bluuebunny/crossref_metadata_2025 huggingface dataset:
Needs assessment for enhancing pediatric clerkship readiness
Authors: Weinstein Adam , MacPherson Peter , Schmidt Suzanne , Van Opstal Elizabeth , Chou Erica , Pogemiller Mark , Gibbs Kathleen , Held Melissa
Published: March 2023

Background

Many students report feeling inadequately prepared for their clinical experiences in pediatrics. There is striking variability on how pediatric clinical skills are taught in pre-clerkship curricula.

Methods

We asked students who completed their clerkships in pediatrics, family medicine, surgery, obstetrics-gynecology and internal medicine to rate their pre-clinical training in preparing them for each clerkship, specifically asking about medical knowledge, communication, and physical exam skills. Based on these results, we surveyed pediatric clerkship and clinical skills course directors at North American medical schools to describe the competence students should have in the pediatric physical exam prior to their pediatric clerkship.

Results

Close to 1/3 of students reported not feeling adequately prepared for their pediatrics, obstetrics-gynecology, or surgery clerkship. Students felt less prepared to perform pediatric physical exam skills compared to physical exam skills in all other clerkships. Pediatric clerkship directors and clinical skills course directors felt students should have knowledge of and some ability to perform a wide spectrum of physical exam skills on children. There were no differences between the two groups except that clinical skills educators identified a slightly higher expected competence for development assessment skills compared to pediatric clerkship directors.

Conclusions

As medical schools undergo cycles of curricular reform, it may be beneficial to integrate more pre-clerkship exposure to pediatric topics and skills. Further exploration and collaboration establishing how and when to incorporate this learning could serve as a starting point for curricular improvements, with evaluation of effects on student experience and performance. A challenge is identifying infants and children for physical exam skills practice.
Improving heart failure care with an Experience-Based Co-Design approach: what matters to persons with heart failure and their family members?
Authors: Suutari Anne-Marie , Thor Johan , Nordin Annika , Josefsson Kristina Areskoug
Published: March 2023

Background

Heart failure is a chronic heart condition. Persons with heart failure often have limited physical capability, cognitive impairments, and low health literacy. These challenges can be barriers to healthcare service co-design with family members and professionals. Experience-Based Co-Design is a participatory healthcare quality improvement approach drawing on patients’, family members’ and professionals’ experiences to improve healthcare. The overall aim of this study was to use Experience-Based Co-Design to identify experiences of heart failure and its care in a Swedish cardiac care setting, and to understand how these experiences can translate into heart failure care improvements for persons with heart failure and their families.

Methods

A convenience sample of 17 persons with heart failure and four family members participated in this single case study as a part of an improvement initiative within cardiac care. In line with Experienced-Based Co-Design methodology, field notes from observations of healthcare consultations, individual interviews and meeting minutes from stakeholders’ feedback events, were used to gather participants’ experiences of heart failure and its care. Reflexive thematic analysis was used to develop themes from data.

Results

Twelve service touchpoints, organized within five overarching themes emerged. The themes told a story about persons with heart failure and family members struggling in everyday life due to a poor quality of life, lack of support networks, and difficulties understanding and applying information about heart failure and its care. To be recognized by professionals was reported to be a key to good quality care. Opportunities to be involved in healthcare varied, Further, participants’ experiences translated into proposed changes to heart failure care such as improved information about heart failure, continuity of care, improved relations, and communication, and being invited to be involved in healthcare.

Conclusions

Our study findings offer knowledge about experiences of life with heart failure and its care, translated into heart failure service touchpoints. Further research is warranted to explore how these touchpoints can be addressed to improve life and care for persons with heart failure and other chronic conditions.
Physicians’ views on optimal use and payment system for telemedicine: a qualitative study
Authors: Raes Sarah , Annemans Lieven , Willems Ruben , Trybou Jeroen
Published: March 2023

Background

Telemedicine is already in use in daily practice, but appropriate reimbursement and physician payment is falling behind in many countries. One reason is the limited availability of research on the matter. This research therefore examined physicians’ views on the optimal use and payment modalities for telemedicine.

Methods

Sixty-one semi-structured interviews were conducted with physicians from 19 medical disciplines. Interviews were encoded using thematic analysis.

Results

Telephone and video televisits tend not to be used as a first patient contact, except for triage of patients in urgency situations. Several minimum required modalities for the payment system of televisits and telemonitoring were identified. For televisits these were: (i) remuneration of both telephone- and videovisits to increase healthcare equity, (ii) little or no differentiation between videovisit and in-person visit fee to make videovisits financially attractive and sustainable for physicians, (iii) differentiation of televisit fee per medical discipline, and (iv) quality requirements such as mandatory reporting in the patient’s medical file. The identified minimum required modalities for telemonitoring were: (i) an alternative payment scheme than fee-for-service, (ii) remunerating not only physicians but also other involved health professionals, (iii) designating and remunerating a coordinator, and (iv) distinguishing sporadic vs. continuously follow-up.

Conclusions

This research investigated the telemedicine usage behavior of physicians. Moreover, several minimum required modalities were identified for a physician-supported payment system of telemedicine, as these innovations necessitate challenging and innovation of the healthcare payment systems as well.
Differences in drug use behaviors that impact overdose risk among individuals who do and do not use fentanyl test strips for drug checking
Authors: Tilhou Alyssa Shell , Zaborek Jen , Baltes Amelia , Salisbury-Afshar Elizabeth , Malicki Julia , Brown Randall
Published: March 2023

Background

Opioid-involved overdose continues to rise, largely explained by fentanyl adulteration of the illicit opioid supply. Fentanyl test strips are a novel drug checking tool that can be used by people who use drugs to detect the presence of fentanyl in drug products. However, it is unclear whether fentanyl test strip use can prompt behavior changes that impact risk of overdose.

Methods

In this mixed-methods study involving a structured survey (n = 341) of syringe service program clients in southern Wisconsin, we examined the association between fentanyl test strip use and overdose risk behaviors in scenarios where the presence of fentanyl is confirmed and unknown. Individual items were transformed into summary scales representing the performance of riskier and safer behaviors. Linear regression examined the association of behaviors with FTS use. Models are adjusted for study site, race/ethnicity, age, gender, drug of choice, indicator of polysubstance use, times used per day, and lifetime overdose count.

