bluuebunny/crossref_metadata_2025 huggingface dataset:
Inhibitors of IFN gene stimulators (STING) improve intestinal ischemia–reperfusion-induced acute lung injury by activating AMPK signaling
Authors: Yang Mei , Ma Yu-Xia , Zhi Ying , Wang Hai-Bin , Zhao Li , Wang Peng-Sheng , Niu Jie-Ting
Published: May 2022

Background

Acute lung injury (ALI) caused by intestinal ischemia–reperfusion is a life-threatening disease. Interferon gene stimulator (STING) is a cytoplasmic DNA sensor that participates in the initiation of the inflammatory response. This study aims to establish whether C-176 (STING inhibitor) improves ALI under intestinal ischemia–reperfusion conditions.

Methods

To induce ALI, 72 male C57BL/6 mice were subjected to intestinal ischemia for 60 min and reperfusion for 3 h. Through intraperitoneal injection, C-176, a selective STING inhibitor, was injected 30 min before surgical treatment; meanwhile, compound C, an antagonist of adenosine monophosphate-activated protein kinase (AMPK), was administered 30 min after surgery. Based on immunofluorescence and Western blot assays, post-ALI assessments included lung water content (TLW), bronchoalveolar lavage fluid (BALF) protein, H&E staining, Masson staining, pulmonary pyroptosis [Gasdermin-D (GSDMD), cleaved caspase-1], and apoptosis (TUNEL, cleaved caspase-3).

Results

C-176 administration significantly attenuated intestinal ischemia–reperfusion-mediated ALI; this effect was reflected by exacerbated TLW and BALF protein, aggravated lung injury score, elevated degree of pulmonary fibrosis, increased TUNEL- and GSDMD-positive cells, and upregulated phospho-AMPK, cleaved caspase-1, cleaved caspase-3 and IFNβ mRNA expression. Moreover, C-176 increased phospho-AMPK under ALI conditions. Nonetheless, compound C partially reversed these beneficial effects.

Conclusion

C-176, a selective STING inhibitor, improves intestinal ischemia–reperfusion-mediated ALI, and its underlying mechanism may be associated with AMPK signal activation.
Heritable genomic diversity in breast cancer driver genes and associations with risk in a Chilean population
Authors: Morales-Pison Sebastian , Gonzalez-Hormazabal Patricio , Tapia Julio C. , Salas-Burgos Alexis , Ampuero Sandra , Gómez Fernando , Waugh Enrique , Reyes José Miguel , Jara Lilian
Published: May 2022

Background

Driver mutations are the genetic components responsible for tumor initiation and progression. These variants, which may be inherited, influence cancer risk and therefore underlie many familial cancers. The present study examines the potential association between SNPs in driver genes SF3B1 (rs4685), TBX3 (rs12366395, rs8853, and rs1061651) and MAP3K1 (rs72758040) and BC in BRCA1/2-negative Chilean families.

Methods

The SNPs were genotyped in 486 BC cases and 1258 controls by TaqMan Assay.

Results

Our data do not support an association between rs4685:C > T, rs8853:T > C, or rs1061651:T > C and BC risk. However, the rs12366395-G allele (A/G + G/G) was associated with risk in families with a strong history of BC (OR = 1.2 [95% CI 1.0–1.6] p = 0.02 and OR = 1.5 [95% CI 1.0–2.2] p = 0.02, respectively). Moreover, rs72758040-C was associated with increased risk in cases with a moderate-to-strong family history of BC (OR = 1.3 [95% CI 1.0–1.7] p = 0.02 and OR = 1.3 [95% CI 1.0–1.8] p = 0.03 respectively). Finally, risk was significantly higher in homozygous C/C cases from families with a moderate-to-strong BC history (OR = 1.8 [95% CI 1.0–3.1] p = 0.03 and OR = 1.9 [95% CI 1.1–3.4] p = 0.01, respectively). We also evaluated the combined impact of rs12366395-G and rs72758040-C. Familial BC risk increased in a dose-dependent manner with risk allele count, reflecting an additive effect (p-trend = 0.0002).

Conclusions

Our study suggests that germline variants in driver genes TBX3 (rs12366395) and MAP3K1 (rs72758040) may influence BC risk in BRCA1/2-negative Chilean families. Moreover, the presence of rs12366395-G and rs72758040-C could increase BC risk in a Chilean population.
Renal health benefits of sustainable diets in Japan: a review
Authors: Nagai Kei , Kosaka Shiho , Kawate Yuka , Itsubo Norihiro
Published: May 2022

Global warming may reduce food production and force people to adopt dietary habits of inadequate quantity or quality. Such dietary habits could trigger chronic kidney disease through inappropriate nutrition or lifestyle diseases. Livestock farming and other types of food production are responsible for many greenhouse gases. These problems are being emphasized as a diet-environment-health trilemma to be addressed on a global scale, with various methods being proposed toward its resolution. Diets like plant-based and low-protein diets not only potentially prevent the progression of chronic kidney disease, but are also rational from an environmental preservation perspective. Evidence from Japan on resolutions for this trilemma is sparse, but one concrete proposal is the use of traditional Japanese diets like washoku, the Okinawa diet, and the traditional Buddhist diet. However, traditional Japanese diets also have several problems, such as excessive salt content and caloric deficiencies, and need to be modified and incorporated into the current lifestyle. The progression of chronic kidney disease needs to be prevented with appropriate dietary treatment and environmental friendly manner.
Causes and treatments of nasal obstruction in children and adolescents: a systematic literature review
Authors: Tanveer Muhammad Saad , Javed Mamoona , Tanveer Muhammad Hassan
Published: May 2022

Objective

To identify the causes and treatments of nasal obstruction in the paediatric population.

