bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation of Wettability Gradient Surfaces on a Copper Slide via Solid Liquid Interface Oxidation and COMSOL-Based Simulation for Directional Droplet Movement
Authors: Zhang Yong , Cheng Jiang
Published: November 2022

A simple approach for preparing wettability gradient surfaces on copper substrates is presented via alkali assistant surface oxidation by using gradual immersion in an NaOH/(NH4)S2O8 solution. Additionally, a 2D model was built applying a finite element
analysis software (COMSOL) to explain the moving velocity of a droplet and the force applied when moving on the gradient surface. The developed approach is simple, effective, and environmentally friendly. Thus, it could potentially be used in applications requiring heat transfer for the enhancement
of the thermal performance of grooved heat pipes.
Proteomic analysis reveals that aging rabbit vocal folds are more vulnerable to changes caused by systemic dehydration
Authors: do Nascimento Naila C. , Bailey Taylor W. , Santos Andrea P. , Duan Chenwei , Mohallem Rodrigo , Franco Jackeline , Aryal Uma K. , Xie Jun , Cox Abigail , Sivasankar M. Preeti
Published: November 2022

Background

Older adults are more prone to develop systemic dehydration. Systemic dehydration has implications for vocal fold biology by affecting gene and protein expression. The objective of this study was to quantify vocal fold protein changes between two age groups and hydration status, and to investigate the interaction of age and hydration status on protein expression, which has not been investigated in the context of vocal folds before. Comparative proteomics was used to analyze the vocal fold proteome of 6.5-month-old and > 3-year-old rabbits subjected to water ad libitum or water volume restriction protocol.

Results

Young and older adult rabbits (n = 22) were either euhydrated (water ad libitum) or dehydrated by water volume restriction. Dehydration was confirmed by body weight loss of − 5.4% and − 4.6% in young and older groups, respectively, and a 1.7-fold increase of kidney renin gene expression in the young rabbits. LC-MS/MS identified 2286 proteins in the rabbit vocal folds of young and older adult rabbits combined. Of these, 177, 169, and 81 proteins were significantly (p ≤ 0.05) affected by age, hydration status, or the interaction of both factors, respectively. Analysis of the interaction effect revealed 32 proteins with opposite change patterns after dehydration between older and young rabbit vocal folds, while 31 proteins were differentially regulated only in the older adult rabbits and ten only in the young rabbits in response to systemic dehydration. The magnitude of changes for either up or downregulated proteins was higher in the older rabbits. These proteins are predominantly related to structural components of the extracellular matrix and muscle layer, suggesting a disturbance in the viscoelastic properties of aging vocal fold tissue, especially when subjected to systemic dehydration.

Conclusions

Water restriction is a laboratory protocol to assess systemic dehydration-related changes in the vocal fold tissue that is translatable to human subjects. Our findings showed a higher number of proteins differentially regulated with a greater magnitude of change in the vocal folds of older adult rabbits in the presence of systemic dehydration compared to younger rabbits. The association of these proteins with vocal fold structure and biomechanical properties suggests that older human subjects may be more vulnerable to the effects of systemic dehydration on vocal function. The clinical implications of these protein changes warrant more investigation, but age should be taken into consideration when evaluating vocal treatment recommendations that interfere with body fluid balance.
Changes in hyperglycaemia-related testing for prediabetes and type 2 diabetes mellitus management: a prospective, cross-sectional survey of 16 years of general practice data from Australia
Authors: Leigh Andrew , Hunter Jennifer , Harrison Christopher , Britt Helena , Molodysky Eugen
Published: November 2022

Background

The rising prevalence of prediabetes increases the population risk of type 2 diabetes mellitus (T2DM), metabolic syndrome and cardiovascular disease. Early identification by General Practitioners (GPs) provides opportunities for lifestyle modifications that can lower these risks.

Methods

This study examined 16 years of hyperglycaemia-related testing for patients in Australia aged 13 years or older with, or at risk of a diagnosis of T2DM. The Bettering the Evaluation and Care of Health (BEACH) study is a national cross-sectional survey, with a single-stage, cluster sampling design. Approximately 1,000 GPs were randomly selected annually (2000/01–20,015/16) from across Australia, who each recorded details of 100 consecutive clinical encounters with consenting patients. Point estimates were adjusted for intracluster correlation and GP characteristics.

Results

Fifteen thousand six hundred seventy nine GPs recorded details of 1,387,190 clinical encounters with patients aged 13 + years. Prediabetes and T2DM were managed at 0.25% (95% CI: 0.24–0.27%) and 3.68% (95% CI: 3.62–3.73%) of encounters respectively. By the end of the study, the proportion of encounters where prediabetes was managed was 2.3 times higher and for T2DM, 1.5 times higher. The proportion of prediabetes (55.9%, 95% CI: 53.9–57.8%) and T2DM (27.3%, 95% CI: 26.7–27.9%) management occasions where one or more hyperglycaemia-related tests were requested were relatively stable. However, differences in the types of tests were observed. For prediabetes, glucose tolerance tests were most common but from 2014/15, requests for HbA1c tests began to increase. For T2DM, HbA1c tests were most common, and requests for one or more glucose tests gradually declined.

