bluuebunny/crossref_metadata_2025 huggingface dataset:
Domestic Violence Against Women in North African and Middle Eastern Countries: A Scoping Review
Authors: Kisa Sezer , Gungor Rusan , Kisa Adnan
Published: August 2021

This scoping review aimed to identify the scope of the current literature on the prevalence, consequences, and risk factors of domestic violence (DV) against women by their husbands or male partners in North African and Middle Eastern countries. The methodology for this scoping review was based on the framework outlined by Arksey and O’Malley. Studies published on DV against women over the age of 15 by partner or husband and published in peer-reviewed scientific journals between January 1970 and April 2018 were included in the review. The databases MEDLINE, PsychINFO, CINAHL, HealthSTAR, EMBASE, Scopus, African Journals Online, Turkish Journal Database, and gray literature sources were searched. On completion of the review process, 151 full-text articles were identified for charting. This review demonstrated that women’s age, women’s education level, duration of marriage, history of childhood abuse/witnessing family violence, living in the rural region, and family income level were negatively associated with DV, indicating that younger women, women with lower education, a longer marriage duration, and a lower income level had a higher risk of exposure to DV in this region. Anxiety, depression/insomnia, and physical injury were the most common health problems reported by victims in the region. The highest proportion of women with no response to violence was reported in Jordan, Saudi Arabia, and Turkey. The findings of this scoping review represent the first attempt to summarize the literature from North African and Middle Eastern countries and demonstrate the similarity in DV-related behaviors among women despite the cultural and regional diversity of the studies.
Computational Fluid Dynamic Analysis Supports the Hemodynamic Stability of Hybrid Combinations With the AFX Bifurcate and Nitinol-Based Proximal Segments in Solutions of Failed Endovascular Aneurysm Repair
Authors: Georgakarakos Efstratios , Ioannidis Georgios , Raptis Anastasios , Xenos Michalis
Published: August 2021

Hybrid endograft combinations of two or more different types of covered stents are rarely reported to treat complex abdominal aortic aneurysm cases or primary and secondary endoleaks. Clinical and laboratory data regarding the clinical efficacy and mechanical stability of such combinations are lacking. Based on a recently published case report, we describe and comment on the hemodynamic profile of a representative simulated hybrid case of AFX and Nitinol-based proximal cuff and support the stability of this combination in non-angulated cases.
Steerable Surgical Instrument for Conventional and Single-Site Minimally Invasive Surgery
Authors: Hernández-Valderrama Victor Gabriel , Ordorica-Flores Ricardo Manuel , Montoya-Alvarez Salvador , Haro-Mendoza Daniel , Ochoa-Toledo Luis , Lorias-Espinoza Daniel , Ortiz-Simón José L. , Pérez-Escamirosa Fernando
Published: August 2021

Background. This article aims to present an innovative design of a steerable surgical instrument for conventional and single-site minimally invasive surgery (MIS), which improves the dexterity and maneuverability of the surgeon while offering a solution to the limitations of current tools. Methods. The steerable MIS instrument consists of a deflection structure with a curved sliding joints design that articulates the distal tip in two additional degrees of freedom (DoFs), relative to the instrument shaft, using transmission by cables. A passive ball-joint mechanism articulates the handle relative to the instrument shaft, improves wrist posture, and prevents collision of instrument handles during single-site MIS procedures. The two additional DoFs of the articulating tip are activated by a thumb-controlled device, using a joystick design mounted on the handle. This steerable MIS instrument was developed by additive manufacturing in a 3D printer using PLA polymer. Results. Prototype testing showed a maximum tip deflection of 60° in the left and right directions, with a total deflection of 120°. With the passive ball-joint fully offset, the steerable tip achieved a deflection of 90° for the right and 40° for the left direction, with a total deflection of 130°. Furthermore, the passive ball-joint mechanism in the handle obtained a maximum range of motion of 60°. Conclusions. This steerable MIS instrument concept offers an alternative to enhance the application fields of conventional and single-site MIS, increasing manual dexterity of the surgeon and the ability to reach narrow anatomies from other directions.
Audit: sonographic report correlation against surgical findings during elective shoulder surgery
Authors: Gallagher Vincent , Buchanan Jamie , Harris Justin , McCrum Carol
Published: August 2021

Introduction

Musculoskeletal diagnostic ultrasound is an expanding clinical tool and increasingly used at point of care in clinical practice. Criticism around the accuracy of this modality is often attributed to operator dependence. This study evaluated the accuracy of a sonographer’s reporting against shoulder surgery.

Methods

A musculoskeletal sonographer performed same-day ultrasound scans prior to elective shoulder surgery procedures. The sonographer was blinded to clinical history and previous investigations. A brief physical examination of resisted external rotation and resisted abduction strength was performed prior to scanning. Scan results were reported using British Elbow and Shoulder Society (BESS) reporting criteria. The sonographer attended surgery to gain immediate visual feedback. Sonographic reports and magnetic resonance imaging (MRI) reports were graded (1= complete agreement; 2 = minor discrepancy unlikely to alter patient care; 3 = potentially significant discrepancy; 4 = definite, significant discrepancy) against surgical findings. The accuracy of sonographic reporting was correlated with patients’ body mass index (BMI).

Results

Fifty-four cases were compared and correlations evaluated. Grade 1 (complete agreement) was reported 87.0% ( n =  47), Grade 2 (minor discrepancy) 9.3% (n =  5) and Grade 3 (potentially significant discrepancy) 3.7% (n =  2). Sonographic reports closely correlated (Grade 1 or 2 scores) with surgical findings in 96% of cases.

