bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful ageing among a national community-dwelling sample of older adults in India in 2017–2018
Authors: Pengpid Supa , Peltzer Karl
Published: November 2021

This study aimed to determine the prevalence and correlates of successful ageing in older community-dwelling adults in India. The cross-sectional sample included 21,343 individuals (≥ 65 years) from the Longitudinal Ageing Study in India (LASI) Wave 1 in 2017–2018. Successful ageing was assessed utilizing a multidimensional concept, including five components: (1) absence of major illness, (2) free of disability, (3) no major depressive disorder, (4) social engagement and (5) life satisfaction. Overall, 27.2% had successful ageing, including 83.3% had no major diseases, 51.0% free from disability, 91.8% had no major depressive disorder, 73.6% were socially engaged and 74.6% had high life satisfaction. In the adjusted logistic regression analysis, male sex (Adjusted Odds Ratio-AOR 1.40, 95% Confidence Interval-CI 1.21–1.26), married (AOR 1.48, 95% CI 1.22–1.79), having formal education (AOR 1.47, 95% CI 1.23–1.74), high subjective socioeconomic status (AOR 1.61, 95% CI 1.29–2.01), urban residence (AOR 1.42, 95% CI 1.19–1.70), Sikhs (AOR 1.76, 95% CI 1.38–2.24), high physical activity (AOR 1.65, 95% CI 1.38–1.97), and daily Yoga practice (AOR 1.34, 95% CI 1.11–1.61) increased the odds of successful ageing, while increasing age (AOR 0.96, 95% CI 0.94–0.79), poor childhood health (AOR: 0.47, 95% CI 0.29–0.75), and underweight (AOR 0.70, 95% CI 0.61–0.81) decreased the odds of successful ageing. Almost one in three older adults in India were successfully ageing. Factors associated with successful ageing included, male sex, married, having formal education, high subjective socioeconomic status, urban residence, Sikhs, physical activity, Yoga practice, younger age, good childhood health, and not having underweight.
Comparison of four healthy lifestyle scores for predicting cardiovascular events in a national cohort study
Authors: Tsai Ming-Chieh , Yeh Tzu-Lin , Hsu Hsin-Yin , Hsu Le-Yin , Lee Chun-Chuan , Tseng Po-Jung , Chien Kuo-Liong
Published: November 2021

The protective effect of different healthy lifestyle scores for the risk of cardiovascular disease (CVD) was reported, although the comparisons of performance were lacking. We compared the performance measures of CVDs from different healthy lifestyle scores among Taiwanese adults. We conducted a nationwide prospective cohort study of 6042 participants (median age 43 years, 50.2% women) in Taiwan’s Hypertensive, Hyperglycemia and Hyperlipidemia Survey, of whom 2002 were free of CVD at baseline. The simple and weighted the Mediterranean diet related healthy lifestyle (MHL) scores were defined as a combination of normal body mass index, Mediterranean diet, adequate physical activity, non-smokers, regular healthy drinking, and each dichotomous lifestyle factor. The World Cancer Research Fund and American Institute for Cancer Research cancer prevention recommended lifestyle and Life's Simple 7 following the guideline definition. The incidence of CVD among the four healthy lifestyle scores, each divided into four subgroups, was estimated. During a median 14.3 years follow-up period, 520 cases developed CVD. In the multivariate-adjusted Cox proportional hazard models, adherence to the highest category compared with the lowest one was associated with a lower incidence of CVD events, based on the simple (hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.2–0.94) and weighted MHL scores (HR 0.44, 95% CI 0.28–0.68). Additionally, age played a role as a significant effect modifier for the protective effect of the healthy lifestyle scores for CVD risk. Specifically, the performance measures by integrated discriminative improvement showed a significant increase after adding the simple MHL score (integrated discriminative improvement: 0.51, 95% CI 0.16–0.86, P = 0.002) and weighted MHL score (integrated discriminative improvement: 0.38, 95% CI 0.01–0.74, P = 0.021). We demonstrated that the healthy lifestyle scores with an inverse association with CVD and reduced CVD risk were more likely for young adults than for old adults. Further studies to study the mechanism of the role of lifestyle on CVD prevention are warranted.
Limited thermal plasticity may constrain ecosystem function in a basally heat tolerant tropical telecoprid dung beetle, Allogymnopleurus thalassinus (Klug, 1855)
Authors: Machekano Honest , Zidana Chipo , Gotcha Nonofo , Nyamukondiwa Casper
Published: November 2021

Tropical organisms are more vulnerable to climate change and associated heat stress as they live close to their upper thermal limits (UTLs). UTLs do not only vary little across tropical species according to the basal versus plasticity ‘trade-off’ theory but may also be further constrained by low genetic variation. We tested this hypothesis, and its effects on ecosystem function using a diurnally active dung rolling beetle (telecoprid),Allogymnopleurus thalassinus(Klug, 1855) that inhabits arid environments. Specifically, (i) we tested basal heat tolerance (critical thermal maxima [CTmax] and heat knockdown time [HKDT]), and (ii) ecological functioning (dung removal) efficiency following dynamic chronic acclimation temperatures of variable high (VT-H) (28–45 °C) and variable low (VT-L) (28–16 °C). Results showed thatA. thalassinushad extremely high basal heat tolerance (> 50 °C CTmaxand high HKDT). Effects of acclimation were significant for heat tolerance, significantly increasing and reducing CTmaxvalues for variable temperature high and variable temperature low respectively. Similarly, effects of acclimation on HKDT were significant, with variable temperature high significantly increasing HKDT, while variable temperature low reduced HKDT. Effects of acclimation on ecological traits showed that beetles acclimated to variable high temperatures were ecologically more efficient in their ecosystem function (dung removal) compared to those acclimated at variable low temperatures.Allogymnopleurus thalassinusnevertheless, had low acclimation response ratios, signifying limited scope for complete plasticity for UTLs tested here. This result supports the ‘trade-off’ theory, and that observed limited plasticity may unlikely bufferA. thalassinusagainst effects of climate change, and by extension, albeit with caveats to other tropical ecological service providing insect species. This work provides insights on the survival mechanisms of tropical species against heat and provides a framework for the conservation of these natural capital species that inhabit arid environments under rapidly changing environmental climate.
Hatching phenology is lagging behind an advancing snowmelt pattern in a high-alpine bird
Authors: Schano Christian , Niffenegger Carole , Jonas Tobias , Korner-Nievergelt Fränzi
Published: November 2021

