bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk of mortality and reoperation in hip fracture patients undergoing cemented versus uncemented hemiarthroplasty
Authors: Viberg Bjarke , Pedersen Alma B. , Kjærsgaard Anders , Lauritsen Jens , Overgaard Søren
Published: December 2021

Aims

The aim of this study was to assess the association of mortality and reoperation when comparing cemented and uncemented hemiarthroplasty (HA) in hip fracture patients aged over 65 years.

Methods

This was a population-based cohort study on hip fracture patients using prospectively gathered data from several national registries in Denmark from 2004 to 2015 with up to five years follow-up. The primary outcome was mortality and the secondary outcome was reoperation. Hazard ratios (HRs) for mortality and subdistributional hazard ratios (sHRs) for reoperations are shown with 95% confidence intervals (CIs).

Results

A total of 17,671 patients with primary HA were identified (9,484 uncemented and 8,187 cemented HAs). Compared to uncemented HA, surgery with cemented HA was associated with an absolute risk difference of 0.4% for mortality within the period zero to one day after surgery and an adjusted HR of 1.70 (95% CI 1.22 to 2.38). After seven days, there was no longer any association, with an adjusted HR of 1.07 (95% CI 0.90 to 1.28). This continued until five years after surgery with a HR of 1.01 (95% CI 0.96 to 1.06). There was a higher proportion of reoperations due to any reason after five years in the uncemented group with 10.2% compared to the cemented group with 6.1%. This yielded an adjusted sHR of 0.65 (95% CI 0.57 to 0.75) and difference continued up until five years after the surgery, demonstrating a sHR of 0.70 (95% CI 0.59 to 0.83).

Conclusion

In a non-selected cohort of hip fracture patients, surgery with cemented HA was associated with a higher relative mortality during the first postoperative day compared to surgery with uncemented HA, but there was no difference after seven days up until five years after. In contrast, surgery with cemented HA was associated with lower risk of reoperation up to five years postoperatively compared with surgery with uncemented HA. There was a higher relative mortality on the first postoperative day for cemented HA versus uncemented HA. There was no difference in mortality after seven days up until five years after surgery. There were 6.1% reoperations for cemented HA compared to 10.2% for uncemented HA after five years. Cite this article: Bone Joint J 2022;104-B(1):127–133.
Should all patients with a culture-negative periprosthetic joint infection be treated with antibiotics?
Authors: van Sloten Maxime , Gómez-Junyent Joan , Ferry Tristan , Rossi Nicolò , Petersdorf Sabine , Lange Jeppe , Corona Pablo , Araújo Abreu Miguel , Borens Olivier , Zlatian Ovidiu , Soundarrajan Dhanasekaran , Rajasekaran S. , Wouthuyzen-Bakker Marjan ,   On behalf of the ESCMID Study Group of Implant Associated Infections (ESGIAI)
Published: December 2021

Aims

The aim of this study was to analyze the prevalence of culture-negative periprosthetic joint infections (PJIs) when adequate methods of culture are used, and to evaluate the outcome in patients who were treated with antibiotics for a culture-negative PJI compared with those in whom antibiotics were withheld.

Methods

A multicentre observational study was undertaken: 1,553 acute and 1,556 chronic PJIs, diagnosed between 2013 and 2018, were retrospectively analyzed. Culture-negative PJIs were diagnosed according to the Muskuloskeletal Infection Society (MSIS), International Consensus Meeting (ICM), and European Bone and Joint Society (EBJIS) definitions. The primary outcome was recurrent infection, and the secondary outcome was removal of the prosthetic components for any indication, both during a follow-up period of two years.

Results

None of the acute PJIs and 70 of the chronic PJIs (4.7%) were culture-negative; a total of 36 culture-negative PJIs (51%) were treated with antibiotics, particularly those with histological signs of infection. After two years of follow-up, no recurrent infections occurred in patients in whom antibiotics were withheld. The requirement for removal of the components for any indication during follow-up was not significantly different in those who received antibiotics compared with those in whom antibiotics were withheld (7.1% vs 2.9%; p = 0.431).

Conclusion

When adequate methods of culture are used, the incidence of culture-negative PJIs is low. In patients with culture-negative PJI, antibiotic treatment can probably be withheld if there are no histological signs of infection. In all other patients, diagnostic efforts should be made to identify the causative microorganism by means of serology or molecular techniques. Cite this article: Bone Joint J 2022;104-B(1):183–188.
The journey to preventing dislocation after total hip arthroplasty
Authors: Wright-Chisem Joshua , Elbuluk Ameer M. , Mayman David J. , Jerabek Seth A. , Sculco Peter K. , Vigdorchik Jonathan M.
Published: December 2021

Dislocation following total hip arthroplasty (THA) is a well-known and potentially devastating complication. Clinicians have used many strategies in attempts to prevent dislocation since the introduction of THA. While the importance of postoperative care cannot be ignored, particular emphasis has been placed on preoperative planning in the prevention of dislocation. The strategies have progressed from more traditional approaches, including modular implants, the size of the femoral head, and augmentation of the offset, to newer concepts, including patient-specific component positioning combined with computer navigation, robotics, and the use of dual-mobility implants. As clinicians continue to pursue improved outcomes and reduced complications, these concepts will lay the foundation for future innovation in THA and ultimately improved outcomes.

