bluuebunny/crossref_metadata_2025 huggingface dataset:
ГІСТОЛОГІЧНІ ЗМІНИ НАДНИРКОВИХ ЗАЛОЗ У ПІЗНІ ТЕРМІНИ ПІСЛЯ ЕКСПЕРИМЕНТАЛЬНОЇ ТЕРМІЧНОЇ ТРАВМИ ТА ЗАСТОСУВАННЯ ПОДРІБНЕНОГО СУБСТРАТУ ЛІОФІЛІЗОВАНОЇ КСЕНОШКІРИ
Authors: Кульбіцька В. В. , Небесна З. М. , Шутурма О. Я.
Published: September 2021

Резюме. Термічні травми за поширеністю, ускладненнями та летальністю займають лідируючі позиції серед інших захворювань у світі. Проте морфофункціональні зміни в надниркових залозах у пізні терміни після опікової травми не достатньо вивчені. На сьогодні важливим завданням є пошук ефективних чинників лікування опікових уражень. Одним із сучасних методів є використання ліофілізованої ксеношкіри.

Мета дослідження – встановити структурну реорганізацію компонентів надниркових залоз у пізні терміни після термічної травми та за умов застосування субстрату ліофілізованої ксеношкіри.

Матеріали і методи. Експериментальна термічна травма змодельована на 20 лабораторних білих щурах-самцях. Опік ІІІ ступеня наносили під тіопентал-натрієвим наркозом мідними пластинами, нагрітими у кип’яченій воді до температури 97–100 0С. Розміри ділянки ураження склали 18–20 % поверхні тіла тварин. Мікроскопічне дослідження структурних компонентів надниркових залоз вивчали за допомогою світлового мікроскопа MICROmed SEO SСAN.

Результати. Згідно з проведеними гістологічними дослідженнями надниркових залоз після експериментальної термічної травми за умов застосування субстрату ксеношкіри на 14 добу експерименту виявлено, що в кірковій речовині кількість некротично і деструктивно змінених клітин менша, порівняно із попередніми мікроскопічними дослідженнями надниркових залоз після опіку, які ми провели. Спостерігаються в невеликій кількості деструктивно змінені клітини з ознаками інтра- і перицелюлярного набряку. В мозковій речовині органа встановлені ознаки незначної деструкції хромафіноцитів, для гемокапілярів характерні розширені просвіти та помірне кровонаповнення. Результати гістологічного дослідження надниркових залоз на 21 добу показали, що структурна організація зон кори органа наближена до норми. Набряк стромального компоненту та паренхіми незначний. Виявлялись поодинокі ендокриноцити з ознаками ушкодження. Ендокриноцити мозкової речовини залоз малозмінені. Крововиливів та периваскулярного набряку не спостерігалось, також не виявлялися явища стазу та дистрофічні порушення.

Висновки. У пізні терміни експерименту за умов корекції відбувається відносна нормалізація структурної організації надниркових залоз, що свідчить про активізацію обмінних процесів в організмі.
Microscopic changes in the neurocytes of the cerebellar cortex in dynamics under conditions of experimental thermal injuryc
Authors: Ohinska N.V. , Nebesna Zoya M.
Published: September 2021

Summary. Thermal injury as a stress factor of exogenous origin, in which the development of multiple organ failure and dysfunction of organs and systems of the body occur. The nervous system is one of the first to perceive and respond to pain impulses. It is important to reorganize all the structural components of the microcirculatory tract and neurons as a result of endogenous intoxication, which develops during thermal trauma. The target of lesions is the cerebellum, as a multifunctional organ of the central nervous system. The aim of the study – to establish the microscopic reorganization of neurocytes of the cerebellar cortex in the dynamics under conditions of experimental thermal trauma to the skin. Materials and Methods. The experimental study was performed on 24 adult white male rats weighing 180–200 g. Simulation of third-degree burns was performed with copper plates heated in boiled water to a temperature of 97–100º on the epilated surface of the skin of animal bodies under thiopental sodium. The size of the affected areas was 18–20 % of the body of rats. Collection of material for microscopic examination was performed in accordance with generally accepted methods. Histological sections obtained on a sled microtome 5–6 μm thick were stained with hematoxylin and eosin, toluidine blue by the method of Nissl. Semi-thin sections made on an ultramicrotome LKB-3 were stained with methylene blue. The micropreparations were studied using a MICROmed SEO SCAN light microscope and photo-documented using a Vision CCD Camera with a histological image output system. Results. Microscopic studies have shown an interdependence between the duration of the experiment and abnormalities in the structural components of neurons in all layers of the cerebellar cortex. In the early stages of the experiment there are reactive changes, which are adaptive-compensatory in nature with initial destructive damage. On day 14, and especially after 21 days, polymorphism is observed, significant cell degeneration, manifested by pycnosis of the nuclei, the development of intra- and pericellular edema in neurons of the granular, ganglionic and granular layers of the cerebellar cortex
ДИНАМІКА АКТИВНОСТІ ПРОЦЕСІВ ЛІПІДНОЇ ПЕРОКСИДАЦІЇ У ТКАНИНАХ ТОНКОЇ КИШКИ ЗА УМОВ ІШЕМІЇ-РЕПЕРФУЗІЇ КІНЦІВКИ, ГОСТРОЇ КРОВОВТРАТИ ТА ЇХ КОРЕКЦІЯ
Authors: Стрельбицька В. В. , Гудима А. А. , Походун К. А.
Published: September 2021

Резюме. У структурі сучасного травматизму воєнного і мирного часу значно зросла частка вогнепальних уражень, які часто супроводжуються масивною зовнішньою крововтратою. Накладання за цих умов кровоспинного джгута вважається єдиним способом порятунку на полі бою. Гостра крововтрата та ішемія-реперфузія кінцівки стимулюють активізацію процесів пероксидного окиснення ліпідів (ПОЛ) у внутрішніх органах. Однак порушення вільнорадикальних процесів у стінці тонкої кишки за цих умов вивчені недостатньо.

