bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated with Antimicrobial Use at the End-Of-Life Among Hospitalized Cancer Patients
Authors: Pandey Shila , Wisniewski Renee , Morjaria Sejal , Bianchi Anabella Lucca , Newman Tiffanny , Tan Carrie , Rosa William E. , Finlayson Catherine S.
Published: February 2023

Background: Antimicrobials are frequently administered at end-of-life (EOL) and their non-beneficial use may subject patients to unnecessary harms. Studies analyzing factors for antimicrobial prescribing in solid tumor cancer patients at the EOL are lacking. Thus, we aimed to identify factors and patterns associated with antimicrobial use in hospitalized adults with cancer at EOL. Methods: We used a retrospective cohort design to review electronic medical records of terminal hospitalized patients ≥18 years with solid tumors admitted to non-intensive care units in a metropolitan comprehensive cancer center during 2019 and assessed antimicrobial use in the last 7 days of life. Results: Among 633 cancer patients, 59% ( n = 376) received antimicrobials (AM+) within the last 7 days of life. AM + patients were older (P = .012), mostly of male gender (55%), and non-Hispanic ethnicity (87%). AM + patients were significantly more likely to have a foreign device, suspected signs of infection, neutropenia, positive blood culture result, documented advance directive; receive laboratory or radiologic testing, and a palliative care or infectious disease consultation (all P < .05). No statistically significant differences were observed in the presence of documented goals of care discussions, or EOL discussions/EOL care orders. Conclusion: Antimicrobial use at the EOL is common in solid tumor cancer patients at the EOL and is associated with increased utilization of invasive interventions. There is an opportunity for infectious disease specialists to build primary palliative care skills and partner with antimicrobial stewardship programs to better advise patients, decision makers, and primary teams on the use of antimicrobials at the EOL.
Determinants of Daytime Sleepiness Among Middle-Aged Adults
Authors: Liu Xiaoyue , Commodore-Mensah Yvonne , Himmelfarb Cheryl R. , Li Junxin , Stoner Lee , Shahane Amit , Logan Jeongok G.
Published: February 2023

Daytime sleepiness is highly prevalent in middle-aged adults and has a detrimental impact on their quality of life. Our study examined the psychological and behavioral determinants of daytime sleepiness among adults aged 35 to 64 years. The main variables of interest were psychological factors (perceived stress and anxiety), physical activity factors (moderate-to-vigorous physical activity and sedentary behaviors), and dietary factors (fat, sugar, fruit, and vegetable intake). Partial correlation and multiple linear regression were conducted to determine their associations with daytime sleepiness, with adjustment for covariates. Our sample included 87 adults with a mean age of 47 ± 9 years. About 21% met the criterion for excessive daytime sleepiness. Greater anxiety, longer time spent in sedentary behaviors, and higher consumption of foods rich in trans fat, sugar, and calories were independently associated with higher daytime sleepiness levels. Targeted interventions or treatments are warranted to address the identified risk factors for middle-aged adults.
COVID-19 and the Mental Health Crisis Faced by Students From a Private University in the Philippines: A Phenomenological Study
Authors: Asiones Noel
Published: February 2023

The focus of this study was the students lived experiences and perspectives of the COVID-19 pandemic and its associated lockdowns. Although there is considerable quantitative evidence that the pandemic significantly strained the general population's mental health, qualitative attempts to explore the psychosocial determinants that could have moderated and mitigated its adverse effects are limited. Based on empirical phenomenological methods of inquiry, this study aimed to provide a more eidetic portrait of the lived experience of the pandemic-induced environment from the perspective of 36 first-year college students from a private university in the Philippines. A thematic analysis of their responses to the online structured written interview surfaced three strands that enabled them to cope, adapt, and even thrive: finding the family, finding faith, and finding meaning. The researchers recommend that youth ministers, positive psychology practitioners, and school guidance counselors enact and implement programs that can strengthen the supportive role of family and religion to enable the youth to respond well to the current pandemic and beyond.
Beyond Family Ethnic Socialization and Heritage Language Ability: The Relation between Desire to Learn Heritage Language and Ethnic Identity
Authors: Tram Jane M. , Huang Amia , Lopez Jacquelene M.
Published: February 2023

We examined the relationship between ethnic identity (EI), family ethnic socialization (FES), heritage language ability (HLA), and desire to learn a heritage language (HLD) in a sample of 91 U.S. psychology graduate students. We had four main findings. First, HLD had a significant positive relation with EI (24.9%). Second, FES had a significant positive relation with EI (33.8%). Above and beyond FES, HLD uniquely accounted for 10.9% of the variance of EI. Third, HLA had a significant positive relation with EI (12.3%). Above and beyond HLA, HLD uniquely accounted for 12.7% of the variance of EI. Accounting for the contribution of HLD decreased the beta associated with HLA; a finding that suggests HLD may mediate the relation between HLA and EI. Fourth, the combined contribution of FES and HLA accounted for approximately 36.3% of the variance of EI. HLD had a significant positive relation to ethnic identity after the other the factors in this study were considered, in combination, and uniquely explained 9.0% of the variance of EI. Our results highlight the importance of considering internal factors, such as desire to learn a heritage language, when examining ethnic identity. Implications for practice and recommendations for future research are discussed.
Safety Assessment of Centella asiatica-Derived Ingredients as Used in Cosmetics
Authors: Johnson Wilbur , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Gill Lillian J. , Heldreth Bart
Published: February 2023

