bluuebunny/crossref_metadata_2025 huggingface dataset:
İHAM’ın (Büyük Daire) Halet vs. Lüksemburg Kararına İlişkin Bilgi Notu
Authors: KOCATEPE Metin , KAPUCU Gizem
Published: June 2023

Lüksemburg vergi idaresi ile PricewaterhouseCoopers (PwC) isimli bağımsız denetim şirketi arasında bazı çok uluslu şirketler adına gerçekleştirilen “özel vergi anlaşmalarını”, PwC çalışanı olan başvuranın basına sızdırması sonucu karşılaştığı hukuki ve cezai sonuçların ifade özgürlüğünü (İHAS m.10) ihlal etmediğine ilişkin 3. Daire tarafından verilen kararın Büyük Daire’ye sevk edilmesi üzerine, İHAM Büyük Daire Guja kriterlerini uygulayarak bir madde 10 incelemesi gerçekleştirmiştir. Bu bilgi notu, Büyük Daire tarafından verilen kararın aktarılmasını ve kısa bir değerlendirmesini içermektedir.
Pandemic Preparedness
Authors: Vandeputte Joris
Published: June 2023

Pandemics will continue to threaten public health and even mankind; what we have learned from past events has been published manyfold, e.g., by WHO.
Pathogens with pandemic potential have been identified and, as the “post-pandemic period is the pre-pandemic period”, organizations and structures with the appropriate financial and human resources to prepare for pandemics are needed within a framework of global collaboration.
Past successes in pandemic preparedness came from decades of multidisciplinary research collaboration and support for basic sciences; thus, to translate innovation into usable products, long-term investments in basic research are essential.
The “One Health Approach” acknowledges that humans, animals and the environment form an interconnected framework for emerging “new” pathogens that may in the future cross the species barrier. The 2010 Nagoya protocol (UNTC) should be fully implemented.
Once all of the above points have been considered and implemented, “ad hoc” vaccine production capacities and the logistics for distribution and vaccination need to be readily available.
Sufficient funding is crucial not only before, but also early on during a pandemic to guarantee that sufficient amounts of life-saving products are available for all populations.
Regulatory responses allowing rapid evaluation of new vaccines without compromising product safety form another cornerstone for successfully fighting pandemics.
Pre-pandemic preparedness efforts must be sustained, even if other urgent public health matters need to be addressed today.
Atuação do enfermeiro no cuidado a paciente com câncer de mama mastectomizada
Authors: Nascimento Marcia do Socorro Manfredo do , Carvalho Thiago dos Santos
Published: June 2023

Objetivo: levantar as evidências científicas acerca da atuação do enfermeiro em frente a paciente acometida pelo câncer de mama mastectomizada. Metodologia: a pesquisa trata-se de uma revisão integrativa de literatura. As bases de dados utilizadas foram o Google Acadêmico, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Biblioteca Virtual em Saúde (BVS) e Scientific Electronic Library Online (SCIELO). A busca da produção envolveu os últimos quinze anos tendo em vista englobar o maior número de estudos. Sendo assim, foi realizada desde o ano de 2008 até 2022. Resultados: a amostra final foi composta por sete artigos, e a maioria possuiu estudos exploratórios ou descritivos como opção de delineamento. A revisão relatou a importância do enfermeiro no auxílio psicossocial e uso de técnicas alternativas no tratamento à pacientes que foram submetidas a cirurgia de mastectomia, bem como também ressalta o misto de emoções que as mulheres sentem antes, durante e após a mastectomia e como o enfermeiro pode auxilia-las nesse período. Conclusão: a mastectomia provoca reações de incertezas, gerando angústia frente ao desconhecido, medo e alteração da autoimagem, assim como mergulha as mulheres em um turbilhão de sentimentos e dúvidas. Portanto, o enfermeiro deve ajudar a superar tais sensações, atentando para a linguagem verbal e não verbal da mulher, orientando-a sobre seus anseios e preocupando-se com a melhoria da qualidade de vida.
Desafios e estratégias na captação de doadores voluntários de sangue no Sul do Tocantins
Authors: Gomes Grazielle Camargo Matias , Silva Raynara Batista da , Alcântara Denise Soares de , Sousa Amanda Pinheiro de , Morais Hellen Cássia de , Silva Eduardo Henrique Alcântara da , Buges Naiana Mota
Published: June 2023

Introdução: A aquisição do sangue é um desafio que se inicia na captação de doadores, a qual requer meios de buscas e estratégias para a fidelização e aquisição de doadores voluntários nos bancos de sangue. Objetivo: Identificar as estratégias e desafios para captação de doadores voluntários de sangue ao Sul do Tocantins. Método: Pesquisa descritiva, de natureza qualitativa. Realizada com 13 servidores de um serviço de hemoterapia do Sul do Tocantins As entrevistas foram gravadas, transcritas e submetidas a análise de conteúdo. Resultados: Da análise de conteúdo emergiram as categorias: estratégias para captação e fidelização de doadores, desafios e dificuldades para captação de doadores, melhorias para captação, dificuldades e estratégias desenvolvidas na captação de doador e opinião sobre captação de doadores que foram apresentadas e discutidas de acordo com a literatura pertinente. Conclusão: A captação de doadores abarca ações externas junto à comunidade e internas com os próprios doadores. A maioria dos entrevistados reconhecem seu papel na captação e manutenção de doadores principalmente por meio do atendimento o qual deve ser acolhedor e esclarecedor de dúvidas.
O uso da toxina botulínica como coadjuvante no tratamento do bruxismo
Authors: Marques Thalita Macedo , Suguihara Roberto Teruo , Muknicka Daniella Pilon
Published: June 2023

