bluuebunny/crossref_metadata_2025 huggingface dataset:
Data-driven research and healthcare: public trust, data governance and the NHS
Authors: Kerasidou Angeliki , Kerasidou Charalampia
Published: July 2023

It is widely acknowledged that trust plays an important role for the acceptability of data sharing practices in research and healthcare, and for the adoption of new health technologies such as AI. Yet there is reported distrust in this domain. Although in the UK, the NHS is one of the most trusted public institutions, public trust does not appear to accompany its data sharing practices for research and innovation, specifically with the private sector, that have been introduced in recent years. In this paper, we examine the question of, what is it about sharing NHS data for research and innovation with for-profit companies that challenges public trust? To address this question, we draw from political theory to provide an account of public trust that helps better understand the relationship between the public and the NHS within a democratic context, as well as, the kind of obligations and expectations that govern this relationship. Then we examine whether the way in which the NHS is managing patient data and its collaboration with the private sector fit under this trust-based relationship. We argue that the datafication of healthcare and the broader ‘health and wealth’ agenda adopted by consecutive UK governments represent a major shift in the institutional character of the NHS, which brings into question the meaning of public good the NHS is expected to provide, challenging public trust. We conclude by suggesting that to address the problem of public trust, a theoretical and empirical examination of the benefits but also the costs associated with this shift needs to take place, as well as an open conversation at public level to determine what values should be promoted by a public institution like the NHS.
Geographic availability of and physical accessibility to tuberculosis diagnostic tests in Ghana: a cross-sectional survey
Authors: Kuupiel Desmond , Cheabu Benjamin S. N. , Yeboah Peter , Duah James , Addae Joseph K. , Ako-Nnubeng Ignatius T. , Osei Francis A. , Ziblim Shamsu-Deen , Mchunu Gugu G. , Pillay Julian D. , Bawontuo Vitalis
Published: July 2023

Background

In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests.

Methods

We assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour.

Results

Of the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 ± 13.8 km and 67.6 ± 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 ± 14.6 km and 108.3 ± 43.9 min, whilst UER recorded the shortest with 10.2 ± 5.8 km and 29.1 ± 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions.

Conclusion

This study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to ≤ 10 km.
The value of the wireless stethoscope in patients with COVID-19 infection in a makeshift hospital
Authors: Zhuge Ying , Rong Liu , Ye Lei , Liu Jiaqi , Su Lingyun , Zhang Zhiping , Wang Junshan , Zhang Zhi
Published: July 2023

Objective

When COVID-19 sweeps the world, traditional stethoscopes are seen as infectious agents and then the use of stethoscopes is limited especially when health providers were in their personal protective equipment. These reasons led to the ignoring of the values of stethoscopes during pandemics. This study aims to explore the value of wireless stethoscopes in patients of a makeshift hospital.

Material and methods

200 consecutive hospitalized patients with confirmed SARS-CoV-2 at Lingang Makeshift Hospital in Shanghai, China, were enrolled from April 10 to May 10, 2022 (Trial Registration Number: ChiCTR2000038272,2020/9/15). They were randomly divided into two groups. In group A (n = 100), patients were examined without a stethoscope. In group B (n = 100), lung breath sounds and heart sounds were examined with a wireless stethoscope, and positive signs were recorded. The duration of cough and tachycardia symptoms, as well as emergency cases, were compared between the two groups. In addition, the pressure, anxiety, and depression of patients in the two groups were investigated using the DAS-21 questionnaire scale, to observe the psychological impact of the stethoscope-based doctor–patient communication on patients in the makeshift hospital.

Results

There was no significant difference in baseline characteristics between the two groups. In group B, some significant positive signs were detected by wireless stethoscopes, including pulmonary rales and tachycardia, etc. Moreover, the therapeutic measures based on these positive signs effectively alleviated the symptoms of cough and tachycardia, which showed that the duration of symptoms was significantly shorter than that of group A (cough: 2.8 ± 0.9 vs. 3.6 ± 0.9; palpitation: 1.4 ± 0.7 vs. 2.6 ± 0.7). In particular, the number of emergency cases in group B is less than that in group A (1% vs. 3%), and the severity is lower. Notably, stethoscope-based doctor–patient communication was found to be effective in alleviating psychological measures of group B patients.

Conclusion

Wireless stethoscopes in makeshift hospitals can avoid cross-infections and detect more valuable positive signs, which can help health providers make accurate decisions and relieve patients' symptoms more quickly. Moreover, stethoscope-based doctor–patient communication can diminish the psychological impacts of the epidemic on isolated patients in makeshift hospitals.

