bluuebunny/crossref_metadata_2025 huggingface dataset:
Modified Atmosphere and Humidity Film Prevents Browning and Improves Quality of Oriental Melons
Authors: Park Me-Hea , Chang Eun-Ha , Min-Sun Chang , Yang Hae-Jo , Lee Jung-Soo , Song Hyun Jong , Do Gyung-Ran , Ku Kang-Mo
Published: September 2020

Oriental melons have a relatively short shelf life as they are harvested during the summer season and susceptible to cold-induced injuries. Typical chilling injury when stored at 4℃ is expressed as browning of the fruit suture. To prolong the shelf life and reduce browning of the fruit, the effects of modified atmosphere packaging (MAP), X-tend modified atmosphere (MA)/modified humidity (MH) bulk packaging (XF), and polyethylene (PE) packaging, on oriental melons were investigated during storage at 4℃ and 10℃ for 14 days and under retail display conditions at 20℃. The O2 concentrations in PE packages stored at 4℃ and 10℃ ranged from 17.4–18.5%, whereas those in XF packages were reduced to 16.3–16.6%. The CO2 content of XF package (4.2–4.6%) was higher than that of PE package (1.4–1.9%) stored at 4℃ or 10℃. Relative humidity (RH) saturated in the PE packages but not in the XF packages after seven days of storage. Furthermore, PE packages performed better at maintaining melon weight and firmness than XF packages during storage at 10℃ for 14 days and under retail display conditions at 20℃. PE and XF packages effectively reduced the browning index of the peel and white linear sutures of oriental melons compared with the unpackaged control during cold storage at 4℃, and this observation was maintained at the retail display condition at 20℃. The enhanced CO2 levels, reduced O2 levels, and optimal RH values that were provided by the MAP, prevented the browning symptoms and improved the marketability and shelf life of oriental melons.
Genetics and Genomics of Pediatric Pulmonary Arterial Hypertension
Authors: Welch Carrie L. , Chung Wendy K.
Published: September 2020

Pulmonary arterial hypertension is a rare disease with high mortality despite recent therapeutic advances. The disease is caused by both genetic and environmental factors, and likely gene x environment interactions. While PAH can manifest across the lifespan, pediatric-onset disease is particularly challenging because it is frequently associated with a more severe clinical course and comorbidities including lung/heart developmental anomalies. In light of these differences, it is perhaps not surprising that emerging data from genetic studies of pediatric-onset PAH indicate that the genetic basis is different than that of adults. There is a greater genetic burden in children, with rare genetic factors contributing to at least 36% of pediatric-onset idiopathic PAH (IPAH) compared to ~11% of adult-onset IPAH. De novo variants are frequently associated with PAH in children, and contribute to at least 15% of all pediatric cases. The standard of medical care for pediatric PAH patients is based on extrapolations from adult data. However, the increased etiologic heterogeneity, poorer prognosis and increased genetic burden for pediatric-onset PAH calls for a dedicated pediatric research agenda to improve molecular diagnosis and clinical management. A genomics-first approach will improve the understanding of pediatric PAH and how it is related to other rare pediatric genetic disorders.
On Cancer, COVID-19 and CT Scan: A Monocentric Retrospective Study
Authors: Martini Francesca , D'Alessio Andrea , Bracchi Federico , Di Mauro Daniela , Fargnoli Anna , Motta Marco , Giussani Cristina , Meazza Prina Marco , Gobbin Giovanni , Taverna Monica
Published: September 2020

Background The acknowledgment of computed tomography (CT) defined diagnosis in high prevalence northern Italy may identify more patients with Coronavirus Disease-2019 (COVID 19) infection, than RT-PCR alone. Methods We retrospectively reviewed 148 chest CT scans of oncological patients who were referred to the Radiological Unit of Policlinico S. Marco from 1st of February 2020 to 30th of April 2020, during the Covid-19 outbreak in Bergamo area. Therefore, we analyzed RT-PCR tests of these 148 patients. Results Among 32 patients with diagnosis of COVID-19 infection: 17 patients were asymptomatic or had mild symptoms (53.1%), while 15 developed severe disease (46.8%). The incidence of COVID-19 infection is 22.9%, the mortality rate is 18.8%. Severe COVID-19 disease is associated with higher median age. We did not find any correlation between disease severity and sex, smoke or cardiovascular comorbidities. Remarkably, patients who were on treatment developed milder disease than cancer patients who were not on treatment. Conclusions The acceptance of CT-defined diagnosis in high prevalence area like Bergamo highlighted a larger number of COVID-19 oncological population than RT-PCR alone, in particular asymptomatic and mild symptomatic patients. We observed that actively treated patients had milder disease, according to previous studies that suggested a protective role of immunosuppression.
High Performance Zinc Oxide Nanorod-Doped Ion Imprinted Polypyrrole for the Selective Electrosensing of Mercury II Ions
Authors: Ait-Touchente Zouhair , Sakhraoui Houssem Eddine El Yamine , Fourati Najla , Zerrouki Chouki , Maouche Naima , Yaakoubi Nourdin , Touzani Rachid , Chehimi Mohamed M.
Published: September 2020

