bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapy free of cells vs human mesenchymal stem cells from umbilical cord stroma to treat the inflammation in OA
Authors: Morente-López Miriam , Mato-Basalo Rocío , Lucio-Gallego Sergio , Silva-Fernández Lucía , González-Rodríguez Alba , De Toro Fco. Javier , Fafián-Labora Juan A. , Arufe María C.
Published: October 2022

Osteoarthritis (OA) is closely linked to the increase in the number of senescent cells in joint tissues, and the senescence-associated secretory phenotype (SASP) is implicated in cartilage degradation. In the last decade, extracellular vesicles (EV) in combination with the use of miRNAs to modify post-transcriptional expressions of multiple genes have shown their utility in new therapies to treat inflammatory diseases. This work delves into the anti-inflammatory effect of extracellular vesicles derived from mesenchymal stem cells (MSC) previously modified to inhibit the expression of miR-21. We compare the efficacy of two treatments, MSC with their miR-21 inhibited through lentiviral transfection and their EV, against inflammation in a new OA animal model. The modified MSC and their EV were intraperitoneally injected in an OA animal model twice. One month after treatment, we checked which therapy was the most effective to reduce inflammation compared with animals untreated. Treated OA model sera were analyzed for cytokines and chemokines. Subsequently, different organs were analyzed to validate the results obtained. EV were the most effective treatment to reduce chemokines and cytokines in serum of OA animals as well as SASP, in their organs checked by proteomic and genomic techniques, compared with MSC alone in a statistically significant way. In conclusion, MSC-miR-21−-derived EV showed a higher therapeutic potential in comparison with MSCs-miR-21-. They ameliorate the systemic inflammation through inactivation of ERK1/2 pathway in OA in vivo model.

Graphical abstract

Workflow of the realization of the animal model of OA by injecting cells into the joint cavity of the left knee of the animals, which produces an increase in serum cytokines and chemokines in the animals in addition to the increase in SASP and markers of inflammation. Inhibition of miR-21 in MSCs, from the stroma of the human umbilical cord, by lentivirus and extraction of their EVs by ultracentrifugation. Finally, application of MSC therapy with its miR-21 inhibited or its EVs produces a decrease in serum cytokines and chemokines in the treated animals, in addition to an increase in SASP and markers of inflammation. The cell-free therapy being the one that produces a greater decrease in the parameters studied
Evidenzbasierte Arzneimittelversorgung bei Seltenen Erkrankungen: die Rolle der Digitalisierung
Authors: Naumann-Winter Frauke , Kaiser Thomas , Behring Antje
Published: October 2022

Bei der Wissensgenerierung im Bereich der Arzneimittelentwicklung für Menschen mit Seltenen Erkrankungen (SE) sind besondere Schwierigkeiten zu überwinden. Welche Verbesserungen durch eine zunehmende Digitalisierung erwartet werden, wird in diesem Beitrag aus der Perspektive von 3 Institutionen im Gesundheitswesen aufgezeigt: dem Bundesinstitut für Arzneimittel und Medizinprodukte, dem Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen und dem Gemeinsamen Bundesausschuss.

Zunächst wird das Potenzial der Digitalisierung vorgestellt, auch durch eine frühere Zusammenarbeit aller Beteiligten die Effizienz der klinischen Entwicklung und der regulatorischen Entscheidungsprozesse zu erhöhen. Im Anschluss wird argumentiert, dass mit Hilfe der Digitalisierung Hürden bei der Durchführung versorgungsnaher, auch registerbasierter randomisiert kontrollierter Studien abgebaut werden sollten. Hochwertige Registerstudien sollten nicht erst nach der Zulassung, sondern bereits während des Zulassungsprozesses begonnen werden, damit die für Therapieentscheidungen notwendige Evidenz zeitnah nach Zulassung vorliegt. Abschließend wird festgestellt, dass die Verbesserung der Datenlage durch qualitative Verbesserung der Datenquellen und deren Vernetzung unmittelbar den Patient*innen zugutekommt. Verwertbare Evidenz, die über einen längeren Zeitraum – auch über die Zulassung hinaus – generiert werden kann und geeignet ist, in Entscheidungen für das Gesundheitssystem einzufließen, stellt eine effektive Arzneimittelversorgung sicher.

Die Institutionen sind sich einig, dass qualitativ hochwertige Indikationsregister als produktunabhängige, stehende Infrastrukturen entwickelt werden sollten, damit bereits früh in der Entwicklung von Arzneimitteln für SE auf hochwertige Daten zurückgegriffen werden kann.
Welche Potenziale und Mehrwerte bieten DiGA für die hausärztliche Versorgung? – Ergebnisse einer Befragung von Hausärzt*innen in Deutschland
Authors: Wangler Julian , Jansky Michael
Published: October 2022

Hintergrund

Für Ärzt*innen besteht die Möglichkeit, Patient*innen digitale Gesundheitsanwendungen (DiGA) auf Rezept zu verordnen. Bislang fehlen Untersuchungen, die Anwendungsmöglichkeiten von DiGA im hausärztlichen Praxiskontext beleuchten und eine erste Bilanz zum Nutzen sowie Optimierungspotenzial ziehen.

Ziel der Arbeit

Die Studie exploriert hausärztliche Einstellungen, Erwartungen und Erfahrungswerte mit Blick auf die Anwendungspotenziale von DiGA.