Trial registration This study was registered in the Chinese Clinical Trial (ChiCTR2000038272) at http://www.chictr.org.cn. http://www.chinadrugtrials.org.cn/clinicaltrials.searchlistdetail.dhtml.
An evaluation of the Compassion, Inclusion, and Engagement initiative: learning from PWLE and communities across British Columbia
Authors: Maguet Sally , Laliberte Nancy , Moore Laura , Milkovich Tammy , Burmeister Charlene , Scow Marnie , Sproule Wendy , Dove Naomi , Martens Sheila
Published: July 2023

Background

The Compassion, Inclusion and Engagement initiative (CIE) was a social contact intervention that operated in British Columbia between 2015 and 2021. The primary objective of CIE was to increase the participation of people with lived experience of substance use (PWLE) in the planning, design, implementation, and evaluation of harm reduction supports and services.

Case presentation

CIE used the developmental evaluation methodology outcome mapping to define and measure progress towards its goals. Developmental evaluation emphasizes learning in contrast to other forms of evaluation which are often more focused on determining the value or success of a project or programme based on predetermined criteria. Outcome mapping is a relational practice which acknowledges that change is achieved by an initiative’s partners and the role of the initiative is to provide access to resources, ideas and opportunities that can facilitate and support change.

Conclusions

Through the implementation and evaluation of CIE, it became clear that directly supporting PWLE facilitated more meaningful and lasting change than solely working to improve the health and social services that supported them. The impacts of the CIE initiative extend far beyond the outcomes of any of the dialogues it facilitated and are largely the result of an increase in social capital. CIE engagements created the opportunity for change by inviting people most affected by the toxic drug supply together with those committed to supporting them, but their ability to bring about systemic change was limited. Both PWLE and service providers noted the lack of support to attend CIE engagements, lack of support for actions that came from those engagements, and lack of PWLE inclusion in decision-making by health authorities as limiting factors for systemic change. The lack of response at a systemic level often resulted in PWLE carrying the burden of responding to toxic drug poisonings, often without resources, support, or compensation.
Intracoronary versus intravenous glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention in patients with STEMI: a systematic review and meta-analysis
Authors: Hahn JongSung , Jeon Jinyoung , Geum Min Jung , Lee Hyun Woo , Shin Jaekyu , Chung Woo-Young , Yu Yun Mi , Ah Young-Mi
Published: July 2023

Background

Intracoronary (IC) administration of glycoprotein IIb/IIIa inhibitors (GPIs) has been studied as an adjunctive therapy to improve outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention. In this systematic review and meta-analysis, we aimed to evaluate the efficacy and safety of IC administration of GPIs compared with those of intravenous (IV) administration in patients with STEMI.

Methods

We searched the MEDLINE, Embase, and Cochrane CENTRAL databases for relevant studies published before September 21, 2022. In total, 22 randomized controlled trials involving 7,699 patients were included.

Results

The proportions of patients achieving thrombolysis in myocardial infarction grade 3 flow, myocardial blush grade 2/3, and complete ST-segment resolution were significantly higher in the IC group than in the IV group. Major adverse cardiac events (MACE) (RR: 0.54, 95% CI: 0.37–0.80) and heart failure (RR: 0.48, 95% CI: 0.25–0.91) within 1 month were significantly lower in the IC group than in the IV group; however, after 6 months, no difference was observed in MACE risk. Additionally, the risks of death and bleeding did not differ between the two routes of administration.

Conclusions

When considering adjunctive GPI administration for patients with STEMI, the IC route may offer greater benefits than the IV route in terms of myocardial reperfusion and reduced occurrence of MACE and heart failure within 1 month. Nonetheless, when making decisions for IC administration of GPIs, the absence of a benefit for bleeding risk and difficulty accessing the administration route should be considered.
Orchestrating smart therapeutics to achieve optimal treatment in small cell lung cancer: recent progress and future directions
Authors: Zhang Chenyue , Zhang Chenxing , Wang Kai , Wang Haiyong
Published: July 2023

Small cell lung cancer (SCLC) is a recalcitrant malignancy with elusive mechanism of pathogenesis and dismal prognosis. Over the past decades, platinum-based chemotherapy has been the backbone treatment for SCLC. However, subsequent chemoresistance after initial effectiveness urges researchers to explore novel therapeutic targets of SCLC. Recent years have witnessed significant improvements in targeted therapy in SCLC. New molecular candidates such as Ataxia telangiectasia and RAD3-related protein (ATR), WEE1, checkpoint kinase 1 (CHK1) and poly-ADP-ribose polymerase (PARP) have shown promising therapeutic utility in SCLC. While immune checkpoint inhibitor (ICI) has emerged as an indispensable treatment modality for SCLC, approaches to boost efficacy and reduce toxicity as well as selection of reliable biomarkers for ICI in SCLC have remained elusive and warrants our further investigation. Given the increasing importance of precision medicine in SCLC, optimal subtyping of SCLC using multi-omics have gradually applied into clinical practice, which may identify more drug targets and better tailor treatment strategies to each individual patient. The present review summarizes recent progress and future directions in SCLC. In addition to the emerging new therapeutics, we also focus on the establishment of predictive model for early detection of SCLC. More importantly, we also propose a multi-dimensional model in the prognosis of SCLC to ultimately attain the goal of accurate treatment of SCLC.
Ethnobotanical study of underutilized wild edible plants and threats to their long-term existence in Midakegn District, West Shewa Zone, Central Ethiopia
Authors: Guzo Sheleme , Lulekal Ermias , Nemomissa Sileshi
Published: July 2023

Background

Ethiopia is endowed with much plant diversity. The insignificant number of studies on wild edible plants with their ethnobotanical perspectives indicated that this plant diversity comprised only hundreds of wild edible plants used to supplement food sources for the local community under different conditions. There still need to be further investigations throughout the country when compared to the total area and cultural diversity of the country. However, they are seriously under pressure due to different natural and human influences. Therefore, the study was conducted to document underutilized wild edible plants along with their associated indigenous knowledge and explore threats to them in Midakegn District.

