bluuebunny/crossref_metadata_2025 huggingface dataset:
Marked aggravation of pyrethroid resistance in major malaria vectors in Malawi between 2014 and 2021 is partly linked with increased expression of P450 alleles
Authors: Menze Benjamin D. , Tchouakui Magellan , Mugenzi Leon M. J. , Tchapga Williams , Tchoupo Micareme , Wondji Murielle J. , Chiumia Martin , Mzilahowa Themba , Wondji Charles S.
Published: July 2022

Background

Increased intensity of pyrethroid resistance is threatening the effectiveness of insecticide-based interventions to control malaria in Africa. Assessing the extent of this aggravation and its impact on the efficacy of these tools is vital to ensure the continued control of major vectors. Here we took advantage of 2009 and 2014 data from Malawi to establish the extent of the resistance escalation in 2021 and assessed its impact on various bed nets performance.

Methods

Indoor blood-fed and wild female Anopheles (An) mosquitoes were collected with an electric aspirator in Chikwawa. Cocktail and SINE PCR were used to identify sibling species belonging toAn. funestusgroup andAn. gambiaecomplex. The susceptibility profile to the four classes of insecticides was assessed using the WHO tubes bioassays. Data were saved in an Excel file. Analysis was done using Vassarstats and figures by Graph Pad.

Results

In this study, a high level of resistance was observed with pyrethroids (permethrin, deltamethrin and alpha-cypermethrin with mortality rate at 5x discriminating concentration (DC) < 50% and Mortality rate at 10x DC < 70%). A high level of resistance was also observed to carbamate (bendiocarb) with mortality rate at 5x DC < 25%). Aggravation of resistance was also noticed between 2009 and 2021. For pyrethroids, the mortality rate for permethrin reduced from 47.2% in 2009 to 13% in 2014 and 6.7% in 2021. For deltamethrin, the mortality rate reduced from 42.3% in 2009 to 1.75% in 2014 and 5.2% in 2021. For Bendiocarb, the mortality rate reduced from 60% in 2009 to 30.1% in 2014 and 12.2% in 2021. The high resistance observed is consistent with a drastic loss of pyrethroid-only bed nets efficacy although Piperonyl butoxide (PBO)-based nets remain effective. The resistance pattern observed was linked with high up-regulation of the P450 genesCYP6P9a, CYP6P9bandCYP6M7inAn. funestuss.s. mosquitoes surviving exposure to deltamethrin at 1x, 5x and 10x DC. A significant association was observed between the 6.5 kb structural variant and resistance escalation with homozygote resistant (SV+/SV+) more likely to survive exposure to 5x and 10x (OR = 4.1; P < 0.001) deltamethrin than heterozygotes. However, a significant proportion of mosquitoes survived the synergist assays with PBO suggesting that other mechanisms than P450s are present.

Conclusions

This resistance aggravation inAn. funestuss.s. Malawian population highlights an urgent need to deploy novel control tools not relying on pyrethroids to improve the effectiveness of vector control.
Detecting COVID-19 patients via MLES-Net deep learning models from X-Ray images
Authors: Wang Wei , Jiang Yongbin , Wang Xin , Zhang Peng , Li Ji
Published: July 2022

Background

Corona Virus Disease 2019 (COVID-19) first appeared in December 2019, and spread rapidly around the world. COVID-19 is a pneumonia caused by novel coronavirus infection in 2019. COVID-19 is highly infectious and transmissible. By 7 May 2021, the total number of cumulative number of deaths is 3,259,033. In order to diagnose the infected person in time to prevent the spread of the virus, the diagnosis method for COVID-19 is extremely important. To solve the above problems, this paper introduces a Multi-Level Enhanced Sensation module (MLES), and proposes a new convolutional neural network model, MLES-Net, based on this module.

Methods

Attention has the ability to automatically focus on the key points in various information, and Attention can realize parallelism, which can replace some recurrent neural networks to a certain extent and improve the efficiency of the model. We used the correlation between global and local features to generate the attention mask. First, the feature map was divided into multiple groups, and the initial attention mask was obtained by the dot product of each feature group and the feature after the global pooling. Then the attention masks were normalized. At the same time, there were two scaling and translating parameters in each group so that the normalize operation could be restored. Then, the final attention mask was obtained through the sigmoid function, and the feature of each location in the original feature group was scaled. Meanwhile, we use different classifiers on the network models with different network layers.

Results

The network uses three classifiers, FC module (fully connected layer), GAP module (global average pooling layer) and GAPFC module (global average pooling layer and fully connected layer), to improve recognition efficiency. GAPFC as a classifier can obtain the best comprehensive effect by comparing the number of parameters, the amount of calculation and the detection accuracy. The experimental results show that the MLES-Net56-GAPFC achieves the best overall accuracy rate (95.27%) and the best recognition rate for COVID-19 category (100%).

Conclusions

MLES-Net56-GAPFC has good classification ability for the characteristics of high similarity between categories of COVID-19 X-Ray images and low intra-category variability. Considering the factors such as accuracy rate, number of network model parameters and calculation amount, we believe that the MLES-Net56-GAPFC network model has better practicability.
Managing thrombosis of arteriovenous fistula accompanied by aneurysm and single outflow of elbow perforating vein: a case report
Authors: Wang Ziqiang , Hong Yifen , Wei Zefeng , Chen Juan , Li Li , Zhu Yongjun
Published: July 2022

Background

We report a case of a patient who suffered thrombosis of a radial artery-cephalic vein fistula accompanied by aneurysm and a single outflow path of the elbow perforating vein. We performed open surgery combined with Fogarty balloon catheter embolectomy, anastomotic reconstruction and forearm median vein transposition.

