bluuebunny/crossref_metadata_2025 huggingface dataset:
Broadband and unidirectional plasmonic hyperlensing in drift-biased graphene
Authors: Paul N. K. , Gomez-Diaz J. S.
Published: March 2021

We suggest and explore the possibility to realize broadband and unidirectional plasmonic hyperlensing over a graphene layer biased with two orthogonal drift-biases. This platform relies on the interplay between nonlocality and nonreciprocity to generate ultraconfined states in the direction aligned with the effective biasing current. The presence of these states shapes, elongates, and significantly flattens the isofrequency contour of the supported modes and enforces the canalization of surface plasmons along the two directions defined by the applied biases. Through a dedicated anisotropic Green's function formalism that takes graphene's intrinsic nonlocality into account, we show that this platform resolves the presence of two point-source emitters with a resolution larger than λ0/500 over a broad frequency range (∼10−25 THz) using realistic biasing schemes. We also discuss how spin–orbit interactions can be exploited to construct unidirectional hyperlenses for near-field images with specific polarization distribution. Our findings may open exciting applications in dynamic, subdiffractive, and planar sensing and imaging systems and in the exciting, routing, and processing of surface plasmons.
Infinite norm of the derivative of the solution operator of Euler equations
Authors: Charles Li Y.
Published: March 2021

Through a simple and elegant argument, we prove that the norm of the derivative of the solution operator of Euler equations posed in the Sobolev space Hn, along any base solution that is in Hn but not in Hn+1, is infinite. We also review the counterpart of this result for Navier–Stokes equations at a high Reynolds number from the perspective of fully developed turbulence. Finally, we present a few examples and numerical simulations to show a more complete picture of the so-called rough dependence upon initial data.
Aero-optical and aero-heating effects of supersonic turbulent boundary layer with a tangential wall-injection film
Authors: Sun Xi-Wan , Yang Xiao-Liang , Liu Wei
Published: March 2021

Film cooling via tangential wall injection is universally employed to alleviate serious aerodynamic heating of the optical window in high-speed target-seeking vehicles; nevertheless the imaging quality should be concomitantly concerned due to the turbulence-aberrated aero-optical phenomenon. This flow phenomenon can be essentially abstracted into the combinational mixing layer and turbulent boundary flow configuration, enabling numerical investigation using an explicit fifth-order weighted compact nonlinear scheme (WCNS-E-5) and a ray-tracing method. The current study considers both the aero-optical effect in a prescribed light pupil and the wall temperature under adiabatic conditions, with snapshots of vorticity contours in the symmetric plane and the wall normal density fluctuation introduced as auxiliary variables for analyzing the flowfield behavior. A parametric investigation on tangential wall injection is conducted by altering the Mach number, total temperature, and total pressure consequently via a variable-controlling procedure. The results reveal that the mutual realization of aero-optical and aero-heating reduction presents considerable difficulty, so that the future optimization of the operating conditions is suggested for engineering applications.
Micro-Gas Flow Induced Stochastic Resonance of a Nonlinear Nanomechanical Resonator
Authors: Lin Shaochun , Tian Tian , Yin Peiran , Huang Pu , Zhang Liang , Du Jiangfeng
Published: March 2021

Fluidics is one of the most historic subjects that are well-established over centuries on the macroscopic scale. In recent years, fluid detection using a number of micro/nano scale devices has been achieved. However, the interaction of microfluid and solid devices on micro/nano-meter scale still lacks in-depth research. We demonstrate a practical nanomechanical detector for microfluidics via a string resonator with high Q-factor, suspended over a hole. This device is placed under a jet nozzle with several microns of diameter, and the interaction between the micro-gas flow and the resonator is observed by monitoring the variation of the fundamental frequency and the quality factor. Moreover, we manage to measure the fluctuations of the micro-gas flow on the nanomechanical resonator by means of stochastic resonance. This work manifests a potential platform for detecting dynamical fluid behaviors at microscopic scale for novel fluid physics.
Self-Similarity Breaking: Anomalous Nonequilibrium Finite-Size Scaling and Finite-Time Scaling
Authors: Yuan Weilun , Yin Shuai , Zhong Fan
Published: March 2021

Symmetry breaking plays a pivotal role in modern physics. Although self-similarity is also a symmetry, and appears ubiquitously in nature, a fundamental question arises as to whether self-similarity breaking makes sense or not. Here, by identifying an important type of critical fluctuation, dubbed ‘phases fluctuations’, and comparing the numerical results for those with self-similarity and those lacking self-similarity with respect to phases fluctuations, we show that self-similarity can indeed be broken, with significant consequences, at least in nonequilibrium situations. We find that the breaking of self-similarity results in new critical exponents, giving rise to a violation of the well-known finite-size scaling, or the less well-known finite-time scaling, and different leading exponents in either the ordered or the disordered phases of the paradigmatic Ising model on two- or three-dimensional finite lattices, when subject to the simplest nonequilibrium driving of linear heating or cooling through its critical point. This is in stark contrast to identical exponents and different amplitudes in usual critical phenomena. Our results demonstrate how surprising driven nonequilibrium critical phenomena can be. The application of this theory to other classical and quantum phase transitions is also anticipated.
Suppressed Thermal Conductivity in Polycrystalline Gold Nanofilm: The Effect of Grain Boundary and Substrate
Authors: Dong Lan , Wu Xiangshui , Hu Yue , Xu Xiangfan , Bao Hua
Published: March 2021

