bluuebunny/crossref_metadata_2025 huggingface dataset:
A cross-sectional study of the epidemic situation on COVID-19 in Gansu Province, China – a big data analysis of the national health information platform
Authors:   on behalf of COVID-19 evidence and recommendations working group, Yan Xuanchen , Wang Jianjian , Yao Jingwen , Estill Janne , Wu Shouyuan , Lu Jie , Liang Baoping , Li Hongmin , Tao Shengxin , Bai Huanli , Liu Hongliang , Chen Yaolong
Published: February 2021

Background

In December 2019, a pneumonia caused by SARS-CoV-2 emerged in Wuhan, China and has rapidly spread around the world since then. This study is to explore the patient characteristics and transmission chains of COVID-19 in the population of Gansu province, and support decision-making.

Methods

We collected data from Gansu Province National Health Information Platform. A cross-sectional study was conducted, including patients with COVID-19 confirmed between January 23 and February 6, 2020, and analyzed the gender and age of the patients. We also described the incubation period, consultation time and sources of infection in the cases, and calculated the secondary cases that occurred within Gansu for each imported case.

Results

We found thirty-six (53.7%) of the patients were women and thirty-one (46.3%) men, and the median ages were 40 (IQR 31–53) years. Twenty-eight (41.8%) of the 67 cases had a history of direct exposure in Wuhan. Twenty-five (52.2%) cases came from ten families, and we found no clear reports of modes of transmission other than family clusters. The largest number of secondary cases linked to a single source was nine.

Conclusion

More women than men were diagnosed with COVID-19 in Gansu Province. Although the age range of confirmed cases of COVID-19 in Gansu Province covered almost all age groups, most patients with confirmed COVID-19 tend to be middle aged persons. The most common suspected mode of transmission was through family cluster. Gansu and other settings worldwide should continue to strengthen the utilization of big data in epidemic control.
High body mass index is a significant risk factor for the progression and prognosis of imported COVID-19: a multicenter, retrospective cohort study
Authors: Cai Huan , Yang Lisha , Lu Yingfeng , Zhang Shanyan , Ye Chanyuan , Zhang Xiaoli , Yu Guodong , Gu Jueqing , Lian Jiangshan , Hao Shaorui , Hu Jianhua , Zhang Yimin , Jin Ciliang , Sheng Jifang , Yang Yida , Jia Hongyu
Published: February 2021

Background

Coronavirus disease 2019(COVID-19) has spread worldwide. The present study aimed to characterize the clinical features and outcomes of imported COVID-19 patients with high body mass index (BMI) and the independent association of BMI with disease severity.

Methods

In this retrospective cohort study, 455 imported COVID-19 patients were admitted and discharged in Zhejiang province by February 28, 2020. Epidemiological, demographic, clinical, laboratory, radiological, treatment, and outcome data were collected, analyzed and compared between patients with BMI ≥ 24and < 24.

Results

A total of 268 patients had BMI < 24, and 187 patients had BMI ≥ 24. Those with high BMI were mostly men, had a smoking history, fever, cough, and sputum than those with BMI < 24. A large number of patients with BMI ≥ 24 were diagnosed as severe/critical types. Some biochemical indicators were significantly elevated in patients with BMI ≥ 24. Also, acute liver injury was the most common complication in these patients. The median days from illness onset to severe acute respiratory syndrome coronavirus 2 detection, duration of hospitalization, and days from illness onset to discharge were significantly longer in patients with BMI ≥ 24 than those with BMI < 24. High BMI, exposure to Wuhan, any coexisting medical condition, high temperature, C-reactive protein (CRP), and increased lactate dehydrogenase (LDH) were independent risk factors for severe/critical COVID-19. After adjusting for age, sex and above factors, BMI was still independently associated with progression to severe/critical illness (P = 0.0040). Hemoglobin, alanine aminotransferase (ALT), CRP, and serum creatinine (Scr) were independent risk factors associated with high BMI.

Conclusions

Contrasted with the imported COVID-19 patients with BMI < 24, high proportion of COVID-19 patients with BMI ≥ 24 in our study, especially those with elevated CRP and LDH, developed to severe type, with longer hospitalization duration and anti-virus course. Thus, high BMI is a risk factor for the progression and prognosis of imported COVID-19.
An easy-to-use nomogram for predicting in-hospital mortality risk in COVID-19: a retrospective cohort study in a university hospital
Authors: Acar Hazal Cansu , Can Günay , Karaali Rıdvan , Börekçi Şermin , Balkan İlker İnanç , Gemicioğlu Bilun , Konukoğlu Dildar , Erginöz Ethem , Erdoğan Mehmet Sarper , Tabak Fehmi
Published: February 2021

Background

One-fifth of COVID-19 patients are seriously and critically ill cases and have a worse prognosis than non-severe cases. Although there is no specific treatment available for COVID-19, early recognition and supportive treatment may reduce the mortality. The aim of this study is to develop a functional nomogram that can be used by clinicians to estimate the risk of in-hospital mortality in patients hospitalized and treated for COVID-19 disease, and to compare the accuracy of model predictions with previous nomograms.

