bluuebunny/crossref_metadata_2025 huggingface dataset:
The Highs and Lows of Research
Authors: Schupmann Will , Grady Christine
Published: March 2022

One way of conceptualizing the principal achievements and failures of human research is to consider to what extent research has contributed value to society. Research is generally considered to have value if it has the prospect of producing knowledge that can be used toward improvements in health or well-being. The authors selected nine case studies of research during the twentieth and twenty-first centuries that illustrate multiple ways research has achieved or failed to achieve value. Included in the “highs” of research are the development of antiretroviral therapy for HIV, Michael Marmot’s Whitehall studies, and the evaluation of hormone replacement therapy, among others. The authors’ cases of “lows” include genetic research on the etiology of homosexuality, the US Public Health Service’s Guatemala sexually transmitted disease experiments, and the gene transfer experiment that Jesse Gelsinger participated in, among others. A retrospective analysis of how research has and hasn’t contributed value may inform more thoughtful assessments of value in future research.
Pregnancy and Work
Authors: Widiss Deborah A.
Published: March 2022

Feminist theorists have long debated what “equal” treatment means in the context of workplace responses to pregnancy and infant care, as well as the appropriate scope of public support for new parents. This chapter explores the historical development and current state of American policy and contrasts it with international norms. Applying an intersectional lens, it also shows how race, class, sexual orientation, gender identity, family structure, and other factors may interact with pregnancy and parenthood to compound disadvantage.In the United States, pregnancy is generally treated like other health conditions, and parental leave is provided on a sex-neutral basis. This same-treatment approach responds to concerns voiced by some feminist theorists that mandating maternity leave would spur discrimination against women and reify traditional gender roles. Policymakers also largely endorsed neoliberal arguments that framed medical and family needs as private responsibilities. The result (until recently) was grossly inadequate support for new parents, disproportionately harming poor and working-class women of color. By contrast, virtually every other country guarantees new mothers a relatively ample period of paid maternity leave; fathers typically receive less time off, although some countries have taken steps to encourage a more equal split. However, there are new federal laws in the United States that provide support within universal structures addressing health needs generally and new state laws specifically addressing pregnancy and paid leave. These are important steps forward, but additional federal legislation is necessary to ensure workers can start a family without jeopardizing their economic security.
Economic and Social Rights in Latin America
Authors: Gargarella Roberto
Published: March 2022

This chapter critically studies the emergence and historical development of social rights in Latin America. Its primary argument is that the role of constitutional organization of power in forming social rights has been obscured by the focus on legal instruments and institutions. The chapter develops the argument across six historical periods: (1) the “creation” of economic and social rights in Mexico (1917); (2) their gradual incorporation in most Latin American constitutions (1917–1950); (3) the characterization of economic and social rights as nonenforceable rights (1950–1980); (4) the emergence of a new discussion and practice during and after the 1980s (particularly thanks to the consolidation of international human rights law); (5) the so-called New Latin American constitutionalism with new constitutions, rights, and remedies (1990–2010); and (6) the modification of debates with the “deliberative turn” that appeared at the beginning of the twenty-first century.
Artificial Intelligence in Healthcare
Authors: Aggarwal Nakul , Matheny Michael E. , Shachar Carmel , Wang Samantha , Thadaney-Israni Sonoo
Published: March 2022

Artificial intelligence (AI) is poised to significantly impact healthcare systems, including clinical diagnosis, healthcare administration and delivery, and public health infrastructures. In the context of the Quintuple Aim of healthcare (patient outcomes, cost reduction, population impact, provider wellness, and equity/inclusion), this chapter discusses the current state of AI in healthcare, focusing on issues that may inform the development of adaptive, efficient, and equitable governance frameworks for AI in healthcare. The chapter introduces prominent examples of clinical AI applications in recent years, highlighting their successes and extant limitations. It emphasizes the processes of clinical AI algorithm development, implementation, and provider adoption, noting important policy considerations for active maintenance and updating of such algorithms. It also focuses on the issue of bias in AI algorithms for healthcare by (1) illustrating how unrepresentative and/or inappropriate datasets can exacerbate health disparities and inequities, and (2) emphasizing the need for diversity, transparency, and accountability in algorithm development. It provides an overview of current national and international regulatory approaches for AI-driven medical devices. It concludes with recommendations of strategic goals for developers, healthcare providers, and governmental agencies to work towards cooperatively in building a productive and equitable future for AI in healthcare.
Social Rights Constitutionalism
Authors: Brinks Daniel M.
Published: March 2022

Latin America is at the forefront of global developments in the constitutionalization and judicial enforcement of social and economic rights (SER). Latin American countries have long included a robust set of SER in their constitutions, and in recent decades have only added more rights and stronger judicial enforcement mechanisms to their foundational texts. As a result, although many courts around the world have taken up the banner of SER, Latin American courts are contributing doctrinal innovation and concrete examples of SER enforcement at a rate and in a manner that eclipses other regions. This chapter first shows the trend toward social rights constitutionalism in the region as found in the foundational texts. It argues that Latin American constitutionalism today marks quite significant transformation of the relationship between ordinary politics and constitutional justice, as a direct result of the constitutionalization of SER and the judicialization of their enforcement. It concludes by exploring the way in which Latin American courts have attempted to overcome some of the challenges of SER enforcement.
Environment
Authors: Mendes Conrado Hübner , Rached Danielle Hanna
Published: March 2022