Methods

A systematic search of Medline and Embase was conducted to identify the relevant articles. A detailed inclusion and exclusion criterion was developed and implemented to screen the abstracts. Full texts of the selected studies were then assessed to establish their inclusion or exclusion in our review. All relevant data were extracted, and the results were summarised narratively.

Results

Fifty-nine studies met out inclusion-exclusion criteria and were included in this systematic review. All of these primary research studies were categorised into causes and treatments. Cleft lip and palate was the most reported cause of nasal obstruction among congenital causes. However, among the acquired causes, allergic rhinitis was the most reported. Twenty-one of 39 studies described treatments for allergic rhinitis, including perennial rhinitis, 9 for adenoid hypertrophy, 2 for the common cold, 5 for septal deviation, and 2 for chronic rhinosinusitis.

Conclusion

This systematic review provides good evidence regarding the causes and treatments of nasal obstruction. Allergic rhinitis is the most common cause of acquired nasal obstruction, and cetirizine, fexofenadine, fluticasone furoate nasal spray, and mometasone furoate monohydrate nasal are the commonly used treatments to alleviate the symptoms.
Electrically evoked auditory brainstem response in cochlear implantation: what you need to know (short review)
Authors: Nada Nashwa , Kolkaila Enaas , Schendzielorz Philipp , El Mahallawi Trandil
Published: May 2022

Background

Electrically evoked auditory brainstem response (E-ABR) is an evoked potential recorded from the auditory nerve in response to electric stimulation. It is considered a short latency evoked potential. It plays a vital role, especially after the increased number of cochlear implant receivers.

Body of abstract

E-ABR is characterized by three positive peaks (eII, eIII, and eV) generated from the auditory nerve, cochlear nucleus, and perhaps from neurons in the lateral lemniscus or inferior colliculus. The largest is corresponding to wave V of the acoustic one. There are differences between both acoustic auditory brainstem response (A-ABR) and E-ABR. E-ABR is characterized by larger amplitudes and shorter latencies than the acoustic, and it has a steeper latency-intensity function. There are many variables affecting the E-ABR waveform, including recording-related variables, stimulus-related variables, and subject-related variables. E-ABR has potential clinical applications in cochlear implants (pre, inter, and postoperative).

Conclusion

After the increase in the number of cochlear implant receivers, E-ABR provides a promising new tool that can be used to evaluate auditory nerve functions. A lot of factors affect its waveform, including recording-related factors and stimulus-related and subject-related variables. E-ABR has many clinical applications, not only in post-implantation situations but also in preimplantation.
HIV and FIV glycoproteins increase cellular tau pathology via cGMP-dependent kinase II activation
Authors: Sathler Matheus F. , Doolittle Michael J. , Cockrell James A. , Nadalin India R. , Hofmann Franz , VandeWoude Sue , Kim Seonil
Published: May 2022

As the development of combination antiretroviral therapy (cART) against human immunodeficiency virus (HIV) drastically improves the lifespan of individuals with HIV, many are now entering the prime age when Alzheimer's disease (AD)-like symptoms begin to manifest. It has been shown that hyperphosphorylated tau, a known AD pathological characteristic, is prematurely increased in the brains of HIV-infected individuals as early as in their 30s and that its levels increase with age. This suggests that HIV infection might lead to accelerated AD phenotypes. However, whether HIV infection causes AD to develop more quickly in the brain is not yet fully determined. Interestingly, we have previously revealed that the viral glycoproteins HIV gp120 and feline immunodeficiency virus (FIV) gp95 induce neuronal hyperexcitation via cGMP-dependent kinase II (cGKII; also known as PRKG2) activation in cultured hippocampal neurons. Here, we use cultured mouse cortical neurons to demonstrate that the presence of HIV gp120 and FIV gp95 are sufficient to increase cellular tau pathology, including intracellular tau hyperphosphorylation and tau release to the extracellular space. We further reveal that viral glycoprotein-induced cellular tau pathology requires cGKII activation. Taken together, HIV infection likely accelerates AD-related tau pathology via cGKII activation.
Impact of water vapour on polymer classification using in situ short-wave infrared hyperspectral imaging
Authors: Shaikh Muhammad , Thörnberg Benny
Published: May 2022

Hyperspectral remote sensing is known to suffer from wavelength bands blocked by atmospheric gases. Short-wave infrared hyperspectral imaging at in situ installations is shown to be affected by water vapour even if the pathlength of light through air is only hundreds of centimetres. This impact is especially noticeable with large variations of relative humidity, the coefficient of variation reaching 5 % in our test case. Using repeated calibrations of imaging system at the same relative humidity as in the measurement, we were able to reduce the coefficient of variation to 1 %. The measurement variations are also shown to induce significant error in material classification. Polymer type identification was selected as the test case for material classification. The measurement variations due to the change in relative humidity are shown to result in 20 % classification error at its minimum. With repeated calibrations or by eliminating the
most affected wavelength bands from measurements, we were able to reduce the classification error to less than 1 %.
Such improvement of measurement and classification precision may be important for industrial applications such as waste
sorting, polymer classification etc.
The Welfare Effects of Peer Entry: The Case of Airbnb and the Accommodation Industry
Authors: Farronato Chiara , Fradkin Andrey
Published: May 2022