We investigate the electrical conductivity and thermal conductivity of polycrystalline gold nanofilms, with thicknesses ranging from 40.5 nm to 115.8 nm, and identify a thickness-dependent electrical conductivity, which can be explained via the Mayadas and Shatzkes (MS) theory. At the same time, a suppressed thermal conductivity is observed, as compared to that found in the bulk material, together with a weak thickness effect. We compare the thermal conductivity of suspended and supported gold films, finding that the supporting substrate can effectively suppress the in-plane thermal conductivity of the polycrystalline gold nanofilms. Our results indicate that grain boundary scattering and substrate scattering can affect electron and phonon transport in polycrystalline metallic systems.
Human–Mosquito Contact: A Missing Link in Our Understanding of Mosquito-Borne Disease Transmission Dynamics
Authors: Thongsripong Panpim , Hyman James M , Kapan Durrell D , Bennett Shannon N
Published: March 2021

Despite the critical role that contact between hosts and vectors, through vector bites, plays in driving vector-borne disease (VBD) transmission, transmission risk is primarily studied through the lens of vector density and overlooks host–vector contact dynamics. This review article synthesizes current knowledge of host–vector contact with an emphasis on mosquito bites. It provides a framework including biological and mathematical definitions of host–mosquito contact rate, blood-feeding rate, and per capita biting rates. We describe how contact rates vary and how this variation is influenced by mosquito and vertebrate factors. Our framework challenges a classic assumption that mosquitoes bite at a fixed rate determined by the duration of their gonotrophic cycle. We explore alternative ecological assumptions based on the functional response, blood index, forage ratio, and ideal free distribution within a mechanistic host–vector contact model. We highlight that host–vector contact is a critical parameter that integrates many factors driving disease transmission. A renewed focus on contact dynamics between hosts and vectors will contribute new insights into the mechanisms behind VBD spread and emergence that are sorely lacking. Given the framework for including contact rates as an explicit component of mathematical models of VBD, as well as different methods to study contact rates empirically to move the field forward, researchers should explicitly test contact rate models with empirical studies. Such integrative studies promise to enhance understanding of extrinsic and intrinsic factors affecting host–vector contact rates and thus are critical to understand both the mechanisms driving VBD emergence and guiding their prevention and control.
Surveillance for Healthcare-Associated Infections: Hospital-Onset Adult Sepsis Events Versus Current Reportable Conditions
Authors: Page Brady , Klompas Michael , Chan Christina , Filbin Michael R , Dutta Sayon , McEvoy Dustin S , Clark Roger , Leibowitz Matthew , Rhee Chanu
Published: March 2021

Background

US hospitals are required by the Centers for Medicare and Medicaid Services to publicly report central line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), Clostridioidesdiffficile, methicillin-resistant Staphylococcus aureus bacteremia, and selected surgical site infections for benchmarking and pay-for-performance programs. It is unclear, however, to what extent these conditions capture the full breadth of serious healthcare-associated infections (HAIs). The Centers for Disease Control and Prevention’s (CDC’s) hospital-onset Adult Sepsis Event (HO-ASE) definition could facilitate more comprehensive and efficient surveillance for serious HAIs, but the overlap between HO-ASE and currently reportable HAIs is unknown.

Methods

We retrospectively assessed the overlap between HO-ASEs and reportable HAIs among adults hospitalized between June 2015–June 2018 in 3 hospitals. Medical record reviews were conducted for 110 randomly selected HO-ASE cases to determine clinical correlates.

Results

Among 282 441 hospitalized patients, 2301 (0.8%) met HO-ASE criteria and 1260 (0.4%) had reportable HAIs. In-hospital mortality rates were higher with HO-ASEs than reportable HAIs (28.6% vs 12.9%). Mortality rates for HO-ASE missed by reportable HAIs were substantially higher than mortality rates for reportable HAIs missed by HO-ASE (28.1% vs 6.3%). Reportable HAIs were only present in 334/2301 (14.5%) HO-ASEs, most commonly CLABSIs (6.0% of HO-ASEs), C. difficile (5.0%), and CAUTIs (3.0%). On medical record review, most HO-ASEs were caused by pneumonia (39.1%, of which only 34.9% were ventilator-associated), bloodstream infections (17.4%, of which only 10.5% were central line–associated), non–C. difficile intra-abdominal infections (14.5%), urinary infections (7.3%, of which 87.5% were catheter-associated), and skin/soft tissue infections (6.4%).

Conclusions

CDC’s HO-ASE definition detects many serious nosocomial infections missed by currently reportable HAIs. HO-ASE surveillance could increase the efficiency and clinical significance of surveillance while identifying new targets for prevention.
Patient-reported indicators in mental health care: towards international standards among members of the OECD
Authors: de Bienassis Katherine , Kristensen Solvejg , Hewlett Emily , Roe David , Mainz Jan , Klazinga Niek
Published: March 2021

Background

Achieving people-centred health care systems requires new and innovative strategies to capture information about whether, and to what degree, health care is successful in improving health from the perspective of the patient. Patient-reported outcome measures (PROMs) and Patient-reported experience measures (PREMs) can bring some of these new insights, and are increasingly used in research, clinical care, and policymaking.