Methods

A questionnaire survey, semi-structured interviews, a market survey, score ranking, and focused group discussions were employed for data collection. Statistical analysis of ethnobotanical knowledge mean variation between different informant groups was computed by using one-way ANOVA in the IBM SPSS Statics version 24 package.

Results

A total of fifty underutilized wild edible plants belonging to 39 genera and 30 families were collected, recorded, and documented. The families Moraceae (four), Fabaceae, Flacourtaceae, Myrtaceae, Rosaceae, and Tiliaceae (each three) represented the highest number of species. It comprised shrubs (44%), trees (36%), herbs (18%), and epiphytes (2%). Fruits (62.3%) were found to be the most frequently used and mostly taken raw, fresh, or dried. These edible resources were consumed to supplement staple foods (67.3%), whereas 25% were used as emergency foods. The majority of species (96%) had multiple uses in addition to their edibility. A significantly higher (P < 0.05) number of underutilized wild edible plants were cited by males than females, by key informants than generals, elders than youngsters, illiterate than literate, and poorer than other wealth class groups of the community. Priority rankings indicate that agricultural expansion, fuel wood harvest, overgrazing, and selective harvesting are the most threatening factors to underutilized wild edible plants.

Conclusions

Fifty underutilized wild edible plants, along with their associated indigenous knowledge, were recorded. Local people utilize them for supplementing staple food, as emergency food, to get relief, trust, and chew during drought. But they are mainly threatened by different human activities in the study area.
Invasive Aedes mosquitoes in an urban—peri-urban gradient in northern Spain: evidence of the wide distribution of Aedes japonicus
Authors: Cevidanes Aitor , Goiri Fátima , Barandika Jesús F. , Vázquez Patricia , Goikolea Joseba , Zuazo Ander , Etxarri Natalia , Ocio Gurutze , García-Pérez Ana L.
Published: July 2023

Background

The expansion of invasive mosquitoes throughout Europe has increased in recent decades. In northern Spain, Aedes albopictus was detected for the first time in 2014, and Aedes japonicus was detected in the three Basque provinces in 2020. This study aimed to evaluate the distribution of these mosquito species and their association with factors related to urbanization.

Methods

In 2021, a total of 568 ovitraps were deployed in 113 sampling sites from 45 municipalities with > 10,000 inhabitants. Oviposition substrate sticks were replaced each fortnight and examined for Aedes eggs from June to November. Aedes eggs were counted, and the eggs from a selection of positive oviposition sticks, encompassing at least one stick from each positive ovitrap, were hatched following their life cycle until the adult stage. When egg hatching was not successful, PCR targeting the COI gene and sequencing of amplicons were carried out.

Results

Eggs were detected in 66.4% of the sampling sites and in 32.4% of the ovitraps distributed in the three provinces of the Basque Country. Aedes albopictus and Ae. japonicus were widespread in the studied area, confirming their presence in 23 and 26 municipalities, respectively. Co-occurrence of both species was observed in 11 municipalities. The analysis of the presence of Aedes invasive mosquitoes and the degree of urbanization (urban, suburban, peri-urban) revealed that Ae. albopictus showed a 4.39 times higher probability of being found in suburban areas than in peri-urban areas, whereas Ae. japonicus had a higher probability of being found in peri-urban areas. Moreover, the presence of Ae. albopictus was significantly associated with municipalities with a higher population density (mean = 2983 inh/km2), whereas Ae. japonicus was associated with lower population density (mean = 1590 inh/km2).

Conclusions

The wide distribution of Ae. albopictus and Ae. japonicus observed confirmed the spread and establishment of these species in northern Spain. A new colonization area of Ae. japonicus in Europe was confirmed. Due to the potential impact of Aedes invasive mosquitoes on public health and according to our results, surveillance programs and control plans should be designed considering different urbanization gradients, types of environments, and population density.

Graphical Abstract
Citation of updated and co-published Cochrane Methodology Reviews
Authors: Zhu Linlin , Yang Ziyu , Deng Hongyu , Zhang Yonggang , Liao Xiaoyang , Clarke Mike
Published: July 2023

Background

To evaluate the number of citations for Cochrane Methodology Reviews after they have been updated or co-published in another journal, and the effect of co-publishing the review on the co-publishing journal’s impact factor (IF).