This chapter discusses the constitutionalization of environmental protection in Latin America. The protection of the environment is one of the most flagged features of contemporary Latin American constitutionalism. However, this is not a unique Latin American phenomenon. Environmental rights have increasingly been enshrined in domestic constitutions around the world. States decided to address the protection of the environment as a first-order legal and political ideal, and the constitutional text was the natural vessel for conveying such commitment. The chapter raises the following questions: How does Latin American environmental constitutionalism fit into the global narrative? Is there something to be fairly called ‘Latin American environmental constitutionalism’? Why have nations entrenched environmental rights within their constitutions? What are the consequences of such entrenchment for the environment? How do Latin American countries partake in such constitutionalist project?
A Self-Determination Theory Perspective on How to Choose, Use, and Lose Personal Goals
Authors: Holding Anne C. , Koestner Richard
Published: March 2022

Personal goals are ubiquitous—our lives are filled with goals that we have recently set, goals we are steadily progressing toward, or goals that we are in the painful process of relinquishing. This article provides a Self-Determination Theory perspective on personal goals from goal setting, to goal pursuit, to goal disengagement. The authors review and synthesize the personal goal literature, discussing how the content and regulation of personal goals relates to goal attainment and well-being outcomes. The authors also examine the role of close others in goal pursuit, highlighting how personal goals are often interpersonal too. Finally, the authors examine what happens with goals when the going gets tough and discuss how motivation relates to later phases of the goal’s lifecycle such as goal disengagement. The central argument of this article is that issues of autonomy versus control are important at all points in the lifecycle of a goal.
The IUGS Nomenclature on Kalsilite-Bearing Volcanic Rocks: A Critical Appraisal and Recommendations
Authors: Oliveira Ítalo L , Brod José A , Junqueira-Brod Tereza C , Reimold Wolf U , Fuck Reinhardt A
Published: March 2022

The current International Union of Geological Sciences (IUGS) recommendations for nomenclature of kalsilite-bearing volcanic rocks do not consider the possible coexistence of kalsilite (KAlSiO4) and nepheline (KNa3Al4Si4O16), nor do they address volcanic rocks containing kalsilite, other than the archetypal kamafugites. This review highlights the most important shortcomings in the existing IUGS nomenclature against the classical literature and the most recent reports on kalsilite-bearing volcanic rocks. In addition, a new modal classification system, more logical and complete, is proposed. This scheme follows the IUGS principles as far as possible and denotes an updated version of the most applied historical terminology. Based on the presence of the main light-coloured constituents of kalsilite-bearing volcanic rocks, only four rock names are required for petrographic classification: katungite (melilite dominant), ugandite (leucite dominant), mafurite (kalsilite dominant), and kalsilite nephelinite (nepheline dominant). Such terminology should only be applied for volcanic rocks that definitely contain kalsilite. This requires the use of advanced analytical methods (e.g. electron microprobe analysis coupled with back-scattered electron imaging), besides conventional transmitted-light microscopy, as kalsilite and nepheline are optically indistinguishable. The coexistence of these two minerals in K-rich volcanic rocks is much more common than previously recognised. Volcanic rocks with kalsilite can be separated into potassic and ultrapotassic groups. This highlights a major problem concerning the indiscriminate use of the term kamafugite and the existing confusion between the modal and chemical classifications of kalsilite-bearing volcanic rocks. Our recommendations are purely based on descriptive attributes.
Soluble interleukin-2 receptor serum levels facilitate prediction of relapses in subgroups of patients with juvenile idiopathic arthritis
Authors: Ziegler Linda , Fuehner Sabrina , Kessel Christoph , Hinze Claas , Klotsche Jens , Niewerth Martina , Minden Kirsten , Foell Dirk
Published: March 2022

Objectives

JIA is characterised by a chronic disease course. Once patients achieve a state of inactive disease, there are no established biomarkers to predict the further course of inflammation for these patients. Therefore, the purpose of this study was to quantify serum biomarkers during quiescent disease to evaluate their use in identifying JIA patients at risk for future disease flare.

Methods

Patients with non-systemic JIA reaching inactive disease status were divided into two groups: 92 patients with future active disease after a median period of 6 months (range 3–9) and 80 patients with persistent inactive disease for the following period (median 11 months, range 7–16) according to the juvenile arthritis DAS (JADAS). Clinical parameters and serum levels of various biomarkers were measured in the state of inactive disease using immunoassays in both groups and were analysed for their potential to predict the further course of disease.

Results

Soluble interleukin-2 receptor (sIL-2R) serum levels were significantly higher in patients with future active disease (P = 0.021), which especially applied to patients with RF-negative polyarticular and extended oligoarticular JIA (P < 0.001). Higher sIL-2R serum levels during inactive disease were associated with a greater number of active joints at future active disease.

