bluuebunny/crossref_metadata_2025 huggingface dataset:
Midterm Survivorship of the INBONE II Total Ankle Arthroplasty
Authors: Gagne Oliver J. , Day Jonathan , Kim Jaeyoung , Caolo Kristin , O’Malley Martin J. , Deland Jonathan T. , Ellis Scott J. , Demetracopoulos Constantine A.
Published: December 2021

Background:

The use of total ankle arthroplasty (TAA) in the treatment of ankle arthritis has grown substantially as advancements are made in design and surgical technique. Among the criteria guiding the choice between arthroplasty and arthrodesis, the long-term survival and postoperative outcomes are of crucial importance. Although outcomes of the INBONE I have been published, there is limited midterm survival data for the INBONE II. The purpose of this study was to determine the radiographic and patient-reported outcomes, and survivorship of this prosthesis in patients with a minimum 5-year follow-up.

Methods:

We retrospectively identified 51 ankles (46 patients) from 2010 to 2015 who underwent TAA with the INBONE II prosthesis at our institution. Of these, 44 cases had minimum clinical follow-up of 5 years (mean, 6.4; range 5-9). Median age was 66 years (range 42-81) and median BMI was 27.5 (range 20.1-33.0). A chart review was performed to record the incidence of revision and reoperation. Preoperative and postoperative radiographs were analyzed to assess the coronal tibiotalar alignment (TTA), the talar inclination angle, and the presence of periprosthetic lucencies and cyst formation. Preoperative and minimum 5-year postoperative Foot and Ankle Outcome Score (FAOS) subscales were compared. Survivorship was determined by incidence of revision, defined as removal of a metallic component.

Results:

The survivorship at 5 years was 98% and the rate of reoperation was 7.8% (n = 4); 2 patients underwent irrigation and debridement for infection, 1 patient underwent a medializing calcaneal osteotomy, and 1 patient underwent open gutter debridement, 1 patient underwent a revision of a subsided talar component at 3.2 years after index surgery. Average postoperative TTA was 88.6 degrees, with 42 rated as neutral (85-95 degrees), 2 varus (<85 degrees), and no valgus (>95 degrees) ankles. At final follow-up, asymptomatic periprosthetic cysts were observed in 8 patients. All FAOS domain scores improved between preoperative and final follow-up.

Conclusion:

At midterm follow-up, we observed significant improvement in radiographic alignment and patient-reported outcome scores for the INBONE II total ankle prosthesis. In addition, this cohort has had a relatively low reoperation rate and high survivorship.

Level of Evidence:

Level IV, case series.
Measurement Invariant but Non-Normal Treatment Responses in Guided Internet Psychotherapies for Depressive and Generalized Anxiety Disorders
Authors: Rosenström Tom H. , Ritola Ville , Saarni Suoma , Joffe Grigori , Stenberg Jan-Henry
Published: December 2021

Assessment of treatment response in psychotherapies can be undermined by lack of longitudinal measurement invariance (LMI) in symptom self-report inventories, by measurement error, and/or by wrong model assumptions. To understand and compare these threats to validity of outcome assessment in psychotherapy research, we studied LMI, sum scores, and Davidian Curve Item Response Theory models in a naturalistic guided internet psychotherapy treatment register of 2,218 generalized anxiety disorder (GAD) patients and 3,922 depressive disorder (DD) patients (aged ≥16 years). Symptoms were repeatedly assessed by Generalized Anxiety Disorder Assessment-7 (GAD-7) or Beck Depression Inventory. The symptom self-reports adhered to LMI under equivalence testing, suggesting sum scores are reasonable proxies for disorder status. However, the standard LMI assumption of normally distributed latent factors did not hold and inflated treatment response estimates by 0.2 to 0.3 standard deviation units compared with sum scores. Further methodological research on non-normally distributed latent constructs holds promise in advancing LMI and mental health assessment.
Caution in Using the Activated Partial Thromboplastin Time to Monitor Argatroban in COVID-19 and Vaccine-Induced Immune Thrombocytopenia and Thrombosis (VITT)
Authors: Guy Susan , Kitchen Steve , Makris Michael , M. Maclean Rhona , Saccullo Giorgia , Vanveen Joost J
Published: December 2021

Introduction

Argatroban is licensed for patients with heparin-induced thrombocytopenia and is conventionally monitored by activated partial thromboplastin time (APTT) ratio. The target range is 1.5 to 3.0 times the patients’ baseline APTT and not exceeding 100 s, however this baseline is not always known. APTT is known to plateau at higher levels of argatroban, and is influenced by coagulopathies, lupus anticoagulant and raised FVIII levels. It has been used as a treatment for COVID-19 and Vaccine-induced Immune Thrombocytopenia and Thrombosis (VITT). Some recent publications have favored the use of anti-IIa methods to determine the plasma drug concentration of argatroban.

Methods

Plasma of 60 samples from 3 COVID-19 patients and 54 samples from 5 VITT patients were tested by APTT ratio and anti-IIa method (dilute thrombin time dTT). Actin FS APTT ratios were derived from the baseline APTT of the patient and the mean normal APTT.

Results

Mean APTT ratio derived from baseline was 1.71 (COVID-19), 1.33 (VITT) compared to APTT ratio by mean normal 1.65 (COVID-19), 1.48 (VITT). dTT mean concentration was 0.64 µg/ml (COVID-19) 0.53 µg/ml (VITT) with poor correlations to COVID-19 baseline APTT ratio r2 = 0.1526 p <0.0001, mean normal r2 = 0.2188 p < 0.0001; VITT baseline APTT ratio r2 = 0.04 p < 0.001, VITT mean normal r2 = 0.0064 p < 0.001.