Case presentation

The patient presented with an arteriovenous fistula (AVF) after haemodialysis 5 years ago. In the process of dialysis, the fistula vein was punctured, resulting in aneurysm, high pressure and difficult haemostasis after needle extraction. AVF occlusion was observed on April 12, 2022. We performed a combined open surgery. First, a Fogarty balloon catheter was used to remove the thrombus, and the anastomosis was then reconstructed to restore AVF fistula patency. Finally, forearm median vein transposition was used to establish dual outflow. Postoperative haemodialysis was possible. There are various methods for removing the thrombus in AVF. Here, we report a case in which we performed open surgery combined with Fogarty balloon catheter embolectomy, anastomotic reconstruction and forearm median vein transposition to ensure fistula patency.

Conclusion

We removed a complete reverse ‘Z’-shaped thrombus of the elbow perforating vein in a haemodialysis fistula. This report provides an effective strategy to manage a high-pressure fistula with single outflow of the elbow perforating vein.
Cerebral venous sinus thrombosis in a patient with Klebsiella pneumoniae primary liver abscess: a case report
Authors: Zhou Lingyu , Wang Chao , Bian Jialan , Xu Siyuan , Yang Minjie , Chen Mingquan
Published: July 2022

Background

Liver abscess is a common emergency in the emergency department. However, cerebral venous sinus thrombosis (CVST) is a rare and serious cerebrovascular disease. Cases of CVST in patients with Klebsiella pneumoniae primary liver abscess (KLA) have not been described in the literature. We report a case of CVST in patients with KLA.

Case presentation

A 54-year-old male patient came to our department with a fever for 2 days and altered mental status for 1 day. Abdominal computed tomography (CT) and liver magnetic resonance imaging (MRI) revealed multiple liver abscesses. The blood culture was identified as Klebsiella pneumoniae sepsis. Head contrast-enhanced MRI and magnetic resonance venography (MRV) imaging showed multiple thrombus formation in the right transverse sinus and sigmoid sinus. The patient's infection and thrombosis were controlled within one week of multidisciplinary comprehensive treatment such as antibiotic and antithrombotic therapy, and a good clinical recovery during the 1-month follow-up.

Conclusion

CVST after liver abscess is rare, clinicians should be aware of this complication and vigilant for the possibility of bacterial meningitis. The underlying mechanisms need to be further studied.
Blockade of the amino acid transporter SLC6A14 suppresses tumor growth in colorectal Cancer
Authors: Lu Ying , Jiang Ziting , Wang Kaijing , Yu Shanshan , Hao Chongbo , Ma Zuan , Fu Xuelian , Qin Ming Qing , Xu Zengguang , Fan Lieying
Published: July 2022

Background

The amino acid transporter SLC6A14, which transports 18 of the 20 proteinogenic amino acids, is too low to be detected in healthy normal tissues but is significantly increased in some solid cancers. However, little is known about the roles of SLC6A14 in colorectal cancer (CRC).

Methods

The mRNA and protein levels of SLC6A14 were detected using TCGA database, real-time polymerase chain reaction, western blot, and tissue microarrays, respectively. Amino acids concentration was determined by LC-MS/MS. Cell proliferation and apoptosis were determined using MTT assay and flow cytometry. Transwell invasion assay and wound healing assay were employed to analyze cell migration and invasion. The protein levels of Akt-mTOR signaling pathway and MMPs proteins were detected by western blot.

Results

Both of the mRNA and protein levels of SLC6A14 were upregulated in CRC tissues, and the protein levels of SLC6A14 were closely related to the tumor cells differentiation: the higher the expression of SLC6A14 was, the poorer the differentiation of the tumor cells was. Further knockdown SLC6A14 with siRNA or treatment with α-MT in CRC cell lines reduced cell proliferation and migration in vitro and inhibited xenograft tumor growth in vivo. Mechanistically, SLC6A14 was demonstrated to regulate the expression and phosphorylation of Akt-mTOR, which mediates the promoting tumor growth function of SLC6A14. Blockade of SLC6A14 with α-MT inhibited the activation of mTOR signaling.

Conclusion

SLC6A14 was upregulated in CRC and could promote tumor progression by activating the Akt-mTOR signaling pathway, which may serve as an effective molecular target for the treatment of CRC.
Video-assisted thoracoscopic treatment as two-day surgery for lung neoplasms: a propensity-matched analysis
Authors: Zhang Guofei , Fan Junqiang , Yu Zipu , Chai Ying , Zhang Sai , Wu Ming , Shen Gang
Published: July 2022

Background

Enhanced recovery after surgery programs have reduced complications and shortened hospital stays after lung resection. This study aimed to determine whether video-assisted thoracoscopic surgery performed as a two-day surgery for lung neoplasms was safe and cost-effective.

Methods

This retrospective, propensity-matched, cohort analysis was conducted from January 2020 to August 2020. Among 959 patients who underwent video-assisted thoracoscopic surgery, 739 underwent inpatient surgery and 220 underwent two-day surgery. Propensity-matched analysis, incorporating preoperative variables, was used to compare postoperative complications, post-discharge follow-up results, and hospitalization costs between the groups.