Conclusion

Patients without clinical signs of disease activity already presented with increased sIL-2R serum levels several months before disease relapses, whereas conventional inflammation parameters were not elevated. Determination of sIL-2R serum levels during inactive disease may facilitate identifying patients with subclinical disease activity at risk for future active disease.
Measuring Gender Inequality in Great Britain: Proposal for a Subnational Gender Inequality Index
Authors: Schmid Caitlin B , Cook Rose , Jones Laura
Published: March 2022

Tackling gender inequality is a key focus for both civil society and government policy in Great Britain (GB). Yet, there is currently no consensus on how to conceptualize or operationalize gender inequalities, nor any detailed measurement of gender inequalities at the subnational level, despite high levels of regional inequality. This is a barrier to the development and evaluation of gender equality programs and policies, and to holding the government accountable. To address this gap, we propose a framework for a subnational index of gender inequalities in GB based on a review of relevant indices, theoretical models, and policy. This framework was further developed in a workshop with stakeholders. We also scope the data currently available from survey and administrative sources to capture the proposed framework, highlighting gaps in our ability to comprehensively measure gender inequalities at the subnational level in GB.
Baseline Sensitivity and Control Efficacy of Two Quinone Outside Inhibitor Fungicides, Azoxystrobin and Pyraclostrobin, AgainstUstilaginoidea virens
Authors: Song Jie-Hui , Zhang Si-Jie , Wang Yan , Chen Yun-Tong , Luo Jun-Fei , Liang You , Zhang Hong-Cheng , Dai Qi-Gen , Xu Ke , Huo Zhong-Yang
Published: March 2022

Rice false smut caused by the filamentous fungus Ustilaginoidea virens is a devastating grain disease in rice. Fungicides have been an important measure for the control of this disease. In this study, baseline sensitivities of 179 isolates of U. virens to the quinone outside inhibitor (QoI) fungicides azoxystrobin and pyraclostrobin were established. The distribution of the 50% effective concentration (EC50) values of each fungicide was unimodal. The frequency distribution of logarithmically transformed EC50values fit or fit closer to a normal distribution. The ranges of EC50values for azoxystrobin and pyraclostrobin were 0.001 to 0.864 and 0.001 to 0.569 μg/ml, with means and standard errors of the mean values of 0.203 ± 0.012 and 0.079 ± 0.006 μg/ml, respectively. There was a statistically significant and moderately positive correlation (n = 100, r = 0.469, P = 0.001) in sensitivity between these two fungicides. No cross-resistance was found between azoxystrobin, pyraclostrobin, and carbendazim or sterol demethylation inhibitor fungicides. Each fungicide had a significantly higher mean preventive efficacy compared with its curative efficacy. Field assays showed that the control efficacy of pyraclostrobin against rice false smut was greater than that of azoxystrobin. Pyraclostrobin had the best control of rice false smut in three rice varieties, with the control efficacy ranging from 81.5 to 95.5%, whereas azoxystrobin decreased the disease index by 64.1 to 69.2% under the same conditions. These results provide us a reference point in the management of U. virens and future QoI fungicide resistance monitoring programs.
Juvenile Xanthogranuloma: A Comparative Immunohistochemical Study of Factor XIIIa, CD11c, and CD4
Authors: Salari Behzad , Dehner Louis P.
Published: March 2022

Juvenile xanthogranuloma is a group C and L non-Langerhans cell histiocytosis, and its cell of origin is still debatable. The expression of CD11c, a more recently described macrophage marker, and CD4 have not been studied comprehensively. This study aimed to expand immunophenotypic profile and hence our understanding of the origin of these lesions. The surgical pathology archive was searched for the cases with the pathologic diagnosis of “xanthogranuloma” from 1995 to 2019. Immunohistochemical (IHC) stains were performed for factor XIIIa, CD11c, and CD4. Morphologically, each lesion was classified into early classic, classic, or transitional subtypes. Seventy-seven cases were included with the median age of 7.8 years (male:female 1.3:1). Uniform positivity was noticed for CD4 (n = 77), CD68 (n = 37), CD163 (n = 5), and vimentin (n = 4) stains. Other stains included CD11c 75/77 (97.4%), factor XIIIa 71/76 (93.4%), S-100 protein 4/23 (17.4%), and CD1a 0/18 (0%). Despite insignificant association between morphologic subtype and main studied IHC stains, factor XIIIa reactivity was highest in transitional lesions and CD11c showed higher reactivity in early classic lesions. CD11c and CD4 are sensitive markers and showed promising results in the diagnosis of juvenile xanthogranuloma compared with factor XIIIa. Despite different reactivity of factor XIIIa and CD11c in various morphologic subtypes, such association was statistically insignificant.
Rare Mimic of a Myxofibrosarcoma: Cutaneous Myxoid Spindle Cell Squamous Cell Carcinoma as a Complication of Chronic Osteomyelitis
Authors: Chen Michelle K. Y. , Henderson Christopher J. A. , Rutland Tristan
Published: March 2022

