bluuebunny/crossref_metadata_2025 huggingface dataset:
A clinically applicable gene expression–based score predicts resistance to induction treatment in acute myeloid leukemia
Authors: Moser Christian , Jurinovic Vindi , Sagebiel-Kohler Sabine , Ksienzyk Bianka , Batcha Aarif M. N. , Dufour Annika , Schneider Stephanie , Rothenberg-Thurley Maja , Sauerland Cristina M. , Görlich Dennis , Berdel Wolfgang E. , Krug Utz , Mansmann Ulrich , Hiddemann Wolfgang , Braess Jan , Spiekermann Karsten , Greif Philipp A. , Vosberg Sebastian , Metzeler Klaus H. , Kumbrink Jörg , Herold Tobias
Published: September 2021

Prediction of resistant disease at initial diagnosis of acute myeloid leukemia (AML) can be achieved with high accuracy using cytogenetic data and 29 gene expression markers (Predictive Score 29 Medical Research Council; PS29MRC). Our aim was to establish PS29MRC as a clinically usable assay by using the widely implemented NanoString platform and further validate the classifier in a more recently treated patient cohort. Analyses were performed on 351 patients with newly diagnosed AML intensively treated within the German AML Cooperative Group registry. As a continuous variable, PS29MRC performed best in predicting induction failure in comparison with previously published risk models. The classifier was strongly associated with overall survival. We were able to establish a previously defined cutoff that allows classifier dichotomization (PS29MRCdic). PS29MRCdic significantly identified induction failure with 59% sensitivity, 77% specificity, and 72% overall accuracy (odds ratio, 4.81; P = 4.15 × 10−10). PS29MRCdic was able to improve the European Leukemia Network 2017 (ELN-2017) risk classification within every category. The median overall survival with high PS29MRCdic was 1.8 years compared with 4.3 years for low-risk patients. In multivariate analysis including ELN-2017 and clinical and genetic markers, only age and PS29MRCdic were independent predictors of refractory disease. In patients aged ≥60 years, only PS29MRCdic remained as a significant variable. In summary, we confirmed PS29MRC as a valuable classifier to identify high-risk patients with AML. Risk classification can still be refined beyond ELN-2017, and predictive classifiers might facilitate clinical trials focusing on these high-risk patients with AML.
DNA damage repair system in C57BL/6 J mice is evolutionarily stable
Authors: Wang Xiaoyu , Wang San Ming
Published: September 2021

Background

DNA damage repair (DDR) system is vital in maintaining genome stability and survival. DDR consists of over 160 genes in 7 different pathways to repair specific type of DNA damage caused by external and internal damaging factors. The functional importance of DDR system implies that evolution could play important roles in maintaining its functional intactness to perform its function. Indeed, it has been observed that positive selection is present in BRCA1 and BRCA2 (BRCA), which are key genes in homologous recombination pathway of DDR system, in the humans and its close relatives of chimpanzee and bonobos. Efforts have been made to investigate whether the same selection could exist for BRCA in other mammals but found no evidence so far. However, as most of the studies in non-human mammals analyzed only a single or few individuals in the studied species, the observation may not reflect the true status in the given species. Furthermore, few studies have studied evolution selection in other DDR genes except BRCA. In current study, we used laboratory mouse C57BL/6 J as a model to address evolution selection on DDR genes in non-primate mammals by dynamically monitoring genetic variation across 30 generations in C57BL/6 J.

Results

Using exome sequencing, we collected coding sequences of 169 DDR genes from 44 C57BL/6 J individual genomes in 2018. We compared the coding sequences with the mouse reference genome sequences derived from 1998 C57BL/6 J DNA, and with the mouse Eve6B reference genome sequences derived from 2003 C57BL/6 J DNA, covering 30 generations of C57BL/6 J from 1998 to 2018. We didn’t identify meaningful coding variation in either Brca1 or Brca2, or in 167 other DDR genes across the 30 generations. In the meantime, we did identify 812 coding variants in 116 non-DNA damage repair genes during the same period, which served as a quality control to validate the reliability of our analytic pipeline and the negative results in DDR genes.

Conclusions

DDR genes in laboratory mouse strain C57BL/6 J were not under positive selection across its 30-generation period, highlighting the possibility that DDR system in rodents could be evolutionarily stable.
The impact of inhalation anesthetics on early postoperative cognitive function and recovery characteristics in Down syndrome patients: a randomized, double – blind study
Authors: Gkliatis Emmanouil , Makris Alexandros , Staikou Chryssoula
Published: September 2021

Background

Down syndrome (DS) is associated with intellectual disability. DS patients may be unable to cooperate and often require general anesthesia even for minor surgeries. Rapid recovery significantly contributes to fast-tracking. This prospective randomized, double - blind study investigates the impact of desflurane and sevoflurane on recovery and early postoperative cognitive function of these patients.

Methods

Forty-four patients undergoing dental surgery, were randomized to receive desflurane (DES-group) or sevoflurane (SEVO-group) for anesthesia maintenance. The primary outcome was postoperative cognitive function (Prudhoe Cognitive Function Test, PCFT) at 90 min and 4 h postoperatively. Secondary outcome measures were the time between volatile discontinuation and spontaneous breath, eye opening, extubation, orientation and response to commands, time to achieve an Aldrete score ≥ 9 in the Post-anesthesia Care Unit and time to fulfill discharge criteria (Post Anesthetic Discharge Scoring System, PADSS).

