bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in a Frailty Index and Association with Mortality
Authors: Shi Sandra M. , Olivieri‐Mui Brianne , McCarthy Ellen P. , Kim Dae H.
Published: December 2020

Background

Although frailty status is dynamic, whether improvements in frailty predict mortality is unknown.

Objective

Describe 1‐year changes in a frailty index (FI) and association with 48‐month mortality.

Design

Secondary analysis of the National Health in Aging Trends Study.

Setting

Community.

Participants

Five thousand six hundred and seventy two Medicare beneficiaries 65 and older (3,267 (55.8%) females).

Measurements

A 40‐item deficit accumulation FI was measured in 2011 and 2012, based on multidomain assessment including comorbidities, activities of daily living, physical tasks, cognition, and performance testing. We categorized 2011 FI into robust (FI < 0.15), pre‐frail (FI = 0.15–0.24), mild frailty (FI = 0.25–0.34), and moderate to severe frailty (FI ≥ 0.35). Change in frailty was calculated as the FI change from 2011 to 2012, categorized as either absolute (>0.045 decrease, 0.015–0.045 decrease, ±0.015 change, 0.015–0.045 increase, >0.045 increase) or proportional change (>20% decrease, 5–20% decrease, ±5% change, 5–20% increase, 20% increase). We measured the association of FI change with 4‐year mortality using Cox regression.

Results

From 2011 to 2012, mean FI increased by 0.02 (standard deviation 0.07), with 58.6% having an increase. Over 4 years, 1,039 participants (13.6%) died. After adjusting for age and sex, compared to stable frailty (±0.015), both absolute (>0.045) and proportional (>20%) increases in frailty were associated with higher mortality among pre‐frail participants (hazard ratio (HR) = 2.35, 95% confidence interval (CI) = (1.45–3.79) and HR (95% CI) = 3.32 (1.76–6.26), respectively), participants with mild frailty (HR (95% CI) = 1.96 (1.35–2.85) and 2.03 (1.37–3.02)) and moderate or severe frailty (HR (95% CI) = 1.99 (1.48–2.67) and 1.94 (1.43–2.63)) but not robust participants (HR (95% CI)= 1.48 (0.86–2.54), HR (95% CI) = 1.62 (0.80–3.28)). However, decreases in FI were not significantly associated with decreased risk of mortality.

Conclusions

Increasing deficit accumulation FI over 1 year is associated with increased mortality risk. While decreasing FI occurs, we did not find evidence to support reduced mortality risk.
Collaborative Practice and Teaching in Perinatal Care: Certified Nurse‐Midwives as Educators of Medical Residents
Authors: Neylan Elizabeth , Farahi Narges , Sloane Philip D. , McConaughey Edie , Silbersack Johanna , Oat‐Judge Julia
Published: December 2020

Introduction

The goal of this study was to update understanding of the current roles and responsibilities of certified nurse‐midwives (CNMs) in the education of resident physicians. Three subaims were to (1) examine the involvement of CNMs in the education of residents in obstetrics and gynecology and family medicine, (2) examine the typology of CNMs’ collaboration with residents, and (3) describe CNMs’ opinions regarding their educational roles and responsibilities.

Methods

This descriptive study used an electronic survey sent to CNMs involved in the education of medical residents. Survey participants were identified using an online directory of CNMs involved in academic midwifery practices in the United States. Survey items included both closed‐ended and open‐ended questions to generate quantitative and qualitative data, respectively.

Results

Of the 146 CNMs invited to participate, surveys were received from 85, a response rate of 58%. Seventy of the respondents fit inclusion criteria of working with family medicine and obstetrics and gynecology resident physician programs. Most of the midwives’ educational roles included informal mentorship of residents, supervision and consultation of intrapartum care, and caring for either their own or residents’ patients. All respondents agreed that incorporating CNMs into clinical teams and faculty roles improves resident education. The majority of respondents desired a greater degree of involvement in resident education, with 57% preferring a blended interaction model.

Discussion

The majority of CNM respondents reported a preference to have greater involvement in the education of residents. Although CNMs desire a blended interaction or fully integrated model of collaboration with resident physicians, the current state of CNM involvement does not fulfill this degree of collaboration. Opportunities exist for further research, including surveys of resident physicians who work with CNMs, leaders in midwifery, residency program directors, and policy makers.
Communicating prognostic information and hope to families of dying patients in intensive care units: A descriptive qualitative study
Authors: Almansour Issa , Abdel Razeq Nadin M.
Published: December 2020

Aims and objectives

To understand how prognostic information is communicated by Jordanian doctors and nurses to the families of dying patients in intensive care units, with an emphasis on exploring how hope and truth telling about patients' poor prognosis are managed.

Background

Improving end‐of‐life care requires a focus on adequate family–professionals prognostic communication, while maintaining a realistic level of hope and family support.

Design

A descriptive qualitative approach was applied.

Methods

Semi‐structured interviews were conducted with 20 nurses and 15 resident doctors caring for dying patients. Bardin's procedure of categorical content analysis was applied. The COREQ checklist for reporting qualitative studies was followed.

Results

Two main categories emerged from the data of this study: ‘perspectives on optimistic hope’ and ‘approaches to prognostic communication’. Health professionals experience extreme difficulty, and therefore, frequently avoid openly disclosing information about patients' poor prognosis to the families. Consequently, the health professionals adopted various methods to balance truth telling against sustaining hope among the patients' families. Providing false assurance was perceived as permissible and understandable, in order to nurture the families' hope.

