bluuebunny/crossref_metadata_2025 huggingface dataset:
A Retrospective Evaluation of Secondary Wound Healing for Extraction of the Maxillary First Molar in Dogs
Authors: Bissett Lana , Niemiec Brook A.
Published: February 2022

Oral surgery and exodontia can present challenges in veterinary patients, with a particular area of challenge being extraction and closure of the maxillary first molar (M1) in dogs. This retrospective assessment evaluated patients that had the maxillary first molar extracted with placement of a cruciate suture across the alveolus to achieve partial closure and secure the blood clot. Patients that had teeth extracted adjacent to M1 (maxillary fourth premolar [PM4] or second molar [M2]) were excluded from the study. Three groups of patients were assessed: Group A – at the time of extraction of M1, both the maxillary PM4 and M2 were still present in the oral cavity. Group B – at the time of M1extraction only PM4 or M2 was present, but not both. The tissue was completely intact at the location of the missing tooth. Group C – at the time of M1 extraction neither PM4 or M2 were present, but tissue in these locations was intact. In a three-and-a half-year time period (2015-2018), 179 dogs with 213 solitary M1 extractions were performed. Of these 213 extraction sites, 127 sites (60%) had follow up examination within a two-week postoperative period. Of these 127 sites, 126 (99.2%) appeared appropriately healed without complication. The results of this retrospective evaluation demonstrate that primary closure of a maxillary first molar extraction site may not be required for appropriate soft tissue wound healing in canine patients.
Volume creates value: The volume–outcome relationship in Scandinavian obesity surgery
Authors: Svarts Anna , Anders Thorell , Engwall Mats
Published: February 2022

This study establishes the relationship between surgical volume and cost and quality outcomes, using patient-level clinical data from a national quality registry for bariatric surgery in Sweden. Data include patient characteristics with comorbidities, surgical and follow-up data for patients that underwent gastric bypass or gastric sleeve operations between 2007 and 2016 (52,703 patients in 51 hospitals). The relationships between surgical volume (annual number of bariatric procedures) and several patient-level outcomes were assessed using multilevel, mixed-effect regression models, controlling for patient characteristics and comorbidities. We found that hospitals with higher volumes had lower risk of intraoperative complications as well as complications within 30 days post-surgery (odds ratios per 100 procedures are 0.78 and 0.87, respectively, p<0.01). In addition, higher-volume hospitals had substantially shorter procedure time (17 min per 100 procedures, p<0.01) and length of stay (0.88 incidence-rate ratio per 100 procedures p<0.01). Our results support the claim that increased surgical volume significantly improves quality. Further, the results strongly suggest that increased volume leads to lower cost per surgery, by reducing cost drivers such as procedure time and length of stay.
Comparison of machinability of nickel alloys using WEDM
Authors: Polzer Ales , Mouralova Katerina , Benes Libor , Zahradnicek Radim , Fries Jiri
Published: February 2022

Heat resistance, heat stableness and corrosion resistance are properties that predispose nickel superalloys such as Inconel 625, Mar-M247, Nimonic C 263 and B1914 to a very wide range of applications. Due to their mechanical properties, their machinability by conventional technologies is relatively difficult, so wire electrical discharge machining (WEDM) is widely used, where only one condition is placed on the material being machined, which is at least minimal electrical conductivity. Despite the fact that the main element of which these superalloys are always composed is nickel, their machinability by WEDM is quite different. For this reason, an extensive study comparing the machinability of the four above-mentioned nickel superalloys using WEDM was performed, examining the effect of setting the machine parameters on the cutting speed as well as on the quality of the surface and subsurface layer. It was found out that the cutting speed is different for individual materials with the same set of machine parameters and so that it is possible to significantly increase the quality of the machined surface for individual materials.
Human-like driving decision at unsignalized intersections based on game theory
Authors: Li Daofei , Liu Guanming , Xiao Bin
Published: February 2022

Unsignalized intersection driving is challenging for automated vehicles. For safe and efficient performances, the diverse and dynamic behaviors of interacting vehicles should be considered. Based on a game-theoretic framework, a human-like payoff design methodology is proposed for the automated decision at unsignalized intersections. Prospect Theory is introduced to map the objective collision risk to the subjective driver payoffs, and the driving style can be quantified as a tradeoff between safety and speed. To account for the dynamics of interaction, a probabilistic model is further introduced to describe the acceleration tendency of drivers. Simulation results show that the proposed decision algorithm can describe the dynamic process of two-vehicle interaction in limit cases. Statistics of uniformly-sampled cases simulation indicate that the success rate of safe interaction reaches 98%, while the speed efficiency can also be guaranteed. The proposed approach is further applied and validated in four-vehicle interaction scenarios at a four-arm intersection.
Experimental and statistical investigation of the effects of MQL, dry and wet machining on machinability and sustainability in turning of AISI 4140 steel
Authors: Gürbüz Hüseyin , Gönülaçar Yunus Emre
Published: February 2022

