bluuebunny/crossref_metadata_2025 huggingface dataset:
Gel Chromatography for Separation of Single-Walled Carbon Nanotubes
Authors: Kim Sunwoo , Kim Woo-Jae
Published: January 2022

Carbon nanotubes (CNTs), having either metallic or semiconducting properties depending on their chirality, are advanced materials that can be used for different devices and materials (e.g., fuel cells, transistors, solar cells, reinforced materials, and medical materials) due to their excellent electrical conductivity, mechanical strength, and thermal conductivity. Single-walled CNTs (SWNTs) have received special attention due to their outstanding electrical and optical properties; however, the inability to selectively synthesize specific types of CNTs has been a major obstacle for their commercialization. Therefore, researchers have studied different methods for the separation of SWNTs based on their electrical and optical properties. Gel chromatography methods enable the large-scale separation of metallic/semiconducting (m/s) SWNTs and single-chirality SWNTs with specific bandgaps. The core principle of gel chromatography-based SWNT separation is the interaction between the SWNTs and gels, which depends on the unique electrical properties of the former. Controlled pore glass, silica gel, agarose-based gel, and allyl dextran-based gel have been exploited as mediums for gel chromatography. In this paper, the interaction between SWNTs and gels and the different gel chromatography-based SWNT separation technologies are introduced. This paper can serve as a reference for researchers who plan to separate SWNTs with gel chromatography.
Transnational Influences on Migrant Identities and Social Cohesion: A Study Protocol
Authors: Sandal-Önal Elif , Bayad Aydın , Zick Andreas , Düzen N. Ekrem
Published: January 2022

This project examines how Turkish postmigrants in Germany position themselves against the influences of the German state’s integration and the Turkish government’s diasporic policies. We argue that the double influx of host and home states lures Turkish postmigrants into an identity trap subjecting their in-between position to exploitation in transnational negotiations. As their own perspective is poorly addressed in literature, this study fills this gap by reference to postmigrants’ standpoint. We hypothesize that the positioning of Turkish postmigrants in Germany is reflected through identity expressions and priority of belongings. We will carry out an exploratory assessment with three work packages. Study 1 will decode the Turkish postmigrant figure addressed by both states. Major media outlets most attended by postmigrants will be analyzed to display the imagined figure. Study 2 will inform the trajectory of the Turkish national identity narrative across important milestones over the migration chronology. A structured archival study will unearth the discursive mutations through political leaders’ speeches. Finally, Study 3 will exclusively confer postmigrants’ viewpoints against both influences. The project consults a conceptual framework in terms of diaspora generating, diaspora shaping, collective nostalgia, and social cohesion to expand on understanding how Turkish postmigrants express their identities and prioritize their belongings across their in-between existence.
The Impact of COVID-19 Pandemic on Medical Doctors’ Work-Family Balance at German University Clinics
Authors: Beutner Caroline , Lipschik Anja , Erpenbeck Luise , Holsapple Jason , Schön Michael P. , Stanisz Hedwig
Published: January 2022

The measures taken to cope with the COVID-19 pandemic by governments worldwide have vast consequences on all areas of life. To assess the impact of the COVID-19 pandemic on long-term career development, we evaluated the work-family balance of medical doctors at nine German university clinics. The results indicate a severely disturbed work-family balance, which was mostly due to insufficient childcare, based on restrictions in school operations and childcare. Despite the newly created emergency childcare options, aiming to ensure the functioning of the “systematically important” professional groups, medical doctors feel that they are not sufficiently supported by the measures taken by local governments. Women, in particular, see their professional development at risk. Our results underline that proper and flexible childcare is essential for the career advancement of female medical doctors and is particularly important in times of crises such as the current COVID-19 pandemic. At university medicine clinics, increased work time flexibility and optimized schooling and childcare are needed to promote the career development of female as well as male medical doctors in the early stage of their careers.
It Is Not Just Stress: A Bayesian Approach to the Shape of the Negative Psychological Features Associated with Sport Injuries
Authors: Zafra Aurelio Olmedilla , Martins Bruno , Ponseti-Verdaguer F. Javier , Ruiz-Barquín Roberto , García-Mas Alejandro
Published: January 2022

The main objective of this study is to extend the stress and injury model of Andersen and Williams to other “negative” psychological variables, such as anxiety and depression, encompassed in the conceptual model of Olmedilla and García-Mas. The relationship is studied of this psychological macro-variable with two other variables related to sports injuries: the search for social support and the search for connections between risk and the environment of athletes. A combination of classic methods and probabilistic approaches through Bayesian networks is used. The study samples comprised 455 traditional and indoor football players (323 male and 132 female) of an average age of 21.66 years (±4.46). An ad hoc questionnaire was used for the corresponding sociodemographic data and data relating to injuries. The variables measured were the emotional states of: stress, depression and anxiety, the attitude towards risk-taking in different areas, and the evaluation of the perception of social support. The results indicate that the probabilistic analysis conducted gives a boost to the classic model focused on stress, as well as the conceptual planning derived from the Global Model of Sports Injuries (GMSI), supporting the possibility of extending the stress model to other variables, such as anxiety and depression (“negative” triad).
Spousal Care Intensity, Socioeconomic Status, and Depression among the Older Caregivers in China: A Study on 2011–2018 CHARLS Panel Data
Authors: Ma Jun , Yang Hongyan , Hu Wenxiu , Khan Hafiz T. A.
Published: January 2022

