bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatic Arterioportal Fistula Following Liver Trauma: Case Series and Review of the Literature
Authors: Noorbakhsh Soroosh , Gomez Lissette , Joung Yoo , Meyer Courtney , Hanos Dustin S. , Freedberg Mari , Klingensmith Nathan , Grant April A. , Koganti Deepika , Nguyen Jonathan , Smith Randi N. , Sciarretta Jason D.
Published: March 2023

Purpose

Hepatic arterioportal fistula (HAPF) is an uncommon complication of hepatic trauma, which can manifest with abdominal pain and the sequelae of portal hypertension months to years after injury. The purpose of this study is to present cases of HAPF from our busy urban trauma center and make recommendations for management.

Methods

One hundred and twenty-seven patients with high-grade penetrating liver injuries (American Association for the Surgery of Trauma [AAST] - Grades IV-V) between January 2019 and October 2022 were retrospectively reviewed. Five patients were identified with an acute hepatic arterioportal fistula following abdominal trauma from our ACS-verified adult Level 1 trauma center. Institutional experience with overall surgical management is described and reviewed with the current literature.

Results

Four of our patients presented in hemorrhagic shock requiring emergent operative intervention. The first patient had postoperative angiography and coil embolization of the HAPF. Patients 2 through 4 underwent damage control laparotomy with temporary abdominal closure followed by postoperative transarterial embolization with gelatin sponge particles (Gelfoam) or combined Gelfoam/n-butyl cyanoacrylate. The final patient went directly for angiography and Gelfoam embolization after identification of the HAPF. All 5 patients had resolution of HAPF on follow-up imaging with continued post management for traumatic injuries.

Conclusion

Hepatic arterioportal fistula can present as a complication of hepatic injury and manifest with significant hemodynamic aberrations. Although surgical intervention was required to achieve hemorrhage control in almost all cases, management of HAPF in the setting of high-grade liver injuries was achieved successfully with modern endovascular techniques. A multidisciplinary approach to such injuries is necessary to optimize care in the acute setting following traumatic injury.
Promises and realities of foreign language medium instruction in the light of internationalization: A case study on EMI and AMI at an Indonesian Islamic University
Authors: Irham Irham , Wahyudi Ribut
Published: March 2023

The desire to improve institutional profile and students’ linguistic skills leads to the growth of English as a Medium of Instruction (EMI). While studies regarding EMI have been sufficiently documented, little is known about Arabic as a Medium of Instruction (AMI) in the expanding circles. To fill in the gap, our study examines EMI and AMI at IIU University (Indonesian Islamic University) using semi-structured interviews with six alumni of the program. Data were analyzed through Phan’s (2017) conceptualization of adjusted desire and transformative mediocrity. The findings demonstrate that EMI and AMI are strategically employed to symbolically legitimize the “international” profile. In practice, both EMI and AMI likely result in below-mediocre quality education. However, the participants still hold the (limited) power of transformation, as they view their recent teaching position and recognition as having been impacted by their below-mediocre EMI and EMI programs.
Reading the mind in the nose
Authors: Broda Maximilian Davide , de Haas Benjamin
Published: March 2023

Humans infer mental states and traits from faces and their expressions. Previous research focused on the role of eyes and mouths in this process, even though most observers fixate somewhere in between. Here, we report that ratings of the nose region are surprisingly consistent with those for the full face and even with subjective feelings of the nose bearer. We propose the nose as central to faces and their perception.
On samples, data, and their mobility in biobanking: How imagined travels help to relate samples and data
Authors: Metzler Ingrid , Ferent Lisa-Maria , Felt Ulrike
Published: March 2023

Biobanking involves the assembling, curating, and distributing of samples and data. While relations between samples and data are often taken as defining properties of biobanking, several studies have pointed to the challenges in relating them in practice. This article investigates how samples and data are curated, connected, and made mobile in practice. Building on an analysis of data collected at five hospital-based biobanks in Austria, the article describes and compares biobanking in three types of biobank collections: ‘departmental collections’, ‘project-specific collections’ and ‘hospital-wide collections’. It draws attention to the invisible work going into this infrastructure and highlights the central role of visions to make samples and data travel to a different location and thus support biomedical research. It shows that while visions of future travels are often epistemologically uncertain, they are informed by social ties and relationships between the collectives involved in the curation of samples and data on the one hand and the imagined users on the other. Finally, we point to the importance that policy actors in this domain consider the aspects we identified—and, in particular, reflect the temporalities inherent in such a research infrastructure.
Determining the Longitudinal Serologic Response to COVID-19 Vaccination in the Chronic Kidney Disease Population: A Clinical Research Protocol
Authors: Yau Kevin , Enilama Omosomi , Levin Adeera , Romney Marc G. , Singer Joel , Blake Peter , Perl Jeffrey , Leis Jerome A. , Kozak Robert , Tsui Hubert , Bolotin Shelly , Tran Vanessa , Chan Christopher T. , Tam Paul , Dhruve Miten , Kandel Christopher , Estrada-Codecido Jose , Brown Tyler , Siwakoti Aswani , Abe Kento T. , Hu Queenie , Colwill Karen , Gingras Anne-Claude , Oliver Matthew J. , Hladunewich Michelle A.
Published: March 2023

Background:

People living with chronic kidney disease (CKD) have been disproportionately affected by the coronavirus disease 2019 (COVID-19) pandemic, including higher rates of infection, hospitalization, and death. Data on responsiveness to COVID-19 vaccination strategies and immunogenicity are limited, yet required to inform vaccination strategies in this at-risk population.

