bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethical, Legal, and Financial Considerations of Artificial Intelligence in Surgery
Authors: Morris Miranda X. , Song Ethan Y. , Rajesh Aashish , Asaad Malke , Phillips Brett T.
Published: August 2022

Machine learning systems have become integrated into some of the most vital decision-making aspects of humanity, including hiring decisions, loan applications, and automobile safety, to name just a few. As applications increase in both gravity and complexity, the data quality and algorithmic interpretability of the systems must rise to meet those challenges. This is especially vital for navigating the nuances of health care, particularly among the high stakes of surgical operations. In addition to inherent ethical challenges of enabling a “black box” system to influence decision-making in patient care, the creation of biased datasets leads to biased algorithms with the power to perpetuate discrimination and reinforce disparities. Transparency and responsibility are paramount to the implementation of artificial intelligence in surgical decision-making and autonomous robotic surgery. Machine learning has been permeating health care across diverse clinical and surgical contexts but continues to face sizable obstacles, including apprehension from patients and providers alike. To integrate the technology fully while upholding standard of care and patient-provider trust, one must acknowledge and address the ethical, financial, and legal implications of using artificial intelligence for patient care.
The Use of Acyclovir in Suspected Encephalitis
Authors: Gleadle Jonathan , Dixon Christine , Brown Martin M , Schon Frederick
Published: August 2022

The early use of intravenous acyclovir in herpes simplex encephalitis (HSE) is essential. However, rapid diagnostic tests are not freely available. Hence, all patients with suspected encephalitis may need to be commenced on acyclovir. In our study, of 34 patients with suspected encephalitis, only two eventually had HSE confirmed, 19 had encephalitis not due to herpes simplex and in 13 a non-encephalitic illness was finally diagnosed. Guidelines for the use of acyclovir in suspected encephalitis are given aimed at minimizing the drug cost whilst still protecting all cases of presumed HSE.
Hyperventilation in Patients Who Have Sustained Myocardial Infarction after a Work Injury
Authors: Rosen Stuart D , King Jenny C , Nixon Peter G F
Published: August 2022

Patients who present with acute myocardial infarction after a work injury (AMI-WI) often report symptoms consistent with chronic hyperventilation which date back as far as the work injury itself, rather than to the AMI. The aim of the study was to test the hypothesis that hyperventilation significantly contributes to the symptoms of AMI-WI patients.

The prevalence of hyperventilation was assessed by clinical capnography in 12 AMI-WI patients, 20 normal controls, 15 AMI patients whose AMI was conventional and not subsequent to a work injury (AMI-C) and 14 patients with post-traumatic stress disorder (PTSD). End-tidal carbon dioxide partial pressure (PetCO2) was measured at rest, after 1 min hyperventilation (FHPT), after recall of the relevant stressor (Think) and when the breathing was felt to be normal (MBIN).

PetCO2 levels after FHPT were: 29.0±1.5 (mean±SD) mmHg for AMI-WI; 26.7±1.9 mmHg for PTSD; 32.1± 4.1mmHg for AMI-C and 33.7±1.4 mmHg for the controls ( P< 0.05 and P< 0.01 for AMI-WI and PTSD, respectively, versus controls). After Think, the levels were 25.8±1.6 mmHg for AMI-WI, 24.6±1.4 mmHg for PTSD, 31.2±4.1mmHg for AMI-C and 31.2± 1.5 mmHg for normals ( P<0.05 and P<0.01 for AMI-WI and PTSD, respectively, versus controls). For MBIN, values of PetCO2 were 26.8±1.7 mmHg and 26.7±1.5mmHg for AMI-WI and PTSD versus 33.8±1.2 mmHg for normals, ( P< 0.01 for both versus controls). Ten AMI-WI and 12 PTSD were positive for hyperventilation versus four AMI-C patients and four controls ( P< 0.01). The implications for rehabilitation, compensation and pathophysiology of AMI-WI are discussed, both from a medical-scientific perspective and in terms of admissible legal evidence.
Robert Seymour Bridges OM: Poet, Physician and Philosopher
Authors: James Theodore
Published: August 2022

There has not been an English poet more interested in prosody nor physician more taken to medicine for its human contact, nor philosopher who lived closer to the tenets of his belief, than Robert Bridges (1844–1930).
Influence of morphology and architecture on properties and applications of MXene polymeric nanocomposites
Authors: Idumah CI
Published: August 2022

Morphological characterization of fabricated MXene (M-X) Polymeric nanocomposites (M-X@PNC) is critically imperative for in depth appraisal of surface-topographical and compositional evaluation of M-X@PNC. The garnered properties of M-X@PNC are function of the degree of nanoparticulate distribution and embedment within the polymeric matrices and their overall effectiveness at improving the nanocomposites properties, vis-a-viz mechanical, heat dissipation as well as heat deflection properties along with potential applications. Inherently interacting functional entities within M-X@PNC architecture are basis for garnered properties including flammability, chemical, thermal, electrical conductivity and so on, which directly affect potential applications. Thus, this paper elucidates the influence of morphology and architecture on M-X@polymeric nanoarchitectures properties and applications.
RBFNN and projection operator based robust adaptive control with input saturation of a quadrotor equipped with two manipulators constrained to a high voltage line
Authors: Dehghani Reza , Mohammadi Mohammad
Published: August 2022

