bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of distance monitoring service in managing healthcare demand: a case study through the lens of cocreation
Authors: Enam Amia , Dreyer Heidi Carin , De Boer Luitzen
Published: June 2022

Background

There is a consensus among healthcare providers, academics, and policy-makers that spiraling demand and diminishing resources are threatening the sustainability of the current healthcare system. Different telemedicine services are seen as potential solutions to the current challenges in healthcare. This paper aims to identify how distance monitoring services rendered for patients with chronic conditions can affect the escalating demand for healthcare. First, we identify how distance monitoring service changes the care delivery process using the lens of service cocreation. Next, we analyze how these changes can impact healthcare demand using the literature on demand and capacity management.

Method

In this qualitative study, we explore a distance monitoring service in a primary healthcare setting in Norway. We collected primary data from nurses and general physicians using the semi-structured interview technique. We used secondary patient data collected from a study conducted to evaluate the distance monitoring project. The deductive content analysis method was used to analyze the data.

Result

This study shows that the application of distance monitoring services changes the care delivery process by creating new activities, new channels for interaction, and new roles for patients, general physicians, and nurses. We define patients’ roles as proactive providers of health information, general physicians’ roles as patient selectors, and nurses’ roles as technical coordinators, data workers, and empathetic listeners. Thus, the co-creation aspect of the service becomes more prominent demonstrating potential for better management of healthcare demand. However, these changes also render the management of demand and resources more complex. To reduce the complexities, we propose three mechanisms: foreseeing and managing new roles, developing capabilities, and adopting a system-wide perspective.

Conclusion

The main contribution of the paper is that it demonstrates that, although distance monitoring services have the potential to have a positive impact on healthcare demand management, in the absence of adequate managerial mechanisms, they can also adversely affect healthcare demand management. This study provides a means for practitioners to reflect upon and refine the decisions that they make regarding telemedicine deployment and resource planning for delivering care.
Landscape of cardiometabolic risk factors in Chinese population: a narrative review
Authors: Li Jian-Jun , Liu Hui-Hui , Li Sha
Published: June 2022

With rapid economic growth and changes at all levels (including environmental, social, individual), China is facing a cardiovascular disease (CVD) crisis. In China, more than 40% of deaths are attributable to CVDs, and the number of CVD deaths has almost doubled in the past decades, in contrast to a decline in high-income countries. The increasing prevalence of cardiometabolic risk factors underlies the rise of CVDs, and thus curbing the rising cardiometabolic pandemic is imperative. Few articles have addressed this topic and provided an updated review of the epidemiology of cardiometabolic risk factors in China.

In this narrative review, we describe the temporal changes in the prevalence of cardiometabolic risk factors in the past decades and their management in China, including both the well-recognized risk factors (general obesity, central obesity, diabetes, prediabetes, dyslipidemia, hypertension) and the less recognized ones (hyperhomocysteinemia, hyperuricemia, and high C-reactive protein). We also summarize findings from landmark clinical trials regarding effective interventions and treatments for cardiometabolic risk factors. Finally, we propose strategies and approaches to tackle the rising pandemic of cardiometabolic risk factors in China. We hope that this review will raise awareness of cardiometabolic risk factors not only in Chinese population but also global visibility, which may help to prevent cardiovascular risk.
Exosomes from human induced pluripotent stem cells-derived keratinocytes accelerate burn wound healing through miR-762 mediated promotion of keratinocytes and endothelial cells migration
Authors: Bo Yunyao , Yang Lijun , Liu Baiting , Tian Guiping , Li Chenxi , Zhang Lin , Yan Yuan
Published: June 2022

Background

The use of keratinocytes derived from induced pluripotent stem cells (iPSCs-KCs) may represent a novel cell therapy strategy for burn treatment. There is growing evidence that extracellular vesicles, including exosomes, are primary mediators of the benefits of stem cell therapy. Herein, we thus explored the effects of exosomes produced by iPSCs-derived keratinocytes (iPSCs-KCs-Exos) in a model of deep second-degree burn wound healing and evaluated the mechanistic basis for the observed activity.

Methods

iPSCs-KCs-Exos were isolated from conditioned medium of iPSCs-KCs and verified by electron micrograph and size distribution. Next, iPSCs-KCs-Exos were injected subcutaneously around wound sites, and its efficacy was evaluated by measuring wound closure areas, histological examination, and immunohistochemistry staining. The effects of iPSCs-KCs-Exos on proliferation and migration of keratinocytes and endothelial cells in vitro were assessed by EdU staining, wound healing assays, and transwell assay. Then, high-throughput microRNA sequencing was used to explore the underlying mechanisms. We assessed the roles of miR-762 in iPSCs-KCs-Exos-induced regulation of keratinocytes and endothelial cells migration. Furthermore, the target gene which mediated the biological effects of miR-762 in keratinocytes and endothelial cells was also been detected.

Results

The analysis revealed that iPSCs-KCs-Exos application to the burn wound drove the acceleration of wound closure, with more robust angiogenesis and re-epithelialization being evident. Such iPSCs-KCs-Exos treatment effectively enhanced endothelial cell and keratinocyte migration in vitro. Moreover, the enrichment of miR-762 was detected in iPSCs-KCs-Exos and was found to target promyelocytic leukemia (PML) as a means of regulating cell migration through a mechanism tie to integrin beta1 (ITGB1).