We study the welfare effects of enabling peer supply through Airbnb in the accommodation industry. We present a model of competition between flexible and dedicated sellers (peer hosts and hotels) who provide differentiated products. We estimate this model using data from major US cities and quantify the welfare effects of Airbnb on travelers, hosts, and hotels. The welfare gains are concentrated in specific locations (New York) and times (New Year’s Eve) when hotel capacity is constrained. This occurs because peer hosts are responsive to market conditions, expand supply as hotels fill up, and keep hotel prices down as a result. (JEL L11, L83, L86, L88, Z31)
Concentration Thresholds for Horizontal Mergers
Authors: Nocke Volker , Whinston Michael D.
Published: May 2022

Concentration-based thresholds for horizontal mergers, such as those in the US Horizontal Merger Guidelines, play a central role in merger analysis but their basis remains unclear. We show that there is both a theoretical and an empirical basis for focusing solely on the change in concentration, and ignoring its level, in screening mergers for whether their unilateral price effects will harm consumers. We also argue that current threshold levels likely are too lax, unless one expects efficiency gains of 5 percent or greater, or other factors such as entry and product repositioning to significantly constrain the exercise of market power postmerger. (JEL D43, G34, G38, K21, L13, L41)
Missing class increases the daily frequency of screen use among schoolchildren
Authors: Jesus Gilmar Mercês de , Araujo Raphael Henrique de Oliveira , Dias Lizziane Andrade , Barros Anna Karolina Cerqueira , Araujo Lara Daniele Matos dos Santos , Assis Maria Alice Altenburg de
Published: May 2022

We analyzed the association between school attendance and the daily frequency of use of different forms of screens (TV, computer, cell phone and videogame) among children and adolescents. Longitudinal study with four repeated measures during the 2015 school year. Children and adolescents from a public school participated in the study (n = 463, 53.6% boys; 9.3 ± 1.3 years old). The daily frequency of screen use was the outcome analyzed, which was reported on an online questionnaire for the previous-day recall, illustrated with 32 icons of activities including 4 types of electronic devices. The participant answered “What did you do yesterday?” in the morning, afternoon, and night. School attendance was assessed by responding to the item “Did you go to school yesterday?”. The analysis was conducted using generalized estimation equations, with adjustment by sex, age, BMI z-scores, and season of the year. The average percentage of absences during the follow-up was 28.7%. The use of screens was 13% higher among students who missed class. Playing a video game was 37% higher among students who missed class. The daily frequency of screen use was 26% higher among adolescents (10-12 years) compared to children (7-9 years), especially in the analysis performed individually for TV and cell phone. The daily frequency of screen use and watching TV among students who missed classes during the winter was, respectively, 24% (IRR = 1.24; 95%CI = 1.11 - 1.39) and 35% (IRR = 1.35; 95%CI = 1.10 - 1.66) higher compared to those who missed classes during the fall. In conclusion, the use of screens predominated among students who missed class, mainly in winter.
Algorithmic Assortative Matching on a Digital Social Medium
Authors: López Vargas Kristian , Runge Julian , Zhang Ruizhi
Published: May 2022

Online algorithms recommend “people we may know” and “content we may like.” Inherent in these recommendations is a notion of positive assortativity in which the people and content being suggested to us match our own preferences and beliefs. In this paper, we focus on such tacit (i.e., behind the scenes) algorithmic facilitation of assortativity at work across digital platforms and social media. To investigate the effects that it has on human online relating and behavior, we conduct a large-scale field experiment in a mobile social game in which we switch algorithmic assortative matching between new users and existing communities on and off over the course of six weeks. With the help of model-based analysis, we find such assortative matching to increase firm profits (measured as user engagement and monetization) via increased sociality (measured as user messaging). Results further show that such behind-the-scenes algorithmic matching leads to a segregating path between engaged and marginal online communities, further marginalizing less engaged and connected users. Our findings, hence, pinpoint a conflict between profit-centered and societally equitable management of online platforms and are important toward more algorithmic transparency and fairness as online algorithms structure ever larger parts of human life.
Incidence and quality of care for open fractures in England between 2008 and 2019
Authors: Shah Anjali , Judge Andrew , Griffin Xavier L.
Published: May 2022

Aims

This study estimated trends in incidence of open fractures and the adherence to clinical standards for open fracture care in England.

Methods

Longitudinal data collected by the Trauma Audit and Research Network were used to identify 38,347 patients with open fractures, and a subgroup of 12,170 with severe open fractures of the tibia, between 2008 and 2019 in England. Incidence rates per 100,000 person-years and 95% confidence intervals were calculated. Clinical care was compared with the British Orthopaedic Association Standards for Trauma and National Major Trauma Centre audit standards.

Results

In total, 60% of all open fractures occurred in males; the median age was 48 years (interquartile range (IQR) 29 to 68). Between 2012 and 2019, the overall incidence in England was 6.94 per 100,000 person-years. In males, the highest incidence observed was in those aged 20 to 29 years (11.50 per 100,000 person-years); in females, incidence increased with age, peaking at 32.11/100,000 person-years at 90 years of age and over. Among those with severe open fractures of the tibia, there was a bimodal distribution in males, peaking at 20 to 29 years (3.71/100,000 person-years) and greater than 90 years of age (2.84/100,000 person-years) respectively; among females, incidence increased with age to a peak of 9.91/100,000 person years at 90 years of age and over. There has been variable improvement with time in the clinical care standards for patients with severe open fractures of the tibia. The median time to debridement was 13.0 hours (IQR 6.4 to 20.9); almost two-thirds of patients underwent definitive soft-tissue coverage within 72 hours from 2016 to 2019.

