bluuebunny/crossref_metadata_2025 huggingface dataset:
A new Neodima species (Coleoptera: Elateridae: Dimini), with notes on the distribution and morphology of the genus
Authors: QIU LU
Published: November 2021

The flightless click-beetle Neodima yutangi sp. nov. is described and illustrated from Beichuan County, Northern Sichuan Province, China. Habitus and important diagnostic characters of the new species are illustrated. An updated distribution map of the genus and key to Neodima species are provided. The distribution, habitat and some notable morphological characters of the genus are discussed.
Factors that Predict Survival From Mesenteric Ischemia in the Geriatric Patient: Not a Death Sentence
Authors: Gebran Anthony , Gallastegi Ander Dorken , Fagenholz Peter , King David , Kaafarani Haytham M. A. , Paranjape Charu , Velmahos George C. , Hwabejire John O.
Published: November 2021

Background

The mortality rate from mesenteric ischemia is reported to be as high as 80%. The goal of our study was to identify demographic and clinical predictors of post-operative mortality and discharge disposition among elderly patients with mesenteric ischemia.

Methods

All patients 65 years and older who underwent emergency surgery (ES) for the management of mesenteric ischemia in the American College of Surgeons–National Surgical Quality Improvement Program database from 2007 to 2017 were included. Univariate analyses and logistic regressions were used to identify independent predictors of mortality and discharge disposition.

Results

A total of 2438 patients met inclusion criteria, with a median age of 77 years and 60.8% being female. The 30-day mortality of the overall cohort was 31.5% and the 30-day morbidity was 65.3%. The following were the major predictors of 30-day mortality: pre-operative diagnosis of septic shock [OR: 2.46, (95% CI: 1.94-3.13)], dialysis dependence [OR: 2.05, (95% CI: 1.45-2.90)], recent weight loss [OR: 1.80, (95% CI: 1.16-2.79)], age ≥80 years [OR: 1.67, (95% CI: 1.25-2.23)], and ventilator dependence [OR: 1.65, (95% CI: 1.23-2.23)]. In the absence of these predictors, survival rate was 84%. The major predictors of discharge to post-acute care (PAC) included age ≥80 years [OR: 3.70, (95% CI: 2.50-5.47)] and pre-operative septic shock [OR: 2.20, (95% CI: 1.42-3.41)].

Conclusion

In the geriatric patient, a diagnosis of mesenteric ischemia does not equate to an automatic death sentence. The presence of certain pre-operative risk factors confers a high risk of mortality, whereas their absence is associated with a high chance of survival.
Recent Advances in Local Thermal Ablation Therapy for Hepatocellular Carcinoma
Authors: Deng Min , Li Shao-Hua , Guo Rong-Ping
Published: November 2021

Image-guided local thermal ablation (LTA) plays an important role in the treatment of hepatocellular carcinoma (HCC), especially in patients with HCC who are not suitable for hepatectomy. Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most widely used LTA clinically. Radiofrequency ablation can achieve the best result; that is, a similar therapeutic effect as hepatectomy if the tumor ≤3 cm, while MWA can effectively ablate tumors ≤5 cm. Local thermal ablation has an advantage over liver resection in terms of minimally invasive surgery and can achieve a comparable prognosis and efficacy to liver resection. For borderline liver function, selecting LTA as the first-line therapy may bring more benefits to patients with cirrhosis background. In addition, a combination of multiple therapies for HCC is a good choice, such as LTA combined with transcatheter arterial chemoembolization (TACE), which can achieve a better prognosis than single therapy for larger tumors. For patients who are awaiting liver transplantation, LTA is a good choice. The main problem of LTA needed to be solved is to prevent the local tumor recurrence after ablation in patients with HCC.
The comfort properties of hemp and flax blended denim fabrics with common industrial washing treatments
Authors: Saricam Canan
Published: November 2021

In this study, the moisture, thermal, and tactile comfort properties of flax and hemp blended denim fabrics treated with selected common industrial washing treatments were analyzed. Being used recently in denim fabric production, four different types of flax and hemp blended fabrics in different compositions and a reference cotton fabric were produced in similar construction and treated with rinse, stone, and bleach washes. The impact of fiber composition and the washing treatments on comfort properties was analyzed statistically. The findings revealed that the blended fabrics had better moisture comfort properties and thermal resistance than the cotton fabrics. Moreover, their tactile comfort properties were within acceptable limits. The washing treatments improved the comfort properties of all fabrics in a similar way.
ALIS: A novel metric in lineage-independent evaluation of scholars
Authors: Dey Sudeepa Roy , Mathur Archana , Dayasagar B.S , Saha Snehanshu
Published: November 2021