O bruxismo é um distúrbio caracterizado pelo apertamento ou ranger dos dentes, que ocorre tanto durante o sono quanto em vigília. O estresse e fatores emocionais são considerados principais desencadeadores, juntamente com distúrbios do sono, uso de medicamentos e presença de dor. O diagnóstico do bruxismo envolve a anamnese e a análise clínica, como dor nos músculos mastigatórios e na articulação temporomandibular (ATM). Os principais sintomas relatados pelos pacientes são dor na ATM, dificuldade na mastigação e limitação na abertura da boca. O tratamento do bruxismo pode incluir o uso de placas miorrelaxantes, que ajudam a reduzir o apertamento e o ranger dos dentes, e a aplicação de toxina botulínica (TXB), que promove o relaxamento dos músculos. No entanto, é importante destacar que o bruxismo é um distúrbio multifatorial e a abordagem terapêutica deve considerar todos os aspectos envolvidos. Além disso, a eficácia e segurança do uso da TXB no tratamento do bruxismo ainda são temas de debate, e mais pesquisas são necessárias para embasar sua recomendação. É fundamental que os profissionais atuem de forma ética e responsável, levando em consideração os aspectos físicos, psicológicos e sociais do paciente, e oferecendo alternativas terapêuticas baseadas em evidências científicas robustas. A utilização da TXB como tratamento coadjuvante do bruxismo na harmonização orofacial (HOF) pode ser promissora, mas é necessário abordar as questões críticas mencionadas. Dessa forma, o objetivo desse artigo é realizar, através de uma revisão narrativa da literatura, a utilização coadjuvante da TXB tipo A para o controle do bruxismo.
Virtual reality for pain reduction during intravenous injection in pediatrics: a systematic review and meta-analysis of controlled clinical trials
Authors: Jenabi Ensiyeh , Bashirian Saeid , Salehi Amir Mohammad , Rafiee Masoud , Bashirian Mozhdeh
Published: June 2023

Background: Intravenous (IV) injections often cause pain, fear, and anxiety in pediatric patients. Virtual reality (VR) is a relatively new intervention that can be used to provide a distraction during or prepare patients for IV injections.Purpose: To date, no meta-analysis has examined the evidence regarding the effectiveness of VR at reducing pain in pediatric IV injections.Methods: The PubMed, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases were searched for articles published through August 7, 2022. The methodological quality of the studies was measured using the Delphi checklist. The chi-square test and the I2 statistic were used to assess heterogeneity across studies. A summary measure of the mean difference in pain scores between the VR and control groups was obtained using a random effects model. All statistical analyses were set at a significance level of 0.05 using Stata 14.Results: Nine studies were included in this meta-analysis of VR interventions used during IV injections in pediatric patients. The difference in mean pain score between the intervention and control groups showed significant reductions in the VR group (mean difference, 0.47; 95% confidence interval, 0.3–0.65; I2=9.1%). No interstudy heterogeneity was observed.Conclusion: Our results suggest that VR effectively reduces pain associated with IV injections in pediatric patients. No interstudy heterogeneity was noted among the analyzed studies. The Delphi checklist was used to assess methodological quality.
High-resolution anorectal manometry in children
Authors: Waikar Yogesh
Published: June 2023

Anorectal manometry is one of the motility tests in children performed by pediatric gastroenterologist. It evaluates the motility function of anorectal tract. It is helpful for diagnosing children with constipation, rectal hypersensitivity, fecal incontinence, Hirschsprung disease, anal achalasia, and anorectal malformations. The most common indication to perform anorectal manometry is to diagnose Hirschsprung disease. It is a safe procedure. This paper discusses recent advances and reviews on anorectal motility disorders in children.
Acetaminophen causes neurodevelopmental injury in susceptible babies and children: no valid rationale for controversy
Authors: Zhao Lisa , Jones John P. , Anderson Lauren G. , Konsoula Zacharoula , Nevison Cynthia D. , Reissner Kathryn J. , Parker William
Published: June 2023

Despite the worldwide acceptance of acetaminophen (APAP) as a necessary medicine in pediatrics, evidence that early exposure to APAP causes neurodevelopmental injury in susceptible babies and children has been mounting for over a decade. The evidence is diverse and includes extensive work with laboratory animals, otherwise unexplained associations, factors associated with APAP metabolism, and limited studies in humans. Although the evidence has reached an overwhelming level and was recently reviewed in detail, controversy persists. This narrative review evaluates some of that controversy. Evidence from the pre- and postpartum periods was considered to avoid controversy raised by consideration of only limited evidence of risks during the prepartum period. Among other issues, the association between APAP use and the prevalence of neurodevelopmental disorders was considered. A systematic review revealed that the use of APAP in the pediatric population was never tracked carefully; however, historical events that affected its use were documented and are sufficient to establish apparent correlations with changes in the prevalence of neurodevelopmental disorders. Moreover, problems with the exclusive reliance on results of meta-analyses of large datasets with limited time frames of drug exposure were reviewed. Furthermore, the evidence of why some children are susceptible to APAPinduced neurodevelopmental injuries was examined. We concluded that available evidence demonstrates that early exposure to APAP causes neurodevelopmental injury in susceptible babies and small children.
Skin and oral intervention for food allergy prevention based on dual allergen exposure hypothesis
Authors: Yamamoto-Hanada Kiwako , Ohya Yukihiro
Published: June 2023