Results

In response to survey questions before prompting about fentanyl risk, people who used fentanyl test strips reported an increased number of safer (p = 0.001) as well as riskier behaviors (p = 0.018) relative to people who did not use fentanyl test strips. The same held true in situations when fentanyl adulteration was suspected, though fentanyl test strip use lost significance in the fully adjusted model examining safer behaviors (safer: p = 0.143; riskier: p = 0.004). Among people who use fentanyl test strips, in unadjusted models, a positive test result was associated with more safer behaviors and fewer riskier behaviors, but these associations became nonsignificant in fully adjusted models (safer: p = 0.998; riskier: p = 0.171). Loss of significance was largely due to the addition of either polysubstance use or age to the model.

Conclusions

Fentanyl test strip use is associated with behaviors that may impact overdose risk, including safer and riskier behaviors. Specifically, a positive test result may promote more risk reducing behaviors and fewer risk enhancing behaviors than a negative test result. Results suggest that while FTS may promote safer drug use behaviors, outreach and education should emphasize the need for multiple harm reduction techniques in all scenarios.
Diagnostic performance of Idylla MSI test in colorectal cancer biopsies
Authors: Ukkola Iiris , Nummela Pirjo , Kero Mia , Ristimäki Ari
Published: March 2023

Universal testing for microsatellite instability (MSI) is recommended in colorectal cancer (CRC) to screen for Lynch syndrome and to guide optimal treatment and follow-up of the patients. Especially in neoadjuvant setting, where immuno-oncological treatments have recently shown excellent responses, identification of MSI status at biopsy is a prerequisite. Idylla MSI test offers a rapid and automated test to assess MSI-status from formalin-fixed paraffin-embedded tumor tissue sections. In this study, we compared the performance of the Idylla MSI test to mismatch repair (MMR) protein immunohistochemistry (IHC) using 117 CRC biopsies with previously known deficient MMR status. The concordance between Idylla and IHC was 99.0% (95/96) for biopsies with the recommended ≥ 20% tumor cell content. Further, 85.7% (18/21) of suboptimal CRC biopsy specimens (tumor cell content 5–15%) were diagnosed as MSI. Overall, we identified four discrepant cases of which three had tumor cell content less than 20%, explaining the discordant result. Our study shows that the Idylla MSI test offers a competent tool for MSI screening in CRC biopsy specimens.
Targeted gene deletion with SpCas9 and multiple guide RNAs in Arabidopsis thaliana: four are better than two
Authors: Ordon Jana , Kiel Niklas , Becker Dieter , Kretschmer Carola , Schulze-Lefert Paul , Stuttmann Johannes
Published: March 2023

Background

In plant genome editing, RNA-guided nucleases such as Cas9 from Streptococcus pyogenes (SpCas9) predominantly induce small insertions or deletions at target sites. This can be used for inactivation of protein-coding genes by frame shift mutations. However, in some cases, it may be advantageous to delete larger chromosomal segments. This is achieved by simultaneously inducing double strand breaks upstream and downstream of the segment to be deleted. Experimental approaches for the deletion of larger chromosomal segments have not been systematically evaluated.

Results

We designed three pairs of guide RNAs for deletion of a ~ 2.2 kb chromosomal segment containing the Arabidopsis WRKY30 locus. We tested how the combination of guide RNA pairs and co-expression of the exonuclease TREX2 affect the frequency of wrky30 deletions in editing experiments. Our data demonstrate that compared to one pair of guide RNAs, two pairs increase the frequency of chromosomal deletions. The exonuclease TREX2 enhanced mutation frequency at individual target sites and shifted the mutation profile towards larger deletions. However, TREX2 did not elevate the frequency of chromosomal segment deletions.

Conclusions

Multiplex editing with at least two pairs of guide RNAs (four guide RNAs in total) elevates the frequency of chromosomal segment deletions at least at the AtWRKY30 locus, and thus simplifies the selection of corresponding mutants. Co-expression of the TREX2 exonuclease can be used as a general strategy to increase editing efficiency in Arabidopsis without obvious negative effects.
Tumor-to-bone distance and radiomic features on MRI distinguish intramuscular lipomas from well-differentiated liposarcomas
Authors: Sudjai Narumol , Siriwanarangsun Palanan , Lektrakul Nittaya , Saiviroonporn Pairash , Maungsomboon Sorranart , Phimolsarnti Rapin , Asavamongkolkul Apichat , Chandhanayingyong Chandhanarat
Published: March 2023

Background

To develop a machine learning model based on tumor-to-bone distance and radiomic features derived from preoperative MRI images to distinguish intramuscular (IM) lipomas and atypical lipomatous tumors/well-differentiated liposarcomas (ALTs/WDLSs) and compared with radiologists.

Methods

The study included patients with IM lipomas and ALTs/WDLSs diagnosed between 2010 and 2022, and with MRI scans (sequence/field strength: T1-weighted (T1W) imaging at 1.5 or 3.0 Tesla MRI). Manual segmentation of tumors based on the three-dimensional T1W images was performed by two observers to appraise the intra- and interobserver variability. After radiomic features and tumor-to-bone distance were extracted, it was used to train a machine learning model to distinguish IM lipomas and ALTs/WDLSs. Both feature selection and classification steps were performed using Least Absolute Shrinkage and Selection Operator logistic regression. The performance of the classification model was assessed using a tenfold cross-validation strategy and subsequently evaluated using the receiver operating characteristic curve (ROC) analysis. The classification agreement of two experienced musculoskeletal (MSK) radiologists was assessed using the kappa statistics. The diagnosis accuracy of each radiologist was evaluated using the final pathological results as the gold standard. Additionally, we compared the performance of the model and two radiologists in terms of the area under the receiver operator characteristic curves (AUCs) using the Delong’s test.

