bluuebunny/crossref_metadata_2025 huggingface dataset:
Production of biodiesel over ZnO-TiO2 bifunctional oxide catalyst supported on natural zeolite
Authors: Al Muttaqii M , Amin M , Prasetyo E , Alviany R , Marlinda L
Published: December 2021

In this paper, biodiesel is produced from palm oil and methanol via the transesterification process over the heterogeneous catalyst. The metal oxide ZnO-TiO2 was impregnated into natural zeolite over the dry impregnation method. The ZnO-TiO2/NZ catalyst was prepared over the dry impregnation method. The catalysts' characteristic was characterized by X-ray diffraction (XRD) and Scanning Electron Microscope (SEM). The biodiesel was analyzed by Fourier-Transform Infrared Spectroscopy (FTIR) and Gas Chromatography-Mass Spectrometry (GC-MS). The results showed a functional group of methyl ester (C=O, carbonyl group) at 1744.51 cm-1. The components of methyl ester such as hexadecanoic acid methyl ester (C17), cis-9-heptadecanoic acid methyl ester (C18), oleic acid methyl ester (C19), are present in the biodiesel with the percent area of 0.05%, 0.08%, 0.63%, 7.06%, 16.3%, respectively, over ZnO-TiO2/NZ catalyst with a metal ratio of 1:1. This catalyst was successful in the transesterification of palm oil to produce biodiesel.
Fabrication of Norbixin-Sensitized Solar Cell and The Effect of Light Intensity on Its Performance and Reusability
Authors: Rahmalia W , Crespo E , Usman T
Published: December 2021

Dye-sensitized solar cell (DSSC) is a third-generation solar cell that has been developed as one of the clean and renewable alternative energies. This study aims to fabricate norbixin-sensitized solar cell (NSSC). Norbixin was obtained from the saponification followed by acidification of bixin and characterized using UV-Visible and FTIR spectroscopy. The solar cell was assembled using anatase-TiO2semiconductor, KI/I2/MPII in acetonitrile as the electrolyte, and a platinum paste-based cathode. The UV-Visible spectrophotometry analysis results showed three peaks of carotenoid characteristics at 434, 457, and 486 nm. The formation of norbixin was proved by the absence of a spectral peak for the C-O-C ester group of bixin at 1254 dan 1159 cm-1” The cells performance test showed that the maximum energy conversion efficiency of NSSC increased with increasing light intensity up to 0.08 W/cm2. Exposure to the light above this intensity causes a decrease in the maximum energy conversion efficiency due to the temperature factor. The data also showed that the cell assembled was reusable. It still showed relatively good performance until the third day of analysis.
Green technologies for air pollution treatment by microalgae in tubular photobioreactor
Authors: Minh T T , Tien N H , Giang L V , Loc H H , Hien V T D , Tran T
Published: December 2021

Air pollution in general and motorcycle exhaust, in particular, is a big problem attracting a lot of attention from people and researchers worldwide because of the significant impacts it has on humans and the environment. The issue of air pollution is growing, and the impact is more evident than ever. Carbon dioxide represents a series of problems that we face daily but have not yet been effectively solved. Currently, microalgae are known to photosynthesize and use free CO2, bicarbonate ions as a source of nutrients to grow. Microalgae are developed under appropriate environmental conditions, which will bring admirable CO2 treatment efficiency and obtain biomass for other applications. The study approach was an inexpensive and natural air purification solution by microalgae, which is designed as a tubular photobioreactor. The study was conducted by evaluating the ability of Chlorella Vulgaris to grow and absorb CO2 emissions in the newly established system with exhaust gas supplied from a mini motorcycle engine. The results showed that microalgae grew stably in the tubular photobioreactor system with a biomass concentration of 6×106 cells/ml after 42 days of the experiment. Simultaneously with the stable growth of microalgae, the CO2 emission concentration was reduced with 26.59% absorption efficiency after 11 days of the experiment. Finally, establishing the tubular photobioreactor technology system has yielded impressive initial results in cultivating stable growing microalgae combined with CO2 emission treatment.
Coral reef monitoring in Panjang Island, Central Bangka
Authors: Adi W , Akhrianti I , Hudatwi M
Published: December 2021

Bangka Island is the largest tin producer in Indonesia and since the granting of tin mining freedom in 2000, unconventional tin mining (TI) is increasingly prevalent. The existence of mining activities will directly or indirectly damage the environment both on land and at sea. Especially the high biodiversity of coral reef ecosystem. The purpose of this research was to analyze a map of the distribution of coral reef based on Sentinel 2A satellite imagery data. Analyze the extent of the coral reefs in shallow waters of Putri Island, and analyze of the condition coral reefs (percentage cover, mortality index and genus diversity) with using collaboration betwen the coral diving data and remote sensing data. Studies of changes in coral reef ecosystems have been ongoing since several decades ago. The combination of satellite imagery and aerial photographs is capable of making long-term and continuous observations on mapping and change detection. Remote sensing technology has several advantages overconventional sampling to monitor a large area in time almost simultaneously and continuously including the difficult to explore areas. This research was conducted with visual interpretation by using standard true color composite band (483) and false color composite band (843) of Sentinel 2A and also using lyzenga transformation. Estimation of coral reefs area based on result is 475,96 ha (2016) and decreased to 475 ha (2021). The condition of coral reefs at the research location is a good condition.
Phosphorus desorption and recovery from aqueous solution using amorphous zirconium hydroxide/MgFe layered double hydroxides composite
Authors: Nuryadin A , Imai T
Published: December 2021