Early-onset atopic dermatitis increases an individual’s risk of food allergies, suggesting that transcutaneous sensitization may occur through inflamed skin. Regarding food allergy causation, the dual allergen exposure hypothesis proposes that oral allergen exposure leads to immune tolerance, whereas allergen exposure via inflamed skin causes food allergies. This hypothesis suggests that it is important to induce oral immune tolerance and prevent allergic food sensitization through the skin. This review focuses on the breakthrough evidence based on the dual allergen exposure hypothesis that involves both skin and oral interventions for food allergy prevention.
Need for palliative care from birth to infancy in pediatric patients with neurological diseases
Authors: Falsaperla Raffaele , Marino Silvia , Moscheo Carla , Tardino Lucia Giovanna , Marino Simona Domenica , Sciuto Concetta , Pavone Piero , Vitaliti Giovanna , Sullo Federica , Ruggieri Martino
Published: June 2023

Background: Palliative care is a comprehensive treatment approach that guarantees comfort for pediatric patients and their families from diagnosis to death. The techniques used for neurological patients in the field of palliative care can enhance the quality of care provided to patients with neurological disorders and support their families.Purpose: This study aimed to analyze the palliative care protocols in use in our department, describe the palliative course in the clinical setting, and propose the implementation of hospital palliative care for long-term prognosis of patients with neurological diseases.Methods: This retrospective observational study examined the application of palliative care from birth to early infancy in neurological patients. We studied 34 newborns with diseases affecting the nervous system impairing prognosis. The study was conducted from 2016 to 2020 at the Neonatology Intensive Care Unit and the Pediatric Unit of the San Marco University Hospital in Catania, Sicily, Italy.Results: Despite current legislation in Italy, no palliative care network has been activated to meet the needs of the population. In our center, given the vast number of patients with neurological conditions requiring palliative care, we should activate a straightforward departmental unit for neurologic pediatric palliative care.Conclusion: The establishment of specialized reference centers that manage significant neurological illnesses is due to neuroscience research progress in recent decades. Integration with specialized palliative care is sparse but now seems essential.
Relationship between nonalcoholic fatty liver disease and hyperandrogenemia in adolescents with polycystic ovary syndrome
Authors: Kara Ozlem , Arsoy Hanife Aysegul , Keskin Murat
Published: June 2023

Background: Nonalcoholic fatty liver disease (NAFLD) is common in adults with polycystic ovary syndrome (PCOS), and several studies on adults have investigated its influencing factors. However, factors associated with NAFLD in adolescents with PCOS remain unknown.Purpose: This study aimed to investigate the presence of NAFLD in adolescents with PCOS using the noninvasive methods of vibration-controlled transient elastography (VCTE) and ultrasonography (USG), along with assessing NAFLD-related metabolic and hormonal risk factors.Methods: This study included patients aged 12–18 years who were diagnosed with PCOS according to the Rotterdam criteria. The control group included young women with similar age and body mass index (BMI) z scores, who had menstruated regularly for more than 2 years. Patients with PCOS were divided into hyperandrogenemia and nonhyperandrogenemia groups based on serum androgen level. USG was performed on all patients to evaluate the presence of hepatic steatosis. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed using VCTE (Fibroscan). Clinical, laboratory, and radiological data were compared between groups.Results: This study included 124 adolescent girls aged 12–18 years (61 with PCOS, 63 controls). BMI z scores were similar between groups. Waist circumference and total cholesterol, triglyceride, and alanine aminotransferase levels were higher in the PCOS versus the control group. The presence of hepatic steatosis on USG was similar between groups. However, the rate of hepatic steatosis on USG was higher in patients with hyperandrogenic PCOS (P=0.01). LSM and CAP measurements were similar between groups.Conclusion: No increase in prevalence of NAFLD was observed among adolescents with PCOS. However, hyperandrogenemia is a risk factor for NAFLD. Therefore, adolescents with PCOS and elevated androgen level should be screened for NAFLD.
Stages of development of the school of ultrasound diagnosis in the Russian Far East
Authors:   Postgraduate Institute for Public Health Workers under Health Ministry of Khabarovsk Krai, Glazun L.G.
Published: June 2023

The article is focused on the history of the development of the school of ultrasound diagnostics in the Russian Far East and specifically in the medical organizations of the Khabarovsk Krai. The period covered is from 1980 to the present. The author notes the specialists who were at the origins of the new specialty, the organization of the educational process and scientific work on the basis of the Postgraduate Insitute of Public Health Workers in Khabarovsk, the promotion of the ultrasound diagnostic method to other regions of the Russian Far East. In the last part of the article, the author notes the number of trained specialists for 2002–2022, as well as the geography of students
Change in mean and extreme precipitation in eastern China since 1901
Authors: Zhan YJ , Ren GY
Published: June 2023

