bluuebunny/crossref_metadata_2025 huggingface dataset:
Mortality of patients with hospital-onset sepsis in hospitals with all-day and non-all-day rapid response teams: a prospective nationwide multicenter cohort study
Authors: Hyun Dong-gon , Lee Su Yeon , Ahn Jee Hwan , Huh Jin Won , Hong Sang-Bum , Koh Younsuck , Lim Chae-Man ,   the Korean Sepsis Alliance (KSA) Investigators, Oh Dong Kyu , Suh Gee Young , Jeon Kyeongman , Ko Ryoung-Eun , Cho Young-Jae , Lee Yeon Joo , Lim Sung Yoon , Park Sunghoon , Heo Jeongwon , Lee Jae-myeong , Kim Kyung Chan , Lee Yeon Joo , Chang Youjin , Jeon Kyeongman , Lee Sang-Min , Hong Suk-Kyung , Cho Woo Hyun , Kwak Sang Hyun , Lee Heung Bum , Ahn Jong-Joon , Seong Gil Myeong , Lee Song-I , Park Sunghoon , Park Tai Sun , Lee Su Hwan , Choi Eun Young , Moon Jae Young
Published: September 2022

Background

Hospital-onset sepsis is associated with a higher in-hospital mortality rate than community-onset sepsis. Many hospitals have implemented rapid response teams (RRTs) for early detection and timely management of at-risk hospitalized patients. However, the effectiveness of an all-day RRT over a non-all-day RRT in reducing the risk of in-hospital mortality in patient with hospital-onset sepsis is unclear. We aimed to determine the effect of the RRT’s operating hours on in-hospital mortality in inpatient patients with sepsis.

Methods

We conducted a nationwide cohort study of adult patients with hospital-onset sepsis prospectively collected from the Korean Sepsis Alliance (KSA) Database from 16 tertiary referral or university-affiliated hospitals in South Korea between September of 2019 and February of 2020. RRT was implemented in 11 hospitals, of which 5 (45.5%) operated 24-h RRT (all-day RRT) and the remaining 6 (54.5%) had part-day RRT (non-all-day RRT). The primary outcome was in-hospital mortality between the two groups.

Results

Of the 405 patients with hospital-onset sepsis, 206 (50.9%) were admitted to hospitals operating all-day RRT, whereas 199 (49.1%) were hospitalized in hospitals with non-all-day RRT. A total of 73 of the 206 patients in the all-day group (35.4%) and 85 of the 199 patients in the non-all-day group (42.7%) died in the hospital (P = 0.133). After adjustments for co-variables, the implementation of all-day RRT was associated with a significant reduction in in-hospital mortality (adjusted odds ratio 0.57; 95% confidence interval 0.35–0.93;P = 0.024).

Conclusions

In comparison with non-all-day RRTs, the availability of all-day RRTs was associated with reduced in-hospital mortality among patients with hospital-onset sepsis.
Remimazolam besylate versus propofol for long-term sedation during invasive mechanical ventilation: a pilot study
Authors: Tang Yun , Yang Xiaobo , Yu Yuan , Shu Huaqing , Yuan Yin , Liu Hong , Zou Xiaojing , Yuan Shiying , Shang You
Published: September 2022

Objective

The aim of this study was to evaluate the efficacy and safety of remimazolam besylate compared with propofol in maintaining mild-to-moderate sedation in patients receiving long-term mechanical ventilation.

Methods

In this single-centered randomized pilot study, adult patients mechanically ventilated longer than 24 h were randomized to receive remimazolam besylate or propofol. The target sedation range was − 3 to 0 on the Richmond Agitation and Sedation Scale (RASS). The primary outcome was the percentage of time in the target sedation range without rescue sedation. The secondary outcomes were ventilator-free days at day 7, the length of ICU stay and 28-day mortality.

Results

Thirty patients were assigned to each group. No difference was identified between the remimazolam group and propofol group in median age [60.0 (IQR, 51.5–66.3) years vs. 64.0 (IQR, 55.0–69.3) years, respectively,p = 0.437] or the median duration of study drug infusion [55.0 (IQR, 28.3–102.0) hours vs. 41.0 (IQR, 24.8–74.3) hours, respectively,p = 0.255]. The median percentage of time in the target RASS range without rescue sedation was similar in remimazolam and propofol groups [73.2% (IQR, 41.5–97.3%) vs. 82.8% (IQR, 65.6–100%),p = 0.269]. No differences were identified between the two groups in terms of ventilator-free days at day 7, length of ICU stay, 28-day mortality or adverse events.

Conclusions

This pilot study suggested that remimazolam besylate was effective and safe for long-term sedation in mechanically ventilated patients compared with propofol.
Study protocol for the management of impacted maxillary central incisors: a multicentre randomised clinical trial: the iMAC Trial
Authors: Seehra Jadbinder , DiBiase Andrew T. , Patel Shruti , Stephens Rachel , Littlewood Simon J. , Spencer Richard J. , Frawley Tom , Benson Philip E. , Ireland Anthony J. , Parvizi Farnaz , Atack Nikki , Kidner Giles , Wojewodka Gabriella , Ward Christopher , Papageorgiou Spyridon N. , Newton Jonathon T. , Cobourne Martyn T.
Published: September 2022

Background

Failure of eruption of the maxillary permanent incisor teeth usually presents in the mixed dentition between the ages of 7 and 9 years. Missing and unerupted maxillary incisors can be regarded as unattractive and have a potentially negative impact on facial and dental aesthetics. The presence of a supernumerary tooth (or odontoma) is commonly responsible for failed eruption or impaction of the permanent maxillary incisors. The primary objective of this trial is to investigate the success of eruption associated with maxillary incisor teeth that have failed to erupt because of a supernumerary tooth in the anterior maxilla.

