bluuebunny/crossref_metadata_2025 huggingface dataset:
Interference Screw vs Suture Button Fixation for Tibialis Anterior Tendon Transfer to Lateral Cuneiform: A Biomechanical Analysis with Implications for Clubfoot Treatment
Authors: Meyer Zachary , Polk Jordan L. , Zide Jacob R. , Kanaan Yassine , Riccio Anthony
Published: November 2022

Category:

Other

Introduction/Purpose:

While transfer of the tibialis anterior tendon (TAT) to the lateral cuneiform (LC) following serial casting has been used for over 60 years to treat relapsed clubfoot deformity, modern methods of tendon fixation remain largely unstudied. Though interference screw fixation has the potential of obviate concerns of pressure necrosis and proper tendon tensioning associated with plantar button suspensory stabilization, a better understanding of LC morphology in young children is a necessary first step in assessing the viability of this fixation technique. The purpose of this investigation is therefore to define LC morphology in children aged 3-6 years.

Methods:

A retrospective radiographic review of 40 healthy pediatric feet aged 3-6 years who had either MRI or CT scans was performed at a single pediatric hospital. The length, width, and height of only the ossified portion of the LC were measured digitally using sagittal, coronal, and axial imaging. In addition, the maximal cross-sectional diameter of the TAT was measured at the level of the tibiotalar joint.

Results:

Average ossified LC width ranged from 8.5mm in the 3-year-old cohort to 10.3mm in 6-year-old children. While the average width increased with each year of age, ANOVA testing revealed no statistically significant difference in width between age groups (p=0.091). Average ossified LC length ranged from 13.5mm in the 3-year-old cohort to 18.3mm in 6-year-old children with statistically significant increases in all age groups separated by two or more years (p=0.017). the TAT to ossified LC width ratio ranged from 44% to 53% across age groups. (table 1).

Conclusion:

The dimensions of the LC ossification center are large enough to allow interference screw fixation in children 3 to 6 years of age.
3-Year Follow-Up of Arthroscopic Debridement and Interposition with Acellular Allograft Dermal Matrix for Ankle Arthritis with Anterior Impingement
Authors: Miller Roslyn
Published: November 2022

Category:

Ankle Arthritis; Ankle; Arthroscopy

Introduction/Purpose:

Early ankle arthritis can present with pain and anterior impingement. Younger, active patients who have exhausted conservative treatment have two options; ankle arthrodesis or ankle arthroplasty. Both are major procedures that have pros and cons. Revision surgery for both of these procedures is a major undertaking. Therefore, fit active patients who are under 65, may benefit from a less invasive procedure of anterior ankle arthroscopy and debridement. There is a risk, however that debridement alone, may inadvertently lead to the acceleration of joint degeneration. Thus the arthroscopic insertion of an acellular allograft dermal matrix acts as a 'cushion' to the joint surface and 'buy some time' for the patient to delay major surgery while having a reduction in their symptoms of pain and stiffness.

Methods:

Patients had surgery performed as a day case under general anaesthetic and tourniquet. No joint distraction was used. Two anterior portals were utilised; anetermedial and anterolateral. A 4mm arthroscope was used to visualise the joint surface. A arthroscopic shave and burr were used to remove any scar soft tissue and tibial and talar osteophytes. Any lateral ankle instability of the ATFL ligament, confirmed, clinically and with MRI imaging, was addressed with stabilisation using arthroscopic placement of an augmented stabilization with synthetic brace. A piece of acellular allograft dermal matrix was cut to size and place through one of the anterior portals onto the joint surface of the talus. The allograft was held in place with tisseal glue. Post-operatively the patient was place in a moonboot which was worn day and night for two weeks, then day only for a further two weeks, non weight- bearing. Three months of physiotherapy followed.

Results:

The majority of patients had an improvement in their range of motion. Most had reduction in their symptoms of pain. Patients who were less active appeared to have a longer duration of benefit versus those who were keen to return to full activity as quickly as possible. There was no incidence of infection or septic arthritis. One allograft tranlated anteriorly out of the joint space, resulting in a degree of impingement. Patients who wanted to consider further surgery presented on average two to three years after the index procedure.

Conclusion:

Anterior ankle arthroscopy with arthroscopic debridement of osteophytes and acellular allograft dermal matrix interposition, is a more minor procedure than ankle arthrodesis or ankle arthroplasty. This provides patients with an alternative to major surgery at a time in their lives where they wish to delay major intervention. The most challenging aspect of the procedure is inserting the acellular allograft dermal matrix through a small anterior portal and inserting it into the joint surface.
Correlation Between Muscle Strength Asymmetry and Its Impact on Functional Scores after Ankle Sprain Rehabilitation
Authors: Mohriak Rafael , Mansur Nacime SB , Alloza José Felipe M.
Published: November 2022

Category:

Sports; Ankle

Introduction/Purpose:

Ankle sprain is one of the most common sports-related injuries. Treatment of these lesions can be performed conservatively with satisfactory results in up to 80% of cases. The main goals of rehabilitation are the recovery of mobility, strength and balance; but there is no consensus on decision make criteria to return to sport. It is known that the time elapsed from trauma may be insufficient reference and may induce early return, while the individual still does not have symmetric parameters of mobility, strength and proprioception. Purpose: To assess the proportionality of muscle strength between the healthy and rehabilitated sides 16 weeks after ankle sprain related to physical activity and to correlate with its impact on function scores.