Methoden

Im Frühjahr 2022 wurden sämtliche 13.913 als Behandler*innen aktive Hausärzt*innen in Baden-Württemberg, Hessen, Rheinland-Pfalz und im Saarland zu einer Online-Befragung eingeladen. 3829 vollständig ausgefüllte Fragebögen gingen in die Auswertung ein (Rücklauf: 28 %). Zur Ermittlung von signifikanten Unterschieden zwischen 2 Gruppen erfolgten ein t‑Test bei unabhängigen Stichproben sowie eine Faktorenanalyse.

Ergebnisse

Die meisten Befragten erachten DiGA als verlässliche (67 %) und sichere (61 %) Anwendungen. 22 % trauen sich zu, Patient*innen zu DiGA kompetent zu beraten. 14 % haben bereits DiGA verschrieben, 13 % haben dies vor. 83 % der Ärzt*innen mit DiGA-Erfahrung bewerten die verordneten Anwendungen als nützlich. Beobachtete Versorgungseffekte betreffen v. a. die Verbesserung von Therapietreue (95 %), Mobilität (94 %) und Aufklärung (93 %) sowie Gewichtsreduktion (82 %). Angeregt wird u. a. eine weitere Optimierung der Nutzerfreundlichkeit (59 %), die systematische Weiterbildung von Ärzt*innen (52 %) und die verstärkte Aufnahme spielerischer Elemente (49 %).

Diskussion

Hausärzt*innen sollten besser über die Grundlagen des Digitale-Versorgung-Gesetzes (DVG) informiert und Bedenken gezielt adressiert werden. Zentral erscheinen flächendeckende Schulungen, die über Rahmenbedingungen und Vorteile des DiGA-Einsatzes aufklären. Auch besteht Bedarf an fundierteren Informations- und Recherchequellen für Ärzt*innen.
Controls on Pt/Pd ratios in Bushveld magmas and cumulates: a review complemented by new W isotope data
Authors: Maier Wolfgang D. , Mundl-Petermeier Andrea
Published: October 2022

The Bushveld Complex of South Africa is underlain by a fine-grained sill complex which most workers interpret to represent the quenched parent magmas to the intrusion. The sills have unusually high Pt contents (up to ~ 25 ppb) and Pt/Pd ratios (average 1.50) exceeding those in most other mantle magmas globally. Unusually high Pt/Pd is also found in many Bushveld cumulates. Understanding the origin of the high Pt/Pd is important for exploration, in view of the contrasting monetary value of the metals, but also for unravelling the petrogenesis of the intrusion. Here, we review existing platinum-group element (PGE) data and present the first radiogenic W isotope data on a Bushveld rock, to evaluate a range of potential models, including PGE fractionation prior to final magma emplacement and within the Bushveld magma chamber, magma derivation from the sub-continental lithospheric mantle (SCLM), contamination of Bushveld magma with Pt-rich continental crust, and a meteoritic component in the mantle source to the magmas or in the crust with which the magmas interacted. We identify three key processes causing fractionation of metals prior to final magma emplacement and within the Bushveld chamber, namely crystallisation of Pt alloys, partial melting of cumulus sulfides triggered by flux of volatiles followed by sulfide melt percolation, and mobilisation of PGE by percolation of volatiles through the cumulate pile. The currently available W and Ru isotope data are inconsistent with derivation of the Bushveld magmas from mantle or crustal sources containing an enhanced meteoritic component relative to normal post-Hadean mantle.
Optimal design of steel–concrete composite bridge based on a transfer function discrete swarm intelligence algorithm
Authors: Martínez-Muñoz David , García Jose , Martí Jose V. , Yepes Víctor
Published: October 2022

Bridge optimization can be complex because of the large number of variables involved in the problem. In this paper, two box-girder steel–concrete composite bridge single objective optimizations have been carried out considering cost and CO$$_{2}$$2emissions as objective functions. Taking CO$$_{2}$$2emissions as an objective function allows to add sustainable criteria to compare the results with cost. SAMO2, SCA, and Jaya metaheuristics have been applied to reach this goal. Transfer functions have been implemented to fit SCA and Jaya to the discontinuous nature of the bridge optimization problem. Furthermore, a Design of Experiments has been carried out to tune the algorithm to set its parameters. Consequently, it has been observed that SCA shows similar values for objective cost function as SAMO2 but improves computational time by 18% while also getting lower values for the objective function result deviation. From a cost and CO$$_{2}$$2optimization analysis, it has been observed that a reduction of 2.51 kg CO$$_{2}$$2is obtained by each euro reduced using metaheuristic techniques. Moreover, for both optimization objectives, it is observed that adding cells to bridge cross-sections improves not only the section behavior but also the optimization results. Finally, it is observed that the proposed design of double composite action in the supports allows to remove continuous longitudinal stiffeners in the bottom flange in this study.
Changes in beer bitterness level during the beer production process
Authors: Klimczak Krystian , Cioch-Skoneczny Monika
Published: October 2022