Using the stress process model and data from the 2011–2018 China Health and Retirement Longitudinal Study (CHARLS), this study examined the effect of spousal caregiving intensity on the depression level of older caregivers in China. The moderating role that socioeconomic status plays in the relationship between spouses was explored by constructing multilevel growth models (MGMs). The care intensity for a spouse was found to relate to significantly increased depression levels in older caregivers, while the degree of disability of the spouse being cared for (B = 0.200, p < 0.001) having a greater effect on depression than the duration of care (B = 0.007, p < 0.01). There was a threshold effect where the provision of more than 10 h of care per week for a spouse (B = 0.931, p < 0.001; B = 0.970; p < 0.01) or caring for a disabled spouse with limited ADLs (B = 0.709, p < 0.01; B = 1.326; p < 0.001; B = 1.469, p < 0.01) increased depression in older caregivers. There were moderating influences, including higher professional prestige before retirement (B = −0.006, p < 0.05) and higher annual family income (B = −0.037, p < 0.10), that increased depression related to the spouse’s degree of disability. It was considered that active familism measures should be formulated for older spousal caregivers, especially those with lower socioeconomic status.
Persisting Endothelial Cell Activation and Hypercoagulability after COVID-19 Recovery—The Prospective Observational ROADMAP-Post COVID-19 Study
Authors: Gerotziafas Grigorios T. , Van Dreden Patrick , Sergentanis Theodoros N. , Politou Marianna , Rousseau Aurélie , Grusse Matthieu , Sabbah Michèle , Elalamy Ismail , Pappa Vasiliki , Skourti Tina , Bagratuni Tina , Ntanasis-Stathopoulos Ioannis , Korompoki Eleni , Labropoulou Stavroula , Dimopoulos Meletios A. , Terpos Evangelos
Published: January 2022

Background. Hypercoagulable state and endothelial cell activation are common alterations in patients with COVID-19. Nevertheless, the hypothesis of persistent hypercoagulability and endothelial cell activation following recovery from COVID-19 remains an unresolved issue. Objectives. To investigate the persistence of endothelial cell activation and hypercoagulability after recovery from COVID-19. Patients/Methods. COVID-19 survivors (n = 208) and 30 healthy individuals were enrolled in this study. The following biomarkers were measured: procoagulant phospholipid-dependent clotting time (PPL-ct), D-Dimer, fibrin monomers (FM), free Tissue factor pathway inhibitor (free-TFP)I, heparinase, and soluble thrombomodulin (sTM). Antibodies against SARS-CoV-2 (IgG and IgA) were also measured. Results. The median interval between symptom onset and screening for SARS-CoV-2 antibodies was 62 days (IQR = 22 days). Survivors showed significantly higher levels of D-Dimers, FM, TFPI, and heparanase as compared to that of the control group. Survivors had significantly shorter PPL-ct. Elevated D-dimer was associated with older age. Elevated FM was associated with female gender. Elevated heparanase was independently associated with male gender. Decreased Procoag-PPL clotting time was associated with female gender. One out of four of COVID-19 survivors showed increase at least one biomarker of endothelial cell activation or hypercoagulability. Conclusions. Two months after onset of COVID-19, a significant activation of endothelial cells and in vivo thrombin generation persists in at least one out of four survivors of COVID-19. The clinical relevance of these biomarkers in the diagnosis and follow-up of patients with long COVID-19 merits to be evaluated in a prospective clinical study.
Adaptalight: An Inexpensive PAR Sensor System for Daylight Harvesting in a Micro Indoor Smart Hydroponic System
Authors: D Stevens Joseph , Murray David , Diepeveen Dean , Toohey Danny
Published: January 2022

Environmental changes and the reduction in arable land have led to food security concerns around the world, particularly in urban settings. Hydroponic soilless growing methods deliver plant nutrients using water, conserving resources and can be constructed nearly anywhere. Hydroponic systems have several complex attributes that need to be managed, and this can be daunting for the layperson. Micro Indoor Smart Hydroponics (MISH) leverage Internet of Things (IoT) technology to manage the complexities of hydroponic techniques, for growing food at home for everyday citizens. Two prohibitive costs in the advancement of MISH systems are power consumption and equipment expense. Reducing cost through harvesting ambient light can potentially reduce power consumption but must be done accurately to sustain sufficient plant yields. Photosynthetic Active Radiation (PAR) meters are commercially used to measure only the light spectrum that plants use, but are expensive. This study presents Adaptalight, a MISH system that harvests ambient light using an inexpensive AS7265x IoT sensor to measure PAR. The system is built on commonly found IoT technology and a well-established architecture for MISH systems. Adpatalight was deployed in a real-world application in the living space of an apartment and experiments were carried out accordingly. A two-phase experiment was conducted over three months, each phase lasting 21 days. Phase one measured the IoT sensor’s capability to accurately measure PAR. Phase two measured the ability of the system to harvest ambient PAR light and produce sufficient yields, using the calibrated IoT sensor from phase one. The results showed that the Adaptalight system was successful in saving a significant amount of power, harvesting ambient PAR light and producing yields with no significant differences from the control. The amount of power savings would be potentially greater in a location with more ambient light. Additionally, the findings show that, when calibrated, the AS7265x sensor is well suited to accurately measure PAR light in MISH systems.
The Effect of Coronavirus 2019 Disease Control Measures on the Incidence of Respiratory Infectious Disease and Air Pollutant Concentrations in the Yangtze River Delta Region, China
Authors: Wang Lan , Wang Kehan , Zhong Hui , Zhao Na , Xu Wangli , Yang Yunmei , He Yiran , Liu Shelan
Published: January 2022