Conclusion

The observed 16-year annual trends align with the rising incidence of prediabetes and T2DM. GPs appeared to be strongly influenced by changes to the national insurance scheme and clinical guidelines for hyperglycaemia-related pathology testing. However, some GPs may have been pre-empting policy changes as there was also evidence of ‘unendorsed’ testing, notably for prediabetes, that warrants further investigation. The increasing proportion of encounters for prediabetes, coupled with a high proportion of management occasions where pathology was requested have substantial resource implications. Calls to lower the risk threshold for prediabetes screening therefore warrant an economic analysis. Ongoing, reliable, up-to-date data is needed to inform clinical practice guidelines and policy in Australia.
Frontal lobe development in fetuses with growth restriction by using ultrasound: a case–control study
Authors: Peng Ruan , Zheng Qiao , Wu Li-Hong , Yin Xia , Zheng Ju , Xie Hong-Ning
Published: November 2022

Background

Fetal growth restriction (FGR) occurs in up to 10% of pregnancies and is a leading cause of perinatal mortality and neonatal morbidity. Three-dimensional ultrasonography of intracranial structure volume revealed significant differences between fetuses with FGR and appropriate for gestational age (AGA) fetuses. We aimed to compare the frontal lobe development between fetuses with FGR and appropriately grown fetuses and evaluate the impact of fetal circulatory redistribution (FCR) on frontal lobe development in fetuses with FGR.

Methods

We performed a case–control study at our institution from August 2020 to April 2021. The frontal antero-posterior diameter (FAPD) and occipito-frontal diameter (OFD) were measured on the trans-ventricle view and we calculated the Z-scores for FAPD and OFD standardized for gestational age (GA) and transverse cerebellar diameter (TCD) by performing a standard regression analysis followed by weighted regression of absolute residual values in appropriately grown fetuses. We calculated the FAPD/OFD ratio as 100 × FAPD/OFD and FAPD/HC (head circumference) as 100 × FAPD/HC. To compare intracranial parameters, we randomly selected a control group of appropriately grown fetuses matched with the FGR group at the time of ultrasonography. We performed between-group comparisons of the FAPD Z-score, OFD Z-score, FAPD/OFD ratio and FAPD/HC. Similarly, we compared intracranial parameters between fetuses with FGR with and without FCR.

Results

FAPD/OFD ratio was curvilinear related to all the independent variables (GA, BPD, FL, and TCD). Compared with appropriately grown fetuses, fetuses with FGR showed a significantly lower FAPD/OFD ratio, FAPD Z-score, and FAPD/HC. There was no significant difference in the FAPD Z-score, FAPD/OFD ratio, and FAPD/HC between FGR fetuses with and without FCR.

Conclusions

The FAPD/OFD ratio varied during pregnancy, with a mild reduction before and a mild increase after about 33 gestational weeks. Fetuses with FGR showed reduced frontal lobe growth; moreover, fetal frontal lobe development disorders were not significantly different in fetuses with FCR.

Trial registration

Date: 09–27-2017; Number: [2017]239.
A prospective registry analysis of psychosocial and metabolic health between women with and without metabolic syndrome after a complicated pregnancy
Authors: Aldridge Emily , Schubert K. Oliver , Pathirana Maleesa , Sierp Susan , Leemaqz Shalem Y. , Roberts Claire T. , Dekker Gustaaf A. , Arstall Margaret A.
Published: November 2022

Purpose

Pregnancy complications affect over one quarter of Australian pregnancies, and this group of mothers is vulnerable and more likely to experience adverse cardiometabolic health outcomes in the postpartum period. Metabolic syndrome is common in this population and may be associated with postpartum mental health issues. However, this relationship remains poorly understood. To compare the differences in psychosocial parameters and mental health outcomes between women with metabolic syndrome and women without metabolic syndrome 6 months after a complicated pregnancy.

Methods

This study is prospective registry analysis of women attending a postpartum healthy lifestyle clinic 6 months following a complicated pregnancy. Mental health measures included 9-item Patient Health Questionnaire (PHQ-9), 7-item Generalised Anxiety Disorder questionnaire (GAD-7), self-reported diagnosed history of depression, anxiety and/or other psychiatric condition, and current psychotropic medication use.

Results

Women with metabolic syndrome reported significantly more subjective mental health concerns, were more likely to have a history of depression and other psychiatric diagnoses and were more likely prescribed psychotropic medications. However, there were no significant differences in PHQ-9 and GAD-7 scores.

Conclusion

Amongst new mothers who experienced complications of pregnancy, those with metabolic syndrome represent a particularly vulnerable group with regards to psychosocial disadvantage and mental health outcomes. These vulnerabilities may not be apparent when using common standardised cross-sectional mental health screening tools such as PHQ-9 and GAD-7.
Community-based intervention improves abortion knowledge and reduces abortion stigma among women in Oromia, Ethiopia: a quasi-experimental mixed methods evaluation
Authors: Chekol Bekalu Mossie , Dijkerman Sally , Muluye Samuel , Wondimu Dereje
Published: November 2022

Background

Since liberalization of the Ethiopian abortion law, there have been significant improvements in the availability and utilization of facility-based abortion services in the country. However, nearly half of abortions still take place outside of health facilities, where the quality of procedures remains unknown. Abortion stigma is one reason that unsafe abortion persists. This study aims to evaluate the effect of community interventions conducted from 2016 to 2019 on the level and manifestation of abortion stigma and knowledge in a community in Oromia region, Ethiopia.

Methods

The study is a quasi-experimental mixed methods evaluation including intervention and comparison communities. Two cross-sectional structured household surveys with independent samples, participatory evaluation wheels, and participatory impact diagrams were conducted with women of reproductive age (15–49) living in the communities. The baseline was conducted in 2016 and the endline in 2019. Difference-in-differences analysis was used to estimate the effect of the intervention on abortion knowledge and Stigmatizing Attitudes, Beliefs, and Actions Scale (SABAS) scores in the intervention community.