Methods

We identified all Cochrane Methodology Reviews published in the Cochrane Database of Systematic Reviews (CDSR) before 2018 and searched for co-published versions in the Web of Science Core Collection database up to 16 August 2022. The included reviews were in two cohorts: those that had been published and updated in CDSR and those that had been published in CDSR and co-published in another journal. The primary outcome measured the citation number to updated and original reviews in the first five years after publication of the updated review, and assessed the citation number of co-published and non-co-published reviews in the first five years after publication of the co-published version.

The secondary outcome was the ratio of an adjusted IF and the actual IF of the co-publishing journal.

Results

Eight updated and six original reviews were identified for the updated cohort of reviews, and four co-published reviews were included in the co-published cohort. The original reviews continued to be cited after the update was published but the median for the total number of citations was non-significantly higher for the updated reviews than for their original version[161 (Interquartile range (IQR) 85, 198) versus 113 (IQR 15, 433)]. The median number of total citations [362 (IQR 179, 840) versus 145 (IQR 75, 445)] and the median number of citations to the review in the first five years after co-publication combined and in each of those years was higher in the co-published group than in the non-co-published group. One of the three journals that co-published Reviews in the first year and two journals in the second year had a lower IF after co-publication.

Conclusions

Earlier versions of Cochrane Methodology Reviews continue to be cited after an update is published, which raises doubts about whether those citing are using the most recent evidence or are aware of the update. Co-publication facilitates broader application and dissemination of Cochrane methodology evidence.
Exploring gender differences in trait preferences among groundnut value chain actors in northern Ghana
Authors: Yila Jummai O. , Martey Edward , Etwire Prince M. , Adogoba Desmond Sunday , Muricho Geoffrey , Desmae Haile
Published: July 2023

Assessing gender differences in trait preferences of groundnut value chain actors can influence the effectiveness of crop breeding programs, the adoption of developed technologies, and policy interventions. However, there is limited evidence to support decisions that meet end users’ demands, given that most studies do not disaggregate trait preferences by sex and age. We use a stated preference method to characterize the preferences and willingness to pay (WTP) for various attributes of improved groundnut varieties by male and female youth and older adults in the different segments of the groundnut value chain. The results indicate heterogeneity in preference and WTP for production, market, and nutrition attributes of groundnut across supply chain actors. The results showed that gender is not a unifying factor in respondents’ WTP, revealing dissimilarities among youth and older adults of the same sex group. Our findings suggest that groundnut breeding programs must prioritize production, market, and nutrition attributes based on gender needs to speed up the process of adoption, commercialization, and utilization of groundnut.
Paleomagnetic evidence for episodic construction of the Mamiyadake tephra ring
Authors: Yasuda Yuki
Published: July 2023

Tephra rings that surround maar craters are typically inferred from field observations to have been emplaced rapidly over a time period of days to years and thus monogenetic, which is, however, rarely assessed quantitatively. This paper describes a polycyclic origin of the Mamiyadake tephra ring (Japan), comparing the paleomagnetic directions obtained from throughout the stratigraphy. The new data show that the paleomagnetic directions change systematically with stratigraphic height through the sections, which is interpreted to record paleosecular variation (PSV) of the geomagnetic field during formation of the tephra ring. The paleomagnetic results, together with using an average rate of PSV in Japan, indicate that the Mamiyadake tephra ring was constructed episodically with five major eruptive episodes, separated by centuries or longer, over a period of at least 1000 years. The findings demonstrate that detailed paleomagnetic characterization can uncover the temporal evolution of tephra rings, providing a useful criterion for identifying time breaks, even where field evidence is lacking, and a minimum estimate of the time interval for their emplacement. The approach used here may be applicable to volcanoes of any type.

Graphical Abstract
Geophysical investigation of the Mado Megamullion oceanic core complex: implications for the end of back-arc spreading
Authors: Okino Kyoko , Tani Kenichiro , Fujii Masakazu , Zhou Fei , Ishizuka Osamu , Ohara Yasuhiko , Hanyu Tomoko , Matamura Yuki
Published: July 2023