Methods

This paper reflects the ongoing discussions and findings of the OECD PaRIS Working Group on Patient-reported Indicators for Mental Health Care.

Results

The OECD has been measuring quality of care for mental health conditions over the last 14 years through the Health Care Quality and Outcomes (HCQO) program; nonetheless, information on how persons with mental health problems value the services they receive, and impact of the services, remains limited. As of 2018, a survey from the OECD showed that only five of the twelve countries surveyed (Australia, Israel, Netherlands, Sweden, United Kingdom) reported PROMs and PREMs collection on a regular basis in mental health settings. The paper details some of the challenges specific to the collection and use of PROMs and PREMs in mental health care, and examples from countries which have implemented comprehensive programmes to gather information about PROMs and PREMs for individuals receiving mental health services.

Conclusions

Given the health and economic impact of mental ill-health across all OECD countries, there is significant value to being able to assess the quality and outcomes of care in this area using internationally-comparable measures. Continued international harmonisation of PROMs and PREMs for mental health through international coordination is a key way to facilitate the sharing of national experiences, promote the use of PROMs and PREMs, and create meaningful indicators for national and international benchmarking.
Saliva-based linezolid monitoring on a mobile UV spectrophotometer
Authors: Kim Hannah Yejin , Ruiter Evelien , Jongedijk Erwin M , AK Hemanth Kumar , Marais Ben J , PK Bhavani , Sawleshwarkar Shailendra , Touw Daan J , Alffenaar Jan-Willem
Published: March 2021

Background

In TB, therapeutic drug monitoring (TDM) is recommended for linezolid; however, implementation is challenging in endemic settings. Non-invasive saliva sampling using a mobile assay would increase the feasibility of TDM.

Objectives

To validate a linezolid saliva assay using a mobile UV spectrophotometer.

Methods

The saliva assay was developed using NanoPhotometer NP80® and linezolid concentrations were quantified using second-order derivative spectroscopy. Sample preparation involved liquid–liquid extraction of saliva, using saturated sodium chloride and ethyl acetate at 1:1:3 (v/v/v). The assay was validated for accuracy, precision, selectivity, specificity, carry-over, matrix effect, stability and filters. Acceptance criteria were bias and coefficient of variation (CV) <15% for quality control (QC) samples and <20% for the lower limit of quantification (LLOQ).

Results

Linezolid concentrations correlated with the amplitude between 250 and 270 nm on the second-order derivative spectra. The linezolid calibration curve was linear over the range of 3.0 to 25 mg/L (R2 = 0.99) and the LLOQ was 3.0 mg/L. Accuracy and precision were demonstrated with bias of −7.5% to 2.7% and CV ≤5.6%. The assay met the criteria for selectivity, matrix effect, carry-over, stability (tested up to 3 days) and use of filters (0.22 μM Millex®-GV and Millex®-GP). Specificity was tested with potential co-medications. Interferences from pyrazinamide, levofloxacin, moxifloxacin, rifampicin, abacavir, acetaminophen and trimethoprim were noted; however, with minimal clinical implications on linezolid dosing.

Conclusions

We validated a UV spectrophotometric assay using non-invasive saliva sampling for linezolid. The next step is to demonstrate clinical feasibility and value to facilitate programmatic implementation of TDM.
Susceptibility of North Carolina Chloridea (Heliothis) virescens (Lepidoptera: Noctuidae) Populations From Flue Cured Tobacco to Chlorantraniliprole
Authors: Zilnik Gabriel , Burrack Hannah J
Published: March 2021

The tobacco budworm, Chloridea (Heliothis) virescens (F.), has evolved resistance to numerous insecticides in the field. In tobacco, chlorantraniliprole can be applied as either a preventative systemic soil application at or near transplant, or a foliar application timed to current treatment thresholds. With a novel mode of action chlorantraniliprole provides an option for rotation with other insecticides to reduce the probability of insecticide resistance development. However, specific usage patterns in tobacco have the potential to increase the risk of resistance development to this insecticide. In particular, soil applied treatments may expose C. virescens to sublethal concentrations of the insecticide. We studied chlorantraniliprole susceptibility in nine field populations and one laboratory strain of C. virescens using a diet incorporation bioassay. Mortality was measured at 7, 10, and 14 d after exposure. Our results demonstrated that bioassays should be evaluated at 14 d after exposure to optimize interpretation of the dose–response due to the antifeeding properties of chlorantraniliprole. We observed low variation within field-collected populations. Field populations were as susceptible as the laboratory strain; the resistance ratio at the 14-d evaluation for field-collected populations ranged from 1.01 to 1.05. A discriminating dose of 0.117, 0.080, and 0.070 μg a.i./g diet could be used at 7, 10, and 14 d, respectively. Larval growth varied between field populations. Two field populations continued growing on diet containing chlorantraniliprole and differed in size from the laboratory and other populations. Further evaluation of growth inhibition will be necessary.
Re-asserting the Specialness of Health Care
Authors: Rumbold Benedict
Published: March 2021