Global phosphorus scarcity implies the importance of phosphorus recovery. Desorption is an essential process in phosphate removal by adsorption technique by enabling two crucial aspects: the reusability of adsorbent and the recovery of phosphorus. In this study, phosphate desorption by NaOH for composite reusability and phosphorus recovery by CaCl2were investigated. Based on the cost analysis, the uncalcined amorphous zirconium hydroxide/MgFe layered double hydroxides composite (am-Zr/MgFe-LDH) with Zr to Fe molar ratio of 1.5 was effective in reducing cost for phosphate adsorption compared to amorphous zirconium hydroxide (am-Zr) and MgFe layered double hydroxide (LDH). The XRD analysis indicated that phosphate desorption was preferably performed by stripping adsorbed phosphate on the composite surface using NaOH solution. The reuse of 2 N NaOH for composite regeneration could effectively maintain a higher adsorption ability (86%) than 1 N NaOH, and additionally, could be considered as an economic regeneration agent. The composite was chemically stable in maintaining its structure during eight adsorption-desorption cycles. The mechanisms involved during phosphate desorption by NaOH were mainly ligand exchange and electrostatic repulsion. The phosphorus recovery showed that the optimum recovery (~95%) was obtained by adding CaCl2at pH 13 and calcium to phosphorus molar ratio of 3.5.
Dynamic optimal power flow calculates intermittent wind turbine using ant colony method
Authors: Siwi R P , Gunadin IC , Said SM , Siswanto A , Humena S
Published: December 2021

Intermittent is electrical energy that is not available continuously due to uncontrollable external factors generated by a power plant which conditions vary in a reasonably short time scale. Intermittent can be limited or even mitigated by electricity storage, which is a rapidly growing area of research. In this research, the renewable energy used is the wind turbine. This study aims to schedule an economic generator by considering the intermittent wind turbine. Dynamic optimal power flow calculate Intermittent wind turbine uses ant colony method to determine the value of optimizing system operation with the integrated wind turbine. To determine the optimization value of the system operation, this study use a south sulawesi system consisting of 76 buses, 21 generators, and two wind power plant. From the results of the dynamic optimal power flow simulation, it is found that the generation costs are reduced from the real system costs using the ant colony method when the peak load time is 18.28% and the out peak load time is 18.08%, so that in only two times the ant colony optimization method, can reduce the cost of generation by Rp. 121,123,830.
Unsupervised construction of computational graphs for gene expression data with explicit structural inductive biases
Authors: Scherer Paul , Trębacz Maja , Simidjievski Nikola , Viñas Ramon , Shams Zohreh , Terre Helena Andres , Jamnik Mateja , Liò Pietro
Published: December 2021

Motivation

Gene expression data are commonly used at the intersection of cancer research and machine learning for better understanding of the molecular status of tumour tissue. Deep learning predictive models have been employed for gene expression data due to their ability to scale and remove the need for manual feature engineering. However, gene expression data are often very high dimensional, noisy and presented with a low number of samples. This poses significant problems for learning algorithms: models often overfit, learn noise and struggle to capture biologically relevant information. In this article, we utilize external biological knowledge embedded within structures of gene interaction graphs such as protein–protein interaction (PPI) networks to guide the construction of predictive models.

Results

We present Gene Interaction Network Constrained Construction (GINCCo), an unsupervised method for automated construction of computational graph models for gene expression data that are structurally constrained by prior knowledge of gene interaction networks. We employ this methodology in a case study on incorporating a PPI network in cancer phenotype prediction tasks. Our computational graphs are structurally constructed using topological clustering algorithms on the PPI networks which incorporate inductive biases stemming from network biology research on protein complex discovery. Each of the entities in the GINCCo computational graph represents biological entities such as genes, candidate protein complexes and phenotypes instead of arbitrary hidden nodes of a neural network. This provides a biologically relevant mechanism for model regularization yielding strong predictive performance while drastically reducing the number of model parameters and enabling guided post-hoc enrichment analyses of influential gene sets with respect to target phenotypes. Our experiments analysing a variety of cancer phenotypes show that GINCCo often outperforms support vector machine, Fully Connected Multi-layer Perceptrons (MLP) and Randomly Connected MLPs despite greatly reduced model complexity.

Availability and implementation

https://github.com/paulmorio/gincco contains the source code for our approach. We also release a library with algorithms for protein complex discovery within PPI networks at https://github.com/paulmorio/protclus. This repository contains implementations of the clustering algorithms used in this article.

Supplementary information

Supplementary data are available at Bioinformatics online.
scShaper: an ensemble method for fast and accurate linear trajectory inference from single-cell RNA-seq data
Authors: Smolander Johannes , Junttila Sini , Venäläinen Mikko S , Elo Laura L
Published: December 2021

Motivation

Computational models are needed to infer a representation of the cells, i.e. a trajectory, from single-cell RNA-sequencing data that model cell differentiation during a dynamic process. Although many trajectory inference methods exist, their performance varies greatly depending on the dataset and hence there is a need to establish more accurate, better generalizable methods.