The aim of this paper is to propose a robust adaptive control for a quadrotor equipped with two manipulators constrained along a high voltage line (HVL). Due to the urgent need of the HVL to inspect, the quadrotor compared to humans has many advantages such as cost and less time, higher accuracy, access to impassable points, and most importantly, reducing human victims. In this paper, two manipulators are used to hang the quadrotor from the HVL and move along it such that the quadrotor can perform monitoring operations more accurately. The motion equations are derived for the constrained quadrotor by the Lagrangian method. A control law is derived based on inverse dynamics of reduced-form equations. A robust adaptive controller is proposed for control of the constrained quadrotor in the presence of dynamic uncertainties and external disturbances. The nonlinear terms in the dynamic model are approximated by radial basis function neural network (RBFNN) and adaptive laws based on the projection operator. Moreover, saturation functions are considered for inputs in the controller by an auxiliary system. Stability analysis of the closed-loop system is performed by the Lyapunov theory. In order to confirm the effectiveness of the proposed method, some numerical simulations are carried out. The simulation results show the quadrotor can move along the HVL in the presence of the dynamic model uncertainties and the external disturbances and satisfy the considered constraints.
Tranexamic Acid Utilization in Foot and Ankle Surgery: A Meta-analysis
Authors: Salameh Motasem , Attia Ahmed Khalil , El Khatib Suhaib , Hantouly Ashraf , Hsu Raymond , Blankenhorn Brad
Published: August 2022

Background:

Tranexamic acid (TXA) has been widely used in various orthopaedic subspecialities to decrease blood loss, transfusions, and wound complications. However, the role of TXA in foot and ankle surgery is not clearly delineated. This meta-analysis aims to report the efficacy and safety of TXA in relation to foot and ankle surgical procedures.

Methods:

Database searches were conducted for eligible studies from data inception through January 2022. Clinical studies on the use of TXA in foot and ankle procedures reporting the desired outcomes were included. Outcomes were estimated blood loss, change in hemoglobin, and overall complications. Risk of bias was assessed using the Newcastle-Ottawa quality assessment scale and the Joanna Briggs Institute (JBI) critical appraisal tool.

Results:

Nine studies met the inclusion criteria. A total of 752 foot and ankle procedures were included, in which 511 (67.95%) procedures received TXA whereas 241 (32.05%) served as controls and did not receive TXA. The pooled data of change in hemoglobin and overall complications showed no difference between the TXA and control group. Estimated blood loss was significantly lower in the patients who received TXA.

Conclusion:

In conclusion, TXA use was associated with lower estimated blood loss in foot and ankle surgeries without increased risk of thromboembolic events, wound complications, or changes in hemoglobin.

Level of Evidence:

Level IV, meta-analysis.
Challenging the White = Neutral Framework in Psychology
Authors: Roberts Steven O. , Mortenson Elizabeth
Published: August 2022

In the United States, White samples are often portrayed as if their racial identities were inconsequential to their thoughts, feelings, and behaviors, and research findings derived from White samples are often portrayed as if they were generalizable to all humans. We argue that these and other practices are rooted in a “White = neutral” framework (i.e., the conceptualization of White samples as nonracial). First, we review existing data and present some new data to highlight the scope of the White = neutral framework. Second, we integrate research from across psychological science to argue that the continued use of the White = neutral framework will prevent psychology from becoming a truly objective and inclusive science for at least three reasons: (a) Research with White samples will be valued over research with samples of color, (b) norms that maintain White neutrality will remain unchallenged, and (c) the role of White identity in psychological processes will remain underspecified and underexamined. Third, we provide recommendations for how to move beyond the White = neutral framework in hopes of encouraging all psychological scientists to move toward a White ≠ neutral framework in which all samples are identified for the unique and diverse perspectives that they bring to the world.
Aversive Self-Focus and Alcohol Consumption Behavior in Women with Sexual Identity-Uncertainty: Changes in Salivary Cortisol Stress Response Among Those who Drink-to-Cope
Authors: Talley Amelia E. , Harris Breanna N. , Le Tran H. , Hohman Zachary P.
Published: August 2022

Background

Individuals who report sexual identity-uncertainty are at-risk for heavy alcohol consumption and alcohol use disorder symptomology. The current study examined the impact of states of aversive self-focus on subsequent consumption of ostensibly alcohol-containing beverages among a sample of women in early adulthood with varying levels of sexual identity-uncertainty ( N = 75).

Methods

Utilizing a 2 ( self-focus: negative vs. neutral) × 2 ( attribution for any psychological discomfort: external vs. none given) between-subjects design with 3 within-person assessments of salivary cortisol, both a moderation model and mixed-effects general linear model were tested.

Results

States of aversive self-focus caused increases in overall consumption among women higher in sexual identity-uncertainty. Findings suggested consumption of ostensibly alcohol-containing beverages was more likely among women higher in sexual identity-uncertainty who also reported consuming beverages to cope with distress. Among women who reported higher levels of sexual identity-uncertainty and drinking-to-cope motives, salivary cortisol concentrations dampened more quickly over time, as they supposedly consumed alcohol.

