bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic changes of rhizosphere soil bacterial community and nutrients in cadmium polluted soils with soybean-corn intercropping
Authors: Li Han , Luo Luyun , Tang Bin , Guo Huanle , Cao Zhongyang , Zeng Qiang , Chen Songlin , Chen Zhihui
Published: February 2022

Background

Soybean-corn intercropping is widely practised by farmers in Southwest China. Although rhizosphere microorganisms are important in nutrient cycling processes, the differences in rhizosphere microbial communities between intercropped soybean and corn and their monoculture are poorly known. Additionally, the effects of cadmium (Cd) pollution on these differences have not been examined. Therefore, a field experiment was conducted in Cd-polluted soil to determine the effects of monocultures and soybean–corn intercropping systems on Cd concentrations in plants, on rhizosphere bacterial communities, soil nutrients and Cd availability. Plants and soils were examined five times in the growing season, and Illumina sequencing of 16S rRNA genes was used to analyze the rhizosphere bacterial communities.

Results

Intercropping did not alter Cd concentrations in corn and soybean, but changed soil available Cd (ACd) concentrations and caused different effects in the rhizosphere soils of the two crop species. However, there was little difference in bacterial community diversity for the same crop species under the two planting modes. Proteobacteria, Chloroflexi, Acidobacteria, Actinobacteria and Firmicutes were the dominant phyla in the soybean and corn rhizospheres. In ecological networks of bacterial communities, intercropping soybean (IS) had more module hubs and connectors, whereas intercropped corn (IC) had fewer module hubs and connectors than those of corresponding monoculture crops. Soil organic matter (SOM) was the key factor affecting soybean rhizosphere bacterial communities, whereas available nutrients (N, P, K) were the key factors affecting those in corn rhizosphere. During the cropping season, the concentration of soil available phosphorus (AP) in the intercropped soybean–corn was significantly higher than that in corresponding monocultures. In addition, the soil available potassium (AK) concentration was higher in intercropped soybean than that in monocropped soybean.

Conclusions

Intercropped soybean–corn lead to an increase in the AP concentration during the growing season, and although crop absorption of Cd was not affected in the Cd-contaminated soil, soil ACd concentration was affected. Intercropped soybean–corn also affected the soil physicochemical properties and rhizosphere bacterial community structure. Thus, intercropped soybean–corn was a key factor in determining changes in microbial community composition and networks. These results provide a basic ecological framework for soil microbial function in Cd-contaminated soil.
Perspectives of physicians and pharmacists on rational use of antibiotics in Turkey and among Turkish migrants in Germany, Sweden and the Netherlands: a qualitative study
Authors: Özcebe Hilal , Üner Sarp , Karadag Ozge , Daryani Achraf , Gershuni Olga , Czabanowska Katarzyna , Brand Helmut , Erdsiek Fabian , Aksakal Tuğba , Brzoska Patrick
Published: February 2022

Background

Antimicrobial resistance may result from inappropriate use of antibiotics in health care. Turkey is one of the countries with the highest antibiotic consumption in the world. Considering the role of transnational ties between Turkish migrants and their social contacts in Turkey, the attitudes and behaviors relating to rational antibiotic use in Turkey can also affect the use of antibiotics by Turkish migrants residing abroad. This study explores physicians’ and pharmacists’ experiences and perspectives on rational antibiotic use among Turkish adults in Turkey and among Turkish migrants in Germany, Sweden, and the Netherlands, three European countries with large populations of Turkish migrants.

Methods

Following a qualitative study design using convenience and snowball sampling, in-depth interviews with 21 family physicians and 24 pharmacists were conducted in the aforementioned countries. We transcribed all interviews verbatim and performed content analysis separately in the countries, followed by translation, pooling and joint interpretation of the findings.

Results

Physicians and pharmacists encountered irrational use of antibiotics among their patients in Turkey. Physicians interviewed in the three European countries explained that Turkish migrants differ from non-migrants with respect to their attitudes towards antibiotics, for example by more often expecting to be prescribed antibiotics. All physicians and pharmacists in the selected countries reported to inform their patients on how to use antibiotics upon prescription; however, Turkish migrants’ poor language proficiency was considered as a substantial communication barrier by the physicians and pharmacists interviewed in the European countries.

Conclusions

The study illustrated some aspects of irrational antibiotic use among the population in Turkey and Turkish migrants in selected European countries. It emphasized the need for closer community participation, adequate information campaigns, as well as in-service training of health care providers in Turkey. The strategies and interventions on rational antibiotic use should also be supported and encouraged by health care providers, who need to reach out to people with various cultural backgrounds.
Validating the use of the revised childbirth experience questionnaire in Hong Kong
Authors: Lok Kris Y. W. , Fan Heidi S. L. , Ko Rachel W. T. , Kwok Jojo Y. Y. , Wong Janet Y. H. , Fong Daniel Y. T. , Shek Noel W. M. , Ngan Hextan Y. S. , Choi Edmond P. H.
Published: February 2022

Objective

To evaluate the psychometric properties of the traditional Chinese version of the Childbirth Experience Questionnaire (CEQ 2.0) and assess the childbirth experiences of Chinese women.