Conclusion

This is the first time the incidence of all open fractures has been studied using data from a national audit in England. While most open fractures occurred in young males, the incidence increased with age in females to a much greater level than observed in older males. The degree of missing data in the national audit is startling, and limits the certainty of inferences drawn concerning open fracture care. Cite this article: Bone Joint J 2022;104-B(6):736–746.
Perioperative myocardial injury and mortality after revision surgery for orthopaedic device-related infection
Authors: Kvarda Peter , Puelacher Christian , Clauss Martin , Kuehl Richard , Gerhard Hatice , Mueller Christian , Morgenstern Mario ,   on behalf of the BASEL-PMI-Ortho Research Group
Published: May 2022

Aims

Periprosthetic joint infections (PJIs) and fracture-related infections (FRIs) are associated with a significant risk of adverse events. However, there is a paucity of data on cardiac complications following revision surgery for PJI and FRI and how they impact overall mortality. Therefore, this study aimed to investigate the risk of perioperative myocardial injury (PMI) and mortality in this patient cohort.

Methods

We prospectively included consecutive patients at high cardiovascular risk (defined as age ≥ 45 years with pre-existing coronary, peripheral, or cerebrovascular artery disease, or any patient aged ≥ 65 years, plus a postoperative hospital stay of > 24 hours) undergoing septic or aseptic major orthopaedic surgery between July 2014 and October 2016. All patients received a systematic screening to reliably detect PMI, using serial measurements of high-sensitivity cardiac troponin T. All-cause mortality was assessed at one year. Multivariable logistic regression models were applied to compare incidence of PMI and mortality between patients undergoing septic revision surgery for PJI or FRI, and patients receiving aseptic major bone and joint surgery.

Results

In total, 911 consecutive patients were included. The overall perioperative myocardial injury (PMI) rate was 15.4% (n = 140). Septic revision surgery for PJI was associated with a significantly higher PMI rate (43.8% (14/32) vs 14.5% (57/393); p = 0.001) and one-year mortality rate (18.6% (6/32) vs 7.4% (29/393); p = 0.038) compared to aseptic revision or primary arthroplasty. The association with PMI persisted in multivariable analysis with an adjusted odds ratio (aOR) of 4.7 (95% confidence interval (CI) 2.1 to 10.7; p < 0.001), but was not statistically significant for one-year mortality (aOR 1.9 (95% CI 0.7 to 5.4; p = 0.240). PMI rate (15.2% (5/33) vs 14.1% (64/453)) and one-year mortality (15.2% (5/33) vs 9.1% (41/453)) after FRI revision surgery were comparable to aseptic long-bone fracture surgery.

Conclusion

Patients undergoing revision surgery for PJI were at a risk of PMI and death compared to those undergoing aseptic arthroplasty surgery. Screening for PMI and treatment in specialized multidisciplinary units should be considered in major bone and joint infections. Cite this article: Bone Joint J 2022;104-B(6):696–702.
No correlation identified between the proportional size of a prolapsed intravertebral disc with disability or leg pain
Authors: Dunsmuir Robert A. , Nisar Sohail , Cruickshank James A. , Loughenbury Peter R.
Published: May 2022

Aims

The aim of the study was to determine if there was a direct correlation between the pain and disability experienced by patients and size of their disc prolapse, measured by the disc’s cross-sectional area on T2 axial MRI scans.

Methods

Patients were asked to prospectively complete visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores on the day of their MRI scan. All patients with primary disc herniation were included. Exclusion criteria included recurrent disc herniation, cauda equina syndrome, or any other associated spinal pathology. T2 weighted MRI scans were reviewed on picture archiving and communications software. The T2 axial image showing the disc protrusion with the largest cross sectional area was used for measurements. The area of the disc and canal were measured at this level. The size of the disc was measured as a percentage of the cross-sectional area of the spinal canal on the chosen image. The VAS leg pain and ODI scores were each correlated with the size of the disc using the Pearson correlation coefficient (PCC). Intraobserver reliability for MRI measurement was assessed using the interclass correlation coefficient (ICC). We assessed if the position of the disc prolapse (central, lateral recess, or foraminal) altered the symptoms described by the patient. The VAS and ODI scores from central and lateral recess disc prolapses were compared.

Results

A total of 56 patients (mean age 41.1 years (22.8 to 70.3)) were included. A high degree of intraobserver reliability was observed for MRI measurement: single measure ICC was 0.99 (95% confidence interval (CI) from 0.97 to 0.99 (p < 0.001)). The PCC comparing VAS leg scores with canal occupancy for herniated disc was 0.056. The PCC comparing ODI for herniated disc was 0.070. We found 13 disc prolapses centrally and 43 lateral recess prolapses. There were no foraminal prolapses in this group. The position of the prolapse was not found to be related to the mean VAS score or ODI experienced by the patients (VAS, p = 0.251; ODI, p = 0.093).

Conclusion

The results of the statistical analysis show that there is no direct correlation between the size or position of the disc prolapse and a patient’s symptoms. The symptoms experienced by patients should be the primary concern in deciding to perform discectomy. Cite this article: Bone Joint J 2022;104-B(6):715–720.
Developing a minimum common dataset for hip fracture audit to help countries set up national audits that can support international comparisons
Authors: Johansen Antony , Ojeda-Thies Cristina , Poacher Arwel T. , Hall Andrew J. , Brent Louise , Ahern Emer C. , Costa Matt L. ,   on behalf of the Global Fragility Fracture Network Hip Fracture Audit Special Interest Group
Published: May 2022

Aims

The aim of this study was to explore current use of the Global Fragility Fracture Network (FFN) Minimum Common Dataset (MCD) within established national hip fracture registries, and to propose a revised MCD to enable international benchmarking for hip fracture care.

