bluuebunny/crossref_metadata_2025 huggingface dataset:
A qualitative exploration of the enablers and barriers to the provision of outpatient clinics by hospital pharmacists.
Authors: Bailey Gerald , Dunlop Emma , Forsyth Paul
Published: March 2022

Background: With increasing demands on the National Health Service (NHS), Scottish Government-led pharmacy strategy has prioritised the development and expansion of modern outpatient services. Pharmacist-led outpatient clinics have been shown to reduce hospital admissions and improve patient outcomes. However, expanding these contemporary models of care has proved challenging, and there are few qualitative data about the factors affecting the provision of these.Aim: This study aimed to explore the enablers and barriers to hospital pharmacists providing outpatient clinics within the largest health authority in Scotland, NHS Greater Glasgow & Clyde (NHSGGC). Method: Between August and October 2020, one-to-one semi-structured interviews were conducted virtually using the videoconferencing platform Microsoft Teams®, with NHSGGC hospital pharmacists. Audio- and video-recordings of the interviews were transcribed in verbatim and underwent thematic analysis.Results: 16 hospital pharmacists were interviewed; 50% were clinic providers and 50% were not. Analysis generated seven themes: clinical or service need, individual psychological factors, clinic structure and processes, additional clinical skills and training, competing priorities, macro-level pharmacy working, and external stakeholder relationships.Conclusion: The enablers and barriers to hospital pharmacists providing outpatient clinics are multifaceted. Changes are required at the micro- and macro-level, with distributed leadership and system transformation remaining crucial. The forthcoming implementation of new professional curricula, should reconfirm whose role it is to develop such services and may enable pharmacists to overcome the individual and systematic barriers that prevent them from currently progressing the development of modern outpatient services; prospective research needs to accompany this vision.
Radiofrequency Echographic Multispectrometry (Rems): An Innovative Technique For The Assessment Of Bone Status In Young Women With Anorexia Nervosa
Authors: Caffarelli Carla , refaie Antonella Al , De Vita Michela , Pitinca Maria Dea Tomai , Goracci Arianna , Fagiolini Andrea , Gonnelli Stefano
Published: March 2022

Purpose Reduced bone mineral density (BMD) and increase risk of fragility fracture are common complication of anorexia nervosa (AN). BMD by Dual-energy X-ray Absorptiometry (DXA) present several limits in subjects with AN. This study aimed to evaluate the usefulness of the new Radiofrequency Echographic Multi Spectrometry (REMS) technique in the assessment of bone status in young women with AN. Methods In a cohort of 50 subjects with restrictive AN and in 30 healthy controls we measured BMD at the lumbar spine (LS-BMD), at femoral neck (FN-BMD) and total hip (TH-BMD) by using both DXA and REMS technique.Results BMD evaluated by DXA and REMS technique at all measurement sites were all significantly (p<0.01) lower in subjects suffering from AN subjects than in controls. Good correlations were detected between BMD by DXA and BMD by REMS measurements at LS (r=0.64, p<0.01) at FN (r=0.86, p<0.01) and at TH (r=0.84, p<0.01) in subjects suffering from AN. Moreover, Bland-Altman analysis confirmed the good agreement between the two techniques. The subjects suffering from AN with previous vertebral fragility fractures presented lower values of both BMD-LS and BMD-TH by DXA and by REMS with respect to those without fractures; however, the difference was significant only for BMD-TH by REMS (p<0.05). Conclusions Our data suggest that REMS technique due to its characteristic of precision and reproducibility may represent an important tool for the evaluation of the changes in bone status in AN young women, especially during the fertile age and in case of pregnancy and breastfeeding. Level of Evidence Level III cohort study
Effect of Gamma Irradiation Combined with Certain Entomopathogenic Fungi on some Biological Aspects of Galleria mellonella
Authors: Mohamed Hussein Farid , El-Naggar Samira Elsayed Mustafa , Sweilem Mahmoud Abd El-Mohsen , Ibrahim Adly Mohamed , El-khawaga Ola Elsayed  Abd Alrahman
Published: March 2022

Background: the prevailing research become analyzing the impact of the one-of-a-kind doses of gamma irradiation (70,100,125 and 150 Gy) one after the other or mixed with the LC50 of certain entomopathogenic fungi (Beauveria bassiana, Paecilomyces lilacinus) on selected biological aspects of the greater wax moth, Galleria mellonella (larval–pupal period, The percentage pupation, The percentage adult emergence, sex ratio and The percentage adult survival) many of the first generations (F1) of G. mellonella. Results: The joint treatment of Gamma irradiation and LC50 of Beauveria bassiana and Paecilomyces lilacinus increased the larval - pupal periods, while, pupation, adult emergence, survival percentage and the sex ratio were reduced in the combined treatments more than each treatment alone. Conclusions: The second instar larvae of Galleria mellonella descending of the irradiated parental male or female pupae with 70,100 and 125 Gy then treated with the LC50 of Beauveria bassiana and Paecilomyces lilacinus adversely affected on the different biological aspects. The combined treatment was greater than either, in the case of fungal or irradiation treatment alone.
Adolescence Obesity Risk Increases with Increased Screen Time: A Systematic Review and Dose-Response Meta-Analysis
Authors: Abbasalizad-Farhangi Mahdieh , Jahangiry Leila
Published: March 2022

