bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined therapy guided by multimodal imaging of fifteen retinal capillary hemangioblastomas in a monocular Von Hippel- Lindau syndrome case report
Authors: Guo Ju , Du Liping , Zhou Pengyi , Guo Xiaohong , Dai Fangfang , Jin Xuemin
Published: May 2022

Background

To report the multimodal imaging and treatment of fifteen retinal capillary hemangioblastomas (RCHs) associated with Von Hippel-Lindau syndrome in a monocular patient during a long-term following-up, which supply high-resolution exquisite SS-OCTA images (VG200; SVision Imaging, Ltd., Luoyang, China) and management experience about multiple RCHs.

Case presentation

A 34-year-old monocular male patient complained decreased visual acuity (20/100) without pain and redness in the left eye five years ago. Von Hippel-Lindau syndrome were diagnosed with genetic testing. He, his son and daughter all carried a heterozygosity missense variant c.499C > T (p. Arg167Trp) in the Hg19 gene, a VHL gene located in Chr3:10,191,506. Fifteen RCHs were identified by the application of multimodal imaging, which including fundus photo, fundus autofluorescence (FAF), B-scan ultrasonography (US), fluorescein fundus angiography (FFA), indocyanine green angiography (ICGA) and swept-source optical coherence tomography angiography (SS-OCTA). Transscleral cryotherapy and laser photocoagulation were performed to destroy the largest RCH with the size of 4 PD in diameter. Laser photocoagulation was conducted to seal the middle or tiny RCHs (< 1.5 PD) and their nourishing vessels. The retinal edema and exudative macular detachment were successfully relieved by intraocular injection of bevacizumab for 5 times. The RCHs in the left eye responded well to these treatments and best corrected visual acuity was 20/25 for three years. Three-month recall visits were recommended for him.

Conclusion

For multiple retinal capillary hemangioblastomas in monocular patients, precise combined therapy guided by multimodal imaging has a profound impact on the management of new and recurrent RCHs.
Glucagon-like peptide-1 receptor agonist, liraglutide, attenuated retinal thickening in spontaneously diabetic Torii fatty rats
Authors: Inoue Kazuho , Yamada Shohei , Hoshino Seiko , Watanabe Minoru , Kimura Kenjiro , Kamijo-Ikemori Atsuko
Published: May 2022

Background

This study aims to investigate the effect of the glucagon-like peptide-1 (GLP-1) receptor agonist (GLP-1RA) liraglutide on retinal pathological findings as compared with insulin and hydralazine using an animal model of type 2 diabetes with obesity, hypertension, and hyperlipidemia.

Methods

Male spontaneously diabetic Torii (SDT) fatty rats at 8 weeks of age were randomly assigned to three groups: the liraglutide group (SDT-lira, n = 6) received a subcutaneous injection of liraglutide from the age of 8 to 16 weeks, the SDT-ins-hyd group (n = 6) was provided both insulin against hyperglycemia and hydralazine against hypertension to match levels of both blood glucose and blood pressure to those of the liraglutide group, and the control group of SDT fatty rats (SDT-vehicle, n = 7) and a nondiabetic control group of Sprague–Dawley rats (SD, n = 7) were injected with vehicle only. Both eyeballs of all groups were collected at the age of 16 weeks.

Results

Retinal thickness, which was found in the SDT-vehicle group, was significantly prevented to similar levels in both the SDT-lira and SDT-ins-hyd groups. Immunohistological analysis revealed that GLP-1 receptor was not expressed in the retina of all rats. The ocular protein expression of monocyte chemoattractant protein-1, which causes a proinflammatory situation, was significantly upregulated in all SDT fatty rats as compared to SD rats, but the expression levels were similar between all SDT fatty rats. With regard to neovascularization in the eyes, there were no significant differences in protein expressions of vascular endothelial growth factor, CD31, or endothelial nitric oxide synthase in all rats.

Conclusions

The present study indicates that liraglutide prevents retinal thickening, dependent on blood glucose and blood pressure levels in SDT fatty rats without ocular neovascularization. However, the effects did not improve the ocular proinflammatory state.
Paediatric traumatic cataracts in Southwest China: epidemiological profile
Authors: Wang Pingping , Fu Qingyu , Yin Hongbo , Wang Lin , Liu Longqian
Published: May 2022

Background

Paediatric traumatic cataracts are an important but preventable cause of acquired blindness. Understanding the epidemiology of paediatric traumatic cataracts is a prerequisite for prevention. This study aimed to characterize the epidemiological profile of paediatric traumatic cataracts in southwest China.

Methods

The medical records of children (age range, 0–14 years old) who developed traumatic cataracts following open-globe injuries and were hospitalized at the Department of Ophthalmology at West China Hospital, between January 2011 and December 2020 were retrospectively analyzed. The demographic data, causes of injuries, posttraumatic complications, and visual acuity were recorded and analysed.