Methods

This protocol describes an interventional multicentre two-arm randomised clinical trial. Participants meeting the eligibility criteria will be randomised (unrestricted equal participant allocation [1:1]) to either space creation with an orthodontic appliance, removal of the supernumerary tooth and application of direct orthodontic traction or space creation with an orthodontic appliance, removal of the supernumerary tooth and monitoring. The primary outcome of this trial is to determine the prevalence of successfully erupted maxillary central permanent incisors at 6 months following removal of the supernumerary tooth. Secondary outcome measures include (1) the effect of initial tooth position (assessed radiographically) on time taken for the tooth to erupt, (2) time taken to align the unerupted tooth to the correct occlusal position, (3) gingival aesthetics and (4) changes in the self-reported Oral Health Related-Quality of Life (OHRQoL) (pre-and post-treatment).

Discussion

There is a lack of high-quality robust prospective studies comparing the effectiveness of interventions to manage this condition. Furthermore, the UK national clinical guidelines have highlighted a lack of definitive treatment protocols for the management of children who present with an unerupted maxillary incisor due to the presence of a supernumerary tooth. The results of this trial will inform future treatment guidelines for the management of this condition in young children.

Trial registration

ISRCTN Registry ISRCTN12709966. Registered on 16 June 2022.
Role of DNA dioxygenase Ten-Eleven translocation 3 (TET3) in rheumatoid arthritis progression
Authors: Kawabe Akio , Yamagata Kaoru , Kato Shigeaki , Nakano Kazuhisa , Sakata Kei , Tsukada Yu-ichi , Ohmura Koichiro , Nakayamada Shingo , Tanaka Yoshiya
Published: September 2022

Background

Rheumatoid arthritis (RA) patients present with abnormal methylation patterns in their fibroblast-like synoviocytes (FLS). Given that DNA demethylation is critical for producing DNA methylation patterns, we hypothesized that DNA demethylation may facilitate RA progression. Therefore, we designed this study to examine the role of DNA dioxygenase family, Ten-Eleven translocation (TET1/2/3), in the pathological process of RA.

Methods

Synovial tissues and FLS were obtained from patients with RA and Osteoarthritis. K/BxN serum-induced arthritis was induced in Wild-type (WT) and TET3 heterozygous-deficient (TET3+/−) C57BL/6 mice.

Results

We found that both TET3 and 5-hydroxymethylcytosine (5hmC) were upregulated in synovitis tissues from RA patients and confirmed this upregulation in the cultured FLS derived from synovitis tissues. Tumor necrosis factor α (TNFα) upregulated TET3 and 5hmC levels in cultured FLS, and the stimulated FLS exhibited high cell mobility with increased transcription of cellular migration-related factors such as C-X-C motif chemokine ligand 8 (CXCL8) and C-C motif chemokine ligand 2 (CCL2) in a TET3-dependent manner. In addition, TET3 haploinsufficiency lowered RA progression in a mouse model of serum-induced arthritis.

Conclusions

Based on these findings, we can assume that TET3-mediated DNA demethylation acts as an epigenetic regulator of RA progression.
Development of a 64Cu-labeled CD4+ T cell targeting PET tracer: evaluation of CD4 specificity and its potential use in collagen-induced arthritis
Authors: Clausen Anne Skovsbo , Christensen Camilla , Christensen Esben , Cold Sigrid , Kristensen Lotte Kellemann , Hansen Anders Elias , Kjaer Andreas
Published: September 2022

Background

CD4+ T cells are central inflammatory mediators in the pathogenesis of autoimmune rheumatoid arthritis (RA), as they are one of the dominating cell types in synovial inflammation. Molecular imaging of CD4+ T cells has potential role for early detection and monitoring of RA. Here, we developed a new radiotracer for in vivo immunoPET imaging of murine CD4+ T cells and tested it in the collagen-induced arthritis (CIA) mouse model of human RA.

Results

The tracer, [64Cu]Cu-NOTA-CD4-F(ab)’2 ([64Cu]Cu-NOTA-CD4), was generated from F(ab)’2 fragments of R-anti-mouse CD4 antibodies conjugated to the 2-S-(isothiocyanatbenzyl)-1,4,7-triazacyclononane-1,4,7-triacetic acid (p-SCN-Bn-NOTA) chelator and radiolabeled with copper-64. Accumulation of the tracer and isotype control was evaluated in the CIA model and mice receiving whole-body irradiation (WBI) (5 Gy). The potential of [64Cu]Cu-NOTA-CD4 for response assessment was evaluated in CIA induced mice treated with dexamethasone (DXM). Imaging data were compared with flow cytometry and immunohistochemistry (IHC) of inflammatory cells including CD4+ T cells. [64Cu]Cu-NOTA-CD4 showed increased accumulation in T cell-rich tissues compared with isotype control (p < 0.0001). In addition, reduced accumulation of [64Cu]Cu-NOTA-CD4 was observed in T cell-depleted tissue (p < 0.0001). Flow cytometry and IHC confirmed the increased infiltration of CD4+ T cells in CIA mice.