Background: Adolescence is a critical time period in human life. Adolescence is associated with reduced physical activity and increased sedentary behaviors. In the current systematic review and dose-response meta-analysis, we evaluated the association between screen time and obesity risk among adolescents. Methods: A systematic search from PubMed, Embase and Scopus electronic databases through September 2021 was performed. Studies that evaluated the association between screen time and obesity among adolescents up to September 2021 were retrieved. A total of 64 qualified studies were included into meta-analysis. Results: The results of the two-class meta-analysis showed that adolescents at the highest category of screen time were 1.4 times more likely to develop obesity (OR=1.393; CI=1.264, 1.536; P <0.001). The results of subgrouping identified that continent was the possible heterogeneity source. No evidence of non-linear association between increased screen time and obesity risk among adolescents was observed (P-nonlinearity= 0.278). Conclusion: For the first time, the current systematic review and meta-analysis revealed a positive association between screen time and obesity among adolescents without any dose-response evidence.Registration: The protocol of the current work has been registered in the PROSPERO system (Registration number: CRD42021233899).
Evaluation of the Retina, Choroid and Optic Disc Vascular Structures In Individuals With a History of Covid-19
Authors: Gedik Birumut , Yuksel Ozdemır , Erol Muhammet Kazim , Duman Fulya , Dogan Berna , Suren Elcin , Yavuz Sibel
Published: March 2022

IntroductionIn this study, we aimed to detect changes in posterior segment structures and posterior segment vascular density caused by COVID-19 using the optical coherence tomography angiography (OCTA) device.Material and MethodThe study included 20 eyes of 20 patients without any systemic or eye disease, who were followed up at the Ophthalmology Clinic of Health Sciences University Antalya Training and Research Hospital. The OCTA images of these individuals taken before COVID-19 and at six months after recovery were examined.ResultsThe mean choriocapillaris blood flow value of the patients was 2.00 ± 0.13 mm2 before COVID-19 and 2.08 ± 0.23 mm2 after the disease, the mean subfoveal choroidal thickness value was 247.33 ± 7.65 μm before the disease and 273.08 ± 4.92 μm after the disease, indicating a statistically significant difference (p = 0.003, p = 0.001, respectively). The mean retinal nerve fiber layer values before and after COVID-19 were 119.33 ± 3.88 and 117.50 ± 3.92 μm, respectively, and there was a statistically significant decrease (p < 0.001). ConclusionThis is the first study in the literature to evaluate the post-COVID-19 changes in the eye vascular structures ​​compared to the pre-disease values. We consider that inflammation and increased vascular permeability are effective in changes.
LED Nonlinearity Mitigation in a NOMA-OFDM VLC System Using a Union
of Precoder and Companding
Authors: Sharan Nishant , Ghorai Swapan Kumar , Kumar Ajit
Published: March 2022

The power domain non-orthogonal multiple access (NOMA) has been considered as an outstanding candidate for 5G visible light communication networks. Due to the various salient features like robustness to multi-path fading, low latency, high compatibility with multiple input multiple output (MIMO) systems, etc. orthogonal frequency division multiplexing access (OFDM) is foreseen to exist in 5G systems. NOMA-based optical OFDM (O-OFDM) is expected to be a promising candidate for supporting high rate internet connectivity, especially for
green indoor mobile networks. The OFDM waveform suffers from high PAPR issue. The high PAPR degrades the BER and also enhances the nonlinearity in an O-OFDM system. In this paper, a hybrid technique using a blend of precoder with compander is implemented to reduce the PAPR of NOMA based DC-biased O-OFDM (DCO-OFDM) system. The proposed NOMA DCO-OFDM system exhibits a low PAPR of only 4.3 dB. Also, for a reference bit error rate of 10^-4, the proposed technique displays an error vector magnitude (EVM) of 13.2 dB.
Functional Cotton Fiber-Based TLC-SERS Matrix for Rapid and Sensitive Detection of Mixed Dyes
Authors: Yao Huifang , Dong Xiaxiao , Xiong Hong , Zhou Ji , Ye Yong
Published: March 2022

A facile cotton fabric with a built-in TLC-SERS structure was fabricated to demonstrate an integrated TLC separation and SERS identification of mixed dyes. The soft and flexible SERS fabric was firstly fabricated using a simple method in which gold nanoparticles were in-situ synthesized on cotton fabrics by heating. β-CD was then grafted onto cotton fabric through crosslinking with citric acid in presence of sodium hypophosphite monohydrate via esterification reaction. The adsorption and TLC development performance of β-CD grafted fabrics were comprehensively investigated with two representative organic dyes, one anionic dye and one nonionic dye. Besides, the recyclable adsorption and separation performance were tested to evaluate its sustainable application prospects. It displayed less adsorption capacity loss and reusable separation performance after several cycles than the pristine cotton fabrics. Finally, two sets of mixed dyes were successfully separated on the TLC fabrics and then identified via on-site SERS according to their different migration distance. The developed TLC-SERS fabric shows the advantage of quick, easy to handle, low-cost, sensitive, and could be exploited in on-site study of synthetic dyes in art objects, textile and packaging products or forensic applications.
Associations Between Paraben In Human Serum And Rheumatoid Arthritis Risks
Authors: Zhao Yun , Qu Jianli , Zhao Meirong , Wu Pengfei , Xue Jing , jin hangbiao
Published: March 2022