Conclusions

Improving end‐of‐life care in intensive care units in Jordan requires a focus on family–professional communication. Jordanian intensive care doctors and nurses perceived honest family–professional communication regarding dying patients to be extremely challenging. Healthcare professionals should develop their competency of meeting the informational and emotional needs of patients in ICUs and their families, while also honouring their cultural values, during prognostic communication.

Relevance to clinical practice

Effective training of healthcare professionals is vital on ways to enhance communication of prognostic information and to foster realistic hope among families of dying patients in intensive care units. There is a need to also explore the families' perspectives on prognostic communication in order to understand the similarities and differences between the professionals' and families' perspectives.
ARE IMPACTS OF EARLY INTERVENTIONS IN THE SCANDINAVIAN WELFARE STATE CONSISTENT WITH A HECKMAN CURVE? A META‐ANALYSIS
Authors: Rosholm Michael , Paul Alexander , Bleses Dorthe , Højen Anders , S. Dale Philip , Jensen Peter , M. Justice Laura , Svarer Michael , Calmar Andersen Simon
Published: December 2020

“Early intervention” has been a mantra in recent debates about human capital investment. Strong theoretical models motivate this focus by predicting that investment in children is most cost‐effective when they are young. The “Heckman curve” summarizes this idea visually (Heckman, 2006). However, hardly any reviews scrutinize this hypothesis empirically in modern welfare states such as those in Scandinavia that already invest heavily during early childhood. Any such review is ideally based on interventions conducted as randomized controlled trials (RCTs), set in the same welfare state, and comparable across ages through cost‐standardized effects. This meta‐analysis assembles cost‐standardized effect estimates from 10 RCTs, including a total of 18 intervention arms and 30,578 participants (aged 1.5–24 years), conducted by the same research center in the Scandinavian welfare state of Denmark. These interventions show significant effects relative to their costs, despite the large baseline investment level. Interventions targeted at younger children tend to produce larger effects, consistent with the Heckman curve. However, variation in the effect size within age groups is as large as it is across age groups. This indicates that both the quality and timing of investments matter and that “early interventions” are not necessarily superior to later interventions.
Effects of myrtle (Myrtus communis L.) essential oils as dietary antioxidant supplementation on carcass and meat quality of goat meat
Authors: Smeti Samir , Tibaoui Souha , Bertolín Juan Ramon , Yagoubi Yathreb , Mekki Ilyes , Joy Margalida , Atti Naziha
Published: December 2020

Despite the fact that the use of rosemary and thyme residues and essential oils in animal feeding was widely documented, that of myrtle is scarce. To test the hypothesis that myrtle essential oils (MEOs) could improve goats' carcass characteristics and meat quality traits, twenty‐one male goats received a ration consisted of 40% oat hay and 60% concentrate. Experimental goat kids received the control diet supplemented with 0, 0.3 and 0.6% of myrtle essential oils (MEOs) for C, Myrt1 and Myrt2 groups respectively. The administration of MEO did not improve the daily DM intake (p > 0.05). Kids of C and Myrt2 groups had higher average daily gain than Myrt1 group (75 versus 55 g). The goats slaughtered at 19.9 kg of weight did not differ (p > 0.05) in carcass weights and carcass yield in terms of commercial dressing percentage (CDP = 41%) and real dressing percentage (RDP = 52%). The administration of MEO increased the meat polyphenol content, being higher in both Myrtle groups (87 versus. 56 μg gallic acid equivalents g‐1 fresh matter, p < 0.05). Myrtle EO administration protected kids’ meat against oxidation (0.48 versus. 0.91 mg MDA/kg of meat for Myrtle and C groups, respectively, at the 9th day of storage; p < 0.05). It could be useful to include MEO as a dietary supplement in goats’ rations since it improves meat's oxidative status without negative effects on FA profile.
Significant otherness nation‐building and identity in postwar Austria
Authors: Tschiggerl Martin
Published: December 2020

Nation‐building in Austria in the first half of the 20th century failed several times before it became possible to construct an independent Austrian nation after 1945. This article traces how Austria's handling of the Nazi era involved a demarcation from Germany, which became an identity‐determining alterity for the idea of an independent Austrian nation. For this purpose, a specifically Austrian history was constructed, which focused on the idea that Austria had been the first victim of National Socialism. The supposed certainty of not being German and the myth of being the first victim of National Socialism were two metanarrative constants along which an Austrian identity could be imagined. They are crucial to the success of the Austrian nation built after 1945.
Vaccinium napoense, a new species of V. sect. Conchophyllum (Ericaceae) from Guangxi, China
Authors: Tong Yi‐Hua , Huang Yu‐Song , Ye Xue‐He , Cai Zhuo‐Yu , Xia Nian‐He
Published: December 2020

Vaccinium napoense (Ericaceae), a new species from Napo County, Guangxi Zhuang Autonomous Region, China is described and illustrated. The new species is assigned to V. sect. Conchophyllum and is closest to V. chengiae, V. saxicola and V. triflorum, but differs in having obovate or oblanceolate leaf blades and urceolate, yellow‐green and pilose corolla.
Germination response of four Arabian desert grasses to low water potential
Authors: Bhatt Arvind , de Moura Souza‐Filho Paulo Roberto , Gallacher David
Published: December 2020