Conclusions

We developed and evaluated a new radiotracer, [64Cu]Cu-NOTA-CD4, for immunoPET imaging of murine CD4+ T cells. [64Cu]Cu-NOTA-CD4 was successfully synthesized by F(ab)’2 fragments of R-anti-mouse CD4 antibodies conjugated to a chelator and radiolabeled with copper-64. We found that our novel CD4 PET tracer can be used for noninvasive visualization of murine CD4+ T cells.
Trade-offs in German wind energy expansion: building bridges between different interests, values and priorities
Authors: Reitz Sybille , Goshen Lauren , Ohlhorst Dörte
Published: September 2022

Background

To achieve climate targets, a transition to low-carbon energy production is necessary. However, conflicts between different interests, values and priorities, particularly at the community level, can constrain this transition. This paper aims to analyze lines of conflict and opportunities to build bridges between conflicting interests in the expansion of wind energy in Germany at the local level, to achieve successful implementation of wind energy projects.

Results

Our analysis of four cases of local-level wind energy projects in Germany shows that limited local options for action reinforce the need for local actors to maximize the benefits of energy transition projects. In addition to the conflict over scarce space, the lines of conflict at the local level run primarily along the dimensions of costs and benefits, winners and losers. Real or perceived procedural and distributive injustices had the potential to fuel resistance to wind energy projects in the analyzed cases. However, wind energy projects were successfully implemented despite the presence of local opposition.

Conclusions

The results show that, by integrating procedural and distributive justice into the project planning and implementation and offering tailored solutions, community support for expansion of renewable energy projects can be enhanced. The paper advances the concept of societal ownership (“gesellschaftliche Trägerschaft”), which suggests the willingness of members of a community to tolerate decisions even when some conflicts related to the decision remain unresolved. Societal ownership is presented as an alternative to the concept of simple acceptance; it implies a more positive, more supportive community attitude, where members aim to address conflict as a normal aspect of decision making. Rather than sweeping alternative opinions aside, the community addresses alternative viewpoints, seeking to achieve greater procedural and distributive justice. In this way, a sense of societal ownership of a project can develop, enhancing its likelihood of success.
Association between abnormal lipid profile and inflammation and progression of myelodysplastic syndrome to acute leukemia
Authors: Qiao Wei , Young Elliana , Feng Chun , Liu Suyu , Jin Jeff , Noor Laila , Rojas Hernandez Cristhiam M. , Borthakur Gautam , Gorlova Olga , Afshar-Kharghan Vahid
Published: September 2022

Clonal hematopoiesis of indeterminate potential (CHIP) is associated with a small risk of developing hematologic malignancies and a higher risk of cardiovascular diseases (CVD). We asked whether the reverse correlation exists and cardiometabolic risk factors have an impact on the progression of myelodysplastic syndrome (MDS) to acute myeloid leukemia (AML). We investigated the association between abnormal lipid profiles and inflammation in MDS, which shares many genetic mutations with CHIP, and the risk of developing acute leukemia. We examined the medical records of 11071 MDS patients. Among them, 5422 had at least one lipid profile or C-reactive protein (CRP) measurement. In univariate and multivariate analyses, elevated triglyceride and high-sensitive C-reactive protein (HS-CRP) were significantly associated with a diagnosis of acute leukemia in MDS patients. Next, we examined these associations in patients with available MDS prognostic scores (International Prognostic Scoring System, IPSS, or its revised version IPSS/R) (n = 2786 patients). We found that the statistical association between CRP and the progression of MDS to leukemia was independent of other variables in the scoring system. MDS patients with elevated CRP in both the high-risk and low-risk groups had a higher risk of progression to AML than those with a lower CRP. We speculate that inflammation might be a common denominator in developing hematologic malignancies and CVD in patients with clonal hematopoiesis.
Use of Serendipita indica to improve soybean growth, physiological properties, and soil enzymatic activities under different Cd concentrations
Authors: Wang Xiaohui , Fan Xiaoxu , Wang Weidong , Song Fuqiang
Published: September 2022

Background

Plants-microbial technology has been regarded as a popular and applied new technique for the remediation of cadmium (Cd) polluted soils.

Methods

Therefore, a pot experiment was conducted to explore the effect of Serendipita indica (S. indica) on soybean growth and the soil enzyme activities, pH and Cd chemical fractions in the soil in 0, 3, 6, and 9 mg·kg−1 Cd concentrations.

Results

Results reflected that compared to uninoculated treatment, S. indica inoculation can still enhance the dry weight (66.57%) and shoot length (90.35%) and promote the net photosynthesis rate (72.18%), transpiration ratio (80.73%), and stomatal conductance (119.05%) of soybean under 9 mg·kg−1 Cd stress. Furthermore, the soil pH, phosphatase (116.39%), and catalase (4.17%) activities in the S. indica treatments were increased under 3 mg·kg−1 Cd concentration. Meanwhile, S. indica could shift Cd from exchangeable fraction to other stable fractions, primarily decreased Cd contamination degree/risk in 6 mg·kg−1 Cd concentration.

Conclusions

This work suggested that S. indica may be a potential biotechnology for low Cd-contaminated farmland, S. indica can not only alleviate Cd phytotoxicity and promote plant growth but also improve soil quality in Cd-contaminated soils.