Conclusion

These results thus provide a foundation for the further study of iPSCs-KCs-Exos as novel cell-free treatments for deep second-degree burns.

Graphical Abstract
Comprehensive analysis of microglia gene and subpathway signatures for glioma prognosis and drug screening: linking microglia to glioma
Authors: Zhang Chunlong , Zhao Jiaxin , Mi Wanqi , Zhang Yuxi , Zhong Xiaoling , Tan Guiyuan , Li Feng , Li Xia , Xu Yanjun , Zhang Yunpeng
Published: June 2022

Glioma is the most common malignant tumors in the brain. Previous studies have revealed that, as the innate immune cells in nervous system, microglia cells were involved in glioma pathology. And, the resident microglia displayed its specific biological roles which distinguished with peripheral macrophages. In this study, an integrated analysis was performed based on public resource database to explore specific biological of microglia within glioma. Through comprehensive analysis, the biological characterization underlying two conditions, glioma microglia compared to glioma macrophage (MicT/MacT) as well as glioma microglia compared to normal microglia (MicT/MicN), were revealed. Notably, nine core MicT/MicN genes displayed closely associations with glioma recurrence and prognosis, such as P2RY2, which was analyzed in more than 2800 glioma samples from 25 studies. Furthermore, we applied a random walk based strategy to identify microglia specific subpathways and developed SubP28 signature for glioma prognostic analysis. Multiple validation data sets confirmed the predictive performance of SubP28 and involvement in molecular subtypes. The associations between SuP28 score and microglia M1/M2 polarization were also explored for both GBM and LGG types. Finally, a comprehensive drug-subpathway network was established for screening candidate medicable molecules (drugs) and identifying therapeutic subpathway targets. In conclusions, the comprehensive analysis of microglia related gene and functional signatures in glioma pathobiologic events by large-scale data sets displayed a framework to dissect inner connection between microglia and glioma, and identify robust signature for glioma clinical implications.
Implementation and challenges to preventing the re-establishment of malaria in China in the COVID-19 era
Authors: Lu Guangyu , Cao Yuanyuan , Zhang Dongying , Zhang Yuying , Xu Yuhui , Lu Yan , Chen Qi , Zhu Guoding , Yan Jun , Müller Olaf , Cao Jun
Published: June 2022

Background

The rapid emergence and global spread of COVID-19 have caused substantial global disruptions that have impacted malaria programs worldwide. Innovative strategies to enable countries aiming to eliminate malaria as well as those that are already certified as malaria-free, are needed to address malaria importation in the context of the COVID-19 pandemic. China was certified as malaria-free in 2021 and now aims to prevent the malaria re-establishment. Nonpharmaceutical interventions such as entry screening, quarantining, and health education for individuals returning from international travel during the COVID-19 pandemic present both opportunities and challenges to the management of imported malaria. This study aimed to describe and analyze the operational challenges associated with an integrated surveillance and case management program in which malaria re-establishment prevention measures were incorporated into the COVID-19 program in China.

Methods

After the integration of malaria re-establishment prevention activities into the COVID-19 program for 10 months in Jiangsu Province, China, a focus-group discussion of public health workers working on preventing malaria re-establishment and controlling COVID-19 was held in June 2021, aiming to explore the operational challenges and lessons learned from the integrated approach.

Results

From 01 August 2020 to 31 May 2021, 8,947 overseas travelers with Yangzhou as the final destination underwent 14-day managed quarantine and 14-day home isolation. Of these travelers, 5,562 were from malaria-endemic regions. A total of 26,026 education booklets and materials were distributed to expand malaria-related knowledge. Twenty-two patients with unknown fever were screened for malaria with rapid diagnostic tests, and one patient was confirmed to have imported malaria. The challenges associated with the implementation of the integrated malaria surveillance and case management program include neglect of malaria due to COVID-19, lack of a standard operating procedure for malaria screening, mobility of public health providers, and difficulties in respecting the timeline of the “1–3-7” surveillance strategy.

Conclusions

China’s experience highlights the feasibility of integrated case surveillance and management of existing infectious diseases and new emerging infections. It also demonstrates the importance of a sound public health infrastructure with adequate, trained field staff for screening, testing, contact tracing, and providing health education, all of which are crucial for the success of both malaria re-establishment prevention program and the effective control of COVID-19.
Effect of intrafraction adaptation on PTV margins for MRI guided online adaptive radiotherapy for rectal cancer
Authors: Kensen Chavelli M. , Janssen Tomas M. , Betgen Anja , Wiersema Lisa , Peters Femke P. , Remeijer Peter , Marijnen Corrie A. M. , van der Heide Uulke A.
Published: June 2022

Purpose

To determine PTV margins for intrafraction motion in MRI-guided online adaptive radiotherapy for rectal cancer and the potential benefit of performing a 2nd adaptation prior to irradiation.

Methods

Thirty patients with rectal cancer received radiotherapy on a 1.5 T MR-Linac. On T2-weighted images for adaptation (MRIadapt), verification prior to (MRIver) and after irradiation (MRIpost) of 5 treatment fractions per patient, the primary tumor GTV (GTVprim) and mesorectum CTV (CTVmeso) were delineated. The structures on MRIadapt were expanded to corresponding PTVs. We determined the required expansion margins such that on average over 5 fractions, 98% of CTVmeso and 95% of GTVprim on MRIpost was covered in 90% of the patients. Furthermore, we studied the benefit of an additional adaptation, just prior to irradiation, by evaluating the coverage between the structures on MRIver and MRIpost. A threshold to assess the need for a secondary adaptation was determined by considering the overlap between MRIadapt and MRIver.