Results

At 90 min, PCFT scores significantly decreased from baseline in both groups. Nevertheless, at 4 h, in DES-group there was no significant change from baseline (p = 0.163), while in SEVO-group the decrease remained significant (p < 0.001). Desflurane was also found superior regarding recovery characteristics, such as time to eye opening (p = 0.021), spatial orientation (p = 0.004), response to commands (p = 0.004). Discharge criteria were met earlier in DES-group (p = 0.018 for Aldrete score / p < 0.001 for PADSS).

Conclusions

Desflurane was found superior to sevoflurane in terms of faster recovery and better preserved postoperative cognitive function in DS patients undergoing dental surgery. We suggest that desflurane, as part of a multimodal anesthetic approach, could be a useful agent to enhance early discharge from hospital of ambulatory patients with intellectual disability.

Trial registration

Registered with ClinicalTrials.gov (NCT02971254, principal investigator: E.G; November 2016).
Proteome-scale profiling reveals MAFF and MAFG as two novel key transcription factors involved in palmitic acid-induced umbilical vein endothelial cell apoptosis
Authors: Wang Mangyuan , Liu Fen , Fang Binbin , Huo Qiang , Yang Yining
Published: September 2021

Background

Vascular endothelial cell apoptosis is the leading risk factor of atherosclerosis (AS). The purpose of our study was to use a new generation high-throughput transcription factor (TF) detection method to identify novel key TFs in vascular endothelial cell apoptosis induced by palmitic acid (PA).

Methods

Human umbilical vein endothelial cells (HUVECs) were treated with 0, 300, or 500 µM PA. Candidate TFs in the three groups were identified by differential expression, pathway enrichment, Western Blot (WB), and RT-qPCR analyses. Apoptosis was assessed by fluorescence-activated cell sorting (FACS) using FITC-annexin V and propidium iodide staining.

Results

We established a HUVEC apoptosis model to simulate the process of atherosclerosis onset and identified 51 significant TFs. of the 51 TFs, v-maf musculoaponeurotic fibrosarcoma oncogene family protein G (MAFG) and v-maf musculoaponeurotic fibrosarcoma oncogene family protein F (MAFF), were matched to known AS signalling pathways and were validated by WB and RT-qPCR analyses in our study. Overexpression of MAFG or MAFF in HUVECs significantly inhibited PA-induced early apoptosis.

Conclusions

We identified MAFF and MAFG as novel key TFs in vascular endothelial cell apoptosis.
Detection of Coccidioides posadasii in a patient with meningitis using metagenomic next-generation sequencing: a case report
Authors: Mao Yuqiao , Li Xia , Lou Haibo , Shang Xiaoyu , Mai Yanjun , Yang Lan , Peng Fuhua , Fu Xihua
Published: September 2021

Background

Coccidioidomycosis is a systemic infection caused by dimorphic fungi Coccidioides spp. endemic to Southwestern United States and Central and South America. A history of residence and travel in these areas is essential for the diagnostic of coccidioidomycosis, which has highly variable symptoms ranging from asymptomatic to severe, disseminated infection, and even death. Immunocompromised patients of coccidioidomycosis experience a high risk of dissemination, chronic infection, and mortality. Meningitis is one of the most deleterious coccidioidomycosis and can cause various life-threatening complications.

Case presentation

Here we report a case of Coccidioides posadasii meningitis in a 49-year-old female who returned to China after one and a half years residence in Los Angeles, USA. The repeated routine cultures using CSF for bacteria or fungi were all negative. To hunt for an infectious etiology, the state-of-the-art technology metagenomic next-generation sequencing (mNGS) was then utilized, suggesting Coccidioides posadasii. Organizational pathological examination and polymerase-chain-reaction (PCR) results subsequently confirmed the mNGS detection.

Conclusion

To our knowledge, cases for coccidioidal meningitis have been rarely reported in China. While global travelling may spread this disease across continents and make the diagnosis more difficult. mNGS can detect almost all known pathogens with high sensitivity and specificity, especially for uncommon pathogen, such as Coccidioides posadasii in China.
The aetiology of pharyngotonsillitis in primary health care: a prospective observational study
Authors: Pallon Jon , Rööst Mattias , Sundqvist Martin , Hedin Katarina
Published: September 2021

Background

Few studies on pharyngotonsillitis have examined the clinical presentation of different aetiologies where pathogens have been detected using molecular methods. We aimed to assess how well clinical signs and symptoms can predict (1) the presence or absence of a broad range of viruses and bacteria, and (2) reconsultations for a sore throat or a complication.

Methods

In this descriptive observational prospective study in primary health care 220 patients aged 15–45 with suspected pharyngotonsillitis were sampled from nose, throat and blood and screened for 20 bacteria and viruses using polymerase chain reaction (PCR), culture and serology. Odds ratios (OR) and predictive values with 95% confidence intervals (CI) were used to show association between microbiological findings and clinical signs and symptoms. Patients were followed up after 3 months by reviewing electronic medical records.

Results

Both cough and coryza were more common in patients with only viruses (67%) than in patients with only bacteria (21%) (p < 0.001), whereas tonsillar coating was more common in patients with only bacteria (53%) than in patients with only viruses (29%) (p = 0.006). Tonsillar coating (adjusted OR 6.0; 95% CI 2.5–14) and a lack of cough (adjusted OR 3.5; 95% CI 1.5–8.0) were significantly associated with Streptococcus pyogenes (group A streptococci; GAS) and with any bacterial finding. A Centor score of 3–4 had a positive predictive value of 49% (95% CI 42–57) for GAS and 66% (95% CI 57–74) for any bacterial findings. The use of rapid antigen detection test for GAS increased the positive predictive value for this group to 93%.

