bluuebunny/crossref_metadata_2025 huggingface dataset:
A Tale of Two Institutions: COVID-19 Positive Rates in Asymptomatic Patients Pre-Screened for Spine Procedures and Surgeries in Los Angeles, California
Authors: Chen Allen S. , Brown Matthew , Arekelyan Anush , Wennemann Sophie , Shamie Nick , Holly Langston , Liu John C. , Wang Jeffrey C. , Buser Zorica
Published: December 2021

Study Design

Retrospective cohort study.

Objectives

The coronavirus disease (COVID-19), caused by the severe respiratory syndrome coronavirus 2 (SARS-CoV-2), has created an unprecedented global public health emergency. The aim of the current study was to report on COVID-19 rates in an asymptomatic population prior to undergoing spine procedures or surgeries at two large Los Angeles healthcare systems.

Methods

Elective spine procedures and surgeries from May 1, 2020 to January 31, 2021 were included. Results from SARS-CoV-2 virus RT-PCR nasopharyngeal testing within 72 hours prior to elective spine procedures were recorded. Los Angeles County COVID-19 rates were calculated using data sets from Los Angeles County Department of Public Health. Chi-squared test and Stata/IC were used for statistical analysis.

Results

A total of 4,062 spine procedures and surgeries were scheduled during this time period. Of these, 4,043 procedures and surgeries were performed, with a total of 19 patients testing positive. Nine positive patients were from UCLA, and 10 from USC. The overall rate of positive tests was low at .47% and reflected similarities with Los Angeles County COVID-19 rates over time.

Conclusions

The current study shows that pre-procedure COVID-19 testing rates remains very low, and follows similar patterns of community rates. While pre-procedure testing increases the safety of elective procedures, universal COVID-19 pre-screening adds an additional barrier to receiving care for patients and increases cost of delivering care. A combination of pre-screening, pre-procedure self-quarantine, and consideration of overall community COVID-19 positivity rates should be further studied.
The Reconstruction of Plastic Surgery: A Historical Perspective on the Etymology of Plastic and Reconstructive Surgery
Authors: Bouhadana Gabriel , Aljerian Albaraa , Thibaudeau Stephanie
Published: December 2021

Although the origins of procedures now falling under the scope of modern plastic surgery date back thousands of years, it was only fairly recently that these were grouped under the umbrella term “plastic” surgery. However, mainly due to the industrialization period, the popular understanding of the term “plastic” would soon change—making way for the addition of the term “reconstructive” to the specialty's name. Through a careful look at historical trends, the authors illustrate how this unintentionally led to an ideological divide between the aesthetic and reconstructive portions of our work, prompting a recent push to unify the field under the one, original, lexical choice: “plastic” surgery.
Double-Layered Quadriceps Tendon Autografts Provide Lower Failure Rates and Improved Clinical Results Compared With Hamstring Tendon Grafts in Revision ACL Reconstruction
Authors: Eggeling Lena , Breer Stefan , Drenck Tobias Claus , Frosch Karl-Heinz , Akoto Ralph
Published: December 2021

Background:

We developed a quadriceps-tendon graft technique using a double-layered, partial-thickness, soft tissue quadriceps tendon graft (dlQUAD) for anterior cruciate ligament reconstruction (ACLR). This technique allows simple femoral loop button fixation and a limited harvest depth of the quadriceps tendon.

Purpose:

To evaluate the outcome of patients undergoing revision ACLR using the dlQUAD technique compared with a hamstring tendon graft (HT).

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 114 patients who underwent revision ACLR between 2017 and 2018 were included in this retrospective case series. At a mean follow-up of 26.9 ± 3.7 months (range, 24-36), 89 patients (dlQUAD: n = 43, HT: n = 46) were clinically examined. In addition, patients completed the Lysholm score, Tegner activity scale, subjective International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score, and visual analog scale (VAS) for pain. Postoperative failure of the revision ACLR was defined as a side-to-side difference (SSD) in Rolimeter testing ≥5 mm or a pivot-shift grade of 2 or 3.

Results:

Nine patients (10.1%) were identified with a failed revision ACLR. There was a significantly lower failure rate with dlQUAD versus the HT group (2.3% vs 17.4%; P = .031). The mean postoperative SSD was significantly less in the dlQUAD group (1.3 ± 1.3 mm [range, 0-5] vs 1.8 ± 2.2 mm [range, 0-9]; P = .043). At the latest follow-up, Tegner and IKDC scores significantly improved in the dlQUAD group compared with the HT group (Tegner: 5.8 ± 1.8 vs 5.6 ± 1.5; P = .043; IKDC: 83.8 ± 12.2 vs 78.6 ± 16.8; P = .037). The pain VAS score was also significantly reduced in the dlQUAD group compared with the HT group (0.9 ± 1.1 vs 1.6 ± 2.0; P = .014).