Methods:

131 individuals, from 18 to 64 years old, were evaluated after rehabilitation of simple sprain. Physical examination was performed with anterior drawer test, measurement of leg circumference by perimetry and by the method of figure in '8'; determination of active and passive range of motion using goniometer; muscle strength conference with hand held dynamometer and finally with the application of function scores. Equality test between two proportions, T-student test, Chi-square test and Pearson correlation were used to determine the significance between the values and correlations found.

Results:

We identified an average age of 36.1 (+- 2.5) years, 56 (42.70%) women and 75 (57.30%) men. 19.8% of sprains were severe. Limb volume and range of motion evaluations did not show significant differences. The anterior drawer remained positive in 19.1% of the individuals with the highest proportion in severe sprains (36.6%). Force asymmetry for flexion (52.7%), extension (50.4%), eversion (46.6%) and inversion (56.5%) movements above the 10% limit were observed. Impact on function scores showed a moderate correlation (0.59) with the proportionality of ankle extension forces.

Conclusion:

Individuals adequately rehabilitated after an ankle sprain and considered able to return to sports may present changes anterior drawer test and asymmetries in lower limb muscle strength impacting performance on function scores.
Diverging roads: Democracy, anocracy, autocracy, dictatorship?
Authors: Sternberg Robert J. , Fischer Christian
Published: November 2022

Some nations of the world have fallen into autocracy or outright dictatorship. Others are democracies, anocracies (quasi-democracies with features of both democracies and autocracies), or pseudo-democracies (autocracies pretending to be democracies). Some of these nations still can prevent themselves from falling into the dictatorship trap. They have a choice, but what will they do? This article discusses the current state of governance in the world, how autocrats emerge, and what can be done—especially in our educational systems—to prevent their emergence. Strengthening democracy, which, according to Freedom House, has been on a steady long-term decline, must be a priority for schooling of young people today.
Zaykovite, Rh3Se4, a new mineral from the Kazan placer, South Urals, Russia
Authors: Belogub Elena V. , Britvin Sergey N. , Shilovskikh Vladimir V. , Pautov Leonid A. , Kotlyarov Vasiliy A. , Zaykova Elisaveta V.
Published: November 2022

Zaykovite, ideally Rh3Se4, is a new mineral, the first natural rhodium selenide. It was discovered in the assemblages of platinum-group minerals from the Kazan gold placer, South Urals, Russia. The mineral occurs as crystals up to 40 μm in size within the grains of Pt3Fe alloy, in association with unnamed Pd–Sb–Te phase and Au–Pd alloy. In reflected light, zaykovite has a grey colour with bluish-greenish tint; it shows weak bireflectance and anisotropy. Reflectance values [Rmax/Rmin(%) for COM approved wavelengths (nm)] are: 30.1/29.3(470), 32.2/31.0(546), 33.4/32.0(589) and 35.1/33.7(650). The chemical composition corresponds to the empirical formula (Rh2.26Pt0.46Ir0.25Ru0.01Pd0.01Fe0.01)Σ3.00(Se2.77S1.21Te0.02)Σ4.00Zaykovite is monoclinic, space groupC2/m,a= 10.877(1),b= 11.192(1),c= 6.4796(6) Å, β = 108.887(2)°,V= 746.3(1) Å3,Z= 6 andDcalc= 8.32 g cm–1. The crystal structure has been solved and refined toR1= 0.016 based on 858 unique observed reflections. The strongest lines of the powder X-ray diffraction pattern [d(Å), (I), (hkl)] are: 5.43(37)($\bar{1}$11), 3.275(75)(310), 3.199(100)($\bar{1}$31), 3.061(87)(002), 2.568(62)(400), 2.545(41)(041), 3.413(34)($\bar{2}$41) and 1.697(34)(441). Zaykovite is a Se analogue of kingstonite, Rh3S4. A continuous series of solid solutions between kingstonite and zaykovite was encountered in the samples from the Kazan placer. The possible sources of this unique Rh–Se mineralisation in the South Urals could be serpentinised dunite–harzburgite or gabbro–clinopyroxenite–dunite complexes in the vicinity.
Matrix factorization for the reconstruction of cervical cancer screening histories and prediction of future screening results
Authors: Langberg Geir Severin R. E. , Stapnes Mikal , Nygård Jan F. , Nygård Mari , Grasmair Markus , Naumova Valeriya
Published: November 2022

Background

Mass screening programs for cervical cancer prevention in the Nordic countries have strongly reduced cancer incidence and mortality at the population level. An alternative to the current mass screening is a more personalised screening strategy adapting the recommendations to each individual. However, this necessitates reliable risk prediction models accounting for disease dynamics and individual data. Herein we propose a novel matrix factorisation framework to classify females by the time-varying risk of being diagnosed with cervical cancer. We cast the problem as a time-series prediction model where the data from females in the Norwegian screening population are represented as sparse vectors in time and then combined into a single matrix. Using novel temporal regularisation and discrepancy terms for the cervical cancer screening context, we reconstruct complete screening profiles from this scarce matrix and use these to predict the next exam results indicating the risk of cervical cancer. The algorithm is validated on both synthetic and registry screening data by measuring the probability of agreement (PoA) between Kaplan-Meier estimates.