Methods

A cross-sectional survey was conducted in Hong Kong from July 2020 to February 2021. In total, 975 mothers, who could read traditional Chinese and gave birth in 2020 or 2021, were included in the analysis. Data were fitted into the model proposed by the original developers using the confirmatory factor analysis. The data were then randomly split into training and validation sets for exploratory and confirmatory factor analyses. Childbirth experiences were assessed. Factor structure, internal construct validity, internal consistency, and known-group validity were assessed.

Results

The originally proposed CEQ2.0 model showed a poor fit. An exploratory factor analysis identified a revised four-factor model (CEQ2.0-R) on a randomly split sample, which showed a satisfactory fit (CFI=0.912; TLI=0.884; SRMR=.053; RMSEA=0.072) on the other split sample. The revised scale comprised 13 items and four domains: (1)“Own capacity” (6 items), (2) “General support” (3 items), (3) “Perceived safety” (2 items), and (4) “Professional support” (2 items). CEQ2.0-R showed high internal construct validity and reliability. It can differentiate between participants with different characteristics, including parity, oxytocin augmentation, and companionship during labour. The childbirth experiences of the participants were merely positive, and participants reported that more support from midwives is needed.

Conclusions

CEQ2.0-R can adequately describe the childbirth experiences of women in Hong Kong. The questionnaire is easy to be administer and can be used to assess several domains of the childbirth experiences. It may be useful to evaluate the aspects of support needed during childbirth.
Retinal microvascular changes in white matter hyperintensities investigated by swept source optical coherence tomography angiography
Authors: Gao Yuzhu , Kwapong William Robert , Zhang Yifan , Yan Yuying , Jin Xurui , Tao Yunhan , Xu Hanyue , Wu Bo , Zhang Ming
Published: February 2022

Backgro

To assess the microvascular changes in the macular region and the foveal avascular zone (FAZ) area in participants with white matter hyperintensities (WMHs) using swept source optical coherence tomography angiography (SS OCTA).

Methods

This cross-sectional study included a total of 23 WMH participants (45 eyes) and 20 age-matched healthy participants (40 eyes). SS OCTA (VG200; SVision Imaging, Ltd., Luoyang, China) was used to assess the retinal vessel density (VD) and the FAZ area. VD was measured in the superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP) within a 6 × 6-mm scan centred on the macula using a 5-mm Macula circle. The FAZ area was automatically measured on the inner retina layer within a 3 × 3-mm scan in the macular region.

Results

There was no significant difference in VD in the SVP between the two groups. However, VD in both the ICP and DCP was significantly decreased in WMH participants (P = 0.028, P = 0.016). The FAZ area was significantly enlarged in WMH participants (P = 0.030). The signal quality was significantly lower in WMH participants (P < 0.001).

Conclusions

This study suggested that WMH participants have retinal microvascular and foveal avascular zone area changes compared with healthy controls. Further longitudinal studies with larger sample sizes are warranted to identify the value of our findings in the early evaluation of WMHs.
The association between pupils´ aggressive behaviour and burnout among Danish school teachers - the role of stress and social support at work
Authors: Winding Trine Nøhr , Aust Birgit , Andersen Lars Peter Sønderbo
Published: February 2022

Background

Pupils´ aggressive behaviour towards teachers is a serious problem which is slowly gaining attention and has been found to be linked to burnout. However, prospective studies investigating the role of stress and social support from colleagues and supervisor are lacking. Therefore, the aims of the present study were 1. to investigate the association between pupils´ aggressive behaviour and burnout among Danish primary and lower secondary school teachers, 2. to investigate whether the association between pupils´ aggressive behaviour and burnout depends on the level and duration of stress, and 3. to investigate whether social support from colleagues or a supervisor at the work place has a mitigating effect on the association between pupils´ aggressive behaviour and burnout among teachers.

Methods

This study is a longitudinal study using data from 1198 teachers collected in two survey rounds at an interval of 1-year. Teacher-reported aggressive behaviour in pupils measured as harassment, threats, and violence towards teachers was collected at baseline. Burnout was measured at follow-up. The analyses were performed using multilevel logistic regression.

Results

Statistically significant associations between harassment, threats, or violence and burnout 1 year later were found (all ORs 1.6) after adjustment for potential confounders. After further adjustment for stress, the estimates attenuated to ORs between 1.4 and 1.5, and were also statistically significant. Pupils´ aggressive behaviour in combination with low support from colleagues increased the risk of burnout, whereas the risk of burnout increased among those experiencing pupils´ aggressive behaviour in combination with receiving high support from the supervisor.

Conclusions

The results indicate associations between all three types of pupils´ aggressive behaviour and burnout among teachers in Danish primary and lower secondary schools. Stress explained only a minor part of the association between teachers’ perceptions of pupils’ aggressive behaviour and burnout in teachers, and the results regarding social support were conflicting. The results of this study emphasize the growing need for preventive initiatives directed towards pupils´ aggressive behaviour, and future research should focus on exploring in depth how to support and prevent burnout in teachers exposed to aggressive behaviour.
Nutritional status and adequacy of feeding Practices in Infants and Toddlers 0-23.9 months living in the United Arab Emirates (UAE): findings from the feeding Infants and Toddlers Study (FITS) 2020
Authors: Cheikh Ismail Leila , Al Dhaheri Ayesha S. , Ibrahim Sarah , Ali Habiba I. , Chokor Fatima Al Zahraa , O’Neill Lynda M. , Mohamad Maysm N. , Kassis Amira , Ayesh Wafaa , Kharroubi Samer , Hwalla Nahla
Published: February 2022

Background

Infant and young child feeding practices (IYCF) impact the early and later health status of the population. Limited data is available regarding IYCF in the United Arab Emirates (UAE). This study aimed to evaluate the nutritional status and adequacy of feeding practices, energy, food, and nutrient intakes of UAE infants and toddlers ages 0-23.9 months.