Species that can germinate under low water potential are likely to have greater utility for fodder production and restoration in arid habitats. We investigated seed germination response of four native grass species (Panicum acuminatum, Panicum turgidum, Pennisetum divisum and Polypogon monspeliensis) to five osmotic potentials (0, −0.3, −0.6, −0.9 and −1.2 MPa) using polyethylene glycol‐6000 and two light treatments (0, 12 h light per day). All the studied species exhibited high germination (> 77%) at ψ = 0 MPa except P. turgidum (42%). Polypogon monspeliensis seeds did not show any significant reduction in germination from ψ = 0 to −0.3 MPa (90–83%), but all other species did, averaging from 75.8 to 60.5%. At ψ = −0.6 MPa seed germination was reduced to around 20%. Germination of most species was unaffected by light, but P. divisum seeds that germinated in darkness were more tolerant to water deficit. Reduction of water potential to −0.3 MPa inhibited the germination timing for P. acuminatum (ca 1.69 days difference to 50% germination [t50]), P. divisum (ca 1.56 day) and P. monspeliensis (ca 1.14 days). Germination of P. acuminatum and P. monspeliensis were similar after stressful exposure to all osmotic potentials, while for P. divisum there was reduced germination (85% at −0.6 MPa to 58% −1.2 MPa), indicating a dormancy induction. Tolerance to low water potentials, and response after release from these low potentials, indicates the species are adapted to survive in drier environments.
Novel gel bolus to improve impedance‐based measurements of esophageal cross‐sectional area during primary peristalsis
Authors: Ledgerwood Melissa , Zifan Ali , Lin William , de Alva Jesse , Chen Haojin , Mittal Ravinder K.
Published: December 2020

Introduction

Intraluminal esophageal impedance (ILEE) has the potential to measure esophageal luminal distension during swallow‐induced peristalsis in the esophagus. A potential cause of inaccuracy in the ILEE measurement is the swallow‐induced air in the bolus.

Aim

Compare a novel gel bolus to the current alternatives for the measurement of impedance‐based luminal distension (cross‐sectional area, CSA) during primary peristalsis.

Methods

12 healthy subjects were studied using high‐resolution impedance manometry (HRMZ) and concurrently performed intraluminal ultrasound (US) imaging of the esophagus. Three test bolus materials were used: 1) novel gel, 2) 0.5 N saline, and 3) commercially available Diversatek EFTV viscous. Testing was performed in the supine and Trendelenburg (−15°) positions. US imaging assessed air in the bolus and luminal CSA. The Nadir impedance values were correlated to the US measured CSA. A custom Matlab software was used to assess the bolus travel times and impedance‐based luminal CSA.

Results

The novel gel bolus had the least amount of air in the bolus during its passage through the esophagus, as assessed by US image analysis. The novel gel bolus in the supine and Trendelenburg positions had the best linear fit between the US measured CSA and nadir impedance value (R2 = 0.88 & R2 = 0.90). The impedance‐based calculation of the CSA correlated best with the US measured CSA with the use of the novel gel bolus.

Conclusion

We suggest the use of novel gel to assess distension along with contraction during routine clinical HRM testing.
Assessing the performance of the Caregiver Reported Early Development Instruments (CREDI) in rural India
Authors: Alderman Harold , Friedman Jed , Ganga Paula , Kak Mohini , Rubio‐Codina Marta
Published: December 2020

Although many education and health programs aim to improve early childhood development, it is challenging to assess developmental levels of infants and small children through large household surveys. The Caregiver Reported Early Development Instruments (CREDI) has been proposed as an adaptable, practical, and low‐cost instrument for measuring the developmental status of children under 3 years of age at scale, as it is relatively short and collected by caregiver report. This study employed the CREDI to measure the development of a sample of 994 children ages 22–35 months in rural India and compared the results to those obtained using the Bayley Scales of Infant and Toddler Development (Bayley‐III), a reliable and widely used instrument, albeit one not always suited to large‐scale data collection efforts given its length, cost, and complexity of administration. The CREDI validation exercise showed that caregivers can provide assessments in keeping with the more interactive (hence more time‐consuming and training‐intensive) Bayley‐III instrument. Noteworthy, there was no indication that concordance of the instruments differed by education of the caregiver. This is important as it points to alternate feasible tools to measure child development outcomes through large‐scale surveys.
Accommodative and binocular disorders in preteens with computer vision syndrome: a cross‐sectional study
Authors: De‐Hita‐Cantalejo Concepción , García‐Pérez Ángel , Sánchez‐González José‐María , Capote‐Puente Raúl , Sánchez‐González María Carmen
Published: December 2020

To assess computer vision syndrome (CVS) in a preteen population through an adult‐validated CVS questionnaire and to evaluate how digital devices affect accommodative and binocular vision, we enrolled 309 preteens in this cross‐sectional study. An adult‐validated CVS questionnaire adapted to preteens was used for all subjects. Visual acuity testing, unilateral and alternate cover tests, and tests for accommodative and vergence responses were performed for all preteens. The mean age was 10.75 ± 0.67 (10–12) years. Subjects were divided into two groups: the mild CVS group with a mean CVS score ≤2 and the severe CVS group with a mean CVS score >2. Between the mild and severe CVS groups, statistically significant differences were found in near point of convergence break and recovery (P = 0.03 and P = 0.02, respectively) and distance negative fusional vergence break and recovery (P = 0.02 and P < 0.01, respectively). More children with severe CVS developed vergence disorders than those with mild CVS. Optometric clinical screening assessments could reduce ocular symptomatology and prevent long‐term effects. However, poor optometric findings might have occurred first, and the poor convergence skills resulted in the symptoms reported while using devices.
Spectral characterization and impact of stepwise ablation protocol including LAA electrical isolation on persistent AF
Authors: Ma Yuedong , Zaman Junaid A. B. , Shi Rui , Karim Nabeela , Panikker Sandeep , Chen Zhong , Chen Wen , Jones David Gareth , Hussain Wajid , Markides Vias , Wong Tom
Published: December 2020

