bluuebunny/crossref_metadata_2025 huggingface dataset:
Perioperative management of wounds with nanosilver dressing after neoadjuvant chemotherapy for breast cancer
Authors: Liu Yaqing , Huang Zhaoyang , Yang Sujuan , Zhou Cuiyun , Chen Mei
Published: July 2021

Neoadjuvant chemotherapy (NAC) can improve the success rate of breast cancer surgery; however, most patients have obvious negative thoughts about NAC. Failure to effectively relieve these negative emotions or thoughts will adversely affect the quality of life of the patients after treatment.
Therefore, a majority of nursing staff are committed toward reducing patients’ negative emotions through good perioperative management as well as improving the treatment effects and postoperative quality of life of patients. A good perioperative management of breast cancer should include
postoperative wound and patient psychological care. This study found that patients using nanosilver dressings have greatly reduced total wound drainage, drainage tube removal time, and postoperative complications within four days after surgery and that the rate of wound healing was obviously
improved. This suggests that nanosilver dressings can improve the rate of wound healing and reduce the risk of complications. At the same time, we found that postoperative negative emotions of patients receiving comprehensive care were effectively relieved and their mental flexibility was
also improved. In addition, the quality of sleep, quality of life, and nursing satisfaction of patients receiving comprehensive care were significantly higher than those receiving traditional care models. This shows that the comprehensive care model is capable of reducing the negative emotions
of patients during the perioperative period and also helps to improve the quality of life of patients after surgery. Therefore, this study demonstrates that the use of nanosilver dressings as a comprehensive care model can reduce the risk of negative emotions and complications in addition
to improving the rate of wound healing and postoperative quality of life.
Preparation of xLi2MnO3·(1-x)(LiMn1/3Co1/3Ni1/3)O2 cathode material and its electrochemical properties for Li-ion batteries
Authors: Zou Yu , Zhou Yueyun
Published: July 2021

The layered xLi2MnO3·(1-x)(LiMn1/3Co1/3Ni1/3)O2 (x = 0.15, 0.3, 0.45) as cathode materials in Li-ion batteries were prepared by co-precipitation of hydroxides. The effects of sintering duration,
chemical composition and temperature on the structure and electrochemical performance were studied. The results show that the 0.3Li2MnO3·0.7(LiMn1/3Co1/3Ni1/3)O2 material prepared at 800 °C for 20 h has higher crystallization
degree and better electrochemical performance. The charge capacity in the first circle was 359.8 mAh·g-1, the discharge capacity was 240.3 mAh·g-1, the discharge efficiency was 66.8% and the capacity retention was also 97.6% after 20 cycles.
Sensitivity Enhancement of Surface Plasmon Resonance Sensor with Two Dimensional Materials Covered on Silver-Nickel Bimetallic Thin Solid Films
Authors: Castañeda L.
Published: July 2021

In this paper a new sensing configuration with enhanced sensitivity utilizing 2D materials on the bimetallic layers of Magnetic Material Ni over Ag for Kretschmann configuration is proposed and analyzed numerically using Fresnel equation and transfer matrix method. Results show that
such a hybrid configuration with well optimized thickness of metallic layer and utilization of specific no. of 2D materials can increases the sensitivity as high as 298°/RIU is absorbed for the configuration consist 10 nm of Ni over 40 nm thickness of Ag added with a 2 layers of WSe2.
Electrochemical Sensor for Acetaminophen Based on a Poly(diphenylamine sulfonic acid) Modified Sensor
Authors: Erdogdu Gamze
Published: July 2021

A sensitive and simple modified sensor was prepared by electrodeposition of diphenylamine sulfonic acid (DPSA) to the glassy carbon electrode surface by cyclic voltammetry (CV) technique. The electrooxidation of Acetaminophen (AC) was accomplished by CV and differential pulse voltammetry
at poly(DPSA) modified sensor. As a result of the findings, the current values were enhanced and both substances were separated at the modified sensor compared to the bare electrode. There was linearly between the oxidation current and concentration of AC from 0.0 to 100 μM in phospate
buffer solution at pH 7.0. The limit of detection was 3.0 nM and the sensitivity was 0.4108 μA/μM. The determination of AC was successfully and satisfactorily carried out in real samples such as human blood serum and urine at the poly(DPSA) sensor. To the best knowledge
of this work, this is the first study that detect the AC in the presence of ascorbic acid at poly(DPSA) sensor in the literature.
Moored Turbulence Measurements using Pulse-Coherent Doppler Sonar
Authors: Zippel Seth F. , Farrar J. Thomas , Zappa Christopher J. , Miller Una , Laurent Louis St. , Ijichi Takashi , Weller Robert A. , McRaven Leah , Nylund Sven , Le Bel Deborah
Published: July 2021

