bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of serotonin reuptake inhibitors increases the risk of bleeding in patients with assist devices
Authors: Auschra Bianca , Wilhelm Markus J. , Husung Claudia , Jenewein Josef , Flammer Andreas J. , Jellestad Lena
Published: March 2022

Background

Bleedings are frequent and dreaded complications in heart failure patients with ventricular assist devices (VAD). Serotonin reuptake inhibitor (SRI) antidepressants are widely used to treat depression in these patients, though they are attributed an increased risk of bleeding due to their modification of hemostasis. Evidence on bleeding risk of VAD patients under SRI medication is scarce and limited. We therefore aimed to assess if SRI use is associated with an elevated bleeding risk in this particularly vulnerable population.

Methods

We analyzed the medical records of 92 VAD patients at the University Heart Center Zurich between September 2004 and April 2018 for the occurrence of bleedings and the concomitant use of an SRI. Bleeding was defined as any type of post-implantation bleeding requiring medical treatment. We performed univariate analyses and linear mixed-effects models, adjusting for baseline clinical characteristics as potential predictors to identify differences in bleeding rates in patients with vs. without SRI intake.

Results

The cohort comprised 60.9% of patients with a continuous-flow VAD and 39.1% with a pulsatile-flow VAD. A total of 77.2% of patients experienced at least one bleeding incident. Overall, 28.6% of bleedings occurred under SRI therapy. A generalized linear mixed model showed a predictive effect of SRI medication on bleeding rate, independent of VAD type (z = 2.091, p = 0.037).

Conclusions

Bleeding events in heart failure patients occur frequently after VAD implantation. Patients with SRI medication were at increased risk of bleeding. The indication and use of SRI, therefore, should be considered carefully.
Assessment of the fatality rate and transmissibility taking account of undetected cases during an unprecedented COVID-19 surge in Taiwan
Authors: Yuan Hsiang-Yu , Hossain M. Pear , Wen Tzai-Hung , Wang Ming-Jiuh
Published: March 2022

Background

During the COVID-19 outbreak in Taiwan between May 11 and June 20, 2021, the observed fatality rate (FR) was 5.3%, higher than the global average at 2.1%. The high number of reported deaths suggests that many patients were not treated promptly or effectively. However, many unexplained deaths were subsequently identified as cases, indicating a few undetected cases, resulting in a higher estimate of FR. Whether the true FR is exceedingly high and what factors determine the detection of cases remain unknown. Estimating the true number of total infected cases (i.e. including undetected cases) can allow an accurate estimation of FR and effective reproduction number ($$R_{t}$$

R
t

).

Methods

We aimed at quantifying the time-varying FR and $$R_{t}$$

R
t

using the estimated true numbers of cases; and, exploring the relationship between the true case number and test and trace data. After adjusting for reporting delays, we developed a model to estimate the number of undetected cases using reported deaths that were and were not previously detected. The daily FR and $$R_{t}$$

R
t

were calculated using the true number of cases. Afterwards, a logistic regression model was used to assess the impact of daily testing and tracing data on the detection ratio of deaths.

Results

The estimated true daily case number at the peak of the outbreak on May 22 was 897, which was 24.3% higher than the reported number, but the difference became less than 4% on June 9 and afterwards. After taking account of undetected cases, our estimated mean FR (4.7%) was still high but the daily rate showed a large decrease from 6.5% on May 19 to 2.8% on June 6. $$R_{t}$$

R
t

reached a maximum value of 6.4 on May 11, compared to 6.0 estimated using the reported case number. The decreasing proportion of undetected cases was found to be associated with the increases in the ratio of the number of tests conducted to reported cases, and the proportion of cases that are contact traced before symptom onset.

Conclusions

Increasing testing capacity and contact tracing coverage without delays not only improve parameter estimation by reducing hidden cases but may also reduce fatality rates.
Pulmonary embolism after dexamethasone treatment for COVID-19: a case report
Authors: Takahashi Hidenori , Iwasaki Yoshinobu , Watanabe Takayasu , Ichinose Naoki , Oda Toshimi
Published: March 2022

Background

Although the RECOVERY trial showed that dexamethasone was efficacious for the treatment of coronavirus disease 2019 (COVID-19), its impact on the risk of pulmonary embolism (PE) and other serious procoagulant events was not assessed.

Case presentation

Here we report the case of a previously healthy 83-year-old woman with COVID-19, without any genetic predisposition to thrombosis. She developed moderate respiratory distress 12 days after symptom onset and a 10-day course of dexamethasone therapy was initiated. Her clinical condition and imaging findings improved initially; however, they deteriorated after the completion of dexamethasone therapy, despite the improvement in her pneumonia and viral clearance. Laboratory tests showed markedly raised serum D-dimer, ferritin, and sIL-2R levels, and contrast-enhanced computed tomography showed deep vein thrombosis (DVT) in the left iliac vein and PE of the right pulmonary artery. The DVT and PE were successfully treated using intravenous heparin administration.

Conclusions

This case illustrates the potential risk of rebound inflammation and procoagulant events following dexamethasone withdrawal. We believe that COVID-19-induced DVT and PE can be affected by dexamethasone therapy. Although dexamethasone reduces procoagulant factors, increases anticoagulant factors, and modulates cytokines, which can suppress/delay thrombus formation during treatment, it confers the risk for rebound cytokine production after treatment completion, triggering cytokine and coagulation cascades that can lead to thromboembolic diseases. In this critical clinical period, the patient’s deteriorating condition may be overlooked because of the masking effects of dexamethasone treatment on fever and other clinical conditions and laboratory changes. Clinicians should follow-up coagulation markers carefully and contrast-enhanced computed tomography is useful for detecting coagulation; and, if PE occurs, therapeutic heparin administration is essential because emboli can also generate cytokines.
Sensitivity and specificity of two WHO approved SARS-CoV2 antigen assays in detecting patients with SARS-CoV2 infection
Authors: Jeewandara Chandima , Guruge Dinuka , Pushpakumara Pradeep Darshana , Madhusanka Deshan , Jayadas Tibutius Thanesh , Chaturanga Indika Prasad , Aberathna Inoka Sepali , Danasekara Saubhagya , Pathmanathan Thilagaraj , Jayathilaka Deshni , Somathilaka Gayasha , Kuruppu Heshan , Gomes Laksiri , Gunasekara Vitjith , Wijayamuni Ruwan , Ogg Graham S. , Malavige Gathsaurie Neelika
Published: March 2022