Results

Propensity matching estimated 218 patients in each group. The mean length of hospital stay was shorter in the two-day surgery group (2.17 ± 0.89 days) than in the inpatient surgery group (6.31 ± 2.13 days) (P < 0.001). Delayed removal of chest tubes accounted for over half of the delayed discharges in the inpatient (17 [54.8%]) and two-day surgery (13 [65.0%]) groups. The postoperative pneumonia/atelectasis incidence was lower in the two-day surgery group than in the inpatient surgery group (P = 0.032). The two-day surgery group patients were readmitted to the hospital due to massive pleural effusion, pneumothorax, fever, severe chest pain, and physical weakness. The mean total hospitalization cost in the two-day surgery group was lower than that in the inpatient surgery group (¥ 33,926.1 versus ¥ 38,422.7, P < 0.001). Basic medical, nursing, drug, laboratory-related, and nonsurgical consumable costs in the two-day surgery group were significantly reduced.

Conclusions

Two-day surgery is a safe, feasible, and cost-effective procedure for selected patients with lung neoplasms when combined with accurate preoperative evaluations, successful intraoperative assessments, and effective postoperative health care guidance.
Conjunctival sac bacterial culture of patients using levofloxacin eye drops before cataract surgery: a real-world, retrospective study
Authors: Wang Zhenyu , Zhang Pei , Huang Chen , Guo Yining , Dong Xuhe , Li Xuemin
Published: July 2022

Background

The use of antibiotics preoperatively is effective to decrease the incidence of ocular bacterial infections but may lead to high resistance rate, especially on patients with multi-risk clinical factors. This study systematically analyzed real-world data (RWD) of patients to reveal the association between clinical factors and conjunctival sac bacterial load and offer prophylaxis suggestions.

Methods

We retrieved RWD of patients using levofloxacin eye drops (5 mL: 24.4 mg, 4 times a day for 3 days) preoperatively. Retrieved data included information on the conjunctival sac bacterial culture, sex, presence of hypertension and diabetes mellitus (DM), and history of hospital-based surgeries. Data was analyzed using SPSS 24.0.

Results

RWD of 15,415 cases (patients) were retrieved. Among these patients, 5,866 (38.1%) were males and 9,549 (61.9%) females. 5,960 (38.7%) patients had a history of hypertension, and 3,493 (22.7%) patients had a history of DM. 7,555 (49.0%) patients had a history of hospital-based operations. There were 274 (1.8%) positive bacterial cultures. Male patients with hypertension and DM may be at increased risk of having positive bacterial cultures (P < 0.05). Staphylococcus epidermidis (n = 56, 20.4%), Kocuria rosea (n = 37, 13.5%), and Micrococcus luteus (n = 32, 11.7%) were the top 3 isolated strains. Most bacterial strains were resistant to various antibiotics except rifampin, and 82.5% (33 of 40 isolates) of Staphylococcus epidermidis isolates had multidrug antibiotic resistance. Numbers of culture-positive Staphylococcus epidermidis isolates in the male group and non-DM group were greater than those in the female and DM groups, respectively. Micrococcus luteus (n = 11, 8.8%) was found less frequently in non-hypertension group than in hypertension group.

Conclusion

Sex (Male) and the presence of hypertension and DM are risk factors for greater conjunctival sac bacterial loads. We offer a prophylactic suggestion based on the combined use of levofloxacin and rifampin. However, this approach may aggravate risk of multidrug resistance.
The feasibility and effectiveness of a novel online mental health literacy course in supporting university student mental health: a pilot study
Authors: King N. , Linden B. , Cunningham S. , Rivera D. , Rose J. , Wagner N. , Mulder J. , Adams M. , Baxter R. , Duffy A.
Published: July 2022

Background

There is a need for effective universal approaches to promote and support university student mental health that are scalable and sustainable. In this pilot study we assess the feasibility and acceptability of a fully-digitalized, comprehensive mental health literacy course co-created with and tailored to the needs of undergraduate students. We also explore preliminary associations with mental health and positive behaviour change.

Methods

An accredited online mental health literacy course was developed using state-of-the-art pedagogical principles and a reverse mentorship approach. The course was offered as an interdisciplinary undergraduate elective. Students completed an online survey before and after the 12-week course that collected demographic information and assessed mental health knowledge, emotional self-awareness, mental health, stigma, and health-related behaviors using validated measures. Dependent group t-tests were used to compare pre- and post-course levels of knowledge, mental health, sleep quality and substance use. Mental health outcomes of students who completed the course were compared to an age and sex-matched sample of students not enrolled in the course and who completed the same survey measures over the same academic year. Multivariable linear regression was used to examine the effect of course participation on outcomes at follow-up.

Results

The course had good uptake and was positively reviewed by participants. Specifically, students found the course engaging, relevant, and applicable, and agreed they would recommend it to their peers. Among course participants there was improvement in mental health knowledge (p < 0.001) and emotional self-awareness (p = 0.02) at course completion. Compared to the matched comparison group, taking the course was associated with reduced alcohol (β = − 0.41, p = 0.01) and cannabis use (β = − 0.35, p = 0.03), and improved sleep quality (β = 1.56, p = 0.09) at the end of the term.