Cite this article: Bone Joint J 2022;104-B(1):8–11.
Favourable outcomes of repeat one-stage exchange for periprosthetic joint infection of the hip
Authors: Liechti Emanuel F. , Neufeld Michael E. , Soto Fernando , Linke Philip , Busch Sophia-Marlene , Gehrke Thorsten , Citak Mustafa
Published: December 2021

Aims

One-stage exchange for periprosthetic joint infection (PJI) in total hip arthroplasty (THA) is gaining popularity. The outcome for a repeat one-stage revision THA after a failed one-stage exchange for infection remains unknown. The aim of this study was to report the infection-free and all-cause revision-free survival of repeat one-stage exchange, and to investigate the association between the Musculoskeletal Infection Society (MSIS) staging system and further infection-related failure.

Methods

We retrospectively reviewed all repeat one-stage revision THAs performed after failed one-stage exchange THA for infection between January 2008 and December 2016. The final cohort included 32 patients. The mean follow-up after repeat one-stage exchange was 5.3 years (1.2 to 13.0). The patients with a further infection-related failure and/or all-cause revision were reported, and Kaplan-Meier survival for these endpoints determined. Patients were categorized according to the MSIS system, and its association with further infection was analyzed.

Results

A total of eight repeat septic revisions (25%) developed a further infection-related failure, and the five-year infection-free survival was 81% (95% confidence interval (CI) 57 to 92). Nine (28%) underwent a further all-cause revision and the five-year all-cause revision-free survival was 74% (95% CI 52 to 88). Neither the MSIS classification of the host status (p = 0.423) nor the limb status (p = 0.366) was significantly associated with further infection-related failure.

Conclusion

Repeat one-stage exchange for PJI in THA is associated with a favourable five-year infection-free and all-cause revision-free survival. Notably, the rate of infection control is encouraging when compared with the reported rates after repeat two-stage exchange. The results can be used to counsel patients and help clinicians make informed decisions about treatment. With the available number of patients, further infection-related failure was not associated with the MSIS host or limb status. Cite this article: Bone Joint J 2022;104-B(1):27–33.
Morpheus Web Testing: A Tool for Generating Test Cases for Widget Based Web Applications
Authors: Neves Romulo de Almeida , Watanabe Willian Massami , Oliveira Rafael
Published: December 2021

Context: Widgets are reusable User Interfaces (UIs) components frequently delivered in Web applications.In the web application, widgets implement different interaction scenarios, such as buttons, menus, and text input.Problem: Tests are performed manually, so the cost associated with preparing and executing test cases is high.Objective: Automate the process of generating functional test cases for web applications, using intermediate artifacts of the web development process that structure widgets in the web application. The goal of this process is to ensure the quality of the software, reduce overall software lifecycle time and the costs associated with tests.Method:We elaborated a test generation strategy and implemented this strategy in a tool, Morpheus Web Testing. Morpheus Web Testing extracts widget information from Java Server Faces artifacts to generate test cases for JSF web applications. We conducted a case study for comparing Morpheus Web Testing with a state of the art tool (CrawlJax).Results: The results indicate evidence that the approach Morpheus Web Testing managed to reach greater code coverage compared to a CrawlJax.Conclusion: The achieved coverage values represent evidence that the results obtained from the proposed approach contribute to the process of automated test software engineering in the industry.
Positional Therapy in a Patient With Refractory Treatment-Emergent Central Sleep Apnea
Authors: Palmer William , Jaziri Miriam , Tovar Maria
Published: December 2021

Treatment-emergent central sleep apnea (TE-CSA) is commonly encountered during the treatment for obstructive sleep apnea (OSA) with positive airway pressure (PAP) and usually remains self-limited. Persistent TE-CSA is sporadically seen with PAP therapy and has only rarely been described with hypoglossal nerve stimulation (HGNS). We report the case of a 60-year-old female patient with moderate OSA that progressed to TE-CSA with PAP therapy. A prolonged trial with PAP therapy was limited because the patient experienced recurrent aerophagia and subsequently underwent HGNS implantation. HGNS titration led to improved control of the patient’s OSA, but TE-CSA recurred and demonstrated a strong positional component. Lateral positional therapy was implemented with adequate control of respiratory events. TE-CSA can persist throughout different treatment modalities, including HGNS. The patient’s successful lateral sleep therapy for persistent and positionally exacerbated TE-CSA demonstrates the benefit of a well-known sleep apnea treatment for this poorly understood condition.
Association Between Obstructive Sleep Apnea and Stroke and Contributory Risk Factors
Authors: Woo Ho Geol , Yang Kwang Ik , Song Tae-Jin
Published: December 2021