Conclusions

We believe that dTT is a superior method to monitor the concentration of argatroban, we have demonstrated significant differences between APTT ratios and dTT levels, which could have clinical impact. This is especially so in COVID-19 and VITT.
Thrombotic and Hemorrhagic Incidences in Patients After Discharge from COVID-19 Infection: A Systematic Review and Meta-Analysis
Authors: Rungjirajittranon Tarinee , Owattanapanich Weerapat , Leelakanok Nattawut , Sasijareonrat Natthaporn , Suwanawiboon Bundarika , Chinthammitr Yingyong , Ruchutrakool Theera
Published: December 2021

Background

The association between coronavirus infection 2019 (COVID-19) and thrombosis has been explicitly shown through numerous reports that demonstrate high rates of thrombotic complications in infected patients. Recently, much evidence has shown that patients who survived COVID-19 might have a high thrombotic risk after hospital discharge. This current systematic review and meta-analysis was conducted to better understand the incidence of thrombosis, bleeding, and mortality rates among patients discharged after COVID-19 hospitalization.

Methods

Using a search strategy that included terms for postdischarge, thrombosis, and COVID-19, 2 investigators independently searched for published articles indexed in the MEDLINE, Embase, and Scopus databases that were published before August 2021. Pooled incidences and 95% confidence intervals were calculated using the DerSimonian-Laird random-effects model with a double arcsine transformation.

Results

Twenty articles were included in the meta-analysis. They provided a total of 19 461 patients discharged after COVID-19 hospitalization. The weighted pooled incidence of overall thrombosis among the patients was 1.3% (95 CI, 0. 6-2; I2 90.5), with a pooled incidence of venous thrombosis of 0.7% (95 CI, 0. 4-1; I2 73.9) and a pooled incidence of arterial thrombosis of 0.6% (95 CI, 0. 2-1; I2 88.1). The weighted pooled incidences of bleeding and mortality were 0.9% (95 CI, 0. 1-1.9; I2 95.1) and 2.8% (95 CI, 0. 6-5; I2 98.2), respectively.

Conclusions

The incidences of thrombosis and bleeding in patients discharged after COVID-19 hospitalization are comparable to those of medically ill patients.
Effect of pin generatrix on the elastohydrodynamic lubrication performance of pin-bush pair in industrial roller chains
Authors: Zhang Ansheng , Wang Jing , Han Yiming , Zhang Jianjun , Liu Yi
Published: December 2021

For industrial roller or bush chains, the bush swings relative to the pin at working condition. If proper lubrication is maintained, an elastohydrodynamic lubrication contact is formed between the pin and the bush. In this study, a custom-made pin was used to replace the steel ball of a ball-disk test rig and optical interferometric experiments were carried out to study the effect of pin generatrix on the lubrication performance. The effects of generatrix shape, stroke length and oil supply condition on the lubrication state were explored. It is found that the change of the generatrix has an important influence on the oil film thickness, especially under rare oil supply condition.
A rule-based decision support system for aiding iron deficiency management
Authors: Çelik Ertuğrul Duygu , Toygar Önsen , Foroutan Neda
Published: December 2021

Iron is a vital mineral for the proper function of hemoglobin which is also a protein needed to transport oxygen in the blood. The lack of iron in human blood causes a range of serious health problems including “anemia.” In this article, the COntAneRS (Clinical ONTology-based Iron Deficiency‐ANEmia‐ Recommendation System) is proposed as a clinical decision support system to diagnose iron deficiency and manage its treatment. The applied methodologies and main technical contributions of this study are discussed in four aspects: (1) Iron Deficiency Domain Ontology (IDDOnt), (2) Semantic Web Rule Knowledgebase (SWRL), (3) Inference Engine, and (4) Physician Portal of the system. Experimental studies of the proposed system have been applied on a population of 200 people, consisting of real anemia patients and healthy individuals. First, a decision tree classifier is used to diagnose iron deficiency condition based on the patients’ demographic information and certain medical data, as well as recently measured hemoglobin CBC levels of the patients. To check the effectiveness of the system, the data of 50 anonymous patients randomly selected from 200 patients are entered manually in the IDDOnt and the system is then verified according to the inferencing results. After inferencing step, the recommendations related to appropriate iron drugs, daily consumption dose, drug consumption periods, and additional medical suggestions about drug interactions are provided by the system to the responsible physician through system ontology, SWRL rules, and web services. As a result of experimental studies, our system has provided very good accuracy (99.5%) and robust results in producing patient-suitable suggestions. In addition, the applicability of the system on the cases is discussed as case studies in this paper. The results reported from the applied case studies are promising in demonstrating the applicability, effectiveness, and efficiency of the proposed approach.
Twelve-Month Outcomes From the Japanese Post-Market Surveillance Study of the Viabahn Endoprosthesis as Treatment for Symptomatic Peripheral Arterial Disease in the Superficial Femoral Arteries
Authors: Iida Osamu , Ohki Takao , Soga Yoshimitsu , Suematsu Nobuhiro , Nakama Tatsuya , Yamaoka Terutoshi , Tobita Kazuki , Ichihashi Shigeo
Published: December 2021

Purpose:

To assess the midterm safety and effectiveness of the Gore® Viabahn® Endoprosthesis as treatment for symptomatic peripheral arterial disease (PAD) in the superficial femoral arteries (SFA).