Methods

This retrospective study enrolled 709 patients who were over 18 years old and received inpatient treatment for COVID-19 disease. Multivariable Logistic Regression analysis was performed to assess the possible predictors of a fatal outcome. A nomogram was developed with the possible predictors and total point were calculated.

Results

Of the 709 patients treated for COVID-19, 75 (11%) died and 634 survived. The elder age, certain comorbidities (cancer, heart failure, chronic renal failure), dyspnea, lower levels of oxygen saturation and hematocrit, higher levels of C-reactive protein, aspartate aminotransferase and ferritin were independent risk factors for mortality. The prediction ability of total points was excellent (Area Under Curve = 0.922).

Conclusions

The nomogram developed in this study can be used by clinicians as a practical and effective tool in mortality risk estimation. So that with early diagnosis and intervention mortality in COVID-19 patients may be reduced.
Pathophysiological clinical features of an infant with hypertension secondary to multicystic dysplastic kidney: a case report
Authors: Sugimoto Keisuke , Enya Takuji , Joh Kensuke , Miyazaki Kohei , Miyazawa Tomoki , Ohshima Rina , Marutani Satoshi , Tsukasa Takemura , Okada Mitsuru
Published: February 2021

Background

The association of hypertension with congenital renal hypoplasia has been established. We report a case of an infant who underwent nephrectomy for hypertension.

Case presentation

Magnetic resonance imaging for the mother revealed fetal renal masses, and fetal multicystic dysplastic kidney was suspected. Following birth, the baby developed hypertension. Numerous investigations revealed that the left kidney was non-functional, and she was initiated on benazepril hydrochloride. However, because the drug response was poor, the left kidney was removed at the age of 7 months. Examination of the renal specimen revealed abrupt transition from normal to atrophic cortex with lobar atrophy and cysts. Tubular atrophy, marked abnormal blood vessels with wall thickening, gathered immature glomeruli, and parenchymal destruction were observed. Renin was partially localized in the proximal tubules and the parietal epithelium of the Bowman’s capsule in the immature glomeruli. We speculated that an abnormal vascular structure and irregular renin localizations may be the cause of hypertension. Serum renin and aldosterone levels gradually reduced post-surgery, reaching normal levels on the 90th postoperative day. A long follow-up is needed due to the possibility of the child developing hypertension in the future.

Conclusion

This is a case of an infant with MCDK, which discusses the clinicopathological features based on the pathophysiological analysis, including renin evaluation.
Associations of the neutrophil to lymphocyte ratio with intracranial artery stenosis and ischemic stroke
Authors: Huang Liang-Yu , Sun Fu-Rong , Yin Jian-Jun , Ma Ya-Hui , Li Hong-Qi , Zhong Xiao-Ling , Yu Jin-Tai , Song Jing-Hui , Tan Lan
Published: February 2021

Background

The neutrophil-to-lymphocyte ratio (NLR) has emerged as an inflammatory marker. However, the associations of NLR with intracranial artery stenosis (ICAS) and ischemic stroke remain unclear. This study aimed to examine the associations of NLR with ICAS and ischemic stroke among a large and high-risk population.

Methods

Participants with records of clinical characteristics were prospectively recruited from the Neurology Department and Health & Physical Examination Center of Qingdao Municipal Hospital. Logistic regression analysis was used to examine the associations of NLR with ICAS and ischemic stroke. Moreover, we also conducted parametric mediation analysis to estimate the effect of NLR on the risk of ischemic stroke mediated through ICAS.

Results

A total of 2989 participants were enrolled in this study. After adjusting for covariates, NLR (OR = 1.125, 95%CI 1.070–1.183) and ICAS (OR = 1.638, 95%CI 1.364–1.967) were significantly associated with ischemic stroke. Compared with the first quartile NLR, the second, third and fourth quartiles NLR were independent risk predictors for ischemic stroke (P for trend < 0.001); the third and fourth quartiles were independent predictors for ICAS (P for trend < 0.001). The mediation analysis showed that ICAS partially mediated the association between NLR and ischemic stroke, accounting for 14.4% of the total effect (P < 0.001).

Conclusions

NLR was significantly associated with ICAS and ischemic stroke. Besides, ICAS partially mediated the association between NLR and ischemic stroke.
Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis
Authors: Servante Juliette , Swallow Gill , Thornton Jim G. , Myers Bethan , Munireddy Sandhya , Malinowski A. Kinga , Othman Maha , Li Wentao , O’Donoghue Keelin , Walker Kate F.
Published: February 2021

Background

As pregnancy is a physiological prothrombotic state, pregnant women may be at increased risk of developing coagulopathic and/or thromboembolic complications associated with COVID-19.

Methods

Two biomedical databases were searched between September 2019 and June 2020 for case reports and series of pregnant women with a diagnosis of COVID-19 based either on a positive swab or high clinical suspicion where no swab had been performed. Additional registry cases known to the authors were included. Steps were taken to minimise duplicate patients. Information on coagulopathy based on abnormal coagulation test results or clinical evidence of disseminated intravascular coagulation (DIC), and on arterial or venous thrombosis, were extracted using a standard form. If available, detailed laboratory results and information on maternal outcomes were analysed.