Conclusions

Findings suggest that delivering mental health literacy as an online accredited course may be an acceptable and effective way of promoting university student mental health through improved knowledge, emotional self-awareness, and healthy lifestyle choices. As the course is expanded to larger and more diverse student cohorts we will be able to further examine the short and long-term effectiveness of the course in supporting student mental health and the underlying mechanisms.
Prevalence and predictors of nomophobia among the general population in two middle eastern countries
Authors: Alwafi Hassan , Naser Abdallah Y. , Aldhahir Abdulelah M. , Fatani Alaa Idrees , Alharbi Rahaf Awaili , Alharbi Khawlah Ghazi , Almutwakkil Braah Ali , Salawati Emad , Ekram Rakan , Samannodi Mohammed , Almatrafi Mohammed A. , Rammal Wael , Assaggaf Hamza , Qedair Jumanah T. , Al Qurashi Abdullah A. , Alqurashi Afnan
Published: August 2022

Background

Nomophobia is a psychological condition caused by a fear of disconnecting from others through mobile phones.

Aim

This study aims to determine the prevalence of and predictors of nomophobia and anxiety symptoms among the general population in Saudi Arabia and Jordan.

Methods

This study was an observational cross-sectional study using a web-based online survey distributed in two middle eastern countries (Saudi Arabia and Jordan) between Jun 24 and Jul 20, 2021. A convenience sample was used to recruit the study participants. Categorical variables were identified as frequencies and percentages. In addition, a binary logistic regression analysis was used to determine the factors associated with nomophobia symptoms. The Statistical Package for Social Science (SPSS) software, version 27 (IBM Corp, Armonk, NY, USA), analyzed the data.

Results

A total of 5,191 responded to the online survey. Around (26.5%) reported that they suffer from an anxiety problem or use a treatment for anxiety. The median daily time spent using a mobile phone (IQR) (minutes) was around 210 min per day. About half of the study sample (51.2%) are diagnosed with dependence syndrome. The binary logistic regression analysis revealed that those within the age group of 30–49 years and 50 years and above) are less likely to have mobile phone dependence compared to those less than 30 years old. Females were 16% at lower risk of developing mobile phone dependence compared to males Married participants were less likely to have mobile phone dependence compared to single participants (OR: 0.62 (95% CI 0.56–0.70)), while divorced participants were at a 46% higher risk of developing mobile phone dependence.

Conclusion

Nomophobia prevalence among Saudi Arabia and Jordon's population is 51.2%. Several factors may predict mobile phone dependence including age, gender, marital status, and previous history of anxiety.
The global burden and associated factors of ovarian cancer in 1990–2019: findings from the Global Burden of Disease Study 2019
Authors: Zhang Shiwen , Cheng Chen , Lin Zejian , Xiao Linzi , Su Xin , Zheng Lu , Mu Yingjun , Liao Minqi , Ouyang Ruiqing , Li Wanlin , Ma Junrong , Cai Jun , Liu Lu , Wang Donghong , Zeng Fangfang , Liu Jun
Published: July 2022

Background

Ovarian cancer (OC) is a major cause of cancer-related deaths among women. The aim of this study was to estimate and report data on the current burden of ovarian cancer worldwide over the past 30 years.

Method

Based on the data provided by GBD 2019, we collected and interpreted the disease data of ovarian cancer by incidence, mortality, disability-adjusted life-years (DALYs), and used corresponding age-standardized rates as indicators. Also, we categorized the data by attributed risk factors and captured deaths due to high fasting plasma glucose, occupational exposure to asbestos and high body-mass index, respectively. All outcomes in the study were reported using mean values and corresponding 95% uncertainty intervals (95% UI).

Results

Globally, there were 294422 (260649 to 329727) incident cases in 2019, and the number of deaths and DALYs were 198412 (175357 to 217665) and 5.36 million (4.69 to 5.95). The overall burden was on the rise, with a percentage change of 107.8% (76.1 to 135.7%) for new cases, 103.8% (75.7 to 126.4%) for deaths and 96.1% (65.0 to 120.5%) for DALYs. Whereas the age-standardized rates kept stable during 1990–2019. The burden of ovarian cancer increased with age. and showed a totally different trends among SDI regions. Although high SDI region had the declining rates, the burden of ovarian cancer remained stable in high-middle and low SDI regions, and the middle and low-middle SDI areas showed increasing trends. High fasting plasma glucose was estimated to be the most important attributable risk factor for ovarian cancer deaths globally, with a percentage change of deaths of 7.9% (1.6 to 18.3%), followed by occupational exposure to asbestos and high body mass index.

Conclusions

Although the age-standardized rates of ovarian cancer didn’t significantly change at the global level, the burden still increased, especially in areas on the lower end of the SDI range. Also, the disease burden due to different attributable risk factors showed heterogeneous, and it became more severe with age.
Prediction of 30-day risk of acute exacerbation of readmission in elderly patients with COPD based on support vector machine model
Authors: Zhang Rui , Lu Hongyan , Chang Yan , Zhang Xiaona , Zhao Jie , Li Xindan
Published: July 2022

Background

Acute exacerbation of chronic obstructive pulmonary disease (COPD) is an important event in the process of disease management. Early identification of high-risk groups for readmission and appropriate measures can avoid readmission in some groups, but there is still a lack of specific prediction tools. The predictive performance of the model built by support vector machine (SVM) has been gradually recognized by the medical field. This study intends to predict the risk of acute exacerbation of readmission in elderly COPD patients within 30 days by SVM, in order to provide scientific basis for screening and prevention of high-risk patients with readmission.

Methods

A total of 1058 elderly COPD patients from the respiratory department of 13 general hospitals in Ningxia region of China from April 2019 to August 2020 were selected as the study subjects by convenience sampling method, and were followed up to 30 days after discharge. Discuss the influencing factors of patient readmission, and built four kernel function models of Linear-SVM, Polynomial-SVM, Sigmoid-SVM and RBF-SVM based on the influencing factors. According to the ratio of training set and test set 7:3, they are divided into training set samples and test set samples, Analyze and Compare the prediction efficiency of the four kernel functions by the precision, recall, accuracy, F1 index and area under the ROC curve (AUC).