Obstructive sleep apnea (OSA), a common comorbidity in patients with stroke, has shown increasing prevalence over the past few decades. OSA is an important risk factor for stroke in addition to other well-known contributors, including hypertension, hyperlipidemia, atrial fibrillation, and diabetes mellitus. Moreover, OSA is an independent predictor of neurological outcomes and mortality. The pathological mechanisms underlying the association between OSA and stroke include autonomic dysfunction, hypertension, cardiac arrhythmia, dyslipidemia, impaired glucose tolerance, hypoxia, and inflammation. Continuous positive airway pressure (CPAP) therapy has proven clinical utility in improvement of neurological symptoms in patients with stroke. Findings from a CPAP withdrawal model have shown increased sympathetic activity in OSA with a consequent significant elevation in blood pressure, relevant cerebral hypoxia, and disturbed cardiac repolarization. In this review, we present an overview of the literature that describes an association between OSA and stroke in addition to the vascular risk factors, including hypertension, hyperlipidemia, atrial fibrillation, and diabetes mellitus. This study highlights the importance of early and accurate diagnosis and management of OSA for stroke prevention and care and will benefit physicians in clinical practice.
Coracoid Osteotomy, Greater Tuberosity Take Down and Latarjet Procedure for Missed Bilateral Locked Anterior Shoulder Fracture-Dislocations in a Young Man
Authors: Jones Neil , Clough Oliver , Kantak Avadhoot , Patnaik Surendra
Published: December 2021

Introduction:It is rare to see chronic bilateral anterior fracture-dislocations as a result of seizure, and we present a case of this type and review of the literature. Despite the signs and symptoms of shoulder dislocation being well documented, and X-ray imaging being good at identifying such pathology, there are a few cases in the literature of missed or chronic shoulder dislocation (a shoulder that has been dislocated for more than 3 weeks) but these are extremely rare. Our case represents the first example of chronic bilateral locked anterior fracture-dislocations requiring open reduction and coracoid osteotomy with GT takedown to gain adequate exposure and allow soft tissue release to facilitate joint reduction. No other case has used anchors to achieve GT fixation, and our patient is the youngest published case with such pathology.

Case Report: A 16-year-old boy presented to the emergency department with reduced range of movements in both shoulders. Six weeks prior he had suffered an epileptic seizure. X-rays confirmed bilateral anterior shoulder dislocations with displaced greater tuberosity (GT) fractures. Staged open reduction was performed in the right and then left shoulder. Coracoid osteotomy with takedown of the malunited GT fracture was needed to assist with gradual soft tissue contracture release and a successful relocation. Latarjet procedure was then performed and the GTs were fixed using rotator cuff anchors. At 6 months post-operation, on the right side, he achieved forward flexion to 150o and abduction to 120o. On the left side, forward flexion was 110o and abduction was 90o. X rays showed satisfactory maintenance of the reduction without signs of avascular necrosis of the humeral head.

Conclusions: Surgical management of this injury in this way is effective and achieves good results in the first 6 months of follow up. A high index of suspicion should be employed for this injury in post-ictal patients with shoulder pain. Early mobilization and
Roadblocks in Chagas disease care in endemic and nonendemic countries: Argentina, Colombia, Spain, and the United States. The NET-Heart project
Authors: Miranda-Arboleda Andrés F. , Zaidel Ezequiel José , Marcus Rachel , Pinazo María Jesús , Echeverría Luis Eduardo , Saldarriaga Clara , Sosa Liprandi Álvaro , Baranchuk Adrián ,   on behalf of the Neglected Tropical Diseases and other Infectious Diseases affecting the Heart (NET-Heart) project
Published: December 2021

Background

Chagas disease (CD) is endemic in Latin America; however, its spread to nontropical areas has raised global interest in this condition. Barriers in access to early diagnosis and treatment of both acute and chronic infection and their complications have led to an increasing disease burden outside of Latin America. Our goal was to identify those barriers and to perform an additional analysis of them based on the Inter American Society of Cardiology (SIAC) and the World Heart Federation (WHF) Chagas Roadmap, at a country level in Argentina, Colombia, Spain, and the United States, which serve as representatives of endemic and nonendemic countries.

Methodology and principal findings

This is a nonsystematic review of articles published in indexed journals from 1955 to 2021 and of gray literature (local health organizations guidelines, local policies, blogs, and media). We classified barriers to access care as (i) existing difficulties limiting healthcare access; (ii) lack of awareness about CD and its complications; (iii) poor transmission control (vectorial and nonvectorial); (iv) scarce availability of antitrypanosomal drugs; and (v) cultural beliefs and stigma. Region-specific barriers may limit the implementation of roadmaps and require the application of tailored strategies to improve access to appropriate care.

Conclusions

Multiple barriers negatively impact the prognosis of CD. Identification of these roadblocks both nationally and globally is important to guide development of appropriate policies and public health programs to reduce the global burden of this disease.
Expanding or shrinking? range shifts in wild ungulates under climate change in Pamir-Karakoram mountains, Pakistan
Authors: Ali Hussain , Din Jaffar Ud , Bosso Luciano , Hameed Shoaib , Kabir Muhammad , Younas Muhammad , Nawaz Muhammad Ali
Published: December 2021