The applications of cutting fluids in metal cutting have negative results such as increasing machining cost and polluting environment, water and soil pollution stemming from wastes. Therefore, use of Minimum Quantity Lubrication (MQL) technique is generally preferred since it not only gives better results but also exhibits favorable influences on environmental pollution and human health. The objective of this experimental and statistical study is to investigate the effects of both machining conditions (MQL, Dry and Wet) and cutting parameters on sustainability and machinability. Another aim of this study is to establish significance of control factors on the response values by using signal to noise (S/N) ratio, Taguchi orthogonal array, analyses of variance (ANOVA), linear and quadratic equations and to select optimal cutting parameters as well. Also, the Pugh matrix approach was utilized to compare different coolant types in terms of sustainable manufacturing. According to the experimental results, it was found that MQL cutting significantly decreased cutting tool wear when compared to dry and wet cutting, while it reduced main cutting force (Fc) and surface roughness (Ra) in general. The results of S/N ratios showed that MQL had more significant effect on Ra and Fc than wet and dry cutting. The values of optimal cutting condition were obtained as 0.16 mm/rev and 125 m/min for feed rate and cutting speed in MQL machining, respectively. According to the experimental results, it was found that MQL cutting, when compared dry and wet cutting, decreased by average 25%dry, 5%wet, 15%dry, 2%wet, 44%dry and 9%wet in terms of cutting tool wear, Fc and Ra, respectively. According to ANOVA, feed rate is the most effective factor on Fc and Ra values. It was found that the results estimated for Fc and Ra values using Taguchi method, linear and quadratic equations are quite successful within 3% deviation. According to Pugh matrix approach assessment results, MQL machining was superior to dry and wet machining in terms of sustainability and cleaner production.
Hydroxyapatite dispersed sulphonated PEEK composite membrane: Synthesis, structural and mechanical characterization
Authors: Chakraborty Tanmoy , Das Apurba , Biswas Bhabatosh , Sarkar Sunit , Mukherjee Nillohit , Sinha Arijit , Datta Shubhabrata
Published: February 2022

A synthetic composite material membrane was synthesized using Polyether ether ketone (PEEK) as a polymer matrix, reinforced with nano-Hydroxyapatite (nHAp) as the ceramic for intended use as a hip bone implant material. Notwithstanding its close resemblance with hip bone material, PEEK is chemically and biologically inert and comes with limited biocompatibility. HAp has chemical and crystallographic similarity with carbonated apatite like human bones. In the present work it was used as reinforcement with PEEK in varying weight percentages, of 2, 5, 8 and 10 to determine the optimum mix for application as a bio hip implant material. HAp reinforcement beyond 10 wt. % was not considered as it resulted in agglomeration and reduction in mechanical properties. The polymer was sulphonated to facilitate chemical interactions with the hydroxyl (-OH) group of HAp to overcome poor interfacial bonding between PEEK and nHAp. The sulphonation also reduced the chances of wear debris from implant site getting resorbed into the body. These synthetic composite samples were then characterized using techniques such as x-ray diffraction, Fourier transform infrared spectroscopy, scanning electron microscope and energy dispersive x-ray spectroscopy, to ascertain its conformity in structure and morphology. Mechanical tensile tests were also carried out to determine tensile strength, yield strength and elastic modulus of the composite membranes. The synthesized sample, with 8 wt. % of HAp reinforcement, demonstrated the most suitable properties. The work propounds a fresh approach towards synthesizing a composite membrane using Polyether ether ketone, subjected to sulphonation (SPEEK), for intended application as a hip implant. The superior surface wetting, obtained on account of sulphonation of PEEK matrix, facilitated more intimate contact with nano-hydroxyapatite (nHAp) reinforcements and assisted in establishing superior, homogeneous and improved mechanical properties throughout the membrane.
Experimental investigation into machinability of hardened AISI D6 steel using newly developed AlTiSiN coated carbide tools under sustainable finish dry hard turning
Authors: Das Anshuman , Das Sudhansu Ranjan , Panda Asutosh , Patel Saroj Kumar
Published: February 2022

In the present study, a newly developed AlTiSiN coating material deposited on carbide insert by scalable pulsed power plasma (SPPP) technique is used for machinability investigation of hardened AISI D6 die steel (65HRC) in finish dry turning. Also, the cutting tool is characterized by various diagnostic tests to evaluate the effectiveness of nanocomposite AlTISiN coating material and its cutting performance. A series of machining trials have been performed under varied cutting conditions (feed, depth of cut, speed) to investigate the machinability concerning surface roughness, flank wear, and chip morphology. Further, an approach towards multi-response optimization and predictive modelling for minimization of flank wear and surface roughness have been performed using response surface methodology. Finally, a unique approach has been proposed for economic analysis and sustainability assessment in hard turning. Result shows that the nanostructured AlTiSiN coating developed lower range of tool wear (VB = 0.044–0.076 mm), produced surface finish (Ra) within 0.322–0.905 µm which is approaching the surface quality to that of cylindrical grinding because of minimum friction coefficient, good bonding capability and enhancement in hardness as well as wear resistance of coating material. Statistical analysis reveals that Ra and VB are influenced principally by feed (84.14%) and cutting speed (53.43%), respectively. With the tool life of 34 min, Gilbert's machining economic model calculated the overall machining cost per part of Rs.61.04 in hard turning using coated carbide insert. Chip morphology confirmed the formation of serrated type saw tooth chips. It is established that machining under dry condition provides environment friendliness, techno-economically feasible to improve sustainability.
Health risk assessment of heavy metals and poly-aromatic hydrocarbons in particulate matter adsorbed by indoor air purifiers
Authors: Li Chunhui , Bai Li , He Zijian , Wang Yujie
Published: February 2022