Background

SARS-CoV-2 rapid antigen (Ag) detection kits are widely used in addition to quantitative reverse transcription PCR PCR (RT-qPCR), as they are cheaper with a rapid turnaround time. As there are many concerns regarding their sensitivity and specificity, in different settings, we evaluated two WHO approved rapid Ag kits in a large cohort of Sri Lankan individuals.

Methods

Paired nasopharangeal swabs were obtained from 4786 participants for validation of the SD-Biosensor rapid Ag assay and 3325 for the Abbott rapid Ag assay, in comparison to RT-qPCR. A short questionnaire was used to record symptoms at the time of testing, and blood samples were obtained from 2721 of them for detection of SARS-CoV-2 specific antibodies.

Results

The overall sensitivity of the SD-Biosensor Ag kit was 36.5% and the Abbott Ag test was 50.76%. The Abbott Ag test showed specificity of 99.4% and the SD-Biosensor Ag test 97.5%. At Ct values < 25, the sensitivity was 71.3% to 76.6% for the SD-Biosensor Ag test and 77.3% to 88.9% for the Abbott Ag test. The Ct values for all genes (RdRP, S, E and N) tested with all RT-qPCR kits were significantly lower for the positive results of the Abbott Ag test compared to the SD-Biosensor test. 209 (48.04%) individuals who had antibodies gave a positive RT-qPCR result, and antibody positivity rates were higher at Ct values > 30 (46.1 to 82.9%). 32.1% of those who gave a positive result with the SD-Biosensor Ag test and 26.3% of those who gave positive results with the Abbott Ag test had SARS-CoV-2 antibodies at the time of detection.

Conclusions

Both rapid Ag tests appeared to be highly sensitive in detecting individuals at lower Ct values, in a community setting in Sri Lanka, but it will be important to further establish the relationship to infectivity.
The relationship of hair glucocorticoid levels to immunological and virological outcomes in a large cohort of combination antiretroviral therapy treated people living with HIV
Authors: Zhang Quan , Li Xiaoming , Qiao Shan , Liu Shuaifeng , Zhou Yuejiao , Shen Zhiyong
Published: March 2022

Background

Existing literature mostly investigated the relationship of acute or short-term glucocorticoid exposure to HIV disease progression using cortisol levels in serum, saliva, or urine. Data are limited on the relationship of long-term glucocorticoid exposure to HIV disease progression. This study examined whether hair glucocorticoid levels, novel retrospective indicators of long-term glucocorticoid exposure, are associated with two common indicators of HIV disease progression (CD4 count and HIV viral load) among a large cohort of combination antiretroviral therapy treated Chinese people living with HIV (PLHIV).

Methods

A total of 1198 treated PLHIV provided hair samples for glucocorticoid (cortisol and cortisone) assay and completed a survey assessing sociodemographic, lifestyle, and HIV-related characteristics. Meanwhile, CD4 count and HIV viral load were retrieved from their medical records. Spearman correlation was used to examine the associations of hair cortisol and cortisone levels to continuous CD4 count and HIV viral load. Multivariate logistic regression was used to predict CD4 count < 500 cells/mm3.

Results

Both hair cortisol and cortisone levels were negatively associated with CD4 count but not with HIV viral load. The odds ratio for CD4 count < 500 cells/mm3 was 1.41 [95% CI 0.99–2.00] and 2.15 [95% CI 1.51–3.05] for those with hair cortisol and cortisone levels in the highest quartile compared to the lowest when controlling for sociodemographic, lifestyle, HIV-related covariates, and HIV viral load.

Conclusion

Hair glucocorticoid levels were associated with CD4 count but not viral load in treated Chinese PLHIV. Our data furtherly supported the hypothesis that elevated glucocorticoid levels are associated with the lower CD4 count.
An evidence-based tailored eHealth patient education tool for patients with knee osteoarthritis: protocol for a randomized controlled trial
Authors: Song Kangping , Zhu Siyi , Xiang Xiaona , Wang Lin , Xie Suhang , Liu Huizhen , Yang Wenjie , He Chengqi
Published: March 2022

Background

Osteoarthritis is a common and disabling condition that places heavy burden to individuals and healthcare systems. Patient education is a facilitator in the treatment decision making process, aiming to develop a treatment plan for the disease management. Electronic health (eHealth) is an alternative forum for the delivery of patient education and given the prevailing of eHealth in healthcare, introducing patient education programs using the technology has the potential to improve patient engagement, self-management and outcomes in patients with osteoarthritis. The study will evaluate the efficacy of eHealth patient education tool on patients’ perception of knee osteoarthritis and treatment options, satisfaction and compliance to treatments.

Methods

This study is a prospective randomized controlled trial with a 1:1 allocation in two groups. We will recruit 216 patients diagnosed with knee osteoarthritis from the outpatient physiatry/physiotherapy clinic at West China Hospital, Sichuan University in Southwest China. Both groups will receive usual care and additionally, the intervention group will use eHealth patient education tool during the process. Measurements will be taken at baseline, post-intervention, 1 month, 3- and 6-months follow-up. Primary outcome will be patients’ knowledge about disease and treatment options, measured by the validated osteoarthritis patient knowledge questionnaire. Secondary outcomes include patients’ satisfaction with the consultation, the eHealth patient education tool, and their trust of the physiotherapist.