To track peaks in resource abundance, temperate-zone animals use predictive environmental cues to rear their offspring when conditions are most favourable. However, climate change threatens the reliability of such cues when an animal and its resource respond differently to a changing environment. This is especially problematic in alpine environments, where climate warming exceeds the Holarctic trend and may thus lead to rapid asynchrony between peaks in resource abundance and periods of increased resource requirements such as reproductive period of high-alpine specialists. We therefore investigated interannual variation and long-term trends in the breeding phenology of a high-alpine specialist, the white-winged snowfinch, Montifringilla nivalis, using a 20-year dataset from Switzerland. We found that two thirds of broods hatched during snowmelt. Hatching dates positively correlated with April and May precipitation, but changes in mean hatching dates did not coincide with earlier snowmelt in recent years. Our results offer a potential explanation for recently observed population declines already recognisable at lower elevations. We discuss non-adaptive phenotypic plasticity as a potential cause for the asynchrony between changes in snowmelt and hatching dates of snowfinches, but the underlying causes are subject to further research.
Magnetoactive acoustic metamaterials based on nanoparticle-enhanced diaphragm
Authors: Tang Xingwei , Liang Shanjun , Jiang Yusheng , Gao Cong , Huang Yujin , Zhang Yuan , Xue Chang , Wen Weijia
Published: November 2021

Magnetoactive membrane-type acoustic metamaterials are fabricated by coating a layer of magnetic nanoparticles on the polyethylene (PE) membranes and their vibration characters are investigated experimentally. From our experiments, we discovered that, under different magnetic fields by varying the distance between a magnet and the membranes, such membranes exhibit tunable vibration eigenfrequencies (the shift towards lower frequencies), which is caused by the variation of the effective mass density and effective tension coefficient resulted from the second derivative of the magnetic field. The strong magnetic force between the layer of magnetic nanoparticles and the magnet enhances the eigenfrequency shift. A spring oscillator model is proposed and it agrees well with the experimental results. We also experimentally observed that the vibration radius, effective mass density, and effective tension coefficient of the membranes can enormously affect the eigenfrequencies of the membranes. We believe that this type of metamaterials may open up some potential applications for acoustic devices with turntable vibration properties.
Polymers in Metal–Organic Frameworks: Synthesis, Recognition, and Hybrid Materials
Authors: Le Ouay Benjamin , Kitao Takashi , Hosono Nobuhiko , Uemura Takashi
Published: November 2021

Metal–organic frameworks (MOFs) have recently emerged as a new class of porous materials. Highly ordered and tunable structures of MOFs can serve as a universal platform for controlled polymer synthesis as well as high-precision polymer recognition. In addition, the integration of MOFs and polymers can achieve host–guest synergies, leading to the emergence of intriguing composites with tailored architectures. The integration of MOFs and polymers has provided new aspects for both MOF and polymer chemistry. In this chapter, we highlight recent advances in the hybridization of MOFs and polymers.
Metal–Organic Frameworks/Polymer Composite Membranes
Authors: Jin Hua , Ma Qiang , Li Yanshuo
Published: November 2021

Metal–organic frameworks (MOFs) represent a fascinating class of porous crystalline materials due to their designable pore structure and functionality. MOF/polymer hybrid membranes, taking advantage of the molecular sieving property of MOFs and good processability of polymers, have been gradually becoming the next-generation competitive membrane materials. Recent years have witnessed significant progress in MOF/polymer composite membranes. In this chapter, we discuss opportunities and challenges related to the rational design of MOF/polymer composite membranes including MOF-based mixed matrix membranes (MMMs) and polymer-supported MOF membranes. We also highlight their latest application progress in the area of liquid separations such as water treatment, organic solvent nanofiltration and pervaporation, along with gas separations.
Applications of Metal–Organic Framework/Polymer Hybrid Materials
Authors: Niu Ziru , Liu Hao , Rassu Pietro , Wang Lu , Ma Xiaojie , Zhang Yuanyuan , Wang Bo
Published: November 2021

Recently, metal–organic frameworks (MOFs) have exhibited great application potential in many fields due to their high porosity, as well as well-defined channels with tunable size, shape, and environment. However, the limited processibility as well as poor electrical conductivity and biosafety hinder their further applications in separation, electrochemistry, biomedicine, etc. Hybridizing polymers with MOFs is an effective way to overcome these shortcomings. The flexibility, optoelectronic properties, biocompatibility, and other features of polymers bring new traits and functions to the hybrid materials. In this chapter, the applications of MOF/polymer hybrid materials in electrochemistry, toxic chemical protection, and biomedicine are summarized. In addition, we also discuss the challenges and future research directions of MOF hybrids in these fields.
Quinolino[7,8-h]quinoline: a ‘just right’ ligand for beryllium(ii) coordination
Authors: Buchanan Jenna K. , Severinsen Rebecca J. , Buchner Magnus R. , Thomas-Hargreaves Lewis R. , Spang Nils , John Kevin D. , Plieger Paul G.
Published: November 2021