Graphical Abstract
Global exposure: an alternative pathway to understanding cultural omnivorousness in East Asian societies
Authors: Du Shichao
Published: September 2022

Previous studies on cultural taste build a class-omnivorousness framework. However, the conceptualization and measure of cultural omnivorousness are highly Western. To examine how cultural omnivorousness is shaped in non-Western societies, this study develops two dimensions of cultural omnivorousness and expands the meaning of social class from socioeconomic status to global exposure. Using data from the East Asian Social Survey, this study finds that the level of global exposure is significantly correlated with vertical cultural omnivorousness (i.e., the appreciation of both highbrow and lowbrow music) in China, Japan, and South Korea; however, the correlation between the level of global exposure and horizontal cultural omnivorousness (i.e., the appreciation of both transnational and traditional music) varies among the three countries. The findings show the diverse nature of cultural consumption in East Asia and challenge the Western discourse in the cultural sphere.
Right thyrocervical trunk rupture after right internal jugular vein puncture: a case report and systematic review of the literature
Authors: Ono Yuko , Ueshima Eisuke , Nakanishi Nobuto , Shinohara Kazuaki , Yamada Isamu , Kotani Joji
Published: September 2022

Background

Thyrocervical trunk rupture is an unusual, but critical, complication associated with central venous catheter (CVC) placement. The management of this complication has not been fully determined because it is rare.

Case presentation

A 53-year-old Japanese woman with anorexia nervosa developed refractory ventricular fibrillation. After returning spontaneous circulation, a CVC was successfully placed at the initial attempt in the right internal jugular vein using real-time ultrasound guidance. Immediately after CVC placement, she developed enlarging swelling around the neck. Contrast-enhanced computed tomography showed massive contrast media extravasation around the neck and mediastinum. Brachiocephalic artery angiography showed a “blush” appearance of the ruptured right thyrocervical trunk. After selective arterial embolization with 33% N-butyl-2-cyanoacrylate, the extravasation completely disappeared and hemostasis was achieved.

Conclusion

Our findings suggest that severe vascular complications arising from CVC placement can occur in patients with a fragile physiological state. Endovascular embolization is an effective treatment for such complications.
Risk factors for wasting among hospitalised children in Nepal
Authors: Inoue Aiko , Dhoubhadel Bhim Gopal , Shrestha Dhruba , Raya Ganendra Bhakta , Hayashi Yumiko , Shrestha Sudeep , Edwards Tansy , Parry Christopher Martin , Ariyoshi Koya , Cox Sharon Elizabeth
Published: September 2022

Background

Malnutrition has various adverse effects in children. This study aimed to determine risk factors for malnutrition among hospitalised children, changes in nutritional status at admission and discharge and effects of use of systematic anthropometric measurement in identification of malnutrition.

Methods

We enrolled 426 children, aged between 6 months and 15 years, admitted to Siddhi Memorial Hospital, Bhaktapur, Nepal, from November 2016 to June 2017. Anthropometric measurements were performed at the time of admission and discharge. Risk factors were assessed by multivariable logistic regression models.

Results

Median age of children was 26 months (IQR: 13–49), and males were 58.7%. The prevalence of wasting was 9.2% (39/426) at admission and 8.5% (36/426) at discharge. Risk factors associated with wasting at admission were ethnic minority (aOR: 3.6, 95% CI 1.2–10.8), diarrhoeal diseases (aOR = 4.0; 95% CI 1.3–11.8), respiratory diseases (aOR: 3.4, 95% CI 1.4–8.1) and earthquake damage to house (aOR = 2.6; 95% CI 1.1–6.3). Clinical observation by care providers identified only 2 out of 112 malnutrition cases at admission and 4 out of 119 cases at discharge that were detected by the systematic anthropometric measurement.

Conclusions

Ethnic minority, diarrhoeal diseases, respiratory infections and house damage due to the earthquake were risk factors associated with wasting. Systematic anthropometric examination can identify significantly more malnourished children than simple observation of care providers.
Effect of alloxan on the locomotor ability and developmental stages of Drosophila melanogaster (Oregon-R)
Authors: Siddique Yasir Hasan , Ansari Mohd Saifullah , Rahul  , Naz Falaq , Jyoti Smita , Faisal Mohammad , Pandey Sharad
Published: September 2022

Background

Various bleaching agents are used in food industries among which some reacts to form alloxan. Therefore, the alloxan can indirectly enter a human body and thus form an important aspects for studying its effect on the development. In the present study, the effect of alloxan was studied on the climbing ability, pupation and emergence of flies. Fifty first instar larvae were introduced separately in the vials containing 0.001, 0.002, 0.003 and 0.004 M of alloxan. Then, the duration of pupation as well as the emergence of flies was noted each day till 20 days. The climbing assay was performed on the emerged flies.

Results

The results suggest that alloxan at 0.002, 0.003 and 0.004 M is potent in inducing the delay in pupation, emergence (of adult flies) and decreased locomotor activity ofDrosophila melanogaster.

