bluuebunny/crossref_metadata_2025 huggingface dataset:
The reliability of a simple novel radiographic finding in the diagnosis of subscapularis tendon tears: the “digitation sign”
Authors: Neyton Lionel , Nigues Ana
Published: March 2022

Objectives:

Subscapularis (SSP) tendon injuries are increasingly being diagnosed by arthroscopy. Preoperative diagnosis remains a challenge with clinical examination and magnetic resonance imaging (MRI) lacking sensitivity. The purpose of the study was to evaluate a new MRI finding in the coronal plane, the ‘Digitation Sign’.

Methods:

A consecutive series of 197 patients who underwent surgery for arthroscopic rotator cuff repair between January 2020 and December 2020 was reviewed. Inclusion criteria were: availability of a preoperative MRI less than 18 months old and age of more than 18 years. SSP injuries were described intraoperatively according to the Lafosse et al. and the French Arthroscopy Society classifications. Of the 197 patients, 44 had a preoperative arthroscan, 21 did not have an available DICOM file, and 1 patient had a history of repair on the side being examined. We included 132 shoulders for analysis. MRI scans were reviewed by 3 independent observers. The SSP was assessed on axial, sagittal, and coronal sections according to Adams’ criteria. The ‘Digitation Sign’ was assessed in the coronal plane on the T2 sequences. The statistical analysis determined the inter-observer agreement, and sensitivity and specificity calculations.

Results:

The inter-observer analysis detected substantial agreement (κ = 0.640). Of the 132 patients included, 74 (56%) had an arthroscopically confirmed SSP injury. 55 (74.3%) of the SSP injuries were correctly diagnosed by the ‘Digitation Sign’ alone, 62 (83.8%) with Adams’ criteria alone and 66 (89.2%) with a combination of both. 49 (84.5%) of the intact SSP were confirmed with the ‘Digitation Sign’ alone, 45 (77.6%) with Adams’ criteria alone and only 39 (67.2%) with a combination of both. The sensitivity of the ‘Digitation Sign’ combined with Adams’ criteria was statistically better than the sensitivity of Adams’ criteria alone (p = 0.046). The ‘Digitation Sign’ was more specific than Adams’ criteria (p = 0.014). The effectiveness of the ‘Digitation Sign’ combined with Adams’ criteria increased with the severity of the injury (grade III or IV). SSP injuries were significantly associated with biceps injuries (p <0.0001).

Conclusion:

Preoperative MRI analyzed according to a protocol that combines Adams’ criteria and the ‘Digitation Sign’ is simple, reproducible and sensitive in the diagnosis of SSP injuries. The specificity of the ‘Digitation Sign’ enables quick verification of the integrity of the subscapularis in the first reading of standard coronal sections of cuff tear analysis.
Clinical Response After Treatment of Knee Osteoarthritis With a Standardized, Closed-System, Low-Cost Platelet-Rich Plasma Product: 1-Year Outcomes
Authors: Fernández-Fuertes Judit , Arias-Fernández Tamara , Acebes-Huerta Andrea , Álvarez-Rico Marlene , Gutiérrez Laura
Published: March 2022

Background:

Intra-articular infiltration of platelet-rich plasma (PRP) is an alternative therapeutic option to classic hyaluronic acid for the treatment of symptomatic knee osteoarthritis (KOA). However, variation in preparation methods and quality assessment of PRP makes the study of its real clinical efficacy difficult.

Purpose:

To (1) evaluate the clinical efficacy of a characterized PRP product prepared in a standardized manner and in a closed-system for the treatment of KOA and to (2) evaluate the association of the clinical response to PRP-related variables.

Study Design:

Case series; Level of evidence, 4.

Methods:

We recruited 130 patients with nonoperative KOA and evaluated them for 1 year. PRP was prepared from a donation of autologous blood, obtaining 3 aliquots of approximately 10mL of product, which were frozen, allowing platelet disruption, platelet factor release, and long-term storage, until administration. Patients were treated 3 consecutive times every 4 weeks with an intra-articular PRP knee injection under sterile conditions. Complete blood count was performed on the whole-blood sample and the processed PRP before freezing it, for product quality assessment. Patients were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and basic satisfaction scale at 3 months, 6 months, and 1 year after intervention.

Results:

Quality assessment confirmed a leukocyte-poor PRP product (white blood cell count, 0.09 ± 0.09 × 109/L) with a high platelet purity (platelet count, 630.86 ± 191.75 × 109/L). WOMAC scores improved, and basic satisfaction was achieved in 70% of patients. No adverse events were reported. No correlations were observed between PRP quality parameters and clinical results. PRP complete treatment production costs were €108/US$125 (€36/US$41.6 per injection).

Conclusion:

This standardized PRP production method resulted in improved WOMAC scores at 1 year postoperatively in 70% of patients with KOA. This technique was safe and affordable and ensured consecutive infiltrations with the same product to each patient.
Education as an Opportunity for Integration: Assessing Colombia, Peru, and Chile's Educational Responses to the Venezuelan Migration Crisis
Authors: Summers Katharine , Crist Jessica , Streitwieser Bernhard
Published: March 2022

With over 5 million Venezuelans fleeing their home country, Latin America is facing the largest migration crisis in its history. Colombia, Peru, and Chile host the largest numbers of Venezuelan migrants in the region. Each country has responded differently to the crisis in terms of the provision of education. Venezuelan migrants attempting to enter the primary, secondary, and higher education systems encounter a variety of barriers, from struggles with documentation, to limited availability of spaces in schools, to cultural barriers and xenophobia.