Results

PTV margins for intrafraction motion without 2nd adaptation were 6.4 mm in the anterior direction and 4.0 mm in all other directions for CTVmeso and 5.0 mm isotropically for GTVprim. A 2nd adaptation, applied for all fractions where the motion between MRIadapt and MRIver exceeded 1 mm (36% of the fractions) would result in a reduction of the PTVmeso margin to 3.2 mm/2.0 mm. For PTVprim a margin reduction to 3.5 mm is feasible when a 2nd adaptation is performed in fractions where the motion exceeded 4 mm (17% of the fractions).

Conclusion

We studied the potential benefit of intrafraction motion monitoring and a 2nd adaptation to reduce PTV margins in online adaptive MRIgRT in rectal cancer. Performing 2nd adaptations immediately after online replanning when motion exceeded 1 mm and 4 mm for CTVmeso and GTVprim respectively, could result in a 30–50% margin reduction with limited reduction of dose to the bowel.
The use of intrathecal morphine for acute postoperative pain in lower limb arthroplasty surgery: a survey of practice at an academic hospital
Authors: Sibanyoni Mpumelelo , Biyase Ntombiyethu , Motshabi Chakane Palesa
Published: June 2022

Background and purpose of the study

Intrathecal morphine (ITM) provides optimal postoperative analgesia in patients who are scheduled for total knee and hip operation with spinal anaesthesia. However, the ideal dose at which maximal analgesic effect occurs with minimal side effects is not known. This study aimed to describe the use of two doses of ITM and side effect profile in patients undergoing elective hip and knee arthroplasty.

Methods

This was a prospective, descriptive, and contextual study conducted on patients who had total hip and knee replacement at Chris Hani Baragwanath Academic Hospital from 1 September to 30 November 2020. The sample size consisted of 66 patients who were 18 years and older, American Society of Anaesthesiology (ASA) classification 1–3, patients who had received either 100 mcg or 150 mcg ITM dose under spinal anaesthesia and sent to the ward postoperatively. Visual Analogue Scale (VAS) score was used to assess pain in the first 24 h, consumption of rescue analgesia and reported side effects were documented.

Results

There was no relationship between age, weight, ASA classification or type of surgery and VAS score classification groups. Patients who received 100 mcg ITM had a higher median VAS pain score 2 (1–5) compared to those who received 150 mcg ITM 1 (0–2), p = 0.01. The need for rescue analgesia between the two groups was marginally less in the 150 mcg ITM group (p = 0.098). There was no difference in the rate of side effects between the 100 mcg ITM group [12 (41%)] and the 150 mcg ITM group [17 (59%)], p = 0.92. Rescue analgesia was marginally different between groups, p = 0.09. There were no real differences in the VAS pain scores between the total knee and total hip surgeries. None of the patients experienced clinically significant respiratory depression.

Conclusion

The 150 mcg ITM dose provided good analgesic effects with longer duration of action and comparable side effect profile to the 100 mcg ITM dose. This dose was not associated with development of respiratory depression and can therefore be administered safely to patients who are discharged to the ward postoperatively in a resource constraint environment.
Dermatologic manifestations in paediatric neurofibromatosis type 2: a cross sectional descriptive multicentric study
Authors: Legoupil S. , Bessis D. , Picard F. , Mallet S. , Mazereeuw J. , Phan A. , Dupin-Deguine D. , Kalamarides M. ,   Research Group of the French Society of Paediatric Dermatology, Chiaverini C.
Published: June 2022

Background

Neurofibromatosis type 2 (NF2) is characterized by bilateral vestibular schwannoma (VS) more often in adults but a severe paediatric form with multiple neurological tumours is also described. In this population, a early diagnosis is important to prevent the onset of neurological complications but is difficult, particularly without a familial history. Cutaneous manifestations, which may precede VS or neurological tumours by several years, may contribute to an early diagnosis, but specific studies are lacking. The objective of this study was to characterize cutaneous manifestations of NF2 in a paediatric population.

Results

This observational, descriptive and multicentric study was conducted from April 2019 to April 2020 in seven academic French hospitals. We included patients ≤ 18 years old who fulfilled the Manchester diagnostic criteria or had a pathogenic mutation identified in the NF2 gene. All patients underwent a dermatological examination guided by a standardized questionnaire. 21 children were included, of whom 20 had at least one skin tumour (mean number 5 ± 4.6 [range 0–15]), which led to a diagnosis in four cases. In the other 17 cases, the diagnosis of NF2 was based on neurosensory complications (n = 10), family screening (n = 4) or ocular signs (n = 3). Before the NF2 diagnosis, 15 children had at least one “undiagnosed” cutaneous tumour that did not lead to a specific management. Patients’ dermatological examination also revealed < 6 non specific café au lait macules (n = 15), hypopigmented macules (n = 12) with more than 3 lesions in 4 cases, and purple reticulated macules of the trunk (n = 4).