Results

We introduce scShaper, a new trajectory inference method that enables accurate linear trajectory inference. The ensemble approach of scShaper generates a continuous smooth pseudotime based on a set of discrete pseudotimes. We demonstrate that scShaper is able to infer accurate trajectories for a variety of trigonometric trajectories, including many for which the commonly used principal curves method fails. A comprehensive benchmarking with state-of-the-art methods revealed that scShaper achieved superior accuracy of the cell ordering and, in particular, the differentially expressed genes. Moreover, scShaper is a fast method with few hyperparameters, making it a promising alternative to the principal curves method for linear pseudotemporal ordering.

Availability and implementation

scShaper is available as an R package at https://github.com/elolab/scshaper. The test data are available at https://doi.org/10.5281/zenodo.5734488.

Supplementary information

Supplementary data are available at Bioinformatics online.
Online Solid-Phase Extraction of Prometon and Prometryne Using MIL-101(Cr) as Sorbent before Gas Chromatographic Analysis: A Computational and Experimental Study and Comparison between Splitless and PTV Inlets
Authors: Torabizadeh Mahsa , Tabar-Heydar Kourosh , Ahmadi Seyyed Hamid
Published: December 2021

In this study, prometryne and prometon were extracted and preconcentrated from aqueous media using an online solid-phase extraction–thermal desorption method coupled with gas chromatography–flame ionization detector (GC-FID), equipped with two different inlets: split and programmable temperature vaporizer (PTV). For this purpose, the applicability of Tenax and a metal–organic framework were investigated as solid-phase sorbents. Several effective parameters on the extraction efficiency, such as the amount of sorbent, sample volume, sample pH and thermal desorption procedure were optimized. The analytical performance of the proposed methods showed an excellent linear dynamic range for prometon and prometryne (0.25–100 μg/L) and relative standard deviation less than 4.01%. Moreover, the detection limits below 0.20 and 0.35 μg/L were determined for prometon and prometryne, respectively. Additionally, molecular docking was applied to clarify the adsorption nature and binding energy of MIL-101(Cr) toward the studied analytes, which indicated an appropriate correlation between computational and experimental results. Finally, the proposed method was developed and validated for prometon and prometryne and successfully applied for their extraction from agricultural water, spiked with prometon and prometryne through its direct introduction into the GC inlet.
Cardiovascular risks associated with use of non-steroidal anti-inflammatory drugs in patients with non-obstructive coronary artery disease
Authors: Gaster Natascha , Pedersen Lars , Ehrenstein Vera , Böttcher Morten , Bøtker Hans Erik , Sørensen Henrik Toft , Schmidt Morten
Published: December 2021

Aims

To examine whether non-aspirin non-steroidal anti-inflammatory drug (NSAID) use is associated with increased cardiovascular risks in patients with non-obstructive coronary artery disease (CAD).

Methods and results

Using Danish medical registries, we conducted a population-based cohort study in Western Denmark during 2008–17. We identified all patients undergoing first-time coronary computed tomography angiography (CCTA) due to suspected CAD (n = 35 399), with results showing no (n = 28 581) or non-obstructive CAD (n = 6818). Multivariate Cox regression was used to compute hazard ratios of major adverse cardiac events (MACEs), including incident myocardial infarction, coronary intervention, and death. The rate of MACE increased by 33% for any NSAID use compared with non-use [hazard ratio 1.33, 95% confidence interval (CI) 1.06–1.68] in patients with no CAD and by 48% (1.48, 95% CI 1.06–2.07) in patients with non-obstructive CAD. Rate difference of MACE, per 100 person-years, was 0.38 (95% CI 0.08–0.67) in patients with no CAD (number needed to harm: 267) and 1.08 (95% CI 0.06–2.11) in patients with non-obstructive CAD (number needed to harm: 92). Current use of older cyclooxygenase-2 inhibitors was associated with the highest hazard ratio in patients with non-obstructive CAD, both when ascertained as pre-CCTA use (2.9-fold increase) and when ascertained from time-varying use (1.8-fold increase).

Conclusion

NSAID use in patients with CCTA-confirmed no and non-obstructive CAD was associated with an increased cardiovascular risk compared with non-use. The absolute risk differences and numbers needed to harm were considered clinically relevant, particularly in patients with non-obstructive CAD.
Review, Assess, Classify, and Evaluate (RACE): a framework for studying m-health apps and its application for opioid apps
Authors: Varshney Upkar , Singh Neetu , Bourgeois Anu G , Dube Shanta R
Published: December 2021

Objective

The proliferation of m-health interventions has led to a growing research area of app analysis. We derived RACE (Review, Assess, Classify, and Evaluate) framework through the integration of existing methodologies for the purpose of analyzing m-health apps, and applied it to study opioid apps.

Materials and Methods

The 3-step RACE framework integrates established methods and evidence-based criteria used in a successive manner to identify and analyze m-health apps: the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, inter-rater reliability analysis, and Nickerson-Varshney-Muntermann taxonomy.

Results

Using RACE, 153 opioid apps were identified, assessed, and classified leading to dimensions of Target Audience, Key Function, Operation, Security & Privacy, and Impact, with Cohen’s kappa < 1.0 suggesting subjectivity in app narrative assessments. The most common functions were education (24%), prescription (16%), reminder-monitoring-support (13%), and treatment & recovery (37%). A majority are passive apps (56%). The target audience are patients (49%), healthcare professionals (39%), and others (12%). Security & Privacy is evident in 84% apps.