Conclusions

The musculoskeletal sonographic reporting had a high correlation with surgery findings. Ultrasound was more accurate than MRI in reporting full thickness rotator cuff tears. Clinical weakness in resisted external rotation or abduction did not correlate with imaging. Ultrasound was found to be unreliable in detecting rotator cuff tears in participants with a BMI ≥ 35.
Risk stratification for pregnancy-associated venous thromboembolism: Potential role for global coagulation assays
Authors: O’Keefe David , Lim Hui Yin , Hui Lisa , Ho Prahlad
Published: August 2021

Risk assessment for venous thromboembolism in pregnancy and the puerperium is currently limited to stratifying clinical surrogate risk factors without high-quality evidence. While the absolute risk of pregnancy-associated venous thromboembolism is low for the vast majority of women, associated morbidity and mortality remains significant. As guidelines for thromboprophylaxis vary widely, some women may be under- or over-anticoagulated, contributing to poor outcomes. New global coagulation assays provide a holistic view of coagulation and may have the potential to detect hypercoagulability in pregnancy, unlike clinically available coagulation assays. However, there are major technical challenges to overcome before global coagulation assays can be realistically proposed as an adjunct to risk assessment for pregnancy-associated venous thromboembolism. This review summarises the literature and controversies in the prediction and prevention of pregnancy-associated venous thromboembolism and outlines the new tools in haematology that may assist in our future understanding of hypercoagulability in pregnancy.
Biomechanical analysis of single-incision anatomic repair technique for distal biceps tendon rupture using tunneling device
Authors: Qazi Sohail , Regal Steven , Greco Victor , Wroblewski Andrew , Schimoler Patrick J , Miller Mark C , Hammarstedt Jon E
Published: August 2021

Hypothesis

Single-incision biceps tendon repair with an arthrotunneling device has previously been shown to be a safe and effective technique that provides the anatomic restoration of a two-incision approach and a reduced complication profile. This repair provides adequate and comparable fixation to repairs utilizing anchors, buttons, screws, etc., at a lower cost.

Material and methods

This study utilized 10 cadaveric specimens. Native and repair specimens were cyclically loaded and graft displacement, flexion/extension (FE) and pronation/supination (PS) moment arms at 12.5° to 152.5° (in 5° increments) before and after repair, and maximum load to failure were measured.

Results

The FE and PS moment arms and overall maximum moment arms were both significantly larger in the repaired case than in the native case (p < 0.01). Moment arms for supinated specimens were significantly greater than neutral specimens, which in turn was greater than pronated specimens (p < 0.01). The maximum load up to 10 mm of repair displacement was 214.5.0 ± 66.6 N and the repair displacement due to 1000 cycles of 50 N was 2.56 ± 2.06 mm.

Conclusion

The single-incision arthrotunneling technique is a safe and effective repair that recreates the anatomic footprint and biomechanics of the native biceps and has a reduced complication profile compared to a two-incision approach.
Contact tracing: Achieving equilibrium between blockchain solutions and privacy amid the novel coronavirus pandemic
Authors: Moraes Trícia Karla Lacerda , Cernev Adrian Kemmer , Diniz Eduardo Henrique
Published: August 2021

In moments of scepticism and hopelessness, the drive to satisfy collective needs pushes humanity to accomplish incredible feats to ensure our survival on earth. Indeed, the current global crisis caused by the novel coronavirus is no exception. We are struggling with the abrupt spread of this illness and continuously striving to find efficient solutions. This has been André Salem Alégo’s primary inspiration since the crisis hit his country in March 2020. He is the chief executive officer of Blockforce, a blockchain-based SocialTech. Having observed the effects of novel coronavirus, André examined various approaches that could help contain the spread of the virus and keep society safe. He came up with the idea for an innovative service called Desviralize, which supports pandemic crisis monitoring through contact-tracing with the use of blockchain technology. This teaching case covers how an emergent technology evolves amid the pandemic. It draws attention to important facts related to the digital era such as data security and privacy in the context of Desviralize and Blockforce’s chief executive officer’s strategies for boosting platform growth within the constraints imposed by data protection regulation, the critical pandemic situation, and the ethical aspects of the application of technology.
A systematic review of historical and current trends in Chagas disease
Authors: Álvarez-Hernández Diego-Abelardo , García-Rodríguez-Arana Rodolfo , Ortiz-Hernández Alejandro , Álvarez-Sánchez Mariana , Wu Meng , Mejia Rojelio , Martínez-Juárez Luis-Alberto , Montoya Alejandra , Gallardo-Rincon Héctor , Vázquez-López Rosalino , Fernández-Presas Ana-María
Published: August 2021

Introduction:

Chagas disease (CD) is caused by Trypanosoma cruzi. When acquired, the disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient’s health should be performed. Treatment consists of the administration of trypanocidal drugs, which may cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide.

Materials and methods:

We performed a systematic review following the PRISMA guidance. PubMed database was explored using the terms ‘American trypanosomiasis’ or ‘Chagas disease’. Results were limited to human case reports written in English or Spanish. A total of 258 reports (322 patients) were included in the analysis. Metadata was obtained from each article. Following this, it was analyzed to obtain descriptive measures.