Conclusion

Dermatological lesions are frequent and early in children with NF2 but rarely lead to the diagnosis. Cutaneous schwannomas are the most frequent but are often underdiagnosed. Café au lait macules are frequent, but atypical and mostly in small numbers. Multiple hypopigmented macules seem suggestive although inconsistent. The sensitivity of reticulated capillary malformation-like lesions remains to be assessed by further studies.
Mitochondrial bioenergetic is impaired in Monocarboxylate transporter 1 deficiency: a new clinical case and review of the literature
Authors: Stanescu Sinziana , Bravo-Alonso Irene , Belanger-Quintana Amaya , Pérez Belen , Medina-Diaz Montserrat , Ruiz-Sala Pedro , Flores Nathaly Paola , Buenache Raquel , Arrieta Francisco , Rodríguez-Pombo Pilar
Published: June 2022

Background

Monocarboxylate transporter 1 (MCT1) deficiency has recently been described as a rare cause of recurrent ketosis, the result of impaired ketone utilization in extrahepatic tissues. To date, only six patients with this condition have been identified, and clinical and biochemical details remain incomplete.

Results

The present work reports a patient suffering from severe, recurrent episodes of metabolic acidosis and psychomotor delay, showing a pathogenic loss-of-function variation c.747_750del in homozygosity in SLC16A1 (which codes for MCT1). Persistent ketotic and lactic acidosis was accompanied by an abnormal excretion of organic acids related to redox balance disturbances. Together with an altered bioenergetic profile detected in patient-derived fibroblasts, this suggests possible mitochondrial dysfunction. Brain MRI revealed extensive, diffuse bilateral, symmetric signal alterations for the subcortical white matter and basal ganglia, together with corpus callosum agenesia.

Conclusions

These findings suggest that the clinical spectrum of MCT1 deficiency not only involves recurrent atacks of ketoacidosis, but may also cause lactic acidosis and neuromotor delay with a distinctive neuroimaging pattern including agenesis of corpus callosum and other brain signal alterations.
The diagnostic and prognostic implications of PRKRA expression in HBV-related hepatocellular carcinoma
Authors: Hu Yi-Min , Ran Ruoxi , Yang Chaoqi , Liu Song-Mei
Published: June 2022

Background

Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) accounts for more than half of total HCC patients in developing countries. Currently, HBV-related HCC diagnosis and prognosis still lack specific biomarkers. Here, we investigated if PRKRA expression in peripheral blood could be a potential biomarker for the diagnosis/prognosis of HBV-related HCC.

Methods

The expression of PRKRA in HBV-related HCC was firstly analyzed using TCGA and GEO databases. The results were confirmed in a validation cohort including 152 blood samples from 77 healthy controls and 75 HCC patients, 60 of which were infected with HBV. The potential diagnostic and prognostic values of PRKRA were also evaluated by the area under the receiver operator characteristic curve (AUROC) and Kaplan–Meier method, respectively.

Results

PRKRA was significantly upregulated in HCC patients, especially in those with HBV infections. In addition, the combination of PRKRA expression in peripheral blood with serum AFP and CEA levels displayed a better diagnostic performance (AUROC = 0.908, 95% CI 0.844–0.972; p < 0.001). Notably, when serum AFP is less than 200 ng/mL, PRKRA expression demonstrated better diagnostic capability. Furthermore, PRKRA expression levels were associated with expression of EIF2AK2 and inflammatory cytokine genes.

Conclusions

Triple combination testing of blood PRKRA expression, serum AFP and CEA levels could be a noninvasive strategy for diagnosis; and the elevation of PRKRA expression could predicate poor prognosis for HBV-related HCC.
Characterizing mental health related service contacts in children and youth: a linkage study of health survey and administrative data
Authors: Edwards Jordan , Wang Li , Duncan Laura , Comeau Jinette , Anderson Kelly K. , Georgiades Katholiki
Published: June 2022

Background

To inform the provision and organization of care, and to improve equitable access to mental health services for children and youth, we must first characterize the children and youth being served, taking into consideration factors related to mental health need. Our objective was to use a population-based survey linked with health administrative data to estimate mental health related contacts and determine socio-demographic correlates, after adjusting for factors related to mental health need.

Methods

Data from the 2014 Ontario Child Health Study (OCHS) were linked at the individual level to health administrative databases from Ontario’s Ministry of Health and Long-Term Care (MOHLTC). Mental health related service contacts were identified in the 6-months prior to the OCHS survey date. Service contacts with physicians were obtained from health administrative data, and non-physician service contacts from survey data (parent-report).

Results

21.7% of Ontarian children (4–11 years) and youth (12–17 years) had at least one mental health related contact in the 6-months prior to their OCHS survey date (18.8% non-physician, 8.0% physician, 5.2% both). Children and youth contacting both physician and non-physician services (ref. contact with physician or non-physician services alone) had higher mean symptom ratings of mental disorders across all classes of disorder. After adjusting for total symptom ratings, children and youth with immigrant parent(s) (ref. non-immigrant) (Prevalence Ratio: 0.65, 95% CI 0.55, 0.75) were less likely to have any mental health related service contact.