Methods

We compared all ten established national hip fracture registries: England, Wales, and Northern Ireland; Scotland; Australia and New Zealand; Republic of Ireland; Germany; the Netherlands; Sweden; Norway; Denmark; and Spain. We tabulated all questions included in each registry, and cross-referenced them against the 32 questions of the MCD dataset. Having identified those questions consistently used in the majority of national audits, and which additional fields were used less commonly, we then used consensus methods to establish a revised MCD.

Results

A total of 215 unique questions were used across the ten registries. Only 72 (34%) were used in more than one national audit, and only 32 (15%) by more than half of audits. Only one registry used all 32 questions from the 2014 MCD, and five questions were only collected by a single registry. Only 21 of the 32 questions in the MCD were used in the majority of national audits. Only three fields (anaesthetic grade, operation, and date/time of surgery) were used by all ten established audits. We presented these findings at the Asia-Pacific FFN meeting, and used an online questionnaire to capture feedback from expert clinicians from different countries. A draft revision of the MCD was then presented to all 95 nations represented at the Global FFN conference in September 2021, with online feedback again used to finalize the revised MCD.

Conclusion

The revised MCD will help aspirant nations establish new registry programmes, facilitate the integration of novel analytic techniques and greater multinational collaboration, and serve as an internationally-accepted standard for monitoring and improving hip fracture services. Cite this article: Bone Joint J 2022;104-B(6):721–728.
Implementation of Transfer Learning for Covid-19 and Pneumonia Disease Detection Through Chest X-Rays Based on Web
Authors: Apsari Nindya Eka , Sugiyanto Sugiyanto , Handajani Sri Sulistijowati
Published: May 2022

Coronavirus disease 2019, known as COVID-19, attacks the human respiratory system caused by severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2). COVID-19 disease and pneumonia show similar symptoms such as fever, cough, even headache. Diagnosis of pneumonia can be tested through diagnostic tests, including blood tests, chest X-rays, and pulse oximetry, while the diagnosis of COVID-19 recommended by WHO is with swab test (RT-PCR). But in fact, the swab test method takes a relatively long time, for about one to seven days, for the result, and is not cheap. For that, there needs to be a development that can be one of the options in diagnosing COVID-19 and pneumonia at once, especially since both diseases have similar symptoms. One option that can be done is the diagnosis using a chest X-ray. This research aims to detect COVID-19 disease and pneumonia through chest X-rays using transfer learning to increase the accuracy of disease diagnosis with a more efficient time. The architecture used is EfficientNet B0 with variations in optimization parameters, learning rates, and epochs. EfficientNet B0 Adam optimization with a learning rate of 0.001 in the 6th epochs is a great model that we obtained. Furthermore, the evaluation of the model got accuracy, precision, recall, and f1-score of 92%. Then the model visualization is done using Grad-CAM. To implement the best model, web application development is done to make it easier to detect COVID-19 disease and pneumonia.

Keywords: COVID-19; pneumonia; EfficientNet; transfer learning; web
Scrotal centesis: a broader role beyond the confines of the scrotum
Authors: Jagwani AV , Mugialan P , Lee CKS , Fairuz M , Lee FY , Yusof MR , Mohd Ghani KA
Published: May 2022

An elderly man was treated for severe acute scrotum pain with centesis. We report the diagnosis, underlying causes and management, and discuss the procedure. Centesis is performed rarely, but could be undertaken more often given the added benefits.
Examining the barriers faced by female surgical trainees: a qualitative study
Authors: Morgan JL , Manning K , Wyld L
Published: May 2022

Introduction

Today, women make up 56% of medical students, yet just 13% of surgical consultants – a number that has remained static since 2013. This qualitative study explored some of the barriers to female success in modern surgery.

Methods

Semistructured qualitative interviews were undertaken primarily with female surgical trainees to determine the barriers they face. Male trainees and training programme directors (TPDs) were also interviewed for triangulation.

Results

20 interviews were performed (16 female trainees, 3 male trainees, and 1 TPD) between October 2019 and March 2020. Family pressures and becoming a mother were significant barriers for women training in surgery – a barrier that did not apply to male trainees who were fathers, often resulting in women choosing to train less than full time (LTFT). Unfortunately LTFT training presents further obstacles for female trainees. The set-up of the national training programme in surgery provides many non-gender-specific barriers, chiefly moving hospital every 6 months causing disrupted training and long commutes, disproportionately affecting females with child care responsibilities. Sexism and discrimination are still common, both from colleagues and patients. Many participants perceived inherent differences between genders in communication and methods for coping with stress.

Conclusion

Greater gender equality in surgery may be achieved by changes in the structure and organisation of training to reduce the tension between the professional role and the predominantly female-led role of raising children. Better equality and diversity training and awareness at all levels in surgery may help to mitigate some of the conscious and unconscious bias that still exists.
Evaluation of the quality of information online for arthroscopic Bankart repair
Authors: Shazil Jamal M , Hurley ET , Davey MS , Asad H , Gaafar M , Mullett H
Published: May 2022

Purpose

The purpose of this study was to evaluate the quality and readability of information online for patients searching terms related to arthroscopic Bankart repair (ABR).