Results

One thousand sixty-three women met the inclusion criteria, of which three (0.28, 95% CI 0.0 to 0.6) had arterial and/or venous thrombosis, seven (0.66, 95% CI 0.17 to 1.1) had DIC, and a further three (0.28, 95% CI 0.0 to 0.6) had coagulopathy without meeting the definition of DIC. Five hundred and thirty-seven women (56%) had been reported as having given birth and 426 (40%) as having an ongoing pregnancy. There were 17 (1.6, 95% CI 0.85 to 2.3) maternal deaths in which DIC was reported as a factor in two.

Conclusions

Our data suggests that coagulopathy and thromboembolism are both increased in pregnancies affected by COVID-19. Detection of the former may be useful in the identification of women at risk of deterioration.
A retrospective study of CT-guided percutaneous irreversible electroporation (IRE) ablation: clinical efficacy and safety
Authors: Wang Ziyin , Lu Jian , Huang Wei , Wu Zhiyuan , Gong Ju , Wang Qingbing , Liu Qin , Wang Cangyi , Zhu Yu , Ding Xiaoyi , Wang Zhongmin
Published: February 2021

Background

To evaluate the clinical efficacy and safety of ablating renal cell carcinoma (RCC) by irreversible electroporation (IRE).

Methods

Fifteen patients (19 lesions) with RCC who underwent IRE were retrospectively reviewed. Seven patients had solitary kidneys. Two lesions were located in the renal hilus. One patient had chronic renal insufficiency. Percutaneous biopsy for histopathology was performed. The best puncture path plan was evaluated before CT-guided IRE. The estimated glomerular filtration rate (eGFR) was compared vs baseline at 1–2 months after the ablation. Contrast-enhanced computed tomography imaging changes were evaluated immediately after IRE. Contrast-enhanced computed tomography/magnetic resonance was performed 1 month, 3 months, 6 months, 12 months and every year thereafter. The complications after treatment were also reviewed.

Results

The success rate of the procedure was 100%. The median tumor size was 2.4 (IQR 1.3–2.9) cm, with an median score of 6 (IQR 5.5–8) per R.E.N.A.L. criteria (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines). Two cases (3 lesions) were punctured through the liver. In other cases, puncture was performed through the perirenal space. There were no severecomplications in interventional therapy. Transient gross hematuria occurred in 2 patients (centrally located). Self-limiting perinephric hematomas occurred in 1 patient. Needle puncture path metastasis was found in 1 patient 2.5 years after IRE. The subcutaneous metastasis was surgically removed, and there was no evidence of recurrence. There was no significant change in eGFR levels in terms of short- term clinical outcomes (t = 0.348, P = 0.733). At 6 months, all 15 patients with imaging studies available had no evidence of recurrence. At 1 year, 1 patient (1 of 15) was noted to have experienced needle tract metastasis and accepted salvage radiofrequency ablation (RFA) therapy.

Conclusions

IRE appears to be a safe and effective treatment for RCC that may offer a tissue-sparing method and complete ablation as an alternative therapy for RCC.
Ologen augmentation of Ahmed glaucoma drainage devices in pediatric glaucomas
Authors: Jacobson Adam , Rojas Carin , Bohnsack Brenda L.
Published: February 2021

Background

Limited data exists on the effectiveness of the collagen matrix, Ologen, on increasing Ahmed glaucoma valve (AGV) success in childhood glaucomas.

Methods

Ocular examination and surgical details of pediatric patients who underwent AGV placement ± Ologen augmentation between 2012 and 2020. Complete success was defined as intraocular pressure (IOP) between 5 and 20 mmHg without glaucoma medications and additional IOP-lowering surgeries. Qualified success was defined as above, except IOP control maintained with or without glaucoma medications.

Results

Twenty-two eyes of 16 patients underwent AGV placement of which 6 eyes had Ologen-augmentation (OAGV) and 16 eyes had conventional surgery (CAGV). Average age was 6.4 ± 5.1 years with 4.2 ± 2.5 follow-up years. There was no difference in age, number of previous surgeries, and preoperative IOP and glaucoma medications. At final follow-up, success rate was 100% (5 eyes complete, 6 eyes qualified) in the OAGV group compared to 31% (0 eyes complete, 5 eyes qualified) in the CAGV group. One and two-year survival rates were 100% for OAGV compared to 62 and 38% for CAGV. Postoperative IOP was significantly lower at 1-month and final follow-up (p = 0.02) as was the number of glaucoma medications at 3, 6, 12-months and final follow-up (p < 0.05) in the OAGV group.