A biomimetic, ion-imprinted polymer (IIP) was prepared by electropolymerization of pyrrole at the surface of gold electrodes decorated with vertically grown ZnO nanorods. The vertical growth of the nanorods was achieved via an ultrathin aryl monolayer grafted by reduction of diazonium salt precursor. Pyrrole was polymerized in the presence of L-cysteine as chelatant agent and Hg(II) (template). Hg(II)-imprinted polypyrrole (PPy) was also prepared on bare gold electrode in order to compare the two methods of sensor design (Au-ZnO-IIP vs Au-IIP). Non-imprinted PPy was prepared in the same conditions, however in the absence of any Hg2+ template. The strategy combining diazonium salt modification and ZnO nanorod decoration of gold electrodes permitted to increase considerably the specific surface and thus to improve the sensor performances. The limit of detection (LOD) of the designed sensor was ~1 pM, the lowest value ever reported in literature. The dissociation constants between PPy and Hg2+ were estimated at [Kd1 = (7.89 ± 3.63) mM and Kd2 = (38.10 ± 9.22) pM]. The sensitivity of the designed sensor was found to be 0.692 ± 0.034 μA/pM. The Au-ZnO-IIP was found to be highly selective towards Hg(II) compared to cadmium, lead and copper ions. This sensor design strategy could open up new horizons in monitoring toxic heavy metal ions in water and therefore contribute to enhance environmental quality.
Spatio – Temporal Characteristics of the Aftershocks Sequences that followed the Strong Earthquakes in Ionian Islands, Greece
Authors: Moshou Alexandra , Drakatos George , Moussas Vassilios , Argyrakis Panagiotis , Konstantaras Antonios , Christina Daverona Anna , Pantazis Dimos , Sagias Nikos C.
Published: September 2020

During the period January 2014 – October 2018, four strong earthquakes occurred in the Ionian Sea, Greece. A rich aftershock sequence followed each event of them. More analytically, according to the manual solutions of National Observatory of Athens, the first event (K1), occurred on 26 January 2014 in Kefallinia Island with magnitude ML = 5.8, which was followed by another in the same region (K2) on 3 February 2014 with magnitude ML = 5.7. The third event occurred on 17 November 2015, ML = 6.0 in Lefkas Island (L1) and the last on 25 October 2018, ML = 6.6 in Zande Island (Z1). The first three of these earthquakes caused moderate structural damages mainly in houses and produced particular unrest to the local population. This work presents first the calculation of the source parameters of the strong events as well as for all earthquakes with magnitude ML > 4.0, using the methodology of the Moment tensor inversion and secondary data from permanent GPS stations were analyzed to confirm the findings from seismological data and to investigate the displacement due to the earthquakes.
Patterns for Living Lab Practice: Describing Key Know-How to Promote Service Co-Creation with Users
Authors: Akasaka Fumiya , Yasuoka Mika , Nakatani Momoko , Kimura Atsunobu , Ihara Masayuki ,   NTT Service Evolution Laboratories 1-1 Hikarino-oka, Yokosuka, Kanagawa 239-0847, Japan,   Roskilde University, Roskilde, Denmark
Published: September 2020

“Value co-creation” among actors related to service provision is one of the key concepts in service design. Living Lab (LL) is a co-creative service design methodology in which designers and users collaboratively design services. In LL, users are actively involved in service design processes over long periods. Because LL is a design methodology based on long-term co-creation with users, its practices involve more direct and indirect communication and collaboration with users than typical service design does. Therefore, in order to make value co-creation successful in LL projects, it is crucial for designers to use not only knowledge of service design methods, but also practical know-how related to “facilitating long-term co-creation with users.” Such know-how is not always shared, however, among LL practitioners, because it is often buried in their experiences. Thus, LL practice currently places heavy reliance on the practitioners’ intuition and experience. Therefore, to support LL practitioners, it is essential to extract key know-how on how to achieve successful LL projects from experienced practitioners, and to describe such know-how. This would allow us to share and reuse know-how in planning and running an LL project. Hence, the purpose of this study is to extract such key know-how for LL practice and describe it in an easy-to-reuse manner. We first developed a workshop to extract key know-how for LL practice. In this study, we held the workshop twice and could extract 30 items of key know-how. Subsequently, we described the extracted key know-how as “patterns” by using the pattern language framework, and we developed a booklet listing the 30 patterns in an easy-to-reuse manner. The booklet can be used by LL practitioners to refer to and reuse the key know-how for LL practice. Through an evaluation, we confirmed that the developed booklet is useful for LL practitioners for referring to and using LL know-how.
How to Choose the Optimal Single-Pill Combination of the First-Line Antihypertensive Drugs? The Benefits of Amlodipine and Telmisartan Combination
Authors: Ostroumova O. D. , Kochetkov A. I. , Butorov V. N. , Krotkova I. F.
Published: September 2020