Methods

This study is a population-based cross-sectional survey of 276 infants and toddlers aged 0-23.9 months of which 180 were nationals and 96 were Arab non-nationals living in the UAE. Data were collected from the three major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometry was collected and assessed using WHO Anthro-Survey Analyzer, and a multicomponent age-specific questionnaire was used to evaluate IYCF and sociodemographic characteristics. Usual intake of energy, micronutrients, and macronutrients, including supplements, were collected using multiple-pass 24-h dietary recall and analyzed using the PC-side software. IYCF practices were assessed using the WHO indicators.

Results

Overall, 4% of children were malnourished, 8% wasted, 15% stunted, 18% at risk of overweight, and 7% overweight and obese. 95% of infants were ever breastfed and 37% exclusively breastfed at 6 months. Around 98% of infants had a timely introduction of complementary food. Macronutrient intake exceeded AMDR for fat, carbohydrates, and protein for 27%, 8% and 2% of toddlers respectively. As for the percentage of those exceeding the ESPGHAN cut-off for free sugars set at 5% of energy intake, 28.6% had excessive intakes overall, 10% in 0-5.9, 21.9% in 6-11.9 and 56.7% in 12-23.9 month. Usual iron intake was below the Estimated Average Requirement (EAR) in 47% of infants 6-11.9 months. Above 12 months, the usual intake of iron and vitamin D were below EAR in 11% and 49% of toddlers respectively. Usual intake exceeded the tolerable upper intake levels (UL) for vitamin A (14 to 18%) and zinc (11 to 22%) across all ages. Approximately 93% of toddlers ages 12–23.9 months did not meet food groups’ recommendations for vegetables, 87% for fruits, 48% for milk/dairy, 54% for lean meat and beans, and 33% for grains.

Conclusions

This study revealed that a high percentage of infants and toddlers aged 0-23.9 m suffer from a double burden of malnutrition, which is the coexistence of both undernutrition, and overweight and obesity in the same population. In addition to suboptimal feeding practices and inadequate/overconsumption of various nutrients. The findings highlight the need for the development of culturally specific programs aiming to improve the nutritional status of infants and toddlers in the UAE.
Alcohol consumption and associated factors among middle-aged and older adults: results from China Health and Retirement Longitudinal Study
Authors: Wang Qianqian , Zhang Yanzhuo , Wu Chengai
Published: February 2022

Background

This study aimed to investigate alcohol consumption and associated factors in middle-aged and older adults.

Materials and methods

We included 15,942 participants (7,384 men, 8558 women) with age range of 45-101 years from the 2011 baseline survey of the China Health and Retirement Longitudinal Study. Variables related to alcohol status and other potential risk factors were selected for analysis. Logistic regression analysis was used to analyze the factors associated with drinking.

Results

There was a significantly higher proportion of current drinkers among men than women (36.42% ± 0.86% vs. 3.73% ± 0.27%). Among the current drinkers, proportions of binge drinking, heavy drinking and daily drinking were 38.2, 53.0, 57.5% for men and 10.9, 37.2, 36.2% for women, respectively. Factors significantly associated with current drinking were age, health situation, smoking, geographic region, work status and social activities among men, and age, smoking, geographic region and work status among women. The favorite type of alcohol was spirits for both men and women. The type of beverage intake was also related socio- cultural-demographic factors as mentioned above.

Conclusions

Alcohol consumption behaviors and type of beverage was significantly influenced by socio- cultural-demographic factors. The socio-cultural-demographic factors affecting alcohol patterns should be further focused on to promote the development of alcohol control strategies.
Application of Wharton jelly-derived mesenchymal stem cells in patients with pulmonary fibrosis
Authors: Saleh Mahshid , Fotook Kiaei Seyedeh Zahra , Kavianpour Maria
Published: February 2022

Pulmonary fibrosis is a devastating disease that eventually leads to death and respiratory failure. Despite the wide range of drugs, including corticosteroids, endothelin antagonist, and pirfenidone, there is no effective treatment, and the only main goal of treatment is to alleviate the symptoms as much as possible to slow down the progression of the disease and improve the quality of life. Lung transplantation may be a treatment option for a few people if pulmonary fibrosis develops and there is no established treatment. Pulmonary fibrosis caused by the COVID19 virus is another problem that we face in most patients despite the efforts of the international medical communities. Therefore, achieving alternative treatment for patients is a great success. Today, basic research using stem cells on pulmonary fibrosis has published promising results. New stem cell-based therapies can be helpful in patients with pulmonary fibrosis. Wharton jelly-derived mesenchymal stem cells are easily isolated in large quantities and made available for clinical trials without causing ethical problems. These cells have higher flexibility and proliferation potential than other cells isolated from different sources and differentiated into various cells in laboratory environments. More clinical trials are needed to determine the safety and efficacy of these cells. This study will investigate the cellular and molecular mechanisms and possible effects of Wharton jelly-derived mesenchymal stem cells in pulmonary fibrosis.
Beyond financial success: success goals of creative entrepreneurs
Authors: Baláž Vladimír , Jeck Tomáš , Balog Miroslav
Published: February 2022

