bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative transcriptome and miRNA analysis of skin pigmentation during embryonic development of Chinese soft-shelled turtle (Pelodiscus sinensis)
Authors: Wang Pei , Xiong Gang , Zeng Dan , Zhang Jianguo , Ge Lingrui , Liu Li , Wang Xiaoqing , Hu Yazhou
Published: December 2022

Background

Aquatic animals show diverse body coloration, and the formation of animal body colour is a complicated process. Increasing evidence has shown that microRNAs (miRNAs) play important regulatory roles in many life processes. The role of miRNAs in pigmentation has been investigated in some species. However, the regulatory patterns of miRNAs in reptile pigmentation remain to be elucidated. In this study, we performed an integrated analysis of miRNA and mRNA expression profiles to explore corresponding regulatory patterns in embryonic body colour formation in the soft-shelled turtle Pelodiscus sinensis.

Results

We identified 8 866 novel genes and 9 061 mature miRNAs in the skin of Chinese soft-shelled turtles in three embryonic stages (initial period: IP, middle period: MP, final period: FP). A total of 16 563 target genes of the miRNAs were identified. Furthermore, we identified 2 867, 1 840 and 4 290 different expression genes (DEGs) and 227, 158 and 678 different expression miRNAs (DEMs) in IP vs. MP, MP vs. FP, and IP vs. FP, respectively. Among which 72 genes and 25 miRNAs may be related to turtle pigmentation in embryonic development. Further analysis of the novel miRNA families revealed that some novel miRNAs related to pigmentation belong to the miR-7386, miR-138, miR-19 and miR-129 families. Novel_miR_2622 and novel_miR_2173 belong to the miR-19 family and target Kit and Gpnmb, respectively. The quantification of novel_miR_2622 and Kit revealed negative regulation, indicating that novel_miR_2622 may participate in embryonic pigmentation in P. sinensis by negatively regulating the expression of Kit.

Conclusions

miRNA act as master regulators of biological processes by controlling the expression of mRNAs. Considering their importance, the identified miRNAs and their target genes in Chinese soft-shelled turtle might be useful for investigating the molecular processes involved in pigmentation. All the results of this study may aid in the improvement of P. sinensis breeding traits for aquaculture.
Association of high body mass index, waist circumference, and body fat percentage with sarcopenia in older women
Authors: Yoo Myung Chul , Won Chang Won , Soh Yunsoo
Published: December 2022

Background

Age-related obesity and body composition changes include loss of muscle mass and increased body fat. This study aimed to investigate sex differences in the impact of sarcopenia, defined by the Asian Working Group for Sarcopenia (AWGS), on obesity in Korean older adults.

Methods

In this 2-year longitudinal study, 3014 participants were excluded based on AWGS sarcopenia parameters (if any one of the sarcopenic parameter criteria was satisfied), including low handgrip strength (HGS), low appendicular skeletal muscle mass index (ASMI), and low short physical performance battery (SPPB). A total of 926 non-sarcopenic participants were recruited for the study. The obese and non-obese groups were compared according to the sarcopenia parameters. The following variables were selected for obesity analysis: body mass index (BMI), waist circumference (WC), and body fat percentage. Unadjusted and fully adjusted logistic regression analyses were performed for each variable to predict sarcopenia and sarcopenic obesity according to sex.

Results

Among the sarcopenia parameters, reduction in ASMI was significantly lower in the obese group with high WC and percentage of body fat (PBF) in both men and women (P < 0.01). Multivariable analysis revealed that different obesity parameters were associated with AWGS criteria: women in the high BMI group presented significantly lower ASMI and sarcopenia (ASMI, OR = 0.289, 95% CI = 0.174-0.480; sarcopenia, OR = 0.152, 95% CI = 0.048-0.483). Women in the high WC group had significantly lower ASMI and sarcopenia (ASMI, OR = 0.307, 95% CI = 0.189-0.500; sarcopenia, OR = 0.262, 95% CI = 0.106-0.649). Women in the high PBF group had a lower incidence of sarcopenia (OR = 0.214, 95% CI = 0.068-0.278).

Conclusions

Our study identified that high BMI had a protective effect on the reduction of muscle mass in men and women. However, obesity parameters including BMI, WC, and PBF were positively correlated with a lower incidence of sarcopenia only in women. Obesity in older women may have a protective effect in reducing ASMI and the incidence of sarcopenia.
Risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for the treatment of periprosthetic joint infection
Authors: Wang Qingkai , Huang Jincheng , Chen Xiao , Jin Yi
Published: December 2022

Background

Prosthesis removal and antibiotic bone cement spacer implantation is a very important link in two-stage revision of periprosthetic joint infection (PJI) after artificial joint replacement, which is key to the smooth progress of second-stage revision surgery. There are few reports on the risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for PJI. This study aimed to investigate the risk factors of reinfection after prosthesis removal and antibiotic bone cement spacer implantation for the treatment of PJI.

Methods

Clinical data of 40 patients who underwent prosthesis removal and antibiotic bone cement spacer implantation for PJI after arthroplasty in our hospital from January 2013 to July 2019 were retrospectively analyzed. During the follow-up period of at least 2 years, 21 patients underwent complete two-stage revision after the removal of the antibiotic bone cement spacer, and 19 patients did not receive a new prosthesis due to other factors, such as reinfection or the patient’s wishes, record the infection control of patients during the treatment. Reinfection after prosthesis removal and antibiotic bone cement spacer implantation was defined as failure of effective control of infection, symptoms of reinfection, requires increased antibiotic therapy or reoperation. Multivariate Cox proportional hazards model was used to analyze the risk factors associated with reinfection after prosthesis removal and antibiotic bone cement spacer implantation.

