bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential Benefits of Curcumin in Rheumatoid Arthritis
Authors: Sotebeer Megan , White Nicole D.
Published: August 2022

Widely known as a curry spice, curcumin has a long history of use in the treatment of inflammatory conditions in Eastern Medicine. The spice is gaining interest in modern medicine for a diverse array of conditions, including rheumatoid arthritis. Evidence indicates curcumin can effectively suppress inflammation through inhibition of pro-inflammatory cytokine production as well as modulate B cell and T cell differentiation and function. The following article will evaluate the existing clinical trial literature assessing the impact of curcumin on patients with rheumatoid arthritis. Potential mechanisms of action, bioavailability issues, and effective dosing will be described.
Development of a new scale for the measurement of interprofessional collaboration among occupational therapists, physical therapists and speech-language therapists
Authors: Ikeda Kohei , Sasada Satoshi
Published: August 2022

Background/Objective

The purpose of this study is to develop and validate an instrument to assess interprofessional collaboration by occupational therapists, physical therapists, and speech-language therapists.

Methods

Item development consisted of a review of interprofessional collaboration and group interviews with occupational therapists, physical therapists, and speech-language therapists. The developed items were surveyed on a 4-point Likert scale among occupational therapists, physical therapists, and speech-language therapists. Ceiling effects, floor effects, and item-total correlation analysis for each item, as well as constructs, internal consistency, and cross-cultural validity of the scales were evaluated.

Results

A total of 47 items were extracted for evaluation and 28 items with five factors (“team-oriented behavior,” “exchange of opinions,” “flexible response,” “sharing the whole picture of the patient,” and “coordination of support methods”) were retained after the evaluation. The correlation coefficients of the five factors ranged from 0.48 to 0.72. The total score of each factor and the total score of all 28 items were compared for occupational therapists, physical therapists, and speech-language therapists, and the result showed that was no statistically significant difference between the total scores of all factors and the job titles. The Cronbach’s alpha coefficients for the five factors are 0.842, 0.840, 0.805, 0.732, and 0.734 for the first, second, third, fourth, and fifth factors, respectively.

Conclusions

The developed scale includes items aimed at facilitating patients' activities of daily living through interprofessional collaboration, and its content reflects the expertise of occupational therapists, physical therapists, and speech-language therapists.
Experimental investigation of dynamic behavior of rotor system with a novel double layers flexible support tilting pad bearing
Authors: Huang Guangyao , Wang Xiaojing , Qin Xin , Zhu Liming , Yi Shuxiang
Published: August 2022

Among all kinds of journal bearings, the tilting pad bearing has the characteristics of high stability. In order to further reduce the vibration and improve the stability of rotor-bearing systems, a novel double layers flexible support tilting pad bearing (DL-FSTPB) is presented in this paper. The bearing utilizes two layers of springs, which have different functions. The offset springs control the swing angle of the tilting pad to ensure the formation of a convergent oil film, and the symmetrical springs are used to change the bearing stiffness coefficient, increase the bearing elasticity, and improve the ability to accommodate misalignment. Experiments were carried out to study the vibration characteristics of the rotor system. The results were analyzed using wavelet analysis of acceleration and displacement, waterfall plots, a wavelet analysis, a run-up process and shaft center orbits areas. The results show that the DL-FSTPB exhibits excellent vibration attenuation characteristics, which can effectively reduce the amplitude and the system vibration level.
Identifying vaccination deserts: The availability and distribution of pharmacists with authorization to administer injections in Ontario
Authors: Houle Sherilyn K.D. , Timony Patrick , Waite Nancy M. , Gauthier Alain
Published: August 2022

Introduction:

Pharmacist-administered immunizations have been associated with improved vaccination rates; however, little is known about whether areas with little to no access to this service (“vaccination deserts”) exist. The objective of this work is to determine the geographic availability of pharmacists with authorization to administer injections in the province of Ontario.

Methods:

Ontario College of Pharmacists registry data were used to identify patient care–providing pharmacists in community pharmacies and their ability to administer injections. Their number of hours worked was converted into full-time equivalents (FTEs), assuming 40 hours per week represents 1 FTE. Practice site(s) were mapped by postal code and presented by Public Health Unit (PHU) area. Communities within PHUs were further categorized as urban or rural and northern or southern, with ratios of FTEs per 1000 population calculated for both injection-trained and non-injection-trained pharmacists.

Results:

In total, 74.6% of Ontario’s practising community pharmacists are authorized to provide injections. Northern PHUs had slightly better access to pharmacist injectors (0.61 FTEs/1000 overall vs 0.56/1000 in the south), while rural communities had lower availability (0.41 FTEs/1000) than urban communities (0.58 FTEs/1000). PHUs with greater population size and density had greater availability of pharmacist immunizers, while PHUs with greater land area were more likely to not have any immunizing pharmacists present ( p < 0.001 for all).