Evaluative bibliometrics often attempts to explore various methods to measure individual scholarly influence. Scholarly independence (SI) is a unique indicator that can be used to understand and assess the research performances of individual scholars. The SI is a rare quality that most funding agencies and universities seek during funding decisions or hiring processes. We propose author lineage independent score (ALIS), a unique model to measure SI of a scholar by using his or her academic genealogy tree as the underlying graph structure. The analysis is performed on real data of 100 authors, collected from the Web of Science (WoS) and the Mathematics Genealogy Project. The analysis is further validated on a larger scale, on a simulated sample of 10,000 authors. The simulation exercise is the proof-of-concept for scalability of the metric and the proposed optimisation model. ALIS exploits genealogical relationships between scholars and their mentors and collaborating communities and constructs an influence scoring model based on the Genealogy tree structure of the respective scholars. The implications from the theoretical model are found to be profound in tracing known and recursive citation patterns among peers. The genealogy tree is used to investigate the advisor–advisee relationship and lays the foundation for defining metrics used to calculate the various indicators such as non-genealogy citations (NGCs), non-community citations (NCCs) and other citation quotient (OCQ). As these indicators/parameters are novel and thus not readily accessible, algorithms are written to compute these indicator values for the scholars under study.
Services for Juveniles With Emotional Disturbances in Secure-Care Settings: An Exploratory Analysis of Racial Disparities and Recidivism
Authors: Strassfeld Natasha M. , Cherng Hua-Yu Sebastian
Published: November 2021

This study examines associations between recidivism rates and groups/programs for legally mandated education, behavioral, and mental health services that court-ordered juvenile youth (“juveniles”) with identified emotional disturbance or related conditions receive in secure-care juvenile facilities. Using statewide agency data in Minnesota, this exploratory analysis investigates whether there are racial/ethnic and county disparities in residential placements or secure-care settings via programs and groups for court-ordered juveniles ( N = 1,092). The study also considers whether program and group placements contribute to racial/ethnic patterns of recidivism. This study finds that recidivism rate differences by program/group level are largely attributed to differences in racial/ethnic compositions. Findings suggest placements lack strong effects on recidivism, and assignments may perpetuate inequalities. In addition, from this exploratory analysis examination, this article offers considerations for future research-to-practice partnerships to strengthen legally and policy-mandated program and service delivery with practices that increase training to juvenile justice system professionals, access to secure-care setting services, and transition services for juveniles.
Gifted boys’ perceptions of their academic underachievement
Authors: Desmet Ophelie , Pereira Nielsen
Published: November 2021

We examined how six gifted boys perceived the onset and development of their academic underachievement and what they identified as contributing aspects. Across the six boys’ experiences, a similar pattern of onset and development of academic underachievement emerged. The boys discussed a lack of academic challenge, investment in hobbies, issues with time management and self-regulation, family transitions, and peer relations as contributing to their academic underachievement. These aspects influenced the boys’ value beliefs (e.g., not caring about grades) or maladaptive beliefs about themselves (e.g., lower self-worth), which contributed to disengagement and underachievement according to students.
A Bivariate Analysis of the Spatial Distributions of Stunting and Wasting Among Children Under-Five in Nigeria
Authors: Adebayo Samson B. , Gayawan Ezra
Published: November 2021

Stunting and wasting are major malnutrition issues among children under five years of age and have continued to remain unacceptably high in Nigeria leading to high rates of child morbidity and mortality. Evidence-based strategies are required by government and non-governmental agencies to mitigate the suffering of these children, and this could be realised when the association between the determinants and the geographical distributions are fully understood. Using data from four waves of the Nigerian Demographic and Health Survey, we employed a distributional bivariate probit model to examine the geographical distributions of the levels and linear association between acute and chronic malnutrition in Nigeria after accounting for possible observed determinants. Bayesian inference was based on Markov chain Monte Carlo simulation. The findings reveal substantial spatial variations in stunting and wasting among under-five children in Nigeria, indicating a north–south divide. The findings show negative linear association between the two malnutrition indicators among children in some northern fringe states but positive for Akwa Ibom, Ebonyi and Anambra. The correlation also peaks around age 20 months indicating that during the first 2 years of life, the children have an increasing likelihood of suffering from stunting and wasting.
Ineffective Esophageal Motility: Need for Improvement in Diagnostic Criteria
Authors: Chen Joan W.
Published: November 2021

Ineffective esophageal motility (IEM) is a hypomotility disorder with decreased contraction vigor and normally relaxing lower esophageal sphincter. Although IEM has been associated with poor esophageal clearance and gastroesophageal reflux, it is also seen in asymptomatic subjects and is often of unclear clinical significance. The Chicago classification version 4.0 updated the diagnostic threshold to require >70% weak or fragmented swallows or ≥50% failed swallows for a conclusive diagnosis of IEM. Provocation testing are recommended in borderline cases to assess clinical relevance. Prospective trials are needed to further refine the diagnostic criteria, understand the pathophysiology, and develop an effective treatment for IEM.
Antineutrophil cytoplasmic antibody-associated interstitial lung disease: a review
Authors: Kadura Suha , Raghu Ganesh
Published: November 2021