Results

Education level, smoking status, coronary heart disease, hospitalization times of acute exacerbation of COPD in the past 1 year, whether long-term home oxygen therapy, whether regular medication, nutritional status and seasonal factors were the influencing factors for readmission. The training set shows that Linear-SVM, Polynomial-SVM, Sigmoid-SVM and RBF-SVM precision respectively were 69.89, 78.07, 79.37 and 84.21; Recall respectively were 50.78, 69.53, 78.74 and 88.19; Accuracy respectively were 83.92, 88.69, 90.81 and 93.82; F1 index respectively were 0.59, 0.74, 0.79 and 0.86; AUC were 0.722, 0.819, 0.866 and 0.918. Test set precision respectively were86.36, 87.50, 80.77 and 88.24; Recall respectively were51.35, 75.68, 56.76 and 81.08; Accuracy respectively were 85.11, 90.78, 85.11 and 92.20; F1 index respectively were 0.64, 0.81, 0.67 and 0.85; AUC respectively were 0.742, 0.858, 0.759 and 0.885.

Conclusions

This study found the factors that may affect readmission, and the SVM model constructed based on the above factors achieved a certain predictive effect on the risk of readmission, which has certain reference value.
The potential performance of serum albumin to globulin ratio, albumin and globulin in the diagnosis of periprosthetic joint infection and prediction of reinfection following reimplantation
Authors: Zhang Haitao , Xie Shuihua , Li YiJin , Li Jiahao , Deng Peng , Zeng Huiliang , Cao Houran , Liu Min , Li Jie , Feng Wenjun , Ye Pengcheng , Ge Yingjie , Zeng Jianchun , Zeng Yirong
Published: July 2022

Background

This study was conducted to evaluate the performance of serum albumin (ALB), globulin (GLO), and albumin to globulin ratio (AGR) in the diagnosis of PJI and prediction of reinfection following reimplantation in PJI patients who underwent two-stage revision.

Methods

We perform a retrospective data collection on identified patients who underwent revision arthroplasties in our institution from January 2010 to January 2020. A total of 241 patients were stratified into: group A (PJI), group B (aseptic loosening). Fifty-five patients who underwent two-stage revision in group A were assigned to group C. Group C was stratified into subgroup 1 (reinfection) and subgroup 2 (non-reinfection). Receiver operating characteristic curves were used to evaluate the utility of serum markers for diagnosing PJI and predicting reinfection following reimplantation.

Results

In the diagnosis of PJI, there were significant differences in the levels of ALB, GLO, and AGR between groups A and group B (P < 0.05). The AUC value of serum AGR (0.851) was similar to ESR (0.841) and CRP (0.866) (all p > 0.05). The AUC values of serum ALB and GLO were 0.757 and 0.753, respectively. As for predicting reinfection following reimplantation, the serum ALB in the non-reinfection group was higher than that in the reinfection group (p = 0.041). The AUC value of serum ALB was 0.7.

Conclusion

AGR was promising adjunct marker for the diagnosis of PJI, similar to CRP and ESR. ALB and GLO have an acceptable value for the diagnosis of PJI. ALB may be expected to be a kind of effective marker for predicting reinfection following reimplantation.
Pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients
Authors: Luan Haopeng , Liu Kai , Kahaer Alafate , Wang Yao , Sheng Weibin , Maimaiti Maierdan , Guo Hailong , Deng Qiang
Published: July 2022

Objective

To evaluate the sagittal parameters and clinical outcome of pedicle subtraction osteotomy (PSO) for the treatment of ankylosing spondylitis (AS) combined with thoracolumbar kyphosis.

Methods

The clinical data of 38 patients with AS combined with thoracolumbar kyphosis who underwent PSO were enrolled and divided into the lumbar lordosis group and the lumbar kyphosis group according to the preoperative sagittal morphology. They were subdivided into the lumbar lordosis T12 group, lordosis L1 group, kyphosis L2 group, and kyphosis L3 group. The spine sagittal parameters were compared between the preoperative and the postoperative. Outcome evaluation was performed by the Japanese Orthopedic Association (JOA) score, visual analogue scale (VAS), and the Oswestry Disability Index (ODI).

Results

A total of 38 patients with AS combined with thoracolumbar kyphosis were successfully treated by PSO, with a mean follow-up time of 26.9 ± 11.9 months. There were 30 males and 8 females with a mean age of 41.6 ± 7.1 years. Twenty patients consisted in the lumbar lordosis group and 18 patients in the lumbar kyphosis group. GK, SVA, and CBVA were improved significantly (P < 0.05) at the final follow-up between the lumbar lordosis T12 group and the L1 group. Patients in the lumbar kyphosis L2 group and L3 group all received satisfactory, including LL, GK, and SVA (P < 0.05). There was no statistically significant difference in the preoperative TK, GK, SVA, PT, and PI between the lumbar lordosis and lumbar kyphosis groups (P > 0.05). Postoperative complications occurred in three cases.