Detachment faulting is one of the main styles of seafloor spreading at slow to intermediate mid-ocean ridges. However, we have limited insight into its role in back-arc basin formation. We surveyed a remnant back-arc spreading center in the Philippine Sea and determined the detailed features and formation processes of the Mado Megamullion (Mado MM) oceanic core complex (OCC). This was undertaken in the context of back-arc evolution, based on the shipborne bathymetry, magnetics, and gravity with radiometric age dating of the rock samples collected. The Mado MM OCC has a typical OCC morphology with prominent corrugations on the domed surface and positive gravity anomalies, suggesting that there has been an exposure of the lower crust and mantle materials by a detachment fault. The downdip side of the detachment continues to the relict axial rift valley, which has indicated that the Mado MM OCC was formed at the end of the back-arc basin opening. The spreading rate of the basin decreased once when the spreading direction changed after six million years of stable trench perpendicular spreading. The rate then further decreased immediately prior to the end of the spreading when the Mado MM OCC was formed. The existence of other OCC-like structures in the neighboring segment and the previously reported OCCs along the Parece Vela Rift have indicated that the melt-poor, tectonic-dominant spreading is a widespread phenomenon at the terminal phase of back-arc spreading. The decrease in spreading rate in the later stage is consistent with the previous numerical modeling because of the decrease in trench retreat. In the Izu–Bonin–Mariana arc trench system, the rotation of the spreading axis and the resultant axis segmentation have enhanced the lithosphere cooling and constrained mantle upwelling, which caused the tectonic-dominant spreading at the final phase of the basin evolution.
A systematic review on machine learning and deep learning techniques in the effective diagnosis of Alzheimer’s disease
Authors: Arya Akhilesh Deep , Verma Sourabh Singh , Chakarabarti Prasun , Chakrabarti Tulika , Elngar Ahmed A. , Kamali Ali-Mohammad , Nami Mohammad
Published: July 2023

Alzheimer’s disease (AD) is a brain-related disease in which the condition of the patient gets worse with time. AD is not a curable disease by any medication. It is impossible to halt the death of brain cells, but with the help of medication, the effects of AD can be delayed. As not all MCI patients will suffer from AD, it is required to accurately diagnose whether a mild cognitive impaired (MCI) patient will convert to AD (namely MCI converter MCI-C) or not (namely MCI non-converter MCI-NC), during early diagnosis. There are two modalities, positron emission tomography (PET) and magnetic resonance image (MRI), used by a physician for the diagnosis of Alzheimer’s disease. Machine learning and deep learning perform exceptionally well in the field of computer vision where there is a requirement to extract information from high-dimensional data. Researchers use deep learning models in the field of medicine for diagnosis, prognosis, and even to predict the future health of the patient under medication. This study is a systematic review of publications using machine learning and deep learning methods for early classification of normal cognitive (NC) and Alzheimer’s disease (AD).This study is an effort to provide the details of the two most commonly used modalities PET and MRI for the identification of AD, and to evaluate the performance of both modalities while working with different classifiers.
Bilateral video-assisted thoracic surgery for esophageal cancer with left inferior pulmonary vein invasion following chemoradiation therapy
Authors: Fujii Masakazu , Okada Naoya , Kato Hiroaki , Ishihara Satoshi , Abe Masaru , Yamabuki Takumi , Kato Kentaro , Takada Minoru , Ambo Yoshiyasu , Yokoyama Takeshi , Kinoshita Yoshihiro
Published: July 2023

Background

The surgical strategy for thoracic esophageal cancer that invades the lungs is controversial. In particular, invasion of the pulmonary vein is often regarded unresectable. We successfully applied bilateral video-assisted thoracic surgery (VATS) in esophagectomy for esophageal cancer with left inferior pulmonary vein invasion following induction chemoradiotherapy (CRT), with a favorable response.

Case presentation

A 64-year-old woman was diagnosed with squamous cell carcinoma of the lower third of the esophagus. Computed tomography (CT) revealed that the tumor was suspected to be invading the main trunk of the left lower pulmonary vein and left lower lung. We initiated induction CRT comprising 5-fluorouracil, cisplatin, and concurrent radiotherapy at 50.4 Gy/28Fr. CT revealed shrinkage of the tumor, and the main trunk of the left inferior pulmonary vein was released from the tumor invasion. We considered the tumor to be completely resectable. VATS esophagectomy is usually performed using a right-sided approach. However, the right-sided approach is inappropriate for evaluating tumors around the left inferior pulmonary vein. We started with left-sided VATS to determine tumor resectability and dissected between the esophagus and the main trunk of the left inferior pulmonary vein. We only needed to perform partial resection of the left lower lobe. We then performed a right-sided VATS esophagectomy and lymphadenectomy with partial en bloc resection of the left lower lobe. Following this, we performed hand-assisted laparoscopic proximal gastrectomy and reconstruction using the gastric remnant. The postoperative course was uneventful. The patient was discharged on postoperative day 14. Histopathological examination of the surgical specimen revealed a complete pathological response without any remnant tumor or lymph node metastasis. There were no signs of recurrence or metastasis at the 1-year follow-up.

Conclusions

Curative resection for thoracic esophageal cancer that invades the pulmonary vein could be possible via the bilateral VATS approach following induction CRT with a favorable response.
Immediate and Delayed Effects of Joint Loading Activities on Knee and Hip Cartilage: A Systematic Review and Meta-analysis
Authors: Coburn Sally L. , Crossley Kay M. , Kemp Joanne L. , Warden Stuart J. , West Tom J. , Bruder Andrea M. , Mentiplay Benjamin F. , Culvenor Adam G.
Published: July 2023

Background

The impact of activity-related joint loading on cartilage is not clear. Abnormal loading is considered to be a mechanical driver of osteoarthritis (OA), yet moderate amounts of physical activity and rehabilitation exercise can have positive effects on articular cartilage. Our aim was to investigate the immediate effects of joint loading activities on knee and hip cartilage in healthy adults, as assessed using magnetic resonance imaging. We also investigated delayed effects of activities on healthy cartilage and the effects of activities on cartilage in adults with, or at risk of, OA. We explored the association of sex, age and loading duration with cartilage changes.