Conclusion

Findings demonstrate that, among women reporting sexual identity-uncertainty who are motivated to consume alcohol to forget about troubles or worries, situations which evoke states of aversive self-focus may contribute to differences in alcohol consumption in early adulthood.
Tombstoneite, a new mineral from Tombstone, Arizona, USA, with a pinwheel-like Te6+O3(Te4+O3)3 cluster
Authors: Kampf Anthony R. , Mills Stuart J. , Housley Robert M. , Ma Chi , Thorne Brent
Published: August 2022

The new mineral tombstoneite (IMA2021-053), (Ca0.5Pb0.5)Pb3Cu2+6Te6+2O6(Te4+O3)6(Se4+O3)2(SO4)2⋅3H2O, occurs at the Grand Central mine in the Tombstone district, Cochise County, Arizona, USA, in cavities in quartz matrix in association with jarosite and rodalquilarite. Tombstoneite crystals are green pseudohexagonal tablets, up to 100 μm across and 20 μm thick. The mineral has a pale green streak and adamantine lustre. It is brittle with irregular fracture and a Mohs hardness of ~2½. It has one perfect cleavage on {001}. The calculated density is 5.680 g cm–3. Optically, the mineral is uniaxial (–) and exhibits pleochroism: O = green, E = light yellow green; O > E. The Raman spectrum exhibits bands consistent with Te6+O6, Te4+O3, Se4+O3 and SO4. Electron microprobe analysis provided the empirical formula (Ca0.51Pb0.49)Σ1.00Pb3.00Cu2+5.85Te6+2.00O6(Te4+1.00O3)6(Se4+0.69Te4+0.24S0.07O3)2(S1.00O4)2⋅3H2O. Tombstoneite is trigonal, P321, a = 9.1377(9), c = 12.2797(9) Å, V = 887.96(18) Å3 and Z = 1. The structure of tombstoneite (R1 = 0.0432 for 1205 I > 2σI) contains thick heteropolyhedral layers comprising Te6+O6 octahedra, Jahn-Teller distorted Cu2+O5 pyramids, Te4+O3 pyramids and Se4+O3 pyramids. Pb2+ cations without stereoactive 6s2 lone-pair electrons are hosted in pockets in the heteropolyhedral layer. Pb2+ cations, possibly with stereoactive 6s2 lone-pair electrons, are located in the interlayer region along with SO4 tetrahedra and H2O groups. Within the heteropolyhedral layer, the Te6+O6 octahedra and the Te4+O3 pyramids form finite Te6+O3(Te4+O3)3 clusters with a pinwheel-like configuration. This is the first known finite complex including both Te4+ and Te6+ polyhedra in any natural or synthetic tellurium oxysalt structure.
COVID-19 infection and its impact on case fatality in patients with pulmonary embolism
Authors: Hobohm Lukas , Sagoschen Ingo , Barco Stefano , Farmakis Ioannis T. , Fedeli Ugo , Koelmel Sebastian , Gori Tommaso , Espinola-Klein Christine , Münzel Thomas , Konstantinides Stavros , Keller Karsten
Published: August 2022

Background

Although a high prevalence of pulmonary embolism (PE) has been reported in association with coronavirus disease 2019 (COVID-19) in critically ill patients, nationwide data on the outcome of hospitalised patients with COVID-19 and PE are still limited. Thus, we investigated seasonal trends and predictors of in-hospital death in patients with COVID-19 and PE in Germany.

Methods

We used a German nationwide inpatient sample to analyse data on hospitalisations among COVID-19 patients with and without PE during 2020, and to detect changes in PE prevalence and case fatality in comparison with 2019.

Results

We analysed 176 137 COVID-19 hospitalisations in 2020; PE was recorded in 1.9% (n=3362) of discharge certificates. Almost one-third of patients with COVID-19 and PE died during the in-hospital course (28.7%) compared with COVID-19 patients without PE (17.7%). Between 2019 and 2020, numbers of PE-related hospitalisations were largely unchanged (98 485versus97 718), whereas the case fatality rate of PE increased slightly in 2020 (from 12.7% to 13.1%; p<0.001). Differences in case fatality were found between PE patients with and without COVID-19 in 2020 (28.7%versus12.5%; p<0.001), corresponding to a 3.1-fold increased risk of PE-related death (OR 3.16, 95% CI 2.91–3.42; p<0.001) in the presence of COVID-19.

Conclusions

In Germany, the prevalence of PE events during hospitalisations was similar in 2019 and 2020. However, the fatality rate among patients with both COVID-19 and PE was substantially higher than that in those with only one of these diseases, suggesting a life-threatening additive prognostic impact of the COVID-19–PE combination.
Mortality associated with metabolic syndrome in people with COPD managed in primary care
Authors: Karsanji Urvee , Evans Rachael A. , Quint Jennifer K. , Khunti Kamlesh , Lawson Claire A. , Petherick Emily , Greening Neil J. , Singh Sally J. , Richardson Matthew , Steiner Michael C.
Published: August 2022

Objective

The prevalence of metabolic syndrome (MetS) has been reported to be higher in selected populations of people with COPD. The impact of MetS on mortality in COPD is unknown. We used routinely collected healthcare data to estimate the prevalence of MetS in people with COPD managed in primary care and determine its impact on 5-year mortality.

Methods

Records from 103 955 patients with COPD from the Clinical Practice Research Datalink (CPRD-GOLD) between 2009 to 2017 were scrutinised. MetS was defined as the presence of three or more of: obesity, hypertension, lowered high-density lipoprotein cholesterol, elevated triglycerides or type 2 diabetes mellitus (T2DM). Univariate and multivariable Cox regression models were constructed to determine the prognostic impact of MetS on 5-year mortality. Similar univariate models were constructed for individual components of the definition of MetS.

Results

The prevalence of MetS in the COPD cohort was 10.1%. Univariate analyses showed the presence of MetS increased mortality (hazard ratio (HR) 1.19, 95% CI: 1.12–1.27, p<0.001), but this risk was substantially attenuated in the multivariable analysis (HR 1.06, 95% CI: 0.99–1.13, p=0.085). The presence of hypertension (HR 1.70, 95% CI: 1.63–1.77, p<0.001) and T2DM (HR 1.41, 95% CI: 1.34–1.48, p<0.001) increased and obesity (HR 0.74, 95% CI: 0.71–0.78, p<0.001) reduced mortality risk.