Conclusions

Ologen-augmentation increased the success and survival rates of AGVs in childhood glaucomas. Further, Ologen mitigated the hypertensive phase and decreased medication dependency. Longer follow-up with a greater number of eyes is required to fully evaluate the effectiveness of OAGV.
Investigation of an anthrax outbreak in Makoni District, Zimbabwe
Authors: Makurumidze Richard , Gombe Notion Tafara , Magure Tapuwa , Tshimanga Mufuta
Published: February 2021

Background

Anthrax continues to be a disease of public health importance in Zimbabwe, with sporadic outbreaks reported annually in many parts of the country. A human anthrax outbreak occurred in wards 22 and 23 of Makoni District from mid-June 2013 to end of January 2014, following cattle deaths in the wards. Laboratory tests confirmed anthrax as the cause for the cattle deaths. This study investigated the clinical characteristics, distribution of cases (places, person and time) and risk factors for contracting the anthrax disease. We also assessed the environment, district preparedness and response, and outbreak prevention and control measures.

Methods

We conducted an outbreak investigation using a mixed-methods design. A 1:1 case-control study was used to assess risk factors for contracting anthrax. The controls were frequency matched to cases by sex. Data were collected using a structured interviewer-administered questionnaire. Environmental assessment, district preparedness and response, and outbreak prevention and control measures were assessed using a checklist, observations, and key informant interviews. Multivariable unconditional logic regression analysis was performed to identify independent risk factors associated with contracting anthrax.

Results

We interviewed 37 of the 64 cases, along with 37 controls. All the cases had cutaneous anthrax, with the hand being the most common site of the eschar (43%). Most of the cases (89%) were managed according to the national guidelines. Multivariable analysis demonstrated that meat sourced from other villages [vs butchery, OR = 15.21, 95% CI (2.32–99.81)], skinning [OR = 4.32, 95% CI (1.25–14.94)], and belonging to religions that permit eating meat from cattle killed due to unknown causes or butchered after unobserved death [OR = 6.12, 95% CI (1.28–29.37)] were associated with contracting anthrax. The poor availability of resources in the district caused a delayed response to the outbreak.

Conclusion

The described anthrax outbreak was caused due to contact with infected cattle meat. Although the outbreak was eventually controlled through cattle vaccination and health education and awareness campaigns, the response of the district office was initially delayed and insufficient. The district should strengthen its emergency preparedness and response capacity, revive zoonotic committees, conduct awareness campaigns and improve surveillance, especially during outbreak seasons.
Positive impact on vitamin D related lifestyle of medical advice in pregnant Somali-born women and new mothers: a mixed method study in Swedish primary care
Authors: Kalliokoski P. , Widarsson M. , Rodhe N. , Löfvander M.
Published: February 2021

Background

A previous study showed that pregnant women/new mothers especially Somali-born and some Swedish-born had extremely low vitamin D levels and poor physical performance. Our study aimed to examine vitamin D related lifestyle, attitudes and behaviour before and after brief information about vitamin D, with special long-term focus on Somali-born women.

Methods

A cohort of 91 pregnant women/new mothers having serum hydroxyvitamin D (S-25-OHD) ≤ 50 nmol/L (n = 51 Somali-born with one third < 10 nmol/L of S-25-OHD) in primary health care in Sweden was targeted for intervention. Brief individual oral and visual information on vitamin D was given by doctors at baseline and after four and ten months. Questionnaires with ordinal scales on vitamin D related lifestyle of food, clothing, and outdoor activities were distributed on all occasions. Focus-group interviews with 15 women from the target-group were performed after two years. A Somali interpreter was available.

Results

Veiled clothing, indoor living, and a low intake of milk, cheese, and fatty fish were common in the target group. Consumption pattern had increased significantly among the Somali-born women at the four-month follow-up but declined to non-significant levels at the ten-month follow-up. The focus-group interviews showed improved understanding of vitamin D deficiency, symptoms and attitudes, but varying applied behaviours related to sun exposure. Sun exposure for the children and increased fish consumption was the most evident positive results.

Conclusions

Vitamin D related lifestyle, attitudes and behaviour improved in a Somali-born group of pregnant women/new mothers with severe vitamin D deficiency. The preventive measures suggested in our study may have impact on public health in relation to bone and muscle strength and immunity especially in vitamin D deficiency risk groups.

Trial registration

ClinicalTrials.gov Identifier: NCT02922803. Date of registration: 28 September 2016.
The role of economic, educational and social resources in supporting the use of digital health technologies by people with T2D: a qualitative study
Authors: Turnbull Sophie , Lucas Patricia J. , Hay Alastair D. , Cabral Christie
Published: February 2021

Background

Type 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity.

Study aims

To gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups.

Methods

A purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically.

Results

A diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender.

Conclusion

This research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented.
Nutritional status and quality of life in interstitial lung disease: a prospective cohort study
Authors: Kanjrawi Alisar A. , Mathers Lara , Webster Susanne , Corte Tamera J. , Carey Sharon
Published: February 2021

Background

Malnutrition and altered body composition are well-documented in chronic pulmonary diseases; however, investigation of nutritional status in interstitial lung disease (ILD) is limited. This study aimed to describe the nutritional status of ILD patients within three diagnostic groups and explore the relationship between nutritional status and quality of life (QoL).

Methods

Consecutive patients attending an ILD clinic within a tertiary referral hospital in Sydney, Australia were studied. Weight, body-mass-index, anthropometrics, handgrip strength (HGS), subjective global assessment and QoL questionnaires (EQ-5D-5L and King’s-Brief Interstitial-Lung-Disease ‘K-BILD’) were collected. Associations between nutritional status and QoL were analysed.