Discussion

The eHealth patient education tool is designed to provide participants with an innovative model of care delivery and this trial will assess the efficacy of the tool and whether this new model of patient education will have the potential to increase patient knowledge and empower self-management. Results collected from this study will further inform future research employing eHealth tool as interventions for the management of a range of other chronic conditions and help participants in communities or rural areas having the equal access to health care services.

Trial registration

This study was prospectively registered on the Chinese Clinical Trials Registry (ChiCTR2100051083) registered 12.09.2021.
Advanced glycation end products are associated with limited range of motion of the shoulder joint in patients with rotator cuff tears associated with diabetes mellitus
Authors: Shinohara Issei , Mifune Yutaka , Inui Atsuyuki , Nishimoto Hanako , Yamaura Kohei , Mukohara Shintaro , Yoshikawa Tomoya , Kato Tatsuo , Furukawa Takahiro , Hoshino Yuichi , Matsushita Takehiko , Kuroda Ryosuke
Published: March 2022

Background

Most degenerative rotator cuff tears (RCTs) are associated with a limited range of motion (ROM) of the shoulder joint. Additionally, patients with diabetes mellitus (DM) show a higher frequency of limited ROM. Recently, advanced glycation end products (AGEs) of proteins have been observed to cause tissue fibrosis, primarily through abnormal collagen cross-linking and oxidative stress. In this study, we investigated the effect of AGEs on ROM limitation in the shoulder capsule and its relationship with DM in the patients with RCTs.

Methods

Sixteen patients (eight in the DM and non-DM groups) who underwent arthroscopic surgery for RCT with limited shoulder ROM were included in this study. AGE-related pathologies in both groups were compared, and the relationship between AGE accumulation and shoulder joint ROM was evaluated. Shoulder capsule tissue was harvested and subjected to histological and in vitro evaluation.

Results

The DM group displayed high levels of AGEs and reactive oxygen species (ROS), and reduced cell viability. There was a significant positive correlation between ROS expression, apoptosis, and preoperative hemoglobin A1c. ROS expression, apoptosis, and ROM of the shoulder joint showed a negative correlation. The NADPH oxidase (NOX) expression and collagen III/I ratio were significantly higher in the DM group than in the non-DM group.

Conclusions

The DM group showed significant AGEs deposition in the shoulder capsule. Additionally, there was a significant association between AGEs and ROM limitation. Collectively, the findings suggest that the oxidative stress induced by AGEs deposition, which leads to fibrosis and local inflammation, might contribute to the limited ROM of the shoulder joint in patients with RCTs accompanied by DM.
Evaluation of a guidelines implementation intervention to reduce work disability and sick leaves related to chronic musculoskeletal pain: a theory-informed qualitative study in occupational health care
Authors: Horppu Ritva , Väänänen Ari , Kausto Johanna
Published: March 2022

Background

Guidelines for pain management and sick leave prescription were formulated and implemented in an occupational health services (OHS) in Finland to reduce work disability and sick leaves related to musculoskeletal pain. We investigated how the guidelines implementation intervention may have produced its effects, how the number of prescribed sick leave days varied before and after the launch of the guidelines, and which factors beyond physician behaviour were seen to influence sick leaves.

Methods

Seventeen physicians, two occupational physiotherapists and one occupational health care nurse were interviewed. Qualitative content analysis using both inductive and deductive approaches was performed, informed by Behaviour Change Wheel and Theoretical Domains Framework. Employees’ sick leave days related to musculoskeletal disorders in 2015–2019 were drawn from the employer’s register.

Results

Physicians’ guidelines adherence was facilitated by psychological capability (e.g., having relevant knowledge, remembering to engage in recommended behaviours), reflective motivation (e.g., guidelines-related behaviours regarded as central part of one’s professional role; beliefs in the positive consequences of recommended behaviours to employees and employers), and physical and social opportunities (e.g., adequate physical resources, culture of social support). Some physicians also described barriers to recommended behaviours (e.g., lack of knowledge or non-pharmacological pain treatment tools). The guidelines had served as sources of new knowledge, reminders of recommended practices and means of self-assessment. Considerable declining trend of prescribed sick leave days was detected, especially during the first years after the intervention, levelling off somewhat thereafter. OHS policies and structures were seen to enable professionals’ focusing on preventing pain-related disability and prolonged sick leaves. The decline of sickness absences was also attributed to the municipal client organization’s commitment and the employees’ positive attitudes towards the alternatives to full-time sick leave.

Conclusions

The guidelines implementation intervention was found successful. The study showed the importance of social and organizational environment supporting physicians’ engagement in recommended practices.
Isolation and identification of a feather degrading Bacillus tropicus strain Gxun-17 from marine environment and its enzyme characteristics
Authors: Shen Naikun , Yang Mengying , Xie Chenjie , Pan Jiangxin , Pang Kunrong , Zhang Hongyan , Wang Yibing , Jiang Mingguo
Published: March 2022

Background

Feathers are the most abundant agricultural waste produced by poultry farms. The accumulation of a large number of feathers not only seriously pollutes the environment but also causes the waste of protein resources. The degradation of feather waste by keratinase-producing strains is currently a promising method. Therefore, screening high-producing keratinase strains from marine environment and studying the fermentation conditions, enzymatic properties and feather degradation mechanism are crucial for efficient degradation of feathers.