Over the past three decades, an increasing number of publications have reported the association between interstitial lung disease (ILD) and anti-neutrophil cytoplasmic antibody (ANCA) or ANCA-associated vasculitis (AAV). With this increased awareness, we have reviewed the literature to date and provide an update in this narrative review. The vast majority of cases of ILD have been shown to be in the setting of positive anti-myeloperoxidase antibody and can be present in up to 45% of patients of microscopic polyangiitis, though cases of ILD associated with proteinase 3 ANCA have rarely been reported. Pulmonary fibrosis and ANCA positivity can occur with or without systemic involvement. The pathogenetic mechanisms establishing the relationship between ANCA and the development of pulmonary fibrosis remain unclear. Histologic and radiographic features of ANCA-ILD most commonly reveal usual interstitial pneumonia or non-specific interstitial pneumonia patterns, though other atypical features such as bronchiolitis have been described. ILD in the setting of AAV has been associated with worse outcomes, and thus early identification and treatment in these patients is appropriate. We advocate that ANCA antibody testing be performed as a baseline evaluation in patients presenting with idiopathic interstitial pneumonia. Suggested treatment of ANCA-ILD includes immunosuppression and/or antifibrotic agents, though supporting data and clinical trials to substantiate use of these therapies are needed.
Cardioprotective responses to aerobic exercise-induced physiological hypertrophy in zebrafish heart
Authors: Chen Zhanglin , Zhou Zuoqiong , Peng Xiyang , Sun Chenchen , Yang Dong , Li Chengli , Zhu Runkang , Zhang Ping , Zheng Lan , Tang Changfa
Published: November 2021

Herein, we aimed to establish an aerobic exercise-induced physiological myocardial hypertrophy zebrafish (Danio rerio) model and to explore the underlying molecular mechanism. After 4 weeks of aerobic exercise, the AMR and Ucrit of the zebrafish increased and the hearts were enlarged, with thickened myocardium, an increased number of myofilament attachment points in the Z-line, and increased compaction of mitochondrial cristae. We also found that the mTOR signaling pathway, angiogenesis, mitochondrial fusion, and fission event, and mitochondrial autophagy were associated with the adaptive changes in the heart during training. In addition, the increased mRNA expression of genes related to fatty acid oxidation and antioxidation suggested that the switch of energy metabolism and the maintenance of mitochondrial homeostasis induced cardiac physiological changes. Therefore, the zebrafish heart physiological hypertrophy model constructed in this study can be helpful in investigating the cardioprotective mechanisms in response to aerobic exercise.
Dimethyl itaconate alleviates the pyroptosis of macrophages through oxidative stress
Authors: Huang Shan-Shan , Guo Dong-Yang , Jia Bing-Bing , Cai Guo-Long , Yan Jing , Lu Yan , Yang Zhou-Xin
Published: November 2021

Macrophages are involved in the pathophysiology of many diseases as critical cells of the innate immune system. Pyroptosis is a form of macrophage death that induces cytokinesis of phagocytic substances in the macrophages, thereby defending against infection. Dimethyl itaconate (DI) is an analog of itaconic acid with anti-inflammatory effects. However, the effect of dimethyl itaconate on macrophage pyroptosis has not been elucidated clearly. Thus, the present study aimed to analyze the effect of DI treatment on a macrophage pyroptosis model (Lipopolysaccharide, LPS + Adenosine Triphosphate, ATP). The results showed that 0.25 mM DI ameliorated macrophage pyroptosis and downregulated interleukin (IL)-1β expression. Then, real-time quantitative polymerase chain reaction (RT-qPCR) was used to confirm the result of RNA-sequencing of the upregulated oxidative stress-related genes (GclcandGss) and downregulated inflammation-related genes (IL-12βandIL-1β). In addition, Gene Ontology (GO) enrichment analysis showed that differential genes were associated with transcript levels and DNA replication. Kyoto encyclopedia of genes and genomes (KEGG) enrichment showed that signaling pathways, such as tumor necrosis factor (TNF), Jak, Toll-like receptor and IL-17, were altered after DI treatment. N-acetyl-L-cysteine (NAC) reversed the DI effect on the LPS + ATP-induced macrophage pyroptosis and upregulated the IL-1β expression. Oxidative stress-related protein Nrf2 is involved in the DI regulation of macrophage pyroptosis. Taken together, these findings suggested that DI alleviates the pyroptosis of macrophages through oxidative stress.
Impact of nanophos in agriculture to improve functional bacterial community and crop productivity
Authors: Chaudhary Parul , Chaudhary Anuj , Parveen Heena , Rani Alka , Kumar Govind , Kumar Rajeew , Sharma Anita
Published: November 2021

Background

Since the World’s population is increasing, it’s critical to boost agricultural productivity to meet the rising demand for food and reduce poverty. Fertilizers are widely used in traditional agricultural methods to improve crop yield, but they have a number of negative environmental consequences such as nutrient losses, decrease fertility and polluted water and air. Researchers have been focusing on alternative crop fertilizers mechanisms to address these issues in recent years and nanobiofertilizers have frequently been suggested. “Nanophos” is a biofertilizer and contains phosphate-solubilising bacteria that solubilises insoluble phosphate and makes it available to the plants for improved growth and productivity as well as maintain soil health. This study evaluated the impact of nanophos on the growth and development of maize plants and its rhizospheric microbial community such as NPK solubilising microbes, soil enzyme activities and soil protein under field condition after 20, 40 and 60 days in randomized block design.