Objectives

To study how left atrial appendage electrical isolation (LAAEI) impacts atrial dominant frequency (DF) in patients with long‐standing persistent atrial fibrillation (LSPAF).

Background

LAAEI is associated with a high probability of freedom from atrial fibrillation (AF) and spectral analysis may identify high‐frequency sources. How LAAEI impacts the AF dynamics and the subgroup of LSPAF patients in whom LAAEI would be most beneficial, is unclear.

Methods

Twenty patients with LSPAF were included in the study. Fast Fourier transforms (FFT) were performed on atrial electrograms recorded from 13 sites in the LA and RA. The highest peak frequency was defined as DF.

Results

There was no significant difference in DF between atrial sites except for at the superior vena cava which had the lowest DF at baseline. Stepwise ablation consisting of circumferential pulmonary vein isolation and a linear ablation set of mitral isthmus and roof significantly reduced the DF within the coronary sinus (CS) (5.93 ± 0.98 Hz vs. 5.09 ± 0.72 Hz, p < .05) and the LA posterior wall (LApos) (6.26 ± 0.92 Hz vs. 5.43 ± 0.98 Hz, p < .01). LAAEI preferentially further decreased the DF at the LApos (p < .01), but not at the CS. In cases where there was < 13.6% reduction in the DF of the LApos following the stepwise ablation, the addition of LAAEI was associated with an increased restoration of sinus rhythm (55%, p < .05).

Conclusion

LAAEI in addition to stepwise ablation results in further reduction of the DF in the LApos, which is associated with acute termination of AF and favorable ablation outcome.
Performance and outcome of the subcutaneous implantable cardioverter‐defibrillator after transvenous lead extraction
Authors: Chung Da‐Un , Tauber Johannes , Kaiser Lukas , Schlichting Andrea , Pecha Simon , Sinning Christoph , Rexha Enida , Reichenspurner Hermann , Willems Stephan , Gosau Nils , Hakmi Samer
Published: December 2020

Aims

The subcutaneous cardioverter‐defibrillator (S‐ICD) may be a valuable option in patients after successful transvenous lead extraction (TLE) without indication for pacemaker therapy and persistent risk of sudden cardiac death. The aim of this study was to evaluate device performance, postoperative outcome, and safety in patients who received a S‐ICD after TLE compared to patients who underwent de‐novo S‐ICD implantation.

Methods

A retrospective analysis of all patients included into our institution's S‐ICD database between September 2010 and May 2019 was conducted.The patients were divided in two groups, depending on whether they had received their S‐ICD after TLE (n = 31) or de‐novo (n = 113).

Results

The TLE group was significantly older with a mean age of 54.3 ± 15.7 versus 46.7 ± 14.4 years; p = .007. Leading S‐ICD indication in the TLE group was previous infection (50%), whereas in the de‐novo group the S‐ICD was primarily chosen due to young patient age (74.6%). Median duration of follow‐up was 527.0 versus 472.5 days, respectively; p = .576. Most common complication during follow‐up was inappropriate ICD therapy (12.9% vs. 13.3%); p = 1.000. Pocket erosion/infection occurred in 3.2% versus 3.5% with no reported cases of systemic (re‐)infection in either group; p = 1.000. All‐cause mortality was low (6.2% vs. 2.7%) and entirely unrelated to S‐ICD implantation or the device itself; p = .293.

Conclusion

The S‐ICD is a safe and effective alternative for patients after TLE with very similar results regarding device performance and postoperative outcome, when compared to patients who underwent de‐novo S‐ICD implantation.
The transcriptional repressor OsPRR73 links circadian clock and photoperiod pathway to control heading date in rice
Authors: Liang Liwen , Zhang Zhanyi , Cheng Niannian , Liu Haiyang , Song Song , Hu Yong , Zhou Xiangchun , Zhang Jia , Xing Yongzhong
Published: December 2020

The phase transition from vegetative to reproductive growth is triggered by internal and external signals that participate in circadian clock in plants. We identified a rice floral inhibitor OsPRR73 encoding a CONSTANS protein. Overexpression of OsPRR73 resulted in late heading under both long‐day (LD) and short‐day (SD) conditions. Knockout mutants led to early heading under LD conditions but no change under SD. OsPRR73 mRNA accumulated at noon and exhibited a robust oscillation under constant light (LL) and constant darkness (DD) conditions. OsPRR73 overexpression exerted negative feedback on endogenous OsPRR73 expression and altered diurnal expressions of key flowering genes and circadian clock genes. OsPRR73 bound to the promoters of the floral gene Ehd1 and the circadian gene OsLHY, and significantly suppressed their expression at dawn. In LL and DD, the oscillatory patterns of the circadian genes OsLHY, OsTOC1, OsGI and OsELF3 were varied in OsPRR73OX and osprr73 mutants. OsPRR73 expression was decreased in osphyb mutants, and overexpression of OsPRR73 complemented the early heading date phenotype of osphyb, indicating OsPRR73 works downstream of OsPhyB. Therefore, OsPRR73 is involved in a feedback loop of the rice clock and connects the photoperiod flowering pathway by binding to the Ehd1 promoter in rice.
Epidermal barrier changes in patients with psoriasis: The role of phototherapy
Authors: Montero‐Vilchez Trinidad , Soler‐Góngora Miguel , Martínez‐López Antonio , Ana Fernández‐González , Buendía‐Eisman Agustín , Molina‐Leyva Alejandro , Arias‐Santiago Salvador
Published: December 2020