The first beryllium(ii) complex with a quinolino[7,8-h]quinoline based proton sponge reveals a complementary size match.
Cobalt nanoparticle–carbon nanoplate as the solar absorber of a wood aerogel evaporator for continuously efficient desalination
Authors: Zhao Yujuan , You Dongyu , Yang Weiting , Yu Han , Pan Qinhe , Song Shuyan
Published: November 2021

Cobalt nanoparticle–carbon nanoplate as the solar absorber of a wood aerogel evaporator for efficient solar steam generation.
Non-excitonic defect-assisted radiative transitions are responsible for new D-type blinking in ternary quantum dots
Authors: Olejniczak Adam , Rich Ryan , Gryczynski Zygmunt , Cichy Bartłomiej
Published: November 2021

Bright defects have been shown to produce specific blinking patterns, which were designated as D-type. This pathway is independent of excitonic emission. Two conditions necessary to observe blinking from defects were identified and analysed.
Laser-direct-writing of molecule-like Agmx+nanoclusters in transparent tellurite glass for 3D volumetric optical storage
Authors: Wu Yaman , Lin Hang , Li Renfu , Lin Shisheng , Wu Chuxin , Huang Qiugui , Xu Ju , Cheng Yao , Wang Yuansheng
Published: November 2021

Laser-direct-writing of molecule-like Agmx+nanoclusters in a developed TeO2–ZnO–Na2O–Ag2O glass with low-melting nature was achieved using a portable low-power miniature desktop laser machine.
pH-Responsive doxorubicin delivery using shear-thinning biomaterials for localized melanoma treatment
Authors: Lee Junmin , Wang Yonggang , Xue Chengbin , Chen Yi , Qu Moyuan , Thakor Jai , Zhou Xingwu , Barros Natan Roberto , Falcone Natashya , Young Patric , van den Dolder Floor W. , Lee KangJu , Zhu Yangzhi , Cho Hyun-Jong , Sun Wujin , Zhao Bo , Ahadian Samad , Jucaud Vadim , Dokmeci Mehmet R. , Khademhosseini Ali , Kim Han-Jun
Published: November 2021

Injectable shear-thinning biomaterials (STBs) have attracted significant attention because of their efficient and localized delivery of cells as well as various molecules ranging from growth factors to drugs.
Orthogonal nanoarchitectonics of M13 phage for receptor targeted anticancer photodynamic therapy
Authors: Ulfo Luca , Cantelli Andrea , Petrosino Annapaola , Costantini Paolo Emidio , Nigro Michela , Starinieri Francesco , Turrini Eleonora , Zadran Suleman Khan , Zuccheri Giampaolo , Saporetti Roberto , Di Giosia Matteo , Danielli Alberto , Calvaresi Matteo
Published: November 2021

Not all viruses are bad. We developed an orthogonal approach (genetic/chemical) to engineer M13 bacteriophages as targeted vectors for efficient photodynamic killing of cancer cells.
Synthesis of 2H-chromenes: recent advances and perspectives
Authors: Zheng Shi-Lu , Chen Long
Published: November 2021

Functionalized 2H-chromenes are one type of important oxygen heterocycle, and have widespread applications in many areas. This review mainly focuses on the two recently established synthetic strategies towards such compounds.
Enhancement of band gap and birefringence induced via π-conjugated chromophore with “tail effect”
Authors: Cai Wenbing , Chen Jiongquan , Pan Shilie , Yang Zhihua
Published: November 2021

The enhancement of band gap and birefringence of template compounds can be attributed to this “tail effect” caused by the extended electronic distribution from [CO3]2−/[BO3]3−/[C3N3O3]3− to [HCO3]−/[HBO3]2−/[HC3N3O3]2−.
Alkali and alkaline-earth metal ion–solvent co-intercalation reactions in nonaqueous rechargeable batteries
Authors: Li Lin , Hu Zhe , Zhao Shuo , Chou Shu-Lei
Published: November 2021

This review summarizes the recent progress of alkali and alkaline-earth metal ion–solvent co-intercalation reactions in nonaqueous rechargeable batteries.
Correction: Influence of the primary and secondary coordination spheres on nitric oxide adsorption and reactivity in cobalt(ii)–triazolate frameworks
Authors: Oktawiec Julia , Jiang Henry Z. H. , Turkiewicz Ari B. , Long Jeffrey R.
Published: November 2021

Correction for ‘Influence of the primary and secondary coordination spheres on nitric oxide adsorption and reactivity in cobalt(ii)–triazolate frameworks’ by Julia Oktawiec et al., Chem. Sci., 2021, DOI: 10.1039/d1sc03994f.
Functional Communication Abilities in Youth With Cerebral Palsy: Association With Impairment Profiles and School-Based Therapy Goals
Authors: Koopmans Clare , Sakash Ashley , Soriano Jennifer , Long Helen L. , Hustad Katherine C.
Published: November 2021

Purpose:

The aim of this study was to examine the relationship between functional communication skills, underlying speech, language, and cognitive impairments and school-based speech pathology services in students with cerebral palsy (CP).