Conclusion:

The dlQUAD and HT techniques both demonstrated significant improvement of preoperative knee laxity and satisfactory patient-reported outcome measures after revision ACLR. Compared with the HT grafts, the dlQUAD technique showed lower failure rates and small increases in Tegner and IKDC scores.
Neutrophil transit time and localization within the megakaryocyte define morphologically distinct forms of emperipolesis
Authors: Huang Frank Y. , Cunin Pierre , Radtke Felix A. , Darbousset Roxane , Grieshaber-Bouyer Ricardo , Nigrovic Peter A.
Published: December 2021

Neutrophils transit through megakaryocytes in a process termed emperipolesis, but it is unknown whether this interaction is a single type of cell-in-cell interaction or a set of distinct processes. Using a murine in vitro model, we characterized emperipolesis by live-cell spinning disk microscopy and electron microscopy. Approximately half of neutrophils exited the megakaryocyte rapidly, typically in 10 minutes or less, displaying ameboid morphology as they passed through the host cell (fast emperipolesis). The remaining neutrophils assumed a sessile morphology, most remaining within the megakaryocyte for at least 60 minutes (slow emperipolesis). These neutrophils typically localized near the megakaryocyte nucleus. By ultrastructural assessment, all internalized neutrophils remained morphologically intact. Most neutrophils resided within emperisomes, but some could be visualized exiting the emperisome to enter the cell cytoplasm. Neutrophils in the cytoplasm assumed close contact with the platelet-forming demarcation membrane system or the perinuclear endoplasmic reticulum. These findings reveal that megakaryocyte emperipolesis reflects at least 2 distinct processes differing in transit time and morphology, fast and slow emperipolesis, suggesting divergent physiologic functions.
Unrelated donor α/β T cell– and B cell–depleted HSCT for the treatment of pediatric acute leukemia
Authors: Leahy Allison Barz , Li Yimei , Talano Julie-An , Elgarten Caitlin W. , Seif Alix E. , Wang Yongping , Johnson Bryon , Monos Dimitri S. , Kadauke Stephan , Olson Timothy S. , Freedman Jason , Wray Lisa , Grupp Stephan A. , Bunin Nancy
Published: December 2021

Unrelated donor (URD) hematopoietic stem cell transplant (HSCT) is associated with an increased risk of severe graft-versus-host disease (GVHD). TCRαβ/CD19 depletion may reduce this risk, whereas maintaining graft-versus-leukemia. Outcome data with TCRαβ/CD19 depletion generally describe haploidentical donors, with relatively few URDs. We hypothesized that TCRαβ/CD19-depletion would attenuate the risks of GVHD and relapse for URD HSCT. Sixty pediatric and young adult (YA) patients with hematologic malignancies who lacked a matched-related donor were enrolled at 2 large pediatric transplantation centers between October 2014 and September 2019. All patients with acute leukemia had minimal residual disease testing, and DP typing was available for 77%. All patients received myeloablative total body irradiation– or busulfan-based conditioning with no posttransplant immune suppression. Engraftment occurred in 98%. Four-year overall survival was 69% (95% confidence interval [CI], 52%-81%), and leukemia-free survival was 64% (95% CI, 48%-76%), with no difference between lymphoid and myeloid malignancies (P = .6297 and P = .5441, respectively). One patient (1.7%) experienced primary graft failure. Relapse occurred in 11 patients (3-year cumulative incidence, 21%; 95% CI, 11-34), and 8 patients (cumulative incidence, 15%; 95% CI, 6.7-26) experienced nonrelapse mortality. Grade III to IV acute GVHD was seen in 8 patients (13%), and 14 patients (26%) developed chronic GVHD, of which 6 (11%) had extensive disease. Nonpermissive DP mismatch was associated with higher likelihood of acute GVHD (odds ratio, 16.50; 95% CI, 1.67-163.42; P = .0166) but not with the development of chronic GVHD. URD TCRαβ/CD19-depleted peripheral HSCT is a safe and effective approach to transplantation for children/YAs with leukemia. This trial was registered at www.clinicaltrials.gov as #NCT02323867.
Targeting CD70 in cutaneous T-cell lymphoma using an antibody-drug conjugate in patient-derived xenograft models
Authors: Wu Chi-Heng , Wang Linlin , Yang Chen-Yen , Wen Kwun Wah , Hinds Brian , Gill Ryan , McCormick Frank , Moasser Mark , Pincus Laura , Ai Weiyun Z.
Published: December 2021

CD70 is a member of the tumor necrosis factor receptor superfamily. Emerging data indicate that CD70 may be a suitable target for various malignancies. We investigated the expression of CD70 in cutaneous and systemic T-cell lymphomas and conducted preclinical studies of SGN-CD70A, a CD70-directed antibody-drug conjugate (ADC), using patient-derived xenograft cutaneous T-cell lymphoma (CTCL PDX) models. CD70 expression was examined by immunohistochemical (IHC) stains in 49 diagnostic specimens of T-cell lymphomas. The activities of SGN-CD70A in growth inhibition and apoptosis induction were examined in CTCL cell lines and primary CTCL tumor cells. Using previously established CTCL PDXs, we conducted a dose-finding trial followed by a phase 2-like trial to evaluate the optimal dosing and the efficacy of SGN-CD70A in tumor-bearing PDX animals. The therapeutic efficacy of SGN-CD70A was measured by tumor-associated cell-free DNA (cfDNA) and survival of treated PDXs. We found that CD70 is highly expressed in T-cell lymphomas, especially in CTCL. SGN-CD70A inhibited cell growth and induced apoptosis in CD70-expressing CTCL cell lines and primary tumors cells. Additionally, SGN-CD70A at 100 μg/kg and 300 μg/kg prolonged the survival of PDXs in a dose-dependent manner. Finally, treatment with 3 doses of SGN-CD70A at 300 μg/kg was superior to a single-dose treatment in survival prolongation (median survival: 111 days vs 39 days; P = .017). Most importantly, multiple dosing of SGN-CD70A induced complete eradication of established tumors in PDXs measured by cfDNA. Our results demonstrated marked antitumor activity of SGN-CD70A in CTCL PDXs, providing compelling support for its clinical investigation.
Whole-genome resequencing of three Coilia nasus population reveals genetic variations in genes related to immune, vision, migration, and osmoregulation
Authors: Gao Jun , Xu Gangchun , Xu Pao
Published: December 2021

Background

Coilia nasus is an important anadromous fish, widely distributed in China, Japan, and Korea. Based on morphological and ecological researches of C. nasus, two ecotypes were identified. One is the anadromous population (AP). The sexually mature fish run thousands of kilometers from marine to river for spawning. Another one is the resident population which cannot migrate. Based on their different habitats, they were classified into landlocked population (LP) and sea population (SP) which were resident in the freshwater lake and marine during the entire lifetime, respectively. However, they have never been systematically studied. Moreover, C. nasus is declining sharply due to overfishing and pollution recently. Therefore, further understandings of C. nasus populations are needed for germplasm protection.