Мета дослідження – зʼясувати динаміку активності процесів ПОЛ у тканинах тонкої кишки за умов ішемії-реперфузії кінцівки, гострої крововтрати та оцінити ефективність карбацетаму в корекції виявлених порушень.

Матеріали і методи. Експерименти виконано на 108 нелінійних щурах-самцях масою 200–220 г. Усіх тварин поділили на пʼять груп: контрольну та чотири дослідних. Під тіопентал-натрієвим наркозом у першій дослідній групі моделювали ішемію-реперфузію кінцівки, у другій – гостру крововтрату, в третій – ці ушкодження поєднували. У четвертій дослідній групі тваринам із гострою крововтратою та ішемією-реперфузією кінцівки внутрішньочеревно вводили карбацетам в дозі 5 мг на кілограм маси тварини. Через 1 і 2 год, а також через 1; 7 і 14 діб у гомогенаті тонкої кишки визначали вміст дієнових кон’югатів та реагентів до тіобарбітурової кислоти.

Результати. За умов ішемії-реперфузії кінцівки та гострої крововтрати посилюються процеси ліпідної пероксидації у стінці тонкої кишки з максимумом через 1 добу експерименту. За умов моделювання лише ішемії-реперфузії кінцівки вміст первинних і вторинних продуктів ПОЛ до 14 доби експерименту нормалізується, то під впливом крововтрати показник до 14 доби залишався суттєво більшим порівняно з конт­ролем. Поєднання ішемії-реперфузії кінцівки та гострої крововтрати вже з 2 год експерименту супроводжується більшим накопиченням продуктів ПОЛ, які до 14 доби статистично значуще перевищують інші дослідні групи. Карбацетам супроводжується позитивною антиоксидантною дією, який вже при семиденному застосуванні супроводжувався істотним зниженням вмісту первинних і вторинних продуктів ПОЛ у стінці тонкої кишки, що вказує на перспективність цього препарату за умов модельованої патології як засобу зниження проявів поліорганної дисфункції.

Висновки. Моделювання ішемії-реперфузії кінцівки на тлі гострої крововтрати супроводжується сумацією прооксидантного впливу обох патологічних втручань і викликає статистично вірогідно більше зростання вмісту ДК і ТБК-активних продуктів ПОЛ у стінці тонкої кишки, починаючи з 2 год експерименту. Застосування карбацетаму, порівняно з тваринами без корекції, вже через 7 діб реперфузійного періоду викликає істотне зниження активності ПОЛ у стінці тонкої кишки.
ESTIMATION OF TOLERANCE OF A DOMESTIC NON-STEROID ANTI-INFLAMMATORY DRUG IN THE POSTOPERATIVE PERIOD OF EXTRACTION OF CATARACTS
Authors: Bakhritdinova F. , Narzikulova Kumri Islamovna K. I. , Yusupov Sh. A. , Egamberdieva M. E.
Published: September 2021

Summary. The article discusses the efficacy and tolerability of a non-steroidal anti-inflammatory domestic drug after cataract extraction, the severity of side effects of a non-steroidal anti-inflammatory drug.

The aim of the study – optimization of methods of postoperative treatment of cataracts using the domestic non-steroidal anti-inflammatory Diclofenac drug, 0.1 % eye drops, produced by JV “Jurabek Laboratories” LLC.

Materials and Methods. The study included patients who were at inpatient treatment at the Clinic No. 2 of the Tashkent Medical Academy. The study group included 60 people: 21 men and 39 women, the age of patients was 18–73 years. In two groups, we compared the efficacy and tolerability of domestic and foreign NSAIDs after cataract extraction.

Results. The effectiveness of the complex treatment is confirmed by the reduction in the duration of relief of the main symptoms of inflammation in patients of both groups. Both drugs did not cause side effects and were well tolerated by patients. Tolerability of the treatment in the group receiving domestic NSAIDs was 93.4 %, in the group receiving foreign NSAIDs – 95.7 %.

Conclusions. According to the results of our studies, it was proved that therapy after cataract extraction with the use of a domestic-made NSAID is not inferior in efficiency and tolerability to a foreign-made drug and can be used in the postoperative period of cataract.
Causal Associations Between Blood Lipids and COVID-19 Risk: A Two-Sample Mendelian Randomization Study
Authors: Zhang Kun , Dong Shan-Shan , Guo Yan , Tang Shi-Hao , Wu Hao , Yao Shi , Wang Peng-Fei , Zhang Kun , Xue Han-Zhong , Huang Wei , Ding Jian , Yang Tie-Lin
Published: September 2021

Objective:

Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the severe acute respiratory syndrome coronavirus 2. It has been reported that dyslipidemia is correlated with COVID-19, and blood lipids levels, including total cholesterol, HDL-C (high-density lipoprotein cholesterol), and LDL-C (low-density lipoprotein cholesterol) levels, were significantly associated with disease severity. However, the causalities of blood lipids on COVID-19 are not clear.

