bluuebunny/crossref_metadata_2025 huggingface dataset:
Colorectal Cancer in Patients Younger than 40 Years of Age
Authors: Keswani Sundeep G. , Boyle Michael J. , Maxwell Johnathon P. , Mains Lindsay , Wilks Sauee M. , Hunt John P. , O'Leary J. Patrick
Published: November 2022

Previous studies have suggested a poor outcome for patients presenting with colorectal cancer under the age of 40 years. This study was conducted to evaluate the outcomes of these patients during a 10-year period at the Medical Center of Louisiana in New Orleans. A retrospective study was designed to review all patients under the age of 40 with a diagnosis of colorectal cancer from January 1990 to December 2000. There were 664 patients presenting with colorectal cancer during the 10-year period; of these 24 presented for surgery under the age of 40. There were 17 male and seven female patients. The median age was 35 years (range 22–39). Eleven (44%) patients had a positive family history of colorectal cancer. Seven lesions were right sided, one transverse, eight left sided, and eight rectal. Histologically 20 lesions were typical adenocarcinomas and four were mucinous. Twelve were stage IV, six stage III, five stage II, and one stage I. Twenty-one patients underwent resection, six with stoma formation; three patients had stoma formation only for a total of nine stomas (38%). The mean operative duration was 3.3 ± 1.9 hours. The operative mortality was 4 per cent with a complication rate of 17 per cent. The eight rectal cancer patients received preoperative chemoradiation therapy (33%). Twelve (50%) patients with colon cancer received postoperative 5-fluorouracil-based chemotherapy. The mean survival for all patients was 24.7 ± 23.2 months. Estimated 5-year survival using Kaplan-Meier analysis was 30 per cent. We conclude that colorectal cancer patients less than 40 years of age present at an advanced stage and tend to have a positive family history. In general patients tolerate surgery well, with stoma formation in more than one-third. Long-term survival is as predicted for their advanced stage of presentation. The study highlights the need for early diagnosis in this patient group.
Endovascular Repair of Acute Innominate Artery Injury Due to Blunt Trauma
Authors: Miles Erik J. , Blake Anna , Thompson William , Jones William G. , Dunn Ernest L.
Published: November 2022

The utility of endovascular techniques has expanded greatly over the past decade. Physicians now have choices regarding the treatment of many injuries that have traditionally required open surgical repair. Technological advances in materials as well as improved training and expertise among practitioners has led to increased availability of endovascular procedures that can often provide an effective and less invasive means of management. The following case report describes the successful treatment of a traumatic blunt injury to the innominate artery using endovascular techniques. Also provided is a review of the physical and radiographic findings associated with innominate artery rupture as well as a discussion on the diagnosis and treatment of such an injury. Isolated injuries of the innominate artery are exceedingly rare, and very little has been published about the endovascular repair of this specific injury. An extensive MEDLINE search was conducted to investigate whether or not endovascular repair of this particular injury had yet been described, and we found no published reports in the American medical literature. Although the technical aspects of this case are not particularly unique this case report demonstrates yet another successful application of endovascular intervention in the acute setting of blunt injury.
Analysis of Both NM23-H1 and NM23-H2 Expression Identifies “At-Risk” Patients with Colorectal Cancer
Authors: Brenner Antonio S. , Thebo Jennifer S. , Senagore Anthony J. , Duepree Hans-Joachim , Gramlich Terry , Ormsby Adrian , Lavery Ian C. , Fazio Victor W.
Published: November 2022

Metastasis is the manifestation most directly affecting survival for patients with colorectal carcinoma. Identification of high-risk markers for metastases would allow focused selection of patients for adjuvant chemotherapy. Reports of the relationship between the putative metastasis suppressor NM23 and metastasis and/or survival in colorectal cancer patients are conflicting. The purpose of this study was to separately assess expression of NM23-H1 and NM23-H2 in primary colon cancers and determine whether expression was associated with regional nodal disease and/or liver metastases. Four patient cohorts were selected on the basis of histopathological staging at primary surgery (lymph node status/liver metastasis): -/- (n = 46), +/- (n = 47), -/+ (n = 43), and +/+ (n = 46). Primary tumors were evaluated by semiquantitative immunohistochemical analysis of NM23-H1 and NM23-H2. NM23-H2 expression was not related to survival; however, there was a modest survival advantage with low expression of NM23-H1 ( P = 0.027). NM23-H1 expression in the +/+ group was increased compared with the other groups ( P < 0.001). The -/+ group had the lowest expression of NM23-H2 ( P < 0.001). This analysis distinguishes two high-risk groups of colorectal cancer patients. Prior discrepancies regarding the usefulness of NM23 staining may be explained by the need to evaluate both serotypes in addition to standard histopathological analysis to identify specific “at-risk” groups.
Management of Adult Splenic Injury: A 20-Year Perspective
Authors: Hartnett Kimberly L. , Winchell Robert J. , Clark David E.
Published: November 2022