Results

In numerical experiments on synthetic data, we demonstrate that the novel regularisation and discrepancy term can improve the data reconstruction ability as well as prediction performance over varying data scarcity. Using a hold-out set of screening data, we compare several numerical models and find that the proposed framework attains the strongest PoA. We observe strong correlations between the empirical survival curves from our method and the hold-out data, and evaluate the ability of our framework to predict the females’ next results for up to five years ahead in time using only their current screening histories as input.

Conclusions

We have proposed a matrix factorization model for predicting future screening results and evaluated its performance in a female cohort to demonstrate the potential for developing prediction models for more personalized cervical cancer screening.
Annotation of structural variants with reported allele frequencies and related metrics from multiple datasets using SVAFotate
Authors: Nicholas Thomas J. , Cormier Michael J. , Quinlan Aaron R.
Published: November 2022

Background

Identification of deleterious genetic variants using DNA sequencing data relies on increasingly detailed filtering strategies to isolate the small subset of variants that are more likely to underlie a disease phenotype. Datasets reflecting population allele frequencies of different types of variants serve as powerful filtering tools, especially in the context of rare disease analysis. While such population-scale allele frequency datasets now exist for structural variants (SVs), it remains a challenge to match SV calls between multiple datasets, thereby complicating estimates of a putative SV's population allele frequency.

Results

We introduce SVAFotate, a software tool that enables the annotation of SVs with variant allele frequency and related information from existing SV datasets. As a result, VCF files annotated by SVAFotate offer a variety of metrics to aid in the stratification of SVs as common or rare in the broader human population.

Conclusions

Here we demonstrate the use of SVAFotate in the classification of SVs with regards to their population frequency and illustrate how SVAFotate's annotations can be used to filter and prioritize SVs. Lastly, we detail how best to utilize these SV annotations in the analysis of genetic variation in studies of rare disease.
INFLECT: an R-package for cytometry cluster evaluation using marker modality
Authors: Verhoeff Jan , Abeln Sanne , Garcia-Vallejo Juan J.
Published: November 2022

Background

Current methods of high-dimensional unsupervised clustering of mass cytometry data lack means to monitor and evaluate clustering results. Whether unsupervised clustering is correct is typically evaluated by agreement with dimensionality reduction techniques or based on benchmarking with manually classified cells. The ambiguity and lack of reproducibility of sequential gating has been replaced with ambiguity in interpretation of clustering results. On the other hand, spurious overclustering of data leads to loss of statistical power. We have developed INFLECT, an R-package designed to give insight in clustering results and provide an optimal number of clusters. In our approach, a mass cytometry dataset is overclustered intentionally to ensure the smallest phenotypically different subsets are captured using FlowSOM. A range of metacluster number endpoints are generated and evaluated using marker interquartile range and distribution unimodality checks. The fraction of marker distributions that pass these checks is taken as a measure of clustering success. The fraction of unimodal distributions within metaclusters is plotted against the number of generated metaclusters and reaches a plateau of diminishing returns. The inflection point at which this occurs gives an optimal point of capturing cellular heterogeneity versus statistical power.

Results

We applied INFLECT to four publically available mass cytometry datasets of different size and number of markers. The unimodality score consistently reached a plateau, with an inflection point dependent on dataset size and number of dimensions. We tested both ConsenusClusterPlus metaclustering and hierarchical clustering. While hierarchical clustering is less computationally expensive and thus faster, it achieved similar results to ConsensusClusterPlus. The four datasets consisted of labeled data and we compared INFLECT metaclustering to published results. INFLECT identified a higher optimal number of metaclusters for all datasets. We illustrated the underlying heterogeneity within labels, showing that these labels encompass distinct types of cells.

Conclusion

INFLECT addresses a knowledge gap in high-dimensional cytometry analysis, namely assessing clustering results. This is done through monitoring marker distributions for interquartile range and unimodality across a range of metacluster numbers. The inflection point is the optimal trade-off between cellular heterogeneity and statistical power, applied in this work for FlowSOM clustering on mass cytometry datasets.
lmerSeq: an R package for analyzing transformed RNA-Seq data with linear mixed effects models
Authors: Vestal Brian E. , Wynn Elizabeth , Moore Camille M.
Published: November 2022

Background

Studies that utilize RNA Sequencing (RNA-Seq) in conjunction with designs that introduce dependence between observations (e.g. longitudinal sampling) require specialized analysis tools to accommodate this additional complexity. This R package contains a set of utilities to fit linear mixed effects models to transformed RNA-Seq counts that properly account for this dependence when performing statistical analyses.

Results

In a simulation study comparing lmerSeq and two existing methodologies that also work with transformed RNA-Seq counts, we found that lmerSeq was comprehensively better in terms of nominal error rate control and statistical power.

Conclusions

Existing R packages for analyzing transformed RNA-Seq data with linear mixed models are limited in the variance structures they allow and/or the transformation methods they support. The lmerSeq package offers more flexibility in both of these areas and gave substantially better results in our simulations.
The phylogeny of Seseli (Apiaceae, Apioideae): insights from molecular and morphological data
Authors: Cai Jing , Qin Huan-Huan , Lei Jia-Qing , Liu Chang-Kun , He Xing-Jin , Zhou Song-Dong
Published: November 2022

Background

The genus Seseli L., which consists of 125–140 species distributed in the Old World from western Europe and northwestern Africa to China and Japan, is one of the largest and most taxonomically difficult genera of Apiaceae Lindl. Although several previous studies have been conducted on Seseli based on limited morphological characteristics and molecular fragments, a robust and comprehensive phylogeny of Seseli remains elusive. Plastomes provide abundant genetic information and have been widely used in studying plant phylogeny and evolution. Consequently, we newly generated the complete plastomes of eleven Seseli taxa. We combined plastome data and morphological characteristics to investigate the phylogeny of Seseli.