Approach and Results:

We performed 2-sample Mendelian randomization (MR) analyses to explore the causal effects of blood lipids on COVID-19 susceptibility and severity. Using the outcome data from the UK Biobank (1221 cases and 4117 controls), we observed potential positive causal effects of dyslipidemia (odds ratio [OR], 1.27 [95% CI, 1.08–1.49],
P
=3.18×10
−3
), total cholesterol (OR, 1.19 [95% CI, 1.07–1.32],
P
=8.54×10
−4
), and ApoB (apolipoprotein B; OR, 1.18 [95% CI, 1.07–1.29],
P
=1.01×10
−3
) on COVID-19 susceptibility after Bonferroni correction. In addition, the effects of total cholesterol (OR, 1.01 [95% CI, 1.00–1.02],
P
=2.29×10
−2
) and ApoB (OR, 1.01 [95% CI, 1.00–1.02],
P
=2.22×10
−2
) on COVID-19 susceptibility were also identified using outcome data from the host genetics initiative (14 134 cases and 1 284 876 controls).

Conclusions:

In conclusion, we found that higher total cholesterol and ApoB levels might increase the risk of COVID-19 infection.

Graphic Abstract:

A graphic abstract is available for this article.
Wage Differentials in Malaysia: Public Employment,  Gender,  and Ethnicity
Authors: Clark Robert L. , Ogawa Naohiro , Mansor Norma , Abe Shigeyuki , Mahidin Mohd Uzir
Published: September 2021

The study examines the earnings differentials between the public and private sector in the Malaysian economy in terms of the moderations of the gender and ethnic wage differences in the public sector. The study uses the annual earnings from the Salaries and Wages Survey for 2011 and 2016. The key findings are that public employees are paid higher wages compared with private sector employees and the overall gender and ethnic wage differentials have declined in recent years. We also find that both gender and ethnic wage differentials are much smaller in the public sector.
Revision of the mining bee subgenus Andrena (Longandrena) (Hymenoptera: Apoidea: Andrenidae)
Authors: RADCHENKO VLADIMIR G. , ALLAHVERDI MOHAMMAD , FEKRAT LIDA
Published: September 2021

All three hitherto described species of the Palearctic subgenus Andrena (Longandrena Osytshnjuk, 1993), are revised and redescribed. This subgenus is characterized by an unusually long glossa, a rare character among short-tongued bees. A revised diagnosis of this subgenus is given. A key to the species of A. (Longandrena) is provided, and all diagnostic morphological features are illustrated in detail. The Central Asian species Andrena longiceps Morawitz 1895 is recorded for the first time from Iran. The distribution map of the subgenus is also presented.
Impacts of CP- and EP-El Niño events on the Antarctic sea ice in austral spring
Authors: Zhang Chao , Li Tim , Li Shuanglin
Published: September 2021

Based on observational data analyses and idealized modeling experiments, we investigated the distinctive impacts of central Pacific (CP-) El Niño and eastern Pacific (EP-) El Niño on the Antarctic sea ice concentration (SIC) in austral spring (September to November). The tropical heat sources associated with EP-El Niño and the co-occurred positive phase of Indian Ocean Dipole (IOD) excite two branches of Rossby wave trains that propagate southeastward, causing an anomalous anticyclone over the eastern Ross-Amundsen-Bellingshausen Seas. Anomalous northerly (southerly) wind west (east) of the anomalous anticyclone favor poleward (offshore) movements of sea ice, resulting in a sea ice loss (growth) in the eastern Ross-Amundsen Seas (the Bellingshausen-Weddell Seas). Meanwhile, the anomalous northerly (southerly) wind also advected warmer and wetter (colder and drier) air into the eastern Ross-Amundsen Seas (the Bellingshausen-Weddell Seas), causing surface warming (cooling) through the enhanced (reduced) surface heat fluxes and thus contributing to the sea ice melting (growth). CP-El Niño, however, forces a Rossby wave train that generates an anomalous anticyclone in the eastern Ross-Amundsen Seas, 20° west of that caused by EP-El Niño. Consequently, a positive SIC anomaly occurs in the Bellingshausen Sea. A dry version of the Princeton atmospheric general circulation model was applied to verify the roles of anomalous heating in the tropics. The result showed that EP-El Niño can remotely induce an anomalous anticyclone and associated dipole temperature pattern in the Antarctic region, whereas CP-El Niño generates a similar anticyclone pattern with its location shift westward by 20° in longitudes.
The 20-y spatio-temporal trends of remotely sensed soil moisture and vegetation and their response to climate change over the Third Pole
Authors: Shi Pengfei , Zeng Jiangyuan , Chen Kun-Shan , Ma Hongliang , Bi Haiyun , Cui Chenyang
Published: September 2021

The Tibetan Plateau (TP), known as the “Third Pole”, is a climate-sensitive and ecology-fragile region. In this study, the spatio-temporal trends of soil moisture (SM) and vegetation were analyzed using satellite-based ESA CCI SM and MODIS LAI data respectively in the growing season during the last 20 years (2000-2019) over the TP covering diverse climate zones. The climatic drivers (precipitation and air temperature) of SM and LAI variations were fully investigated by using both ERA5 reanalysis and observation-based gridded data. The results reveal the TP is generally wetting and significantly greening in the last 20 years. The SM with significant increasing trend accounts for 21.80% (fraction of grid cells) of the TP, and is about twice of the SM with significant decreasing trend (10.19%), while more than half of the TP (58.21%) exhibits significant increasing trend of LAI. Though the responses of SM and LAI to climatic factors are spatially heterogeneous, precipitation is the dominant driver of SM variation with 48.36% (ERA5) and 32.51% (observation-based) precipitation data showing the strongest significant positive partial correlation with SM. Temperature rise largely explains the vegetation greening though precipitation also plays an important role in vegetation growth in arid and semi-arid zones. The combined trend of SM and LAI indicates the TP is mainly composed of wetting and greening areas, followed by drying and greening regions. The change rate of SM is negative at low altitudes and becomes positive as altitude increases, while the LAI value and its change rate decrease as altitude increases.
Improved survival of patients with aggressive ATL by increased use of allo-HCT: a prospective observational study
Authors: Ito Ayumu , Nakano Nobuaki , Tanaka Takashi , Fuji Shigeo , Makiyama Junya , Inoue Yoshitaka , Choi Ilseung , Nakamae Hirohisa , Nagafuji Koji , Takase Ken , Machida Shinichiro , Takahashi Tsutomu , Sawayama Yasushi , Kamimura Tomohiko , Kato Koji , Kawakita Toshiro , Ogata Masao , Sakai Rika , Shiratori Souichi , Uchimaru Kaoru , Inamoto Yoshihiro , Utsunomiya Atae , Fukuda Takahiro
Published: September 2021