Parabens are widely used in consumer products resulting in frequent exposure to humans and some toxic effects in humans. However, little is known about the association between human paraben exposure and rheumatoid arthritis (RA). In this study, a case-control cohort (n = 290) were established in Hangzhou, China, aiming to quantify the residues of MeP, EtP, PrP, and BuP in serum samples and to determine their associations with RA risks. MeP (mean 4.7 ng/mL, < LOD–20 ng/mL) was the predominant paraben in human serum, followed by PrP (1.9 ng/mL, < LOD–24 ng/mL), EtP (1.4 ng/mL, < LOD–10 ng/mL), and BuP (1.09 ng/mL, < LOD–10 ng/mL). Human serum concentrations of MeP were correlated with the levels of rheumatoid factors [adjusted β = 0.19, 95% confidence interval (CI): 0.12, 0.46], anti-cyclic citrullinated peptide antibody (adjusted β = 0.30, 95% CI: 0.26, 0.58), immunoglobulin G (adjusted β = 0.24, 95% CI: 0.21, 0.30). Significant associations between MeP (adjusted β = 0.15, 95% CI: 0.037, 0.28) and PrP (adjusted β = 0.23, 95% CI: 0.080, 0.38) exposure were correlated with C-reactive protein levels. In addtion, a correlation between MeP and odds ratios (OR) of RA (ORcrude = 1.337, CI: 1.110, 1.624, p = 0.03; ORadjusted = 1.866, CI: 1.321, 2.636, p = 0.02) was positive and significant. To our knowledge, this study first finds the significant associations among parabens exposure, change of specific immune marker, and RA risks, indicating that human exposure to parabens may increase the risk of RA.
How depression and sleep quality are associated with state-trait anxiety in medical school undergraduates in Anhui Province, China: A mediation analysis
Authors: Chen Jiangyun , Tuersun Yusupujiang , Yang Jiao , Xiong Man , Wang Yueying , Rao Xinyi , Jiang Shuai
Published: March 2022

Background: To investigate the relationship between depression and sleep quality and state-trait anxiety among undergraduate students in medical colleges and universities in Anhui Province, to enhance the attention to the mental health of undergraduate students in medical colleges and universities, and to provide a basis for mental health intervention strategies for undergraduate students in medical colleges and universities. Methods: The Pittsburgh Sleep Quality Index, State-Trait Anxiety Inventory, and Depression Self-Rating Scale were used to investigate 1300 college students in four medical undergraduate colleges and universities in Anhui Province. Results: The Pittsburgh Sleep Quality Index score was (5.87+2.944), the State-Trait Anxiety Inventory score was (84.10+17.276), and the Depression Self-Rating Scale score was (49.04+10.845). Depression status and Pittsburgh Sleep Quality Index were positively correlated (r=0.381, p<0.001), and Pittsburgh Sleep Quality Index and State-Trait Anxiety were positively correlated (r=0.428, p<0.001). Conclusions: Taking four undergraduate medical colleges and universities in Anhui Province as an example, sleep quality of college students in medical colleges and universities was positively correlated with depressive state, sleep quality and state-trait anxiety were positively correlated, and sleep quality was influencing depressive state through state-trait anxiety.
Impact of COVID-19 RT-PCR Testing of Asymptomatic Health Care Workers on Absenteeism and Hospital Transmission During the Pandemic
Authors: Mendes Elisa Teixeira , Neto Danilo Glauco Pereira Villagelin , Ferreira Giulia Magalhães , Valença Ian Nunes , Lima Maria Patelli Juliani Souza , Freitas Maria Fernanda Marciano Barros , Donalisio Maria Rita , Melo Marcio Cristiano , Lazari Carolina , Goes Jacqueline , Morales Ingra , Jardim Ana Carolina Gomes , Santos Pamela Andrade dos , Franco Lucas Augusto Moyses , Sabino Ester Cerdeiro , Costa Silvia Figueiredo
Published: March 2022

Reducing the transmission of SARS-CoV-2 from asymptomatic and pre-symptomatic patients is critical in controlling the circulation of the virus. This study evaluated the prevalence of RT-PCR positivity in serial tests (every 20 days) in 429 asymptomatic health care workers (HCW) and its impact on absenteeism from May to August 2020. Asymptomatic HCW from a COVID-19 reference hospital in Campinas (1.2 million inhabitants), Brazil, were tested, screened, and placed on leave. A time-series segmented regression of weekly absenteeism rates was used, and cases of infection among hospitalized patients were analyzed. Viral gene sequencing and phylogenetic analysis were performed on samples gathered from professionals who had a positive result. A significant decrease in absenteeism was detected 3–4 weeks after the intervention at a time of increased transmission within the city. The prevalence of RT-PCR positivity among asymptomatic professionals was 17.3%. Phylogenetic analyses of 59 samples detected nine clusters, two of them strongly suggestive of intra-hospital transmission with strains (75% B.1.1.28) circulating in the region during this period.Testing and placing asymptomatic professionals on leave contributed to control strategy for COVID-19 transmission in the hospital environment, and in reducing positivity and absenteeism, which directly influences the quality of care and exposes professionals to an extra load of stress.
Psychological distress and resilience in patients with advanced cancer during the Covid-19 pandemic: the mediating role of spirituality
Authors: Mihic-Góngora Luka , Jiménez-Fonseca Paula , Hernández Raquel , Gil-Raga Mireia , Pacheco-Barcia Vilma , Manzano-Fernández Aranzazu , Hernando-Polo Susana , Antoñanzas-Basa Monica , Corral Maria J. , Valero-Arbizu María , Calderon Caterina
Published: March 2022