Conclusions

Signs and symptoms, both single and combined, were insufficient to rule in GAS or other pathogens. However, both cough and coryza were useful to rule out GAS. The results support the clinical approach of restricting rapid antigen detection testing to patients with 3–4 Centor criteria. The low carriage rate of bacteria among asymptomatic controls implied that most detections in patients represented a true infection.
Women empowerment and minimum daily meal frequency among infants and young children in Ghana: analysis of Ghana demographic and health survey
Authors: Dadzie Louis Kobina , Amo-Adjei Joshua , Esia-Donkoh Kobina
Published: September 2021

Background

The nutritional quality of food has an important impact on the health and well-being of families, especially children whose bodies need to grow, develop and reach their full physical and mental potential. Traditionally, women in Ghana provide care and nourishment for their children and families if they have the means to do so or if they are financially, legally and socially empowered. Women’s empowerment is not only important for women’s human rights, but also improves nutrition and health outcomes of both mothers and their children. Women’s empowerment is concerned with increasing ability to make strategic life choices in situations where the ability was hitherto denied. This study sought to investigate the association between women’s empowerment and minimum daily meal frequency (minimum number of meals to be consumed in a day) in Ghana.

Methods

The study used data from the 2014 Ghana Demographic and Health Survey (GDHS). A sample of 1640 mother-child dyad was used. Mothers ages ranged from 15 to 49 while children’s ages ranged from 6 to 23 months. Univariate and multiple linear regression techniques were applied to identify women empowerment (economic, socio-familial and legal) and sociodemographic factors associated with minimum daily meal frequency scores. Data was analyzed by the STATA statistical package software version 13.0. Statistical significance level was set at P < 0.10.

Results

Data from decisions on large household purchases (β = 0.351, p < 0.01) family visits (β = 0.743, p < 0.01), home ownership (β = − 0.245, p < 0.10), age of child (β = 1.387, p < 0.01), mother’s educational attainment (β = 0.496, p < 0.10) and place of residence (β = − 0.298, p < 0.10) showed significant positive association with minimum daily meal frequency in Ghana.

Conclusion

Minimum daily meal frequency was largely influenced by economic and socio-familial factors that contribute to empowerment of women. as decisions on large household purchases and family visits showed significant positive association with minimum daily meal frequency. Interventional programs should target households and mothers with lower socio-demographic characteristics such as lower educational levels and low economic status to improve minimal daily meal frequency in their children thereby ensuring better child health and well-being.
Development and validation of a set of patient reported outcome measures to assess effectiveness of asthma prophylaxis
Authors: Guruparan Yalini , Navaratinaraja Thiyahiny S. , Selvaratnam Gowry , Gunawardena Nalika , Sri Ranganathan Shalini
Published: September 2021

Background

In the local setting, asthma control is assessed by symptoms and signs elicited by clinicians because of the limited availability of spirometry. Hence, we intended to develop a patient reported outcome measure (PROM) with more holistic interpretation that could also serve as a tool to measure the asthma control in resource limited settings. Therefore, this study was carried out in Northern Sri Lanka to develop and validate the Asthma Control PROM (AC-PROM) Tamil to measure the effectiveness of asthma prophylaxis based on symptoms, exacerbation and limitation of activity which could also serve as an easy measure of asthma control to the provider.

Methods

The AC-PROM Tamil was developed in 3 steps: item generation, item reduction and psychometric evaluation. Items were generated through thematic analysis from focus group discussions among patients with asthma. Items were converted to an interviewer administered questionnaire in Tamil in the format of 5-point Likert scale. Item reduction was done by two rounds of online Delphi surveys among 10 experts and an exploratory factor analysis among 200 patients with asthma. The face and content validity were assessed by a panel of experts during Delphi survey and patients during the pre-test of the tool. Criterion validity of the tool was assessed against the forced expiratory volume in one second of 187 patients with asthma. The cut-off value to assess the asthma control was determined by receiver operating characteristic curve. Reliability was verified by Cronbach’s alpha coefficient.

Results

From thematic analysis of focus group discussions 10 items were generated. One item was removed during Delphi survey. Exploratory factor analysis indicated removal of another item with 8 items categorised into two factors. Cronbach’s alpha coefficient of factors 1 and 2 were 0.821 and 0.903 respectively, indicating good reliability. Observations made by experts and responses made by patients were incorporated to improve the clarity and relevance of the items. Criterion validity was demonstrated by significant correlation between the AC-PROM Tamil and forced expiratory volume in one second (r = 0.66, p = 0.001). The cut-off value of the AC-PROM Tamil to detect asthma control was 28.5 with 79% (95% CI 71.3–86.9) sensitivity and 71% (95% CI 61.9–79.6) specificity. The AC-PROM Tamil showed moderate accuracy (the area under the receiver operating characteristic curve = 0.796; 95% CI 0.73–0.86). Response rate of the AC-PROM Tamil was 100% and time taken to complete was 3–4 min.

Conclusion

The AC-PROM Tamil is a simple, feasible and reasonably accurate tool to assesses the effectiveness of asthma prophylaxis, particularly in resource limited settings.
Sulfamethoxazole-induced sulfamethoxazole urolithiasis: a case report
Authors: Roedel Megan M. , Nakada Stephen Y. , Penniston Kristina L.
Published: September 2021

Background

Drug-induced urolithiasis falls into two categories: drug-induced and metabolically-induced. Certain antimicrobials are associated with each; sulfonamides are associated with drug- or metabolite-containing calculi when taken in large doses over a long period of time. Trimethoprim-sulfamethoxazole, a member of the sulfonamide family, is a rare cause of drug-induced calculi. Cases of sulfonamide urolithiasis occurring in patients with known stone disease have rarely been reported.