Conclusions

Results indicate that children and youth with the highest mental health symptom ratings are more likely to have contact with multiple providers across sectors. As such, the coordination of care across and within sectors are critical components of mental health related services for children and youth. Our results indicate that the greatest disparities in mental health related service contacts may exist for children and youth with immigrant parent(s) and that targeted outreach efforts are required to reduce barriers to care and improve equitable access to mental health related services for children and youth in Ontario.
The cumulative live birth rate of recombinant follicle-stimulating hormone alfa verse urinary human follicle-stimulating hormone for ovarian stimulation in assisted reproductive technology cycles
Authors: Yang Chunxia , Dong Naijun , Li Feng , Ji Yurong , Pan Yu , She Hong
Published: June 2022

Background

Infertility remains a significant public health concern. An issue with controlled ovarian stimulation (COS) is the selection of an exogenous gonadotropin (Gn) regimen, which is mainly based on urinary follicle-stimulating hormone (uFSH), recombinant follicle-stimulating hormone alfa (rFSH-alfa), and human menopausal gonadotropin (HMG). In addition, most previous studies focused on the clinical pregnancy rates or live birth rates (LBR) per transfer cycle, but not on the cumulative live birth rate (CLBR) per started cycle. The CLBR, appears to be a more comprehensive and accurate universal measure of IVF treatment success. Therefore, this study aimed to compare the cumulative live birth rate (CLBR) between rFSH-alfa and uFSH regimens for ovarian stimulation.

Methods

This retrospective cohort study included patients who underwent assisted reproductive technology (ART) with gonadotropin-releasing hormone (GnRH) agonist long protocol between March 2009 and December 2018. Patients were grouped according to the Gn regimen received (rFSH-alfa or uFSH). The main outcome was CLBR, which defined as the first live birth following the use of all fresh and frozen embryos derived from a single COS cycle.

Results

A total of 1078 cycles were analyzed (314 with rFSH-alfa and 764 with uFSH). The rFSH-alfa group was characterized by a higher number of retrieved oocytes (13.3 vs. 11.0) and transferable embryos (5.0 vs. 4.0), a higher fresh embryo transfer rate (35.0% vs. 26.3%), and a higher multiple birth rate among the fresh embryo transfer cycles (8.2% vs. 2.5%) (P < 0.05). There were no differences in pregnancy rate (32.7% vs. 33.8%) and LBR (25.5% vs. 26.9%) per transfer cycle (P > 0.05). No significant difference was found in clinical outcomes among the frozen embryo transfer cycles (P > 0.05). The CLBR per started cycle in the rFSH-alfa group was higher than in the uFSH group (53.5% vs. 43.1%, P < 0.05). After adjustment, rFSH-alfa was independently associated with a higher CLBR (OR = 1.56; 95%CI = 1.18–2.05; P = 0.0018).

Conclusions

rFSH-alfa and uFSH have similar pregnancy rates and LBR per transfer cycle, rFSH-alfa might achieve more transferrable blastocysts and higher CLBR per started cycle compared to uFSH.
High serum uric acid trajectories are associated with risk of myocardial infarction and all-cause mortality in general Chinese population
Authors: Tian Xue , Zuo Yingting , Chen Shuohua , Wu Shouling , Wang Anxin , Luo Yanxia
Published: June 2022

Background

Long-term patterns of serum uric acid (SUA) and their association with the risk of myocardial infarction (MI) and mortality are poorly characterized as prior studies measured SUA at a single time point. This study aimed to identify SUA trajectories and determine their associations with incident MI and all-cause mortality.

Methods

We included 85,503 participants who were free of MI in or prior 2012 from the Kailuan study. SUA trajectories during 2006–2012 were identified by group-based trajectory modeling. Cox proportional hazard models were used to assess the association of SUA trajectories with MI and all-cause mortality.

Results

We identified three SUA trajectories during 2006–2012: low-stable (n=44,124, mean SUA: 236–249 μmol/L), moderate-stable (n=34,431, mean SUA: 324–354 μmol/L) and high-stable (n=6,984, mean SUA: 425–463 μmol/L). During a median follow-up of 6.8 years, we documented 817 (0.96%) incident MI and 6498 (7.60%) mortality. Compared with the low-stable group, high-stable group experienced a higher risk of MI (hazard ratio [HR], 1.35; 95% confidence [CI], 1.07–1.71) and all-cause mortality (HR, 1.22; 95% CI, 1.12–1.33). Multiple sensitivity analyses yielded similar results. Additionally, the association of SUA trajectory with MI and all-cause mortality was more pronounced in individuals without a history of hypertension (P-interaction=0.0359) and those aged <60 years (P-interaction<0.0001), respectively.

Conclusions

Higher SUA trajectories were associated with altered risk of MI and all-cause mortality, suggesting that monitoring SUA trajectory may assist in identifying subpopulations at higher risk of MI and all-cause mortality.
Leveling up evidence syntheses: filling conceptual gaps of the role of midwifery in health systems through a network analysis
Authors: Mattison Cristina A. , Bourret Kirsty , Dion Michelle L.
Published: June 2022

Objective

In the research note, our main objective is to explore the value of combining an evidence synthesis with a network analysis. The discussion is based on a critical interpretive synthesis, which combines systematic review methodology with qualitive inquiry, and ‘research concept’ network analysis focused on understanding the roles of midwives in health systems. The interpretative analytic approach of a critical interpretive synthesis has a high explanatory value by allowing for the review of a diverse body of literature and is well-suited to delving into areas that are not well understood, such as midwifery.