Discussion:

As pharmacists increasingly become preferred vaccination providers, awareness of disparities related to access to pharmacy-based immunizations and collaboration with public health and primary care providers to address them (e.g., through mobile vaccination clinics) will be required to ensure equitable access. Can Pharm J (Ott) 2022;155:xx-xx.
Pemigatinib for adults with previously treated, locally advanced or metastatic cholangiocarcinoma with FGFR2 fusions/rearrangements
Authors: Walden Daniel , Eslinger Cody , Bekaii-Saab Tanios
Published: August 2022

Biliary tract cancers are a diverse and aggressive malignancy that carry a poor chance for curative treatment and significant associated mortality. Current first-line treatment only extends median overall survival to roughly 1 year and is associated with a significant adverse event profile. Recently, advancements in genetic sequencing have opened new avenues of targeted treatment. In cholangiocarcinoma, FGFR2 alterations have been shown to be present in roughly 10–15% of intrahepatic cholangiocarcinoma. Pemigatinib, a FGFR1–4 inhibitor, has been shown to significantly extend survival in the second-line setting to over 20 months in patients who harbor FGFR2 fusions. Here, we outline the development and future direction of pemigatinib and other FGFR2 inhibitors in the field of advanced biliary tract cancers.
Disabled students doing activism: Borrowing from and trespassing neoliberal reason in English higher education
Authors: Raaper Rille , Peruzzo Francesca , Westander Mette
Published: August 2022

The neoliberal rationale in English higher education promotes institutional and individual competition for economic success, often at the cost of equity and universalism. Within such context, there is a tendency to formalise student voice, for example, through professionalisation of students’ unions. This paper argues that neoliberalism and its effects on university practices enforce ableist culture, further marginalising disabled students. More specifically, the paper is concerned with how Disabled Students’ Officers – official full- or part-time student representatives of disabled students in English students’ unions – practise activism in response to universities’ neoliberal agendas. By utilising Foucault’s concept of governmentality and qualitative analysis of in-depth interviews with Disabled Students’ Officers, we explore the ways of doing disability activism in their experience. The findings indicate that activism as it is practised by participants is complex and contradictory, combining neoliberal ways of acting, i.e., evidence production, committee-based work and lobbying, with more subtle forms of critique and resistance related to collectivism, arts and ethics of care. By enabling critical reflections on participants’ experiences, this paper strives to encourage debate on renewed strategies and complexity and contradiction in activism, but also to highlight the potential for trespassing the dominant neoliberal rationale in higher education.
Thymic squamous cell carcinoma lurking in a growing large cyst: A case report
Authors: Nakagawa Tomoki , Masuda Ryota , Shinichiro Hiraiwa , Yamada Shunsuke , Iwazaki Masayuki
Published: August 2022

An 81-year-old man was admitted for resection of an asymptomatic left anterior mediastinal tumor. Chest computed tomography showed that a small, homogeneous lesion had grown to a large, cystic lesion (80 mm) over a 5-year period. The cystic tumor was removed with adherent structures such as the left upper pulmonary parenchyma and lower part of the left innominate vein via median sternotomy with assistance from a left thoracoscopic procedure. Macroscopically, a solid tumor was located within the large multilocular cyst. The pathological diagnosis was cystic squamous cell carcinoma (12 mm), which had not infiltrated any surrounding organs. The patient has remained well without recurrence as of 4 years postoperatively.
Insight from a novel humanities-based education intervention to teach empathy to internal medicine residents locally
Authors: Ong Eng Koon
Published: August 2022

The medical humanities have the potential to develop empathy in junior doctors through perspective taking and critique of deep-seated beliefs. An education intervention to develop empathy was integrated into an internal medicine residency curriculum in Singapore. All junior residents currently in the programme were invited to participate in individual interviews after the humanities sessions. Data collected was analysed qualitatively using thematic analysis. A total of three sessions were conducted over one year from April 2020. Two participants were recruited successfully for the study. A total of 4 interviews were completed and themes relating to the role of the humanities in empathy education, barriers to its implementation, and cynicism to the sessions were elicited. The results provided insight about how residents experienced a novel humanities-based postgraduate medical education program. However, the low recruitment is a major limitation in this study and data collected may not be confidently interpreted. There is still significant work needed to create greater awareness about the role of the humanities in medical education and research. Improvement in the pandemic situation may also improve participation in future studies.
Online student engagement in times of emergency: Listening to the voices of students
Authors: Addae David
Published: August 2022

The closure of schools and colleges worldwide, as a result of the COVID-19 lockdown and stay-at-home protocols, were timely actions given the surge in infection rates. It became immediately necessary for innovative strategies to be put in place to engage students while they remained at home. In Ghana, many traditional universities adopted the use of online learning tools to promote learning amongst their students during this period of uncertainty. In this exploratory case study, I explore the experiences of final year undergraduate students ( N = 18) in the University of Ghana with the intention of examining: (1) the various strategies adopted by lecturers to engage students in online learning during this time when they were at home; (2) the challenges the students experienced; and (3) the students’ views on ways of promoting effective student online learning engagement during future emergencies. Three strategies were identified by the students as being used by the lecturers for online learning engagement, namely videoconferencing, use of discussion boards, and use of regular assignments. It was found that the students experienced manifold engagement challenges in online learning including data and network problems, technical difficulties, assessment overload, as well as administrative issues. In order to ensure effective student online learning engagement in future national emergencies, it was suggested that resources such as internet facilities should be made available to students; assessment load should be reduced while interactive and active online learning engagement strategies are prioritized; and administrative support should be offered to students. The study’s findings have significant implications for the planning, design and the implementation of online learning programmes in higher education.
Drivers affecting Indonesian pre-service teachers’ intention to use m-learning: Structural equation modeling at three universities
Authors: Habibi Akhmad , Riady Yasir , Alqahtani Turki Mesfer , Muhaimin Muhaimin , Albelbisi Nour Awni , Jaya Aswadi , Yaqin Lalu Nurul
Published: August 2022