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 9 Centella asiatica-derived ingredients, which reportedly function primarily as skin conditioning agents in cosmetic products. The Panel reviewed relevant data relating to the safety of these ingredients. The Panel concluded that Centella Asiatica Extract, Centella Asiatica Callus Culture, Centella Asiatica Flower/Leaf/Stem Extract, Centella Asiatica Leaf Cell Culture Extract, Centella Asiatica Leaf Extract, Centella Asiatica Leaf Water, Centella Asiatica Meristem Cell Culture, Centella Asiatica Meristem Cell Culture Extract, and Centella Asiatica Root Extract are safe in the present practices of use and concentration in cosmetics, as described in this safety assessment, when formulated to be non-sensitizing.
The influence of a thin, natural cellulose fibre membrane on the acoustic absorption of a layer of melamine foam
Authors: Xu Wenhao , Horoshenkov Kirill V , Jin Yun
Published: February 2023

Porous materials such a melamine foam are commonly used to absorb noise and to control reverberation time in buildings. However, the ability of a thin porous layer to absorb noise at acoustic wavelengths that is much greater than the layer thickness is limited. This work investigates theoretically and experimentally the influence of a very thin, natural cellulose membrane on the sound absorption coefficient of a melamine foam substrate. The experimental results demonstrate that the presence of a 120 μm cellulose membrane can more than double the sound absorption coefficient of a relatively thin (17.4 mm) layer of melamine foam at frequencies above 600 Hz (577 mm wavelength). The theoretical part of work explains this effect through a careful simulation. The results show that there are analytical models that can accurately predict the acoustical behaviour of the cellulose membrane combined with a layer of melamine foam. The effects of the flow resistivity and thickness of a cellulose fibre membrane on the acoustic absorption coefficient of the melamine foam substrate are also studied through modelling and experiment. It is found that the optimum thickness of the cellulose fibre membrane should be between 75 and 100 µm when laminated on the top of a 20 mm melamine foam substrate. This work suggests that thin layers of sustainable natural materials such as cellulose fibres can be used to significantly improve the ability of traditional porous media to absorb sound.
Music therapy for adolescents in a child welfare setting - a qualitative interview study
Authors: Krüger Viggo , Murphy Kathleen M. , Nordanger Dag , Wilhelmsen Christine
Published: February 2023

In this article, we explore challenges and possibilities as expressed by young people who participated in a music workshop in Norway (MWS). The participants in the workshop had a background referred to as looked after children (LAC) in the Norway. All participants had experiences with foster care or/and residential care. The music activities they reported on took place in a public “cultural house”, and included listening to music, songwriting, playing in a band and performing, led by music therapists. The study is based on a qualitative research methodology, using a thematic analysis of semi-structured interviews, where we ask the following research question; What are the challenges and possibilities of participating in community music therapy for looked after children who have been removed from their families by Norwegian child protection service? To answer this question, we interviewed eleven young adults between the ages of sixteen and 23. We identified three themes; Music is a vehicle for the creation of meaning in a challening life situation, Building peer relationships and sharing life experiences through participation in the music workshop and Dealing with complex emotions and identity through music therapy. Findings are discussed in the light of theoretical perspectives on child protection, music therapy and psychology, and more specifically, trauma informed care and community music therapy. Implications for practice and research are highlighted. We suggest that work with LAC should follow a person oriented and community-oriented approach, where the child is empowered to take part in activities in community settings where support can be found from peers and adults.
Triangulation and violence in the Caribbean: Crimes retold from a Curaçaoan juvenile detention centre
Authors: Mutsaers Paul , Meijeren Maikel
Published: February 2023

In a special issue in Ethnography, the question was raised how to study violence ethnographically in Latin America and the Caribbean. The present article seeks to extend this special issue with reflections on how to study different forms of violence ‘after the fact’, based on fieldwork at a juvenile detention centre in Curaçao in 2019 and 2020. We present intersubjectively realistic accounts of violence in the family sphere. These accounts came into being by means of two acts of empirical triangulation: (1) looking at violent episodes through the eyes of different people involved and (2) contrasting the counterstories that emerged from this with the detention centre’s case files that construct particular images of the detained youth and their family members. We end the article with critical reflections on our own unwitting contribution to the production of silence, which frustrated the youth’s counterstories.
Conducting Life History Interviews With Older Adults With Lived Experiences of Poverty: Reflections From Millennial and Gen Z Researchers
Authors: Kwan Crystal , Tam Ho Chung , Lin Xin Yu , Chung Yan Ho , Mah Tak Shuen
Published: February 2023

The life history approach, a common interviewing method within the social sciences, involves collecting longitudinal data retrospectively by seeking an individual’s account of their life over different periods of time. The exploratory, in-depth and narrative nature of life history interviews make it a compelling narrative method that can illicit rich and in-depth data and understanding (of the “other” and self). At the same time, this attribute raises various ethical complexities that must be considered. This paper documents the personal and professional reflections of a research team conducting life history interviews for a specific research project. It highlights the value of life history interview as a narrative method, and discusses the ethical complexities that can arise.
Abdominal Aortic Aneurysm Repair in Patients with Concomitant Cancer: A Literature Review
Authors: Nielsen Anne C , Nicolajsen Chalotte W , Eldrup Nikolaj
Published: February 2023

Objectives

Abdominal aortic aneurysmal (AAA) repair in patients with concomitant cancer is controversial due to increased comorbidity and reduced life expectancy in this specific patient group. This literature review aims to investigate the evidence supporting one treatment modality over another (endovascular aortic repair (EVAR) or open repair (OR)), as well as treatment strategy (staged AAA-, cancer first or simultaneous procedures) in patients with AAA and concomitant cancer.