Is health care “special”? That is, do we have moral reason to treat health care differently from how we treat other sorts of social goods? Intuitively, perhaps, we might think the proper response is “yes.” However, to date, philosophers have often struggled to justify this idea—known as the “specialness thesis about health care” or STHC. In this article, I offer a new justification of STHC, one I take to be immune from objections that have undercut other defenses. Notably, unlike previous utility- and opportunity-based theories, I argue that we can find normative justification for STHC in what I term our special duty to assist those unable to help themselves. It is this duty, I argue, that ultimately gives us reason to treat health care differently from other sorts of goods (even other goods meeting health needs) and to distribute it independently of individuals’ ability to pay.
A common bean truncated CRINKLY4 kinase controls gene-for-gene resistance to the fungusColletotrichum lindemuthianum
Authors: Richard Manon M S , Gratias Ariane , Alvarez Diaz Juan C , Thareau Vincent , Pflieger Stéphanie , Meziadi Chouaib , Blanchet Sophie , Marande William , Bitocchi Elena , Papa Roberto , Miklas Phillip N , Geffroy Valérie
Published: March 2021

Identifying the molecular basis of resistance to pathogens is critical to promote a chemical-free cropping system. In plants, nucleotide-binding leucine-rich repeat constitute the largest family of disease resistance (R) genes, but this resistance can be rapidly overcome by the pathogen, prompting research into alternative sources of resistance. Anthracnose, caused by the fungus Colletotrichum lindemuthianum, is one of the most important diseases of common bean. This study aimed to identify the molecular basis of Co-x, an anthracnose R gene conferring total resistance to the extremely virulent C. lindemuthianum strain 100. To that end, we sequenced the Co-x 58 kb target region in the resistant JaloEEP558 (Co-x) common bean and identified KTR2/3, an additional gene encoding a truncated and chimeric CRINKLY4 kinase, located within a CRINKLY4 kinase cluster. The presence of KTR2/3 is strictly correlated with resistance to strain 100 in a diversity panel of common beans. Furthermore, KTR2/3 expression is up-regulated 24 hours post-inoculation and its transient expression in a susceptible genotype increases resistance to strain 100. Our results provide evidence that Co-x encodes a truncated and chimeric CRINKLY4 kinase probably resulting from an unequal recombination event that occurred recently in the Andean domesticated gene pool. This atypical R gene may act as a decoy involved in indirect recognition of a fungal effector.
Scatter-free acceleration of particles by interaction with plasma shock waves in the interstellar medium
Authors: Rashed-Mohassel P , Ghorbanalilu M
Published: March 2021

Scatter-free acceleration is investigated for a test particle thrusted by a moving magnetized cloud in the presence of the uniform interstellar magnetic field. It is found that depending on the orientation of the background magnetic field, three different scenarios occur for the interacting particle. In some cases, the particle reflects into space with a negligible increase in energy. Otherwise, the particle is either trapped at the wavefront or is injected inside the cloud. The trapped particle moves with the cloud and gains energy through the magnetic trapping acceleration mechanism, which is already investigated in previous reports. The injected particle accelerates through a different mechanism, which is introduced in this paper as the spiral acceleration. In this mechanism, the particle moves in a spiral path and gains energy by the convective electric field of the cloud. The radius of the spiral increases as the particle gains more energy and the process continues until the particle is located inside the cloud. Since in most cases the trapping condition is not satisfied, the spiral acceleration mechanism is of great importance.
Unexpected LIGO events and the mirror world
Authors: Beradze Revaz , Gogberashvili Merab
Published: March 2021

We consider the possibility that LIGO events GW190521, GW190425, and GW190814 may have emerged from the mirror world binaries. Theories of star evolution predict so-called upper and lower mass gaps and masses of these merger components lie in that gaps. In order to explain these challenging events very specific assumptions are required and we argue that such scenarios are order of magnitude more probable in mirror world, where star formation begins earlier and matter density can exceed five times the ordinary matter density.
Review
Authors: Durand Claire , Johnson Timothy P
Published: March 2021

The twenty-first century has seen an important transition in survey modes used for electoral polls. This transition has not ended yet. It is thus possible to examine differences between modes used in the same election. Different modes are more or less prone to social desirability and use different sampling frames and recruitment strategies that may lead to differences in estimation. However, available literature does not show systematic and substantial differences between modes. In this article, we examine differences between modes across 15 elections and referendums that took place since 2005 in four countries: Canada, France, the United Kingdom, and the United States. We first assess differences in average estimates, variance, trends, and forecasts. We then pool the data to analyze whether there are differences that apply in all contexts. We conclude that differences between modes vary with context and over time. There are some consistent differences, however, as online polls are less likely to detect movement than are telephone or IVR polls. In a context in which online polls are becoming dominant, citizens may not be provided with a reliable portrait of the state of public opinion. IVR polls tended to be more precise than other polls recently, but they also tended to have a conservative bias. For the future, it will be important to monitor closely new developments in the methodology used for election polls. The presence of multiple modes in pre-election polling and new developments in mixed modes would be beneficial to voters and researchers alike.
Laparoscopic versus open surgery in the treatment of hepatic hemangioma
Authors: Jien He , Xiaohua Li
Published: March 2021

Background:

The aim of this study was to systematically evaluate and compare the effectiveness and safety of laparoscopic versus open resection (LR vs OR) in the treatment of hepatic hemangioma.