Climate change is expected to impact a large number of organisms in many ecosystems, including several threatened mammals. A better understanding of climate impacts on species can make conservation efforts more effective. The Himalayan ibex (Capra ibex sibirica) and blue sheep (Pseudois nayaur) are economically important wild ungulates in northern Pakistan because they are sought-after hunting trophies. However, both species are threatened due to several human-induced factors, and these factors are expected to aggravate under changing climate in the High Himalayas. In this study, we investigated populations of ibex and blue sheep in the Pamir-Karakoram mountains in order to (i) update and validate their geographical distributions through empirical data; (ii) understand range shifts under climate change scenarios; and (iii) predict future habitats to aid long-term conservation planning. Presence records of target species were collected through camera trapping and sightings in the field. We constructed Maximum Entropy (MaxEnt) model on presence record and six key climatic variables to predict the current and future distributions of ibex and blue sheep. Two representative concentration pathways (4.5 and 8.5) and two-time projections (2050 and 2070) were used for future range predictions. Our results indicated that ca. 37% and 9% of the total study area (Gilgit-Baltistan) was suitable under current climatic conditions for Himalayan ibex and blue sheep, respectively. Annual mean precipitation was a key determinant of suitable habitat for both ungulate species. Under changing climate scenarios, both species will lose a significant part of their habitats, particularly in the Himalayan and Hindu Kush ranges. The Pamir-Karakoram ranges will serve as climate refugia for both species. This area shall remain focus of future conservation efforts to protect Pakistan’s mountain ungulates.
Association between leisure-time physical activity and the built environment in China: Empirical evidence from an accelerometer and GPS-based fitness app
Authors: Chen Long , Zhang Zhaoxi , Long Ying
Published: December 2021

To reexamine the relationship between leisure-time physical activity (LTPA) and the built environment (BE), this paper takes advantage of the massive amount of data collected by an accelerometer and GPS-based fitness mobile app. Massive LTPA data from more than 3 million users were recorded by Codoon in 500m by 500m grid cells and aggregated to 742 natural cities in mainland China. Six BE indicators were quantified using GIS at the city scale. Robust regression analysis was used to estimate the correlation between LTPA and BE. Five of six BE indicators—connectivity, road density, land use mix, points of interest density, and density of parks and squares—were significantly, positively, independently, and linearly related to LTPA in the regression analysis. The study obtains findings that are consistent with the previous literature but also provides novel insights into the important role of POI density in encouraging LTPA, as well as how the relationship between LTPA and BE varies by time of day. The study also sheds light on the embrace of new technology and new data in public health and urban studies.
Barriers and enablers to access childhood cataract services across India. A qualitative study using the Theoretical Domains Framework (TDF) of behaviour change
Authors: Sethu Sheeladevi , Lawrenson John G. , Kekunnaya Ramesh , Ali Rahul , Borah Rishi R. , Suttle Catherine
Published: December 2021

Early presentation for childhood cataract surgery is an important first step in preventing related visual impairment and blindness. In the absence of neonatal eye screening programmes in developing countries, the early identification of childhood cataract remains a major challenge. The primary aim of this study was to identify potential barriers to accessing childhood cataract services from the perspective of parents and carers, as a critical step towards increasing the timely uptake of cataract surgery. In-depth interviews were conducted using a pre-designed topic guide developed for this study to seek the views of parents and carers in nine geographic locations across eight states in India regarding their perceived barriers and enablers to accessing childhood cataract services. A total of 35 in-depth interviews were conducted including 30 at the hospital premises and 5 in the participants’ homes. All interviews were conducted in the local language and audio taped for further transcription and analysis. Data were organised using NVivo 11 and a thematic analysis was conducted utilising the Theoretical Domains Framework (TDF), an integrative framework of behavioural theories. The themes identified from interviews related to 11 out of 12 TDF domains. TDF domains associated with barriers included: ‘Environmental context and resources’, ‘Beliefs about consequences’ and ‘Social influences’. Reported enablers were identified in three theoretical domains: ‘Social influences’, ‘Beliefs about consequences’ and ‘Motivations and goals’. This comprehensive TDF approach enabled us to understand parents’ perceived barriers and enablers to accessing childhood cataract services, which could be targeted in future interventions to improve timely uptake.
Predicting speech discrimination scores from pure-tone thresholds—A machine learning-based approach using data from 12,697 subjects
Authors: Kim Hantai , Park JaeYeon , Choung Yun-Hoon , Jang Jeong Hun , Ko JeongGil
Published: December 2021

Diagnostic tests for hearing impairment not only determines the presence (or absence) of hearing loss, but also evaluates its degree and type, and provides physicians with essential data for future treatment and rehabilitation. Therefore, accurately measuring hearing loss conditions is very important for proper patient understanding and treatment. In current-day practice, to quantify the level of hearing loss, physicians exploit specialized test scores such as the pure-tone audiometry (PTA) thresholds and speech discrimination scores (SDS) as quantitative metrics in examining a patient’s auditory function. However, given that these metrics can be easily affected by various human factors, which includes intentional (or accidental) patient intervention, there are needs to cross validate the accuracy of each metric. By understanding a “normal” relationship between the SDS and PTA, physicians can reveal the need for re-testing, additional testing in different dimensions, and also potential malingering cases. For this purpose, in this work, we propose a prediction model for estimating the SDS of a patient by using PTA thresholds via a Random Forest-based machine learning approach to overcome the limitations of the conventional statistical (or even manual) methods. For designing and evaluating the Random Forest-based prediction model, we collected a large-scale dataset from 12,697 subjects, and report a SDS level prediction accuracy of 95.05% and 96.64% for the left and right ears, respectively. We also present comparisons with other widely-used machine learning algorithms (e.g., Support Vector Machine, Multi-layer Perceptron) to show the effectiveness of our proposed Random Forest-based approach. Results obtained from this study provides implications and potential feasibility in providing a practically-applicable screening tool for identifying patient-intended malingering in hearing loss-related tests.
Incidence and predictors of reoccurrence of opportunistic infection among adult HIV/AIDS patients attending ART clinic at public health facilities in Arba Minch town, southern Ethiopia: A retrospective cohort study
Authors: Dembelu Maycas , Kote Mesfin , Gilano Girma , Mohammed Temesgen
Published: December 2021