Upper-ocean turbulence is central to the exchanges of heat, momentum, and gasses across the air/sea interface, and therefore plays a large role in weather and climate. Current understanding of upper-ocean mixing is lacking, often leading models to misrepresent mixed-layer depths and sea surface temperature. In part, progress has been limited due to the difficulty of measuring turbulence from fixed moorings which can simultaneously measure surface fluxes and upper-ocean stratification over long time periods. Here we introduce a direct wavenumber method for measuring Turbulent Kinetic Energy (TKE) dissipation rates, ϵ, from long-enduring moorings using pulse-coherent ADCPs. We discuss optimal programming of the ADCPs, a robust mechanical design for use on a mooring to maximize data return, and data processing techniques including phase-ambiguity unwrapping, spectral analysis, and a correction for instrument response. The method was used in the Salinity Processes Upper-ocean Regional Study (SPURS) to collect two year-long data sets. We find the mooring-derived TKE dissipation rates compare favorably to estimates made nearby from a microstructure shear probe mounted to a glider during its two separate two-week missions for (10−8) ≤ ϵ ≤ (10−5) m2 s−3. Periods of disagreement between turbulence estimates from the two platforms coincide with differences in vertical temperature profiles, which may indicate that barrier layers can substantially modulate upper-ocean turbulence over horizontal scales of 1-10 km. We also find that dissipation estimates from two different moorings at 12.5 m, and at 7 m are in agreement with the surface buoyancy flux during periods of strong nighttime convection, consistent with classic boundary layer theory.
Citizenship as a caste marker: How persons experience cross-national inequality
Authors: Velitchkova Ana
Published: July 2021

Extrapolating a recent conceptualization of caste from India to the global level, this article argues that persons experience cross-national inequalities via their citizenship as a caste marker. Rather than imagine castes as features of the fixed pre-modern Hindu social order, the article posits that castes are variable modern ascriptive social hierarchies subject to contestation and change in which economic and social distinctions are maintained through physical and symbolic violence. The study shows how, globally, nation-states exert physical and symbolic violence to normalize cross-national inequalities instituting a global citizenship-based caste order. This approach recognizes the importance of both global material relations emphasized by world-systems approaches and of symbolic structures central to global institutionalist approaches. The study also underscores persons’ positions and experiences confronting nation-states’ might. Power struggles concentrated on nation-states result in variability of global relations’ mutually reinforcing material and symbolic dimensions. The author uses caste features that appear ‘essential’ (i.e. ascriptive social closure, ‘ethnic,’ ‘religious,’ and ‘purity’ distinctions) as heuristics for identifying possible locations of caste construction and contestation, and identifies citizenship rules, nation-states’ territorial nature, nationalism, and visa, border, and naturalization rituals as such caste development sites. Vulnerable groups (stateless persons, refugees, migrants) both challenge the citizenship caste order and experience viscerally its physical and symbolic violence.
Combination Therapy of Chloramphenicol and Daptomycin for the Treatment of Infective Endocarditis Secondary to Multidrug Resistant Enterococcus faecium
Authors: Shah Sunish , McManus Dayna , Topal Jeffrey E.
Published: July 2021

A 38-years-old female with an aortic valve replacement presented to an outside hospital (OSH) with fevers and malaise. Blood cultures revealed VRE which was resistant to linezolid, resistant to ampicillin, non-susceptible to daptomycin (MIC of 8 mcg/mL), and exhibited susceptibility to gentamicin. The patient was therefore initiated on intravenous (IV) daptomycin 6 mg/kg q24h and gentamicin IV 1 mg/kg q8h. However, after 14 days of therapy with daptomycin and gentamicin, the patient was transferred to our institution for the management of cardiogenic shock and hypoxemic respiratory failure. Given the concern for treatment failure, her antimicrobial regimen was changed to IV chloramphenicol 12.5 mg/kg every 6 hours with IV daptomycin 10 mg/kg every 48 hours given an estimated creatinine clearance of 30 mL/minutes. In vitro susceptibilities for chloramphenicol were performed which confirmed susceptibility. A transesophageal echocardiogram revealed a possible abscess at the left coronary cusp and aortic valve dehiscence. The patient underwent aortic valve replacement with aortic root reconstruction. The aortic valve culture grew VRE susceptible to linezolid but resistant to ampicillin and doxycycline. The patient was deemed clinically cured after 42 days of combination therapy with daptomycin and chloramphenicol. After 6 years of follow-up, the patient has not had a recurrent VRE infection. To our knowledge, this is the first case of endocarditis secondary to VRE that was successfully managed with the combination of daptomycin and chloramphenicol.
Regulatory approach to management of radioactive waste generated during remediation activities in the Chernobyl contaminated areas
Authors: Rozdyalouskaya L.F.
Published: July 2021

This paper does not necessarily reflect the views of the International Commission on Radiological Protection. It is known that remediation activities in areas affected by radiological accidents may result in generation of huge volumes of very low-level radioactive waste that can overwhelm national capabilities, and be outside of the existing national regulation requirements for radioactive waste management. This may pose a challenge for adoption of an adequate strategy for remediation waste management and application of regulatory requirements that are commensurate with the waste hazard. The Republic of Belarus faced this problem after the Chernobyl accident when performing remediation activities in the contaminated areas. This article presents the experience of the Republic of Belarus in overcoming the challenges and conflicts that arose in the process of developing a rational strategy for safety management of remediation waste, and its justification and optimisation, bearing in mind the need to adopt advanced regulatory instruments of relevance to the management of this waste.
Characterizing the Particle Variations and Human Exposure in Port and Urban Areas
Authors: Zhao Hong-Mei , He Hong-Di , Zhao Ji-Qiang , Ding Yi , Peng Zhong-Ren , Wang Hong-Wei
Published: July 2021