Background. The purpose of this study was to investigate the sociodemographic factors related to psychological distress, spirituality, and resilience, and to examine the mediating role of spirituality with respect to psychological distress and resilience in patients with advanced, unresectable cancer during the Covid-19 pandemic.Methods. A prospective, cross-sectional design was adopted. Data were collected from 636 participants with advanced cancer at 15 tertiary hospitals in Spain between February 2019 and December 2021. Participants completed self-report measures: Brief Resilient Coping Scale (BRCS), Brief Symptom Inventory (BSI-18), and Spiritual well‐being (FACIT-Sp). Hierarchical linear regression models were used to explore the mediating role of spirituality. Results. Spirituality was significantly different according to the person’s age and marital status. Psychological distress accounted for 12% of the variance in resilience (β =-0.32, p<0.001) and spirituality, another 15% (β =0.48, p<0.001). Spirituality acted as a partial mediator in the relationship between psychological distress and resilience in individuals with advanced cancer.Conclusions. Both psychological distress and spirituality played a role in resilience in cases of advanced cancer. Spirituality can help promote subjective well-being and increased resilience in these subjects.
The İmpact Of The Apelinergic System In Coronary Collateral Formation
Authors: Ozsoyler Ibrahim , Ucak Haci Ali , Badak Tolga Onur , Cakallioglu Ahmet , Bayraktar Muhammed , Arslan Ahmet Suha
Published: March 2022

Background: İn coronary artery disease, the positive contribution of the presence of coronary collateral circulation to the course of the disease is known. As for the factors that trigger the formation of collateral circulation and interactions at the cellular level, no satisfactory results have yet been reached. Studies on this issue will also pave the way for potential treatment opportunities in the future. The aim of this study is to try to determine the relationship between coronary collateral circulation and elabela and apelinergic system.Methods: This is a cross sectional study. Totally 150 subjects were included the study. Demographic data, laboratory test data, and comorbidities were collected from the hospital data. Welch, One Way Anova, Chi-Square, and Kruskal-Wallis H tests were used for comparison of the groups. Games-Howell, Tukey HSD, and Dunn tests were used for post-hoc analysis where necessary.Results: Evaluating the differences between the groups in terms of the parameters examined. Looking at which groups the differences arise from; it was observed that the statistically significant difference observed for elabela, HDL-C, NT-ProBNP, LVEF and HS-C-Reactive protein was between all groups separately.Conclusions: In this study, we aim to reveal a positive relationship between the development of coronary collateral vessels and apelinergic systems. Our results indicated that Elabela protein could be evaluated as a potential agent for treatment.
Clinical Significance of Germline Telomere Length and Associated Genetic Factors in Patients with Neuroblastoma
Authors: Sung Ki Woong , Bae Joon Seol , Lee Ji Won , Joung Je-Gun , Cho Hee Won , Ju Hee Young , Yoo Keon Hee , Koo Hong Hoe
Published: March 2022

Background: Studies investigating the relationship between germline telomere length and the clinical characteristics of tumors are very limited. This study evaluated the relationship between germline telomere length and the clinical characteristics of neuroblastoma. In addition, a genome-wide association study (GWAS) was performed to investigate the genetic factors associated with telomere length. Methods: The telomere length of peripheral blood mononuclear cells from 186 patients with neuroblastoma was measured by quantitative PCR. The association between germline telomere length and clinical characteristics, including long-term survival, was investigated. For the GWAS, genotyping was performed with a high-density Illumina bead chip. After strict quality control checks of the samples, an association analysis was conducted. Results: An extra-abdominal primary site, lower stage (stage 1/2), MYCN non-amplified tumor, and being in the low-risk group were associated with longer telomere lengths (P = 0.015, 0.007, 0.046 and 0.042, respectively). Patients with longer third telomeres had longer event-free survival than other patients (P = 0.032). In the GWAS, rs2492082, located in the 3’UTR of the HIVEP3 gene, showed the highest association with telomere length (P = 1.7E-06). Patients with long telomeres had a recessive allele A. A gene-based analysis using the VEGAS2 algorithm showed that the CNTN4 gene had the most significant association with telomere length (P = 1.0E-06). Patients with the CC homozygote in the rs71311728 marker within the CNTN4 gene had a longer telomere length than those with the TC heterozygote. A gene ontology analysis showed that genetically susceptible genes associated with telomere length were mainly distributed in neurite morphogenesis and neuron development.Conclusions: Longer germline telomere length is associated with favorable prognostic factors at diagnosis and eventually better event-free survival in patients with neuroblastoma. In addition, the GWAS demonstrated that genetic markers and genes related to telomere length are associated with neurite morphogenesis and neuron development. A further study with a larger cohort of patients and functional studies are needed.
The Connectional Anatomy of Visual Mental Imagery: Evidence From a Patient with Left Occipito-Temporal Damage
Authors: Hajhajate Dounia , Kaufmann Brigitte , Liu Jianghao , Siuda-Krzywicka Katarzyna , Bartolomeo Paolo
Published: March 2022

Most of us can use their “mind’s eye” to mentally visualize things that are not in their direct line of sight, an ability known as visual mental imagery. Extensive left temporal damage can impair patients’ visual mental imagery experience, but the critical locus of lesion is unknown. Our recent meta-analysis of 27 fMRI studies of visual mental imagery highlighted a well-delimited region in the left lateral midfusiform gyrus, which was consistently activated during visual mental imagery, and which we called the Fusiform Imagery Node (FIN). Here we describe the connectional anatomy of FIN in neurotypical participants and in RDS, a right-handed patient with an extensive occipitotemporal stroke in the left hemisphere. The stroke provoked right homonymous hemianopia, alexia without agraphia, and color anomia. Despite these deficits, RDS had normal subjective experience of visual mental imagery and reasonably preserved behavioral performance on tests of visual mental imagery of object shape, object color, letters, faces, and spatial relationships. We found that the FIN was spared by the lesion. We then assessed the connectional anatomy of the FIN in the MNI space and in the patient’s native space, by visualizing the fibers of the inferior longitudinal fasciculus (ILF) and of the arcuate fasciculus (AF) passing through the FIN. In both spaces, the ILF connected the FIN with the anterior temporal lobe, and the AF linked it with frontal regions. Our evidence is consistent with the hypothesis that the FIN is a node of a brain network dedicated to voluntary visual mental imagery. The FIN could have a specific role in integrating high-level visual representations in domain-preferring regions in the ventral temporal lobe with elements of semantic knowledge stored in the anterior temporal lobe and in the language circuits.
Obtaining Single Shot High-Resolution Frequency Spectrum of an Ultra-Short Signal Using an Analog Optical Auto-Correlation Technique
Authors: Zhou Weimin
Published: March 2022