Results

There were 68 tumors (38 IM lipomas and 30 ALTs/WDLSs). The AUC of the machine learning model was 0.88 [95% CI 0.72–1] (sensitivity, 91.6%; specificity, 85.7%; and accuracy, 89.0%). For Radiologist 1, the AUC was 0.94 [95% CI 0.87–1] (sensitivity, 97.4%; specificity, 90.9%; and accuracy, 95.0%), and as to Radiologist 2, the AUC was 0.91 [95% CI 0.83–0.99] (sensitivity, 100%; specificity, 81.8%; and accuracy, 93.3%). The classification agreement of the radiologists was 0.89 of kappa value (95% CI 0.76–1). Although the AUC of the model was lower than of two experienced MSK radiologists, there was no statistically significant difference between the model and two radiologists (allP > 0.05).

Conclusions

The novel machine learning model based on tumor-to-bone distance and radiomic features is a noninvasive procedure that has the potential for distinguishing IM lipomas from ALTs/WDLSs. The predictive features that suggested malignancy were size, shape, depth, texture, histogram, and tumor-to-bone distance.
Relationship between preoperative red blood cell distribution width and postoperative pneumonia in elderly patients with hip fracture: a retrospective cohort study
Authors: Zhang Daxue , Zhang Yu , Yang Shiwei , Sun Lixin , Zhang Ning , Huang Shaocai
Published: March 2023

Objective

The relationship between the preoperative red blood cell distribution width and postoperative pneumonia in elderly patients with hip fractures remains unclear. This study investigated whether the preoperative red blood cell distribution width was associated with postoperative pneumonia in elderly patients with hip fractures.

Methods

Clinical data of patients with hip fractures in the Department of orthopedics of a hospital from January 2012 to December 2021 were retrospectively analyzed. A generalized additive model was used to identify both linear and nonlinear relationships between red blood cell distribution width and postoperative pneumonia. A two-piecewise linear regression model was used to calculate the saturation effect. Subgroup analyses were performed using stratified logistic regression.

Results

This study included a total of 1444 patients. The incidence of postoperative pneumonia was 6.30% (91/1444), the mean age of the patients was 77.55 ± 8.75 years, and 73.06% of them (1055/1444) were female. After full adjustment for covariates, the preoperative red blood cell distribution width showed a nonlinear relationship with postoperative pneumonia. The two-piecewise regression model showed an inflection point at 14.3%. On the left side of the inflection point, the incidence of postoperative pneumonia increased by 61% for every 1% increase in red blood cell distribution width (OR: 1.61, 95% CI 1.13–2.31, P = 0.0089). The effect size was not statistically significant on the right side of the inflection point (OR: 0.83, 95% CI 0.61–1.12, P = 0.2171).

Conclusion

The relationship between preoperative red blood cell distribution width and incidence or postoperative pneumonia was nonlinear in elderly patients with hip fractures. The incidence of postoperative pneumonia was positively correlated with red blood cell distribution width when it was < 14.3%. A saturation effect was observed when the red blood cell distribution width reached 14.3%.
Alzheimer’s disease genetic risk and cognitive reserve in relationship to long-term cognitive trajectories among cognitively normal individuals
Authors: Pettigrew Corinne , Nazarovs Jurijs , Soldan Anja , Singh Vikas , Wang Jiangxia , Hohman Timothy , Dumitrescu Logan , Libby Julia , Kunkle Brian , Gross Alden L. , Johnson Sterling , Lu Qiongshi , Engelman Corinne , Masters Colin L. , Maruff Paul , Laws Simon M. , Morris John C. , Hassenstab Jason , Cruchaga Carlos , Resnick Susan M. , Kitner-Triolo Melissa H. , An Yang , Albert Marilyn
Published: March 2023

Background

Both Alzheimer’s disease (AD) genetic risk factors and indices of cognitive reserve (CR) influence risk of cognitive decline, but it remains unclear whether they interact. This study examined whether a CR index score modifies the relationship between AD genetic risk factors and long-term cognitive trajectories in a large sample of individuals with normal cognition.

Methods

Analyses used data from the Preclinical AD Consortium, including harmonized data from 5 longitudinal cohort studies. Participants were cognitively normal at baseline (M baseline age = 64 years, 59% female) and underwent 10 years of follow-up, on average. AD genetic risk was measured by (i) apolipoprotein-E (APOE) genetic status (APOE-ε2 and APOE-ε4 vs. APOE-ε3; N = 1819) and (ii) AD polygenic risk scores (AD-PRS; N = 1175). A CR index was calculated by combining years of education and literacy scores. Longitudinal cognitive performance was measured by harmonized factor scores for global cognition, episodic memory, and executive function.

Results

In mixed-effects models, higher CR index scores were associated with better baseline cognitive performance for all cognitive outcomes. APOE-ε4 genotype and AD-PRS that included the APOE region (AD-PRSAPOE) were associated with declines in all cognitive domains, whereas AD-PRS that excluded the APOE region (AD-PRSw/oAPOE) was associated with declines in executive function and global cognition, but not memory. There were significant 3-way CR index score × APOE-ε4 × time interactions for the global (p = 0.04, effect size = 0.16) and memory scores (p = 0.01, effect size = 0.22), indicating the negative effect of APOE-ε4 genotype on global and episodic memory score change was attenuated among individuals with higher CR index scores. In contrast, levels of CR did not attenuate APOE-ε4-related declines in executive function or declines associated with higher AD-PRS. APOE-ε2 genotype was unrelated to cognition.

Conclusions

These results suggest that APOE-ε4 and non-APOE-ε4 AD polygenic risk are independently associated with global cognitive and executive function declines among individuals with normal cognition at baseline, but only APOE-ε4 is associated with declines in episodic memory. Importantly, higher levels of CR may mitigate APOE-ε4-related declines in some cognitive domains. Future research is needed to address study limitations, including generalizability due to cohort demographic characteristics.
The microbial dark matter and “wanted list” in worldwide wastewater treatment plants
Authors: Zhang Yulin , Wang Yulin , Tang Mingxi , Zhou Jizhong , Zhang Tong
Published: March 2023

Background

Wastewater treatment plants (WWTPs) are one of the largest biotechnology applications in the world and are of critical importance to modern urban societies. An accurate evaluation of the microbial dark matter (MDM, microorganisms whose genomes remain uncharacterized) proportions in WWTPs is of great value, while there is no such research yet. This study conducted a global meta-analysis of MDM in WWTPs with 317,542 prokaryotic genomes from the Genome Taxonomy Database and proposed a “wanted list” for priority targets in further investigations of activated sludge.