Results:

From the sample, 56.2% were males and 43.8% were females. Most cases were from endemic countries (85.4%). The most common clinical manifestations were fever during the acute stage (70.0%), dyspnea during the chronic stage in its cardiac form (53.7%), and constipation during the chronic stage in its digestive form (73.7%). Most patients were diagnosed in the chronic stage (72.0%). Treatment was administered in 56.2% of cases. The mortality rate for the acute stage cases was 24.4%, while for the chronic stage this was 28.4%.

Discussion:

CD is a parasitic disease endemic to Latin America, with increasing importance due to human and vector migration. In this review, we report reasons for delays in diagnosis and treatment, and trends in medical practices. Community awareness must be increased to improve CD’s diagnoses; health professionals should be appropriately trained to detect and treat infected individuals. Furthermore, public health policies are needed to increase the availability of screening and diagnostic tools, trypanocidal drugs, and, eventually, vaccines.
Characteristics of patients who were able to switch from benzodiazepine hypnotics to lemborexant
Authors: Suzuki Hidenobu , Hibino Hiroyuki
Published: August 2021

Objectives:

There is little evidence of insomnia treatment, especially exit strategies for hypnotics. We examined on the characteristics of patients who were able to switch from benzodiazepine hypnotics to lemborexant.

Methods:

Insomnia was assessed using the Athens Insomnia Scale. Efficacy outcome assessment was the Clinical Global Impressions-Improvement scale.

Results:

Eighty patients switched from benzodiazepine hypnotic monotherapy to lemborexant and 57 patients who continued the use of benzodiazepine hypnotics. The switched group had a significantly lower benzodiazepine hypnotic diazepam equivalent and a significantly shorter dosing period than the continued group ( p < 0.001 for all). The mean Athens Insomnia Scale total score of the switched group was a significant improved (5.8 ± 3.3 to 4.0 ± 3.3; p < 0.05). The mean Clinical Global Impressions-Improvement score of the switched group was 3.3 ± 0.7.

Conclusion:

Our findings suggest that when administering benzodiazepine hypnotics, shortening the administration period, as much as possible, allows a smooth switch to safe long-term maintenance therapy using lemborexant, without exacerbating insomnia.
A life-threatening spontaneous ascending aortic rupture due to a small penetrating aortic ulcer
Authors: Nakamura Yasuhito , Doi Kiyoshi , Yamaguchi Syojiro , Umeda Etsuji , Sakai Osamu , Shimabukuro Katsuya
Published: August 2021

We reported a rare case of spontaneous frank rupture of a small (4 mm) penetrating aortic ulcer in the ascending aorta resulted in catastrophic bleeding. The ulcer only created a pinhole wound in the adventitia without saccular aneurysms, intramural hematomas, or aortic dissections. Notably, the wound could be directly closed because the aortic wall was intact only 5 mm away from the bleeding site. The postoperative course was uneventful, and the patient was discharged on the 11th postoperative day. After 8 months, follow-up computed tomography showed no abnormality of the aortic wall at the repair site.
A loss of function mutation in the filaggrin gene associated with ichthyosis vulgaris and rheumatoid arthritis
Authors: Xu Xinxin , Ma Qingqing , Lin Mu , Liu Mubo , Huang Chaolin , Ying Jianchao , Ye Jun
Published: August 2021

Introduction

Mutations in the filaggrin ( FLG) gene are known to cause ichthyosis vulgaris.

Methods

We used whole-genome sequencing (WGS) technology to investigate the genetic causes of rare and complex inherited diseases including rheumatoid arthritis, ichthyosis, and congenital fibrosis of the extraocular muscles type 1 (CFEOM1) in a Chinese family. WGS was performed in four topics, and the identified candidate mutations were further verified through Sanger sequencing.

Results

We identified a mutation in FLG gene (g.152280098 C>A, p.E2422∗) that may be associated with ichthyosis and arthritis. Moreover, a mutation in KIF21A (g.39726207 G>A, p.R954 W) was also determined in affected members as the cause of CFEOM1. The gene interaction network demonstrated an interesting correlation between FLG and genes associated with arthritis and ichthyosis. Functional enrichment analysis of these interacting genes revealed several possible pathways that might be linked to arthritis and ichthyosis.

Conclusion

In general, we confirmed a loss of function mutation in the FLG gene associated with ichthyosis vulgaris and rheumatoid arthritis in this family.
Involvement of L5-S1 level as an independent risk factor for adverse outcomes after surgical treatment of lumbar pyogenic spondylitis: A multivariate analysis
Authors: Park Sung Cheol , Chang Sam Yeol , Gimm GeunWu , Mok Sujung , Kim Hyoungmin , Chang Bong-Soon , Lee Choon-Ki
Published: August 2021

Purpose:

To identify the independent risk factors for adverse outcomes and determine the effect of L5-S1 involvement on the outcome of surgical treatment of lumbar pyogenic spondylitis (PS).

Methods:

A retrospective analysis was performed for all consecutive patients who underwent surgery for lumbar PS between November 2004 and June 2020 at a single institution. The patients were divided into two groups based on the outcomes: good and adverse (treatment failure, relapse, or death). Treatment failure was defined as persistent or worsening pain with C-reactive protein (CRP) reduction less than 25% from preoperative measurement or requiring additional debridement. Relapse was defined as the reappearance of symptoms and signs with an elevated white blood cell count, erythrocyte sedimentation rate, and CRP after the first period of treatment. Binary logistic regression analyses were performed to identify the independent risk factors for adverse outcomes.