Background

Human immunodeficiency virus (HIV) infected individuals are prone to opportunistic infections (OIs) due to HIV mediated immune suppression. When opportunistic infections occur in the form of relapse or reinfection, it is said to be reoccurrence. This study was aimed to assess Incidence and predictors of reoccurrence of opportunistic infections among adult people living with HIV (PLHIV) attending ART clinics in Arba Minch Town, Southern Ethiopia

Methods

This retrospective cohort study was conducted on 450 HIV/AIDS patients attending anti-retro viral therapy (ART) clinics in Arba Minch town, southern Ethiopia. Simple random sampling technique was used. Kaplan-Meier graph and log rank test were used for group wise comparison. Bivariate and multivariable Cox Proportional Hazard Regression model were used to identify independent predictors of reoccurrence of opportunistic infection.

Result

One hundred nineteen HIV/AIDS patient had reoccurrence of opportunistic infection. The incidence rate was 11.5 per 1000 person months. The mean time of reoccurrence was 56 months. One of the most reoccurred OIs was pulmonary tuberculosis (PTB). Predictors that were associated significantly were recent cell differentiation 4 (CD4) count, recent body mass index (BMI), recent functional status, and duration on anti-retroviral therapy (ART).

Conclusion

Though the incidence rate of OIs decreased from previous findings, attention should be given to HIV patients with low CD4 count, low BMI and for those bedridden patients.
DAVS-NET: Dense Aggregation Vessel Segmentation Network for retinal vasculature detection in fundus images
Authors: Raza Mohsin , Naveed Khuram , Akram Awais , Salem Nema , Afaq Amir , Madni Hussain Ahmad , Khan Mohammad A. U. , din Mui-zzud-
Published: December 2021

In this era, deep learning-based medical image analysis has become a reliable source in assisting medical practitioners for various retinal disease diagnosis like hypertension, diabetic retinopathy (DR), arteriosclerosis glaucoma, and macular edema etc. Among these retinal diseases, DR can lead to vision detachment in diabetic patients which cause swelling of these retinal blood vessels or even can create new vessels. This creation or the new vessels and swelling can be analyzed as biomarker for screening and analysis of DR. Deep learning-based semantic segmentation of these vessels can be an effective tool to detect changes in retinal vasculature for diagnostic purposes. This segmentation task becomes challenging because of the low-quality retinal images with different image acquisition conditions, and intensity variations. Existing retinal blood vessels segmentation methods require a large number of trainable parameters for training of their networks. This paper introduces a novel Dense Aggregation Vessel Segmentation Network (DAVS-Net), which can achieve high segmentation performance with only a few trainable parameters. For faster convergence, this network uses an encoder-decoder framework in which edge information is transferred from the first layers of the encoder to the last layer of the decoder. Performance of the proposed network is evaluated on publicly available retinal blood vessels datasets of DRIVE, CHASE_DB1, and STARE. Proposed method achieved state-of-the-art segmentation accuracy using a few number of trainable parameters.
Assessment of soil erosion in the Dongting Lake Basin, China: Patterns, drivers, and implications
Authors: Xiao Jianyong , Xie Binggeng , Zhou Kaichun , Shi Shana , Li Junhan , Yang Mingxia , Liu ChangChang
Published: December 2021

Soil loss caused by erosion is a global problem. Therefore, the assessment of soil erosion and the its driving mechanism are of great significance to soil conservation. However, soil erosion is affected by both climate change and human activities, which have not been quantified, and few researchers studied the differences in the driving mechanisms of soil erosion depending on the land use type. Therefore, the spatiotemporal characteristics and changing trends of soil erosion in the Dongting Lake Basin were analyzed in this study. Geographic detectors were used to identify the dominant factors affecting soil erosion in different land use types. In this study, a sensitivity experiment was conducted to clarify the relative contributions of climate change and human activities to soil erosion changes. In addition, we studied the effects of different land use types and vegetation cover restoration on soil erosion. The results show that soil erosion in the Dongting Lake Basin decreased from 2000 to 2018. Human activities represented by land use types and vegetation coverage significantly contributed to the alleviation of soil erosion in the Dongting Lake Basin, whereas climate change represented by rainfall slightly aggravated soil erosion in the study area. The restoration of grassland vegetation and transfer of cultivated land to woodlands in the study area improved the soil erosion. The slope steepness is the key factor affecting the intensity of soil erosion in dry land, paddy fields, and unused land, whereas the vegetation coverage is the key factor affecting the intensity of soil erosion in woodland, garden land, and grassland. Detailed spatiotemporally mapping of soil erosion was used to determine the connections between soil erosion and potential drivers, which have important implications for vegetation restoration and the optimization of land use planning.
Post-cesarean section surgical site infection and associated factors in East Gojjam zone primary hospitals, Amhara region, North West Ethiopia, 2020
Authors: Bizuayew Hulubante , Abebe Haimanot , Mullu Getachew , Bewuket Likinaw , Tsega Daniel , Alemye Tsegaw
Published: December 2021

