed. The optimal dose range of intraoperative DEX for antiemetic effects of PONV is 50–100 μg in elective thoracic surgery.

Conclusions

Intraoperative DEX was associated with a decreased incidence of PONV in the large-scale retrospective cohort study. A dose-response relationship between intraoperative DEX and PONV was observed. The optimal dose range of intraoperative DEX for antiemetic effects of PONV is 50–100 μg in elective thoracic surgery.
Outcome-based reimbursement in Central-Eastern Europe and Middle-East
Authors: Ádám Ildikó , Callenbach Marcelien , Németh Bertalan , Vreman Rick A. , Tollin Cecilia , Pontén Johan , Dawoud Dalia , Elvidge Jamie , Crabb Nick , van Waalwijk van Doorn-Khosrovani Sahar Barjesteh , Pisters-van Roy Anke , Vincziczki Áron , Almomani Emad , Vajagic Maja , Oner Z. Gulsen , Matni Mirna , Fürst Jurij , Kahveci Rabia , Goettsch Wim G. , Kaló Zoltán
Published: September 2022

Outcome-based reimbursement models can effectively reduce the financial risk to health care payers in cases when there is important uncertainty or heterogeneity regarding the clinical value of health technologies. Still, health care payers in lower income countries rely mainly on financial based agreements to manage uncertainties associated with new therapies. We performed a survey, an exploratory literature review and an iterative brainstorming in parallel about potential barriers and solutions to outcome-based agreements in Central and Eastern Europe (CEE) and in the Middle East (ME). A draft list of recommendations deriving from these steps was validated in a follow-up workshop with payer experts from these regions. 20 different barriers were identified in five groups, including transaction costs and administrative burden, measurement issues, information technology and data infrastructure, governance, and perverse policy outcomes. Though implementing outcome-based reimbursement models is challenging, especially in lower income countries, those challenges can be mitigated by conducting pilot agreements and preparing for predictable barriers. Our guidance paper provides an initial step in this process. The generalizability of our recommendations can be improved by monitoring experiences from pilot reimbursement models in CEE and ME countries and continuing the multistakeholder dialogue at national levels.
The Thai version of the nursing delirium screening scale-Thai: Adaptation and validation study in postoperative patients
Authors: Somnuke Pawit , Limprapassorn Peleen , Srinonprasert Varalak , Wongviriyawong Titima , Suraarunsumrit Patumporn , Morkphrom Ekkaphop , Sura-amonrattana Unchana , Phannarus Harisd , Choorerk Duangcheewan , Radtke Finn M. , Chaiwat Onuma
Published: September 2022

Background

The Nursing Delirium Screening Scale (Nu-DESC) is an effective instrument for assessing postoperative delirium (POD). This study translated the Nu-DESC into Thai (“Nu-DESC-Thai”), validated it, and compared its accuracy with the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5).

Methods

The translation process followed the International Society for Pharmacoeconomics Outcome Research guidelines. Recruited participants were ≥ 70 years old, fluent in Thai, and scheduled for surgery. The exclusion criteria were cancellation or postponement of an operation, severe visual or auditory impairment, and patients with a Richmond Agitation Sedation Scale score of –4 or less before delirium assessment. Post-anesthesia care unit (PACU) nurses and residents on wards each used the Nu-DESC to assess delirium in 70 participants (i.e., 140 assessments) after the operation and after patient arrival at wards, respectively. Geriatricians confirmed the diagnoses using video observations and direct patient contact.

Results

The participants’ mean age was 76.5 ± 4.6 years. The sensitivity and specificity of the Nu-DESC-Thai at a threshold of ≥ 2 were 55% (95% CI, 31.5–76.9%) and 90.8% (84.2–95.3%), respectively, with an area under a receiver operating characteristic curve (AUC) of 0.73. At a threshold of ≥ 1, the sensitivity and specificity were 85% (62.1–96.8%) and 71.7% (62.7–79.5%), respectively (AUC, 0.78). Adding 1 point for failing backward-digit counting (30–1) to the Nu-DESC-Thai and screening at a threshold of ≥ 2 increased its sensitivity to 85% (62.1–96.8%) with the same specificity of 90.8% (84.2–95.3%).

Conclusion

The Nu-DESC-Thai showed good validity and reliability for postoperative use. Its sensitivity was inadequate at a cutoff ≥ 2. However, the sensitivity improved when the threshold was ≥ 1 or with the addition of backward counting to Nu-DESC-Thai and screening at a threshold of ≥ 2.
In vivo behavior of [64Cu]NOTA-terpyridine platinum, a novel chemo-radio-theranostic agent for imaging, and therapy of colorectal cancer
Authors: Khosravifarsani Meysam , Ait-Mohand Samia , Paquette Benoit , Sanche Léon , Guérin Brigitte
Published: September 2022