Results

Ninety participants were recruited and categorised: (1) Idiopathic Pulmonary Fibrosis (IPF) (2) Connective-Tissue Disease associated-ILD (CTD-ILD) or (3) Other (non-IPF/non-CTD ILD). Median age was 66.5 (18) years. Four-percent of patients were underweight and 50% were overweight or obese. Median HGS was 71%-(25.3) of predicted and was correlated to all measures of QoL including EQ-5D health-state index (r = 0.376, p < 0.0001), patient-reported EQ-5D-5L Visual Analogue Score (r = 0.367, p < 0.0001) and K-BILD total score (r = 0.346, p = 0.001). Twenty-three percent of the variance in K-BILD total score (F = 12.888, p < 0.0001) was explained by HGS (ß = 0.273, p = 0.006) and forced vital capacity % predicted (ß = 0.331, p = 0.001).

Conclusions

Although a small number of ILD patients were malnourished, a large proportion of the cohort were overweight or obese. Handgrip strength was compromised and correlated to QoL. Future research with a larger cohort is required to explore the role of HGS as a predictor of QoL.
Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany
Authors: Reisenauer Christl , Amend Bastian , Falch Claudius , Abele Harald , Brucker Sara Yvonne , Andress Jürgen
Published: February 2021

Background

Obstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre.

Methods

Women who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified, and their records were reviewed retrospectively.

Results

Eleven out of 40 women presented with genitourinary fistulas, and 29 suffered from rectovaginal fistulas. In our cohort, genitourinary fistulas were more common in multiparous women (9/11), and rectovaginal fistulas were more common in primiparous women (24/29). The majority of the genitourinary fistulas were at a high anterior position in the vagina, and all rectovaginal fistulas were at a low posterior position. While all genitourinary fistulas were successfully closed, rectovaginal fistula closure was achieved in 88.65% of cases. Women who suffered from rectovaginal fistulas and were at high risk of recurrence or postoperative functional discomfort and desired another child, we recommended fistula repair in the context of a subsequent delivery. For the first time, pregnancy-related changes in the vaginal wall were used to optimize the success rate of fistula closure.

Conclusions

In developed countries, birth itself can lead to injury-related genital fistulas. As fistula repair lacks evidence-based guidance, management must be tailored to the underlying pathology and the surgeon’s experience. Attention should be directed towards preventive obstetric practice and adequate perinatal and postpartum care. Although vesicovaginal fistulas occur rarely, in case of urinary incontinence after delivery, attention should be paid to the patient, and a vesicovaginal fistula should be ruled out.

Trial registration Retrospectively registered, DRKS 00022543, 28.07.2020.
“What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework
Authors: Ly Anh , Zemek Roger , Wright Bruce , Zwicker Jennifer , Schneider Kathryn , Mikrogianakis Angelo , Conradi Alf , Johnson David , Clark Brenda , Barlow Karen , Burey Joseph , Kolstad Ash , Yeates Keith Owen
Published: February 2021

Background

Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion.

Methods

Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation.

Results

The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes.

Conclusion

Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.
Intraoperative collection of autologous platelet-rich plasma from the cardiopulmonary bypass circuit upon initiation of extracorporeal circulation
Authors: Honda Takeshi , Kanaoka Yuji , Furukawa Hiroshi , Tamura Taishi , Kuwada Noriaki , Yamasawa Takahiko , Watanabe Yoshiko , Yunoki Yasuhiro , Tabuchi Atsushi , Tanemoto Kazuo
Published: February 2021

Objectives

The aim of this study is to evaluate the possibility of the autologous platelet-rich plasma (PRP) collection from the cardiopulmonary bypass (CPB) circuit and to evaluate its effect on the aggregative function.

Methods

For seventy-two patients undergoing cardiac surgery with CPB, an autologous PRP was prepared using the Haemonetics Component Collection System® by drawing blood from the CPB circuit immediately after CPB was established. The blood samples were taken at three points for examination, A: beginning of surgery, B: immediately after heparin reversal with protamine following discontinuation of CPB, C: after the collected autologous PRP was returned to the patient. Platelet count and platelet aggregation ability were analyzed.

Results

The mean platelet count in autologous PRP was 5.5 (range: 3–14) units. Platelet count decreased by 115.0 (±27.3) × 1000/μl from A to B and increased by 27.3 ± 17.2 (× 1000/μl) from B to C.

When platelet aggregation was measured by Adenosine Diphosphate (ADP) 3.0 μM, it decreased by 42.6% ± 12.1% from A to B and increased by 8.7% ± 7.4% from B to C.

Conclusions

Autologous PRP can be safely collected by drawing blood from the CPB circuit, platelet count and aggregation ability significantly decreased after CPB including autologous PRP collection. Some improvement was detected in the number of the platelets count and platelet aggregation ability by administrating an autologous PRP even if autologous PRP is collected from CPB circuit.