Beer has been enjoyed by consumers for years. Today, hops are inextricably associated with this beverage. Although they have been the subject of research for decades, knowledge of their bittering components and interactions during the beer production process is still incomplete. Current literature clearly indicates that the bitterness experienced in beer comes from a much wider range of compounds than just iso-α-acids. Although compounds that can be classified into β-acids, humulinones, hulupones, hard resins, and polyphenols are characterized by lower levels of bitterness and are present in hops in lower quantities than α-acids, they might determine, together with them, the final level of bitterness in beer. Unlike α-acids, the influence of compounds from these groups, their transformations, changes in their content during the beer production process and factors that affect their final concentration in beer have not yet been thoroughly studied. In case of α-acids, it is known that factors, such as chemical composition of wort, its extract and pH, amount of hops added and α-acids’ content, boiling time, and temperature at which hops were added influence the level of bitterness. This phenomenon is further complicated when dry hopping is used. Due to the presence of humulinones, polyphenols, and α-acids, a relatively simple spectrophotometric determination of IBU can give erroneous results. IBU determination, especially in dry-hopped beers, should be coupled with HPLC analysis, taking into account appropriate bitterness coefficients.
The Medical Historical Cultural Foundations of Western Nasal Surgery from Ancient Greece to the Middle Ages
Authors: Marinozzi Silvia , Carbonaro Riccardo , Messineo Daniela , Raposio Edoardo , Codolini Luca , Sanese Giuseppe , Cervelli Valerio
Published: October 2022

The manuscript aims to clarify the origins of Western rhinosurgery through the ancient texts of the greatest physicians of the past, up to the Byzantine Era, focusing on the “exchange of knowledge” between peoples. This excursus is carried out by quoting the texts of the greatest doctors of the past, such as Hippocrates, Galen and Celsus and by analysing the works of Byzantine authors such as Oribasius, Aetius, Antillus, which, more than others, represent the moment of fusion and interpenetration of Ancient Medical knowledge, paving the way for the Medieval Scholae Medicae in the West. The aim, therefore, is to fill that sort of "great gap" (from the foundation of Constantinople in the 4th century AD to the early Arab culture in the 11th century AD) due to the fact that figures such as Branca, Vianeo and, finally, Tagliacozzi, are considered direct actors of a recovery of the “ancient knowledge” of classic authors. This literature tends to less evaluate, instead, that important and huge cultural exchange -literally osmotic- in medical and surgical knowledge between peoples and civilizations, that find a trait d'union in the application of medical knowledge and surgical practical techniques matured in the Byzantine, Arab and Early Medieval period. In final analysis, through the History of Rhinosurgery, this paper aims to highlight how Western medical knowledge is made up of the ensemble of cultures which are apparently distant and different from each other, which merge themselves in a truly universal and transcultural knowledge: the Medical knowledge.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Endoscopic Anterior Component Separation and Transversus Abdominus Release are not Associated with Increased Wound Morbidity Following Retromuscular Incisional Hernia Repair
Authors: Gaspar Freia J. L. , Midtgaard Helle G. , Jensen Anna K. , Jørgensen Lars N. , Jensen Kristian K.
Published: October 2022

Introduction

Traditional anterior component separation during incisional hernia repair (IHR) is associated with a high rate of postoperative wound morbidity. Because extensive subcutaneous dissection is avoided by endoscopic anterior component separation (eACS) or open transversus abdominis release (TAR), we hypothesized that these techniques did not increase the incidence of surgical site occurrence (SSO) compared to IHR without component separation (CS).

Material and method

This was a retrospective single‐center cohort study of patients undergoing open retromuscular IHR comparing patients with or without the use of CS. Retromuscular mesh repair was performed in all patients, and CS was obtained by eACS or TAR. The primary outcome was 90‐day incidence of postoperative SSO. Secondary outcomes included length of stay (LOS), 90‐day readmission, 90‐day reoperation rate and 3‐year recurrence rate.

Results

A total of 321 patients underwent retromuscular repair, 168 (52.3%) of whom received either eACS or TAR. The addition of eACS or TAR was associated neither with development of SSO (odds ratio: 1.80, 95% confidence interval: 0.94–3.46, P = 0.077) nor with hernia recurrence (hazard ratio 0.77, 0.26–2.34, P = 0.648). There was no significant difference between the groups regarding the frequencies of 90‐day readmission or 90‐day reoperation.

Conclusion

eACS or TAR as adjuncts to open retromuscular IHR were not associated with increased wound morbidity or hernia recurrence.
The prevalence of foot health problems in people living with a rheumatic condition: a cross-sectional observational epidemiological study
Authors: Stolt Minna , Laitinen Anne-Marie , Kankaanpää Katja , Katajisto Jouko , Cherry Lindsey
Published: October 2022

This study aimed to determine the prevalence of foot health problems in people living with any rheumatic condition and explore potential associations with exposure variables. A cross-sectional observational epidemiological design was applied. The participants were recruited from one regional patient association in southwest Finland. The data were collected in January–February 2019 and included the Self-reported Foot Health Assessment Instrument (S-FHAI) and demographic questions. In total, 495 responses were obtained. Overall, participants had many foot problems. The point prevalence of self-reported foot problems was 99 per 100 people living with a rheumatic condition. The most prevalent problems were foot pain (73%), dry soles (68%), thickened toenails (58%) and cold feet (57%). Lower educational attainment, increased amount of daily standing and accessing medical or nursing care for foot problems were associated with poorer foot health. The results reveal a high frequency of foot pain among people with rheumatic conditions. The study highlighted the importance of person-centred care and the biological focus that underpins and impacts foot health (what we understand, what we do, and our health-seeking behaviour). Interventions to promote biopsychosocial approaches to personalised foot care could advance people’s readiness, knowledge and skill to care for their own feet.
Low frequency-to-intensity noise conversion in a pulsed laser cavity locking by exploiting carrier envelope offset
Authors: Canella Francesco , Suerra Edoardo , Giannotti Dario , Galzerano Gianluca , Cialdi Simone
Published: October 2022