Results:

Twenty-four (21.2%) of the 113 patients were classified as having adverse outcomes: treatment failure, relapse, and death occurred in 15, 7, and 2 patients, respectively. The involvement of L5-S1 (adjusted odds ratio [aOR] = 6.561, P = 0.004), Methicillin-resistant Staphylococcus aureus (MRSA) infection (aOR = 6.870, P = 0.008), polymicrobial infection (aOR = 12.210, P = 0.022), and Charlson comorbidity index (CCI; P = 0.005) were identified as significant risk factors for adverse outcomes.

Conclusion:

Involvement of L5-S1, MRSA, polymicrobial infection, and CCI were identified as independent risk factors for adverse outcomes after surgical treatment of lumbar PS. Because L5-S1 is anatomically demanding to access anteriorly, judicious access and thorough debridement are recommended in patients requiring anterior debridement of L5-S1.
Maternal Attentional Control Moderates the Association Between Increased Depression and Controlling Feeding Practices During the COVID-19 Pandemic
Authors: Giuliani Nicole R. , Kelly Nichole R.
Published: August 2021

Parental distress is associated with less healthful child feeding practices. In this preliminary study, we examined how changes in distress from before to during the COVID-19 pandemic were associated with similar changes in feeding practices in a sample of mothers of preschool-aged children. In addition, we examined how pre-pandemic laboratory measures of maternal self-regulation moderated this association. A total of 36 mothers from an ongoing study on parent and child self-regulation completed surveys assessing parental distress (i.e., maternal depression, parenting stress) and child feeding practices during pandemic-related stay-at-home orders in May–June 2020. These mothers had completed the same measures approximately 2 years earlier, along with laboratory assessments of inhibitory and attentional control. Pre-pandemic laboratory measures of attentional control significantly moderated the association between increased maternal depression and use of controlling feeding practices, such that mothers with better attentional, but not inhibitory, control scores did not show an effect of increased depression on feeding practices. These results provide preliminary evidence that acute increases in parental distress associated with “stay-at-home” orders affect feeding practices, specifically for mothers with lower levels of attentional control abilities.
Acute Angle-Closure Crisis Secondary to Topiramate-Induced Ciliochoroidal Effusion With Underlying Plateau Iris Configuration
Authors: Shen Steven R. , Boese Erin A. , Clark Courtney P. , Man Xiaofei , Nika Melisa , Moroi Sayoko E.
Published: August 2021

Objective:

The development of ciliochoroidal effusions and secondary acute angle-closure crisis (AACC) is an uncommon side effect of topiramate, a common antiepileptic now FDA-approved for migraine prophylaxis. The mechanisms that underlie the development of ciliochoroidal effusions after topiramate use remain unclear.

Materials and Methods:

Ultrasound biomicroscopy (UBM) was also performed in all participants after stopping topiramate.

Results:

Six patient cases are presented with medication-induced AACC following the initiation or escalation of topiramate. Ciliochoroidal effusions were confirmed by gray-scale sonography in all patients at presentation. The images revealed either plateau iris configuration or atypical plateau iris configuration. Plateau iris configuration is defined by presence of an anteriorly rotated ciliary body processes and an absent posterior sulcus. Atypical plateau iris configuration refers to when the iris inserts directly into the ciliary body face. This case series, of medication-induced angle-closure crisis, suggests that plateau iris configuration is a shared anatomical feature in the development of topiramate-induced ciliochoroidal effusions.
Multi-locus genome-wide association mapping for spike-related traits in bread wheat (Triticum aestivum L.)
Authors: Malik Parveen , Kumar Jitendra , Sharma Shiveta , Sharma Rajiv , Sharma Shailendra
Published: August 2021

Background

Bread wheat (Triticum aestivum L.) is one of the most important cereal food crops for the global population. Spike-layer uniformity (the consistency of the spike distribution in the vertical space)-related traits (SLURTs) are quantitative and have been shown to directly affect yield potential by modifying the plant architecture. Therefore, these parameters are important breeding targets for wheat improvement. The present study is the first genome-wide association study (GWAS) targeting SLURTs in wheat. In this study, a set of 225 diverse spring wheat accessions were used for multi-locus GWAS to evaluate SLURTs, including the number of spikes per plant (NSPP), spike length (SL), number of spikelets per spike (NSPS), grain weight per spike (GWPS), lowest tiller height (LTH), spike-layer thickness (SLT), spike-layer number (SLN) and spike-layer uniformity (SLU).

Results

In total, 136 significant marker trait associations (MTAs) were identified when the analysis was both performed individually and combined for two environments. Twenty-nine MTAs were detected in environment one, 48 MTAs were discovered in environment two and 59 MTAs were detected using combined data from the two environments. Altogether, 15 significant MTAs were found for five traits in one of the two environments, and four significant MTAs were detected for the two traits, LTH and SLU, in both environments i.e. E1, E2 and also in combined data from the two environments. In total, 279 candidate genes (CGs) were identified, including Chaperone DnaJ, ABC transporter-like, AP2/ERF, SWEET sugar transporter, as well as genes that have previously been associated with wheat spike development, seed development and grain yield.