In patients with arterial hypertension (AH), an extremely important measure of the effectiveness of antihypertensive drugs (AHD) is not only a direct decrease in blood pressure (BP), but also its stable control throughout the 24 hours, preventing excessive morning surge and increased BP variability, which in turn are recognized cardiovascular risk factors. Currently, in the vast majority of hypertensive patients, the main antihypertensive therapy approach is using single-pill combinations (SPC) of AHD. Among the first-line combinations for a wide range of patients with AH and no special clinical conditions is amlodipine/telmisartan SPC. Distinctive features of these drugs, on the one hand, are unique pharmacological properties, consisting in an ultra-long antihypertensive effects, superior to other AHD in their classes; and on the other hand, there is an large body of evidence from numerous clinical trials confirming their high antihypertensive and target-organ protective potential as well as excellent capabilities in cardiovascular risk reduction. To assess the AHD effectiveness extent, several parameters have been proposed, of which the most rational and useful is the smoothness index, calculated using the ambulatory blood pressure monitoring data. Smoothness index describes both the degree of BP reduction and its distribution during the monitoring period. This index inversely associates with the changes in BP variability, and has predictive value in relation to the hypertension-mediated organ damage regression during different antihypertensive regimens. Amlodipine/telmisartan SPC has also been studied in many trials, including comparative ones with other AHD. In these works its direct powerful antihypertensive effect and a pronounced beneficial impact on the smoothness index have been proved, demonstrating stable BP control throughout the 24 hours (especially in the most dangerous morning hours), and also a decrease in BP variability. Therefore, amlodipine/telmisartan SPC can effectively reduce cardiovascular risk and improve prognosis in patients with AH.
From Low-Dose Fixed Combinations for Arterial Hypertension Treatment to Multi-Target Therapy of Cardiovascular Diseases
Authors: Lebedev P. A. , Garanin A. A.
Published: September 2020

The article presents the evolutionary development of combination therapy from the creation of a multicomponent tablet for the treatment of arterial hypertension (AH) to modern multi-target fixed combinations as the most effective approach to the fight against cardiovascular diseases (CVD). The priority of domestic scientists, in particular academician A.L. Myasnikov, in the development and creation of a combined drug for AH treatment is shown. The development of pharmacology and pharmaceutical technologies has allowed to expand the range of possible drug combinations for AH therapy, and the discovery of new pathophysiological mechanisms involved in the cardiovascular continuum has led to the understanding of the close links between AH and atherosclerosis. This fact prompted the scientific community to search for and implement in practice drug combinations that would allow multi-target therapy, that is, to influence several pathological processes and achieve a number of therapeutic goals. The presented review testifies to the transformation of the concept of fixed combinations for patients with AH into the concept of a multi-target drug. Multi-targeting is achieved not only by the pleotropic of components known as hypotensive agents, but also by combination with statins. Taking into account the wide AH prevalence in the population, its high medical and social significance, the critical importance as a risk factor for CVD, the authors consider a justified clinical and epidemiological approach to primary prevention of CVD with the widespread use of multi-targeted therapy in all high-risk patients with AH. It is expedient to develop new domestic medicines that implement the concept of a multi-targeted drug, to include them in the list of vital medicines, to increase the availability of these drugs to the population on the basis of preferential programs.
Changes in Arterial Wall Stiffness in Patients with Obesity and Paroxysmal Form of Atrial Fibrillation
Authors: Podzolkov V. I. , Tarzimanova A. I. , Bragina A. E. , Osadchiy K. K. , Gataulin R. G. , Oganesyan K. A. , Lobova N. V. , Jafarova Z. B.
Published: September 2020

Aim. To study changes in vascular wall stiffness in patients with obesity and paroxysmal atrial fibrillation (AF) during sinus rhythm retention.

Material and methods. The study included 86 obese patients aged 38 to 72 years. Patients were divided into 2 groups: 42 patients with paroxysmal AF and obesity (Group I) and 44 patients with obesity and without rhythm disturbance (Group II). All patients were evaluated for the main parameters of arterial wall stiffness: the heart-ankle vascular index (CAVI) and the ankle-brachial index (ABI) in the right and left main arteries.

Results. Body mass index (BMI) did not differ significantly between groups. The prevalence of visceral obesity in patients with paroxysmal AF was significantly higher than in patients without heart rhythm disorders. The study of vascular wall rigidity revealed a significant increase in the CAVI index in patients with paroxysmal AF compared with this in patients without cardiac arrhythmia. The average value of the CAVI index was 9.61±1.51 and 7.92±0.18, respectively (p=0.0003). In patients with obesity and paroxysmal AF, correlations were found between waist circumference to hip circumference (WC/HC) ratio and CAVI index (r=0.455, p=0.004); WC/height ratio and CAVI index (r=0.443, p=0.003); between WC and CAVI index (r=0.493, p=0.002). A positive direct relationship was found between CAVI index and the frequency of AF attacks during the year: r=0.782 (p=0.001).