Particulate matter (PM) adsorbed by air purifiers, normally used in residential buildings, was collected and analysed by this study. The concentrations of eight heavy metals and 16 poly-aromatic hydrocarbons (PAHs) in PM were determined by inductively coupled plasma-optical emission spectroscopy (ICP-OES) and gas chromatography-mass spectroscopy (GC-MS). The health risk of heavy metals and PAHs was assessed using the health assessment model recommended by the US Environment Protection Agency (EPA). The results showed that the total concentrations of heavy metals during the heating period and non-heating period were 771.27 mg/kg and 441.10 mg/kg, respectively. The carcinogenicity and non-carcinogenicity of chemicals found are higher during the heating period than the non-heating period. The exposure of children was higher than that of adults. Eight heavy metals would pose non-carcinogenic risks for children, but four of these would pose carcinogenic risks for adults and children. The total concentrations of 16 PAHs during the heating period and non-heating period were 106.69 μg/kg and 68.72 μg/kg, respectively. Total toxicity equivalents (TEQs) were 16.37 μg/kg and 9.20 μg/kg, respectively. Among them, 4-rings PAHs accounted for the highest proportion, followed by 5-rings PAHs and 6-rings PAHs. The proportion of 2-rings and 3-rings PAHs were the lowest. 16 PAHs could pose a high carcinogenic risk to adults and children during the heating period, and there was a potential carcinogenic risk during the non-heating period.
Effects of simultaneous rotational ultrasonication and vortex-induced casting technique on particle distribution and grain refinement in AA7075/h-BN nanocomposites
Authors: Amith SC , Lakshmanan Poovazhagan
Published: February 2022

A simultaneous rotational ultrasonication with mechanical stirring (RUMS) technique was applied to successfully produce aluminum alloy/hexagonal boron nitride (AA7075/h-BN) metal matrix nanocomposites (MMNCs). The rotating ultrasonic probe with a mechanical stirring impeller arrangement was employed in the casting process. The ultrasonic probe with 20 kHz frequency, 2.5 kW power, and 400 rpm rotational speed was used for the experimental work. The five variations of MMNCs (AA7075 – 0 wt.%, 0.15 wt.%, 0.3 wt.%, 0.6 wt.% and 1.0 wt% h-BN) were fabricated by RUMS process. The MMNCs were solutionized and artificially aged as per ASTM T6 heat-treatment conditions. The tensile test, Vickers microhardness, and porosity measurements were conducted. The tensile strength of RUMS-fabricated AA7075/0.6 wt% h-BN MMNC was improved by 29.46% for as-cast, and 15.90% for T6 heat-treated condition when compared with AA7075/0 wt.% h-BN as-cast and T6 heat-treated MMNCs, respectively. The microstructures and morphologies of the fractured surfaces were evaluated through optical microscopy and SEM. The elemental composition of the MMNCs was studied using SEM-EDS. The XRD was used to investigate the phase composition of the MMNCs. The dislocation density and the interfacial bonding between the matrix and reinforcements were reviewed by TEM. The presence of nano h-BN particles was confirmed by TEM-SAED and XPS techniques. The rheological effects of rotational ultrasonication and combined mechanical stirring mechanism were explained schematically. The RUMS-fabricated AA7075/0.6 wt.% h-BN MMNC showed good improvement in the mechanical properties when compared with AA7075/0.6 wt.% h-BN MMNCs synthesized by conventional mechanical stir (MS) and ultrasonic (UT) assisted casting process. The enhancement in mechanical properties of RUMS-synthesized MMNCs is attributed to the amalgamated effect of ultrasonic transient cavitation and rotational acoustic streaming along with vortex motion in the novel RUMS fabrication process, which have assisted in dendritic fragmentation, and accelerated the refinement of grains to achieve consistent scattering of nano h-BN particulates without any agglomeration.
A Missionary Inheritance: Tonic Sol-fa in India
Authors: Stevens Robin S.
Published: February 2022

Choral singing was embraced by many missionaries as a means of attracting potential converts to Christianity. A principal choral singing method in 19th century Britain, Tonic Sol-fa, was introduced by missionaries and others to the Indian subcontinent where it was used as both a pedagogical method and a music notation system. Building on the inherent musicality of the Mizo people in Assam, a fine choral singing tradition developed. Hymnbooks were published with Mizo words and Tonic Sol-fa notation. Although aspects of Tonic Sol-fa are utilized in some contemporary school music teaching methods, there is now little or no use made of the original Tonic Sol-fa method for community choral singing in Britain. Nevertheless, it is still used in some former British colonies, particularly for congregational hymn singing in Sub-Saharan Africa and the Asia-Pacific. Tonic Sol-fa has been, and remains, the mainstay of choral music making in Mizoram and neighboring areas. As such, it is a worthy inheritance from the missionary presence in India during the 19th century.
A Rare Case Report of Endovascular Therapy for Basilar Artery Occlusion in a Young Adult with Marfan Syndrome
Authors: Zhu FeiYan , Zhang ZhenZhong , Lv Chenling , Wang BaiChen , Wei Fuquan
Published: February 2022