Methods

Literature review, including studies published from 2000 to 2021 on surgical treatment in patients with AAA and concomitant cancer and related outcomes (30-day morbidity/complications as well as 30-day and 3-year mortality).

Results

24 studies comprising 560 patients undergoing surgical treatment of AAA and concomitant cancer were included. Of these, 220 cases were treated with EVAR and 340 with OR. Simultaneous procedures were performed in 190 cases, 370 received staged procedures. The 30-day mortality for EVAR versus OR was 1% and 8%, corresponding to a relative risk (RR) of 0.11 (95% CI: 0.03–0.46, p = 0.002). No difference in mortality was observed between staged versus simultaneous procedure nor between AAA-first versus cancer-first strategy, RR 0.59 (95% CI: 0.29–1.1, p = 0.13) and 0.88 (95% CI 0.34–2.31, p = 0.80), respectively. Overall, 3-year mortality was 21% for EVAR and 39% for OR from 2000–2021, while the mortality up to 3 years after EVAR within recent years (2015–2021) was 16%.

Conclusion

This review supports EVAR treatment as first choice if suitable. No consensus was established on treating either the aneurysm or the cancer first or simultaneously . Long-term mortality after EVAR was comparable to non-cancer patients within recent years.
Towards maximizing expected possession outcome in soccer
Authors: Rahimian Pegah , Van Haaren Jan , Toka Laszlo
Published: February 2023

Soccer players need to make many decisions throughout a match in order to maximize their team’s chances of winning. Unfortunately, these decisions are challenging to measure and evaluate due to the low-scoring, complex, and highly dynamic nature of soccer. This article proposes an end-to-end deep reinforcement learning framework that receives raw tracking data for each situation in a game, and yields optimal ball destination location on the full surface of the pitch. Using the proposed approach, soccer players and coaches are able to analyze the actual behavior in their historical games, obtain the optimal behavior and plan for future games, and evaluate the outcome of the optimal decisions prior to deployment in a match. Concisely, the results of our optimization model propose more short passes (Tiki-Taka playing style) in all phases of a ball possession, and higher propensity of low distance shots (i.e. shots in attack phase). Such a modification will let the typical teams to increase their likelihood of possession ending in a goal by 0.025.
Vulval pruritus
Authors: Freeman Natasha Elizabeth Alice
Published: February 2023

Pruritus or itch can be a symptom of many dermatological conditions of the vulva and can range from mildly annoying to severely impacting a patient’s quality of life. The dermatological causes of vulval pruritus are many; those that will be discussed in this article are inflammatory dermatoses, infection, neoplasia and atrophy. It is important to identify and manage vulval conditions, because of the impact on patients’ quality of life and because they may represent a malignancy or a precursor to one. A tailored history and examination will help direct clinicians to the appropriate management and referral pathway. Alongside the correct medical treatment, patients should be provided with information on the principles of vulval care and where to access further information on their condition.
Challenging the Global Cultural Conflict Narrative: An Automated Content Analysis on How PerPetrator Identity Shapes Worldwide News Coverage of Islamist and Right-Wing Terror Attacks
Authors: Chan Chung-hong , Wessler Hartmut , Jungblut Marc , Welbers Kasper , Althaus Scott , Bajjalieh Joseph , van Atteveldt Wouter
Published: February 2023

Recent terrorist attacks such as the Christchurch mosque attacks in 2019 renew the discussion of whether right-wing attacks are reported less negatively than Islamist attacks. To clarify this point, our study is the first to combine the selection of media inside and outside the West with a distinction between Islamist and right-wing attacks. We compare coverage given to thirty-two right-wing and forty Islamist attacks from 2015 to 2019 in nine Western and eight non-Western English-language media outlets, tapping the differential use of the “terrorist/terrorism” label and textual sentiment. Both (many) Western and (some) non-Western media use this label more frequently in the coverage of Islamist attacks. Importantly, public diplomacy channels from non-Western countries such as China Daily and Sputnik also demonstrate this pattern. Delegitimizing Islamist attacks more than right-wing attacks thus cannot be explained as merely a Western phenomenon alone. We point to alternative explanations and call for greater standardization of coverage across Islamist and right-wing attacks.
Achieving no evidence of disease activity-3 in highly active multiple sclerosis patients treated with cladribine and monoclonal antibodies
Authors: Alonso Ricardo , Casas Magdalena , Lazaro Luciana , Fernandez Liguori Nora , Pita Cecilia , Cohen Leila , Rojas Juan Ignacio , Pappolla Agustín , Patrucco Liliana , Cristiano Edgardo , Burgos Marcos , Vrech Carlos , Piedrabuena Raul , Pablo Lopez , Deri Norma , Luetic Geraldine , Miguez Jimena , Cabrera Mariela , Martinez Alejandra , Zanga Gisela , Tkachuk Verónica , Tizio Santiago , Carnero Contentti Edgar , Knorre Eduardo , Leguizamon Felisa , Mainella Carolina , Nofal Pedro , Liwacki Susana , Hryb Javier , Menichini Maria , Pestchanker Claudia , Alonso Marina , Garcea Orlando , Silva Berenice
Published: February 2023