It is very difficult to obtain a high-resolution real-time frequency spectrum from an ultra-short duration pulsed high frequency signals due to the lack of a high speed analog-to-digital converters (ADC). Even if such an ADC exist, there is a fundamental limit by the uncertainty principle for the ultra-short observation/detection/digitization time. This work demonstrated a Radio frequency (RF)-Photonic real time spectrum analyzing technique by sending a single 30ns short microwave signal pulse into a fiber optic recirculation loop circuit to perform analog auto-correlation to resolve a two-tone signal pulse separated by 25 MHz for a 50 GHz wideband spectrum. This optical correlation technique allow us to increase the observation/measurement time by keep the “live” signal in the loop system over long time and “stretching” time using the dispersion of the two RF sidebands for time-correlation. This technique provides a “snapshot” in the frequency domain of ultra-short or transient events without the need of a high-speed ADC, and is able to push the fundamental physical limit in spectrum analyzation of short duration signals.
The effect of polyethersulfone and nylon 6 micromembrane filters on the pyraclostrobin detection：Adsorption performance and mechanism
Authors: Shao Xiaolan , Liu Lejun , Li Hui , Luo Yue , Zhao Jingyu , Liu Shuai , Yan Bei , Wang Dan , Luo Kun , Liu Min , Bai Lianyang , Li Xiaoyun , Liu Kailin
Published: March 2022

Adsorption of test substances on micromembrane filters during sample pretreatment before qualitative and quantitative analysis has greatly affected the accuracy of the measurement. In the present study, it was found that the adsorption rate of pyraclostrobin reached 77.7-100% when water samples of pyraclostrobin (1 mL) were filtered with polyethersulfone (PES) and nylon 6 filters. Therefore, the adsorption mechanisms were investigated from the kinetics, isotherms, and thermodynamics of the pyraclostrobin adsorption process, combined with Attenuated Total Reflection-Fourier Transform Infra-Red (ATR-FTIR) spectroscopy and X-ray Photoelectron Spectroscopy (XPS) analysis. The adsorption of pyraclostrobin on the PES micromembrane is chemical adsorption; while Nylon 6 is physical adsorption. However, pyraclostrobin adsorption onto surface sites of Nylon 6 micromembrane was mostly through physical monolayer. The π-π electron-donor-acceptor (EDA) between pyraclostrobin and PES may promote the adsorption of PES to pyraclostrobin, and hydrogen bonding between pyraclostrobin and Nylon 6 micromembrane may be involved in the adsorption. Our study also proved the addition of methanol and iodine solution was an effective strategy to reduce the adsorption effects and to increase the accuracy of the detection.
Referral Criteria for Chronic Kidney Disease: Implications for Disease Management and Healthcare Expenditure - Analysis of a Population-Based Sample
Authors: Kiel Simone , Weckmann Gesine , Chenot Jean-François , Stracke Sylvia , Spallek Jacob , Angelow Aniela
Published: March 2022

Background Clinical practice guidelines recommend specialist referral according to different criteria. The aim was to assess recommended and observed referral rate and health care expenditure according to recommendations from:· Kidney Disease Improving Global Outcomes (KDIGO,2012)· National Institute for Health and Care Excellence (NICE,2014)· German Society of Nephrology/German Society of Internal Medicine (DGfN/DGIM,2015)· German Society of General Practitioners and Family Physicians (DEGAM,2019)· Kidney failure risk equation (NICE,2021)MethodsData of the population-based cohort Study of Health in Pomerania were matched with claims data. Proportion of subjects meeting referral criteria and corresponding health care expenditures were calculated and projected to the population of Mecklenburg-Vorpommern.ResultsData from 1927 subjects were analysed. Overall proportion of subjects meeting referral criteria ranged from 4.9% (DEGAM) to 8.3% (DGfN/DGIM). The majority of patients eligible for referral were ≥60 years. Estimated population level costs varied between €1,432,440 (DEGAM) and €2,386,186 (DGfN/DGIM). From 190 patients with eGFR < 60 ml/min, 15 had a risk of end stage renal disease >5% within the next 5 years.ConclusionsApplying different referral criteria results in different referral rates and costs. Referral rates exceed actually observed consultation rates. Criteria need to be evaluated in terms of available workforce, resources and regarding over- and underutilization of nephrology services.
Analysis of Rare Thalassemia Genetic Variants Based on Third Generation Sequencing
Authors: Peng Cuiting , Zhang Haixia , Chen Han , Ren Jun , Du Ze , Zhao Tong , Mao Aiping , Xu Ruofan , Lu Yulin , Wang He , Chen Xinlian , Liu Shanling
Published: March 2022