Method:

Thirty-five participants with CP who had Individualized Education Programs (IEPs) were classified according to the Communication Function Classification System (CFCS). Participants completed laboratory assessments of speech, receptive language, executive functioning, and nonverbal cognition. Each participant's speech and language IEP goals were coded into treatment units and then categorized into seven, mutually exclusive target goal areas. Nonparametric analyses were employed to examine differences among CFCS groups in the number of deficit areas and the number of goal areas from the IEP. Descriptive analyses were used to evaluate the extent to which deficit and goal areas in the IEP co-occurred by CFCS level.

Results:

Those in more involved CFCS levels demonstrated more severe speech, receptive language, and cognitive impairments. However, there were no significant differences in the number of deficit areas across CFCS groups. Regardless of CFCS level, there were no differences in the number of treatment goals specified in the IEP. Literacy was the only goal area addressed across all CFCS levels. Those in the most involved CFCS levels had augmentative and alternative communication (AAC) goals, but those with more moderate restrictions in functional communication who also had markedly reduced speech intelligibility did not typically have speech or AAC goals.

Interpretation:

Individuals with CP across CFCS levels demonstrate variability in underlying deficit profiles, suggesting that measures of both functional communication and of underlying deficits are necessary to provide a complete picture of communication needs. Literacy goals were common across all CFCS levels, but AAC goals were limited to the most severely involved individuals, suggesting that continuing education may be necessary to support speech-language pathologists in developing treatments involving the integration of AAC and speech to foster functional communication at school.

Supplemental Material:

https://doi.org/10.23641/asha.16968073
Factors Influencing Oral Bolus Hold Type: Tipper or Dipper
Authors: Garand Kendrea L. (Focht) , Reilly Mary Catherine , Choi Dahye , Dey Rajarshi , Estis Julie , Hill Grayson
Published: November 2021

Purpose:

This retrospective study investigated the impact of age, sex, and swallow task on bolus hold location during cued liquid swallows in healthy, community-dwelling adults. Furthermore, we investigated the association between bolus hold location and Modified Barium Swallow Impairment Profile (MBSImP) Components 2 (bolus hold) and 4 (lingual transport) scores.

Method:

Cued swallows of standardized barium liquids (thin, nectar-thickened, honey-thickened) observed during videofluoroscopy in 195 participants were judged as either tipper or dipper bolus hold type. Logistic regression was used to determine relationships between bolus hold location and age, sex, and swallow task. Fisher's exact test was used to determine associations between MBSImP scores and bolus hold type.

Results:

The majority of swallow tasks (95%) were of tipper bolus hold type. A significant relationship was observed between age and bolus hold type for swallows of 5-ml thin liquid and 5-ml honey-thickened liquid, with older individuals more likely to demonstrate a tipper bolus hold type. Sex was observed to be a significant factor for two swallow tasks (cup sip of thin liquid and 5 ml of nectar-thickened liquid), with males being more likely to be dippers. No significant relationships were observed between bolus hold type and MBSImP Component 2 or 4 scores.

Conclusions:

A tipper bolus hold type was the most common type observed in healthy adults, although the dipper bolus hold type was also observed (albeit at a lower frequency). These study findings further contribute to defining typical swallowing behaviors.
Fault tolerant control in an unmanned bicycle robot via sliding mode theory
Authors: Alizadeh Mousa , Ramezani Amin , Saadatinezhad Hadis
Published: November 2021

In this work, a new active fault tolerant control (FTC) is developed for an unmanned bicycle robot based on an integration between a sliding mode control (SMC), fault detection (FD), and fault estimation (FE) via a residual signal. A sliding surface in accordance with the fault tolerant sliding mode control (FTSMC) is designed for the bicycle robot to get multiple exciting features such as fast transient response with finite time convergence, small overshoot and quick stabilisation in the presence of an actuator fault. To obtain an effective performance for the FTSMC, a fault estimation system is employed and in order to attain estimation, an extended Kalman filter (EKF) as an estimator and a change detection algorithm called cumulative sum (CUSUM) as a residual evaluation function are developed. The innovative features of the proposed approach, that is FTSMC, are verified when compared with the other up‐to‐date control techniques like fault tolerant model‐based predictive control with feedback linearisation (FTMPC + FBL) and fault tolerant linear quadratic regulator with feedback linearisation (FTLQR + FBL) on an unmanned bicycle robot.
Hydroxyapatite nanomaterials with tailored length regulated by different fatty acids
Authors: Qi Mei‐li , Yao Shengkun , Wang Wen , Qi Liang , Wang Yanmin , Zhang Haijun
Published: November 2021

The morphology and structures of hydroxyapatite (HA) nanomaterials greatly influence their physicochemical properties and bio‐applications. In this study, HA nanostructures with tailored length regulated by different fatty acids were prepared via a solvothermal route. By using ricinoleic acid, linoleic acid and oleic acid as the template, the growth of HA crystals was regulated and the morphology of HA nanomaterials was transformed from long nanowires to short nanowires and then nanorods. The underlying mechanism for the formation of HA nanomaterials synthesized by different kinds of fatty acids under solvothermal condition was proposed. This study provides a simple and environmentally friendly way to obtain HA nanomaterials with tailored length for biomedical applications.
Online current cut‐off frequency self‐tuning active damping speed controller for permanent magnet synchronous motors
Authors: You Sung Hyun , Kim Ki‐Chan , Kim Seok‐Kyoon
Published: November 2021