Discussion

Applying the 3-step RACE framework revealed patterns and gaps in opioid apps leading to systematization of knowledge. Lessons learned can be applied to the study of m-health apps for other health conditions.

Conclusion

With over 350 000 existing and emerging m-health apps, RACE shows promise as a robust and replicable framework for analyzing m-health apps for specific health conditions. Future research can utilize the RACE framework toward understanding the dimensions and characteristics of existing m-health apps to inform best practices for collaborative, connected and continued care.
The Relationship Between Pain-Related Threat and Motor Behavior in Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis
Authors: Ippersiel Patrick , Teoli Anthony , Wideman Timothy H , Preuss Richard A , Robbins Shawn M
Published: December 2021

Objective

Although pain-related fear and catastrophizing are predictors of disability in low back pain (LBP), their relationship with guarded motor behavior is unclear. The aim of this meta-analysis was to determine the relationship between pain-related threat (via pain-related fear and catastrophizing) and motor behavior during functional tasks in adults with LBP.

Methods

This review followed PRISMA guidelines. MEDLINE, Embase, PsychINFO, and CINAHL databases were searched to April 2021. Included studies measured the association between pain-related fear or pain catastrophizing and motor behavior (spinal range of motion, trunk coordination and variability, muscle activity) during movement in adults with nonspecific LBP. Studies were excluded if participants were postsurgery or diagnosed with specific LBP. Two independent reviewers extracted all data. The Newcastle-Ottawa Scale was used to assess for risk of bias. Correlation coefficients were pooled using the random-effects model.

Results

Reduced spinal range of motion during flexion tasks was weakly related to pain-related fear (15 studies, r = −0.21, 95% CI = −0.31 to −0.11) and pain catastrophizing (7 studies, r = −0.24, 95% CI = −0.38 to −0.087). Pain-related fear was unrelated to spinal extension (3 studies, r = −0.16, 95% CI = −0.33 to 0.026). Greater trunk extensor muscle activity during bending was moderately related to pain-related fear (2 studies, r = −0.40, 95% CI = −0.55 to −0.23). Pain catastrophizing, but not fear, was related to higher trunk activity during gait (2 studies, r = 0.25, 95% CI = 0.063 to 0.42). Methodological differences and missing data limited robust syntheses of studies examining muscle activity, so these findings should be interpreted carefully.

Conclusion

This study found a weak to moderate relationship between pain-related threat and guarded motor behavior during flexion-based tasks, but not consistently during other movements.

Impact

These findings provide a jumping-off point for future clinical research to explore the advantages of integrated treatment strategies that target both psychological and motor behavior processes compared with traditional approaches.
Legal professional Privilege—what do we make of it in jurisdiction Malta? The anchors: Part 2
Authors: Galea Patrick J
Published: December 2021

This article is a continuation of Part 1 which appeared in the previous issue of Trusts and Trustees. The concluding note there was that Privilege in Malta is one and unitary, encompassing without distinction litigation Privilege and legal advice Privilege. Part 2 argues that Malta has received various influences over time on Privilege, not least the European Convention on Human Rights and the EU. However, the law on Privilege should never lose sight of the fundamental and defining link between the Maltese Code of Civil Procedure and the traditional Common Law rules on evidence—these should remain, partly at least, a defining anchor of the Maltese Law on Privilege. This article argues that Privilege extends to all materials communicated between counsel and client in the proper course of professional activity. It also reviews areas such as disclosure and Privilege, asks whether Privilege is a substantive rule of law or one of evidence. Other areas considered are loss of Privilege, partial waiver thereof, secondary evidence referred to in otherwise Privileged material and finally inadvertent disclosure. The conclusion is that Privilege is a deep-seated rule of law, procedure and practice of which Advocates and the Judiciary remain the gatekeepers.
Momentous decisions in Jersey—wishes, taxes, conflicts and protectors
Authors: Sanders Nigel , Yates Charlotte
Published: December 2021

This article considers a recent example of Public Trustee v Cooper applications in Jersey reported as In the Matter of the Piedmont Trust & Riviera Trust [2021] JRC 24. In Piedmont & Riviera, the Jersey Royal Court’s judgment provides useful guidance on, inter alia the significance of and approach to situations where there are multiple letters of wishes, conflict of interests sufficient to warrant a trustee seeking to surrender its discretion, the importance for a trustee to take advice on the fiscal consequences of their proposed decision (and the risk of the Court declining to bless the decision where such advice was absent) and the role of a protector who holds a power of veto in respect of the power the trustee is proposing to exercise.
AudioChip: A Deep Phenotyping Approach for Deconstructing and Quantifying Audiological Phenotypes of Self-Reported Speech Perception Difficulties
Authors: Bhatt Ishan Sunilkumar , Dias Raquel , Wineinger Nathan , Pratt Sheila , Wang Jin , Washnik Nilesh , Guthrie O’neil , Wilder Jason , Torkamani Ali
Published: December 2021

Objectives:

About 15% of U.S. adults report speech perception difficulties despite showing normal audiograms. Recent research suggests that genetic factors might influence the phenotypic spectrum of speech perception difficulties. The primary objective of the present study was to describe a conceptual framework of a deep phenotyping method, referred to as AudioChipping, for deconstructing and quantifying complex audiometric phenotypes.

