bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness of Tuina in Relieving Pain, Negative Emotions, and Disability in Knee Osteoarthritis: A Randomized Controlled Trial
Authors: Xu Hui , Zhao Chi , Guo Guangxin , Li Yulin , A Xinyu , Qiu Guowei , Wang Yuxia , Kang Bingxin , Xu Xirui , Xie Jun , Xiao Lianbo
Published: August 2022

Objective

To evaluate the effectiveness of Tuina in relieving the pain, negative emotions, and disability of patients with knee osteoarthritis (KOA).

Design

Single-center, parallel, randomized controlled trial.

Setting

Shanghai Guanghua Integrated Chinese and Western Medicine Hospital, Shanghai, China.

Subjects

Adult patients with KOA who were able to speak Chinese and self-report symptoms were eligible.

Methods

A total of 104 patients were randomly allocated to receive the 6-week treatment of Tuina (Tuina group) or celecoxib (celecoxib group). Data on pain, negative emotions, and disability were collected at baseline, at week 2, 4, and 6, and follow-up (1 month after the last treatment). The primary outcomes were the pressure pain thresholds. The secondary outcomes were: (1) numerical rating scale at rest and with movement; (2) Hamilton Anxiety Scale; (3) Hamilton Depression Scale; (4) Western Ontario and McMaster Universities Osteoarthritis Index; and (5) clinical effective rate. The adverse events of the trial were evaluated.

Results

In total, 99 patients completed the follow-up. Generalized linear mixed models were constructed to analyse the between-group differences. Statistically significant differences were found in the interaction effects (P < .05). In evaluating the group effect, statistical differences were found at week 6 and follow-up (P < .05). Further, all variables showed a time effect (P < .05). A statistical difference in the clinical effective rate was found between the Tuina and celecoxib groups (P < .05).

Conclusions

Tuina produced superior effects for pain, negative emotions, and disability over time, as compared to celecoxib in patients with KOA.
MITOCHONDRIA IN BIODOSIMETRY: FLOW CYTOMETRY ASSESMENT IN VITRO
Authors: Šinkorová Zuzana , Lierová Anna , Filipová Alžběta , Čížková Jana , Tichý Aleš , Pejchal Jaroslav , Milanová Marcela , Vilasová Zdena , Andrejsová Lenka
Published: August 2022

The JC-1 dye is widely used in apoptosis studies to monitor mitochondrial health. The probe was tested in vitro on two established cell lines and peripheral porcine blood lymphocytes after gamma irradiation (IR) to assess its potential in biodosimetric evaluation. In brief, we stained irradiated and non-irradiated cells with the JC-1 dye to determine the existing changes in mitochondrial membrane potential and monitor cell health through flow cytometry. The stage of injury in these cells was evaluated through an irradiated versus non-irradiated ratio (IVNIR), comparing the relative proportion of polarised cells containing red JC-1 aggregates. We observed a decreasing IVNIR as the radiation dose increased (i.e. 0.5; 1; 2; 4; 6; 8 and 10 Gy), performing the analysis at 4, 8 and 24 h after IR in all the tested cells. The results from the JC1-dye test showed that CD4 T lymphocytes were more sensitive to irradiation than other subpopulations.
PLASTIC SCINTILLATOR BASED 2D DETECTOR FOR PHOTON RADIOTHERAPY: PRELIMINARY RESULTS
Authors: Hanušová Tereza , Linhart Vladimír , Vrba Tomáš
Published: August 2022

A proof-of-concept study of a new detector based on a thin plastic scintillator monitored by a Charge-Coupled Device (CCD) camera designed for monitoring and characterisation of Linac photon beams is presented. The response of the detector is compared with radiochromic film using 6 and 18 MV radiotherapeutic beams. We have observed: (i) all instruments survived the secondary radiation fields during Linac operation, (ii) it was possible to process the measured data using statistical techniques and (iii) the processed data from the CCD camera qualitatively correspond to film dosimetry results. A statistical technique based on the selection of minimal values provides the clearest results. Quantitatively, CCD and film results can only be compared as 6 to 18 MV response rates. We have observed that the rates from the CCD data are systematically higher than the rates from film dosimetry. Differences are not too high, namely 1.9–2.4 times the combined standard deviation.
COMPARISON OF TWO TYPES EYE LENS DOSEMETERS USED IN INTERVENTIONAL CARDIOLOGY AND RADIOLOGY
Authors: Martinčík Jiří , Čechák Tomáš , Urban Tomáš , Tamášová Jana , Siková Lenka , Jakubcová Iva , Balogová Zdenka
Published: August 2022

The aim of this contribution is to provide an overview of comparison of two types of eye lens dosemeter systems. The comparison was performed at the Department of Intravenous Cardiology using patient and physician phantoms and supplemented by dose simulation using the Monte Carlo method. The tests were performed in several specific geometries and in addition to eye lens dosemeters the value of a personal dosemeter located at the reference point was also monitored. The value of Hp(3) and Hp(10) was monitored. It is clear from the results that film dosemeters achieve more correct results in most cases. It is probably due to a better correction for the angle of exposure. This assumption must be verified by more detailed measurements in laboratory conditions.
CALIBRATION OF SILICON DETECTORS LIULIN AND AIRDOS USING COSMIC RAYS AND TIMEPIX FOR USE AT FLIGHT ALTITUDES
Authors: Sommer Marek , Štěpánová Dagmar , Kákona Martin , Velychko Olena , Ambrožová Iva , Ploc Ondřej
Published: August 2022