We report on the dependence of the frequency-to-intensity noise conversion in the locking of an ultrafast laser against a high-finesse optical enhancement resonator from the carrier envelope offset frequency. By a proper combination of the cavity finesse and laser carrier envelope offset frequency, it is possible to optimize the signal-to-noise ratio of the laser intensity trapped into the optical resonator. In this paper, we describe the effect of the laser-enhancement cavity coupling on the intracavity power relative noise, and we demonstrate both theoretically and experimentally its reduction.
Diagnosis and treatment of benign adipocytic tumors in children
Authors: Pérez Daza Laura Daniela , González Villarreal Laura Camila , Sánchez Rodríguez Laura Camila , Molina Ramírez Iván Darío , Quintero Canasto Edna Margarita
Published: October 2022

Purpose

To describe demographic, clinical, diagnostic and therapeutic aspects of pediatric patients with benign adipocytic tumors admitted to a high complexity teaching hospital from 2007 to 2021.

Methods

Retrospective observational descriptive study. Patient information was retrieved from clinical records. A descriptive analysis was carried out for qualitative data and frequencies were calculated for quantitative data.

Results

76 patients were included with a mean age of 7.5 years old where 60.5% were boys. The main symptom was a mass (73.7%) mostly found in the lower limbs (23.6%). Congenital birth defects were identified in 48.6% of the cases. Preoperative imaging was available in 78.9% of the patients allowing characterization of lesions or differential diagnosis. The therapeutic goal was resection with negative margins, which was feasible in all cases except for one case. The histopathological diagnosis was lipoma in 68.4% of the cases followed by lipoblastoma in 13.1%. The mean follow-up period was 17.9 months. 79.7% of the patients were asymptomatic at their last out-patient visit.

Conclusion

Benign adipocytic tumors constitute a wide spectrum of lesions, which involve diverse anatomic segments from the neural axis to the inguinoscrotal region. The present work contributes to the general understanding of the clinical presentation and differential diagnosis for these infrequent neoplasms.
Development and validation of a nomogram to predict overall survival in young non-metastatic rectal cancer patients after curative resection: a population-based analysis
Authors: Jia Zhenya , Wu Huo , Xu Jing , Sun Guoping
Published: October 2022

Purpose

This study aimed to establish and validate a nomogram for predicting overall survival (OS) in young non-metastatic rectal cancer (RC) patients after curative resection.

Methods

Young RC patients (under 50 years of age) from 2010 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Those patients randomly assigned to a training cohort and a validation cohort at a ratio of 7:3. The independent prognostic factors for OS were identified by univariate and multivariate Cox regression analysis. A nomogram model was built based on the independent prognostic variables and was evaluated by concordance index (C-index), receiver operating characteristics (ROC) curves, calibration plot, and decision curve analysis (DCA).

Results

A total number of 3026 young RC patients were extracted from SEER database. OS nomogram was constructed based on race, histological type, tumor grade, T stage, N stage, carcinoembryonic antigen (CEA) level, and number of lymph nodes (LN) examined. C-index, ROC curves, calibration plot, and DCA curves presented satisfactory performance of the above nomogram in predicting the prognosis of young non-metastatic RC patients after curative resection. The nomogram can identify three subgroups of patients at different risks, which showed different prognostic outcomes both in the training cohort and validation cohort.

Conclusion

We successfully established a reliable and insightful nomogram to predict OS for young non-metastatic RC patients after curative resection. The nomogram may provide accurate prognosis prediction to guide individualized follow-up and treatment plans.
Influence of light conditions (colour temperature and illuminance) on the evaluation of root translucency for the application of Lamendin’s age-at-death estimation technique
Authors: Viciano Joan , Icaro Iuri , Tanga Carmen , Tripodi Domenico
Published: October 2022

Estimation of age-at-death represents a central focus in forensic human identification, as it is a key parameter used in the identification of unidentified bodies. In 1992, Lamendin et al. published a simple technique for estimating the age-at-death of adult skeletal remains based on two dental criteria: the gingival regression and the extent of dentine translucency. Although Lamendin’s technique is widely used in forensic contexts and the evaluation of root translucency is a key element in the technique, the light conditions for measuring this parameter have not been adequately established. The aim of the present study is to analyse the influence of colour temperature and illuminance level of a LED light source when root translucency is evaluated to optimize the use of Lamendin’s technique for age-at-death estimation. The results describe how light settings may affect the visual perception of root translucency by different examiners and, therefore, affect the accuracy of the age-at-death estimation methods and techniques based on this parameter.
A century of exercise physiology: lung fluid balance during and following exercise
Authors: Miserocchi Giuseppe , Beretta Egidio
Published: October 2022

Purpose

This review recalls the principles developed over a century to describe trans-capillary fluid exchanges concerning in particular the lung during exercise, a specific condition where dyspnea is a leading symptom, the question being whether this symptom simply relates to fatigue or also implies some degree of lung edema.

Method

Data from experimental models of lung edema are recalled aiming to: (1) describe how extravascular lung water is strictly controlled by “safety factors” in physiological conditions, (2) consider how waning of “safety factors” inevitably leads to development of lung edema, (3) correlate data from experimental models with data from exercising humans.