Conclusion

PSO was a practical method for the treatment of patients with AS combined with thoracolumbar kyphosis. PSO at L3 was recommended to be selected for the lumbar kyphosis to obtain greater SVA correction. CBVA of single-segment PSO may be significantly lower than the two-segment PSO in the management of patients with kyphosis of lower CBVA.
Publication in the Australian medical student journal is associated with future academic success: a matched-cohort study
Authors: Wilton Alexander , Pananwala Hasitha
Published: July 2022

Background

Medical student journals (MSJs) help to introduce the fundamentals of academic research and publication to future doctors. It has recently been shown that MSJs can influence doctors’ future academic and professional success, however these findings have not been replicated in an Australian cohort. The aim of this study was to examine the association between publication in the Australian Medical Student Journal (AMSJ) and markers of a student’s future academic trajectory, including future publication, attainment of higher academic degree or entry into specialist training.

Methods

Articles authored by medical students in the AMSJ from 2010 to 2015 were retrospectively identified. A list of these student authors was made, with university- and year- matched control students randomly selected from university graduation databases. For all students, data related to academic success were obtained from multiple sources including PubMed®, Google, university databases and author affiliation information from publications. A multivariable conditional logistic regression model was used to assess correlation between variables. The primary outcome measure was the number of postgraduate PubMed®-indexed publications. Secondary outcome measures included attainment of higher degree or faculty position. Clinical speciality was also recorded.

Results

Fifty-five AMSJ authors (14 case reports, 17 original research, 21 review articles) from 14 Australian universities were included. Publication in the AMSJ was associated with future PubMed® indexed publications (OR 3.43, 95% CI 1.74–6.77, P < 0.001) and higher degree attainment (OR 4.05, 95% CI 1.99–8.22, P = 0.0001). AMSJ authors were also significantly more likely to enter into surgical training (OR 2.53, 95% CI 1.10–5.84, P = 0.029). A multivariable conditional logistic regression model demonstrated that publication in the AMSJ was predictive of future PubMed indexed publication, independent of higher degree or faculty position attainment (OR 2.56, CI 1.22–5.39, P = 0.01).

Conclusion

We have shown that publication in a MSJ is associated with markers of academic success in an Australian cohort. PubMed®-indexed publications, attainment of a Masters degree, and entry in to surgical training were all significantly correlated to AMSJ publication. A conditional logistic regression model demonstrated that medical student publication in the AMSJ influences the number of future PubMed®-indexed publications, independent of major academic confounding variables.
Implementation of simulation-based health systems science modules for resident physicians
Authors: Li Luming , Ray Jessica M. , Bathgate Meghan , Kulp William , Cron Julia , Huot Stephen J. , Wong Ambrose H.
Published: July 2022

Background

Health system science (HSS) encompasses both core and cross-cutting domains that emphasize the complex interplay of care delivery, finances, teamwork, and clinical practice that impact care quality and safety in health care. Although HSS skills are required during residency training for physicians, current HSS didactics have less emphasis on hands-on practice and experiential learning. Medical simulation can allow for experiential participation and reflection in a controlled environment. Our goal was to develop and pilot three simulation scenarios as part of an educational module for resident physicians that incorporated core and cross-cutting HSS domains. 

Methods

Each scenario included a brief didactic, an interactive simulation in small-group breakout rooms, and a structured debriefing. The case scenario topics consisted of educational leadership, quality and safety, and implementation science. Learners from four residency programs (psychiatry, emergency medicine, orthopedics, ophthalmology) participated January – March 2021.

Results

A total of 95 resident physicians received our curricular module, and nearly all (95%) participants who completed a post-session survey reported perceived learning gains. Emotional reactions to the session were positive especially regarding the interactive role-play format. Recommendations for improvement included participation from non-physician professions and tailoring of scenarios for specific disciplines/role. Knowledge transfer included use of multiple stakeholder perspectives and effective negotiation by considering power/social structures.

Conclusions

The simulation-based scenarios can be feasibly applied for learner groups across different residency training programs. Simulations were conducted in a virtual learning environment, but future work can include in-person and actor-based simulations to further enhance emotional reactions and the reality of the case scenarios.
Mitigating structural racism to reduce inequities in sepsis outcomes: a mixed methods, longitudinal intervention study
Authors: Linnander Erika L. , Ayedun Adeola , Boatright Dowin , Ackerman-Barger Kupiri , Morgenthaler Timothy I. , Ray Natasha , Roy Brita , Simpson Steven , Curry Leslie A.
Published: July 2022

Background

Sepsis affects 1.7 million patients in the US annually, is one of the leading causes of mortality, and is a major driver of US healthcare costs. African American/Black and LatinX populations experience higher rates of sepsis complications, deviations from standard care, and readmissions compared with Non-Hispanic White populations. Despite clear evidence of structural racism in sepsis care and outcomes, there are no prospective interventions to mitigate structural racism in sepsis care, nor are we aware of studies that report reductions in racial inequities in sepsis care as an outcome. Therefore, we will deliver and evaluate a coalition-based intervention to equip health systems and their surrounding communities to mitigate structural racism, driving measurable reductions in inequities in sepsis outcomes. This paper presents the theoretical foundation for the study, summarizes key elements of the intervention, and describes the methodology to evaluate the intervention.

Methods

Our aims are to: (1) deliver a coalition-based leadership intervention in eight U.S. health systems and their surrounding communities; (2) evaluate the impact of the intervention on organizational culture using a longitudinal, convergent mixed methods approach, and (3) evaluate the impact of the intervention on reduction of racial inequities in three clinical outcomes: a) early identification (time to antibiotic), b) clinical management (in-hospital sepsis mortality) and c) standards-based follow up (same-hospital, all-cause sepsis readmissions) using interrupted time series analysis.