Objective:

The objective of this study is to characterize the longitudinal serologic response to COVID-19 vaccination.

Design:

This is a prospective observational cohort study.

Setting:

Participating outpatient kidney programs within Ontario and British Columbia.

Patients:

Up to 2500 participants with CKD G3b-5D receiving COVID-19 vaccination, including participants receiving dialysis and kidney transplant recipients (CKD G1T-5T).

Measurements:

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibodies (anti-spike, anti-receptor binding domain, anti-nucleocapsid) will be detected by ELISA (enzyme-linked immunosorbent assay) from serum or dried blood spot testing. In a subset of participants, neutralizing antibodies against novel variants of concern will be evaluated. Peripheral blood mononuclear cells will be collected for exploratory immune profiling of SARS-CoV-2 specific cellular immunity.

Methods:

Participants will be recruited prior to or following any COVID-19 vaccine dose and have blood sampled for serological testing at multiple timepoints: 1, 3, 6, 9, and 12 months post vaccination. When possible, samples will be collected prior to a dose or booster. Participants will remain in the study for at least 1 year following their last COVID-19 vaccine dose.

Strengths and limitations:

The adaptive design of this study allows for planned modification based on emerging evidence or rapid changes in public health policy surrounding vaccination. Limitations include incomplete earlier timepoints for blood collection due to rapid vaccination of the population.

Conclusions:

This large multicenter serologic study of participants living with kidney disease will generate data on the kinetics of SARS-CoV-2 immune response to vaccination across the spectrum of CKD, providing insights into the amplitude and duration of immunity conferred by COVID-19 vaccination and allowing for characterization of factors associated with immune response. The results of this study may be used to inform immunization guidelines and public health recommendations for the 4 million Canadians living with CKD.
Can Isolated Discordant Atrioventricular Connections Survive Without Interatrial or Interventricular Shunt?
Authors: Kandachar Pranav Subbaraya , Thomas Eapen , Al Maskary Areej , Campbell Andrew
Published: March 2023

Clinical presentation of isolated discordant atrioventricular connections is akin to transposition of the great arteries. In the absence of a significant intracardiac shunt, profound cyanosis is expected at birth. We report one such 5-month-old infant who had only mild cyanosis. The left-sided tricuspid valve straddled the interventricular septum with a closed interventricular communication, a type of “Double Outlet Left Atrium with three atrioventricular valves,” which provided the necessary “left to right” shunt while severe regurgitation through the straddling part and a patent ductus arteriosus provided the effective pulmonary blood flow.
A Comparison of Magnetic Resonance Imaging and SPECT-CT Imaging in Complex Spine Pathology: Does SPECT-CT Provide Additional Diagnostic Information Over Magnetic Resonance Imaging?
Authors: Thurston Daniel , Hurley Patrick , Raheel Falaq , James Steven , Gadvi Rakesh , Botchu Rajesh , Gardner Adrian C. , Mehta Jwalant S.
Published: March 2023

Study Design

Retrospective cohort study.

Objective

Magnetic Resonance Imaging (MRI) is often regarded as the gold standard for spinal pathology, as it provides good structural visualisation. SPECT-CT, however, provides combined structural and functional information. There is a paucity of literature comparing SPECT-CT with MRI in the spine. Our aim was to determine whether SPECT-CT provides additional information to MRI in individuals with complex spinal pathology, including deformity, which altered management.

Methods

We conducted a retrospective review of all individuals seen at our tertiary spinal unit that were investigated with both MRI and SPECT-CT of the spine between 2007-2020. We reviewed imaging reports, and collated diagnoses, surgical treatment and the relative contributions of MRI and SPECT-CT to management decisions.

Results

104 individuals identified, with a mean age of 30 years (89 females and 15 males). Diagnostic categories were adolescent, adult, and congenital deformity, degenerative pathology, and miscellaneous pathology. MRI returned positive findings in 58 (55.8%), and SPECT-CT in 41 (39.4%) cases. SPECT-CT identified 10 cases of facet joint degeneration, 5 of increased uptake around metalwork suggestive of loosening, 1 pseudoarthrosis, 1 partial failure of fusion and 1 osteoid osteoma which were not reported on MRI, all in individuals who had previously undergone spinal instrumentation. Despite this, SPECT-CT only altered management for 6 individuals (5.8%).