Myxoid spindle cell squamous cell carcinoma is a rare variant of squamous cell carcinoma that can pose diagnostic challenges because of its unusual morphology. In this article, we report the case of a 68-year-old man who presented with a slow-growing, fungating mass on the right tibia at the site of his long-standing draining sinus tract. Biopsy revealed a malignant spindle cell tumor with prominent myxoid stroma and areas containing thin-walled blood vessels with a curvilinear appearance. The immunohistochemical profile indicated that the neoplastic cells were positive for a variety of keratins (MNF116, Cam 5.2, AE1/AE3, 34βE12, and CK5/6) and transcriptional markers classically expressed in squamous cell carcinomas (p63 and p40). The tumor cells were negative for melanocytic and mesenchymal markers smooth muscle antibody, S100, caldesmon-h, desmin and CD34. Together, the clinical history, histologic appearance, and immunohistochemical panel was diagnostic of a myxoid spindle cell squamous cell carcinoma. The main differential diagnosis was myxofibrosarcoma. In addition to this clinical case, we also outline the current state of knowledge on this rare entity and discuss the importance of recognizing a Marjolin ulcer in this scenario.
Temper Tantrums in Toddlers and Preschoolers: Longitudinal Associations with Adjustment Problems
Authors: Van den akker Alithe L. , Hoffenaar Peter , Overbeek Geertjan
Published: March 2022

Objective:

We examined parent reports of temper tantrum characteristics (e.g., frequency, duration, and behavioral profile) in toddlers and preschoolers and their longitudinal association with internalizing and externalizing adjustment problems.

Methods:

Parents of 1- to 5-year-olds (N = 861, Mage = 36 months, 47% girls) reported their child's temper tantrum frequency, duration, and behaviors. A subsample also reported on their child's tantrums and adjustment problems 1 year later (n = 252). We first compared the distribution of temper tantrum frequency and duration for different ages. Next, we examined which factors underlie the tantrum behaviors and whether behavioral profiles could be distinguished based on configurations of these factors within children. Finally, we performed regression analyses predicting internalizing and externalizing adjustment problems by temper tantrum frequency, duration, and behavioral profile, controlling for child sex and age.

Results:

Chi-square tests indicated that overall, tantrum frequency declined, whereas tantrum duration increased across the 1- to 5-year age range. We found that based on 4 tantrum behavior factors (anger, distress, aggression, and self-injurious behavior), 3 profiles characterized the tantrum behavior of children in the sample: a low-intensity profile (26%), a moderate-intensity profile (32%), and a high aggressive/self-injurious profile (42%). More frequent tantrums predicted more externalizing problems, whereas longer tantrum duration predicted internalizing problems. The high aggressive/self-injurious profile predicted adjustment problems above and beyond tantrum duration and frequency.

Conclusion:

Parent reports of different tantrum characteristics are uniquely predictive of different types of problems and may each be important to include in screening efforts for adjustment problems in young children.
The Origin and Development of Interrupted Subcuticular Suture: An Important Technique for Achieving Optimum Wound Closure
Authors: Zhang WenChao , Xie Jiangmiao , Zeng Ang
Published: March 2022

BACKGROUND

Subcuticular suture is an important technique for achieving optimum wound closure, and there has been no comprehensive summary of subcuticular sutures to date.

OBJECTIVE

To summarize the origin and development of interrupted subcuticular suture to help clinicians improve their wound closure skills.

MATERIALS AND METHODS

A comprehensive review of subcuticular suture techniques was conducted in PubMed to summarize the advantages and disadvantages of various methods and clinical indications.

RESULTS

Buried suture is the oldest subcuticular suture technique, followed by buried vertical mattress suture, intracutaneous butterfly suture, modified/variant buried vertical mattress suture, intradermal buried vertical mattress suture, buried horizontal mattress suture, wedge-section and modified buried vertical mattress suture, set-back suture, and modified buried horizontal mattress suture, which have gradually been applied in clinical practice. Buried vertical mattress suture is currently the most widely used subcuticular suture technique.

CONCLUSION

Patients can certainly benefit from the appropriate application of subcuticular suture. There is also no single ideal method for achieving optimal results in all cases. Fully understanding the history of subcuticular suture can help doctors improve their wound closure technique.
Developing a Risk Prediction Model for Early Atrial Fibrillation Recurrence After Maze Procedure
Authors: Seyedhoseinpour Amirhosein , Vasheghani-Farahani Ali , Abbasi Kyomars , Jalali Arash , Zahed Tajreshi Farbod , Fazeli Amir , Ghorashi Seyyed Mojtaba , Omidi Negar
Published: March 2022

Background:

The efficiency of maze is a safe procedure in AF patients who underwent concomitant mitral valve surgery was more than 60%. The aim of this study was to define predictors of early AF recurrence after concomitant maze procedure with valvular surgery.

Methods:

In this retrospective study, 234 patients with AF underwent concomitant valvular replacement and maze procedure. Patients were classified into 2 groups of sinus and atrial fibrillation (AF). Baseline characteristics of patients were then compared between 2 groups.

Results:

Totally, 234 patients were enrolled, 148 of which maintained sinus rhythm during hospitalization. Left atrial diameter and type of valvular surgery were similar in both groups. Age, number of replaced valves, concomitant coronary artery bypass grafting, and history of preoperative persistent AF and beta-blocker therapy were independent predictors of in-hospital AF recurrence. We used these variables to build a model to anticipate early AF recurrence.