Results

In our study, we observed that the genome length, gene numbers, IR/SC borders, and repeat composition of the eleven Seseli plastomes were variable. Several appropriate mutation hotspot regions may be developed as candidate DNA barcodes for evolution, phylogeny, and species identification of Seseli. The phylogenetic results identified that Seseli was not a monophyletic group. Moreover, the eleven newly sequenced Seseli taxa did not cluster with S. tortuosum (the type species of Seseli, belonging to the tribe Selineae), where S. delavayi clustered with Eriocycla belonging to the tribe Echinophoreae and the other ten belonged to Selineae. The comparative plastome and morphological characteristics analyses confirmed the reliability of the phylogenetic analyses and implied the complex evolution of Seseli.

Conclusion

Combining molecular and morphological data is efficient and useful for studying the phylogeny of Seseli. We suggest that “a narrow sense” of Seseli will be meaningful for further study and the current taxonomic system of Seseli needs to be revised. In summary, our study can provide new insights into the phylogenetic relationships and taxonomic framework of Seseli.
Enhanced stent visualization system for percutaneous coronary intervention in patients with chronic kidney disease: effects on contrast media volume and radiation exposure
Authors: Tian Yunpeng , Zhao Xiangdong , Yang Yang , Cai Xiaoshu , Jian Lian , Guo Suzhen , Xia Dasheng , Chen Xin , Li Chao , Guo Qianyu , Chen Bingwei , Lu Chengzhi
Published: November 2022

Objective

We aimed to assess the impact of using enhanced stent visualization (ESV) systems on contrast media volume and radiation dose in percutaneous coronary intervention (PCI), especially for patients with chronic kidney disease (CKD).

Background

Coronary heart disease (CHD) is associated with chronic kidney disease (CKD), as they share a similar pathological pathway. In addition, the iodinated contrast media used for angiography is a risk factor for contrast-associated acute kidney injury (CA-AKI), which could aggravate the progression of CKD. We hypothesized that ESV systems have the potential to reduce the use of contrast media as well as the radiation dose; however, few studies have reported the impact on contrast media with the use of ESV systems.

Methods

We retrospectively collected 124 patients with acute coronary syndrome who underwent PCI from May 2020 to July 2021. The patients were divided into the ESV-guided group (n = 64) and angiography-guided group (n = 60). Procedural parameters, including contrast media volume, radiation exposure (in Air Kerma-AK and Dose Area Product-DAP), number of cines, cine frames, fluoroscopy and procedure time, were recorded and analysed.

Results

The groups were comparable regarding the patient characteristics. There was a significant reduction in contrast media volume (174.7 ± 29.6 ml vs.132.6 ± 22.3 ml, p = 0.0001), radiation exposure (776 (499 - 1200) mGy vs. 1065 (791 - 1603) mGy, p = 0.002 in AK; 43 (37 - 73) Gycm2 vs. 80 (64 - 133) Gycm2, p = 0.030 in DAP) and procedure time (53.06 ± 21.20 min vs. 72.00 ± 30.55 min, p = 0.01) with the use of ESV systems. Similar results were observed in the subgroup analysis for the patients with CKD.

Conclusion

This study suggested that the use of ESV is associated with reduced contrast media usage, radiation dose and procedure time during PCI. The same results were observed in a subgroup analysis in patients with CKD, and this shows that ESV-guided PCI has the potential to reduce renal impairment and mitigate the progression of CKD for those CHD patients with CKD.
The CT-based intratumoral and peritumoral machine learning radiomics analysis in predicting lymph node metastasis in rectal carcinoma
Authors: Yuan Hang , Xu Xiren , Tu Shiliang , Chen Bingchen , Wei Yuguo , Ma Yanqing
Published: November 2022

Background

To construct clinical and machine learning nomogram for predicting the lymph node metastasis (LNM) status of rectal carcinoma (RC) based on radiomics and clinical characteristics.

Methods

788 RC patients were enrolled from January 2015 to January 2021, including 303 RCs with LNM and 485 RCs without LNM. The radiomics features were calculated and selected with the methods of variance, correlation analysis, and gradient boosting decision tree. After feature selection, the machine learning algorithms of Bayes, k-nearest neighbor (KNN), logistic regression (LR), support vector machine (SVM), and decision tree (DT) were used to construct prediction models. The clinical characteristics combined with intratumoral and peritumoral radiomics was taken to develop a radiomics and machine learning nomogram. The relative standard deviation (RSD) was used to predict the stability of machine learning algorithms. The area under curves (AUCs) with 95% confidence interval (CI) were calculated to evaluate the predictive efficacy of all models.