Materials and Methods:

A prospective, multicenter, post-market surveillance study was conducted in Japan. Patients with symptomatic SFA lesions ≥ 10 cm and reference vessel diameters ranging from 4.0 to 7.5 mm were eligible for enrollment; patients with traumatic or iatrogenic vessel injury in the thoracic, abdominal, or pelvic arteries were excluded. Outcomes evaluated at 12 months were primary patency (PP), primary-assisted patency (PAP), secondary patency (SP), freedom from target lesion revascularization (fTLR), occurrence of device- or procedure-related serious adverse events (SAEs), and stent fractures.

Results:

From August 2016 to May 2017, 321 patients were enrolled at 64 Japanese sites (mean age, 73.9±8.7 years; 77.3% male). Hypertension, diabetes, and end stage renal disease were present in 84.4%, 54.8%, and 23.1% of patients, respectively. Mean lesion length was 23.6 cm±6.6 cm, with lesions ≥ 15 cm in 271 patients (84.4%). TASC C/D lesions accounted for 86.6% (39.1% TASC C, 47.5% TASC D); 26.5% had critical limb ischemia. Baseline ABI was 0.60±0.16. A total of 562 devices were implanted in 324 limbs, with a majority of patients (68.8%) receiving 2 stents. Through 12 months, 92.1% of patients were evaluable. Kaplan-Meier-estimated PP, PAP, and SP at 12 months was 85.6%, 91.7%, and 94.8%, respectively. Twelve-month fTLR was 92.3%. Mean change in ABI at 12 months was 0.343±0.21; mean improvement in Rutherford class was 2.5. Device- or procedure-related SAEs occurred in 3.1% through 30 days, with a majority of early SAEs consisting of access complications. Through 12 months, a cumulative 10.6% had device- or procedure-related SAEs, with the most common being device occlusions in 4.0%. Lower limb amputation occurred in 0.9% and was related to pre-existing ulceration or gangrene in all 3 cases. No stent fractures were observed at 12-month x-ray evaluation.

Conclusion:

In a real-world Japanese patient population characterized by long SFA lesions and complex PAD, the Viabahn endoprosthesis was associated with excellent patency rates through 12 months and an acceptable safety profile.
Player Mobility and Competitive Balance Regulation in Professional Sports Leagues
Authors: Runkel Marco
Published: December 2021

Competitive balance regulation is more widespread in North American than in Europan sports leagues. The present paper addresses the question whether this observation can be explained with the help of differences in the degree of player mobility. Using an extended version of the workhorse contest model of sports leagues, the paper shows that the answer depends on the kind of competitive balance regulation. While player mobility may help to explain the difference with respect to salary regulation (e.g., salary caps), the choice of revenue sharing schemes turns out to be independent of player mobility.
Veno-Arterial Index (VAI)—A Promising Tool For Identifying Renal Transplant Rejection
Authors: Lubinus Badillo Federico Guillermo , Zuñiga Hadechni Evelyn Elena , Valenzuela Santos Diana Maria , Mantilla Suarez Juan Carlos , Ochoa Vera Miguel Enrique , Vera Campos Silvia Nathalia , Villarreal Ibañez Erick Daniel , Carrillo Manuela Fernanda
Published: December 2021

The objective of this study is to evaluate the veno-arterial index (VAI) as a predictor of renal rejection in kidney transplant patients. A diagnostic test study was conducted between January 2014 and May 2018. Renal transplant patients who underwent percutaneous renal biopsy were included. The VAI was obtained by measuring the flow velocity in the renal segmental vein and dividing this value by the peak systolic velocity of the segmental artery in this same location. The records of 77 patients were analyzed. Among these patients, 32 (42%) were positive for transplant rejection and 29 presented with acute rejection. In patients with renal rejection, the median VAI was 0.67 (interquartile range [IQR] = 0.56-0.87), and in kidneys with a negative biopsy for rejection, the median VAI was 0.41 (IQR = 0.27-0.57), with a statistically significant difference ( P = .007) and a value much higher than that obtained for the general population of 0.30 (IQR = 0.18-0.44). Subacute and acute rejected kidneys had an even higher VAI of 0.725 (IQR = 0.57-0.87; P = .0001). Although the resistive index has a good correlation with glomerular filtration, it is not possible by that index to differentiate among the multiple causes that can lead to graft dysfunction. The results of this study show that the VAI might be a useful parameter, which when elevated could predict renal transplant rejection.
Systemic Inflammation Response Index as a Prognostic Marker in Cancer Patients: A Systematic Review and Meta-Analysis of 38 Cohorts
Authors: Zhou Qian , Su Si , You Wen , Wang Tao , Ren Tong , Zhu Lan
Published: December 2021

Background

The systemic inflammation response index (SIRI), a novel and cost-effective serum biomarker, is associated with prognosis in patients with cancer. However, the prognostic value of the SIRI in cancer remains unclear. This study aimed to evaluate the potential role of the SIRI as a prognostic indicator in cancer.

Methods

Reports in which the prognostic value of the SIRI in cancer was evaluated were retrieved from electronic databases. The pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated to evaluate the prognostic significance of the SIRI. The odds ratio (OR) was also calculated to explore the association between the SIRI and clinicopathological features.