Conclusion. A significant increase in the CAVI index, indicating a change in vascular wall stiffness, was found in patients with obesity and paroxysmal AF when compared with overweight patients without heart rhythm disorders. The increase in the CAVI index was correlated with the increase in WC, the WC/HC ratio, and WC/height ratio. There was a significant direct relationship between the CAVI index and the frequency of arrhythmia attacks in patients with obesity and paroxysmal AF.
Felodipine in Treatment of Arterial Hypertension and Ischemic Heart Disease
Authors: Ostroumova O. D. , Alautdinova I. A. , Kochetkov A. I. , Litvinova S. N.
Published: September 2020

Cardiovascular diseases are the leading cause of death both in the world and in the Russian Federation. The most significant contributors to the increase in mortality are arterial hypertension (AH) and ischemic heart disease (IHD). Dihydropyridine calcium channel blockers (CCBs) are the first line of treatment for these conditions. This is noted in the clinical guidelines for the diagnosis and treatment of AH and in the guidelines for the management of patients with chronic coronary syndromes. CCBs are a heterogeneous group of drugs that have both general and individual pharmacokinetic and pharmacodynamic properties. They are used in patients with AH and/or IHD, including those with concomitant diseases (diabetes mellitus, chronic kidney disease, bronchial asthma, chronic obstructive pulmonary disease, peripheral arterial disease). Felodipine is one of the CCBs. It has a combination of clinical effects, allowing the drug to be prescribed as a first-line therapy for AH, IHD and a combination of these diseases. This is noted in the registered indications for its use. This CCB has a sufficient evidence base of clinical trials demonstrating not only good antihypertensive and antianginal potential of the drug, but also the nephroprotection and cerebroprotection properties. The nephroprotective effect of felodipine is associated with a slowdown in the progression of chronic kidney disease, and the cerebroprotective effect is associated with a decrease in the risk of stroke and an improvement in cognitive functioning. The safety profile of felodipine is favorable: peripheral edema develops much less frequently. This is confirmed by the results of comparative studies. Felodipine is recommended for a wide range of patients with AH, IHD and their combination due to such clinical and pharmacological properties.
COVID-19 Pneumonia in Patients with Chronic Myocarditis (Recurrent Infectious Immune): Specifics of the Diseases Course, the Role of Basic Therapy (Part 1)
Authors: Blagova O. V. , Varionchik N. V. , Beraia M. M. , Zaidenov V. A. , Kogan E. A. , Sarkisova N. D. , Nedostup A. V.
Published: September 2020

Patients with chronic myocarditis have a high risk of an unfavorable course of the novel coronavirus disease (COVID-19) due to the ability of the SARS-Cov-2 virus to independently cause acute myocarditis, to have a direct and cytokine-mediated cytopathic effect on the myocardium, as well as immunosuppressive therapy. At the same time, the features of the interaction of chronic myocarditis and COVID-19 have not been studied. The article describes a 31-year-old patient with a 10-year history of chronic recurrent infectious-immune myocarditis, who was on long-term immunosuppressive therapy (methylprednisolone and azathioprine in the past, then hydroxychloroquine). In May 2020, a serologically confirmed COVID-19 diagnosis was made. There were risk factors for the unfavorable course of coronavirus infection: heart failure and a history of persistent atrial fibrillation, male sex. Basic therapy with hydroxychloroquine (with an increase in its dose to 800-400 mg/day), ceftriaxone, and levofloxacin was carried out. The severity of pneumonia was moderate, despite febrile fever and severe intoxication. No relapses of arrhythmias, respiratory or heart failure were observed. Minimal laboratory (some increase in anticardial antibody titers) and echocardiographic signs of exacerbation of myocarditis without an increase in troponin T levels were revealed, which quickly regressed. It can be assumed that the maintenance immunosuppressive therapy of myocarditis with hydroxychloroquine had a positive effect on the course of coronavirus pneumonia and made it possible to avoid recurrence of myocarditis. Further study of the features of the course of the pre-existing myocarditis and pneumonia in COVID-19 is necessary.
Studies on the Prevalence of Hepatitis C Virus Infection in Diabetic Patients attending a Tertiary Health-care Facility South-west Nigeria.
Authors: NDAKO James A. , Owolabi Akinyomade O , Olisa Joseph A. , Akinwumi Jeremiah A. , Dojumo Victor T. , Olatinsu Oludolapo , Adebayo Blessing A.
Published: September 2020