Results

Of the 40 patients, nine (22.5%) developed reinfection after prosthesis removal and antibiotic bone cement spacer implantation with a mean follow-up duration of 31 months, and multivariate analysis revealed that history of prior revision surgery (hazard ratio [HR] = 6.317, confidence interval [CI]: 1.495–26.700; p = 0.012) and presence of sinus tract before treatment (HR = 5.117, 95% CI: 1.199–21.828; p = 0.027) were independent risk factors for reinfection after prosthesis removal and antibiotic bone cement spacer implantation.

Conclusion

History of prior revision surgery and presence of sinus tract are two independent risk factors for reinfection in patients with PJI treated with prosthesis removal and antibiotic bone cement spacer implantation.
Dynamic contrast enhanced MRI of pulmonary adenocarcinomas for early risk stratification: higher contrast uptake associated with response and better prognosis
Authors: Rheinheimer Stephan , Christopoulos Petros , Erdmann Stella , Saupe Julia , Golpon Heiko , Vogel-Claussen Jens , Dinkel Julien , Thomas Michael , Heussel Claus Peter , Kauczor Hans-Ulrich , Heussel Gudula
Published: December 2022

Background

To explore the prognostic value of serial dynamic contrast-enhanced (DCE) MRI in patients with advanced pulmonary adenocarcinoma undergoing first-line therapy with either tyrosine-kinase inhibitors (TKI) or platinum-based chemotherapy (PBC).

Methods

Patients underwent baseline (day 0, n = 98), and post-therapeutic DCE MRI (PBC: day + 1, n = 52); TKI: day + 7, n = 46) at 1.5T. Perfusion curves were acquired at 10, 40, and 70 s after contrast application and analysed semiquantitatively. Treatment response was evaluated at 6 weeks by CT (RECIST 1.1); progression-free survival (PFS) and overall survival  were analysed with respect to clinical and perfusion parameters. Relative uptake was defined as signal difference between contrast and non-contrast images, divided by the non-contrast signal. Predictors of survival were selected using Cox regression analysis. Median follow-up was 825 days.

Results

In pre-therapeutic and early post-therapeutic MRI, treatment responders (n = 27) showed significantly higher relative contrast uptake within the tumor at 70 s after application as compared to non-responders (n = 71, p ≤ 0.02), response defined as PR by RECIST 1.1 at 6 weeks. There was no significant change of perfusion at early MRI after treatment. In multivariate regression analysis of selected parameters, the strongest association with PFS were relative uptake at 40 s in the early post-treatment MRI and pre-treatment clinical data (presence of liver metastases, ECOG performance status).

Conclusion

Higher contrast uptake within the tumor at pre-treatment and early post-treatment MRI was associated with treatment response and better prognosis. DCE MRI of pulmonary adenocarcinoma may provide important prognostic information.
The problem of pulmonary arterial hypertension in end-stage renal disease: can peritoneal dialysis be the solution
Authors: Alhwiesh Abdullah K. , Abdul-Rahman Ibrahiem Saeed , Alshehri Abdullah , Alhwiesh Amani , Elnokeety Mahmoud , Essam Syed , Sakr Mohamad , Al-Oudah Nadia , Abdulrahman Abdulla , Mohammed Abdelgalil Moaz , Mansour Hany , El-Salamoni Tamer , Al-Oudah Nehad , Alayoobi Lamees , Aljenaidi Hend , Al-Harbi Ali , Mousa Dujanah , Abdulnasir Abdulghani , Skhiri Sami
Published: December 2022

Background

Pulmonary arterial hypertension (PAH) in the setting of end-stage renal disease (ESRD) has important prognostic and therapeutic consequences. We estimated the prevalence of PAH among patients with ESRD treated with automated peritoneal dialysis (APD), investigated the effect of different variables and compared pulmonary artery pressure and cardiac function at the beginning and end of the study.

Methods

This is a 5-year study in which 31 ESRD patients on APD were recruited after fulfilling inclusion criteria. Blood samples were collected from all patients for the biochemical and hematological data at the beginning of the study and every month and at the study termination. Total body water (TBW) and extracellular water (ECW) were calculated using Watson’s and Bird’s calculation methods. All patients were followed-up at 3-month interval for cardiac evaluation. Logistic regression analysis was used to assess the relation between different variables and PAH.

Results

The mean age of the study population (n = 31) was 51.23 ± 15.24 years. PAH was found in 24.2% of the patients. Mean systolic pulmonary artery pressure (sPAP) and mean pulmonary artery pressure (mPAP) were significantly higher in the APD patients at study initiation than at the end of the study (40.75 + 10.61 vs 23.55 + 9.20 and 29.66 + 11.35 vs 18.24 + 6.75 mmHg respectively, p = 0.001). The median ejection fraction was significantly lower in patients with PAH at zero point than at study termination [31% (27-34) vs 50% (46-52), p = 0.002]. Hypervolemia decreased significantly at the end of study (p <  0.001) and correlated positively with the PAP (r = 0.371 and r = 0.369), p = 0.002). sPAP correlated with left ventricular mass index, hemoglobin level, and duration on APD.