Extreme precipitation in the monsoon region of China can cause a variety of weather and climate disasters, and its long-term change has a significant impact on human life and social production. However, due to the lack of high-resolution precipitation data for the early 20th century, the variation characteristics and causes or mechanisms of extreme precipitation change in eastern China in the last 100 yr or more are still unclear. Based on the ‘daily precipitation dataset of 60 city stations in mainland China from 1901 to 2020’ developed by the National Meteorological Information Center, China Meteorological Administration, the main characteristics of extreme precipitation changes at 38 stations in eastern China during a recent 120 yr period (1901-2020) are analyzed in this paper. The results show that: (1) From 1901 to 2020, there was no significant trend in precipitation amount and precipitation days in the region, but a quasi-period of about 15 to 20 yr or longer existed during the period. (2) The average daily precipitation intensity and most of the extreme precipitation indices first decreased and then increased over the whole time period. In the period 1901-1950, which has rarely been studied in the past, most of the extreme precipitation indices, including intense rainfall, rainstorms, and the maximum precipitation within 1 day, 3 consecutive days, and 5 consecutive days, showed a significant decreasing trend. Since 1951, however, various indices have tended to increase. (3) From 1901 to 2020, the precipitation and extreme precipitation indices to the north of 35° N generally decreased, while they consistently increased in the south. The spatial pattern of extreme precipitation changes for the first half of 20th century was also quite different from that of the last 70 yr. Overall, the mean and extreme precipitation change trends in eastern China were not consistent in different sub-periods during the past century.
The diversity of demersal assemblages of the western English Channel and the Celtic Sea
Authors: Fincham JI , Ellis JR , Veneziano A , Barry J
Published: June 2023

Adapting the current management of marine resources to align with an ecosystem-based approach is becoming increasingly common. Understanding the communities within an area—their species and distribution—is crucial to managing marine activities whilst maintaining ecological function. We performed a broad-scale community analysis of the demersal assemblages of the western English Channel and Celtic Sea. The diversity of the study area was investigated through K-means cluster analysis, indicator species analysis, diversity indices and discussion in relation to relevant environmental variables. The demersal species studied formed 7 distinct demersal assemblages, broadly aligned with environmental variables such as natural disturbance and substrate. Several assemblages were defined by notable characterising species, including Norway lobster Nephrops norvegicus in the Celtic Sea, queen scallop Aequipecten opercularis in the central western English Channel and boarfish Capros aper off the coast of the Cornish peninsula and the Isles of Scilly. The area of the central English Channel dominated by queen scallop had lower diversity relative to neighbouring demersal assemblages. This study provides the most spatially comprehensive delineation of demersal assemblage structure for this region, and is an example of the spatial analyses needed to inform future biodiversity monitoring and marine spatial planning, which are both key aspects of an ecosystem-based approach for the management of human activities in marine waters.
Pengaruh Terapi Pijat terhadap Kenaikan Berat Badan Balita di PMB Bidan Lena Rangkapan Jaya Kota Depok Tahun 2023
Authors: Faizah Nur , Arlym Lisa Trina , Rukmaini Rukmaini
Published: June 2023

The 1000 HPK period is important in the process of growth and development of children in obtaining optimal nutritional intake. One of the non-pharmacological ways that is done is by giving massage therapy. The research objective was to determine the effect of massage therapy on toddlers' weight gain and the differences in weight gain between the intervention and control groups. This research is a quasi-experimental design, a pretest-posttest control group design and a combination intervention of healthy massage therapy and the elderly. Therapy was given 6x/week consecutively for 1 month, weighing was carried out on the 7th, 14th, 21st and 28th days. The purposive sampling sample consisted of 30 toddlers. Data analysis paired t-test and independent t-test. Results of data analysis paired t-test p-value 0.000<0.05. The mean difference in the intervention group on day 7: 160 grams, 14th: 353.333 grams, 21st: 626.667 grams, 28th: 986.667 grams. The mean difference in the control group on day 7:86.667 grams, 14th: 193.333 grams, 21st: 300 grams, 28th: 440 grams. Independent t-test results with a p-value of 0.034<0.05 on the 21st day and a p-value of 0.011<0.05 on the 28th day. There is an effect of massage therapy on toddlers' weight gain. There are differences in toddlers' weight gain between the intervention group and the control group. It is hoped that all health workers and families can apply it to toddlers to prevent malnutrition.
Technical upgrade of an open-source liquid handler to support bacterial colony screening
Authors: del Olmo Lianes Irene , Yubero Pablo , Gómez-Luengo Álvaro , Nogales Juan , Espeso David R.
Published: June 2023

The optimization of genetically engineered biological constructs is a key step to deliver high-impact biotechnological applications. The use of high-throughput DNA assembly methods allows the construction of enough genotypic variants to successfully cover the target design space. This, however, entails extra workload for researchers during the screening stage of candidate variants. Despite the existence of commercial colony pickers, their high price excludes small research laboratories and budget-adjusted institutions from accessing such extensive screening capability. In this work we present COPICK, a technical solution to automatize colony picking in an open-source liquid handler Opentrons OT-2. COPICK relies on a mounted camera to capture images of regular Petri dishes and detect microbial colonies for automated screening. COPICK’s software can then automatically select the best colonies according to different criteria (size, color and fluorescence) and execute a protocol to pick them for further analysis. Benchmark tests performed for E. coli and P. putida colonies delivers a raw picking performance over pickable colonies of 82% with an accuracy of 73.4% at an estimated rate of 240 colonies/h. These results validate the utility of COPICK, and highlight the importance of ongoing technical improvements in open-source laboratory equipment to support smaller research teams.
Dissociative electron attachment to gold(I)-based compounds: 4,5-dichloro-1,3-diethyl-imidazolylidene trifluoromethyl gold(I)
Authors: Pintea Maria , Mason Nigel , Peiró-Franch Anna , Clark Ewan , Samanta Kushal , Glessi Cristiano , Schmidtke Inga Lena , Luxford Thomas
Published: June 2023