Conclusion

MRI is less useful in the setting of previous instrumentation due to metal artefact. Where MRI is inconclusive, particularly in individuals with previous spinal instrumentation, SPECT-CT may provide a diagnosis, but is not recommended as primary imaging.
Tension and transition between technical and conformance devices in sino-foreign university alliances towards innovativeness
Authors: Malik Tariq H
Published: March 2023

Organisational literature draws a tension between technical and conformance goals and means for socio-economic development and the merits of one versus the other. However, the tension between the technical and conformance core might be transitive when the focus shifts from evaluating the outcome to assessing the intentions. This study addresses this issue in the context of the Sino-foreign university alliance and its technical-conformance tension at the earlier stages of organisational development through innovativeness. How does conformance influence the link between the intended technical core and organisational innovativeness? This study addresses the question of the tension and transition between conformance and technical core devices used in the strategic alliance formation between universities. We used a unique set of data: the MOU (memorandum of understanding) signed for the Sino-foreign alliance in the internationalisation of Chinese universities. Based on 831 MOUs (1994 to 2013) available in the press release, we coded and developed integrated three main concepts: innovativeness (dependent variable), technical core for technical devices, and conformance for normative devices. After normalising and standardising the dependent variable, we tested the direct and interaction effects. The main effect of the technical core is positive, but the main effect of the conformance core is negative. Thus, the interaction between them is positive. Furthermore, the path of the conformance-to-technical core has stronger effects on the negative correlation than the path from technical-to-conformance.
Read to Lead: Developing a Leadership Book Club Curriculum for Graduate Medical Education
Authors: Schulte Sarah B. , Johnson William Rainey , Greco Anthony J. , Blickle John G. , Brooke Thomas R. , Wiseman Melanie L. , Hartzell Joshua D.
Published: March 2023

Background

The importance of effective leadership for improving patient care and physician well-being is gaining increased attention in medicine. Despite this, few residency programs have formalized education on leadership in medicine. The most effective ways to train graduate medical education (GME) trainees in leadership are unclear.

Methods

Our large internal medicine residency program implemented a book club to develop leadership skills in residency. Through independent reading of the selected book and resident-led small group discussions, we facilitated dialogue on the challenges of leading effectively.

Results

A survey-based curricular evaluation demonstrated that 61% of respondents felt that the book club influenced their thoughts about leadership and that 66% of participants would recommend the book club to other residency programs. Lack of time was the main barrier to participation while addition of complementary media or alternative book formats were identified as possible solutions to increase engagement.

Conclusions

Leadership book clubs are a practical and effective way to teach leadership during residency. More research is needed to identify the best formats for book club discussion and to develop additional tools to foster future physician leaders.
Unearthing the decolonial environmental worldview (DEW): The case of Jamaica
Authors: Baptiste April Karen , Baptiste-Garrin Rachael
Published: March 2023

Environmentalism has been defined in multiple ways across the literature from a global perspective, both as an ideology and as a movement. However, the definitions of environmentalism have been either vaguely defined or broad with the most common characterization being that of conservation and preservation being at the heart of environmentalism. While there is considerable research on environmentalism in the industrialized world context, there is still limited research in developing regions, with a dearth of research in the Caribbean, hence the rationale for this research. The physical environments of former colonial states have always been subjected to exploitation, yet the way in which this resource has been used by local populations have not been characterized. This paper begins to examine the ways in which local populations of former colonized states view environmentalism. Taking a case study approach, Jamaica is used as the beginning point of reference. Using interviews with self-identified environmental activists, results indicate that there is, what is uniquely referred to in this paper, a decolonial environmental worldview (DEW) that exists among environmental activists. This worldview is grounded in a number of principles that are tied to the way in which the decolonization process continues to proceed in the Caribbean region. The paper postulates that this DEW framework has elasticity and should be applied to other postcolonial societies to determine its salience.
Chronic Constrictive Pericarditis After CABG or Hemodialysis?
Authors: Kannan Lakshmi
Published: March 2023

Acute uremic pericarditis is an indication for initiating dialysis in patients with stage V chronic kidney disease. Even in patients with end-stage renal disease (ESRD), cardiac involvement manifests itself mostly as uremic pericarditis. Chronic constrictive pericarditis, also known as dialysis pericarditis, is relatively rare. The cause of chronic constrictive pericarditis is multifactorial and, in most cases, remains uncertain. The most common symptoms are fatigue, dyspnea, and peripheral edema. We present a case of a woman with history of coronary artery bypass graft surgery a year back and on chronic dialysis who developed constrictive pericarditis. Our case illustrates the importance of this rare entity in dialysis patients as timely intervention with intensification of dialysis and pericardiectomy is needed to prevent progression to an incapacitating state.
Indications and Options for Esophago-Gastric Junction Resection and Reconstruction in Failed Anti-Reflux Surgery
Authors: Wisniowski Paul , Lipham John
Published: March 2023

Revisional anti-reflux surgery is complex. The most common revisional procedure following anti-reflux surgery is redo-fundoplication; however, there is a rate of diminishing return for each subsequent redo-fundoplication. In addition, postoperative complications involving the gastroesophageal junction or intraoperative complications may require resection of the gastroesophageal junction and reconstruction. There is limited data evaluating the options for patients undergoing resectional surgery following ARS, but this paper will review the current literature and provide an overview on the indications and reconstructive options following gastro-esophageal junction resection.
Older patients with chronic myeloid leukemia face suboptimal molecular testing and tyrosine kinase inhibitor adherence
Authors: Shallis Rory M. , Wang Rong , Zeidan Amer M. , Huntington Scott F. , Neparidze Natalia , Stempel Jessica M. , Mendez Lourdes M. , Di Mengyang , Ma Xiaomei , Podoltsev Nikolai A.
Published: March 2023