Conclusions

Long term APD (> 1 years) seemed to decrease pulmonary arterial pressure, right atrial pressure and improve left ventricular ejection fraction (LVEF). Risk factors for PAH in ESRD were hypervolemia, abnormal ECHO findings and low hemoglobin levels. Clinical and echocardiographic abnormalities and complications are not uncommon among ESRD patients with PAH. Identification of those patients on transthoracic echocardiography may warrant further attention to treatment with APD.
Clinical-epidemiological characteristics and maternal-foetal outcomes in pregnant women hospitalised with COVID-19 in Venezuela: a retrospective study
Authors: Carrión-Nessi Fhabián S. , Castro Mercedes P. , Freitas-De Nobrega Diana C. , Moncada-Ortega Augusto , Omaña-Ávila Óscar D. , Mendoza-Millán Daniela L. , Marcano-Rojas María V. , Trejo Nayren J. , Virriel Isabella V. , Chavero Melynar , Camejo-Ávila Natasha A. , Rodriguez-Morales Alfonso J. , Forero-Peña David A.
Published: December 2022

Background

In low- and middle-income countries, pregnant women and newborns are more vulnerable to adverse outcomes from coronavirus disease 2019 (COVID-19). However, in Venezuela, there are no integrated data in a national surveillance system to identify the clinical-epidemiological characteristics and maternal-foetal outcomes of pregnant women hospitalised with COVID-19.

Methods

A retrospective study was conducted among Venezuelan pregnant women hospitalised with COVID-19 seen at the “Ruiz y Páez” University Hospital Complex and the San Cristobal Central Hospital between June 2020 and September 2021. Information was obtained from physical and digitised clinical records using a purpose-designed proforma to collect epidemiological, clinical, paraclinical, treatment, obstetric and perinatal complications, and maternal-foetal outcomes data.

Results

A total of 80 pregnant women with confirmed severe acute respiratory syndrome coronavirus 2 infection were seen within the study period, 59 (73.8%) survived and 21 (26.2%) died. The median (interquartile range) age was 29 (23–33) years, the majority being in the third trimester of pregnancy (81.2%; n = 65). Interestingly, four (5%) pregnant women were co-infected with malaria by Plasmodium vivax and three (3.8%) with syphilis. The most frequent symptoms were fever (75%; n = 60), dry cough (68.8%; n = 55), dyspnoea (55%; n = 44), and headache (53.8%; n = 43). The most frequent maternal complications were anaemia (51.5%; n = 66) and hypertensive disorders of pregnancy (17.5%; n = 14). The most frequent perinatal complications were preterm delivery (39.2%; n = 20/51) and oligohydramnios (31.3%; n = 25). A total of 29 (36.3%) adverse foetal outcomes were documented, 21 stillbirth and eight abortions.

Conclusion

This is the first study to describe the clinical-epidemiological behaviour of COVID-19 in hospitalised Venezuelan pregnant women. Anaemia, hypertensive disorders of pregnancy, oligohydramnios, and low birth weight were the most frequent maternal-foetal complications in this population of pregnant women.
The LINC00852/miR-29a-3p/JARID2 axis regulates the proliferation and invasion of prostate cancer cell
Authors: Zhang Hao , Du Yang , Xin Peng , Man Xiaojun
Published: December 2022

Long intergenic non-coding RNA 00852 (LINC00852) has been shown to promote the progression of many different cancers including prostate cancer. However, the involved mechanism in promoting the proliferation, migration and invasion of prostate cancer cells has not been reported. In this study, we found that LINC00852 was highly expressed in the tissue of prostate cancer using quantitative reverse transcription PCR (qRT-PCR). CCK-8 assay, colony formation experiment, Transwell migration and invasion experiments were performed to prove that the up-regulation of LINC00852 could promote the proliferation, migration and invasion of prostate cancer cells in vitro. Xenograft tumors experiments in nude mice confirmed that up-regulation of LINC00852 promoted the proliferation of prostate cancer cells in vivo. Bioinformatics predictions and dual-luciferase reporter gene assay showed that miR-29a-3p binds to the 3’-untranslated region of JARID2, and the enhancement of miR-29a-3p could reverse the effect of LINC00852 overexpression in vitro. Moreover, the results of qRT-PCR and western blot showed that LINC00852 could regulate the expression of JARID2 through miR-29a-3p induction. In summary, we demonstrated that LINC00852 played a key role in promoting the prostate cancer, and LINC00852/miR-29a-3p/JARID2 axis could be used as a target for prostate cancer treatment.
Combination of smoking and Epstein-Barr virus DNA is a predictor of poor prognosis for nasopharyngeal carcinoma: a long-term follow-up retrospective study
Authors: Li Wanxia , Yang Chao , Zhao Feipeng , Li Junzheng , Li Zonghua , Ouyang Ping , Yuan Xiaofei , Wu Shuting , Yuan Yue , Cui Linchong , Feng Huiru , Lin Danfan , Chen Zilu , Lu Juan , Peng Xiaohong , Chen Jing
Published: December 2022

Background

This retrospective study was performed to determine the prognostic potential of smoking and its combination with pre-treatment plasma Epstein-Barr virus (EBV) DNA levels in patients with nasopharyngeal carcinoma (NPC).

Methods

Medical records of 1080 non-metastatic NPC patients who received intensity-modulated radiotherapy were reviewed. Male patients were categorized as never and ever smokers, and the smoking amount, duration, and cumulative consumption were used to evaluate dose-dependent effects. Survival outcomes were assessed using Kaplan-Meier survival analysis and the multivariate Cox regression analysis. Propensity score matching (PSM) was constructed.