This paper presents evidence on the identities, values and success goals of creative entrepreneurs in Slovakia. The research relies on a database of creative firms supported by the Slovak Creative Voucher Scheme. The survey-based research compares the success goals of creative entrepreneurs with those of people from conventional industries. The research design acknowledges substantial regional economic disparities in Slovakia. The success goals of creative entrepreneurs from the Bratislava region are compared with those of entrepreneurs from less developed regions. Non-parametric tests are applied in order to establish between-group differences. We found that creative entrepreneurs indeed had their own sets of business motives and success goals, different from those of entrepreneurs in conventional industries. The success goals of creative entrepreneurs were not impacted by the location of the business. Creative entrepreneurs located in the capital region of Bratislava had the same structure of success goals as that of people from underdeveloped regions.
The long path to achieving green economy performance for micro small medium enterprise
Authors: Pangarso Astadi , Sisilia Kristina , Setyorini Retno , Peranginangin Yahya , Awirya Agni Alam
Published: February 2022

Micro small medium enterprises (MSMEs) play an important role in a country's economy, so managers must try to run their business according to the current concept of the green economy (GE). Green economy is an economic concept that makes environmental sustainability an important part of realizing sustainable development goals (SDGs). The performance of MSMEs in terms of GE is a measure of how successful an MSME is in implementing the GE concept. Apart from GE, an equally important element regarding MSMEs is business digitization/digitalization. In the era of society 5.0, MSMEs are increasingly affected by digital technology while running their business. With digitalization, MSME managers can run their company in a more environmentally friendly way to align with the GE concept. Not all MSMEs are ready to implement the GE concept and digitalization, which is a serious problem that deserves attention. To produce a tangible solution related to the implementation of the GE concept and digitization requires a literature review. The literature review helps identify research gaps and formulate a theoretical process in terms of MSME readiness regarding the implementation of the GE concept and digitalization to the performance of GE MSMEs. There is still a limited research framework that comprehensively explains the readiness process related to the GE concept. The digitization of MSMEs on GE's performance is the background of this research. This study aims to develop a research framework for GE MSME performance related to MSME readiness related to the GE concept and digitalization. The research method uses a literature review, and summative content analysis for secondary data in Scopus indexed scientific research publication documents in English, which can be downloaded and relevant until March 2021. The research framework formed consists of 15 constructs for 15 propositions derived from 16 publication documents, using Scopus indexed articles. This research framework contributes to the study of entrepreneurship in general and GE's performance for MSMEs. The research framework formed because of the findings of this study is helpful as a basis for empirical research in the future.
Cognitive flexibility, central coherence, and quality of life in anorexia nervosa
Authors: Brockmeyer Timo , Febry Hagen , Leiteritz-Rausch Anna , Wünsch-Leiteritz Wally , Leiteritz Andreas , Friederich Hans-Christoph
Published: February 2022

Background

Anorexia nervosa (AN) has consistently been found to be associated with poor cognitive flexibility and central coherence. These two cognitive functions have been considered important maintenance factors in AN and are addressed by specific treatment approaches such as cognitive remediation therapy. While there is clear empirical evidence that difficulties in such cognitive functions are related to impaired daily functioning in schizophrenia and bipolar disorder, this potential association has received only little attention in AN research so far. Therefore, the aim of this study was to examine potential relationships between weak cognitive flexibility, central coherence, and poor quality of life (QoL) in AN.

Methods

Cognitive flexibility and central coherence were measured by both neuropsychological (i.e., performance based) and self-report measures alongside with self-reported QoL in a sample of 138 adult patients with AN.

Results

Self-report but not performance based measures of cognitive flexibility and central coherence were associated with QoL. Weaker cognitive flexibility and central coherence were correlated with poorer QoL. These associations were independent of comorbid depression. The link between weak central coherence and poor QoL was particularly strong in patients with the restricting subtype of AN. The link between cognitive flexibility and QoL, however, was independent of AN subtype.

Conclusions

Weak cognitive flexibility and central coherence are associated with low QoL in AN, especially in patients with the restrictive subtype. However, this relationship is dependent on the method of measurement, where self-report measures seem to be more relevant than performance based measures.
Multiple perspectives and dialogue in understanding experiences of living with eating disorders: Two narratives—four unpackings
Authors: Brinchmann Berit Støre , Lyngmo Siri , Herholdt-Lomholdt Sine Maria , Blix Bodil H.
Published: February 2022

Background

This is a response to Conti et al.’s article, “Listening in the dark: why we need stories of people living with severe and enduring anorexia nervosa” (published in JED, 2016), and its call for relational metaphors and a relational approach to supplement the traditional medical/psychological diagnostic language used to describe the life experiences and complex emotions of people affected by an eating disorder.