Results

Exercise is a strong edemagenic condition as the increase in cardiac output leads to lung capillary recruitment, increase in capillary surface for fluid exchange and potential increase in capillary pressure. The physiological low microvascular permeability may be impaired by conditions causing damage to the interstitial matrix macromolecular assembly leading to alveolar edema and haemorrhage. These conditions include hypoxia, cyclic alveolar unfolding/folding during hyperventilation putting a tensile stress on septa, intensity and duration of exercise as well as inter-individual proneness to develop lung edema.

Conclusion

Data from exercising humans showed inter-individual differences in the dispersion of the lung ventilation/perfusion ratio and increase in oxygen alveolar-capillary gradient. More recent data in humans support the hypothesis that greater vasoconstriction, pulmonary hypertension and slower kinetics of alveolar-capillary O2 equilibration relate with greater proneness to develop lung edema due higher inborn microvascular permeability possibly reflecting the morpho-functional features of the air–blood barrier.
The spread of SARS-CoV-2 at school through the different pandemic waves: a population-based study in Italy
Authors: Pistellato Ilaria , Fonzo Marco , Calzavara Andrea , Sorrentino Paola , Selle Vittorio , Sbrogiò Luca Gino , Bertoncello Chiara
Published: October 2022

Proactive school closures are often considered an effective strategy by policy-makers and the public to limit SARS-CoV-2 transmission. While evidence on the role of students in the spread is debated, the effects of closures on children's well-being are well known. In the light of this, we aimed to assess viral spread in educational settings, by calculating the rate of secondary infections per school class and identifying factors associated with cluster generation. We conducted a combined longitudinal and cross-sectional population-based study between October 2020 and November 2021. Secondary screening was conducted whenever a SARS-CoV-2 positive subject had been in the school environment in 48 h prior to symptoms onset or on the date of swab, if asymptomatic. The effect of selected variables on COVID-19 cluster generation was assessed by logistic regression. We identified 1623 primary COVID-19 cases. Of these, 72.5% resulted in no secondary case, 15.6% in 1, and 11.9% in 2 + . The probability of generating a 2 + cluster was lower when the index case was a student, rather than school staff (AOR = 0.42; 95%CI: 0.29–0.60). The number of clusters per week was in line with COVID-19 incidence trend in the general population.

Conclusions: Index cases at school led to no secondary case in about three out of four times and only to a secondary case in about 15%. School environment does not facilitate viral spread, but rather reflects circulation in the community. Appropriate measures and timely monitoring of cases make school a safe place. Given the effects on children’s learning and well-being, it is essential to favour school attendance over distance learning.

What is Known:• During the COVID-19 pandemic, most European countries resorted to school closures to counter viral transmission.• Although the scientific debate on the suitability of school closures as a non-pharmaceutical intervention is still open and the role of school children in facilitating the spread of SARS-CoV-2 is not supported by unequivocal evidence, there is now a growing awareness of the impact on children's well-being.

What is New:• The contribution of educational settings and students in facilitating viral spread appears limited, as exposure to a positive individual in the school environment led to no secondary cases among students in 72% of cases and only one secondary case in about 15%.• The likelihood of generating school clusters was approximately halved when the index case was a student compared to teachers or other school personnel.
Feasibility of a comprehensive medication review to improve medication use for patients with cancer and comorbid conditions
Authors: Mackler Emily R. , Azar Michelle K. , Johengen Emily , Farris Karen B. , Thompson Amy N.
Published: October 2022

Purpose

A focus on oral medications for patients receiving care from both oncologists and primary care providers elicits an opportunity for improvement in patient outcomes. The purpose of this pilot study was to explore the feasibility and appropriateness of a comprehensive medication review (CMR) by a primary care pharmacist in a population of patients with cancer and chronic conditions.

Methods

Adult patients who received both cancer and primary care at Michigan Medicine, received active systemic cancer treatment, and had a comorbid condition of diabetes, hypertension, chronic heart failure, depression, and/or anxiety were eligible to receive a CMR by the primary care clinical pharmacist. Data collected included number eligible for the CMR (feasibility), patient demographics, medication-related problems (MRPs) and medication interventions (appropriate), number of patients requiring follow-up with the clinical pharmacist or physician, and pre/post-intervention changes in A1c and BP, as applicable.

Results

Of the 96 patients that met inclusion criteria, 55 patients (57%) received a CMR. Pharmacists provided 66 instances of patient education and identified 22 medication-related problems (MRPs) in 15 (27%) of patients. After CMRs were completed, 22 patients (40%) were referred to primary care pharmacists or physician providers for ongoing care.

Conclusion

A CMR was feasible and appropriate for patients with chronic conditions receiving treatment for cancer.
War in Ukraine: a neurosurgical perspective
Authors: Dubinski Daniel , Kolesnyk Volodymyr
Published: October 2022

Background

The ongoing war in Ukraine leads to the destruction of critical infrastructure and the displacement of millions of civilians while the necessity for neurosurgical care has increased tremendously. The consequences of this armed conflict on the practice of neurosurgery are uncertain to date.

Methods

A cloud-based questionnaire including 10 single- and multiple-choice questions was sent through the email distribution list of the Ukrainian Neurosurgical Society and the Association of Neurosurgeons of Ukraine.

Results

Between June 2022 and July 2022, a link to the online survey was distributed to a total of 134 (100%) departments of neurosurgery across Ukraine. After 21 days of being available, a total of 96 questionnaires (72%) returned.