To overcome resistance to chemotherapy for colorectal cancer, we propose to validate in vivo a novel terpyridine-platinum (TP) compound radiolabeled with the radio-theranostic isotope 64Cu. In vivo stability, biodistribution, PET imaging, tumor growth delay, toxicity and dosimetry of [64Cu]NOTA-C3-TP were determined. The current experimental studies show that [64Cu]NOTA-C3-TP is stable in vivo, rapidly eliminated by the kidneys and has a promising tumor uptake ranging from 1.8 ± 0.4 to 3.0 ± 0.2 %ID/g over 48 h. [64Cu]NOTA-C3-TP retarded tumor growth by up to 6 ± 2.0 days and improved survival relative to vehicle and non-radioactive [NatCu]NOTA-C3-TP over 17 days of tumor growth observation. This effect was obtained with only 0.4 nmol i.v. injection of [64Cu]NOTA-C3-TP, which delivers 3.4 ± 0.3 Gy tumoral absorbed dose. No evidence of toxicity, by weight loss or mortality was revealed. These findings confirm the high potential of [64Cu]NOTA-TP as a novel radio-theranostic agent.
Predictive analytical model for ectopic pregnancy diagnosis: Statistics vs. machine learning
Authors: Rueangket Ploywarong , Rittiluechai Kristsanamon , Prayote Akara
Published: September 2022

Objective

Ectopic pregnancy (EP) is well known for its critical maternal outcome. Early detection could make the difference between life and death in pregnancy. Our aim was to make a prompt diagnosis before the rupture occur. Thus, the predictive analytical models using both conventional statistics and machine learning (ML) methods were studied.

Materials and methods

A retrospective cohort study was conducted on 407 pregnancies with unknown location (PULs): 306 PULs for internal validation and 101 PULs for external validation, randomized with a nested cross-validation technique. Using a set of 22 study features based on clinical factors, serum marker and ultrasound findings from electronic medical records, analyzing with neural networks (NNs), decision tree (DT), support vector machines (SVMs), and a statistical logistic regression (LR). Diagnostic performances were compared with the area under the curve (ROC-AUC), including sensitivity and specificity for decisional use.

Results

Comparing model performance (internal validation) to predict EP, LR ranked first, with a mean ROC-AUC ± SD of 0.879 ± 0.010. In testing data (external validation), NNs ranked first, followed closely by LR, SVMs, and DT with average ROC-AUC ± SD of 0.898 ± 0.027, 0.896 ± 0.034, 0.882 ± 0.029, and 0.856 ± 0.033, respectively. For clinical aid, we report sensitivity of mean ± SD in LR: 90.20% ± 3.49%; SVM: 89.79% ± 3.66%; DT: 89.22% ± 4.53%; and NNs: 86.92% ± 3.24%, consecutively. However, specificity ± SD was ranked by NNs, followed by SVMs, LR, and DT, which were 82.02 ± 8.34%, 80.37 ± 5.15%, 79.65% ± 6.01%, and 78.97% ± 4.07%, respectively.

Conclusion

Both statistics and the ML model could achieve satisfactory predictions for EP. In model learning, the highest ranked model was LR, showing that EP prediction might possess linear or causal data pattern. However, in new testing data, NNs could overcome statistics. This highlights the potency of ML in solving complicated problems with various patterns, while overcoming generalization error of data.
An artificial intelligence-enabled smartphone app for real-time pressure injury assessment
Authors: Lau Chun Hon , Yu Ken Hung-On , Yip Tsz Fung , Luk Luke Yik Fung , Wai Abraham Ka Chung , Sit Tin-Yan , Wong Janet Yuen-Ha , Ho Joshua Wing Kei
Published: September 2022

The management of chronic wounds in the elderly such as pressure injury (also known as bedsore or pressure ulcer) is increasingly important in an ageing population. Accurate classification of the stage of pressure injury is important for wound care planning. Nonetheless, the expertise required for staging is often not available in a residential care home setting. Artificial-intelligence (AI)-based computer vision techniques have opened up opportunities to harness the inbuilt camera in modern smartphones to support pressure injury staging by nursing home carers. In this paper, we summarise the recent development of smartphone or tablet-based applications for wound assessment. Furthermore, we present a new smartphone application (app) to perform real-time detection and staging classification of pressure injury wounds using a deep learning-based object detection system, YOLOv4. Based on our validation set of 144 photos, our app obtained an overall prediction accuracy of 63.2%. The per-class prediction specificity is generally high (85.1%–100%), but have variable sensitivity: 73.3% (stage 1 vs. others), 37% (stage 2 vs. others), 76.7 (stage 3 vs. others), 70% (stage 4 vs. others), and 55.6% (unstageable vs. others). Using another independent test set, 8 out of 10 images were predicted correctly by the YOLOv4 model. When deployed in a real-life setting with two different ambient brightness levels with three different Android phone models, the prediction accuracy of the 10 test images ranges from 80 to 90%, which highlight the importance of evaluation of mobile health (mHealth) application in a simulated real-life setting. This study details the development and evaluation process and demonstrates the feasibility of applying such a real-time staging app in wound care management.