In port areas, traffic is characterized by container trucks which run on diesel, while in urban areas it is characterized by private cars which run on petrol. The different fuels as pollution sources cause distinct particle pollution. This study offers an in-depth investigation of particle pollution and corresponding short-term exposures in port and urban areas. Field measurements were carried out to collect the data including particulate matter and traffic volume. Based on the data, firstly, the Pearson correlation analysis was performed to analyze the relationships between traffic volume and particles. Secondly, the Anderson–Darling test was adopted to identify the “best-fit” distributions on particles. Thirdly, comparisons of particle pollution levels in port and urban areas were analyzed. Finally, the pedestrian respiratory deposition doses of particles were estimated. The results indicate the importance and urgency of reducing air pollution, especially for port cities, and provide policymakers with a foundation for possible measures in the port city.
Achieving Asphalt Pavement Density with Minimal Mat Defects
Authors: Hand Adam J. T. , Aschenbrener Timothy , Tran Nam , Leiva Fabricio
Published: July 2021

It is well established that in-place density significantly influences asphalt pavement performance and service life. This paper discusses solutions to challenges that agencies and contractors often face when trying to achieve density requirements, or increase density, while eliminating compaction-related mat defects during the construction process. The basics of the asphalt pavement compaction processes, equipment, operations, and asphalt mixture densification are first presented, followed by information collected on a series of FHWA sponsored departments of transportation (DOTs) density demonstration projects. The authors then summarize the root causes associated with challenges in obtaining the desired density without compaction-related mat defects in a series of categories based on the DOT demonstration projects and experience assisting contractors with obtaining density on hundreds of projects. Examples are described for each category along with potential opportunities for improvements to overcome them. The demonstration projects illustrated that it is possible to make improvements when agencies and contractors embrace the idea of increasing density and reducing mat defects.
Entre peur et désir de la digitalisation du commerce de détail : une première conceptualisation pour comprendre les réactions ambivalentes des chalands
Authors: Rogeon Fabien , Michaud-Trévinal Aurélia , Collin-Lachaud Isabelle
Published: July 2021

Résumé

La digitalisation a entraîné de profonds changements dans le paysage de la distribution qui ont fait l’objet de recherches approfondies. La plupart des recherches ont considéré ce phénomène uniquement comme une source d’avantages pour les chalands. Cependant, quelques chercheurs ont récemment souligné l’écart entre cet optimisme technologique et les problèmes auxquels sont confrontés les distributeurs lorsque les technologies qu’ils proposent sont fréquemment ignorées ou rapidement abandonnées par les chalands. Pour combler cette lacune, notre recherche étudie la manière dont les chalands réagissent face à la digitalisation de la distribution à travers le prisme de l’ambivalence. Une revue systématique de la littérature a permis d’identifier un ensemble de 108 articles publiés dans des revues majeures entre 2005 et 2020. Notre analyse critique a révélé des réactions positives et négatives des chalands à l’égard de la digitalisation. En regroupant ces derniers par paires de deux opposés, nous proposons une conceptualisation initiale de l’ambivalence des acheteurs divisée en huit composantes distinctes. De plus, nous mettons en évidence les composantes de l’ambivalence des acheteurs qui nécessitent une plus grande attention des chercheurs et proposons un agenda de recherche en conséquence. Enfin, notre conceptualisation peut aider les managers à mieux comprendre le sens des réactions hétérogènes des chalands confrontés aux technologies qu’ils proposent.
Running to stand still? Two decades of trade union activity in the Irish long-term care sector
Authors: Murphy Caroline , O’Sullivan Michelle
Published: July 2021

This article examines the ongoing efforts of trade unions in Ireland to protect and improve the working conditions of personal care workers amid employment and social policy regimes associated with a liberal welfare state. Comparatively low public expenditure on care and the increasing marketisation of care services have undermined the provision of decent work. This article assesses two major union campaigns related to personal care workers over two decades, and reviews the key priorities that have emerged for unions during the COVID-19 pandemic. We consider whether the outcomes of these campaigns have been converted into enhanced rewards for workers and discuss the continuing challenges for union campaigning.
Lower Kolyma multilingualism: Historical setting and sociolinguistic trends
Authors: Pupynina Maria , Aralova Natalia
Published: July 2021

Aims and objectives/purpose/research questions:

The region of Lower Kolyma (LK), Russia, exhibits a unique multilingual situation which involves five languages from five different families: Even (Tungusic), Yakut (Turkic), Chukchi (Chukotko-Kamchatkan), Tundra Yukaghir (Yukaghir), and Russian (Slavic, Indo-European). Our research aims to show the ongoing changes in this setting and to explain the historical background of these trends.

Design/methodology/approach:

Our approach combines the results of a sociolinguistic survey, published data about the history and ethnography of the region, and observed linguistic effects of language contact.

Data and analysis:

The sample for our sociolinguistic study includes 196 individuals, born between 1878 and 1996. To assess the patterns of multilingualism we use two parameters: the number of acquired languages and the composition of the linguistic repertoires. To model the linguistic situation in the 20th century, an average life span parameter is used.

Findings/conclusions:

We demonstrate that in 1940 to 1980 it was most common for LK residents to use all languages of the region. Partly, at least, this was a consequence of the introduction of boarding schools, which became an additional domain for interethnic communication. In recent decades we observe a tendency for a shift to Russian with a concomitant decrease in speakers of the minority languages.

Originality:

We use an approach of retrospective interviews which allows us to cover a large time period and to provide an overview of changes in the multilingual setting during the 20th century. Thus, even though multilingualism in this area has already been discussed by Vakhtin, the methodological approach is different.