The current study uses the technology acceptance model to understand the drivers affecting Indonesian pre-service teachers’ intention to use m-learning. Eleven hypotheses were proposed within seven variables; self-efficacy, subjective norms, facilitating conditions, perceived usefulness, perceived ease of use, attitudes, and intention to use m-learning. Content validity index and pilot study were conducted before the data collection. The survey instrument was distributed to more than 1000 Indonesian pre-service teachers; however, 772 responses were measurable. The analysis was achieved through the partial least square structural equation modeling and t-test. Findings revealed that 10 out of 11 relationships were significant. Intention to use m-learning was significantly predicted by perceived usefulness and attitude. Perceived usefulness and perceived ease of use were the significant predictors of attitude. Self-efficacy, perceived ease of use, and subjective norms were reported to predict perceived usefulness, while an insignificant correlation emerged between facilitating conditions and perceived usefulness. Perceived ease of use was significantly affected by facilitating conditions, subjective norms, and self-efficacy. Additionally, the difference test reported that the mean scores between participants’ gender were different regarding intention to use m-learning; female teachers’ intention to use m-learning was lower than their male teacher counterparts. An insignificant difference was confirmed based on age. Suggestions are proposed to improve technology integration in education, especially m-learning integration in Indonesia.
A progressing inflammatory pulmonary infiltrate in a patient with hyper IgE syndrome
Authors: Jakobsen Samal , Hilberg Ole , Larsen Carsten Schade , Løkke Anders
Published: August 2022

A young man known with autosomal dominant hyper IgE syndrome and changes on his chest radiograph was presumed to be infected with Aspergillus and treated with antifungal medicine for 11 months without effect. Positron emission tomography/computed tomography imaging was suggestive of Aspergilloma but bronchoalveolar lavage cultures, cytology as well as biochemistry were negative for Aspergillus. Finally, a transthoracic computed tomography-guided biopsy did not support the diagnosis of fungal infection as only chronic inflammatory changes were found. The patient was treated with Prednisolone after which the changes on his chest X-ray regressed.
Effects of ultra-low dose hormone therapy on biochemical bone turnover markers in postmenopausal women: A randomized, placebo-controlled, double-blind trial
Authors: Costa-Paiva Lucia , O Wender Maria Celeste , Machado Rogerio B , Pompei Luciano M , Nahas Eliana A , Nahas-Neto Jorge , Del Debbio Sonia Y , Badalotti Mariangela , Cruz Achilles M
Published: August 2022

Objective

Evaluate the effects of ultra-low-dose hormone therapy (Ultra-LD HT) with 17β-estradiol 0.5 mg and norethisterone acetate 0.1 mg (E2 0.5/NETA 0.1) versus placebo on bone turnover markers (BTM) in postmenopausal women.

Study Design

A multicenter, double-blind, randomized, placebo-controlled study was performed with 107 participants who received one tablet daily of E2 0.5/NETA 0.1 or placebo for 24-weeks. Bone formation markers-N-terminal propeptide of type I procollagen (PINP) and Bone-specific alkaline phosphatase (BSAP), and bone resorption markers-C-telopeptide of type I collagen (CTX-I) and N-telopeptide crosslinked of type I collagen (NTX) were assessed before and at 12 and 24-weeks of treatment.

Results

Women treated with E2 0.5/NETA 0.1 had a significant reduction in the PINP marker from baseline (58.49 ± 21.12 μg/L) to week 12 (48.31 ± 20.99 μg/L) and week 24 (39.16 ± 16.50 μg/L). Placebo group, the PINP marker did not differ significantly. The analysis of the BSAP indicated a significant increase in the placebo group (13.8 ± 5.09 μg/L and 16.29 ± 4.3 μg/L, at baseline and week 24, respectively), whereas in the treatment group the values did not change. The analysis of the NTX marker showed a significant reduction only in the treatment group (43.21 ± 15.26 nM/mM and 33.89 ± 14.9 nM/mM, at baseline and week 24, respectively). CTX-I had a significant decrease in the treatment group from baseline (0.3 ± 0.16 ng/L) to week 12 (0.21 ± 0.14 ng/L) and week 24 (0.21 ± 0.12 ng/L).