Results

Whole-genome resequencing of AP, LP, and SP were performed to enrich the understanding of different populations of C. nasus. At the genome level, 3,176,204, 3,307,069, and 3,207,906 single nucleotide polymorphisms (SNPs) and 1,892,068, 2,002,912, and 1,922,168 insertion/deletion polymorphisms (InDels) were generated in AP, LP, and SP, respectively. Selective sweeping analysis showed that 1022 genes were selected in AP vs LP; 983 genes were selected in LP vs SP; 116 genes were selected in AP vs SP. Among them, selected genes related to immune, vision, migration, and osmoregulation were identified. Furthermore, their expression profiles were detected by quantitative real-time PCR. Expression levels of selected genes related to immune, and vision in LP were significantly lower than AP and SP. Selected genes related to migration in AP were expressed significantly more highly than LP. Expression levels of selected genes related to osmoregulation were also detected. The expression of NKAα and NKCC1 in LP were significantly lower than SP, while expression of NCC, SLC4A4, NHE3, and V-ATPase in LP was significantly higher than SP.

Conclusions

Combined to life history of C. nasus populations, our results revealed that the molecular mechanisms of their differences of immune, vision, migration, and osmoregulation. Our findings will provide a further understanding of different populations of C. nasus and will be beneficial for wild C. nasus protection.
Frailty as a growing challenge for anesthesiologists – results of a Dutch national survey
Authors: Bouwhuis A. , van den Brom C. E. , Loer S. A. , Bulte C. S. E.
Published: December 2021

Background

Frailty is a multidimensional condition characterized by loss of functional reserve, which results in increased vulnerability to adverse outcomes following surgery. Anesthesiologists can reduce adverse outcomes when risk factors are recognized early and dedicated care pathways are operational. As the frail elderly population is growing, we investigated the perspective on the aging population, familiarity with the frailty syndrome and current organization of perioperative care for elderly patients among Dutch anesthesiologists.

Methods

A fifteen-item survey was distributed among anesthesiologists and residents during the annual meeting of the Dutch Society of Anesthesiology. The first section included questions on self-reported competence on identification of frailty, acquaintance with local protocols and attitude towards the increasing amounts of elderly patients presenting for surgery. The second part included questions on demographic features of the participant such as job position, experience and type of hospital. Answers are presented as percentages, using the total number of replies for the question per group as a denominator.

Results

A sample of 132 surveys was obtained. The increasing number of elderly patients was primarily perceived as challenging by 76% of respondents. Ninety-nine percent agreed that frailty should influence anesthetic management, while 85% of respondents claimed to feel competent to recognize frailty. Thirty-four percent of respondents reported the use of a dedicated pathway in the preoperative approach of frail elderly patients. However, only 30% of respondents reported to know where to find the frailty screening in the patient file and appointed that frailty is not consistently documented. Interestingly, only 43% of respondents reported adequate collaboration with geriatricians. This could include for example a standardized preoperative multidisciplinary approach or dedicated pathway for the elderly patient.

Conclusions

This survey demonstrated that the increasing number of frail elderly patients is perceived as important and relevant for anesthetic management. Opportunities lie in improving the organization and effectuation of perioperative care by more consistent involvement of anesthesiologists.
Safety and efficacy of hydroxychloroquine for treatment of non-severe COVID-19 among adults in Uganda: a randomized open label phase II clinical trial
Authors: Byakika-Kibwika Pauline , Sekaggya-Wiltshire Christine , Semakula Jerome Roy , Nakibuuka Jane , Musaazi Joseph , Kayima James , Sendagire Cornelius , Meya David , Kirenga Bruce , Nanzigu Sarah , Kwizera Arthur , Nakwagala Fred , Kisuule Ivan , Wayengera Misaki , Mwebesa Henry G. , Kamya Moses R. , Bazeyo William
Published: December 2021

Background

Several repurposed drugs such as hydroxychloroquine (HCQ) have been investigated for treatment of COVID-19, but none was confirmed to be efficacious. While in vitro studies have demonstrated antiviral properties of HCQ, data from clinical trials were conflicting regarding its benefit for COVID-19 treatment. Drugs that limit viral replication may be beneficial in the earlier course of the disease thus slowing progression to severe and critical illness.

Design

We conducted a randomized open label Phase II clinical trial from October–December 2020.

Methods

Patients diagnosed with COVID-19 using RT-PCR were included in the study if they were 18 years and above and had a diagnosis of COVID-19 made in the last 3 days. Patients were randomized in blocks, to receive either HCQ 400 mg twice a day for the first day followed by 200 mg twice daily for the next 4 days plus standard of care (SOC) treatment or SOC treatment alone. SARS COV-2 viral load (CT values) from RT-PCR testing of samples collected using nasal/orapharyngeal swabs was performed at baseline, day 2, 4, 6, 8 and 10. The primary outcome was median time from randomization to SARS COV-2 viral clearance by day 6.