Tyrosine kinase inhibitor (TKI) use is critical in the care of patients with chronic myeloid leukemia (CML). Quantitative polymerase chain reaction (qPCR) testing for BCR-ABL1 every 3 months during the first year of TKI treatment is recommended to assure achievement of milestone response goals. Real-world evidence for the patterns of qPCR monitoring and TKI adherence in the older patient population is lacking. Using the Surveillance, Epidemiology, and End Results–Medicare database, we identified 1192 patients aged ≥66 years (median age, 74 years) with newly diagnosed CML who were followed up for ≥13 months from TKI initiation. In total, 965 patients (81.0%) had ≥1 test, with 425 (35.7%) and 540 (45.3%) of the patients tested during 1, 2, and ≥3 quarters (optimal monitoring) of the first year from TKI initiation, respectively. In multivariable analysis, diagnosis in later years and influenza vaccination before diagnosis, a proxy for health care access, were associated with optimal qPCR monitoring. Use of low-income subsidy and residing in census tracts with the lowest socioeconomic status were associated with less optimal monitoring. Patients with optimal monitoring were 60% more likely to be TKI adherent (odds ratio, 1.60; 95% CI, 1.11-2.31; P = .01) and had improved 5-year survival (hazard ratio, 0.66; 95% CI, 0.49-0.90; P < .01) than those without such monitoring. In this large, real-world study of CML management patterns, many older patients had suboptimal molecular monitoring, which was associated with decreased TKI adherence and worse survival.
Assessment of acute myeloid leukemia molecular measurable residual disease testing in an interlaboratory study
Authors: Scott Stuart , Dillon Richard , Thiede Christian , Sadiq Sadia , Cartwright Ashley , Clouston Hazel J. , Travis Debbie , Mokretar Katya , Potter Nicola , Chantry Andrew , Whitby Liam
Published: March 2023

The European LeukaemiaNet (ELN) measurable residual disease (MRD) working group has published consensus guidelines to standardize molecular genetic MRD testing of the t(8;21)(q22;q22.1) RUNX1::RUNX1T1, inv(16)(p13.1q22) CBFB::MYH11, t(15;17)(q24.1;q21.2) PML::RARA, and NPM1 type A markers. A study featuring 29 international laboratories was performed to assess interlaboratory variation in testing and the subsequent interpretation of results, both crucial to patient safety. Most participants in this study were able to detect, accurately quantify, and correctly interpret MRD testing results, with a level of proficiency expected from a clinical trial or standard-of-care setting. However, a few testing and interpretive errors were identified that, in a patient setting, would have led to misclassification of patient outcomes and inappropriate treatment pathways being followed. Of note, a high proportion of participants reported false-positive results in the NPM1 marker-negative sample. False-positive results may have clinical consequences, committing patients to unneeded additional chemotherapy and/or transplant with the attendant risk of morbidity and mortality, which therefore highlights the need for ongoing external quality assessment/proficiency testing in this area. Most errors identified in the study were related to the interpretation of results. It was noted that the ELN guidance lacks clarity for certain clinical scenarios and highlights the requirement for urgent revision of the guidelines to elucidate these issues and related educational efforts around the revisions to ensure effective dissemination.
A new genome assembly of an African weakly electric fish (Campylomormyrus compressirostris, Mormyridae) indicates rapid gene family evolution in Osteoglossomorpha
Authors: Cheng Feng , Dennis Alice B. , Osuoha Josephine Ijeoma , Canitz Julia , Kirschbaum Frank , Tiedemann Ralph
Published: March 2023

Background

Teleost fishes comprise more than half of the vertebrate species. Within teleosts, most phylogenies consider the split between Osteoglossomorpha and Euteleosteomorpha/Otomorpha as basal, preceded only by the derivation of the most primitive group of teleosts, the Elopomorpha. While Osteoglossomorpha are generally species poor, the taxon contains the African weakly electric fish (Mormyroidei), which have radiated into numerous species. Within the mormyrids, the genusCampylomormyrusis mostly endemic to the Congo Basin.Campylomormyrusserves as a model to understand mechanisms of adaptive radiation and ecological speciation, especially with regard to its highly diverse species-specific electric organ discharges (EOD). Currently, there are few well-annotated genomes available for electric fish in general and mormyrids in particular. Our study aims at producing a high-quality genome assembly and to use this to examine genome evolution in relation to other teleosts. This will facilitate further understanding of the evolution of the osteoglossomorpha fish in general and of electric fish in particular.

Results

A high-quality weakly electric fish (C. compressirostris) genome was produced from a single individual with a genome size of 862 Mb, consisting of 1,497 contigs with an N50 of 1,399 kb and a GC-content of 43.69%. Gene predictions identified 34,492 protein-coding genes, which is a higher number than in the two other available Osteoglossomorpha genomes ofParamormyrops kingsleyaeandScleropages formosus. A Computational Analysis of gene Family Evolution (CAFE5) comparing 33 teleost fish genomes suggests an overall faster gene family turnover rate in Osteoglossomorpha than in Otomorpha and Euteleosteomorpha. Moreover, the ratios of expanded/contracted gene family numbers in Osteoglossomorpha are significantly higher than in the other two taxa, except for species that had undergone an additional genome duplication (Cyprinus carpioandOncorhynchus mykiss).As potassium channel proteins are hypothesized to play a key role in EOD diversity among species, we put a special focus on them, and manually curated 16Kv1genes. We identified a tandem duplication in theKCNA7agene in the genome ofC. compressirostris.