Results

This study included 30 retrospective studies with 38 cohorts and 10 754 cases. The meta-analysis indicated that a high SIRI was associated with short overall survival (OS) (HR = 2.04, 95% CI = 1.82–2.29, P < .001) and disease-free survival (DFS)/recurrence-free survival (RFS)/progression-free survival (PFS) (HR = 2.08, 95% CI = 1.84–2.34, P < .001). Subgroup analysis showed that the prognostic value of the SIRI was significant in all kinds of cancer included. Moreover, the SIRI was significantly correlated with sex, tumor size, T stage, N stage, TNM stage, and lymphovascular invasion.

Conclusion

The pretreatment SIRI could be a promising universal prognostic indicator in cancer.
Distribution parameter modeling and experimental verification of constant-pressure variable displacement pump
Authors: Yan Zheng
Published: December 2021

To provide a precise model of dynamic components in the constant pressure pump, and to improve the accuracy of dynamic calculation of the constant-pressure hydraulic system in its design stage, the research undertook mapping on a particular constant pressure pump and determined its basic structural parameters. Then, with the AMESim software, the research adopted separate structures from the level of basic components to establish the model of single-piston pump, the model of variable displacement pump, and the model of adjustable mechanism for the swashplate, respectively. The three models were combined with the constant-pressure variable displacement pump before it was encapsulated in a super component. By controlling the flow discharge of the constant pressure pump, and by switching on and off the constant pressure valve with the internal and long-distance pressure control, the research undertook the simulative test and the corresponding experimental test on the characteristics of pressure response of the constant pressure pump. The results of both tests agreed well with each other. Thus, it verifies the precision of the established constant pressure pump model in performing accurately in response design and analytical calculation.
Novel surface optimization for trajectory reconstruction in industrial robot tasks
Authors: Funes-Lora Miguel Angel , Vega-Alvarado Eduardo , Rivera-Blas Raúl , Calva-Yáñez María Barbara , Sepúlveda-Cervantes Gabriel
Published: December 2021

This study presents a novel algorithm implementation that optimizes manually recorded toolpaths with the use of a 3D-workpiece model to reduce manual error induced. The novel algorithm has three steps: workpiece declaration, manual toolpath declaration, and toolpath optimization using steepest descent algorithm. Steepest descent finds the surface route wherein the manually recorded toolpaths traverse over a 3D-workpiece surface. The optimized toolpaths were simulated and tested with an industrial robot showing minimal error compared to the desired optimized toolpaths. The results obtained from the presented implementation on three different trajectories demonstrate that the proposed methodology can reduce the manual error induced using as a reference the CAD-workpiece surface.
Motives and risk perceptions of participants in a phase 1 trial for Hepatitis C Virus investigational therapy in pregnancy
Authors: Kislovskiy Yasaswi , Chappell Catherine , Flaherty Emily , Hamm Megan E , de Abril Cameron Flor , Krans Elizabeth , Chang Judy C
Published: December 2021

Limited research has been done among pregnant people participating in investigational drug trials. To enhance the ethical understanding of pregnant people’s perspectives on research participation, we sought to describe motives and risk perceptions of participants in a phase 1 trial of ledipasvir/sofosbuvir (LDV/SOF) treatment for chronic Hepatitis C virus (HCV) during pregnancy. Pregnant people with chronic HCV infection enrolled in an open-label, phase 1 study of LDV/SOF participated in semi-structured, in-depth interviews to explore their reasons for participation and experiences within the study. Pregnant people took 12 weeks of LDV/SOF and were interviewed at enrollment and at the end of study. We recorded the interviews, transcribed them verbatim, coded them using NVivo software, and performed inductive thematic analysis. Nine women completed the study yielding 18 interview transcripts. We identified two themes regarding motives and one regarding risk perception. Motives—(1) Women conceptualized study participation as part of the caregiving role they associate with motherhood; participating was viewed as an act of caregiving for their infants, their families, themselves, and other pregnant women with chronic HCV. (2) Women also noted that they faced multiple barriers to treatment prior to pregnancy that created a desire to receive therapy through trial participation. Risk perception—(3) Women acknowledged personal and fetal risk associated with participation. Acceptance of risk was influenced by women’s concepts of motherhood, preexisting knowledge of HCV and medical research, family members, intimate partners, or by the study design. Women enrolled in a phase 1 trial for chronic HCV therapy during pregnancy acknowledged risks of participation and were motivated by hopes for fetal and personal benefit and by lack of prenatal access to treatment. Ethical inclusion of pregnant people in research should acknowledge structural factors that contribute to vulnerability and data deficiencies for treatment in pregnancy.
Determinants of COVID-19 Response Strategies in Selected African Countries
Authors: Asare-Nuamah Peter , Dick-Sagoe Christopher , Sakah Bernard Nsaidzedze , Muzee Hannah , Asamoah Joycelyn Oteng , Kessie Kingsley Obeng
Published: December 2021

Using protection motivation theory as the theoretical framework, this study investigates the factors that motivate COVID-19 response in Ghana, Cameroon, Lesotho and Uganda. Through simple random and snowball sampling techniques, 651 participants were selected. The study collected data with the aid of a survey questionnaire, which was analyzed through descriptive and inferential statistics. Results show high perceived COVID-19 threats among the respondents. Consequently, response strategies, such as wearing of nose mask, hand sanitizer application and social distancing, which are perceived to be effective, have been adopted. It is evident that respondents’ demographics influence their COVID-19 threats and coping strategies. Nevertheless, the severity of COVID-19 impacts ( p = .00), efficacy of response strategies ( p = .00) and access to COVID-19 information ( p = .02) were the significant predictors of COVID-19 response, even though the efficacy of COVID-19 response strategies (beta = .55) emerged as the best predictor. It is imperative for African governments to prioritize COVID-19 education to control the spread of the pandemic and minimize its impact.
Understanding perspectives and choices for sedentary behaviour and physical activity in older adults’ post-acute exacerbation of chronic obstructive pulmonary disease
Authors: Chang Chevonne , Wong John , Kamari Ahmad Iqbal , Hui Cheah Sophia C , Chan Mark A , Zainuldin Rahizan
Published: December 2021