Results

The 5-year overall survival (OS) was worse for ever smokers than never smokers, and significantly decreased with the increase of smoking amount, duration, and cumulative consumption. Compared with never smokers, the multivariate-adjusted hazard ratio (HR) of death was higher in ever smokers (HR = 1.361,P = 0.049), those smoked ≥20 cigarettes/day (HR = 1.473,P = 0.017), those smoked for ≥30 years (HR = 1.523,P = 0.023), and those cumulative smoked for ≥30 pack-years (HR = 1.649,P = 0.005). The poor prognostic effects of smoking was also confirmed in the PSM analysis. The combination of cumulative smoking consumption and pre-treatment EBV DNA levels was proven to be an independent poor prognostic factor for male NPC, and the risk of death, progression, and distant metastases gradually increased with both factors (P < 0.001).

Conclusions

Combination of smoking and pre-treatment EBV DNA levels as a predictor of poor prognosis could further improve the risk stratification and prognostication for NPC.
The co-development of personalised 10-year breast cancer risk communications: a ‘think-aloud’ study
Authors: Gorman Louise S. , Ruane Helen , Woof Victoria G. , Southworth Jake , Ulph Fiona , Evans D. Gareth , French David P.
Published: December 2022

Background

Risk stratified breast cancer screening is being considered as a means of improving the balance of benefits and harms of mammography. Stratified screening requires the communication of risk estimates. We aimed to co-develop personalised 10-year breast cancer risk communications for women attending routine mammography.

Methods

We conducted think-aloud interviews on prototype breast cancer risk letters and accompanying information leaflets with women receiving breast screening through the UK National Breast Screening Programme. Risk information was redesigned following feedback from 55 women in three iterations. A deductive thematic analysis of participants’ speech is presented.

Results

Overall, participants appreciated receiving their breast cancer risk. Their comments focused on positive framing and presentation of the risk estimate, a desire for detail on the contribution of individual risk factors to overall risk and effective risk management strategies, and clearly signposted support pathways.

Conclusion

Provision of breast cancer risk information should strive to be personal, understandable and meaningful. Risk information should be continually refined to reflect developments in risk management. Receipt of risk via letter is welcomed but concerns remain around the acceptability of informing women at higher risk in this way, highlighting a need for co-development of risk dissemination and support pathways.
Daily irradiation versus irradiation at two- to three-day intervals in stereotactic radiotherapy for patients with 1-5 brain metastases: study protocol for a multicenter open-label randomized phase II trial
Authors: Tomita Natsuo , Ishiyama Hiromichi , Makita Chiyoko , Ohshima Yukihiko , Nagai Aiko , Baba Fumiya , Kuno Mayu , Otsuka Shinya , Kondo Takuhito , Sugie Chikao , Kawai Tatsuya , Takaoka Taiki , Okazaki Dai , Torii Akira , Niwa Masanari , Kita Nozomi , Takano Seiya , Kawakami Shogo , Matsuo Masayuki , Kumano Tomoyasu , Ito Makoto , Adachi Sou , Abe Souichiro , Murao Takayuki , Hiwatashi Akio
Published: December 2022

Background

Radiobiological daily changes within tumors are considered to be quite different between stereotactic radiotherapy (SRT) (e.g., 50 Gy in 4 fractions) and conventional radiotherapy (e.g., 60 Gy in 30 fractions). We aim to assess the optimal interval of irradiation in SRT and compare outcomes of daily irradiation with irradiation at two- to three-day intervals in SRT for patients with one to five brain metastases (BM).

Methods

This study is conducted as a multicenter open-label randomized phase II trial. Patients aged 20 or older with one to five BM, less than 3.0 cm diameter, and Karnofsky Performance Status ≥70 are eligible. A total of 70 eligible patients will be enrolled. After stratifying by the number of BMs (1, 2 vs. 3–5) and diameter of the largest tumor (< 2 cm vs. ≥ 2 cm), we randomly assigned patients (1:1) to receive daily irradiation (Arm 1), or irradiation at two- to three-day intervals (Arm 2). Both arms are performed with total dose of 27-30 Gy in 3 fractions. The primary endpoint is an intracranial local control rate, defined as intracranial local control at initially treated sites. We use a randomized phase II screening design with a two-sided α of 0∙20. The phase II trial is positive with p < 0.20. All analyses are intention to treat. This study is registered with the UMIN-clinical trials registry, number UMIN000048728.

Discussion

This study will provide an assessment of the impact of SRT interval on local control, survival, and toxicity for patients with 1–5 BM. The trial is ongoing and is recruiting now.

Trial registration

UMIN000048728. Date of registration: August 23, 2022.

https://center6.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000055515.
Association and interaction of O3 and NO2 with emergency room visits for respiratory diseases in Beijing, China: a time-series study
Authors: Fu Yuanwei , Zhang Wenlou , Li Yan , Li Hongyu , Deng Furong , Ma Qingbian
Published: December 2022

Background

Ozone (O3) and nitrogen dioxide (NO2) are the two main gaseous pollutants in the atmosphere that act as oxidants. Their short-term effects and interaction on emergency room visits (ERVs) for respiratory diseases remain unclear.