Conclusion

Women receiving E2 0.5/NETA 0.1 experienced reductions in bone resorption and formation markers, an expected effect during the anti-resorptive therapy, suggesting a protective bone effect with the Ultra-LD HT.
ELIMINATOR: essentiality analysis using multisystem networks and integer programming
Authors: Antoranz Asier , Ortiz María , Pey Jon
Published: August 2022

A gene is considered as essential when it is indispensable for cells to grow and replicate in a certain environment. However, gene essentiality is not a structural property but rather a contextual one, which depends on the specific biological conditions affecting the cell. This circumstantial essentiality of genes is what brings the attention of scientist since we can identify genes essential for cancer cells but not essential for healthy cells. This same contextuality makes their identification extremely challenging. Huge experimental efforts such as Project Achilles where the essentiality of thousands of genes is measured together with a plethora of molecular data (transcriptomics, copy number, mutations, etc.) in over one thousand cell lines can shed light on the causality behind the essentiality of a gene in a given environment. Here, we present an in-silico method for the identification of patient-specific essential genes using constraint-based modelling (CBM). Our method expands the ideas behind traditional CBM to accommodate multisystem networks. In essence, it first calculates the minimum number of lowly expressed genes required to be activated by the cell to sustain life as defined by a set of requirements; and second, it performs an exhaustive in-silico gene knockout to find those that lead to the need of activating additional lowly expressed genes. We validated the proposed methodology using a set of 452 cancer cell lines derived from the Cancer Cell Line Encyclopedia where an exhaustive experimental large-scale gene knockout study using CRISPR (Achilles Project) evaluates the impact of each removal. We also show that the integration of different essentiality predictions per gene, what we called Essentiality Congruity Score, reduces the number of false positives. Finally, we explored our method in a breast cancer patient dataset, and our results showed high concordance with previous publications. These findings suggest that identifying genes whose activity is fundamental to sustain cellular life in a patient-specific manner is feasible using in-silico methods. The patient-level gene essentiality predictions can pave the way for precision medicine by identifying potential drug targets whose deletion can induce death in tumour cells.
Risk score prediction model based on single nucleotide polymorphism for predicting malaria: a machine learning approach
Authors: Tai Kah Yee , Dhaliwal Jasbir , Wong KokSheik
Published: August 2022

Background

The malaria risk prediction is currently limited to using advanced statistical methods, such as time series and cluster analysis on epidemiological data. Nevertheless, machine learning models have been explored to study the complexity of malaria through blood smear images and environmental data. However, to the best of our knowledge, no study analyses the contribution of Single Nucleotide Polymorphisms (SNPs) to malaria using a machine learning model. More specifically, this study aims to quantify an individual's susceptibility to the development of malaria by using risk scores obtained from the cumulative effects of SNPs, known as weighted genetic risk scores (wGRS).

Results

We proposed an SNP-based feature extraction algorithm that incorporates the susceptibility information of an individual to malaria to generate the feature set. However, it can become computationally expensive for a machine learning model to learn from many SNPs. Therefore, we reduced the feature set by employing the Logistic Regression and Recursive Feature Elimination (LR-RFE) method to select SNPs that improve the efficacy of our model. Next, we calculated the wGRS of the selected feature set, which is used as the model's target variables. Moreover, to compare the performance of the wGRS-only model, we calculated and evaluated the combination of wGRS with genotype frequency (wGRS + GF). Finally, Light Gradient Boosting Machine (LightGBM), eXtreme Gradient Boosting (XGBoost), and Ridge regression algorithms are utilized to establish the machine learning models for malaria risk prediction.

Conclusions

Our proposed approach identified SNP rs334 as the most contributing feature with an importance score of 6.224 compared to the baseline, with an importance score of 1.1314. This is an important result as prior studies have proven that rs334 is a major genetic risk factor for malaria. The analysis and comparison of the three machine learning models demonstrated that LightGBM achieves the highest model performance with a Mean Absolute Error (MAE) score of 0.0373. Furthermore, based on wGRS + GF, all models performed significantly better than wGRS alone, in which LightGBM obtained the best performance (0.0033 MAE score).
The Pericapsular Nerve Group (PENG) block combined with Local Infiltration Analgesia (LIA) compared to placebo and LIA in hip arthroplasty surgery: a multi-center double-blinded randomized-controlled trial
Authors: Lin D.-Yin , Brown Brigid , Morrison Craig , Fraser Nikolai S. , Chooi Cheryl S. L. , Cehic Matthew G. , McLeod David H. , Henningsen Michael D. , Sladojevic Nikolina , Kroon Hidde M. , Jaarsma Ruurd L.
Published: August 2022

Background

The PEricapsular Nerve Group (PENG) block is a novel regional analgesia technique that provides improved analgesia in patients undergoing hip surgery while preserving motor function. In this study the PENG block was investigated for analgesia in elective total hip arthroplasty (THA).

Methods

In this multi-centre double-blinded randomized-controlled trial, in addition to spinal anesthesia and local infiltration analgesia (LIA), THA patients received either a PENG block or a sham block. The primary outcome was pain score (numeric rating scale 0–10) 3 h postoperatively (Day 0). Secondary outcomes were postoperative quadriceps muscle strength, postoperative Day 1 pain scores, opiate use, complications, length of hospital stay, and patient-reported outcome measures.

Results

Sixty patients were randomized and equally allocated between groups. Baseline demographics were similar. Postoperative Day 0, the PENG group experienced less pain compared to the sham group (PENG: 14 (47%) patients no pain, 14 (47%) mild pain, 2 (6%) moderate/severe pain versus sham: 6 (20%) no pain, 14 (47%) mild pain, 10 (33%) moderate/severe pain; p = 0.03). There was no difference in quadriceps muscle strength between groups on Day 0 (PENG: 23 (77%) intact versus sham: 24 (80%) intact; p = 0.24) and there were no differences in other secondary outcomes.