With the use of proton-NMR and powder XRD (XRPD) studies, the suitability of specific Au-focused electron beam induced deposition (FEBID) precursors has been investigated with low electron energy, structure, excited states and resonances, structural crystal modifications, flexibility, and vaporization level. 4,5-Dichloro-1,3-diethyl-imidazolylidene trifluoromethyl gold(I) is a compound that is a uniquely designed precursor to meet the needs of focused electron beam-induced deposition at the nanostructure level, which proves its capability in creating high purity structures, and its growing importance in other AuImx and AuClnB (where x and n are the number of radicals, B = CH, CH3, or Br) compounds in the radiation cancer therapy increases the efforts to design more suitable bonds in processes of SEM (scanning electron microscopy) deposition and in gas-phase studies. The investigation performed of its powder shape using the XRPD XPERT3 panalytical diffractometer based on CoKα lines shows changes to its structure with change in temperature, level of vacuum, and light; the sensitivity of this compound makes it highly interesting in particular to the radiation research. Used in FEBID, though its smaller number of C, H, and O atoms has lower levels of C contamination in the structures and on the surface, it replaces these bonds with C–Cl and C–N bonds that have lower bond-breaking energy. However, it still needs an extra purification step in the deposition process, either H2O, O2, or H jets.
A novel Gardnerella, Prevotella, and Lactobacillus standard that improves accuracy in quantifying bacterial burden in vaginal microbial communities
Authors: Elnaggar Jacob H. , Ardizzone Caleb M. , Cerca Nuno , Toh Evelyn , Łaniewski Paweł , Lillis Rebecca A. , Herbst-Kralovetz Melissa M. , Quayle Alison J. , Muzny Christina A. , Taylor Christopher M.
Published: June 2023

Bacterial vaginosis (BV) is the most common vaginal dysbiosis. In this condition, a polymicrobial biofilm develops on vaginal epithelial cells. Accurately quantifying the bacterial burden of the BV biofilm is necessary to further our understanding of BV pathogenesis. Historically, the standard for calculating total bacterial burden of the BV biofilm has been based on quantifying Escherichia coli 16S rRNA gene copy number. However, E. coli is improper for measuring the bacterial burden of this unique micro-environment. Here, we propose a novel qPCR standard to quantify bacterial burden in vaginal microbial communities, from an optimal state to a mature BV biofilm. These standards consist of different combinations of vaginal bacteria including three common BV-associated bacteria (BVAB) Gardnerella spp. (G), Prevotella spp. (P), and Fannyhessea spp. (F) and commensal Lactobacillus spp. (L) using the 16S rRNA gene (G:P:F:L, G:P:F, G:P:L and 1G:9L). We compared these standards to the traditional E. coli (E) reference standard using known quantities of mock vaginal communities and 16 vaginal samples from women. The E standard significantly underestimated the copy numbers of the mock communities, and this underestimation was significantly greater at lower copy numbers of these communities. The G:P:L standard was the most accurate across all mock communities and when compared to other mixed vaginal standards. Mixed vaginal standards were further validated with vaginal samples. This new G:P:L standard can be used in BV pathogenesis research to enhance reproducibility and reliability in quantitative measurements of BVAB, spanning from the optimal to non-optimal (including BV) vaginal microbiota.
Case report: Complex arterial findings in vascular ehlers-danlos syndrome with a novel COL3A1 variant and death at young age
Authors: Taurino Jacopo , Micaglio Emanuele , Russo Raucci Annalisa , Zanussi Monica , Chessa Massimo , Udugampolage Nathasha Samali , Carrera Paola , Pappone Carlo , Pini Alessandro
Published: June 2023

Vascular Ehlers-Danlos syndrome (vEDS) is a genetic disease caused by a pathogenic mutation in the COL3A1 gene. Despite its severe course, the rarity and extreme clinical variability of the disease can pose significant obstacles to a timely diagnosis. Early and accurate diagnosis may lead to improved patient outcomes by providing access to targeted pharmacological treatments like celiprolol and enhancing the management of vEDS-related complications. Herein, we report a patient harboring a novel de novo COL3A1 missense variant, in which the diagnosis was only possible belatedly due to delayed referral for genetic evaluation. The patient developed pulmonary complications, aneurysms, and vascular malformations, and died at the age of 26 years due to massive pulmonary bleeding.
The pivotal role of ECG in cardiomyopathies
Authors: Silvetti Elisa , Lanza Oreste , Romeo Fabiana , Martino Annamaria , Fedele Elisa , Lanzillo Chiara , Crescenzi Cinzia , Fanisio Francesca , Calò Leonardo
Published: June 2023