Silicon detectors such as Liulin and AIRDOS are used for cosmic radiation measurements onboard aircraft. These measurements can be used for the verification of computer programs assessing aircraft crew radiation exposure. Recently performed intercomparison flights showed large variances of absorbed doses among individual detectors and significant differences between results of silicon detectors and computer programs. In order to explain for these differences, we have developed energy calibration method that can be performed on short flights. The method is based on cross-calibration of Liulin and AIRDOS deposited energy spectra with deposited energy spectra measured by Timepix which has superior detection properties in terms of energy resolution and the detection threshold. Moreover, the portion of dose which is omitted due to low sensitivity for low-energy deposits was calculated. The resulting absorbed dose rates at two intercomparison flights show significantly improved variation of results and better agreement with modelled absorbed dose rates.
CHARACTERISATION OF AIRDOS-C DETECTOR FOR MEASUREMENT OF HIGH-ENERGY EVENTS IN THE ATMOSPHERE
Authors: Velychko Olena , Ambrožová Iva , Kákona Martin , Ploc Ondřej
Published: August 2022

At the flight altitudes of modern airplanes, cosmic rays intensity is several times higher than on the Earth’s surface. The radiation field is not constant in time and due to various effects, not routinely considered in calculations, the exposure can increase several times. Therefore, a continuous monitoring of radiation exposure on board is required. This article characterises newly developed detectors Airdos-C with diverse scintillation crystals. Unlike detectors based on a Si diode, which are commonly used for long-term measurements, these detectors can also be used for detection of high-energy gamma-rays generated in thunderstorms. For a correct interpretation of the measured data it is important to perform an energy calibration and to verify the detector response in known radiation fields. The results obtained with several radionuclide sources were analysed using mathematical statistics methods. The detectors were also exposed onboard aircraft under well-defined conditions.
ON UNCERTAINTIES IN THE MANGANESE SULPHATE BATH TECHNIQUES
Authors: Lüley Jakub , Čerba Štefan , Vrban Branislav , Nečas Vladimír
Published: August 2022

The manganese sulphate bath is a globally recognized method for determining emission of neutrons from radionuclide since 1959. In combination with the measurement of neutron emission anisotropy, this method is standardly used for the primary standardization of dosimetry quantities of neutron radiation. To achieve results at the metrology level, it is essential to have all quantities which contribute to the overall uncertainty properly determined and contributing uncertainty minimized. This paper is focused on the quantification of the main uncertainty sources for in-house developed manganese bath. In previous analyses, the final uncertainty of neutron emission rate was <1%, which was considered as a target value. Nevertheless, the relative change from reference values was relatively high and out of this uncertainty. This relative change raised questions about the accuracy of contributed parameters, like vessel volume, concentration of MnSO4 or computational model. Therefore, this paper focuses on determination and re-evaluation of these parameters with corresponding uncertainties.
OSL SENSITIVITY OF QUARTZ EXTRACTED FROM FIRED BRICKS FOR RETROSPECTIVE DOSIMETRY
Authors: Reimitz Dan , Hupka Ivan , Ekendahl Daniela
Published: August 2022

Optically stimulated luminescence of quartz extracted from fired materials has been used for retrospective dosimetry for about 40 years. Quartz sensitivity to thermoluminescence and optically stimulated luminescence can vary over few orders of magnitude. These discrepancies in sensitivity for the quartz originating from different parts of the world are still not yet fully understood. We have extracted quartz from bricks produced by three different companies in the Czech Republic. Quartz was extracted from fired bricks, as well as from the bricks before firing. Significant changes in quartz sensitivity were observed after firing process. Sensitivity can either increase or decrease, depending mainly on the maximum temperature achieved during firing process. For some samples, the sensitivity increased significantly after firing (7 times). Sensitivity also increased after repeated irradiation exposures. On the other hand, there were also samples for which the sensitivity did not increase after repeated cycles of irradiation.
APPARATUS FOR LOCALIZATION AND DOSIMETRY OF WOUNDS WITH RADIOACTIVE CONTAMINATION
Authors: Slavíček Tomáš , Broulím Jan , Fojtík Pavel , Prokop Matěj , Rubovič Peter
Published: August 2022

Disasters involving radioactive materials are one of the most dangerous accidents a living organism can be exposed to. Individuals and first responders are in risk during accidents or interventions, due to radioactive debris impact, due to the use of depleted uranium ammunition or a malevolent act against individuals. Moreover, radioactive contamination of wounds causes internal exposure in the body and standard decontamination procedures cannot be applied. In order to deal with such situations, we are developing a measurement system consisting of a robotic arm, an array of various detectors and a corresponding methodology, which allows quantifying timely the spatial distribution of contamination and the radiation dose for the adequate medical response. The aim of this publication is to the present current status of the development of the described apparatus.
COMPARISON OF THE BACKGROUND GAMMA-RAY SPECTRUM FROM SOIL OBTAINED BY DIRECT MEASUREMENT AND BY CALCULATION USING MCNP6 WITH NAI(TL) SCINTILLATION DETECTOR
Authors: Bednár Dávid , Lištjak Martin , Nečas Vladimír
Published: August 2022