Conclusions

Patients receiving a PENG block for analgesia in elective THA experience less postoperative pain on Day 0 with preservation of quadriceps muscle strength. Despite these short-term benefits, no quality of recovery or longer lasting postoperative effects were detected.
Recruitable alveolar collapse and overdistension during laparoscopic gynecological surgery and mechanical ventilation: a prospective clinical study
Authors: Dargvainis Mantas , Ohnesorge Henning , Schädler Dirk , Alkatout Ibrahim , Frerichs Inéz , Becher Tobias
Published: August 2022

Background

Laparoscopic surgery in Trendelenburg position may impede mechanical ventilation (MV) due to positioning and high intra-abdominal pressure. We sought to identify the positive end-expiratory pressure (PEEP) levels necessary to counteract atelectasis formation (“Open-Lung-PEEP”) and to provide an equal balance between overdistension and alveolar collapse (“Best-Compromise-PEEP”).

Methods

In 30 patients undergoing laparoscopic gynecological surgery, relative overdistension and alveolar collapse were assessed with electrical impedance tomography (EIT) during a decremental PEEP trial ranging from 20 to 4 cmH2O in supine position without capnoperitoneum and in Trendelenburg position with capnoperitoneum.

Results

In supine position, the median Open-Lung-PEEP was 12 (8–14) cmH2O with 8.7 (4.7–15.5)% of overdistension and 1.7 (0.4–2.2)% of collapse. Best-Compromise-PEEP was 8 (6.5–10) cmH2O with 4.2 (2.4–7.2)% of overdistension and 5.1 (3.9–6.5)% of collapse. In Trendelenburg position with capnoperitoneum, Open-Lung-PEEP was 18 (18–20) cmH 2 O (p < 0.0001 vs supine position) with 1.8 (0.5–3.9)% of overdistension and 0 (0–1.2)% of collapse and Best-Compromise-PEEP was 18 (16–20) cmH2O (p < 0.0001 vs supine position) with 1.5 (0.7–3.0)% of overdistension and 0.2 (0–2.7)% of collapse. Open-Lung-PEEP and Best-Compromise-PEEP were positively correlated with body mass index during MV in supine position but not in Trendelenburg position.

Conclusion

The PEEP levels required for preventing alveolar collapse and for balancing collapse and overdistension in Trendelenburg position with capnoperitoneum were significantly higher than those required for achieving the same goals in supine position without capnoperitoneum. Even with high PEEP levels, alveolar overdistension was negligible during MV in Trendelenburg position with capnoperitoneum.

Trial registration

This study was prospectively registered at German Clinical Trials registry (DRKS00016974).
Outcome of life-threatening arrhythmias among patients presenting in an emergency setting at a tertiary hospital in Accra-Ghana
Authors: Doku Alfred , Asare Bernard Yeboah-Asiamah , Osei Richard , Owoo Christian , Djagbletey Robert , Akamah Joseph , Aniteye Ernest , Ahadzi Dzifa
Published: August 2022

Background

Management of life-threatening arrhythmia can be incredibly challenging in advanced health systems. In sub-Saharan Africa (SSA), this is likely more challenging because of weak pre-hospital and in-hospital critical care systems. Little is known about life-threatening arrhythmia and their outcomes in SSA. The aim of this study was to examine the types and outcomes of arrhythmias among haemodynamically unstable patients presenting at a tertiary hospital in Accra-Ghana.

Method

This was a retrospective case series study conducted at the Korle-Bu Teaching Hospital (KBTH), Accra-Ghana. Medical records of patients who presented with or developed haemodynamically unstable arrhythmias within 24h of admission from January 2018 to December 2020 were reviewed. The demographic characteristics and clinical data including outcomes of patients were collected. Descriptive statistics were used and results presented in frequency tables.

Results

A total of 42 patients with life-threatening arrhythmias were included. Haemodynamically unstable tachyarrhythmias were the most common arrhythmias found among the patients (66.7%). Approximately 52% of patients had structural heart diseases whereas 26.2% had no apparent underlying cause or predisposing factor. Cardioversion (52.4%), commonly electrical (63.6%), and transvenous pacemaker implantation (23.8%) were the common initial interventions. The majority of the patients (88.1%) survived and were discharged home.

Conclusion

Tachyarrhythmias are the most common haemodynamically unstable arrhythmias seen among patients presenting emergently in a leading tertiary hospital in Ghana. A high survival rate was observed and cannot be extrapolated to other healthcare settings in sub-Saharan Africa with limited resources to manage these clinical entities.
Life-space, frailty, and health-related quality of life
Authors: Chitalu Petronella , Tsui Alex , Searle Samuel D. , Davis Daniel
Published: August 2022

Introduction

Life-space and frailty are closely linked to health-related quality of life and understanding their inter-relationship could indicate potential intervention targets for improving quality of life. We set out to examine the relationship between frailty and life-space and their relative impact on quality of life measures.

Methods

Using cross-sectional data from a population-representative cohort of people aged ≥ 70 years, we assessed quality of life with the EuroQol Health Index tool (5-levels) (EQ-5D-5L). We also undertook a life-space assessment and derived a frailty index. Linear regression models estimated EQ-5D-5L scores (dependent variable) using life-space assessment, frailty index and interactions between them. All models were adjusted by age, sex, lifestyle, and social care factors.