Results

Compared with the Earth Microbiome Project data, WWTPs had relatively lower genome-sequenced proportions of prokaryotes than other ecosystems, such as the animal related environments. Analysis showed that the median proportions of the genome-sequenced cells and taxa (100% identity and 100% coverage in 16S rRNA gene region) in WWTPs reached 56.3% and 34.5% for activated sludge, 48.6% and 28.5% for aerobic biofilm, and 48.3% and 28.5% for anaerobic digestion sludge, respectively. This result meant MDM had high proportions in WWTPs. Besides, all of the samples were occupied by a few predominant taxa, and the majority of the sequenced genomes were from pure cultures. The global-scale “wanted list” for activated sludge contained four phyla that have few representatives and 71 operational taxonomic units with the majority of them having no genome or isolate yet. Finally, several genome mining methods were verified to successfully recover genomes from activated sludge such as hybrid assembly of the second- and third-generation sequencing.

Conclusions

This work elucidated the proportion of MDM in WWTPs, defined the “wanted list” of activated sludge for future investigations, and certified potential genome recovery methods. The proposed methodology of this study can be applied to other ecosystems and improve understanding of ecosystem structure across diverse habitats.
Mental health and its influencing factors of maintenance hemodialysis patients: a semi-structured interview study
Authors: Wen Junjun , Fang Yuan , Su Zhongyan , Cai Jimin , Chen Zhiyan
Published: March 2023

Background

Maintenance hemodialysis (MHD) is a commonly used renal replacement therapy for end-stage renal disease patients. MHD patients have undergone multiple physiological stressors, which may cause physical problems and affect their mental health; however, few qualitative studies have been done on the mental health of MHD patients. Such qualitative research becomes the basis for further quantitative research and is critical to validating its results. Therefore, the current qualitative study used a semi-structured interview format, and aimed to explore the mental health and its influencing factors of MHD patients who are not receiving intervention treatment to determine how best to ameliorate their mental health.

Methods

Based on the application of Grounded Theory, semi-structured face-to-face interviews were conducted with 35 MHD patients, following consolidated criteria for reporting qualitative studies (COREQ) guidelines. Two indicators (emotional state and well-being) were used to assess MHD patients’ mental health. All interviews were recorded, after which two researchers independently performed data analyses using NVivo.

Results

Acceptance of disease, complications, stress and coping styles, and social support were found to be the influencing factors of MHD patients’ mental health. High acceptance of disease, healthy coping styles, and high social support were positively correlated with mental health. In contrast, low acceptance of disease, multiple complications, increased stress, and unhealthy coping styles were negatively correlated with mental health.

Conclusion

One’s acceptance of the disease played a more significant role than other factors in affecting MHD patients’ mental health.
Homogeneity and heterogeneity in near-infrared FTIR spectra of Ryugu returned samples
Authors: Hatakeda Kentaro , Yada Toru , Abe Masanao , Okada Tatsuaki , Nakato Aiko , Yogata Kasumi , Miyazaki Akiko , Kumagai Kazuya , Nishimura Masahiro , Hitomi Yuya , Soejima Hiromichi , Nagashima Kana , Yoshitake Miwa , Iwamae Ayako , Furuya Shizuho , Usui Tomohiro , Kitazato Kohei
Published: March 2023

Surface and subsurface materials of C-type near-Earth asteroid 162173 Ryugu were collected and successfully returned to the Earth in the Hayabusa2 mission. Fourier Transform Infrared Spectroscopy (FTIR) has been conducted to characterize these returned samples as one of the initial descriptions in a non-destructive manner under a purified nitrogen condition without terrestrial contamination. We selected the individual grains and aggregate samples that were not severely influenced by the reflection of incident beam at the sapphire dish and analyzed their reflectance spectra using the primary component analysis (PCA). The result indicates that Ryugu returned samples are highly homogeneous with only a little heterogeneity. The average spectrum of the main PCA group is represented by four absorption bands at 2.7, 3.05, 3.4, and 3.95 μm. The spectral feature is consistent with that obtained from bulk FTIR measurements, indicating potential presence of hydroxyl, organics, and carbonates. Rarely observed types of grains with unique spectra are categorized into three groups: significantly high reflectance, carbonates, and hydroxyl compounds with broad OH absorption.

Graphical Abstract
Income and rural–urban status moderate the association between income inequality and life expectancy in US census tracts
Authors: Cohen Steven A. , Nash Caitlin C. , Byrne Erin N. , Greaney Mary L.
Published: March 2023

Background

A preponderance of evidence suggests that higher income inequality is associated with poorer population health, yet recent research suggests that this association may vary based on other social determinants, such as socioeconomic status (SES) and other geographic factors, such as rural–urban status. The objective of this empirical study was to assess the potential for SES and rural–urban status to moderate the association between income inequality and life expectancy (LE) at the census-tract level.

Methods

Census-tract LE values for 2010–2015 were abstracted from the US Small-area Life Expectancy Estimates Project and linked by census tract to Gini index, a summary measure of income inequality, median household income, and population density for all US census tracts with non-zero populations (n = 66,857). Partial correlation and multivariable linear regression modeling was used to examine the association between Gini index and LE using stratification by median household income and interaction terms to assess statistical significance.

Results

In the four lowest quintiles of income in the four most rural quintiles of census tracts, the associations between LE and Gini index were significant and negative (p between < 0.001 and 0.021). In contrast, the associations between LE and Gini index were significant and positive for the census tracts in the highest income quintiles, regardless of rural–urban status.