Methods

Four authors with different backgrounds unpack two narratives, ‘The Prima Donna with the Green Dress’ and ‘Breaking down the Wall’, both narrated during fieldwork in multifamily therapy. The narratives are unpacked from the perspective of a therapist within multifamily therapy, a researcher who conducted the fieldwork, a researcher based in phenomenology and a researcher based in narrative inquiry. The authors enter into dialogue with the narratives, and with each other.

Results

The four authors focus on different elements within the narratives and understand them differently. One, focuses on strength and pride, and art expression as a different form of language for people living with an eating disorder. Another, on the experience of isolation, boundaries, and balancing openness and closedness. A third, sees the narratives as expressing a wish to see and be seen, and the fourth focuses on the absence of, and longing for, a shared space to explore.

Conclusion

The aim is not to reach a correct or shared interpretation of the narratives but to explore how different perspectives may contribute to different insights, not only about one family in particular but about, more generally, the experiences of people living with an eating disorder. Our work shows the significance of engaging with multiple perspectives and dialogue as supplements to the traditional medical/psychiatric diagnostic language in both clinical practice and research.
Experimental study on capillary water absorption of sandstones from different grotto heritage sites in China
Authors: Zhang Yue , Zhang Yunmeng , Huang Jizhong
Published: February 2022

Sandstone grottoes, with their elaborate carvings and decorations, hold high historic, artistic and scientific values and therefore constitute an important part of China’s stone cultural heritage. Although capillary water accounts for severe pathologies at the grottoes, so far there have been limited comprehensive investigations concerned with the capillary water absorption behavior of sandstones. Aiming at three significant and famous sites in China, i.e., Yungang Grottoes (YG), Dazu Rock Carvings (DZ) and Leshan Grand Buddha (LS), capillary water absorption tests were performed on samples from local sandstones. During the test, evolution of cumulative inflow was measured and variation in the height of capillary rise over time was also monitored by combining visual observation and infrared thermography. Scanning electron microscope and mercury intrusion porosimetry were adopted to characterize the pore structure. The results indicate that all the tested sandstones had a medium capacity of water uptake. Kinetics for capillary water absorption was the highest for LS sandstone and the lowest for DZ sandstone. Differences in macroscopic properties were contributed to microstructural features such as average pore diameter and pore size distribution. An irregular shaped water front was only observed in LS sandstone due to its heterogeneity. Infrared thermography provides an efficient and nondestructive way to detect the transition zone between wet and dry portions of the sample, which was not visible to the naked eyes. A proper understanding of the interaction of the sandstones with capillary water is essential for revealing the deterioration of grottoes and the underlying mechanisms.
Effectiveness of proximal tibial tubercle transfer in patients with patella baja after total knee arthroplasty
Authors: Unterfrauner Ines , Loretz Ruben , Kühne Nathalie , Grubhofer Florian , Fucentese Sandro F.
Published: February 2022

Purpose

Patella baja after total knee arthroplasty (TKA) is a common problem that is usually treated via proximal transfer of the tibial tubercle. As the long-term outcomes of this procedure are unclarified, this study aimed to investigate the changes in clinical function and radiographic patellar height during five years of follow-up.

Methods

Sixty patients with patella baja after TKA who underwent proximalisation of the tibial tubercle were followed up for a mean of 71 months (range 21–153 months). The pre- and postoperative range of motion (ROM) and clinical scores (Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) were compared. The radiographic patellar height was measured with the Caton-Deschamps index (CDI), Blackburne-Peel ratio (BP), and modified Insall-Salvati index (MIS).

Results

Proximalisation of the tibial tubercle resulted in a significant improvement in the ROM from 80° to 88°. The KSS and WOMAC did not improve or even worsened after the intervention. The radiographic patellar height immediately after tibial tubercle transfer was not better than prior to the intervention (CDI 0.72 vs. 0.63, p = 0.72; BP 0.66 vs. 0.61, p = 0.72; MIS 1.59 vs. 1.55, p = 1.00) and further decreased significantly so that the mean final values were worse than the values in the native joint (CDI 0.59 vs. 0.78, p = 0.001; BP 0.58 vs. 0.74, p = 0.001; MIS 1.39 vs. 1.81, p < 0.001).

Conclusion

Proximalisation of the tibial tubercle in patients with patella baja after TKA does neither lead to significant improvements in the clinical outcome nor in the radiographic patellar height during long-term follow-up.

Level of evidence

III
Correlation between short-term blood pressure variability parameters with mobil-O-graph pulse wave velocity
Authors: Silva Marco Antonio Vieira , Resende Luiz Antonio Pertilli Rodrigues , Vieira Mateus Marchiori , Jajah Camila Blanco Ferreira , Berzotti Lucas Alves , Rambourg Nicole Cristine , de Souza Pierson Ian Dias , Achkar João Lucas Carvalho , Vieira Livia Marchiori , Moreira Guilherme Marchiori , Borges Geisa Ribeiro , Correia Dalmo
Published: February 2022

Background

Blood pressure variability (BPV) and arterial stiffness show an association with increased cardiovascular events. Evidences demonstrated an association between higher short-term systolic BPV and stiffer arteries. There is no previous study assessed the correlation between BPV and arterial stiffness measured by a Mobil-O-Graph device. We issued to evaluate the correlation between short-term BPV parameters and Mobil-O-Graph pulse wave velocity (PWV) among suspected hypertensive individuals under treatment.