Results

Maize seeds treated with nanophos showed improvement in germination of seeds, plant height, number of leaves, photosynthetic pigments, total sugar and protein level over control. A higher activity of phenol, flavonoid, antioxidant activities and yield were noticed in nanophos treated plants over control. Positive shift in total bacterial count, nitrogen fixing bacteria, phosphate and potassium solubilizers were observed in the presence of nanophos as compared to control. Soil enzyme activities were significantly (P < 0.05) improved in treated soil and showed moderately correlation between treatments estimated using Spearman rank correlation test. Real time PCR and total soil protein content analysis showed enhanced microbial population in nanophos treated soil. Obtained results showed that nanophos improved the soil microbial population and thus improved the plant growth and productivity.

Conclusion

The study concluded a stimulating effect of nanophos on Zea mays health and productivity and indicates good response towards total bacterial, NPK solubilising bacteria, soil enzymes, soil protein which equally showed positive response towards soil nutrient status. It can be a potential way to boost soil nutrient use efficiency and can be a better alternative to fertilizers used in the agriculture.
Measuring therapeutic engagement in acute mental health inpatient environments: the perspectives of service users and mental health nurses
Authors: Chambers M. , McAndrew S. , Nolan F. , Thomas B. , Watts P. , Kantaris X.
Published: November 2021

Background

A key component of caring for service users (SUs) in acute mental health inpatient environments is Therapeutic Engagement (TE). To that end, the Therapeutic Engagement Questionnaire (TEQ) was developed and validated. The TEQ measures TE between SUs and registered mental health nurses (RMHNs) from the perspective of both parties and can quantify and recognise how nurses engage with SUs and monitor this activity as well as its enhancement of SU care and recovery. The aim of this study was to explore the views of SUs and RMHNs in relation to the TEQ and how it could be adopted into clinical practice within an acute inpatient environment.

Methods

As part of the validation stage of the development of the TEQ, the views of 628 SUs and 543 RMHNs were collected using a qualitative approach by way of free text at the end of the questionnaire. Two questions required free text response: – ‘what do you think of the TEQ?’, and ‘how can it be utilised?’

Results

Following thematic analysis, it was found that both sets of participants stated that such a tool could be utilised to improve the service, could help nurses with reflective practice, be utilised as part of clinical supervision and to aid nurses’ professional development. The nurse participants also stated that such a tool would help track SU participation and enablement in their care. Furthermore, the nurses noted that the tool would help to reinforce the core ‘caring’ value of nursing and the overall goal of recovery. The SUs added that the TEQ would recognise the work of mental health nurses and provide them with a clear opportunity to express their views in relation to nursing staff.

Conclusions

Therapeutic engagement (TE) has been identified as part of the repertoire of mental health nursing and both groups of participants identified how a tool to assess this construct may be utilised in day-to-day clinical practice to the benefit of each group.
Congenital midureteral stenosis in children: a 13-year retrospective study based on data from a large pediatric medical center
Authors: Meng Zhaoyi , Lin Defu , Wang Guannan , Qu Yanchao , Sun Ning
Published: November 2021

Background

Midureteral stenosis is very rare in children and can cause congenital hydronephrosis. We report our experience treating children with congenital midureteral stenosis at our center, focusing on the differences in preoperative diagnosis and treatment compared with other congenital obstructive uropathies.

Methods

We retrospectively reviewed the medical records of 26 children diagnosed with congenital midureteral stenosis at our center between January 2007 and December 2020, such as preoperative examination methods, intraoperative conditions, and postoperative follow-up results.

Results

Of the 1625 children treated surgically for ureteral narrowing, only 26 (1.6%) were diagnosed with midureteral stenosis, including 15 infants and 11 children. Eighteen (69.2%) were boys, 13 (50%) were affected on the left side, and 23 (88.5%) had isolated ureteral stenosis. Overall, 13 (50%) of the children presented with prenatal hydronephrosis, and 13 (50%) presented with abdominal pain or a mass. All the children had undergone urinary ultrasound and intravenous urography preoperatively; the diagnostic rate of ultrasound was 92.3%. Only 7 (26.9%) children had undergone pyelography. All the children had undergone surgery. The ureteral stenotic segment was less than 1 cm long in 25 (96.2)% of the children. The mean follow-up duration was 22 months (range: 6–50 months). One child developed anastomotic strictures. Urinary tract obstruction was relieved in the other children without long-term complications.

Conclusions

Congenital midureteral stenosis is rare, accounting for 1.6% of all ureteral obstructions, and its diagnosis is crucial. Urinary ultrasound has a high diagnostic rate and should be the first choice for midureteral stenosis. Retrograde pyelography can be used when the diagnosis is difficult, but routine retrograde pyelography is not recommended. Congenital ureteral stenosis has a relatively short lesion range, largely within 1 cm. The treatment is mainly resection of the stenotic segment and end-to-end ureteral anastomosis, with a good prognosis.
Effects of health-promoting school strategy on dental plaque control and preventive behaviors in schoolchildren in high-caries, rural areas of Taiwan: a quasi-experimental design
Authors: Wei Chun-Ting , Lo Kai-Yang , Lin Yi-Ching , Hu Chih-Yang , Chen Fu-Li , Huang Hsiao-Ling
Published: November 2021

Background

We evaluated the effects of health-promoting school (HPS) strategy on plaque control and behavior change in high-caries schoolchildren in Taitung, Taiwan.