Trial registration

UMI-CTR, UMIN000023776. Registered 1 October 2016.
Improved spectral clustering approach — A new tool for unsupervised seismic facies analysis of variable window length
Authors: Hong Zhong , Li Kunhong , Su Mingjun , Hu Guangmin
Published: February 2021

The traditional constant time window-based waveform classification method is a robust tool for seismic facies analysis. However, when the interval thickness is seismically variable, the fixed time window is not able to contain the complete geologic information of interest. Therefore, the constant time window-based waveform classification method is inapplicable to conduct seismic facies analysis. To expand the application scope of seismic waveform classification in the strata with varying thickness, we have proposed a novel scheme for unsupervised seismic facies analysis of variable window length. The input of the top and bottom horizons can guarantee the comprehensive geologic information of the target interval. Throughout the whole workflow, we use the dynamic time warping (DTW) distance to measure the similarities between seismic waveforms of different lengths. First, we improve the traditional spectral clustering algorithm by replacing the Euclidean distance with the DTW distance. Therefore, it can be applicable in the interval of variable thickness. Second, to solve the problem of large computation when applying the improved spectral clustering approach, we adopt the method of seismic data thinning based on the technology of the superpixel. We combine these two algorithms and perform the integrated workflow of improved spectral clustering. The experiments on synthetic data show that the proposed workflow outperforms the traditional fixed time window-based clustering algorithm in recognizing the boundaries of different lithologies and lithologic associations with varying thickness. The practical application shows great promise for reservoir characterization of interval with varying thickness. The plane map of waveform classification provides convincing reference to delineate reservoir distribution of the data set.
Latour, Tiananmen, and Glass Slippers; or, What We Talk about When We Talk about Chinese Studies
Authors: Lee Haiyan
Published: February 2021

This article revisits a controversy that initially unfolded three decades ago. The immediate impetus for revisiting the controversy is the thirtieth anniversary of the 1989 protests that ended in a massacre in Tiananmen Square. An intermediate reason is to reflect on how the methodological questions at the heart of that controversy are still very much alive as the protean field of Chinese studies continues reinventing itself in relation to theory. A still deeper reason is to rethink, via Bruno Latour, the status of fiction in the age of posttruth and fake news—a task incumbent upon all of us who call ourselves literary scholars.
Saccharomyces cerevisiae Ecm2 modulates the catalytic steps of pre-mRNA splicing
Authors: van der Feltz Clarisse , Nikolai Brandon , Schneider Charles , Paulson Joshua C. , Fu Xingyang , Hoskins Aaron A.
Published: February 2021

Genetic, biochemical, and structural studies have elucidated the molecular basis for spliceosome catalysis. Splicing is RNA catalyzed and the essential snRNA and protein factors are well-conserved. However, little is known about how nonessential components of the spliceosome contribute to the reaction and modulate the activities of the fundamental core machinery. Ecm2 is a nonessential yeast splicing factor that is a member of the Prp19-related complex of proteins. Cryo-electron microscopy (cryo-EM) structures have revealed that Ecm2 binds the U6 snRNA and is entangled with Cwc2, a factor previously found to promote a catalytically active conformation of the spliceosome. These structures also indicate that Ecm2 and the U2 snRNA likely form a transient interaction during 5′ splice site (SS) cleavage. We have characterized genetic interactions between ECM2 and alleles of splicing factors that alter the catalytic steps in splicing. In addition, we have studied how loss of ECM2 impacts splicing of pre-mRNAs containing nonconsensus or competing SS. Our results show that ECM2 functions during the catalytic stages of splicing. Our data are consistent with Ecm2 facilitating the formation and stabilization of the first-step catalytic site, promoting second-step catalysis, and permitting alternate 5′ SS usage. We propose that Cwc2 and Ecm2 can each fine-tune the spliceosome active site in unique ways. Their interaction network may act as a conduit through which splicing of certain pre-mRNAs, such as those containing weak or alternate splice sites, can be regulated.
Provenance-specific climate sensitivity of Pinus massoniana – a multi-environmental trial in subtropical China
Authors: Zhang Zhen , Jin Guoqing , Feng Zhongping , Sun Linshan , Jin Guoqing , Feng Zhongping , Sun Linshan , Zhou Zhichun
Published: February 2021

Climate change is causing changes in tree species performance and distribution, impacting breeding programme effectiveness. Our aim was to analyse the effects of provenance and climatic factorson the annual ring density of Masson pine (Pinus massoniana Lamb.) at different experimental sites and potential breeding strategies that may be developed in response to future climate change. The study trees represented provenances originating from the western, east-central, northern, and southern regions of P. massoniana distribution in China. The wood density differed significantly among provenances. A multisite variance analysis test showed that the type B correlation coefficients for ring density at the two sites studied were less than 0.8, indicating an interaction effect of genotype by environment (G×E) on tree ring density. Climatic factors directly affected the wood density properties. At Chun’an (CA), the maximum latewood density (MXD) and minimum earlywood density (MND) were positively correlated with absolute maximum temperatures in August and May of the current growing season, respectively. At Taizi Mountain (TZS), MXD was significantly positively correlated with absolute maximum temperature in September ofthe current year and significantly negatively correlated with precipitation in June. MND was significantly positively correlated with absolute maximum temperature in May of the current year and significantly negatively correlated with precipitation in April. The climatic effects on P. massoniana wood density differed among seed-source origins. This study showed that ring density characteristics differed significantly among provenances, and provenance selection could promote wood density. MXD and MND exhibited significant genotype-by-environment interaction effects, and significant correlations were found between ring density and temperature, and precipitation conditions. These findings suggest that climatic factors and site conditionsin addition to genetics could be strong drivers of wood density variation, and/or that wood density is a highly plastic trait.
Book Review:S. NEOCLEOUS, Heretics, Schismatics, or Catholics? Latin Attitudes to the Greeks in the Long Twelfth Century, Toronto: Pontifical Institute of Mediaeval Studies, 2019
Authors: ΤΟΥΝΤΑ Ελένη
Published: February 2021