Results

A higher EQ-5D Index was associated with higher life-space (0.02 per life-space assessment score, 95%CI: 0.01 to 0.03, p < 0.01) and decreasing frailty (-0.1 per SD, 95%CI: -0.1 to -0.1, p < 0.01). There was evidence of an interaction between life-space and frailty, where the steepest gradient for life-space and EQ-5D was in those with the highest frailty (interaction term = 0.02 per SD of frailty, 95%CI: 0.01 to 0.03, p < 0.01).

Conclusion

Individuals with the highest frailty were twice as likely to have higher quality of life in association with a larger life-space. Interventions designed to improve quality of life in frail older people could focus on increasing a person’s life-space.
Composite scoring system and optimal tumor budding cut-off number for estimating lymph node metastasis in submucosal colorectal cancer
Authors: Kim Jeong-ki , Rhee Ye-Young , Bae Jeong Mo , Kim Jung Ho , Koh Seong-Joon , Lee Hyun Jung , Im Jong Pil , Kim Min Jung , Ryoo Seung-Bum , Jeong Seung-Yong , Park Kyu Joo , Park Ji Won , Kang Gyeong Hoon
Published: August 2022

Background

Tumor budding is associated with lymph node (LN) metastasis in submucosal colorectal cancer (CRC). However, the rate of LN metastasis associated with the number of tumor buds is unknown. Here, we determined the optimal tumor budding cut-off number and developed a composite scoring system (CSS) for estimating LN metastasis of submucosal CRC.

Methods

In total, 395 patients with histologically confirmed T1N0–2M0 CRC were evaluated. The clinicopathological characteristics were subjected to univariate and multivariate analyses. The Akaike information criterion (AIC) values of the multivariate models were evaluated to identify the optimal cut-off number. A CSS for LN metastasis was developed using independent risk factors.

Results

The prevalence of LN metastasis was 13.2%. Histological differentiation, lymphatic or venous invasion, and tumor budding were associated with LN metastasis in univariate analyses. In multivariate models adjusted for histological differentiation and lymphatic or venous invasion, the AIC value was lowest for five tumor buds. Unfavorable differentiation (odds ratio [OR], 8.16; 95% confidence interval [CI], 1.80–36.89), lymphatic or venous invasion (OR, 5.91; 95% CI, 2.91–11.97), and five or more tumor buds (OR, 3.01; 95% CI, 1.21–7.69) were independent risk factors. In a CSS using these three risk factors, the rates of LN metastasis were 5.6%, 15.5%, 31.0%, and 52.4% for total composite scores of 0, 1, 2, and ≥ 3, respectively.

Conclusions

For the estimation of LN metastasis in submucosal CRC, the optimal tumor budding cut-off number was five. Our CSS can be utilized to estimate LN metastasis.
A retrospective study of the efficacy of intense pulsed light delivered by the Lacrystim® for meibomian gland dysfunction therapy
Authors: Trone Marie-Caroline , Garcin Thibaud , Ollier Edouard , Thuret Gilles , Gain Philippe
Published: August 2022

Background

Meibomian gland dysfunction is the most common etiology of dry eye disease worldwide and intense pulsed light appears to be a promising treatment with encouraging results. Lacrystim® is a new IPL device (CE marking in 2019) and no studies have yet been published on it. We propose the first study on this device with an objective assessment of its efficacy and an extended follow-up over 6 months.

Methods

Patients presenting with a dry eye disease (DED) with stable mild to moderate MGD and having received Lacrystim® treatment between june 2019 and june 2020 were included. 3 IPL sessions were performed at D0, D15 and D45 with 4 shots per side at a fluence of 8 mJ/cm2. DED clinical evaluation was performed at D0, D15, D45, 3rd month and 6th month: Oxford scale and break up time, Schirmer test and Ocular Surface Disease Index (OSDI) questionnaire. Lacrydiag® imaging device carried out an objective examination of tear film: interferometry, meibography, tear meniscus height and non-invasive break up time (NIBUT). The primary endpoint was the evolution in NIBUT between the first visit D0 and 3rd month. Data collection was done retrospectively. Statistical analysis was done using a linear mixed-effects model and a non-parametric linear mixed-effects model (R software).

Results

Forthy five consecutive patients were included. NIBUT significantly increased between D0 and 3rd month: mean difference of 1.63 seconds, IC95% [0.51; 2.62], (p = 0.002) with a prolonged effect at 6th month. OSDI and OXFORD scores and interferometry were also significantly improved at 3rd month and 6th month. There was no significant change in BUT, Schirmer test and tear meniscus height. No adverse event was noted.

Conclusions

IPL delivered by Lacrystim® appears effective and safe to treat MGD although a randomized controlled trial is needed to validate its results.