Conclusions

We present the fourth genome of an electric fish and the third well-annotated genome for Osteoglossomorpha, enabling us to compare gene family evolution among major teleost lineages. Osteoglossomorpha appear to exhibit rapid gene family evolution, with more gene family expansions than contractions. The curatedKv1gene family showed seven gene clusters, which is more than in other analyzed fish genomes outside Osteoglossomorpha. TheKCNA7a, encoding for a potassium channel central for EOD production and modulation, is tandemly duplicated which may related to the diverse EOD observed amongCampylomormyrusspecies.
Comparative proteome profiles of Polygonatum cyrtonema Hua rhizomes (Rhizoma Ploygonati) in response to different levels of cadmium stress
Authors: Song Rong , Yan Bei , Xie Jin , Zhou Li , Xu Rui , Zhou Jia Min , Ji Xiong Hui , Yi Zi Li
Published: March 2023

Background

The Polygonatum cyrtonema Hua rhizomes (also known as Rhizoma Polygonati, RP) are consumed for their health benefits. The main source of the RP is wild P. cyrtonema populations in the Hunan province of China. However, the soil Cadmium (Cd) content in Huanan is increasing, thus increasing the risks of Cd accumulation in RP which may end up in the human food chain. To understand the mechanism of Cd accumulation and resistance in P. cyrtonema, we subjected P. cyrtonema plants to four levels of Cd stress [(D2) 1, (D3) 2, (D4) 4, and (D5) 8 mg/kg)] compared to (D1) 0.5 mg/kg.

Results

The increase in soil Cd content up to 4 mg/kg resulted in a significant increase in tissue (root hair, rhizome, stem, and leaf) Cd content. The increase in Cd concentration variably affected the antioxidant enzyme activities. We could identify 14,171 and 12,115 protein groups and peptides, respectively. There were 193, 227, 260, and 163 differentially expressed proteins (DEPs) in D2, D3, D4, and D5, respectively, compared to D1. The number of downregulated DEPs increased with an increase in Cd content up to 4 mg/kg. These downregulated proteins belonged to sugar biosynthesis, amino acid biosynthesis-related pathways, and secondary metabolism-related pathways. Our results indicate that Cd stress increases ROS generation, against which, different ROS scavenging proteins are upregulated in P. cyrtonema. Moreover, Cd stress affected the expression of lipid transport and assembly, glycolysis/gluconeogenesis, sugar biosynthesis, and ATP generation.

Conclusion

These results suggest that an increase in soil Cd content may end up in Huangjing. Cadmium stress initiates expression changes in multiple pathways related to energy metabolism, sugar biosynthesis, and secondary metabolite biosynthesis. The proteins involved in these pathways are potential candidates for manipulation and development of Cd stress-tolerant genotypes.
Sex differences in utilisation of extracorporeal membrane oxygenation support and outcomes in Taiwan
Authors: Chang Feng-Cheng , Chou An-Hsun , Huang Yu-Tung , Huang Jhen-Ling , Wu Victor Chien-Chia , Chang Chih-Hsiang , Hung Kuo-Chun , Chang Shang-Hung , Chu Pao-Hsien , Chen Shao-Wei
Published: March 2023

Background

The impact of sex-related differences in patients receiving extracorporeal membrane oxygenation support (ECMO) support is still inconclusive. This population-based study aimed to investigate sex differences in short- or long-term outcomes in order to improve clinical practice.

Methods

Patients who received ECMO between 2001 to 2017 were identified from the Taiwan National Health Insurance Research Database. Propensity score matching with a 1:1 ratio was conducted in female-to-male groups, to reduce confounding of baseline covariates. Outcomes included in-hospital mortality, all-cause mortality, all-cause readmission, and ECMO-related complications. Logistic regression analysis, Cox proportional hazard model, and join point regression were used to compare sex differences in both short- or long-term outcomes.

Results

In total, 7,010 matched patients from 11,734 ECMO receivers were included for analysis. The use of ECMO increased dramatically in past years, although the proportion of females was still lower than males. There was a decreasing trend of females undergoing ECMO over time. Female patients have lower risks of in-hospital mortality (64.08% in females vs 66.48% in males; P = 0.0352) and ECMO-related complications compared with males. Furthermore, females also had favorable long-term late outcomes such as all-cause mortality (73.35% in females vs 76.98% in males; P = 0.009) and readmission rate (6.99% in females vs 9.19% in males; P = 0.001).

Conclusions

Female patients had more favorable in-hospital and long-term survival outcomes. Despite improvement in modern ECMO technique and equipment, ECMO remains underutilized in eligible female patients. Thus, females should undergo ECMO treatment if available and indicated.

Trial registration

The institutional review board of Chang Gung Memorial Hospital approved all data usage and the study protocol (registration number: 202100151B0C502; date of registration: 23/08/2021).
Impact of dysautonomic symptom burden on the quality of life in Neuromyelitis optica spectrum disorder patients
Authors: Yang Lili , Li Wenjing , Xie Yan , Ma Shuai , Zhou Xiaobo , Huang Xinyue , Tan Song
Published: March 2023

Background

This study aimed to investigate the clinical risk factors of dysautonomic symptom burden in neuromyelitis optica spectrum disorder (NMOSD) and its impact on patients’ quality of life.