This paper examines the distinct educational policy responses to Venezuelan migrants in Colombia, Peru, and Chile. It begins by contextualizing the current crisis through a sociopolitical and economic analysis of the origins of the Venezuelan migration phenomenon. Venezuelans are not officially and legally recognized as refugees by the UNHCR. Refugee status is considered on a case-by-case basis at the country level. The regional coordinating bodies tasked with promoting safe, orderly, and legal migration of Venezuelans to host countries have given uneven attention to education.

The paper examines each country's response to Venezuelan migrants from a human rights perspective. It provides sociopolitical context and discusses the specific educational offerings from the primary to tertiary levels in Colombia, Peru, and Chile. It considers alternative or flexible education models, second shift schools, access to school transportation and feeding programs, and teacher training opportunities that cater to the growing migrant population. It explores barriers to entry into the educational system, including documentation challenges due to legal and enrollment requirements, constraints on the host countries’ education systems, and discrimination due to lack of intercultural training and xenophobia. It also discusses challenges related to the quality of the educational opportunities for Venezuelan migrant children, and the specific needs of these children.

The paper considers several ideas to protect Venezuelan migrants’ rights to an education and to strengthen their integration. Finally, it offers recommendations on sustainable education solutions for Venezuelan migrants at all levels in the three countries. These recommendations include improving information sharing, addressing structural bottlenecks to school enrollment, and expanding pathways (existing and complementary) to higher education.
Writing Rights to Right Wrongs: A Critical Analysis of Young Children Composing Nationalist Narratives as Part of the Larger Body Politic
Authors: Brownell Cassie J.
Published: March 2022

Many researchers have considered recent and intergenerational immigrant children’s perspectives on immigration policies. Fewer have investigated nonimmigrant children’s views despite children’s sociopolitical identities forming long before they can vote. Drawing from data generated in spring 2017, the author illustrates how young children at an urban, midwestern school argued against the Republican administration’s (anti-)immigration policies. Framed as an ethnographic case study, the author focuses on how third graders enacted justice-oriented identities as they wrote to congressional representatives about contemporary immigration policies. By attuning to how children embedded multiple institutional and political contexts in their written rationale, the author explicates the tensions and possibilities for nonimmigrant children in writing policies and possibilities for tomorrow. Ultimately, the author argues adults must intentionally sustain children’s civic participation in ways beyond the niceties that plague early years classrooms.
Do “one-size” employment policies fit all young workers? Heterogeneity in work attribute preferences among the Millennial generation
Authors: Ng Eddy S , Posch Arthur , Köllen Thomas , Kraiczy Nils , Thom Norbert
Published: March 2022

There has been a stream of research that explores how the present generation of workers (i.e., Millennials) may be different from previous generations (e.g., Baby Boomers and Gen Xers). This line of research often considers Millennials as homogeneous and concludes any differences to be “generational effects.” However, it is unlikely for a generation, which spans almost 20 years, to be uniformly homogeneous with respect to their work values and attitudes. Findings on generational differences conducted in the United States are also often generalized to other countries, ignoring the potential for national influences. In this regard, we apply a multi-method approach using three samples to demonstrate that there are differences within the Millennial generation that affect work values, preferences for work/life balance, and attraction to employer attributes. Specifically, we focus on the heterogeneity resulting from differences in age, gender, relationship status, and nationality. Our results suggest that Millennials are not as homogeneous as we assumed, and this can limit the effectiveness of managerial policies designed to improve individual and work outcomes for an entire generation of workers. Our study demonstrates that it is important for us to understand how individual, relational, and contextual factors may contribute to the heterogeneity within a generation.

JEL CLASSIFICATION M12, M14, M54
Trending Tubes: A Social Media Analysis of Tympanostomy Tubes in Children
Authors: Rossi Nicholas A. , French Katherine R. , Evans Chad L. , Ohlstein Jason F. , Neve Luis D. , Daram Shiva , Young Dayton L. , McKinnon Brian J. , Pine Harold S.
Published: March 2022

Objective

To investigate the popular social media platforms Instagram and Facebook for public posts related to tympanostomy tubes in children, to discern attitudes and perceptions surrounding tympanostomy tubes, and to evaluate the content of social media posts related to tympanostomy tubes.

Study Design

Qualitative study.

Setting

Instagram and Facebook social media platforms.

Methods

Instagram and Facebook were searched for public posts from 2018 and 2019 including the search terms “ear tubes,”“ear tube surgery,”“tympanostomy,” and “myringotomy.” Posts were excluded if they were unrelated to pediatric tympanostomy tubes or written in a non‐English language. Relevant posts underwent subgroup analysis based on 6 domains: media type, perspective, topic, timeframe, popularity, and overall tone.