Case presentation

We report a case of a patient with a brief history of recurrent calcium oxalate nephrolithiasis requiring 2 ureteroscopic procedures whose existing 6 mm lower pole renal stone more than quadrupled in size to form a 4 cm renal staghorn after 4 months of high-dose treatment for Nocardia pneumonia with trimethoprim-sulfamethoxazole. After ureteroscopy with laser lithotripsy and basketing of fragments, the stone was found to be predominantly composed of N4-acetyl-sulfamethoxazole, a metabolite of sulfamethoxazole.

Conclusion

Stones composed of sulfamethoxazole or its metabolites are rare but have known associated risk factors that should be considered when prescribing this antibiotic. This case report illustrates additional risk factors for consideration, including pre-existing urinary calculi that may serve as a nidus for sulfamethoxazole deposition, and reviews treatment and prevention methods.
Real-time co-site optical microscopy study on the morphological changes of the dentine’s surface after citric acid and sodium hypochlorite: a single-tooth model
Authors: Wilkoński Wojciech , Jamróz-Wilkońska Lidia , Zapotoczny Szczepan , Opiła Janusz , Giardino Luciano
Published: September 2021

Background

To this day, the effects of sodium hypochlorite and chelating agents on the smear layer and on the dentine’s surface, remain not fully examined. The study is aimed to analyze the dentine's surface treated with 40% citric acid and 5.25% sodium hypochlorite according to two irrigation protocols.

Materials and methods

The study employed a computer-controlled Nikon Eclipse LV100 optical microscope. Ten roots split longitudinally with canals prepared mechanically using the MTwo system to a size of 40/04 were observed. The root halves were divided into two study groups, one half in each of the groups. According to two irrigation protocols, the dentine's surface was irrigated with 40% citric acid and 5.25% sodium hypochlorite, separated with water. Dentine surface was observed in a fixed place and photographed in 500 × magnification after each irrigation stage. The obtained images were then analyzed using computer software (NIS-Elements AR, GIMP-2.6, ImageJ 1.45s).

Results

Various speed of removal of the smear layer and varied morphological changes of the dentine's surface were observed in both examined groups. Double irrigation of the dentine with citric acid for 30 s resulted in complete removal of the smear layer, and double irrigation for 60 s resulted in increased mean diameter of the dentine tubules (degradation of the dentine's surface).

Conclusions

Double alternating irrigation with citric acid and sodium hypochlorite for 30 s yielded satisfactory results, while double irrigation for 60 s resulted in increased mean diameter of the dentine tubules. A real time assessment of the dentine’s surface changes after both tested solutions can improve understanding of the phenomena that occur during the irrigation and as a result it might help to improve clinical outcomes in root canal treatment.
Patterns of hospital utilization in the Unified Health System in six Brazilian capitals: comparison between the year before and the first six first months of the COVID-19 pandemic
Authors: Portela Margareth Crisóstomo , de Aguiar Pereira Claudia Cristina , Lima Sheyla Maria Lemos , de Andrade Carla Lourenço Tavares , Martins Mônica
Published: September 2021

Objective

To analyze the temporal evolution of the pattern of hospital use in the context of the COVID-19 pandemic in Brazil.

Methods

This retrospective observational study compared hospital use and mortality in the Brazilian Unified Health System (SUS) in the first six months of the COVID-19 pandemic with the year before the onset of the pandemic in six Brazilian capitals (São Paulo, Rio de Janeiro, Manaus, Fortaleza, Recife, and Brasilia). It was based on secondary administrative data from the SUS Hospital Information System (SIH), focusing on the number of hospitalizations per fortnight, age, and gender of patients, hospital length of stay, and the proportions of surgical, elective, with the use of ICU, and resulting in death hospitalizations. It also compared the number of hospitalizations and mortality related to frequent diagnostic groups.

Results

A significant drop was identified in the number of hospitalizations as of March 2020, with the first peak of COVID-19 hospitalizations in five capitals recorded in May 2020. In the six capitals, we observed significant reductions in the mean number of hospitalizations per fortnight from the beginning of the pandemic. We also identified an increase in the mean age of the patients and the proportion of male patients. The proportion of surgical and elective hospitalizations dropped significantly in all capitals, while the proportion of hospitalizations with ICU use increased significantly. Significant increases in-hospital mortality were also recorded in the six capitals with the pandemic, including or excluding COVID-19 hospitalizations from the comparison.

Conclusion

The pandemic caused changes in the pattern of use and hospital indicators in the first six months in the cities considered, evidencing the need for attention to diseases with a hospital production altered by the COVID-19 course and health system performance problems in the face of challenges.
Clinical and laboratory findings and PCR results in severe and non-severe COVID19 patients based on CURB-65 and WHO severity indices
Authors: Karimi Farnaz , Saleh Mahshid , Vaezi Amir Abbas , Qorbani Mostafa , Avanaki Foroogh Alborzi
Published: September 2021

Background

The importance of clinicolaboratory characteristics of COVID-19 made us report our findings in the Alborz province according to the latest National Guideline for the diagnosis and treatment of COVID-19 in outpatients and inpatients (trial five versions, 25 March 2020) of Iran by emphasizing rRT-PCR results, clinical features, comorbidities, and other laboratory findings in patients according to the severity of the disease.