Conclusions

Alloxan exhibits toxic effects at 0.002, 0.003 and 0.004 M inDrosophila.
Natural polyphenol self-assembled pH-responsive nanoparticles loaded into reversible hydrogel to inhibit oral bacterial activity
Authors: Qi Yunyun , Yang Jinxiang , Chi Yaping , Wen Peng , Wang Zhongying , Yu Shiyi , Xue Rui , Fan Jingmin , Li Hong , Chen Wen , Wang Xinjun , Zhang Yan , Guo Gang , Han Bo
Published: September 2022

Periodontitis is one of the most prevalent chronic inflammatory diseases and Polyphenols isolated from Turkish gall play a major role in the treatment of inflammatory diseases for their antibacterial, anti-inflammatory and antioxidant activities. In this work, Turkish Galls effective constituent (TGEC, T) was prepared into nanoparticles (T-NPs) by principle of oxidative self-polymerization. The pH-sensitive T-NPs was encapsulated into thermosensitive type in-situ hydrogel, and 42.29 ± 1.12% of effective constituent from T-NPs were continuously released within 96 h under the periodontitis environment. In addition, the weakly alkaline oral micro-environment of patients with periodontitis is more conducive to the sustained release of effective constituent, which is 10.83% more than that of healthy periodontal environment. The bacteriostatic test showed that T-NPs had stronger antibacterial activity on oral pathogens than that of TGEC. Compared with TGEC, the minimum inhibitory concentration (MIC) of T-NPs against P. gingivalis and A. viscosus was reduced by 50% and 25%, respectively. Interestingly, T-NPs induced bacteria lysis by promoting the excessive production of ROS without periodontal tissue damage caused by excessive oxidation reaction. In conclusion, a simple method of preparing microspheres with natural polyphenols was developed, which provides beneficial reference for one-step prepared drug carriers from effective components of natural product, likewise the method offers a green and effective solution to synthesis a new adjuvant therapy drugs for treatment of gingivitis associated with periodontal pockets.
Putting the Pieces Together: Student Thinking about Transformations of Energy and Matter
Authors: Bhatia Kush S. , Stack Austin , Sensibaugh Cheryl A. , Lemons Paula P.
Published: September 2022

Research on student thinking from the pieces perspective reveals students’ independent, fluctuating ideas about metabolism.
Climate change, biodiversity loss and mental health: a global perspective
Authors: Cianconi Paolo , Hirsch Daniele , Chiappini Stefania , Martinotti Giovanni , Janiri Luigi
Published: September 2022

Climate change can have various psychopathological manifestations which have been more actively addressed by scientific research only in recent years. Indeed, extreme weather events and environmental changes have been shown to be associated with a range of mental health problems. Following the destruction of ecosystems, biodiversity loss can cause mental distress and emotional responses, including so-called ‘psychoterratic’ syndromes arising from negatively felt and perceived environmental change. Studies investigating relationships between biodiversity and mental health reveal a complex landscape of scientific evidence, calling for a better understanding of this challenging issue.
A Century-long Journey From the Discovery of Insulin to the Implantation of Stem Cell–derived Islets
Authors: Ramzy Adam , Belmonte Paul J , Braam Mitchell J S , Ida Shogo , Wilts Emily M , Levings Megan K , Rezania Alireza , Kieffer Timothy J
Published: September 2022

For the past century, insulin injections have saved millions of lives, but glycemic instability is still a persistent challenge for people with diabetes, leading to tremendous morbidity and premature mortality. Research in the field of islet transplantation has demonstrated that replacing insulin-producing β cells can restore euglycemia comparable to individuals without diabetes. However, a short supply of cadaveric islet donors, the technically challenging process of isolating islets, and the requirement for chronic immune suppression have impeded widespread clinical adoption. Rather than relying on cadaveric cells, pluripotent stem cells could serve as a virtually unlimited supply of insulin-producing β cells. Protocols have been developed that mimic the normal in vivo development of the human pancreas to generate pancreatic progenitor cells in vitro. Ongoing investigations have yielded progressively more mature β-like cells in vitro that produce insulin but do not yet fully mimic healthy mature β cells. Alongside development of differentiation protocols, other work has provided insight into potential implantation sites for stem cell–derived islet cells including the subcutaneous space, portal vein, and omentum. To optimize implanted cell survival and function, development of immune modulation therapies is ongoing, including selection of immunomodulatory medications and genetic modification of implanted cells to evade immune responses. Further, macroencapsulation or microencapsulation devices could be used to contain and/or immunoprotect implanted cells from the immune response including by using 3-dimensional bioprinting to facilitate the process. Remarkably, ongoing clinical trials have now yielded the first patient relying on differentiated stem cells rather than syringes as their insulin replacement therapy.
Poetics of Cohabitation: An Ecosemiotic Theory of Oral Poiesis
Authors: Ribó Ignasi
Published: September 2022

This article exposes the principles of an ecosemiotic theory of oral poiesis, which conceives of singing as a highly specific habit or skilled practice within the human domain of languaging. It is claimed that oral poiesis may contribute to the semiotic alignment of human and nonhuman own-worlds (Umwelten), playing a role in processes of structural coupling within a habitat, understood as a hybrid assemblage or collective of multispecies inhabitants. The article describes how oral poiesis, as a modeling system, contributes to sustaining the various modes of identification that characterize collective human ontologies (animism, naturalism, totemism, analogism) through distinctive operations of symbolization (literality, metaphor, metonymy, analogy). These modes of ecopoetic symbolization serve to bring nonhumans, such as animals, plants, mountains, or rivers, into human own-worlds. Moreover, as one of many skilled practices of humans, oral poiesis is characterized by certain intrinsic features, such as attention, play, feeling, ritualization, musicality, or remembrance, which contribute to human sociality and hence to a system-wide relationality. All these elements constitute the foundations of a poetics of cohabitation.
A Decade of ACOs in Medicare: Have They Delivered on Their Promise?
Authors: Spivack Steven B. , Murray Genevra F. , Lewis Valerie A.
Published: September 2022