Conclusion

The magnitude and direction of the association between income inequality and population health depend upon area-level income and, to a lesser extent, on rural–urban status. The rationale behind these unexpected findings remains unclear. Further research is needed to understand the mechanisms driving these patterns.
Identification of an inhibitor for atherosclerotic enzyme NOX-1 to inhibit ROS production
Authors: Ganguly Rik , Ngoruh Angneh , Ingty Prosperwell , Yadav Shashi Kumar , Bhattacharjee Atanu
Published: March 2023

Background

NOX-1 overexpression has been observed in various studies, persons with diabetes or cardiovascular conditions. NOX-1 orchestrates the disease pathogenesis of various cardiovascular conditions such as atherosclerotic plaque development and is a very crucial biomarker. Therefore, this study was carried out to deduce the three-dimensional modelled structure of NOX-1 using DeepMind AlphaFold-2 to find meaningful insight into the structural biology. Extensive in silico approaches have been used to determine the active pocket, virtually screen large chemical space to identify potential inhibitors. The role of the key amino acid residues was also deduced using alanine scanning mutagenesis contributing to the catalytic process and to the overall stability of NOX-1.

Results

The modelled structure of NOX-1 protein was validated using ERRAT. The ERRAT statistics with 9 amino acids sliding window have shown a confidence score of 96.937%. According to the Ramachandran statistics, 96.60% of the residues lie within the most favoured region, and 2.80% of residues lie in the additionally allowed region, which gives an overall of 99.4% residues in the three quadrants in the plot. GKT-831 which is a referral drug in this study has shown a GOLD interaction score of 62.12 with respect to the lead molecule zinc000059139266 which has shown a higher GOLD score of 78.07. Alanine scanning mutagenesis studies has shown that Phe201, Leu98 and Leu76 are found to be the key interacting residues in hydrophobic interactions. Similarly, Tyr324, Arg287 and Cys73 are major amino acid residues in the hydrogen bond interactions.

Conclusions

NOX-1 overexpression leads to heightened ROS production resulting in catastrophic outcomes. The modelled structure of NOX-1 has a good stereochemistry with respect to Ramachandran plot. The lead molecule zinc000059139266 has shown to have a very high interaction score of 78.07 compared to the referral drug GKT-831 with a score of 62.12. There is an excellent scope for the lead molecule to progress further into in vitro and in vivo studies.
Pulmonary artery reconstruction using a pulmonary vein conduit in case having an imbalanced dissection length during double-sleeve lobectomy
Authors: Fujiwara Toshiya , Okada Kazuhiro , Hirano Yutaka , Maki Yuho , Saiki Munehiro , Yunoki Keiji , Matsuura Motoki
Published: March 2023

Background

Among the types of lung resection procedures, pneumonectomy carries the highest risk for mortality. In recent years, bronchovascular double-sleeve lobectomy has been performed for centrally located non-small cell lung cancer involving both the bronchus and the pulmonary artery (PA) in order to avoid pneumonectomy. The use of an autologous pulmonary vein (PV) conduit for PA reconstruction during lung-sparing resections had first been reported in 2009. Such situations may occur in cases requiring the resection of a long segment of the PA without associated bronchial sleeve resection.

Case presentation

We experienced two cases who underwent PA reconstruction using a PV conduit after double-sleeve resection. In both cases, the tumor was located in the left upper lobe and invaded the long segment of the PA; however, it had not significantly invaded the bronchus. Our strategy for bronchovascular reconstruction involved the use of a PV conduit to avoid high tension on direct anastomosis given the imbalance in the excision length between the PA and the bronchus. The intraoperative and postoperative courses were uneventful, with both cases not receiving anticoagulant agents during the postoperative period. The reconstructed bronchus and PA functioned well during postoperative follow-up visits.

Conclusions

Following sleeve resection, an autologous PV conduit may be indicated for PA reconstruction when an excessive distance exists between the two vascular stumps.
Assessment of Tribo-charging and Continuous Feeding Performance of Direct Compression Grades of Isomalt and Mannitol Powders
Authors: Beretta Michela , Kruisz Julia , Hörmann-Kincses Theresa R. , Magosi Viktoria , Guo Meishan , Naderi Majid , Heupl Sarah , Kastner Johann , Spoerk Martin , Paudel Amrit
Published: March 2023

Tribo-charging is often a root cause of mass flow deviations and powder adhesion during continuous feeding. Thus, it may critically impact product quality. In this study, we characterized the volumetric (split- and pre-blend) feeding behavior and process-induced charge of two direct compression grades of polyols, galenIQ™ 721 (G721) for isomalt and PEARLITOL® 200SD (P200SD) for mannitol, under different processing conditions. The feeding mass flow range and variability, hopper end fill level, and powder adhesion were profiled. The feeding-induced tribo-charging was measured using a Faraday cup. Both materials were comprehensively characterized for relevant powder properties, and their tribo-charging was investigated for its dependence on particle size and relative humidity. During split-feeding experiments, G721 showed a comparable feeding performance to P200SD with lower tribo-charging and adhesion to the screw outlet of the feeder. Depending on the processing condition, the charge density of G721 ranged from -0.01 up to -0.39 nC/g, and for P200SD from -3.19 up to -5.99 nC/g. Rather than differences in the particle size distribution of the two materials, their distinct surface and structural characteristics were found as the main factors affecting their tribo-charging. The good feeding performance of both polyol grades was also maintained during pre-blend feeding, where reduced tribo-charging and adhesion propensity was observed for P200SD (decreasing from -5.27 to -0.17 nC/g under the same feeding settings). Here, it is proposed that the mitigation of tribo-charging occurs due to a particle size-driven mechanism.

Graphical abstract
CT and MRI of head and neck cutaneous lesions
Authors: Gan Jason , Nourzaie Romman , Doolan Brent J. , Connor Steve
Published: March 2023

Cutaneous lesions are derived from the epidermis, dermis and cutaneous appendages. Whilst imaging may occasionally be performed to evaluate such lesions, they may be undiagnosed and demonstrated for the first time on head and neck imaging studies. Although usually amenable to clinical examination and biopsy, CT or MRI studies may also demonstrate characteristic imaging features which aid the radiological differential diagnosis. In addition, imaging studies define the extent and staging of malignant lesions, as well as the complications of benign lesions. It is important for the radiologist to understanding the clinical significance and associations of these cutaneous conditions. This pictorial review will describe and depict the imaging appearances of benign, malignant, overgrowth, blistering, appendage and syndromic cutaneous lesions. An increasing awareness of the imaging characteristics of cutaneous lesions and related conditions will help the framing of a clinically relevant report.
Covid-19 Aşılarına İlişkin Komplo İnancının Aşı Tutumuna Etkisi: Sakarya Örneği
Authors: Durmuş Ayhan , Ünal Özgün
Published: March 2023