Significance/implications:

The paper contributes to the field of sociolinguistics, presenting a new case study of multilingualism from an area of Siberia which is understudied in this regard.
“Nudging” intergroup contact: Normative social influences on intergroup contact engagement
Authors: Meleady Rose
Published: July 2021

Much research has shown that intergroup contact is associated with a reduction in prejudice. Far less attention has been paid to the conditions that promote intergroup contact. This research explored the role of normative social influence in predicting contact engagement (total N = 1,538). Cross-sectional Study 1 found that individuals’ perception of descriptive levels of intergroup contact amongst the ingroup predicted their own contact engagement whilst controlling for outgroup attitudes. Study 2 and Study 3 demonstrated that an experimental manipulation of descriptive norms promoted outgroup approach intentions, and actual approach behaviour. Participants were more open to future intergroup contact when they learnt of the high prevalence of this behaviour amongst the ingroup. Study 4 then considered how normative techniques could be used when intergroup contact is not commonplace. Together, the findings provide a new understanding of the antecedents of intergroup contact and new techniques for encouraging greater inclusion and integration.
A satellite selection algorithm based on adaptive simulated annealing particle swarm optimization for the BeiDou Navigation Satellite System/Global Positioning System receiver
Authors: Wang Ershen , Sun Caimiao , Wang Chuanyun , Qu Pingping , Huang Yufeng , Pang Tao
Published: July 2021

In this article, we propose a new particle swarm optimization–based satellite selection algorithm for BeiDou Navigation Satellite System/Global Positioning System receiver, which aims to reduce the computational complexity of receivers under the multi-constellation Global Navigation Satellite System. The influences of the key parameters of the algorithm—such as the inertia weighting factor, acceleration coefficient, and population size—on the performance of the particle swarm optimization satellite selection algorithm are discussed herein. In addition, the algorithm is improved using the adaptive simulated annealing particle swarm optimization (ASAPSO) approach to prevent converging to a local minimum. The new approach takes advantage of the adaptive adjustment of the evolutionary parameters and particle velocity; thus, it improves the ability of the approach to escape local extrema. The theoretical derivations are discussed. The experiments are validated using 3-h real Global Navigation Satellite System observation data. The results show that in terms of the accuracy of the geometric dilution of precision error of the algorithm, the ASAPSO satellite selection algorithm is about 86% smaller than the greedy satellite selection algorithm, and about 80% is less than the geometric dilution of precision error of the particle swarm optimization satellite selection algorithm. In addition, the speed of selecting the minimum geometric dilution of precision value of satellites based on the ASAPSO algorithm is better than that of the traditional traversal algorithm and particle swarm optimization algorithm. Therefore, the proposed ASAPSO algorithm reduces the satellite selection time and improves the geometric dilution of precision using the selected satellite algorithm.
Comparing the Efficacy of Radiation Free Machine-Vision Image-Guided Surgery With Traditional 2-Dimensional Fluoroscopy: A Randomized, Single-Center Study
Authors: Dorilio Jessica , Utah Nicole , Dowe Christina , Avrumova Fedan , Alicea Daniel , Brecevich Antonio , Callanan Tucker , Sama Andrew , Lebl Darren R. , Abjornson Celeste , Cammisa Frank P.
Published: July 2021

Background: Three-dimensional (3D) computer-assisted navigation (CAN) has emerged as a potential alternative to 2-dimensional (2D) fluoroscopy in the surgical placement of spinal instrumentation. Recently, 3D-CAN systems have improved significantly in their ability to provide real-time anatomical referencing while shortening the registration and set-up time. A novel system in navigation, Machine-Vision Image-Guided Surgery (MvIGS; 7D Surgical, Toronto, Canada) was cleared by the US Food and Drug Administration, but its potential benefits in reducing intra-operative radiation exposure to patients and enhancing surgical accuracy of pedicle screw placement are not fully known. Purpose: We sought to conduct a prospective, randomized, clinical study comparing the 3D-MvIGS spinal navigation system and 2D-fluoroscopy for pedicle screw insertion up to 3 levels (T10-S1) and for various measures of surgical efficacy. Methods: Sixty-two eligible patients were randomized to receive spine surgery using either the 3D-MvIGS group or the conventional 2D-fluoroscopy for pedicle screw fixation for the treatment of spinal stenosis and degenerative spondylolisthesis. Intra-operative parameters and procedure-related unintended protocol violations were recorded. Results: Operative time and estimated blood loss were not significantly different between groups. Radiation time and exposure to patients were significantly reduced in the 3D-MvIGS group. There was no difference between groups in pedicle screw placement accuracy (2D-fluoroscopy group, 96.6%; 3D-MvIGS group, 94.2%). There were no major complications or cases that required revision surgery. Conclusion: The 3D-MvIGS navigation system performed comparably with 2D-fluoroscopy in terms of pedicle screw placement accuracy and operative time. The 3D-MvIGS showed a significant reduction in radiation exposure to patients. In more complex cases or larger cohorts, the true value of greater anatomical visualization can be elucidated.
Social Processes Associated With Health and Health Behaviors Linked to Early Mortality in People With a Diagnosis of a Serious Mental Illness
Authors: Fortuna Karen L. , Williams Ashley , Mois George , Jason Kendra , Bianco Cynthia L.
Published: July 2021