Background

Some skin diseases may modify epidermal barrier function. Psoriasis is a chronic multi‐systemic inflammatory disease that affects the epidermal barrier. Phototherapy is an option for treating psoriasis, but little is known about how epidermal barrier function is modified by phototherapy in psoriatic patients.

Objectives

(a) To compare skin homeostasis between involved and uninvolved skin in psoriatic patients with healthy controls (b) To evaluate changes in the epidermal barrier function in psoriatic patients treated with phototherapy.

Methods

Sixty patients with plaque‐type psoriasis and sixty gender and age‐matched healthy controls were enrolled. Temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH), pH, elasticity, erythema and melanin index were measured using non‐invasive tools in the healthy control and involved and uninvolved psoriatic skin before and after phototherapy.

Results

Healthy controls had lower TEWL and erythema index and higher SCH than psoriatic patients, both at uninvolved psoriatic skin and psoriasis plaques. TEWL was higher at psoriasis plaques than at uninvolved skin (19.20 vs 11.57 g/h/m2; P < .001). Following phototherapy, a decreasing trend was observed for TEWL, of 1.03 (SD 0.75) and 0.97 (SD 0.81) g/h/m2 for uninvolved and involved skin respectively. SCH was significantly lower at psoriatic plaques than at uninvolved skin (7.32 vs 36.62Arbitrary Units [AU]; P < .001). SCH increased by 1.15AU (SD 0.26) on psoriatic plaques after the phototherapy session (P < .001).

Conclusion

Psoriatic plaques showed epidermal barrier dysfunction compared to uninvolved skin and healthy controls. Phototherapy may improve epidermal barrier function in psoriatic patients. SCH increased after a phototherapy session on the psoriatic plaques.
Gene therapy in wound healing using nanotechnology
Authors: Pang Calver , Fan Ka Siu , Wei Lanxuan , Kolar Mallappa K
Published: December 2020

Wound healing is a complex and highly regulated process that is susceptible to a variety of failures leading to delayed wound healing or chronic wounds. This is becoming an increasingly global burden on the healthcare system. Treatment of wounds has evolved considerably to overcome barriers to wound healing especially within the field of regenerative medicine that focuses on the replacement of tissues or organs. Improved understanding of the pathophysiology of wound healing has enabled current advances in technology to allow better optimization of microenvironment within wounds. This approach may help tackle wounds that are difficult to treat and help reduce the global burden of the disease. This article provides an overview of the physiology in wound healing and the application of gene therapy using nanotechnology in the management of wounds.
Hyperbaric oxygen therapy for nonhealing wounds: Treatment results of a single center
Authors: Teguh David N. , Bol Raap René , Koole Arne , Knippenberg Bob , Smit Casper , Oomen Jan , van Hulst Rob A.
Published: December 2020

The present article evaluates the results of the treatment with adjuvant hyperbaric oxygen therapy (HBOT) of patients with nonhealing, chronic wounds. In the period 2013 to 2016, 248 patients were referred from various hospitals because of chronic wounds that were recalcitrant in healing despite standard wound care as described in national and international guidelines. After inclusion, all patients were treated with HBOT and subjected to a weekly standard wound care treatment. During each HBOT session, 100% O2was administered for 75 minutes under increased pressure of 2.4 ATA. Wounds and quality of life were assessed before and after the total treatment period. A total of 248 patients have been evaluated. Diabetic foot ulcers were present in 134 patients, the remainder (114 patients) showed a variety of wound locations and etiologies. The number of HBOT treatments amounted to an average of 48 (range 20‐68) sessions. Before referral to our clinic, 31% of all wounds had existed for at least 18 months (72 patients). After HBOT, 81% of all wounds were near complete healing or completely healed, in 13% of the cases the wound was stable, and in 2% minor or major amputation had to be carried out. The mean treatment time for wounds pre‐existing fewer than 6 weeks (“early referrals”) was 67 days, and 119 days for wounds pre‐existing more than 18 months (“late referrals”). A majority of the patients in our study referred with nonhealing wounds clinically improved when adjuvant HBOT was added to standard wound care protocols. No differences in success rate were seen between diabetic and nondiabetic wounds. It showed that HBOT is a well‐tolerated treatment.
Reviewer Acknowledgements
Authors: Young James
Published: December 2020