Methods

A quasi-experimental design was adopted; six intervention schools (intervention group [IG]) and six comparison schools (comparison group [CG]) were selected from elementary schools with higher-than-average caries rates (> 68%). The IG was selected using cluster sampling, and the CG was selected to match the IG. In total, the IG and CG groups included 166 and 174 children each. The selected schools implemented the HPS framework for 3 months in the 2019 academic year. An oral examination of dental plaque was administered, and a self-administered questionnaire regarding knowledge, attitude, self-efficacy, and behaviors was distributed at baseline and at 2-week follow-up. A linear and logistic regression model using generalized estimating equations (GEEs) was used to analyze the differences between baseline and the follow-up data.

Results

Compared with the CG, the IG had a greater reduction in plaque index among second graders (β =  − 0.36) and plaque control record scores among second, fourth, and sixth graders (β =  − 27.48, − 26.04, and − 18.38, respectively). The IG also exhibited a greater increase at follow-up with respect to oral health–related knowledge among second graders and fourth graders (β = 1.46 and β = 0.92, respectively), attitude toward oral hygiene behaviors among sixth graders (β = 1.78), and self-efficacy regarding flossing for sixth graders (β = 1.43). Sixth graders in the IG were significantly more likely to brush before sleeping (adjusted odds ratio [aOR] = 2.99) and use fluoride toothpaste (aOR = 5.88) than those in the CG.

Conclusions

The HPS strategy was effective in reducing dental plaque and promoting preventing behaviors in rural high-caries schoolchildren.
Effect of deep learning-based assistive technology use on chest radiograph interpretation by emergency department physicians: a prospective interventional simulation-based study
Authors: Kim Ji Hoon , Han Sang Gil , Cho Ara , Shin Hye Jung , Baek Song-Ee
Published: November 2021

Background

Interpretation of chest radiographs (CRs) by emergency department (ED) physicians is inferior to that by radiologists. Recent studies have investigated the effect of deep learning-based assistive technology on CR interpretation (DLCR), although its relevance to ED physicians remains unclear. This study aimed to investigate whether DLCR supports CR interpretation and the clinical decision-making of ED physicians.

Methods

We conducted a prospective interventional study using a web-based performance assessment system. Study participants were recruited through the official notice targeting board for certified emergency physicians and residents working at the present ED. Of the eight ED physicians who volunteered to participate in the study, seven ED physicians were included, while one participant declared withdrawal during performance assessment. Seven physicians’ CR interpretations and clinical decision-making were assessed based on the clinical data from 388 patients, including detecting the target lesion with DLCR. Participant performance was evaluated by area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, and accuracy analyses; decision-making consistency was measured by kappa statistics. ED physicians with < 24 months of experience were defined as ‘inexperienced’.

Results

Among the 388 simulated cases, 259 (66.8%) had CR abnormality. Their median value of abnormality score measured by DLCR was 59.3 (31.77, 76.25) compared to a score of 3.35 (1.57, 8.89) for cases of normal CR. There was a difference in performance between ED physicians working with and without DLCR (AUROC: 0.801, P < 0.001). The diagnostic sensitivity and accuracy of CR were higher for all ED physicians working with DLCR than for those working without it. The overall kappa value for decision-making consistency was 0.902 (95% confidence interval [CI] 0.884–0.920); concurrently, the kappa value for the experienced group was 0.956 (95% CI 0.934–0.979), and that for the inexperienced group was 0.862 (95% CI 0.835–0.889).

Conclusions

This study presents preliminary evidence that ED physicians using DLCR in a clinical setting perform better at CR interpretation than their counterparts who do not use this technology. DLCR use influenced the clinical decision-making of inexperienced physicians more strongly than that of experienced physicians. These findings require prospective validation before DLCR can be recommended for use in routine clinical practice.
A situation analysis of child delivery facilities at primary health centers (PHCs) in rural India and its association with likelihood of selecting PHC for child delivery
Authors: Mustafa Akif , Shekhar Chander , Shri Neha
Published: November 2021

Background

Primary Health Centers (PHCs) are crucial in providing primary and secondary level healthcare services in rural India. Despite immense efforts and huge funding, a very small proportion of deliveries are carried out at PHCs. The present study aims to explore the availability of facilities at PHCs and its association with likelihood of delivering the child at PHC.

Methods

We extracted PHC level health infrastructure data from Health Management and Information system (HMIS) and created ‘Facility Index’ using exploratory factor analysis. We merged the ‘Facility Index’ with data of the 4th National Family Health Survey (NFHS-4) to explore the relationship between availability of facilities and healthcare-seeking behavior. Bivariate analysis and multilevel logistic regressions were employed to analyze the association between Facility Index and the likelihood of delivering the child at PHC.

Results

Availability of facilities (Facility Index) was found to be positively associated with utilization of PHC for childbirth but up to only a certain level of Facility Index. Women living in districts with ‘good’ Facility index were having 2.45 (OR = 2.45; 95% CI: 2.12–2.84) times higher odds of delivering the child at PHC compared to women living in districts with ‘very poor’ Facility Index; however, the odds ratio decreased to 2.11 (95% CI: 1.83–2.43) for ‘Very Good’ Facility Index. The regression line and predicted probabilities also exhibited similar results.