Conclusion

MetS in patients with COPD is associated with higher 5-year mortality, but this impact was minimal when adjusted for indices of COPD disease severity and other comorbidities. Individual components of the MetS definition exerted differential impacts on mortality suggesting limitation to the use of MetS as a multicomponent condition in predicting outcome in COPD.
Comparison of the accuracy of three methods measured the length of the right main stem bronchus by chest computed tomography as a guide to the use of right sided double-lumen tube
Authors: Liu Zhuo , Liu Meiqi , Zhao Li , Qi Xiaohang , yu Yang , Liang Shujuan , Yang Xiaochun , Ma Zhongfeng
Published: August 2022

Background

The variation of right main stem bronchus leads to the orifice of the right upper lobe bronchus may be obstructed or increase the incidence of malposition intraoperatively when the right sided double-lumen tube is used. Therefore, the aim of this study was to compare the accuracy of three methods measured the length of the right main stem bronchus via chest computed tomography as a guide to the use of right sided double-lumen tube.

Methods

In this study, 168 adult patients undergoing left sided thoracic surgery were included. All these patients were allocated to carina-proximal (C-P) group, carina-distal (C-D) group and carina-carina (C-C) group. The position of endobronchial cuff observed via Fiberoptic bronchoscopy after successful initial placement and after turning the patients to the lateral decubitus position, as well as the incidence of malposition of right sided double-lumen tube intraoperative were recorded to assess the accuracy of three methods in predicting the position of right sided double-lumen tube.

Results

The distance between the carina to the proximal margin of the right upper lobe orifice, carina to the distal margin of the right upper lobe orifice and carina to the first right interlobar carina of the right upper lobe orifice were 17.2 ± 2.3 mm, 25.4 ± 3.7 mm and 28.5 ± 3.1 mm (P < 0.05). In the C-D group, the number of endobronchial cuffs seen to be herniating out of the carina, the number of bronchoscopies during initial placement and on the lateral position, the number of total malposition intraoperative and the number of reposition manoeuvres intraoperative were significantly less than the C-P group or the C-C group (P < 0.05).

Conclusions

The length of the right main stem bronchus measured by the carina to distal margin of right upper lobe orifice method was more accurate than the other two methods in guiding the use of right sided double-lumen tube.

Trials registration

Clinical Trials. gov. no. NCT04127903. Registered at https://register.clinicaltrials.gov on 16/10/2019.
Potential influence of anaesthesia techniques on the recurrence and progression after resection of non-muscle-invasive bladder cancer: a propensity score-matched analysis
Authors: Xue Ruifeng , Zhao Chongxi , Chen Dongtai , Wang Peizong , Xing Wei , Zeng Weian , Li Qiang
Published: August 2022

Background

The non-muscle-invasive bladder cancer is a common malignancy of the urinary system. Many patients relapse after transurethral resection surgery. Different anaesthesia techniques may influence a patient’s immune system during the perioperative time. In this study, we examined the effects of different anaesthesia techniques on the prognosis of primary non-muscle-invasive bladder cancer after transurethral resection surgery.

Methods

In the period 2008 to 2017, a total of 926 patients suffered primary non-muscle-invasive bladder and underwent transurethral resection of bladder tumour surgery for the first time. These patients were divided into two groups according to the techniques that were used. There were 662 patients in the general anaesthesia group, who received propofol, opioid drugs (fentanyl family), non-depolarizing muscle relaxants, and sevoflurane, and 264 patients in the epidural anaesthesia group, who had an epidural catheter placed in the L2-L3 or L3-L4 interspace with a combination of lidocaine and ropivacaine or bupivacaine. We analyzed the influence factors that might affect prognosis and compared the recurrence-free survival time and the progression between the two groups.

Results

The differences between the two groups in recurrence rate and progression rate were not statistically significant. Progression-free survival time of the epidural anaesthesia group was longer. Multivariate regression analysis showed that anaesthesia techniques were not independent influencing factors for recurrence and progression.

Conclusions

It was not found that anaesthesia techniques affected the recurrence or progression of patients with primary non-muscle-invasive bladder cancer after transurethral resection of bladder tumour.
Association of depression symptoms and sleep quality with state-trait anxiety in medical university students in Anhui Province, China: a mediation analysis
Authors: Chen Jiangyun , Tuersun Yusupujiang , Yang Jiao , Xiong Man , Wang Yueying , Rao Xinyi , Jiang Shuai
Published: August 2022

Background

The prevalence of depression symptoms among medical students is particularly high, and it has increased during the COVID-19 epidemic. Sleep quality and state-trait anxiety are risk factors for depression, but no study has yet investigated the mediating role of state-trait anxiety in the relationship between poor sleep quality and depression symptoms in medical students. This study aims to investigate the relationship among depression symptoms, sleep quality and state-trait anxiety in medical university students in Anhui Province.

Methods

This was a cross-sectional survey of 1227 students’ online questionnaires collected from four medical universities in Anhui Province using a convenience sampling method. We measured respondents’ sleep quality, state-trait anxiety, and depression symptoms using three scales: the Pittsburgh Sleep Quality Index (PSQI), the State-Trait Anxiety Inventory (STAI) and the Self-rating Depression Scale (SDS). We analysed the mediating role of STAI scores on the association between PSQI scores and SDS scores through the Sobel-Goodman Mediation Test while controlling for covariates. P < 0.05 was considered statistically significant.