Discussion

This study is aligned with calls to action by the NIH and the Sepsis Alliance to address inequities in sepsis care and outcomes. It is the first to intervene to mitigate effects of structural racism by developing the domains of organizational culture that are required for anti-racist action, with implications for inequities in complex health outcomes beyond sepsis.
Standardization of the assessment process within telerehabilitation in chronic diseases: a scoping meta-review
Authors: Chapel Blandine , Alexandre François , Heraud Nelly , Ologeanu-Taddei Roxana , Cases Anne-Sophie , Bughin François , Hayot Maurice
Published: August 2022

Background

Telerehabilitation (TR) interventions are receiving increasing attention. They have been evaluated in various scientific areas through systematic reviews. However, there is a lack of data on how to standardize assessment and report on their domains to guide researchers across studies and bring together the best evidence to assess TR for chronic diseases.

Aims and objectives

The aim of this study was to identify domains of assessment in TR and to qualitatively and quantitatively analyze how and when they are examined to gain an overview of assessment in chronic disease.

Methods

A scoping meta-review was carried out on 9 databases and gray literature from 2009 to 2019. The keyword search strategy was based on "telerehabilitation", “evaluation", “chronic disease" and their synonyms. All articles were subjected to qualitative analysis using the Health Technology Assessment (HTA) Core Model prior to further analysis and narrative synthesis.

Results

Among the 7412 identified articles, 80 studies met the inclusion criteria and addressed at least one of the noncommunicable diseases (NCD) categories of cardiovascular disease (cardiovascular accidents), cancer, chronic respiratory disease, diabetes, and obesity. Regarding the domains of assessment, the most frequently occurring were “social aspect” (n = 63, 79%) (e.g., effects on behavioral changes) and “clinical efficacy” (n = 53, 66%), and the least frequently occurring was “safety aspects” (n = 2, 3%). We also identified the phases of TR in which the assessment was conducted and found that it most commonly occurred in the pilot study and randomized trial phases and least commonly occurred in the design, pretest, and post-implementation phases.

Conclusions

Through the HTA model, this scoping meta-review highlighted 10 assessment domains which have not been studied with the same degree of interest in the recent literature. We showed that each of these assessment domains could appear at different phases of TR development and proposed a new cross-disciplinary and comprehensive method for assessing TR interventions. Future studies will benefit from approaches that leverage the best evidence regarding the assessment of TR, and it will be interesting to extend this assessment framework to other chronic diseases.
Retraction Note: Exosome-transmitted miR-128-3p increase chemosensitivity of oxaliplatin-resistant colorectal cancer
Authors: Liu Tong , Zhang Xin , Du Lutao , Wang Yunshan , Liu Xiaoming , Tian Hui , Wang Lili , Li Peilong , Zhao Yinghui , Duan Weili , Xie Yujiao , Sun Zhaowei , Wang Chuanxin
Published: July 2022

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12943-019-0981-7.
Management of dyslipidemia after allogeneic hematopoietic stem cell transplantation
Authors: Lu Yingxue , Ma Xiaojing , Pan Jie , Ma Rongqiang , Jiang Yujie
Published: August 2022

Dyslipidemia is one of the complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT), and it is often underestimated and undertreated. Dyslipidemia in allo-HSCT recipients has been confirmed to be associated with endocrine dysfunction, acute and chronic graft-versus-host disease (aGVHD and cGVHD), immunosuppressive agent application, etc. However, few studies have illustrated the accurate molecular signaling pathways involved in dyslipidemia, and there are no standard guidelines for dyslipidemia management after HSCT. This review will discuss the pathogenesis of dyslipidemia, especially the association with aGVHD and/or cGVHD. Comprehensive treatment methods for dyslipidemia after HSCT will also be summarized.
Bilateral anterior and intermediate uveitis in SARS-CoV-2 associated multisystem inflammatory syndrome in a pediatric patient
Authors: Shantha Jessica , Reddy Amit K. , Sura Amol , Tsang Adrian , Moussa Kareem , Acharya Nisha , Gonzales John , Doan Thuy
Published: July 2022

Purpose

To report a case of bilateral anterior intermediate uveitis after recovery from SARS-CoV-2 associated multisystem inflammatory syndrome in children (MIS-C).

Case Report

A 9-year-old male presented with bilateral anterior intermediate uveitis with fluorescein angiography (FA) leakage of the disc and peripheral vasculature 1 month after recovery from MIS-C. He was treated with difluprednate 0.05% in both eyes with resolution of FA leakage, but our patient has required an extended treatment of topical therapy and the need long term immunosuppression.

Conclusions

This is a case of uveitis presenting after recent MIS-C related to SARS-CoV-2. Ongoing follow up and monitoring is required, and it is important for the ophthalmologist and rheumatologist to be aware of this rare complication during the current COVID-19 pandemic.
Is an association of acro-osteolysis, bone fragility, and enchondromatosis a newfound disease caused by an amplification of PTHLH? A case report
Authors: Echaubard Stéphane , Pebrel-Richard Céline , Chausset Aurélie , Kemeny Jean-Louis , Merlin Etienne , Laffargue Fanny
Published: July 2022

Background

Acro-osteolysis (AO) refers to resorption of the distal finger and toe phalanges. It displays two patterns: (i) diffuse AO and (ii) transverse or bandlike AO. AO can be a sign of local distress (e.g. of toxic origin), but is very often a sign of a constitutional or systemic acquired disorder.