Methods

In this study, 202 patients were included, primarily of whom 164 had fulfilled the inclusion criteria. This cross-sectional, two-center study that involved 164 symptomatic adults hospitalized with the diagnosis of COVID-19 between March 5 and April 5, 2020, was performed to analyze the frequency of rRT-PCR results, distribution of comorbidities, and initial clinicolaboratory data in severe and non-severe cases, comparing the compatibility of two methods for categorizing the severity of the disease.

Results

According to our findings, 111 patients were rRT-PCR positive (67.6%), and 53 were rRT-PCR negative (32.4%), indicating no significant difference between severity groups that were not related to the date of symptoms' onset before admission.

Based on the National Guideline, among vital signs and symptoms, mean oxygen saturation and frequency of nausea showed a significant difference between the two groups (P < 0.05); however, no significant difference was observed in comorbidities. In CURB-65 groups, among vital signs and comorbidities, mean oxygen saturation, diabetes, hypertension (HTN), hyperlipidemia, chronic heart disease (CHD), and asthma showed a significant difference between the two groups (P < 0.05), but no significant difference was seen in symptoms.

Conclusion

In this study, rRT-PCR results of hospitalized patients with COVID-19 were not related to severity categories. From initial clinical characteristics, decreased oxygen saturation appears to be a more common abnormality in severe and non-severe categories. National Guideline indices seem to be more comprehensive to categorize patients in severity groups than CURB-65, and there was compatibility just in non-severe groups of National Guideline and CURB-65 categories.
Lung ultrasound in a tertiary intensive care unit population: a diagnostic accuracy study
Authors: Smit Jasper M. , Haaksma Mark E. , Winkler Michiel H. , Heldeweg Micah L. A. , Arts Luca , Lust Erik J. , Elbers Paul W. G. , Meijboom Lilian J. , Girbes Armand R. J. , Heunks Leo M. A. , Tuinman Pieter R.
Published: September 2021

Background

Evidence from previous studies comparing lung ultrasound to thoracic computed tomography (CT) in intensive care unit (ICU) patients is limited due to multiple methodologic weaknesses. While addressing methodologic weaknesses of previous studies, the primary aim of this study is to investigate the diagnostic accuracy of lung ultrasound in a tertiary ICU population.

Methods

This is a single-center, prospective diagnostic accuracy study conducted at a tertiary ICU in the Netherlands. Critically ill patients undergoing thoracic CT for any clinical indication were included. Patients were excluded if time between the index and reference test was over eight hours. Index test and reference test consisted of 6-zone lung ultrasound and thoracic CT, respectively. Hemithoraces were classified by the index and reference test as follows: consolidation, interstitial syndrome, pneumothorax and pleural effusion. Sensitivity, specificity, positive and negative likelihood ratio were estimated.

Results

In total, 87 patients were included of which eight exceeded the time limit and were subsequently excluded. In total, there were 147 respiratory conditions in 79 patients. The estimated sensitivity and specificity to detect consolidation were 0.76 (95%CI: 0.68 to 0.82) and 0.92 (0.87 to 0.96), respectively. For interstitial syndrome they were 0.60 (95%CI: 0.48 to 0.71) and 0.69 (95%CI: 0.58 to 0.79). For pneumothorax they were 0.59 (95%CI: 0.33 to 0.82) and 0.97 (95%CI: 0.93 to 0.99). For pleural effusion they were 0.85 (95%CI: 0.77 to 0.91) and 0.77 (95%CI: 0.62 to 0.88).

Conclusions

In conclusion, lung ultrasound is an adequate diagnostic modality in a tertiary ICU population to detect consolidations, interstitial syndrome, pneumothorax and pleural effusion. Moreover, one should be careful not to interpret lung ultrasound results in deterministic fashion as multiple respiratory conditions can be present in one patient.

Trial registrationThis study was retrospectively registered at Netherlands Trial Register on March 17, 2021, with registration number NL9344.
Use of CytoSorb therapy to treat critically ill coronavirus disease 2019 patients: a case series
Authors: Mehta Yatin , Mehta Chitra , Nanda Saurabh , Kochar Gaurav , George Joby V. , Singh Manish Kumar
Published: September 2021

Background

Acute respiratory distress syndrome is an important clinical presentation of respiratory complications caused by severe acute respiratory syndrome coronavirus 2, a novel coronavirus responsible for the ongoing pandemic. The disease is poorly understood, and immunopathogenesis is constantly evolving. Cytokine release syndrome remains central to pathology of coronavirus disease 2019. Antivirals, anticytokine treatment, and other pharmacological approaches have failed to treat it. CytoSorb, an extracorporeal cytokine adsorber that reduces the cytokine storm and other inflammatory mediators in the blood, seems promising in treating severely ill patients with coronavirus disease 2019.

Case presentation

This article presents three cases of Asian ethnicity of severely ill adult patients with coronavirus disease 2019 admitted to intensive care unit who were treated with CytoSorb therapy. All patients used single CytoSorb device. During their clinical course, all patients were prescribed tocilizumab (an interleukin-6 receptor blocker), antivirals, hydroxychloroquine, azithromycin, and other antibiotics and general antipyretic drugs. No vasopressor treatment was required. The patients’ average duration of stay in intensive care unit was 30 days; the average duration of stay in hospital was 31 days. All three patients showed significant improvement in biochemical parameters and clinical outcomes post CytoSorb therapy. C-reactive protein levels decreased by 91.5%, 97.4%, and 55.75 %, and mean arterial pressure improved by 18%, 23%, and 17 % in patient 1, 2, and 3, respectively, on day 7 post-therapy.