The Yangtze River Delta is one of the top five Chinese regions affected by COVID-19, as it is adjacent to Hubei Province, where COVID-19 first emerged. We investigated the impact of COVID-19 non-pharmaceutical interventions (NPIs) on changes in respiratory infectious diseases (RIDs) incidence and air quality in the Yangtze River Delta by constructing two proportional tests and fitting ARIMA and linear regression models. Compared with the pre-COVID-19 period, the average monthly incidence of seven RIDs decreased by 37.80% (p < 0.001) and 37.11% (p < 0.001) during the COVID-19 period and the post-vaccination period, respectively, in Shanghai, and decreased by 20.39% (p < 0.001) and 22.86% (p < 0.001), respectively, in Zhejiang. Similarly, compared with the pre-COVID-19 period, the monthly overall concentrations of six air pollutants decreased by 12.7% (p = 0.003) and 18.79% (p < 0.001) during the COVID-19 period and the post-vaccination period, respectively, in Shanghai, and decreased by 12.85% (p = 0.008) and 15.26% (p = 0.001), respectively, in Zhejiang. Interestingly, no significant difference in overall incidence of RIDs and concentrations of air quality was shown between the COVID-19 period and the post-vaccination period in either Shanghai or Zhejiang. This study provides additional evidence that the NPIs measures taken to control COVID-19 were effective in improving air quality and reducing the spread of RIDs. However, a direct causal relationship has not been established.
The Assessment of Prolonged Inferior Alveolar Nerve Blockade for Postoperative Analgesia in Mandibular Third Molar Surgery by a Perineural Addition of Dexamethasone to 0.5% Ropivacaine: A Randomized Comparison Study
Authors: Stojanović Simona , Burić Nikola , Tijanić Milos , Todorović Kosta , Burić Kristina , Burić Nina , Jovanović Marija , Bajagić Vukadin
Published: January 2022

Background: Perineurally adding dexamethasone to local anesthetics could enable postoperative analgesia. Our aim was to investigate the efficacy of 4 mg dexamethasone and 0.5% ropivacaine on the prolonged duration of mandibular anesthesia for postoperative analgesia during third molar surgery. Materials and method: The patients of both sexes, and in the age range of 17 to 50 yrs of age, received the Gow-Gates anesthesia. Group I received 4 mL of plain 0.5% ropivacaine, with perineurally added 1 mL/4 mg of dexamethasone; group II received 4 mL of plain 0.5% ropivacaine with perineurally added 1 mL of 0.9% saline; group III received 4 mL of plain 0.5 bupivacaine with perineurally added 1 mL of 0.9% saline. The prime anesthesia outcome was the duration of conduction anesthesia (DCA); the secondary outcome was the duration of analgesia (DAN) and analgesia before analgesic intake. Results: In 45 randomly selected subjects (mean age 27.06 ± 8.20), DCA was statistically longest in group I (n = 15) (592.50 ± 161.75 min, p = 0.001), collated with groups II (n = 15) and III (n = 15) (307.40 ± 84.71 and 367.07 ± 170.52 min, respectively). DAN was significantly the longest in group I (mean: 654.9 ± 198.4 min, p = 0.001), compared with group II (345.4 ± 88.0 min) and group III (413.7 ± 152.3 min), with insignificant adverse reactions. One-third of the operated patients absented from the use of analgesics. Conclusion: A amount 0.5% ropivacaine with dexamethasone usefully served as an analgesic with a success rate of 93.4% of the given anesthesia.
Common Demand vs. Limited Supply—How to Serve the Global Fight against COVID-19 through Proper Supply of COVID-19 Vaccines
Authors: Su Yiqing , Li Yanyan , Liu Yanggui
Published: January 2022

Vaccination plays an essential role in the fight against Coronavirus Disease 2019 (COVID-19). The currently insufficient vaccine production capacity makes it difficult to balance supply with demand, which has led to a contradiction between command demand and limited supply. According to analysis based on game theory, the attributes of COVID-19 vaccines vary with supply strategies formulated by vaccine-producing countries. This means that vaccine-receiving countries can only be motivated to prepare operable vaccine distribution plans through the supply of COVID-19 vaccines as global public goods. The rational distribution of global public goods must be guaranteed by a global supply institution system. To that end, Elinor Ostrom’s eight design principles provide a basis for designing such a global supply system. This paper proposes a nested institution solution for guaranteeing the global supply of COVID-19 vaccines based on the design principles, which include clearly defined boundaries, proportional equivalence between benefits and costs, collective-choice arrangements, monitoring, graduated sanctions, conflict-resolution mechanisms, minimal recognition of rights to organize, and nested enterprises. To win this global fight against COVID-19, COVID-19 vaccines must not only be treated as global public goods, but countries must also be urged to coordinate cooperation in global institutional design, thus ensuring that COVID-19 vaccines can truly benefit all mankind.
Emerging Technologies for Smart Cities’ Transportation: Geo-Information, Data Analytics and Machine Learning Approaches
Authors: Ang Kenneth Li-Minn , Seng Jasmine Kah Phooi , Ngharamike Ericmoore , Ijemaru Gerald K.
Published: January 2022