The objective of this study was to identify changes in the management of blunt splenic injury in adults. Hospital discharge abstract data from Maine were used to identify patients ≥16 years old discharged between January 1, 1981 and December 31, 2000 with International Classification of Diseases (9th revision) codes indicating splenic injury. Incidence of operative intervention and outcomes for trauma hospitals and other hospitals were determined. The number of splenic injuries was about 75 per year for the first 15 years increasing to 96 per year in the last 5-year period. The rate of operative intervention declined from 71 to 41 per cent and was lower at the trauma hospitals during the last two 5-year periods (41% vs 53%). The rate of operative intervention >24 hours after admission was 2.2 per cent during the last 10 years of study. The rate of splenorrhaphy remained stable at about 12 per cent throughout the study period. Mortality rates were higher at the trauma hospitals as were the numbers of patients with very severe injuries (Injury Severity Score >25). There has been a marked decrease in rate of operative intervention for splenic injury in adults especially in the last 10 years. Rates of operative intervention were lower at the trauma hospitals despite higher injury severity. Frequency of delayed intervention was low and did not increase with lower operative rate.
Laparoscopic Bile Duct Injuries: Management at a Tertiary Liver Center
Authors: Savar Aaron , Carmody Ian , Hiatt Jonathan R. , Busuttil Ronald W.
Published: November 2022

Bile duct injury is a rare but morbid complication of laparoscopic cholecystectomy (LC). This study was undertaken to evaluate the management of 20 patients with bile duct injuries during LC who were referred to a tertiary center with expertise in hepatobiliary surgery and liver transplantation. Sixteen (80%) were female. Mean age was 44 (range 13–70) years. Half of the injuries were distal (Bismuth I), and nearly half were diagnosed at LC. Reoperative repair was attempted in 30 per cent. Mean interval between injury and operation was 6.55 months (range 0 to 36 months). Eighteen patients underwent Roux-en-Y hepaticojejunostomy (HJ). Of the two patients who did not undergo HJ (both Bismuth I), one was treated with transhepatic cholangiography only, and one died of multiorgan failure. There were four minor complications and one late reoperation for stricture. We conclude that bile duct injury after LC is successfully managed in a tertiary center by a hepatobiliary-liver transplant team. Principles of management include anatomic definition of injury, control of sepsis, staged approach involving interventional radiology, and operative techniques refined in liver transplantation including magnification, fine sutures, selective use of internal stent, and liver biopsy.
The Use of Delayed Computerized Tomography in the Evaluation of Blunt Abdominal Trauma: A Preliminary Report
Authors: Stanley Andrew C. , Vittemberger Frank , Napolitano Lena M. , O'Hara Kathleen P. , Mcginnis Karen , Lockhart Diane , Silva Wayne E.
Published: November 2022

This purpose of this study was to analyze the use of abdominal computed tomography (CT) imaging in patients with possible blunt abdominal trauma. A retrospective analysis of all trauma patients over a 1-year period (1993–1994) was conducted, with prospective study protocol in 52 patients using serial abdominal exam and hematocrits (Hcts) instead of abdominal CT for evaluation of blunt abdominal trauma. Urgent abdominal CT was used as the initial diagnostic test for evaluation of blunt abdominal trauma in 813 patients over this 1-year period. CT was obtained in 379 (46.6%) of these patients who arrived hemodynamically stable (admission systolic blood pressure ≥ 90), had a Glasgow Coma Scale > 13, and had admission Hct ≥ 35 because of distracting injuries, possible traumatic brain injury, or alcohol/drug use, which might render the abdominal physical exam unreliable. Only 47 CT scans (12.4%) were positive, and three patients (0.8%) required laparotomy. In an effort to more efficiently use abdominal CT, we performed a prospective study in 52 patients with possible blunt abdominal trauma, admission systolic blood pressure ≥ 90, Hct ≥ 35, Glasgow Coma Scale > 13, and a normal abdominal exam on admission. These patients were followed with serial abdominal examinations and Hcts every 6 hours for 24 hours, and delayed CT, when applicable. CT was obtained in seven patients (13.5%) for evaluation of fall in Hct or abnormal abdominal examination; all were negative for abdominal injury. A protocol using serial abdominal exams, Hcts, and delayed abdominal CT imaging may be useful in select patients to decrease the high number of negative routine abdominal CTs that are obtained in the evaluation of blunt abdominal trauma.
The Effects of Minidose Heparin and Low Molecular Weight Heparin on Peritonitis in the Rat
Authors: Vela A. Richard , Littleton Jeffrey C. , O'leary J. Patrick
Published: November 2022

Intraperitoneal bacteria, ischemic tissue, and the inflammatory response have all been implicated in the development of intra-abdominal adhesions and abscess formation. Sprague Dawley rats were subjected to a peritonitis challenge induced by fecal contamination of the peritoneum in conjunction with necrotic ileal tissue in an attempt to further elucidate the role of these stimuli and to evaluate the potential protective effect of regular heparin and of low molecular weight heparin (LMWH) Lovenox. Rats treated with a subcutaneous minidose heparin and LMWH Lovenox showed a significant decrease in adhesion and abscess formation when compared with the nontreatment control rats. There was no statistical difference between the two treatment groups. These findings confirm the efficacy of minidose heparin in reducing both the grade and incidence of adhesion and abscess formation and suggest a similar role for LMWH Lovenox. No conclusions could be reached on the effect of heparin or LMWH Lovenox on survival time due to the high survival rate noted in the nontreatment control rats, despite severe peritonitis.
Elemental Characterization of Leaded and Lead-Free Inorganic Primer Gunshot Residue Standards Using Single Particle Inductively Coupled Plasma Time-of-Flight Mass Spectrometry
Authors: Szakas Sarah E. , Menking-Hoggatt Korina , Trejos Tatiana , Gundlach-Graham Alexander
Published: November 2022