Individuals with serious mental illness (SMI) experience a 10- to 25-year reduced life expectancy compared with the general population. Early mortality for people with SMI has mainly been attributed to unhealthy behaviors (e.g., poor diet, sedentary lifestyle), which has led to the development of health promotion and self-management interventions specifically for people with SMI to promote health behavior change. Yet after decades of research, the mortality gap between people with SMI and the general population is increasing. To address this early mortality disparity for individuals with SMI, a new paradigm must be explored. In this article, we present the social processes impacting early mortality in people with SMI paradigm, which highlights the powerful role of social processes in shaping the health and health behaviors of people with SMI. This paradigm explores how loneliness, stigma (social and self), trauma, social exclusion, social isolation, and social norms are related to early mortality in people with SMI. This new paradigm is an important step in understanding and potentially addressing early mortality in people with SMI.
Exploration of the Experiences That Shape Engineering Students’ Entrepreneurial Mindset Development
Authors: Jackson Alexandra , Resnick Samantha , Hansson Rebecca , Burgess Kenyon , Bodnar Cheryl A.
Published: July 2021

The overall purpose of this research is to be able to understand how engineering students believe they are developing EM throughout their higher education experiences. Is EM development attributed to the inclusion of EM based projects and activities within their engineering course work? Perhaps, EM development occurs more readily through engineering students’ participation in extracurricular or co-curricular activities? Alternatively, maybe EM development is not tied to the higher education ecosystem at all, and engineering students develop EM as a result of job or volunteer experiences. As such, this research study seeks to answer the following research questions: (1) Which types of experiences contribute to engineering students' EM development? And (2) What types of attributes of EM do engineering students perceive are developed through these experiences? The study involves a qualitative analysis of engineering student interviews to determine the experiences that have contributed to student EM development as well as EM traits that were specifically focused upon within these experiences. Through understanding engineering students’ perceptions of how they developed an EM, it will provide the necessary information to determine best practices for EM student development in the future.
Panicle Apical Abortion 3 Controls Panicle Development and Seed Size in Rice
Authors: Yang Fayu , Xiong Mao , Huang Mingjiang , Li Zhongcheng , Wang Ziyi , Zhu Honghui , Chen Rui , Lu Lu , Cheng Qinglan , Wang Yan , Tang Jun , Zhuang Hui , Li Yunfeng
Published: July 2021

Background

In rice, panicle apical abortion is a common phenomenon that usually results in a decreased number of branches and grains per panicle, and consequently a reduced grain yield. A better understanding of the molecular mechanism of panicle abortion is thus critical for maintaining and increasing rice production.

Results

We reported a new rice mutant panicle apical abortion 3 (paa3), which exhibited severe abortion of spikelet development on the upper part of the branches as well as decreased grain size over the whole panicle. Using mapping-based clone, the PAA3 was characterized as the LOC_ Os04g56160 gene, encoding an H+-ATPase. The PAA3 was expressed highly in the stem and panicle, and its protein was localized in the plasma membrane. Our data further showed that PAA3 played an important role in maintaining normal panicle development by participating in the removal of reactive oxygen species (ROS) in rice.

Conclusions

Our studies suggested that PAA3 might function to remove ROS, the accumulation of which leads to programmed cell death, and ultimately panicle apical abortion and decreased seed size in the paa3 panicle.
Serum free fatty acids are associated with severe coronary artery calcification, especially in diabetes: a retrospective study
Authors: Xin Yangxun , Zhang Junfeng , Fan Yuqi , Wang Changqian
Published: July 2021

Background

Serum free fatty acid (FFA) concentrations are associated with coronary heart disease and diabetes mellitus (DM). Few studies focused on the relationship between serum FFA levels and coronary artery calcification (CAC).

Methods

This was a retrospective, single-centered study recruiting patients underwent FFA quantification, coronary angiography and intravascular ultrasound (IVUS). CAC severity was assessed with the maximum calcific angle (arc) of the calcified plaque scanned by IVUS. Patients with an arc ≥ 180° were classified into the severe CAC (SCAC) group, and those with an arc < 180° were classified into the non-SCAC group. Clinical characteristics, serum indices were compared between 2 groups. Logistic regression, receiver operating characteristic (ROC) curves and area under the curves (AUC) were performed.

Results

Totally, 426 patients with coronary artery disease were consecutively included. Serum FFA levels were significantly higher in the SCAC group than non-SCAC group (6.62 ± 2.17 vs. 5.13 ± 1.73 mmol/dl, p < 0.001). Logistic regression revealed that serum FFAs were independently associated with SCAC after adjusting for confounding factors in the whole cohort (OR 1.414, CI 1.237–1.617, p < 0.001), the non-DM group (OR 1.273, CI 1.087–1.492, p = 0.003) and the DM group (OR 1.939, CI 1.388–2.710, p < 0.001). ROC analysis revealed a serum FFA AUC of 0.695 (CI 0.641–0.750, p < 0.001) in the whole population. The diagnostic predictability was augmented (AUC = 0.775, CI 0.690–0.859, p < 0.001) in the DM group and decreased (AUC = 0.649, CI 0.580–0.718, p < 0.001) in the non-DM group.