With the recent increase in urban drift, which has led to an unprecedented surge in urban population, the smart city (SC) transportation industry faces a myriad of challenges, including the development of efficient strategies to utilize available infrastructures and minimize traffic. There is, therefore, the need to devise efficient transportation strategies to tackle the issues affecting the SC transportation industry. This paper reviews the state-of-the-art for SC transportation techniques and approaches. The paper gives a comprehensive review and discussion with a focus on emerging technologies from several information and data-driven perspectives including (1) geoinformation approaches; (2) data analytics approaches; (3) machine learning approaches; (4) integrated deep learning approaches; (5) artificial intelligence (AI) approaches. The paper contains core discussions on the impacts of geo-information on SC transportation, data-driven transportation and big data technology, machine learning approaches for SC transportation, innovative artificial intelligence (AI) approaches for SC transportation, and recent trends revealed by using integrated deep learning towards SC transportation. This survey paper aimed to give useful insights to researchers regarding the roles that data-driven approaches can be utilized for in smart cities (SCs) and transportation. An objective of this paper was to acquaint researchers with the recent trends and emerging technologies for SC transportation applications, and to give useful insights to researchers on how these technologies can be exploited for SC transportation strategies. To the best of our knowledge, this is the first comprehensive review that examines the impacts of the various five driving technological forces—geoinformation, data-driven and big data technology, machine learning, integrated deep learning, and AI—in the context of SC transportation applications.
Augmented Multi-Component Recurrent Graph Convolutional Network for Traffic Flow Forecasting
Authors: Zhang Chi , Zhou Hong-Yu , Qiu Qiang , Jian Zhichun , Zhu Daoye , Cheng Chengqi , He Liesong , Liu Guoping , Wen Xiang , Hu Runbo
Published: January 2022

Due to the periodic and dynamic changes of traffic flow and the spatial–temporal coupling interaction of complex road networks, traffic flow forecasting is highly challenging and rarely yields satisfactory prediction results. In this paper, we propose a novel methodology named the Augmented Multi-component Recurrent Graph Convolutional Network (AM-RGCN) for traffic flow forecasting by addressing the problems above. We first introduce the augmented multi-component module to the traffic forecasting model to tackle the problem of periodic temporal shift emerging in traffic series. Then, we propose an encoder–decoder architecture for spatial–temporal prediction. Specifically, we propose the Temporal Correlation Learner (TCL) which incorporates one-dimensional convolution into LSTM to utilize the intrinsic temporal characteristics of traffic flow. Moreover, we combine TCL with the graph convolutional network to handle the spatial–temporal coupling interaction of the road network. Similarly, the decoder consists of TCL and convolutional neural networks to obtain high-dimensional representations from multi-step predictions based on spatial–temporal sequences. Extensive experiments on two real-world road traffic datasets, PEMSD4 and PEMSD8, demonstrate that our AM-RGCN achieves the best results.
Using the Unity Game Engine to Develop a 3D Simulated Ecological System Based on a Predator–Prey Model Extended by Gene Evolution
Authors: Kiss Attila , Pusztai Gábor
Published: January 2022

In this paper, we present a novel implementation of an ecosystem simulation. In our previous work, we implemented a 3D environment based on a predator–prey model, but we found that in most cases, regardless of the choice of starting parameters, the simulation quickly led to extinctions. We wanted to achieve system stabilization, long-term operation, and better simulation of reality by incorporating genetic evolution. Therefore we applied the predator–prey model with an evolutional approach. Using the Unity game engine we created and managed a closed 3D ecosystem environment defined by an artificial or real uploaded map. We present some demonstrative runs while gathering data, observing interesting events (such as extinction, sustainability, and behavior of swarms), and analyzing possible effects on the initial parameters of the system. We found that incorporating genetic evolution into the simulation slightly stabilized the system, thus reducing the likelihood of extinction of different types of objects. The simulation of ecosystems and the analysis of the data generated during the simulations can also be a starting point for further research, especially in relation to sustainability. Our system is publicly available, so anyone can customize and upload their own parameters, maps, objects, and biological species, as well as inheritance and behavioral habits, so they can test their own hypotheses from the data generated during its operation. The goal of this article was not to create and validate a model but to create an IT tool for evolutionary researchers who want to test their own models and to present them, for example, as animated conference presentations. The use of 3D simulation is primarily useful for educational purposes, such as to engage students and to increase their interest in biology. Students can learn in a playful way while observing in the graphical scenery how the ecosystem behaves, how natural selection helps the adaptability and survival of species, and what effects overpopulation and competition can have.
Comparative Assessment of Criticality Indices Extracted from Acoustic and Electrical Signals Detected in Marble Specimens
Authors: Kourkoulis Stavros K. , Pasiou Ermioni D. , Loukidis Andronikos , Stavrakas Ilias , Triantis Dimos
Published: January 2022

The quantitative determination of the current load carrying capability of already loaded structural elements and the possibility to detect proper indices that could be considered as signals for timely warning that the load carrying capacity is exhausted is the subject of this study. More specifically, it aims to explore the possibility of detecting signals that can be considered as indices warning about upcoming fracture and then to compare quantitatively such signals provided by different techniques. The novelty of the present study lies exactly in this quantitative comparison of the pre-failure signals provided by various sensing techniques and various methods of analysis of the experimental data. To achieve this target, advantage is taken of data concerning the acoustic and electrical activities produced while marble specimens are subjected to mechanical loading. The respective signals are detected and recorded by means of the acoustic emissions technique and that of the pressure stimulated currents. The signals detected by the acoustic emissions technique are analyzed in terms of three formulations, i.e., the b-value, the F-function and the parameters variance κ1, entropy S and entropy under time reversal S_ according to the natural time analysis. The signals detected by the pressure stimulated currents technique are analyzed by means of the intensity of the electric current recorded. The study indicates that all quantities considered provide promising pre-failure indicators. Furthermore, when the specimen is subjected to near-to-failure load levels, the temporal evolution of three of the quantities studied (b-value, F-function, pressure stimulated currents) is governed by a specific power law. The onset of validity of this law designates some differentiation of the damage mechanisms activated. Quantitative differences are observed between the time instants at which this power law starts dictating the evolution of the above parameters, indicating the imperative need for further investigation, despite the quite encouraging results of the present study.
Acknowledgment to Reviewers of Instruments in 2021
Authors:   Instruments Editorial Office
Published: January 2022