Results

A total of 716 eyes from 716 patients were analysed in this study, including 521 (72.8%) males and 195 females in a gender ratio of 2.67:1; 117 of the patients were of ethnic minorities. Paediatric traumatic cataracts occurred more frequently in winter (32.5%). Sharp metal objects (scissors/knives/needles/sheet metal/nails/darts) – induced ocular injuries accounted for the highest proportion, followed by botanical sticks (wooden sticks /bamboo sticks /bamboo skewers)-induced injuries, and then stationery items (pencils/pens/rulers/paper)-induced injuries. The majority (68.7%) of the patients were aged 2–8 years, and the peak range of age was 4 - 6 years. The injuries were a result of penetrating trauma in 64.9% of patients, and blunt force trauma in the remainder (35.1%). Additionally, 131 (18.3%) cases developed posttraumatic infectious endophthalmitis after injuries. Patients with eye injuries caused by needles (P < 0.001), wooden sticks (P = 0.016), and bamboo skewers (P = 0.002) were at a greater risk of developing infectious endophthalmitis. The most common identified foreign organism was Streptococcus, which accounted for 42% (21/50) of all culture-positive specimens and was sensitive to vancomycin. Among the children who were younger than 5 years, 44.4% (55/124) of those with traumatic cataracts presented a corrected distance visual acuity less than or equal to 0.1 after undergoing cataract surgery, but among the children who were older than 5 years, this proportion was significantly smaller, just 20.4% of children aged 6-10 years (P < 0.001) and 18.4% of children aged 11-14 years (P < 0.001).

Conclusion

The main causative agents of paediatric traumatic cataracts in southwest China were sharp metal objects, botanical sticks, and stationery items. Specific preventive measures are essential to reduce the incidence of paediatric traumatic cataract.
Disproportionate reduction in respiratory vs. non-respiratory outpatient clinic visits and antibiotic use in children during the COVID-19 pandemic
Authors: Givon-Lavi Noga , Danino Dana , van der Beek Bart Adriaan , Sharf Amir , Greenberg David , Ben-Shimol Shalom
Published: May 2022

Background

The COVID-19 pandemic led to improved hygiene and reduced social encounters. Near elimination of the activity of respiratory syncytial virus and influenza viruses were observed, worldwide. Therefore, we assessed the rates of pediatric outpatient clinic visits and medications prescribed at those visits during the coronavirus disease 2019 (COVID-19) pandemic and pre-COVID-19 period (2016–2019).

Methods

Monthly and annual incidence rates for respiratory and non-respiratory diagnoses and dispensed prescription rates were calculated. Acute gastroenteritis (AGE) visits were analyzed separately since the mode of transmission is influenced by hygiene and social distancing.

Results

Overall, 5,588,702 visits were recorded. Respiratory and AGE visits declined by 49.9% and 47.3% comparing the COVID-19 and pre-COVID-19 periods. The respective rate reductions for urinary tract infections, trauma, and skin and soft tissue infections were 18.2%, 19.9%, and 21.8%. Epilepsy visits increased by 8.2%. Overall visits rates declined by 21.6%. Dispensed prescription rates of antibiotics and non-antibiotics respiratory medications declined by 49.3% and 44.4%, respectively. The respective declines for non-respiratory antibiotics and non-antibiotics were 15.1% and 0.2%. Clinic visits and prescription rates reductions were highest in April–May, following the first lockdown in Israel.

Conclusions

COVID-19 pandemic resulted in a substantial reduction in respiratory outpatient clinic visits and dispensed respiratory drugs, with only a mild reduction seen for non-respiratory visits. These trends were probably driven by COVID-19 mitigation measures and by the profound disruption to non-SARS COV-2 respiratory virus activity.
The predictive performance of surgical treatment in upper molars with combined bony defect and furcation involvement: a retrospective cohort study
Authors: Chiu Meng-Yao , Lin Cho-Ying , Kuo Pe-Yi
Published: May 2022

Background

To evaluate the impact of combined defects, bony destruction and furcation involvement, on disease resolution after surgery in terms of pocket elimination, absence of inflammation, furcation improvement and predictive performance.

Methods

Combined bony (intrabony (+) or (−)) and furcation defects (FI degree 1 or 2) at maxillary molars in patients diagnosed as periodontitis stage III to IV, being through periodontal surgery and at least 6 months follow-up were retrospectively screened. Cumulative predictability (CR, %), failure of treatment and the change of clinical parameters from baseline at pre-operative visit to the latest maintenance care, including pocket depth (PD), horizontal and vertical furcation involvement (FI) were analyzed. Failure of treatment with low predictability was defined as residual PD > 4 mm with bleeding on probing during maintenance period.

Results

Thirty-three patients with fifty-one combined defects were included. Statistical analysis showed significant overall PD reduction and FI improvement (p < 0.001). Combined FI degree 2 with intrabony (+) defects revealed more horizontal furcation improvement compared with FI degree 2 with suprabony defect (p = 0.007). However, type of combined defects was not relevant to CR (p = 0.702) and PD reduction (p = 0.707). Among all parameters, baseline PD with proximal FI degree 2 was indicated to failure of treatment.

Conclusions

Different types of combined defects, deep baseline pocket and proximal FI degree 2 would compromise the predictability of treatment outcomes in upper molars. Nevertheless, the combination of surgical treatment and strict maintenance care could still yield high predictability and survival rate.