Conclusions

Serum FFA levels were independently associated with SCAC, and could have some predictive capacity for SCAC. The association was strongest in the DM group.
Proton-pump inhibitor vs. H2-receptor blocker use and overall risk of CKD progression
Authors: Cholin Liza , Ashour Tarek , Mehdi Ali , Taliercio Jonathan J. , Daou Remy , Arrigain Susana , Schold Jesse D. , Thomas George , Nally Joseph , Nakhoul Nazih L. , Nakhoul Georges N.
Published: July 2021

Background

The relationship between proton-pump inhibitor (PPI) use and chronic kidney disease (CKD) progression remains controversial. Specifically, there is a lack of data evaluating renal outcomes in established CKD patients. The aim of our study is to determine the risk of progression to end-stage kidney disease (ESKD) or death amongst CKD patients on PPI, histamine-2 receptor blocker (H2B), or no anti-acid therapy.

Methods

Using our CKD registry, we evaluated the relationship between PPI and H2B use and outcomes amongst patients with CKD (eGFR < 60), with at least 2 PCP visits in the year prior. A Cox proportional hazards model was used to evaluate the relationship between medication groups and overall mortality, while competing risks regression models were used to determine the risk of ESKD with death as a competing risk.

Results

25,455 patients met inclusion criteria and were stratified according to medication group: no antacid therapy (15,961), PPI use (8646), or H2B use (848). At 4 years, the cumulative incidence of ESKD with death as a competing risk was 2.0% (95% CI: 1.7, 2.4), 1.5% (0.8, 2.8), and 1.6%(1.4, 1.9) among PPI, H2B, and no medication respectively (P = 0.22). The cumulative incidence of death with ESKD as a competing risk was 17.6% (95% CI: 16.6, 18.6), 16.7% (13.7, 19.8), and 17.3% (16.6, 18.0) (P = 0.71).

Conclusions

Use of PPI in a CKD population was not associated with increased mortality or progression to ESKD when compared to H2 blocker and to no acid suppressing therapy.
Renal recipients’ knowledge and self-efficacy during first year after implementing an evidence based educational intervention as routine care at the transplantation clinic
Authors: Urstad Kristin Hjorthaug , Wahl Astrid Klopstad , Moum Torbjørn , Engebretsen Eivind , Andersen Marit Helen
Published: July 2021

Background

Following an implementation plan based on dynamic dialogue between researchers and clinicians, this study implemented an evidence-based patient education program (tested in an RCT) into routine care at a clinical transplant center. The aim of this study was to investigate renal recipients’ knowledge and self-efficacy during first year the after the intervention was provided in an everyday life setting.

Methods

The study has a longitudinal design. The sample consisted of 196 renal recipients. Measurement points were 5 days (baseline), 2 months (T1), 6 months (T2), and one-year post transplantation (T3). Outcome measures were post-transplant knowledge, self-efficacy, and self-perceived general health.

Results

No statistically significant changes were found from baseline to T1, T2, and T3. Participants’ levels of knowledge and self-efficacy were high prior to the education program and did not change throughout the first year post transplantation.

Conclusion

Renal recipients self-efficacy and insight in post-transplant aspects seem to be more robust when admitted to the hospital for transplantation compared to baseline observations in the RCT study. This may explain why the implemented educational intervention did not lead to the same positive increase in outcome measures as in the RCT. This study supports that replicating clinical interventions in real-life settings may provide different results compared to results from RCT’s. In order to gain a complete picture of the impacts of an implemented intervention, it is vital also to evaluate results after implementing findings from RCT-studies into everyday practice.
Adenoid cystic Carcinoma and Carbon ion Only irradiation (ACCO): Study protocol for a prospective, open, randomized, two-armed, phase II study
Authors: Lang Kristin , Adeberg Sebastian , Harrabi Semi , Held Thomas , Kieser Meinhard , Debus Jürgen , Herfarth Klaus
Published: July 2021

Background

Adenoid cystic carcinoma is a rare form of head and neck cancer with a slow, but aggressive growth pattern which remains a challenge for local tumor control. Based on phase II data, radiation treatment using partially high LET radiation results in a prolonged PFS and OS. There is a paucity of randomized clinical data examining the role of the use of high LET radiation only. Therefore, the purpose of this prospective clinical trial is to analyze local control rates in patients with node negative ACC treated with carbon ion radiotherapy alone compared to a combined modality approach.

Methods

This trial is conducted as a prospective, open-label, phase II, two-armed, investigator-initiated study comparing the local control rates in node negative ACCs of the head and neck treated either with sole carbon ion radiotherapy or a combination of carbon ions and photons. Secondary outcomes investigated are progression-free survival, overall survival, acute and late toxicity, and quality of life. A total of 314 patients will be randomly assigned to C12 treatment alone or bimodal treatment: Patients in the experimental group will receive a dose of 51 Gy (RBE) in 17 fractions and a boost of 15 Gy (RBE) in 5 fractions. Patients in the control group will receive 25 fractions photon IMRT 50Gy and a boost using 8 × 3 Gy (RBE) carbon ions. Local control will be assessed in regular follow up examinations until 5 years after the completion of treatment.

Discussion

The present trial aims to evaluate local control rates to compare sole carbon ion radiotherapy to bimodal radiotherapy with carbon ions and photons in patients with node negative ACCs of the head and neck region. Local control is selected as the primary endpoint due to its major clinical relevance because of slow but aggressive growth patterns.

Trial registration

The study was prospectively registered on 2nd January 2020: ClinicalTrials.gov, NCT04214366. “Adenoid Cystic Carcinoma and Carbon Ion Only Irradiation (ACCO)”.