Aggressive adult T-cell leukemia/lymphoma (ATL) is a hematological malignancy that is difficult to treat with chemotherapy alone, and allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapy. We conducted a multicenter, prospective, observational study to clarify the treatment outcomes of aggressive ATL in the current era. Between 2015 and 2018, 113 patients aged 70 years or younger with newly diagnosed aggressive ATL were enrolled. The median age at diagnosis was 61 years. Treatment outcomes were compared with those of 1792 ATL patients diagnosed between 2000 and 2013 in our previous retrospective study. The inclusion criteria were the same in both studies. The prospective cohort demonstrated better overall survival (OS) than the retrospective cohort (2-year OS, 45% vs 29%, respectively; P < .001), with a much higher proportion of patients receiving allo-HCT (80% vs 34%, respectively; P < .001) and a shorter interval from diagnosis to allo-HCT (median, 128 vs 170 days, respectively; P < .001). Among the 90 patients who received allo-HCT (cord blood, n = 30; HLA-haploidentical related donors, n = 20; other related donors, n = 14; other unrelated donors, n = 26), the 2-year probabilities of OS, non-relapse mortality (NRM), and disease progression were 44%, 23%, and 46%, respectively. OS and NRM did not differ statistically according to donor type. Our results suggest that increased application of allo-HCT improved the survival of patients with aggressive ATL. The use of cord blood or HLA-haploidentical donors may be feasible for aggressive ATL when HLA-matched related donors are unavailable. This study was registered at the UMIN Clinical Trials Registry as #000017672.
Screening male prisoners for depression and anxiety with the PHQ-9 and GAD-7 at NHS Healthcheck: patterns of symptoms and caseness threshold
Authors: Butcher Elizabeth , Packham Christopher , Williams Marie , Miksza Joanne , Kaul Adarsh , Khunti Kamlesh , Morriss Richard
Published: September 2021

Background

Screening for depression and anxiety disorders has been proposed in prison populations but little is known about caseness thresholds on commonly used self-report measures in relation to core symptoms, risk factors and symptom patterns.

Method

A cross-sectional prevalence survey measured depression and anxiety caseness (threshold scores > 10 and > 15 on PHQ-9 and GAD-7 and diagnostic algorithm on PHQ-9) in 1205 male prisoners aged 35–74 years eligible for an NHS Healthcheck from six English prisons. Caseness scores were compared with the presence or absence of daily core symptoms of depression and generalised anxiety disorder (GAD), demographic, prison and cardiovascular risk factors. Cluster analysis was applied to PHQ-9 and GAD-7 items in prisoners scoring > 10 on PHQ-9.

Results

453(37.6%) and 249(20.7%) prisoners scored > 10 and > 15 respectively on PHQ-9; 216 (17.9%) had a depressive episode on the PHQ-9 algorithm; 378(31.4%) and 217(18.0%) scored > 10 and > 15 on GAD-7 respectively. Daily core items for depression were scored in 232(56.2%) and 139(74.3%) prisoners reaching > 10 and > 15 respectively on PHQ-9; daily core anxiety items in 282(74.9%) and 179(96.3%) reaching > 10 and > 15 on GAD-7. Young age, prison and previous high alcohol intake were associated with > 15 on the PHQ-9. Cluster analysis showed a cluster with core symptoms of depression, slowness, restlessness, suicidality, poor concentration, irritability or fear. Altered appetite, poor sleep, lack of energy, guilt or worthlessness belonged to other clusters and may not be indicative of depression.

Conclusions

In male prisoners > 35 years, a score of > 10 on the PHQ-9 over diagnoses depressive episodes but a score of > 10 on the GAD-7 may detect cases of GAD more efficiently. Further research utilising standardised psychiatric interviews is required to determine whether the diagnostic algorithm, a higher cut-off on the PHQ-9 or the profile of symptoms on the PHQ-9 and GAD-7 used singly or in combination may be used to screen depressive episodes efficiently in prisoners.
Psychometric evaluation of medication safety competence scale for clinical nurses
Authors: Yang Zhen , Chen Fengmin , Lu Yingying , Zhang Huijun
Published: September 2021

Background

Nurses are the most important members of the health care system for medication safety, there are few tools to evaluate their medication safety competence. This study aimed to translate the Medication Safety Competence Scale into Chinese and validate its reliability and validity among clinical nurses.

Methods

A total of 894 clinical nurses were recruited from three cities in China. The original version of the Medication Safety Competence Scale was translated into Chinese using the backward and forward translation procedure. The reliability of the scale was measured by internal consistency, split-half reliability, and stability. The validity of the scale was assessed by the content validity index, exploratory factor analysis and confirmatory factor analysis.