Cardiomyopathies are a heterogeneous group of pathologies characterized by structural and functional alterations of the heart. Recent technological advances in cardiovascular imaging offer an opportunity for deep phenotypic and etiological definition. Electrocardiogram (ECG) is the first-line diagnostic tool in the evaluation of both asymptomatic and symptomatic individuals. Some electrocardiographic signs are pathognomonic or fall within validated diagnostic criteria of individual cardiomyopathy such as the inverted T waves in right precordial leads (V1–V3) or beyond in individuals with complete pubertal development in the absence of complete right bundle branch block for the diagnosis of arrhythmogenic cardiomyopathy of the right ventricle (ARVC) or the presence of low voltages typically seen in more than 60% of patients with amyloidosis. Most other electrocardiographic findings such as the presence of depolarization changes including QRS fragmentation, the presence of epsilon wave, the presence of reduced or increased voltages as well as alterations in the repolarization phase including the negative T waves in the lateral leads, or the profound inversion of the T waves or downsloping of the ST tract are more non-specific signs which can however raise the clinical suspicion of cardiomyopathy in order to initiate a diagnostic procedure especially using imaging techniques for diagnostic confirmation. Such electrocardiographic alterations not only have a counterpart in imaging investigations such as evidence of late gadolinium enhancement on magnetic resonance imaging, but may also have an important prognostic value once a definite diagnosis has been made. In addition, the presence of electrical stimulus conduction disturbances or advanced atrioventricular blocks that can be seen especially in conditions such as cardiac amyloidosis or sarcoidosis, or the presence of left bundle branch block or posterior fascicular block in dilated or arrhythmogenic left ventricular cardiomyopathies are recognized as a possible expression of advanced pathology. Similarly, the presence of ventricular arrhythmias with typical patterns such as non-sustained or sustained ventricular tachycardia of LBBB morphology in ARVC or non-sustained or sustained ventricular tachycardia with an RBBB morphology (excluding the “fascicular pattern”) in arrhythmogenic left ventricle cardiomyopathy could have a significant impact on the course of each disease. It is therefore clear that a learned and careful interpretation of ECG features can raise suspicion of the presence of a cardiomyopathy, identify diagnostic “red flags” useful for orienting the diagnosis toward specific forms, and provide useful tools for risk stratification. The purpose of this review is to emphasize the important role of the ECG in the diagnostic workup, describing the main ECG findings of different cardiomyopathies.
Safety and efficacy of renal sympathetic denervation: a 9-year long-term follow-up of 24-hour ambulatory blood pressure measurements
Authors: Vogt Alexander , Dutzmann Jochen , Nußbaum Michael , Hoyer Daniel , Tongers Jörn , Schlitt Axel , Sedding Daniel , Plehn Alexander
Published: June 2023

Background

Renal sympathetic denervation (RDN) has been shown to lower arterial blood pressure both in the presence and in the absence of antihypertensive medication in an observation period of up to 3 years. However, long-term results beyond 3 years are scarcely reported.

Methods

We performed a long-term follow-up on patients who were previously enrolled in a local renal denervation registry and who underwent radiofrequency RDN with the Symplicity Flex® renal denervation system between 2011 and 2014. The patients were assessed to evaluate their renal function by performing 24-hour ambulatory blood pressure measurement (ABPM), recording their medical history, and conducting laboratory tests.

Results

Ambulatory blood pressure readings for 24 h were available for 72 patients at long-term follow-up (FU) [9.3 years (IQR: 8.5–10.1)]. We found a significant reduction of ABP from 150.1/86.1 ± 16.9/12.0 mmHg at baseline to 138.3/77.1 ± 16.5/11.1 mmHg at long-term FU (P < 0.001 for both systolic and diastolic ABP). The number of antihypertensive medications used by the patients significantly decreased from 5.4 ± 1.5 at baseline to 4.8 ± 1.6 at long-term FU (P < 0.01). Renal function showed a significant but expected age-associated decrease in the eGFR from 87.8 (IQR: 81.0–100.0) to 72.5 (IQR: 55.8–86.8) ml/min/1.73 m2 (P < 0.01) in patients with an initial eGFR > 60 ml/min/1.73 m2, while a non-significant decrease was observed in patients with an initial eGFR < 60 ml/min/1.73 m2 at long-term FU [56.0 (IQR: 40.9–58.4) vs. 39.0 (IQR: 13.5–56.3) ml/min/1.73 m2].

Conclusions

RDN was accompanied by a long-lasting reduction in blood pressure with a concomitant reduction in antihypertensive medication. No negative effects could be detected, especially with regard to renal function.
A study of cloud microphysical processes and a mesoscale environment in a heavy rainfall case over Yan’an
Authors: Xu Jin , Ping Fan , Li Jian Yang , Du Han
Published: June 2023

A cloud-resolved numerical simulation was carried out for an extreme rainfall case in Yan’an, a city in arid and semi-arid regions in northwest China, on 3–4 September 2021, by using Mesoscale Weather Research and Forecasting Model. The Auto Weather Station and Doppler radar were applied to verify simulated results. The characteristics of mesoscale cloud environment and cloud microphysical processes were analyzed. Then, the quantitative rainwater mass budget and latent heat budget of microphysical conversions about water condensates calculated in Yan’an. The possible mechanism by which cloud microphysics affected the rainstorm was investigated and discussed. It was found that: (1) There was positive feedback between mesoscale cloud environment and cloud microphysical processes, especially diabatic heating processes due to ice phase particles conversions. (2) The process of snow conversions processes was the most important process of this heavy rainfall in Yan’an. It not only promoted the production of rain, but also contributed to the enhancement of updraft through latent heat release and produced positive feedback to other microphysical processes in cloud. (3) Heavy rainfall in arid regions of China is mostly cold-type precipitation, mainly manifested by snow-dominated cloud microphysical processes producing deep convection.
Influence of stone content on face stability for tunnels in sandy cobble strata
Authors: Xue Haifang , Wang Haoteng , Li Lingyun , Gong Xiaoqin , Zhao Ying , Zhao Jianbin , Zhang Yonghao
Published: June 2023