Efficiency calibration is an essential part of any gamma-spectrometric or non-spectrometric measurement. The article describes all steps leading to the reconstruction of the gamma-ray spectrum from the soil — mathematical calibration of the NaI(Tl) detector and optimization of the model in the MCNP6 code, determination of radionuclide vector of soil around NPPs in Slovakia, calculation of the detector response matrix using the calculation code MCNP6 and finally the reconstruction of the gamma-ray spectrum. The results were compared in the energy range of 50–1620 keV for the spectrum obtained by direct measurement of the soil sample and for the spectrum obtained by calculation using the code MCNP6. The relative deviation in the whole spectrum between direct measurement and calculation is not more than 2%, which can be considered as the satisfactory result. The detector model thus created can be used to calculate the response matrix for any geometry arrangement.
RADON-PRONE AREAS IN SLOVAKIA PREDICTED BY RESCALED RADON POTENTIAL MAPS
Authors: Brandýsová Alžbeta , Bulko Martin , Holý Karol , Müllerová Monika , Masarik Jozef
Published: August 2022

Several scientific studies have shown that high content of radon in the soil environment can be a precursor of increased indoor radon levels. Inhabited areas where elevated indoor radon concentration appears for natural (geogenic) reasons are commonly referred to as radon-prone areas. In this study, radon-prone areas in the Slovak Republic were predicted on the basis of radon potential maps after its specific rescaling. In total, 99 municipalities have been identified in Slovakia where the annual average indoor radon concentration is expected to exceed the reference level of 300 Bq m−3; five of those are even expected to exceed 1000 Bq m−3. In these municipalities it is then required to conduct a survey of indoor radon measurements. Compared with a nationwide survey, the proposed approach of searching for houses with potentially high radon exposure is more efficient.
INDOOR RADON MONITORING IN SELECTED BUILDINGS IN VYDRNÍK (VIKARTOVCE FAULT, SLOVAKIA)
Authors: Smetanová Iveta , Mojzeš Andrej , Csicsay Kristian , Marko František
Published: August 2022

To test the relation of indoor radon concentration to fault zone, a survey was conducted in selected buildings in Vydrník, situated close to the neotectonically active Vikartovce fault trace. Monitoring was performed using RamaRn track detectors during a period of 1 year. Annual average of indoor radon ranged from 60 to 940 Bq/m3, with an average of 160 Bq/m3. Seasonal variation of indoor radon concentration was confirmed, with minimum in summer (June–August). The results confirmed that radon concentration in rooms above the cellar was lower than in rooms with the direct contact with subsoil. High indoor radon up to 940 Bq/m3 was detected only in one of monitored houses situated close to the generally E–W trending Vikartovce fault and can be attributed to this fault zone used as pathway for radon migration. Influence of nearby situated NW–SE trending crosscutting fault on radon concentration is probable too.
DOSE RATE MAPPING INSIDE THE STRAZ POD RALSKEM CALIBRATION FACILITY—MONTE CARLO APPROACH
Authors: Johnová Kamila , Klusoň Jaroslav
Published: August 2022

The gamma spectrometry is one of the fundamental methods used in nuclear technology with well-established procedures of data acquisition and evaluation. Yet with expanding possibilities of detection and data processing, the question of accurate calibration very often rises, since the traditional approach to calibration might not always be the most efficient. In our work, we focus on field spectrometry and present a way of utilizing an already established and well working calibration facility and expanding its scope for new types of radiation detectors.
INFLUENCE OF AIRWAY GEOMETRY ON RADON RISK ASSESSMENT IN ADULTS AND CHILDREN (MICRODOSIMETRIC APPROACH)
Authors: Böhm Radoslav , Bulko Martin , Holý Karol
Published: August 2022

The aim of this work was to use the microdosimetric threshold energy model to study the effects of alpha-emitting 222Rn progeny on the probability of developing lung cancer. The results suggest that the radiation risk may increase by several times as the thickness of the surface layer decreases. The thicker the protective mucus layer and the deeper the sensitive target cells are located in the tissue, the less radiation damage the same dose produces. These findings have been applied to children of various ages. As children grow older, their lungs enlarge, the mucus layer thickens and the cells sensitive to radiation damage move deeper into the lung tissue, resulting in a reduction of radiation risk. The fraction of affected target cells is not only a function of dose but also of lung tissue depth. The results indicate that children can be several times more vulnerable to radiation than adults.
MONTE CARLO SIMULATIONS OF OUT-OF-FIELD LET SPECTRA IN WATER PHANTOM IRRADIATED BY SCANNING PENCIL PROTON BEAM
Authors: Štika Jan , Jelínek Michaelidesová Anna , Davídková Marie
Published: August 2022

LET spectra can be measured by track-etched detectors. However, these detectors are not able to identify the type of interacting particles. Monte Carlo simulations can provide this missing information. In this work, Monte Carlo simulations based on the EURADOS Work Group 9 experiment consisting of systematic 3D mapping of out-of-field doses and LET spectra in a prototype water phantom were performed. The simulations aimed to identify the types of particles contributing to the out-of-field LET spectra. The total absorbed dose, LET and energy spectra were calculated. The calculated dose distributions and LET spectra were compared with the ones measured by radiophotoluminiscence and track-etched detectors. The out-of-field particles and their LET values were identified. No statistically significant differences between the measured and simulated spectra were revealed in the LET range of 100–2000 keV μm−1.
RADON MONITORING IN SELECTED KINDERGARTENS IN SLOVAKIA
Authors: Müllerová Monika , Holý Karol , Kureková Patrícia , Smetanová Iveta
Published: August 2022