Accountable care organizations (ACOs) were envisioned as a way to address both health care cost growth and uneven quality in US health care. They emerged in the early 2000s, with the 2010 Affordable Care Act (ACA) establishing a Medicare ACO program. In the decade since their launch, ACOs have grown into one of Medicare's flagship payment reform programs, with millions of beneficiaries receiving care from hundreds of ACOs. While great expectations surrounded ACOs' introduction into Medicare, their impacts to date have been modest. ACOs have achieved some savings and improvements in measured quality, but disagreement persists over the meaning of those results: Do ACOs represent important, incremental steps forward on the path toward a more efficient, high-quality health care system? Or do their modest achievements signal a failure of large-scale progress despite the substantial investments of resources? ACOs have proven to be politically resilient, largely sidestepping the controversies and partisan polarization that have led to the demise of other ACA provisions. But the same features that have enabled ACOs to evade backlash have constrained their impacts and effectiveness. After a decade, ACOs' long-term influence on Medicare and the US health care system remains uncertain.
Uric acid as a prognostic predictor in COVID-19
Authors: Parmaksız Ergün , Torun Parmaksız Elif
Published: September 2022

Objective: The purpose of our study was to investigate the incidence and prognostic significance of baseline and control uric acid values in COVID-19.

Methods: The study population included patients admitted with the diagnosis of SARS-CoV-2 between March 2020 and March 2021. The demographic data, clinical, laboratory, and radiological findings were recorded. Uric acid levels were measured at the time of admission for 498 patients and at the most severe period of the disease in 143 patients. Length of hospital stay, need for admission to intensive care unit, the course, and outcomes during hospitalization were recorded.

Results: The mean age of 261 male and 207 female patients was 62.7(21-95) years. At the time of admission, 21 patients had hypouricemia and 170 had hyperuricemia. The need for ICU was 47.6% in the hypouricemic, 19.2% in the normouricemic, and 21.2% in the hyperuricemic groups. The mean uric acid level was 5.24±2.54 mg/dl in patients who required ICU admission and 5.18±1.98 mg/dl in patients who were discharged from the ward. The difference was not statistically significant. The mean uric acid level was not significantly different in the deceased and survivors. In 143 subjects, uric acid levels were measured after the progression of COVID-19; 73 of them were admitted to the ICU. The mean uric acid levels were found to be significantly decreased in patients with a negative prognosis

Conclusion: In our study, hypouricemia was not found to be a major feature of SARS-CoV-2 infection. Low baseline uric acid levels were associated with increased ICU admission. The decline in uric acid levels during hospital stay predicted poor prognosis, as well.

doi: https://doi.org/10.12669/pjms.38.8.6636

How to cite this:Parmaksız E, Parmaksız ET. Uric acid as a prognostic predictor in COVID-19. Pak J Med Sci. 2022;38(8):---------.  doi: https://doi.org/10.12669/pjms.38.8.6636

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Stress and depression among students: Are we doing enough?
Authors: Tariq Sundus , Tariq Saba , Mubarak Naeem
Published: September 2022

doi: https://doi.org/10.12669/pjms.38.8.7076

How to cite this:Tariq S, Tariq S, Mubarak N. Stress and depression among students: Are we doing enough? Pak J Med Sci. 2022;38(8):2056-2057.  doi: https://doi.org/10.12669/pjms.38.8.7076

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Detection of SARS-CoV-2 in conjunctival secretion and tears in patients with COVID-19 in a tertiary care centre, South India. .
Authors: R. Nayak Rajesh , Bhat Sevitha , R Kamath Ajay , Chandak Anshul , Khare Kanishk
Published: September 2022

Aims and objectives: Purpose of this study is to detect the presence of SAR-CoV-2 viral RNA in conjunctival secretions of COVID-19 patients and to compare the RT-PCR positivity rate for SARS-CoV-2 in conjunctival and nasopharyngeal swab.

Materials and method: Eighty hospitalised COVID-19 patients whose nasopharyngeal swab tested positive for SARS-CoV-2 by RT-PCR were included in the study. Conjunctival swab was collected from eyes of these patients and sent for detection of SARS-CoV-2 by RT-PCR method.

Results: Among the eighty patients, 51 (63.7%) were males and 29 (36.3%) were females. The mean age of the patients was 55.93 ± 16.59. Six patients had ocular manifestations. Eleven (13.75%) patients tested positive on conjunctival swab for SARS-CoV-2 viral RNA and only one of them had ocular manifestations out of the eleven.

Conclusion: In our study the presence of SARS-CoV-2 in conjunctival secretions of COVID-19 patients was detected and this was not dependent on presence of ocular manifestations or duration of disease. Though the conjunctival positivity is lower compared to the nasopharyngeal swab sampling, ocular surface and secretions can be a potential route of viral transmission.
Primary sclerosing cholangitis - an insidious enemy of the liver - case report
Authors: Knop Kinga , Piasecka Zuzanna , Kochanowska Anna , Glaz Aneta , Wesolek Ewelina , Kasztelan-Szczerbinska Beata , Skrzydlo-Radomanska Barbara
Published: September 2022

Background and introduction

Primary sclerosing cholangitis (PSC) is a chronic liver disease with features of cholestasis as a result of inflammation and damage to the bile ducts, which can eventually lead to liver fibrosis and parenchymal failure at an advanced stage.