International Journal of Social Science Studies (IJSSS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether IJSSS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 9, Number 1Agboola O. Paul, Universiti Teknologi Malaysia, MalaysiaAna Uka, Beder University, AlbaniaAnna Maria Mouza, International Hellenic University, GreeceAntónio Calha, Polytechnic Institute of Portalegre, PortugalAurora Pestaño, University of San Jose Recoletos (USJR), PhilippinesBashar Malkawi, University of Sharjah, College of Law, UAEBegoña Montero-Fleta, Universitat Politécnica de València, SpainElena Montanari, Politecnico Di Milano, ItalyEncarnación ABAD ARENAS, National University of Distance Education (UNED), SpainFahri ÖZSUNGUR, Adana Science and Technology University, TurkeyFroilan Mobo, Philippine Merchant Marine Academy, PhilippinesHao Liu, Beijing Normal University, ChinaIoannis Makris, High School of Pedagogical and Technical Education, GreeceJehu Onyekwere Nnaji, University of Naples II,Italy and Globe Visions Network Italy, ItalyJesster Pasule Eduardo, Nueva Ecija University of Science and Technology, PhilippinesJulia M. Mack, Gannon University, USALaura Diaconu Maxim, "Alexandru Ioan Cuza University" of Iasi, RomaniaMei-Ling Lin, National Open University, TaiwanMichael Brooks, North Carolina A&T State University, USAOzgur Demirtas, Inonu University, TurkeyPeriyasami Anbarasan, Indian Institute of technology Delhi, IndiaQingzhi Huan, Peking University, ChinaRima Meilita Sari, STKIP Al-Washliyah, IndonesiaXian-Liang Tian, Zhongnan University of Economics and Law, ChinaYanzhe Zhang, Jilin University, China , China/AustraliaYusramizza Md Isa, Universiti Utara Malaysia, Malaysia James YoungEditorial AssistantOn behalf of,The Editorial Board of International Journal of Social Science StudiesRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAURL: http://ijsss.redfame.com
Electromyographic Analysis of Hip and Trunk Muscle Activity During Side Bridge Exercises in Subjects With Gluteus Medius Weakness
Authors: Lee Kyung-eun , Baik Seung-min , Yi Chung-hwi , Kwon Oh-yun , Cynn Heon-seock
Published: December 2020

Context: Side bridge exercises strengthen the hip, trunk, and abdominal muscles and challenge the trunk muscles without the high lumbar compression associated with trunk extension or curls. Previous research using electromyography (EMG) reports that performance of the side bridge exercise highly activates the gluteus medius (Gmed). However, to the best of our knowledge, no previous research has investigated EMG amplitude in the hip and trunk muscles during side bridge exercise in subjects with Gmed weakness. Objective: The purpose of this study was to examine the EMG activity of the hip and trunk muscles during 3 variations of the side bridge exercise (side bridge, side bridge with knee flexion, and side bridge with knee flexion and hip abduction of the top leg) in subjects with Gmed weakness. Design: Repeated-measures experimental design. Setting: Research laboratory. Patients: Thirty subjects (15 females and 15 males) with Gmed weakness participated in this study. Intervention: Each subject performed 3 variations of the side bridge exercise in random order. Main Outcome Measures: Surface EMG was used to measure the muscle activities of the rectus abdominis, external oblique, longissimus thoracis, multifidus, Gmed, gluteus maximus, and tensor fasciae latae (TFL), and Gmed/TFL muscle activity ratio during 3 variations of the side bridge exercise. Results: There were significant differences in Gmed (F2,56 = 110.054, P < .001), gluteus maximus (F2,56 = 36.416, P < .001), and TFL (F2,56 = 108.342, P < .001) muscles among the 3 side bridge exercises. There were significant differences in the Gmed/TFL muscle ratio (F2,56 = 20.738, P < .001). Conclusion: Among 3 side bridge exercises, the side bridge with knee flexion may be effective for the individuals with Gmed weakness among 3 side bridge exercises to strengthen the gluteal muscles, considering the difficulty of the exercise and relative contribution of Gmed and TFL.
Structure and Expression of Large (+)RNA Genomes of Viruses of Higher Eukaryotes
Authors: Agranovsky Alexey A.
Published: December 2020

Viral positive-sense RNA genomes evolve rapidly due to the high mutation rates during replication and RNA recombination, which allowing the viruses to acquire and modify genes for their adaptation. The size of RNA genome is limited by several factors, including low fidelity of RNA polymerases and packaging constraints. However, the 12-kb size limit is exceeded in the two groups of eukaryotic (+)RNA viruses – animal nidoviruses and plant closteroviruses. These virus groups have several traits in common. Their genomes contain 5′-proximal genes that are expressed via ribosomal frameshifting and encode one or two papain-like protease domains, membrane-binding domain(s), methyltransferase, RNA helicase, and RNA polymerase. In addition, some nidoviruses (i.e., coronaviruses) contain replication-associated domains, such as proofreading exonuclease, putative primase, nucleotidyltransferase, and endonuclease. In both nidoviruses and closteroviruses, the 3′-terminal part of the genome contains genes for structural and accessory proteins expressed via a nested set of coterminal subgenomic RNAs. Coronaviruses and closteroviruses have evolved to form flexuous helically symmetrical nucleocapsids as a mean to resolve packaging constraints. Since phylogenetic reconstructions of the RNA polymerase domains indicate only a marginal relationship between the nidoviruses and closteroviruses, their similar properties likely have evolved convergently, along with the increase in the genome size.
How health systems approached respiratory viral pandemics over time: a systematic review
Authors: Cascini Fidelia , Hoxhaj Ilda , Zaçe Drieda , Ferranti Margherita , Di Pietro Maria Luisa , Boccia Stefania , Ricciardi Walter
Published: December 2020

Background

Several healthcare systems facing respiratory viral infections outbreaks, like COVID-19, have not been prepared to manage them. Public health mitigation solutions ranging from isolation of infected or suspected cases to implementation of national lockdowns have proven their effectiveness for the outbreak’s control. However, the adjustment of public health measures is crucial during transition phases to avoid new outbreaks. To address the need for designing evidence-based strategies, we performed a systematic review to identify healthcare systems interventions, experiences and recommendations that have been used to manage different respiratory viral infections outbreaks in the past.