Design:

In a sample of 70 females 18 to 35 years of age with normal audiograms (from 250 to 8000 Hz), the study measured behavioral hearing thresholds (250 to 16,000 Hz), distortion product otoacoustic emissions (1000 to 16,000 Hz), click-evoked auditory brainstem responses (ABR), complex ABR (cABR), QuickSIN, dichotic digit test score, loudness discomfort level, and noise exposure background. The speech perception difficulties were evaluated using the Speech, Spatial, and Quality of Hearing Scale–12-item version (SSQ). A multiple linear regression model was used to determine the relationship between SSQ scores and audiometric measures. Participants were categorized into three groups (i.e., high, mid, and low) using the SSQ scores before performing the clustering analysis. Audiometric measures were normalized and standardized before performing unsupervised k-means clustering to generate AudioChip.

Results:

The results showed that SSQ and noise exposure background exhibited a significant negative correlation. ABR wave I amplitude, cABR offset latency, cABR response morphology, and loudness discomfort level were significant predictors for SSQ scores. These predictors explained about 18% of the variance in the SSQ score. The k-means clustering was used to split the participants into three major groups; one of these clusters revealed 53% of participants with low SSQ.

Conclusions:

Our study highlighted the relationship between SSQ and auditory coding precision in the auditory brainstem in normal-hearing young females. AudioChip was useful in delineating and quantifying internal homogeneity and heterogeneity in audiometric measures among individuals with a range of SSQ scores. AudioChip could help identify the genotype-phenotype relationship, document longitudinal changes in auditory phenotypes, and pair individuals in case-control groups for the genetic association analysis.
Pure Tone Audiometry Evaluation Method Effectiveness in Detecting Hearing Changes Due to Workplace Ototoxicant, Continuous Noise, and Impulse Noise Exposures
Authors: Blair Marc , Slagley Jeremy , Schaal Nicholas Cody
Published: December 2021

Objectives:

The purpose of this retrospective cohort study was to compare the relative risks (RR) of hearing impairment due to co-exposure of continuous noise, impulse noise, metal ototoxicants, and organic solvent ototoxicants using several pure tone audiometry (PTA) evaluation methods.

Design:

Noise and ototoxicant exposure and PTA records were extracted from a DoD longitudinal repository and were analyzed for U.S. Air Force personnel (n = 2372) at a depot-level aircraft maintenance activity at Tinker Air Force Base, Oklahoma using an historical cohort study design. Eight similar exposure groups based on combinations of ototoxicant and noise exposure were created: (1) Continuous noise (reference group); (2) Continuous noise + Impulse noise; (3) Metal exposure + Continuous noise; (4) Metal exposure + Continuous noise + Impulse noise; (5) Solvent exposure + Continuous noise; (6) Solvent exposure + Continuous noise + Impulse noise; (7) Metal exposure + Solvent exposure + Continuous noise; and (8) Metal exposure + Solvent exposure + Continuous noise + Impulse noise. RR of hearing impairment compared to the Continuous noise-exposed reference group was assessed with five PTA evaluation methods including (1) U.S. Department of Defense (DoD) Significant Threshold Shift (STS), (2) Occupational Safety and Health Administration (OSHA) age-adjusted STS, (3) National Institute for Occupational Safety and Health (NIOSH) STS, (4) NIOSH Material Hearing Impairment, and (5) All Frequency Threshold Average.

Results:

Hearing impairment was significantly worse for SEG (2) combined exposure to continuous noise and impulse noise only for the PTA evaluation method (2) OSHA Age Adjusted with an RR of 3.11, [95% confidence interval (CI), 1.16–8.31] and was nearly significantly different using PTA evaluation method (4) NIOSH Material Hearing Impairment with an RR of 3.16 (95% CI, 0.99–10.15). Despite no significant differences for SEGs with an ototoxicant exposure, PTA evaluation method (3) NIOSH STS was most sensitive in detecting hearing changes for SEG (8) Metal exposure + Solvent exposure + Continuous noise + Impulse noise as demonstrated by a RR of 1.12 (95% CI, 0.99–1.27).

Conclusions:

Results suggest that a single PTA evaluation technique may not be adequate in fully revealing hearing impairment risk due to all stressors and tailoring the PTA evaluation technique to the hazards present in the workplace could better detect hearing impairment. Additionally, results suggest that PTA may not be effective as the sole technique for evaluating hearing impairment due to ototoxicant exposure with continuous noise co-exposure.
Epidemiological Study of Equestrian Trauma in Geneva
Authors: Naef Sarah , Steiger Christina N. , Tabard-Fougère Anne , Dayer Romain , Ceroni Dimitri
Published: December 2021

Background:

Horse-related activities are increasingly popular among young people but are frequently associated with severe injuries requiring hospital treatment. There are few data on the incidence of equestrian injuries, especially in child populations, or on means of prevention. Thus, this study’s purpose was to highlight the epidemiological data on specific injuries due to equestrianism and serve as the groundwork for future studies on the prevention of equestrian accidents.