Results

Of 1862 public social media posts, the majority (78.2%) were made by the patient’s parents/caregivers and the rest by physicians (6.0%), hospitals (8.2%), and chiropractors (6.1%), with a few posts by the patients themselves (0.4%). The majority (79.3%) of posts portrayed tympanostomy tubes positively. Most negative posts were made by chiropractors (50.8%) and the patient’s parents/caregivers (42.9%). The most common themes of posts were reassurance regarding surgery (74.9%), advertisements (12.5%), apprehension (12.4%), and education (10.3%).

Conclusion

Most social media posts were made by parents/caregivers in the perioperative period, and there was a low percentage of educational posts. This information could be used by otolaryngologists to optimize their interactions with patients and parents and to potentially increase physician involvement and educational material related to tympanostomy tubes on social media.
A survey on traditional Chinese characters learning needs of learners of Chinese as a second language
Authors: Zhu Jianjun , Yang Yujie
Published: March 2022

This paper aims to study through a questionnaire survey the needs of learners of Chinese as a second language for learning traditional Chinese characters. To achieve the aim, analysis was conducted from various perspectives such as the learners’ background, Chinese proficiency, Chinese instruction, exposure to traditional Chinese characters and attitudes towards traditional Chinese characters. Factors that influenced the participants’ learning needs and motivations were analyzed with the Statistical Package for the Social Sciences. The results showed that the participants had a moderate level of traditional Chinese characters learning needs, and that reading and appreciating arts were two most significant motivations for learning traditional Chinese characters.
Cyberbullying Prevention and Intervention: Current Practices in Schools
Authors: Burlet Rachel E. , Panahon Carlos J.
Published: March 2022

Recent studies have found that increasing numbers of students are experiencing cyberbullying during middle and high school. The current study examined how school psychologists and school counselors are involved in the prevention and intervention of cyberbullying, as well as what practices schools are implementing to address this issue. School counselors were more involved than school psychologists with cyberbullying prevention and intervention efforts. However, about half of school psychologists felt their skills were being underutilized and expressed a desire to be more involved in cyberbullying prevention and intervention efforts. A majority of participants reported that their schools are currently using reactive rather than proactive cyberbullying prevention and intervention strategies. Schools may benefit from examining their current cyberbullying prevention and intervention practices to ensure the use of proactive approaches as well as ensuring the utilization of all qualified staff to address this issue.
Nintedanib plus chemotherapy for nonsmall cell lung cancer with idiopathic pulmonary fibrosis: a randomised phase 3 trial
Authors: Otsubo Kohei , Kishimoto Junji , Ando Masahiko , Kenmotsu Hirotsugu , Minegishi Yuji , Horinouchi Hidehito , Kato Terufumi , Ichihara Eiki , Kondo Masashi , Atagi Shinji , Tamiya Motohiro , Ikeda Satoshi , Harada Toshiyuki , Takemoto Shinnosuke , Hayashi Hidetoshi , Nakatomi Keita , Kimura Yuichiro , Kondoh Yasuhiro , Kusumoto Masahiko , Ichikado Kazuya , Yamamoto Nobuyuki , Nakagawa Kazuhiko , Nakanishi Yoichi , Okamoto Isamu
Published: March 2022

Background

Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease implicated as an independent risk factor for lung cancer. However, optimal treatment for advanced lung cancer with IPF remains to be established. We performed a randomised phase 3 trial (J-SONIC) to assess the efficacy and safety of nintedanib plus chemotherapy (experimental arm) compared with chemotherapy alone (standard-of-care arm) for advanced nonsmall cell lung cancer (NSCLC) with IPF.

Methods

Chemotherapy-naïve advanced NSCLC patients with IPF were allocated to receive carboplatin (area under the curve of 6 on day 1) plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel) (100 mg·m−2on days 1, 8 and 15) every 3 weeks with or without nintedanib (150 mg twice daily, daily). The primary end-point was exacerbation-free survival (EFS).

Results

Between May 2017 and February 2020, 243 patients were enrolled. Median EFS was 14.6 months in the nintedanib plus chemotherapy group and 11.8 months in the chemotherapy group (hazard ratio (HR) 0.89, 90% CI 0.67–1.17; p=0.24), whereas median progression-free survival was 6.2 and 5.5 months, respectively (HR 0.68, 95% CI 0.50–0.92). Overall survival was improved by nintedanib in patients with nonsquamous histology (HR 0.61, 95% CI 0.40–0.93) and in those at GAP (gender–age–physiology) stage I (HR 0.61, 95% CI 0.38–0.98). Seven (2.9%) out of 240 patients experienced acute exacerbation during study treatment.