Methods

We conducted a time-series study based on 144,326 ERVs for respiratory diseases of Peking University Third Hospital from 2014 to 2019 in Beijing, China. Generalized additive models with quasi-Poisson regression were performed to analyze the association of O3, NO2 and their composite indicators (Ox and Oxwt) with ERVs for respiratory diseases. An interaction model was further performed to evaluate the interaction between O3 and NO2.

Results

Exposure to O3, NO2, Ox and Oxwt was positively associated with ERVs for total respiratory diseases and acute upper respiratory infection (AURI). For instance, a 10 μg/m3 increase in O3 and NO2 were associated with 0.93% (95%CI: 0.05%, 1.81%) and 5.87% (95%CI: 3.92%, 7.85%) increase in AURI at lag0-5 days, respectively. Significant linear exposure–response relationships were observed in Ox and Oxwt over the entire concentration range. In stratification analysis, stronger associations were observed in the group aged < 18 years for both O3 and NO2, in the warm season for O3, but in the cold season for NO2. In interaction analysis, the effect of O3 on total respiratory emergency room visits and AURI visits was the strongest at high levels (> 75% quantile) of NO2 in the < 18 years group.

Conclusions

Short-term exposure to O3 and NO2 was positively associated with ERVs for respiratory diseases, particularly in younger people (< 18 years). This study for the first time demonstrated the synergistic effect of O3 and NO2 on respiratory ERVs, and Ox and Oxwt may be potential proxies.
Impact of job demands on police stress response—the roles of basic psychological needs and job autonomy
Authors: Chen Pei-feng , Wu Lin
Published: December 2022

Background

Police
officers are a high-stress group with special job characteristics, and the Chinese police management system places particularly high demands on police officers. Whether the influence of job demands on officers’ job burnout can be deduced to general stress response needs to be verified. Based on the JD-R model, the study aims to explore the impact of job demands on police stress response, whether job autonomy as a job resource has a moderating effect, and whether basic psychological needs mediate this effect.

Methods

A total of 251 police officers in a district-level public security bureau of China, were surveyed using Chinese-language versions of the Job Demands Scale, the Stress Response Scale, the Job Autonomy Scale, and the Basic Psychological Needs Scale. The mediating effect of basic psychological needs and the moderating effect of job autonomy were tested by regression analysis and bootstrap test.

Results

Job demands increase police officers’ stress response, and job autonomy does not play a buffer role but enhances this impact, and job demands can partially reduce the police stress response through the satisfaction of basic psychological needs, that is, there is a masking effect of basic psychological needs.

Conclusions

Adjusting and optimizing the ratio of job demands and autonomy in police work to provide high guidance under high demands is of great value to reduce the negative stress responses among police officers.
Effect of subsequent vertebral body fractures on the outcome after posterior stabilization of unstable geriatric fractures of the thoracolumbar spine
Authors: Spiegl U. J. , Jarvers J.-S. , Osterhoff G. , Kobbe P. , Hölbing P.-L. , Schnake K. J. , Heyde C.-E.
Published: December 2022

Purpose

The purpose of this study was analyzing the effect of subsequent vertebral body fractures on the clinical outcome in geriatric patients with thoracolumbar fractures treated operatively.

Methods

Retrospectively, all patients aged ≥ 60 with a fracture of the thoracolumbar spine included. Further inclusion parameters were acute and unstable fractures that were treated by posterior stabilization with a low to moderate loss of reduction of less than 10°. The minimal follow-up period was 18 months. Demographic data including the trauma mechanism, ASA score, and the treatment strategy were recorded. The following outcome parameters were analyzed: the ODI score, pain level, satisfaction level, SF 36 score as well as the radiologic outcome parameters.

Results

Altogether, 73 patients were included (mean age: 72 years; 45 women). The majority of fractures consisted of incomplete or complete burst fractures (OF 3 + 4). The mean follow-up period was 46.6 months. Fourteen patients suffered from subsequent vertebral body fractures (19.2%). No trauma was recordable in 5 out of 6 patients; 42.8% of patients experienced a low-energy trauma (significant association: p < 0.01). There was a significant correlation between subsequent vertebral body fracture and female gender (p = 0.01) as well as the amount of loss of reduction (p = 0.02). Thereby, patients with subsequent vertebral fractures had significant worse clinical outcomes (ODI: 49.8 vs 16.6, p < 0.01; VAS pain: 5.0 vs 2.6, p < 0.01).

Conclusion

Patient with subsequent vertebral body fractures had significantly inferior clinical midterm outcome. The trauma mechanism correlated significantly with both the rate of subsequent vertebral body fractures and the outcome. Another risk factor is female gender.
Higher magnesium levels are associated with better glycaemic control and diabetes remission post-bariatric surgery
Authors: MM Silva , JS Neves , M Borges-Canha , AP Mendes , MJ Fonseca , F Mendonça , MJ Ferreira , D Salazar , J Pedro , V Guerreiro , E Lau , A Varela , P Freitas , D Carvalho ,   CRIO group
Published: December 2022

Background

Low Magnesium (Mg) dietary intake has been associated with increased risk of type 2 diabetes mellitus (T2DM). Furthermore, in patients with T2DM, hypomagnesemia is associated with worst glycaemic control. Bariatric surgery (BS) remains the most effective treatment in severe obesity and also provides resolution/improvement of T2DM. Our aim is to evaluate the association between Mg supplementation post-BS and Mg serum levels with diabetes status after BS.

Methods

We performed an observational study on patients with obesity and T2DM who underwent BS. Data was assessed pre-BS and one-year post-BS.