Çalışmada bireylerin aşı komplo inançlarının aşılara yönelik tutumları üzerindeki etkisinin belirlenmesi ve katılımcıların demografik özelliklerinin değişkenlerle arasındaki farklılığın ortaya çıkarılması amaçlanmaktadır. Çalışmada veri toplama aracı olarak Demografik Bilgi Formu, Aşıya Komplo İnancı Ölçeği ve Aşıya Yönelik Tutumlar Ölçeği’nden oluşan çevrim içi anket formu kullanılmıştır. Veri analizinde; tanımlayıcı istatistiksel yöntemler, keşfedici faktör analizi, doğrulayıcı faktör analizi, güvenilirlik analizi, korelasyon analizi, regresyon analizi ve fark analizleri kullanılmıştır. Aşı komplo inancının olumlu aşı tutumu üzerinde negatif, olumsuz aşı tutumu üzerinde ise pozitif etkisi olduğu belirlenmiştir. Ayrıca bireylerin cinsiyetleri ile olumlu aşı tutumu ve olumsuz aşı tutumu arasında, B1 (Aşılar güvensiz olduklarından dolayı bence uygun değiller) ve B2 (Doğal bağışıklığımız olduğu için aşı olmamıza gerek yoktur) ifadeleri ile olumlu aşı tutumu, olumsuz aşı tutumu ve aşı komplo inancı arasında istatistiksel açıdan anlamlı farklılıklar tespit edilmiştir. Covid-19 aşıları hakkında ortaya atılan komplo teorileri ve bilime olan inanç eksikliği veya güvensizliği, aşıya yönelik olumlu tutumu negatif etkilediği için toplumsal bağışıklığın kazanımının gecikmesine veya azalmasına yol açmaktadır. Bundan dolayı bireylerin güvenlik endişeleri giderilmeli, yanlış bilgi ve komplo teorileri çürütülmeli, bireylerin Covid-19 aşısı olma niyeti artırılmalıdır.
Soykırımın Mekândaki İz Düşümü Olarak Kentkırım Anlatıları: Bosna Hersek Örneği Üzerinden Belgesel Film Analizi
Authors: Sipahi Esra Banu , Çakar Rabia
Published: March 2023

Savaşlar sırasında kentlerin sahip olduğu değerlerin doğrudan hedef alınarak kent halkına zarar verilmesinin yanında kentsel hafızanın da silinmeye çalışılması, soykırımın bir uzantısı olarak değerlendirilmekte ve buna da kentkırım adı verilmektedir. Kavram, ilk kez Bosna Hersek Savaşı sırasında yaşanan yıkımı nitelemek üzere kullanılmıştır. Savaşla ilgili çok sayıda belgesel film çekilmiş ve bu yapımların bir kısmında yaşananlar soykırım olarak nitelendirilmiştir. Bu çalışmada belgesellerde yaşanan kentkırımın varlığına ve boyutlarına yönelik vurgu, içerik analizi yönteminden yararlanılarak değerlendirilmiştir. Bu bağlamda çalışmada İngilizce ve Türkçe olarak yayınlanmış toplam 12 belgesel film mercek altına alınarak mekânsal, etnik ve dinsel unsurlara yapılan saldırılar, işitsel ve görsel imgeler aracılığı ile analiz edilmiştir. Çalışmada Türk yapımı belgesellerle diğer belgeseller arasında konunun ele alınış ve aktarılış biçiminde kimi farklılıklar olduğu bulgulanmıştır. Ayrıca belgesellerin birçoğunda kentkırım olgusu işlenmesine karşın soykırım kavramının yapımlarda daha fazla yer bulduğu tespit edilmiştir.
Προσδιορισμός των παραγόντων κινδύνου αποικισμού με στελέχη Enterobacteriaceae που παράγουν καρβαπενεμάσες ασθενών που εισάγονται σε τριτοβάθμιο νοσοκομείο
Authors: Παπαφωτίου Χρυσάνθη
Published: March 2023

Σκοπός: Τα Εντεροβακτηριακά που παράγουν καρβαπενεμάσες (CPE) αποτελούν σημαντικά νοσοκομειακά παθογόνα σε παγκόσμιο επίπεδο. Οι ασυμπτωματικοί αποικισμένοι ασθενείς είναι η πηγή της περαιτέρω διασποράς στις μονάδες υγείας. Δεδομένου ότι η έγκαιρη ανίχνευση των φορέων CPE είναι εξαιρετικής σημασίας αλλά η καθολική εφαρμογή ελέγχου αποικισμών δεν είναι πραγματοποιήσιμη, στοχεύσαμε στην ανάπτυξη και την επικύρωση μίας κλίμακας κινδύνου για την ανίχνευση των ασθενών-φορέων CPE κατά την εισαγωγή τους στο νοσοκομείο.Μεθοδολογία: Η έρευνα πραγματοποιήθηκε σε ένα τριτοβάθμιο νοσοκομείο με δύναμη 500 κλινών στην Αθήνα, η οποία είναι ενδημική για CPE περιοχή. Ελήφθησαν ορθικά δείγματα αποικισμού από 2303 ασθενείς σε σύντομο χρονικό διάστημα μετά την εισαγωγή τους. Τα Εντεροβακτηριακά που απομονώθηκαν μέσω καλλιεργειών εξετάσθηκαν για την παρουσία blaVIM, KPC, NDM, OXA-48 μέσω PCR και καταγράφηκαν τα δημογραφικά στοιχεία και το ιστορικό των ασθενών για το προηγούμενο εξάμηνο. Οι παράγοντες κινδύνου για φορεία CPE προσδιορίστηκαν με χρήση μοντέλων πολλαπλής λογιστικής παλινδρόμησης και δημιουργήθηκε μία κλίμακα κινδύνου. Η διαχωριστική ικανότητα της κλίμακας αξιολογήθηκε μέσω της επιφάνειας κάτω από την καμπύλη ROC (AUROC) και η προγνωστική της απόδοση επικυρώθηκε σε ένα δεύτερο πληθυσμό 1391 ασθενών, σε μία διαφορετική χρονική περίοδο.Αποτελέσματα: Προσδιορίστηκαν επτά παράγοντες κινδύνου: ο προηγούμενος αποικισμός ή λοίμωξη από CPE, η προηγούμενη νοσηλεία η διαμονή σε ίδρυμα μακροχρόνιας φροντίδας υγείας το ιστορικό διανέργειας ≥2 παρεμβατικών διαδικασιών, το ιστορικό αιμοκάθαρσης, ο διαβήτης με βλάβη οργάνου-στόχου και η βαθμολογία στην κλίμακα Karnofsky. Η κλίμακα που αναπτύχθηκε είχε εύρος 0 εως 79 βαθμούς. Η AUC στον πληθυσμό προέλευσης ήταν 0.84 και στον πληθυσμό επικύρωσης 0.85.Συμπεράσματα: Το συγκεκριμένο προγνωστικό εργαλείο μπορεί να βοηθήσει στην ανίχνευση ασθενών που φέρουν CPE κατά την εισαγωγή τους στο νοσοκομείο σε μία ενδημική περιοχή και μπορεί να καθοδηγήσει την έγκαιρη εφαρμογή κατάλληλων μέτρων θεραπείας και ελέγχου της διασποράς λοιμώξεων.
Η επίδραση του τακτικού και φορολογικού ελέγχου από Ορκωτούς Ελεγκτές στην ποιότητα της λογιστικής πληροφόρησης των οικονομικών καταστάσεων και στη φορολογική συμμόρφωση των εταιρειών
Authors: Γκούμα Μαρίνα
Published: March 2023