Background

Individuals recovering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are most likely to exhibit sedentary behaviour (SB) and low levels of physical activity (PA). This study seeks to explore their choices for adopting current patterns of SB and PA post AECOPD and add to current literature on stable COPD.

Method

A semi-structured interview, based on the broad framework of the Behaviour Change Wheel, was conducted on patients post AECOPD. A phenomenological approach was utilised inductively.

Results

Six participants were interviewed at their homes. Four major themes were identified: (1) low perceived capabilities for engaging in PA; (2) limited understanding on COPD and PA; (3) lack of translation of health knowledge and intentions into actions; and (4) poor adherence to movement-advice from physiotherapist.

Conclusion

Our findings revealed largely psychological and behavioural deficits influencing SB and PA in people post AECOPD, similar to those in stable COPD.
A Conceptual Framework of How Meeting Mindsets Shape and Are Shaped by Leader–Follower Interactions in Meetings
Authors: Gerpott Fabiola H. , Kerschreiter Rudolf
Published: December 2021

In this conceptual paper, we define a person's meeting mindset as the individual belief that meetings represent opportunities to realize goals falling into one of three categories: personal, relational, and collective. We propose that in alignment with their respective meeting mindsets, managers use specific leadership claiming behaviors in team meetings and express these behaviors in alignment with the meeting setting (virtual or face-to-face) and their prior experiences with their employees. Employees’ responses, however, are also influenced by their meeting mindsets, the meeting setting, and prior experiences with their managers. The interplay between managers’ leadership claiming behavior and their employees’ responses shapes leader–follower relations. Embedded in the team context, the emerging leader–follower relations impact the meaning of meetings. We outline match/mismatch combinations of manager–employee meeting mindsets and discuss the influence that a manager and employee can have on each other's meeting mindset through their behavior in a meeting. Plain Language Summary Have you ever had the experience of entering a team meeting and quickly realizing that your idea of how the meeting conversation should be approached did not align with your boss's understanding of the meeting purpose? This is indeed a common experience in meetings between managers and their employees. While we understand much about the communication dynamics that occur in meetings, we know less about what motivates people to communicate in certain ways in meetings. In this conceptual paper, we classify people's understanding of meetings as being driven by one of three purposes: [1] to strategically position and promote themselves (which reflects a personal meeting mindset), [2] to shape collaborations and to ensure reciprocation (which reflects a relational meeting mindset), or [3] to strengthen the team identity and increase the willingness to go the extra mile for the team (which reflects a collective meeting mindset). Meeting mindsets shape how people enact their leader or follower role in meetings—that is, how a manager exhibits leadership and how employees react. However, managers’ and employees’ meeting mindsets may not necessarily match, which can trigger tensions and may ultimately change the way in which managers or employees define the meaning of meetings. Our research helps managers to comprehend the reasoning behind their own and other people's meeting behavior and may promote reflection on one's leadership approach, particularly in a team meeting context. It can also help employees to grasp the power they can have in terms of actively shaping their managers’ meeting mindsets.
Closed-loop audit of muscle sampling in Trans-Urethral Resection of Bladder Tumour
Authors: Varma Raghav , Deb Abdalla , Roy Dorina , Ahmed Ali
Published: December 2021

Introduction:

Our experience with the presence of detrusor muscle (DM) following Trans-Urethral Resection of Bladder Tumour (TURBT).

Objectives:

To evaluate the presence of DM in primary TURBT specimens as a quality improvement exercise in Frimley Park Hospital, UK. And to assess if the level of the surgeon has impact on outcomes.

Methods:

Retrospective and prospective analysis of the electronic records from a single urology centre, servicing a group of urologists. Data collected over three consecutive audit loops between January 2014 and May 2018.

Results:

A total of 301 cases were performed under the care of seven consultant urologists. Analysis revealed a significant improvement in the overall quality of resections from 39% to 66% (50–84% for intermediate and high grade) after the introduction of the following interventions: (1) analysis and improved awareness of current practice; (2) introduction of European Association of Urology (EAU) guidelines by separating samples and sending a second specimen pot marked as bladder tumour base to look for DM; (3) dedicated urologists with an interest in bladder cancer performing en-bloc resection technique in appropriate cases.

Conclusion:

Through our closed-loop audits, we have demonstrated a considerable improvement in the quality of resections, resulting in accurate staging from the initial resection. This could in turn lead to improved over all prognoses and negating the need for re-resection in all cases of high-risk non-muscle invasive bladder cancer (NMIBC).

Level of evidence:

3
A review of the quality and content of mobile apps to support lifestyle modifications following a transient ischaemic attack or ‘minor’ stroke
Authors: O’Connor Seán R , Kee Frank , Thompson David R , Cupples Margaret E , Donnelly Michael , Heron Neil
Published: December 2021

Objective

Secondary prevention is recommended to reduce cardiovascular risk after transient ischaemic attack (TIA) or ‘minor’ stroke. Mobile health interventions can provide accessible, cost-effective approaches to address modifiable risk factors, such as physical inactivity, hypertension and being overweight. The objective of this study was to evaluate the quality of apps for supporting lifestyle change following a TIA or ‘minor’ stroke.