Conclusions:

Being older, multivalvular surgery, and persistent preoperative AF were the predictors of higher risk of early recurrent AF, whereas concomitant coronary artery bypass grafting and using beta-blocker had a protective effect. This model based on preoperative and operative characteristics can help us to better evaluate if the patient benefits from maze procedure coincide with valvular surgery.
Predicting Individual Changes in Terminal Half-Life After Switching to Extended Half-Life Concentrates in Patients With Severe Hemophilia
Authors: Versloot Olav , Iserman Emma , Chelle Pierre , Germini Federico , Edginton Andrea N. , Schutgens Roger E. G. , Iorio Alfonso , Fischer Kathelijn ,   on behalf of the prophylaxis working group of the International Prophylaxis Study Group
Published: March 2022

Predicting individual effects of switching from standard half-life (SHL) to extended half-life (EHL) FVIII/FIX concentrates is pivotal in clinical care, but large-scale individual data are scarce. The aim of this study was to assess individual changes in terminal half-life (THL) after switching to EHL concentrates and identifying determinants of a clinically relevant THL extension in people with severe hemophilia. Data from participants with pharmacokinetic studies on both SHL and EHL were extracted from the Web-Accessible Population Pharmacokinetics Service (WAPPS) database and stratified according to hemophilia type and age groups (children/adults). A 30% increase in THL was considered clinically relevant. Predictors of a relevant increase were identified using logistic regression. Data from 688 persons with severe hemophilia (2174 infusions) were included: 89% hemophilia A; median age: 21.7 (interquartile range [IQR]: 11.5–37.7); positive inhibitor history: 11.7%. THL increased by 38% (IQR: 17%–67%) and 212% (139%–367%) for hemophilia A and B, respectively. All EHL-FIX concentrate users showed clinically relevant THL extension. However, 40% (242/612) of people with hemophilia A showed limited extension or decrease in THL after switching. Relevant FVIII-THL extension was predicted by short baseline THL and blood group non-O in both children and adults. In conclusion, clinically relevant THL extension was observed in all 75/76 participants switching to EHL-FIX, and in 60% of 612 switching to EHL-FVIII. Short THL on SHL-FVIII and blood group non-O were identified as predictors for a relevant THL increase after switching to EHL-FVIII. Individualized pharmacokinetic assessment may guide clinical decision-making when switching from SHL to EHL-FVIII.
Pain severity ratings in the 11th revision of the International Classification of Diseases: a versatile tool for rapid assessment
Authors: Hay Ginea , Korwisi Beatrice , Rief Winfried , Smith Blair H. , Treede Rolf-Detlef , Barke Antonia
Published: March 2022

An improved classification of chronic pain is included in the 11th revision of the International Classification of Diseases and Related Health Problems. For all diagnoses of chronic pain, an optional dimensional code for the chronic pain severity will supplement the categorical diagnoses. Pain severity combines pain intensity, pain-related interference, and pain-related distress. Each component is rated by the patient on a numerical rating scale (NRS) from 0 to 10 and subsequently translated into severity stages (“mild,” “moderate,” and “severe”). This study aimed to evaluate this severity code by comparing the ratings with established psychometric measures of pain-related interference and distress. An online survey was posted to self-help groups for chronic pain, and 595 participants (88.7% women, 59.5 ± 13.5 years) rated each of the severity parameters (pain intensity, pain-related interference, and pain-related distress) on an NRS from 0 to 10 and completed the Pain Disability Index and the Pain Coping Questionnaire (FESV, 3 subscales). The participants reported a mean pain intensity of 6.4 ± 1.9, mean pain-related interference of 6.7 ± 2.1, and mean pain-related distress of 5.7 ± 2.5. The respective NRS ratings showed substantial correlations with the Pain Disability Index score (r = 0.65) and the FESV subscales (r = 0.65, r = 0.56, r = 0.37). The extension code for pain severity is a valid and efficient way of recording additional dimensional pain parameters, which can be used to monitor the course of chronic pain and its treatment. The specifier's efficiency makes it possible to use the code when a questionnaire would not be feasible due to time constraints, such as in primary care.
Prevalence, Anatomic Distribution, and Correlates of Chlamydia trachomatis and Neisseria gonorrhoeae Infections Among a Cohort of Men Who Have Sex With Men in Hanoi, Vietnam
Authors: Adamson Paul C. , Bhatia Ramona , Tran Khoa D.C. , Bui Hao T.M. , Vu Diep , Shiraishi Ray W. , Giang Le Minh
Published: March 2022

Background

Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) disproportionately affect men who have sex with men (MSM). Data on the prevalence, anatomical distribution, and correlates of NG and CT infections among MSM in Vietnam are limited.

Methods

Between July 2017 and April 2019, MSM 16 years or older without HIV were enrolled into an observational cohort study. Baseline data, including sociodemographics, sexual behavior, and HIV status, were collected. Testing for NG and CT were performed on urine, rectal, and pharyngeal specimens. Multivariate logistic regression models identified factors associated with NG and CT infections at baseline.

Results

In total, 1489 participants underwent NG/CT testing. The median age was 22 years (interquartile range, 20–26 years). There were 424 (28.5%) NG or CT infections: 322 (21.6%) with CT and 173 (11.6%) with NG. Rectal infections were most common for CT (73.9%), whereas pharyngeal infections were most common for NG (70.5%). Independent risk factors for CT or NG infection included ≥2 sex partners in the prior month (adjusted odds ratio [aOR], 2.04; 95% confidence interval [CI], 1.44–2.91), condomless anal sex (aOR, 1.44; 95% CI, 1.12–1.86), and meeting sex partners online (aOR, 1.35; 95% CI, 1.03–1.76). Recent genitourinary or rectal symptoms were not associated with infections.