Results

Network analyses use graphs to represent relationships between concepts and brought to light important additional insights into the literature that were not present in the evidence synthesis alone. Given the lack of theoretical development in the area of midwifery in health systems, the critical interpretive synthesis allowed for the generation of concepts used to inform a theoretical framework, while the novel application of an exploratory network analysis deepened understanding of conceptual areas of saturation within the field, as well as identifying critical gaps in the literature.
Current practical experience with artificial intelligence in clinical radiology: a survey of the European Society of Radiology
Authors:   European Society of Radiology (ESR), Becker Christoph D. , Kotter Elmar , Fournier Laure , Martí-Bonmatí Luis
Published: June 2022

A survey among the members of European Society of Radiology (ESR) was conducted regarding the current practical clinical experience of radiologists with Artificial Intelligence (AI)-powered tools. 690 radiologists completed the survey. Among these were 276 radiologists from 229 institutions in 32 countries who had practical clinical experience with an AI-based algorithm and formed the basis of this study. The respondents with clinical AI experience included 143 radiologists (52%) from academic institutions, 102 radiologists (37%) from regional hospitals, and 31 radiologists (11%) from private practice. The use case scenarios of the AI algorithm were mainly related to diagnostic interpretation, image post-processing, and prioritisation of workflow. Technical difficulties with integration of AI-based tools into the workflow were experienced by only 49 respondents (17.8%). Of 185 radiologists who used AI-based algorithms for diagnostic purposes, 140 (75.7%) considered the results of the algorithms generally reliable. The use of a diagnostic algorithm was mentioned in the report by 64 respondents (34.6%) and disclosed to patients by 32 (17.3%). Only 42 (22.7%) experienced a significant reduction of their workload, whereas 129 (69.8%) found that there was no such effect. Of 111 respondents who used AI-based algorithms for clinical workflow prioritisation, 26 (23.4%) considered algorithms to be very helpful for reducing the workload of the medical staff whereas the others found them only moderately helpful (62.2%) or not helpful at all (14.4%). Only 92 (13.3%) of the total 690 respondents indicated that they had intentions to acquire AI tools. In summary, although the assistance of AI algorithms was found to be reliable for different use case scenarios, the majority of radiologists experienced no reduction of practical clinical workload.
Systemic sclerosis and tachycardia–bradycardia syndrome: a case report
Authors: Faraj Raid , Laktib Nabil , Hilal Safae , Hassan Fadoun , Krimech Amine , Bouanani Alaa , Sarsari Mohamed , Fellat Ibtissam , Zarzur Jamila , Cherti Mohamed
Published: June 2022

Background

Systemic sclerosis is a multisystemic character autoimmune disease. It is characterized by vascular dysfunction and progressive fibrosis affecting mainly the skin but also different internal organs. All heart structures are commonly affected, including the pericardium, myocardium, and conduction system. However, tachycardia–bradycardia syndrome is not common in the literature as a cardiac complication of systemic sclerosis.

Case presentation

We report a case of tachycardia–bradycardia syndrome in a 46-year-old Moroccan woman followed for systemic sclerosis with cutaneous, vascular, and articular manifestations. The diagnosis was based mainly on patient-reported symptoms and electrocardiogram data. A permanent pacemaker was implanted, allowing the introduction of beta-blockers with good outcomes.

Conclusions

This case aims to show that even minor electrocardiogram abnormalities should be monitored in this group of patients, preferably by 24-hour ambulatory electrocardiogram because they could be a good indicator of the activity and progression of cardiac fibrosis.
Vascular anomaly diagnosis by central venous catheter misplacement: a case report
Authors: de Smalen Peter Paul , Stoutjesdijk Mark Jeroen
Published: June 2022

Background

Congenital heart diseases rarely have a primary manifestation in adulthood. They are a rare cause of pulmonary hypertension in adults.

Case presentation

A 70-year-old woman of Eurasian descent underwent emergency surgery for bowel ischemia. Her history of mild pulmonary hypertension likely correlates with a peculiar diagnosis of an anatomic anomaly on the postoperative x-ray and computed tomography scan. The central venous catheter was misplaced. Initial management consisted of removal of the catheter. The diagnosis, partial anomalous pulmonary venous return, may pose a clinical therapeutic dilemma.

Conclusions

Partial anomalous pulmonary venous return is a potentially treatable cause of pulmonary hypertension. With the current trend toward more medical imaging, we expect this diagnosis to be made more often in the future.
Signal design and processing for noise radar
Authors: Galati Gaspare , Pavan Gabriele , Wasserzier Christoph
Published: June 2022

An efficient and secure use of the electromagnetic spectrum by different telecommunications and radar systems represents, today, a focal research point, as the coexistence of different radio-frequency sources at the same time and in the same frequency band requires the solution of a non-trivial interference problem. Normally, this is addressed with diversity in frequency, space, time, polarization, or code. In some radar applications, a secure use of the spectrum calls for the design of a set of transmitted waveforms highly resilient to interception and exploitation, i.e., with low probability of intercept/exploitation capability. In this frame, the noise radar technology (NRT) transmits noise-like waveforms and uses correlation processing of radar echoes for their optimal reception. After a review of the NRT as developed in the last decades, the aim of this paper is to show that NRT can represent a valid solution to the aforesaid problems.
Toward energy saving and food safety in Central Mozambique: the role of improved cook stoves and heat retention boxes
Authors: Matavel Custodio E. , Hafner Johannes M. , Hoffmann Harry , Uckert Götz , Massuque Jonas , Rybak Constance , Sieber Stefan
Published: June 2022