This study suggests a dynamic current cut‐off frequency‐based pole‐zero cancellation speed controller for permanent magnet synchronous motors (PMSMs). The proposed self‐tuning algorithm automatically increases the current cut‐off frequency during only the transient periods and restores it as approaching the steady‐state operation. The outer loop control injects the active damping effect, resulting in a closed‐loop order reduction by pole‐zero cancellation from the particularly structured feedback gain. These two benefits contribute to the following advantages: (a) lowering the steady‐state current cut‐off frequency to improve the relative stability margin and (b) securing the capability of assigning the desired cut‐off frequency to both the inner and outer loops in the first‐order low‐pass filter form. A 500‐W PMSM experimental prototype platform confirms the effectiveness of the proposed controller.
Simulation-based training improves polypectomy skills among practicing endoscopists
Authors: Patel Ronak V. , Barsuk Jeffrey H. , Cohen Elaine R. , Wani Sachin B. , Rastogi Amit , McGaghie William C. , Wayne Diane B. , Keswani Rajesh N. , Komanduri Srinadh
Published: November 2021

Background and study aims Practicing endoscopists have variable polypectomy skills during colonoscopy and limited training opportunities for improvement. Simulation-based training enhances procedural skill, but its impact on polypectomy is unclear. We developed a simulation-based polypectomy intervention to improve polypectomy competency.

Methods All faculty endoscopists at our tertiary care center who perform colonoscopy with polypectomy were recruited for a simulation-based intervention assessing sessile and stalked polypectomy. Endoscopists removed five polyps in a simulation environment at pretest followed by a training intervention including a video, practice, and one-on-one feedback. Within 1–4 weeks, endoscopists removed five new simulated polyps at post-test. We used the Direct Observation of Polypectomy Skills (DOPyS) checklist for assessment, evaluating individual polypectomy skills, and global competency (scale: 1–4). Competency was defined as an average global competency score of ≥ 3.

Results 83 % (29/35) of eligible endoscopists participated and 95 % (276/290) of planned polypectomies were completed. Only 17 % (5/29) of endoscopists had average global competency scores that were competent at pretest compared with 52 % (15/29) at post-test (P = 0.01). Of all completed polypectomies, the competent polypectomy rate significantly improved from pretest to post-test (55 % vs. 71 %; P < 0.01). This improvement was significant for sessile polypectomy (37 % vs. 65 %; P < 0.01) but not for stalked polypectomy (82 % vs. 80 %; P = 0.70).

Conclusions Simulation-based training improved polypectomy skills among practicing endoscopists. Further studies are needed to assess the translation of simulation-based education to clinical practice.
Accreditation program for gastrointestinal endoscopes reprocessing in Italy: An on-site survey
Authors: Spinzi Giancarlo , Milano Angelo , Brosolo Piero , Da Massa Carrara Paola , Labardi Maurizio , Merighi Alberto , Riccardi Luisa , Torresan Francesco , Capelli Maurizio
Published: November 2021

Background and study aims Endoscope reprocessing has been associated with a variable failure rate. Our aim was to present an overview on current practices for reprocessing in Italian facilities and discuss the principle critical points.

Methods In 2014 the Italian Society for Digestive Diseases implemented an accreditation program in collaboration with an independent organization for certification and with the Italian Association for Endoscopy Technical Operators. During a 1-day site visit of the endoscopy center, two endoscopists, one nurse, and the representative of the certification body evaluated the endoscope reprocessing.

Results As of July 1, 2020, 28 endoscopy centers had been accredited. Ten centers are completing the measures to correct deficiencies found at the visit. Three centers withdrew from the program. The accreditation program has found variations between the various centers, confirming the poor compliance with guidelines. Major deviations from the standards, established by the model before the site visit according to national and international guidelines, concerned instrument cleaning (44.7 % of the centers), instrument storage (23.7 %), and microbiological tests (31.6 %).

Conclusions Our overview demonstrated the lack of many reprocessing phases, which are important to prevent endoscopy-associated infections. Accreditation can achieve a transformation in quality and safety of reprocessing with the Italian centrally-led approach.
Colon capsule endoscopy in colorectal cancer screening: Interim analyses of randomized controlled trial CareForColon2015
Authors: Deding Ulrik , Bjørsum-Meyer Thomas , Kaalby Lasse , Kobaek-Larsen Morten , Thygesen Marianne Kirstine , Madsen Jeppe Buur , Kroijer Rasmus , Baatrup Gunnar
Published: November 2021

Background and study aims The Danish CareForColon2015 trial, launched in 2020 as part of the Danish Colorectal Cancer Screening program, is the largest randomized controlled trial to date on colon capsule endoscopy (CCE). This paper presents the interim analysis with the objective of ensuring the safety of patients in the intervention group and evaluating the clinical performance of the trial’s predefined clinical parameters.

Patients and methods We evaluated the initial 234 CCEs according to quality, safety, and completion. The participation rates and preference distribution of all individuals invited were analyzed and sample size calculations were adjusted.

Results Fecal immunochemical test and diagnostic participation rates were 62.1 % and 91.1 %, respectively. The completion rate for CCEs was 67.9 % and the rate of conclusive investigations was 80.3 %. The polyp detection rate (PDR) was high (73.5 %), only two (0.85 %) technical failures in 234 videos were observed, and six suspected cancers were identified (2.6 %). No major adverse events were recorded. The required number of invitations had been underestimated due to inaccurate assumptions in sample size calculations.