Case Report

A 22-year-old man was admitted urgently to the Department of Gastroenterology for complaints of abdominal pain, weakness and tarry stools. A panel of detailed examinations was performed to establish the diagnosis. An abdominal ultrasound scan showed significant enlargement of the liver and spleen. Gastroscopy  revealed variceal columns of II degree in the lower esophagus, which were cauterized. Laboratory tests confirmed anemia, reduced platelet and white blood cell counts, increased activity of ALT, ASP, GTP, ALP and slight elevation of total bilirubin in the blood. Based on the clinical disease manifestation and the results of diagnostic tests, cirrhosis of unknown origin was suspected. Subsequent magnetic resonance cholangiopancreatography (MRCP) revealed the presence of multiple strictures in the intra- and extrahepatic bile ducts and gave rise to the diagnosis of PSC. Pharmacological treatment was administered. Currently, the patient remains under the close care of the Transplant Clinic, where he undergoes regular checks of liver function, and endoscopic variceal ligation (EVL) as required.

Discussion with conclusions

The case presented here shows that the course of PSC can be insidious and asymptomatic. Despite the absence of clinical symptoms, the disease can lead to the development of advanced cirrhosis even in patients of young age and be diagnosed as late as at the decompensated stage, when the only treatment option remains organ transplantation.
Israel Cruz Velandia (1965 – 2022). El visionario de la fisioterapia
Authors: Cruz Velandia Israel , Páez Torres Magda
Published: September 2022

En las aulas de la Universidad del Rosario aún hacen eco las enseñanzas del profesor Cruz Velandia, quien partió tempranamente, pero dejó un robusto legado al campo de la fisioterapia, a la academia, pero sobre todo a sus estudiantes, a quienes les inculcó la perseverancia; los instó a cuestionarse sobre las realidades de los pacientes y, ante todo, les enseñó a pensar con el cuerpo, a ver su profesión desde un enfoque holístico, desde una visión humanista.
¡No a la política del 'polizón climático'!
Authors: Franchini Matias , Abultaif Kadamani Amira
Published: September 2022

Aunque la región de Latinoamérica y el Caribe no es un gran emisor de gases de efecto invernadero, no puede seguir siendo un actor tímido en la imperiosa necesidad de mitigar el cambio climático, el problema de civilización y gobernanza global más apremiante del siglo XXI. Le urge contener la deforestación, incentivar una agricultura más limpia y descarbonizar su economía.
Ratings and Cooperative Information Transmission
Authors: Martel Jordan , Van Wesep Edward Dickersin , Van Wesep Robert
Published: September 2022

Researchers have often attributed discrete messages such as ratings to a difference in preferences between sender and receiver. By extending a standard model of information transmission, we show that discreteness can also arise when preferences are identical but misinterpretation is possible. Whereas discrete messages are less precise, they are easier to interpret. We provide predictions for the distribution of ratings. If we believe that an observed distribution results from cooperative behavior, the model provides a method for inferring the objectives of the sender and receiver. Ratings inflation and deflation arise as emergent properties of an optimal distribution.

This paper was accepted by Gustavo Manso, finance.

Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2022.4297 .
A vision for improving children's mental health
Authors: Hancock Dave
Published: September 2022

A 2021 survey of half a million children found that one in five worried about their mental health. The Children's Commissioner for England reported her six ambitions for early mental health support for children. Dave Hancock reports
An exploration of public perceptions and attitudes towards maggot therapy
Authors: Nigam Yamni , Williams Sharon , Humphreys Ioan , Clifford Rebecca , Brown Amy
Published: September 2022

Objective:

The aim of the study was to explore public opinion and perceptions of maggot therapy (larval therapy), a treatment option for hard-to-heal wounds.

Method:

The study used a mixed-method approach to obtain quantitative and qualitative data. A focus group was convened to explore opinions and views of maggot therapy with a small group of members of the public. Analysis of emerging themes from the focus group was used to design an anonymised web-based survey, which was made available online to members of the public through email and social media.

Results:

The focus group participants identified four key themes concerning the acceptability of maggot therapy. The subsequent online survey was completed by 412 participants, analysis of which revealed some worries and fears. Only 36% of survey participants agreed that they would accept maggot therapy as a first choice for a hypothetical painful wound, although this number increased with wound severity. The most predominant concerns regarding maggot therapy were sensation and a feeling of disgust associated with the therapy. However, participants could see some benefits to maggot therapy.

Conclusion:

Our study showed that public perception of maggot therapy is varied. Survey participants expressed worries and fears associated with its use. However, positive relationships existed between knowledge scores and potential acceptability of maggot therapy, suggesting that information dissemination and education may be an important factor in public perception and acceptability of maggot therapy.
Effects of resveratrol topical ointment on wound healing of full-thickness cutaneous burns in albino rats
Authors: Yoksa Daniel T , Abba Yusuf , Shamaki Bala U , Satumari Ngamarju A
Published: September 2022

Objective:

In this study, the effects of resveratrol topical ointment on wound contraction and histopathology of full-thickness cutaneous burn wounds were evaluated.

Method:

Adult albino rats were grouped into four equal-sized groups of 15 rats each, as follows: Group A—no wound, no treatment (control); Group B—1% silver sulphadiazine; Group C—5% resveratrol, and Group D—wound without treatment (control). A burn wound measuring 23.5mm was created on the skin at the dorsum of all rats in groups B—D after shaving. The percentage of wound contraction was measured using a digital Vernier Caliper on days 1, 3, 5, 7, 10, 14, 16, 18 and 21, post-wounding. From each group, five rats were then euthanised and tissue samples of the skin, liver and kidney were collected in 10% buffered formalin for histopathology.