In 17 kindergartens in Slovakia indoor radon survey was performed over a period of 1 y. In selected kindergartens also continuous monitoring of indoor radon activity concentration was conducted for ~2 weeks, as well as soil radon measurements. Annual average of indoor radon concentration, measured using track detectors, ranged between 75 and 1810 Bq m−3. Soil radon concentration ranged from 13 to 320 kBq m−3. The relationship between activity concentrations measured in soil air and indoors has a linear character.
Economic nostalgia: the salience of economic identity for the Brexit campaign
Authors: Suckert Lisa
Published: August 2022

The rise of ‘new populism’ is commonly explained by two opposing approaches known as cultural backlash and economic deprivation. Their antagonism perpetuates a dichotomous understanding of economy versus identity. This article contributes to scholarly attempts to overcome this dichotomy by introducing the concept of economic identity. It suggests to bring ‘the economic’ back into culturalist explanations as a discursive motif that can be charged with identity and tradition. I argue that shared assumptions about what economic practices, institutions and conventions appear appropriate for the nation can serve the purpose of national identification. A qualitative discourse analysis of almost 400 Brexit campaign documents shows that those in favour of withdrawal and often considered ‘populist’ did not neglect economic arguments. But instead of relying on brute economic calculus, they referred to Britain’s economic traditions and images of a glorious economic past. By linking economic critique of the EU to issues of British heritage, Leave made Brexit a question of national economic identity—a discursive strategy particularly resonating with those economically deprived.
Regulation of sleep quantity and intensity by long and short isoforms of SLEEPY kinase
Authors: Xu Junjie , Zhou Rui , Wang Guodong , Guo Ying , Gao Xue , Zhou Shuang , Ma Chengyuan , Chen Lin , Shi Bihan , Wang Haiyan , Wang Fengchao , Liu Qinghua
Published: August 2022

In Sleepy (Sik3Slp) or Sik3S551A mice, deletion or mutation of inhibitory phosphorylation site serine551 from salt-inducible kinase 3 (SIK3) markedly increases daily non-rapid eye movement sleep (NREMS) amount, accompanied with constitutively elevated NREMS delta power density–a measure of sleep intensity. Multiple SLP/SIK3 isoforms are expressed in mouse brain neurons, however, their respective roles in sleep regulation remain to be elucidated. Here, we identified a new and most abundant short isoform of SLP/SIK3 and examined sleep phenotypes resulted from isoform-specific expression of SLP-short (S) and long (L) isoforms. Adeno-associated virus (AAV)-mediated adult brain chimeric (ABC)-expression of SLP-S in neurons, but not in astrocytes, significantly and constitutively elevates NREMS delta power, whereas slightly increases NREMS amount. The ability of SLP-S to regulate sleep quantity/intensity is abrogated by kinase-inactivating mutations, suggesting that the sleep-promoting activity of SLP-S is dependent on its kinase activity. In Sik3S551A-L knock-in mice, isoform-specific expression of SIK3S551A-L (or SLP-L) significantly increases NREMS amount with a modest effect on NREMS delta power. ABC-expression of SLP-S complements the sleep phenotypes of heterozygous Sik3S551A-L mice by further increasing NREMS amount and NREMS delta power to levels of Sik3Slp or Sik3S551A mice. Taken together, these results indicate that both SLP-L and SLP-S isoforms contribute critically to the increases of sleep quantity and intensity in Sik3Slp or Sik3S551A mice.
KCNQ5 activation by tannins mediates vasorelaxant effects of barks used in Native American botanical medicine
Authors: Manville Rían W. , Redford Kaitlyn E. , van der Horst Jennifer , Hogenkamp Derk J. , Jepps Thomas A. , Abbott Geoffrey W.
Published: August 2022

Tree and shrub barks have been used as folk medicine by numerous cultures across the globe for millennia, for a variety of indications, including as vasorelaxants and antispasmodics. Here, using electrophysiology and myography, we discovered that the KCNQ5 voltage‐gated potassium channel mediates vascular smooth muscle relaxant effects of barks used in Native American folk medicine. Bark extracts (1%) from Birch, Cramp Bark, Slippery Elm, White Oak, Red Willow, White Willow, and Wild Cherry each strongly activated KCNQ5 expressed in Xenopus oocytes. Testing of a subset including both the most and the least efficacious extracts revealed that Red Willow, White Willow, and White Oak KCNQ‐dependently relaxed rat mesenteric arteries; in contrast, Black Haw bark neither activated KCNQ5 nor induced vasorelaxation. Two compounds common to the active barks (gallic acid and tannic acid) had similarly potent and efficacious effects on both KCNQ5 activation and vascular relaxation, and this together with KCNQ5 modulation by other tannins provides a molecular basis for smooth muscle relaxation effects of Native American folk medicine bark extracts.
Identifying Chronic Pain Subgroups in Pediatric Sickle Cell Disease
Authors: Sil Soumitri , Manikowski Alison , Schneider Mallory , Cohen Lindsey L. , Dampier Carlton
Published: August 2022

Objectives:

Youth with sickle cell disease (SCD) and chronic pain, defined in this study as pain on most days for 3 months, experience variability in daily pain and physical and psychosocial functioning. This study aimed to (1) empirically derive chronic pain subgroups based on pain characteristics among youth with chronic SCD pain; and (2) investigate derived subgroups for differences in sociodemographics, clinical characteristics, and psychosocial and functional outcomes.