Conclusions

The primary end-point of the study was not met. However, carboplatin plus nab-paclitaxel was found to be effective and tolerable in advanced NSCLC patients with IPF. Moreover, nintedanib in combination with such chemotherapy improved overall survival in patients with nonsquamous histology.
Asthma remission: what is it and how can it be achieved?
Authors: Thomas Dennis , McDonald Vanessa M. , Pavord Ian D. , Gibson Peter G.
Published: March 2022

Asthma treatment goals currently focus on symptom and exacerbation control rather than remission. Remission is not identical to cure, but is a step closer. This review considers the current definitions of remission in asthma, the prevalence and predictors, the pathophysiology of remission, the possibility of achieving it using the available treatment options, and the future research directions. Asthma remission is characterised by a high level of disease control, including the absence of symptoms and exacerbations, and normalisation or optimisation of lung function with or without ongoing treatment. Even in those who develop a symptomatic remission of asthma, persistent pathological abnormalities are common, leading to a risk of subsequent relapse at any time. Complete remission requires normalisation or stabilisation of any underlying pathology in addition to symptomatic remission. Remission is possible as part of the natural history of asthma, and the prevalence of remission in the adult asthma population varies between 2% and 52%. The factors associated with remission include mild asthma, better lung function, better asthma control, younger age, early-onset asthma, shorter duration of asthma, milder bronchial hyperresponsiveness, fewer comorbidities and smoking cessation or never smoking. Although previous studies have not targeted treatment-induced remission, there is some evidence to show that the current long-term add-on therapies such as biologics and azithromycin can achieve some criteria for asthma remission on treatment, at least in a subgroup of patients. However, more research is required. Long-term remission could be included as a therapeutic goal in studies of asthma treatments.
Longitudinal passive cough monitoring and its implications for detecting changes in clinical status
Authors: Gabaldón-Figueira Juan C. , Keen Eric , Rudd Matthew , Orrilo Virginia , Blavia Isabel , Chaccour Juliane , Galvosas Mindaugas , Small Peter , Grandjean Lapierre Simon , Chaccour Carlos
Published: March 2022

Research question

What is the impact of the duration of cough monitoring on its accuracy in detecting changes in the cough frequency?

Materials and methods

This is a statistical analysis of a prospective cohort study. Participants were recruited in the city of Pamplona (Northern Spain), and their cough frequency was passively monitored using smartphone-based acoustic artificial intelligence software. Differences in cough frequency were compared using a one-tailed Mann–Whitney U test and a randomisation routine to simulate 24-h monitoring.

Results

616 participants were monitored for an aggregated duration of over 9 person-years and registered 62 325 coughs. This empiric analysis found that an individual's cough patterns are stochastic, following a binomial distribution. When compared to continuous monitoring, limiting observation to 24 h can lead to inaccurate estimates of change in cough frequency, particularly in persons with low or small changes in rate.

Interpretation

Detecting changes in an individual's rate of coughing is complicated by significant stochastic variability within and between days. Assessing change based solely on intermittent sampling, including 24-h, can be misleading. This is particularly problematic in detecting small changes in individuals who have a low rate and/or high variance in cough pattern.
Influence of sex, season and environmental air quality on experimental human pneumococcal carriage acquisition: a retrospective cohort analysis
Authors: Cheliotis Katerina S. , Jewell Christopher P. , Solórzano Carla , Urban Britta , Collins Andrea M. , Mitsi Elena , Pojar Sherin , Nikolaou Elissavet , German Esther L. , Reiné Jesús , Gordon Stephen B. , Jochems Simon P. , Rylance Jamie , Ferreira Daniela M.
Published: March 2022

Streptococcus pneumoniae(pneumococcus) is the most commonly identified bacterial cause of pneumonia and the leading infectious cause of death in children under 5 years of age worldwide. Pneumococcal disease follows a seasonal pattern with increased incidence during winter. Pneumonia burden is also associated with poor air quality. Nasopharyngeal carriage of the bacterium is a pre-requisite of invasive disease.

We aimed to determine if susceptibility to nasopharyngeal pneumococcal carriage varied by season and which environmental factors might explain such variation. We also evaluated the influence of sex on susceptibility of carriage. We collated data from five studies in which human volunteers underwent intranasal pneumococcal challenge. Generalised linear mixed-effects models were used to identify factors associated with altered risk of carriage acquisition, specifically climate and air-quality data.

During 2011–2017, 374 healthy adults were challenged with type 6B pneumococcus. Odds of carriage were significantly lower in males (OR, 0.61; 95% CI, 0.40–0.92; p=0.02), and higher with cooler temperatures (OR, 0.79; 95% CI, 0.63–0.99; p=0.04). Likelihood of carriage was also associated with lower concentrations of local fine particulate matter concentrations (PM2.5) and increased local rainfall.

In contrast to epidemiological series, experimental challenge allowed us to test propensity to acquisition during controlled exposures; immunological explanations for sex and climatic differences should be sought.
TBGA: a large-scale Gene-Disease Association dataset for Biomedical Relation Extraction
Authors: Marchesin Stefano , Silvello Gianmaria
Published: March 2022

Background

Databases are fundamental to advance biomedical science. However, most of them are populated and updated with a great deal of human effort. Biomedical Relation Extraction (BioRE) aims to shift this burden to machines. Among its different applications, the discovery of Gene-Disease Associations (GDAs) is one of BioRE most relevant tasks. Nevertheless, few resources have been developed to train models for GDA extraction. Besides, these resources are all limited in size—preventing models from scaling effectively to large amounts of data.

Results

To overcome this limitation, we have exploited the DisGeNET database to build a large-scale, semi-automatically annotated dataset for GDA extraction. DisGeNET stores one of the largest available collections of genes and variants involved in human diseases. Relying on DisGeNET, we developed TBGA: a GDA extraction dataset generated from more than 700K publications that consists of over 200K instances and 100K gene-disease pairs. Each instance consists of the sentence from which the GDA was extracted, the corresponding GDA, and the information about the gene-disease pair.