Rigorous peer-reviews are the basis of high-quality academic publishing [...]
Combining Prognostic Nutritional Index and Brain Natriuretic Peptide as a Predicting Tool for Heart Transplantation
Authors: Cai Ziwen , Tu Jingrong , Xu Li , Lin Yao , Deng Bowen , Li Fei , Chen Si , Dong Nianguo
Published: January 2022

Our study aimed to evaluate the potential of prognostic nutritional index (PNI) and Brain natriuretic peptide (BNP) in predicting the prognosis of heart transplantation (HTx). We retrospectively investigated 489 patients undergoing HTx between 2015 and 2020 in our center. The relationship between preoperative index and prognosis was analyzed respectively, the optimal cut-off values for preoperative PNI and BNP level were evaluated with receiver operating curve analysis. Uni-variate analysis and multivariate analysis were used to compare baseline data (sex, age, diagnosis, etc.) of groups divided by the level of PNI and BNP. Propensity score matching (PSM) was applied to eliminate bias. We calculated the C-index from the prediction efficiency of PNI and BNP. During the period, 489 recipients undergoing HTx in our center were included according to the inclusion criteria; 383 (78.3%) males and 106 (21.7%) females were included in this study, with a median age of 47.57 years old. The ROC curve showed that the optimal cut-off values of each indicator were verified as 49.345 for PNI, and 4397.500 for BNP. The multivariate analyses indicated that PNI (p = 0.047), BNP (p = 0.024), age (p = 0.0023), and waiting time (p = 0.012) were risk factors for all-cause death after HTx. Propensity score matching generated 116 pairs based on PNI level and 126 pairs based on BNP level, and the results showed that OS (overall survival) was significantly correlated with PNI (n = 232, p = 0.0113) and BNP (n = 252, p = 0.0146). Our study implied that higher PNI and lower BNP level had direct correlation with better survival after HTx. Combining PNI and BNP together would be a potential clinical preoperative instrument to predict the survival of patients after HTx, especially in short-term survival.
It Is Not Carved in Stone—The Need for a Genetic Reevaluation of Variants in Pediatric Cardiomyopathies
Authors: Westphal Dominik Sebastian , Pollmann Kathrin , Marschall Christoph , Wacker-Gussmann Annette , Oberhoffer-Fritz Renate , Laugwitz Karl-Ludwig , Ewert Peter , Wolf Cordula Maria
Published: January 2022

(1) Background: In cardiomyopathies, identification of genetic variants is important for the correct diagnosis and impacts family cascade screening. A classification system was published by the American College of Medical Genetics and Genomics (ACMG) in 2015 to standardize variants’ classification. The aim of the study was to determine the rate of reclassification of previously identified variants in patients with childhood-onset cardiomyopathies. (2) Methods: Medical records of patients and their relatives were screened for clinical and genetic information at the Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich. Patients without an identified genetic variant were excluded from further analyses. Previously reported variants were reevaluated by the ACMG criteria in November 2021. (3) Results: Data from 167 patients or relatives of patients with childhood-onset cardiomyopathy from 137 families were analyzed. In total, 45 different genetic variants were identified in 71 individuals. Classification changed in 29% (13/45) with the greatest shift in “variants of unknown significance” to “(likely) benign” (9/13). (4) Conclusions: In patients with childhood-onset cardiomyopathies, nearly a third of reported genetic variants change mostly to more benign classes upon reclassification. Given the impact on patient management and cascade screening, this finding underlines the importance of continuous genetic counseling and variant.
The Combination of Lymph Node Transfer and Excisional Procedures in Bilateral Lower Extremity Lymphedema: Clinical Outcomes and Quality of Life Assessment with Long-Term Follow-Up
Authors: Losco Luigi , Bolletta Alberto , de Sire Alessandro , Chen Shih-Heng , Sert Gokhan , Aksoyler Dicle , Velazquez-Mujica Jonathan , Invernizzi Marco , Cigna Emanuele , Chen Hung-Chi
Published: January 2022