Materials and Methods:

Youth with chronic SCD pain (n=62, M
age=13.9, SD=2.5, 10 to 18 y; 58% female, 60% HbSS) completed a battery of questionnaires. Clinical characteristics (eg, medications, treatments) and health care utilization were abstracted from electronic medical records. Hierarchical cluster analysis informed the number of clusters at the patient level. k-means cluster analysis used multidimensional pain assessment to identify and assign patients to clusters.

Results:

Cluster 1 (n=35; Moderate Frequency, Moderate Pain) demonstrated significantly lower worst pain intensity, number of pain days per month, number of body sites affected by pain, and pain quality ratings. Cluster 2 (n=27; Almost Daily, High Pain) reported high ratings of worst pain intensity, almost daily to daily pain, greater number of body sites affected by pain, and higher ratings of pain quality (all P’s <0.05). There were no differences between subgroups by sociodemographics, clinical characteristics, or health care utilization. The Almost Daily, High Pain subgroup reported significantly higher pain interference, depressive symptoms, and pain catastrophizing than the Moderate Frequency, Moderate Pain subgroup.

Discussion:

Identifying chronic SCD pain subgroups may inform tailored assessment and intervention to mitigate poor pain and functional outcomes.
Benefits of fixing 3 proximal vertebral bodies vs. 2 in the treatment of early-onset scoliosis with growing rods
Authors: Cao Jun , Zhu Weiwei , Zhang Xuejun , Bai Yunsong , Guo Dong , Yao Ziming , Gao Rongxuan
Published: August 2022

Additional proximal fixation for growing rods in early-onset scoliosis (EOS) may offer a more effective and safer option for severe scoliosis patients with hyper-kyphosis. Here, we compared the outcomes of EOS patients treated with growing rods in which 6 proximal anchor points on 3 vertebrae were used vs. 4 proximal anchor points on 2 vertebrae. The records of patients with EOS treated surgically from January 2016 to December 2017 were retrospectively reviewed. In the Proximal 4 group, 2 vertebral bodies were anchored proximally with 4 anchor points; in the Proximal 6 group, 3 vertebral bodies were anchored proximally with 6 anchor points. Forty-two patients (mean age 5.11 ± 1.93 years) were included; 22 Proximal 4 group, 20 Proximal 6 group. Mean follow-up was 40.86 ± 13.49 months. The decrease in main curve Cobb angle postoperatively was significantly greater in the Proximal 6 group (33.22° vs. 19.08°) (P < 0.05). Cobb thoracic kyphosis (TK) was significantly decreased postoperatively in the Proximal 6 group (mean 20.70°); no significant decrease occurred in the Proximal 4 group. The main curve Cobb angle decrease at last follow-up was significantly greater in the Proximal 6 group (37.84° vs. 24.23°) (P < 0.05). Cobb TK was significantly decreased at last follow-up in the Proximal 6 group (mean 25.17°, P < 0.05); no significant decrease occurred in the Proximal 4 group. Instrument complications were lower in the Proximal 6 group (15.00% vs. 45.45%) (P < 0.05). No proximal junctional kyphosis was noted. Fixing 3 proximal vertebral bodies with 6 anchors improves radiographic outcomes of EOS treated with growing rods, and has a lower rate of screw pull-out.
Do Interventions Improve Symptoms Among ICU Surrogates Facing End-of-Life Decisions? A Prognostically-Enriched Systematic Review and Meta-Analysis
Authors: DeForge Christine E. , George Maureen , Baldwin Matthew R. , South Katherine , Beauchemin Melissa , McHugh Marlene E. , Smaldone Arlene
Published: August 2022

OBJECTIVES:

Evaluate the efficacy of interventions to improve symptoms for ICU surrogates at highest risk of developing psychologic distress: those facing end-of-life care decisions.

DATA SOURCES:

MEDLINE, CINAHL, PsycInfo, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched through April 16, 2022.

STUDY SELECTION:

Following an a priori protocol, randomized trials of interventions delivered to surrogates of adult ICU patients who died or had high likelihood of mortality evaluating surrogate symptoms were identified.

DATA EXTRACTION:

Two reviewers performed screening and data extraction and assessed risk of bias (Cochrane Risk of Bias [RoB] 2 tool). Trials were eligible for meta-analysis if group mean symptom scores were provided at 3 or 6 months. Pooled effects were estimated using a random effects model. Heterogeneity was assessed (Cochrane Q, I
2). Certainty of evidence was assessed (Grading of Recommendations Assessment, Development and Evaluation).

DATA SYNTHESIS:

Of 1,660 records, 10 trials met inclusion criteria representing 3,824 surrogates; eight were included in the meta-analysis. Overall RoB was rated Some Concerns. Most (n = 8) interventions focused on improving communication and enhancing psychologic support in the ICU. All trials measured anxiety, depression, and posttraumatic stress. Significant improvement was seen at 3 months (depression, mean difference [MD], –0.68; 95% CI, –1.14 to –0.22, moderate certainty; posttraumatic stress, standardized MD, –0.25; 95% CI, –0.49 to –0.01, very low certainty) and 6 months (anxiety, MD, –0.70; 95% CI, –1.18 to –0.22, moderate certainty). Sensitivity analyses suggest significant findings may be unstable. Subgroup analyses demonstrated differences in effect by trial location, interventionist, and intervention dose.