Στόχος της διδακτορικής διατριβής είναι η διερεύνηση της σχέσης του εξωτερικού και του φορολογικού ελέγχου με την ποιότητα της λογιστικής πληροφόρησης και τη φορολογική συμμόρφωση των εταιρειών. Για την εξέταση της σχέσης αυτής, χρησιμοποιήθηκαν δύο μέθοδοι. Ειδικότερα, διανεμήθηκαν ερωτηματολόγια σε 150 ορκωτούς ελεγκτές από Big4 και Non-Big4 ελεγκτικές εταιρείες, τα οποία εξετάζουν την σχέση αυτή, μέσα από την εξέταση παραγόντων που θεωρείται ότι επιδρούν στην ανεξαρτησία του ελεγκτή και την ορθή απεικόνιση των λογιστικών πληροφοριών καθώς και παραγόντων που οδηγούν στη φορολογική συμμόρφωση των εταιρειών. Ακόμη, αναπτύχθηκε ένα οικονομετρικό μοντέλο για την διερεύνηση της επίδρασης του εξωτερικού ελέγχου στην ποιότητα της λογιστικής πληροφόρησης. Η ανάπτυξη του μοντέλου βασίζεται σε ένα δείγμα 30 εταιρειών, εισηγμένων στο Χρηματιστήριο Αξιών Αθηνών, από διαφορετικούς κλάδους για 9 έτη (2012-2020). Η ποιότητα της λογιστικής πληροφόρησης προσεγγίζεται με βάση την συνέπεια που εμφανίζουν τα κέρδη (persistence), που αποτελεί ένα από τα ποιοτικά χαρακτηριστικά των λογιστικών πληροφοριών. Η καινοτομία της έρευνας έγκειται στο ότι εξετάζει συνδυαστικά τους παράγοντες του εξωτερικού ελέγχου που οδηγούν σε καλύτερη λογιστική πληροφόρηση και συνεισφέρει στον προσδιορισμό των βέλτιστων παραγόντων που αυξάνουν την αξιοπιστία των οικονομικών καταστάσεων και την φορολογική συμμόρφωση των εταιρειών. Τα αποτελέσματα που προέκυψαν από τις δύο μεθόδους εξετάστηκαν συνδυαστικά και αμφότερες κατέληξαν στα εξής δύο συμπεράσματα: α) το μέγεθος της ελεγκτικής εταιρείας (δηλαδή Big4 σε σχέση με μια Non Big4) συμβάλλει θετικά στην ποιότητα της λογιστικής πληροφόρησης και β) η ύπαρξη ανεξάρτητων μελών στο Διοικητικό Συμβούλιο συμβάλλει θετικά στην ανεξαρτησία των Ορκωτών Ελεγκτών. Αναφορικά με τη παροχή από τον εξωτερικό ελεγκτή εξειδικευμένων διοικητικών υπηρεσιών, πέραν των ελεγκτικών, η πρώτη μέθοδος καταλήγει στο συμπέρασμα ότι επηρεάζει αρνητικά την ποιότητα του εξωτερικού ελέγχου ενώ η οικονομετρική μέθοδος καταλήγει στο αντίθετο αποτέλεσμα. Τέλος, συμπεραίνεται ότι ο φορολογικός έλεγχος συσχετίζεται θετικά με την φορολογική συμμόρφωση των εταιρειών.
Development of advanced cementitious systems with enhanced mechanical properties, improved microstructure and chemical resistance
Authors: Μαλακόπουλος Αθανάσιος
Published: March 2023