Background: Bilateral lower extremity lymphedema is a rare and invalidating condition that poses a great challenge to the scientific community, and deeply affects the quality of life (QoL) of affected patients. A combined protocol consisting of lymph node transfer and a reductive method have never been reported for the treatment of this condition, except for small case series with brief follow-up periods. Methods: This retrospective study analyzed data of 29 patients, mean age 51 ± 17.1 years, who had been diagnosed with bilateral lower extremity lymphedema. Gastroepiploic vascularized lymph node transfer was performed in all the patients, and an excisional procedure was associated according to the clinical stage. Clinical history, circumferential limb measurements, complications, episodes of cellulitis, and responses to the Lymphedema Quality of Life Questionnaire were analyzed. Results: The mean follow-up was 38.4 ± 11.8 months. A significant reduction in the episodes of cellulitis per year was observed (p < 0.001). In our series, BMI and duration of symptoms were significantly related to the development of cellulitis during the postoperative period, p = 0.006 and p = 0.020, respectively. The LYMQoL questionnaire showed a significant quality of life improvement from 3.4 ± 0.9 to 6.2 ± 0.8 (p < 0.05). Conclusions: An integrated approach is essential for the treatment of bilateral lower extremity lymphedema: reductive and reconstructive methods are complementary to achieve a successful outcome. Timely treatment and BMI reduction are relevant in order to decrease the number of episodes of cellulitis. An attentive follow-up is necessary to identify recurrence and treat affected patients in time.
Lab-Based Retrospective 10-Year Analysis Shows Seasonal Variation of Vaginal Candida Infection Rates in Belgium
Authors: Donders Gilbert G. G. , Ruban Kateryna , Donders Francesca , Reybrouck Reinhilde
Published: January 2022

Candida vulvovaginitis is a frequent condition, and although several risk factors are known, its behavior is still enigmatic. The seasonal influence of climate conditions and living habits on its prevalence was studied. In a retrospective lab-based cohort over 10 years, we studied the prevalence of Candida in 12,941 vaginal cultures taken from women attending a vulvovaginitis clinic. The prevalence of non-albicans and albicans species were compared per month to detect differences in positivity rates in summer versus winter months. Chi-square and chi-square for trend were used. Of the 2109 (16.3%) Candida spp. positive swabs, 201 (1.0%) revealed non-albicans species, varying between 1.0% and 2.0% per month, but without significant monthly differences. Over the 10 years, compared to other months, vaginal Candida was more frequent in June (19.0%, p = 0.008) and less frequent in December (14.5%, p = 0.04). The Candida prevalence was 15.5% in summer (June/July/August) versus 14.0% in the winter (Dec/Jan/Feb, p = 0.04). Change in temperature, dietary habits, and bodily adaptations due to increased amount of sunlight were discussed as potential pathophysiological mechanisms to explain the excess of Candida in summertime. Further confirmatory research would be beneficial. Women at risk for Candida vulvovaginitis should pay more attention to living habits in summertime to avoid recurrences.
Utility of Simultaneous Biatrial Atrial Anti-Tachycardia Pacing for the Termination of Atrial Fibrillation during Catheter Ablation of Atrial Fibrillation
Authors: Maeda Shingo , Goya Masahiko , Shirai Yasuhiro , Yagishita Atsuhiko , Tao Susumu , Liang Jackson , Casado Arroyo Ruben , Takahashi Yoshihide , Kawabata Mihoko , Sasano Tetsuo , Hirao Kenzo
Published: January 2022

Background: Atrial anti-tachycardia pacing (A-ATP) of the right atrium (RA) has been shown to decrease the burden of atrial fibrillation (AF) in patients with dual-chamber pacemakers. The aim of this study is to identify the novel predictors of effective A-ATP for terminating AF in patients with AF undergoing catheter ablation. Methods: This study included 41 consecutive patients undergoing a first ablation procedure for paroxysmal (PAF: n = 21) or persistent (PEF: n = 20) AF. We prospectively evaluated predictors of AF termination after A-ATP. The coefficient of variation (CoV = SD/mean × 100) of the dominant frequencies (DFs) was calculated to evaluate the variability in atrial activation. Results: AF was terminated by A-ATP in 29% of PAF and 5% of PEF patients. In these patients, simultaneous high-rate pacing from the RA and the coronary sinus (CS) terminated AF in 71% of patients, in whom the mean AF cycle length (CL) before A-ATP was longer (214 ± 23 vs. 177 ± 35 ms, p = 0.02) and became slower after A-ATP (234 ± 37 vs. 176 ± 32 ms, p < 0.01), compared to unsuccessful patients. The CoV of the DFs before A-ATP were lower in both RA (6.2 ± 2.0 vs. 15.3 ± 7.9, p = 0.02) and CS (11.0 ± 7.9 vs. 24.3 ± 9.3, p < 0.01) in successful patients. Conclusions: Simultaneous biatrial A-ATP from the RA and CS could terminate AF in patients with PAF. The predictors for successful termination include longer AF CL and higher AF stability.
Minimal Change Disease Is Associated with Mitochondrial Injury and STING Pathway Activation
Authors: Yu Byung Chul , Moon Ahrim , Lee Kyung Ho , Oh Young Seung , Park Moo Yong , Choi Soo Jeong , Kim Jin Kuk
Published: January 2022

We hypothesized that minimal change disease (MCD) pathogenesis may be associated with mitochondrial injury, and that the degree of mitochondrial injury at the time of diagnosis may serve as a valuable prognostic marker. We compared urinary mitochondrial DNA (mtDNA) at the time of diagnosis in patients with MCD and age- and sex-matched healthy controls (MHC) (n = 10 each). We analyzed the site and signal intensity of immunohistochemical (IHC) staining of stimulator of interferon genes (STING) using kidney tissues at the time of diagnosis in patients with MCD. Patients with MCD were divided into high (n = 6) and low-intensity (n = 14) subgroups according to the signal intensity. Urinary mtDNA levels were elevated in the MCD groups more than in the MHC group (p < 0.001). Time-averaged proteinuria and frequency of relapses during the follow-up period were higher in the high-intensity than in the low-intensity subgroup (1.18 ± 0.54 vs. 0.57 ± 0.45 g/day, p = 0.022; and 0.72 ± 0.60 vs. 0.09 ± 0.22 episodes/year, p = 0.022, respectively). Mitochondrial injury may be associated with MCD pathogenesis, and the signal intensity of STING IHC staining at the time of diagnosis could be used as a valuable prognostic marker in MCD.
The Relationship between the SARC-F Score and the Controlling Nutritional Status Score in Gastrointestinal Diseases
Authors: Ikegami Takako , Nishikawa Hiroki , Goto Masahiro , Matsui Masahiro , Asai Akira , Ushiro Kosuke , Ogura Takeshi , Takeuchi Toshihisa , Nakamura Shiro , Kakimoto Kazuki , Miyazaki Takako , Fukunishi Shinya , Ohama Hideko , Yokohama Keisuke , Yasuoka Hidetaka , Higuchi Kazuhide
Published: January 2022