Methods:

A retrospective study collected data on all children younger than 16 years old who attended our regional emergency department after involvement in an equestrian accident. The study covered the periods from 1990 to 2003 and 2011 to 2018. Twenty-two years of data on trauma circumstances, injury patterns (mechanism, anatomic site, and severity), treatment protocols, and hospital lengths of stay were analyzed.

Results:

This study confirmed that more young females participating in equestrian sports attended our emergency department than males. The leading cause of equestrian injury was falling from a horse (80.2%). Orthopaedic injuries represented around 60% of all reported lesions, far ahead of head injuries (30%). More than half of the injured children required hospitalization for inpatient medical care, and almost 50% of these underwent a surgical procedure, especially for upper extremity fractures (72% of all fractures). One patient died due to severe cerebral injury.

Conclusions:

Horse riding injuries occur more frequently and are more serious than in many other sporting activities. There is an urgent need to reassess preventive measures to reduce the incidence and severity of equestrian injuries.

Level of Evidence:

Level IV.
Strategies for Providing Culturally Sensitive Care to Diverse Populations
Authors: Turkson-Ocran Ruth-Alma N. , Nkimbeng Manka , Erol Daffcar , Hwang DaSol Amy , Aryitey Akasi A. , Hughes Victoria
Published: December 2021

Nurses are called to care for patients and families from many backgrounds and cultural groups. This article discusses the key strategies of cultural humility, conscientious practice, and establishing trust that promotes cultural sensitivity as well as congruence with Christian values. When implemented, these strategies can facilitate the provision of quality, culturally sensitive patient care that conforms to a biblical worldview.
Developing Community-Based Palliative Care Services for People Living with HIV in Africa
Authors: Wright Patricia Moyle
Published: December 2021

Africa continues to be disproportionately affected by HIV/AIDS. Poor access to medical care, limited access to antiretroviral drugs, and lack of supportive care for persons who are symptomatic lead to disease progression. Community-based palliative care services are effective in providing supportive services throughout the course of the illness, but palliative care services are limited in Africa. This article presents a theoretical approach to developing community-based palliative care services to bridge this gap.
Hypoplastic Left Heart Syndrome: A Review
Authors: Ramonfaur Diego , Zhang Xiaoya , Garza Abraham P. , García-Pons José Fernando , Britton-Robles Sylvia C.
Published: December 2021

Hypoplastic left heart syndrome is a rare and poorly understood congenital disorder featuring a univentricular myocardium, invariably resulting in early childhood death if left untreated. The process to palliate this congenital cardiomyopathy is of high complexity and may include invasive interventions in the first week of life. The preferred treatment strategy involves a staged correction with 3 surgical procedures at different points in time. The Norwood procedure is usually performed within the first weeks of life and aims to increase systemic circulation and relieve pulmonary vascular pressure. This procedure is followed by the bidirectional Glenn and the Fontan procedures in later life, which offer to decrease stress in the ventricular chamber. The prognosis of children with this disease has greatly improved in the past decades; however, it is still largely driven by multiple modifiable and nonmodifiable variables. Novel and clever alternatives have been proposed to improve the survival and neurodevelopment of these patients, although they are not used as standard of care in all centers. The neurodevelopmental outcomes among these patients have received particular attention in the last decade in light to improve this very limiting associated comorbidity that compromises quality of life.
Natural Orifice Endosonographic Colposuspension With Rectopexy for Combined Pelvic Organ Prolapse: A Feasibility Study
Authors: Chandra Abhijit , Rajan Pritheesh , Gupta Vivek , Ahmad Arshad , Parihar Anit , Yadav Gourav , Singh Uma , Rajashekhara Mahesh , Patankar Sanjiv K. , Patel Ravi
Published: December 2021

BACKGROUND:

We describe a natural orifice technique for simultaneous endoluminal lateral suspension of apical vaginal wall and rectal prolapse fixation with ultrasound and fluoroscopic assistance.

IMPACT OF INNOVATION:

The technique is minimally invasive, can be performed under regional anaesthesia, and avoids laparotomy or use of a mesh in addition to preserving the uterus.

TECHNOLOGY MATERIALS AND METHODS:

This technique involves suprapubic transvaginal ventral suture colposuspension, fixation of the anterior rectal wall to the undersurface of the anterior abdominal wall and tack fixation of the posterior rectal wall to the underlying sacral promontory through a submucosal tunnel performed endoscopically with fluoroscopic and ultrasound assistance.

PRELIMINARY RESULTS:

Seven patients with a mean age of 63 years were followed between 3 to 11 months.

CONCLUSIONS:

This is a novel minimally invasive transluminal procedure that repairs concomitant rectal and vaginal prolapse in the same sitting.

FUTURE DIRECTIONS:

Improvement in the instrument design and incorporation of endoluminal robotic systems will enhance the technical ease. The study needs validation in larger series of patients with longer follow-up.
Protection in the eye room: minimising risks of COVID-19 transmission during eye examinations in the emergency department
Authors: Wilson Matthew M.
Published: December 2021

Ocular examinations in the emergency department (ED) provide an increased risk of coronavirus disease 2019 (COVID-19) transmission due to the close-proximity to the patient and inability to physical distance. In this article, I discuss the appropriate personal protective wear when undertaking an ocular examination in the ED.
Urinary Cadmium and Incident Heart Failure
Authors: Sears Clara G. , Eliot Melissa , Raaschou-Nielsen Ole , Poulsen Aslak Harbo , Harrington James M. , Howe Chanelle J. , James Katherine A. , Roswall Nina , Overvad Kim , Tjønneland Anne , Meliker Jaymie , Wellenius Gregory A.
Published: December 2021

Background:

Epidemiologic studies suggest cadmium exposure is associated with cardiovascular disease risk, including heart failure. However, prior findings may be influenced by tobacco smoking, a dominant source of cadmium exposure and risk factor for heart failure. The present study leverages up to 20 years of follow-up in the Danish Diet, Cancer and Health cohort to examine the relationship between urinary cadmium and incident heart failure among people who never smoked.