Basilar artery occlusion (BAO) is one of the most devastating types of ischaemic stroke and is identified by using computed tomography (CT) angiography. Marfan syndrome is an autosomal dominant disorder involving multisystem connective tissue, and the neurological complications are relatively rare. In this article, we report a case of a young Marfan syndrome patient complicated with BAO ischaemic stroke. The patient was an 18-year-old man with right hemiparesis, aphasia and impaired consciousness. CT angiography of the brain showed an occlusion distal to the basilar artery. Endovascular therapy including intravenous thrombolysis and mechanical thrombectomy (MT) was administered to this patient inside the therapeutic window. The patient had a favourable clinical outcome after endovascular therapy. Marfan syndrome may be a rare cause of ischaemic stroke with BAO. In addition, our report provides some evidence that can be used as a reference when planning therapeutic strategies for BAO patients with Marfan syndrome.
An interesting finding: What is the relation between aortic enlargement and COVID-19?
Authors: Bitargil Macit , Demir Tolga , Çetin Hakkı Kürşat , Bektaş Nilüfer , Kasapoğlu Begüm Özüekren , El Kilic Helin , Balkaya Ahmet Ibrahim , Koramaz Ismail , Özdemir Hacı Mustafa
Published: February 2022

Background

We aim to compare the diameters of ascending aorta in COVID-19 patients and COVID–19-free individuals referred to our pandemic hospital.

Methods

The medical records and thorax tomographies of patients admitted to the “pandemic central” state hospital with symptoms of COVID-19 were observed between April 2020 and May 2020 in this case-control study. The first group consisted of patients diagnosed with COVID-19, and the second group consisted of patients without the disease. The diameter of the ascending aorta is measured via tomography and compared to each other. The most causative risk factors for aortic enlargements underwent a multivariate regression analysis.

Results

Charts of 156 patients (104 COVID-19 positives, 52 COVID-19 negatives) were reviewed. There was a statistical difference ( p: .01) between the mean aortic diameter of COVID-19 patients (39 mm) and COVID-free patients (32.5 mm) even though comorbid factors and patient characteristics were similar in the two groups at the time of hospital admission. The regression analysis result demonstrates that COVID-19 (leading factor), age, and coronary artery disease were the most significant factors associated with increasing aortic dimensions. ( p: .001, B: 5.3/, p: .02, B: 3.36/, p: .002, B: 0.13/, R square: 40.2%).

Conclusion

This study shows that the mean aortic diameter of COVID-19 patients is larger than non–COVID-19 patients with similar comorbidities referred to a pandemic hospital. COVID-19, age, and coronary artery disease are the most influential factors that affect the aortic diameter, and the COVID-19 was the leading factor.
Experiences and practices of key research team members in obtaining informed consent for pharmacogenetic research among people living with HIV: a qualitative study
Authors: Sylvia Nabukenya , Joseph Ochieng , David Kaawa-Mafigiri , Ian Munabi , Janet Nakigudde , Nelson Nakwagala Frederick , John Barugahare , Betty Kwagala , Charles Ibingira , Adelline Twimwijukye , Nelson Sewankambo , Erisa Sabakaki Mwaka
Published: February 2022

This study aimed to explore experiences and practices of key research team members in obtaining informed consent for pharmacogenetics research and to identify the approaches used for enhancing understanding during the consenting process. Data collection involved 15 qualitative, in-depth interviews with key researchers who were involved in obtaining informed consent from HIV infected individuals in Uganda for participation in pharmacogenetic clinical trials. The study explored two prominent themes: approaches used to convey information and enhance research participants’ understanding and challenges faced during the consenting process. Several barriers and facilitators for obtaining consent were identified. Innovative and potentially effective consenting strategies were identified in this study that should be studied and independently verified.
Achieving SDGs and addressing health emergencies in Africa: strengthening health promotion
Authors: Munodawafa Davison , Onya Handsome , Amuyunzu-Nyamongo Mary , Mweemba Oliver , Phori Peter , Kobie Aminata Grace
Published: February 2022