Results:

The percentage of wound contraction was significant (p<0.05) on 7, 14 and 18 days post treatment. Histopathologically, 5% resveratrol topical ointment application resulted in a thicker epidermis with neovascularisation and an increased collagen distribution. Resveratrol topical ointment ameliorated the extent of hepatocellular and nephrotubular injuries following burn-induced hepatocellular and acute kidney injuries.

Conclusion:

In this study, topical application of 5% resveratrol ointment appeared to enhance burn wound healing by increasing the rate of wound contraction through collagen fibre synthesis, granulation tissue formation and epithelial regeneration.
Integrating the Contents of Financial Literacy in the Teaching Process: Teachers’ Perspectives
Authors: Kozina Francka Lovšin , Metljak Mira
Published: September 2022

The article deals with financial education. The data were collected as part of the Slovenian project “NA-MA POTI” (NAroslovje, MAtematika, Pismenost, Opolnomočenje, Tehnologija, Interaktivnost- Science, Mathematics, Literacy, Empowerment, Technology, Interactivity), which aims, among other things, to promote financial literacy at the national level. The aim of the survey presented here is to determine teachers’ attitudes towards financial literacy and their teaching strategies in teaching topics related to financial literacy. A total of 158 teachers participated in the survey. The results show that most teachers agree that financial literacy is important. Those teachers who agreed that financial literacy is important were also statistically significantly more likely to use group work, approaches and work methods that require the development of critical thinking and authentic tasks, which provides a good foundation for knowledge transfer in everyday life.
Virtual labeling of mitochondria in living cells using correlative imaging and physics-guided deep learning
Authors: Somani Ayush , Ahmed Sekh Arif , Opstad Ida S. , Birna Birgisdottir Åsa , Myrmel Truls , Singh Ahluwalia Balpreet , Horsch Alexander , Agarwal Krishna , Prasad Dilip K.
Published: September 2022

Mitochondria play a crucial role in cellular metabolism. This paper presents a novel method to visualize mitochondria in living cells without the use of fluorescent markers. We propose a physics-guided deep learning approach for obtaining virtually labeled micrographs of mitochondria from bright-field images. We integrate a microscope’s point spread function in the learning of an adversarial neural network for improving virtual labeling. We show results (average Pearson correlation 0.86) significantly better than what was achieved by state-of-the-art (0.71) for virtual labeling of mitochondria. We also provide new insights into the virtual labeling problem and suggest additional metrics for quality assessment. The results show that our virtual labeling approach is a powerful way of segmenting and tracking individual mitochondria in bright-field images, results previously achievable only for fluorescently labeled mitochondria.
Retinal oxygen kinetics imaging and analysis (ROKIA) based on the integration and fusion of structural-functional imaging
Authors: Feng Ximeng , Jin Zi , Zhou Zixia , Gao Mengdi , Jiang Chunxia , Hu Yicheng , Lu Yanye , Li Jinying , Ren Qiushi , Zhou Chuanqing
Published: September 2022

The retina is one of the most metabolically active tissues in the body.
The dysfunction of oxygen kinetics in the retina is closely related to
the disease and has important clinical value. Dynamic imaging and
comprehensive analyses of oxygen kinetics in the retina depend on the
fusion of structural and functional imaging and high spatiotemporal
resolution. But it’s currently not clinically available,
particularly via a single imaging device. Therefore, this work aims to
develop a retinal oxygen kinetics imaging and analysis (ROKIA)
technology by integrating dual-wavelength imaging with laser speckle
contrast imaging modalities, which achieves structural and functional
analysis with high spatial resolution and dynamic measurement, taking
both external and lumen vessel diameters into account. The ROKIA
systematically evaluated eight vascular metrics, four blood flow
metrics, and fifteen oxygenation metrics. The single device scheme
overcomes the incompatibility of optical design, harmonizes the field
of view and resolution of different modalities, and reduces the
difficulty of registration and image processing algorithms. More
importantly, many of the metrics (such as oxygen delivery, oxygen
metabolism, vessel wall thickness, etc.) derived from the fusion of
structural and functional information, are unique to ROKIA. The oxygen
kinetic analysis technology proposed in this paper, to our knowledge,
is the first demonstration of the vascular metrics, blood flow
metrics, and oxygenation metrics via a single system, which will
potentially become a powerful tool for disease diagnosis and clinical
research.
Non-differentiable angular dispersion as an optical resource
Authors: Hall Layton A. , Abouraddy Ayman F.
Published: September 2022

Introducing angular dispersion into a pulsed field associates each
frequency with a particular angle with respect to the propagation
axis. A perennial yet implicit assumption is that the propagation
angle is differentiable with respect to the frequency. Recent work on
space–time wave packets has shown that the existence of a frequency at
which the derivative of the propagation angle does not exist—which we
refer to as non-differentiable angular dispersion—allows for the
optical field to exhibit unique and useful characteristics that are
unattainable by endowing optical fields with conventional angular
dispersion. Because these novel, to the best of our knowledge,
features are retained in principle even when the specific
non-differentiable frequency is not part of the selected spectrum, the
question arises as to the impact of the proximity of the spectrum to
this frequency. We show here that operating in the vicinity of the
non-differentiable frequency is imperative to reduce the deleterious
impact of (1) errors in implementing the angular-dispersion profile
and (2) the spectral uncertainty intrinsic to finite-energy wave
packets in any realistic system. Non-differential angular dispersion
can then be viewed as a resource—quantified by a Schmidt number—that
is maximized in the vicinity of the non-differentiable frequency.
These results will be useful in designing novel phase-matching of
nonlinear interactions in dispersive media.