Conclusions The trial was efficient and safe in terms of CCE quality and time to diagnostic investigation. Participation rates and PDRs were high. The proportion of suspected cancers was lower than expected and will be followed. The completion rate for CCEs was acceptable but lower than expected and the CCE procedure was reviewed for potential improvements and Resolor was added to the regime. The number of invitations for the intervention group of the trial has been adjusted from 62,107 to 185,153.
Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for gastroesophageal reflux disease: a systematic review and meta-analysis
Authors: Rodríguez de Santiago Enrique , Sanchez-Vegazo Carlos Teruel , Peñas Beatriz , Shimamura Yuto , Tanabe Mayo , Álvarez-Díaz Noelia , Parejo Sofía , Kazuya Sumi , Marcos-Carrasco Natalia , Vazquez-Sequeiros Enrique , Inoue Haruhiro , Albillos Agustín
Published: November 2021

Background and study aims Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) are new endoscopic procedures for patients with gastroesophageal reflux disease (GERD). We conducted a meta-analysis to systematically assess the feasibility, clinical success, and safety of these procedures.

Patients and methods We searched Embase, PubMed, and Cochrane Central from inception to October 2020. Overlapping reports, animal studies, and case reports were excluded. Our primary outcomes were clinical success and adverse events (AEs). Secondary outcomes included technical success, endoscopic esophagitis, 24-hour pH monitoring, and proton pump inhibitor (PPI) use. A random effects model was used to pool data.

Results In total, 15 nonrandomized studies (12 ARMS, n = 331; 3 ARMA, n = 130) were included; 10 were conducted in patients with refractory GERD. The technical success rate was 100 %. The pooled short-term (first assessment within the first 6 months), 1-year, and 3-year clinical success rates were 78 % (95 % confidence interval [95 %CI] 70 %–85 %), 72% (95 %CI 47 %–92 %), and 73 % (95 %CI 65 %–81 %), respectively. ARMS and ARMA yielded similar clinical success. The proportion of patients off PPIs at 1 year was 64 % (95 %CI 52 %–75 %). There were significant drops (P < 0.01) in validated clinical questionnaires scores, presence of esophagitis, and acid exposure time. The most common AE (11 %, 95 %CI 8 %–15 %) was dysphagia requiring dilation (7%, 95 %CI 5 %–11 %). Four cases of perforation were recorded, all in patients undergoing ARMS.

Conclusions Our meta-analysis of nonrandomized studies suggests that ARMS and ARMA are safe and effective for patients with GERD.
Positive white nipple sign on esophageal varices: Not a just bystander; our experience
Authors: Prajhapati Ritesh , Sethia Mohit , Desai Pankaj , Kabrawala Mayank , Mehta Rajiv , Nandwani Subhash , Patel Chintan , Patel Nisharg
Published: November 2021

Background and study aims The goal of this study was to assess whether a white nipple sign on esophageal varices is of no prognostic significance or mandates more attention.

Patients and methods We retrospectively analyzed data from 2601 patients undergoing upper gastrointestinal endoscopy for variceal bleed from January 2008 to January 2020. Intraprocedural events like onset of active spurt while performing endoscopy, active spurt while attempting to band the varix with a nipple, need for rescue glue therapy required to control bleed in cases of failed endoscopic variceal ligation (EVL), slipping of band and rebleed despite successful band application, need for emergency intubation, and pulmonary aspiration-related complications were noted.

Results A total of 2601 patients underwent endoscopy for variceal bleeding. Of them, 631 had a positive white nipple sign. Of that subgroup, 137 (21.7 %) patients developed active spurt during endoscopy. In patients with the white nipple sign, 12.3 % required endotracheal intubation and 6.7 % developed aspiration pneumonia, which were significantly higher than in those without the sign. Rescue glue injection in esophageal varices was needed in 5.6 % as compared to 0.6 % in those without white nipple.

Conclusions The white nipple sign is not only a predictor of recent bleed, but it carries statistically significant increased risk of intraoperative bleeding, need for endotracheal intubation, esophageal glue injections, and aspiration-related complications. Therefore, it is not just a bystander, but rather, a sign of increased danger and a need to be more vigilant with patient management.
Dose estimates of occupational radiation exposure during radioguided surgery of Tc-99m-PSMA-labeled lymph nodes in recurrent prostate cancer
Authors: Schmidt Daniel , Grosse Jirka , Mayr Roman , Burger Maximilian , Hellwig Dirk
Published: November 2021

Aim [99mTc]Tc-PSMA-based radioguided surgery (TPRS) represents a curative approach for localized relapse of prostate cancer. For its simplified regulatory permission, the radiation protection authorities require a 99mTc- activity below the exemption limit of 10 MBq at the time of surgery. Our aim was to determine the optimal amount of radioactivity (OAR) to comply with that limit and to estimate the maximum number of TPRS procedures per year and surgeon without triggering the full monitoring obligations.

Methods In this retrospective study, a dose rate meter was calibrated using measurements on phantoms and from recently injected (1 min p. i.) patients to determine the activity in the patient from measured dose rates. The effective half-life of 99mTc-PSMA-I&S in patients was determined from repeated dose rate measurements to estimate dose parameters of relevance for radiation protection. External exposures of the surgeons were measured with personal dosimeters calibrated in Hp(10). The surgeon’s finger dose Hp(0.07) is estimated from radioactivity measured in resected lymph nodes. Potenzial incorporations were estimated for an activity of 10 MBq.