In 1986, the World Health Organization (WHO) convened the first Global Conference on Health Promotion held in Ottawa, Canada. This conference yielded the Ottawa Charter which defined health promotion as the process of enabling people to increase control over, and to improve, their health. A series of conferences followed and in 2005, WHO convened the Sixth Global Conference in Bangkok, Thailand, which yielded the Bangkok Charter for Health Promotion. This Charter for the first time expanded the role of health promotion to include addressing social determinants of health. Ministers of Health from 47 countries of the WHO Regional Office for Africa in 2012 endorsed the Health Promotion: Strategy for the African Region. This Strategy highlighted eight priority interventions required to address health risk factors and their determinants. In 2011, the Rio Political Declaration on Addressing Social Determinants of Health was adopted by Health Ministers and civil society groups to address inequalities and inequities within and between populations. The main action areas were good governance to tackle the root causes of health inequities; promoting participation and ownership; community leadership for action on social determinants; global action on social determinants to align priorities and stakeholders; and monitoring progress on implementation of policies and strategies. Health promotion has been prominent as part of disease outbreak response, including for Ebola and COVID-19. It has been an integral part of improving maternal and child health mortality and morbidity as well as TB, HIV/AIDS and malaria; and lately reducing the impact of noncommunicable diseases, namely diabetes, high blood pressure and cancer. While challenges continue in strengthening health promotion, there have been concerted efforts to place health promotion on the development agenda in countries through Health in All Policies (HiAP), capacity strengthening, monitoring and evaluation, and innovative financing policy options using dedicated tax from tobacco and alcohol, and road use.
Safety and Effectiveness of the Use of an Electronic Glucose Monitoring System Versus Weight-Based Dosing Nomogram for Treatment of Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Syndrome in a VA Hospital
Authors: Brown Madeline , Roberts Justin , Smith Cole , Eash Dakota
Published: February 2022

Objective:

The objective of this study is to assess the safety and effectiveness of an electronic glucose monitoring system (eGMS) versus paper-based protocols (PBPs) to manage diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS) within the VA setting.

Methods:

This study is a retrospective chart review of patients on an insulin drip, treated in the emergency department (ED) or intensive care unit (ICU) at Veteran Health Indiana for DKA or HHS. The primary outcome was evaluating the percentage of patients with hypoglycemia (blood glucose [BG] level <70 mg/dL) in patients admitted with DKA and HHS comparing an eGMS versus a PBP. A total of 168 patients were included in the analysis, with 84 patients in each group.

Results:

The primary outcome comparing rates of hypoglycemia in the eGMS group versus the PBP group showed a lower rate of hypoglycemia in the eGMS group (0.024%) compared with the PBP group (0.060%); however, this difference was not found to be statistically significant ( P = .90). Statistically significant secondary outcomes include the percentage of glucose checks drawn within the protocol recommendation (80.7% vs 52.6%, P = .02).

Conclusions:

While the primary endpoint of decreased hypoglycemia was not found to be statistically significant, it did reduce the overall number of hypoglycemia events in the eGMS group compared with the PBP group which may be clinically significant. This demonstrates that eGMS use has the potential to minimize hypoglycemia and glycemic variability in a critically-ill Veteran population by individualizing insulin drip titration based on a variety of patient-specific factors and providing reminders for staff to obtain BG checks in a timely manner.
Key Considerations for Understanding Usability of Digital Health Initiatives for Adults With Type 2 Diabetes: A Systematic Qualitative Literature Review
Authors: Hall Larissa , Islam Md Shahidul
Published: February 2022

Aims:

The rapidly growing number of adults with type 2 diabetes globally means the uses and benefits of digital health initiatives to enhance self-management of diabetes warrant review. This systematic qualitative literature review aimed to understand usability of digital health initiatives for adults with type 2 diabetes.

Methods:

This systematic qualitative literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the PRISMA 2020 Statement methodology. Three databases were used (SCOPUS, Medline, and CINAHL) to identify studies published from 2016 to 2021 that focused on experiences, evaluations, and usability of digital health initiatives aimed at helping adults with type 2 diabetes to self-manage their condition.

Results:

From the 407 studies identified, 35 studies were assessed for eligibility with 10 studies included in the final synthesis. Five main themes emerged: (1) unmet emotional needs, (2) enhancing self-management, (3) desire for education, (4) usability/user-experience, and (5) risk of biomedical marker reductionism.

Conclusions:

This review identified 5 key themes for consideration to understand usability of digital health initiatives. If these unmet psychosocial needs of adults with type 2 diabetes are better addressed in digital health initiatives, enhanced daily self-management will lead to more optimal diabetes management which can increase overall health outcomes, reduce the risk of longer-term complications, enhance quality of life for type 2 diabetes and improve more widespread adoption of digital health initiatives.
Accuracy of Continuous Glucose Monitors for Inpatient Diabetes Management
Authors: Wright Jordan J. , Williams Alexander J. , Friedman Sally B. , Weaver Rita G. , Williams Jonathan M. , Hodge Elizabeth , Fowler Michael , Bao Shichun
Published: February 2022

Introduction:

In hospitalized patients, continuous glucose monitoring (CGM) may improve glycemic control, prevent hypoglycemic events, and reduce staff workload compared with point-of-care (POC) capillary glucose monitoring.

Methods:

To evaluate CGM accuracy and safety of use in the inpatient setting, two versions of CGM sensors were placed on 43 and 34 adult patients with diabetes admitted to non-intensive care unit (ICU) medical wards, respectively. CGM accuracy relative to POC and safety of use were measured by calculating mean absolute relative difference (MARD) and by Clarke Error Grid (CEG) analysis.

Results:

CGM version 2 had improved accuracy compared with CGM version 1 with MARD 17.7 compared with 21.4%. CGM accuracy did not change with POC value or with time of sensor wear. On CEG, 98.8% of paired values fell within acceptable zones A and B.