Methods

Google, Yahoo and Bing were searched with terms related to ABR. The quality of information was assessed using the Journal of the American Medical Association (JAMA) Benchmark criteria, DISCERN Score, and the Flesch–Kincaid Reading Ease & Grade Level. The presence of the HONcode marker was noted. Additionally, we used a scoring system specific to content relating to the ABR (AB score), a 1–20 Likert scale. Websites were also categorised according to the source: academic institution, physician, allied healthcare, commercial, media or social media. Statistical analysis was performed using GraphPad Prism.

Results

Ninety-six unique websites were evaluated, with the most common website category being physician websites (52) and academic institution websites (24). There were nine websites with the HONcode marker. The average JAMA Benchmark criteria score was 1.95 (1–4), the average DISCERN score was 48.8 (20–78), with an average Flesch–Kincaid reading ease of 50.9 (11–96) and grade level of 8 (1–18). The average AB score was 5.9 (0–18), and there was a strong correlation with a higher DISCERN score (r=0.57), but not JAMA score (r=0.18) or Flesch–Kincaid grade (r=0.16). Websites with the HONcode marker did not score higher in any criteria than those without it (p>0.05). The quality of information on physician websites was better than (statistically insignificant) non-physician websites; however, the readability of information in the former was poorer (statistically significant) than the latter.

Conclusion

There was wide variability in the quality and readability online of the information on ABR, and the AB scoring system was shown to correlate strongly with increased quality.
Patient-reported outcome measures show FIT as an acceptable investigation to rule out colorectal cancer in the two-week wait cohort
Authors: Maclean W , Whyte MB , Farkas N , Benton SC , Rockall T , Jourdan I
Published: May 2022

Introduction

Use of faecal immunochemical testing (FIT) for symptomatic patients is increasing. FIT is recommended as a triage tool from primary care to the two-week wait (TWW) suspected cancer pathway, but there is still little known about patient attitudes.

Aim

The aim of this study was to explore patient opinions of FIT and how it might be applied in the TWW pathway.

Methods

A telephone survey was conducted for patients from the TWW pathway who had undergone both conventional colonic investigation and FIT. Five questions explored expectations, attitudes towards results and experience of the investigations using a Likert scale 1–5. Differences in opinion were compared using median and mode scores and visualised using bar charts.

Results

One hundred and nine TWW patients agreed to answer the five questions. All had taken a stool sample for FIT, 50 underwent colonoscopy, 51 had a CT colonography and 8 underwent flexible sigmoidoscopy. Most patients (85%) scored 5 (completely satisfied) with these conventional colonic investigation methods they underwent for ruling out colorectal cancer (median 5). However, 30% of patients scored 5 (completely satisfied) if using a negative FIT to not require additional colonic investigation. The median score to perform FIT was 5 (very easy) compared with a median of 4 (easy) to undergo the other colonic investigations.

Conclusions

Symptomatic patients can perform FIT with little difficulty, and often would have been happy to avoid conventional colonic investigations with a negative result. However, shared decision-making should be employed to identify those who would be dissatisfied with relying on FIT for further investigation decisions.
Drowning in antibiotics
Authors: Gelder CL , Robinson S , Leitch F , McMahon AJ
Published: May 2022

Introduction

The National Confidential Enquiry into Perioperative Deaths (NCEPOD) report recommended that ‘fluid prescribing be given the same value as drug prescribing’, yet fluid prescription is commonly delegated to junior doctors despite being a notoriously challenging topic. When antibiotics are given as an infusion they are diluted in 100ml of fluid, which is often unaccounted for when thinking about a patient’s fluid requirements. This closed-loop audit aimed to assess first, intravenous (IV) fluid therapy and second, electrolyte prescribing compliance with National Institute for Health and Care Excellence (NICE) guidelines, with and without the additional fluid given with antibiotic administration.

Methods

Two retrospective audits were performed. Total fluid and electrolyte volume received with and without antibiotic fluids was correlated with recommendations in the NICE guidelines. Between cycles 1 and 2, potassium chloride with sodium chloride and glucose (PSG) was introduced as an alternative to IV maintenance fluid, and bolusing of antibiotics was mandatory.

Results

When analysing total fluid volume input per day, 10.4% and 7.45% of patients met their fluid requirement accurately in the first and second cycles, respectively. Within cycle 1, the mean total additional fluid that was given over 3 days with antibiotics was 1,572.73ml. In cycle 2, this decreased to 469.44ml when antibiotics were given as a bolus.

Conclusions

In this closed-loop audit we noted that patients receiving IV fluids and IV antibiotics received too much additional fluid when the antibiotic dilution fluid was taken into account. Additional fluid was reduced alongside the proportion of electrolyte complications when bolusing of antibiotics was introduced. We recommend that that all nurses are trained to give antibiotics as a bolus because it can help to reduce fluid-related complications.
All dielectric metasurfaces for spin-dependent terahertz wavefront control
Authors: Wu Tong , Zhang Huifang , Kumaran Sivaloganathan , Xu Yuehong , Wang Qingwei , Michailow Wladislaw , Zhang Xueqian , Beere Harvey E. , Ritchie David A. , Han Jiaguang
Published: May 2022