Results From the first 6 subsequent patients, an effective half-life of 4.15 h was observed. Assuming an operation time 24 h p. i., the OAR was 550 MBq. Operations lasting in average 2 h in a distance of 0.25 m to the patient imply a body dose for surgeons of 4.16 µSv per procedure. Based on these estimates, the surgeon’s Hp(10) is less than 1 mSv per year with up to 241 operations per year. Hp(0.07) and potential incorporation of activity do not lead to further limitations.

Summary All radiation protection regulations are met with adherence to OAR recommended here without triggering the full monitoring obligations from radiation protection regulations.
Die Autonomie von Rehabilitanden in der stationären
medizinischen Rehabilitation – Aspekte der Gefährdung und
Wahrung
Authors: Klemmt Malte , Henking Tanja , Neuderth Silke
Published: November 2021

Ziel der Studie Ziel der Studie ist die Identifizierung von Aspekten
innerhalb der stationären medizinischen Rehabilitation, die die
Autonomie von Rehabilitanden gefährden bzw. wahren können.

Methodik Durchgeführt wurde ein Scoping Review auf Basis des
aktuellen wissenschaftlichen Erkenntnisstandes. Das methodische Vorgehen
orientierte sich an den Vorgaben des Joanna Briggs Institute. Die Recherche und
Befundgenerierung wurden in Anlehnung an die PRISMA-ScR-Checklist
protokolliert.

Ergebnisse Der finale Studieneinschluss umfasst 39 empirische und
normativ-theoretische Beiträge. Autonomiegefährdende Aspekte
wurden den Bereichen: Rehabilitationssystem, Rehabilitationseinrichtungen,
Einrichtungspersonal, Rehabilitanden und Dritte zugeordnet. Aspekte, die die
Autonomie von Rehabilitanden potenziell wahren können, umfassen die
Bereiche: Rehabilitationseinrichtungen, Einrichtungspersonal, Konzepte und
Ausprägungsformen sowie Instrumente.

Schlussfolgerung Eine Vielzahl von heterogenen Aspekten kann die Autonomie
von Rehabilitanden während des Rehabilitationsaufenthaltes in der
stationären medizinischen Rehabilitation gefährden, aber auch
wahren bzw. fördern. Diese sind im gesamten Verlauf der rehabilitativen
Leistung angesiedelt und betreffen sowohl die strukturelle, organisationale als
auch die personale Ebene. Die Autonomie von Rehabilitanden sollte nicht nur als
Outcome der Rehabilitation, sondern auch als Anforderung an Strukturen und
Akteure während des Rehabilitationsaufenthaltes behandelt werden.
Rehabilitandenzufriedenheit in den sozialen Medien und auf
Online-Bewertungsportalen
Authors: Patzelt Christiane , Kiss Susann , Hopf Felix , Biedermann Irina , Schindler Anja , Emmert Martin , Sander Uwe
Published: November 2021

Ziel Rehabilitanden äußern sich zu ihrem
Rehabilitationsaufenthalt vermehrt im Internet, bewerten die Leistungserbringer
mit Sterneratings und schreiben Erfahrungsberichte. Bisher liegen keine
Erkenntnisse zur im Internet kommunizierten Rehabilitandenzufriedenheit
für die stationäre medizinische Rehabilitation in Deutschland
vor. Die Studie verfolgte erstmalig das Ziel einer systematischen Analyse der
Rehabilitandenzufriedenheit in den sozialen Medien und auf
Klinikvergleichsportalen.

Methoden Bewertungen zur Rehabilitation auf dem Portal
Klinikbewertungen.de und dem sozialen Netzwerk Facebook wurden für 8
Indikationsgruppen (Orthopädie, Psychosomatik/Psychotherapie,
Onkologie, Kardiologie, Neurologie, Innere Medizin,
Pneumologie/Dermatologie, Gastroenterologie) in einer Vollerhebung
über drei Jahre (10/2014–09/2017) für
federführend belegte Reha-Kliniken der Rentenversicherung
(N=497) erhoben. Zur Bestimmung der Rehabilitandenzufriedenheit wurden
die Sternebewertungen, aggregriert nach Indikationsgruppen, ausgewertet
(Chi-Quadrat-Test nach Pearson, Exakter Test nach Fisher, Phi-Koeffizient).

Ergebnisse Auf Klinikbewertungen.de waren 97,2% der Reha-Kliniken
mit 24 806 Bewertungen vertreten. Die am häufigsten bewerteten
Indikationsgruppen waren die Orthopädie (38,5%) und die
Psychosomatik/Psychotherapie (27,1%). Für Facebook
wurden Bewertungen (N=4127) zu Reha-Kliniken (38,6%) mit jeweils
einer Fachabteilung erfasst, um eine Indikationsgruppenzuordnung
sicherzustellen. Es wurden annährend gleich viele Bewertungen auf
offiziellen (48,7%) wie inoffiziellen Facebookseiten (51,3%)
ermittelt, wobei kein signifikanter Zusammenhang der Seitenverwaltung zur
Gesamtzufriedenheit bestand (p>0,05). Auf den Facebookseiten waren
49,1% der Bewertungen von Frauen (38,5% männlich;
12,4% nicht zuordenbar). Soziodemografische Angaben auf
Klinikbewertungen.de bezogen sich einzig auf den Versichertenstatus
(89,1% gesetzlich Versicherte). Die Bewertungen wurden zu 95,4%
von Rehabilitanden und 4,0% von Angehörigen verfasst.
77,5% der Rehabilitanden gaben eine Weiterempfehlung ab
(Angehörige: 37,2%). Die meisten Rehabilitandenbewertungen waren
positiv. Es zeigten sich Unterschiede in der Gesamtzufriedenheit zwischen den
Indikationsgruppen. Die Rehabilitanden in der Onkologie (77,9%) waren
zufriedener als in der Neurologie (59,0%).