Results

Of the 105 participants enrolled, 55 were assigned to the intervention group (HCQ plus SOC) and 50 to the control group (SOC only). Baseline characteristics were similar across treatment arms. Viral clearance did not differ by treatment arm, 20 and 19 participants respectively had SARS COV-2 viral load clearance by day 6 with no significant difference, median (IQR) number of days to viral load clearance between the two groups was 4(3–4) vs 4(2–4): p = 0.457. There were no significant differences in secondary outcomes (symptom resolution and adverse events) between the intervention group and the control group. There were no significant differences in specific adverse events such as elevated alkaline phosphatase, prolonged QTc interval on ECG, among patients in the intervention group as compared to the control group.

Conclusion

Our results show that HCQ 400 mg twice a day for the first day followed by 200 mg twice daily for the next 4 days was safe but not associated with reduction in viral clearance or symptom resolution among adults with COVID-19 in Uganda.

Trial registration: NCT04860284.
Long-term ocular damage after recovery from COVID-19: lack of evidence at three months
Authors: Brantl Victor , Schworm Benedikt , Weber Gregor , Schiefelbein Johannes , Kreutzer Thomas C. , Michalakis Stylianos , Siedlecki Jakob , Priglinger Siegfried G.
Published: December 2021

Importance

A small number of COVID-19 patients has been reported to suffer from acute keratoconjunctivitis. In very rare cases, acute inflammatory retinal vein occlusion, papillophlebitis or retinopathy have been observed.

Objective

To determine possible long-term effects on the eye, especially on the retina, in patients who had suffered from COVID-19 at least 3 months after recovery.

Design

Prospective cross-sectional study.

Setting

Hospital of the Ludwig Maximilians University, Munich.

Participants

Patients who had been tested positive for SARS-CoV-2 or for anti-SARS-CoV-2 IgG serum antibodies in the Hospital of the Ludwig Maximilians University, Munich between May and September.

Methods

Patients who had tested positive were either hospitalized or discharged into home quarantine via the emergency room. Three months after recovery, they were invited to participate voluntarily for this study during their follow-up in our clinic. A complete ophthalmological exam including functional and imaging end points (including optical coherence tomography (OCT), OCT angiography) was performed.

Main outcomes and measures

Visual acuity, slit lamp, bio microscopy and fundoscopy, multimodal imaging findings.

Results

In total, 21 patients were examined. The mean age (SD) of the patients was 48.7 (18.3) years. Of these, 14 (66.6%) were hospitalized and 7 (33.3) were discharged home. Two hospitalized patients (9.5%) received invasive ventilation.

During the infection, 14 of the 21 patients (66.6%) were in regular care whereas 2 patients (9.5%) received intensive care ventilation for 8.5 (SD) (0.7) days on average in the COVID ICU. Ophthalmological examination of the previously hospitalized group took place 111.4 (23.2) days after recovery and discharge from the hospital, while non-hospitalized patients were examined after mean 123.4 (44.7) days. All patients showed normal findings for anterior and posterior segment of both eyes. OCT and OCT-A showed no evidence of retinal damage, or vascular or microvascular events.

Conclusion and relevance

This study with a small prospective cohort of 21 patients indicates that there might be no evidence of ocular complications at 3 months after recovery from COVID-19, without previous eye involvement. Further studies with more participants with and without acute ocular symptoms are necessary for final evidence.
Factors associated with stunting among children aged 6–59 months in Bensa District, Sidama Region, South Ethiopia: unmatched case-control study
Authors: Tafesse Temesgen , Yoseph Amanuel , Mayiso Kaleb , Gari Taye
Published: December 2021

Background

Stunting remains one of the most common malnutrition problems among children in Ethiopia. Identifying the risk factors of stunting assists health planners to prioritize prevention strategies, and is a fundamental step for intervention. Therefore, this study aimed to assess factors associated with stunting among children aged 6–59 months in Bensa district, Sidama Region, South Ethiopia, 2018.

Methods

A facility-based unmatched case-control study was conducted from January 10 to March 10, 2018, on a sample of 237(79 cases and 158 controls) children aged 6–59 months with their respective mothers/caretakers. Data were collected using a structured, face-to-face interviewer-administered questionnaire and standard physical measurements. The data were entered into EP INFO version 7 and WHO Anthro software and analyzed using SPSS version 20. The variables were entered into the multivariable model using the backward stepwise regression approach. Multivariable logistic regression analysis was used to identify factors associated with stunting. Adjusted odds ratio (AOR) with 95% confidence interval (95%CI) and p-value <0.05 was used to declare the significance.

Results

Sex distribution was almost equal (Males = 52.3%, Females = 47.7%).The mean (standard deviation) age of cases and controls was 27.35 (±12.71) and 28.70 (±13.27) months respectively.

The risk factors for stunting were diarrhea in the past two weeks (AOR = 2.71, 95% CI: 1.42–5.16), being male (AOR = 2.37, 95% CI: 1.224–4.59), inappropriate exclusive breastfeeding (AOR =2.07, 95%CI: 1.07–4.01), having less than or equal to three under-five children in the household (AOR = 2.18, 95%CI: 1.03–4.64), and mothers who had no formal education (AOR =3.28, 95%CI :1.56–6.924).