This study describes the use of single particle inductively coupled plasma time-of-flight mass spectrometry (spICP-TOFMS) for the detection and classification of inorganic gunshot residue (IGSR) particles. To establish reliable multi-element criteria to classify IGSR particles, leaded and lead-free IGSR reference materials were analyzed, and the elemental compositions of the individual particles were quantified. The results suggest that expanded element compositions may be used to classify IGSR particles via spICP-TOFMS compared to those used in conventional IGSR analysis using scanning electron microscopy energy dispersive X-ray spectroscopy (SEM-EDS). For spICP-TOFMS analysis of leaded IGSR particles, classification may be based on the presence of lead (Pb), antimony (Sb), and barium (Ba) just as in SEM-EDS; however, additional particle types, such as lead-copper (Pb–Cu) particles, contribute significantly (∼30%) to the leaded IGSR particle population. In lead-free IGSR particles, the dominate multi-metal particle composition found is titanium–zinc (Ti–Zn) with a conserved Zn:Ti ratio of 1.4:1, but other elements, such as copper (Cu), are also characteristic. In mixtures of the two IGSR reference materials, we were able to classify over 80% of the multi-metal particles detected with no false-positive particle-type assignments. With spICP-TOFMS, particles smaller than those typically measured by SEM-EDS are detected, with estimated median diameters for leaded and lead-free IGSR of 180 and 320 nm, respectively. Through measuring these smaller particles, up to ∼two times more particles per mL are recorded by spICP-TOFMS compared to that found by SEM-EDS. Overall, high-sensitivity and high-throughput analysis using spICP-TOFMS enables quantitative, rapid multi-elemental characterization, and classification of individual IGSR particles.
De Lubac and Suárez: A Reappraisal
Authors: Grumett David
Published: November 2022

Because of his hostility to pure nature theory, Henri de Lubac has typically been viewed as opposing Francisco Suárez’s metaphysics. His proximate target was the neo-Suárezianism to which he was exposed during his Jesuit formation. Suárez was the Jesuit order’s intellectual founding father and his ideas continued to shape Jesuit philosophy and theology, sometimes in opposition to neo-Thomism. Although de Lubac contested Suárez’s promotion of new and modern theology, Suárez positively informed his approach to key topics: appetite and its end; nature, desire, and the supernatural; the perfection of nature; essences as unique existents; eclecticism; and political resistance.
Homophobic Bullying as Gender Policing: Population-Based Evidence
Authors: Mittleman Joel
Published: November 2022

Although the policing of gendered embodiment is central to ethnographic accounts of sexual minority bullying, data limitations have prevented population-level analyses of how gender expression shapes bullying victimization. Using novel data on gender expression, I document the dynamics of gender policing in contemporary American high schools. Analyzing population-representative surveys from eight states and 10 school districts, I examine how students’ assigned sex, sexual identity, and gender expression intersectionally shape their risk for bullying. Consistent with patterns of cultural sexism that stigmatize male “femininity” more harshly than female “masculinity,” I find that gender expression powerfully stratifies bullying among boys but is seemingly unrelated to bullying for girls. Boys who report feeling seen as “very feminine” are 3.5 times more likely to be bullied than their “very masculine” peers. By contrast, girls’ bullying rates are roughly constant across the gender expression spectrum. Stratifying by sexuality, I find that highly conforming gender expression offers some protection against bullying for sexual minority boys but no protection for sexual minority girls. This study illustrates the value of gradational measures of gendered embodiment and makes newly visible the powerful sanctions pressuring boys into narrow, heteronormative enactments of masculinity.
Design of a non-cooperative target capture mechanism for capturing satellite launch adapter ring
Authors: Sun Yongjun , Wang Qian , Jiao Rihua , Liu Rongqiang , Jin Minghe
Published: November 2022

Space debris is growing dramatically, which poses a serious threat to space exploration activities. Especially the large non-cooperative target, such as malfunctioning satellites. This paper proposes a capture mechanism for the launch adapter ring that is usually available on satellites as the capture object, which used for in-orbit capture of malfunctioning satellites. Firstly, introduce the design conditions, the overall design plan, carry out the mechanical mechanism design, sensor system configuration, electrical system design, and explain the capture process. Secondly, analyze the capture tolerance. Thirdly, by establishing the kinematics model of the captured finger, use D-H parameter method for kinematic analysis, and analyze the dynamic in the capturing process. In addition, the control strategy is proposed, and the clamping force model, friction identification model, and servo control strategy are established. Then, the prototype is manufactured, and the clamping force, stiffness, capture loads, and capture tolerance are tested. Finally, the air-floating platform is used to verify the capture test of the launch adapter ring in a microgravity environment. The experimental results show that the developed capture mechanism meets the design conditions and has the ability to capture launch adapter ring of satellites in orbit.
When Do Observers Deprioritize Due Process for the Perpetrator and Prioritize Safety for the Victim in Response to Information-Poor Allegations of Harm?
Authors: Graso Maja , Aquino Karl , Chen Fan Xuan , Camps Jeroen , Strah Nicole , van den Bos Kees
Published: November 2022