Conclusion:

Despite reduced accuracy compared with the outpatient setting, both versions of CGMs had acceptable safety profiles in the inpatient setting.
A case of hyperlipoprotein(a)emia undergoing catheter interventions for coronary artery disease, aortic valve stenosis, and peripheral artery disease
Authors: Nakamura Akihiro , Sato Kenjiro , Kondo Masateru , Endo Hideaki
Published: February 2022

A 79-year-old woman was admitted to our hospital for ischemic necrosis of the right first toe. During having normal lipid profiles, such as low-density lipoprotein cholesterol and triglyceride, plasma levels of lipoprotein(a) (Lp(a)] were abnormally high (141 mg/dL). She had a history of heart failure (HF) due to aortic valve stenosis (AS) and drug-eluting coronary stenting due to angina pectoris. To avoid worsening of HF and limb ischemia during minor amputation, she underwent balloon aortic valvuloplasty and endovascular therapy. She was also placed on proprotein convertase subtilisin/kexin type 9 inhibitors (140 mg of evolocumab) every 2 weeks, which decreased her plasma Lp(a) levels to 105 mg/dL (26% decrease) at discharge. Elevated plasma Lp(a) levels could strongly affect the development of AS and progression of systemic atherosclerosis. The screening and treatment of increased plasma Lp(a) are imperative for patients with AS having peripheral arterial disease.
Quercetin attenuates the proliferation, inflammation, and oxidative stress of high glucose-induced human mesangial cells by regulating the miR-485-5p/YAP1 pathway
Authors: Wan Huan , Wang Yaping , Pan Qingyun , Chen Xia , Chen Sijun , Li Xiaohui , Yao Weiguo
Published: February 2022

Background

Diabetic nephropathy (DN) is a kidney damage caused by diabetes and the main cause of end-stage renal disease. However, the current treatment of DN has many limitations. Quercetin is a bioflavonoid compound with therapeutic benefits in metabolic diseases. This study aims to determine the therapeutic potentials and underlying mechanism of quercetin on DN.

Methods

We collected blood samples from DN patients and healthy controls and treated human mesangial cells (HMCs) with high glucose (HG) to establish an in vitro model of DN. Then we assessed the expression difference of miR-485-5p as well as YAP1 in serum of DN patients and healthy controls and between HG-induced HMCs and control cells. qRT-PCR and western blot were performed to assess miR-485-5p and YAP1 expression levels; CCK-8 and ELISAs were used to examine cell proliferation, inflammation, and oxidative stress. Dual luciferase reporter assay was implemented to detect the binding of miR-485-5p and YAP1 mRNA sequence.

Results

Quercetin suppressed proliferation, inflammation, and oxidative stress of HMCs induced by HG. As for mechanism, miR-485-5p directly bound to YAP1 and inhibited YAP1 expression. The downregulation of miR-485-5p and upregulation of YAP1 were also observed in the serum of DN patients. Quercetin modulated miR-485-5p/YAP1 axis to regulate HG-induced inflammation and oxidative stress.

Conclusion:

Quercetin inhibits the proliferation, inflammation, and oxidative stress of HMCs induced by HG through miR-485-5p/YAP1 axis, which might provide a novel treatment strategy for DN.
The Efficacy of Cannabis in Reducing Back Pain: A Systematic Review
Authors: Price Richard L. , Charlot Kaarina V. , Frieler Sven , Dettori Joseph R. , Oskouian Rod , Chapman Jens R.
Published: February 2022

Objective

To critically analyze the evidence and efficacy of cannabis to treat surgical and nonsurgical back pain via a Systematic Review.

Methods

We conducted a systematic review to investigate the efficacy of cannabis to treat non-surgical and surgical back pain. A literature search was performed with MEDLINE and Embase databases. Only RCTs and prospective cohort studies with concurrent control were included in this study. Risk of bias and quality grading was assessed for each included study.

Results

Database searches returned 1738 non-duplicated results. An initial screening excluded 1716 results. Twenty-two full text articles were assessed for eligibility. Four articles ultimately met pre-determined eligibility and were included in the study. Two studies addressed post-SCI pain while other two studies addressed low back pain. No studies specifically examined the use of cannabis for surgical back pain. The type of cannabis varied between study and included THC, dronabinol, and Nabilone. A total of 110 patients were included in the four studies reviewed. In each study, there was a quantifiable advantage of cannabis therapy for alleviating back pain. There were no serious adverse effects reported.

Conclusions

In all articles, cannabis was shown to be effective to treat back pain with an acceptable side effect profile. However, long-term follow up is lacking. As medicinal cannabis is being used more commonly for analgesic effect and patients are “self-prescribing” cannabis for back pain, additional studies are needed for healthcare providers to confidently recommend cannabis therapy for back pain.