Conclusions

All three patients improved clinically and survived.
Personnel emotion recognition model for Internet of vehicles security monitoring in community public space
Authors: Fu Erkang , Li Xi , Yao Zhi , Ren Yuxin , Wu Yuanhao , Fan Qiqi
Published: September 2021

In recent years, the Internet of vehicles (IOV) with intelligent networked automobiles as terminal node has gradually become the development trend of automotive industry and research hot spot in related fields. This is due to its characteristics of intelligence, networking, low-carbon and energy saving. Real time emotion recognition for drivers and pedestrians in the community can be utilized to prevent fatigue driving and malicious collision, keep safety verification and pedestrian safety detection. This paper mainly studies the face emotion recognition model that can be utilized for IOV. Considering the fluctuation of image acquisition perspective and image quality in the application scene of IOV, the natural scene video similar to vehicle environment and its galvanic skin response (GSR) are utilized to make the testing set of emotion recognition. Then an expression recognition model combining codec and Support Vector Machine classifier is proposed. Finally, emotion recognition testing is completed on the basis of Algorithm 1. The matching accuracy between the emotion recognition model and GSR is 82.01%. In the process of model testing, 189 effective videos are involved and 155 are correctly identified.
Performance enhancement method for multiple license plate recognition in challenging environments
Authors: Khan Khurram , Imran Abid , Rehman Hafiz Zia Ur , Fazil Adnan , Zakwan Muhammad , Mahmood Zahid
Published: September 2021

Multiple-license plate recognition is gaining popularity in the Intelligent Transport System (ITS) applications for security monitoring and surveillance. Advancements in acquisition devices have increased the availability of high definition (HD) images, which can capture images of multiple vehicles. Since license plate (LP) occupies a relatively small portion of an image, therefore, detection of LP in an image is considered a challenging task. Moreover, the overall performance deteriorates when the aforementioned factor combines with varying illumination conditions, such as night, dusk, and rainy. As it is difficult to locate a small object in an entire image, this paper proposes a two-step approach for plate localization in challenging conditions. In the first step, the Faster-Region-based Convolutional Neural Network algorithm (Faster R-CNN) is used to detect all the vehicles in an image, which results in scaled information to locate plates. In the second step, morphological operations are employed to reduce non-plate regions. Meanwhile, geometric properties are used to localize plates in the HSI color space. This approach increases accuracy and reduces processing time. For character recognition, the look-up table (LUT) classifier using adaptive boosting with modified census transform (MCT) as a feature extractor is used. Both proposed plate detection and character recognition methods have significantly outperformed conventional approaches in terms of precision and recall for multiple plate recognition.
Emergent heritage: the digital conservation of archaeological sites in reservoirs and the case of the Dolmen de Guadalperal (Spain)
Authors: Cerrillo-Cuenca Enrique , de Sanjosé Blasco José Juan , Bueno-Ramírez Primitiva , Pérez-Álvarez Juan Antonio , de Balbín Behrmann Rodrigo , Sánchez-Fernández Manuel
Published: September 2021

The dolmen of Guadalperal (Spain) became well known in 2019 when the waters of the reservoir in which it had long been submerged became so depleted as to leave it above water and highly visible. This gave rise to great media and social polemic. In this study, we deal with the ‘recovery’ of the dolmen using digital techniques, including a strategy of geometrical documentation of long, medium and short-range through the use of terrestrial laser scanning (TLS) and photogrammetry. The result is a set of products that trace the changes that have taken place in the monument since its excavation in 1925, the identification of conditions affecting it and the acquisition of new information on the decorated supports that formed part of the megalithic architecture. To do so, the time during which it was accessible (i.e., not underwater) was used to acquire the only heritage information currently available on the monument. This new information offers a complete assessment of a megalithic monument using a protocol that is exportable to other sites submerged in lakes or reservoirs.
Patient perspectives on digital patient reported outcomes in routine care of inflammatory bowel disease
Authors: Nielsen Amalie Søgaard , Appel Charlotte W. , Larsen Birgit Furstrand , Kayser Lars , Hanna Lisa
Published: September 2021

Background

Digital patient reported outcomes are used increasingly in daily care and treatment of inflammatory bowel disease. Their purpose includes increased focus on patient wellbeing, reduction in avoidable follow-up consultations and increased patient self-management. However, implementation issues occur and studies indicate patients may have concerns, particularly regarding having fewer face-to-face consultations. This study aims to explore patients’ perspectives of use and non-use of digital patient reported outcomes and to understand the mechanisms underpinning patient reluctance to engage with this health technology.

Results

Sixteen patients with inflammatory bowel disease at a regional hospital in Denmark were interviewed about their experiences of, and perspectives on, digital patient reported outcomes. A certain level of eHealth literacy was found to be a fundamental condition for use, while other factors were barriers or facilitators for use of digital PROs. Patients’ main concerns were about potential consequences for their care and relationship with the clinic. Most patients in stable remission were satisfied with the hospital being a “life-line” if their symptoms worsened, and perceived digital patient reported outcomes to be an efficient tool to establish that “life-line”. Patients with severe symptoms and a high degree of emotional distress related to their disease valued the potential for digital patient reported outcomes to increase their clinicians’ focus on mental health and extra-intestinal symptoms.