Methods

Systematic searches of Google Play and the Apple Store were carried out to identify mobile apps released between 1 November 2019 and 1 October 2021. Keywords were used including stroke, TIA, lifestyle, prevention and recovery. Quality was assessed using the Mobile Application Rating Scale (MARS). Common components were identified with the Behaviour Change Technique (BCT) Taxonomy. Descriptive statistics were used to summarize the performance results for each app.

Results

Searches identified 2545 potential apps. Thirty remained after removing duplicates and screening titles and descriptions. Six were eligible after full review of their content. All apps included at least one BCT (range: 1–16 BCTs). The most frequent BCTs included ‘information about health consequences’ ( n = 5/6), ‘verbal or visual communication from a credible source’ ( n = 4/6) and ‘action planning’ ( n = 4/6). The mean MARS score was 2.57/5 (SD: 0.51; range: 1.78–3.36). No apps were of ‘good’ overall quality (scoring more than 4/5).

Conclusions

This is the first review of mobile health interventions for this population. Only a small number of apps were available. None were targeted specifically at people with a TIA or ‘minor’ stroke. Overall quality was low. Further work is needed to develop and test accessible, user designed, and evidence-informed digital interventions in this population.
Mental Health Disorders During COVID-19 Pandemic Among Southwest Ethiopia University Students: An Institutional-Based Cross-Sectional Study
Authors: Assefa Zebene M. , Haile Tariku G. , Wazema Deribachew H. , Tafese Wubishet T. , Berrie Fantahun W. , Beketie Eskedar D. , Hailemariam Bereket Z. , Zewudie Bitew T. , Teke Natinael E. , Metebo Keyredin N.
Published: December 2021

Introduction

Coronavirus disease 2019 (COVID-19) outbreak originated in Wuhan, Hubei Province, China, at the end of 2019. The COVID-19 incidence of new cases and fatality has continued to fast-track. The mental state and well-being of entire societies are severely suffering from this crisis and are a precedence to be immediately addressed.

Objective

To assess mental health disorders during the COVID-19 pandemic among university students, Southwest, Ethiopia, 2020/2021.

Method

Institutional-based cross-sectional study was conducted. Pretested self-administered a structured questionnaire was used. Depression, anxiety, and stress were measured by depression, anxiety, stress Scale-21 (DASS-21). Data were arrived by Epi Data version 3.1 and exported to SPSS version 25 for analysis. Bivariate and multivariate analyses were applied. In multivariate logistic regression; p-value < .05 at 95% CI was declared as significant.

Results

Seven hundred ten university students with 95.6% of the response rate participated in the study. Of the participants, 91.3% were between the ages of 18 and 24 years, and 57.2% were male. The magnitude of anxiety, depression, and stress was 35.1%, 30.0%, and 38.2%, respectively. In this study, age [Formula: see text] 25years, easy access to handwashing facilities, relative death due to COVID-19, wearing a face mask, a program of education, marital status, worried about academic activities, and family psychiatric history were predictors for mental health disorders and insomnia was a predictor of both anxiety and depression during COVID-19 pandemic.

Conclusion

In this study, the prevalence of depression, anxiety, and stress was above one-third, which was higher than the previous studies done in the country. Therefore, the continuing increase in new cases of disease infectivity and fatality throughout the country, providing psychological counseling, and developing coping strategies to predictors are important to prevent mental health impacts of the COVID-19 pandemic.
Mothers Delivery Kit: Antenatal Care Innovation in West Africa
Authors: Ahmed Jashim Uddin , Meem Umme Hani , Islam Quazi Tafsirul , Ahmed Asma
Published: December 2021

The Mothers Delivery Kit discusses an innovative healthcare package sold in the poor West African region to aid with the delivery of expectant mothers. The package combines various necessary items used for proper and hygienic delivery of the rural and remote mothers with the help of a local midwife or medical practitioner. Antenatal care in the region is poor due to lack of infrastructure and government funding in healthcare. The Mothers Delivery Kit addresses that issue by providing a cheap and hygienic alternative to conventional delivery methods. The kit has decreased newborn death in the region noticeably. The founders have worked closely with local midwives to train them and enable them to use the Mothers Delivery Kit properly to improve delivery conditions. Regardless of the setbacks caused by local traditional beliefs and culture, the kit has proven to be an active effort to improve delivery conditions.
An Ode to Gillies and Millard: “The Ten Commandments Applied to Self-Inflicted Head and Neck Gunshot Wounds”
Authors: Assi Patrick E. , Hunzicker Alixendra , Jones John , Pemberton John , Golinko Michael Samuel
Published: December 2021