Results

We included a total of 403 patients with T2DM. At baseline, 43.4% of the patients had Mg deficiency. Pre-BS, patients with Mg deficiency had poorer glycaemic control – HbA1c 7.2 ± 1.6% vs 6.4 ± 1.0% (p < 0.001), fasting plasma glucose 146.2 ± 58.8 mg/dL vs 117.5 ± 36.6 mg/dL (p < 0.001) and were under a greater number of anti-diabetic drugs 1.0 (IQR 0–2.0) vs 1.0 (IQR 0–1.0) (p = 0.002). These findings persisted at one-year post-BS. At the first-year post-BS, 58.4% of the patients had total remission of T2DM and 4.1% had partial remission. Patients without Mg deficiency at one-year post-BS had higher rates of total and partial remission. Higher serum Mg levels at baseline is an independent predictor of total T2DM remission (p < 0.0001). The optimal cut-off of baseline Mg to predict total T2DM remission was 1.50 mg/dL with a sensitivity of 73% and a specificity of 58% (area under ROC = 0.65). Patients that were under Mg supplementation post-BS had serum Mg values, glycaemic control and total remission of T2DM similar to patients non-supplemented.

Conclusion

In patients with T2DM submitted to BS, higher Mg serum levels at baseline and 1-year after BS were associated with better glycaemic control and higher rates of total T2DM remission at the first year post-BS.
The APSY-SED study: protocol of an observational, longitudinal, mixed methods and multicenter study exploring the psychological adjustment of relatives and healthcare providers of patients with cancer with continuous deep sedation until death
Authors: Fasse L. , Roche N. , Flahault C. , Garrouste-Orgeas M. , Ximenes M. , Pages A. , Evin A. , Dauchy S. , Scotte F. , Le Provost JB. , Blot F. , Mateus C.
Published: December 2022

Background

Since 2016, France is the only country in the World where continuous deep sedation until death (CDSUD) is regulated by law. CDSUD serves as a response to refractory suffering in palliative situations where the patients’ death is expected to occur in the following hours or days. Little is known on the psychological adjustment surrounding a CDSUD procedure for healthcare providers (HCPs) and relatives. Our study aims to gather qualitative and quantitative data on the specific processes behind the psychological adjustment of both relatives and HCPs, after the administration of CDSUD for patients with cancer.

Methods

The APSY-SED study is a prospective, longitudinal, mixed-methods and multicenter study. Recruitment will involve any French-speaking adult cancer patient for who a CDSUD is discussed, their relatives and HCPs. We plan to include 150 patients, 150 relatives, and 50 HCPs. The evaluation criteria of this research are: 1/ Primary criterion: Psychological adjustment of relatives and HCPs 6 and 13 months after the death of the patient with cancer (psychological adjustment = intensity of anxiety, depression and grief reactions, CDSUD-related distress, job satisfaction, Professional Stress and Professional experience). Secondary criteria: a)occurrence of wish for a CDSUD in patients in palliative phase; b)occurrence of wish for hastened death in patients in palliative phase; c)potential predictors of adjustment assessed after the discussion concerning CDSUD as an option and before the setting of the CDSUD; d) Thematic analysis and narrative account of meaning-making process concerning the grief experience.

Discussion

The APSY-SED study will be the first to investigate the psychological adjustment of HCPs and relatives in the context of a CDSUD procedure implemented according to French law. Gathering data on the grief process for relatives can help understand bereavement after CDSUD, and participate in the elaboration of specific tailored interventions to support HCPs and relatives. Empirical findings on CDSUD among patients with cancer in France could be compared with existing data in other countries and with results related to other medical fields where CDSUD is also conducted.

Trial registration

This protocol received the National Registration Number: ID-RCB2021-A03042-39 on 14/12/2021.
Understanding motivations behind medical student involvement in COVID-19 pandemic relief efforts
Authors: Bellomo Tiffany R. , Prasad Sanjana , Bhaumik Deesha , Cartwright Julia , Zhang Yibing , Azzouz Lyna , Vercler Christian
Published: December 2022

Background

Although students were removed from patient-facing settings at the beginning of the COVID-19 pandemic due to concerns of burdening teaching physicians and depleting personal protective equipment, some leaders suggest students can be effectively utilized when personnel resources may be scarce. There have been narrative discussions surrounding medical student involvement, but no studies exploring the attitudes of these students. The authors aim to quantify the degree to which factors influenced a medical student’s decision to or to not volunteer during the pandemic and to characterize medical students’ attitudes towards medical professionals’ duty to serve in a pandemic.

Methods

The authors developed and tested a secure web-based survey before distribution to students at 23 different US allopathic medical schools that did not graduate medical students early to aid in pandemic efforts between April and June 2020. Of the 599 students who completed the survey, 65.5% self-identified as female and were on average 25.94 years old (SD = 2.5). Multiple comparisons were made based on volunteer status. Ordinal scale questions were compared with the Mann Whitney U test, and the Chi-Squared test was used for categorical variables using R version 3.62.

Results

67.6% of students volunteered in pandemic relief activities and a majority of those students volunteered in non-patient-facing roles. Community service, new skills, and time commitment were top 3 influencing factors for students who volunteered, while risk to other, time commitment, and risk to self were top 3 influencing factors for students who chose not to volunteer. Compared to other specialties, students interested in primary care specialties agreed to a greater degree that physicians have a duty to serve in pandemic relief efforts.