Conclusion

Based on the findings, we conclude that improvement in availability and quality of facilities might help in improving healthcare utilization from PHCs up to a certain level.
A pilot study evaluating the Calibrated Automated Thrombogram assay and application of plasma-thromboelastography for detection of hemostatic aberrations in horses with gastrointestinal disease
Authors: Honoré Marie Louise , Pihl Tina Holberg , Nielsen Lise Nikolic
Published: November 2021

Background

Critically ill horses, such as horses with gastrointestinal (GI) disease, often suffer from hemostatic aberrations. Global hemostatic tests examining the initiation of coagulation, clot strength and fibrinolysis, such as the Calibrated Automated Thrombogram (CAT) and plasma-thromboelastography (TEG) have not been evaluated in horses. This study aimed to evaluate CAT and apply plasma-TEG in horses.

Test performance of CAT was evaluated on equine platelet poor plasma with intra- and inter-assay variability (CV) and a heparin dilution curve. To examine clinical performance of both tests, group comparisons were assessed comparing healthy horses, horses with mild and severe GI disease with both CAT and plasma-TEG.

Results

For CAT, intra- and inter-assay CVs were established for lag-time (1.7, 4.7%), endogenous thrombin potential (1.6, 4.6%), peak (2.6, 3.9%) and time to peak (ttPeak) (1.9, 3.4%). Increasing heparin concentrations led to the expected decrease in thrombin generation. In the group comparison analysis, CAT showed significant higher peak (p = 0.04) and ttPeak (p = 0.008) in the severe GI disease group compared to horses with mild GI disease and healthy horses, respectively. Plasma-TEG showed an increased angle (p = 0.032), maximum amplitude (p = 0.017) and shear elastic force (G) (p = 0.017) in the severe GI disease group compared to healthy horses.

Conclusions

CAT performed well in horses. Both CAT and plasma-TEG identified hemostatic aberrations in horses with severe GI disease compared to healthy horses. Further studies including more horses, are needed to fully appreciate the use of CAT and plasma-TEG in this species.
mapMECFS: a portal to enhance data discovery across biological disciplines and collaborative sites
Authors: Mathur Ravi , Carnes Megan U. , Harding Alexander , Moore Amy , Thomas Ian , Giarrocco Alex , Long Michael , Underwood Marcia , Townsend Christopher , Ruiz-Esparza Roman , Barnette Quinn , Brown Linda Morris , Schu Matthew
Published: November 2021

Background

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disease which involves multiple body systems (e.g., immune, nervous, digestive, circulatory) and research domains (e.g., immunology, metabolomics, the gut microbiome, genomics, neurology). Despite several decades of research, there are no established ME/CFS biomarkers available to diagnose and treat ME/CFS. Sharing data and integrating findings across these domains is essential to advance understanding of this complex disease by revealing diagnostic biomarkers and facilitating discovery of novel effective therapies.

Methods

The National Institutes of Health funded the development of a data sharing portal to support collaborative efforts among an initial group of three funded research centers. This was subsequently expanded to include the global ME/CFS research community. Using the open-source comprehensive knowledge archive network (CKAN) framework as the base, the ME/CFS Data Management and Coordinating Center developed an online portal with metadata collection, smart search capabilities, and domain-agnostic data integration to support data findability and reusability while reducing the barriers to sustainable data sharing.

Results

We designed the mapMECFS data portal to facilitate data sharing and integration by allowing ME/CFS researchers to browse, share, compare, and download molecular datasets from within one data repository. At the time of publication, mapMECFS contains data curated from public data repositories, peer-reviewed publications, and current ME/CFS Research Network members.

Conclusions

mapMECFS is a disease-specific data portal to improve data sharing and collaboration among ME/CFS researchers around the world. mapMECFS is accessible to the broader research community with registration. Further development is ongoing to include novel systems biology and data integration methods.
Giant bilateral axillary artery aneurysms with left complete obstructive thrombus in intravenous immunoglobulin-sensitive Kawasaki disease: a case report
Authors: Chu Chen , He Lan , Lin Yi-xiang , Xie Li-ping , Liu Fang
Published: November 2021

Background

Kawasaki disease (KD) is a systemic vasculitis that predominantly affects medium-sized arteries. In addition to well-known coronary artery aneurysms (CAAs), peripheral systemic artery aneurysms (SAAs) have also been sporadically reported. In the literatures, SAAs occurred mainly in untreated, intravenous immunoglobin (IVIG)-resistant, or severe refractory KD, and thrombotic events in SAAs were rarely reported.