Book Review: S. Neocleous, Heretics, Schismatics, or Catholics? Latin Attitudes to the Greeks in the Long Twelfth Century, Toronto: Pontifical Institute of Mediaeval Studies, 2019
Βιβλιογραφικό σημείωμα: M.-H. BLANCHET- I.-A. TUDORIE (éd.), L'apport des Assomptionnistes francais aux etudes Byzantines, Paris 2017
Authors: ΛΑΜΠΑΚΗΣ Στυλιανός
Published: February 2021

Bibliographical note: M.-H. Blanchet – I.-A. Tudorie (éd.), L’apport des Assomptionnistes français aux études byzantines. Une approche critique. Actes du colloque de Bucarest, 25- 27 septembre 2014 [Archives de l’Orient chrétien 21], σελ. 536. Institut français d’études byzantines, Paris 2017.
Η Βιοηθική και ο γενναίος, νέος κόσμος
Authors: Πρωτοπαπαδάκης Ευάγγελος Δ.
Published: February 2021

Οι άνθρωποι επιλέγουμε τις ενασχολήσεις μας είτε παίζοντες είτε σπουδάζοντες  – δηλαδή, είτε επειδή μας σαγηνεύουν κάποια αντικείμενα είτε διότι η ανάγκη μας επιβάλλει να εγκύπτουμε σε αυτά. Ενίοτε, όχι πολύ συχνά, η σαγήνη συναντάται με την ανάγκη, και η σύμπτωσή τους γεννά πεδία σπάνιας γονιμότητας – αυτή είναι η περίπτωση της Βιοηθικής. Στο σύντομο αυτό δοκίμιο θα σκιαγραφήσω τους λόγους οι οποίοι επιβάλλουν σήμερα την ενασχόλησή μας με τη Βιοηθική, ενώ, παράλληλα, φιλοδοξώ να μεταφέρω λίγη από τη γοητεία που αυτή ασκεί σε όποιον έρχεται σε επαφή μαζί της.
Bionic man: Principles and limits
Authors: Roumeliotis George
Published: February 2021

The subject of this paper is the ethical considerations raised in the issue of “bionic man”, a man whose many organs have been replaced by artificial, and the principles and ethical limitations that are inherent in this process. Four basic bioethical principles are acknowledged in the international bibliography: a) the principle of beneficence; b) the principle of autonomy and informed consentof patients; c) the principle of justice; d) the principle of equality. Apart from this,some more issues should be taken into consideration in the discussion about theethics of artificial implants: the allocation of health care and economic resources, the patentability of implants, the use of implants in the human consciousness itself and the subsequent changes of implants in one’s personality, as well as the willingness of a patient to accept an implant under the prism of his/her belonging to a specific subculture, due to his/her impairment.
„Die vornehmsten Plätze und Gebäude, die in Danzig zu sehen sind“. Aegidius Dickmans Ansichten von Danzig 1617
Authors: Larsson Lars Olof
Published: February 2021

The paper discusses a set of etchings depicting different buildingsin Gdansk (Danzig) and different parts of the city, first publishedin 1617. The artist was the little known Ægidius Dickman, active inGdánsk and probably also in the Netherlands in the first quarter ofthe 17th century. In the same year that these etchings were published,Dickman also finished a large birds-eye view of Gdánsk. The setof town views and the panorama were both republished by ClaesJanszoon Visscher in 1625.The author of the article discusses the relationship betweenDickman and Visscher and their collaboration on this project, aswell as their wider artistic relationship. Dickman seems to have beentrained in the Netherlands, the etchings proving his familiarity withVisscher´s topographical prints.
A case report of acute Marchiafava-Bignami disease: a rare clinical entity in chronic alcoholism
Authors: Khiew Mohd Arif Abdul Malik , Khan Abdul Hanif Khan Yusof , Loh Wei Chao , Mat Liyana Najwa Inche , Chia Peck Kee , Sulaiman Wan Aliaa Wan , Hoo Fan Kee , Basri Hamidon
Published: February 2021