Conclusions

TBGA is amongst the largest datasets for GDA extraction. We have evaluated state-of-the-art models for GDA extraction on TBGA, showing that it is a challenging and well-suited dataset for the task. We made the dataset publicly available to foster the development of state-of-the-art BioRE models for GDA extraction.
ENNGene: an Easy Neural Network model building tool for Genomics
Authors: Chalupová Eliška , Vaculík Ondřej , Poláček Jakub , Jozefov Filip , Majtner Tomáš , Alexiou Panagiotis
Published: March 2022

Background

The recent big data revolution in Genomics, coupled with the emergence of Deep Learning as a set of powerful machine learning methods, has shifted the standard practices of machine learning for Genomics. Even though Deep Learning methods such as Convolutional Neural Networks (CNNs) and Recurrent Neural Networks (RNNs) are becoming widespread in Genomics, developing and training such models is outside the ability of most researchers in the field.

Results

Here we present ENNGene—Easy Neural Network model building tool for Genomics. This tool simplifies training of custom CNN or hybrid CNN-RNN models on genomic data via an easy-to-use Graphical User Interface. ENNGene allows multiple input branches, including sequence, evolutionary conservation, and secondary structure, and performs all the necessary preprocessing steps, allowing simple input such as genomic coordinates. The network architecture is selected and fully customized by the user, from the number and types of the layers to each layer's precise set-up. ENNGene then deals with all steps of training and evaluation of the model, exporting valuable metrics such as multi-class ROC and precision-recall curve plots or TensorBoard log files. To facilitate interpretation of the predicted results, we deploy Integrated Gradients, providing the user with a graphical representation of an attribution level of each input position. To showcase the usage of ENNGene, we train multiple models on the RBP24 dataset, quickly reaching the state of the art while improving the performance on more than half of the proteins by including the evolutionary conservation score and tuning the network per protein.

Conclusions

As the role of DL in big data analysis in the near future is indisputable, it is important to make it available for a broader range of researchers. We believe that an easy-to-use tool such as ENNGene can allow Genomics researchers without a background in Computational Sciences to harness the power of DL to gain better insights into and extract important information from the large amounts of data available in the field.
A comparison of first-attempt cannulation success of peripheral venous catheter systems with and without wings and injection ports in surgical patients—a randomized trial
Authors: Mörgeli Rudolf , Schmidt Katrin , Neumann Tim , Kruppa Jochen , Föhring Ulrich , Hofmann Pascal , Rosenberger Peter , Falk Elke , Boemke Willehad , Spies Claudia
Published: March 2022

Background

A peripheral venous catheter (PVC) is the most widely used device for obtaining vascular access, allowing the administration of fluids and medication. Up to 25% of adult patients, and 50% of pediatric patients experience a first-attempt cannulation failure. In addition to patient and clinician characteristics, device features might affect the handling and success rates. The objective of the study was to compare the first-attempt cannulation success rate between PVCs with wings and a port access (Vasofix® Safety, B. Braun, abbreviated hereon in as VS) with those without (Introcan® Safety, B. Braun, abbreviated hereon in as IS) in an anesthesiological cohort.

Methods

An open label, multi-center, randomized trial was performed. First-attempt cannulation success rates were examined, along with relevant patient, clinician, and device characteristics with univariate and multivariate analyses. Information on handling and adherence to use instructions was gathered, and available catheters were assessed for damage.

Results

Two thousand three hundred four patients were included in the intention to treat analysis. First-attempt success rate was significantly higher with winged and ported catheters (VS) than with the non-winged, non-ported design (IS) (87.5% with VS vs. 78.2% with IS;PChi < .001). Operators rated the handling of VS as superior (rating of “good” or “very good: 86.1% VS vs. 20.8% IS,PChi < .001). Reinsertion of the needle into the catheter after partial withdrawal—prior or during the catheterization attempt—was associated with an increased risk of cannulation failure (7.909, CI 5.989–10.443,P < .001 and 23.023, CI 10.372–51.105,P < .001, respectively) and a twofold risk of catheter damage (OR 1.999, CI 1.347–2.967,P = .001).

Conclusions

First-attempt cannulation success of peripheral, ported, winged catheters was higher compared to non-ported, non-winged devices. The handling of the winged and ported design was better rated by the clinicians. Needle reinsertions are related to an increase in rates of catheter damage and cannulation failure.

Trial registration

ClinicalTrials.gov, Identifier:NCT02213965, Date: 12/08/2014.
Cardiac disease and prognosis associated with ventricular tachyarrhythmias in young adults and adults
Authors: Weidner Kathrin , Behnes Michael , Schupp Tobias , Hoppner Jorge , El-Battrawy Ibrahim , Ansari Uzair , Saleh Ahmad , Taton Gabriel , Reiser Linda , Bollow Armin , Reichelt Thomas , Ellguth Dominik , Engelke Niko , Bertsch Thomas , Große Meininghaus Dirk , Hoffmann Ursula , Akin Ibrahim
Published: March 2022

Background

This study evaluates cardiac diseases and prognosis in young adults and adults presenting with ventricular tachyarrhythmias (VTA).