Purpose

Maternal surgical site infection after cesarean delivery is a clinical problem which contributes to significant morbidity and mortality. In Ethiopia admissions following cesarean section due to surgical site infection have been routine activities of health care institutions but there is limited scientific evidence on both the magnitude of the problem and factors associated with it making prevention mechanisms less effective. Therefore, this study aimed to assess magnitude and risk factors of post-cesarean section surgical site infection at primary hospitals of East Gojjam Zone, Northwest Ethiopia.

Methods

Institution-based cross sectional study with retrospective chart review was conducted from September 10–30 /2020 at 3 randomly selected primary hospitals of east Gojjam zone. The data were entered in Epi data version 3.1 and exported to Statistical Package for Social Science Software version 26. Post-cesarean section surgical site infection was measured based on disease classification and definition of the term by Center for Disease Control and Prevention. After checking for presence of multicollinarity, presence and degree of association of factors with outcome variable were computed through logistic regression analysis. Factors with P value ≤ 0.2 in bi-variable logistic regression analysis were included in the multivariable logistic regression analysis and those variables with P-value of <0.05 in multivariable analysis were considered statistically significant.

Result

From 622 medical records of women who underwent cesarean section, 77 (12.4%) of them developed surgical site infection. Rural residence [(AOR = 2.30, 95%CI: (1.29, 4.09)], duration of labor greater than 24hrs [(AOR = 3.48, 95%CI: (1.49, 8.09)], rupture of membrane>12hrs[(AOR = 4.61,95%CI:(2.34,9.09)], hypertension[(AOR = 3.14,95%CI:(1.29,7.59)] and preoperative Hematocrit ≤30%[(AOR = 3.22,95%CI:(1.25,8.31)] were factors significantly associated with post-cesarean section surgical site infections.

Conclusion

Magnitude of post-cesarean section surgical site infection was a significant problem in primary hospitals. Minimizing prolonged labor; minimize early rupture of membrane, properly managing patients with comorbidities like hypertension, strengthen prophylaxis and treatment for anemia during antenatal care and raising awareness for rural residents can reduce the problem. Zonal police makers should give emphasis to reduce its burden.
Evaluation of micro-RNA in extracellular vesicles from blood of patients with prostate cancer
Authors: Kim Jiyoon , Cho Siwoo , Park Yonghyun , Lee Jiyoul , Park Jaesung
Published: December 2021

Extracellular vesicles (EVs) contain various types of molecules including micro-RNAs, so isolating EVs can be an effective way to analyze and diagnose diseases. A lot of micro-RNAs have been known in relation to prostate cancer (PCa), and we evaluate miR-21, miR-141, and miR-221 in EVs and compare them with prostate-specific antigen (PSA). EVs were isolated from plasma of 38 patients with prostate cancer and 8 patients with benign prostatic hyperplasia (BPH), using a method that showed the highest recovery of RNA. Isolation of EVs concentrated micro-RNAs, reducing the cycle threshold (Ct) value of RT-qPCR amplification of micro-RNA such as miR-16 by 5.12 and miR-191 by 4.65, compared to the values before EV isolation. Normalization of target micro-RNAs was done using miR-191. For miR-221, the mean expression level of patients with localized PCa was significantly higher than that of the control group, having 33.45 times higher expression than the control group (p < 0.01). Area under curve (AUC) between BPH and PCa for miR-221 was 0.98 (p < 0.0001), which was better than AUC for prostate-specific antigen (PSA) level in serum for the same patients. The levels of miR-21 and miR-141 in EVs did not show significant changes in patients with PCa compared to the control group in this study. This study suggests isolating EVs can be a helpful approach in analyzing micro-RNAs with regard to disease.
Science maps for exploration, navigation, and reflection—A graphic approach to strategic thinking
Authors: Skov Flemming
Published: December 2021