Case presentation

A 10-month-old boy with a history of KD was referred to our hospital for suspected pseudoaneurysm of the axillary arteries. Four months prior to presentation, he had persistent fever, conjunctival congestion, and rash. On the 10th day of fever echocardiogram showed biliteral CAAs. He was then diagnosed with KD and given IVIG 2 g/kg and aspirin at a local hospital. His fever and symptoms soon subsided and he was discharged with low dose aspirin and dipyridamole. One month prior to presentation, his parents incidentally palpated swellings in his bilateral axillae. On admission, physical examination revealed a pulsatile swelling in his right axilla and a non-pulsatile swelling in the left with impalpable left brachial and radial pulses, cooler and less active left upper limb than the right one. While the pulses of other three limbs were normal. Ultrasound examination revealed giant bilateral axillary artery aneurysms (AAAs) with massive thrombus in the left. Angiography confirmed giant bilateral AAAs with left AAAs completely occluded and fine collateral vessels connecting to the distal brachial artery, in addition to giant bilateral multiple CAAs without stenoses. The patient was given intravenous prostaglandin for 10 days to allow for formation of collateral circulation, as well as aspirin, low molecular weight heparin (which was switched to warfarin before discharge) and metoprolol. At discharge, the temperature and movement of his left upper limb improved significantly. On follow-up at 7 months, his left upper limb further improved and was similar to the right with no occurrence of cardiovascular events. The images of CAAs and AAAs on echocardiogram and computerized tomography remained the same.

Conclusions

This case highlights the importance of evaluating peripheral SAAs in KD patients with CAAs, even if their course of treatment appears smooth. For both large non-aortic SAAs and CAAs in KD patients, antithrombotic therapy is of utmost importance.
Headache and immunological/autoimmune disorders: a comprehensive review of available epidemiological evidence with insights on potential underlying mechanisms
Authors: Biscetti Leonardo , De Vanna Gioacchino , Cresta Elena , Corbelli Ilenia , Gaetani Lorenzo , Cupini Letizia , Calabresi Paolo , Sarchielli Paola
Published: November 2021

Several lines of evidence support a role of the immune system in headache pathogenesis, with particular regard to migraine. Firstly, alterations in cytokine profile and in lymphocyte subsets have been reported in headache patients. Secondly, several genetic and environmental pathogenic factors seem to be frequently shared by headache and immunological/autoimmune diseases. Accordingly, immunological alterations in primary headaches, in particular in migraine, have been suggested to predispose some patients to the development of immunological and autoimmune diseases. On the other hand, pathogenic mechanisms underlying autoimmune disorders, in some cases, seem to favour the onset of headache. Therefore, an association between headache and immunological/autoimmune disorders has been thoroughly investigated in the last years. The knowledge of this possible association may have relevant implications in the clinical practice when deciding diagnostic and therapeutic approaches. The present review summarizes findings to date regarding the plausible relationship between headache and immunological/autoimmune disorders, starting from a description of immunological alteration of primary headaches, and moving onward to the evidence supporting a potential link between headache and each specific autoimmune/immunological disease.
Progressive pseudorheumatoid dysplasia misdiagnosed as juvenile idiopathic arthritis: a case report
Authors: Omar Anjumanara Anver , Ahmed Salman , Rodrigues John Chris , Kayiza Allan , Owino Lawrence
Published: November 2021

Background

Progressive pseudorheumatoid dysplasia is a rare, autosomal recessively inherited, noninflammatory musculoskeletal disorder caused by mutations occurring in the WNT1-inducible signaling pathway protein 3 gene. Joint cartilage is the primary site of involvement, leading to arthralgia, joint stiffness, contractures, enlargement of the epiphyses and metaphysis of the hand joints, spinal abnormalities, short stature, early osteoarthritis, and osteoporosis. Juvenile idiopathic arthritis is the most common chronic rheumatic disease in childhood and has unknown etiology. Clinical features of progressive pseudorheumatoid dysplasia resemble those of juvenile idiopathic arthritis. Patients with progressive pseudorheumatoid dysplasia are usually misdiagnosed as having juvenile idiopathic arthritis.

Case presentation

A 13-year-old Yemeni female presented to the rheumatology clinic with a history of joint pains, bone pains, and bone deformity for 7 years. Weight and height were below the third percentiles. There was no tender swelling of metacarpophalangeal and interphalangeal joints, and she presented with scoliosis. Radiographs of the hands revealed the widening of the epiphyses. Progressive pseudorheumatoid dysplasia was suspected, and genetic testing for WNT1-inducible signaling pathway protein 1, 2, and 3 was requested with these findings. A homozygous, likely pathogenic variant was identified in the WNT1-inducible signaling pathway protein 3 gene, which confirmed our diagnosis.

Conclusion

Progressive pseudorheumatoid dysplasia is a rare form of spondyloepimetaphyseal dysplasia and is clinically misdiagnosed as juvenile idiopathic arthritis. It is crucial to consider progressive pseudorheumatoid dysplasia, especially in patients with standard inflammatory markers who are being followed up for juvenile idiopathic arthritis and not improving with antirheumatic intervention.
XRF elemental analysis of inks in South American manuscripts from 1779 to 1825
Authors: Luízar Obregón Celina , Zamalloa Jara Marco A. , Rojas Arizapana Flor L. , Chura Huayllani Yuri J. , Gonzales Bellido Janet F. , Olivera Olivera Jorge
Published: November 2021