Results

One thousand five hundred fifty-five women participated in the household survey and 28 women participated in participatory evaluation meetings. Over one-third (37%) of women surveyed in the intervention community were exposed to the intervention activities. Knowledge of one or more indications of legal abortion increased from 21 to 85% in the intervention community, compared to an increase from 30 to 57% in the comparison. Mean SABAS scores decreased by 9.3 points in the intervention community and increased by 5.3 points in the comparison community. Differences-in-differences models indicate that exposure to the intervention resulted in decreased stigma scores (coefficient = − 9.33, p < 0.001) and increased knowledge (coefficient = 0.26, p < 0.001).

Conclusions

This is one of the first studies to measure changes in community-level abortion stigma and knowledge over time in Ethiopia using a mixed method, quasi-experimental design. The results indicate that the community-based intervention improved abortion knowledge and reduced abortion stigma.
“They make a difference”: a qualitative study of providers’ experiences of peer support in outpatient clinics for people living with HIV
Authors: Øgård-Repål Anita , Berg Rigmor C. , Skogen Vegard , Fossum Mariann
Published: November 2022

Background

Although the life expectancy of people living with HIV has increased, they are still often disconnected from society through stigma and discrimination. Peer support has been found to increase social support. Given the limited research on peer support from the providers’ perspective, this study explored how peer supporters experience their roles and contributions in outpatient clinics (OPCs). Additionally, healthcare professionals’ perceptions of working with peer supporters in OPCs were examined. 

Methods

This qualitative study included purposively selected peer supporters (n = 10) and healthcare professionals (n = 5) from five OPCs in Norway in 2020. In-depth interviews and focus group discussions were conducted in Norwegian or English, using interview guides. Interview transcripts were analysed in NVivo 12 using reflexive and collaborative thematic analysis.

Results

The results show that peer supporters experience mutual support through emotional and honest interactions. Further, the peer supporters found it essential to negotiate with the service users about their preconception of HIV, confront their views through dialogue, and replicate positive experiences by being credible role models. The participants expressed that integrating peer support in the OPCs’ usual care processes increased the prospect of equitable services. Quality of peer support and role clarity were identified as critical components. The results demonstrate that emotional and honest conversations promote support between peers and that peer supporters identify a need for a reframed understanding of HIV by modelling plausible alternative interpretations and coping experiences.

Conclusions

This study contributes to knowledge on how peer support can meet the needs of people living with HIV. Incorporating people living with HIV in the co-production and distribution of healthcare services may improve the knowledge and perspectives in healthcare services. However, the skill standards of peer supporters should be addressed when implementing peer support in usual care.
E2 level > 2950 pg/ml on hCG trigger day is an independent predictor for birthweight loss of full-term singletons born after fresh embryo transfers in non-PCOS patients
Authors: Wu Jing , Zhang Hengde , Wang Xiaohong
Published: November 2022

Background

Previous studies have demonstrated that the supraphysiological E2 level is negatively correlated with birthweight. However, the cut-off value of E2 level that significantly affects birthweight is unknown, and there is no definite conclusion regarding this level. Our study aimed to explore the threshold of the effect of E2 levels on birthweight.

Design

A retrospective cohort study of 1846 samples was performed. All patients ≤42-years-old underwent autologous IVF cycles between August 1st, 2016 and April 30th, 2020. We categorized our data into four groups according to the E2 level: Group 1: ≤2000 pg/mL; Group 2: 2001–3000 pg/mL; Group 3: 3001–4000 pg/mL; and Group 4: > 4000 pg/mL.

Results

The results of the multivariate regression analyses showed that when the E2 level was 3001–4000 pg/mL (adjusted β: − 89.64, 95% [CI]: − 180.29 to − 6.01; P = 0.0336) and greater than 4000 pg/mL (adjusted β: − 138.10, 95% [CI]: − 272.87 to − 10.33; P = 0.0181), weight loss was significant. Furthermore, the odds of full-term SGA were 1.40 times higher with E2 levels of 3001–4000 pg/mL (adjusted OR: 1.40, 95% [CI]: 1.090 to 3.18; P = 0.0256) and 2.55 times higher with E2 > 4000 pg/mL (adjusted OR: 2.55, 95% [CI]: 1.84 to 3.86; P = 0.0063) compared to the reference group. It can also be seen from the adjusted curves and the threshold effects that when the E2 level > 2950 pg/mL and > 3121 pg/mL, the incidence of SGA increased and the birthweight decreased, respectively.

Conclusions

Our data suggest that E2 levels > 2950 pg/mL is an independent predictor for greater odds of full-term SGA singletons born after fresh embryo transfer.
Endoplasmic reticulum stress increases exosome biogenesis and packaging relevant to sperm maturation in response to oxidative stress in obese mice
Authors: Li Yangyang , Zhao Wenzhen , Fu Rong , Ma Zhuoyao , Hu Yanqin , Liu Yue , Ding Zhide
Published: November 2022

Background

Mammalian sperm maturation in the epididymis is mainly modulated by exosomes that are secreted into the epididymal lumen from epididymal epithelial cells (EECs). Exposure to oxidative stress (OS) resulting from being fed a high fat diet (HFD) reduces sperm fertility, which is one of the cause inducing male infertility. Thus, we hypothesize that stress-induced changes in exosome content play a critical role in mediating this detrimental process. 