Methods:

Between 1993 and 1997, 19,394 never-smoking participants (ages 50–64 years) enrolled and provided a urine sample. From this sample, we randomly selected a subcohort of 600 men and 600 women and identified 958 incident heart failure cases occurring between baseline and 2015. Using a case–cohort approach, we estimated adjusted hazard ratios (aHR) for heart failure in Cox proportional hazards models with age as the time scale.

Results:

Participants had relatively low concentrations of urinary cadmium, as expected for never smokers (median = 0.20; 25th, 75th = 0.13, 0.32 μg cadmium/g creatinine). In adjusted models, we found that higher urinary cadmium was associated with a higher rate of incident heart failure overall (aHR = 1.1 per interquartile range difference [95% CI = 1.0, 1.2). In sex-stratified analyses, the association seemed restricted to men (aHR = 1.5 [95% CI = 1.2, 1.9]).

Conclusions:

In this cohort of people who never smoked tobacco, environmental cadmium was positively associated with incident heart failure, especially among men.
Visual Acuity and the Risk of Cycling Injuries
Authors: Hiyoshi Ayako , Sato Yuki , Grotta Alessandra , Fall Katja , Montgomery Scott
Published: December 2021

Background:

Cycling is increasingly encouraged in many countries as an inexpensive and healthy choice of transportation. Operating any vehicle on the road requires high visual acuity, but few studies to our knowledge have examined the association between vision and cycling injuries.

Methods:

We examined whether poorer visual acuity is associated with increased risk of fatal and nonfatal cycling injuries. We used prospectively recorded register data for 691,402 men born between 1970 and 1992 in Sweden. We followed these men from an average age of 18 years, when visual acuity was assessed during the conscription assessment, to age 45 at the latest. We identified fatal and nonfatal cycling and car injuries using Patient and Cause of Death registers. Cox regression models were used to estimate hazard ratios and 95% confidence intervals.

Results:

Based on visual acuity for the eye with the best vision, moderately impaired acuity 0.9 to 0.6 when wearing refractive correction was associated with increased risk for cycling injuries (hazard ratio = 1.44 [95% confidence interval = 1.16, 1.79]) compared with unimpaired vision (uncorrected visual acuity 1.0) and after adjustment for a wide range of potential confounders. This association remained consistent across various sensitivity analyses. Visual acuity was not associated with car injury risk.

Conclusions:

In this cohort study, poorer vision was specifically associated with a higher rate of cycling injuries.
PREDICTIVE ROLE OF SWEPT SOURCE OCT ANGIOGRAPHY IN RELAPSING VOGT–KOYANAGI–HARADA DISEASE
Authors: Interlandi Emanuela , Pellegrini Francesco , Papayannis Alessandro , Latanza Loredana , Pece Alfredo , Pavesio Carlos
Published: December 2021

Purpose:

The purpose of this study was to describe the optical coherence tomography (OCT) angiography findings as a predictive role in the chronic relapsing stage of Vogt–Koyanagi–Harada disease and its comparison with other imaging modalities such as fluorescein angiography, indocyanine-green angiography, and spectral domain OCT.

Methods:

A 37-year-old woman from Bangladesh was diagnosed with Vogt–Koyanagi–Harada disease. She was evaluated 8 months before for a routine examination when she was in clinical remission. Full ophthalmic evaluation with multimodal imaging and OCT angiography was performed.

Results:

Ophthalmic evaluation was unremarkable. Spectral domain OCT disclosed increased choroidal thickness in both eyes while swept source OCT angiography imaging showed choroidal flow voids well-matching hypofluorescent round lesions found by indocyanine-green angiography. A week later the disease reactivated.

Conclusion:

Optical coherence tomography angiography may provide novel insights into inflammatory activity of the choroid and potentially have a predictive role in relapsing Vogt–Koyanagi–Harada disease.
Myopia Control With Orthokeratology: A Review
Authors: Hiraoka Takahiro
Published: December 2021

A number of studies regarding the effect of orthokeratology (OK) on myopia progression have been published and shown that it can slow myopia progression in school-aged children. Recently, OK has been considered to be one of the most effective optical treatments for myopia control. This article reviewed the peer-reviewed literature on the efficacy of OK for myopia control. Although it cannot halt myopia progression completely, the inhibitory effect on axial elongation for 2 years has been reported to be from 32% to 63%, as compared with single-vision spectacles and contact lenses. In addition, the efficacy and acceptable safety have been confirmed even in several long-term studies up to 10 years. However, the possibility of a rebound phenomenon in myopia progression after OK discontinuation remains unknown. It is also unclear how long the treatment should be continued to attain the maximum benefit in each patient. In the near future, further research including assessment of rebound phenomenon should be conducted with longer follow-up periods in more diverse populations.
Diagnostic performance of magnetic resonance imaging and ultrasonography on the detection of cesarean scar pregnancy
Authors: Xiao Xiaoyi , Ding Rixing , Peng Lei , Liu Huaping , Zhu Yun
Published: December 2021

Background

: There is still a debate on which imaging method is the best to diagnose cesarean scar pregnancy (CSP). Accordingly, this study aimed to analyze the diagnostic performance of magnetic resonance imaging (MRI) and ultrasonography (US) on the detection of CSP based on current evidence in the literature.