As a result of the complex geological conditions of sand-cobble stratum, various types of problems may arise during construction of tunnels crossing sand-cobble stratum, the most prominent of which is the stability problem of the face. In order to study the stability of the tunnel face in sand-cobble stratum, first, a continuous medium model of sandstone soil is established, and numerical simulation is carried out on the three-axis compression test of sandstone soil to analyze its micro-mechanical characteristics. Second, a calculation model of simulated sandstone strata excavation is established by FLAC3D finite difference software. Then, the safety factor K calculated by the strength reduction method is introduced as the evaluation index of the face stability, and the face stability of sand-cobble tunnels with a series of stone content, tunnel burial depth and tunnel diameter are analyzed. The results show that the macro stress-strain curve of sand-cobble soil in the three-axis compression test can be divided into linear stage, elastic-plastic stage and ideal plastic stage, and the shear strength of sand-cobble soil increases with the increase of stone content. In the process of tunnel excavation, the stability of tunnel face increases with the increase of stone content in the stratum; while the tunnel buried depth and diameter increase, the stability of tunnel face decreases. These results provide a reference for predicting the instability and failure of sand-cobble tunnels, which is critical for the construction and safety of tunnels in sand-cobble stratum.
Teaching efficacy of undergraduate PE students; what are the key predictors and what can PE educators learn from this?
Authors: Magill Ceriann , Cronin Colum , Walsh Barbara , Polman Remco , Rudd James
Published: June 2023

Introduction

Teaching efficacy describes the belief in a teacher's ability to promote learning and this belief is an invaluable asset for all teachers. This study examined the contextual influences that predict the teaching efficacy of first-year undergraduate PE students wishing to enter teacher training programs.

Method

Using a mixed methods study design, 168 PE students completed an online questionnaire and 16 of these participants took part in semi-structured focus groups. The data collection procedures investigated students' perceptions of PE teaching efficacy and examined students' awareness of how their involvement in PE or sports influenced their decision to study PE.

Results

Teaching experiences and role model influences were the key predictors of students' perceived PE teaching efficacy.

Discussions

We recommend that higher education PE programs should facilitate theoretically informed reflective learning opportunities to enable students to understand and make sense of the impact of these key predictors. These opportunities will enable students to understand their starting point in PE teaching efficacy and identify the requirements to develop it. The study extends the existing literature by identifying the key predictors of PE teaching efficacy derived from the acculturation experiences of undergraduate PE students.
Bidirectional associations between adiposity and physical activity: a longitudinal study from pre-puberty to early adulthood
Authors: Le Shenglong , Törmäkangas Timo , Wang Xiuqiang , Lei Si Man , Møller Niels Christian , Brønd Jan Christian , Wedderkopp Niels , Wiklund Petri , Cheng Sulin
Published: June 2023

Objective

This study aimed to investigate directional influences in the association between adiposity and physical activity (PA) from pre-puberty to early adulthood.

Methods

In the Calex-study, height, weight, body fat and leisure-time physical activity (LTPA) were measured at age11.2-years, 13.2-years and 18.3-years in 396 Finnish girls. Body fat was measured by dual-energy X-ray absorptiometry, calculating fat mass index (FMI) as total fat mass in kilograms divided by height in meters squared. LTPA level was evaluated using a physical activity questionnaire. In the European Youth Heart Study (EYHS), height, weight and habitual PA were measured at age 9.6-years, 15.7-years and 21.8-years in 399 Danish boys and girls. Habitual PA and sedentary behaviour were assessed with an accelerometer. Directional influences of adiposity and PA were examined using a bivariate cross-lagged path panel model.

Results

The temporal stability of BMI from pre-puberty to early adulthood was higher than the temporal stability of PA or physical inactivity over the same time period both in girls and boys. In the Calex-study, BMI and FMI at age 11.2-years were both directly associated with LTPA at age 13.2-years (β = 0.167, p = 0.005 and β = 0.167, p = 0.005, respectively), whereas FMI at age 13.2-years showed an inverse association with LTPA at age 18.3-years (β = - 0.187, p = 0.048). However, earlier LTPA level was not associated with subsequent BMI or FMI. In the EYHS, no directional association was found for physical inactivity, light-, moderate-, and vigorous-PA with BMI during the follow-up in girls. In boys, BMI at age 15.7-years was directly associated with moderate PA (β = 0.301, p = 0.017) at age 21.8-years, while vigorous PA at age 15.7-years showed inverse associations with BMI at age 21.8-years (β = - 0.185, p = 0.023).

Conclusion

Our study indicates that previous fatness level is a much stronger predictor of future fatness than level of leisure-time or habitual physical activity during adolescence. The directional associations between adiposity and physical activity are not clear during adolescence, and may differ between boys and girls depending on pubertal status.
Huobahuagen tablet improves renal function in diabetic kidney disease: a real-world retrospective cohort study
Authors: Tan Ying , Li Ruihan , Zhou Peipei , Li Nan , Xu Weilong , Zhou Xiqiao , Yan Qianhua , Yu Jiangyi
Published: June 2023

Objective

We aimed to explore the value of Huobahuagen tablet (HBT) in improving decreased renal function for patients with diabetic kidney disease (DKD) over time.