Schlussfolgerung Online-Bewertungen über die stationäre
medizinische Rehabilitation konnten im erheblichen Umfang erhoben werden. Diese
fallen überwiegend positiv aus und sind mit Ergebnissen standardisierter
Befragungen vergleichbar. Trotz Einschränkungen bei der Nutzung von
Daten aus den sozialen Medien weisen die Ergebnisse darauf hin, dass das
öffentlich zugängliche zeitnahe Online-Feedback von
Rehabilitanden nützliche Informationen für das
Qualitätsmanagement der Kliniken sowie für Patienten in der
Wahrnehmung des Wunsch- und Wahlrechts haben kann.
Hypoehoic lesions on Transrectal Ultrasound and its correlation to Gleason grade in the diagnosis of Clinically Significant Prostate Cancer: A Prospective Study
Authors: Sharma Manas , Nerli Rajendra B. , Nutalapati Sree Harsha , Ghagane Shridhar C.
Published: November 2021

Context The importance of hypoechoic lesions on transrectal ultrasound (TRUS) merits re-assessment in the present era of widespread prostate-specific antigen (PSA) testing.

Aims We aimed to investigate the predictive accuracy of hypoechoic lesions on TRUS of prostate in the diagnosis of prostate cancer and to examine the association of hypoechoic lesions with the aggressiveness of prostate cancer.

Settings and Design This prospective study was conducted in a tertiary care center in South India from November 2017 to December 2019.

Methods and Material We included 151 patients undergoing TRUS-guided 12-core prostate biopsy in view of raised serum PSA with or without suspicious digital rectal examination (DRE) findings in the study. Age, DRE findings, serum PSA level, TRUS findings, and histopathology reports were documented. These were compared between patients with and without hypoechoic lesions on TRUS.

Statistical Analysis Used The statistical analysis for this study was performed using SPSS v20.0 software.

Results Among 151 men, prostate cancer was diagnosed in 68 (45.03%) with mean age at presentation 69.81 ± 6.49 years. Fifty-eight cases (38.41%) had hypoechoic lesion on TRUS and the cancer detection rate (68.96%) amongst this group was significantly higher than in those without hypoechoic lesion (p <0.0001). Patients with hypoechoic lesion were more likely to have higher grade cancer. Abnormal DRE findings and hypoechoic lesion on TRUS were independent predictors of a clinically significant cancer (p <0.05).

Conclusion Hypoechoic lesion on TRUS can be considered as an indicator of clinically significant prostate cancer.
Epigenetic Approach to PTSD: In the Aspects of Rat Models
Authors: Aykac Asli , Kalkan Rasime
Published: November 2021

Posttraumatic stress disorder (PTSD) is a stress-related mental disorder and develops after exposure to life-threatening traumatic experiences. The risk factors of PTSD included genetic factors; alterations in hypothalamic–pituitary–adrenal (HPA) axis; neurotrophic, serotonergic, dopaminergic, and catecholaminergic systems; and a variety of environmental factors, such as war, accident, natural disaster, pandemic, physical, or sexual abuse, that cause stress or trauma in individuals. To be able to understand the molecular background of PTSD, rodent animal models are widely used by researchers. When looking for a solution for PTSD, it is important to consider preexisting genetic risk factors and physiological, molecular, and biochemical processes caused by trauma that may cause susceptibility to this disorder. In studies, it is reported that epigenetic mechanisms play important roles in the biological response affected by environmental factors, as well as the task of programming cell identity. In this article, we provided an overview of the role of epigenetic modifications in understanding the biology of PTSD. We also summarized the data from animal studies and their importance during the investigation of PTSD. This study shed light on the epigenetic background of stress and PTSD.
Hypoalbuminemia Predicts Adverse Events following Unicompartmental Knee Arthroplasty
Authors: Hur Edward S. , Bohl Daniel D. , Della Valle Craig J. , Villalobos Felipe , Gerlinger Tad L.
Published: November 2021

Hypoalbuminemia is a potentially modifiable risk factor associated with adverse events following total knee arthroplasty. The present study aimed to evaluate whether hypoalbuminemia similarly predisposes to adverse events following unicompartmental knee arthroplasty (UKA). Patients who underwent UKA during 2006–2018 were identified through the American College of Surgeons National Surgical Quality Improvement Program. Only patients with preoperative serum albumin concentration were included. Outcomes were compared between patients with and without hypoalbuminemia (serum albumin concentration < 3.5 g/dL). All associations were adjusted for demographic, comorbidity, and laboratory differences between populations. A total of 11,342 patients were identified, of whom 6,049 (53.3%) had preoperative serum albumin laboratory values available for analysis. After adjustment for potential confounders, patients with hypoalbuminemia had a greater than 2-fold increased probability for occurrence of any complication (7.02% vs. 2.23%, p = 0.009) and a 4-fold increased probability of receiving a blood transfusion (1.81% vs. 0.25%, p = 0.045). Among procedures performed as inpatients, mean postoperative length of stay (LOS) was longer in patients with hypoalbuminemia (2.2 vs. 1.8 days; p = 0.031). Hypoalbuminemia is independently associated with complications and increased LOS following UKA and a marker for patients at higher risk of postoperative complications. Patients should be screened for hypoalbuminemia and nutritional deficiencies addressed prior to UKA.