Background: Hepatitis C virus (HCV) infection and type 2 diabetes mellitus (T2DM) are two major public health problems associated with increasing complications and mortality rates worldwide. The objective of this study to evaluate the prevalence of hepatitis C virus (HCV) infection in diabetic patients and to investigate the influence of several epidemiological and clinical factors on HCV infection. Method: A total number of one hundred and eighty diabetic patients were recruited for this study. Consented subjects made up of 71(39.4%) males and 109(60.56%) females were recruited for the study. While one-Hundred (100) Non-Diabetics (Controls) were recruited for this study. Structured questionnaires were administered to the consented participants to obtain relevant data. Sera samples were assayed for antibodies to HCV using an enzyme linked immunosorbent assay [Inteco Diagnostic Limited]. ELISA technique. Result: Overall prevalence of HCV infection among diabetes patients assayed was 13.3%. Out of which 8(11.3%) was obtained from the male subjects compared to 16 (14.7%) seropositivity recorded for the female subjects (P = 0.511; P > 0.05). Considering age distribution, Subjects aged 41-50 years recorded, 9 (22.5%) positivity (P= 0.238; P>0.05).Considering educational status of subjects screened, 22 (14.9%) positivity was rescored among subjects who have attained tertiary status of education.( P = 0.574;P>0.05).Risk factors considered showed that, 7 (18.9%) seropositive subject were alcoholic consumers(P value = 0.2621;P>0.05) while 5 (8.9%) recorded history of sharing sharp objects P= 0.2427;P>0.05). Conclusion: Our study shows a slightly higher prevalence of hepatitis C infection in type 2 diabetics. This call for urgent routine screening exercise among diabetic patients for HCV infection. This study also emphasizes the need for public enlightenment of the association between HCV infection and T2DM, to avert possible complications among diabetic patients. Keywords: HCV, Type 2 diabetes mellitus (T2DM), Patients
The Value and Feasibility of South-South Medical Elective Exchanges in Africa
Authors: Daniels Katy , Thomson Emma , Nawagi Faith , Flinkenflogel Maaike
Published: September 2020

Background An elective is part of the curriculum where students have the flexibility to choose both the study topic and location. International medical electives are a well-established part of curricula at most medical schools in high-income countries. They are highly valued by students and have proven educational benefits, though do come with challenges, such as lack of reciprocity. Low and middle-income countries frequently host students from high-income countries providing learning opportunities, yet also carry the burden of supervision and resource consumption, whilst their students get few elective opportunities. This study explores the value and feasibility of South-South Medical Elective Exchanges (SSMEE), which creates elective opportunities for African medical students in other African countries to create reciprocity within the elective system.Method A qualitative evaluation of the South-South Medical Elective Exchanges was conducted using a case study approach. Four African medical schools, College of Medicine, Malawi; University of Rwanda, Rwanda; University of Witwatersrand, South Africa and Makerere University, Uganda participated in the pilot study in 2017/18. Each institution selected two students to participate in a four-week elective to another participating institute. Participating students completed a pre-elective questionnaire and a post-elective interview exploring expectations, learning outcomes, challenges and how they are applying this learning. Data was analysed thematically.Results Data presented is from six of the eight participating students. All students found the elective a valuable experience and learning was demonstrated in four key areas: clinical knowledge and skills; attitudes; personal and professional development and global perspectives. For some, it challenged their assumptions of what an elective is because valuable learning can be achieved whilst remaining in Africa. The main challenge found related to funding the elective. Conclusions The SSMEE model is feasible and provides valuable learning for participating students and their peers/colleagues. Financing electives remains the biggest challenge. Since this pilot study, SSMEE has become part of a regional elective exchange network in Africa with an additional four institutions in three other countries. As such SSMEE has resulted in increased opportunities for African medical students and better educational outcomes that are likely to have a positive effect on healthcare systems in Africa.
Use of Spinal Anaesthesia In Neonates And Infants In Antananarivo, Madagascar: A Retrospective Descriptive Study  
Authors: Randriamizao Harifetra Mamy Richard , Rakotondrainibe Aurelia , Razafindrabekoto Lova Dany Ella , Ravoaviarivelo Prisca Funken , Rajaonera Andriambelo Tovohery , Andriamanarivo Mamy Lalatiana
Published: September 2020

Objective: The aim of this study was to present the first cases of spinal anesthesia, in newborns and infants, preterm / ex-prematures, in order to determine its feasibility and its potential harmlessness, in Antananarivo – Madagascar. Indeed, spinal anesthesia is a low cost technique and can limit respiratory complications, postoperative apnea a contrario with pediatric general anesthesia which can lead to perioperative risks. Results: In a retrospective, descriptive, seven-year (2013 to 2019) period study, conducted in the University Hospital Joseph Ravoahangy Andrianavalona, 69 patients’ data files planned to have spinal anesthesia were recorded. These pediatric patients were predominantly male (sex ratio = 2.8) and 37 [28 - 52] days old. The smallest anesthetized child weighed 880g; the youngest was 4 days old. Twenty-seven (27) of them were premature and 20.3% presented respiratory diseases. They were mostly scheduled for hernia repair (90%). Spinal anesthesia was performed, with a Gauge 25 Quincke spinal needle, after 2 [1 - 2] attempts with hyperbaric bupivacaine of 4 [3.5 - 4] mg. Failure rate was 5.8%. The heart rate was stable throughout perioperative period and no complications were observed.
Duodenal major papilla morphology can affect biliary cannulation and complications during ERCP, an observational study
Authors: Chen Po-Han , Tung Chun-Fang , Peng Yen-Chung , Yeh Hong-Zen , Chang Chi-Sen , Chen ChiaChang
Published: September 2020