Marchiafava‑Bignami disease (MBD) is a rare neurological disease often associated with a chronic consumption of alcohol and malnutrition, which is characterized by a demyelination and necrosis of the corpus callosum. We present a case of a 21-year-old male with chronic alcoholism who presented with an acute altered sensorium and seizure, which were initially treated as meningoencephalitis. His persistent poor Glasgow coma scale score and ideomotor recovery with encephalitic changes on his electroencephalogram prompted urgent magnetic resonance imaging (MRI) of his brain, which revealed extensive symmetrical hyperintensities in the corpus callosum. The diagnosis of MBD was made because of the typical MRI findings and after the exclusion of other possible diagnosis. The patient was promptly treated with a parenteral thiamine and showed a good recovery at 3 months follow-up. This case highlights the importance of diagnosing and recognizing MBD in a patient with chronic alcoholism as prompt treatment could prevent irreversible damage, which could carry high morbidity.
Novel In-line NIR Solutions for Monitoring and Control of Complex Food Processes
Authors: Wold Jens Petter , O’Farrell Marion , Tschudi Jon
Published: February 2021

A novel NIR instrument (760 - 1080 nm) probes 10-15 mm into complex foods at high speed. Dry matter in whole potatoes in movement can be determined with a prediction error of 0.90%-points.
Reference Spectra for Optical Sensing in the Extraction Industries: Free Spectral Databases Available for Oil, Mining & Gas Applications
Authors: Tonkyn Russell G. , Smith Steven C. , Bradley Ashley M. , Loring John S. , Bernacki Bruce E. , Myers Tanya L. , Banach Catherine A. , Saunders Danielle L. , Szecsody James E. , Su Yin-Fong , Johnson Timothy J.
Published: February 2021

We report on recent work on spectral databases that can be used for (near-) infrared sensing of solids and liquids relevant to both passive/active sensing of materials related to mining, oil and gas exploration.
Using HP Nanofinger SERS Sensors to Identify and Monitor the Health of Bacteria Through Metabolite Detection
Authors: Overbay Milo , Sengupta Raghuvir , Aronoff Jason , D’Apuzzo Fausto , Barcelo Steven
Published: February 2021

HP, Inc. has developed a Surface Enhanced Raman Spectroscopy (SERS) sensor based on self-assembled nanofingers that maximize plasmon resonance from hot spot gaps. One promising application is the identification of bacteria through metabolite detection.
Industrial Applications of THz Imaging: Plastics, Food Industry, Moisture Detection, and Additive Manufacturing
Authors: Federici John F. , Rizzo Louis , Clark Alexander , Bolton Christopher , Gatley Samuel , Gatley Ian
Published: February 2021

While Terahertz imaging has shown promise, there have been relatively few implementations of Terahertz non-destructive evaluation in industry. Current industrial implementations of THz imaging are described as well as several highly promising applications.
Portable Shifted Excitation Raman Difference Spectroscopy - From Laboratory Investigations to in-situ Agri-Photonics
Authors: Maiwald Martin , Sumpf Bernd
Published: February 2021

Portable shifted excitation Raman difference spectroscopy (SERDS) will be presented using one-chip dual-wavelength Y-branch DBR diode laser at 785 nm as excitation source. Experimental results from laboratory analysis and outdoor investigations will be shown.
High-Resolution and Gapless Dual Comb Spectroscopy with Current-Tuned Quantum Cascade Lasers for Environmental Applications
Authors: Hugi Andreas , Gianella Michele , Nataraj Akshay , Tuzson Béla , Jouy Pierre , Kapsalidis Filippos , Beck Mattias , Mangold Markus , Faist Jérôme , Emmenegger Lukas
Published: February 2021

Dual-comb spectrometers based on QCLs offer a unique tool for environmental sensing. We present high-resolution absorption and dispersion spectra covering 55 cm-' of methane and time-resolved spectroscopy of combustion diagnostics, stopped-flow reaction monitoring and photochemistiy.
Hyperspectral imaging using a Wollaston prism
Authors: Chamoun Jacob , Farhadi Somaye
Published: February 2021

A novel pushbroom hyperspectral imaging (HSI) system based on a Wollaston prism is demonstrated. HSI measurements of the spectra of three RGB LEDs are presented and are found to agree well with a commercial spectrometer.
Dispersion analysis of a low cost hyper-spectral imaging system based on Risley prism scanner
Authors: Arad Or , Klapp Iftach
Published: February 2021

Dispersion analysis, model validation and a white balancing procedure of a low-cost hyperspectral sampling system, are presented.
Dual-wavelength high-spectral-resolution lidar using a scanning interferometer for monitoring aerosol profiles
Authors: Jin Yoshitaka
Published: February 2021

Measurement method of a simple dual-wavelength high-spectral-resolution lidar (HSRL) using a single interferometer is described. By scanning the interferometer periodically for the range of one fringe, HSRL measurement is achieved without wavelength locking control systems.
Profiling Boundary Layer Aerosols in The Bahamas at Various Time of Year using a Camera-based Imaging Lidar
Authors: Kabir Amin S. , Sharma Nimmi C. , Knowles Edward , Bain Chaneaka , Gagnon Seth , Fagnoni Justin , Barnes John E.
Published: February 2021

A wide-angle camera-based bistatic imaging lidar is used to profile altitude dependent aerosol extinction at various time of year in the Bahamas. The instrument provides excellent altitude resolution in the near ground regions.