Study Design

Systematic review.
Second-Order Derivation Fourier Transform Infrared Spectral Analysis of Regenerated Wool Keratin Structural Changes
Authors: Jiang Zhe , Li Wenjia , Wang Yuxia , Wang Qiang
Published: February 2022

Keratin is a natural biopolymer with excellent biocompatibility and biodegradability properties. It is widely used in biomaterial construction. The secondary structure of keratin is essential in its applications. This structure is associated with its regeneration. In this study, the structure of regenerated keratin from wool was analyzed using the amide I, II, and III bands from second-order derivation Fourier transform infrared spectroscopy. The results showed that the regenerated wool keratin retained its molecular backbone with the cleavage of disulfide bonds. The amide I and II bands indicated that the content ratio of α-helix to non-α-helix structure was less in the regenerated keratin than that of raw wool. The amide III band confirmed the contents of α-helix/β-sheet/β-turn/random coil for raw wool (35%/31%/22%/13%) and regenerated keratin (26%/35%/23%/15%).
Increasing Faculty Participation and Mentorship in Quality Improvement with an Experiential Four-Hour Workshop
Authors: Pflipsen Matthew , Lustik Michael , Bunin Jessica
Published: February 2022

Background

Graduate medical education programs lack enough faculty trained in quality improvement (QI). A major barrier to increasing the number of faculty competent in QI is insufficient time to engage in training. Research is missing on the effectiveness of short faculty development workshops to teach academic faculty QI principles and promote participation and mentorship in QI projects.

Objective

The authors assessed the ability of a four-hour experiential QI workshop to increase faculty proficiency in QI principles, enhance faculty involvement in QI, and improve resident mentorship in QI.

Methods

From 2016 to 2017, the authors conducted seven QI faculty development workshops at a large academic medical center with 12 ACGME training programs. We evaluated the workshop using pre- and post-workshop surveys, as well as six- and twelve-month follow up surveys.

Results

Sixty-five faculty participated in seven workshops over 13 months. All participants completed pre- and post-workshop surveys, while 38% (n = 25) responded to the six- and twelve-month follow up surveys. Overall, the workshop significantly increased confidence to lead and mentor residents on a QI project (25% pre vs. 72% post, p < .001), increased ability to teach QI (8% pre vs. 36% post, p < .001), increased participation in planning and decision making on a QI team (32% pre vs. 50% post, p = .002), and increased the mean number of QI projects implemented (.45 pre vs. 1.24 post; p < .05).

Conclusion

A four-hour QI workshop is a quick and effective training method to develop academic faculty to teach and mentor residents in QI. The principles taught increased perceived knowledge, confidence in mentorship, and participation in QI.
Beware to ignore the rare: how imputing zero-values can improve the quality of 16S rRNA gene studies results
Authors: Baruzzo Giacomo , Patuzzi Ilaria , Di Camillo Barbara
Published: February 2022

Background

16S rRNA-gene sequencing is a valuable approach to characterize the taxonomic content of the whole bacterial population inhabiting a metabolic and spatial niche, providing an important opportunity to study bacteria and their role in many health and environmental mechanisms. The analysis of data produced by amplicon sequencing, however, brings very specific methodological issues that need to be properly addressed to obtain reliable biological conclusions. Among these, 16S count data tend to be very sparse, with many null values reflecting species that are present but got unobserved due to the multiplexing constraints. However, current data workflows do not consider a step in which the information about unobserved species is recovered.

Results

In this work, we evaluate for the first time the effects of introducing in the 16S data workflow a new preprocessing step, zero-imputation, to recover this lost information. Due to the lack of published zero-imputation methods specifically designed for 16S count data, we considered a set of zero-imputation strategies available for other frameworks, and benchmarked them using in silico 16S count data reflecting different experimental designs. Additionally, we assessed the effect of combining zero-imputation and normalization, i.e. the only preprocessing step in current 16S workflow. Overall, we benchmarked 35 16S preprocessing pipelines assessing their ability to handle data sparsity, identify species presence/absence, recovery sample proportional abundance distributions, and improve typical downstream analyses such as computation of alpha and beta diversity indices and differential abundance analysis.

Conclusions

The results clearly show that 16S data analysis greatly benefits from a properly-performed zero-imputation step, despite the choice of the right zero-imputation method having a pivotal role. In addition, we identify a set of best-performing pipelines that could be a valuable indication for data analysts.
Genetic testing of dogs predicts problem behaviors in clinical and nonclinical samples
Authors: Zapata Isain , Lilly M. Leanne , Herron Meghan E. , Serpell James A. , Alvarez Carlos E.
Published: February 2022

Background

Very little is known about the etiology of personality and psychiatric disorders. Because the core neurobiology of many such traits is evolutionarily conserved, dogs present a powerful model. We previously reported genome scans of breed averages of ten traits related to fear, anxiety, aggression and social behavior in multiple cohorts of pedigree dogs. As a second phase of that discovery, here we tested the ability of markers at 13 of those loci to predict canine behavior in a community sample of 397 pedigree and mixed-breed dogs with individual-level genotype and phenotype data.