Results

A novel efficient feather-degrading bacteria, Gxun-17, isolated from the soil sample of a marine duck farm of Beibu Gulf in Guangxi, China, was identified as Bacillus tropicus. The optimum fermentation conditions were obtained by single factor and orthogonal tests as follows: feather concentration of 15 g/L, maltose concentration of 10.0 g/L, MgSO4 concentration of 0.1 g/L, initial pH of 7.0 and temperature of 32.5 °C. The strain completely degraded the feathers within 48 h, and the highest keratinase activity was 112.57 U/mL, which was 3.18-fold that obtained with the basic medium (35.37 U/mL). Detecting the keratinase activity and the content of sulphur-containing compounds in the fermentation products showed that the degradation of feathers by the strain might be a synergistic effect of the enzyme and sulphite. The keratinase showed optimal enzyme activity at pH 7.0 and temperature of 60 °C. The keratinase had the best performance on the casein substrate. When casein was used as the substrate, the Km and Vmax values were 15.24 mg/mL and 0.01 mg/(mL·min), respectively. Mg2+, Ca2+, K+, Co2+, Al3+, phenylmethylsulphonyl fluoride and isopropanol inhibited keratinase activity, which indicated that it was a serine keratinase. Conversely, the keratinase activity strongly increased with the addition of Mn2+ and β-mercaptoethanol.

Conclusions

A novel feather-degrading B. tropicus Gxun-17 was obtained from marine environment. The strain adapted the extreme conditions such as low temperature, high salt and high pressure. Thus, the keratinase had high activity, wide range of temperature and pH, salt tolerance and other characteristics, which had potential application value.
Cultivating cultural awareness among medical educators by integrating cultural anthropology in faculty development: an action research study
Authors: Oikawa Sayaka , Iida Junko , Ito Yasunobu , Nishigori Hiroshi
Published: March 2022

Background

In faculty development, understanding each participant’s cultural context is important. However, there is scarce evidence on how to improve cultural understanding in faculty development. Cultural anthropology is a discipline that focuses on developing cultural self-awareness by understanding different cultures. Professionals from this field can be crucial to the goal of cultivating cultural awareness among medical educators. The aims of this study are to 1) develop and modify cultural anthropology sessions in faculty development and 2) evaluate the effectiveness of these sessions, including their long-term impacts.

Methods

The cultural anthropology sessions were organized as part of a longitudinal faculty development program—Foundation Course for Medical Education—at Kyoto University in Japan. The study included 47 medical educators participating in faculty development and three lecturers: two cultural anthropologists and a medical educator. We developed the cultural anthropology sessions and implemented them in the longitudinal faculty development program. In these sessions, cultural anthropologists used inquiry-guided reflection. An action research methodology was employed and repeated in four cycles from 2015 to 2018. Qualitative and quantitative data were collected during the action research cycles. The qualitative data were thematically analyzed.

Results

The cultural anthropologists’ inquiries fostered learning during the sessions, and three themes—cultural relativism, attention to context, and reframing—were synthesized. As a long-term impact of the sessions, the learners reported becoming more aware of the cultural contexts in their daily educational and clinical activities.

Conclusions

The cultural anthropology sessions in the faculty development program were shown to have enhanced the participants’ awareness of cultural contexts. The concept and format of these sessions may be used more widely in faculty development programs.
Sphingosine-1-phosphate and CRP as potential combination biomarkers in discrimination of COPD with community-acquired pneumonia and acute exacerbation of COPD
Authors: Hsu Chin-Wang , Suk Chi-Won , Hsu Yuan-Pin , Chang Jer-Hwa , Liu Chung-Te , Huang Shau-Ku , Hsu Shih-Chang
Published: March 2022

Background

 Chronic obstructive pulmonary disease (COPD) is a significant public health concern. The patients with acute exacerbations of COPD (AECOPD) and pneumonia have similar clinical presentations. The use of conventional diagnostic markers, such as complete blood count with differential and C-reactive protein (CRP), is the current mainstream method for differentiating clinically relevant pneumonia from other mimics. However, those conventional methods have suboptimal sensitivity and specificity for patients with a clinical suspicion of infection. The limitations often cause the ambiguity of the initiation of antibiotic treatment. Recently, our pilot study suggested that the patients with pneumonia have significantly higher plasma Sphingosine-1-phosphate (S1P) levels than controls. The initial findings suggest that plasma S1P is a potential biomarker for predicting prognosis in pneumonia. The aim of this study was to evaluate the value of S1P and CRP for discriminating COPD with pneumonia and AECOPD in an Emergency Department (ED) setting.

Methods

 Patients diagnosed with AECOPD or COPD with pneumonia were recruited from the Emergency Department of Wan Fang Hospital. The clinical data, demographics, and blood samples were collected upon ED admission. The concentration of plasma S1P was measured by ELISA.

Results

 Thirty-nine patients with AECOPD and 78 with COPD plus pneumonia were enrolled in this observational study. The levels of blood S1P and CRP were significantly higher in patients with COPD plus CAP compared to those in AE COPD patients. The area under the receiver operator characteristic (ROC) curve for the S1P and CRP for distinguishing between patients with COPD plus CAP and AECOPD is 0.939 (95% CI: 0.894–0.984) and 0.886 (95% CI: 0.826–0.945), whereas the combination of S1P and CRP yielded a value of 0.994 (95% CI: 0.897–1.000). By comparing with CRP or S1P, combining CRP and S1P had significantly higher AUC value for differentiating between the COPD with pneumonia group and the AECOPD group.

Conclusions

Our findings suggest that S1P is a potential diagnostic biomarker in distinguishing COPD with CAP from AECOPD. Additionally, the diagnostic ability of S1P can be improved when used in combination with CRP.
CTHRC1 is a prognosis-related biomarker correlated with immune infiltrates in colon adenocarcinoma
Authors: Meng Chuang , Zhang Yue , Jiang Dujun , Wang Jian
Published: March 2022

Background

Colon adenocarcinoma (COAD) is one of the common cancers worldwide. Collagen triple helix repeat containing 1 (CTHRC1) has been reported to be involved in cell invasion, angiogenesis, and the promotion of epithelial-mesenchymal transformation by mediating multiple signaling pathways. However, the role of CTHRC1 in COAD has not yet been determined.