CONCLUSIONS:

Communication and psychological support interventions in the ICU yielded small but significant improvement in psychological symptoms with moderate to very low certainty evidence in a prognostically-enriched sample of ICU surrogates facing end-of-life care decisions. A new approach to interventions that extend beyond the ICU may be needed.
Facelift Surgery after Permanent Filler: Outcomes after Removal of Permanent Filler under Local Anesthesia
Authors: Alaslawi Ahmad A. F. , Zeina Ahmed M. , Zahra Tarek
Published: August 2022

Background:

Permanent fillers were previously used to fix wrinkles associated with aging as they were considered a reasonable choice for facial rejuvenation. However, the subsequent removal of permanent fillers is of great concern to surgeons before performing a facelift surgery. Many studies have evaluated the outcomes of facelift surgery; however, we sought to evaluate the outcomes of facelift surgery which required removal of fillers beforehand.

Methods:

This retrospective cohort study evaluated the outcomes of 50 patients with regard to patient satisfaction and postoperative complications of facelift surgery with removal of permanent filler under local anesthesia. A short scar rhytidectomy with superficial muscular aponeurotic system plication was performed. Preoperative and postoperative photographs were analyzed by two independent surgeons to report asymmetry scores ranging from one to three (one none, two slight, and three obvious asymmetries). Patient satisfaction scores were also recorded.

Results:

The preoperative presentations of the permanent filler were asymmetry (82%) and disfiguring facial edema (26%). Removing fillers under local anesthesia is generally tolerable, with 56% of patients tolerating rhytidectomy. The degree of the participants’ satisfaction after follow-up was satisfactory; two-thirds of patients (62%) were satisfied. There was a significant difference between surgeons’ preoperative and postoperative assessment of asymmetry scores (P < 0.05).

Conclusions:

Permanent filler removal with concomitant face-neck lift surgery has satisfactory outcomes. The procedure length was primarily determined by the patient’s skin characteristics and the severity of the local condition.
Standard Precaution Knowledge and Behavioral Intentions Among Students in the Healthcare Field: A Cross-Sectional Study
Authors: LIVSHIZ-RIVEN Ilana , HURVITZ Nancy , ZIV-BARAN Tomer
Published: August 2022

Background

Infectious diseases are a major threat to healthcare workers and patients alike. Standard precautions (SPs) are a pivotal element in controlling their spread. However, worldwide reported compliance with SP guidelines is suboptimal among workers and students in the healthcare field.

Purpose

The objective of this study was to identify the knowledge and behavioral intent patterns of students in the healthcare field as well as the relationship of these patterns to the students' study program, clinical exposure, and attitudes.

Methods

This cross-sectional study employed a web-based structured questionnaire. Participants were students of nursing, emergency medicine for paramedics, physiotherapy, and medicine studying at a public university in Israel. The questionnaire assessed SP-related knowledge and behavioral intent, perceptions of personal responsibility, and the presence of mentors as role models. The K-means clustering method was used.

Results

The 259 students (33% response rate) who completed the questionnaire were enrolled as participants and divided into two knowledge and behavioral intent clusters. Cluster 1 (n = 156) had a higher proportion of nursing students and a lower proportion of medical students than Cluster 2 (n = 103). Emergency medicine for paramedics and physiotherapy students were more evenly distributed between the clusters. Participants who were classified in Cluster 1 reported higher intent with regard to proper hand hygiene, use of personal protective equipment, and decontamination practices. In multivariable analysis, only three variables predicted belonging to Cluster 1: nursing students, perception of their mentors as role models, and perception of having higher personal responsibility for microbiological safety.

Conclusions

We observed clear patterns of knowledge and behavior among the students in the healthcare field examined in this study. These patterns were influenced by profession, role mentoring, and sense of responsibility. This use of cluster analysis may contribute to the development of better SP educational endeavors. The patterns identified highlight the need for improved training and the importance of role modeling for healthcare students in all areas of specialization.
Do Physician Assistant Students Use Retrieval-Based Strategies While Studying?
Authors: Pinheiro Sandro O. , Hibbard Susan T. , Hudak Nicholas M.
Published: August 2022

Introduction

Research on learning indicates that active retrieval of information (ie, testing) enhances student retention of knowledge, yet, it is underutilized by learners. This research investigated physician assistant (PA) students’ study strategies and the extent to which retrieval-based strategies (RBS) are used.

Methods

A survey instrument adapting items from Hartwig and Dunlosky’s Study Habits Survey was administered to first-year PA students to investigate their study behaviors over a 4-week time frame in preparation for multiple-choice exams.

Results

Seventy-eight students (88%) completed the survey. The most common study strategies were reviewing lecture slide decks (83%), reading notes (78%), and taking notes (73%). Retrieval-based study strategies most often used were practicing test questions (38%) and creating questions and responding to them (12%).