Results

The Cronbach’s coefficient of the scale was 0.940, and the coefficient values for the six domains ranged between 0.843 and 0.948. The split-half reliability and stability were 0.671 and 0.703, respectively. The content validity index of the scale was 0.952. The 6-factor structure, supported by the eigenvalues, total variance explained, and scree plot accounted for 71.485 % of the total variance. Moreover, as a result of the confirmatory factor analysis, the average variance extracted values were 0.55 to 0.70, and the model fitting indexes were all in the acceptable range.

Conclusions

The Chinese version of the Medication Safety Competence Scale had ideal reliability and validity among clinical nurses. The evaluation results of the scale can provide a reference for nursing managers to formulate education plans and intervention measures to improve clinical nurses’ safe medication competence.
Health economic benefits through the use of diagnostic support systems and expert knowledge
Authors: Willmen Tina , Völkel Lukas , Ronicke Simon , Hirsch Martin C. , Kaufeld Jessica , Rychlik Reinhard P. , Wagner Annette D.
Published: September 2021

Background

Rare diseases are difficult to diagnose. Due to their rarity, heterogeneity, and variability, rare diseases often result not only in extensive diagnostic tests and imaging studies, but also in unnecessary repetitions of examinations, which places a greater overall burden on the healthcare system.

Diagnostic decision support systems (DDSS) optimized by rare disease experts and used early by primary care physicians and specialists are able to significantly shorten diagnostic processes. The objective of this study was to evaluate reductions in diagnostic costs incurred in rare disease cases brought about by rapid referral to an expert and diagnostic decision support systems.

Methods

Retrospectively, diagnostic costs from disease onset to diagnosis were analyzed in 78 patient cases from the outpatient clinic for rare inflammatory systemic diseases at Hannover Medical School. From the onset of the first symptoms, all diagnostic measures related to the disease were taken from the patient files and documented for each day.

The basis for the health economic calculations was the Einheitlicher Bewertungsmaßstab (EBM) used in Germany for statutory health insurance, which assigns a fixed flat rate to the various medical services.

For 76 cases we also calculated the cost savings that would have been achieved by the diagnosis support system Ada DX applied by an expert.

Results

The expert was able to achieve significant savings for patients with long courses of disease. On average, the expert needed only 27 % of the total costs incurred in the individual treatment odysseys to make the correct diagnosis. The expert also needed significantly less time and avoided unnecessary examination repetitions.

If a DDSS had been applied early in the 76 cases studied, only 51–68 % of the total costs would have incurred and the diagnosis would have been made earlier. Earlier diagnosis would have significantly reduced costs.

Conclusion

The study showed that significant savings in the diagnostic process of rare diseases can be achieved through rapid referral to an expert and the use of DDSS. Faster diagnosis not only achieves savings, but also enables the right therapy and thus an increase in the quality of life for patients.
Optimising symptom management in children with cancer using a novel mobile phone application: protocol for a controlled hybrid effectiveness implementation trial (RESPONSE)
Authors: Bradford Natalie , Condon Paula , Pitt Erin , Tyack Zephanie , Alexander Kimberly
Published: September 2021

Background

Intense and aggressive treatment regimens for most children’s cancer have achieved vast improvements in survival but are also responsible for both a high number and burden of symptoms. The use of Patient Reported Outcome Measures (PROMs) demonstrates a range of benefits for improved symptom management in adults with cancer. There are, however, multiple barriers to integrating PROMs into routine care in children and adolescents with cancer. This study aims to evaluate: (1) the effectiveness of electronic PROMs to generate stratified alerts, symptom management recommendations and graphical summaries (the RESPONSE system) to improve health outcomes and (2) the implementation of the RESPONSE system by assessing feasibility, acceptability, satisfaction, and sustainability.

Methods

A pragmatic hybrid II effectiveness-implementation controlled trial, using mixed methods, will be undertaken, advancing both knowledge of the effectiveness of the intervention and implementation factors. One-hundred and sixty children with cancer receiving active treatment will be recruited 1:1 to a non-randomised study involving two groups with an equal number of participants in each group. The intervention group (n = 80) will be prospectively recruited to receive the RESPONSE system intervention over eight weeks, versus the historical matched control group (n = 80) who will complete the ePROMs without access to the RESPONSE system. The primary outcome of the effectiveness trial is change between groups in total symptom burden. Secondary outcomes include child health-related quality-of-life and implementation outcomes. Trial data will be analysed using linear mixed-effects models. Formative implementation evaluation is informed by CFIR and ERIC frameworks and implementation outcomes will be mapped to the RE-AIM framework and include interviews, field notes, as well as administrative data to evaluate feasibility, acceptability, satisfaction and sustainability.

Trial registration number

ACTRN12621001084875. Retrospectively Registered 16 August 2021.
Healthcare professionals’ practice and interactions in older peoples’ cross-sectoral clinical care trajectories when acutely hospitalized - a qualitative observation study
Authors: Persson Maiken Hjuler , Mogensen Christian Backer , Søndergaard Jens , Skjøt-Arkil Helene , Andersen Pernille Tanggaard
Published: September 2021

Background

Healthcare services have become more complex, globally and nationally. Denmark is renowned for an advanced and robust healthcare system, aiming at a less fragmented structure. However, challenges within the coordination of care remain. Comprehensive restructures based on marketization and efficiency, e.g. New Public Management (NPM) strategies has gained momentum in Denmark including. Simultaneously, changes to healthcare professionals’ identities have affected the relationship between patients and healthcare professionals, and patient involvement in decision-making was acknowledged as a quality- and safety measure. An understanding of a less linear patient pathway can give rise to conflict in the care practice. Social scientists, including Jürgen Habermas, have highlighted the importance of communication, particularly when shared decision-making models were introduced. Healthcare professionals must simultaneously deliver highly effective services and practice person-centered care. Co-morbidities of older people further complicate healthcare professionals’ practice.