Results

To intratumoral radiomics analysis, the RSD of Bayes was minimal compared with other four machine learning algorithms. The AUCs of arterial-phase based intratumoral Bayes model (0.626 and 0.627) were higher than these of unenhanced-phase and venous-phase ones in both the training and validation group.The AUCs of intratumoral and peritumoral Bayes model were 0.656 in the training group and were 0.638 in the validation group, and the relevant Bayes-score was quantified. The clinical-Bayes nomogram containing significant clinical variables of diameter, PNI, EMVI, CEA, and CA19-9, and Bayes-score was constructed. The AUC (95%CI), specificity, and sensitivity of this nomogram was 0.828 (95%CI, 0.800-0.854), 74.85%, and 77.23%.

Conclusion

Intratumoral and peritumoral radiomics can help predict the LNM status of RCs. The machine learning algorithm of Bayes in arterial-phase conducted better in consideration of terms of RSD and AUC. The clinical-Bayes nomogram achieved a better performance in predicting the LNM status of RCs.
Association of social capital with obesity among older adults in China: a cross-sectional analysis
Authors: Yang Le , Wang Hongman , Cheng Jingmin
Published: November 2022

Background

Under the global aging trend, health issues of the elderly have received more and more attention. Among them, older adults’ obesity is one of the common health problems of the elderly. The association between social capital and obesity in the older adults has been analysed and discussed in previous studies but remains controversial. There are few studies on the association between social capital and obesity in the older adults in China. We examined whether social capital was associated with obesity in Chinese older adults.

Methods

The data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) —wave 8 (2017–2018) was used in this study. Totally, 10,164 respondents were included in the final analysis. Generalized trust, social participation (informal social interaction and participation of organized social activities), and social support was used as measures of social capital. Obesity status was defined by body mass index (BMI). Logistic regression analyses were used to assess associations between the social capital and obesity, adjusting for confounders.

Results

We found that the older adults who did not trust people around had greater odds of being overweighted/obese compared to those who trust [Adjusted Odds Ratio (AOR) 1.155, 95% CI 1.045 to 1.265]. The older adults having formal participation (participating in organized social activities) registered considerably higher BMI (AOR 1.155, 95% CI 1.041 to 1.269). The older adults who did not trust people around them had greater odds of being overweighted/obese both in males (AOR 1.172, 95% CI 1.012–1.333) and in females (AOR 1.155, 95% CI 1.004–1.306). Males having formal social participation were more likely to be overweighted/obese (AOR 1.181, 95% CI 1.024 to 1.337), but not in females.

Conclusions

Generalized trust and formal social participation was associated with overweight/obesity among older adults in China. Targeted obesity interventions for older adults are needed by developing public health policies for social capital optimization.
Sarcopenic obesity is associated with frailty among community-dwelling older adults: findings from the WCHAT study
Authors: Yang Mei , Hu Meng , Zhang Yan , Jia Shuli , Sun Xuelian , Zhao Wanyu , Ge Meiling , Dong Birong
Published: November 2022

Objective

Uncertainties remain regarding the relationship between sarcopenic obesity and frailty. This study aimed to explore the association of these two common geriatric syndromes among community-dwelling older adults.

Methods

Baseline data from the West China Health and Aging Trend (WCHAT) study was used. Sarcopenia was assessed based on the criteria established by the Asian working group for sarcopenia. Body fat percentages above the 60th percentile specified by sex were classified as obesity. Sarcopenic obesity was defined as the concurrence of obesity and sarcopenia. Frailty was assessed by Fried criteria. Multinomial logistic regression was adopted to explore associations of sarcopenic obesity with frailty.

Results

Overall, 2372 older adults (mean age 67.6 ± 5.9) were involved in this study. The prevalence of frailty and sarcopenic obesity was 6.2 and 6.28%, respectively. After adjusting for covariates, sarcopenic obesity was significantly associated with prefrailty (OR = 1.74, 95% CI = 1.15–2.64, P = 0.009) and frailty (OR = 4.42, 95% CI = 2.19–8.93, P < 0.001) compared to nonsarcopenia and nonobesity.

Conclusions

Sarcopenic obesity was significantly correlated with prefrailty and frailty among older adults. Intervention for sarcopenic obesity may contribute to the prevention of incident frailty.
March hemoglobinuria progressed to acute kidney injury after kendo practice: a case report
Authors: Yoshida Maiko , Suzuki Hitoshi , Hamaguchi Sho , Iwasaki Masako , Fukuda Hiromitsu , Takahara Hisatsugu , Tomita Shigeki , Suzuki Yusuke
Published: November 2022

Background

March hemoglobinuria is caused by a hemolytic mechanism due to transient hematuria after physical exercise which, although rare, may lead to acute kidney injury. We report a case of a patient with march hemoglobinuria induced by kendo, which was diagnosed by the presence of Berlin blue iron staining in the proximal tubules through renal biopsy.

Case presentation

A 15-year-old male complained of fever (37 °C), general malaise, and nausea after hard kendo sessions. Laboratory findings revealed indirect bilirubin dominant hyperbilirubinemia (total bilirubin 3.8 mg/dL), high lactate dehydrogenase (LDH), and acute kidney injury (serum creatinine: 3.11 mg/dL and estimated glomerular filtration rate: 26 mL/min/1.73m2). Urine test was positive for occult blood but without hematuria. Renal biopsy was performed to clarify the cause of renal injury, which showed minor glomerular abnormalities. Meanwhile, hemosiderin deposition was identified in the proximal tubules by Berlin blue iron staining, and lysosomes were observed to contain granular iron. In addition to clinical background of strenuous kendo exercise, renal biopsy led to a definitive diagnosis of march hemoglobinuria.