Background

We aimed to determine the proportion of highly active multiple sclerosis patients under high-efficacy therapies (HETs) achieve no evidence of disease activity-3 (NEDA-3) at 1 and 2 years, and to identify factors associated with failing to meet no evidence of disease activity 3 at 2 years.

Methods

This retrospective cohort study based on Argentina Multiple Sclerosis patient registry (RelevarEM), includes highly active multiple sclerosis patients who received HETs.

Results

In total, 254 (78.51%) achieved NEDA-3 at year 1 and 220 (68.12%) achieved NEDA-3 at year 2. Patients who achieved NEDA-3 at 2 years had a shorter duration of multiple sclerosis ( p < 0.01) and a shorter time between first treatment and current treatment ( p = 0.01). Early high-efficacy strategy patients reached NEDA-3 more frequently ( p < 0.01). Being a naïve patient (odds ratio: 3.78, 95% confidence interval 1.50–9.86, p < 0.01) was an independent predictor to reach NEDA-3 at 2 years. No association was found between type of HETs and NEDA-3 at 2 years when adjusted for potential confounders (odds ratio: 1.73; 95% confidence interval 0.51–6.06, p 0.57).

Conclusion

We found a high proportion of patients who achieved NEDA-3 at 1 and 2 years. Early high-efficacy strategy patients had a higher probability of achieving NEDA-3 at 2 years.
Short Video Activism With and on Douyin: An Innovative Repertoire of Contention for Chinese Consumers
Authors: Yu Zizheng , Hou Jiaxi , Zhou Oscar Tianyang
Published: February 2023

This article examines consumer video activism tactics in China and their impact on Chinese consumers and society. Drawing upon 56 semistructured interviews and a case study analysis of Chinese online consumer protest in 2018, we argue that short-video-activism tactics have become an innovative repertoire of contention for Chinese consumers and Douyin, the “sister app” of TikTok, has become a real-time updated database of this repertoire. Using Douyin as a case study, we argue that it plays three key roles in mediating Chinese consumer activism: a techno-cultural construct that affords highly heterogeneous users to present everyday experiences via short videos; a multisided market that profoundly affects the tactics consumers choose to amplify their voices; and a governing entity that both moderates content for its users and simultaneously is subject to government regulations.
Surgical Repair of Anomalous Origin of the Left Subclavian Artery From the Pulmonary Artery Using a Supraclavicular Approach
Authors: Soynov Ilya A. , Kulyabin Yuriy Y. , Arkhipov Alexey N. , Ivanzov Sergey M. , Galstyan Meline G. , Voitov Alexey V.
Published: February 2023

Anomalous origin of the left subclavian artery from the pulmonary artery is a rare congenital cardiac malformation. We describe a case of anomalous origin of the left subclavian artery from the pulmonary artery in a patient who presented with symptoms of vertebrobasilar insufficiency and underwent reimplantation of the left subclavian artery into the left common carotid artery from the supraclavicular approach.
Facilitating and Complicating Factors in Distance Language Teaching: Instructors’ Views
Authors: Güven Ahmet Zeki
Published: February 2023

The present paper employed instructors’ views to address the facilitating and complicating factors in distance teaching of Turkish. The data were collected through a semi-structured interview form consisting of five questions. The questions were designed by the author and reviewed by two Turkish language teaching specialists. The data were collected through one-on-one online interviews with the participants over Microsoft Teams. To increase the reliability, the participants’ responses, deciphered by the author one Turkish language teaching specialist were explored for interrater consistency. According to the formula proposed by Miles and Huberman, the consistency was found to be 0.94. Accordingly, the difficulties in distance teaching of Turkish were addressed within two themes: technical and teaching-oriented problems. Yet, the participants brought positive remarks on personal, technological, and financial aspects of distance Turkish teaching. Besides, the emerging views regarding educational materials were grouped under distance education platforms and digital tools. The measurement and evaluation problems were also discussed under the reliability of exams and types of language skills assessment. Finally, the recommendations brought by the instructors for distance Turkish teaching were themed under three headings: recommendations for technology, materials, and practice. Overall, future comparative research may employ a larger sample of instructors working in other Turkish language centers and compare the findings. Moreover, further research may seek the attitudes of larger groups of instructors within a quantitative design to suggest more generalizable results. Or, the subject may be addressed by mixed-design research to bring a more comprehensive understanding of the phenomenon.
Quantifying the environmental characteristics influencing the attractiveness of commercial agglomerations with big geo-data
Authors: Huang Zhou , Yin Ganmin , Peng Xia , Zhou Xiao , Dong Quanhua
Published: February 2023