Methods

An obese mouse model was established by feeding a HFD. Then oxidative stress status was measured in the mouse caput epididymis, epididymal fluid and spermatozoa. Meanwhile, epididymis-derived purified exosomes were isolated and validated. Subsequently, liquid chromatography tandem mass spectrometry (LC-MS) was used to perform proteomic analysis of purified exosomes. Gene Ontology (GO) analysis was performed along with pathway enrichment to identify differentially expressed proteins (DEPs).

Results

Two hundred and two DEPs mostly related to endoplasmic reticulum (ER) function were identified in the exosomes separated from the epididymis of control mice and obese mice. The ER stress and CD63 (an exosome marker), both increased in the caput epididymis of obese mice. Furthermore, an in vitro study showed that palmitic acid (PA), an-oxidative stress inducer, increased exosome biogenesis and secretion in the EECs.

Conclusion

Oxidative stress in the epididymal microenvironment induces ER stress in the EECs. This effect alters the epididymis-derived exosome content, profile and amounts of their differentially expressed ER proteins. Such changes may affect exosome biogenesis and cargo packaging, finally leading to abnormalities in sperm maturation and fertility.
Reduced oxidative stress suppresses neurotoxicity in the Drosophila model of TAF15-associated proteinopathies
Authors: Han Yeo Jeong , Kim Kiyoung
Published: November 2022

TATA-binding protein associated factor 15 (TAF15) is involved in the pathology of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Although TAF15 accumulates as cytoplasmic aggregates in neurons and the clearance of aggregates may be a therapeutic strategy for ALS, the underlying mechanisms of TAF15 in ALS remain poorly understood. Recently, we found that glutathione transferase omega 2 (GstO2) expression level is significantly reduced in the brain tissue of TAF15-expressing flies. In this study, we demonstrated that GstO2 overexpression in TAF15-induced flies rescues the locomotive activity and neuromuscular junctional defects. Furthermore, TAF15 levels in both cytoplasm and nuclear fractions significantly decreased in the heads of GstO2 co-expressing flies. GstO2-co-overexpression in neurons caused a marked decrease in intracellular reactive oxygen species generation in TAF15-induced flies. Our findings demonstrated that GstO2 was a pathogenic regulator of TAF15-associated proteinopathies. They help expand our understanding of TAF15-associated ALS pathogenesis.
Extracellular matrix profiles determine risk and prognosis of the squamous cell carcinoma subtype of non-small cell lung carcinoma
Authors: Parker Amelia L. , Bowman Elise , Zingone Adriana , Ryan Brid M. , Cooper Wendy A. , Kohonen-Corish Maija , Harris Curtis C. , Cox Thomas R.
Published: November 2022

Background

Squamous cell carcinoma (SqCC) is a subtype of non-small cell lung cancer for which patient prognosis remains poor. The extracellular matrix (ECM) is critical in regulating cell behavior; however, its importance in tumor aggressiveness remains to be comprehensively characterized.

Methods

Multi-omics data of SqCC human tumor specimens was combined to characterize ECM features associated with initiation and recurrence. Penalized logistic regression was used to define a matrix risk signature for SqCC tumors and its performance across a panel of tumor types and in SqCC premalignant lesions was evaluated. Consensus clustering was used to define prognostic matreotypes for SqCC tumors. Matreotype-specific tumor biology was defined by integration of bulk RNAseq with scRNAseq data, cell type deconvolution, analysis of ligand-receptor interactions and enriched biological pathways, and through cross comparison of matreotype expression profiles with aging and idiopathic pulmonary fibrosis lung profiles.

Results

This analysis revealed subtype-specific ECM signatures associated with tumor initiation that were predictive of premalignant progression. We identified an ECM-enriched tumor subtype associated with the poorest prognosis. In silico analysis indicates that matrix remodeling programs differentially activate intracellular signaling in tumor and stromal cells to reinforce matrix remodeling associated with resistance and progression. The matrix subtype with the poorest prognosis resembles ECM remodeling in idiopathic pulmonary fibrosis and may represent a field of cancerization associated with elevated cancer risk.

Conclusions

Collectively, this analysis defines matrix-driven features of poor prognosis to inform precision medicine prevention and treatment strategies towards improving SqCC patient outcome.
Prevalence and determinants of unmet need for contraception among women in low and high-priority segments for family planning demand generation in Nigeria
Authors: Solanke Bola Lukman , Adetutu Olufemi Mayowa , Rahman Semiu Adebayo , Soladoye Daniel Alabi , Owoeye Michael Olumide
Published: November 2022

Background

Studies have identified various determinants of unmet need for contraception. These determinants cut across individual, household, community, and health facility levels. Despite this evidence, there remains a lack of information regarding differentials in the prevalence and determinants of unmet need for contraception among women in the low-priority segments (such as women of advanced reproductive age and women living with disabilities) and high-priority segments (such as adolescents, young adults, and unmarried women) for family planning demand generation, hence this study.

Methods

The study design is cross-sectional. The study analyzed merged data from the individual, and persons recode of the 2018 Nigeria Demographic and Health Survey (NDHS). The samples analyzed are 5,147 women in the high-priority segment and 7,536 women in the low-priority segment. The outcome variable in the study was unmet need for contraception. The explanatory variables were selected at the individual, household, community, and facility levels. Statistical analyzes were performed using Stata 14. Three multilevel mixed-effects regression models were fitted. Model 1 was the empty model, while Model 2 included the sets of individual, household, and community variables. Model 3 controlled for the facility-level variables.