Background We investigated whether duodenal major papilla morphology could be a risk factor for failure of selective biliary cannulation (SBC) and post endoscopic retrograde cholangiography and pancreatography (ERCP) complications.Methods A prospectively recorded database was reviewed retrospectively. Patients were included if they received therapeutic ERCP and had naïve major duodenal papilla. We used Haraldsson’s classification for papilla morphology, as follows: Regular (Type 1), Small (Type 2), Protruding or Pendulous (Type 3) and Creased or Ridged (Type 4). Risk factors for failing SBC and post-ERCP complications were analyzed by multivariate analysis.Results A total of 286 cases were included. Age, gender, indications and therapeutic procedures were not different among the four types of papillae. The failure rates of SBC with Type 3 papilla and Type 4 papilla were 11.11% and 6.25%, respectively. In the multivariate analysis, Type 2 papilla (odd ratio 7.18, p= 0.045) and Type 3 papilla (odd ratio 7.44, p= 0.016) were associated with greater SBC failure compared with Type 1 papilla. Malignant obstruction compared to stone (odds ratio 4.45, p=0.014) and age (odd ratio=1.06, p=0.010) were also risk factors for cannulation failure. Type 2 papilla was correlated with a higher rate of post-ERCP pancreatitis (20%, p=0.020) compared to the other types of papilla However, papilla morphology was not a significant risk factor for any complications in the multivariate analysis.Conclusion Small papilla and protruding or pendulous papilla are more difficult to cannulate compared to regular papilla. Small papilla is associated with a higher rate of post-ERCP pancreatitis.
Identification of infrasonic and seismic components of tremors in single-station records: application to the 2013 and 2018 events at Ioto Island, Japan
Authors: Kurokawa Aika K , Ichihara Mie
Published: September 2020

Infrasonic stations are sparse at many volcanoes, especially those on remote islands and those with less frequent eruptions. When only a single infrasound station is available, the seismic-infrasonic cross-correlation method has been used to extract infrasound from wind noise. However, it does not work with intense seismicity and sometimes mistakes ground-to-atmosphere signals as infrasound. This paper proposes a complementary method to identify the seismic component and the infrasonic component using a single microphone and a seismometer. We applied the method to estimate the surface activity on Ioto Island. We focused on volcanic tremors during the phreatic eruption on April 11, 2013, and during an unconfirmed event on September 12, 2018. We used the spectral amplitude ratios of the vertical ground motion to the pressure oscillation and compared those for the tremors with those for known signals generated by volcano-tectonic earthquakes and airplanes flying over the station. We were able to identify the infrasound component in the part of the seismic tremor with the 2013 eruption. On the other hand, the tremor with the unconfirmed 2018 event was accompanied by no apparent infrasound. We interpreted the results that the infrasound with the 2013 event was excited by the vent opening or the ejection of ballistic rocks, and the 2018 event was not an explosive eruption either on the ground or in the shallow water. If there was any gas (and ash) emission, it might have occurred gently undersea. As the method uses the relative values of on-site records instead of the absolute values, it is available even if the instrument sensitivity and the station site effects are poorly calibrated.
Rasch analysis of the Living with Chronic Illness Scale in Parkinson’s disease
Authors: Ambrosio Leire , Rodriguez-Blazquez Carmen , Ayala Alba , Forjaz Maria João
Published: September 2020

Background Neurologists play an essential role in facilitating the patient’s process of living with Parkinson’s disease (PD). The Living with Chronic Illness Scale-PD (LW-CI-PD) is a unique available clinical tool that evaluates how the patient is living with PD. The objective of the study was to analyse the LW-CI-PD properties according to the Rasch model.Methods An open, international, cross-sectional study was carried out in 324 patients with Parkinson’s disease from four Latin American countries and Spain. Psychometric properties of the LW-CI-PD were tested using Rasch analysis: fit to the Rasch model, item local independency, unidimensionality, reliability, and differential item functioning by age and gender.Results Original LW-CI-PD do not fit Rasch model. Modifications emerged included simplifying the response scale and deleting misfit items, the dimensions Acceptance, Coping and Integration showed a satisfactory fit to the Rasch model, with reliability indices greater than 0.70. The dimensions Self-management and Adjustment to the disease did not reach fit to the Rasch model.Conclusion Suggestions for improving the LW-CI-PD include a multidimensional and shorter scale with 12 items grouped in three subscales with a simpler response scheme. The final LW-CI-PD Scale version is a reliable scale, with good internal construct validity, that provides Rasch transformed results on linear metric scale.
Long-term Effects of Mixed Planting on Arbuscular Mycorrhizal Fungal Communities in the Roots and Soils of Juglans mandshurica Plantations
Authors: Ji Li , Zhang Yan , Yang Yuchun , Yang Lixue , Yang Na , Zhang Depeng
Published: September 2020