Understanding the attractiveness of commercial agglomerations contributes to urban planning. Existing studies focus less on commercial agglomerations, and most directly use environmental supply factors to characterize attractiveness. This study measures attractiveness from the perspective of human demand. Specifically, we build a novel bipartite graph based on big geo-data of human mobility, using node centralities (degree, betweenness, and pagerank) to measure attractiveness. Next, we summarize multisource environmental features such as Point-of-Interests (POIs), land cover, transportation, and population, and use them as inputs to accurately predict attractiveness based on random forest. Finally, the spatial heterogeneity of the effects of these environmental variables on attractiveness is analyzed by multiscale geographically weighted regression. The results of the Beijing case show that: (1) All three centralities show a trend that the urban center is higher than the surrounding area, and betweenness is more reasonable. (2) Random forest can accurately predict attractiveness, with R2 for degree, betweenness, and pagerank at 0.903, 0.846, and 0.760, respectively. (3) The number of shopping POIs, the length of main roads, and the number of bus stops positively affect attractiveness, while the effects of greening ratio and population density are bidirectional. As for the service scope, about 70% of commercial agglomerations have an average service radius of less than 15 km, which is significantly correlated with the Voronoi diagram. Our results can inspire understanding the human–environment relationship and guide urban policymakers in business planning.
Clinical factors associated with adverse clinical outcomes in elderly versus non-elderly COVID-19 emergency patients: a multi-center observational study
Authors: Puchongmart Chanokporn , Boonmee Phetsinee , Jirathanavichai Supawich , Phanprasert Nutthida , Thirawattanasoot Netiporn , Dorongthom Thawonrat , Monsomboon Apichaya , Praphruetkit Nattakarn , Ruangsomboon Onlak
Published: February 2023

Background

The COVID-19 pandemic has caused over 6 million deaths worldwide. The elderly accounted for a large proportion of patients with their mortality rate largely higher than the non-elderly. However, limited studies have explored clinical factors associated with poor clinical outcomes in this important population. Therefore, this study aimed to determine factors independently associated with adverse clinical outcomes among COVID-19 elderly patients.

Methods

We conducted a multicenter observational study at five emergency departments (EDs) in Thailand. Patients over 18 years old diagnosed with COVID-19 between January and December 2021 were included. We classified patients into elderly (age ≥ 65 years) and non-elderly (age < 65 years). The primary clinical outcome was in-hospital mortality. The secondary outcomes were endotracheal intubation and intensive care unit admission. We identified independent factors associating with these outcomes both in the whole population and separately by age group using multivariate logistic regression models.

Results

A total of 978 patients were included, 519 (53.1%) were elderly and 459 (46.9%) were non-elderly, and 254 (26%) died at hospital discharge. The mortality rate was significantly higher in the elderly group (39.1% versus 14.3%, p<0.001)). In the elderly, age (adjusted odds ratio (aOR) 1.13; 95% confidence interval (CI) 1.1—1.2; p<0.001), male sex (aOR 3.64; 95%CI 1.5–8.8; p=0.004), do-not-resuscitate (DNR) status (aOR 12.46; 95%CI 3.8–40.7; p<0.001), diastolic blood pressure (aOR 0.96; 95%CI 0.9–1.0; p=0.002), body temperature (aOR 1.74; 95%CI 1.0–2.9; p=0.036), and Glasgow Coma Scale (GCS) score (aOR 0.71; 95%CI 0.5–1.0; p=0.026) were independent baseline and physiologic factors associated with in-hospital mortality. Only DNR status and GCS score were associated with in-hospital mortality in both the elderly and non-elderly, as well as the overall population. Lower total bilirubin was independently associated with in-hospital mortality in the elderly (aOR 0.34; 95%CI 0.1–0.9; p=0.035), while a higher level was associated with the outcome in the non-elderly. C-reactive protein (CRP) was the only laboratory factor independently associated with all three study outcomes in the elderly (aOR for in-hospital mortality 1.01; 95%CI 1.0–1.0; p=0.006).

Conclusion

Important clinical factors associated with in-hospital mortality in elderly COVID-19 patients were age, sex, DNR status, diastolic blood pressure, body temperature, GCS score, total bilirubin, and CRP. These parameters may aid in triage and ED disposition decision-making in this very important patient population during times of limited resources during the COVID-19 pandemic.
Epidemiology and source of infection in cancer patients with febrile neutropenia: an experience from a developing country
Authors: Joudeh Nagham , Sawafta Elana , Abu Taha Adham , Hamed Allah Majd , Amer Riad , Odeh Razan Y. , Salameh Husam , Sabateen Ali , Aiesh Banan M. , Zyoud Sa’ed H.
Published: February 2023

Background

Febrile neutropenia (FN) is a life-threatening complication that predisposes cancer patients to serious infections. This study aims to describe the epidemiology and source of infection in cancer patients with FN in a tertiary care hospital.

Methods

A hospital-based retrospective study was conducted in a large tertiary care hospital from January 2020 to December 2021. Data on cancer patients with FN were collected from the hospital information system.