Conclusions

March hemoglobinuria is a hemolytic disease that can occur after intense exercise, especially kendo. Considering its rarity due to the lack of critical symptoms, it is important to note that occult blood-positive findings may be indicative of march hemoglobinuria if the patient underwent strenuous exercise. Therefore, clinicians should be aware of this possibility to provide timely and appropriate treatment.
Mothers’ experiences with mHealth intervention for postnatal care utilisation in Nigeria: a qualitative study
Authors: Olajubu Aanuoluwapo Omobolanle , Fajemilehin Boluwaji Reuben , Olajubu Temitope Oluwafemi
Published: November 2022

Background

The postnatal period implies a crucial and delicate time for both the mother and the newborn. There is a growing body of evidence that is increasingly pointing to mHealth interventions as a potential tool for improved utilisation of maternal and child health services, including postnatal care. This can promote the health of mother and baby during this delicate period. However, the success of the interventions must be explored to validate their usefulness and reliability. Hence, this study explored the experiences of postpartum women on the usefulness of the mHealth intervention (postnatal care assistant) they received.

Methods

Twenty women, who were involved in mHealth intervention were interviewed using a semi-structured interview guide. They were recruited from the intervention group of a quasi-experimental study that evaluated the effect of a mHealth intervention on the uptake of postnatal care services. Thematic analysis of data was done using NVivo software version 10.

Results

Five major themes emerged from data shared by the participants. They are general feelings about the messages, benefits derived from the messages about pregnancy and hospital delivery, increased knowledge about baby care, facilitation of PNC utilisation and involvement of significant others in decision making. They affirmed that the information and reminder messages gave them the impetus to utilise postnatal care services.

Conclusion

Mothers reported that mHealth intervention provided immense support and assistance during pregnancy and the reminder messages encouraged them to utilise postnatal care services. This study suggests that improved education and reminder messages via mobile phones are needed during pregnancy and after childbirth to promote mother and child health through the utilization of postnatal care services, and efforts to put this approach to action should be pursued.
Herpes simplex keratitis following Smart Pulse Technology assisted transepithelial photorefractive keratectomy: a case report
Authors: Nie Ai-qin , Chen Xiao-min , Li Qiang
Published: November 2022

Background

Herpes simplex keratitis (HSK) is a rare and sight-threatening complication following refractive surgery. SmartSurfACE surgery is the result of combining transepithelial photorefractive keratectomy (trans-PRK) with Smart Pulse Technology (SPT) to diminish surface irregularities of the residual stromal bed after surgery with less pain, faster re-epithelialization, and better postoperative visual acuity. In this article, we report the first case of HSK following SmartSurf ACE without history of herpetic eye disease.

Case presentation

A 21-year-old woman underwent bilateral SmartSurfACE without history of clinical herpetic infection, active eye disease, or systemic disease. Mild superficial punctate keratitis occurred on the tenth postoperative day. The condition was not improved by ophthalmic drugs of anti-inflammation or epithelial healings. Dendritic corneal ulcer appeared within one month, which is the commonly recognized clinical manifestation of herpes simplex keratitis. The patient was managed with topical and systemic antiviral agents. After nine days of antiviral therapy, the lesion healed up, remaining mild stromal scarring in both eyes ultimately.

Conclusion

Herpes simplex keratitis is a rare but sight-threatening complication following refractive surgery. For the ocular irritation symptoms of postoperative patients, we should consider the possibility of HSK and give timely treatment.
Von Hipple-Lindau disease complicated with central retinal vein occlusion: a case report
Authors: Chen Xingwang , Wang Mengyao , Tang Yuan , Xie Bing , Nie Xiaomei , Cai Shanjun
Published: November 2022

Background

Central Retinal Vein Occlusion (CRVO) is a rare complication of von Hipple-Lindau (VHL) disease. This report presents the first case of VHL disease complicated with CRVO caused by VHL c.208G > A mutation.

Case presentation

A 20 s man whose left eye visual acuity gradually declined for half a year. The visual acuity of the left eye is counting fingers. Fundus examination revealed that retinal hemangioblastoma was also found in addition to typical CRVO signs such as tortuous expansion of retinal veins and flame-shaped hemorrhage of the retina. Liver tumor, cerebral infarction and erythrocytosis were found during systemic examination, and the diagnosis of polycythemia was confirmed by bone marrow smear. Furthermore, both family history and genetic analysis indicated that the patient had VHL disease caused by VHL c.208G > A. In this patient, a large number of bone marrow erythrocytes proliferated due to VHL disease, which led to the increase of blood viscosity and erythrocyte vascular adhesion, resulting in the obstruction of central retinal vein blood flow, and finally CRVO. For CRVO and its pathogenic factor polycythemia, patient received laser retinal photocoagulation and phlebotomies. After a 1-year follow-up, the vision in the left eye improved to 0.2 logMAR.