We examined how observers assess information-poor allegations of harm (e.g., “my word against yours” cases), in which the outcomes of procedurally fair investigations may favor the alleged perpetrator because the evidentiary standards are unmet. Yet this lack of evidence does not mean no harm occurred, and some observers may be charged with deciding whether the allegation is actionable within a collective. On the basis of theories of moral typecasting, procedural justice, and uncertainty management, we hypothesized that observers would be more likely to prioritize the victim’s safety (vs. to prioritize due process for the perpetrator) and view the allegation as actionable when the victim-alleged perpetrator dyad members exhibit features that align with stereotypes of victims and perpetrators. We supported our hypothesis with four studies using various contexts, sources of perceived prototypicality, due-process prioritization, and samples (students from New Zealand, Ns = 137 and 114; Mechanical Turk workers from the United States; Ns = 260 and 336).
Vibration control of very large and lightweight structures mounted on a four-legged platform
Authors: Feliu-Talegon Daniel , Feliu-Batlle Vicente
Published: November 2022

Large lightweight slender links mounted on mobile robots enlarge their workspace. This work presents one of these robots that has been endowed with 4 legs to improve its static stability—which is put at risk by the large link—and help in the positioning of the link. The efficiency of this system depends on its accuracy in positioning and orientating the end-effector placed at the tip of the link, which is compromised by vibrations that appear in the link during the movement and permanent deflections caused by gravity. A relatively simple control scheme that combines a feedback control of the pose of the mobile platform with a feedforward term that orientates the link is proposed. It uses three legs as actuators; and feeds back measurements of the extensions of the three legs and the orientation of the platform given by an inertial sensor placed in the upper part of the mobile platform. Based on the flatness property of a simplified dynamic model of the link, its dynamics can be easily inverted, being used to implement the proposed feedforward term. Since such feedforward term is used, extra sensors to measure the deflection of the link are not needed, and since the legs are used to move the link, extra actuators mounted on the link are neither needed. All this allows us to reduce the weight and the volume of the payload carried by the mobile platform. Results obtained through a finite elements software and experimentation of the real prototype show the good performance attained with the proposed control strategy.
Being Negatively Cued, are People Less Cooperative? The Influence of Watching Eyes on Cooperative Behavior
Authors: Wang Xiaoming , Zhao Qinying , Bao Xiulin , Wang Yaru , Wang Xiuxin
Published: November 2022

In the course of human evolution, watching eyes have had an important influence on individual cooperative behavior. However, researchers have not explored how the valence of watching eyes affects cooperative behavior. Therefore, this study includes three studies to investigate the effect of watching eyes with different valences on cooperative behavior. The results showed that positive watching eyes (vs. negative watching eyes) induced positive emotions (PA) in the participants and thus increased their tendency to cooperate (Studies 1–2). The role of the decision maker (making decisions for oneself vs. making decisions on behalf of others) moderates the effect of watching eyes on cooperative behavior through emotion (Study 3). In conclusion, the valence of watching eyes significantly affects cooperation. This study not only further enriches research on environmental stimulation and cooperation but also provides inspiration and a reference for solving problems of cooperation in social dilemmas.
Using LGBTQIA2S+ Inclusive Practices When Filming Sex Education Training Videos: Lessons Learned
Authors: Barrett Mia , Laris B. A. , Firpo-Triplett Regina , Kuhn Tamara
Published: November 2022

To effectively teach sex education, educators need professional development to develop skills, specifically skills for being LGBTQIA2S+ inclusive. This article describes the lessons learned when developing an LGBTQIA2S+ inclusive collection of training video for sexuality educators. SkillFlix for Educators is a streaming video training resource created to improve educators’ skills in facilitating sexuality education to youth. The creation of this training tool included formative research, design and development, and filming. Lessons learned include avoiding siloing the inclusion, using inclusive design strategies, and creating welcoming workspaces.
Accuracy of a Photo-based Smartphone Application to Assess Salivary Cortisol Sampling Time in Adolescents
Authors: Fred Wen Cheng K. , Schneider Stefan , Weigensberg Marc J. , Weerman Bas , Spruijt-Metz Donna
Published: November 2022

Accurate assessment of saliva sampling time is essential for studies that collect cortisol sample in ambulatory settings. This study examined the sampling time assessed by user-submitted photos via a mobile application (ZEMI) compared with MEMSCaps™. Intra-class correlation coefficient (ICC) of the time differences between when the 16 adolescents in the study were prompted to collect the sample and (1) when the MEMSCaps™ was opened (TimeM), and (2) when photos of the corresponding sample were submitted (TimeZ) was computed to evaluate the agreement of sampling times. The average TimeM and TimeZ 12.06 ± 65.80 and 16.13 ± 52.07 minutes, respectively. The pooled ICC between TimeM and TimeZ was 0.986 (95% CI: 0.959–0.995), suggesting excellent correspondence between the two measurements.
The Experiences of Hispanic and African American Student-Fathers on College Campuses
Authors: Roy Roudi N. , Brown Tiffany L. , Roy Donovan R. , Rockett India , Hailey Afriyah
Published: November 2022