Methods:

We searched PubMed, the Cochrane Library, Web of Science, Medline, EMBASE, and the Chinese Biomedicine Database from January 2000 to April 2020 for studies comparing the outcomes of laparoscopic versus open surgery in hepatic hemangioma treatment.

Results:

Based on the preset criteria, 12 randomized clinical trials (RCTs) and 12 observational clinical studies (OCSs) were selected for analysis. Our results showed that laparoscopic surgery was more effective than open surgery in terms of reducing operation time, intraoperative blood loss, postoperative exhaust time, postoperative complications, postoperative bile leak, postoperative intra-abdominal infection, postoperative alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values, postoperative visual analog scale (VAS) scores, and hospitalize length. No significant differences were found between the 2 groups in hepatectomy time, hospitalized cost, intra-abdominal hemorrhage, and the postoperative recurrence of hemangioma.

Conclusion:

While similar therapeutic effect was achieved by the compared herein surgical methods, the findings of our analysis revealed that laparoscopic surgery is superior over open surgery in terms of less trauma, faster recovery, less postoperative pain, shorter hospitalize length, and reduced postoperative complications. Therefore, laparoscopic resection of hepatic hemangioma is a safe, effective, and feasible surgical method that is worth considering in clinical applications.
Efficacy evaluation of acupuncture combined with Liujunzi Decoction in the treatment of functional dyspepsia
Authors: Zhang Yulan , Bian Lihong , Long Huan , Zhang Weichen , Hu Yuqiong
Published: March 2021

Background:

Functional dyspepsia (FD) is a common and frequently-occurring disease in internal medicine. It is known that Liujunzi decoction and acupuncture are widely used in the treatment of FD, but there are few studies on the combination of Liujunzi decoction and acupuncture in the treatment of FD, and its safety and efficacy are still controversial. Therefore, the purpose of this study is to evaluate the efficacy and safety of acupuncture combined with Liujunzi decoction in the treatment of FD.

Methods:

We designed a prospective randomized controlled trial. The study protocol was approved by the Clinical Research Ethics Committee of our hospital. Patients with FD were randomly assigned to the treatment group of acupuncture combined with Liujunzi Decoction (the experimental group) and the treatment group of Liujunzi Decoction (the control group) in a ratio of 1:1. Outcome indicators were Nepean Dyspepsia Index, the MOS item short from health survey, and adverse reactions. Finally, SPSS 18.0 software would be used for statistical analysis of the data.

Discussion:

This study will evaluate the efficacy and safety of acupuncture combined with Liujunzi Decoction in the treatment of FD and provide clinical basis for the use of acupuncture combined with Liujunzi Decoction in the treatment of FD.

OSF Registration number:

DOI 10.17605/OSF.IO/67GKN
Efficacy and safety of immunosuppressive therapies in the treatment of high-risk IgA nephropathy
Authors: Liu Tongtong , Wang Yuyang , Mao Huimin , Yang Liping , Zhan Yongli
Published: March 2021

Background:

IgA nephropathy (IgAN) is one of the significant contributing factors of end-stage renal disease (ESRD). It is reported that over half of patients with IgAN accompany multiple high-risk factors, which increase the risk of ESRD progression. Studies have shown that immunosuppressive agents were beneficial in high-risk IgAN, but the efficacy and safety have not been fully demonstrated yet. The present study aims to elucidate the efficacy of commonly used immunosuppressants in high-risk IgAN and their relative safety profiles via a network meta-analysis strategy.

Methods:

Randomized controlled trials (RCTs) eligible for this network meta-analysis were included to evaluate the efficacy and safety of different immunosuppressants for high-risk IgAN. Main outcomes and measures include incidence of renal composite end point, the rate of total remission, adverse events, and proteinuria. Besides, subgroup analysis and cluster analysis were carried out.

Results:

This network meta-analysis of 37 RCTs involving 3012 participants found that Mycophenolate mofetil (MMF) combined with corticosteroids (CS) was superior to other interventions in end point events and proteinuria. Cyclosporine A (CsA) plus CS was the best option for clinical remission rate, and supportive care (SC) was the safest treatment. Cluster analysis showed that MMF+CS and Leflunomide (LEF)+CS were best protocols in efficacy and safety. Subgroup analysis indicated the best benefits of MMF were presented among the Asian population, and the benefits increased with the increase of follow-up duration. The effect of Cyclophosphamide (CTX) +CS on crescent IgAN was better than that of other risk factors. Moreover, the increasing follow-up duration was negatively associated with the effect.

Conclusions:

MMF+CS and LEF+CS appear to serve as the best choice for treating high-risk IgAN than other immunosuppressive therapies.
Prenatal serum sFlt-1/PlGF ratio predicts the adverse neonatal outcomes among small-for-gestational-age fetuses in normotensive pregnant women
Authors: Shim So Hyun , Jeon Haeng Jun , Ryu Hye Jin , Kim So Hyun , Min Seung Gi , Kang Min Kyu , Park Hee Jin , Cha Dong Hyun
Published: March 2021

We investigated the predictive value of the soluble fms-like tyrosine kinase-1 (sFlt-1)-to-placental growth factor (PlGF) ratio for poor neonatal outcomes of SGA neonates in the absence of preeclampsia.