Conclusion

This study found that if patients had sufficient digital literacy, they perceived digital patient reported outcomes to be a useful replacement for face-to-face consultations. However, they were concerned about digital patient reported outcomes’ effect on the patient–clinician relationship and its ability to detect worsening of symptoms. These concerns may be mitigated by good patient–clinician relationships, and the option for patients to maintain direct telephone contact with their gastroenterology specialist.
Looking through the lens of a sexual assault examiner: novel trends and approaches in forensic photography
Authors: Yesodharan Renjulal , Jose Tessy Treesa , Nirmal Krishnan M. , Anitha S. , Nayak Vinod C.
Published: September 2021

Background

Sexual violence is cancerous, and it malignantly affects all strata of our community regardless of age, gender, race, ability, and social status. Excellent healthcare service requires professionals who can do a sexual assault examination, collect medico-legal evidence, take photographs of patients' anatomy that was involved in the assault and document what is there and where it is in relation to the victims or perpetrators body or other parts of the crime scene, whether or not it is connected to the crime.

Main text

The objective of this article to orient the professions to the novel trends and approaches in forensic photography, namely e-consent, digital cameras and their accessories, dedicated forensic software, and photographic protocols and procedures.

Conclusion

The inadequate and improper collection, preservation and presentation of evidence can lead to crime scene errors and fewer conviction rates. Training in forensic photography is vital and a game-changer in the sexual assault examination.
The recording of mental health consultations by patients: clinical, ethical and legal considerations
Authors: Hewson Thomas , Abraham Seri , Randles Nathan , Akinola Adeola , Cliff Richard , Byrne Paul , Ramkisson Roshelle
Published: September 2021

The topic of patients recording healthcare consultations has been previously debated in the literature, but little consideration has been given to the risks and benefits of such recordings in the context of mental health assessments and treatment. This issue is of growing importance given the increasing use of technology in healthcare and the recent increase in online healthcare services, largely accelerated by the COVID-19 pandemic. We discuss the clinical, ethical and legal considerations relevant to audio or visual recordings of mental health consultations by patients, with reference to existing UK guidance and the inclusion of a patient's perspective.
Relationship Between Time in Range, Glycemic Variability, HbA1c, and Complications in Adults With Type 1 Diabetes Mellitus
Authors: El Malahi Anass , Van Elsen Michiel , Charleer Sara , Dirinck Eveline , Ledeganck Kristien , Keymeulen Bart , Crenier Laurent , Radermecker Régis , Taes Youri , Vercammen Chris , Nobels Frank , Mathieu Chantal , Gillard Pieter , De Block Christophe
Published: September 2021

Purpose

Real-time continuous glucose monitoring (RT-CGM) provides information on glycemic variability (GV), time in range (TIR), and guidance to avoid hypoglycemia, thereby complimenting HbA1c for diabetes management. We investigated whether GV and TIR were independently associated with chronic and acute diabetes complications.

Methods

Between September 2014 and January 2017, 515 subjects with type 1 diabetes using sensor-augmented pump therapy were followed for 24 months. The link between baseline HbA1c and CGM-derived glucometrics (TIR [70-180 mg/dL], coefficient of variation [CV], and SD) obtained from the first 2 weeks of RT-CGM use and the presence of complications was investigated. Complications were defined as: composite microvascular complications (presence of neuropathy, retinopathy, or nephropathy), macrovascular complications, and hospitalization for hypoglycemia and/or ketoacidosis.

Results

Individuals with microvascular complications were older (P < 0.001), had a longer diabetes duration (P < 0.001), a higher HbA1c (7.8 ± 0.9 vs 7.5 ± 0.9%, P < 0.001), and spent less time in range (60.4 ± 12.2 vs 63.9 ± 13.8%, P = 0.022) compared with those without microvascular complication. Diabetes duration (odds ratio [OR] = 1.12 [1.09-1.15], P < 0.001) and TIR (OR = 0.97 [0.95-0.99], P = 0.005) were independent risk factors for composite microvascular complications, whereas SD and CV were not. Age (OR = 1.08 [1.03-1.14], P = 0.003) and HbA1c (OR = 1.80 [1.02-3.14], P = 0.044) were risk factors for macrovascular complications. TIR (OR = 0.97 [0.95-0.99], P = 0.021) was the only independent risk factor for hospitalizations for hypoglycemia or ketoacidosis.

Conclusions

Lower TIR was associated with the presence of composite microvascular complications and with hospitalization for hypoglycemia or ketoacidosis. TIR, SD, and CV were not associated with macrovascular complications.
OBSERVAÇÕES SOBRE A COMPLETUDE DO ORDENAMENTO ESTATAL
Authors: Romano Santi , Campos Felipe Pante Leme de
Published: September 2021

Sumário: §1. O problema das lacunas do ordenamento jurídico: imprecisão dos termos em que frequentemente se coloca. — §2. O problema não concerne às matérias do ordenamento jurídico. — §3. e nem tampouco às suas normas. Crítica de outas opiniões. — §4. Possibilidade de lacunas institucionais. Independência de tais lacunas em relação à existência ou não de regras que as prevejam. — §5. Possibilidade excepcional de lacunas em relação aos sujeitos.
Exploring the role of RRM domains and conserved aromatic residues in RGG motif of eIF4G-binding translation repressor protein Sbp1
Authors: Bhatter Nupur , Iyyappan Rajan , Mohanan Gayatri , Rajyaguru Purusharth I
Published: September 2021

Background: RNA binding proteins play crucial role in determining if a given mRNA will be translated, stored, or degraded. Sbp1 is an RGG-motif containing protein that is implicated in affecting mRNA decapping and translation. Sbp1 represses translation by binding eIF4G1 through its RGG-motif and activates decapping when overexpressed. In this report, we have assessed the genetic interaction of Sbp1 with decapping activators such as Dhh1, Pat1, and Scd6. We have further analyzed the importance of different domains and specific conserved residues of Sbp1 in its ability to cause over-expression mediated growth defect.