Conclusions

The overall and extragenital prevalences of NG and CT infections were high within this sample of young MSM without HIV in Hanoi. Testing limited to urethral specimens would have missed nearly three-quarters of CT and NG infections, supporting the need for routine testing at multiple anatomic sites.
Representation of Ethics in COVID-19 Research: A Systematic Review
Authors: Seyferth Anne V. , Wood Shannon M. , Kane Robert L. , Chung Kevin C.
Published: March 2022

Background:

Ethical discourse in the scientific community facilitates the humane conduct of research. The urgent response to COVID-19 has rapidly generated a large body of literature to help policymakers and physicians address novel pandemic challenges. Plastic surgeons, in particular, have to manage the postponement of elective procedures and safely provide care for non–COVID-19 patients. Although COVID-19 research may provide guidance on these challenges, the extent to which ethical discussions are present in these publications remains unknown.

Methods:

Articles were identified systematically by searching the PubMed, Embase, Central, and Scopus databases using search terms related to ethics and COVID-19. The search included articles published during the first 9 months of the COVID-19 pandemic. The following data were extracted: presence of an ethical discussion, date of publication, topic of ethical discussion, and scientific discipline of the article.

Results:

One thousand seven hundred fifty-three articles were included, of which seven were related to plastic surgery. The ethical principle with the greatest representation was nonmaleficence, whereas autonomy had the least representation. Equity and access to care was the most common topic of ethical discussion; the mental health effects of COVID-19 were the least common. The principle of justice had the greatest variation in representation.

Conclusions:

In a systematic review of COVID-19–related articles that were published during the first 9 months of the pandemic, the ethical principles of autonomy and justice are neglected in ethical discussions. As ethical dilemmas related to COVID-19 remain prevalent in plastic surgery, attention to ethical discourse should remain a top priority for leaders in the field.
The effects of small variations in shoe heel height on gait in people with a transtibial amputation
Authors: van Oorschot Wieneke , Hofstad Cheriel Josephien , Slagman Daan , Van Ee René Frederik , Keijsers Noël Leonardus Wilhelmus
Published: March 2022

Background:

Shoe heel height is considered to influence prosthetic alignment, walking comfort, and gait symmetry in people with a transtibial amputation (TTA). However, research on the effect of heel height is scarce, and no evidence is available on the effects of variations smaller than 20 mm. These small heel height variations between store-bought shoes are often overlooked by people with an amputation and may cause secondary musculoskeletal problems in the long term.

Objective:

To examine the effects of small increases in heel height on gait symmetry in people with a TTA and healthy individuals.

Study design:

Experimental repeated measures study.

Methods:

Fourteen participants with a TTA and 15 healthy controls were included. Pressure data, spatiotemporal data, and experienced walking comfort were measured during walking with four heel height conditions: original height and increased heights of 3, 5, and 8 mm. Symmetry in center of pressure velocity (VCOP), gait parameters, and experienced walking comfort were compared between the heel heights and between healthy controls and prosthetic walkers.

Results:

Increased heel height resulted in a significant decrease in VCOP symmetry (P = 0.001) and experienced walking comfort (P < 0.001). The VCOP trajectory of the prosthetic leg mainly differed within the first 14.5% of the stance phase. Healthy individuals showed better VCOP symmetry in all conditions (P < 0.001).

Conclusions:

Healthcare professionals should advice their clients to be alert of small heel height differences between store-bought shoes, especially those larger than 5 mm. A prosthetic alignment adjustment should be considered when purchasing new shoes.
The Impact of Personal Protective Equipment on Speech Discrimination and Verbal Communication in the Operating Room and the Role of Audio Communication Devices
Authors: Hall Andrew C. , Silver Benjamin H. , Ellis Wayne , Manjaly Joseph G. , Utoomprurkporn Nattawan , Blencowe Natalie , Birchall Martin , Patel Anil
Published: March 2022

Introduction

Recent work has highlighted communication difficulties when wearing personal protective equipment (PPE) in the clinical setting, but currently, there are little objective data on its effects. We assessed the impact of PPE on verbal communication in a simulated operating room and evaluated use of an audio communication device.

Methodology

Frontline health professionals across specialties including surgery, anesthetics, and nursing undertook speech discrimination testing with and without standardized levels of PPE in a simulated operating room environment. Background noise (30- and 70-a-weighted decibel multitalker babble) at 2 distances (2 and 4 m) were selected representative of operating room environments. Bamford-Kowal-Bench (BKB) scoring (192 sentences per participant) was performed. A Digital Multichannel Transceiver System (DMTS) was evaluated. We assessed the effects of PPE use, distance, and use of the DMTS with pairwise comparisons, using a Bonferroni correction, and assessed participant experience via Likert scales.