Results

A total of 74.33% (912) and 41.40% (518) of the respondents reported suffering from poor sleep quality and depression symptoms. Sleep quality, state-trait anxiety, and depression symptoms were positively associated with each other (β = 0.381 ~ 0.775, P < 0.001). State-trait anxiety partially mediated the association between sleep quality and depression symptoms (Sobel test Z = 15.090, P < 0.001), and this mediating variable accounted for 83.79% of the association when adjusting for potential confounders. Subgroup analysis further revealed that STAI scores partially mediated the association between PSQI scores and SDS scores in females and rural students and fully mediated the association between PSQI scores and SDS scores in males and urban students.

Conclusions

This study found that sleep quality and state-trait anxiety have a significant predictive effect on depression symptoms. State-trait anxiety mediated the relationship between sleep quality and depression symptoms, with a more complex mechanism observed among rural and female medical students. Multiple pathways of intervention should be adopted, such as encouraging students to self-adjust, providing professional psychological intervention and timely monitoring, enriching extracurricular activities, and making changes in policies regarding long shifts and working hours.
Preparedness for practice of newly qualified dental practitioners in the Australian context: an exploratory study
Authors: Mariño Rodrigo , Delany Clare , Manton David J. , Reid Katharine , Satur Julie , Crombie Felicity , Wong Rebecca , McNally Clare , Adams Geoffrey G. , Lopez Diego , Celentano Antonio , Lim Mathew , Morgan Mike
Published: August 2022

Background

The current study explored the perspectives of preparedness for dental practice from a range of relevant stakeholders (i.e., educators, employers, final-year students, graduates, practitioners, and professional associations) using an anonymous online survey in which participants described either their preparedness for practice, or the preparedness of graduates they have encountered, across six domains.

Results

A total of 120 participants completed the survey. Participants were from several Australian states and territories; regional, rural, and urban locations; and working in the public and private sector. Students and new graduates generally felt prepared for activities in all the identified domains. Stakeholders reported consistently that the knowledge of dental profession graduates was at the required level to enter practice in Australia in a safe way. Activities involving the knowledge of clinical entrepreneurship and financial solvency were the dimensions where students and graduates felt least prepared (e.g., explaining fees, negotiating finances). In the domains involving clinical and technical competencies, students and new graduates self-assessed as less prepared around managing dental trauma and medical emergencies. On the other hand, activities around social and community orientation, and to a lesser extent professional attitudes and ethical judgements, were the dimensions where students and graduates felt the most prepared.

Conclusions

Present findings indicate that there appear to be good standards of preparedness for practice for graduate dental professionals. This exploratory study provides insights into the nature of preparedness for Australian dental professionals and provides a basis for targeting education and professional development to address areas of need.
Development of an indirect ELISA to detect PEDV specific IgA antibody based on a PEDV epidemic strain
Authors: Wang Kun , Hu Zhiqiang , Fan Mingyu , Shao Zhenwen , Yu Qiannan , Li Xiaowen
Published: August 2022

Background

Porcine epidemic diarrhea (PED), a swine epidemic disease caused by porcine epidemic diarrhea virus (PEDV), is characterized by severe watery diarrhea, vomiting, dehydration and high mortality in piglets, and has caused serious economic losses to the global porcine industry. The level of PEDV IgA antibody is a key marker to assess the extent of passive immunity of the resistance against PEDV infection. However, current commercial structure proteins-based kits for detection of PEDV antibody are not affordable, and those kits require complicated antigen preparation procedures, which cannot meet the scope of economic benefits of many large-scale pig companies in China. Therefore, there is an urgent need to develop an accurate, simple, and economical method for IgA detection in clinical samples. In this study, an indirect ELISA (i-ELISA) method was developed based on a purified PEDV epidemic strain (NH-TA2020).

Results

The results show that optimal working dilution ratios of PEDV antigen and HRP anti-swine IgA are at 1: 1000 and 1:15000 respectively. The sensitivity of this method is high with the maximum dilution of samples up to 1:160, and coefficients of variation (CV) of both the intra assays and inter assays were no more than 15%. In addition, the relative sensitivities of the i-ELISA were above 90% compared with values from commercial kits in both serum and oral fluid samples.

Conclusions

Our results suggested that the i-ELISA developed in this study was an accurate, simple, and economical method for PEDV-IgA detection in clinical samples.
A circular RNA blood panel that differentiates Alzheimer’s disease from other dementia types
Authors: Ren Ziye , Chu Changbiao , Pang Yana , Cai Huimin , Jia Longfei
Published: August 2022

Background

Circular RNAs (circRNAs) have been demonstrated to be associated with Alzheimer’s disease (AD). Here, we conducted a study to explore whether circRNAs have the ability to differentiate AD from cognitively normal controls and other types of dementia, such as vascular dementia (VaD), Parkinson’s disease dementia (PDD), behavioral variant frontotemporal dementia (bvFTD), and dementia with Lewy body (DLB).

Methods

Three datasets were included in this study to measure blood circRNAs. The pilot study (Dataset 1, n = 40; controls, 20; AD, 20) was used to screen differentially expressed circRNAs. Dataset 2 (n = 124; controls, 61; AD, 63) was recruited for the establishment of the diagnostic model using a circRNA panel. Further, the Dataset 3 (n = 321; control, 58; AD, 60; VaD, 50; PDD, 51; bvFTD, 52; DLB, 50) was used to verify the diagnostic model.

Results

In Dataset 1, 22 upregulated and 19 downregulated circRNAs were revealed. In Dataset 2, a six-circRNA panel was found to be able to distinguish patients with AD from controls. Then this panel was applied to Dataset 3 and successfully differentiated AD from other types of dementia.