Ο σκοπός της παρούσας μελέτης είναι η ανάπτυξη προηγμένων συστημάτων τσιμέντου με ενισχυμένες μηχανικές ιδιότητες, βελτιωμένη μικροδομή, και χημική αντοχή. Η χρήση υποκατάστατων τσιμέντου έχει προφανή οφέλη στην μείωση του αποτυπώματος άνθρακα και στη βελτίωση της ανθεκτικότητας των κατασκευών από σκυρόδεμα. Στην παρούσα πειραματική έρευνα, αξιοποιήθηκαν συνδυασμοί τσιμέντου Portland και υποκατάστατων τσιμέντου, όπως εξαιρετικά λεπτόκοκκος ασβεστόλιθος και σκωρία υψικαμίνου. Η συμβατότητα των προσμίκτων με τα υποκατάστατα τσιμέντου είναι μια συνεχής πρόκληση για τον κατασκευαστικό κλάδο. Το σχήμα, η υφή και η διαβάθμιση των αδρανών έχουν σημαντική επίδραση στην απόδοση του κονιάματος και του σκυροδέματος. Οι συνδυασμοί αδρανών με καλοσχηματισμένα και σφαιρικά σωματίδια απαιτούν λιγότερες ποσότητες προσμίκτων σε ένα σύστημα τσιμέντου για δεδομένη εργασιμότητα. Οι κατανομές μεγέθους σωματιδίων με επαρκείς ποσότητες του κάθε μεγέθους βοηθούν στη βελτίωση της συμπύκνωσης μιγμάτων. Ως αποτέλεσμα, συστήματα τσιμέντου που περιέχουν αυτά τα αδρανή αναμένονται να παρουσιάσουν βελτιωμένη ανθεκτικότητα και μηχανικές ιδιότητες. Στην παρούσα πρωτότυπη μελέτη, η επίδραση των αδρανών αξιολογήθηκε στις πρώιμες πειραματικές έρευνες για να επιλεχθούν τα κατάλληλα υλικά και οι αναλογίες στην ανάπτυξη των μιγμάτων αναφοράς. Η απόδοση των σύνθετων υλικών ασβεστολιθικού τσιμέντου Portland που περιέχουν στεατικό βουτυλεστέρα, στεατικό ψευδάργυρο, ανθρακικό ασβέστιο και ελαϊκό οξύ αξιολογήθηκε στη συνέχεια, χρησιμοποιώντας προσεγγίσεις που βασίζονται στην απόδοση και ανάλυση μικροσκοπίας. Τα αποτελέσματα υποδεικνύουν τη δυνατότητα του στεατικού βουτυλεστέρα, ως ενός αποτελεσματικού πρόσμικτου που μειώνει τη διαπερατότητα σε νερό είτε μόνο του είτε σε συνδυασμό με ανθρακικό ασβέστιο και ελαϊκό οξύ. Μετρήσεις της συρρίκνωσης κατά την ξήρανση και της θερμικής διαστολής πραγματοποιήθηκαν στη συνέχεια ώστε να επαληθευτεί η ανθεκτικότητα. Τα αποτελέσματα υποδηλώνουν την κυρίαρχη επίδραση του τύπου του αδρανούς και της συνδετικής ύλης. Ωστόσο, συνιστάται η επικύρωση αυτών των παρατηρήσεων μέσω περαιτέρω δοκιμών. Ως μέρος του τελικού σταδίου αυτής της εργασίας, εξετάστηκαν συνδυασμοί υδροκαρβοξυλικών, πολυκαρβοξυλικών (τροποποιημένων και μη), λιγνοσουλφονικών σε μίγματα τσιμέντου που περιέχουν σκωρία υψικαμίνου και τσιμέντο Portland. Μελέτες απώλειας εργασιμότητας υποδεικνύουν την αποτελεσματικότητα των λιγνοσουλφονικών και υδροκαρβοξυλικών στη διατήρηση της συνοχής και εργασιμότητας έως 5 ώρες. Επιπλέον, η προσθήκη πολυκαρβοξυλικών είχε θετική επίδραση στη λήψη μιγμάτων με συντελεστές διείσδυσης ιόντων χλωρίου μέχρι 1.2 × 10−12 m2/s.
Ausgrabungen auf dem Basler Münsterhügel an der Rittergasse 4
Authors: Hecht Yolanda
Published: March 2023

Die Publikation ist ein Beitrag zur Erforschung des Übergangs von der Spätlatènezeit zur augusteischen Epoche auf dem Basler Münsterhügel. Funde (mehrheitlich Keramik) und Befunde (u.a. Gruben) sprechen dafür, dass im Bereich der Rittergasse in der Spätlatènezeit ein Wohn- und Hauswirtschaftsbereich der Oberschicht bestand. Das bescheidene augusteische Fundmaterial (wenig Keramik) bestätigt die Vermutung von Andres Furger-Gunti, dass der Beginn des römischen Militärlagers in frühaugusteischer Zeit anzusetzen ist. Mörtelböden und Planien von Brandschutt deuten auf Fachwerkgebäude in dieser Epoche.
Überlegungen zur spätlatènezeitlichen und augusteischen Epoche aus archäozoologischer Sicht
Authors: Deschler-Erb Sabine , Schibler Jörg , Veszeli Marcel
Published: March 2023

Aus der Grabung Basel-Rittergasse 4 (1982/6) konnten insgesamt 3424 Tierknochen, die aus spätlatènezeit-lichen Schichten bzw. Gruben und frühaugusteischen Schichten stammen, archäozoologisch untersucht werden. In Bezug auf den Erhaltungszustand, das Tierartenspektrum, das Skelettteilspektrum und das Schlachtalter liessen sich einerseits Unterschiede zwischen dem Material aus den spätlatènezeitlichen Gruben und Schichten, andererseits zwischen den Funden aus den spätlatènezeitlichen und frühaugusteischen Phasen feststellen. Aus archäozoologischer Sicht wurde die der keltischen Oberschicht zugehörige Bewohnerschaft der untersuchten Fläche in augusteischer Zeit durch romanisiertere, womöglich dem Militär zuzurechnende Bewohner abgelöst.
Alte Landvogtei in Riehen
Authors: Matteotti René
Published: March 2023

Beschrieben werden ein spätmittelalterlicher Vorgängerbau sowie die Überreste einer neuzeitlichen Kelteranlage von ca. 1620/30 mit Zufahrt, Trottenfundament und gemauerter Grube. Die Analyse des Geschirrspektrums ergab, dass die spätmittelalterlichen Töpfe sehr lange im Umlauf waren. Die vorliegende Baukeramik des 17. Jahrhunderts ermöglichte, die Entwicklung der Ziegel zu verfolgen. Das jüngste Fundspektrum (1798–1807) gab einen repräsentativen Einblick in den Geschirrbestand und das Gebrauchsglas eines bürgerlichen Haushaltes aus dem späten 18. und beginnenden 19. Jahrhundert. Anhand der Alltagsgegenstände konnten auch Angaben zur Herkunft (Manufaktur) und zum Handel der Region Basel gemacht werden.