Hispanic and African American student-fathers are an invisible population in the student support literature on college campuses. In this qualitative study, we examined the lived experiences of 17 student-fathers attending Hispanic Serving Institutions and Historically Black Colleges and Universities. Six themes emerged from our data: family support, uncertainty in parenting practices, co-parenting relationships, responsibility as a father, negative stereotypes, and fatherhood as motivation. Our findings have implications for institutions of higher education.
Dùthchas, a Scottish Gaelic Methodology to Guide Self-Decolonization and Conceptualize a Kincentric and Relational Approach to Community-Led Research
Authors: Meighan Paul J.
Published: November 2022

A researcher’s worldview shapes the research methodology, design, and ensuing relationship with participants and the local environment. Western research has traditionally been carried out on, rather than in collaboration with Indigenous Peoples and has largely been conducted through eurocentric and ethnocentric knowledge systems, methods, values, and beliefs which have perpetuated extractions, racisms, and harm. To counteract harmful research, Indigenous scholarship stresses the necessity of articulating and clarifying researcher positionality and self-location prior to embarking on research with or by Indigenous communities. A fundamental component of positionality and self-location is clarifying one’s own relationships with colonialism and embarking on a process of self-decolonization. With this focus in mind, this paper shares methodological insights from an Anishinaabe community-led pilot project for Indigenous language revitalization in the Great Lakes Region of Turtle Island (also known as North and Central America) with participants to whom the researcher is related by marriage or known. This paper adds to existing qualitative methodological knowledge by introducing and operationalizing Dùthchas—a millennia-old Scottish Gaelic concept, worldview, and way of life—as kincentric methodology. The researcher begins the methodological inquiry with his own positionality and self-location as a Gàidheal (Scottish Gael) who is not Indigenous to Turtle Island. Following Dùthchas, the researcher identifies five key methodological principles that informed a kincentric and relational approach to community-led research. The paper demonstrates how Dùthchas has served as a guide for the researcher’s ongoing self-decolonization processes and for emplaced ethical relations. The paper illustrates how Dùthchas enabled the researcher to be in-relation to the lands and Peoples where the research project took place and to conceptualize and conduct research as part of a greater Indigenous Anishinaabe research paradigm, Mino-Bimaadiziwin (The Good Life). Dùthchas has implications for Indigenous—non-Indigenous reconciliatory relations and for the conceptualization and implementation of future (qualitative) research in-relation methodologies.
Influence of spatial position of double turntable swing on dynamic characteristics of five-axis machine tool
Authors: Wu Shi , Yu Tai , Yuan Chunqiang , Wang Yupeng , Liu Taorui
Published: November 2022

In the machining of a five-axis machine tool with a double turntable, the dynamic characteristics of the machine tool are affected by different spatial positions of workpieces. Predicting the dynamic characteristics of machine tools at different spatial positions can effectively improve the machining accuracy of workpieces. In the present study, a five-axis CNC machine tool (Tuopu VMC-C50, China) is considered as the research object. Firstly, the bearing stiffness model of the double turntable rotary system is established, and the influence of the joint stiffness of the turntable bearing on the dynamic characteristics of the five-axis machine tool table rotary system is studied. Based on the established three-dimensional model and rigidity of the sliding joint surface of the machine tool, the machine tool modes at 81 working positions are analyzed. Accordingly, the influence of different swinging positions of the double turntable on the dynamic characteristics of the five-axis machine tool is studied. Finally, based on the three-dimensional Kriging prediction model, variations of the natural frequency and vibration amplitude of the system in the machining space for different swing table angles are analyzed.
Hearing Aid Adoption is Associated with the Type of Significant Other in Attendance at Hearing Care Appointments
Authors: Ellis Blair K. , Singh Gurjit , Launer Stefan
Published: November 2022

There is increasing evidence to suggest that the implementation of family-centered care practices in clinical audiology yields positive patient outcomes. Previous work showed that significant-other attendance at audiology appointments, a recommended practice consistent with family-centered care, was associated with greater odds of hearing aid adoption and increased satisfaction with hearing aids. The primary goal of this retrospective explorative study was to investigate the unexplored question of whether an association exists between the type of significant other (SO) in attendance at appointments and hearing aid adoption. The study sample consisted of adult patients from a chain of private clinics in the United Kingdom who either attended their audiology appointment with a SO (n = 10,015) or alone (n = 37,152). Six SO types were identified and classified: partner (n = 6,608), parent (n = 76), child (n = 2,577), sibling (n = 208), friend (n = 518), and carer (n = 28). In addition to replicating previous findings which showed that significant-other attendance at audiology appointments was positively associated with hearing aid adoption, results from the current paper also revealed that the odds of hearing aid adoption were greater if the SO was of a stronger relationship tie (i.e., partners, parents, children, and siblings) and not a weaker relationship tie (i.e., friends, carers). These findings suggest that an extension of the non-audiological factor of significant-other attendance during the hearing rehabilitation process should be considered: the relationship type patients have with their significant others.
Anterior Quadratus Lumborum block area comparison in the three different volumes of Ropivacaine: a double-blind, randomized controlled trial in healthy volunteers
Authors: Shao Liang , Luo Xu , Ye Yingchao , Liu Le , Cai Yaoyao , Xia Yun , Papadimos Thomas J. , Wang Quanguang , Pan Linmin
Published: November 2022

Background

In abdominal surgery, ultrasound-guided anterior quadratus lumborum blocks (QLB) are performed to induce analgesia. However, no study reported suitable volumes of the anterior QLB for the different postoperative analgesia regions. Therefore, this prospective randomized controlled study assessed the dermatomal spread and analgesic effects of the three different volumes of a local anesthetic for anterior QLB.