Methods

A systematic review of six databases identified studies assessing change in adult hip and knee cartilage using MRI within 48 h before and after application of a joint loading intervention/activity. Studies included adults with healthy cartilage or those with, or at risk of, OA. Joint loading activities included walking, hopping, cycling, weightbearing knee bends and simulated standing within the scanner. Risk of bias was assessed using the Newcastle–Ottawa Scale. Random-effects meta-analysis estimated the percentage change in compartment-specific cartilage thickness or volume and composition (T2 relaxation time) outcomes. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system evaluated certainty of evidence.

Results

Forty studies of 653 participants were included after screening 5159 retrieved studies. Knee cartilage thickness or volume decreased immediately following all loading activities investigating healthy adults; however, GRADE assessment indicated very low certainty evidence. Patellar cartilage thickness and volume reduced 5.0% (95% CI 3.5, 6.4, I2 = 89.3%) after body weight knee bends, and tibial cartilage composition (T2 relaxation time) decreased 5.1% (95% CI 3.7, 6.5, I2 = 0.0%) after simulated standing within the scanner. Hip cartilage data were insufficient for pooling. Secondary outcomes synthesised narratively suggest knee cartilage recovers within 30 min of walking and 90 min of 100 knee bends. We found contrasting effects of simulated standing and walking in adults with, or at risk of, OA. An increase of 10 knee bend repetitions was associated with 2% greater reduction in patellar thickness or volume.

Conclusion

There is very low certainty evidence that minimal knee cartilage thickness and volume and composition (T2 relaxation time) reductions (0–5%) occur after weightbearing knee bends, simulated standing, walking, hopping/jumping and cycling, and the impact of knee bends may be dose dependent. Our findings provide a framework of cartilage responses to loading in healthy adults which may have utility for clinicians when designing and prescribing rehabilitation programs and providing exercise advice.
Open source board based acoustofluidic transwells for reversible disruption of the blood–brain barrier for therapeutic delivery
Authors: Wang Ke , Sun Chao , Dumčius Povilas , Zhang Hongxin , Liao Hanlin , Wu Zhenlin , Tian Liangfei , Peng Wang , Fu Yongqing , Wei Jun , Cai Meng , Zhong Yi , Li Xiaoyu , Yang Xin , Cui Min
Published: July 2023

Background

Blood–brain barrier (BBB) is a crucial but dynamic structure that functions as a gatekeeper for the central nervous system (CNS). Managing sufficient substances across the BBB is a major challenge, especially in the development of therapeutics for CNS disorders.

Methods

To achieve an efficient, fast and safe strategy for BBB opening, an acoustofluidic transwell (AFT) was developed for reversible disruption of the BBB. The proposed AFT was consisted of a transwell insert where the BBB model was established, and a surface acoustic wave (SAW) transducer realized using open-source electronics based on printed circuit board techniques.

Results

In the AFT device, the SAW produced acousto-mechanical stimulations to the BBB model resulting in decreased transendothelial electrical resistance in a dose dependent manner, indicating the disruption of the BBB. Moreover, SAW stimulation enhanced transendothelial permeability to sodium fluorescein and FITC-dextran with various molecular weight in the AFT device. Further study indicated BBB opening was mainly attributed to the apparent stretching of intercellular spaces. An in vivo study using a zebrafish model demonstrated SAW exposure promoted penetration of sodium fluorescein to the CNS.

Conclusions

In summary, AFT effectively disrupts the BBB under the SAW stimulation, which is promising as a new drug delivery methodology for neurodegenerative diseases.

Graphical Abstract
Anopheles mosquito diversity, entomological indicators of malaria transmission and challenges of morphological identification in southwestern Ethiopia
Authors: Assa Adilo , Eligo Nigatu , Massebo Fekadu
Published: July 2023

Background

A number of Anopheles species play either a primary or secondary role in malaria transmission. This necessitates understanding the species composition, bionomics, and behaviors of malaria mosquitoes in a particular geographic area, which is relevant to design and implement tailored intervention tools. This study aimed to assess the species composition, sporozoite infection rate, and blood meal origins of malaria mosquitoes in two malaria-endemic villages of Boreda district in Gamo Zone, southwest Ethiopia.

Methods

Thirty houses, 20 for Center for Disease Control and Prevention (CDC) light traps and 10 for Pyrethrum Spray Catches (PSC) were randomly selected for bimonthly mosquito collection from October 2019 to February 2020. An enzyme-linked immunosorbent assay (ELISA) was carried out to detect the blood meal origins and circumsporozoite proteins (CSPs). The entomological inoculation rate (EIR) was calculated by multiplying the sporozoite and human biting rates from PSCs. Anopheles gambiae complex and An. funestus group samples were further identified to species by the polymerase chain reaction (PCR). Anopheles species with some morphological similarity with An. gambiae complex or An. funestus group were tested using the primers of the two species complexes.