Methods

Differentially expressed genes were evaluated using gene expression data from the Oncomine and TIMER databases. Correlations between CTHRC1 gene expression and clinicopathological factors were analyzed using gene expression data from UALCAN databases. Then, we searched the GEPIA database to evaluate the association of CTHRC1 gene expression with clinical outcomes. The cBioPortal database was used to analyze CTHRC1 genetic alterations. Subsequently, the TIMER website was chosen to assess the correlation of CTHRC1 with the tumor immune cell infiltration level. The TCGA dataset was used for a gene set enrichment analysis (GSEA).

Result

CTHRC1 was highly expressed in COAD patients, and significantly related to poor prognosis. In addition, elevated expression of CTHRC1 was related to the clinical stage and pathological type of COAD. The GSEA analysis showed that CTHRC1 was enriched in Gα signaling, GCPR ligand binding, neutrophil degranulation, interleukin signaling, and tumor-associated pathways. In addition, CTHRC1 was significantly associated with the expression of multiple immune markers related to specific immune cells.

Conclusion

This study suggest that CTHRC1 expression is related to the prognosis and immune infiltration of COAD patients. Therefore, CTHRC1 may be a new candidate prognostic biomarker for determining immune infiltration levels and providing COAD prognoses.
Effectiveness of a flow confirmation study of a central venous port of the upper arm versus the chest wall in patients with suspected system-related mechanical complications
Authors: Tokue Hiroyuki , Tokue Azusa , Tsushima Yoshito
Published: March 2022

Background

If mechanical complications associated with a central venous port (CVP) system are suspected, evaluation with a flow confirmation study (FCS) using fluorescence fluoroscopy or digital subtraction angiography should be performed. Evaluations of mechanical complications related to CVP of the chest wall using FCS performed via the subclavian vein have been reported. However, the delayed complications of a CVP placed in the upper arm have not been sufficiently evaluated in a large population. We evaluated the effectiveness of FCS of CVPs implanted following percutaneous cannulation of the subclavian (chest wall group) or brachial (upper arm group) vein.

Methods

A CVP was implanted in patients with advanced cancer requiring chemotherapy. FCS was performed if there were complaints suggestive of CVP dysfunction when initiating chemotherapy.

Results

CVPs were placed in the brachial vein in 390 patients and in the subclavian vein in 800 patients. FCS was performed in 26/390 (6.7%) patients in the upper arm group and 40/800 (5.0%) patients in the chest wall group. The clinical characteristics of the patients were similar in both groups. The duration of CVP implantation until FCS was significantly shorter in the upper arm group (136 ± 96.6 vs. 284 ± 260, p = 0.022). After FCS, the incidence of CVP removal/reimplantation being deemed unnecessary was higher in the upper arm group (21/26 [80.8%] vs. 26/40 [65.0%], p = 0.27). In the upper arm group, no cases of catheter kinking or catheter-related injury were observed, and the incidence of temporary obstruction because of blood clots that could be continued using CVP was significantly higher than that in the chest wall group (10/26 [38.5%] vs. 4/40 [10.0%], p = 0.012).

Conclusions

FCS was effective in evaluating CVP system-related mechanical complications and deciding whether removal and reimplantation were required in both groups.
Diabetes as a potential compounding factor in COVID-19-mediated male subfertility
Authors: Jiang Qingkui , Linn Thomas , Drlica Karl , Shi Lanbo
Published: March 2022

Recent work indicates that male fertility is compromised by SARS-CoV-2 infection. Direct effects derive from the presence of viral entry receptors (ACE2 and/or CD147) on the surface of testicular cells, such as spermatocytes, Sertoli cells, and Leydig cells. Indirect effects on testis and concentrations of male reproductive hormones derive from (1) virus-stimulated inflammation; (2) viral-induced diabetes, and (3) an interaction between diabetes and inflammation that exacerbates the deleterious effect of each perturbation. Reproductive hormones affected include testosterone, luteinizing hormone, and follicle-stimulating hormone. Reduction of male fertility is also observed with other viral infections, but the global pandemic of COVID-19 makes demographic and public health implications of reduced male fertility of major concern, especially if it occurs in the absence of serious symptoms that would otherwise encourage vaccination. Clinical documentation of COVID-19-associated male subfertility is now warranted to obtain quantitative relationships between infection severity and subfertility; mechanistic studies using animal models may reveal ways to mitigate the problem. In the meantime, the possibility of subfertility due to COVID-19 should enter considerations of vaccine hesitancy by reproductive-age males.
Uni-ventricular palliation vs. bi-ventricular repair: differential inflammatory response
Authors: Sigler Matthias , Rouatbi Hatem , Vazquez-Jimenez Jaime , Seghaye Marie-Christine
Published: March 2022

Background

To examine whether uni-ventricular palliation (UVP) and bi-ventricular repair (BVR) result in a different pattern of systemic inflammatory response to pediatric cardiac surgery with extra-corporeal circulation (ECC).

Methods

In 20 children (median age 39.5 months) undergoing either UVP (n = 12) or BVR (n = 8), plasma levels of the inflammatory cytokines TNF-α, IL-6, IL-10, and IL-12 and of procalcitonin (PCT), were measured before, during and after open cardiac surgery up to postoperative day (POD) 10.

Results

Epidemiologic, operative- and outcome variables were similar in both groups but post-operative central venous pressure that was higher in UVP. In the whole cohort, the inflammatory response was characterized by an early important, significant and parallel increase of IL-6 and IL-10 that reached their peak values either at the end of ECC (IL-10) or 4 h postoperatively (IL-6), respectively and by a significant and parallel decrease of TNF-α and IL-12 levels after connection to ECC, followed by a bi-phasic significant increase with a first peak 4 h after ECC and a second at POD 10, respectively. Patients after UVP showed a shift of the cytokine balance with lower IL-6- (p = 0.01) after connection to ECC, lower early post-operative TNF-α - (p = 0.02) and IL-12- (p = 0.04) concentrations and lower TNF-α/IL-10-ratio (p = 0.03) as compared with patients with BVR. Levels of PCT were similar in both groups.