Methods

Ultrasound-guided anterior QLB was performed at the L2 level on 30 healthy volunteers. The volunteers were randomized to receive 20 ml (n = 10), 30 ml (n = 10), and 40 mL (n = 10) of 0.375% ropivacaine. The cutaneous sensory blocked area (CSBA), the number of block dermatomes, and the block duration time were measured by determining the extent of the cold sensation.

Results

The CSBA was significantly larger in the 40 ml group than in the 30 (P = 0.001; 1350.6 ± 234.4 vs. 1009.5 ± 151.6 cm2) and 20 ml groups (P < 0.001; 1350.6 ± 234.4 vs. 808.1 ± 120.5 cm2). Similarly, the number of blocked dermatomes was significantly higher in the 40 ml group than in the 30- and 20-ml groups. However, no significant difference was observed in block duration among the groups.

Conclusions

No difference was observed in block duration with the various volumes of 0.375% ropivacaine. However, the larger volume for anterior QLB contributed to a larger area of cutaneous sensory blockade. Appropriate volumes in anterior QLB can create suitable postoperative analgesia levels for the different operative sites.

Trial registration

The study was registered in the Chinese Clinical Trial Registration Center onwww.chictr.org.cnon 27th April 2018 (registration number: ChiCTR-IOR-17010853).
Under age five children survival times in Nigeria: a Bayesian spatial modeling approach
Authors: Egbon Osafu Augustine , Bogoni Mariella Ananias , Babalola Bayowa Teniola , Louzada Francisco
Published: November 2022

Background

Nigeria is among the top five countries in the world with the highest under-five mortality rates. In addition to the general leading causes of under-five mortality, studies have shown that disparity in sociocultural values and practices across ethnic groups in Nigeria influence child survival, thus there is a need for scientific validation. This study quantified the survival probabilities and the impact of socioeconomic and demographic factors, proximate and biological determinants, and environmental factors on the risk of under-five mortality in Nigeria.

Methods

The Kaplan-Meier survival curve, Nelson Aalen hazard curve, and components survival probabilities were estimated. The Exponential, Gamma, Log-normal, Weibull, and Cox hazard models in a Bayesian mixed effect hierarchical hazard modeling framework with spatial components were considered, and the Deviance and Watanabe Akaike information criteria were used to select the best model for inference. A$$5\%$$5%level of significance was assumed throughout this work. The 2018 Nigeria Demographic and Health Survey dataset was used, and the outcome variable was the time between birth and death or birth and the date of interview for children who were alive on the day of the interview.

Results

Findings show that the probability of a child dying within the first two months is 0.04, and the probability of a boy child dying before attaining age five is 0.106, while a girl child is 0.094 probability. Gender, maternal education, household wealth status, source of water and toilet facility, residence, mass media, frequency of antenatal and postnatal visits, marital status, place of delivery, multiple births, who decide healthcare use, use of bednet are significant risk factors of child mortality in Nigeria. The mortality risk is high among the maternal age group below 24 and above 44years, and birth weight below 2.5Kg and above 4.5Kg. The under-five mortality risk is severe in Kebbi, Kaduna, Jigawa, Adamawa, Gombe, Kano, Kogi, Nasarawa, Plateau, and Sokoto states in Nigeria.

Conclusion

This study accentuates the need for special attention for the first two months after childbirth as it is the age group with the highest expected mortality. A practicable way to minimize death in the early life of children is to improve maternal healthcare service, promote maternal education, encourage delivery in healthcare facilities, positive parental attitude to support multiple births, poverty alleviation programs for the less privileged, and a prioritized intervention to Northern Nigeria.
Tobacco chewing and associated factors among a vulnerable youth population in Sri Lanka
Authors: Dhanapriyanka Manori , Kanthi R. D. F. C. , Jayasekara Prasanna , Ha Diep Hong
Published: November 2022

Background

Tobacco in any form kills millions of people every year.Tobacco addiction among youth shows an increasing trend while smokeless type is becoming more common. This study aimed to describe the lifestyle of chewing smokeless tobacco among a group of high-risk youth population in Sri Lanka.

Methods

A descriptive cross-sectional study was conducted among a sample of 1431 youths aged between 15 to 24 years residing in urban slums in Colombo Sri Lanka, using a cluster sampling technique combined with probability proportionate to size technique. Data were collected using an interviewer-administered questionnaire. Chewing smokeless tobacco was assessed using betel quid chewing and commercially prepared tobacco and areca nut packet chewing. Current chewer was defined as who had the practice of chewing during past 30 days.

Results

The mean age of the study sample was 17.53 (95% CI: 17.40–17.65). Of the 1431 respondents, 57% were males and 43% were females. The prevalence of current smokeless tobacco chewers was 44.9% and among them 90.8% were males and 9.8% were females. Around 31.3% did not have smokeless tobacco chewing practice (Male-5.9%, Female-64.9%). Among the current smokeless tobacco chewers 21.5% chew both types of smokeless tobacco products and all of them were males. Male gender (OR 17.9; 11.4 -27.9) and ever smoking lifestyle (OR 4.4; 2.9–6.6) were significant determinants of current smokeless tobacco chewing lifestyle.