Results

A total of 14 Anopheles species were documented, of which An. demeilloni was found to be the dominant species. An. arabiensis was found to be positive for P. falciparum CSP with the overall CSP rate of 0.53% (1/190: 95% CI 0.01–2.9). The overall estimated P. falciparum EIR of An. arabiensis from PSC was 1.5 infectious bites/person/5 months. Of the 145 freshly fed Anopheles mosquitoes tested for blood meal sources, 57.9% (84/145) had bovine blood meal, 15.2% (22/145) had human blood meal origin alone, and 16.5% (24/145) had a mixed blood meal origin of human and bovine. Anopheles demeilloni were more likely to feed on blood meals of bovine origin (102/126 = 80.9%), while An. arabiensis were more likely to have blood meals of human origin. Eleven samples (2.6%; 11/420) were morphologically categorized as An. demeilloni, but it has been identified as An. leesoni (the only An. funestus group identified in the area) by PCR, though it requires additional verification by sequencing, because different species genes may have amplified for these species specific primers. Similarly, a small number of An. arabiensis were morphologically identified as An. salbaii, An. maculipalpis and An. fuscivenosus.

Conclusions and recommendations

In spite of the wide variety of Anopheles mosquito species, An. arabiensis dominates indoor malaria transmission, necessitating additional interventions targeting this species. In addition, increasing entomological knowledge may make morphological identification less difficult.
Evolving market-shaping strategies to boost access to essential medical products in developing countries with HIV self-testing as a case study
Authors: Yang Jian , Feng Xiangning , Zhou Shuduo , Zhang Li , Hu Yunxuan , Chen Ying , Zhang Zhenyu , Xu Ming
Published: July 2023

The COVID-19 pandemic has exacerbated health inequities among countries in the Global South with limited access to essential medical products, leading to a higher infection and mortality rate, especially among vulnerable populations. Despite tremendous progress in global health financing, the estimated annual financing gap in developing countries is projected to reach US$371 billion per year by 2030. Therefore, developing market-shaping strategies is of great importance in ensuring adequate supply, affordable prices, and equitable access to essential medical products in low-and middle-income countries. We propose a strategic and appropriate market-shaping intervention framework for governments, international organizations, and NGOs to maximize access to essential medical products in developing countries. In the health field, we believe that market shaping strategy could be defined as a set of purposeful activities that market forces may intervene with to advance the development, production, supply, and distribution of global goods for health, making essential medical products more affordable, accessible, innovative, sustainable and quality assured. We argue that when designing a market-shaping strategy, policy or decision-makers must take full advantage of the key drivers to keep the market dynamic, interactive, and constantly evolving to meet the unmet medical needs. In addition, different forms of market-shaping interventions are determined by objectives and specific issues to be addressed. More comprehensive market shaping strategies, including the strategic use of market expansion, market disruption, market maintenance, and market contraction alone or together, deserve to be explored and key stakeholders are also expected to join forces to make the intervention more efficient and productive.
Validation of NASH-CHECK: a novel patient-reported outcome measure for nonalcoholic steatohepatitis
Authors: Twiss James , Whalley Diane , Doward Lynda , Balp Maria-Magdalena , Brass Clifford A. , Cryer Donna , Sanyal Arun , Anstee Quentin M.
Published: July 2023

Background

Standardized measures for evaluating patients’ experiences with nonalcoholic steatohepatitis (NASH) and their perceived changes with treatment in clinical trials have been limited. To meet this need, a patient-reported outcome (PRO) measure, NASH-CHECK, was developed to evaluate symptoms and health-related quality of life for patients with NASH. The objective of this study was to conduct a quantitative evaluation of the psychometric properties of NASH-CHECK.

Methods

The study used data from a phase 2, randomized controlled trial of adult patients with NASH (NCT02855164). Analyses were conducted to determine the optimal scoring of NASH-CHECK and to evaluate reliability, construct validity, and ability to detect change in NASH-CHECK scale scores.

Results

Data were available for 253 patients with NASH (61% female; mean [standard deviation] age = 53 [12] years). Following initial item-level analyses, including correlations and exploratory factor analysis, three items were removed from the measure. Confirmatory factor analysis supported the formation of four multi-item scales (Cognitive Symptoms, Activity Limitations, Social Impact, and Emotional Impact) and five single-item scales (Abdominal Pain, Abdominal Bloating, Fatigue, Sleep, and Itchy Skin). Psychometric analyses of the final NASH-CHECK scales provided support for their internal reliability, test–retest reliability, construct validity, and ability to detect change.