Conclusions

UVP is associated with an anti-inflammatory shift of the inflammatory response to cardiac surgery that might be related to the particular hemodynamic situation of patients with UVP.
Establishment of MOS-SF36 percentile ranks in the general youth French population
Authors: Trognon Arthur , Tinti Emilie , Beaupain Blandine , Donadieu Jean , Musiol Michel
Published: March 2022

Background

The SF-36 is a generic quality of life questionnaire, massively translated and widely used to obtain physical and mental health status. However, validation work in the French language was carried out over a generation ago. The objective of this study was to obtain the norms of the SF-36 in the French young population.

Method

The sample consisted of 958 non-pre-screened French people aged between 18 and 24 years.

Results

The internal consistencies of the scales were high and the metrics associated with the factor structure were satisfactory. In general, women presented significantly higher scores than men.

Conclusion

Our results suggest that the SF-36 remains a reliable tool for studying quality of life in the young French population.
Injection laryngoplasty during transoral laser microsurgery for early glottic cancer: A randomized controlled trial
Authors: Al Afif Ayham , Rigby Matthew H. , MacKay Colin , Brown Timothy F. , Phillips Timothy J. , Khan Usman , Trites Jonathan R. B. , Corsten Martin , Taylor S. Mark
Published: March 2022

Background

Transoral laser microsurgery is widely used for treating T1/T2 glottic cancers. Hyaluronic acid (HA) is commonly used in vocal cord augmentation. We investigated the impact of intra-operative injection laryngoplasty on voice outcomes in early glottic cancer.

Methods

Twenty patients were randomized to the treatment group receiving HA injection to the vocal cord contralateral to the lesion; or the control group, receiving no injection. Patients had a Voice Handicap Index-10 (VHI-10) questionnaire and a Maximum Phonation Time (MPT) measurement preoperatively and at 3, 12 and 24 months post-operatively. Mean change in VHI-10 and MPT, compared to baseline and between time points, were compared. Survival estimates were calculated.

Results

Mean VHI-10 scores improved over time amongst all patients. There were no changes in mean VHI-10 from pre-operative values to 3, 12 or 24 months post-operatively. There were no significant differences when comparing various timepoints between groups. There were no significant changes in MPT amongst the groups, or the time-points compared. Two-year overall survival was 91.7%; disease free survival was 80.9%; no difference in recurrence free survival was seen between the groups.

Conclusion

Subjective voice scores improved over time in both groups; there were no improvements in VHI-10 or MPT scores in the injection group, over control, at any time points. We saw no significant impact for intra-operative HA injection laryngoplasty on subjective or objective voice outcomes following surgery for early glottic cancers.

Graphical Abstract
The Nemestrinidae in Egypt and Saudi Arabia (Brachycera: Diptera)
Authors: El-Hawagry Magdi , Al-Khalaf Areej A. , Soliman Ahmed M. , Abdel-Dayem Mahmoud S. , Al Dhafer Hathal M.
Published: March 2022

Background

The Nemestrinidae are a widespread group of moderate to large-sized rather stout flies. All known larvae of these flies are internal parasitoids of nymphs and adults of grasshoppers and larvae of scarabaeid beetles and have the potential to be used as biocontrol agents.

Results

All known Egyptian and Saudi Arabian nemestrinid taxa are systematically catalogued in the present study. A total number of 13 species classified in only 2 genera, Nemestrinus (subfamily Nemestrininae) and Trichopsidea (subfamily Falleniinae), were investigated. Twelve of these species are represented in Egypt, out of which 5 species are represented in Saudi Arabia as well. Two of the treated species, Nemestrinus ater (Olivier) and N. rufipes (Olivier), are newly recorded herein from Saudi Arabia. Only one species, Trichopsidea costata (Loew), was recorded exclusively from Saudi Arabia. An updated classification, taxonomic data, world and local distributions with collection dates and coloured photographs of some species were provided. Hope that the results of this study will provide the basis for systematic studies and fauna analyses of future works on Nemestrinidae. It seems likely that further species will be discovered with more research involving a variety of collecting methods.

Conclusion

Thirteen nemestrinid species belonging to 2 genera and 2 subfamilies were represented in both Egypt and Saudi Arabia. Two of these species are newly recorded herein from Saudi Arabia.
Long-Term Outcomes and Exploratory Analyses of the Randomized Phase III BILCAP Study
Authors: Bridgewater John , Fletcher Peter , Palmer Daniel H. , Malik Hassan Z. , Prasad Raj , Mirza Darius , Anthony Alan , Corrie Pippa , Falk Stephen , Finch-Jones Meg , Wasan Harpreet , Ross Paul , Wall Lucy , Wadsley Jonathan , Evans Thomas R. , Stocken Deborah , Stubbs Clive , Praseedom Raaj , Ma Yuk Ting , Davidson Brian , Neoptolemos John , Iveson Tim , Cunningham David , Garden O. James , Valle Juan W. , Primrose John ,   on behalf of the BILCAP study group
Published: March 2022

PURPOSE

The BILCAP study described a modest benefit for capecitabine as adjuvant therapy for curatively resected biliary tract cancer (BTC), and capecitabine has become the standard of care. We present the long-term data and novel exploratory subgroup analyses.

METHODS

This randomized, controlled, multicenter, phase III study recruited patients age 18 years or older with histologically confirmed cholangiocarcinoma or muscle-invasive gallbladder cancer after resection with curative intent and an Eastern Cooperative Oncology Group performance status of < 2. Patients were randomly assigned 1:1 to receive oral capecitabine (1,250 mg/m2 twice daily on days 1-14 of a 21-day cycle, for eight cycles) or observation. The primary outcome was overall survival (OS). This study is registered with EudraCT 2005-003318-13.