Methods

The present longitudinal, observational, registry-based, monocentric cohort study includes all consecutive patients 45 years old or younger presenting with VTA at admission from 2002 to 2016. Rates of coronary angiography, coronary artery disease (CAD) and need for percutaneous coronary intervention (PCI), cardiac diseases associated with VTA, and differences in long-term prognostic endpoints for young adults (20–34 years old) were analyzed and compared to those of adults (35–45 years old), for whom multivariable risk prediction models were developed. Kaplan–Meier analyses were performed according to age and type of VTA.

Results

A total of 259 consecutive patients were included in the study (36% young adults and 64% adults). At admission, 38% of young adults had VTA due to CAD that required PCI. Furthermore, VTA in young adults was commonly idiopathic (27%), or had underlying channelopathies (18%), primary cardiomyopathies (13%) or acute myocardial infarction (AMI, 11%). In adults, VTA was mostly associated with AMI (28%), though the rate of idiopathy was still high (20%). A total 41% of all patients received cardiopulmonary resuscitation (CPR), for whom AMI (STEMI 17%, NSTEMI 24%) was most frequently observed. Irrespective of the type of VTA, all-cause mortality was similar for young adults and adults. In young adults, left ventricular ejection fraction (LVEF) < 35% (HR = 33.590) was associated with increased long-term all-cause mortality.

Conclusion

Despite high rates of idiopathic ventricular tachyarrhythmias, CAD and AMI are common causes of VTA and CPR in adults 45 years old and younger. Young adults and adults had comparable survival at index hospitalization and after 2.5 years irrespective of the type of VTA.

Clinical trial registration clinicaltrials.gov identifier: NCT02982473.
A cohort study measuring SARS-CoV-2 seroconversion and serial viral testing in university students
Authors: Lee Christine C. , Segaloff Hannah E. , Cole Devlin , Rosenblum Hannah G. , Morgan Clint N. , Somers Tarah , Desamu-Thorpe Rodel , Foster Monique A. , Currie Dustin , Ruff Jeanne , Payne David , Whyte Thomas J. , Abedi Glen R. , Bigouette John Paul , Kahrs Juliana , Langolf Kimberly , Remington Patrick , Sterkel Alana , Kelly Patrick , Westergaard Ryan P. , Bateman Allen C. , Hsu Christopher H. , Tate Jacqueline E. , Kirking Hannah L.
Published: March 2022

Background

To improve understanding of the antibody response to SARS-CoV-2 infection, we examined seroprevalence, incidence of infection, and seroconversion among a cohort of young adults living on university campuses during the fall of 2020.

Methods

At the beginning (semester start) and end (semester end) of an 11-week period, serum collected from 107 students was tested using the qualitative Abbott Architect SARS-CoV-2 IgG and AdviseDx SARS-CoV-2 IgG II assays. Results were matched to interim weekly surveillance viral testing and symptom data.

Results

With the SARS-CoV-2 IgG assay, 15 (14.0%) students were seropositive at semester start; 29 (27.1%) students were seropositive at semester end; 10 (9.3%) were seropositive at both times. With the AdviseDx SARS-CoV-2 IgG II assay, 17 (16.3%) students were seropositive at semester start, 37 (35.6%) were seropositive at semester end, and 16 (15.3%) were seropositive at both times. Overall, 23 students (21.5%) had positive viral tests during the semester. Infection was identified by serial testing in a large majority of individuals who seroconverted using both assays. Those seropositive at semester end more frequently reported symptomatic infections (56.5%) than asymptomatic infections (30.4%).

Conclusion

Differences between antibody targets were observed, with more declines in antibody index values below the threshold of positivity with the anti-nucleocapsid assay compared to the anti-spike assay. Serology testing, combined with serial viral testing, can detect seroconversions, and help understand the potential correlates of protection provided by antibodies to SARS-CoV-2.
Accurate interpretation of thyroid dysfunction during pregnancy: should we continue to use published guidelines instead of population-based gestation-specific reference intervals for the thyroid-stimulating hormone (TSH)?
Authors: Turkal Rana , Turan Cem Armağan , Elbasan Onur , Aytan Serenay , Çakmak Burcu , Gözaydınoğlu Büşra , Takır Duygu Ceyda , Ünlü Ozan , Bahramzada Günel , Tekin Ahmet Faruk , Çevlik Tülay , Büyükbayrak Esra Esim , Şirikçi Önder , Gözü Hülya , Haklar Goncagül
Published: March 2022

Background

Considering the changes in thyroid physiology associated with pregnancy and poor outcomes related to abnormal maternal thyroid function, international guidelines recommend using population-based trimester-specific reference intervals (RIs) for thyroid testing. If these RIs are not available in the laboratory, implementing recommended fixed cut-off values globally is still controversial. To address this issue, we aimed to establish appropriate RI of thyroid-stimulating hormone (TSH) in pregnant Turkish women for our laboratory and compare the prevalence of thyroid dysfunction based on the established and recommended criteria.