Methods:

PubMed, Embase, Cochrane, Chinese Biomedical Documentation Service System, WanFang, and China National Knowledge Infrastructure databases were searched up to June 2020. The included studies were all comparisons of MRI and US in the diagnosis of CSP that adopted postoperative histological examination as the reference standard. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the summary receiver operating characteristic curve (AUC) were calculated for MRI and US.

Results:

Thirteen studies were included, with a total sample size of 948 patients. The pooled sensitivity, specificity, PLR, NLR, and AUC of MRI in diagnosing CSP were 0.93 (95% CI, 0.91-0.95), 0.83 (95% CI, 0.75-0.89), 5.46 (95% CI, 3.70-8.05), 0.08 (95% CI, 0.06-0.11), and 0.96 (95% CI, 0.93-0.97), respectively; for US they were 0.84 (95% CI, 0.79-0.88), 0.73 (95% CI, 0.62-0.81), 3.06 (95% CI, 2.22-4.21), 0.23 (95% CI, 0.18-0.28), and 0.86 (95% CI, 0.83-0.89), respectively.

Conclusion:

We found that both MRI and US effectively diagnosed CSP; however, MRI had a higher diagnostic performance in detecting CSP than US.
Pancreaticoduodenectomy preserving aberrant gastroduodenal artery utilized in a previous coronary artery bypass grafting
Authors: Toda Takeo , Kanemoto Hideyuki , Tokuda Satoshi , Takagi Akihiko , Oba Noriyuki
Published: December 2021

Rationale:

Pancreaticoduodenectomy (PD) is a technically demanding procedure with high rates of morbidity and mortality. Therefore, preoperative evaluation of anatomy is indispensable. Multi-detector row computed tomography (CT) enables us to precisely understand arterial anatomy. It is a well-known fact that anatomical variants are often present in the hepatic artery (HA) but rarely in the gastroduodenal artery (GDA). We present the case of a patient with ampullary cancer with a rare anatomical anomaly, “replaced GDA (rGDA) ” arising from the superior mesenteric artery, along with a history of coronary artery bypass grafting (CABG) using right gastroepiploic artery (RGEA).

Patient concerns:

A 69-year-old male patient was referred to our department for further investigation of elevated hepatobiliary enzymes. He presented with no symptoms besides intermittent fever of 38°C. He had an operative history of CABG using the RGEA.

Diagnosis:

Abdominal CT and esophagogastroduodenoscopy showed an ampullary tumor and biopsy specimen from the lesion revealed adenocarcinoma. CT angiography revealed the rGDA instead of a normal common HA.

Intervention:

We performed a safe PD, preserving the rGDA and the RGEA to maintain hepatic and cardiac perfusion.

Outcomes:

Owing to the presence of a refractory pancreatic fistula, the length-of-hospital stay was extended, and he was discharged on postoperative day 72 without vascular complications. At present, the patient is in good physical condition and does not present with cardiovascular complications as well as tumor recurrence at 6 months after surgery.

Lessons:

This is possibly the first case of a patient who underwent PD and has a proper HA following a GDA arising from a superior mesenteric artery (rGDA) and has a previous operative history of CABG using the gastroepiploic artery. The coexistence of the history of cardiovascular surgery made PD for this patient considerably more challenging.

In the case of a rare anatomical anomaly, a coronary artery bypass via the RGEA should not be considered as an obstacle when R0 resection is achievable.
A case report of a lung abscess as a rare complication of a pyogenic liver abscess
Authors: Kim Hee Yeon , Lee Hyo-Jin
Published: December 2021

Rationale:

A hepatobronchial fistula and lung abscess following a pyogenic liver abscess is a rare entity and it is not easy to diagnose this condition based on the symptoms and chest radiography.

Patient concerns:

An 81-year-old man presented with productive cough and dyspnea.

Diagnosis:

Chest radiography indicated increased opacities in the right lower lung field with an air-fluid level suggestive of pneumonia complicated by a lung abscess. Chest and abdominal computed tomography revealed an abscess in the right lower lung field that bordered an abscess at segment 7 of the liver. Tubography confirmed a fistula between the liver and lung abscesses.

Interventions:

Due to communication between 2 abscesses, transhepatic approach was done instead of transpleural approach to avoid complications.

Outcomes:

A liver abscess complicated by a lung abscess was resolved following percutaneous transhepatic drainage of the liver abscess and antibiotic administration.

Lessons:

Though uncommon, the lack of suspicion of sub-diaphragmatic liver abscess often lead to a delay in diagnosis and proper treatment. Our case implies the importance of computed tomography in early diagnosis of liver abscess in case of lung abscess in the right lower lung field.