Conclusions

The survey highlights the field of activity as well as the severe impact on professional and personal life of Ukrainian neurosurgeons during the ongoing war.
Comparative study of the modified VISTA technique (m-VISTA) versus the coronally advanced flap (CAF) in the treatment of multiple Miller class III/RT2 recessions: a randomized clinical trial
Authors: Fernández-Jiménez Aitziber , Estefanía-Fresco Ruth , García-De-La-Fuente Ana María , Marichalar-Mendia Xabier , Aguirre-Urizar José Manuel , Aguirre-Zorzano Luis Antonio
Published: October 2022

Objectives

To compare the percentage of mean root coverage (MRC%) obtained in the treatment of multiple Miller class III/RT2 gingival recessions using the modified VISTA (m-VISTA) technique versus the coronally advanced flap (CAF) technique, using a connective tissue graft (CTG) in both cases.

Materials and methods

Twenty-four patients were randomly treated with m-VISTA (test group (TG) = 12) or CAF (control group (CG) = 12). A calibrated, experienced, and blinded examiner collected data related to multiple periodontal clinical variables, especially the recession (REC) in order to calculate the MRC% at 6 and 12 months, which was the primary outcome of the study. Also, the radiological bone level, the characteristics of the CTG, and postsurgical incidences were assessed. Finally, a descriptive and an analytical statistical analysis of the variables and their associations was performed.

Results

The recessions (n = 84) were located mainly in the mandible (n = 65) and in posterior sectors (premolars: n = 35; molars: n = 8). At 6 months, the MRC% was 61% (2 mm) for both study groups, and at 12 months, it increased to 73.26% (2.11 mm) in the TG and decreased to 56.49% (1.78 mm) in the CG.

Conclusion

When approaching multiple Miller class III/RT2 recessions, there were no statistically significant differences in the MRC% at 6 and 12 months between the group treated with the m-VISTA technique and the group treated with the CAF.

Clinical relevance

The characteristics of the m-VISTA technique, such as the closed approach, the mobilization of the papilla, and the coronal stabilization of the CTG, could facilitate the maturation of the tissues in the treatment of Miller class III/RT2 recessions. This would favor better root coverage.

Trial registration

NCT03258996.
Auswirkungen der Fit-for-55-Instrumente auf die Preise in der Luftfahrt
Authors: Ehlers Thorsten , Kölker Katrin , Lütjens Klaus
Published: October 2022

Die Europäische Union strebt mit den Maßnahmen des Fit-for-55-Pakets eine Verringerung der CO2-Emissionen bis 2030 um 55% an, verglichen mit dem Stand von 1990. Diese Reduktion soll durch verschiedene Maßnahmen erreicht werden, die auch die kommerzielle Luftfahrt betreffen. Dies sind unter anderem eine Verschärfung des Emissionshandels, bei der insbesondere die frei zugeteilten Zertifikate zügig abgebaut werden sollen, eine verpflichtende Beimischungsquote für nachhaltige Flugtreibstoffe an europäischen Flughäfen sowie eine europaweite Mindesthöhe für Steuern auf Treibstoffe. Dadurch verteuern sich die Flüge in verschiedenen Gebieten unterschiedlich.
Regionale Wasserstoffpotenziale
Authors: Bräuninger Michael , Stiller Silvia , Teuber Mark-Oliver
Published: October 2022

The paper analyses the potential of the hydrogen economy in German districts and cities. The paper focuses particularly on regions suffering from strong ongoing structural change. The assessment is based on quantitative indicators for the supply structures (renewable energy, pipeline network), the demand side (industry, transport and heat), and on regional knowledge (research institutions and projects). The results show four regional clusters suffering from structural change that could potentially establish a hydrogen economy. These regions will benefit from investments in hydrogen structures and the associated strengthening of regional value chains.
Differential effects and success stories of distance education in Covid-19 lockdowns on the development of reading comprehension in primary schools
Authors: Segers Eliane , In ’t Zandt M. , Stoep J. , Daniels L. , Roelofs J. , Gubbels J.
Published: October 2022

In the current study, the development in reading comprehension performance of students in lower-SES versus higher-SES schools during and after school closures due to Covid-19 lockdowns was examined, and compared to a normed reference group. Furthermore, we explored protective factors against negative effects at the time of school closures, by pinpointing successful practices in a sub sample of resilient lower-SES schools. The total sample consisted of 2202 students followed from grade 2–4. Overall, we found that students in lower-SES schools made less progress over time than students in higher-SES schools. On average, students made less progress during the lockdowns, but here, the interaction with SES was not significant. Students' reading comprehension levels partially recovered after the lockdowns. Questionnaire-data revealed that schools were better prepared during the second lockdown, with teachers making more use of digital means, and providing more online reading instruction. In addition, collaboration with the parents seemed to have improved. The in depth interviews with resilient lower-SES schools revealed that the introduction of online education and investing in educational partnerships with parents may have helped to minimize the negative impact of lockdowns. We conclude that lockdowns have a negative effect on the development of reading education, but that students are resilient. Digital means and partnership with parents may be seen as protective factors to attenuate the negative effects of emergency remote teaching.
Mates and the hierarchy
Authors: Rattan Gurpreet , Durand Marion
Published: October 2022