Trial registration

This work was approved by a local ethics committee “Terre d’éthique” (institutional review board number: IRBN672019/CHUSTE) and registered on the clinicaltrial.gov website (NCT04147962, 01/11/2019).
Corneal endothelial cell density and its correlation with birth weight, anthropometric parameters, and ocular biometric parameters in Chinese school children
Authors: Wang Zijin , Zuo Xiaoxia , Liu Lei , Chen Xuejuan , Li Rui , Zhu Hui , Huang Dan , Tong Haohai , Zhao Xiaoyan , Yan Wen , Shen Shiya , Wang Yun , Li Xiaoxiao , Zhao Andi , Chen Danni , Ding Ranran , Li Shiding , Liu Hu
Published: August 2022

Background

To describe the distribution of corneal endothelial cell density (ECD), and to explore its correlation with birth weight (BW), anthropometric parameters, and ocular biometric parameters in Chinese school children.

Methods

In the population-based cross-sectional Nanjing Eye Study, children were measured for anthropometric information, for ECD by the noncontact specular microscope and for ocular biometric parameters by the optic low-coherent reflectometer. Data from right eyes were analyzed to illustrate the distribution of ECD and for determining correlated factors with ECD using univariate and multiple linear regression analysis. Comparisons among three different BW groups were performed using a one-way ANOVA analysis followed by the Bonferroni correction for pairwise comparisons.

Results

Of 1171 children, the mean (± standard deviation) ECD was 2875.34 ± 195.00 cells/mm2. In the Multiple Linear Regression analysis, BW, gender and central corneal thickness were significantly associated with ECD. The ECD increased by 36.16 cells/mm2 with BW increasing by 1 kg (P = 0.001) and increased by 0.44 cells/mm2 for every additional 1 mm in central corneal thickness (P = 0.01). The ECD of girls was 54.41 cells/mm2 higher than boys (P < 0.001). Children born with low BW presented significantly lower ECD than those born with normal BW (P < 0.05) and high BW (P < 0.05). Age and axial length were not significantly associated with ECD (P = 0.06 and P = 0.21, respectively).

Conclusions

In Chinese school children aged 82 to 94 months, the ECD is positively correlated with BW and central corneal thickness, in which BW is a newly identified associated factor. It is like that gender plays an important role in ECD distribution while girls have relatively greater ECD than boys.
Association between maternal fermented food consumption and child sleep duration at the age of 3 years: the Japan Environment and Children’s Study
Authors: Inoue Mariko , Sugimori Narumi , Hamazaki Kei , Matsumura Kenta , Tsuchida Akiko , Inadera Hidekuni ,   The Japan Environment and Children’s Study (JECS) Group, Kamijima Michihiro , Yamazaki Shin , Ohya Yukihiro , Kishi Reiko , Yaegashi Nobuo , Hashimoto Koichi , Mori Chisato , Ito Shuichi , Yamagata Zentaro , Nakayama Takeo , Iso Hiroyasu , Shima Masayuki , Nakamura Hiroshige , Suganuma Narufumi , Kusuhara Koichi , Katoh Takahiko
Published: August 2022

Background

Using cohort data from the Japan Environment and Children’s Study (JECS), we previously reported that the risk of sleep deprivation in 1-year-old children was reduced with a higher maternal intake of fermented foods, particularly miso. The present study, which evaluates children from the same cohort at 3 years of age, is a continuation of that work.

Methods

After applying exclusion criteria to 104,062 records in the JECS dataset, we evaluated 64,200 mother-child pairs in which the child was 3 years old. We examined the association of the dietary intake of fermented foods during pregnancy with child sleep duration < 10 h at the age of 3 years.

Results

Multivariable logistic regression analysis with the lowest quartile used as a reference revealed adjusted odds ratios (95% confidence intervals) for the second through fourth quartiles of 0.98 (0.90–1.06), 0.93 (0.85–1.01), and 0.85 (0.78–0.94) for cheese intake.

Conclusions

The consumption of fermented foods during pregnancy is associated with reduced risk of sleep deprivation in 3-year-old children, albeit in a limited way.
Application of depithelized gracilis adipofascial flap for pelvic floor reconstruction after pelvic exenteration
Authors: Zhang Chen , Yang Xin , Bi Hongsen
Published: August 2022

Background

Pelvic exenteration is a radical surgery performed in selected patients with locally advanced or recurrent pelvic malignancy. It involves radical en bloc resection of the adjacent anatomical structures affected by the tumor. The authors sought to evaluate the clinical application of a depithelized gracilis adipofascial flap for pelvic floor reconstruction after pelvic exenteration.

Methods

A total of 31 patients who underwent pelvic floor reconstruction with a gracilis adipofascial flap after pelvic exenterationat Peking University Third Hospital from 2014 to 2022 were enrolled in the study. The postoperative follow-up durations varied from 4 to 12 months.

Results

The survival rate of the flap was 96.77% with partial flap necrosis in one case. The total incidence of postoperative complications associated with the flap was 25.81%, with an incidence of 6.45% in the donor site and 19.35% in the recipient site. All complications were early complications, including postoperative infection and flap necrosis. All patients recovered after treatments, including anti-infectives, dressing change, debridement, and local flap repair. Long-term follow-up showed good outcomes without flap-related complications.