Results

Thirty-one healthcare professionals were tested. Without PPE in 70-a-weighted decibel “babble,” median BKB sentence scores were 90% and 76% at 2 and 4 m (adjusted P < 0.0005). The median BKB sentence scores dropped to 8% and 4% at 2 and 4 m in PPE (adjusted P < 0.0005). Improved speech discrimination was achieved with DMTS use to 70% and 76% at 2 and 4 m. Personal protective equipment led to a statistically significant reduction in BKB scores across all conditions compared with baseline. Overall participant confidence in PPE clinical communication was low.

Conclusions

Addition of PPE dramatically impairs speech discrimination and communication in high levels of background noise characteristic of clinical environments, which can be significantly improved using DMTS. Measures should be taken by teams through both through reduction of background noise and consideration of assistive technologies maximizing patient safety. This may be further rehearsed in a simulation environment.
A retrospective study examining the clinical significance of testing respiratory panels in children who presented to a tertiary hospital in 2019
Authors: Almannaei Lulwa , Alsaadoon Ebrahim , AlbinAli Sultan , Taha Mohammed , Lambert Imelda
Published: March 2022

Background. Respiratory tract infections are a leading cause of hospital visits in the paediatric population and carry significant associated morbidity and mortality in this population. The introduction of respiratory panel testing has been said to guide clinicians in the overall management of patients.

Methods. We conducted a retrospective study examining all respiratory panels carried out in our hospital during 2019 on paediatric patients. Patients included were those who had symptoms indicative of respiratory infections who presented acutely, including those with chronic respiratory conditions. A total of 188 respiratory panel results were obtained along with collected patient data. These were analysed using SPSS V. 25.0 to get the below mentioned results.

Results. The majority (76.6 %) of patients were less than 3 years with 59 % of total population being males. The majority (80.9 %) had mild clinical severity score. The most common pathogen that was detected on the respiratory panel was Enterovirus Human Rhinovirus spp, followed by the influenza viruses. Only four cases were positive for bacterial pathogens (two

Mycoplasma pneumoniae

, one

Bordetella pertussis

and one

Chlamydia pneumoniae

), which accounts for 2.1 % of all panels analysed. The significance of respiratory panels in influencing treatment were analysed in the forms of change of management plans before and after results of respiratory panels. This was observed in 14.4 % of patients who were not on any empiric medication and then based on panel results were started on medications, as well as 11.7 % who were on medications already, and the medications were altered based on the result of the panel (Chi square P=0.057). This was mainly seen with cases of influenza A H1N1 patients and to a lesser extent, Mycoplasma pneumonia.

Conclusion. The use of respiratory panels in our hospital had little impact on patient care and management. The main organisms that influenced clinician decision in treatment were influenza A viruses and bacterial organisms (

Mycoplasma pneumoniae

,

Chlamydia pneumoniae

and

Bordetella pertussis

). Other than that, the use of clinical judgement proved more beneficial. We recommend use of specific testing for these organisms rather than the whole panel as case to case bases, which would be more cost-effective and consistent with patient management.
Niabella beijingensis sp. nov. and Thermomonas beijingensis sp. nov., two bacteria from constructed wetland
Authors: Guo Sheng-Zhi , Wu Tong , Zhu Hai-Zhen , Yan Lei , Liu Zhi-Pei , Li De-Feng , Jiang Cheng-Ying , Liu Shuang-Jiang , Shen Xi-Hui
Published: March 2022

Two Gram-stain-negative, aerobic, non-motile and rod-shaped bacterial strains designated 3A5MI-3T and RSS-23T were isolated from the Dragon-shaped Wetland System in Beijing Olympic Park, PR China. Strain 3A5MI-3T grew at 15–45 °C, pH 5.0–9.0 and with 0–2 % NaCl (w/v), and strain RSS-23T grew at 15-40 oC, pH 5.5–9.0 and with 0–1 % NaCl (w/v). Phylogenetic analyses of 16S rRNA gene sequences revealed that strains 3A5MI-3T and RSS-23T were members of

Bacteroidetes

and

Proteobacteria

, respectively. Phylogenetically closest relatives of strains 3A5MI-3T and RSS-23T were

Niabella pedocola

R384T and

Thermomonas aquatica

SY21T, respectively. The cells of strain 3A5MI-3T contained menaquinone MK-7 and phosphatidylethanolamine, and the major cellular fatty acids were composed of iso-C15 : 0, iso-C15 : 1 ω6c and/or iso-C15 : 1 ω7c, iso-C17 : 0 3-OH, C16 : 0 and summed feature 3 (C16 : 1 ω7c/C16 : 1 ω6c). Strain RSS-23T contained ubiquinone Q-8 and diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, two unknown phospholipids and an unknown lipid, and its major cellular fatty acids were iso-C15 : 0, iso-C17 : 1 ω9c, iso-C11 : 0 3-OH and summed feature 3 (C16 : 1 ω7c/C16 : 1 ω6c). DNA sequencing resulted in 6.59 Mb for the strain 3A5MI-3T genome and 2.79 Mb for the strain RSS-23T genome. The calculated G+C molar contents for strains 3A5MI-3T and RSS-23T were 47.07 and 61.21 mol%, respectively. According to phenotypic and phylogenetic characteristics, strains 3A5MI-3T and RSS-23T represent novel species of the genera