Background: Establishing mixed plantations is an effective way to improve soil fertility and increase forest productivity. Arbuscular mycorrhizal (AM) fungi are obligate symbiotic fungi that can promote mineral nutrient absorption and regulate intraspecific and interspecific competition in plants. However, the effects of mixed plantations on the community structure and abundance of AM fungi are still unclear. Illumina MiSeq sequencing was used to investigate the AM fungal community in the roots and soils of pure and mixed plantations (Juglans mandshurica × Larix gmelinii). The objective of this study is to compare the differential responses of the root and rhizosphere soil AM fungal communities of Juglans mandshurica to long-term mixed plantation management.Results: Glomus and Paraglomus were the dominant genera in the root samples, accounting for more than 80% of the sequences. Compared with that in the pure plantation, the relative abundance of Glomus was higher in the mixed plantation. Glomus, Diversispora and Paraglomus accounted for more than 85% of the sequences in the soil samples. The relative abundances of Diversispora and an unidentified genus of Glomeromycetes were higher and lower in the pure plantation, respectively. The Root_P samples (the roots in the pure plantation) had the highest number of unique OTUs (operational taxonomic units), which belonged mainly to an unidentified genus of Glomeromycetes, Paraglomus, Glomus and Acaulospora. The number of unique OTUs detected in the soil was lower than that in the roots. In both the root and soil samples, the forest type did not have a significant effect on AM fungal diversity, but the Sobs value and the Shannon, Chao1 and Ace indices of AM fungi in the roots were significantly higher than those in the soil.Conclusions: Mixed forest management had little effect on the AM fungal community of Juglans mandshurica roots and significantly changed the community composition of the soil AM fungi, but not the diversity.
Exploiting an early warning nomogram for predicting the risk of ICU admission in COVID-19 patients: A multi-center study in China
Authors: Zhou Yiwu , He Yanqi , Yang Huan , Yu He , Wang Ting , Chen Zhu , Yao Rong , Liang Zongan
Published: September 2020

Background Novel coronavirus disease 2019 (COVID-19) is a global public health emergency. Here, we developed and validated a practical model based on the data from a multi-center cohort in China for early identification and prediction of which patients will be admitted to the intensive care unit (ICU).Methods Data of 1087 patients with laboratory-confirmed COVID-19 were collected from 49 sites between January 2 and February 28, 2020, in Sichuan and Wuhan. Patients were randomly categorized into the training and validation cohorts (7:3). The least absolute shrinkage and selection operator and logistic regression analyses were used to develop the nomogram. The performance of the nomogram was evaluated for the C-index, calibration, discrimination, and clinical usefulness. Further, the nomogram was externally validated in a different cohort.Results The individualized prediction nomogram included 6 predictors: age, respiratory rate, systolic blood pressure, smoking status, fever, and chronic kidney disease. The model demonstrated a high discriminative ability in the training cohort (C-index = 0.829), which was confirmed in the external validation cohort (C-index = 0.776). In addition, the calibration plots confirmed good concordance for predicting the risk of ICU admission. Decision curve analysis revealed that the prediction nomogram was clinically useful.Conclusion We established an early prediction model incorporating clinical characteristics that could be quickly obtained on hospital admission, even in community health centers. This model can be conveniently used to predict the individual risk for ICU admission of patients with COVID-19 and optimize the use of limited resources.
Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis
Authors: Duarte Vinicius Campos , Coelho Fabricio , Valverde Alain , Danoussou Divia , Kruger Jaime , Zuber Kevin , Fonseca Gilton , Jeismann Vagner , Herman Paulo , Lupinacci Renato
Published: September 2020

Background: Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs). Methods: Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups. \Results: During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P=0.01), lower rate of minor complications (13.5% vs. 35%, P=0.03) and larger resection margins (10 mm vs. 5 mm, P=0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P=0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, major complications or perioperative mortality were observed. OS was similar between the groups (P=0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P=0.09) and liver metastasis (P=0.80). \Conclusions: MIRHs are feasible and safe. Minimally invasive approach is associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.
Improvement of Near-field Tsunami Forecasting Method Using Ocean Bottom Pressure Sensor Network (S-net)
Authors: Tanioka Yuichiro
Published: September 2020

Since the installation of a dense cabled observation network around the Japan Trench (S-net) by the Japanese government that includes 150 sensors, several tsunami forecasting methods that use the data collected from the ocean floor sensors were developed. One of such methods is the tsunami forecasting method which assimilates the data without any information of earthquakes. The tsunami forecasting method based on the assimilation of the ocean-bottom pressure data near the source area was developed by Tanioka in 2018. However, the method is too simple to be used for an actual station distribution of S-net. To overcome its limitation, we developed an interpolation method to generate the appropriate data at the equally spaced positions for the assimilation from the data observed at sensors in S-net. The method was numerically tested for two large underthrust fault models, a giant earthquake (Mw8.8) and the Nemuro-oki earthquake (Mw8.0) models. Those fault models off Hokkaido in Japan are expected to be ruptured in the future. The weighted interpolation method, in which weights of data are inversely proportional to the square of the distance, showed good results for the tsunami forecast method with the data assimilation. Furthermore, results indicated that the method is applicable to the actual observed data at the S-net stations. The only limitation of the weighted interpolation method is that the computed tsunami wavelengths tend to be longer than the actual tsunamis wavelength.
Efficacy of closed reduction for developmental dysplasia of the hip: midterm outcomes and risk factors associated with treatment failure and avascular necrosis
Authors: Zhang Ge , Li Ming , Qu Xiangyang , Cao Yujiang , Liu Xing , Luo Cong , Zhang Yuan
Published: September 2020