Method: Sequence alignment was performed to identify conserved aromatic residues to be mutated. Using site-directed mutagenesis several point mutations and domain deletions were created in Sbp1 expressed under a galactose-inducible promoter. The mutants were tested for their ability to cause growth defect upon over-expression. The ability of Sbp1 to affect over-expression mediated growth defect of other decapping activators was tested using growth assay. Live cell imaging was done to study localization of Sbp1 and its RRM-deletion mutants to RNA granules upon glucose starvation.

Results: Mutation of several aromatic residues in the RGG-motif and that of the phosphorylation sites in the RRM domain of Sbp1 did not affect the growth defect phenotype. Deletion of another eIF4G1-binding RGG-motif protein Scd6 does not affect the ability of Sbp1 to cause growth defect. Moreover, absence of Sbp1 did not affect the growth defect phenotypes observed upon overexpression of decapping activators Dhh1 and Pat1. Strikingly deletion of both the RRM domains (RRM1 and RRM2) and not the RNP motifs within them compromised the growth defect phenotype. Sbp1 mutant lacking both RRM1 and RRM2 was highly defective in localizing to RNA granules.  

Conclusion: This study identifies an important role of RRM domains independent of the RNP motif in Sbp1 function.
Kościół luterański Gdańska w obliczu „kryzysu pobożności” pod koniec XVII wieku
Authors: Lewandowska Liliana
Published: September 2021

W artykule przedstawiono doświadczenia gdańskiego Kościoła luterańskiego oraz wypracowany przez pietystów paradygmat jego upadku oraz naprawy życia chrześcijańskiego na przykładzie pism polemicznych Constantina Schütza (1646–1712) i Samuela Schelwiga (1643–1715). Pod koniec XVII wieku Kościół luterański musiał zmierzyć się z wysuwanymi przez pietystów propozycjami reform oraz opanować kryzys pobożności. Zarówno ortodoksyjni luteranie, jak i pietyści uznawali, że poprawa życia chrześcijańskiego jest konieczna, choć inaczej rozumieli jej założenia, co doprowadziło ostatecznie do rozłamu między nimi. W ten sposób pietystyczne próby zreformowania Kościoła zostały odrzucone, a poglądy ortodoksji ugruntowane jako jedynie słuszne.
„Co jest największym szczęściem młynarza? Że worki nie mówią”. Zarządzenia młyńskie w południowych Niemczech
Authors: Wüst Wolfgang
Published: September 2021

W południowych Niemczech i całej Europie przed 1800 rokiem stereotyp „nieuczciwego młynarza” wypierał stopniowo pozytywny wizerunek tego zawodu, dziś wysoko cenionego. Badane źródła – przede wszystkim zarządzenia młyńskie i policyjne – pochodzą między innymi z dawnych miast cesarskich Augsburga, Kempten, Memmingen i Norymbergi, z margrabstw Brandenburg-Ansbach, Brandenburg-Bayreuth oraz z Saksonii. W rezultacie można stwierdzić, że: 1. Istnieje wiele zarządzeń młyńskich różnych ustawodawców (miasta, miejscowości targowe, terytoria) ze zróżnicowanych kulturowo regionów. 2. Liczne przepisy wspierały – poprzez sankcje oraz szczegółowe i prawnie wiążące objaśnienia – „dobre rządy” w młynach. 3. Pomimo regionalnego zróżnicowania oraz nakazywanej ochrony konsumentów, negatywny wizerunek zarządców młynów utrzymywał się przez długi czas. W konsekwencji nowożytne normy prawne i codzienne funkcjonowanie młynów muszą być rozpatrywane badawczo pod kątem historii regionalnej, historii prawa, aspektów społeczno-ekonomicznych i geograficznych.
Jezus w początkowej fazie judaizmu naukowego
Authors: Skierkowski Marek
Published: September 2021

Artykuł dotyczy początkowej fazy judaizmu naukowego w relacji do Jezusa. W XIX wieku niektórzy europejscy Żydzi przerwali swoje tradycyjne milczenie o najważniejszej  ziemskiej postaci chrześcijństwa. Przede wszystkim zaczęli oni czytać Nowy Testament, traktując go w kategorach niezbędnego źródła na tym polu. Odkryli, że Jezus był prawdziwie żydowski. Niektórzy z nich (I.M. Jost, M. Zipser, L. Philippson, I.M. Rabbinowicz, A. Geiger, H. Rodrigues, M. Duschak, E. Grünebaum, M. Güdemann, A.A. Weill, E. Soloweyczyk, S. Hirsch) umieścili Go w centrum judaizmu, nawet jako faryzeusza, a niektórzy (J.L. Saalschütz, H. Graetz, J. Hamburger, E. Benamozegh, K. Magnus) ulokowali Go na obrzeżach judaizmu, np jako esseńczyka. W ten sposób chrześcijańska apologia, zwana tradycyjnie “Contra/Adversus Judaeos”, zyskała nowy konstruktywny i dynamiczny początek.