Aim

This study aimed to explore and analyse how healthcare professionals’ interactions and practice influence older peoples’ clinical care trajectory when admitted to an emergency department (ED) and the challenges that emerged.

Methods

This qualitative study arises from a hermeneutical stand within the interpretative paradigm.

Focusing on the healthcare professionals’ interactions and practice we followed the clinical care trajectories of seven older people (aged> 65, receiving daily homecare) acutely hospitalized to the ED. Participant observations were combined with interviews with healthcare professionals involved in the clinical care trajectory. We followed-up with the older person by phone call until four weeks after discharge. The study followed the code of conduct for research integrity and is reported in accordance with the Standards for Reporting Qualitative Research (SRQR) guidelines.

Results

The analysis revealed four themes: 1)“The end justifies the means – ‘I know what is best for you’”, 2)“Basic needs of care overruled by system effectiveness”, 3)“Treatment as a bargain”, and 4)“Healthcare professionals as solo detectives”.

Conclusion

Dissonance between system logics and the goal of person-centered care disturb the healthcare practice and service culture negatively affecting the clinical care trajectory. A practice culture embracing better communication and more person-centered care should be enhanced to improve the quality of care in cross-sectoral trajectories.
A budget impact analysis of bezlotoxumab versus standard of care antibiotics only in patients at high risk of CDI recurrence from a hospital management perspective in Germany
Authors: Jakobs Florian , Wingen-Heimann Sebastian Marcel , Jeck Julia , Kron Anna , Cornely Oliver Andreas , Kron Florian
Published: September 2021

Background

Clostridioides difficile infection (CDI) is one of the leading nosocomial infections, resulting in increased hospital length of stay and additional treatment costs. Bezlotoxumab, the first monoclonal antibody against CDI, has an 1 A guideline recommendation for prevention of CDI, after randomized clinical trials demonstrated its superior efficacy vs. placebo.

Methods

The budget impact analysis at hand is focused on patients at high risk of CDI recurrence. Treatment with standard of care (SoC) + bezlotoxumab was compared with current SoC alone in the 10 most associated Diagnosis Related Groups to identify, analyze, and evaluate potential cost savings per case from the German hospital management perspective. Based on variation in days to rehospitalization, three different case consolidation scenarios were assessed: no case consolidation, case consolidation for the SoC + bezlotoxumab treatment arm only, and case consolidation for both treatment arms.

Results

On average, the budget impact amounted to € 508.56 [range: € 424.85 - € 642.19] for no case consolidation, € 470.50 [range: € 378.75 - € 601.77] for case consolidation in the SoC + bezlotoxumab treatment arm, and € 618.00 [range: € 557.40 - € 758.41] for case consolidation in both treatment arms.

Conclusions

The study demonstrated administration of SoC + bezlotoxumab in patients at high risk of CDI recurrence is cost-saving from a hospital management perspective. Reduced length of stay in bezlotoxumab treated patients creates free spatial and personnel capacities for the treating hospital. Yet, a requirement for hospitals to administer bezlotoxumab is the previously made request for additional fees and a successful price negotiation.
Potential biomarkers of miRNA in non-functional pituitary adenomas
Authors: Zhang Qizhi , Wang Ying , Zhou Yinting , Zhang Qiujuan , Xu Chuan
Published: September 2021

Background

The abnormal expression of microRNA (miRNA) has been proved to be closely related to the occurrence and progression of tumors. A unique expression of multiple miRNAs has been found in different types of tumors. However, the correlation between miRNA and non-functional pituitary adenoma (NFPA) is not clear. In this study, miRNAs (miRNA-26b, miRNA-138, miRNA-206, and miRNA-let-7e) have been used as detection genes to compare the miRNA expression levels of NFPA subjects and healthy controls and to explore the expression of four different miRNAs in NFPA.

Methods

Ten untreated NFPA volunteers were served as subjects, and 10 normal subjects were selected as controls. Peripheral blood samples were collected, and four differentiated expressed miRNAs (miRNA-26b, miRNA-138, miRNA-206, and miRNA-let-7e) obtained in the early stage of the test group were detected, recorded, and archived by quantitative real-time PCR (qPCR). The difference and significance of endogenous miRNA expressions were explored through statistical analysis, hoping to find biomarkers for clinical treatment.

Results

The levels of miRNA-26b, miRNA-138, miRNA-206, and miRNA-let-7e in the peripheral serum of patients with NFPA were significantly lower than those in normal subjects (P < 0.05).