Conclusions

Medical students who volunteered cited self-serving factors and altruistic values as significant motivators. Students who did not volunteer were significantly more concerned with risks of COVID-19 exposure. However, medical students in general agreed that students should be allowed to volunteer in COVID-19 related relief efforts. As large areas of the United States continue to experience increases in COVID-19 cases, institutions should involve medical students in balancing the level of acceptable risk with the educational benefits.
Guardians and research staff experiences and views about the consent process in hospital-based paediatric research studies in urban Malawi: A qualitative study
Authors: Gondwe Mtisunge Joshua , Toto Neema Mtunthama , Gunda Charity , Gmeiner Markus , MacCormick Ian J. C. , Lalloo David , Parker Michael , Desmond Nicola
Published: December 2022

Background

Obtaining consent has become a standard way of respecting the patient’s rights and autonomy in clinical research. Ethical guidelines recommend that the child’s parent/s or authorised legal guardian provides informed consent for their child’s participation. However, obtaining informed consent in paediatric research is challenging. Parents become vulnerable because of stress related to their child’s illness. Understanding the views held by guardians and researchers about the consent process in Malawi, where there are limitations in health care access and research literacy will assist in developing appropriate consent guidelines.

Methods

We conducted 20 in-depth interviews with guardians of children and research staff who had participated in paediatric clinical trial and observational studies in acute and non-acute settings in the Southern Region of Malawi. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. Interviews were compared across studies and settings to identify differences and similarities in participants’ views about informed consent processes. Data analysis was facilitated by NVIVO 11 software.

Results

All participants across study types and settings reported that they associated participating in research with therapeutic benefits. Substantial differences were noted in the decision-making process across study settings. Guardians from acute studies felt that the role of their spouses was neglected during consenting, while staff reported that they had problems obtaining consent from guardians when their partners were not present. Across all study types and settings, research staff reported that they emphasised the benefits more than the risks of the study to participants, due to pressure to recruit. Participants from non-acute settings were more likely to recall information shared during the consent process than participants in the acute setting.

Conclusion

The health care context, culture and research process influenced participants’ understanding of study information across study types and settings. We advise research managers or principal investigators to define minimum requirements that would not compromise the consent process and conduct study specific training for staff. The use of one size fits all consent process may not be ideal. More guidance is needed on how these differences can be incorporated during the consent process to improve understanding and delivery of consent.

Trial registration Not applicable.
Barriers, facilitators, and implementation strategies for the initiation of Child Death Review system in Japan: a modified Delphi method study
Authors: Yatake Haruko , Aoki Ai , Numaguchi Atsushi , Takehara Kenji
Published: December 2022

Background:

To further curb preventable child deaths, some countries have implemented Child Death Review (CDR). CDR is a comprehensive multidisciplinary process that investigates, reviews, and registers all child deaths to consider prevention strategies. This study deciphered the barriers, facilitators, and implementation strategies in Japan.

Methods:

This study used a three-round modified Delphi method. The expert panel consisted of local government officers and health professionals responsible for the CDR pilot project in Japan. As a modification, the initial list of barriers, facilitators, and implementation strategies to address each barrier and facilitator was prepared based on project reports and interviews with local government officers. Throughout the three rounds, the panel evaluated predefined barriers and facilitators, suggested and evaluated additional items, and appraised the potential effectiveness of the implementation strategies on barriers and facilitators which they were meant to address. The importance of barriers and facilitators, and the potential effectiveness of implementation strategies were evaluated using 5-point Likert scale. The priority of the combinations of barriers, facilitators, and implementation strategies were determined considering their importance and effectiveness.

Results:

A total of 31 experts participated in the panel. Response rates were 96.8%, 80.6%, and 90.3% for the first, second, and third rounds, respectively. A total of 13 barriers, eight facilitators, and 72 implementation strategies corresponding to the barriers and facilitators reached consensus. At the national government level, a barrier-strategy combination of “lack of legislation (barrier)” and “legislation for CDR (strategy),” and a facilitator-strategy combination of “good multi-agency collaboration (facilitator)” and “official notices from the national government (strategy)” were at the highest priority. At the local government level, combinations of “lack of legislation (barrier)” and “constant budget allocations (strategy),” “lack of legislation (barrier)” and “citizens’ acceptance (strategy),” and “good multi-agency collaboration (facilitator)” and “appointment of a full-time staff (strategy)” were at the highest priority.

Conclusion:

This study demonstrated that legislation is the key to better implementation of CDR in Japan. Legislation can address various barriers such as personal information collection, multi-agency collaboration, high workload, and budget instability. Without legislation, careful strategies must be taken to solve difficulties caused by its absence.

Trial registrations:

None.
The development and validation of a novel COVID19 stigma scale among healthcare workers (COVISS-HCWs)
Authors: Al Houri Hasan Nabil , Alhouri Abdullah , Akasheh Rand T. , Jovanovic Christine E. S. , Al-tarcheh Heba , Arrouk Douaa Mohammad Nazir , Alhouri Ahmad Nabil , Marrawi Marah , Juweid Malik E. , Latifeh Youssef
Published: December 2022

Background and aim

Fear of coronavirus disease 2019 (COVID-19) and its complications may result in stigmatization of individuals who may carry the virus. This is of special concern to healthcare workers who tolerate additional physical and emotional stress at times of pandemic. The aims of this study are to (1) develop and validate the COVID-19 Stigma Scale (COVISS-HCWs) survey; and (2) investigate the experience of stigma among healthcare workers possibly dealing with COVID-19 patients in five major public hospitals in Damascus, Syria.