Conclusion and recommendations

The study shows a high prevalence of smokeless tobacco use by youth aged between 15 to 24 years who were residing in urban slum areas in the district of Colombo, in Sri Lanka, highlighting this target group for early intervention to reduce the uptake and promote the quitting of this practice.
Barriers to hospital-based phase 2 cardiac rehabilitation among patients with coronary heart disease in China: a mixed-methods study
Authors: Xie Xiaoqi , Chen Qiongshan , Liu Hui
Published: November 2022

Background

Coronary heart disease (CHD) has become a leading cause of morbidity and premature death worldwide. Cardiac rehabilitation (CR) was proved to have substantial benefits for patients with CHD. The CR was divided into three phases. Phase 2 is the important part of CR which involves hospital-based structured and closely monitored exercises and activities. However, CR utilization is low worldwide. The barriers to hospital-based phase 2 CR in China have not been well identified.

Aims

To investigate barriers to hospital-based phase 2 cardiac rehabilitation among coronary heart disease patients in China and to explore the reasons.

Methods

This study employed an explanatory sequential mixed-methods design. The study was conducted in a university hospital in China from July 2021 to December 2021. Quantitative data was collected through the Cardiac Rehabilitation Barrier Scale. Qualitative data was collected through unstructured face-to-face interviews. Data analysis included descriptive statistics and inductive qualitative content analysis.

Results

One hundred and sixty patients completed the Cardiac Rehabilitation Barrier Scale and 17 patients participated in unstructured face-to-face interviews. The main barriers identified were distance (3.29 ± 1.565), transportation (2.99 ± 1.503), cost (2.76 ± 1.425), doing exercise at home (2.69 ± 1.509) and time constraints (2.48 ± 1.496). Six themes were identified; logistical factors, social support, misunderstanding of cardiac rehabilitation, program and health system-level factors, impression of CR team and psychological distress. The first four themes confirmed the quantitative results and provide a deeper explanation for the quantitative results. The last two themes were new information that emerged in the qualitative phase.

Conclusion

This study provides a better understanding of the barriers to hospital-based phase 2 cardiac rehabilitation among coronary heart disease patients in the Chinese context during the Covid-19 pandemic. Innovative programs such as home-based CR, mobile health, and hybrid programs might be considered to overcome some of these barriers. In addition, psychosocial intervention should be included in these programs to mitigate some of the barriers associated with the impression of CR team and psychological distress.
Whose rights are being violated when receiving HIV and sexual and reproductive health services in Nigeria?
Authors: Folayan Morenike Oluwatoyin , Stevens-Murphy Erva-Jean , Nwakamma Ikenna , Lusher Joanne , Oloniniyi Ibidunni Olapeju
Published: November 2022

Background

In Nigeria, vulnerability status may increase the risk for the violation of human rights while receiving health care. The present study determined the proportion and profile of people who reported rights violation while accessing HIV and sexual and reproductive health (SRH) services.

Methods

This was a cross sectional study with data collected between February and March 2021. The dependent variables were patients’ rights to autonomy: right to privacy and confidentiality of medical records; right to be treated with respect, regardless of gender, race, religion, ethnicity, allegations of crime, disability or economic circumstances; right to decline or consent to participation in medical research, experimental procedures or clinical trials; right to quality care in accordance to prevailing standards; and right to complain and express dissatisfaction regarding services received. The independent variables were sexual identity (heterosexual/straight, gay, lesbian, bisexual, queer), HIV status (positive, negative, do not know), living with disability (yes/no), and access point to HIV services (public or donor funded/private). Five multivariate regression models were developed to determine associations between the dependent and independent variable after adjusting for age, education level (no formal education, primary, secondary, tertiary), sex (male, female, intersex), marital status (single, married, separated/divorced, cohabiting) and gender identity (male, female, transgender).

Results

Complete data from 2119 study participants were analysed. Transgender individuals had significantly higher odds of experiencing violation of their rights to privacy and confidentiality of medical records (AOR:1.70), right to be treated with respect (AOR:1.71), right to complain and express dissatisfaction regarding services received (AOR:1.57) and right to decline consent to participate in medical research, experimental research, experimental procedures or clinical trials (AOR:1.81) compared to individuals who were males.

Conclusion

A high proportion of recipients of HIV and SRH services in Nigeria reported rights violations. Transgender individuals appear to have higher risk and those in spousal relationships have lower risk for rights violations. Studies are needed to learn how to improve rights-based HIV and SRH service delivery in Nigeria especially for transgender individuals.
Human behaviour directs household-level exposure to malaria vectors in Bandarban, Bangladesh
Authors: Aubourg Matthew A. , Al-Amin Hasan Mohammad , Sunkara Anoop , Chetan Sanjna , Monroe April , Phru Ching Swe , Haque Rashidul , Khan Wasif A. , Hendershot Allison , Alam Mohammad Shafiul , Lobo Neil F.
Published: November 2022

Background

Bangladesh has reduced malaria incidence and mortality by over 75% between 2010 and 2020. Widespread long-lasting insecticidal net (LLIN) distribution and use is one of the measures responsible for this success. Recalcitrant malaria hotspots within the Chittagong Hill Tracts districts suggest important drivers of malaria risk may remain uncharacterized.