Methods

Of 2638 pregnant women, 1777 women followed in the obstetric outpatient were enrolled in the reference interval study after applying exclusion criteria related to medical and prenatal history. A retrospective study was conducted by collecting data from July 2016 to March 2019. Serum TSH was measured by UniCel DxI 800 Immunoassay System (Beckman Coulter Inc., Brea, CA, USA). The study design relied on two approaches in order to classify pregnant women: trimester-specific and subgroup-specific; the latter involved dividing each trimester into two subgroups: T1a, T1b, T2a, T2b, T3a, T3b. The lower and upper limits of the RIs were derived by the parametric method after normalizing the data distribution using the modified Box-Cox power transformation method.

Results

The lowest TSH value was detected at 8-12 weeks in early pregnancy, and the median value of TSH in the T1b subgroup was significantly lower than the T1a subgroup (P < 0.05). TSH levels showed a gradual trend of increase along with the pregnancy and increased significantly in the T2a, T2b, and T3b subgroups compared to the preceding subgroups (P < 0.05). Compared to the diagnostic criteria recommended by American Thyroid Association (ATA), the prevalence of thyroid dysfunction was significantly different from the established trimester- and subgroup-specific RIs throughout the pregnancy (P < 0.001).

Conclusions

We conclude that establishing gestation- and laboratory-specific RIs, especially for TSH, is essential for diagnosing thyroid disorders in pregnancy, and the recommended universal cut-off values, which may contribute to the risk of a misdiagnosis or a missed diagnosis, should be taken with caution in the clinical setting. However, regarding the fluctuation of thyroid function tests throughout pregnancy, trimester-specific RIs are insufficient, and implementing split phases is required.
Causal relationship between genetically predicted depression and cancer risk: a two-sample bi-directional mendelian randomization
Authors: Zhu Guang-Li , Xu Cheng , Yang Kai-bin , Tang Si-Qi , Tang Ling-Long , Chen Lei , Li Wen-Fei , Mao Yan-Ping , Ma Jun
Published: March 2022

Background

Depression has been reported to be associated with some types of cancer in observational studies. However, the direction and magnitude of the causal relationships between depression and different types of cancer remain unclear.

Methods

We performed the two-sample bi-directional mendelian randomization with the publicly available GWAS summary statistics to investigate the causal relationship between the genetically predicted depression and the risk of multiple types of cancers, including ovarian cancer, breast cancer, lung cancer, glioma, pancreatic cancer, lymphoma, colorectal cancer, thyroid cancer, bladder cancer, and kidney cancer. The total sample size varies from 504,034 to 729,150. Causal estimate was calculated by inverse variance weighted method. We also performed additional sensitivity tests to evaluate the validity of the causal relationship.

Results

After correction for heterogeneity and horizontal pleiotropy, we only detected suggestive evidence for the causality of genetically predicted depression on breast cancer (OR = 1.09, 95% CI: 1.03–1.15, P = 0.0022). The causal effect of depression on breast cancer was consistent in direction and magnitude in the sensitivity analysis. No evidence of causal effects of depression on other types of cancer and reverse causality was detected.

Conclusions

The result of this study suggests a causative effect of genetically predicted depression on specific type of cancer. Our findings emphasize the importance of depression in the prevention and treatment of breast cancer.
Irinotecan plus temozolomide in relapsed Ewing sarcoma: an integrated analysis of retrospective studies
Authors: Wang Bi-Cheng , Xiao Bo-Ya , Lin Guo-He
Published: March 2022

Background

The prognosis of patients with relapsed Ewing sarcoma is poor. In this study, we aimed to pooled-analyze the efficacy and safety of the combination of irinotecan and temozolomide in treating patients with relapsed Ewing sarcoma.

Methods

PubMed, Cochrane CENTRAL, Web of Science, and EMBASE were systematically searched on September 27, 2021. The primary outcomes were rates of objective response and disease control, and the secondary outcomes were toxicities.

Results

Six retrospective studies with 184 patients were enrolled in the analysis. The median age ranged from 14 to 21. The integrated rates were 44% (95% confidence interval [CI] 31–58) for objective response and 66% (55–77) for disease control. Grade 3–4 neutropenia, thrombocytopenia, and diarrhea occurred in 8% (3–16), 7% (3–11), and 8% (5–10) of chemotherapeutic cycles, respectively. 18% (7–32) and 6% (2–11) of patients suffered grade 3–4 neutropenia and thrombocytopenia after irinotecan plus temozolomide treatment.

Conclusion

Irinotecan plus temozolomide combination chemotherapy showed antitumor activity and an acceptable safety profile in patients with relapsed Ewing sarcoma. More future prospective studies are needed to confirm the retrospective results.
The temporal pattern and lifestyle associations of respiratory virus infection in a cohort study spanning the first two years of life
Authors: Powell Elizabeth , Sumner Edward , Shaw Alex G. , Calvez Ronan , Fink Colin G. , Kroll J. Simon
Published: March 2022

Background

Respiratory virus infection is common in early childhood, and children may be symptomatic or symptom-free. Little is known regarding the association between symptomatic/asymptomatic infection and particular clinical factors such as breastfeeding as well as the consequences of such infection.