Methods

Mobil-O-Graph device estimated arterial stiffness (oscillometric PWV [oPWV]) in 649 individuals, and they recorded 24-h ambulatory BP; 428 had suspected hypertension and 221 under treatment. We analyzed the correlation between oPWV and measures of BPV: SD of 24 h BP (24-h SD), SD of daytime BP (daytime-SD), and SD of nighttime BP (nighttime-SD), weighted SD of 24-h BP (wSD), coefficient of variation of 24-h BP (CV 24-h) and average real variability (ARV).

Results

Oscillometric PWV showed a positive correlation with all systolic BPV measures, in both groups. Among suspected hypertensives: 24-h SD, r = 0.30; SD daytime-SD, r = 0.34; nighttime-SD, r = 0.16; wSD, r = 0.30; CV 24-h, r = 0.24; ARV, r = 0.22. In the treated individuals: 24-h SD, r = 0.46; daytime-SD, r = 0.47; nighttime-SD, r = 0.35; wSD, r = 0.50; CV 24-h, r = 0.43; ARV, r = 0.37, all P < 0.001. Diastolic BPV demonstrated association with some measures of BPV. In suspected hypertensive group: nighttime-SD, r = 0.13; wSD, r = 0.10, both P < 0.001. And in treated individuals: daytime-SD, r = 0.23; wSD, r = 0.22; CV 24-h, r = 0.19 (all P < 0.001), ARV, r = 0.15 (P < 0.05). Systolic daytime-SD in suspected and diastolic CV 24-h in treated group independently predicted oPWV.

Conclusion

We observed a positive and independent correlation between Mobil-O-Graph pulse wave velocity and BPV measures, strong to systolic BPV and weak to diastolic BP.
Impact of charge patches on tumor disposition and biodistribution of therapeutic antibodies
Authors: Stüber Jakob C. , Rechberger Karin F. , Miladinović Saša M. , Pöschinger Thomas , Zimmermann Tamara , Villenave Remi , Eigenmann Miro J. , Kraft Thomas E. , Shah Dhaval K. , Kettenberger Hubert , Richter Wolfgang F.
Published: February 2022

This study explores the impact of antibody surface charge on tissue distribution into various tissues including tumor. Tumor-bearing mice were dosed intravenously with a mixture comprising three antibodies engineered to carry negative charge patches, a balanced charge distribution, or positive patches, respectively (cassette dosing). Tissue levels were analyzed with a specific LC-MS/MS method. In addition, the antibody mix was administered to non-tumor bearing mice. Muscle and skin interstitial fluid were obtained by centrifugation and analyzed by LC-MS/MS. An in vitro endothelium model was explored for its feasibility to mimic the observed distribution differences.

A balanced charge distribution was optimal in terms of total tumor exposure, while in other tissues, negatively charged and balanced charged antibodies gave similar results. In contrast, positive charge patches generally resulted in increased serum clearance but markedly enhanced tumor and organ uptake, leading to higher tissue-to-serum ratios. The uptake and availability in the interstitial space were confirmed by specific assessment of antibody levels in the interstitial fluid of the muscle and skin, with similar charge impact as in total tissue. The in vitro model was able to differentiate the transport propensity of this series of antibody variants. In summary, our results show the differential effects of charge patches on an antibody surface on biodistribution and tumor uptake. These insights may help in the design of molecules with biodistribution properties tailored to their purpose, and an optimized safety profile.
Integrated Palliative Outcome Scale for People with Dementia: easy language adaption and translation
Authors: Spichiger Frank , Keller Senn Anita , Volken Thomas , Larkin Philip , Koppitz Andrea
Published: February 2022

Background

In this article, we report the cultural adaption and translation of the Integrated Palliative Care Outcome Scale for People with Dementia (IPOS-Dem) into a Swiss-German easy language version for proxy assessment of people with dementia living in Swiss nursing homes. The Swiss-German easy language version of the IPOS-Dem was developed and culturally adapted in a six-phase process from the German IPOS-Dem using recommended guidelines. With nursing home staff and laypeople, the conceptual definition and relevance of IPOS-Dem items were established during phase I. Phase II encompassed the completion of forward translations. Independent native speakers blind to the original scale translated and back-translated the Swiss-German easy language version. The resulting IPOS-Dem version was then blindly back-translated in phase III. Experts reviewed all resulting translations in phase IV to produce a pre-final IPOS-Dem version. Finally, the phase V cognitive debriefing involved two focus groups assessing the pre-final IPOS-Dem version. Phase V included cognitive interviews with laypeople (n = 2), family members of those with dementia (n = 4) and staff from different care contexts (n = 12).

Results

Using easy language specialists yielded a clinically relevant, comprehensive and understandable translation. In addition, face and content validity for the easy language version were established in the cognitive interviews.