Conclusions

A depithelized gracilis adipofascial flap can be applied for pelvic floor reconstruction after pelvic exenteration. The flap is an ideal and reliable choice for pelvic floor reconstruction with few complications, an elevated survival rate, sufficient volume, and mild effects on the function of the donor site.
Ultrasound combined with hysteroscopy for optimum treatment of Robert’s uterus: a case report and a review
Authors: Liu Ying , Hou Chenxiao , Zhou Yingjie
Published: August 2022

Background

Rbert’s uterus, also known as asymmetric septate uterus, is a rare genital malformation first reported by Dr. Robert in 1970. Robert’s uterus is characterized by a septate uterus with a blind hemicavity and an intact external fundus. According to some reports, Robert’s uterus was typically managed by laparoscopic uterine resection of a hemicavity, laparoscopic endometrectomy, and even hysterectomy. Considering that fertility preservation is important in young patients, we recommend ultrasound-guided hysteroscopic septum resection as an optimum treatment for Robert’s uterus.

Case presentation

Herein is described a clinical case of Robert’s uterus in a 15-year-old girl who was misdiagnosed for primary dysmenorrhea in the beginning. Magnetic resonance imaging (MRI) and 3-dimensional (3D) ultrasound identified an asymmetrical uterine septum. The patient was treated using ultrasound-guided hysteroscopic treatment without laparoscopy. The surgical procedure lasted less than an hour, and the symptoms of dysmenorrhea were relieved during a six months follow-up.

Conclusions

Ultrasound-guided hysteroscopic septum resection is the preferred treatment for Robert’s uterus.
Incorporating modified team-based learning into a flipped basic medical laboratory course: impact on student performance and perceptions
Authors: Shen Jing , Qi Hongyan , Chen Yingying , Mei Ruhuan , Sun Cencen , Wang Zhengyang
Published: August 2022

Background

Basic medical laboratory courses (BMLCs) play an essential role in medical education and offer several benefits to students. Although various student-centered and active learning strategies have been increasingly incorporated into medical education, their applications in BMLCs are limited. This paper aimed to explore the educational effects of a flipped classroom (FC) combined with team-based learning (TBL) strategy in BMLCs at Zhejiang University School of Medicine.

Methods

Four hundred eight 3rd-Year medical students were assigned to either the FC-TBL group (n = 235) or the FC group (n = 173) to complete three experiments on the respiration block of BMLCs. The two groups’ immediate and long-term academic performance were compared, and the FC-TBL students’ perceptions of different instructional strategies were surveyed.

Results

Students in the FC-TBL group scored higher on the immediate post-tests after class and higher on the final exams in two of the three experiment sessions. They preferred FC-TBL to FC for its higher engagement, more feedback, and better learning environment. Students felt the FC with TBL blended instructional strategy stimulated their interest in learning and deep thinking.

Conclusions

Compared with the FC group, students in the FC-TBL group improved academic performance and had a more positive experience overall. Our findings support the feasibility and advantage of the flipped classroom with team-based learning as a blended learning strategy in the BMLC curriculum.
Dietary supplementation with sodium gluconate improves the growth performance and intestinal function in weaned pigs challenged with a recombinant Escherichia coli strain
Authors: Zhang Yanyan , Yi Dan , Xu Haiwang , Tan Zihan , Meng Yuxuan , Wu Tao , Wang Lei , Zhao Di , Hou Yongqing
Published: August 2022

Background

The purpose of this research is to determine the effects of sodium gluconate (SG) on the growth performance and intestinal function in weaned pigs challenged with a recombinant Escherichia coli strain expressing heat-stable type I toxin (STa).

Results

Pigs (n = 24, 21 days of age) were randomly allocated to three treatments: Control group (pigs were fed basal diet), STa group (pigs were fed basal diet and challenged with a recombinant E. coli strain expressing STa), and SG group (pigs were fed basal diet supplemented with 2500 mg/kg sodium gluconate and challenged with a recombinant E. coli strain expressing STa). The trial period lasted for 15 days. On days 12 and 13, pigs in the STa and SG groups were orally administered with the recombinant Escherichia coli strain, while those in the control group were orally administered with normal saline at the same volume. On day 15, blood, intestinal tissues and colonic contents were collected for further analysis. Results showed that dietary SG supplementation had a tendency to increase average daily gain, and reduced (P < 0.05) feed to gain ratio, plasma glucose concentration, and mean corpuscular hemoglobin concentration as compared with control group on days 0-10 of trial. Additionally, dietary SG supplementation attenuated(P < 0.05) the morphological abnormalities of small intestinal and the increase of the number of eosinophils in blood of pigs challenged with the recombinant Escherichia coli strain on day 15 of trial. Compared with control group, diarrhea rate and the number of eosinophils in blood and the concentrations of malondialdehyde in the jejunum were increased (P < 0.05). The height, width and surface area of the villi of the duodenum, the width and surface area of villi of jejunum and the height and width of villi of ileum were decreased (P < 0.05) in pigs challenged with the recombinant Escherichia coli strain in the STa group compared with those in control group on day 15 of trial. However, these adverse effects were ameliorated (P < 0.05) by SG supplementation in the SG group on day 15 of trial. Furthermore, dietary SG supplementation could reduce (P < 0.05) the total bacterial abundance in the colon, but SG did not restore the recombinant Escherichia coli-induced microbiota imbalance in colon.

Conclusions

In conclusion, dietary supplementation with SG could improve piglet growth performance and alleviate the recombinant Escherichia coli-induced intestinal injury, suggesting that SG may be a promising feed additive for swine.