Methods

A total of 63 NMOSD patients and healthy controls were enrolled. All participants completed the Composite Autonomic Symptom Score 31 (COMPASS-31) to screen for symptoms of autonomic dysfunction. A comprehensive clinical evaluation was performed on NMOSD patients, such as disease characteristics and composite evaluations of life status, including quality of life, anxiety/depression, sleep, and fatigue. Correlated factors of dysautonomic symptoms and quality of life were analyzed.

Results

The score of COMPASS-31 in the NMOSD group was 17.2 ± 10.3, significantly higher than that in healthy controls (P = 0.002). In NMOSD patients, the higher COMPASS-31 score was correlated with more attacks (r = 0.49, P < 0.001), longer disease duration (r = 0.52, P < 0.001), severer disability (r = 0.50, P < 0.001), more thoracic cord lesions (r = 0.29, P = 0.02), more total spinal cord lesions (r = 0.35, P = 0.005), severer anxiety (r = 0.55, P < 0.001), severer depression (r = 0.48, P < 0.001), severer sleep disturbances (r = 0.59, P < 0.001), and severer fatigue (r = 0.56, P < 0.001). The disability, total spinal cord lesions, and fatigue were revealed to be independently associated factors. Further analysis revealed that the COMPASS-31 score was independently correlated with scores of all the domains of patients’ quality of life scale (P < 0.05).

Conclusions

Dysautonomic symptom burden is correlated with decreased quality of life and certain clinical characteristics such as disability, the burden of spinal cord lesions, and fatigue in NMOSD patients. Investigation and proper management of autonomic dysfunction may help to improve the quality of life in patients with NMOSD.
Association of smoking, alcohol, and coffee consumption with the risk of ovarian cancer and prognosis: a mendelian randomization study
Authors: Liu Sicong , Feng Songwei , Du Furong , Zhang Ke , Shen Yang
Published: March 2023

Objective

Currently, the association between smoking, alcohol, and coffee intake and the risk of ovarian cancer (OC) remains conflicting. In this study, we used a two-sample mendelian randomization (MR) method to evaluate the association of smoking, drinking and coffee consumption with the risk of OC and prognosis.

Methods

Five risk factors related to lifestyles (cigarettes per day, smoking initiation, smoking cessation, alcohol consumption and coffee consumption) were chosen from the Genome-Wide Association Study, and 28, 105, 10, 36 and 36 single-nucleotide polymorphisms (SNPs) were obtained as instrumental variables (IVs). Outcome variables were achieved from the Ovarian Cancer Association Consortium. Inverse-variance-weighted method was mainly used to compute odds ratios (OR) and 95% confidence intervals (Cl).

Results

The two-sample MR analysis supported the causal association of genetically predicted smoking initiation (OR: 1.15 per SD, 95%CI: 1.02–1.29, P = 0.027) and coffee consumption (OR: 1.40 per 50% increase, 95%CI: 1.02–1.93, P = 0.040) with the risk of OC, but not cigarettes per day, smoking cessation, and alcohol consumption. Subgroup analysis based on histological subtypes revealed a positive genetical predictive association between coffee consumption and endometrioid OC (OR: 3.01, 95%CI: 1.50–6.04, P = 0.002). Several smoking initiation-related SNPs (rs7585579, rs7929518, rs2378662, rs10001365, rs11078713, rs7929518, and rs62098013), and coffee consumption-related SNPs (rs4410790, and rs1057868) were all associated with overall survival and cancer-specific survival in OC.

Conclusion

Our findings provide the evidence for a favorable causal association of genetically predicted smoking initiation and coffee consumption with OC risk, and coffee consumption is linked to a greater risk of endometrioid OC.
The state of diabetes care and obstacles to better care in Aceh, Indonesia: a mixed-methods study
Authors: Sofyan Hizir , Diba Farah , Susanti Suryane S. , Marthoenis Marthoenis , Ichsan Ichsan , Sasmita Novi Reandy , Seuring Till , Vollmer Sebastian
Published: March 2023

Background

Cardio-metabolic diseases are a major cause of death worldwide, including in Indonesia, where diabetes is one of the most critical diseases for the health system to manage.

Methods

We describe the characteristics, levels of control, health behavior, and diabetes-related complications of diabetes patients in Aceh, Indonesia. We use baseline data and blood testing from a randomized-controlled trial. We conducted semi-structured interviews with eight health providers from Posbindu and Prolanis programs that target diabetes and other non-communicable diseases (NCDs). We also conducted three focus group discussions with 24 diabetes patients about their experiences of living with diabetes and the existing support programs.

Results

The blood tests revealed average HbA1c levels indicative of poor glycemic control in 75.8 percent of patients and only 20.3 percent were free from any symptoms. Our qualitative findings suggest that patients are diagnosed after diabetes-related symptoms manifest, and that they find it hard to comply with treatment recommendations and lifestyle advice. The existing programs related to NCDs are not tailored to their needs.