Conclusions

This is a rare case of polycythemia complicated by CRVO in patient with VHL disease. It reminds us that the systemic disease factors should be fully considered in the diagnosis of young patients with CRVO, and that treatment requires a coordinated effort of physicians.
Preliminary studies on apparent mendelian psychotic disorders in consanguineous families
Authors: Kanwal Ambreen , Sheikh Sohail A. , Iftikhar Amina , Naz Sadaf , Pardo José V.
Published: November 2022

Background

Psychiatric disorders are characterized by alteration in emotions, mood and behavior. Genetics is known to play a significant role in the development of psychiatric disorders. Genome-wide association studies have identified several loci associated with psychiatric illnesses. We hypothesize the existence of rare variants following Mendelian recessive mode of inheritance. These variants can be identified in families with multiple affected individuals born to unaffected consanguineous parents.

Methods

We visited psychiatric outpatient departments of multiple hospitals in Lahore, Pakistan. We focused on psychosis, as it can occur in several DSM disorders such as schizophrenia, dementia and bipolar disorder. After clinical diagnosis by an American trained psychiatrist, detailed clinical assessments using Diagnostic Interview for Genetic Studies (DIGS), Diagnostic Interview for Psychosis and Affective Disorders (DI-PAD), Positive and Negative Syndrome Scale (PANSS), Hamilton Depression and Anxiety Rating Scale (HAM-D; HAM-A) were administered to all willing affected and unaffected participants.

Results

We identified eight pedigrees with two or more psychotic individuals in each family. Clinical diagnoses determined by their psychiatrists included ten individuals with schizophrenia; four individuals with psychosis and bipolar disorder; and two patients with “unspecified psychosis.” The rating instruments rigorously confirmed the diagnosis of psychosis in the affected patients from the six families as well as the absence of psychotic disorders in unaffected individuals from the six families. We obtained DNA samples from willing members of all eight families for future genetic analyses.

Conclusion

Our research highlights an alternative approach to discovery of rare recessively inherited genetic variants causing psychiatric disorders that have remained unidentified to date. These findings could illuminate underlying biological mechanisms leading toward development of targeted therapies in future.
Mental health literacy questionnaire-short version for adults (MHLq-SVa): validation study in China, India, Indonesia, Portugal, Thailand, and the United States
Authors: Campos Luísa , Dias Pedro , Costa Marisa , Rabin Laura , Miles Rona , Lestari Sumi , Feraihan Rania , Pant Neera , Sriwichai Natthaphansan , Boonchieng Waraporn , Yu Luxi
Published: November 2022

Background:

Mental Health Literacy (MHL) has become a focus of research in recent decades, as a prerequisite for early identification and intervention for mental health problems. Although several instruments have been developed for assessing MHL, there is a need for brief and psychometrically sound measures to capture important aspects of MHL in large and diverse adult samples. The present study aimed to: (1) provide a revised and shorter version of a previously validated questionnaire for assessing MHL; and (2) examine the psychometric properties of the MHLq-SVa in student samples from six different countries (China, India, Indonesia, Portugal, Thailand, and United States).

Methods:

The study involved 2180 senior school and undergraduate students, aged between 17 and 25 years old, from China, India, Indonesia, Portugal, Thailand, and the United States. Participants responded to the Mental Health Literacy Questionnaire for young adults (MHLq-ya), in their native language, following its translation and adaptation for each culture. The MHLq-ya comprises 29 items, organized into four dimensions: Knowledge of mental health problems; Erroneous beliefs/stereotypes; First-aid skills and help-seeking behavior; Self-help strategies. Confirmatory factor analyses and internal consistency analyses were performed on the combined data.

Results:

Data from the different countries supported a shorter version of the questionnaire (MHLq-SVa), composed of 16 items that fit with previously defined dimensions. Internal consistency and between-factor correlations further supported the adequacy of the instrument’s psychometric properties.

Conclusion:

The study provided preliminary support for the construct validity and reliability of the MHLq-SVa as a measure for assessing MHL in young adults from six different countries and languages. Future studies are needed to further validate the measure and undertake multicultural comparisons of MHL in diverse samples from around the globe.
Social anxiety disorder in an adolescent with agenesis of the corpus callosum: a case report
Authors: Yang Runnan , Cao Yuan , He Danmei , Dang Wen , Qiu Changjian , Zhang Wei
Published: November 2022

Background

The agenesis of corpus callosum (ACC) could impair the connectivity of the hemispheres of the cerebral cortex and cause cognitive impairments, social and behavioral issues, and even psychiatric disorders. Although social deficits are common in ACC patients, it is rare for a social anxiety disorder to occur.

Case presentation

To report a 17-year-old adolescent with complete ACC associated with social anxiety disorder, depression, impulsive behavior, and other neurodevelopmental defects such as intellectual disabilities. His avoidance and fear were improved after treatment with sertraline.

Conclusions

This is the first report of social anxiety disorder in ACC patients. The possible relationship between brain structural abnormities and anxiety syndrome should be investigated in more studies.
Impact of the COVID-19 pandemic on family carers of those with profound and multiple intellectual disabilities: perspectives from UK and Irish Non-Governmental Organisations
Authors: Linden M. A. , Forbes T. , Brown M. , Marsh L. , Truesdale M. , McCann E. , Todd S. , Hughes N.
Published: November 2022

Background

Family carers of people with profound and multiple intellectual disabilities (PMID) experienced a reduction in healthcare services due to the COVID-19 pandemic. Many subsequently turned to Non-Governmental Organisations who worked to support families. However, little research has sought to capture the experiences of family carers or identify effective interventions which might support them. To address these concerns we explored the views of Non-Governmental sector workers across the UK and Ireland who supported families people with PMID during the COVID-19 pandemic. We also sought to explore their views on the characteristics of online support programmes for family carers. 