Methods

We divided the sample into two parts and then underwent EFA on the first 350 participants, dividing the 14 questions into two dimensions. Furthermore, CFA was conducted on the other 350 participants to confirm how correctly a hypothesized model matched the factor structure by EFA, as described above. Moreover, the coefficient of determination (R2) and item–scale correlations (standardized factor loading) were estimated to establish the acceptability of the final structure of the COVISS-HCWs. Through a cross-sectional study, a convenience sample of 700 healthcare workers participated in a self-administered questionnaire containing a section for demographic variables and another for newly designed COVISS-HCWs. The scale comprises 14 adapted and novel items that measure two subscales: feelings of perceived harm and inferiority, and avoidance. Descriptive statistics, reliability, and validity were evaluated.

Results

The 14 COVISS-HCWs items were reduced to 11 items with a high Cronbach’s α of 0.909. A significant correlation was observed between the responses to each COVISS-HCWs item and the corresponding subscale, and between each subscale and the overall scale. Feeling stigmatized was reported by 9.86% of the participants. Younger age, low socioeconomic status, and higher intensity of contact with COVID-19 patients significantly correlated with higher stigmatization.

Conclusions

The novel COVISS-HCWs is a reliable and valid tool to evaluate stigma among healthcare workers during the COVID-19 pandemic. The Stigma prevalence among healthcare workers was 9.86%. Therefore, this must be addressed to prevent possible psychosocial and public health repercussions.
Short stature and language development in the United Kingdom: a longitudinal analysis of children from the Millennium Cohort Study
Authors: Freer Joseph , Orr Joanna , Morris Joan K. , Walton Robert , Dunkel Leo , Storr Helen L. , Prendergast Andrew J.
Published: December 2022

Background

In low- and middle-income countries, poverty and impaired growth prevent children from meeting their cognitive developmental potential. There are few studies investigating these relationships in high-income settings.

Methods

Participants were 12,536 children born between 2000 and 2002 in the UK and participating in the Millennium Cohort Study (MCS). Short stature was defined as having a height-for-age 2 or more standard deviations below the median (≤ − 2 SDS) at age 3 years. Standardized British Abilities Scales II (BAS II) language measures, used to assess language development at ages 3, 5, 7 and 11 years, were the main outcome assessed.

Results

Children with short stature at age 3 years (4.1%) had language development scores that were consistently lower from ages 3 to 11 years (− 0.26 standard deviations (SD) (95% CI − 0.37, − 0.15)). This effect was attenuated but remained significant after adjustment for covariates. Trajectory analysis produced four distinct patterns of language development scores (low-declining, low-improving, average and high). Multinomial logistic regression models showed that children with short stature had a higher risk of being in the low-declining group, relative to the average group (relative risk ratio (RRR) = 2.11 (95% CI 1.51, 2.95)). They were also less likely to be in the high-scoring group (RRR = 0.65 (0.52, 0.82)). Children with short stature at age 3 years who had ‘caught up’ by age 5 years (height-for-age ≥ 2 SDS) did not have significantly different scores from children with persistent short stature, but had a higher probability of being in the high-performing group than children without catch-up growth (RRR = 1.84 (1.11, 3.07)).

Conclusions

Short stature at age 3 years was associated with lower language development scores at ages 3 to 11 years in UK children. These associations remained significant after adjustment for socioeconomic, child and parental factors.
Surveillance of pfhrp2 and pfhrp3 gene deletions among symptomatic Plasmodium falciparum malaria patients in Central Vietnam
Authors: Thang Ngo Duc , Rovira-Vallbona Eduard , Binh Nguyen Thi Huong , Dung Dang Viet , Ngoc Nguyen Thi Hong , Long Tran Khanh , Duong Tran Thanh , Martin Nicholas J. , Edgel Kimberly A.
Published: December 2022

Background

Malaria rapid diagnostic tests (RDTs) remain the main point-of-care tests for diagnosis of symptomatic Plasmodium falciparum malaria in endemic areas. However, parasites with gene deletions in the most common RDT target, histidine rich protein 2 (pfhrp2/HRP2), can produce false-negative RDT results leading to inadequate case management. The objective of this study was to determine the prevalence of hrp2/3 deletions causing false-negative RDT results in Vietnam (Gia Lai and Dak Lak provinces).

Methods

Individuals presenting with malaria symptoms at health facilities were screened for P. falciparum infection using light microscopy and HRP2-RDT (SD Bioline Malaria Antigen Pf/Pv RDT, Abbott). Microscopically confirmed P. falciparum infections were analysed for parasite species by 18S rRNA qPCR, and pfhrp2 and pfhrp3 exon2 deletions were investigated by nested PCR. pfhrp2 amplicons were sequenced by the Sanger method and HRP2 plasma levels were determined by enzyme-linked immunosorbent assay (ELISA).

Results

The prevalence of false-negative RDT results among symptomatic cases was 5.6% (15/270). No pfhrp2 and pfhrp3 deletions were identified. False-negative RDT results were associated with lower parasite density (p = 0.005) and lower HRP2 plasma concentrations (p < 0.001), as compared to positive RDT.

Conclusions

The absence of hrp2/3 deletions detected in this survey suggests that HRP2-based malaria RDTs remain effective for the diagnosis of symptomatic P. falciparum malaria in Central Vietnam.