Results

We found support for all markers and loci. By including 122 dogs with veterinary behavioral diagnoses in our cohort, we were able to identify eight loci associated with those diagnoses. Logistic regression models showed subsets of those loci could predict behavioral diagnoses. We corroborated our previous findings that small body size is associated with many problem behaviors and large body size is associated with increased trainability. Children in the home were associated with anxiety traits; illness and other animals in the home with coprophagia; working-dog status with increased energy and separation-related problems; and competitive dogs with increased aggression directed at familiar dogs, but reduced fear directed at humans and unfamiliar dogs. Compared to other dogs, Pit Bull-type dogs were not defined by a set of our markers and were not more aggressive; but they were strongly associated with pulling on the leash. Using severity-threshold models, Pit Bull-type dogs showed reduced risk of owner-directed aggression (75th quantile) and increased risk of dog-directed fear (95th quantile).

Conclusions

Our association analysis in a community sample of pedigree and mixed-breed dogs supports the interbreed mapping. The modeling shows some markers are predictive of behavioral diagnoses. Our findings have broad utility, including for clinical and breeding purposes, but we caution that thorough understanding is necessary for their interpretation and use.
Comparison of noninvasive continuous arterial blood pressure measured by NICAP with arterial line in elderly patients
Authors: Xu Zhao , Chen Hongyang , Zhou Hongyu , Sun Xiaohui , Ren Jun , Sun Hongxia , Chen Chan , Chen Guo
Published: February 2022

Background

Non-Invasive Continuous Arterial Pressure system (NICAP) allows continuous monitoring, timely detection of hypotension, and avoiding risks from invasive procedures. A previous study showed good comparability of NICAP with arterial line in people with no evidence of cardiovascular disease. Therefore, the goal of this study was to investigate whether NICAP could be accurately applied to elderly patients.

Methods

In this single-centered observational study, forty-one patients above 65 undergoing elective surgeries requiring artery catheterizations were enrolled from July 17, 2020, to June 25, 2021. Radial artery cannulation and NICAP monitoring were started before anesthesia. Blood pressure during the anesthesia induction and the whole surgery, trend of blood pressure changes, time needed for establishing continuous monitoring, and complications were recorded.

Results

A total of 6751 valid pairs of blood pressure measurements were analyzed. In the Bland-Altman analysis, the arithmetic means for systolic, diastolic, and mean arterial pressure were 2.2, 3.3, and 2.8 mmHg, respectively. NICAP and arterial line correlation coefficients for systolic, diastolic, and mean arterial pressure were 0.51, 0.40, and 0.47, respectively. In the trending analysis, the polar concordance rates at 30 degrees were 70.9% for systolic, 67.7% for diastolic, and 69.3% for mean arterial blood pressure. During the anesthesia induction, the arithmetic means for systolic, diastolic, and mean arterial pressure in the Bland-Altman analysis were 1.7, -0.2, and 0.5 mmHg, respectively. NICAP and arterial line correlation coefficients for systolic, diastolic, and mean arterial pressure were 0.72, 0.58 and 0.69, respectively. No severe complications occurred.

Conclusions

NICAP has a poor correlation with the arterial line in elderly patients for the whole surgery or during anesthesia induction. Moreover, it showed poor comparability in the detection of blood pressure change trends with arterial lines. Our findings suggest that NICAP might not be sufficiently accurate to be applied clinically in elderly patients with comorbidities. More accurate calibration and iteration are needed.
Determining target populations for leprosy prophylactic interventions: a hotspot analysis in Indonesia
Authors: Taal A. T. , Blok D. J. , Handito A. , Wibowo S. , Sumarsono  , Wardana A. , Pontororing G. , Sari D. F. , van Brakel W. H. , Richardus J. H. , Prakoeswa C. R. S.
Published: February 2022

Background

Leprosy incidence remained at around 200,000 new cases globally for the last decade. Current strategies to reduce the number of new patients include early detection and providing post-exposure prophylaxis (PEP) to at-risk populations. Because leprosy is distributed unevenly, it is crucial to identify high-risk clusters of leprosy cases for targeting interventions. Geographic Information Systems (GIS) methodology can be used to optimize leprosy control activities by identifying clustering of leprosy cases and determining optimal target populations for PEP.

Methods

The geolocations of leprosy cases registered from 2014 to 2018 in Pasuruan and Pamekasan (Indonesia) were collected and tested for spatial autocorrelation with the Moran’s I statistic. We did a hotspot analysis using the Heatmap tool of QGIS to identify clusters of leprosy cases in both areas. Fifteen cluster settings were compared, varying the heatmap radius (i.e., 500 m, 1000 m, 1500 m, 2000 m, or 2500 m) and the density of clustering (low, moderate, and high). For each cluster setting, we calculated the number of cases in clusters, the size of the cluster (km2), and the total population targeted for PEP under various strategies.

Results

The distribution of cases was more focused in Pasuruan (Moran’s I = 0.44) than in Pamekasan (0.27). The proportion of total cases within identified clusters increased with heatmap radius and ranged from 3% to almost 100% in both areas. The proportion of the population in clusters targeted for PEP decreased with heatmap radius from > 100% to 5% in high and from 88 to 3% in moderate and low density clusters. We have developed an example of a practical guideline to determine optimal cluster settings based on a given PEP strategy, distribution of cases, resources available, and proportion of population targeted for PEP.

Conclusion

Policy and operational decisions related to leprosy control programs can be guided by a hotspot analysis which aid in identifying high-risk clusters and estimating the number of people targeted for prophylactic interventions.