Discussion

Many PA students are underutilizing retrieval-based study strategies and might benefit from more awareness of this learning approach as well as faculty guidance about how to incorporate it into their exam preparation.
Extracorporeal CO2 Removal During Renal Replacement Therapy to Allow Lung-Protective Ventilation in Patients With COVID-19–Associated Acute Respiratory Distress Syndrome
Authors: Alessandri Francesco , Tonetti Tommaso , Pistidda Laura , Busani Stefano , Borrazzo Cristian , Fanelli Vito , Polzoni Mauro , Piazza Ornella , Lorini Luca , Cattaneo Sergio , Ricci Davide , Zanoni Andrea , Girardis Massimo , Terragni Pierpaolo , Tempesta Michele , Di Luca Marina , Pugliese Francesco , Ranieri V. Marco ,   On behalf of the RECORD Group
Published: August 2022

The aim of this retrospective multicenter observational study is to test the feasibility and safety of a combined extracorporeal CO2 removal (ECCO2R) plus renal replacement therapy (RRT) system to use an ultraprotective ventilator setting while maintaining (1) an effective support of renal function and (2) values of pH within the physiologic limits in a cohort of coronavirus infectious disease 2019 (COVID-19) patients. Among COVID-19 patients admitted to the intensive care unit of 9 participating hospitals, 27 patients with acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI) requiring invasive mechanical ventilation undergoing ECCO2R-plus-RRT treatment were included in the analysis. The treatment allowed to reduce VT from 6.0 ± 0.6 mL/kg at baseline to 4.8 ± 0.8, 4.6 ± 1.0, and 4.3 ± 0.3 mL/kg, driving pressure (ΔP) from 19.8 ± 2.5 cm H2O to 14.8 ± 3.6, 14.38 ± 4.1 and 10.2 ± 1.6 cm H2O after 24 hours, 48 hours, and at discontinuation of ECCO2R-plus-RRT (T3), respectively (p < 0.001). PaCO2 and pH remained stable. Plasma creatinine decreased over the study period from 3.30 ± 1.27 to 1.90 ± 1.30 and 1.27 ± 0.90 mg/dL after 24 and 48 hours of treatment, respectively (p < 0.01). No patient-related events associated with the extracorporeal system were reported. These data show that in patients with COVID-19–induced ARDS and AKI, ECCO2R-plus-RRT is effective in allowing ultraprotective ventilator settings while maintaining an effective support of renal function and values of pH within physiologic limits.
Racial and Ethnic Disparities Among Patients Hospitalized for Acute Cholangitis in the United States
Authors: Wang Melinda , Wadhwani Sharad I. , Cullaro Giuseppe , Lai Jennifer C. , Rubin Jessica B.
Published: August 2022

Goals:

We sought to determine whether race/ethnicity is associated with hospitalization outcomes among patients admitted with acute cholangitis.

Background:

Few studies have evaluated the association between race and outcomes in patients with acute cholangitis.

Study:

We analyzed United States hospitalizations from 2009 to 2018 using the Nationwide Inpatient Sample (NIS). We included patients 18 years old or above admitted with an ICD9/10 diagnosis of cholangitis. Race/ethnicity was categorized as White, Black, Hispanic, or Other. We used multivariable regression to determine the association between race/ethnicity and in-hospital outcomes of interest, including endoscopic retrograde cholangiopancreatography (ERCP), early ERCP (<48 h from admission), length of stay (LOS), and in-hospital mortality.

Results:

Of 116,889 hospitalizations for acute cholangitis, 70% identified as White, 10% identified as Black, 11% identified as Hispanic, and 9% identified as Other. The proportion of non-White patients increased over time. On multivariate analysis controlling for clinical and sociodemographic variables, compared with White patients, Black patients had higher in-hospital mortality (adjusted odds ratio: 1.4, 95% confidence interval: 1.2-1.6, P<0.001). Black patients were also less likely to undergo ERCP, more likely to undergo delayed ERCP, and had longer LOS (P<0.001 for all).

Conclusions:

In this contemporary cohort of hospitalized patients with cholangitis, Black race was independently associated with fewer and delayed ERCP procedures, longer LOS, and higher mortality rates. Future studies with more granular social determinants of health data should further explore the underlying reasons for these disparities to develop interventions aimed at reducing racial disparities in outcomes among patients with acute cholangitis.
Thermal stabilization of enterovirus A 71 and production of antigenically stabilized empty capsids
Authors: Kingston Natalie J. , Shegdar Mona , Snowden Joseph S. , Fox Helen , Groppelli Elisabetta , Macadam Andrew , Rowlands David J. , Stonehouse Nicola J.
Published: August 2022

Enterovirus A71 (EVA71) infection can result in paralysis and may be fatal. In common with other picornaviruses, empty capsids are produced alongside infectious virions during the viral lifecycle. These empty capsids are antigenically indistinguishable from infectious virus, but at moderate temperatures they are converted to an expanded conformation. In the closely related poliovirus, native and expanded antigenic forms of particle have different long-term protective efficacies when used as vaccines. The native form provides long-lived protective immunity, while expanded capsids fail to generate immunological protection. Whether this is true for EVA71 remains to be determined. Here, we selected an antigenically stable EVA71 virus population using successive rounds of heating and passage and characterized the antigenic conversion of both virions and empty capsids. The mutations identified within the heated passaged virus were dispersed across the capsid, including at key sites associated with particle expansion. The data presented here indicate that the mutant sequence may be a useful resource to address the importance of antigenic conformation in EVA71 vaccines.
Desulfuromonas sp. 'CSMB_57’, isolation and genomic insights from the most abundant bacterial taxon in eastern Australian coals
Authors: McLeish Andrew G. , Greenfield Paul , Midgley David J. , Paulsen Ian T.
Published: August 2022

One of the most abundant and ubiquitous taxa observed in eastern Australian coal seams is an uncultured

Desulfuromonas

species and part of the Coal Seam Microbiome dataset assigned as ‘CSMB_57’. Despite this abundance and ubiquity, knowledge about this taxon is limited. The present study aimed to generate an enrichment culture of