Thalassemia is a group of common hereditary anemia that cause significant morbidity and mortality around the world, yet precisely diagnosing of thalassemia especially for rare thalassemia variants are still challenging. Long range PCR and long-molecule sequencing on the PacBio Sequel II platform utilized in this study could cover the entire HBA1, HBA2 and HBB gene which enable to diagnose most of common and rare types of thalassemia variants. In this study, 100 cases of suspected thalassemia were conducted traditional thalassemia testing and third generation sequencing for thalassemia genetic diagnosing. Compared with traditional diagnostic methods, here additional 10 cases of rare clinically significant variants, including 3 cases of structure variants (SVs) and 7 cases of single nucleotide variations (SNVs) were identified, of which a case with -α3.7 subtype III (-α3.7III) was first identified and validated in Chinese population. Other rare variants of 11.1 kb deletions (--11.1/αα), triplicate α-globin genes (aaa3.7/αα) and rare SNVs have also been thoroughly detected. The results showed that rare thalassemia variants are not rare but just been miss-diagnosed by conventional methods. The results further validated third generation sequencing as a promising method for rare thalassemia genetic testing.
The Role of Notch Signaling in Endometrial Mesenchymal Stromal/Stem-like Cells Maintenance
Authors: Zhang Sisi , Chan Rachel , Ng Ernest H.Y. , Yeung William S.B.
Published: March 2022

Background: Human endometrium undergoes cycles of regeneration in reproductive women and endometrial mesenchymal stromal/stem like cells (eMSC) contribute to this process. Notch signaling is essential for the homeostasis of somatic stem cells, however its role in eMSC remains largely unknown.Methods: RT-qPCR was used to compare the activity of Notch signaling between endometrial fibroblast (eSF) and eMSC. Flow cytometry, immunofluorescence, western blotting, ﻿in vitro clonogenicity and proliferation assays were used to assess the properties of eMSC after Notch signaling activation or inhibition. The crosstalk between Notch and Wnt signaling in eMSC was determined by western blotting, in situ proximity ligation assay and luciferase assay. Using a label-retaining cell method, hematoxylin-eosin staining, immunohistochemistry, immunofluorescence and western blotting were applied to characterize the features of label-retaining stromal cells (LRSC) in mouse menstrual-like model. Intrauterine injection of Notch inhibitor was performed at the time of breakdown to explore the potential role Notch signaling in endometrial regeneration in vivo.Results: The gain and loss function showed that activation of Notch signaling promoted eMSC maintenance, while inhibition displayed opposite effect. Activation of Notch pathway better maintained eMSC in a quiescent state. However, these quiescent eMSC can re-enter into the cell cycle depending on Notch and Wnt activity in the microenvironment, suggesting a crosstalk between two signaling pathways. In a mouse menstrual-like model, Notch signaling was highly involved in the dynamic endometrial remodeling event. Suppression of Notch signaling significantly reduced the proliferation of Notch1+ label-retaining stromal cells and consequently delayed the endometrial repair.Conclusions: These results demonstrate the importance of Notch signaling in regulating the endometrial stem/progenitor cells in vitro and in vivo. ﻿Understanding the precise mechanism of endometrial stem/progenitor cells provides a promising therapeutic approach for women with atrophic endometrium or Asherman syndrome.
Does a Widespread Species Have a Higher Competition Ability Than an Endemic Species? A Case Study in the Dongting Lake Wetlands
Authors: Du Yuhang , Zhou Qiaoqiao , Peng Zenghui , Peng Fangcheng , Xi Lianlian , Li Youzhi
Published: March 2022

This study aimed to compare the competition abilities of Phragmites australis (PA), a widespread species, and Triarrhena lutarioriparia (TL), an endemic species, in the Dongting Lake wetlands. Field monitoring indicated that during flooding, the two plant species showed decreased survival percentage, which did not differ noticeably between them. Control experiment indicated that PA exhibited higher survival percentage than TL. In the field monitoring, PA showed higher aboveground biomass before flooding and higher relative elongation rate, whereas TL showed higher aboveground biomass after flooding and higher relative growth rate. However, in the control experiment, plant biomass, relative growth rate, and relative elongation rate were not obviously different between the two species, and PA showed higher competition ability than TL in the early stage and lower competition ability than those of TL in the middle and later stages. The relative yield total in both the field monitoring and control experiment were greater than one, indicating that the two plant species occupied different niches. Compared to TL, PA had higher competition ability in non-submergence habitat and lower competition ability in water submergence habitat. Niche difference between the two species enabled their coexistence in the Dongting Lake wetlands under the influence of seasonal flooding.
The 11-year solar cycle modulates the occurrence of off-season super typhoons in the western North Pacific
Authors: Yu Jin-Yi , Wu Chau-Ron , Lin Yong-Fu
Published: March 2022

The unexpected occurrence of super typhoons outside the regular typhoon season can cause tragic loss of life and property damage. Here we show with observational analyses and climate model experiments that the occurrence frequency of off-season (November-April) super typhoons in the western North Pacific is modulated by the 11-year solar cycle through a sea surface temperature (SST) footprint mechanism. The variation in super typhoon number during 1985-2018 matches the intensity variation of the solar cycle, with the off-season typhoons occurring more (less) often during the active (inactive) periods of the cycle. The solar cycle induces an SST footprint extending equatorward from the northeastern Pacific, altering atmospheric conditions over the tropical central-to-western Pacific to affect typhoon intensities and trajectories. During active periods, the solar cycle’s footprint causes the mean Pacific Walker circulation to become weaker than normal. The weaker circulation provides favorable atmospheric conditions for super typhoon formation, which include a weak vertical wind-shear environment, a more-eastward located typhoon genesis region, and weaker background trade winds that steer typhoons westward more slowly. Typhoons can stay over ocean for a longer time under these conditions and receive more energy from the ocean to become super typhoons. The powerful and devastating 2013 typhoon Haiyan occurred near the peak of the latest active period of the solar cycle. The 11-year solar cycle can be used to aid decadal disaster preparation and management planning.
Evaluating the Rare Cases of Cortical Vertigo Using Disconnectome Mapping
Authors: Conrad Julian , Bögle Rainer , Ruehl Ria Maxine , Dieterich Marianne
Published: March 2022