Conclusions

Diarrhea in the past two weeks, sex of a child, inappropriate exclusive breastfeeding, number of under-five children in the household, and mothers who had no formal education were the risk factors of stunting. Thus organized efforts aimed at focus on prevention of diarrhea as part of an overall public health strategy for improving child health and nutrition. Educating mothers/caretakers on the importance of exclusive breastfeeding should be considered. Moreover, mothers need to be encouraged to space birth between children through the use of family planning services.
Employment of color Doppler echocardiographic video clips in a cardiac auscultation class with a cardiology patient simulator: discrepancy between students’ satisfaction and learning
Authors: Kagaya Yutaka , Tabata Masao , Arata Yutaro , Kameoka Junichi , Ishii Seiichi
Published: December 2021

Background

We have provided fourth-year medical students with a three-hour cardiac auscultation class using a cardiology patient simulator since 2010. The test results of 2010-2012 revealed that as compared with aortic stenosis murmur, students correctly identified murmurs of other valvular diseases less often. We investigated whether employment of color Doppler echocardiographic video clips would improve proficiency in identifying murmurs of aortic regurgitation and mitral regurgitation, and whether students’ favorable responses to a questionnaire were associated with improved proficiency.

Methods

A total of 250 fourth-year medical students were divided into groups of 7-9 students in 2014 and 2015. Each group attended a three-hour cardiac auscultation class comprising a mini-lecture, facilitated training, two different auscultation tests (the second test being closer to clinical setting than the first) and a questionnaire. We provided each student with color Doppler echocardiographic videos of aortic regurgitation and mitral regurgitation using a tablet computer, which they freely referred to before and after listening to corresponding murmurs. The test results were compared with those in 2010-2012. The students had already completed the course of cardiovascular medicine, comprising lectures including those of physical examination, echocardiography, and valvular heart diseases, before participating in this auscultation training class.

Results

Most students indicated that the videos were useful or somewhat useful regarding aortic regurgitation (86.3%) and mitral regurgitation (85.7%). The accuracy rates were 78.4% (81.2% in 2010-2012) in aortic regurgitation and 76.0% (77.8%) in mitral regurgitation in the first test, and 83.3% (71.4%) in aortic regurgitation and 77.1% (77.6%) in mitral regurgitation in the second test, showing no significant differences as compared to 2010-2012. Overall accuracy rate of all heart sounds and murmurs in the first test and that of second/third/fourth sounds in the first and second tests were significantly lower in 2014-2015 than in 2010-2012.

Conclusions

Referring to color Doppler echocardiographic video clips in the way employed in the present study, which most students regarded as useful, did not improve their proficiency in identifying the two important regurgitant murmurs, revealing a discrepancy between students’ satisfaction and learning. Video clips synchronized with their corresponding murmurs may contribute toward improving students’ proficiency.
Value of pharmacy services upon admission to an orthopedic surgery unit
Authors: Ouweini Ahmad El , Karaoui Lamis R. , Chamoun Nibal , Assi Chahine , Yammine Kaissar , Ramia Elsy
Published: December 2021

Background

In Lebanon, the role of the pharmacist remains underestimated in the medication reconciliation process, especially in surgical departments. This study aims to assess the impact of pharmacist-conducted medication reconciliation performed within 48 h of hospital admission to the orthopedic surgical department.

Methods

This was a prospective single-arm study conducted in a tertiary-care teaching hospital in Lebanon between October 2019 and April 2020. Participants were adult inpatients hospitalized for orthopedic surgeries with ≥ 1 outpatient medications. Properly trained pharmacy resident obtained the Best Possible Medication History (BPMH) and led the reconciliation process. The primary endpoint was the number of reconciliation errors (REs) identified. Descriptive statistics were used to report participants’ responses and relevant findings. Linear regression was performed with the number of REs as a continuous dependent variable using backward method. Results were assumed to be significant when p was < 0.05.

Results

The study included 100 patients with a mean age of 73.8 years, admitted for elective (54%) or emergency (46%) surgeries. Half of the study population had ≥ 5 home medications. The mean time for taking BPMH was around 8 min. A total of 110 REs were identified in 74 patient cases. The most common discrepancies consisted of medication omission (89.1%) and the most common medications involved were antihyperlipidemic agents. Twenty-four REs were judged as clinically significant, and four as serious. The most common interventions included the addition of a medication (71.9%). Most of the relayed interventions (84.5%) were accepted. The number of home medications was the only variable significantly associated with the number of REs (β 0.492; p < 0.001).

Conclusion

Pharmacy-led medication reconciliation upon admission to orthopedic surgery department can reduce reconciliation errors and improve medication safety.

Trial registration

Retrospectively registered in the Lebanon Clinical Trials Registry (LBCTR2020124680).
Assessment of the potential impact of resolving drug-related problems by clinical pharmacists in Japan: a retrospective observational study
Authors: Oki Toshiya , Ishii Sachi , Furukawa Koya , Shono Aiko , Akazawa Manabu
Published: December 2021

Background

Clinical pharmacists play a role in limiting the disadvantages of pharmacotherapy for patients by detecting and resolving drug-related problems (DRPs) through medication reviews. Although their contributions to patient care have been analyzed and understood in various countries, the role of Japanese clinical pharmacists in this context remains to be clearly elucidated. Thus, in this study, we aimed to elucidate the detection of DRPs by clinical pharmacists and determine the potential impact of pharmacist interventions in Japan.