Conclusion

This study suggested that a six-circRNA panel is AD-specific and a promising biomarker of AD.
Current challenges and best practices for cell-free long RNA biomarker discovery
Authors: Cabús Lluc , Lagarde Julien , Curado Joao , Lizano Esther , Pérez-Boza Jennifer
Published: August 2022

The analysis of biomarkers in biological fluids, also known as liquid biopsies, is seen with great potential to diagnose complex diseases such as cancer with a high sensitivity and minimal invasiveness. Although it can target any biomolecule, most liquid biopsy studies have focused on circulating nucleic acids. Historically, studies have aimed at the detection of specific mutations on cell-free DNA (cfDNA), but recently, the study of cell-free RNA (cfRNA) has gained traction. Since 2020, a handful of cfDNA tests have been approved for therapy selection by the FDA, however, no cfRNA tests are approved to date. One of the main drawbacks in the field of RNA-based liquid biopsies is the low reproducibility of the results, often caused by technical and biological variability, a lack of standardized protocols and insufficient cohorts. In this review, we will identify the main challenges and biases introduced during the different stages of biomarker discovery in liquid biopsies with cfRNA and propose solutions to minimize them.
Fast versus slow infusion of 20% albumin: a randomized controlled cross-over trial in volunteers
Authors: Zdolsek Markus , Sjöberg Folke , Hahn Robert G.
Published: August 2022

Background

We investigated whether plasma volume (PV) expansion of 20% albumin is larger when the fluid is administered rapidly compared with a slow infusion.

Methods

In this open-labeled randomized interventional controlled trial, 12 volunteers (mean age, 28 years) received 3 mL/kg of 20% albumin (approximately 225 mL) over 30 min (fast) and 120 min (slow) in a cross-over fashion. Blood hemoglobin and plasma albumin were measured on 15 occasions during 6 h to estimate the PV expansion and the capillary leakage of albumin and fluid.

Results

The largest PV expansion was 16.1% ± 6.5% (mean ± SD) for fast infusion and 12.8% ± 4.0% for slow infusion (p = 0.52). The median area under the curve for the PV expansion was 69% larger for the fast infusion during the first 2 h (p = 0.034), but was then similar for both infusions. The half-life of the PV expansion did not differ significantly (median, 5.6 h versus 5.4 h, p = 0.345), whereas the intravascular half-life of the excess albumin was 8.0 h for fast infusion and 6.3 h for slow infusion (p = 0.028). The measured urine output was almost three times larger than the infused volume. The plasma concentration of atrial natriuretic peptide (MR-proANP) accelerated the capillary leakage of albumin and the urine flow.

Conclusions

The intravascular persistence of albumin was longer, but the fluid kinetics was the same, when 20% albumin was infused over 30 min compared with 120 min. We found no disadvantages of administering the albumin at the higher rate.

Trial registration EU Clinical Trials Register, EudraCT2017-003687-12, registered September 22, 2017, https://www.clinicaltrialsregister.eu/ctr-search/trial/2017-003687-12/SE
Fingolimod does not prevent syndecan-4 shedding from the endothelial glycocalyx in a cultured human umbilical vein endothelial cell model of vascular injury
Authors: Milford Elissa M. , Meital Lara , Kuballa Anna , Reade Michael C. , Russell Fraser D.
Published: August 2022

Background

Shedding of the endothelial glycocalyx (EG) is associated with poor outcomes in a range of conditions including sepsis. Fresh frozen plasma (FFP) restores the damaged EG to baseline thickness, however the mechanism for this effect is unknown, and some components of FFP have adverse effects unrelated to the EG. There is some limited evidence that sphingosine-1-phosphate (S1P) within FFP restores the EG by activating the endothelial cell S1P receptor 1 (S1PR1). However, there are disadvantages to using S1P clinically as an EG restorative therapy. A potential alternative is the S1PR agonist fingolimod (FTY720). The aim of this study was to assess whether FTY720 prevents EG shedding in injured cultured human umbilical vein endothelial cells.

Methods

Shedding of the EG was induced in cultured human umbilical vein endothelial cells (HUVECs) by exposure to adrenaline, TNF-α and H2O2. The cells were then assigned to one of six conditions for 4 h: uninjured and untreated, injured and untreated, injured and treated with FTY720 with and without the S1PR1 inhibitor W146, and injured and treated with 25% FFP with and without W146. Syndecan-4, a component of the EG, was measured in cell supernatants, and syndecan-4 and thrombomodulin mRNA expression was quantitated in cell lysates.

Results

The injury resulted in a 2.1-fold increase in syndecan-4 (p < 0.001), consistent with EG shedding. Syndecan-4 and thrombomodulin mRNA expression was increased (p < 0.001) and decreased (p < 0.05), respectively, by the injury. Syndecan-4 shedding was not affected by treatment with FTY720, whereas FFP attenuated syndecan-4 shedding back to baseline levels in the injured cells and this was unaffected by W146. Neither treatment affected syndecan-4 or thrombomodulin mRNA expression.