Desulfuromonas

sp. ‘CSMB_57’ using culturing strategies that exploit its sulphur-reducing capabilities by utilizing a polysulfide solution in a liquid medium. Using dilution to extinction methods, a highly enriched culture was successfully generated. The full-length 16S rRNA sequence revealed that all closely related taxa were observed in subsurface environments suggesting that D. sp. ‘CSMB_57’ may be a subsurface specialist. Subsequently, the DNA from the enrichment culture was sequenced and the genome of D. sp. ‘CSMB_57’ was assembled. Genomic annotation revealed a high number of CRISPR arrays for viral defence, a large array of ABC transporters for amino acid and peptide uptake, as well as genes likely associated with syntrophy such as genes associated with type-IVa pilus, often used for direct interspecies electron transfer, and multiple hydrogenases capable of producing hydrogen. From the various genomic observations, a conceptual ecological model was developed that explores its possible syntrophic roles with hydrogenotrophic methanogens and acetogenic bacteria within coal-seam environments.
Circulating cell-free messenger RNA secretome characterization of primary sclerosing cholangitis
Authors: Chalasani Naga , Vuppalanchi Raj , Lammert Craig , Gawrieh Samer , Braun Jerome V. , Zhuang Jiali , Ibarra Arkaitz , Ross David A. , Nerenberg Michael , Quake Stephen R. , Sninsky John J. , Toden Shusuke
Published: August 2022

BACKGROUND & AIMS

Primary sclerosing cholangitis (PSC) is a rare chronic cholestatic liver disease characterized by multi-focal bile duct strictures. To date, underlying molecular mechanisms of PSC remain unclear and therapeutic options for PSC patients are limited. We performed cell-free messenger RNA (cf-mRNA) next generation sequencing (RNA-Seq) to characterize the circulating transcriptome of PSC and non-invasively investigate potentially bioactive signals that are associated with PSC.

METHODS

Serum cf-mRNA profiles were compared among 50 individuals with PSC, 20 healthy controls, and 235 individuals with non-alcoholic fatty liver disease (NAFLD). Tissue and cell type-of-origin genes that are dysregulated in subjects with PSC were evaluated. Subsequently, diagnostic classifiers were built using PSC dysregulated cf-mRNA genes.

RESULTS

Differential expression analysis of the cf-mRNA transcriptomes of PSC and healthy controls resulted in identification of 1407 dysregulated genes. Furthermore, differentially expressed genes between PSC and the liver diseases (NAFL and Non-Alcohol Steatohepatitis (NASH)) or healthy controls shared common genes known to be involved in liver pathophysiology. In particular, genes from liver- and specific cell type-origin, including hepatocyte, hepatic stellate cells and Kupffer cells, were highly abundant in cf-mRNA of subjects with PSC. Gene cluster analysis revealed that liver-specific genes dysregulated in PSC form a distinct cluster which corresponded to a subset of the PSC subject population. Finally, we developed a cf-mRNA classifier using liver-specific genes which discriminated PSC from healthy control subjects using gene transcripts of liver origin.

CONCLUSIONS

Blood-based whole transcriptome cf-mRNA profiling revealed high abundance of liver-specific genes in PSC subject sera which may be used to diagnose PSC patients. We identified several unique cf-mRNA profiles of subjects with PSC. These findings may also have utility for non-invasive molecular stratification of subjects with PSC for pharmacotherapy safety and response studies.

Graphical Abstract
Mapping topography and network of brain injury in patients with disorders of consciousness
Authors: Arachige Manoj Liyana , Seneviratne Udaya , John Nevin , Ma Henry , Phan Thanh
Published: August 2022

There is growing interest in the topography of brain regions associated with disorders of consciousness. This has caused increased research output, yielding many publications investigating the topic with varying methodologies. The objective of this study was to ascertain the topographical regions of the brain most frequently associated with disorders of consciousness.

We performed a cross-sectional text mining analysis of disorders of consciousness studies. A text mining algorithm built in the Python programming language searched documents for anatomical brain terminology. We reviewed PubMed studies up to 9thJuly 2021 for the search query “Disorders of Consciousness.” The frequency of brain regions mentioned in these articles was recorded, ranked, then built into a graphical network. Subgroup analysis was performed by evaluating the impact on our results if analyses were based on abstracts, full-texts, or topic modelled groups (non-negative matric factorization was used to create subgroups of each collection based on their key topics). Brain terms were ranked by their frequency and concordance was measured between subgroups. Graphical analysis was performed to explore relationships between anatomical regions mentioned. The PageRank algorithm (used by Google to list search results in order of relevance) was used to determine global importance of the regions.

The PubMed search yielded 14,945 abstracts and 2178 full-texts. The topic-modelled subgroups contained 2440 abstracts and 367 full-texts. Text Mining across all document groups concordantly ranked the thalamus the highest (Savage score = 14.191). Graphical analysis had 4 clusters: cluster 1 had 20 members with the insular cortex [PageRank =0.167] as the most important member; cluster 2 had 29 members with the amygdala [PageRank =0.0199] being most important; cluster 3 had 10 members with the thalamus [PageRank = 0. 0205] being most important; cluster 4 had 19 members with the cingulate cortex [PageRank = 0. 0.020] being the most important.

The cingulate cortex and thalamus are strongly associated with disorders of consciousness, likely due to the roles they play in maintaining awareness and involvement in the Default Mode Network respectively. Other areas of the brain like the cuneus, amygdala and hippocampus should be further investigated.