Conclusions

The MTAs detected through multi-locus GWAS will be useful for improving SLURTs and thus yield in wheat production through marker-assisted and genomic selection.
QTL mapping for starch paste viscosity of rice (Oryza sativa L.) using chromosome segment substitution lines derived from two sequenced cultivars with the same Wx allele
Authors: Zhao Ling , Zhao Chunfang , Zhou Lihui , Zhao Qingyong , Zhu Zhen , Chen Tao , Yao Shu , Zhang Yadong , Wang Cailin
Published: August 2021

Background

The eating and cooking qualities (ECQs) of rice (Oryza sativa L.) are key characteristics affecting variety adoption and market value. Starch viscosity profiles tested by a rapid visco analyzer (RVA) offer a direct measure of ECQs and represent the changes in viscosity associated with starch gelatinization. RVA profiles of rice are controlled by a complex genetic system and are also affected by the environment. Although Waxy (Wx) is the major gene controlling amylose content (AC) and ECQs, there are still other unknown genetic factors that affect ECQs.

Results

Quantitative trait loci (QTLs) for starch paste viscosity in rice were analyzed using chromosome segment substitution lines (CSSLs) developed from the two cultivars 9311 and Nipponbare, which have same Wx-b allele. Thus, the effect of the major locus Wx was eliminated and the other locus associated with the RVA profile could be identified. QTLs for seven parameters of the starch RVA profile were tested over four years in Nanjing, China. A total of 310 QTLs were identified (from 1 to 55 QTLs per trait) and 136 QTLs were identified in more than one year. Among them, 6 QTLs were stalely detected in four years and 26 QTLs were detected in at least three years including 13 pleiotropic loci, controlling 2 to 6 RVA properties simultaneously. These stable QTL hotspots were co-located with several known starch synthesis-related genes (SSRGs). Sequence alignments showed that nucleotide and amino acid sequences of most SSRGs were different between the two parents. Finally, we detected stable QTLs associated with multiple starch viscosity traits near Wx itself, supporting the notion that additional QTLs near Wx control multiple characteristic values of starch viscosity.

Conclusions

By eliminating the contribution from the major locus Wx, multiple QTLs associated with the RVA profile of rice were identified, several of which were stably detected over four years. The complexity of the genetic basis of rice starch viscosity traits might be due to their pleiotropic effects and the multiple QTL hot spots. Minor QTLs controlling starch viscosity traits were identified by using the chromosome segment substitution strategy. Allele polymorphism might be the reason that QTLs controlling RVA profile characteristics were detected in some known SSRG regions.
Model estimates of hospitalization discharge rates for norovirus gastroenteritis in Europe, 2004–2015
Authors: Calduch Elsa Negro , Cattaert Tom , Verstraeten Thomas
Published: August 2021

Background

Norovirus is an important cause of acute gastroenteritis globally. However, norovirus is rarely laboratory confirmed or recorded explicitly as a cause of hospitalization. In recent years, there has been an interest in using medical databases and indirect modelling methods to estimate the incidence of norovirus gastroenteritis. The objective of this study was to estimate the incidence of hospitalizations for norovirus gastroenteritis in Europe (2004–2015) using nationwide in-patient discharge records from different European countries.

Methods

National hospital discharge registers in all 28 European Union countries (at that time) and all 4 European Free Trade Association countries were contacted and invited to participate in the study. Discharges with ICD9/ICD10 codes for acute gastroenteritis (AGE) as first-listed (principal) diagnosis were extracted to assess hospitalization rates for AGE and norovirus gastroenteritis (NGE), overall, by age group, country, month, and seasonal year. The number of cause-unspecified episodes was regressed against pathogen-specific AGE episodes: Rotavirus, Clostridium difficile, Other Bacterial, Other Viral and Parasitic separately. NGE hospital discharges were estimated for each month by calculating the difference between observed cause-unspecified and model-predicted counts, assuming that any remaining seasonality not otherwise captured in the model was due to norovirus, and adding those to the coded NGE episodes to get the total number of norovirus-associated episodes.

Results

Data were available from 15 countries, representing 68% of the total population in Europe. Only 24.4% of all AGE discharges were coded as cause-specified. We estimated that between 2004 and 2015, the overall rate of NGE hospital discharges in Europe was 3.9 per 10,000 person-years, ranging from 1.2 (Portugal) to 10.7 (Lithuania). Norovirus was predicted to be responsible for 17% of all AGE hospital discharges in Europe in this period. Norovirus affects individuals of all ages, but NGE discharge rates were highest in children < 5 years (24.8 per 10,000 person-years), and adults aged ≥80 years (10.7 per 10,000 person-years).

Conclusion

We estimated that 1 in 400 hospitalizations in Europe can be attributed to Norovirus. In the absence of routine norovirus testing and recording in hospital settings, modelling methods are useful resources to estimate the incidence of norovirus gastroenteritis.
Dynamic profile of SARS-CoV-2 infection among hospitalized patients in Kuwait: a descriptive study
Authors: Madi Nada , Al-Awadhi Ebaa’ , Al-Assaf Fajer
Published: August 2021

Background

The coronavirus induced disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan (China) in December 2019 is currently spreading rapidly worldwide. This study aimed to analyze the dynamic profile of SARS-CoV-2 infection among hospitalized patients that would characterize the period of viral shedding and detection among patients.

Methods

Retrospectively, 103 confirmed SARS-CoV-2 patients hospitalized at Jaber hospital in Kuwait were included. Demographic and clinical characteristics of the patients were collected. Nasopharyngeal swabs were obtained at different time intervals and analyzed by Real-Time RT-PCR for SARS-CoV-2 infection.