Methods

This study employed a qualitative design using focus groups with participants (n = 24) from five Non-Governmental Organisations across the UK and Ireland. A focus group guide included questions on challenges, supports, coping and resources which helped during lockdown restrictions. Focus groups were held online, were audio recorded and transcribed verbatim. The resulting transcripts were pseudonymised and subjected to thematic analysis.

Findings

Four themes were identified (i) ‘mental and emotional health’, (ii) ‘they who shout the loudest’ (fighting for services), (iii) ‘lack of trust in statutory services’ and (iv) ‘creating an online support programme’. Mental and emotional health emerged as the most prominent theme and included three subthemes named as ‘isolation’, ‘fear of COVID-19’ and ‘the exhaustion of caring’.

Conclusions

The COVID-19 pandemic has increased the vulnerability of family carers who were already experiencing difficulties in accessing services and supports for their families. While Non-Governmental Organisations have been a crucial lifeline there is urgent need to design services, including online support programmes, in partnership with family carers which adequately address their needs.
COVID-19 mortality rate determinants in selected Eastern European countries
Authors: Sobczak Marharyta , Pawliczak Rafał
Published: November 2022

Background

The COVID-19 pandemic has caused increased mortality worldwide. We noticed a tendency for higher number of deaths in Eastern European countries. Therefore, we decided to investigate whether any common factor that might be responsible for the increased COVID-19 mortality exists.

Methods

In our cross-sectional study, we conducted the correlation and multiple regression analysis using R basing on the data gathered in publicly available databases. In the analysis, we included variables such as: number of deaths, number of new cases, number of hospitalizations, number of ICU (intensive care units) patients, number of vaccinations, number of boosters, number of fully vaccinated individuals, stringency index, number of reported COVID-19 variant cases, and number of flights. Additionally, we analyzed the influence of population density and median age in particular European countries on total number of COVID-19 deaths. Analyzed data represents periods from start of the COVID-19 pandemic in particular Eastern European Countries: Bulgaria, Croatia, Czech Republic, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia and Slovenia, while as the end of the study the day of January 31, 2022 is considered. Results were considered statistically significant at p < 0.05.

Results

Our study showed that mortality rate reflects the number of COVID-19 cases (e.g. for Poland was 0.0058, p < 0.001), number of hospitalized patients (e.g. for Poland 0.0116, p < 0.001), and patients in intensive care (e.g. for Slovakia 0.2326, p < 0.001). Stringency index corresponding to level of introduced restrictions and vaccination can affect the mortality rate of COVID-19 in a country-dependent manner: e.g. for Romania 0.0006, p < 0.001; whereas in Lithuania − 0.0002, p < 0.001. Moreover, occurrence of B.1.1.7 and B.1.617.2 variants increased COVID-19 mortality rates.

Conclusion

Our analysis showed that crucial factor for decreasing mortality is proper healthcare joined by accurate restriction policy. Additionally, our study shows that COVID-19 vaccination proven successful in COVID-19 mortality prevention.
Low frequency pulsed electromagnetic fields exposure alleviate the abnormal subchondral bone remodeling at the early stage of temporomandibular joint osteoarthritis
Authors: Ma Yuanjun , Chen Xiaohua , He Feng , Li Shi , He Rui , Liu Qian , Dong Qingshan , Zhou Shuncheng , Miao Hui , Lu Qian , Li Feifei , Yang Hongxu , Zhang Mian , Lin Yuan , Yu Shibin
Published: November 2022

Background

Temporomandibular joint osteoarthritis (TMJOA) is characterized by abnormal subchondral bone remodeling and cartilage degeneration. As a non-invasive biophysical technology, pulsed electromagnetic field (PEMF) treatment has been proven to be efficient in promoting osteogenesis. However, the potential bone protective effect and mechanism of PEMF on abnormal subchondral bone remodeling in TMJOA are unknown.

Methods

Unilateral anterior crossbite (UAC) was used to create TMJOA model in rats, and 17β-estradiol (E2) were injected daily to mimic patients with high-physiological levels of estrogen. Mouse osteoblast-like MC3T3-E1 cells treated with recombinant murine IL-1β was used to establish inflammatory environment in vitro. The treatment group were subjected to PEMF (2.0mT, 15 Hz, 2 h/d). Micro-CT scanning, histological staining, real-time PCR and western blotting assays were preformed to observe the changes in the subchondral bone.

Results

Abnormal resorption of subchondral bone induced by UAC, characterized by decreased bone mineral density, increased osteoclast activity and expression of osteoclast-related factors (RANKL) and down-regulated expression of osteogenesis-related factors (OPG, ALP, Runx2 and OCN) at the early stage, could be reversed by PEMF exposure, which was similar to the effect of estrogen. In addition, PEMF exposure and E2supplement may have a synergistic effect to some extent. Moreover, PEMF exposure could promote the ALP activity and osteogenic mineralization ability of MC3T3-E1 cells. PEMF promoted the expression of factors related to Wnt/β-Catenin signal pathway both in vivo and in vitro.

Conclusions

Appropriate PEMF exposure have a protective effect on subchondral bone in TMJOA at early stage, in which canonical Wnt/β-Catenin pathway may be involved. PEMF may be a promising biophysical approach for early intervention of TMJOA in clinic.