Within the field of craniofacial trauma surgery, reconstruction following high-energy ballistic injuries to the face remains a daunting task requiring a multidisciplinary approach for best outcomes. These injuries are complex with large defects requiring reconstruction of different lamellae and skeletal buttresses of the face and no 2 are exactly alike. The reconstruction efforts are multidimensional and focus on restoring facial height, width, projection, jaw occlusion, and function. We present a challenging course of a 56 year old patient with a self- inflicted gunshot wound to the face that resulted in devastating injuries to the mandible and midface. We describe our multistage and multiple technique surgical approach that spanned nearly 2 years and 11 operations that included open reduction, internal fixation of extensive facial fractures, primary bone grafting, free fibula for maxillary reconstruction and palatal fistula obliteration, pre-expanded paramedian forehead flap, and mandibular distraction. In reviewing the patient’s course, his complications, and wins, we were inspired by the fundamentals principles of head and neck reconstruction as we interpreted from the famous “Ten Commandments of Drs. Gillies and Millard.” We discuss these Commandments with the reader in our reflection of this challenging reconstruction and hope others, particularly, those in training are encouraged to find application of the “Ten Commandments” we review as they develop their own surgical practices and styles.
qtlXplorer: an online systems genetics browser in the Eucalyptus Genome Integrative Explorer (EucGenIE)
Authors: Christie Nanette , Mannapperuma Chanaka , Ployet Raphael , van der Merwe Karen , Mähler Niklas , Delhomme Nicolas , Naidoo Sanushka , Mizrachi Eshchar , Street Nathaniel R. , Myburg Alexander A.
Published: December 2021

Background

Affordable high-throughput DNA and RNA sequencing technologies are allowing genomic analysis of plant and animal populations and as a result empowering new systems genetics approaches to study complex traits. The availability of intuitive tools to browse and analyze the resulting large-scale genetic and genomic datasets remain a significant challenge. Furthermore, these integrative genomics approaches require innovative methods to dissect the flow and interconnectedness of biological information underlying complex trait variation. The Plant Genome Integrative Explorer (PlantGenIE.org) is a multi-species database and domain that houses online tools for model and woody plant species including Eucalyptus. Since the Eucalyptus Genome Integrative Explorer (EucGenIE) is integrated within PlantGenIE, it shares genome and expression analysis tools previously implemented within the various subdomains (ConGenIE, PopGenIE and AtGenIE). Despite the success in setting up integrative genomics databases, online tools for systems genetics modelling and high-resolution dissection of complex trait variation in plant populations have been lacking.

Results

We have developed qtlXplorer (https://eucgenie.org/QTLXplorer) for visualizing and exploring systems genetics data from genome-wide association studies including quantitative trait loci (QTLs) and expression-based QTL (eQTL) associations. This module allows users to, for example, find co-located QTLs and eQTLs using an interactive version of Circos, or explore underlying genes using JBrowse. It provides users with a means to build systems genetics models and generate hypotheses from large-scale population genomics data. We also substantially upgraded the EucGenIE resource and show how it enables users to combine genomics and systems genetics approaches to discover candidate genes involved in biotic stress responses and wood formation by focusing on two multigene families, laccases and peroxidases.

Conclusions

qtlXplorer adds a new dimension, population genomics, to the EucGenIE and PlantGenIE environment. The resource will be of interest to researchers and molecular breeders working in Eucalyptus and other woody plant species. It provides an example of how systems genetics data can be integrated with functional genetics data to provide biological insight and formulate hypotheses. Importantly, integration within PlantGenIE enables novel comparative genomics analyses to be performed from population-scale data.
Drought mitigation in cocoa (Theobroma cacao L.) through developing tolerant hybrids
Authors: Juby Baby , Minimol Janaki Seifudeen , Suma Basura , Santhoshkumar Adiyodi Venugopal , Jiji Joseph , Panchami Pottekkat Sidharthan
Published: December 2021

Background

Cocoa, being a shade loving crop cannot withstand long periods of water stress. Breeding for drought tolerance is the need of the hour due to change in climatic condition and extension of crop to non-traditional areas. Hybrids were produced by crossing four tolerant genotypes in all possible combination. The cross GV1 55 x M 13.12 didn’t yield any fruit due to cross incompatibility between these genotypes. Various biochemical parameters act as the true indicators to select tolerant and susceptible types. The major biochemical parameters considered after imposing stress included proline, nitrate reductase activity, superoxide dismutase content and glycine betaine.

Results

The drought tolerant hybrids were having high amount of proline, superoxide dismutase enzyme and glycine betaine content. Normally, plants having drought stress show low amount of nitrate reductase activity. However, in case of hybrids, the drought tolerant hybrids were having higher NR activity than the susceptible hybrids. The highest amount of NR was found in the control plants kept at fully irrigated conditions.

Conclusions

This experiment showed the role of different biochemical enzymes and osmolytes in giving tolerance to plants during drought stress. Logistic regression analysis selected proline and nitrate reductase as the two biochemical markers for identifying efficient drought tolerant genotypes in the future breeding programmes.
Effect of coarctation of aorta anatomy and balloon profile on the outcome of balloon angioplasty in infantile coarctation
Authors: Amoozgar Hamid , Nouri Narjes , Shabanpourhaghighi Sajad , Bagherian Neda , Mehdizadegan Nima , Edraki Mohammad Reza , Naghshzan Amir , Mohammadi Hamid , Ajami Gholamhossein , Abdollahi Ashkan
Published: December 2021

Objective

Coarctation of the Aorta (CoA) is a relatively common cardiovascular disorder. The present study aimed to evaluate the effect of COA anatomy and high versus low-pressure balloons on the outcome of balloon angioplasty among neonates and infants.

Methods

In this retrospective study, the neonates and infants undergoing balloon angioplasty at Namazi hospital were enrolled. After balloon angioplasty, immediate data results were promptly recorded.Moreover, midterm echocardiographic information was collected via electronic cardiac records of pediatric wards and clinical and echocardiographic data at least 12 months after balloon angioplasty. Finally, data were analyzed using SPSS-20.