This prospective cohort study included 530 singleton pregnant women who attended a prenatal screening program at a single institution. The sFlt-1/PlGF values at 24 to 28+6 weeks and 29 to 36+6 weeks of gestation were analyzed and compared between control and SGA group (subdivided as with normal neonatal outcomes and with poor neonatal outcomes).

After 22 preeclampsia cases were excluded, 47 SGA neonates and 461 control neonates were included. In the SGA group, 17 neonates had adverse neonatal outcomes (36.1%, 17/47). The mean (±D) sFlt-1/PlGF ratio of early third trimester was significantly higher in SGA with averse neonatal outcome group than in the control group (14.42 ± 23.8 vs 109.12 3.96, P = .041) and the ratio retained an independent and significant association with SGA with adverse neonatal outcomes (odds ratio = 1.017, P = .01). A sFlt-1/PlGF ratio cut-off of 28.15 at 29 to 36+6 weeks significantly predicted adverse outcomes among SGA neonates (sensitivity = 76.9%, specificity = 88%).

In this study, sFlt-1/PlGF ratio at 29 to 36 + 6wks of SGA with adverse neonatal outcome group was significantly higher than control group. This study suggests the feasibility of the sFlt-1/PlGF ratio as helpful objective measurement for predicting the adverse SGA neonatal outcome by providing sFlt-1/PlGF cut-off value.
Effectiveness of endoscopic hemostasis in preventing diverticular bleeding with extravasation detected by contrast-enhanced computed tomography
Authors: Yamagishi Toshinobu , Kashiura Masahiro , Shindo Yuji , Yamanaka Kenichi , Tsuboi Ken , Shinhata Hakuei
Published: March 2021

In diverticular bleeding, extravasation detected by computed tomography indicates active bleeding. It is unclear whether an endoscopic procedure is the best method of hemostasis for diverticular bleeding. This retrospective study was conducted to examine the effectiveness of endoscopic hemostasis in preventing diverticular rebleeding with extravasation visualized by contrast-enhanced computed tomography.

This single-center, retrospective, the observational study utilized data from an endoscopic database. Adult patients admitted to our hospital due to diverticular bleeding diagnosed by colonoscopy were included. We compared the data between the extravasation-positive and extravasation-negative groups. The primary outcome was the proportion of successful hemostasis without rebleeding within 1 month after the first endoscopic procedure. Altogether, 69 patients were included in the study (n = 17, extravasation-positive group; n = 52, extravasation-negative group). The overall rebleeding rate was 30.4% (21/69). The rebleeding rate was higher in the extravasation-positive group than in the extravasation-negative group, although without a statistically significant difference. However, among the patients who underwent endoscopic hemostasis, the rebleeding rate was significantly higher in the extravasation-positive group than in the extravasation-negative group (50% [8/16] vs 10.5% [2/19], p = .022). In the extravasation-positive group, all 8 patients with rebleeding underwent repeat colonoscopy. Of these, 5 patients required additional clips; bleeding was controlled in 3 patients, while arterial embolization or surgery was required for hemostasis in 2 patients. None of the remaining 3 patients with rebleeding in the extravasation-positive group required clipping; thus, their conditions were only observed.

Many patients with diverticular bleeding who exhibited extravasation on computed tomography experienced rebleeding after endoscopic hemostasis. However, bleeding in more than half of these patients could be stopped by 2 endoscopic procedures, without performing transcatheter arterial embolization or surgery even if rebleeding occurred. Some serious major complications due to such invasive interventions are reported in the literature, but colonoscopic complications did not occur in our patients. Endoscopic hemostasis may be the preferred and effective first-line therapy for patients with diverticular bleeding who have extravasation, as visualized by contrast-enhanced computed tomography.
Calcitonin gene-related peptide receptor antagonist ubrogepant for the treatment of acute migraine
Authors: Zhang Zizhen , Shu Yunfeng , Diao Yun , Du Yang , Chen Lizhi , Liu Ying , Du Biao
Published: March 2021

Background:

The objective of this study is to systematically evaluate the efficacy and safety of the calcitonin gene-related peptide (CGRP) receptor antagonist ubrogepant for the treatment of acute migraine.

Methods:

Randomized controlled trials (RCTs) of ubrogepant for treatment of acute migraine were identified in PubMed, MEDLINE, EMBASE, and the Cochrane Library from database establishment to June 2020; we also searched ClinicalTrials.gov manually during the same period. Then, RevMan 5.3 software was used to perform a meta-analysis on each outcome measure.

Results:

A total of 5 RCTs involving 4903 patients were included; there were 3358 cases in the ubrogepant group and 1545 cases in the placebo group. The meta-analysis showed the following results: at 2 hours postdose, the percentages of participants reporting pain relief and the absence of photophobia, nausea, and phonophobia were significantly higher in the ubrogepant group than in the placebo group (odds ratio [OR] = 1.71, 95%CI: 1.48–1.97, P < .00001; OR = 1.33, 95%CI: 1.22–1.45, P < .00001; OR = 1.07, 95%CI: 1.03–1.11, P = .0006; OR = 1.21, 95%CI: 1.14–1.28, P < .00001). The incidence of common adverse events was similar between the 2 groups (P > .05).