We sought to examine the relationship between the SARC-F score and the Controlling Nutritional Status (CONUT) score in patients with gastrointestinal diseases (GDs, n = 735, median age = 71 years, and 188 advanced cancer cases). The SARC-F score ≥ 4 (highly suspicious of sarcopenia) was found in 93 cases (12.7%). Mild malnutritional condition was seen in 310 cases (42.2%), moderate in 127 (17.3%) and severe in 27 (3.7%). The median SARC-F scores in categories of normal, mild, moderate and severe malnutritional condition were 0, 0, 1 and 1 (overall p < 0.0001). The percentage of SARC-F score ≥ 4 in categories of normal, mild, moderate and severe malnutritional condition were 4.4%, 12.9%, 26.8% and 25.9% (overall p < 0.0001). The SARC-F score was an independent factor for both the CONUT score ≥ 2 (mild, moderate or severe malnutrition) and ≥5 (moderate or severe malnutrition). In the receiver operating characteristic (ROC) curve analysis for the CONUT score ≥ 2, C reactive protein (CRP) had the highest area under the ROC (AUC = 0.70), followed by the SARC-F score (AUC = 0.60). In the ROC analysis for the CONUT score ≥ 5, CRP had the highest AUC (AUC = 0.79), followed by the SARC-F score (AUC = 0.63). In conclusion, the SARC-F score in patients with GDs can reflect malnutritional status.
Content Validity and Reliability of the Pressure Ulcer Knowledge Test and the Knowledge Level of Portuguese Nurses at Long-Term Care Units: A Cross-Sectional Survey
Authors: Furtado Katia , Lopes Teresa , Afonso Anabela , Infante Paulo , Voorham Jaco , Lopes Manuel
Published: January 2022

(1) Background: Improvement in pressure ulcer care depends both on the dissemination of knowledge and its implementation. This study aims to translate the Pressure Ulcer Knowledge Test into Portuguese from Portugal and evaluate the internal consistency of the questionnaire. The second aim is to assess nurses’ pressure ulcer knowledge level. (2) Methods: The Pressure Ulcer Knowledge Test was translated into Portuguese, and the translated test’s internal consistency and content validity were assessed. Further, the authors conducted a cross-sectional survey using the test among 221 nurses working in long-term care units. (3) Results: The Cronbach’s alpha internal coefficient of reliability recorded for the 47 items was 0.738, which is higher than the minimum acceptable level of 0.7. The Cronbach’s alpha for the subscales was 0.709 for prevention/risk and less than 0.5 for staging and wound description. Only two of the 221 nurses achieved a score of 90% correct answers or more. The nurses scored lower in questions related to prevention/risk (Me = 67.4%, IQR = 60.6–75.8% vs. staging: ME = 85.7%, IQR = 71.4–85.7%, description: ME = 85.7%, IQR = 71.4–85.7%, p < 0.001). (4) Conclusion: The internal consistency of the instrument was acceptable. The instrument can accurately measure Portuguese nurses’ knowledge of pressure ulcers, and its information can help improve education and implementation of best practices.
Albumin Binds COVID-19 Spike 1 Subunit and Predicts In-Hospital Survival of Infected Patients—Possible Alteration by Glucose
Authors: Zekri-Nechar Khaoula , Zamorano-León José J. , Segura-Fragoso Antonio , Alcaide José R. , Reche Carmen , Andrés-Castillo Alcira , Martínez-Martínez Carlos H. , Giner Manel , Jiménez-García Rodrigo , López-de-Andrés Ana , Navarro-Cuellar Carlos , García-Fernández Miguel A. , López-Farré Antonio
Published: January 2022

(1) Background: This study aimed to analyze if the serum albumin levels of hospitalized SARS-CoV-2 (COVID-19) patients on admission could predict <30 days in-hospital all-cause mortality, and if glucose levels on admission affected this predictive ability. (2) Methods: A multicenter retrospective cohort of 1555 COVID-19-infected adult patients from public hospitals of the Madrid community were analyzed. (3) Results: Logistic regression analysis showed increased mortality for ages higher than 49 y. After adjusting for age, comorbidities and on-admission glucose levels, it was found that on-admission serum albumin ≥3.5 g/dL was significantly associated with reduced mortality (OR 0.48; 95%CI:0.36–0.62). There was an inverse concentration-dependent association between on-admission albumin levels and <30 days in-hospital all-cause mortality. However, when on-admission glucose levels were above 125 mg/dL, higher levels of serum albumin were needed to reach an association with survival. In vitro experiments showed that the spike protein S1 subunit of SARS-CoV-2 binds to native albumin. The binding ability of native albumin to the spike protein S1 subunit was decreased in the presence of an increasing concentration of glycated albumin. (4) Conclusions: On-admission serum albumin levels were inversely associated with <30 days in-hospital all-cause mortality. Native albumin binds the spike protein S1 subunit, suggesting that native albumin may act as a scavenger of the SARS-CoV-2 virus.
Characteristics of Interleukin-6 Signaling in Elective Cardiac Surgery—A Prospective Cohort Study
Authors: Puchinger Jürgen , Ryz Sylvia , Nixdorf Larissa , Edlinger-Stanger Maximilian , Lassnigg Andrea , Wiedemann Dominik , Hiesmayr Michael , Spittler Andreas , Bernardi Martin H.
Published: January 2022