Results

150 cancer patients with FN were identified during the study period. Most patients were males (98; 65.3%), and the mean age of participants was 42.2 ± 16.0 years. Most patients (127; 84.7%) had hematologic malignancies, and acute myeloid leukemia was the most common diagnosis (42; 28%), followed by acute lymphocytic leukemia (28; 18.7%) and Hodgkin’s lymphoma (20; 13.3%). Fifty-four (36%) patients had a median Multinational Association for Supportive Care in Cancer (MASCC) scores greater than 21. Regarding the outcome, nine (6%) died, and 141(94%) were discharged. The focus of fever was unknown in most patients (108; 72%). Among the known origins of fever were colitis (12; 8%), pneumonia (8; 5.3%), cellulitis (6; 4%), bloodstream infections (7; 4.6%), perianal abscess (2; 1.3%) and others. The median duration of fever was two days, and the median duration of neutropenia was seven days. Sixty-three (42%) patients had infections: 56 (73.3%) were bacterial, four (2.6%) were viral, two (1%) were fungal and 1 (0.7%) was parasitic. Among the bacterial causes, 50 cases (89.2%) were culture-positive. Among the culture-positive cases, 34 (68%) were gram-positive and 22 (44%) were gram-negative. The most frequent gram-positive bacteria were E. faecalis (9; 18% of culture-positive cases), and the most frequent gram-negative organisms were Klebsiella pneumoniae (5; 10%). Levofloxacin was the most commonly used prophylactic antibiotic (23; 15.33%), followed by acyclovir (1610.7%) and fluconazole in 15 patients (10%). Amikacin was the most popular empiric therapy, followed by piperacillin/tazobactam (74; 49.3%), ceftazidime (70; 46.7%), and vancomycin (63; 42%). One-third of E. faecalis isolates were resistant to ampicillin. Approximately two-thirds of Klebsiella pneumoniae isolates were resistant to piperacillin/tazobactam and ceftazidime. Amikacin resistance was proven in 20% of isolates.

Conclusions

The majority of patients suffered from hematologic malignancies. Less than half of the patients had infections, and the majority were bacterial. Gram-positive bacteria comprised two-thirds of cases. Therefore, empiric therapy was appropriate and in accordance with the antibiogram of the isolated bacteria.
The value of the Nutrition and Obesity Policy Research and Evaluation Network in advancing the evidence base for effective nutrition and obesity policy: assessment using the Consolidated Framework for Collaborative Research
Authors: Vasquez Taylor , Levi Ronli , Akers Melissa , Lowry-Warnock Amy , Blanck Heidi M. , Seligman Hilary
Published: February 2023

Introduction

Addressing nutrition disparities and preventing obesity require multi-level interventions, including policies that address the nutrition environment and other social determinants of health. The Nutrition and Obesity Policy Research Evaluation Network (NOPREN) was established in 2009 to conduct transdisciplinary research and accelerate the translation and implementation of science-based policy interventions. This study examined NOPREN’s collaborative practices and identified opportunities to improve network impact.

Methods

Using a mixed-methods approach, we combined quantitative survey data (n = 106) and in-depth, qualitative interviews (n = 18) to evaluate the experiences of NOPREN members and understand the extent to which NOPREN was achieving its goals.

Results

Using the Consolidated Framework for Collaborative Research (CFCR), quantitative and qualitative results were organized into 11 themes. We find that NOPREN’s structure and standardized processes facilitate connections to individuals and resources, foster relationships, and support effective cross-sector collaborations. Areas of improvement include capacity building and a more intentional approach towards recruitment of a diverse membership.

Conclusion

A collaborative research network can build synergy across sectors and accelerate knowledge transfer. These findings will be used to inform the network’s strategic priorities to maximize impact. Findings may also inform similar collaborative efforts for addressing complex public health problems.
Characteristics of pneumoconiosis in Zhejiang Province, China from 2006 to 2020: a descriptive study
Authors: Wei Fang , Xue Panqi , Zhou Lifang , Fang Xinglin , Zhang Yixin , Hu Yong , Zou Hua , Lou Xiaoming
Published: February 2023

Background

Pneumoconiosis is the most prevalent occupational disease and displays different patterns in each province of China. Clarifying specific incidence patterns and temporal trends in Zhejiang Province can help provide valuable information on the prevention of pneumoconiosis.

Methods

Annual reports of pneumoconiosis for Zhejiang Province from 2006 to 2020 were extracted from the National Occupational Disease and Occupational Health Information Monitoring System. The information of cases included regions, diagnosis ages, genders, exposure durations, pneumoconiosis categories and stages, the first year of exposure, enterprise industries, scales and ownerships.

Results

Totally 6037 new cases of pneumoconiosis were reported between 2006 and 2020, which increased at first and then gradually declined since 2013. Among all pneumoconiosis cases, silicosis accounted for the majority (72.17%). Most of the cases occurred in small-scale and domestic-funded enterprises, which accounted for 71.75% and 96.97%, respectively. When analyzing the industry distribution, the cases were mainly concentrated in mining (37.12%), manufacturing (31.11%) and ‘public administration and social organization’ (23.94%) industry. The average diagnosis age among the pneumoconiosis cases was 55.44 years, and the median exposure duration was 11.00 years. Significantly older diagnosis age and longer exposure duration were found in females, coal workers’ pneumoconiosis cases, cases with higher stages, cases with the first year of dust exposure earlier and cases from large-scale companies. In regional distribution, the top three cities reporting the most pneumoconiosis cases in Zhejiang Province were Taizhou, Quzhou and Hangzhou.