Background: The purpose of this study was to evaluate the efficacy after closed reduction (CR) in the treatment of developmental dysplasia of the hip (DDH) and to investigate risk factors associated with CR failure and avascular necrosis (AVN) occurrence in follow-ups. Mehtods: The study retrospectively included 110 patients and 138 hips with DDH diagnosis that underwent closed reduction between February 2012 and November 2015 in our single tertiary medical institution. The failure rate of CR and the underlying risk factors were evaluated. Meanwhile, the incidence of AVN and the related risk factors among the successful CR cases were assessed.Results: The overall failure rate of DDH treated by CR in present study was 31.16% (43/138). Risk factors for the CR failure was older age at the time of CR (≥18.35 month), large medical interval before CR (≥35.35 millimeters), and severer dislocation of the affected hip (IDHI grade III and IV). The incidence of AVN was 8.33% (6/72) in the patients with successful CR at last follow-up. No significant risk factors had been established in present study that associated with the AVN occurrence.Conclusions: For the treatment of DDH with CR, patients with younger age might achieve better outcomes, early diagnosis and early treatment might be the key point in the DDH treatment.
The strategies of perioperative management in orthopedic department during the pandemic of COVID-19
Authors: Zeng Hui , Li Guoqing , Weng Jian , Xiong Ao , Xu Chang , Yang Yifei , Wang Deli
Published: September 2020

Background: Coronavirus disease 2019 (COVID-19) broken out and spread rapidly nationwide at the beginning of 2020, which has brought huge impacts to people and work. The current situation of prevention and control is severe and urge guidance for clinicians, especially for medical systems. In the hope of providing a reference and recommendation for the prevention and control of the COVID-19, we carried out research to improve the quality of patients care and prevention during this epidemic.Methods: All of the staff were trained rapidly to master personal protection in our department. We reviewed the patients’ discharged records who underwent surgery in our department during January 1st to March 1st in 2019 and January 1st to March 1st in 2020. The managements of the surgery patients and flow charts were described and analyzed. Post-operation outcomes of the patients including duration, complications, surgical site infection (SSI), system infection, re-operation, and mortality. Both chi-squared test and Student’s t-test were performed to determine the relationship between the two periods in term of post-operation outcomes.Results: Descriptive statistics analysis revealed that demographic of the patients between the two periods is similar. We had been benefited from the strict flow charts, smart robot and protection equipment in management of perioperative for orthopedic patients. With the help of the strict flow charts and smart equipment, post-operation outcomes of the patients revealed that the rates of the complications and re-operation had been reduced significantly (p＜0.05), while duration of operation, SSI and system infection had no significantly difference between two periods (p＞0.05). No patient and staff caught COVID-19 infection or mortality during the epidemic. Conclusions: Our study indicated that medical quality and efficiency were affected little with the help of strategies described above during the epidemic, which could be a reference tool for medical staff in routine clinical practice for admission of patients around the world. What’s more, the provided strategies, which may evolve over time, could be used as empirical guidance and reference for orthopedic peers to get through the pandemic and ensure the normal operation of the hospital.
Detection and prevalence of depression among adult type 2 diabetes mellitus patients attending non-communicable diseases clinics in Lilongwe, Malawi
Authors: Udedi Michael , Pence Brian W. , Stewart Robert C. , Muula Adamson S.
Published: September 2020

Background Depression is associated with chronic physical illnesses and negatively affects health outcomes. However, it often goes undiagnosed and untreated. We investigated the prevalence of depression among adult type 2 diabetes mellitus (T2DM) patients attending non-communicable diseases (NCD) clinics in Lilongwe, Malawi, and estimated the level of routine detection by NCD clinicians. This study set out to determine the prevalence of major depression and its detection among adult type 2 diabetes mellitus (T2DM) patients attending NCD clinics in Lilongwe, Malawi. Methods In a cross-sectional study design, 323 T2DM patients aged ≥18 years were screened for depression with the Patient Health Questionnare-9 (PHQ-9) followed by diagnostic assessment with the Structured Clinical Interview for DSM-IV (SCID). We analysed the association between presence of major depression and sociodemographic factors using logistic regression. Results Three quarters of the participants (76%) were females. The participants’ ages ranged from 21-79 years. Of the 323 participants, 58 (18%) met criteria for DSM-IV major depression. None of the cases of major depression had been identified by the NCD clinicians. Major depression was found not to be significantly associated with any of the sociodemographic factors.Conclusions We found that depression is common among NCD clinic attendees with T2DM in Malawi,, and poorly detected by NCD clinicians. Given the high prevalence and challenges in clinical identification, integration of depression screening with a standardized validated tool should be a high priority so as to link patients to appropriate services.