Mates’s Puzzle has flown below many philosophers’ radar, despite its relations to both Frege’s Puzzle and the Paradox of Analysis. We explain the relations amongst these puzzles on the way to arguing that Mates’s Puzzle suggests a generalization of Frege’s Puzzle, and of the sense-reference distinction itself, in the form of hierarchy of senses. We explain how Mates’s Puzzle and the hierarchy, to different degrees, illuminate each other, and how their connection is missed in the literature. However, we argue that the potential of Mates’s Puzzle to illuminate the hierarchy is yet to be fully actualised. We suggest that in order to do better, we need to formulate Mates’s Puzzle as a puzzle in the philosophy of thought and not as puzzle in the philosophy of language. What is needed, to which the present paper is a precursor, is an account of the cognitive significance of higher-order senses.
Seroprevalence of camel brucellosis in Qatar
Authors: Alhussain Hashim , Zughaier Susu M. , Gawish Ahmed , Mahmoud Mahmoud H. , Yassine Hadi M. , Al Thani Asmaa , Obied Tahra El- , Al-Zeyara Abdulaziz M. , Eltai Nahla O.
Published: October 2022

Brucellosis is a significant zoonotic disease and one of the most common neglected diseases worldwide. It can infect a wide range of domestic and wild animal species. Infected animals are usually culled, causing substantial economic losses to animal owners and the country’s economy in general. The disease is endemic among cattle, sheep, and goats in many countries around the Middle East and prevalent in most Gulf Cooperation Council countries, comprising a significant public health risk in the region. This study investigated the seroprevalence of brucellosis among camels in Qatar. Two hundred and forty-eight samples were collected from dromedary camels from 28 farms across the entire country. Each sample was tested for Brucella antibodies with both Rose Bengal and competitive enzyme-linked immunosorbent assay. Only samples that tested positive by both tests were considered seropositive for brucellosis. The overall prevalence was (20.6%, 95% CI, 15.7–26.1). The association between sex and seropositivity was slightly significant (Χ2 = 4.32, P = 0.04), with higher seroprevalence in females. Camels below breeding age (i.e., < 4 years old) showed decreased seropositivity (3.4%, 95% CI, 0.1–17.8), compared to (22.8%, 95% CI, 17.4–29.0) seropositivity in camels ≥ 4 years of age, with a significant association between age groups and seropositivity (P = 0.02). Our results indicate that the seroprevalence of brucellosis in Qatar’s camels is alarming, mandating more efforts to control the disease. The findings of this study will aid in selecting better effective measures to control camel brucellosis in Qatar. Further studies need to be conducted on Brucella infection among camels to determine the predisposing risk factors and the steps that should be followed to control brucellosis.
Concentration of mercury in human hair and associated factors in residents of the Gulf of Trieste (North-Eastern Italy)
Authors: Cegolon Luca , Petranich Elisa , Pavoni Elena , Floreani Federico , Barago Nicolò , Papassissa Elisa , Larese Filon Francesca , Covelli Stefano
Published: October 2022

The Gulf of Trieste (Northern Adriatic Sea, Italy) is the coastal area of the Mediterranean Sea most highly contaminated by mercury (Hg) due to fluvial inputs from the Isonzo/Soča River system, draining over 500 years’ worth of cinnabar extraction activity from the Idrija mining district (Western Slovenia). The aim of this research is to investigate the concentration of Hg in hair samples taken from the general population of the Friuli Venezia Giulia (FVG) Region coastal area, as a marker of chronic exposure to Hg. Three hundred and one individuals — 119 males and 182 females — were recruited by convenience sampling in Trieste in September 2021. An amount of approximately 100 mg of hair was collected from the occipital scalp of each participant to measure the respective Hg concentrations (expressed as mg/kg). Moreover, participants completed a self-report questionnaire collecting extensive socio-demographic and life-style information. A multiple linear regression analysis was employed to investigate factors associated with increased levels of Hg concentration in hair. A mean Hg concentration in hair of 1.63 mg/kg was found, slightly above the 1.0 mg/kg threshold recommended by the WHO for pregnant women and children, although still well below the no observed adverse effects level (NOAEL) of 10 mg/kg. Among respondents, 55.6% showed a Hg concentration in hair > 1 mg/kg, 22.9% > 2 mg/kg, and 2 participants exhibited Hg levels > 10 mg/kg. The adjusted mean hair Hg level increased in those subjects who reported a preference for shellfish/crayfish/mollusks (RC = 0.35; 95%CI: 0.16; 0.55), whereas it decreased in those who reported a preference for frozen fish (RC = -0.23; 95%CI: − 0.39; − 0.06). Though a risk alert for Hg exposure for coastal residents from FVG is deemed unnecessary at this time, it is recommended that pregnant women limit their ingestion of locally caught fish to < 4 servings/month.
Interactive visual exploration of surgical process data
Authors: Mayer Benedikt , Meuschke Monique , Chen Jimmy , Müller-Stich Beat P. , Wagner Martin , Preim Bernhard , Engelhardt Sandy
Published: October 2022

Purpose

Integrated operating rooms provide rich sources of temporal information about surgical procedures, which has led to the emergence of surgical data science. However, little emphasis has been put on interactive visualization of such temporal datasets to gain further insights. Our goal is to put heterogeneous data sequences in relation to better understand the workflows of individual procedures as well as selected subsets, e.g., with respect to different surgical phase distributions and surgical instrument usage patterns.

Methods

We developed a reusable web-based application design to analyze data derived from surgical procedure recordings. It consists of aggregated, synchronized visualizations for the original temporal data as well as for derived information, and includes tailored interaction techniques for selection and filtering. To enable reproducibility, we evaluated it across four types of surgeries from two openly available datasets (HeiCo and Cholec80). User evaluation has been conducted with twelve students and practitioners with surgical and technical background.