Objective In rare cases, cortical infarcts lead to vertigo. We evaluated structural and functional disconnection in patients with acute vertigo due to ischemic cortical infarcts compared to infarcts without vertigo in a similar location with a focus on the connectivity of the parieto-opercular (retro-)insular cortex (PIVC). Methods Using lesion maps from the published case reports, we computed lesion functional connectivity networks (FCN) in a set of 100 healthy individuals from the human connectome project (HCP). The probability of lesion disconnection was evaluated by white-matter disconnectome mapping. Results The lesion-FCN included vestibulo-cerebellar hubs (lobules IX, X), the vestibular nuclei, the PIVC (anterior and posterior long insular gyri, area OP2), the retroinsular and posterior insular cortex (area PIC), the multisensory vestibular ventral intraparietal area, motion-sensitive areas (temporal area MT+ and cingulate visual sulcus) as well as hubs for ocular motor control (lateral intraparietal area, cingulate and frontal eye fields). However, this was not sufficient to differentiate between lesions with and without vertigo. Disconnection of interhemispheric connections via the corpus callosum (CC) were present in all ten cases with rotational vertigo, but the CC was spared in lesions of the PIVC without vertigo. Further, the arcuate fascicle (AF) was affected in 90% of the lesions with vertigo and spared in lesions without vertigo. Conclusion Disruption of interhemispheric connections of the PIVC via the corpus callosum and intra-hemispheric disconnection via the AF seem to be the distinguishing factor between vestibular cortical network lesions that manifest with vertigo compared to those without vertigo.
Survey of neonatal resuscitation practices in metropolitan and non-metropolitan non-tertiary birthing units in New South Wales and Australian Capital Territory.
Authors: Shah Dharmesh , Jain Kalpesh , Tracy Mark , Badawi Nadia
Published: March 2022

PurposeNewborn infant is particularly vulnerable around the time of birth and events during this period can have impact on survival and neurodevelopmental outcomes. Having trained personnel with familiar equipment is of paramount importance. We aimed to explore the neonatal training experience of birth attendants in New South Wales (NSW) and Australian Capital Territory (ACT) and explore the variations in respiratory management and equipment use at birth. Methods We contacted 119 non-tertiary units in NSW/ACT by a written survey followed by telephone contact. A set questionnaire was offered, asking for details of the availability and skill levels of staff at neonatal resuscitation, and of the equipment available at all births.Results Staff from 103 out of 119 units (87%) participated in the study. Resuscitation at all metropolitan units was supported by qualified Paediatricians whereas midwives provided neonatal resuscitation as the first responder in a non-metropolitan unit, with support from a general medical practitioner. Twenty two percent of non-tertiary units relied on external agencies or online support for neonatal resuscitation training. Three quarters of the units used a T-piece resuscitator as the primary device to provide positive pressure ventilation, 65.3% of non-metropolitan units had blenders available, and 19% of units administered some oxygen at initiation of resuscitation. Thirty eight percent units responded having no prior knowledge of the pressure relief valve setting.Conclusion Equipment and availability of trained personnel for neonatal resuscitation in non-tertiary birthing units across NSW and ACT wary widely. The resources to provide training and education are variable.
Variations in lignin monomer contents and stable hydrogen isotope ratios in methoxy groups during the biodegradation of garden biomass
Authors: LU Qiangqiang , JIA Lili , AWASTHI Mukesh Kumar , JING Guanghua , WANG Yabo , HE Liyan , ZHAO Ning , CHEN Zhikun , ZHANG Zhao , SHI Xinwei
Published: March 2022

Lignin is the most difficult aromatic substance to degrade. Selective biodegradation under mild conditions is a promising method, but the dynamic variations in lignin monomers during the biodegradation of lignocellulose are not fully understood. In this study, we examined degradation of lignin monomers and changes in stable hydrogen isotope ratios (δ2HLM) in methoxy groups to test the potential of Pseudomonas mandelii, Aspergillus fumigatus, and their co-culture. The degradation weight loss and net degradation loss of lignocellulosic biomass during biodegradation improved dramatically with fungal inoculation. Syringyl monolignol (S-lignin), which contains two methoxy groups, was more difficult to degrade than guaiacyl (G-lignin), which contains only one methoxy group. The δ2HLM values generally remained stable during the depolymerization of lignin. The fluctuation of δ2HLM values during the initial phase of biodegradation may be related to the loss of pectic polysaccharides (another methoxy donor) from the leaves. Our statistical analysis showed that δ2HLM values did not differ among the microbial cultures or change over time despite decreasing G/S ratios. Our results suggest that lignin monomer ratios can be used to monitor differences in microbial metabolism during lignocellulose biodegradation, whereas δ2HLM signatures cannot be used.
Risk Factor Analysis of Postoperative Pancreatic Fistula After Distal Pancreatectomy, with A Focus on Pancreas-Visceral Fat CT Value Ratio and Serrated Pancreatic Contour, Evaluated Using Preoperative CT Images: A Retrospective Single Center Study
Authors: Maeda Koki , Kuriyama Naohisa , Yuge Takuya , Ito Takahiro , Gyoten Kazuyuki , Hayasaki Aoi , Fujii Takehiro , Iizawa Yusuke , Murata Yasuhiro , Tanemura Akihiro , Kishiwada Masashi , Sakurai Hiroyuki , Mizuno Shugo
Published: March 2022