Results

Of 103 hospitalized patients with SARS-CoV-2 infection, the median age was 41 years, and 64% were male. The median period from admission to the positive SARS-CoV-2 RT-PCR test was 19 days (IQR, 13–22). The median period from admission to active negative SARS-CoV-2 RT-PCR test result was 22 days (IQR, 16–26). Older patients, patients with comorbidities, and patients with symptoms were more likely to have extended viral shedding.

Conclusion

For the first time, this descriptive study conducted in Kuwait on SARS-CoV-2 RT-PCR test results from 103 patients positive for SARS-provided solid proof and a good understanding of the dynamic profile of SARS-CoV-2 infection among patients in Kuwait. This information will further enrich the global knowledge on the emerging SARS-CoV-2.
Differential effects of HIF2α antagonist and HIF2α silencing in renal cancer and sensitivity to repurposed drugs
Authors: Arnaiz Esther , Miar Ana , Bridges Esther , Prasad Naveen , Hatch Stephanie B. , Ebner Daniel , Lawrie Charles H. , Harris Adrian L.
Published: August 2021

Background

In clear cell renal cell carcinoma, 80% of cases have biallelic inactivation of theVHLgene, leading to constitutive activation of both HIF1α and HIF2α. As HIF2α is the driver of the disease promoting tumour growth and metastasis, drugs targeting HIF2α have been developed. However, resistance is common, therefore new therapies are needed.

Methods

We assessed the effect of the HIF2α antagonist PT2385 in several steps of tumour development and performed RNAseq to identify genes differentially expressed upon treatment. A drug screening was used to identify drugs with antiproliferative effects onVHL-mutated HIF2α-expressing cells and could increase effectiveness of PT2385.

Results

PT2385 did not reduce cell proliferation or clonogenicity but, in contrast to the genetic silencing of HIF2α, it reduced in vitro cell invasion. Many HIF-inducible genes were down-regulated upon PT2385 treatment, whereas some genes involved in cell migration or extracellular matrix were up-regulated. HIF2α was associated with resistance to statins, addition to PT2385 did not increase the sensitivity. Conclusions: this study shows key differences between inhibiting a target versus knockdown, which are potentially targetable.
Impact of lenvatinib on renal function: long-term analysis of differentiated thyroid cancer patients
Authors: Masaki Chie , Sugino Kiminori , Kobayashi Sakiko , Hosoi Yoshie , Ono Reiko , Yamazaki Haruhiko , Akaishi Junko , Hames Kiyomi Y. , Tomoda Chisato , Suzuki Akifumi , Matsuzu Kenichi , Ohkuwa Keiko , Kitagawa Wataru , Nagahama Mitsuji , Ito Koichi
Published: August 2021

Background

Because lenvatinib is well known to induce proteinuria by blocking the vascular endothelial growth factor (VEGF) pathway, renal function is a concern with long-term administration of lenvatinib. The long-term effects of lenvatinib on renal function in patients with advanced differentiated thyroid carcinoma (DTC) were analyzed.

Method

This study involved 40 DTC patients who continued lenvatinib therapy for ≥6 months. Estimated glomerular filtration rate (eGFR) was calculated as an indicator of renal function. The temporal course of eGFR, effects of baseline eGFR on eGFR changes, and factors affecting renal impairment were investigated.

Results

The overall cohort showed sustainable decreases in eGFR, with decreased values of 11.4, 18.3, and 21.0 mL/min/1.73 m2 at 24, 36, and 48 months after starting treatment, respectively. No differences in eGFR decrease every 6 months were seen for three groups classified by baseline eGFR ≥90 mL/min/1.73 m2 (n = 6), < 90 but ≥60 mL/min/1.73 m2 (n = 26), or < 60 but ≥45 mL/min/1.73 m2 (n = 8). Grade 3 proteinuria was associated with declines in eGFR (p = 0.0283). Long observation period was also associated with decreases in eGFR (p = 0.0115), indicating that eGFR may decrease in a time-dependent manner.

Conclusion

Lenvatinib can induce declines in eGFR, particularly with treatment duration > 2 years, regardless of baseline eGFR. Proteinuria is a risk factor for declines in eGFR. Patients who start lenvatinib with better renal function show a renal reserve capacity, prolonging clinical outcomes. Decision-making protocols must balance the benefits of lenvatinib continuation with acceptable risks of harm.
New onset ANCA-associated vasculitis in an adolescent during an acute COVID-19 infection: a case report
Authors: Reiff Daniel D. , Meyer Chloe G. , Marlin Brittany , Mannion Melissa L.
Published: August 2021

Background

SARS-CoV-2 has been found to be exquisitely adept at triggering autoimmunity and multiple new onset autoimmune diseases have been described as a post-infectious complication of COVID-19 infection in the adult population. Less has been described in the pediatric population, as infections are more likely to be asymptomatic and less severe. This case reports a previously healthy adolescent patient with new onset antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) diagnosed in the setting of acute COVID-19 infection.

Case presentation

A previously healthy adolescent male was diagnosed with COVID-19 pneumonia after presenting with infectious symptoms of fever, cough, congestion, and shortness of breath. After worsening of disease, he was found to have pulmonary nodules, atypical for COVID-19. Further imaging and laboratory workup showed elevated inflammatory markers, negative infectious testing, and positive antineutrophil cytoplasmic antibodies (ANCA) diagnostic for AAV. He was treated with pulse dose steroids followed by a prolonged taper and rituximab. Symptoms resolved and laboratory abnormalities improved over time. At six-month follow-up, lesions were much improved, laboratory markers were within normal limits, and patient remained asymptomatic off medications.