Background

Almost 80% of the population in sub-Saharan Africa relies on traditional biomass for cooking, which is typically associated with negative environmental, health, economic, and social impacts. Thus, many stakeholders, including development agencies and national governments in the Global South are promoting the use of the improved cookstove in order to save cooking time, save financial assets, maximize fuel efficiency, and reduce indoor air pollution. However, little attention is paid to the heating practices among households, which can determine food safety levels. Specifically, cooked food should be kept at temperatures above the danger zone (from 5 to 57 °C) prior to its consumption to prevent its contamination by bacteria and other unhealthy contaminants. In general, many studies address food preparation and storage separately, despite being complementary. In this study, we attempt to understand whether, the use of improved cookstove combined with heat retention box would result in improvements with regard to fuel and time saving, and adequate food storage temperatures. Furthermore, we examine the acceptability of food prepared with these two systems based on consumers’ preference analysis. Involving 122 participants, the study was conducted in Gurué district, central Mozambique.

Results

The use of improved cookstove resulted in energy savings of 9% and 17% for cooking maize porridge and beans curry, respectively. The overall time consumption for cooking decreased by 14% (beans curry) and 24% (maize porridge). The use of heat retention boxes shows a better heat retention ability as compared to the locally used heat retention systems (leftovers, banana leaves).

Conclusions

The study concludes that improved cookstove is a sustainable mean for saving cooking time and fuel. Heat retention box has a potential to maintain adequate food storage temperatures. Both improved cookstove and heat retention box present a superior performance compared to traditional technologies; thus, can easily be diffused for not affecting the quality of food.
Effect of Lonicera edulis polysaccharide on reducing oral dyeing of lonicera edulis juice
Authors: Wang Xin , Luo Yu , Ma Rui , Wang Zhili , Yu Shiyou , Li Chenchen , Han Chunran
Published: June 2022

Fluorescence spectroscopy, particle size determination, and potential analysis were exploited to elucidate the effect of Lonicera edulis polysaccharide on polyphenol protein. The results revealed that Lonicera edulis polysaccharides mediated the binding of polyphenols and proteins through competition and formation of ternary complexes and were also able to enhance the stability of the polyphenol-protein complex solution system. A certain electrostatic effect was also present in the process simultaneously. As confirmed by the dyeing test, to improve oral dyeing, the optimum conditions of adding polysaccharide, pectin, and casein were as follows: the dosage of the polysaccharide group was 1.2 mg/mL, coloring time was 100 min, pH value was 4.0. Pectin group added 0.8 mg/mL with coloring time 80 min, pH 5.0. The addition of casein was 1.2 mg/mL; the coloring time was 100 min with pH 5.0. The sample juice substantiated a significant improvement in the dyeing of porcine tongue mucosa. Under the optimal conditions, microscopic observation validates that the mucosal color of the porcine tongue epidermis was closer to that of unstained porcine tongue epidermis, which significantly improved astringency and oral staining.
Changes in the BTK/NF-κB signaling pathway and related cytokines in different stages of neuromyelitis optica spectrum disorders
Authors: Qiao Huimin , Mao Zhuofeng , Wang Wei , Chen Xin , Wang Suhuan , Fan Haolong , Zhao Tianyi , Hou Huiqing , Dong Mei
Published: June 2022

Objective

Neuromyelitis optica spectrum disorders (NMOSDs) are blindness-causing neuritis; their pathogenesis is still not fully elucidated. Although it has been determined that Bruton tyrosine kinase (BTK) and NF-κB are associated with NMOSD, the changes that occur in different periods remain unknown. The study aimed to demonstrate the changes in the BTK/NF-κB pathway and related chemokines in different stages of NMOSDs.

Methods

A total of 32 patients with NMOSD were selected as the experimental group, and 32 healthy volunteers were included in the control group. In this study, the BTK/NF-κB pathway and related chemokines in the cerebrospinal fluid and peripheral blood samples of patients with NMOSD were analyzed in the acute or remission phase.

Results

BTK, NF-κB, PI3K, IKK, CXCL2, and CXCL12 levels in the NMOSD group in the acute or remission phase were significantly higher than those in the control group (p < 0.05).

Conclusion

The BTK/NF-κB pathway plays a vital role in the progression of NMOSD pathology. Our results shed light on its important role as a therapeutic target for NMOSD.
Reproductive performance and functional response of Eretmocerus mundus Mercet (Hymenoptera: Aphelinidae) obtained from cold-stored red-eyed pupae
Authors: Keser Berivan , Karaca Mahmut Mete , Karut Kamil
Published: June 2022

Background

Cold storage of reared natural enemies is important in terms of planning the release time and quantity, eliminating unpredicted demand increases, and reducing production costs. However, the tolerance of reared natural enemies at low temperatures varies depending on the species and needs to be determined.Eretmocerus mundusMercet (Hymenoptera: Aphelinidae) is one of the most important natural enemies used in biological control ofBemisia tabaci(Gennadius) (Hemiptera: Aleyrodidae) in greenhouses.