The world of science is growing at an unprecedented speed with more and more scholarly papers produced each year. The scientific landscape is constantly changing as research specialties evolve, merge or become obsolete. It is difficult for researchers, research managers and the public alike to keep abreast with these changes and maintain a true and fair overview of the world of science. Such an overview is necessary to stimulate scientific progress, to maintain flexible and responsive research organizations, and to secure collaboration and knowledge exchange between different research specialties and the wider community. Although science mapping is applied to a wide range of scientific areas, examples of their practical use are sparse. This paper demonstrates how to use a topical, scientific reference maps to understand and navigate in dynamic research landscapes and how to utilize science maps to facilitate strategic thinking. In this study, the research domain of biology at Aarhus University serves as an example. All scientific papers authored by the current, permanent staff were extracted (6,830 in total). These papers were used to create a semantic cognitive map of the research field using a co-word analysis based on keywords and keyword phrases. A workflow was written in Python for easy and fast retrieval of information for topic maps (including tokens from keywords section and title) to generate intelligible research maps, and to visualize the distribution of topics (keywords), papers, journal categories, individual researchers and research groups on any scale. The resulting projections revealed new insights into the structure of the research community and made it possible to compare researchers or research groups to describe differences and similarities, to find scientific overlaps or gaps, and to understand how they relate and connect. Science mapping can be used for intended (top-down) as well as emergent (bottom-up) strategy development. The paper concludes that science maps provide alternative views of the intricate structures of science to supplement traditional bibliometric information. These insights may help strengthen strategic thinking and boost creativity and thus contribute to the progress of science.
Emergency-department accesses in home care paediatric patients: Occurrence and risks of use in a six-year retrospective investigation in Northern Italy
Authors: Campagna Sara , Borraccino Alberto , Politano Gianfranco , Dalmasso Marco , Ravaglia Aldo , Dimonte Valerio , Gianino Maria Michela
Published: December 2021

Objective

To assess the determinants of ED use in paediatric patients enrolled in an Integrated Paediatric Home Care (IPHC) program.

Methods

A retrospective study was conducted using administrative databases on a cohort of patients enrolled in an IPHC program between January 1st, 2012, and December 31st, 2017, in Northern Italy. ED visits that occurred during the IPHC program were considered. Data were collected considering sociodemographic, clinical and organizational variables. A multivariable stepwise logistic regression analysis was performed. The dependent variable to identify possible associations was ED visit.

Results

A total of 463 ED visits occurred in 465 children, with an incidence rate of 1. The risk of ED visits significantly increased among children involved in the IPHC program after hospital discharge (OR 1.94). Additionally, the risk of ED visits increased significantly as the duration of IPHC increased (OR 5.80 between 101 and 200 days, to OR 7.84 between 201 and 300 days, OR 12.54 between 301 and 400 days and OR 18.67 to more than 400 days).

Conclusion

The overall results represent a practical perspective to contribute improving both the service quality of IPHC and reducing low acuity and improper ED use.
Association between occupational testicular radiation exposure and lower male sex ratio of offspring among orthopedic surgeons
Authors: Hijikata Yasukazu , Nakahara Masayuki , Kusumegi Akira , Morii Junji , Okubo Naoki , Hatano Nozomi , Takahashi Yuichi
Published: December 2021

Background

Exposure to occupational radiation can lower the male sex ratio. However, specific radiation exposure to the testes has not been evaluated.

Objective

This study aimed to examine the association between testicular radiation exposure and lower male sex ratio in children.

Methods

A comprehensive questionnaire survey was administered to 62 full-time male doctors with children aged < 10 years at 5 hospitals. Based on the possibility of testicular radiation exposure 1 year before the child’s birth, participants were assigned to 3 groups as follows: RT (orthopedic surgery), RNT (cardiology/neurosurgery), and N (others). Intergroup differences in the proportion of female children were ascertained, and the female sex ratio (number of female/total number) of each group was compared against the standard value of 0.486. Multivariate logistic regression analysis with a generalized estimating equation was used to model the effects on the probability of female birth while controlling for the correlation among the same fathers.

Results

The study population included 62 fathers and 109 children, 49 were female: 19/27, 11/30, and 19/52 in the RT, RNT, and N group, respectively; the RT group had the highest proportion of females (p = 0.009). The p values for comparisons with the standard sex ratio (0.486) were 0.02, 0.19, and 0.08 for the RT, RNT, and N groups, respectively. Based on the N group, the adjusted odds ratios for the child to be female were 4.40 (95% confidence interval 1.60–2.48) and 1.03 (0.40–2.61) for the RT and RNT groups, respectively.

Conclusions

Our results imply an association between testicular radiation exposure and low male sex ratio of offspring. Confirmatory evidence is needed from larger studies which measure the pre-conceptional doses accumulated in various temporal periods, separating out spermatogonial and spermatid effects.
Effects of osmolality and solutes on the morphology of red blood cells according to three-dimensional refractive index tomography
Authors: Son Minkook , Lee Ye Sung , Lee Mahn Jae , Park YongKeun , Bae Hae-Rahn , Lee Seung Yeob , Shin Myung-Geun , Yang Sung
Published: December 2021