Background: In pancreaticoduodenectomy, the pancreas-visceral fat CT value ratio and serrated pancreatic contour on preoperative CT have been revealed as risk factors for postoperative pancreatic fistulas. We aimed to evaluate whether they could also serve as risk factors for postoperative pancreatic fistulas after distal pancreatectomy. Methods: A total of 251 patients that underwent distal pancreatectomy at our department from 2006 to 2020 were enrolled for the study. We retrospectively analyzed risk factors for postoperative pancreatic fistulas after distal pancreatectomy using various pre and intraoperative factors, including preoperative CT findings, such as pancreas-visceral fat CT value ratio and serrated pancreatic contour. Results: The study population included 147 male and 104 female participants (median age, 68 years; median body mass index, 21.4 kg/m2), including 64 patients with diabetes mellitus (25.5%). Preoperative CT evaluation showed a serrated pancreatic contour in 80 patients (31.9%), a pancreatic thickness of 9.3 mm (4.0–22.0 mm), pancreatic parenchymal CT value of 41.8 HU (4.3–22.0 HU), and pancreas-visceral fat CT value ratio of -0.41 (-4.88 to -0.04). Postoperative pancreatic fistulas were developed in 34.2% of the patients. Univariate analysis of risk factors for postoperative pancreatic fistulas showed that younger age (P = 0.005), high body mass index (P = 0.001), absence of diabetes mellitus (P = 0.002), high preoperative C-reactive protein level (P = 0.024), pancreatic thickness (P < 0.001), and high pancreatic parenchymal CT value (P = 0.018) were significant risk factors; however, pancreas-visceral fat CT value ratio (P = 0.337) and a serrated pancreatic contour (P = 0.122) did not serve as risk factors. Multivariate analysis showed that high body mass index (P = 0.032), absence of diabetes mellitus (P = 0.001), and pancreatic thickness (P < 0.001) were independent risk factors. Conclusion: The pancreas-visceral fat CT value ratio and serrated pancreatic contour evaluated using preoperative CT were not risk factors for postoperative pancreatic fistulas after distal pancreatectomy. High body mass index, absence of diabetes mellitus, and pancreatic thickness were independent risk factors, and a close-to-normal pancreas with minimal fat deposition or atrophy is thought to indicate a higher risk of postoperative pancreatic fistulas after distal pancreatectomy.
Short Communication: Ligase Detection Reaction as a genotyping technique to identify cats carrying the c.1024G>T mutation on TRPV4 gene
Authors: Sartore Stefano , Moretti Riccardo , Iamone Giulia , Piras Lisa Adele , Chessa Stefania , Sacchi Paola
Published: March 2022

One of the major issues in Scottish and Highland Fold cats is osteochondrodysplasia, a bone and cartilage development disorder. A point mutation in TRPV4 gene, associated to the ear-folded phenotype, is responsible of osteochondrodysplasia in those cat breeds. DNA amplification and genotyping by sequencing are currently the standard techniques to identify carrier animals. We developed a Ligase Detection Reaction technique, which is cheaper, more affordable and time saving analysis, obtaining 100% of correct genotyping and identification of all the fold animals as heterozygous for the c.1024G > T mutation. Ligase Detection Reaction can be used to determine the genotype of kittens even before the manifestation of the folded ears character. Despite the presence of the mutation, none of the fold animals presented clinical or radiographic signs of the disease. Thus, the association between the c.1024G > T genotype and osteochondrodysplasia, at least in young animals, is not evident. Further studies are required to fully evaluate this association.
Pineal cysts without hydrocephalus: Microsurgical resection via an infratentorial-supracerebellar approach – Surgical strategies, complications and their avoidance – How we do it.
Authors: Fleck Steffen , Damaty Ahmed El , Lange Ina , Matthes Marc , Marx Sascha , Rafaee Ehab El , Baldauf Jörg , Schroeder Henry WS
Published: March 2022

Introduction Indications for surgery of pineal cysts without ventriculomegaly are still under debate. In view of the limited data for pineal cyst resection in the absence of hydrocephalus, and the potential risk of this approach, we have analysed our patient cohort focussing on strategies to avoid complications according to our experience in a series of 73 pineal cyst patients. MethodsFrom 2003 to 2015, we reviewed our database retrospectively for all patients operated on a pineal cyst. Furthermore, we prospectively collected patients from 2016 to 2020. In summary, 73 patients with a pineal cyst were treated surgically between 2003 and 2020. All patients were operated on via a microscopic supracerebellar-infratentorial (SCIT) approach. The mean follow-up period was 26.6 months (range: 6-139 months).Results73 patients underwent surgery for a pineal cyst. An absence of enlarged ventricles was documented in 62 patients (51 female, 11 male, mean age 27.67 yrs). Main presenting symptoms included headache, visual disturbances, dizziness/vertigo, nausea/emesis, sleep disturbances. Complete cyst resection was achieved in 59/62 patients. 55 of 62 (89%) patients improved after surgery with good or even excellent results according to the Chicago Chiari Outcome Scale, with complete or partial resolution of the leading symptoms.ConclusionPineal cysts resection might be an indication in certain patients for surgery even in the absence of ventriculomegaly. The high percentage of postoperative resolution of quality-of-life impairing symptoms in our series seems to justify surgery. Preoperatively, other causes of the leading symptoms have to be excluded.