The Regional Archive of Cusco in Peru guards valuable history collections with exceptional regional and international value dating from the sixteenth century to the present. Historical manuscripts are part of the identity of all people; they constitute a tangible cultural heritage that must be studied, valued, and protected. In this sense, the objective of this research was to identify the chemical compositions of inks and paper, with the goals of setting the background of their originality, identifying relationships between them, and glimpsing antecedents that generated degradation due to the compositions of the inks. This study is the first of its kind in Peru and reveals the chemical elements present in the writing ink, the seal, and the paper of five documents from the late eighteenth and early nineteenth centuries. Duplicate in situ nondestructive analyses were carried out using a hand-held X-ray fluorescence spectrometer under ambient conditions in soil mode, configured with three sequential shots, and energies from zero to 40, 40, and 15 keV, respectively. The elements S and Fe were present as components of iron gall inks. Cu and Zn were less abundant; probably, they provided less corrosion and more color intensity to the inks. The minor elements Pb, As, and especially Ag in all manuscripts differentiate them from European inks of the same period. Additionally, the five documents reflect the same elemental compositions but with different concentrations. This could mean that writers used local raw materials and Spanish ink recipes. Finally, the analyses of standard reference material, SRM 1646a and SRM 196b, gave results with acceptable precision.

Graphical Abstract
Are some feasibility studies more feasible than others? A review of the outcomes of feasibility studies on the ISRCTN registry
Authors: Morgan Ben , Hejdenberg Jennie , Kuleszewicz Kasia , Armstrong David , Ziebland Sue
Published: November 2021

Background

Feasibility studies are often conducted before committing to a randomised controlled trial (RCT), yet there is little published evidence to inform how useful feasibility studies are, especially in terms of adding or reducing waste in research. This study attempted to examine how many feasibility studies demonstrated that the full trial was feasible and whether some feasibility studies were inherently likely to be feasible or not feasible, based on the topic area and/or research setting.

Methods

Keyword searches were conducted on the International Standard Randomised Controlled Trials Number (ISRCTN) registry to identify all completed feasibility studies which had been conducted in the UK.

Results

A total of 625 records from the 1933 identified were reviewed before it became evident that it would be futile to continue. Of 329 feasibility studies identified, 160 had a known outcome (49%), 133 (83%) trials were deemed to be feasible and only 27 (17%) were reported to be non-feasible. There were therefore too few studies to allow the intended comparison of differences in non-feasible studies by topic and/or setting.

Conclusions

There were too few studies reported as non-feasible to draw any useful conclusions on whether topic and/or setting had an effect. However, the high feasibility rate (83%) may suggest that non-feasible studies are subject to publication bias or that many feasible studies are redundant and may be adding waste to the research pathway.
Study protocol for a pilot high-intensity interval training intervention in inpatient mental health settings: a two-part study using a randomised controlled trial and naturalistic study design
Authors: Martland Rebecca , Onwumere Juliana , Stubbs Brendon , Gaughran Fiona
Published: November 2021

Background

Severe mental illnesses (SMI), including schizophrenia spectrum disorder, bipolar disorder and major depressive disorder, are associated with physical health comorbidities and premature mortality. Physical activity and structured exercise have a beneficial impact on cardiometabolic risk and ameliorate mental health symptomology and cognition. This protocol describes a feasibility study for a high-intensity interval training (HIIT) intervention among inpatients with SMI, to improve their physical and mental health.

Methods

The feasibility study follows a two-part design owing to COVID-19-related adaptations to project design: (a) a non-blinded randomised controlled trial (RCT) of 12 weeks of bicycle-based HIIT, delivered twice weekly in a face-to-face, one-to-one setting, compared to treatment as usual (TAU) and (b) a naturalistic study of inpatient HIIT; eligible participants will be invited to two sessions of HIIT per week, delivered by the research team remotely or in person. Additionally, participants in the naturalistic study may use the bike to conduct self-directed sessions of their chosen length and intensity. We will measure the feasibility and acceptability of the HIIT intervention as primary outcomes, alongside secondary and tertiary outcomes evaluating the physical, mental and cognitive effects of HIIT. The study aims to recruit 40 patients to the RCT and 6–8 patients to the naturalistic design.

Discussion

Exercise is a modifiable lifestyle barrier that can reverse cardiometabolic disease risk. If HIIT is found to be feasible and acceptable in inpatients with SMI, there would be scope for large-scale work to evaluate the clinical, cost and implementation effectiveness of HIIT in inpatient mental health settings.

Trial registration

ClinicalTrials.gov NCT03959735. Registered June 22, 2019.
Supportive tactics for innovative and sustainability performance in emerging SMEs
Authors: Ullah Farid , Degong Ma , Anwar Muhammad , Hussain Saddam , Ullah Rizwan
Published: November 2021

For this research, we examined the influence of access to domestic and international financing on sustainability performance with a mediating role of innovative performance and a moderating role of access to government support. Data were collected from 317 small and medium-sized enterprises (SMEs) through structured questionnaires. The results indicated that access to domestic and international financing significantly contributes to sustainability and innovative performances. Accordingly, we found a partial mediating role of innovative performance between access to domestic financing and sustainability performance as well as between access to international financing and sustainability performance. Access to government support significantly moderates the relationship between access to domestic finances and innovative performance as well as between access to international finances and innovative performance. Practitioners and policymakers should encourage national and international financial institutions and banks to facilitate SMEs by lending them funds for innovative activities and sustainability performance. Moreover, the government should support SMEs, so that they can contribute to economic growth and the gross domestic product. The implications from these matters will be further discussed in this paper.