Conclusion

The results support NASH-CHECK as a reliable, valid, and responsive measure to assess patients’ perspectives of symptoms and the health-related quality of life impact of NASH in clinical trials and in routine practice.
Postoperative throat discomfort and associated factors among surgical patients at Ethiopian Teaching Hospitals: cross-sectional study
Authors: Jisha Hunduma , Bekele Zenebe
Published: July 2023

Background

Throat pain and airway discomfort are the most commonly upsetting conditions for patients’ wellbeing after surgery. However, little is known about the problem and associated factors, especially in developing countries like Ethiopia. Therefore, this work determined the magnitude, severity, and associated factors of throat discomfort within 24 h after elective surgery.

Results

The majority (63.2%, or 211) of the participants were female, with a mean age of 35.7 ± 9.7 years. The overall postoperative throat discomfort was observed in 122 (36.5%) patients, and it was severe in 20.5% of them. However, the severity level declined over time to 21.9% (21/96), 15.3% (18/118), and 5.6% (5/89), respectively, on the 1st, 6th, and 24th hours, as indicated by participants. Utilization of a larger ETT (AOR = 6.26, CI 2.13–18.43, P = 0.001), surgery lasting two or more hours (AOR = 11.20, CI 3.53–35.50, P = 0.000), awake extubation (AOR = 0.16, CI 0.05–0.43 P = 0.000), frequent episodes of hypotension (AOR = 12.85, CI 4.56–36.18, P = 0.000), and a less experienced anesthetist (AOR = 18.10, CI 6.51–50.31, P = 0.000) were significantly associated with throat discomfort.

Conclusions

Post-extubation throat discomfort complaints are high (36.5%). Due attention has to be given to minimize or prevent perioperative frequent episodes of hypotension, higher ETT size utilization, blood loss, and the duration of surgery as much as possible. Postoperative throat discomfort should not be ignored. And we recommend that patient reassurance and orientation with analgesia has to be considered during the postoperative period.
Stability evaluation of a grid-tied hybrid wind/PV farm joined with a hybrid energy-storage system
Authors: Wang Li , Ke Wang Jun-Yi , Wu Rui-Xuan , Tripathy Manoj , Mokhlis Hazlie , Chua Kein Huat , Prokhorov Anton V. , Nguyen Thi Ha , Farid Mohammed Mehdi , Subiantoro Alison , Li Kang , Chong Benjamin , Azizi Sadegh , Jahromi Amir Abiri , Xu Dehong
Published: July 2023

This paper presents the stability-evaluation outcomes of a multimachine power system (MMPS) connected with a large-scale hybrid wind farm (WF) and photovoltaic (PV) farm or hybrid wind/PV farm (HWPF) and a hybrid energy-storage system (HESS) consisting of a vanadium redox flow battery (VRFB) and a supercapacitor (SC). A probability scheme is used to determine the rated power of the proposed HESS, where the capacities of the VRFB-ESS and the SC-ESS are designed to effectively utilize their operating features. The control strategy of the HESS is proposed to reduce the pressure of the VRFB-ESS and smooth the output power fluctuations of the HWPF. The steady-state stability, small-signal stability, dynamic performances, and transient simulations of the studied grid-tied HWPF fed to the MMPS with and without the HESS are achieved. The simulation outcomes show that the proposed HESS can enhance the stability and power-smoothing performance of the HWPF fed to the MMPS.
Parotid pilomatricoma: a case presentation and literature review
Authors: Arioua Abdelilah , Youbi Anouar Benameur El , Ouattassi Naouar , Oudidi Abdellatif , Alami Mohamed Noureddine El Amine El
Published: July 2023

Background

Pilomatrixoma is a rare benign tumor of the hair follicle. It is more common in children and women. The cervical and facial region are the most frequent location for this type of tumor. Due to its variable clinical presentations, it can sometimes be misdiagnosed as a malignant tumor of surrounding tissues, as described in our case.

The diagnosis confirmation is pathological.

Case presentation

We report the case of a 34-year-old patient, who presented a swelling in the right parotid region gradually increasing in size for two years, with no facial asymmetry. Clinical examination revealed a rounded, well-defined mass, fixed to the superficial plan, without any cervical lymph nodes. The MRI showed a tumor that seems to be evolving from the superficial lobe of the right parotid, suggesting a pleomorphic adenoma. Total excision of the tumor without margins was performed, preserving the parotid tissue and the facial nerve. The postoperative course was normal; and the pathological study confirmed the diagnosis of pilomatrixoma.

Conclusion

Pilomatrixoma is a rare benign tumor but it remains a differential diagnosis of large tumors of the neck and parotid. It is mainly a pathological diagnosis, The treatment of choice still complete surgical excision.
RETRACTED AND REPLACED: Comparison of Cumulative Live Birth Rates Between Progestin and GnRH Analogues in Preimplantation Genetic Testing Cycles
Authors: Zhou Ruiqiong , Dong Mei , Huang Li , Wang Songlu , Wang Zhaoyi , Xu Liqing , Zhang Xiqian , Liu Fenghua
Published: July 2023

This article has been retracted and replaced. Please see this notice for details: https://doi.org/10.1210/clinem/dgae853.