Metasurfaces consisting of artificial subwavelength structure arrays have shown unprecedented ability to manipulate the phase, amplitude, and polarization of light. Separate and complete control over different spin states, namely the orthogonal circular polarizations, has proven more challenging as compared to the control over orthogonal linear polarizations. Here, we present and experimentally demonstrate several spin-dependent wavefront control metasurfaces in the terahertz regime using all-silicon dielectric structures. Such spin-dependent all-silicon metasurfaces are easy to fabricate and have potential applications in spin-involved ultracompact and miniaturized terahertz optical systems as well as terahertz communication systems.
Kritische Erfolgsfaktoren für ideales Arbeiten im Home-Office – eine empirische Analyse aus Arbeitgeber- und Arbeitnehmersicht
Authors: Jeske Maik , Schmidt Andreas , Gadatsch Andreas
Published: May 2022

Vor dem Hintergrund der Covid-19-Pandemie hat sich das Home-Office in Deutschland seit dem Jahr 2020 weit verbreitet und wird seitdem bei vielen Arbeitgebern als neue Arbeitsmethode genutzt. Der Einsatz von Home-Office kann verschiedene positive als auch negative Effekte auf die Beschäftigten und den Arbeitgeber sowie die Gesellschaft allgemein haben. Damit von möglichst vielen positiven Effekten profitiert werden kann, ist ein gutes Home-Office Konzept erforderlich. Welche Anforderungen an ein solches Konzept bestehen und welche Voraussetzungen grundlegend mit der Nutzung von Home-Office verbunden sind, wird in dem Beitrag aufgezeigt. Dabei werden von technischen bis hin zu sozialen Aspekten Anforderungen verschiedener Arten berücksichtigt, welche durch eine durch den Autor durchgeführte Studie gebildet worden sind. Im Fokus dieses Beitrages sollen die kritischen Erfolgsfaktoren für das ideale Arbeiten im Home-Office stehen, also die Anforderungen, welche ausschlaggebend für die erfolgreiche Umsetzung eines Home-Office Konzeptes sind und Einfluss auf die wahrgenommenen Effekte des Home-Office haben. Die im Beitrag aufgeführte Studie des Autors wurde im Rahmen der Abschlussarbeit von Herrn Jeske durchgeführt, auf welcher der Beitrag basiert.
Association of pneumococcal carriage in infants with the risk of carriage among their contacts in Nha Trang, Vietnam: A nested cross-sectional survey
Authors: Qian George , Toizumi Michiko , Clifford Sam , Le Lien Thuy , Papastylianou Tasos , Satzke Catherine , Quilty Billy , Iwasaki Chihiro , Kitamura Noriko , Takegata Mizuki , Bui Minh Xuan , Nguyen Hien Anh Thi , Dang Duc Anh , van Hoek Albert Jan , Yoshida Lay Myint , Flasche Stefan
Published: May 2022

Background

Infants are at highest risk of pneumococcal disease. Their added protection through herd effects is a key part in the considerations on optimal pneumococcal vaccination strategies. Yet, little is currently known about the main transmission pathways to this vulnerable age group. Hence, this study investigates pneumococcal transmission routes to infants in the coastal city of Nha Trang, Vietnam.

Methods and findings

In October 2018, we conducted a nested cross-sectional contact and pneumococcal carriage survey in randomly selected 4- to 11-month-old infants across all 27 communes of Nha Trang. Bayesian logistic regression models were used to estimate age specific carriage prevalence in the population, a proxy for the probability that a contact of a given age could lead to pneumococcal exposure for the infant. We used another Bayesian logistic regression model to estimate the correlation between infant carriage and the probability that at least one of their reported contacts carried pneumococci, controlling for age and locality. In total, 1,583 infants between 4 and 13 months old participated, with 7,428 contacts reported. Few infants (5%, or 86 infants) attended day care, and carriage prevalence was 22% (353 infants). Most infants (61%, or 966 infants) had less than a 25% probability to have had close contact with a pneumococcal carrier on the surveyed day. Pneumococcal infection risk and contact behaviour were highly correlated: If adjusted for age and locality, the odds of an infant’s carriage increased by 22% (95% confidence interval (CI): 15 to 29) per 10 percentage points increase in the probability to have had close contact with at least 1 pneumococcal carrier. Moreover, 2- to 6-year-old children contributed 51% (95% CI: 39 to 63) to the total direct pneumococcal exposure risks to infants in this setting. The main limitation of this study is that exposure risk was assessed indirectly by the age-dependent propensity for carriage of a contact and not by assessing carriage of such contacts directly.

Conclusions

In this study, we observed that cross-sectional contact and infection studies could help identify pneumococcal transmission routes and that preschool-age children may be the largest reservoir for pneumococcal transmission to infants in Nha Trang, Vietnam.
Maternal diabetes independent of BMI is associated with altered accretion of adipose tissue in large for gestational age fetuses
Authors: Lam Penny , Mein Brendan J. , Benzie Ronald J. , Ormerod John T. , Robledo Kristy P. , Hibbert Emily J. , Nanan Ralph K.
Published: May 2022

Aim

To analyse the effects of maternal diabetes mellitus (DM) and body mass Index (BMI) on central and peripheral fat accretion of large for gestational age (LGA) offspring.

Methods

This retrospective study included LGA fetuses (n = 595) with ultrasound scans at early (19.23 ± 0.68 weeks), mid (28.98 ± 1.62 weeks) and late (36.20 ± 1.59 weeks) stages of adipogenesis and measured abdominal (AFT) and mid-thigh (TFT) fat as surrogates for central and peripheral adiposity. Women were categorised according to BMI and DM status [pre-gestational (P-DM; n = 59), insulin managed (I-GDM; n = 132) and diet managed gestational diabetes (D-GDM; n = 29)]. Analysis of variance and linear regressions were applied.