Results

The evaluation showed that the application has the complexity of an expert tool (System Usability Score of 57.73) but allowed the participants to solve various analysis tasks correctly (78.8% on average) and to come up with novel hypotheses regarding the data.

Conclusion

The novel application supports postoperative expert-driven analysis, improving the understanding of surgical workflows and the underlying datasets. It facilitates analysis across multiple synchronized views representing information from different data sources and, thereby, advances the field of surgical data science.
Kind – und dann? Wandel partnerschaftlicher Erwerbsverläufe drei Jahre nach dem Übergang in die Elternschaft
Authors: Kelle Nadiya , Romeu Gordo Laura , Simonson Julia
Published: October 2022

Der Übergang in die Elternschaft markiert für viele Elternpaare den Übergang in geschlechterspezifische Erwerbsarrangements, oft unabhängig von der gelebten vorgeburtlichen Arbeitsteilung. Dabei können die Entscheidungen über die Erwerbsarrangements nach der Geburt des ersten Kindes richtungsgebend für die zukünftigen Erwerbsverläufe und Alterssicherung sein. Vor diesem Hintergrund fokussiert der Beitrag auf zwei Fragen: erstens, ob sich gerade für jüngere Elternpaare der in den 1980er-Jahren Geborenen eine Konvergenz in den Erwerbsverläufen nach dem Übergang in die Elternschaft im Vergleich zu den in den 1970er-Jahren geborenen Elternpaaren zeigt und zweitens, ob die Arbeitsteilung vor dem Übergang in die Elternschaft eine zunehmende Rolle für die Erwerbskonstellationen danach spielt. Unter Verwendung der Daten des Sozio-oekonomischen Panels (SOEP) werden anhand sequenz-, cluster- und regressionsanalytischer Verfahren Erwerbsverläufe von 900 Paaren über 36 Monate nach dem Übergang in die Elternschaft analysiert. Für die Kohorte der in den 1980er-Jahren Geborenen setzt sich die Bedeutungsabnahme traditioneller Erwerbsarrangements fort. Zudem gibt es immer mehr Elternpaare, in denen beide Elternteile relativ schnell nach der Geburt eines Kindes in die Erwerbstätigkeit zurückkehren. Kaum zu beobachten ist, dass Väter ihre Erwerbstätigkeit zunehmend zugunsten einer stärkeren Einbindung in Haushalts- oder Familientätigkeiten einschränken. Hingegen scheinen die Konvergenzen in den Erwerbsverläufen zwischen Müttern und Vätern vielmehr ein Resultat zunehmender Erwerbsdiskontinuitäten zu sein. Darüber hinaus hat die vorgeburtliche Arbeitsteilung auch für die jüngeren Elternpaare einen eher geringen Einfluss auf ihre nachgeburtlichen Erwerbskonstellationen. Die Ergebnisse legen nahe, dass der Abbau von geschlechterspezifischen Ungleichheiten am Arbeitsmarkt verstärkt voranzutreiben ist, damit weitere Anreize für die gleichmäßigere Erwerbsaufteilung im Paarkontext entstehen können.
Surgical Principles in the Management of Lung Neuroendocrine Tumors: Open Questions and Controversial Technical Issues
Authors: Brascia Debora , Marulli Giuseppe
Published: October 2022

Opinion statement

Primary neuroendocrine tumors (NETs) of the lung represent a heterogeneous group of malignancies arising from the endocrine cells, involving different entities, from well differentiated to highly undifferentiated neoplasms. Because of the predominance of poorly differentiated tumors, advanced disease is observed at diagnosis in more than one third of patients making chemo- or chemoradiotherapy the only possible treatment. Complete surgical resection, as defined as anatomical resection plus systematic lymphadenectomy, becomes a reliable curative option only for that little percentage of patients presenting with stage I (N0) high-grade NETs. On the other hand, complete surgical resection is considered the mainstay treatment for localized low- and intermediate-grade NETs. Therefore, in the era of the mini-invasive surgery, their indolent behavior has suggested that parenchyma-sparing resections could be as adequate as the anatomical ones in terms of oncological outcomes, leading to discuss about the correct extent of resection and about the role of lymphadenectomy when dealing with highly differentiated NETs.
Awareness-independent gradual spread of object-based attention
Authors: Huang Ling , Chen Yu , Shen Shiqi , Ye Haoxian , Ou Shipei , Zhang Xilin
Published: October 2022

Although attention can be directed at certain objects, how object-based attention spreads within an object and whether this spread interacts with awareness remain unclear. Using a modified spatial cuing paradigm with backward masking, we addressed these issues with either visible or invisible displays presenting the real (Experiment 1) and illusory (Experiment 2) U-shaped objects (UOs), whose ends and middles, the possible locations of the cue and target, have iso-eccentric distances from the fixation. These equidistant ends and middles of UOs offered us a unique opportunity to examine whether attention gradually spreads within a given object, i.e., within an UO, attention spreads from its cued-end to uncued-end via the uncued-middle. Despite the visibility (visible or invisible) of UOs, both experiments supported this gradual spread manner by showing a faster response of human participants (male and female) to the target in the uncued-middle than that in the uncued-end. Our results thus indicate a gradual spread of object-based attention and further reveal that this gradual spread is independent of both the “visual objectness” (whether the object is defined as the real or illusory boundaries) and conscious access to objects.