Methods

This study was conducted in a 273-bed hospital and targeted hospitalized patients over a period of 6 months. DRPs detected by clinical pharmacists during the study period were investigated and classified into 10 types. Furthermore, medications were categorized according to the Anatomical Therapeutic Chemical classification. A review committee consisting of two pharmacists independently reviewed the pharmacist interventions on a six-point scale (extremely significant, very significant, significant, somewhat significant, no significance, adverse significance) according to the potential impact on patient care.

Results

During the study period, 1711 patients (mean age: 71.2 years, 54.1% male) were included, and 2149 DRPs were detected (1.26 DRPs/patient). Pharmacists intervened in all the DRPs detected. The most common DRP was supratherapeutic dosage (19.3%), followed by untreated indication (18.1%). The most common medication classification causing DRPs was “Antiinfectives for Systemic Use” (25.1%), followed by “Alimentary Tract and Metabolism” (19.9%). Most of the pharmacist interventions (99.6%) were rated “somewhat significant” or more significant, of which 1.1% were rated “extremely significant,” and none were rated as “adverse significance.”

Conclusions

Our results show that in Japan, as in other countries, clinical pharmacists detect and resolve DRPs in hospitalized patients through medication review. Our findings also show that clinical pharmacists have a positive impact on patient care and suggest the need for their involvement.
Comparison of dynamic updating strategies for clinical prediction models
Authors: Schnellinger Erin M. , Yang Wei , Kimmel Stephen E.
Published: December 2021

Background

Prediction models inform many medical decisions, but their performance often deteriorates over time. Several discrete-time update strategies have been proposed in the literature, including model recalibration and revision. However, these strategies have not been compared in the dynamic updating setting.

Methods

We used post-lung transplant survival data during 2010-2015 and compared the Brier Score (BS), discrimination, and calibration of the following update strategies: (1) never update, (2) update using the closed testing procedure proposed in the literature, (3) always recalibrate the intercept, (4) always recalibrate the intercept and slope, and (5) always refit/revise the model. In each case, we explored update intervals of every 1, 2, 4, and 8 quarters. We also examined how the performance of the update strategies changed as the amount of old data included in the update (i.e., sliding window length) increased.

Results

All methods of updating the model led to meaningful improvement in BS relative to never updating. More frequent updating yielded better BS, discrimination, and calibration, regardless of update strategy. Recalibration strategies led to more consistent improvements and less variability over time compared to the other updating strategies. Using longer sliding windows did not substantially impact the recalibration strategies, but did improve the discrimination and calibration of the closed testing procedure and model revision strategies.

Conclusions

Model updating leads to improved BS, with more frequent updating performing better than less frequent updating. Model recalibration strategies appeared to be the least sensitive to the update interval and sliding window length.
Fifth lumbar vertebrae solitary osteochondroma arising from the neural arch, a case report
Authors: Zaher Mohamed Abdel , Alzohiry Mohammad Ali , Fadle Amr A. , Khalifa Ahmed A. , Refai Omar
Published: December 2021

Background

Osteochondromas are a benign outgrowth of bone and cartilage and one of the most common bone tumors that usually occur in long bones, with only 1–4% being located in the spine, more frequently in the cervical and upper dorsal region, and rarely the lumbar spine. Here, we report a case of lumbar spine (L5) osteochondroma arising from the neural arch.

Case presentation

A 30-year-old man presenting with a solid painless mass at the lower lumbar region. No neurological symptoms. Radiological examinations revealed an exophytic lesion in the fifth lumbar articular process, and the spinous process appears to be a solitary osteochondroma. Lumbar spine magnetic resonance imaging showed a bony lesion covered by a 2-mm-thick cartilaginous cap. Surgical en bloc resection of the mass was performed, and the histopathological examination confirmed the diagnosis of osteochondroma. No evidence of recurrence at the end of 4-year follow-up.

Conclusion

Osteochondromas are benign tumors rarely present in the spine; diagnosis can be made by the typical appearance of the cartilaginous cap over the mass in the magnetic resonance imaging. Surgical excision is the best management option.
A universal Wi-Fi fingerprint localization method based on machine learning and sample differences
Authors: Cao Xiaoxiang , Zhuang Yuan , Yang Xiansheng , Sun Xiao , Wang Xuan
Published: December 2021

Wi-Fi technology has become an important candidate for localization due to its low cost and no need of additional installation. The Wi-Fi fingerprint-based positioning is widely used because of its ready hardware and acceptable accuracy, especially with the current fingerprint localization algorithms based on Machine Learning (ML) and Deep Learning (DL). However, there exists two challenges. Firstly, the traditional ML methods train a specific classification model for each scene; therefore, it is hard to deploy and manage it on the cloud. Secondly, it is difficult to train an effective multi-classification model by using a small number of fingerprint samples. To solve these two problems, a novel binary classification model based on the samples’ differences is proposed in this paper. We divide the raw fingerprint pairs into positive and negative samples based on each pair’s distance. New relative features (e.g., sort features) are introduced to replace the traditional pair features which use the Media Access Control (MAC) address and Received Signal Strength (RSS). Finally, the boosting algorithm is used to train the classification model. The UJIndoorLoc dataset including the data from three different buildings is used to evaluate our proposed method. The preliminary results show that the floor success detection rate of the proposed method can reach 99.54% (eXtreme Gradient Boosting, XGBoost) and 99.22% (Gradient Boosting Decision Tree, GBDT), and the positioning error can reach 3.460 m (XGBoost) and 4.022 m (GBDT). Another important advantage of the proposed algorithm is that the model trained by one building’s data can be well applied to another building, which shows strong generalizable ability.
Iron deficiency in preschool non-anemic Egyptian children
Authors: El-Asheer Osama M. , Naeem Mary S. , Abdel-Hafez Fardos A. , Abdou Madleen A. A. , Mohamed Khalil A.
Published: December 2021

Background

Iron deficiency anemia remains a common cause of anemia in young children. The term iron deficiency without anemia, or the so-called latent iron deficiency, has become increasingly significant as it is not only difficult to identify this condition in non-anemic children, but it also adversely affects neurocognitive development, and unfortunately, some of these effects may be irreversible and not respond to treatment. This cross-sectional study was conducted to evaluate iron status in 68 apparently healthy, non-anemic Egyptian children aged 1–6 years. They were subjected to detailed history-taking, physical examination, complete blood count, and tests for serum iron, total iron binding capacity, serum ferritin, and transferrin saturation.