Conclusion

miRNA-26b, miRNA-138, miRNA-206, and miRNA-let-7e may be involved in the occurrence and progress of NFPAs. This study aims to study the biological targets of NFPA. It starts from the study of whether miRNA, miRNA-26b, miRNA-138, miRNA-206, and miRNA-let-7e may be tumor suppressor genes in NFPA, which provides a basis for further exploration of tumor markers of pituitary adenoma.
Antimicrobial peptides: mechanism of action, activity and clinical potential
Authors: Zhang Qi-Yu , Yan Zhi-Bin , Meng Yue-Ming , Hong Xiang-Yu , Shao Gang , Ma Jun-Jie , Cheng Xu-Rui , Liu Jun , Kang Jian , Fu Cai-Yun
Published: September 2021

The management of bacterial infections is becoming a major clinical challenge due to the rapid evolution of antibiotic resistant bacteria. As an excellent candidate to overcome antibiotic resistance, antimicrobial peptides (AMPs) that are produced from the synthetic and natural sources demonstrate a broad-spectrum antimicrobial activity with the high specificity and low toxicity. These peptides possess distinctive structures and functions by employing sophisticated mechanisms of action. This comprehensive review provides a broad overview of AMPs from the origin, structural characteristics, mechanisms of action, biological activities to clinical applications. We finally discuss the strategies to optimize and develop AMP-based treatment as the potential antimicrobial and anticancer therapeutics.
TGFβ1 pathway components in breast cancer tissue from aggressive subtypes correlate with better prognostic parameters in ER-positive and p53-negative cancers
Authors: Vitiello Glauco Akelinghton Freire , Amarante Marla Karine , Crespigio Jefferson , Banin Hirata Bruna Karina , de Sousa Pereira Nathalia , de Oliveira Karen Brajão , Guembarovski Roberta Losi , Watanabe Maria Angelica Ehara
Published: September 2021

Background

TGFβ signaling exerts context-specific effects in breast cancer (BC) pathogenesis and single nucleotide polymorphisms (SNPs) in TGFβ-signaling components play a role in the genetic control of their expression and in BC susceptibility and clinical presentation. However, studies investigating the association between the TGFβ-signaling molecules and BC prognosis rarely considered disease subtypes and SNPs. Therefore, the present study aimed to evaluate the expression of TGFβ-signaling components in BC tissue from patients with available data regardingTGFB1andTGFBR2SNPs and plasmatic TGFβ1 levels.

Methods

Immunostaining for TGFβ1, TGFβRII and phosphorylated (p)-SMAD2/3 was investigated in primary tumor tissue from 34 patients with luminal-B-HER2+(LB-HER2), HER2-enriched (HER2) and triple negative (TN) BC subtypes genotyped forTGFB1(rs1800468, rs1800469, rs1800470 and rs1800471) andTGFBR2(rs3087465) SNPs.

Results

Strong positive correlations were observed between TGFβ1, TGFβRII and p-SMAD2/3 in tumor tissue, and an inverse correlation was observed between intratumor and plasmatic TGFβ1 levels in TN BCs. In LB-HER2+tumors, p-SMAD2/3 was associated with older age at diagnosis and inversely correlated with p53 staining and lymph-node metastasis, while tumor-size negatively correlated with TGFβ1 and TGFβRII in this BC subgroup. Also, in p53-negative BCs, tumor size and Ki67 negatively correlated with both TGFβ1, TGFβRII and p-SMAD2/3. No correlation was found between SNPs and TGFβ1-signaling components expression.

Conclusion

TGFβ1 canonical signaling is activated in approximately half of BCs, and correlation between TGFβ components indicate a paracrine activation, which may exert tumor suppressor effects in p53-negative or Luminal-B-HER2+subgroups.
The PostStroke-Manager – combining mobile, digital and sensor-based technology with personal assistance: protocol of the feasibility study
Authors: Michalski Dominik , Prost Alexander , Handel Till , Schreiber Max , Tylcz Jean-Baptiste , Geisler Daniela , Urban Daniela , Schramm Stephanie , Lippmann Stefan , Gullnick Jenny , Neumuth Thomas , Classen Joseph , Ivanova Galina
Published: September 2021

Introduction

Post stroke management has moved into the focus as it represents the only way to secure acute treatment effects in the long term. Due to individual courses, post stroke management appears rather challenging and is hindered by existing barriers between treatment sectors. As a novel concept, the PostStroke-Manager combines digital and sensor-based technology with personal assistance to enable intersectoral cooperation, best possible reduction of stroke-related disability, optimal secondary prevention, and detection of physical and psychological comorbidities.

Methods

This prospective single-center observational study aims to investigate the feasibility of the PostStroke-Manager concept in an outpatient setting. Ninety patients who have suffered an ischemic or hemorrhagic stroke or transient ischemic attack will be equipped with a tablet and mobile devices recording physical activity, blood pressure, and electrocardiographic signals. Through a server-based platform, patients will be connected with the primary care physician, a stroke pilot and, if necessary, other specialists who will use web-based platforms. Via the tablet, patients will have access to an application with 10 newly designed components including, for instance, a communication tool, medication schedule, medical records platform, and psychometric screenings (e.g., depression, anxiety symptoms, quality of life, adherence, cognitive impairment). During the 1-year follow-up period, clinical visits are scheduled at three-month intervals. In the interim, communication will be secured by an appropriate tool that includes text messenger, audio, and video telephony. As the primary endpoint, feasibility will be measured by a 14-item questionnaire that addresses digital components, technical support, and personal assistance. The PostStroke-Manager will be judged feasible if at least 50% of these aspects are rated positively by at least 75% of patients. Secondary endpoints include feedback from professionals and longitudinal analyses on clinical and psychometric parameters.

Perspective

This study will answer the question of whether combined digital and personal support is a feasible approach to post stroke management. Furthermore, the patient perspective gained regarding digital support may help to specify future applications. This study will also provide information regarding the potential use of remote therapies and mobile devices in situations with limited face-to-face contacts.