Results

In this study, 42 infants were included. The median age at the time of balloon angioplasty was 1.55 (range 0.1–12) months and 66.7% of the patients were male. The mean pressure gradient of coarctation was 38.49 ± 24.97 mmHg, which decreased to 7.61 ± 8.00 mmHg (P < 0.001). A high-pressure balloon was used in 27, and a low-pressure balloon was used in 15 patients. COA's pressure gradient changed 30.89 ± 18.06 in the high-pressure group and 24.53 ± 20.79 in the low-pressure balloon group (P = 0.282). In the high-pressure balloon group, 14.81% and in the low-pressure group, 33.33% had recoarctation and need second balloon angioplasty (p < 0.021). The infant with discrete coarctation had a higher decrease in gradient and lower recoarctation.

Conclusion

Recoarctation rate was lower in the high-pressure balloon. The infant with discrete COA had a better response to the balloon with more decrease in gradient and lower recoarctation rate. Therefore, the stenotic segment anatomy needs to be considered in the selection of treatment methods.
Prevalence and correlates of carotid plaque in a mixed HIV-serostatus cohort in Uganda
Authors: Bibangambah Prossy , Hemphill Linda C. , Acan Moses , Tsai Alexander C. , Sentongo Ruth N. , Kim June-Ho , Yang Isabelle T. , Siedner Mark J. , Okello Samson
Published: December 2021

Background

The extent to which the risk of atherosclerotic cardiovascular disease (ACVD) is increased among people living with HIV (PLWH) in sub-Saharan Africa remains unknown.

Setting

Cross-sectional analysis nested within the Ugandan Noncommunicable Diseases and Aging Cohort, including PLWH in rural Uganda > 40 years taking antiretroviral therapy (ART) for at least 3 years, and a population-based control group of HIV-uninfected age- and sex-matched persons.

Methods

We conducted carotid ultrasonography and collected ACVD risk factor data. Our outcome of interest was carotid plaque, defined as > 1.5 mm thickness from the intima-lumen interface to the media-adventitia interface. We fit multivariable logistic regression models to estimate correlates of carotid plaque including HIV-specific and traditional cardiovascular risk factors.

Results

We enrolled 155 (50.2%) PLWH and 154 (49.8%) HIV-uninfected comparators, with a mean age of  51.4 years. Among PLWH, the median CD4 count was 433 cells/mm3 and 97.4% were virologically suppressed. Carotid plaque prevalence was higher among PLWH (8.4% vs 3.3%). HIV infection (aOR 3.90; 95% CI 1.12–13.60) and current smokers (aOR 6.60; 95% CI 1.22–35.80) had higher odds of carotid plaque, whereas moderate (aOR 0.13, 95% CI 0.01–1.55) and vigorous intensity of physical activity (aOR 0.34, 95% CI 0.07–1.52) were associated with decreased odds of carotid plaque.

Conclusion

In rural Uganda, PLWH have higher prevalence of carotid plaque compared to age- and sex-matched HIV-uninfected comparators. Future work should explore how biomedical and lifestyle modifications might reduce atherosclerotic burden among PLWH in the region.
Development and validation of the nomogram based on INR and eGFR for estimation of mortality in patients with acute-on-chronic hepatitis B liver failure
Authors: Li Shengnan , Zhang Xiehua , Li Qian , Lv Binyue , Zhang Yefan , Jia Jianwei , Yue Xiaofen , Lu Wei
Published: December 2021

Aims and objectives

Acute-on-chronic hepatitis B liver failure (ACHBLF) is a critical clinical syndrome with a high short-term mortality evolved from chronic hepatitis B (CHB)-related liver disease. Prediction of mortality risk and early intervention can improve the prognosis of patients. This study aimed to develop and validate the nomogram for short-time mortality estimation in ACHBLF patients defined according to Asian Pacific Association for the Study of the Liver (APASL).

Methods

A study of 105 ACHBLF patients with 90-day follow up was performed to develop the nomogram. Patients were randomly assigned to derivation cohort (n = 75) and validation cohort (n = 35) according to 7:3. Concordance index (C-index), calibration curve and decision curve analysis (DCA) were used to evaluate the nomogram. We also compared the nomogram with APASL ACLF research consortium (AARC) score, model for end-stage liver disease (MELD) score, MELD with serum sodium (MELD-Na) score and albumin-bilirubin (ALBI) score. The nomogram was validated using an external cohort including 40 patients.

Results

The 28-day and 90-day mortality of 105 patients were respectively 49.52% and 55.24%. Albumin (ALB), international normalized ratio (INR) and estimated glomerular filtration rate (eGFR) were independent predictors for 28-day mortality; INR and eGFR were independent predictors for 90-day mortality. C-index of Nomogram-1 for 28-day mortality and Nomogram-2 for 90-day mortality were respectively 0.82 and 0.81. Calibration curve and Hosmer–Lemeshow test (Nomogram-1, 0.323; Nomogram-2, 0.231) showed optimal agreement between observed and predicted death. Areas under receiver operator characteristic curve(AUROC) of Nomogram-1(0.772) and Nomogram-2(0.771) were larger compared with AARC, MELD, MELD-Na and ALBI score. The results were well estimated in the external validation cohort.

Conclusions

This study highlighted the predictive value of eGFR, and the nomogram based on INR and eGFR could effectively estimate individualized risk for short-term mortality of ACHBLF patients defined according to APASL.