Niabella

and

Thermomonas

for which the names Niabella beijingensis sp. nov. and Thermomonas beijingensis sp. nov. are proposed. The type strain for N. beijingensis sp. nov. is 3A5MI-3T (=CGMCC 1.17737T=KCTC 82817T). The type strain for T. beijingensis sp. nov. is RSS-23T (=CGMCC 1.17738T=KCTC 82820T).
Array Comparative Genomic Hybridisation and Droplet Digital PCR uncover recurrent copy number variation of the titin segmental duplication region
Authors: Sagath Lydia , Lehtokari Vilma-Lotta , Pelin Katarina , Kiiski Kirsi
Published: March 2022

Intragenic segmental duplication regions are potential hotspots for recurrent copy number variation and possible pathogenic aberrations. Two large sarcomeric genes, nebulin and titin, both contain such segmental duplication regions. Using our custom Comparative Genomic Hybridization array, we have previously shown that a gain or loss of more than one copy of the repeated block of the nebulin triplicate region constitutes a recessive pathogenic mutation. Using targeted array-CGH, similar copy number variants can be detected in the segmental duplication region of titin. Due to the limitations of the array-CGH methodology and the repetitiveness of the region, the exact copy numbers of the blocks could not be determined. Therefore, we developed complementary custom Droplet Digital PCR assays for the titin segmental duplication region to confirm true variation. Our combined methods show that the titin segmental duplication region is subject to recurrent copy number variants, which is surprisingly common. Gains and losses were detected in samples from healthy individuals as well as in samples from patients with different muscle disorders. The copy number variation observed in our cohort is likely benign, but pathogenic copy number variants in the segmental duplication region of titin cannot be excluded. Further investigations are needed, however, this region should no longer be neglected in genetic analyses.
Using single molecule Molecular Inversion Probes as a cost-effective, high-throughput sequencing approach to target all genes and loci associated with macular diseases
Authors: Hitti-Malin Rebekkah J. , Dhaenens Claire-Marie , Panneman Daan M. , Corradi Zelia , Khan Mubeen , den Hollander Anneke I. , Farrar G. Jane , Gilissen Christian , Hoischen Alexander , van de Vorst Maartje , Bults Femke , Boonen Erica G.M. , Saunders Patrick ,   MD Study Group, Roosing Susanne , Cremers Frans P.M.
Published: March 2022

Background

Macular diseases (MDs) are a subgroup of retinal disorders characterized by central vision loss that represent a major cause of vision impairment. Despite the identification of numerous genes associated with inherited MD (iMD) and risk factors associated with age-related MD (AMD), the extent of genetic and non-genetic factors that influence the expression of MD is still not fully explained. Single molecule Molecular Inversion Probes (smMIPs) have proven effective in sequencing the ABCA4 gene in patients with Stargardt disease in a cost-effective manner to identify associated coding and non-coding variation, however a large portion of patients with MDs still remain genetically unexplained.

Methods

For MD patients, we hypothesized that the missing heritability may be revealed by smMIPs-based sequencing of all MD-associated genes and risk factors. We used 17,394 smMIPs to sequence the coding regions of 105 genes and non-coding or regulatory loci associated with iMD and AMD, known pseudo-exons, and the mitochondrial genome in two test cohorts that had previously been screened for variants in the entire ABCA4 gene.

Results

Sequencing of 379 probands achieved an average nucleotide coverage of 431× across all targets. Following detailed sequencing analysis of 110 probands, a diagnostic yield of 38% was observed. This established an ‘‘MD-smMIPs panel’’ that allows a genotype-first approach in a high-throughput and cost-effective manner, whilst achieving uniform and high coverage across targets.

Conclusions

Further analysis will identify known and novel variants in MD-associated genes to offer an accurate clinical diagnosis to patients and their families. Furthermore, this will reveal new genetic associations for MD and potential genetic overlaps between iMD and AMD.
Measuring Repositioning in Home Care for Pressure Injury Prevention and Management
Authors: Gabison Sharon , Pupic Nikola , Evans Gary , Dolatabadi Elham , Fernie Geoff , Dutta Tilak
Published: March 2022

A critical best practice for prevention and management of pressure injuries is regularly repositioning individuals who are at risk of these injuries are when they are in bed. However, despite the widespread agreement of the need for regular repositioning (typically every two hours), adherence to repositioning schedules remains poor in the clinical environment and there are some indications that the situation in home environment is even worse.

Our team has recently developed a non-contact system that can continuously determine an individual’s position in bed (left-side lying, right-side lying or supine) using data from a set of inexpensive load cells placed under the bed frame. A proof of principle study showed that our system was able to detect whether healthy participants were supine, left-side lying or right-side lying with 94.2% accuracy in the lab environment.

The objective of the present work was to deploy our system into the home environment to evaluate how well the system was able to detect the position of individuals sleeping in their own beds overnight by comparing to ground truth time-lapse camera images using eight machine learning classifiers. Nine participants were recruited for this study and we found our system was able to detect an individual’s position in bed with 98.1% accuracy and an F1 score of 0.982 using the XGBoost classifier.

Future work will include using this system to evaluate interventions focused on improving adherence to 2-hour repositioning schedules for pressure injury prevention or management as well as incorporating this technology in a repositioning prompting system to alert caregiver when a patient has remained in the same position for too long.