Results

Findings show a higher prevalence of unmet need for contraception among women in the family planning low-priority segment compared to women in the family planning high-priority segment. Religion and desired family size were the two individual characteristics that significantly predicted the unmet need for contraception among women in the two segments. Sexual autonomy was the only household characteristic that predicted unmet need for contraception in both segments. There were differences in the community characteristics that predicted unmet need for contraception among women in the two segments.

Conclusion

The prevalence of unmet need for contraception is not the same among women in low and high family planning priority segments. The determinants also differ among women in the two segments. Though, women in different family planning segments have the same contraceptive needs of avoiding pregnancy when not needed, however, getting the needs satisfied requires that existing programs be further examined to develop initiatives that will resonate with each segment of reproductive-age women.
Fifteen years’ experience of radiation therapy for resected advanced heterotopic ossification following motor vehicle accidents: outcome and side effects
Authors: Mohamed Reham , Iqbal Asif , Elawadi Abosaleh Abosaleh
Published: November 2022

Background

Surgical resection is the primary treatment for advanced-stage heterotopic ossification (HO), with a high incidence of local recurrence reaching up to 50%. Postoperative radiotherapy (PORT) and indomethacin are commonly used prophylactic strategies following surgery. The study aims to assess the safety and effectiveness of PORT in advanced-stage HO patients having motor vehicle accidents (MVA).

Methods

Medical records of patients having HO following MVA between 2006 and 2021 were retrospectively reviewed. Thirty-nine patients with advanced disease (35 had hip HO and 4 had elbow HO) were included in the study.

Results

Excision of HO with joint preservation was performed for 82% of patients, while 18% had a joint replacement. Seven to 8 Gy radiation was given to all patients within 3 days postoperatively. A ninty seven percent of patients regained partially the movement range. The mean follow-up time was 74 months. Six patients had treatment failure, with only one having a recurrence of HO. The 8-year treatment failure-free rate (8-y TFFR) was 79.3±9%, and the 5-year HO failure-free rate (5y-HOFFR) was 97.2±3%. Acute side effects were experienced in 13% of patients but resolved without any consequences. Despite the relatively long follow-up time, we did not report any absolute infertility or secondary malignancies related to the radiation. The testicular mean calculated dose was 33±44 cGy, and the mean measured dose was 58±40 cGy. Of the 35 patients who received radiation to the pelvis, 26 were married, and all did not experience infertility post-treatment.

Conclusion

PORT proved an effective and safe treatment for advanced-stage HO disease. The treatment failure is mainly related to surgical difficulties due to advanced disease. Treatment using a 3-dimensional or intensity-modulated radiation therapy is not associated with serious side effects like second malignancy or absolute infertility.
Factors associated with severe childhood community-acquired pneumonia: a retrospective study from two hospitals
Authors: Muljono Michelle Patricia , Halim Glenny , Heriyanto Rivaldo Steven , Meliani Fellisa , Budiputri Charista Lydia , Vanessa Maria Gabrielle , Andraina  , Juliansen Andry , Octavius Gilbert Sterling
Published: November 2022

Background

Community-acquired pneumonia (CAP) is the leading cause of death in children globally. Indonesia is ranked 1st in South East Asia with the highest burden of pneumonia. Identification of risk factors is necessary for early intervention and better management. This study intended to describe CAP’s clinical signs and laboratory findings and explore the risk factors of severe CAP among children in Indonesia.

Methods

This was a retrospective study of childhood hospitalizations in Siloam General Hospitals and Siloam Hospitals Lippo Village from December 2015 to December 2019. Demographic data, clinical signs, and laboratory findings were collected and processed using IBM SPSS 26.0.

Results

This study included 217 participants with 66 (30.4%) severe pneumonia cases. Multivariate analysis shows that fever that lasts more than 7 days (ORadj = 4.95; 95%CI 1.61–15.21, Padj = 0.005) and increase in respiratory rate (ORadj = 1.05, 95%CI 1.01–1.08, Padj = 0.009) are two predictors of severe pneumonia. Meanwhile, a normal hematocrit level (ORadj = 0.9; 95%CI 0.83–0.98, Padj = 0.011) and children with normal BMI (ORadj = 0.7; 95%CI 0.57–0.84, Padj < 0.001) are significant independent predictors of severe pneumonia. The Hosmer-Lemeshow test shows that this model is a good fit with a P-value of 0.281. The AUC for this model is 0.819 (95%CI = 0.746–0.891, P-value < 0.001) which shows that this model has good discrimination.

Conclusion

Pediatric CAP hospitalizations with fever lasting > 7 days and tachypnea were at higher risk for progressing to severe pneumonia. A normal hematocrit level and a normal BMI are protective factors for severe pneumonia.
A novel random finite element model for holistically modeling of the frost effects on soils and cold region pavements
Authors: Dong Shaoyang , Jiang Yusheng , Yu Xiong
Published: November 2022

This paper describes the development of a random finite element model (RFEM) that allows holistic simulation of frozen soil behaviors, including the effects of phase transition and the consequent internal stress and volume changes. The performance of the model is firstly validated with laboratory experiments. The model is implemented to simulate the effects of frost action on pavement. The coupled thermal-mechanical actions including the mechanical responses of subgrade soils subjected to freezing temperature and its effects on the pavement structure are analyzed. The results show that the frost action and expansion of ice lenses change the interaction modes between pavement layers. This leads to increase of stress and deformation in the pavement layer. Methods to mitigate the effects of frost heave are analyzed with this model. The simulation results indicate that the detrimental effects of frost heave on the pavement structure can be mitigated by increasing the thickness of base layer, use of thermal insulation layer or improve drainage in the subgrade layer. The RFEM combines the advantages of discrete element model (DEM) in holistically describing the microstructure effects and in the finite element model (FEM) in terms of computational efficiency. This allows to focus research on understanding the behaviors of individual soils phase and their interfacial interactions.
Immunotherapy in the Management of Esophagogastric Cancer: A Practical Review
Authors: Patruni Sunita , Fayyaz Fatima , Bien Jeffrey , Phillip Tony , King Daniel A.
Published: November 2022