Study status

Under recruitment, participant recruitment is not completed. Start of recruitment was January 2020. There are no results been published or submitted to any journal.
Bioinformatics analysis of C3 and CXCR4 demonstrates their potential as prognostic biomarkers in clear cell renal cell carcinoma (ccRCC)
Authors: Quan Jing , Bai Yuchen , Yang Yunbei , Han Er Lei , Bai Hong , Zhang Qi , Zhang Dahong
Published: July 2021

Background

The molecular prognostic biomarkers of clear cell renal cell carcinoma (ccRCC) are still unknown. We aimed at researching the candidate biomarkers and potential therapeutic targets of ccRCC.

Methods

Three ccRCC expression microarray datasets (include GSE14762, GSE66270 and GSE53757) were downloaded from the gene expression omnibus (GEO) database. The differentially expressed genes (DEGs) between ccRCC and normal tissues were explored. The potential functions of identified DEGs were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). And then the protein - protein interaction network (PPI) was established to screen the hub genes. After that, the expressions of hub genes were identified by the oncomine database. The hub genes’ prognostic values of patients with ccRCC were analyzed by GEPIA database.

Results

A total of 137 DEGs were identified by utilizing the limma package and RRA method, including 63 upregulated genes and 74 downregulated genes. It is found that 137 DEGs were mainly enriched in 82 functional terms and 24 pathways in accordance with the research results. Thirteen highest-scoring genes were screened as hub genes (include 10 upregulated genes and 3 downregulated candidate genes) by utilizing the PPI network and module analysis. Through integrating the oncoming database and GEPIA database, the author found that C3 and CXCR4 are not only overexpressed in ccRCC, but also associated with the prognosis of ccRCC. Further results could reveal that patients with high C3 expression had a poor overall survival (OS), while patients with high CTSS and TLR3 expressions had a good OS; patients with high C3 and CXCR4 expressions had a poor disease-free survival (DFS), while ccRCC patients with high TLR3 expression had a good DFS.

Conclusion

These findings suggested that C3 and CXCR4 were the candidate biomarkers and potential therapeutic targets of ccRCC patients.
DNA index as prognostic factor in childhood acute lymphoblastic leukemia in the COG-TARGET database
Authors: Qiu Kun-yin , Liao Xiong-yu , He Zhan-wen , Wu Ruo-hao , Li Yang , Xu Lu-hong , Zhou Dun-hua , Fang Jian-pei
Published: July 2021

Background

This study was aimed to evaluate the value of DNA index(DI) among pediatric acute lymphoblastic leukemia (ALL) treated on Children’s Oncology Group (COG) protocols between 2000 and 2015.

Methods

Retrospective study were analysis among pediatric ALL patients from the TARGET dataset.

Result

Totally, 1668 eligible pediatric patients were enrolled in this study. Of them, 993 are male and 675 are female with a median age of 7.6 years old. The median follow-up for those patients was 7.7 years (range 0.1–15.7 years). The probability of 15-year EFS and OS were reported to be 67.5 ± 3.1% and 78.3 ± 2.5%, respectively. BCR/ABL1 fusion gene affected the early treatment response and the survival of childhood ALL. Moreover, those patients with ETV6/RUNX1 fusion gene were also significantly associated with better EFS (HR = 0.6, 95% CI 0.4–0.8, P = 0.003) and OS (HR = 0.3, 95%CI 0.2–0.5, P < 0.001) compared to patients with no ETV6/RUNX1. On the contrary, BM NR on Day+ 29 showed a significant decrease in EFS (HR = 3.1, 95%CI 2.1–4.5, P < 0.001) and OS (HR = 1.7, 95%CI 1.1–2.8, P = 0.026).

Multivariate analysis showed that DI was significantly associated with better EFS and OS. The threshold effect of DI on poor outcome was significant after adjusting for potential confounders. The adjusted regression coefficient (Log RR) was 0.7 (95%CI 0.1–3.2, P = 0.597) for DI < 1.1 while 8.8 (95%CI 1.4–56.0, P = 0.021) for DI ≥ 1.2 and 0.0 (95%CI 0.0–0.8, P = 0.041) for 1.1 ≤ DI < 1.2. Generalized additive models revealed that the lowest rates of the adverse outcomes estimated to occur among DI between 1.1 and 1.2.

Conclusion

For those childhood ALL treated on COG protocols between 2000 and 2015, ETV6/RUNX1 and BM NR were closely related to the prognosis. Moreover, the DI between 1.1 and 1.2 can serve as a significant cut-point discriminating the risk group, which indicated a favourable prognostic factor.
Risk assessment in interstitial lung disease: the incremental prognostic value of cardiopulmonary ultrasound
Authors: Zhu Wei-wei , Li Hong , Li Yi-dan , Sun Lanlan , Kong Lingyun , Ye Xiaoguang , Cai Qizhe , Lv Xiu-zhang
Published: July 2021

Background

The mortality risk of chronic interstitial lung disease (ILD) is currently assessed using the ILD-GAP score. The present study evaluates whether the addition of cardiopulmonary ultrasound parameters to the ILD-GAP score can further improve the predictive value of ILD-GAP.

Methods

Medical records from 91 patients with ILD hospitalized from June 2015 to March 2016 were retrospectively examined. The Lung ultrasound (LUS) score, right ventricular (RV) function, and mechanics were obtained from the cardiopulmonary ultrasound. The ILD-GAP score was calculated from demographic characteristics and pulmonary function parameters. Patients were followed up with until May 2020. The primary endpoint was all-cause death.