RESULTS

Between March 15, 2006, and December 4, 2014, 447 patients were enrolled; 223 patients with BTC resected with curative intent were randomly assigned to the capecitabine group and 224 to the observation group. At the data cutoff of January 21, 2021, the median follow-up for all patients was 106 months (95% CI, 98 to 108). In the intention-to-treat analysis, the median OS was 49.6 months (95% CI, 35.1 to 59.1) in the capecitabine group compared with 36.1 months (95% CI, 29.7 to 44.2) in the observation group (adjusted hazard ratio 0.84; 95% CI, 0.67 to 1.06). In a protocol-specified sensitivity analysis, adjusting for minimization factors, nodal status, grade, and sex, the OS hazard ratio was 0.74 (95% CI, 0.59 to 0.94). We further describe the prognostic impact of R status, grade, nodal status, and sex.

CONCLUSION

This long-term analysis supports the previous analysis, suggesting that capecitabine can improve OS in patients with resected BTC when used as adjuvant chemotherapy after surgery and should be considered as the standard of care.
Thermodynamic characterization of naturally occurring RNA pentaloops
Authors: Saon Md. Sharear , Znosko Brent M.
Published: March 2022

RNA folding is hierarchical; therefore, predicting RNA secondary structure from sequence is an intermediate step in predicting tertiary structure. Secondary structure prediction is based on a nearest neighbor model using free energy minimization. To improve secondary structure prediction, all types of naturally occurring secondary structure motifs need to be thermodynamically characterized. However, not all secondary structure motifs are well characterized. Pentaloops, the second most abundant hairpin size, is one such uncharacterized motif. In fact, the current thermodynamic model used to predict the stability of pentaloops was derived from a small data set of pentaloops and from data for other hairpins of different sizes. Here, the most commonly occurring pentaloops were identified and optically melted. New experimental data for 22 pentaloop sequences were combined with previously published data for nine pentaloop sequences. Using linear regression, a pentaloop-specific model was derived. This new model is simpler and more accurate than the current model. The new experimental data and improved model can be incorporated into software that is used to predict RNA secondary structure from sequence.
Επαναορίζοντας τους ηχητικούς περιπάτους ως εικονικά, ψηφιακά και υβριδικά ηχοτοπία
Authors: Ταλιάννη Κατερίνα
Published: March 2022

Στο παρόν άρθρο μελετώ το αστικό περιβάλλον μέσα από τις διαστάσεις του ήχου για να επαναπροσδιορίσω τη σημασία των ηχητικών περιπάτων στο πεδίο της τέχνης του ήχου. Ως εκ τούτου, στο κείμενο αναφέρομαι σε μελέτες της ακουστικής κουλτούρας σε συνδυασμό με θεωρητικές πτυχές της κοινωνιολογίας, των πολιτισμικών σπουδών, της ανθρωπολογίας, της φιλοσοφίας, της γεωγραφίας και της μουσικολογίας που αποτελούν το διεπιστημονικό πεδίο των Σπουδών Ήχου. Συζητώ παραδείγματα έργων ηχητικής τέχνης που καταδεικνύουν την ανάπτυξη των εικονικών, ψηφιακών και υβριδικών ηχοτοπίων ως ηχητικών χωρικοτήτων και τεχνολογικών χρονικοτήτων, που σχηματίζονται από τη συνένωση χωρικών, ακουστικών και πληροφοριακών στρωμάτων, μικτών πραγματικοτήτων και εικονικών τοπίων. Τα έργα στα οποία αναφέρομαι χρησιμοποιούν μεθόδους ακρόασης, ηχογράφησης πεδίου και σχεδίασης ήχου για να οραματιστούν μελλοντικές, μυθοποιητικές, και εναλλακτικές μορφές των αστικών χώρων. Στην παρούσα μελέτη, έτσι, αντιλαμβάνομαι τον ήχο ως ένα θεμελιώδες στοιχείο της σχέσης μας με τους άλλους και με τον κόσμο, και διερευνώ το πως οι τρέχουσες περιβαλλοντικές, κοινωνικοπολιτικές, πολιτιστικές και οικονομικές διαστάσεις της κοινωνίας μας μπορούν να αποτυπωθούν και να μελετηθούν μέσω του ήχου.
Τεχνικά μέσα, μνήμη και δικτύωση στην ηλεκτρονική μουσική
Authors: Κυριακόπουλος Λέανδρος
Published: March 2022

H Techno μουσική και τα rave πάρτι έχουν απόλαβει τεράστια αναγνώριση στην Αθήνα της λιτότητας και της κρίσης. Αυτή η έκρηξη αναγνωρισιμότητας της «ηλεκτρονικής χορευτικής μουσικής» συνοδεύτηκε και ίσως υποστηρίχθηκε από την αντίστοιχη ανάπτυξη των μέσων κοινωνικής δικτύωσης. Το κείμενο διερωτάται για το κατά πόσο η πρόσφατη αναγνώριση της ηλεκτρονικής μουσικής στην Αθήνα συνδέεται με την αυτοδιαχείριση, της εικονική έκφραση και τη δημοσιότητα που επιτρέπουν τα κοινωνικά δίκτυα, και διερευνά την επιθυμία για καλλιτεχνική πρωτοπορία, τον πειραματισμό με τον τρόπο ζωής και τον κοσμοπολιτισμό, ως ζωτικής σημασίας στοιχεία που όχι απλώς καθορίζουν την κουλτούρα της ηλεκτρονικής μουσικής αλλά αποτελούν άξονες διαπραγμάτευσης του μύθου της προόδου και της προσωπικής καταξίωσης. Από την εποχή της διαμόρφωσης της ηχητικής της ταυτότητας στο Ντιτρόιτ και στο Βερολίνο του 1980, η Techno μουσική απέβη ένα ηχητικό παλίμψηστο εγγεγραμμένο με μνήμες της λιτότητας, της επιθυμίας για δημιουργική έκφραση και της διεκδίκησης του μποέμ τρόπου ζωής των πάρτι. Στο πλαίσιο αυτό δηλαδή, η διερεύνηση της κουλτούρας δικτύωσης στην ηλεκτρονική μουσική, αποκεντρώνεται από τις σημασιολογικές βεβαιότητες της «δημόσιας αναγνώρισης» και της «προσωπικής επιτυχίας», και καταδύεται στις τεχνικές υποδομές των ψηφιακών και οπτικοακουστικών μέσων για να συλλάβει το πώς εντυπώνονται τα φαντάσματα της τεχνολογικής προόδου.
Ρεφλεξολογία και ανακουφιστική φροντίδα
Authors: Μαντούδη Αλεξάνδρα-Ξένη
Published: March 2022