Recent data support incorporation of immune checkpoint inhibitors into the treatment armamentarium for esophageal, gastroesophageal junction, and gastric (esophagogastric) cancer. This practical review focuses on clinical trials that influenced US Food and Drug Administration approvals and treatment guidelines in esophagogastric cancer, including the impact of location, stage, histology, human epidermal growth factor receptor 2 status, and PD-(L)1 expression on these guidelines. The role of immunotherapy in the locally advanced and metastatic setting is constantly expanding. Over the next few years, the many ongoing trials exploring immunotherapy are anticipated to bring new treatment regimens into the frontline setting with the potential to improve survival in patients with advanced disease.
Approach to the Patient With Adrenal Hemorrhage
Authors: Elhassan Yasir S , Ronchi Cristina L , Wijewickrama Piyumi , Baldeweg Stephanie E
Published: November 2022

Adrenal hemorrhage is an uncommon, underrecognized condition that can be encountered in several clinical contexts. Diagnosing adrenal hemorrhage is challenging due to its nonspecific clinical features. Therefore, it remains a diagnosis that is made serendipitously on imaging of acutely unwell patients rather than with prospective clinical suspicion. Adrenal hemorrhage can follow abdominal trauma or appear on a background of predisposing conditions such as adrenal tumors, sepsis, or coagulopathy. Adrenal hemorrhage is also increasingly reported in patients with COVID-19 infection and in the context of vaccine-induced immune thrombocytopenia and thrombosis. Unexplained abdominal pain with hemodynamic instability in a patient with a predisposing condition should alert the physician to the possibility of adrenal hemorrhage. Bilateral adrenal hemorrhage can lead to adrenal insufficiency and potentially fatal adrenal crisis without timely recognition and treatment. In this article, we highlight the clinical circumstances that are associated with higher risk of adrenal hemorrhage, encouraging clinicians to prospectively consider the diagnosis, and we share a diagnostic and management strategy.
Rolf Hammerschmidt’s Boytropolis and the Ethno-Ecological Imaginary
Authors: Fleishman Ian
Published: November 2022

Rolf Hammerschmidt, one of Europe’s most prolific gay porn directors and producers, first came to notoriety with an eco-utopian fantasy that descends into the dystopian. His two-part Boytropolis (1993, 1996) imagines a secluded woodland society of horny loincloth-clad young men whose insatiable sexual appetite appears to derive from a juice diet consisting of a mysterious emerald-colored potion that they extract from the local foliage, at least until they are denied indulgence in either this nectar or the sexual activity it inspires and vanish in a puff of smog. Attending to the unexpectedly rich cinematic history on which the film draws, which centrally includes not only Fritz Lang’s Metropolis but also Frank Capra’s Lost Horizon (1937), this article puts forth that Boytropolis exposes and explores a troublingly normative homotopian vision, one that relies on environmental and racial homogeneity, and on an eco-imperialist politics of conquest, for its erotic charge.
Trade-offs in muscle physiology in selectively bred high runner mice
Authors: Castro Alberto A. , Garland Theodore , Ahmed Saad , Holt Natalie C.
Published: November 2022

A trade-off between locomotor speed and endurance occurs in various taxa, and is thought to be underpinned by a muscle-level trade-off. Among four replicate high runner (HR) lines of mice, selectively bred for voluntary wheel-running behavior, a negative correlation between average running speed and time spent running has evolved. We hypothesize that this trade-off is due to changes in muscle physiology. We studied the HR lines at generation 90, at which time one line (L3) is fixed for the mini-muscle phenotype, another is polymorphic (L6) and the others (L7, L8) lack mini-muscle individuals. We used in situ preparations to quantify the contractile properties of the triceps surae muscle complex. Maximal shortening velocity varied significantly, being lowest in mini-muscle mice (L3 mini=25.2 mm s−1, L6 mini=25.5 mm s−1), highest in normal-muscle mice L6 and L8 (40.4 and 50.3 mm s−1, respectively) and intermediate in normal-muscle L7 mice (37.2 mm s−1). Endurance, measured both as the slope of the decline in force and the proportion of initial force that could be sustained, also varied significantly. The slope was shallowest in mini-muscle mice (L3 mini=−0.00348, L6 mini=−0.00238), steepest in lines L6 and L8 (−0.01676 and −0.01853), and intermediate in L7 (−0.01145). Normalized sustained force was highest in mini-muscle mice (L3 mini=0.98, L6 mini=0.92) and lowest in L8 (0.36). There were significant, negative correlations between velocity and endurance metrics, indicating a muscle-level trade-off. However, this muscle-level trade-off does not seem to underpin the organismal-level speed and endurance trade-off previously reported as the ordering of the lines is reversed: the lines that run the fastest for the least time have the lowest muscle complex velocity and highest endurance.
Parallel evolution of opsin visual pigments in hawkmoths by tuning of spectral sensitivities during transition from a nocturnal to a diurnal ecology
Authors: Akiyama Tokiho , Uchiyama Hironobu , Yajima Shunsuke , Arikawa Kentaro , Terai Yohey
Published: November 2022