Case presentation

A 15-year-old girl was referred to a paediatric rheumatologist for recurrent pain in her fingertips. She presented a particular cross-sectional AO associated with the presence of intraosseous cysts and bone fragility with atypical fractures. Initial laboratory tests and radiological examination did not allow an etiological diagnosis. Genetic studies revealed a 12p11.22-p11.23 microduplication of 900 kb including the PTHLH (parathyroid hormone-like hormone) gene, which encodes for a hormone involved in the regulation of endochondral ossification and differentiation of chondrocytes, via its PTHLH receptor.

Conclusions

To date, 12p11.22-p11.23 duplications have been reported in five families with skeletal abnormalities, and in particular AO and enchondromatosis associated with bone fragility. This new observation, added to the other reported cases, suggests a close relationship between the presence of this microduplication and the skeletal abnormalities found in the patient. We suggest the descriptive name ABES (acro-osteolysis, bone fragility and enchondromatosis syndrome) to designate this disorder.
Factors associated with knowledge about family planning and access to sexual and reproductive health services by sexually active immigrant youths in Hillbrow, South Africa: a cross-sectional study
Authors: Obisie-Nmehielle Nkechi , Kalule-Sabiti Ishmael , Palamuleni Martin
Published: July 2022

Background

In South Africa, universal access to health care services, including those relating to sexual and reproductive health (SRH) care, is contained in Section 27 of the Constitution and commits the country to supporting the United Nations 2030 Agenda for the Sustainable Development Goals (SDGs). The objective of this study was to examine the factors associated with knowledge about family planning and access to SRH services among sexually active immigrant youths in Hillbrow, South Africa.

Method

This cross-sectional study was based on data from a household survey conducted in Hillbrow during December 2019. Interviewer-administered questionnaires were used to collect information from immigrant youths (18–34 years old). Data on 437 sexually active respondents was analysed in STATA 14 using univariate, bivariate, logistic, and multinomial regression models. A p-value of < 0.05 was chosen as the level of significance.

Results

About half of the respondents had poor knowledge about family planning; about one-third (35%) of the immigrant youths had no access to SRH services, 42% had some access, and 23% had access. The adjusted logistic regression model showed that being a female (AOR = 3.85, CI: 2.34–6.35, belonging to age group 30–34 years (AOR = 3.88, CI: 2.00–7.53); belonging to the rich wealth index (AOR = 2.55 (1.32–4.93); not having received information about family planning (AOR = 0.17, CI = 0.10–0.29) and not using a contraceptive at the time of the survey (AOR = 0.37, CI: 0.19–0.70) were factors associated with having knowledge about family planning. The adjusted multinomial regression shows that the factors associated with not having access to SRH services were secondary or higher level of education (ARRR = 1.89, 95% CI = 1.06–3.36), belonging to the rich wealth quintile (ARRR = 2.25, 95% CI = 1.00–5.07), being undocumented (ARRR = 0.49, 95% CI = 0.27–0.88), having experienced discrimination in Hillbrow (ARRR = 2.06, 95% CI = 1.15–3.67) and having received information about family planning 6 months prior to the survey (ARRR = 0.49, 95% CI = 0.26–0.90, p-value < 0.05).

Conclusion

To move towards realization of the Constitution of South Africa, achieve the SDGs, and curb associated negative SRH outcomes, there is a need to advocate for the implementation of universal access to SRH services that is inclusive of immigrant youths.
Robotic-assisted versus manual total hip arthroplasty in obese patients: a retrospective case–control study
Authors: Zhang Shuai , Liu Yubo , Yang Minzhi , Ma Mingyang , Cao Zheng , Kong Xiangpeng , Chai Wei
Published: July 2022

Aims

The objective of this study was to evaluate the accuracy of acetabular cup positioning in the obese patients when using robotic-assisted technology during total hip arthroplasty (THA).

Methods

Data were retrospectively collected from patients who underwent primary (THA) with a body mass index (BMI) ≥ 28 kg/m2and ≥ 1 year of follow-up between January 2018 and December 2019. Their demographics, diagnosis, acetabular cup positioning, American Society of Anesthesiologists (ASA) score, Harris Hip Score (HHS), and Forgotten Joint Score (FJS) at the final follow-up were recorded for analysis.

Results

There were no statistically significant differences between the two groups in height, weight, BMI, ASA score, or preoperative Harris Hip Score (HHS). Also, there was no difference in inclination angle between the two groups (R-THA: 41.29° ± 3.04°; manual THA (M-THA): 40.47° ± 5.46°;P = 0.312). However, the mean anteversion angle was greater in the R-THA group (20.71° ± 1.98° vs. 19.08° ± 4.04°;P < 0.001). Compared to M-THA, R-THA more frequently achieved an acetabular cup angle within 5° of the target (anteversion, 98.1% vs. 78.1%P = 0.001; inclination, 88.5% vs. 53.1%,P < 0.001). The R-THA group was more advantageous in restoring the hip center of rotation (COR) and leg length difference (LLD). There was no statistical difference in postoperative HHS (P = 0.404) or FJS (P = 0.497) between the two groups.

Conclusions

Compared to manual technique, robotic-assisted technique provided more precise acetabular cup positioning and better leg length restoration for obese patients. The robotic-assisted technique was more advantageous in recovering the center of rotation position and achieved a higher proportion of the acetabular cup placed in the target safety zone. Further studies are needed to confirm the clinical outcomes of surgeries in obese patients using robotic-assisted technology.