Conclusion

The current situation of pneumoconiosis in Zhejiang Province was still serious, and government should further strengthen the surveillance of occupational diseases and supervision of enterprises. Moreover, publicity and education regarding pneumoconiosis should be carried out to raise awareness of dust exposure risk and associated health consequences.
Rehabilitation approach in robot assisted total knee arthroplasty: an observational study
Authors: Scaturro Dalila , Vitagliani Fabio , Caracappa Dario , Tomasello Sofia , Chiaramonte Rita , Vecchio Michele , Camarda Lawrence , Mauro Giulia Letizia
Published: February 2023

Background

The purpose of this study is to evaluate the impact of total knee arthroplasty (TKA) with the aid of Navio Robot, comparing it with standard prosthetic surgery on the functional outcomes of patients after an intensive rehabilitation program.

Method

A case–control observational study was conducted on patients undergoing TKA for severe KOA. All patients underwent the same intensive hospital rehabilitation program of 14 daily sessions lasting 3 h. The following rating scales were administered: Numeric Rating Scale (NRS), Knee Society Score (KSS) and 12-Item Short Form Survey scale. Patient assessments were performed 1 week post-surgery (T0), 1 month post-surgery (T2), and 3 months post-surgery (T3). The primary outcomes were active knee extension and flexion and pain severity. The secondary outcomes were functional capacity and quality of life.

Results

Using repeated measures ANOVA, we observed at T1 a statistically different difference for the treatment group compared to the control group about KSS (p < 0.05), pain (p < 0.05), and knee flexion (p < 0.05). No statistically significant difference between the two groups was observed for knee extension (p = 0.09) and the SF-12 scale (p = 0.52). At T2 instead, we observed a statistically significant difference for the treatment group compared to the control group as regards KSS (p < 0.05) and knee flexion (p < 0.05), while no statistically significant difference was observed for pain (p = 0.83), knee extension (p = 0.60), and the SF-12 scale (0.44).

Conclusions

Our study has demonstrated that robot-NAVIO assisted knee prosthesis surgery, associated with a specific intensive rehabilitation treatment, in the short and medium term, determines good pain control, better flexion recovery and a improvement of functional capacity.
Diabetes remission of bariatric surgery and nonsurgical treatments in type 2 diabetes patients who failure to meet the criteria for surgery: a systematic review and meta-analysis
Authors: Zhou Xiaoying , Zeng Chunping
Published: February 2023

Background

The efficacy of bariatric surgery in moderate and severe obesity patients to reach diabetes remission is clear, but for mild obesity patients, the choice of surgical and non-surgical treatment is still unclear. This study we aim to compare the effect of surgical and nonsurgical treatment on patients BMI < 35 kg/m2 to reach diabetes remission.

Method

We searched relevant articles publish between Jan 1,2010 and Jan 1, 2023 in the following databases: Embase, PubMed/MEDLINE, Scopus, and Cochrane Library. We got the OR, MD and P-value using random effect model to compare the efficiency between bariatric surgery and nonsurgical treatment on diabetes remission, the reduction of BMI, Hb1Ac and FPG.

Results

In 7 included studies including 544 participants, bariatric surgery is more effective than non-surgical treatment to reach diabetes remission [OR 25.06, 95%CL 9.58–65.54]. Bariatric surgery more likely resulted in significant reductions in HbA1c [MD -1.44, 95%CL (-1.84)-(-1.04)] and FPG [MD -2.61, 95%CL (-3.20)-(-2.20)]. Bariatric surgery may resulted in reductions in BMI [MD -3.14, 95%CL (-4.41)-(-1.88)], which more significant in Asian.

Conclusion

In type 2 diabetes patients who BMI < 35 kg/m2, bariatric surgery is more likely to achieve diabetes remission and better blood glucose control than nonsurgical treatment.
Expression of EMT-related genes in lymph node metastasis in endometrial cancer: a TCGA-based study
Authors: Li He , Wang Junzhu , Li Liwei , Zhao Luyang , Wang Zhiqi
Published: February 2023

Background

Endometrial cancer (EC) with metastasis in pelvic/para-aortic lymph nodes suggests an unsatisfactory prognosis. Nevertheless, there is still rare literature focusing on the role of epithelial-mesenchymal transition (EMT) in lymph node metastasis (LNM) in EC.

Methods

Transcriptional data were derived from the TCGA database. Patients with stage IA–IIIC2 EC were included, constituting the LN-positive and LN-negative groups. To evaluate the extent of EMT, an EMT signature composed of 315 genes was adopted. The EMT-related genes (ERGs) were obtained from the dbEMT2 database, and the differentially expressed ERGs (DEERGs) between these two groups were screened. On the basis of DEERGs, pathway analysis was carried out. We eventually adopted the logistic regression model to build an ERG-based gene signature with predictive value for LNM in EC.