Results

Low serum ferritin level and low transferrin saturation were detected in 41.2% and 47% of the children, respectively. Iron deficiency parameters were significantly affected among toddlers aged “1” to “3” years compared with preschool children, and boys were found to be more affected than girls of the same age group.

Conclusions

A normal hemoglobin level does not exclude iron deficiency, which should be screened in healthy children to prevent the possible long-term effects of iron deficiency on their cognition and mental development.
Management of labial adhesion in a developing country—an observational study
Authors: Srivastava Saurabh , Pandey Anand , Kumar Piyush , Gupta Survesh K. , Singh Sudhir , Rawat Jiledar
Published: December 2021

Background

Labial adhesion is the fusion of the labia minora or majora. The literature reports conservative management. However, the situation may be different in our setup, where management differs due to prevailing circumstances. The present study was conducted to evaluate labial adhesion presentation, management, and outcome in our center.

Methods

It was a retrospective observational study from January 2015 to January 2020. The patients were evaluated for age at presentation, presenting symptoms, type of adhesions, treatment, recurrence, and follow-up. The treatment included the manual release of labial adhesion and Mupirocin ointment application for 15 days. They were advised to attend the outpatient department after 1 month for evaluation and later on in case of any problem.

Results

The total number of patients was 150, of which 104 (69.33%) were from rural backgrounds. The complaint was of the absent vaginal opening in all patients. Seventeen (11.33%) were advised ultrasonography of the abdomen elsewhere to look for the presence of internal genital organs. The local examination revealed poor hygiene in 65 (43.33%) patients. The patient with thick adhesions has minor erythema after the release of adhesions. Ten (6.66%) patients had a recurrence managed by repeat release with no recurrence.

Conclusion

Despite being a benign entity, labial adhesion may be a cause of severe concern. Manual separation and antibiotic ointment may be a viable first option in its management with minimal recurrence. Maintenance of local hygiene may be needed to prevent a recurrence. The overall outcome is excellent.
Histopathology of intersymphyseal band and its correlation with continence in bladder exstrophy repair
Authors: Kulkarni Bharati K. , Saxena Nandita , Borwankar Shyam S. , Lahoti Hemant N. , Multani Pooja , Goel Dipesh
Published: December 2021

Background

Urinary incontinence is a major problem in operated exstrophy patients. Most of the repairs described in literature stress on the importance of dividing the intersymphyseal band (ISB) to place the bladder in the pelvis. But the origin of this band and its importance has hardly been discussed in literature. The purpose of this study is to establish the nature of tissue the ISB is composed of. This can be used to determine its role in the surgical management of exstrophy epispadias complex (EEC) patients.

Results

Thirty out of 33 operated patients demonstrated smooth muscle with/without fibrous tissue in the sections taken through the ISB.

A significant percentage of patients (χ2= 38.319, p < 0.0001) in whom this band was reconstructed around the bladder neck gradually became continent/partly continent with an increase in the dry interval with time.

Conclusion

It can be a considerable factor to pay attention to the step of wrapping the ISB around the bladder neck during EEC repair. This serves to function as the smooth muscle of the bladder neck as proven histologically in our operated patients. It may have a role to support future continence in these patients.
Mental health support for children and adolescents with hearing loss: scoping review
Authors: Scherer Nathaniel , Bright Tess , Musendo David John , O'Fallon Timothy , Kubwimana Chris , Eaton Julian , Kakuma Ritsuko , Smythe Tracey , Polack Sarah
Published: December 2021

Background

Children with hearing loss are at increased risk of mental health conditions, including behavioural problems, but there is limited evidence about available mental health support.

Aims

We aimed to map the evidence on mental health support for children and adolescents with hearing loss.

Method

Medline, Embase, PsycINFO and grey literature databases were searched until April 2021. Articles of any study design were eligible if they described an intervention supporting the mental health of children with hearing loss. No restrictions were placed on geography or publication date. Four reviewers independently screened results by title, abstract and full text. Study characteristics and outcome data were extracted, with results narratively synthesised.

Results

From 5629 search results, 27 articles were included. A large majority of the studies (81%, n = 22) were from high-income settings, with two-thirds (67%, n = 18) conducted in the USA. Less than half (41%, n = 11) of the articles adopted experimental research designs, and the majority of studies included small samples. The interventions presented were diverse, with the majority either therapy based (30%, n = 8) or skills training (30%, n = 8). Interventions included ice-skating, parent–child interaction therapy and resilience training. When measured, interventions demonstrated at least some evidence of effectiveness, although this was not always assessed with gold-standard methodology.