Results

After exclusions, 74 patients with ILD were included in the analysis. During the follow-up period, 36 patients with ILD survived (ILDs), and 38 patients died (ILDd). Compared to ILDs, the ILDd cases exhibited a higher number of B-lines, LUS score, and RV end-diastolic base dimension (RVD), but lower RV function. In multivariate analysis, the ILD-GAP score (hazard ratio, 2.88; 95% CI 1.38–5.99, P = 0.005), LUS score (hazard ratio 1.13; 95% CI 1.04–1.24, P = 0.006), and RVD (hazard ratio 1.09, 95% CI 1.03–1.16, P = 0.004) were significantly related to the risk of death. Adding the LUS score and RVD to the ILD-GAP score significantly improved the predictive value compared to the ILD-GAP score alone (C statistics 0.90 vs 0.76, P = 0.018).

Conclusion

We investigated the utility of a new prognostic model for ILD that includes both cardiopulmonary ultrasound parameters (LUS score and RVD) and the ILD-GAP score. This model better reflects the severity of pulmonary fibrosis and cardiac involvement, and has incremental predictive value over the ILD-GAP score alone.
Effect of concurrent repair of medial meniscal posterior root tears during high tibial osteotomy for medial osteoarthritis during short-term follow-up: a systematic review and meta-analysis
Authors: Kyun-Ho Shin , Hyun-Jae Ryoo , Ki-Mo Jang , Seung-Beom Han
Published: July 2021

Background

Medial meniscal posterior root tears (MMPRTs) are frequently associated with medial compartment osteoarthritis, leading to loss of meniscal hoop tension. This study aimed to evaluate the efficacy of concurrent MMPRT repair during high tibial osteotomy (HTO) compared to HTO alone in patients with medial osteoarthritis and MMPRTs.

Methods

The MEDLINE/PubMed, EMBASE, and Cochrane Library databases were searched for studies reporting on concurrent MMPRT repair during HTO. Pre- and postoperative data were pooled to investigate the treatment effects of concurrent MMPRT repair during HTO, and compare postoperative clinical, radiological, and arthroscopic outcomes including cartilage status and healing event rates according to the arthroscopic classification of MMPRT healing (complete, partial [lax or scar tissue], or failed healing) between HTO patients with and without concurrent MMPRT repair. The random-effect model was used to pool the standardized mean differences, odds ratios (ORs), 95% confidence intervals (CIs), and event rates.

Results

Seven patient subgroups in six articles divided according to meniscal repair techniques were included in the final analysis. Concurrent MMPRT repair during HTO significantly improved the Lysholm score, while no intergroup differences were observed in the postoperative Lysholm and WOMAC scores, as well as radiological and arthroscopic outcomes. Those who underwent concurrent MMPRT repair showed a higher rate of complete meniscal healing (OR: 4.792, 95% CI, 1.95–11.79), with a pooled rate of complete meniscal healing of 0.327 (95% CI, 0.19–0.46).

Conclusion

Concurrent MMPRT repair during HTO for medial osteoarthritis with MMPRTs has little benefits on the clinical, radiological, and arthroscopic outcomes during short-term follow-up. Further accumulation of evidence is needed for long-term effects.
Trends in treatment for patients with depression in general practice in Norway, 2009–2015: nationwide registry-based cohort study (The Norwegian GP-DEP Study)
Authors: Ruths Sabine , Haukenes Inger , Hetlevik Øystein , Smith-Sivertsen Tone , Hjørleifsson Stefan , Hansen Anneli B , Riiser Sharline , Meling Heidi Marie , Baste Valborg
Published: July 2021

Background

Depression is highly prevalent, but knowledge is scarce as to whether increased public awareness and strengthened government focus on mental health have changed how general practitioners (GPs) help their depressed patients. This study aimed to examine national time trends in GP depression care and whether trends varied regarding patient gender, age, and comorbidity.

Methods

Nationwide registry-based cohort study, Norway. The study population comprised all residents aged 20 years or older with new depression diagnoses recorded in general practice, 2009–2015. We linked reimbursement claims data from all consultations in general practice for depression with information on demographics and antidepressant medication. The outcome was type(s) of GP depression care during 12 months from the date of diagnosis: (long) consultation, talking therapy, antidepressant drug treatment, sickness absence certification, and referral to secondary mental health care. Covariates were patient gender, age, and comorbidity. The data are presented as frequencies and tested with generalized linear models.

Results

We included 365,947 new depression diagnoses. Mean patient age was 44 years (SD = 16), 61.9 % were women, 41.2 % had comorbidity. From 2009 to 2015, proportions of patients receiving talking therapy (42.3–63.4 %), long consultations (56.4–71.8 %), and referral to secondary care (16.6–21.6 %) increased, while those receiving drug treatment (31.3–25.9 %) and sick-listing (58.1–50 %) decreased. The trends were different for gender (women had a greater increase in talking therapy and a smaller decrease in sick-listing, compared to men), age (working-aged patients had a smaller increase in talking therapy, a greater increase in long consultations, and a smaller decrease in antidepressant drug use, compared to older patients) and comorbidity (patients with mental comorbidity had a smaller increase in talking therapy and a greater increase in long consultations, compared to those with no comorbidity and somatic comorbidity).

Conclusions

The observed time trends in GP depression care towards increased provision of psychological treatment and less drug treatment and sick-listing were in the desired direction according to Norwegian health care policy. However, the large and persistent differences in treatment rates between working-aged and older patients needs further investigation.