Methods

PubMed, Web of Science, Scopus and Cochrane were searched to retrieve eligible studies of any study design, published in English until 17 April 2020. Double-blinded screening process was conducted by titles/abstracts and subsequently eligible full texts were read and pertinent data were extracted. When applicable, quality assessment was conducted for the included articles. We performed a narrative synthesis of each implemented public health approaches.

Results

We included a total of 24 articles addressing the public health approaches implemented for respiratory viral infections outbreaksforCOVID-19, influenza A H1N1, MERS and severe acute respiratory syndrome . The identified approaches are ascribable to two main categories: healthcare system strategies and healthcare provider interventions. The key components of an effective response on respiratory viral outbreaks included the implementation of evidence-based contextual policies, intrahospital management actions, community healthcare facilities, non-pharmaceutical interventions, enhanced surveillance, workplace preventive measures, mental health interventions and communication plans.

Conclusion

The identified healthcare system strategies applied worldwide to face epidemics or pandemics are a useful knowledge base to inform decision-makers about control measures to be used in the transition phases of COVID-19 and beyond.
Does the EU’s Paediatric Regulation work for new medicines for children in Denmark, Finland, Norway and Sweden? A cross-sectional study
Authors: Lepola Pirkko , Wang Siri , Tötterman Ann Marie , Gullberg Ninna , Harboe Kirstine Moll , Kimland Elin
Published: December 2020

Objective

The aim of this study was to assess the marketing status of the new paediatric medicinal products listed in the 10-year report as initially authorised between 2007 and 2016, reflecting the product availability in four Nordic countries.

Design

This is a cross-sectional study.

Setting

Analysis of the national medicine agency’s databases in Denmark, Finland, Norway and Sweden.

Data source

New medicinal products with paediatric indications and new paediatric formulations listed in the Annex of European Medicines Agency’s EU Paediatric Regulation 10-year report.

Data analysis

The products were classified according to national marketing status between January 2019 and March 2019, whether a product was authorised and whether the product was marketed.

Main outcome measures

The percentages of the new medicinal products with paediatric indications and new paediatric formulations having a valid marketing authorisation and being marketed, both in terms of the sums of all countries and separately for each country.

Results

Across the four countries, 21%–32% (16/76–24/76) of the new medicinal products were not marketed. Of the new formulations relevant to children, 29%–50% (16/56–28/56) were not marketed, and a significant proportion of these products had never been marketed.

Conclusions

This study reflects the reality of the implementation of the Paediatric Regulation. The results show that several new paediatric medicines and new formulations are not marketed. This affects the product availability. Similar data from other countries are needed to evaluate the overall European status to find remedies to current situation and increase the availability of the medicines for children.
Significance of adenosquamous proliferation in breast lesions
Authors: Wilsher Mark James
Published: December 2020

Adenosquamous proliferation (ASP), characterised by ductal structures with a dual glandular and squamous phenotype within desmoplastic stroma, is essentially a hallmark of various sclerosing lesions of the breast (SL) and breast lesions with sclerosis (BLWS), not including sclerosing adenosis. In radial scar/complex sclerosing lesion (RS/CSL), clonality has been previously demonstrated in microdissected ASP. SL/BLWS encompass a diverse range of pathological entities that historically have an equally diverse list of names, often for histologically alike or identical lesions at different anatomical locations. In common they are comprised of one or more components of fibrocystic or proliferative breast disease and papillomata, which become distorted and even obliterated by a sclerosing process that appears to be associated with and/or secondary to ASP, which in an individual lesion may be inconspicuous at the time of biopsy. The histological overlap of various SL/BLWS with RS/CSL, in which a nidus containing ASP is pathognomonic of early lesions, also supports a common element of ASP across various SL/BLWS. SL/BLWS show an interesting association with low-grade metaplastic carcinoma, particularly low-grade adenosquamous carcinoma (LGASC) with which, they appear to form a histological and possible biological spectrum because ASP and LGASC share similar histological and immunophenotypical characteristics. The presentation of ASP in various SL/BLWS will be discussed.
Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune effector cell-related adverse events
Authors: Maus Marcela V , Alexander Sara , Bishop Michael R , Brudno Jennifer N , Callahan Colleen , Davila Marco L , Diamonte Claudia , Dietrich Jorg , Fitzgerald Julie C , Frigault Matthew J , Fry Terry J , Holter-Chakrabarty Jennifer L , Komanduri Krishna V , Lee Daniel W , Locke Frederick L , Maude Shannon L , McCarthy Philip L , Mead Elena , Neelapu Sattva S , Neilan Tomas G , Santomasso Bianca D , Shpall Elizabeth J , Teachey David T , Turtle Cameron J , Whitehead Tom , Grupp Stephan A
Published: December 2020