Conclusions

The evidence is lacking in breadth, study quality and geographical spread. That said, what is available indicates a range of effective approaches to support the mental health of children with hearing loss. Additional research is needed to improve the breadth of evidence on mental health support for this population.
Electroencephalographic Burst-Suppression, Perioperative Neuroprotection, Postoperative Cognitive Function, and Mortality: A Focused Narrative Review of the Literature
Authors: Ma Kan , Bebawy John F.
Published: December 2021

Burst-suppression is an electroencephalographic pattern that results from a diverse array of pathophysiological causes and/or metabolic neuronal suppression secondary to the administration of anesthetic medications. The purpose of this review is to provide an overview of the physiological mechanisms that underlie the burst-suppression pattern and to present in a comprehensive way the available evidence both supporting and in opposition to the clinical use of this electroencephalographic pattern as a therapeutic measure in various perioperative settings.
Black Church Rumor
Authors: Greene-Hayes Ahmad
Published: December 2021

In 1992, Jet published “James Cleveland Infected L.A. Youth with HIV, $9 Mil. Lawsuit Claims,” which detailed how the Chicago-born gospel musician had not only allegedly sexually abused his foster son, Christopher B. Harris, but had also “[given] him the AIDS virus.” This article takes this incident of rumor or accusation as a critical opportunity to think about the archival reality of Black queer sexuality, on one hand, and sexual violence in Black gospel music history on the other. Using the legal documents from Christopher B. Harris v. Irwin Goldring as Special Administrator of the Estate of James Cleveland and commentary from Cleveland's contemporaries, it exhumes Cleveland from dusty church closets for consideration in the history of HIV and AIDS in African American Protestant church and gospel communities and in Black queer studies, ethnomusicology, and gender and sexuality studies. Further, it theorizes “Black church rumor” as a lens for Black queer religious studies and argues that Cleveland's perceived queer sexuality distracted from Harris's allegations of sexual abuse. Thus, it situates Cleveland—the person, the preacher, and the gospel legend—in the literature on “down low” sexuality and explicates the implications of Cleveland's legacy and role in Black gospel music production.
Διερεύνηση της ποιότητας ζωής ασθενών με παθήσεις της ωχράς κηλίδας
Authors: Παπαλάμπρου Μάριος
Published: December 2021

Σκοπός: Ο σκοπός αυτής της µελέτης ήταν να διερευνήσει τον αντίκτυπο στην ποιότητα ζωής των ασθενών µε ηλικιακή εκφύλιση της ωχράς κηλίδας (AMD) σε σχέση µε τις πιο συχνές ψυχικές διαταραχές, δηλαδή το άγχος και την κατάθλιψη, και να προσδιορίσει συγκεκριµένους παράγοντες (π.χ. σκέψεις/συναισθήµατα, κοινωνικοδηµογραφικά χαρακτηριστικά) που µπορούν να χρησιµοποιηθούν για την παραποµπή τέτοιων ασθενών σε ψυχίατρους.Υλικά – Μέθοδοι: Για να ταξινοµηθούν οι ασθενείς σε διαφορετικές κατηγορίες, σχετικά µε την ανάπτυξη των υπό εξέταση ψυχικών διαταραχών, χρησιµοποιήθηκε το Ερωτηµατολόγιο «Νοσοκοµειακής Κλίµακας ΄Αγχους και Κατάθλιψης» (HADS). Οι κύριες στατιστικές µεθοδολογίες που εφαρµόζονται είναι τα δέντρα ταξινόµησης και παλινδρόµησης (CART) και η λογιστική παλινδρόµηση. Για τους σκοπούς της προαναφερθείσας στατιστικής ανάλυσης, έχει χρησιµοποιηθεί το πακέτο λογισµικού R.Αποτελέσµατα: Τόσο η βαθµολογία της κατάθλιψης όσο και του άγχους διέφεραν σηµαντικά ανάλογα µε την σοβαρότητα της οπτικής οξύτητας. Οι ασθενείς µε σοβαρά προβλήµατα οπτικής οξύτητας τείνουν να έχουν επίσης υψηλότερες βαθµολογίες HADS. Οι γυναίκες ήταν πιο πιθανό να επηρεαστούν από την κατάθλιψη. Οι κοινωνιοδηµογραφικοί παράγοντες δεν είχαν καµία σηµαντική επίδραση. Σύµφωνα µε την ανάλυση CART που πραγµατοποιήθηκε, οι απαντήσεις σε δύο ερωτήσεις του ερωτηµατολογίου HADS (συγκεκριµένα, «Μπορώ να απολαµβάνω ένα ενδιαφέρον βιβλίο ή ένα ραδιοφωνικό/τηλεοπτικό πρόγραµµα » και «΄Εχασα το ενδιαφέρον για την εµφάνισή µου») αναγνώρισαν την συντριπτική πλειονότητα των ασθενών µε σοβαρή έως µέτρια κατάθλιψη. Επιπλέον, το επίπεδο σοβαρότητας της οπτικής οξύτητας βρέθηκε ως βασικός παράγοντας για τη διάγνωση ασθενών µε AMD µε κατάθλιψη.Συµπεράσµατα: Το επίπεδο σοβαρότητας της οπτικής οξύτητας (ή της µείωσης της) βρέθηκε να είναι ο κύριος παράγοντας που σχετίζεται µε την κατάθλιψη σε ασθενείς µε AMD. Επιπλέον, συγκεκριµένες σκέψεις/συναισθήµατα που υπάρχουν σε ασθενείς µε AMD έχουν βρεθεί ως σηµαντικά σχετικά µε το επίπεδο των υπό εξέταση ψυχικών διαταραχών τους και θα µπορούσε ο οφθαλµίατρος να τους παραπέµψει σε ψυχίατρο.