Conclusion

We identify the need to improve diabetes screening to enable earlier treatment and achieve better control of the disease. Among diagnosed patients, there are widespread beliefs about diabetes medication and alternative forms of treatment that need to be addressed in a respectful dialogue between healthcare professionals and patients. Current diabetes screening, treatment and management programs should be revised to meet the needs of the affected population and to better respond to the increasing burden of this disease.
Hemangioblastoma with late leptomeningeal metastasis: a case report
Authors: Poiset Spencer J. , Reddy Aneesh , Tucker Catherine M. , Kenyon Lawrence C. , Judy Kevin D. , Shi Wenyin
Published: March 2023

Background

Hemangioblastoma of the central nervous system is an uncommon benign neoplasm, with about 25% of cases in patients with von Hippel–Lindau disease. The incidence of metastasis is rare, particularly in patients without von Hippel–Lindau disease. We report a case of hemangioblastoma with leptomeningeal dissemination as a late recurrence.

Case presentation

A 65-year-old Caucasian man with a history of World Health Organization grade I hemangioblastoma of the cerebellar vermis underwent gross total resection in 1997. In early 2018, he developed intracranial recurrences with diffuse leptomeningeal disease of the entire spine. The patient underwent resection of intracranial recurrence, followed by palliative craniospinal irradiation. The disease progressed quickly, and he died 8 months after recurrence.

Conclusions

Despite a benign pathology, hemangioblastoma has a low risk of metastasis. The outcome for hemangioblastoma patients with metastasis is poor. Multidisciplinary care for patients with metastatic hemangioblastoma warrants further investigation, and an effective systemic option is urgently needed. Regular lifelong follow-up of at-risk patients is recommended.
Pulp-to-palm distance after plate fixation of a distal radius fracture corresponds to functional outcome
Authors: Jakobsson Hugo , Lundqvist Eva , Wretenberg Per , Sagerfors Marcus
Published: March 2023

Introduction

Several factors can influence the outcome after a distal radius fracture (DRF). The aim of this study was to assess whether postoperative pulp-to-palm (PTP) distance correlated with functional outcomes after plate fixation of DRF.

Materials & methods

This is a secondary analysis of a randomized controlled trial aimed to investigate the effects of plate fixation in patients with type-C fractures. Subjects (N = 135) were divided into 2 groups based on PTP distance (equal to or higher than 0 cm) at 4 weeks postoperatively. Outcome measures were collected prospectively at 3, 6 and 12 months and included Patient-Rated Wrist Evaluation (PRWE), Quick Disabilities of the Arm Shoulder and Hand (QuickDASH) scores, wrist range of motion (ROM), Visual Analog Scale (VAS) pain scores, and hand grip strength.

Results

Overall, at 3 and 6 months patients with PTP > 0 cm had significantly worse outcomes (PRWE, QuickDASH, wrist ROM) than those with PTP =0 cm. At 12 months, QuickDASH and wrist ROM were still significantly worse. In the volar-plating subgroup, patients with PTP > 0 cm had significantly worse wrist ROM and grip strength at 3 months, but no significant differences were found in subsequent follow-ups. In the combined-plating group, patients with PTP > 0 cm had significantly worse QuickDASH, wrist ROM and grip strength at 3 months. At 6 and 12 months, wrist ROM was still significantly worse.

Conclusions

Measurement of PTP distance appears to be useful to identify patients likely to have worse outcome after plating of a DRF. This could be a tool to improve the allocation of hand rehabilitation resources.
Uptake of formal childcare among second generation and native mothers in Belgium: can increasing local childcare availability narrow migrant-native gaps?
Authors: Maes Julie , Neels Karel , Biegel Naomi , Wood Jonas
Published: March 2023

Research indicates that the uptake of formal childcare for children under age 3 is lower among migrant origin parents than among native parents in most European countries, and that these differentials extend to the second generation. Despite considerable investments in formal childcare availability in many European countries, it remains unclear whether and to what extent expanding local childcare availability effectively diminishes migrant-native uptake differentials due to the lack of longitudinal research. Therefore, this study assesses for Belgium to what extent expansions in childcare availability within municipalities in the period 2010–2014 has increased the uptake of formal childcare for children under age 3 among households where the mother has a second generation Southern European, Maghreb or Turkish background, versus no migration background. We use longitudinal census and register data for Belgium that were linked to longitudinal tax return data on childcare expenses and municipality-level data on childcare availability for children aged 0–3. Our results show that Southern European and Turkish origin mothers become more likely to use formal childcare when childcare places become more widely available within their municipalities, but also that the uptake gap with native mothers persists, since there is no differential effect of increasing local childcare availability. Since local childcare expansions entail a slightly stronger increase in formal childcare uptake among Maghreb origin mothers compared to native mothers, this results in slightly decreasing migrant-native uptake gaps, although considerable uptake gaps remain. To our knowledge, this is the first longitudinal study addressing the relationship between local childcare availability and uptake differentials by migration background. This study can inspire avenues for follow-up research which could provide additional insight into the possible mechanisms behind the varying effects of increasing local childcare availability by migration background and the persisting migrant-native uptake gaps.
Interactive effects of scaffolding digital game-based learning and cognitive style on adult learners’ emotion, cognitive load and learning performance
Authors: Chang Chi-Cheng , Yang Szu-Ting
Published: March 2023