Method

We followed an unselected cohort of term neonates to two years of age (220 infants at recruitment, 159 who remained in the study to 24 months), taking oral swabs at birth and oropharyngeal swabs at intervals subsequently (at 1.5, 6, 9, 12, 18 and 24 months and in a subset at 3 and 4.5 months) while recording extensive metadata including the presence of respiratory symptoms and breastfeeding status. After 2 years medical notes from the general practitioner were inspected to ascertain whether doctor-diagnosed wheeze had occurred by this timepoint. Multiplex PCR was used to detect a range of respiratory viruses: influenza (A&B), parainfluenza (1–4), bocavirus, human metapneumovirus, rhinovirus, coronavirus (OC43, 229E, NL63, HKU1), adenovirus, respiratory syncytial virus (RSV), and polyomavirus (KI, WU). Logistic regression and generalised estimating equations were used to identify associations between clinical factors and virus detection.

Results

Overall respiratory viral incidence increased with age. Rhinovirus was the virus most frequently detected. The detection of a respiratory virus was positively associated with respiratory symptoms, male sex, season, childcare and living with another child. We did not observe breastfeeding (whether assessed as the number of completed months of breastfeeding or current feed status) to be associated with the detection of a respiratory virus. There was no association between early viral infection and doctor-diagnosed wheeze by age 2 years.

Conclusion

Asymptomatic and symptomatic viral infection is common in the first 2 years of life with rhinovirus infection being the most common. Whilst there was no association between early respiratory viral infection and doctor-diagnosed wheeze, we have not ruled out an association of early viral infections with later asthma, and long-term follow-up of the cohort continues.
Childhood disability in rural Niger: a population-based assessment using the Key Informant Method
Authors: Banks Lena Morgon , Liu Jing , Kielland Anne , Tahirou Ali Bako , Harouna Abdoul Karim Seydou , Mactaggart Islay , Dybdahl Ragnhild , Mounkaila Dan Firoun , Grønningsæter Arne
Published: March 2022

Background

Data on childhood disability is essential for planning health, education and other services. However, information is lacking in many low- and middle-income countries, including Niger. This study uses the Key Informant Method, an innovative and cost-effective strategy for generating population-based estimates of childhood disability, to estimate the prevalence and causes of moderate/severe impairments and disabling health conditions in children of school-going age (7–16 years) in the Kollo department of western Niger.

Methods

Community-based key informants were trained to identify children who were suspected of having the impairment types/health conditions included in this study. Children identified by key informants were visited by paediatricians and underwent an assessment for moderate/severe vision, hearing, physical and intellectual impairments, as well as epilepsy, albinism and emotional distress.

Results

Two thousand, five hundred sixty-one children were identified by key informants, of whom 2191 were visited by paediatricians (response rate = 85.6%). Overall, 597 children were determined to have an impairment/health condition, giving a prevalence of disability of 11.4 per 1000 children (10.6- 12.2). Intellectual impairment was most common (6.5 per 1000), followed by physical (4.9 per 1000) and hearing impairments (4.7 per 1000). Many children had never sought medical attention for their impairment/health condition, with health seeking ranging from 40.0% of children with visual impairment to 67.2% for children with physical impairments.

Conclusion

The Key Informant Method enabled the identification of a large number of children with disabling impairments and health conditions in rural Niger, many of whom have unmet needs for health and other services.
Study protocol for evaluating Brown Buttabean Motivation (BBM): a community-based, Pacific-driven approach to health
Authors: Savila Fa’asisila , Bagg Warwick , Swinburn Boyd , van der Werf Bert , Letele Dave , Bamber Anele , Harding Truely , Goodyear-Smith Felicity
Published: March 2022

Background

Buttabean Motivation (BBM) is a Pacific-led organisation which aims to reduce obesity amongst Pacific and Māori people in New Zealand enabling them to choose a healthy and active life-style for the duration of their lives, their children, their wider family and the community. BBM offers a holistic approach to weight loss, recognising that mental health, family and cultural factors all play essential and critical role in nutrition and physical activity patterns. This study aims to evaluate the effectiveness of BBM for sustained health and wellbeing outcomes among its predominantly Pacific and Māori participants for both general BBM members and those with morbid obesity attending the ‘From the Couch’ programme.

Methods

Quasi-experimental pre-post quantitative cohort study design with measured or self-reported weight at various time intervals for both cohorts. Weight will be analysed with general linear mixed model for repeated measures, and compared with a prediction model generated from the literature using a mixed method meta-analysis. The secondary outcome is change in pre- and post scores of Māori scale of health and well-being, Hua Oranga.

Discussion

Multiple studies have shown that many diet and physical activity programmes can create short-term weight loss. The fundamental question is whether BBM members maintain weight loss over time. In New Zealand, Pacific and Māori engagement in health enhancing programmes remains an important strategy for achieving better health and wellbeing outcomes, and quality of life. Internationally, the collectivist cultures of indigenous and migrant and minority populations, living within dominant individualist western ideologies, have much greater burdens of obesity. If BBM members demonstrate sustained weight loss, this culturally informed community-based approach could benefit to other indigenous and migrant populations.

Trial registration

Australian New Zealand Clinical Trial RegistryACTRN12621000931875(BBM general members) First submitted 10 May 2021, registration completed 15 July 2021.ACTRN126210016768087 (From the Couch) First submitted 28 October 2021, registration completed 7 December 2021.