Light environments differ dramatically between day and night. The transition between diurnal and nocturnal visual ecology has happened repeatedly throughout evolution in many species. However, the molecular mechanism underlying the evolution of vision in recent diurnal–nocturnal transition is poorly understood. Here, we focus on hawkmoths (Lepidoptera: Sphingidae) to address this question by investigating five nocturnal and five diurnal species. We performed RNA-sequencing analysis and identified opsin genes corresponding to the ultraviolet (UV), short-wavelength (SW) and long-wavelength (LW)-absorbing visual pigments. We found no significant differences in the expression patterns of opsin genes between the nocturnal and diurnal species. We then constructed the phylogenetic trees of hawkmoth species and opsins. The diurnal lineages had emerged at least three times from the nocturnal ancestors. The evolutionary rates of amino acid substitutions in the three opsins differed between the nocturnal and diurnal species. We found an excess number of parallel amino acid substitutions in the opsins in three independent diurnal lineages. The numbers were significantly more than those inferred from neutral evolution, suggesting that positive selection acted on these parallel substitutions. Moreover, we predicted the visual pigment absorption spectra based on electrophysiologically determined spectral sensitivity in two nocturnal and two diurnal species belonging to different clades. In the diurnal species, the LW pigments shift 10 nm towards shorter wavelengths, and the SW pigments shift 10 nm in the opposite direction. Taken together, our results suggest that parallel evolution of opsins may have enhanced the colour discrimination properties of diurnal hawkmoths in ambient light.
Heat tolerance limits of Mediterranean songbirds and their current and future vulnerabilities to temperature extremes
Authors: Cabello-Vergel Julián , González-Medina Erick , Parejo Manuel , Abad-Gómez José M. , Playà-Montmany Núria , Patón Daniel , Sánchez-Guzmán Juan M. , Masero José A. , Gutiérrez Jorge S. , Villegas Auxiliadora
Published: November 2022

Songbirds are one of the groups most vulnerable to extreme heat events. Although several recent studies have assessed their physiological responses to heat, most of them have focused solely on arid-zone species. We investigated thermoregulatory responses to heat in eight small-sized songbirds occurring in the Mediterranean Basin, where heatwaves are becoming more frequent and intense. Specifically, we determined their heat tolerance limits (HTLs) and evaporative cooling efficiency, and evaluated their current and future vulnerabilities to heat in southwestern Iberia, a Mediterranean climate warming hotspot. To do this, we exposed birds to an increasing profile of air temperatures (Ta) and measured resting metabolic rate (RMR), evaporative water loss (EWL), evaporative cooling efficiency (the ratio between evaporative heat loss and metabolic heat production) and body temperature (Tb). HTL ranged between 40 and 46°C across species, and all species showed rapid increases in RMR, EWL and Tb in response to increasing Ta. However, only the crested lark (Galerida cristata) achieved an evaporative cooling efficiency greater than 1. The studied songbirds currently experience summer Ta maxima that surpass the upper critical temperatures of their thermoneutral zone and even their HTL. Our estimates indicate that five of the eight species will experience moderate risk of lethal dehydration by the end of the century. We argue that the limited heat tolerance and evaporative cooling efficiency of small-sized Mediterranean songbirds make them particularly vulnerable to heatwaves, which will be exacerbated under future climate change scenarios.
System Dynamics
Authors: Λενακάκη Αγγελική
Published: November 2022

Οι ερευνητές σε όλο τον κόσμο δεν έχουν ακόμη καταλήξει όσον αφορά τον υποτιθέμενο θετικό αντίκτυπο των παραδοσιακών συστημάτων διαχείρισης απόδοσης στην υγειονομική περίθαλψη και ορισμένες έρευνες έχουν δείξει ότι, παραδόξως, οι πολιτικές διαχείρισης απόδοσης δεν οδηγούν πάντα σε βελτιωμένη απόδοση των νοσοκομείων. Παρά την εκτεταμένη έρευνα παγκοσμίως που εντοπίζει τις «παγίδες» των υγειονομικών μεταρρυθμίσεων σε όλη την Ευρώπη και τις ανεπιθύμητες συνέπειες για το νοσοκομειακό προσωπικό και τους ασθενείς, λίγα είναι γνωστά για τους μηχανισμούς που προκάλεσαν αυτές τις αρνητικές επιπτώσεις, γεγονός που ουσιαστικά δημιουργεί ένα ερευνητικό κενό που αξίζει να διερευνηθεί. Η παρούσα διδακτορική διατριβή προσπαθεί να αντιμετωπίσει αυτό το κενό και να εξηγήσει γιατί τα παραδοσιακά συστήματα διαχείρισης απόδοσης στην υγειονομική περίθαλψη δεν οδηγούν πάντα σε βελτιωμένες επιδόσεις, περιγράφοντας τις ακούσιες συνέπειες της ελληνικής υγειονομικής μεταρρύθμισης σε ένα δημόσιο νοσοκομείο. Διεξάγοντας εμπειρική έρευνα, χρησιμοποιώντας μια μελέτη περίπτωσης και υιοθετώντας μια συστημική ματιά, αυτή η έρευνα αντιμετωπίζει αυτό το κενό και ρίχνει φως στο πώς αντιλαμβάνονται οι ενδιαφερόμενοι φορείς ενός ελληνικού δημόσιου νοσοκομείου την απόδοση του νοσοκομείου και ποιοι μηχανισμοί καθορίζουν τη δυναμική της. Ακολουθώντας μια συστημική προσέγγιση, η επιλεγμένη μελέτη περίπτωσης - που είναι ένα πραγματικό νοσοκομείο στο ελληνικό σύστημα Υγείας - διερευνήθηκαν οι μηχανισμοί πρόκλησης των αρνητικών συνεπειών της ελληνικής υγειονομικής μεταρρύθμισης στην απόδοση του νοσοκομείου. Η ανάλυσή μας πλαισιώθηκε χρησιμοποιώντας τη μεθοδολογία Δυναμικής Διαχείρισης Απόδοσης.
New treatment strategies for bipolar disorder in the elderly
Authors: Kędziora-Kornatowska Kornelia , Winiarek Karolina , Murawska Joanna , Guzowski Cezary , Jabłońska Monika , Błasik Natalia , Wójcik Agata , Lamch Magdalena
Published: November 2022