There has been a little research on emotion, cognitive load, or learning performance for digital game-based learning (DGBL). However, there is still a dearth of research on investigating the interactive effects of scaffolding DGBL and cognitive style on the above three outcomes. Participants were 97 middle-aged and elder adults from a community college and randomly assigned into three groups. Taking prior knowledge as the covariate, 3 × 2 two-way MANCOVA was adopted to verify the interactive effects of scaffolding DGBL (hard scaffolding DGBL, soft scaffolding DGBL, and non-scaffolding DGBL) and cognitive style (Serialist and Holist). The findings presented that there exited significantly interactive effects of scaffolding DGBL and cognitive style on learning emotion, cognitive load, and learning performance. In hard scaffolding DGBL, learning emotion, cognitive load, and learning performance of Serialist learners were significantly better than those of Holist learners. Conversely, in soft scaffolding DGBL, learning emotion, cognitive load, and learning performance of Holist learners were significantly better than those of Serialist learners. Learning emotion, cognitive load, and learning performance of Serialist learners using hard scaffolding DGBL and Holist learners using soft scaffolding DGBL were significantly better than those of learners using non-scaffolding DGBL. The findings demonstrated concrete contributions and implications on practical promotion and theoretical development. This study ensures sufficiency of applying the cognitive-affective theory of learning with media (CATLM), cognitive load theory and cognitive style theory on DGBL, suggesting to extend the application of these theories to scaffolding.
Surgical management of idiopathic thoracal ventral spinal cord herniation: a case report
Authors: Sarigul Buse , Ogrenci Ahmet , Dalbayrak Sedat
Published: March 2023

Introduction

Idiopathic spinal cord herniation is a rare entity that is characterized by the displacement of the spinal cord through a defect in the dural layer and presents with symptoms of myelopathy. Surgical management usually results in good outcomes.

Case presentation

A 58-year-old female patient presented with weakness of both legs since four months. Her neurological examination showed paraplegia in the lower extremities, and ventral herniation was detected in the T9 vertebral level. The patient underwent surgery. Left T9 hemilaminectomy was followed by the reduction in the herniated spinal cord into its physiological location and the covering the anteriorly located dural defect via circumferentially covering the dural surface of the corresponding vertebral level. Postoperatively, the patient’s neurological status improved gradually and radiological scans showed a total reduction in the herniation.

Conclusion

Despite the rarity of the pathology, spinal cord herniation should be included in the differential diagnosis of the patients presenting with myelopathy or Brown–Séquard syndrome.
Pulmonary hemosiderosis secondary to mitral stenosis: a case report
Authors: Laudelino Jadson Soares , Aguiar Fernando Moreira Batista , Martins Filadélfia Passos Rodrigues , de Oliveira Rosineli Leopoldino , Cruz Glauberto Rolim Cartaxo Bezerra , Ramos Aline Lobo
Published: March 2023

Background

Pulmonary hemosiderosis is a rare disease that may be idiopathic or have a secondary etiology, such as mitral stenosis. The disease is a clinical and functional consequence of iron overload in the lungs in the form of hemosiderin. The diagnosis should be considered in patients with miliary nodules on chest tomography.

Case presentation

We report a case of a 30-year-old man with severe mitral stenosis who presented with chest pain and dyspnea. High-resolution chest tomography showed bilateral centrilobular micronodules. The diagnosis of pulmonary hemosiderosis secondary to mitral stenosis was suggested by transbronchial biopsy.

Conclusion

The diagnosis of idiopathic pulmonary hemosiderosis requires the exclusion of other etiologies of alveolar hemorrhage, including infections and vasculitis. One possible etiology is mitral stenosis.
Sustainability within interventional radiology: opportunities and hurdles
Authors: de Reeder Anouk , Hendriks Pim , Plug - van der Plas Helena , Zweers Dirk , van Overbeeke Philine S. M. , Gravendeel Joost , Kruimer Johan W. H. , van der Meer Rutger W. , Burgmans Mark C.
Published: March 2023

Background

Healthcare is a highly polluting industry and attention to the need for making this sector more sustainable is growing. The interventional radiology (IR) department is a relatively unique department in the hospital because of its synergetic use of both imaging equipment and medical instruments. As a result, the interventional radiology department causes a significant environmental burden in terms of energy usage, waste and water pollution. The aim of this study was to explore the current state of sustainability within IR by conducting a survey and interviews among IR specialists in the Netherlands.

Results

The main findings of this study were that there is a high awareness for the need of sustainability within IR, but that there is still limited action. Previous studies point towards the various opportunities in the field of energy, waste and water pollution, yet our study unveils these opportunities are often not implemented because of (1) sustainability not being a priority, (2) a dependency on employees, and (3) factors that simply cannot be changed by an individual IR department or hospital. Generally, our study indicates that there is a willingness to become more sustainable, but that the current system involves a wide range barriers that hinder true change. Furthermore, it seems that no one is currently taking the lead and a leading role from higher management, government, healthcare authorities or professional societies is lacking.

Conclusions

Despite the hurdles found in our study, IR departments can implement several improvements. An important factor is that sustainability should not lead to lower convenience for employees, which can be ensured by a sufficiently designed waste infrastructure and behavioral nudges. Furthermore, there lies an opportunity in more collaboration between IR departments in knowledge sharing and open innovation.