Conclusions

FTY720 did not prevent syndecan-4 shedding from the EG in the HUVEC model of endothelial injury, suggesting that activation of S1PR does not prevent EG damage. FFP prevented syndecan-4 shedding from the EG via a mechanism that was independent of S1PR1 and upregulation of SDC-4 production. Further studies to examine whether FTY720 or another S1PR agonist might have EG-protective effects under different conditions are warranted, as are investigations seeking the mechanism of EG protection conferred by FFP in this experimental model.
Granulocyte colony-stimulating factor-associated aortitis in a woman with breast cancer: a case report
Authors: Matsumoto Nana , Kondo Naoto , Wanifuchi-Endo Yumi , Asano Tomoko , Hisada Tomoka , Uemoto Yasuaki , Kato Akiko , Terada Mitsuo , Yamanaka Natsumi , Isogai Ayaka , Takayama Muneyuki , Hasegawa Takeshi , Ito Koichi , Mashita Keiji , Toyama Tatsuya
Published: August 2022

Background

Granulocyte colony-stimulating factor (G-CSF) is increasingly used to prevent chemotherapy-associated febrile neutropenia. Generally, aortitis is not considered a side effect of G-CSF and is thought to be extremely rare. Aortitis is an inflammation of the aorta and occurs mainly in connective tissue diseases (Takayasu arteritis, giant cell arteritis, etc.) and infectious diseases (bacterial endocarditis, syphilis, etc.). We report herein a rare case of G-CSF associated with aortitis in a woman with breast cancer.

Case presentation

Here, we present a case involving a 63-year-old woman with luminal type stage IIa breast cancer. The patient’s treatment was initiated with docetaxel and cyclophosphamide, with pegfilgrastim (PEG-G) as support. After PEG-G administration on day 3, the patient developed an intermittent fever of up to 39.4 °C on day 10 and visited our outpatient clinic on day 13 with persistent high fever. Laboratory tests revealed a high neutrophil count (14,000/μL) and a high C-reactive protein (CRP) level (42.8 mg/dL) without any other abnormalities. Contrast-enhanced computed tomography scanning revealed soft tissue thickening with weak enhancement around the wall of the thoraco-abdominal aorta, aortic arch and left subclavian artery. The patient did not respond to antimicrobial agents. On the basis of these observations, the patient was diagnosed with PEG-G-induced aortitis, and her condition rapidly improved without corticosteroids.

Conclusions

Clinicians should be aware of aortitis as a potential complication in patients undergoing G-CSF chemotherapy. In cases with persistent high fever after PEG-G administration, and in the absence of infection, aortitis should be suspected.
A case of laparoscopic distal gastrectomy and median arcuate ligament release for a gastric cancer patient with median arcuate ligament syndrome
Authors: Ueda Sho , Maeda Masato , Nishitani Kenta , Seiichiro Tada , Kawamorita Keisuke , Takayanagi Tomoyasu , Kobayashi Toshiki , Hashimoto Yosuke , Yonezawa Kei
Published: August 2022

Background

The median arcuate ligament syndrome (MALS) is a disease in which the celiac artery is compressed by the arcuate ligament and causes stenosis. If abdominal pain or an aneurysm is observed in the head of the pancreas, it is necessary to release the arcuate ligament, and recently laparoscopic surgery has been reported. However, the indication for treatment in asymptomatic cases is unknown. The treatment for asymptomatic MALS in patients with gastric cancer who are indicated for surgery is also novel.

Case presentation

A 70-year-old female was found with early gastric cancer in the middle body of the stomach. An enhanced CT scan showed no metastasis, but a gallstone and stenosis of the celiac artery due to the MALS were found. The patient underwent releasing median arcuate ligament after lymph node dissection. A median arcuate ligament was located on the ventral side of the left gastric artery stump, and the celiac artery was exposed when cutting it off. The operation time was 4 h and 59 min, and the bleeding was 6 ml. It took about 5 min to dissect the medial arcuate ligament. The postoperative course was satisfactory, and the patient was discharged 7 days after the operation. CT scan and 3-D CT angiography were performed about 2 months after the operation, and the findings revealed that the celiac artery's stenosis resolved.

Conclusion

The patient underwent laparoscopic gastrectomy and simultaneously the median arcuate ligament release under an excellent visual field. Therefore, median arcuate ligament release may be considered if MALS is found in a gastrectomy case.
Mobile phone virtual reality game for pediatric home burn dressing pain management: a randomized feasibility clinical trial
Authors: Armstrong Megan , Lun Jonathan , Groner Jonathan I. , Thakkar Rajan K. , Fabia Renata , Noffsinger Dana , Ni Ai , Keesari Rohali , Xiang Henry
Published: August 2022

Background

Virtual reality (VR) gaming is considered a safe and effective alternative to standard pain alleviation in the hospital. This study addressed the potential effectiveness and feasibility of a VR game that was developed by our research team for repeated at-home burn dressing changes.

Methods

A randomized clinical trial was conducted among patients recruited from the outpatient burn clinic of a large American Burn Association–verified pediatric burn center between September 2019 and June 2021. We included English-speaking burn patients aged 5–17 years old requiring daily dressing changes for at least 1 week after first outpatient dressing change. One group played an interactive VR game during dressing changes, while the other utilized standard distraction techniques available in the home for up to a week. Both child and caretaker were asked to assess perceived pain on a numerical rating scale (NRS) of 0–10. For the VR group, patients were also asked to rate various aspects of the VR game on a NRS of 0–10 and caregivers were asked questions assessing ease of use.

Results

A total of 35 children were recruited for this study with 24 fully completing study measures. The majority of participants were male (n=19, 54.3%), White (n=29, 82.9%), and with second degree burns (n=32, 91.4%). Children and caregivers in the VR group reported less pain than the control group at the 4th dressing change. Participants in the VR group showed a clinically meaningful (≥30%) reduction in child-reported overall pain (33.3%) and caregiver-reported worst pain (31.6%) in comparison with subjects in the control group. Children’s satisfaction with the VR remained at a high level across dressing changes over the 1-week period, with reported realism and engagement increasing over time. Over half of the children (54.5%) enjoyed playing the game and did not report any challenges nor any side effects.

Conclusions

Subjects found the VR to be a useful distraction during home dressing changes and reported no challenges/side effects. VR should be considered as a nonpharmacologic companion for pain management during at-home burn dressing changes.