Conclusions

With an easy language IPOS-Dem, all frontline staff and family members can be empowered to communicate their observations after caring interactions. Enhanced clinical communication with easy language tools shows the potential for research and clinical applications. In addition, attentive use in scales of easy language communication may foster increased engagement with untrained laypeople in clinical and care research.
Knee joint line related to bony landmarks of the knee: a radiologic study in a Thai population
Authors: Tantavisut S. , Amarase C. , Ngarmukos S. , Tanavalee C. , Tanavalee A.
Published: February 2022

Background

During revision total knee arthroplasty (TKA), knee joint line restoration may be difficult due to bone loss or structural changes. Although bony landmarks are consistent and can be used as references, there are limited data in Asian patients. We studied the knee joint line related to bony landmarks of the knee in a Thai population.

Materials and methods

Magnetic resonance imaging (MRI) of 140 healthy knees of Thai patients (70 males, 70 females) were investigated. In all knees, a perpendicular line from knee joint line to the medial epicondyle (distance A) and the lateral epicondyle (distance B) in the coronal plane were measured. In the sagittal plane, a perpendicular line from the knee joint line to the fibular head (distance C), the tibial tubercle (distance D), and the inferior patellar pole (distance E) were measured. The femoral transepicondylar width (FW) was measured along the transepicondylar axis. The ratios of distances A, B, C, D, and E related to FW were evaluated (epicondylar ratio).

Results

The mean and standard deviation (SD) of distances A, B, C, D, E, and FW were 27.1 ± 2.7 mm, 21.7 ± 2.5 mm, 12.6 ± 3 mm, 21.3 ± 3.6 mm, 7.6 ± 4.8 mm, and 76.7 ± 3.99, respectively. There was wide variation of measured values, with statistically significant differences between genders in distances A, B, C, and FW. The mean and SD of epicondylar ratios A/FW, B/FW, C/FW, D/FW, and E/FW were 0.35 ± 0.02, 0.29 ± 0.02, 0.16 ± 0.05, 0.28 ± 0.04, and 0.09 ± 0.04, respectively. All epicondylar ratios demonstrated less variation than all measured distances, with statistical differences between genders in the A/FW and D/FW ratios. However, the B/FW ratio had the highest consistent mean value. In addition, it had narrower SD than the rest (0.29 ± 0.02; range, 0.22–0.33).

Conclusions

In Thai knees, the measured distances from bony landmarks to the knee joint line had higher variation than the epicondylar ratio. Among all studied epicondylar ratios, the ratio between lateral epicondyle to joint line distance (distance B)/FW demonstrated the narrowest range of mean and SD values; therefore, this could be the most reliable landmark for intraoperative knee joint line verification by multiplying the FW of the patient by 0.29 to get distance B in that patient.
Can MRI chemical shift imaging replace thymic biopsy in myasthenia gravis patients?
Authors: Taymour Takeya Ahmed , Soliman Enas Samy , Al-Sayyad Enas Hamed , Tadros Sally Fouad
Published: February 2022

Background

Myasthenia gravis is a neuromuscular junction autoimmune condition characterized by muscle weakness. Many people with myasthenia gravis have thymic abnormalities, such as thymic lymphoid hyperplasia and thymic tumors, therefore, the thymus plays a significant role in the disease. The imaging properties of thymic hyperplasia and thymoma on CT and conventional MRI are very similar, yet, MRI has recently revealed promising capability by adding novel sequences. Chemical shift MRI was demonstrated to consistently distinguish thymic hyperplasia from thymus gland tumors. The aim of this study was to determine the value of chemical shift MRI imaging in characterizing thymic lesions in patients diagnosed with myasthenia gravis and its ability to differentiate thymic hyperplasia from thymoma.

Results

MRI showed that thymic lymphoid hyperplasia was more common to be convex in shape while thymoma was more likely to be round or irregular (P = 0.004). Paired comparison between histopathology and chemical shift MRI showed that MRI had 90% sensitivity and 100% specificity in detecting thymoma with overall diagnostic accuracy 93.3% (P = 0.5). MRI chemical shift ratio showed 100% sensitivity by using > 0.85 as a cut off value for diagnosis of thymoma, with specificity 83.3% (P = 0.0001). There was statistically significant difference in chemical shift ratio between thymic lymphoid hyperplasia and thymoma groups, as thymoma group had a higher chemical shift ratio of 1.06 ± 0.06 compared to 0.48 ± 0.13 in thymic hyperplasia group (P = 0.0001).

Conclusion

MRI chemical shift imaging with chemical shift ratio offers a highly sensitive and specific tool in assessment of thymus lesions in myasthenia gravis patients and it can differentiate between thymic hyperplasia and thymoma using cutoff value of > 0.85, hence, unwarranted invasive procedures as thymic biopsy or thymectomy can be avoided and proper management could be planned.
Replaced right hepatic artery passing anterior to pancreas: a rare and challenging anatomical variant during pancreaticoduodenectomy
Authors: Raghavendra D. , Balachandar T. G. , Prabhakaran R. , Swain Sudeepta Kumar , Nirmal J. , Sunil N. , Shekhar Himanshu
Published: February 2022

Background

During pancreaticoduodenectomy proper dissection of local vessels is required. Normal coeliac and hepatic arterial anatomy can be found in only 50–70% of individuals. Good knowledge about aberrant vascular anatomies is necessary to avoid unnecessary complications.