Conclusions

This case is one of the first in the pediatric population to describe new onset AAV presenting with an acute, symptomatic COVID-19 infection. There is increasing evidence for COVID-19 induced autoimmunity in the pediatric population and pediatric care providers should be on high alert for new onset autoimmune disease in children afflicted by COVID-19.
Tobacco treatment clinics in urban public housing: feasibility and outcomes of a hands-on tobacco dependence service in the community
Authors: Galiatsatos Panagis , Soybel Alexandria , Jassal Mandeep , Cruz Sergio Axel Perez , Spartin Caroline , Shaw Katie , Cunningham Jodi , Kanarek Norma Fox
Published: August 2021

Background

As a further extension of smoke-free laws in indoor public places and workplaces, the Department of Housing and Urban Development’s declaration to propose a regulation that would make housing units smoke-free was inevitable. Of note is the challenge this regulation poses to current tenants of housing units who are active smokers. We aimed to assess the efficacy of a tobacco treatment clinic in public housing. The utilization of the clinic by tenants and tenants’ respective outcomes regarding smoking status were used to determine the intervention’s effectiveness.

Methods

Tobacco treatment clinics were held in two urban-based housing units for 1-year. The clinics provided on-site motivational interviewing and prescriptions for pharmacological agents if warranted. Outcomes collected include the tenants’ clinic attendance and 3- and 6-month self-reported smoking status.

Results

Twenty-nine tobacco treatment clinic sessions were implemented, recruiting 47 tenants to participate in smoking cessation. The mean age of the cohort was 53 ± 12.3 years old. Of the 47 tenants who participated, 21 (44.7%) attended three or more clinic sessions. At the 3-month mark, five (10.6%) tenants were identified to have quit smoking; at 6-months, 13 (27.7%) tenants had quit smoking. All 13 of the tenants who quit smoking at the end of 6-months attended three or more sessions.

Conclusion

An on-site tobacco treatment clinic to provide strategies on smoking cessation was feasible. Efforts are warranted to ensure more frequent follow-ups for tenants aiming to quit smoking. While further resources should be allocated to help tenants comply with smoke-free housing units’ regulations, we believe an on-site tobacco treatment clinic is impactful.
Influence of weekday of admission and level of distress on length of hospital stay in patients with low back pain: a retrospective cohort study
Authors: Brunner Emanuel , Meichtry André , Vancampfort Davy , Imoberdorf Reinhard , Gisi David , Dankaerts Wim , Graf Anita , Wipf Rebsamen Stefanie , Suter Daniela , Wildi Lukas Martin , Buechi Stefan , Sieber Cornel
Published: August 2021

Background

Low back pain (LBP) is often a complex problem requiring interdisciplinary management to address patients’ multidimensional needs. Providing inpatient care for patients with LBP in primary care hospitals is a challenge. In this setting, interdisciplinary LBP management is often unavailable during weekends. Delays in therapeutic procedures may result in a prolonged length of hospital stay (LoS). The impact of delays on LoS might be strongest in patients reporting high levels of psychological distress. Therefore, this study investigates the influence of weekday of admission and distress on LoS of inpatients with LBP.

Methods

This retrospective cohort study was conducted between 1 February 2019 and 31 January 2020. In part 1, a negative binomial model was fitted to LoS with weekday of admission as a predictor. In part 2, the same model included weekday of admission, distress level, and their interaction as covariates. Planned contrast was used in part 1 to estimate the difference in log-expected LoS between group 1 (admissions Friday/Saturday) and the reference group (admissions Sunday-Thursday). In part 2, the same contrast was used to estimate the corresponding difference in (per-unit) distress trends.

Results

We identified 173 patients with LBP. The mean LoS was 7.8 days (SD = 5.59). Patients admitted on Friday (mean LoS = 10.3) and Saturday (LoS = 10.6) had longer stays, but not those admitted on Sunday (LoS = 7.1). Analysis of the weekday effect and planned contrast showed that admission on Friday or Saturday was associated with a significant increase in LoS (log ratio = 0.42, 95% CI = 0.21 to 0.63). A total of 101 patients (58%) returned questionnaires, and complete data on distress were available from 86 patients (49%). According to the negative binomial model for LoS and the planned contrast, the distress effect on LoS was significantly influenced (difference in slopes = 0.816, 95% CI = 0.03 to 1.60) by dichotomic weekdays of admission (Friday/Saturday vs. Sunday-Thursday).

Conclusions

Delays in interdisciplinary LBP management over the weekend may prolong LoS. This may particularly affect patients reporting high levels of distress. Our study provides a platform to further explore whether interdisciplinary LBP management addressing patients’ multidimensional needs reduces LoS in primary care hospitals.
Inflammatory vaginitis in women on long-term rituximab treatment for autoimmune disorders
Authors: Yockey Laura , Dowst Sarah , Zonozi Reza , Huizenga Noah , Murphy Patrick , Laliberte Karen , Rosenthal Jillian , Niles John L. , Mitchell Caroline M.
Published: August 2021

Background

Consequences of long-term B cell depletion with rituximab are not well understood. We describe inflammatory vaginitis as a potential side effect of long-term rituximab treatment, distinct from previously described vulvovaginal pyoderma gangrenosum.