Σκοπός της ερευνητικής μελέτης ήταν να διερευνηθεί η σχέση της ρεφλεξολογίας με το άγχος, τον πόνο, την ποιότητα ύπνου και την ποιότητα ζωής ατόμων που πάσχουν από καρκίνο στην κοινότητα, όταν αυτή εφαρμόζεται παράλληλα με τη συνήθη αγωγή. Διεξήχθη προοπτική στρωματοποιημένη μελέτη με συνολικό μέγεθος δείγματος 180 άτομα και τυχαιοποιημένη κατανομή των συμμετεχόντων σε τρεις ομάδες των 60: ομάδα παρέμβασης με εφαρμογή ρεφλεξολογίας, ομάδα σύγκρισης με εφαρμογή χαλάρωσης και ομάδα ελέγχου. Χρησιμοποιήθηκαν οι κλίμακες «Νοσοκομειακή Κλίμακα Άγχους και Κατάθλιψης», «Έρευνα Υγείας SF12», «Δείκτης Ποιότητας Ύπνου του Pittsburgh» και «Ελληνικό Συνοπτικό Ερωτηματολόγιο Πόνου». Ως προς τα αποτελέσματα, οι συγκρίσεις κατά ζεύγη των ποσοστιαίων μεταβολών μεταξύ baseline-8ης εβδομάδας για την μεταβλητή άγχος αναδεικνύουν στατιστικά σημαντική διαφορά ανάμεσα στην ομάδα ρεφλεξολογίας και τις ομάδες χαλάρωσης και ελέγχου (p<0,0005). Για τη σωματική συνιστώσα της ποιότητας ζωής, η ποσοστιαία μεταβολή baseline-8ης εβδομάδας αναδεικνύει σημαντική διαφορά μεταξύ της ομάδας ρεφλεξολογίας και των ομάδων χαλάρωσης (p<0,0005) και ελέγχου (p=0,003) και αντίστοιχα για την ψυχική συνιστώσα με p=0,019 και p=0,012. Για την μεταβλητή «πόνος κατά την παρούσα στιγμή», η ποσοστιαία μεταβολή baseline-8ης εβδομάδας αναδεικνύει σημαντική διαφορά ανάμεσα στην ομάδα ρεφλεξολογίας και τις ομάδες χαλάρωσης (p<0,0005) και ελέγχου (p=0,016) και αντίστοιχα για τη μεταβλητή «παρέμβαση του πόνου στη γενική δραστηριότητα το τελευταίο 24ωρο», ανάμεσα στις ομάδες ρεφλεξολογίας και χαλάρωσης (p=0,003). Για τη μεταβλητή της ποιότητας ύπνου, στις ποσοστιαίες μεταβολές baseline-8ης εβδομάδας παρατηρείται στατιστικά σημαντική διαφορά (p<0,05) μεταξύ των ομάδων ρεφλεξολογίας και χαλάρωσης. Επομένως, η συμπληρωματική παρέμβαση της ρεφλεξολογίας φαίνεται να είναι σημαντικά πιο αποτελεσματική στη μείωση του άγχους και τη βελτίωση της ποιότητας ζωής συγκριτικά με την παρέμβαση της χαλάρωσης και τη συνήθη φροντίδα και αγωγή από μόνη της. Ως προς τον πόνο και τη βελτίωση της ποιότητας του ύπνου, η ρεφλεξολογία επιδεικνύει καλύτερα αποτελέσματα σε σχέση με τις άλλες δύο προσεγγίσεις.
Mortality in extremely low BMI anorexia nervosa patients – implications of gastrointestinal and endocrine system dysfunction
Authors: Suszko Monika , Sobocki Jacek , Imieliński Christian
Published: March 2022

Streszczenie
Jadłowstręt psychiczny to choroba przewlekła, zaliczana do grupy zaburzeń odżywiania. Choroba ta ma wieloczynnikową etiologię, a leczenie powinno odbywać się pod okiem wielodyscyplinarnego zespołu specjalistów. Jest to zespół objawowy, który dotyka głównie młode kobiety, również w Polsce. Złożony obraz kliniczny anoreksji tworzą liczne objawy somatyczne oraz psychiczne. Duże ryzyko śmiertelności wiąże się z powikłaniami ze strony wszystkich narządów i układów. Jednym z kryterium rozpoznania choroby jest wskaźnik masy ciała (BMI), według którego wartość BMI <15 kg / m² określa stan ekstremalny pacjenta. Przegląd literatury naukowej oraz praktyka kliniczna wykazuje, że BMI <10 kg / m² nie jest jednak rzadkością. Dotychczas nie określono jaka wartość BMI jest związana z konkretnym powikłaniem medycznym, istnieje natomiast wiele zależności. Niniejszy artykuł wyjaśnia jakie powikłania ze strony układu pokarmowego oraz wewnątrzwydzielniczego towarzyszą anoreksji. Opisuje jakie adaptacje metaboliczne aktywuje organizm do przetrwania, mimo tak niskiej wartości wskaźnika masy ciała (najniższa zaraportowana wartość BMI wynosi zaledwie 6,7 kg / m²).