Case presentation

An elderly gentleman presented to us with history of jaundice. Periampullary carcinoma with abnormal right and left hepatic artery morphology was discovered after a contrast enhanced computerized tomography scan.

Conclusion

Despite the anomalous origin and anterior course of replaced right hepatic artery, Classical pancreatoduodenectomy with preservation of replaced right hepatic artery and regional lymphadenectomy with no major intra and post-operative problems was conducted by superior mesenteric artery first approach. Prior to major hepato-pancreatobiliary surgery, a thorough examination of a contrast enhanced computerized tomography scan is required to understand vascular anatomy, recognize anomalous vessels, and understand their significance. Nevertheless, if the abnormal vessel anatomy like replaced right hepatic artery are identified during surgery, a careful dissection of the anomalous vessel is essential to identify all vascular relationships and avoid irreversible injury.
Role of ultrasonography in screening of spinal dysraphism in infants at risk
Authors: Hussein Nada Ahmed , Ahmed Khaled A. , Osman Noha Mohamed , Yacoub George Ezzat Elkess
Published: February 2022

Background

Spinal dysraphism (SD) encompasses congenital spinal defects that result from inappropriate fusion of the different midline osseous, mesenchymal, and neural elements. The primary tools for diagnosis of SD are both spinal ultrasonography (USG) and magnetic resonance imaging (MRI). Spinal USG is growingly being used as an initial screening modality with sensitivities and accuracies equivalent to those of MRI. Anorectal malformations (ARM) have ultimate association with many other congenital abnormalities, of which spinal dysraphism is one of the most common. The main aim of study was to assess the diagnostic accuracy of spinal USG as a screening modality in comparison with MRI in infants with closed spinal dysraphism. We also endeavored to highlight the associated spinal dysraphism radiological findings in patients with either ARM or back cutaneous stigmata.

Results

Our prospective diagnostic comparative study included 33 patients, all of whom underwent both MRI and USG. Both MRI and USG showed appreciable agreement in the assessment of spinal dysraphism. In comparison with the gold standard MRI, spinal USG revealed comparable diagnostic metrics: specificity (98.6–100%), sensitivity (66.6–91.6%), PPV (90–100%) and NPV (94.1–98.7%) in diagnosis of different types of spinal dysraphism. The main clinical presentation of nineteen patients was anorectal malformation (ARM), 11 of whom (57.9%) had evidence of associated spinal dysraphism. The most common types of ARM were cloacal malformation, recto-urethral fistula, and rectal atresia with no fistula. On the other hand, sixteen patients were mainly presented with back cutaneous stigmata, 11 of whom (68.8%) had associated spinal dysraphism. The most common presenting cutaneous stigmata were low back swelling and atypical dimples.

Conclusion

The front-line screening modality for infants with closed SD should be spinal USG, however, its main limitation is the restrained time window in the first 6 months of life. Infants with ARM should be screened for spinal anomalies, especially those with high and complex types. Infants with high-risk back cutaneous stigmata should be similarly screened, as well.
Facilitators and barriers to implementing provider-initiated HIV counselling and testing at the clinic-level in Ekurhuleni District, South Africa
Authors: Mshweshwe-Pakela Nolundi , Mabuto Tonderai , Ntombela Nasiphi , Hlongwane Mpho , Kubeka Griffiths , Kerrigan Deanna L. , Hoffmann Christopher J.
Published: February 2022

Background

HIV testing is the entry point into the HIV care continuum and critical for HIV epidemic control. Facility-based HIV testing services (HTS) reach individuals who are already seeking clinical care and engaging with the medical care system. For this reason, individuals diagnosed with HIV during facility-based HIV testing are more likely to continue into HIV care. To increase the number of PLHIV who are diagnosed and initiated on ART, in 2015, the South African Department of Health instituted Provider-Initiated Counselling and Testing (PICT) policy—encouraging healthcare providers to recommend HIV testing, but this strategy remains under-utilized. We aimed to identify key constraints to the normalization of PICT implementation in 10 Ekurhuleni District healthcare facilities in South Africa.

Methods

In-depth interviews were conducted with 40 healthcare workers (28 clinicians and 12 lay counsellors). Health care workers were purposefully selected to participate in the interviews, stratified by health facility and work category. Interviews were audio-recorded, transcribed, and translated for analysis. Thematic analysis was guided by the normalization process theory (NPT). NPT theory explains how practices are routinely embedded within organizational contexts. We used NVivo 10 software for qualitative data management.

Results

Both clinicians and lay counsellors exhibited a clear understanding of the PICT policy— acknowledging its purpose and value. The identified barrier to normalization of PICT among clinicians was offering HIV testing based on suspicion of HIV despite understanding that PICT involves offering testing to all clients. Additionally, clinicians perceived PICT as incongruent with their clinical roles and perceived it to be lay counsellors’ responsibility. The main facilitator was the participation of all healthcare workers, specifically the presence of lay counsellors, although they also faced barriers such as a lack of workspace and under-appreciation.

Conclusions

Use of NPT helped identify barriers that prevent the normalization of PITC and its integration into routine patient care. These barriers can be modified by low-cost interventions that promote congruence of PICT to the roles of clinicians and integrate the role of lay counsellors within the patient flow in the facility.