Methods

We performed a retrospective analysis of women treated with rituximab for more than 1 year to determine the prevalence and clinical characteristics of vaginitis cases. We conducted a case–control analysis with up to 3 controls for each vaginitis case.

Results

We identified sixteen inflammatory vaginitis cases. Women with vaginitis were age 23–68 (median 42), primarily being treated for ANCA-associated vasculitis (11/16; 69%). Most reported copious vaginal discharge (100%) and pain with sex (75%). All women with return of circulating B-cells to > 10 cells/mL had complete (5/9) or significant (4/9) improvement in symptoms. In case–control analysis there was no significant difference in length of B-cell depletion, immune parameters, creatinine levels, and history of neutropenia.

Conclusion

Inflammatory vaginitis is a potential side effect of prolonged continuous B cell depletion with rituximab. More studies are needed to characterize the incidence and etiology of vaginitis among women on long term rituximab therapy and establish a causal relationship.
The relationship between ethical climate and nursing service behavior in public and private hospitals: a cross-sectional study in China
Authors: Zhang Na , Li Jingjing , Bu Xing , Gong Zhen-Xing
Published: August 2021

Background

Workplace climate is a great significant element that has an impact on nurses’ behavior and practice; moreover, nurses’ service behavior contributes to the patients’ satisfaction and subsequently to the long-term success of hospitals. Few studies explore how different types of organizational ethical climate encourage nurses to engage in both in-role and extra-role service behaviors, especially in comparing the influencing process between public and private hospitals. This study aimed to compare the relationship between the five types of ethical climate and nurses’ in-role and extra-role service behaviors in public and private hospitals.

Methods

This study conducted a cross-sectional survey on 559 nurses from China in May 2019. The questionnaire was distributed to nurses by sending a web link via the mobile phone application WeChat through snowball sampling methods. All participants were investigated using the Ethical Climate Scale and Service Behavior Questionnaire. SPSS 22.0 was used for correlation analysis, t-test, and analysis of variance test, and Mplus 7.4 was used for group comparison (p < .05).

Results

The law and code climate has a much greater influence on nurses’ in-role service behavior in private hospitals than on that in public hospitals (β = − 0.277; CI 95 % = [-0.452, − 0.075]; p < .01), and the instrumental climate has a stronger influence on nurses’ extra-role service behavior private hospitals than on that in public hospitals (β = − 0.352; CI 95 % = [-0.651, − 0.056]; p < .05). Meanwhile, the rules climate has a greater effect on nurses’ extra-role service behavior in public hospitals than it does in private hospitals (β = 0.397; CI 95 % = [0.120, 0.651]; p < .01).

Conclusions

As the relationship between the five types of ethical climate and nurses’ in-role and extra-role service behaviors in public and private hospitals were different, the strategies used to foster and enhance the types of ethical climate are various from public to private hospitals. The caring and instrumental climate are the key to promote extra-role service behavior for nurses in private hospitals. And the independent climate has a great effect on extra-role service behaviors for nurses in public hospitals.
Blocking circ-SCMH1 (hsa_circ_0011946) suppresses acquired DDP resistance of oral squamous cell carcinoma (OSCC) cells both in vitro and in vivo by sponging miR-338-3p and regulating LIN28B
Authors: Qiu Feng , Qiao Bin , Zhang Nan , Fang Zheng , Feng Lu , Zhang Shanfeng , Qiu Weiliu
Published: August 2021

Background

Circular RNAs (circRNAs) could participate in cis-dichlorodiammineplatinum (DDP) resistance of human cancers. However, circRNAs role in DDP resistance of oral squamous cell carcinoma (OSCC) progression remains largely undeveloped. Here, we attempted to explore the role of circ-SCMH1 (ID hsa_circ_0011946) in acquired DDP resistance.

Methods

Expression of circ-SCMH1, microRNA (miR)-338-3p and Lin-28 homolog B (LIN28B) was detected by real-time quantitative PCR and western blotting, and their interactions were confirmed by dual-luciferase reporter assay, RNA immunoprecipitation and RNA pull-down assay. DDP resistance was assessed by MTT assay, colony formation assay, flow cytometry, transwell assays, western blotting, and xenograft experiment. Transmission electron microscopic analysis, nanoparticle tracking analysis and western blotting confirmed the characterizations of extracellular vesicles (EVs).

Results

Circ-SCMH1 was upregulated in DDP-resistant OSCC tissues and cells (SCC-15/DDP and CAL-27/DDP). Circ-SCMH1 knockdown suppressed the half-maximal inhibitory concentration of DDP, colony formation, and migration/invasion in SCC-15/DDP and CAL-27/DDP cells, but promoted apoptosis rate and apoptotic proteins (Bax and cleaved-caspase-3) expression. However, silencing miR-338-3p abrogated above effects, and overexpressing miR-338-3p mimicked that. Similarly, miR-338-3p overexpression role could be counteracted by restoring LIN28B. Moreover, interfering circ-SCMH1 retarded tumor growth of SCC-15/DDP cells in vivo with DDP treatment or not. Mechanistically, circ-SCMH1 directly sponged miR-338-3p in regulating LIN28B, a target gene for miR-338-3p. Notably, circ-SCMH1 was an EVs cargo, and DDP-resistant OSCC cells-derived EVs could provoke circ-SCMH1 upregulation in parental cells.

Conclusion

Circ-SCMH1 contributes to chemoresistance of DDP-resistant OSCC cells partially via EVs secretion and circ-SCMH1/miR-338-3p/LIN28B axis.