Results

In a laboratory study, longevity, parasitism capacity and functional response ofE. mundusadults obtained from 8-days cold-stored red-eyedE.munduspupae at 10 °C with 45 ± 5% RH conditions were determined. Mean longevity obtained from storedE.munduspupae of female and male were 23.6 and 16.2 days, respectively. However, parasitism capacity was negatively affected so that the total mean number of immatureB.tabaciparasitized by anE.mundusfemale obtained from cold-stored pupae (13.6) was statistically lower than that obtained from the colony (26.8) reared at room temperature. Adults obtained from both non-stored and storedE.munduspupae exhibited a type II functional response to increasing host density. Although cold storage did not alter the type of functional response, it negatively affected the maximum attack rate (α) and handling time (Th) of the parasitoid. The lowest maximum attack rate (1.56) and highest handling time (0.059) were obtained for adults of cold-storedE.munduspupae.

Conclusions

The results obtained may contribute to the augmentative biological control ofB. tabaciin greenhouses.
Sparus aurata and Lates calcarifer skin microbiota under healthy and diseased conditions in UV and non-UV treated water
Authors: Al-Ashhab Ashraf , Alexander-Shani Rivka , Avrahami Yosef , Ehrlich Roberto , Strem Rosa Ines , Meshner Shiri , Shental Noam , Sharon Galit
Published: June 2022

Background

The welfare of farmed fish is influenced by numerous environmental and management factors. Fish skin is an important site for immunity and a major route by which infections are acquired. The objective of this study was to characterize bacterial composition variability on skin of healthy, diseased, and recovered Gilthead Seabream (Sparus aurata) and Barramundi (Lates calcarifer). S. aurata, which are highly sensitive to gram-negative bacteria, were challenged with Vibrio harveyi. In addition, and to provide a wider range of infections, both fish species (S. aurata and L. calcarifer) were infected with gram-positive Streptococcus iniae, to compare the response of the highly sensitive L. calcarifer to that of the more resistant S. aurata. All experiments also compared microbial communities found on skin of fish reared in UV (a general practice used in aquaculture) and non-UV treated water tanks.

Results

Skin swab samples were taken from different areas of the fish (lateral lines, abdomen and gills) prior to controlled infection, and 24, 48 and 72 h, 5 days, one week and one-month post-infection. Fish skin microbial communities were determined using Illumina iSeq100 16S rDNA for bacterial sequencing. The results showed that naturally present bacterial composition is similar on all sampled fish skin sites prior to infection, but the controlled infections (T1 24 h post infection) altered the bacterial communities found on fish skin. Moreover, when the naturally occurring skin microbiota did not quickly recover, fish mortality was common following T1 (24 h post infection). We further confirmed the differences in bacterial communities found on skin and in the water of fish reared in non-UV and UV treated water under healthy and diseased conditions.

Conclusions

Our experimental findings shed light on the fish skin microbiota in relation to fish survival (in diseased and healthy conditions). The results can be harnessed to provide management tools for commercial fish farmers; predicting and preventing fish diseases can increase fish health, welfare, and enhance commercial fish yields.
Time-honored praxis in preparing smoked meat delicacy (kinuday) of the ibaloy indigenous people in Benguet, Philippines
Authors: Garambas Cynthia D. , Luna Myrna Benita Z. , Chua Consuelo T.
Published: June 2022

Every culture protects its indigenous knowledge and practices, distinguishing them from other cultures. A qualitative inquiry described the traditional processing methods in preparing smoked meat or kinuday, produced by the Ibaloy Indigenous Ethnic group in the Philippines. The saturation method was used to determine data sufficiency. Fifteen participants from the two Ibaloy-speaking municipalities of Benguet, Philippines served as the key informants for the study. Results show that Benguet native pork and rock salt are the usual raw materials for kinuday. Additionally, branches and trunks from locally available trees are utilized as smoking materials. Traditionally, meat is smoked on top of the cooking area called so-olan for one day, continuous to one month intermittent until fully consumed. Kinuday is attributed to the festivities performed by the Ibaloy IP group and the availability of the elements in producing the traditional food is the primary factor for continuing the practice. To ensure preservation and cultural transmission of traditional kinuday preparation practices, it is recommended that a formal documentary be developed and disseminated to various stakeholders.
A survey of laxoox/canjeero, a traditional Somali flatbread: production styles
Authors: Wolgamuth Erin , Yusuf Salwa , Hussein Ali , Pasqualone Antonella
Published: June 2022

Flatbreads are traditional food products of ancient origin, still produced and appreciated in their original locations and beyond, having spread through historical and modern migration. While the history and preparation of Somali flatbread, known ascanjeeroin southern regions andlaxooxin northern regions, has been shared orally for generations among the women who cook it at home, it has not been the object of scientific studies. An in-field study was therefore carried out in various cities in Somalia, Somaliland, and Ethiopia’s Somali State to document the formulation, production methods, and consumption patterns of this Somali flatbread.Laxoox/canjeeroproduction was found to be relatively homogenous, but the data revealed two significant divergences: in bread formulation and in the procedure for structure development. These divergences result from disparities in the mechanization of bread production between rural and urban, and from the destruction of infrastructure, including food processing machines in public markets, leading up to the Somali civil war. An original framework of four production styles (“heritage,” “new heritage,” “innovative,” and “global”) illustrates these divergences in detail. Heritage production is linked to the historic era of nomadic Somali pastoralism, while the other three styles originated in civil conflict and continue today.

Graphical abstract