Methods

Towards understanding how household-level human behaviour impacts exposure to mosquitoes, parallel human landing catches and human behavioural observations were conducted in four households for 6 months (May–October) over the rainy season in the Bandarban District. Analysis quantifies spatiotemporal human behaviour-adjusted exposure to Anopheles with and without LLINs.

Results

This small-scale operational study demonstrates that human spatial and temporal presence along with LLIN use drives exposure to Anopheles. Though the four households had both outdoor and indoor exposure, especially in the evening (1800–2000 h) and early morning (0400–0500 h), data points to household-based heterogeneity in malaria exposure even with similar LLIN access.

Conclusion

Incorporating human behaviour into exposure estimates can be used to understand the efficacy and limitations of local vector control strategies and identify gaps in protection, as well as where present intervention strategies may be optimized.
Impact of chronic graft-versus-host disease on quality of life and cognitive function of long-term transplant survivors after allogeneic hematopoietic stem cell transplantation with total body irradiation
Authors: Gruber Isabella , Koelbl Oliver , Herr Wolfgang , Holler Ernst , Edinger Matthias , Wolff Daniel
Published: November 2022

Background

Total body irradiation (TBI)-based-conditioning before allogeneic hematopoietic stem cell transplantation (allo-HSCT) is standard of care in patients with acute myeloid leukemia (AML) but can cause long-term morbidity. Data on the impact of chronic Graft-versus-host disease (cGvHD) on cognitive function (CF) and quality of life (QoL) of long-term transplant survivors are sparse.

Methods

We analyzed patient-reported outcomes focusing on progression-free AML patients and 1st allo-HSCT applying a standardized TBI-technique with an average dose rate of 4 cGy/min to the total body and lung shielding in case of doses > 8 Gy. Instruments included the Functional Assessment of Cancer Therapy-Bone marrow transplant (FACT-BMT, version 4), the FACT-Cognition Function (FACT-Cog, version 3) and the Patient Health Questionaire-4 (PHQ-4). We put focus on the impact of cGvHD and compared the results to normative data derived from the general population.

Results

Out of 41 eligible patients contacted, 32 (78.0%) patients with a medium follow-up of 154 months (Interquartile range 113, 191 months) participated in the study. Eleven patients (34.4%) had active cGvHD, 11 (34.4%) resolved cGvHD and 10 (31.3%) never had cGvHD. Patients with active cGvHD had poorer FACT-BMT, FACT-Cog and higher PHQ-4 scores compared to patients with resolved cGvHD or who never had cGvHD. Outcomes were similar in patients with resolved cGvHD and those who never had cGvHD. Patients with active cGvHD had similar FACT-Cog, but lower FACT-BMT in comparison to normative data. However, the overall patient sample had similar FACT-BMT and FACT-Cog in comparison to normative data.

Conclusion

Our data indicate that CF of long-term survivors upon TBI-based allo-HSCT is not impaired, even in the presence of active cGvHD. However, active cGvHD has a negative impact on QoL.

Trial registration  The local Ethics Board of the University of Regensburg approved this study (Number 20-1810_1-101).
Small extracellular vesicles derived from Nrf2-overexpressing human amniotic mesenchymal stem cells protect against lipopolysaccharide-induced acute lung injury by inhibiting NLRP3
Authors: Xu Lijuan , Zhu Yunlou , Li Congye , Wang Qixing , Ma Lijie , Wang Junjie , Zhang Shouqin
Published: November 2022

Background

Acute lung injury (ALI) is a major cause of respiratory failure in critically ill patients that results in significant morbidity and mortality. Recent studies indicate that cell-based therapies may be beneficial in the treatment of ALI. We recently demonstrated that Nrf2-overexpressing human amniotic mesenchymal stem cells (hAMSCs) reduce lung injury, fibrosis and inflammation in lipopolysaccharide (LPS)-challenged mice. Here we tested whether small extracellular vesicles (sEVs) derived from Nrf2-overexpressing hAMSCs (Nrf2-sEVs) could protect against ALI. sEVs were isolated from hAMSCs that overexpressed (Nrf2-sEVs) or silenced (siNrf2-sEVs) Nrf2. We examined the effects of sEVs treatment on lung inflammation in a mouse model of ALI, where LPS was administered intratracheally to mice, and lung tissues and bronchoalveolar lavage fluid (BALF) were analyzed 24 h later.

Methods

Histological analysis, immunofluorescence microscopy, western blotting, RT-PCR and ELISA were used to measure the inflammatory response in the lungs and BALF.

Results

We found that sEVs from hAMSCs are protective in ALI and that Nrf2 overexpression promotes protection against lung disease. Nrf2-sEVs significantly reduced lung injury in LPS-challenged mice, which was associated with decreased apoptosis, reduced infiltration of neutrophils and macrophages, and inhibition of pro-inflammatory cytokine expression. We further show that Nrf2-sEVs act by inhibiting the activation of the NLRP3 inflammasome and promoting the polarization of M2 macrophages.

Conclusion

Our data show that overexpression of Nrf2 protects against LPS-induced lung injury, and indicate that a novel therapeutic strategy using Nrf2-sEVs may be beneficial against ALI.