Immune effector cell (IEC) therapies offer durable and sustained remissions in significant numbers of patients with hematological cancers. While these unique immunotherapies have improved outcomes for pediatric and adult patients in a number of disease states, as ‘living drugs,’ their toxicity profiles, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), differ markedly from conventional cancer therapeutics. At the time of article preparation, the US Food and Drug Administration (FDA) has approved tisagenlecleucel, axicabtagene ciloleucel, and brexucabtagene autoleucel, all of which are IEC therapies based on genetically modified T cells engineered to express chimeric antigen receptors (CARs), and additional products are expected to reach marketing authorization soon and to enter clinical development in due course. As IEC therapies, especially CAR T cell therapies, enter more widespread clinical use, there is a need for clear, cohesive recommendations on toxicity management, motivating the Society for Immunotherapy of Cancer (SITC) to convene an expert panel to develop a clinical practice guideline. The panel discussed the recognition and management of common toxicities in the context of IEC treatment, including baseline laboratory parameters for monitoring, timing to onset, and pharmacological interventions, ultimately forming evidence- and consensus-based recommendations to assist medical professionals in decision-making and to improve outcomes for patients.
Beta-synuclein in cerebrospinal fluid as an early diagnostic marker of Alzheimer’s disease
Authors: Halbgebauer Steffen , Oeckl Patrick , Steinacker Petra , Yilmazer-Hanke Deniz , Anderl-Straub Sarah , von Arnim Christine , Froelich Lutz , Gomes Luis Aragão , Hausner Lucrezia , Huss Andre , Jahn Holger , Weishaupt Jochen , Ludolph Albert C , Thal Dietmar R , Otto Markus
Published: December 2020

Objective

Synaptic loss plays a major role in Alzheimer’s disease (AD). However so far no neurochemical marker for synaptic loss has been introduced into clinical routine. By mass spectrometry beta-synuclein was established as a candidate marker. We now aimed to set up a novel ELISA for beta-synuclein for evaluation of its potential as a diagnostic and predictive marker for AD.

Methods

We analysed in total 393 patients from four specialised centres. The diagnostic groups comprised: AD (n=151), behavioural variant frontotemporal dementia (bvFTD, n=18), Parkinson syndrome (n=46), Creutzfeldt-Jakob disease (CJD, n=23), amyotrophic lateral sclerosis (ALS, n=29), disease control (n=66) and 60 non-neurodegenerative control patients. Results were compared with core AD biomarkers (total tau, phospho-tau and amyloid-β peptide 1–42). Additionally, coexistence of beta-synuclein with vesicular glutamate transporter 1 (VGLUT1) was determined and beta-synuclein levels were quantified in brain homogenates.

Results

Beta-synuclein levels quantified with the newly established ELISA correlated strongly with antibody-free quantitative mass spectrometry data (r=0.92 (95% CI: 0.89 to 0.94), p<0.0001). Cerebrospinal fluid (CSF) beta-synuclein levels were increased in AD-mild cognitive impairment (p<0.0001), AD dementia (p<0.0001) and CJD (p<0.0001), but not in bvFTD, Parkinson syndrome or ALS. Furthermore, beta-synuclein was localised in VGLUT1-positive glutamatergic synapses, and its expression was significantly reduced in brain tissue from patients with AD (p<0.01).

Conclusion

We successfully established a sensitive and robust ELISA for the measurement of brain-enriched beta-synuclein, which we could show is localised in glutamatergic synapses. We confirmed previous, mass spectrometry-based observations of increased beta-synuclein levels in CSF of patients with AD and CJD supporting its potential use as a marker of synaptic degeneration.
Joint associations of occupational standing and occupational exertion with musculoskeletal symptoms in a US national sample
Authors: Friel Ciaran P , Pascual Christian B , Duran Andrea T , Goldsmith Jeff , Diaz Keith M
Published: December 2020

Objective

Observational studies have linked occupational standing or walking to musculoskeletal pain. These prior studies, however, are flawed as few accounted for physical exertion; a potential confounder that accompanies many standing-based occupations. The purpose of this study was to examine the individual and joint associations of occupational standing/walking and exertion with musculoskeletal symptoms.

Methods

Data for this analysis come from the 2015 National Health Interview Survey, a US nationally representative survey. Occupational standing/walking and exertion were assessed by self-report on a 5-point Likert scale. The presence of musculoskeletal symptoms (pain, aching and stiffness) for upper extremities (neck, shoulders, elbows, wrists and fingers), lower extremities (hips, knees, ankles and toes) and lower back was also assessed.

Results

Occupational standing/walking was associated with a greater likelihood of upper extremity, lower extremity and lower back musculoskeletal symptoms; however, associations were attenuated and no longer significant with adjustment for exertion. When stratified by levels of occupational exertion, occupational standing/walking was associated with musculoskeletal symptoms only among the group with high exertion (eg, OR=1.69 (95% CI: 1.48 to 1.94) for lower back symptoms comparing high/high for standing or walking/exertion vs low/low). Among groups with low exertion, occupational standing/walking was not associated with musculoskeletal symptoms (eg, OR=1.00 (95% CI: 0.85 to 1.16) for lower back symptoms comparing high/low for standing or walking/exertion vs low/low).

Conclusion

Results from this US representative survey suggest that the association between occupational standing/walking and musculoskeletal symptoms is largely driven by the co-occurrence of occupational exertion and does not provide evidence that standing or walking incurs adverse musculoskeletal symptoms.