Results

A total of 498 patients were included, with 75 in the LN-positive group. Median EMT score of tumor tissues from LN-negative group was − 0.369, while that from the LN-positive group was − 0.296 (P < 0.001), which clearly exhibited a more mesenchymal phenotype for LNM cases on the EMT continuum. By comparing expression profiles, 266 genes were identified as DEERGs, in which 184 were upregulated and 82 were downregulated. In pathway analysis, various EMT-related pathways were enriched. DEERGs shared between molecular subtypes were comparatively few. The ROC curve and logistic regression analysis screened 7 genes with the best performance to distinguish between the LN-positive and LN-negative group, i.e., CIRBP, DDR1, F2RL2, HOXA10, PPARGC1A, SEMA3E, and TGFB1. A logistic regression model including the 7-gene-based risk score, age, grade, myometrial invasion, and histological subtype was built, with an AUC of 0.850 and a favorite calibration (P = 0.074). In the validation dataset composed of 83 EC patients, the model exhibited a satisfactory predictive value and was well-calibrated (P = 0.42).

Conclusion

The EMT status and expression of ERGs varied in LNM and non-LNM EC tissues, involving multiple EMT-related signaling pathways. Aside from that, the distribution of DEERGs differed among molecular subtypes. An ERG-based gene signature including 7 DEERGs exhibited a desirable predictive value for LNM in EC, which required further validation based upon clinical specimens in the future.
Identification and validation of a novel prognostic signature based on mitochondria and oxidative stress related genes for glioblastoma
Authors: Tong Shiao , Xia Minqi , Xu Yang , Sun Qian , Ye Liguo , Yuan Fanen , Wang Yixuan , Cai Jiayang , Ye Zhang , Tian Daofeng
Published: February 2023

Background

Mitochondria represent a major source of reactive oxygen species (ROS) in cells, and the direct increase in ROS content is the primary cause of oxidative stress, which plays an important role in tumor proliferation, invasion, angiogenesis, and treatment. However, the relationship between mitochondrial oxidative stress-related genes and glioblastoma (GBM) remains unclear. This study aimed to investigate the value of mitochondria and oxidative stress-related genes in the prognosis and therapeutic targets of GBM.

Methods

We retrieved mitochondria and oxidative stress-related genes from several public databases. The LASSO regression and Cox analyses were utilized to build a risk model and the ROC curve was used to assess its performance. Then, we analyzed the correlation between the model and immunity and mutation. Furthermore, CCK8 and EdU assays were utilized to verify the proliferative capacity of GBM cells and flow cytometry was used to analyze apoptosis rates. Finally, the JC-1 assay and ATP levels were utilized to detect mitochondrial function, and the intracellular ROS levels were determined using MitoSOX and BODIPY 581/591 C11.

Results

5 mitochondrial oxidative stress-related genes (CTSL, TXNRD2, NUDT1, STOX1, CYP2E1) were screened by differential expression analysis and Cox analysis and incorporated in a risk model which yielded a strong prediction accuracy (AUC value = 0.967). Furthermore, this model was strongly related to immune cell infiltration and mutation status and could identify potential targeted therapeutic drugs for GBM. Finally, we selected NUDT1 for further validation in vitro. The results showed that NUDT1 was elevated in GBM, and knockdown of NUDT1 inhibited the proliferation and induced apoptosis of GBM cells, while knockdown of NUDT1 damaged mitochondrial homeostasis and induced oxidative stress in GBM cells.

Conclusion

Our study was the first to propose a prognostic model of mitochondria and oxidative stress-related genes, which provided potential therapeutic strategies for GBM patients.
Contemplate iliosacral screw in patients with developmental dysplasia of the hip
Authors: Oztermeli Ahmet , Karahan Nazım , Aktan Ahmet
Published: February 2023

Objectives

Our aim in the study was evaluating sacroiliac morphology in patients with DDH and its possible effect on appropriate iliosacral screw fixation.

Design

Retrospective cohort study.

Setting

Level of evidence 3.

Patients/participants

We evaluated the anteroposterior pelvis X-ray and pelvic CT scans of patients. We mainly divided the patients into two groups: DDH group (n:105) and control group (n:105).

Intervention

The presence of the five qualitative characteristics of sacral dysplasia evaluated according to Route in both groups. The DDH group was divided into four subgroups according to the degree of hip dysplasia.

Main outcome measurement

The cross-sectional area, length of the osseous corridor, coronal and vertical angulation evaluated in both groups.

Results

The DDH group also exhibited a significantly higher S1 coronal and axial angulation, lower S1 cross-sectional area and S1 iliosacral screw length than the control group (p:0.033, p:0,002, p:0.006, p:0,019, respectively). According to the Rout classification, 9% were normal, 31% transient, 58% dysplastic in the DDH group. 45.7% were normal, 38% transient, 17% dysplastic in the control groups. These differences between the groups were statistically significant (p < 0.001). When the DDH groups were evaluated within themselves; no statistically significant difference was observed in S1 and S2 cross-sectional area, S1 and S2 maximum estimated iliosacral screw length, S1 and S2 axial and coronal angles assessment.

Conclusion

Sacral dysplasia was more common, narrower and more angled osseous canal for the iliosacral screw was found in the DDH group. There was no relation between the degree of hip dysplasia and sacrum morphology in the DDH group. Thus, we suggest the surgeons be aware of iatrogenic injury even in constrained dysplastic hips.