Trial registration

German Register for Clinical Trials (DRKS00023213.), registered 27 April 2021.
Study on the parameterization response of probabilistic neural networks for seismic facies classification in the Gulf of Mexico
Authors: Salazar Florez Diana , Bedle Heather
Published: September 2021

Nowadays, there are many unsupervised and supervised machine learning techniques available for performing seismic facies classification. However, those classification methods either demand high computational costs or do not provide an accurate measure of confidence. Probabilistic neural networks (PNNs) overcome these limitations and have demonstrated their superiority among other algorithms. PNNs have been extensively applied for some prediction tasks, but they have not been well studied regarding the prediction of seismic facies volumes using seismic attributes. We have explored the capability of the PNN algorithm when classifying large- and small-scale seismic facies. In addition, we evaluate the impact of user-chosen parameters on the final classification volumes. After performing seven tests, each with a parameter variation, we assess the impact of the parameter change on the resultant classification volumes. We find that the processing task can have a significant impact on the classification volumes, but we also find how the most geologically complex areas are the most challenging for the algorithm. Moreover, we determine that even if the PNN technique is performing and producing considerably accurate results, it is possible to overcome those limitations and significantly improve the final classification volumes by including the geologic insight provided by the geoscientist. We conclude by proposing a new workflow that can guide future geoscientists interested in applying PNNs, to obtain better seismic facies classification volumes by considering some initial steps and advice.
A Reference Range for Plasma Levels of Inorganic Pyrophosphate in Children Using the ATP Sulfurylase Method
Authors: Bernhard Eva , Nitschke Yvonne , Khursigara Gus , Sabbagh Yves , Wang Yongbao , Rutsch Frank
Published: September 2021

Purpose

Generalized arterial calcification of infancy, pseudoxanthoma elasticum, autosomal recessive hypophosphatemic rickets type 2, and hypophosphatasia are rare inherited disorders associated with altered plasma levels of inorganic pyrophosphate (PPi). In this study, we aimed to establish a reference range for plasma PPi in the pediatric population, which would be essential to support its use as a biomarker in children with mineralization disorders.

Methods

Plasma samples were collected from 200 children aged 1 day to 18 years who underwent blood testing for medical conditions not affecting plasma PPi levels. PPi was measured in proband plasma utilizing a validated adenosine triphosphate (ATP) sulfurylase method.

Results

The analytical sensitivity of the ATP sulfurylase assay consisted of 0.15 to 10 µM PPi. Inter- and intra-assay coefficients of variability on identical samples were below 10%. The standard range of PPi in the blood plasma of children and adolescents aged 0 to 18 years was calculated as 2.36 to 4.44 µM, with a median of 3.17 µM, with no difference between male and female probands. PPi plasma levels did not differ significantly in different pediatric age groups.

Main Conclusions

Our results yielded no noteworthy discrepancy to the reported standard range of plasma PPi in adults (2-5 µM). We propose the described ATP sulfurylase method as a diagnostic tool to measure PPi levels in plasma as a biomarker in the pediatric population.
A Review of Matthias Doepke and Fabrizio Zilibotti’s Love, Money and Parenting: How Economics Explains the Way We Raise Our Kids
Authors: Edlund Lena
Published: September 2021

As Generation X’s (born in the 1960s and 1970s) child bearing years draw to a close, its parenting practices are due for assessment, the topic of the book under review. The book organizes its discussion around Diana Baumrind’s three parenting styles: authoritarian, permissive, and authoritative. It chronicles the drift toward the two latter and argues that income inequality determines which one of the two will be popular. When inequality is low, less is at stake and the parenting style can be more relaxed. By contrast, high inequality pushes parents toward the achievement- oriented authoritative style. More generally, the book argues, cultural differences in parenting styles can be understood as the outcome of altruistic parents’ efforts to prepare their children for adulthood, a useful perspective when parental rights are limited, long the case in the West.(JEL D13, D63, I20, J12, J13, J16)
Rapid inactivation of SARS-CoV-2 by titanium dioxide surface coating
Authors: Micochova Petra , Chadha Ambika , Hesseloj Timi , Fraternali Franca , Ramsden Jeremy J. , Gupta Ravindra K.
Published: September 2021

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission occurs via airborne droplets and surface contamination. Titanium dioxide (TiO2) coating of surfaces is a promising infection control measure, though to date has not been tested against SARS-CoV-2.

Methods: Virus stability was evaluated on TiO2- and TiO2–Ag (Ti:Ag atomic ratio 1:0.04)-coated 45 x 45 mm ceramic tiles. After coating the tiles were stored for 2–4 months before use. We tested the stability of both SARS-CoV-2 Spike pseudotyped virions based on a lentiviral system, as well as fully infectious SARS-CoV-2 virus. For the former, tile surfaces were inoculated with SARS-CoV-2 spike pseudotyped HIV-1 luciferase virus. At intervals virus was recovered from surfaces and target cells infected. For live virus,  after illuminating tiles for 0–300 min virus was recovered from surfaces followed by infection of Vero E6 cells. % of infected cells was determined by flow cytometry detecting SARS-CoV-2 nucleocapsid protein 24 h post-infection.

Results: After 1 h illumination the pseudotyped viral titre was decreased by four orders of magnitude. There was no significant difference between the TiO2 and TiO2–Ag coatings. Light alone had no significant effect on viral viability. For live SARS-CoV-2, virus was already significantly inactivated on the TiO2 surfaces after 20 min illumination. After 5 h no detectable active virus remained. Significantly, SARS-CoV-2 on the untreated surface was still fully infectious at 5 h post-addition of virus. Overall, tiles coated with TiO2 120 days previously were able to inactivate SARS-CoV-2 under ambient indoor lighting with 87% reduction in titres at 1h and complete loss by 5h exposure.

Conclusions: In the context of emerging viral variants with increased transmissibility, TiO2 coatings could be an important tool in containing SARS-CoV-2, particularly in health care facilities where nosocomial infection rates are high.