Conclusion:

Ubrogepant is effective and safe for the treatment of acute migraine.

Registration number:

PROSPERO CRD42019145286.
Association between 30-day readmission rates and health information technology capabilities in US hospitals
Authors: Elysee Gerald , Yu Huihui , Herrin Jeph , Horwitz Leora I.
Published: March 2021

Health information technology (IT) is often proposed as a solution to fragmentation of care, and has been hypothesized to reduce readmission risk through better information flow. However, there are numerous distinct health IT capabilities, and it is unclear which, if any, are associated with lower readmission risk.

To identify the specific health IT capabilities adopted by hospitals that are associated with hospital-level risk-standardized readmission rates (RSRRs) through path analyses using structural equation modeling.

This STROBE-compliant retrospective cross-sectional study included non-federal U.S. acute care hospitals, based on their adoption of specific types of health IT capabilities self-reported in a 2013 American Hospital Association IT survey as independent variables. The outcome measure included the 2014 RSRRs reported on Hospital Compare website.

A 54-indicator 7-factor structure of hospital health IT capabilities was identified by exploratory factor analysis, and corroborated by confirmatory factor analysis. Subsequent path analysis using Structural equation modeling revealed that a one-point increase in the hospital adoption of patient engagement capability latent scores (median path coefficient ß = −0.086; 95% Confidence Interval, −0.162 to −0.008), including functionalities like direct access to the electronic health records, would generally lead to a decrease in RSRRs by 0.086%. However, computerized hospital discharge and information exchange capabilities with other inpatient and outpatient providers were not associated with readmission rates.

These findings suggest that improving patient access to and use of their electronic health records may be helpful in improving hospital performance on readmission; however, computerized hospital discharge and information exchange among clinicians did not seem as beneficial – perhaps because of the quality or timeliness of information transmitted. Future research should use more recent data to study, not just adoption of health IT capabilities, but also whether their usage is associated with lower readmission risk. Understanding which capabilities impact readmission risk can help policymakers and clinical stakeholders better focus their scarce resources as they invest in health IT to improve care delivery.
Delirium screening tools in the emergency department
Authors: Zhang Qian , Li Sheng , Chen Meixi , Yang Qiuyu , Cao Xiao , Ge Long , Di Baoshan
Published: March 2021

Background:

Delirium is a common type of acute brain dysfunction among emergency department (ED) patients. The prevalence of delirium in the ED is up to 40%. Although screening instruments used to identify delirium have been developed, it is unclear which tool is the most accurate in the ED. To address this challenging, we systematically examine the accuracy of delirium screening tools used to assess the ED patients.

Methods:

This study has been registered at the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY), and the registration number is INPLASY202110041. We will search the PubMed, EMBASE, PsycINFO, and the Cochrane Library. Studies involving patients which compared diagnostic instruments with the criteria in Diagnostic and Statistical Manual of Mental Disorders (DSM) as a reference standard will be included. We will use STATA 15.1 and MetaDiSC to make careful analysis of the results. The quality of included studies will be assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 scale.

Results:

In this study, the accuracy of different screening methods among ED patients is assessed by a high-quality synthesis. The number of tools available for screening delirium in the ED, the information of studies including the countries, the study design, the sample size and the characteristic of studies, the quality of the studies and the results of meta-analysis. The systematic review and meta-analysis will be published in a peer-reviewed journal.

Conclusion:

According to the conclusion of the systematic review, evidence will be provided to judge which screening method is the best for the ED patients. The results will bring better understanding of screening methods in the ED and highlight gaps for future research.
Safety and efficacy of edaravone for patients with acute stroke
Authors: Shan Hailei , Jiao Guangmei , Cheng Xi , Dou Zhijie
Published: March 2021

Background:

We performed a randomized clinical trial protocol to assess the effectiveness of edaravone for acute stroke. We hypothesized that edaravone is beneficial in improving neurological impairment resulting from acute stroke.

Method:

The protocol was reviewed and approved by the Research Ethics Board of Affiliated Hospital of Chengde Medical University (0092-2394), each participant signed a written consent before participating, and SPIRIT guidelines were followed throughout. The inclusion criteria for patients were as follows: diagnosed as acute stroke (ischemic stroke or intracerebral hemorrhage) by head CT or MRI within 72 hours; age greater than 18; motor function disorder; Glasgow Coma Scale greater than 12. Patients with the following symptoms were excluded: concurrent serious complications, such as coma, drug allergy, mental disorder, and other severe organic lesions in the brain. Sixty patients were finally included in the study. The control group accepted conventional treatment, while the treatment group received edaravone treatment on top of the conventional treatment of the control group. After treatment, the differences in functional movement, living ability score, neurological score, treatment effect, and adverse reaction of these 2 groups were tested and compared.