Introduction and objective: The purpose of this paper is to systematically review articles and new research in the context of bipolar geriatric patients.
Materials and methods: PubMed searches were completed using the key terms bipolar disorder, bipolar elderly, bipolar depression, bipolar elderly treatment and review articles. In addition, references in these resources were searched. Search dates: 2010 to 2022.
Description of the state of knowledge: Mental disorders in the context of the elderly concern all depressive disorders. A problem with other disorders such as bipolar disorder is also increasingly recognized. In the elderly, it is quite rare in the general cross-section of society, but it may have a higher percentage, e.g. in nursing homes and care institutions. This review article shows both the difference and the similarities in the course of this disease in older and younger patients. The most important and common aspect for both age groups is psychotherapy with parallel pharmacological treatment. The greatest difficulty in pharmacotherapy in the elderly is polypharmacy and numerous drug interactions, as well as different pharmacodynamics and pharmacokinetics of the drugs used compared to younger patients. Attention should also be paid to the differentiation of bipolar disorder from different types of dementia and other cognitive disorders. Therefore, one should strive to carefully assess the patient's need for a given treatment, establish appropriate periodic monitoring of treatment, and assess the risk of taking or not intervening. This article also aims to review new research and drugs that seem promising, while the individualized and interdisciplinary approach to a geriatric patient with BD is the most important finding of this review.
Summary: Bipolar disorder in older people, compared to the younger population, should be treated pharmacologically in combination with psychotherapy. The elderly patient population requires a multidisciplinary approach due to the number of drugs used in a large number of diseases.
LA ARQUITECTURA DE LO ESPECÍFICO. COOPERATIVA PIRINEOS EN ZARAGOZA
Authors: Salas Ballestín Juan Carlos , Bambó Naya Raimundo
Published: November 2022

La Cooperativa Pirineos es un conjunto residencial proyectado en Zaragoza en 1979 por Saturnino Cisneros y Juan Carmona, componentes principales del Grupo Z, colectivo que contribuyó a renovar el panorama arquitectónico aragonés desde su formación en 1970. El análisis del proyecto muestra el cambio que se produjo en la manera de abordar la cuestión de la vivienda colectiva respecto a las décadas previas. Su concepción del trabajo en equipo permitía eludir aproximaciones personalistas, dando lugar a propuestas consensuadas como las óptimas frente a problemas concretos. La lectura del entorno urbano se afrontó atendiendo a las condiciones particulares del lugar, planteando soluciones que diferían de los desarrollos residenciales vecinos. La incorporación de los usuarios a través de procesos participativos permitió definir los tipos residenciales o los espacios comunes, reforzando la idea de comunidad. Es por eso por lo que se prestó particular atención a los espacios intermedios de relación, presentes en todas las escalas del proyecto. El lenguaje buscaba una expresión rotunda, que hiciera reconocible el conjunto en un entorno desestructurado. En todas estas cuestiones está presente la particular atención a lo específico de cada situación, a diferentes escalas, renunciando a soluciones genéricas más propias de periodos anteriores.
LA FÁBRICA-CASA: HÁBITATS COLABORATIVOS Y PATRIMONIO INDUSTRIAL DESDE LOS 60 EN NYC
Authors: Carrascal Pérez María F. , Rodrigues de Oliveira Silvana
Published: November 2022

Nueva York, paradigma de la ciudad vertical, fue también escenario de procesos disruptivos que reaccionaban a las numerosas acciones de renovación urbana iniciadas en los años cincuenta en los que se adoptaba el modelo moderno residencial sobre operaciones de tabula rasa. En la siguiente década, desde el mundo del arte se produjeron ciertos proyectos que supusieron una alternativa habitacional en espacios productivos obsoletos Esta investigación, apoyada en la metodología de estudio de casos, presenta tres propuestas en las que antiguas industrias se relacionarían de forma innovadora y complementaria con el proyecto de vivienda colectiva. El primer caso, ideado por el artista I. Noguchi, con el apoyo de Buckminster Fuller, supuso la transformación de una antigua fábrica en un jardín abierto de esculturas en el contexto de la comunidad residencial de Astoria. Las dos iniciativas siguientes fueron impulsadas por J.K. Davidson y el J.M. Kaplan Fund: un sistema de viviendas cooperativas en el distrito manufacturero de SoHo ideado por el artista G. Maciunas y el arquitecto S. Shapiro, y un proyecto de conversión de los antiguos Bell Labs en el Westbeth Artists Housing, por el arquitecto R. Meier. Estas iniciativas pioneras indagarán en la construcción de hábitats inclusivos y colaborativos en espacios industriales, en su rehabilitación adaptativa y configuración como espacio doméstico creativo, así como en su significación como patrimonio contemporáneo.