Trial registration

ClinicalTrials.gov Identifier: NCT04548635. Registered September 14, 2020—retrospectively registered
State-of-the-art review of the seismic performance of precast segmental columns
Authors: Bi Kaiming , Li Chao , Hao Hong
Published: August 2022

Prefabricated construction is attracting increasing interest in recent years, since this construction method has various advantages as compared to the cast-in-situ construction method, such as less construction time, higher quality control and reduced environmental impact. As a typical type of prefabricated structures, precast segmental column (PSC) has been used as the substructure to accelerate the construction speed of bridges. This paper reviews the performances of the PSCs under seismic loadings. In particular, the seismic performances of the PSC itself under cyclic loading and real earthquake ground motions, the seismic behaviours of PSC-supported bridge structures, and the responses of precast rocking column (PRC)-supported bridges, are comprehensively reviewed and their pros and cons are discussed. For the completeness of the paper, the performances of the PSCs under multiple dynamic hazards, namely impact and blast loadings here are also briefly summarized at the end of this paper.
Focal sources of FGF-10 promote the buckling morphogenesis of the embryonic airway epithelium
Authors: Peak Kara E. , Mohr-Allen Shelby R. , Gleghorn Jason P. , Varner Victor D.
Published: August 2022

During airway branching morphogenesis, focal regions of FGF-10 expression in the pulmonary mesenchyme are thought to provide a local guidance cue, which promotes chemotactically the directional outgrowth of the airway epithelium. Here, however, we show that an ectopic source of FGF-10 induces epithelial buckling morphogenesis and the formation of multiple new supernumerary buds. FGF-10-induced budding can be modulated by altered epithelial tension and luminal fluid pressure. Increased tension suppresses the formation of ectopic branches, while a collapse of the embryonic airway promotes more expansive buckling and additional FGF-10-induced supernumerary buds. Our results indicate that a focal source of FGF-10 can promote epithelial buckling and suggest that the overall branching pattern cannot be explained entirely by the templated expression of FGF-10. Both FGF-10-mediated cell behaviors and exogenous mechanical forces must be integrated to properly shape the bronchial tree.
The effect of a deep-learning tool on dentists’ performances in detecting apical radiolucencies on periapical radiographs
Authors: Hamdan Manal H. , Tuzova Lyudmila , Mol André , Tawil Peter Z. , Tuzoff Dmitry , Tyndall Donald A.
Published: August 2022

Objectives:

To determine the efficacy of a deep-learning (DL) tool in assisting dentists in detecting apical radiolucencies on periapical radiographs.

Methods:

Sixty-eight intraoral periapical radiographs with CBCT-proven presence or absence of apical radiolucencies were selected to serve as the testing subset. Eight readers examined the subset, denoted the positions of apical radiolucencies, and used a 5-point confidence scale to score each radiolucency. The same subset was assessed by readers under two conditions: with and without Denti.AI DL tool predictions. For the two sessions, the performance of the readers was compared. The comparison was performed with the alternate free response receiver operating characteristic (AFROC) methodology.

Results:

Localization of lesion accuracy (AFROC-AUC), specificity and sensitivity (by lesion) detection demonstrated improvements in the DL aided session in comparison with the unaided reading session. Subgroup performance analysis revealed an increase in sensitivity for small radiolucencies and in radiolucencies located apical to endodontically treated teeth..

Conclusion:

The study revealed that the DL technology (Denti.AI) enhances dental professionals' abilities to detect apical radiolucencies on intraoral radiographs.

Advances in knowledge:

DL tools have the potential to improve diagnostic efficacy of dentists in identifying apical radiolucencies on periapical radiographs.
Ο μεταβυζαντινός Μυστράς
Authors: Πάντου Ευαγγελία
Published: August 2022

Στην παρούσα διατριβή επιχειρείται η ερευνητική ανάγνωση της μεταμεσαιωνικής διαδρομής του Μυστρά από την παράδοσή του στους Οθωμανούς το 1460, μέχρι τα μέσα περίπου του 20ού αιώνα, με έμφαση στα σωζόμενα υλικά τεκμήρια και με την αξιοποίηση ποικίλων πηγών. Με επίκεντρο τη μελέτη της αρχιτεκτονικής και της ζωγραφικής του εξέχοντος μεταβυζαντινού ναού του Αγίου Νικολάου αναλύονται όψεις του μεταβυζαντινού Μυστρά και συγχρόνως εκφράσεις της αναδυόμενης νεοελληνικής αυτοσυνειδησίας. Περαιτέρω αρχαιολογικά τεκμήρια και γραπτές πηγές συνθέτουν ερμηνευτικές αναπαραστάσεις της πνευματικής, κοινωνικής και πολιτικής ζωής του Μυστρά και της ευρύτερης περιοχής του από τις αρχές του 18ου αιώνα έως και λίγα χρόνια μετά τα μέσα του.Υλικές και επιλεγμένες αρχειακές μαρτυρίες περιγράφουν την αφύπνιση αρχικά του ευρωπαϊκού και ακολούθως του ελληνικού ενδιαφέροντος για τη μελέτη και την προστασία του Μυστρά κατά τον 19ο και το πρώτο ήμισυ του 20ού αιώνα.Τέλος παρουσιάζονται δόκιμες και πρωτότυπες διαχειριστικές επιλογές που στοχεύουν στην πολυφασματική ανασύνθεση της μεταβυζαντινής φυσιογνωμίας του Μυστρά σε συνάρτηση με το βυζαντινό της υπόστρωμα.