Results

AFT and TFT did not differ significantly between BMI categories (normal, overweight and obese). In contrast, AFT was significantly higher in pregnancies affected by D-GDM compared to non-DM pregnancies from mid stage (0.44 mm difference, p = 0.002) and for all DM categories in late stage of adipogenesis (≥ 0.49 mm difference, p < 0.008). Late stage TFT accretion was higher than controls for P-DM and I-GDM but not for D-GDM (0.67 mm difference, p < 0.001; 0.49 mm difference, p = 0.001, 0.56 mm difference, p = 0.22 respectively). In comparison to the early non-DM group with an AFT to TFT ratio of 1.07, the I-GDM group ratio was 1.25 (p < 0.001), which normalised by 28 weeks becoming similar to control ratios.

Conclusions

DM, independent of BMI, was associated with higher abdominal and mid-thigh fat accretion in fetuses. Use of insulin improved central to peripheral fat ratios in fetuses of GDM mothers.
The road to change: Broadband China strategy and enterprise digitization
Authors: Wang Chao , Zhang Man
Published: May 2022

The digitization of a company necessitates not only the effort of the company but also state backing of network infrastructure. In this study, we applied the difference-in-differences method to examine the impact of the Broadband China Strategy on corporate digitalization and its heterogeneity using the data from Chinese listed firms from 2010 to 2020. The results show that the improvement in network infrastructure plays a vital role in promoting company digitization; this improvement is extremely varied due to variances in market demand and endowments. Non-state-owned firms, businesses in the eastern area, and technology-intensive businesses have profited the most. Among the five types of digitization, artificial intelligence and cloud computing are top priorities for enterprises. Our findings add to the literature on the spillover effects of broadband construction and the factors affecting enterprise digitalization.
Transgene expression of Stanniocalcin-1 provides sustained intraocular pressure reduction by increasing outflow facility
Authors: Roddy Gavin W. , Roy Chowdhury Uttio , Anderson Kjersten J. , Rinkoski Tommy A. , Hann Cheryl R. , Chiodo Vince A. , Smith W. Clay , Fautsch Michael P.
Published: May 2022

Glaucoma is the leading cause of irreversible blindness worldwide. Therapies for glaucoma are directed toward reducing intraocular pressure (IOP), the leading risk factor and only reliable therapeutic target via topical medications or with procedural intervention including laser or surgery. Though topical therapeutics are typically first line, less than 50% of patients take drops as prescribed. Sustained release technologies that decrease IOP for extended periods of time are being examined for clinical use. We recently identified Stanniocalcin-1, a naturally occurring hormone, as an IOP-lowering agent. Here, we show that a single injection into the anterior chamber of mice with an adeno-associated viral vector containing the transgene of stanniocalcin-1 results in diffuse and sustained expression of the protein and produces IOP reduction for up to 6 months. As the treatment effect begins to wane, IOP-lowering can be rescued with a repeat injection. Aqueous humor dynamic studies revealed an increase in outflow facility as the mechanism of action. This first-in-class therapeutic approach has the potential to improve care and reduce the rates of vision loss in the 80 million people worldwide currently affected by glaucoma.
Nuevas miradas para ver el cine español
Authors: Durán Manso Valeriano
Published: May 2022

Reseña del libro 'Resistencias y disidencias en el cine español: el compromiso con la realidad’, de Ernesto Pérez Morán y José Luis Sánchez Noriega (eds.), editado por Ediciones Complutense. 2021. 234 palabras.
Comparative diagnosis of bovine tuberculosis using single intradermal cervical tuberculin technique, conventional methods, enzyme-linked immunosorbent assay, and the gamma-interferon assay
Authors: Hekal Sahar Hussein Abdalla , Dapgh Amany N. , Abd-Elhafeez Mai Badr-Eldien , Sobhy Hassan Mohamed , Khalifa Fatma Ahmed
Published: May 2022

Background and Aim: Bovine tuberculosis (TB) is a zoonotic disease that causes huge economic losses. This study aimed to compare the result obtained from the single intradermal test, conventional methods (culture and microscopy), gamma-interferon (IFN-γ) assay, and indirect enzyme-linked immunosorbent assay (ELISA) to diagnose bovine TB.

Materials and Methods: This study evaluated 2913 animals from milk farms in Cairo, El-Sharkia, and El-Qalyubia Governorates by single intradermal cervical tuberculin technique (SICTT), ELISA, and IFN-γ assay.

Results: Of the 2913 dairy cows surveyed, 3.7% yielded positive results. Culture prepared samples on Lowenstein-Jensen and Middlebrook 7H10 agar media yielded 52 (1.85%) isolates of Mycobacterium spp. from 2805 milk samples that yielded negative tuberculin reactions and 56 (51.85%) isolates of Mycobacterium spp. were recovered from 108 lymph node samples from positive cases. ELISA analysis of the sera of 108 positive SICTT reactors revealed that 94 (87.03%) and 97 (89.81%) animals were positive for bovine purified protein derivative (PPD-B) antigen and commercial polypeptide antigen, respectively. IFN-γ assays were performed on whole blood samples collected from positive SICTT reactors and showed that 103 (95.37%) animals were positive.

Conclusion: M. tuberculosis complex may be isolated from raw milk and not all infected animals shed mycobacterial bacilli in their milk. The use of polypeptide antigen in ELISA provides better diagnostic efficacy than PPD-B antigen. The IFN-γ assay is more sensitive than both SICTT and ELISA. It should be used in parallel with SICTT to allow the detection of more positive animals before they become a source of infection to other animals and humans.