Phosphate-buffered saline (PBS) and Alsever’s solution (AS) are frequently used as media in blood-related studies, while 0.9% normal saline (NS) is frequently used in transfusion medicine. Despite the frequent use, the effects of these solutions on the shape and volume of red blood cells (RBCs) have not been reported. We collected blood samples from five healthy adults and used three-dimensional refractive index tomography to investigate the changes in the morphology of RBCs caused by changes in osmolality and solutes at the single-cell level. After diluting 2 μL of RBCs 200-fold with each solution (PBS, AS, and 0.9% NS), 40 randomly selected RBCs were microscopically observed. RBC shape was measured considering sphericity, which is a dimensionless quantity ranging from 0 (flat) to 1 (spherical). RBCs in plasma or AS showed a biconcave shape with a small sphericity, whereas those in 0.9% NS or PBS showed a spherical shape with a large sphericity. Moreover, we confirmed that sodium chloride alone could not elicit the biconcave shape of RBCs, which could be maintained only in the presence of an osmotic pressure-maintaining substance, such as glucose or mannitol. Although 0.9% NS solution is one of the most commonly used fluids in hematology and transfusion medicine, RBCs in 0.9% NS or PBS are not biconcave. Therefore, as the debate on the use of NS continues, future clinical studies or applications should consider the effect of glucose or mannitol on the shape of RBCs.
Real-world clinical predictors of manic/hypomanic episodes among outpatients with bipolar disorder
Authors: Tokumitsu Keita , Norio Yasui-Furukori , Adachi Naoto , Kubota Yukihisa , Watanabe Yoichiro , Miki Kazuhira , Azekawa Takaharu , Edagawa Koji , Katsumoto Eiichi , Hongo Seiji , Goto Eiichiro , Ueda Hitoshi , Kato Masaki , Nakagawa Atsuo , Kikuchi Toshiaki , Tsuboi Takashi , Watanabe Koichiro , Shimoda Kazutaka , Yoshimura Reiji
Published: December 2021

Background

Bipolar disorder is a mental illness in which manic and depressive states are repeated, causing psychosocial dysfunction. Manic/hypomanic episodes cause problems with interpersonal, social and financial activities, but there is limited evidence regarding the predictors of manic/hypomanic episodes in real-world clinical practice.

Methods

The multicenter treatment survey on bipolar disorder (MUSUBI) in Japanese psychiatric clinics was administered in an observational study that was conducted to accumulate evidence regarding bipolar disorder in real-world clinical practice. Psychiatrists were asked to complete a questionnaire about patients with bipolar disorder who visited 176 member clinics of the Japanese Association of Neuro-Psychiatric Clinics by conducting a retrospective medical record survey. Our study extracted baseline patient characteristics from September to October 2016, including comorbidities, mental status, duration of treatment, Global Assessment of Functioning (GAF) score, and pharmacological treatment details. We investigated the presence or absence of manic/hypomanic episodes over the course of one year from baseline to September-October 2017.

Results

In total, 2231 participants were included in our study, 29.1% of whom had manic/hypomanic episodes over the course of one year from baseline. Binomial logistic regression analysis revealed that the presence of manic/hypomanic episodes was correlated with lower baseline GAF scores, rapid cycling, personality disorder, bipolar I disorder, and a mood state with manic or mixed features. Substance abuse was also a risk factor for manic episodes. There was no significant association between a baseline antidepressant prescription and manic/hypomanic episodes.

Conclusions

In Japan, 29.1% of outpatients with bipolar disorder had manic/hypomanic episodes over the course of one year. Our study suggested that a low GAF score, rapid cycling, personality disorder, bipolar I disorder, substance abuse, and baseline mood state could be predictors of manic/hypomanic episodes. Based on our findings, an antidepressant prescription is not a predictor of manic/hypomanic episodes.
The evaluation of the utility of the GENECUBE HQ SARS-CoV-2 for anterior nasal samples and saliva samples with a new rapid examination protocol
Authors: Naito Asami , Kiyasu Yoshihiko , Akashi Yusaku , Sugiyama Akio , Michibuchi Masashi , Takeuchi Yuto , Notake Shigeyuki , Nakamura Koji , Ishikawa Hiroichi , Suzuki Hiromichi
Published: December 2021

Introduction

GENECUBE® is a rapid molecular identification system, and previous studies demonstrated that GENECUBE® HQ SARS-CoV-2 showed excellent analytical performance for the detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) with nasopharyngeal samples. However, other respiratory samples have not been evaluated.

Methods

This prospective comparison between GENECUBE® HQ SARS-CoV-2 and reference real-time reverse transcriptase polymerase chain reaction (RT-PCR) was performed for the detection of SARS-CoV-2 using anterior nasal samples and saliva samples. Additionally, we evaluated a new rapid examination protocol using GENECUBE® HQ SARS-CoV-2 for the detection of SARS-CoV-2 with saliva samples. For the rapid protocol, in the preparation of saliva samples, purification and extraction processes were adjusted, and the total process time was shortened to approximately 35 minutes.

Results

For 359 anterior nasal samples, the total-, positive-, and negative concordance of the two assays was 99.7% (358/359), 98.1% (51/52), and 100% (307/307), respectively. For saliva samples, the total-, positive-, and negative concordance of the two assays was 99.6% (239/240), 100% (56/56), and 99.5% (183/184), respectively. With the new protocol, total-, positive-, and negative concordance of the two assays was 98.8% (237/240), 100% (56/56), and 98.4% (181/184), respectively. In all discordance cases, SARS-CoV-2 was detected by additional molecular examinations.

Conclusion

GENECUBE® HQ SARS-CoV-2 provided high analytical performance for the detection of SARS-CoV-2 in anterior nasal samples and saliva samples.