Interleukin-6 (IL-6) can cause pro- and anti-inflammatory effects via different signaling pathways. This prospective study investigated the perioperative kinetics of IL-6, soluble IL-6 receptor (sIL-6R), and soluble glycoprotein 130 (sgp130) in elective patients undergoing cardiopulmonary bypass (CPB). IL-6, sIL-6R, and sgp130 were measured simultaneously and consecutively at 19 timepoints until the 10th postoperative day (POD). The proportion of pro- and anti-inflammatory pathways were determined by calculating sIL-6R/IL-6 and sIL-6R/sgp130 ratios. We analyzed 93 patients. IL-6 increased during surgery with reaching a plateau two hours after CPB and peaking on POD 1 (188.5 pg mL−1 (IQR, 126.6; 309.2)). sIL-6R decreased at the beginning of the surgical procedure, reaching a nadir level on POD 2 (26,311 pg mL−1 (IQR, 22,222; 33,606)). sgp130 dropped immediately after CPB initiation (0.13 ng mL−1 (IQR, 0.12; 0.15)), followed by a continuous recovery until POD10. The sIL-6R/IL-6 ratio decreased substantially at the beginning of the procedure, reaching a nadir on POD 1 (149.7 (IQR, 82.4; 237.4)), while the sIL-6R/sgp130 ratio increased simultaneously until 6 h post CPB (0.219 (IQR 0.18; 0.27)). In conclusion, IL-6 exhibited high inter-individual variability reflecting an inhomogeneous inflammatory response. Pro-inflammatory effects and overwhelming inflammation were rare and predominantly anti-inflammatory effects were found.
In Vitro Accuracy of Digital and Conventional Impressions for Full-Arch Implant-Supported Prostheses
Authors: D’haese Rani , Vrombaut Tom , Roeykens Herman , Vandeweghe Stefan
Published: January 2022

The aim of this study was to evaluate the accuracy of full-arch digital impressions when compared to conventional impressions, when performed on the abutment or implant level. Methods: One resin cast with six implants and another cast with six abutments were scanned with Primescan v5.1 (PS51), Primescan v5.2 (PS52), Trios 3 (T3), and Trios 4 (T4). Additionally, conventional impressions (A) were made, poured in gypsum, and digitized using a lab scanner (IScan D104i). A coordinate machine (Atos, GOM, Braunschweig, Germany) was used to generate the reference scan of both casts. For all scans, the position of the implants was calculated and matched with the reference scan. Angular and coronal measurements per implant were considered for trueness and precision. Results: For the implant-level model, PS52 performed significantly better in terms of trueness and precision compared to all other impressions, except for the angular trueness of A (p = 0.072) and the coronal trueness of PS51 (p = 1.000). For the abutment-level model, PS52 also performed significantly better than all other impressions, except for the coronal trueness and precision of A (p = 1.000). Conclusions: Digital impressions for full-arch implant supported prostheses can be as accurate as conventional impressions, depending on the intra-oral scanner and software. Overall, abutment level impressions were more accurate compared to implant level impressions.
Effect of Continuous Positive Airway Pressure on Lipid Profiles in Obstructive Sleep Apnea: A Meta-Analysis
Authors: Chen Baixin , Guo Miaolan , Peker Yüksel , Salord Neus , Drager Luciano F. , Lorenzi-Filho Geraldo , Tang Xiangdong , Li Yun
Published: January 2022

Background: Obstructive sleep apnea (OSA) is associated with dyslipidemia. However, the effects of continuous positive airway pressure (CPAP) treatment on lipid profiles are unclear. Methods: PubMed/Medline, Embase and Cochrane were searched up to July 2021. Randomized controlled trials (RCTs) of CPAP versus controls with ≥4 weeks treatment and reported pre- and post-intervention lipid profiles were included. Weighted mean difference (WMD) was used to assess the effect size. Meta-regression was used to explore the potential moderators of post-CPAP treatment changes in lipid profiles. Results: A total of 14 RCTs with 1792 subjects were included. CPAP treatment was associated with a significant decrease in total cholesterol compared to controls (WMD = −0.098 mmol/L, 95% CI = −0.169 to −0.027, p = 0.007, I2 = 0.0%). No significant changes in triglyceride, high-density lipoprotein nor low-density lipoprotein were observed after CPAP treatment (all p > 0.2). Furthermore, meta-regression models showed that age, gender, body mass index, daytime sleepiness, OSA severity, follow-up study duration, CPAP compliance nor patients with cardiometabolic disease did not moderate the effects of CPAP treatment on lipid profiles (all p > 0.05). Conclusions: CPAP treatment decreases total cholesterol at a small magnitude but has no effect on other markers of dyslipidemia in OSA patients. Future studies of CPAP therapy should target combined treatment strategies with lifestyle modifications and/or anti-hyperlipidemic medications in the primary as well as secondary cardiovascular prevention models.