Discussion:

As aging worsens, the incidence of acute stroke continues to increase. Brain damage will induce the production of oxygen radicals, which can damage the cytomembrane of brain cells and finally damage the nervous system and cause cerebral injury as well as the cerebral edema. Edaravone is an antioxidant and oxygen radical scavenger that can inhibit lipid peroxidation during the scavenging of oxygen free radicals. Besides, it can also elicit anti-inflammatory protective effects for nerve cells, increase cerebral blood flow volume, prevent the aggravation of cerebral hypoperfusion toward necrosis, reduce nerve damage, and improve neurological functions and prognosis. This is the first randomized controlled trial to assess the efficacy of edaravone for treating acute stroke. High quality, large sample size, multicenter randomized trials are still required.

Trial registration:

researchregistry6492.
The usefulness of a three-dimensional printed segmental scapula prosthesis for recovering shoulder function in a patient with scapula chondrosarcoma
Authors: Park Jong Hoon , Jung Hae Woon , Jang Woo Young
Published: March 2021

Rationale:

Localized chondrosarcoma of the scapula has a favorable long-term survival outcome. Therefore, recovery of shoulder function after surgery is important in middle-aged patients. Currently, three-dimensional (3-D) printing implants can be applied for personalized limb salvage surgery.

Patient concerns:

A 41-year-old woman with a palpable scapular area presented with shoulder pain for 3 months, which was aggravated during shoulder exercise.

Diagnoses:

Chondrosarcoma at left scapular (Malawer S1, Enniking II B, and grade II chondrosarcoma).

Interventions:

Wide excision for a localized chondrosarcoma at the infrascapular lesion was performed and the resected muscles around the scapula were repaired with a 3-D printed segmental scapula prosthesis for recovery of shoulder function.

Outcomes:

The affected shoulder achieved satisfactory function after operation using the 3-D printed segmental scapula prosthesis at 1 year 6 months after the operation.

Lessons:

The 3-D printed segmental scapula prosthesis is a useful method for shoulder functional recovery in patients with scapula chondrosarcoma.
The Use of hx-index to compare research achievements for ophthalmology authors in Mainland China, Hong Kong, and Taiwan since 2010
Authors: Yeh Yu-Tsen , Chien Tsair-Wei , Kan Wei-Chih , Kuo Shu-Chun
Published: March 2021

Background:

Ophthalmology authors in mainland China, Hong Kong, or Taiwan were interested in knowing their individual research achievements (IRAs). This study was to evaluate the most cited authors, institutes, and regions in the mainland, Hong Kong, and Taiwan in the field of ophthalmology in the recent 10 years using the hx-index and to display the result with visual representations.

Methods:

Using the PubMed search engine to download data, we conducted an observational study of citation analyses in affiliated research institutes and regions (provinces/areas) of all ophthalmology authors since 2010. A total of 19,364 published articles from 22,393 authors in the mainland, Hong Kong, and Taiwan were analyzed. The x-index and the Kano model were complemental to the hx-index in identifying IRAs. A pyramid plot was used to illustrate the importance of the author-weighted scheme (AWS) used in evaluating IRAs in academics. The hx-index combining both advantages of the h and x-index was proposed to assess individual IRAs. Furthermore, we drew

Results:

There is a significant rise over time in the number of publications. The top-ranking regions in hx-index were Shanghai (26.82), Guangdong (25.82), and Beijing (25.81). We demonstrated that Dr Wu from Taiwan published 144 articles in PMC and used the example to explain the importance of AWS when IRAs were assessed.

Conclusions:

With an overall increase in publications in the field of ophthalmology, contributions assessed by hx-indexes and the AWS should be encouraged and promoted more in the future.
The safety and efficacy of low-dose mineralocorticoid receptor antagonists in dialysis patients
Authors: Zhu Yifan , Liu Yueming , Cai Ruyi , Zheng Danna , Liang Xudong , Tao Mei , Jin Juan , Li Yiwen , He Qiang
Published: March 2021

Introduction:

Our aim was to evaluate the safety and efficacy of low-dose mineralocorticoid receptor antagonists (MRAs) in dialysis patients.

Methods:

We systematically searched PubMed, EMBASE, and Cochrane libraries for clinical trials on the use of MRAs in dialysis patients. Review Manager 5.3 software was used to analyze relevant data and evaluate the quality of evidence.

Results:

We identified nine randomized controlled trials including 1128 chronic dialysis patients. In terms of safety, when hyperkalemia was defined as serum potassium level ≥5.5 mmol/L, low-dose MRAs were significantly associated with hyperkalemia (relative risk [RR] 1.76, 95% confidence intervals [CI] 1.07–2.89, P = .02); however, when hyperkalemia was defined as serum potassium level ≥6.0 mmol/L or serum potassium level ≥6.5 mmol/L, no significant association was observed between low-dose MRAs and hyperkalemia (RR 1.40, 95% CI 0.83–2.37, P = .20; RR 1.98, 95% CI 0.91–4.30, P = .09, respectively). Use of low-dose MRAs can reduce cardiovascular mortality by 54% compared with the control group (0.46, 95% CI 0.28–0.76, P = .003). Similarly, the RR of all-cause mortality for the low-dose MRAs group was 0.48 (95% CI 0.33–0.72, P = .0003).

Conclusion:

Low-dose MRAs may benefit dialysis patients without significantly increasing moderate to severe hyperkalemia.