Methods

This was a single-center, retrospective, real-world study on eligible 122 DKD patients who continued to use HBT + Huangkui capsule (HKC) therapy or HKC therapy without interruption or alteration in Jiangsu Province Hospital of Chinese Medicine from July 2016 to March 2022. The primary observation outcomes included estimated glomerular filtration rate (eGFR) at baseline and 1-, 3-, 6-, 9-, and 12-month follow-up visits and changes in eGFR from baseline (ΔeGFR). Propensity score (PS) and inverse probability treatment weighting (IPTW) were used to control for confounders.

Results

eGFR was significantly higher in the HBT + HKC group than in the HKC alone group at the 6-, 9-, and 12-month follow-up visits (p = 0.0448, 0.0002, and 0.0037, respectively), indicating the superiority of HBT + HKC over HBT alone. Furthermore, the ΔeGFR of the HBT + HKC group was significantly higher than that of the HKC alone group at the 6- and 12-month follow-up visits (p = 0.0369 and 0.0267, respectively). In the DKD G4 patients, eGFR was higher in the HBT + HKC group at the 1-, 3-, 6-, 9-, and 12-month follow-up visits compared with baseline, with statistically significant differences at the 1-, 3-, and 6- month follow-up visits (p = 0.0256, 0.0069, and 0.0252, respectively). The fluctuations in ΔeGFR ranged from 2.54 ± 4.34 to 5.01 ± 5.55 ml/min/1.73 m2. Change in the urinary albumin/creatinine ratio from baseline did not exhibit a significant difference between the two groups at any of the follow-up visits (p > 0.05 for all). Adverse event incidence was low in both groups.

Conclusion

The findings of this study based on real-world clinical practice indicate that HBT + HKC therapy exhibited better efficacy in improving and protecting renal function with a favorable safety profile than HKC therapy alone. However, further large-scale prospective randomized controlled trials are warranted to confirm these results.
Duration of late-follicular elevated progesterone and in vitro fertilization outcomes in pituitary down-regulation treatment cycles
Authors: Zhang Jiaxin , Ge Xiaofei , Bu Zhiqin
Published: June 2023

Background

The objective of this study was to explore whether the duration of LFEP (late-follicular elevated progesterone) affected pregnancy outcomes in IVF (in vitro fertilization) patients treated with pituitary downregulation protocols.

Method

Patients with their first IVF/ICSI cycles between January 2016 and December 2016 were included. LFEP was set either at P > 1.0ng/ml or P > 1.5ng/ml. Clinical pregnancy rate was compared among three different groups (no LFEP; LFEP for 1 day; LFEP for ≥ 2 days). Then multivariate logistic regression analysis was performed to explore the influencing factors of clinical pregnancy rate.

Results

This retrospective analysis involved 3,521 first IVF/ICSI cycles with fresh embryo transfers. Clinical pregnancy rate was the lowest in patients with a LFEP duration of ≥ 2 days, irrespective of whether LFEP was defined as P > 1.0 ng/ml (68.79% vs. 63.02% vs. 56.20%; P = 0.000) or as P > 1.5 ng/ml (67.24% vs. 55.95% vs. 45.51%; P = 0.000). In addition, LFEP duration was significantly associated with clinical pregnancy outcomes in unadjusted logistic regression analysis. However, in multivariate regression models after adjusting confounders, adjusted OR for LFEP duration (≥ 2 days) in the two models was 0.808 (P = 0.064; LFEP as P > 1.0 ng/ml) and 0.720 (P = 0.098; LFEP as P > 1.5 ng/ml), respectively.

Conclusion

LFEP adversely affects clinical pregnancy outcomes. However, the duration of LFEP seems to have no influence on the clinical pregnancy rate in pituitary downregulation treatment cycles.
Association between Helicobacter pylori infection and metabolic syndrome and its components
Authors: Liu Ying , Shuai Ping , Chen Wanjing , Liu Yuping , Li Dongyu
Published: June 2023

Background and aim

The association between Helicobacter pylori (H. pylori) infection and metabolic syndrome (MetS) has been studied previously; however, the results remain controversial, which could be partly due to the different criteria used for defining MetS. We adopted five MetS criteria to provide better understanding of the association between H. pylori infection and MetS.

Methods

Physical examination data of 100,708 subjects were obtained from January 2014 to December 2018. MetS was defined based on five criteria including: International Diabetes Federation (IDF), The Third Report of the National Cholesterol Education Program Expert Panel, Adult Treatment Panel III (ATP III), Joint Statement of International Multi-Societies (JIS), Chinese Diabetes Society (CDS), and the Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2017 edition)(CDS DM). Multivariate logistic regression analysis was performed to elucidate the association between H. pylori infection and MetS and its components.

Results

The prevalence of MetS defined assessed using IDF, ATP III, JIS, CDS and CDS DM criteria was 15.8%, 19.9%, 23.7%, 8.7% and 15.4%, respectively. In males, the prevalence of MetS assessed using the five criteria in H. pylori-positive group was higher than that in negative-group; however, in females, same results were obtained using the three international criteria. In males, the prevalence of all MetS components was found to be higher in the H. pylori-positive group than those in the negative group; however, in females, only the prevalence of dyslipidemia and waist circumferences exhibited significant differences. Multivariate logistic regression analysis revealed that H. pylori infection in males was positively correlated with MetS. Additionally, H. pylori infection was found to be positively correlated with the waist circumference in the general population, and with hypertension and hyperglycemia in males.

Conclusions

H. pylori infection was found to be positively associated with MetS in males in China.