Trial registration: retrospectively registered.
Antimicrobial effects and mechanical properties of poly(methyl methacrylate) as an orthodontic acrylic resin containing Curcumin-Nisin-poly(l-lactic acid) nanoparticle: an in vitro study
Authors: Pourhajibagher Maryam , Noroozian Mohammad , Ahmad Akhoundi Mohammad Sadegh , Bahador Abbas
Published: May 2022

Background

The porous surface of acrylic orthodontic removable appliances creates a niche for microbial plaque accumulation, and changes the oral flora by raising cariogenic bacteria including Streptococcus mutans. In this study, we evaluated the mechanical properties and antimicrobial activities of incorporating different concentrations of Curcumin-Nisin-poly(l-lactic acid) nanoparticle (CurNisNps) into orthodontic acrylic resin against Streptococcus mutans and Candida albicans.

Methods

Following synthesis and characterization of CurNisNps, acrylic resin specimens with different concentrations of CurNisNps (0, 1, 2, 5, and 10% w/w) were fabricated. Flexural strength values, antimicrobial effects, anti-biofilm potential, and anti-metabolic activity against S. mutans and C. albicans were assessed at different time intervals. Also, the expression of the virulence-factor-related genes of S. mutans and C. albicans was assessed by quantitative real-time polymerase chain reaction following treatment with CurNisNps.

Results

Acrylic resin containing 10% CurNisNps (30.76 ± 3.91 MPa) showed flexural failure in comparison with acrylic resin specimens without CurNisNps (50.67 ± 1.82 MPa) as the control group (P < 0.05). There was no significant decrease in the flexural strength values in samples containing 1, 2, and 5% of CurNisNps in comparison to the control group (P > 0.05). Acrylic resin with 5% CurNisNps showed the highest concentration of CurNisNps and clinically accepted flexural strength value (14.89 ± 3.26 MPa, P < 0.05) simultaneously. In the disc agar diffusion assay, 5% CurNisNps showed a high level of inhibitory activity for the test microorganisms. The reduction of growth inhibition zones of the different concentrations of CurNisNps against test microorganisms was positively associated with the time, in such a way that it was reduced significantly after 60 days. The anti-biofilm and anti-metabolic activities of acrylic resin specimens containing a 5% concentration of CurNisNps against S. mutans and C. albicans could significantly decrease the expression levels of gtfB (6.8-fold) and HWP (3.4-fold) in S. mutans and C. albicans, respectively.

Conclusions

Our data support that 5% (w/w) of CurNisNps can serve as an excellent orthodontic acrylic resin additive against S. mutans and C. albicans biofilm without adverse effects on its mechanical property.
Prediction models for early diagnosis of actinomycotic osteomyelitis of the jaw using machine learning techniques: a preliminary study
Authors: Choi Sun-Gyu , Lee Eun-Young , Lee Ok-Jun , Kim Somi , Kang Ji-Yeon , Lim Jae Seok
Published: May 2022

Background

This study aimed to develop and validate five machine learning models designed to predict actinomycotic osteomyelitis of the jaw. Furthermore, this study determined the relative importance of the predictive variables for actinomycotic osteomyelitis of the jaw, which are crucial for clinical decision-making.

Methods

A total of 222 patients with osteomyelitis of the jaw were analyzed, and Actinomyces were identified in 70 cases (31.5%). Logistic regression, random forest, support vector machine, artificial neural network, and extreme gradient boosting machine learning methods were used to train the models. The models were subsequently validated using testing datasets. These models were compared with each other and also with single predictors, such as age, using area under the receiver operating characteristic (ROC) curve (AUC).

Results

The AUC of the machine learning models ranged from 0.81 to 0.88. The performance of the machine learning models, such as random forest, support vector machine and extreme gradient boosting was significantly superior to that of single predictors. Presumed causes, antiresorptive agents, age, malignancy, hypertension, and rheumatoid arthritis were the six features that were identified as relevant predictors.

Conclusions

This prediction model would improve the overall patient care by enhancing prognosis counseling and informing treatment decisions for high-risk groups of actinomycotic osteomyelitis of the jaw.
Long non-coding RNA TFAP2A-AS1 plays an important role in oral squamous cell carcinoma: research includes bioinformatics analysis and experiments
Authors: Jie Guo , Peng ShiXiong , Cui ZiFeng , He Chen , Feng XuPo , yang Kaicheng
Published: May 2022

Background

Oral squamous cell carcinoma (OSCC) is the most common neck and head malignancies, and the prognosis is not good. Studies shown that the long non-coding RNA (lncRNA) TFAP2A-AS1 is involved in the progression of multiple cancers. However, the role of lncRNA TFAP2A-AS1 in OSCC remains unclear. We aimed to explore the functions and expression in OSCC.

Methods

The lncRNA profiles for OSCC patients were acquired from the TCGA. Based on these data, the data mining of TFAP2A-AS1 in patients with OSCC were performed. The functions of TFAP2A-AS1 were determined by bioinformatics analysis. The expression and roles in cell growth were tested by RT-qPCR and MTS assay. Cell invasion and migration were tested by wound healing and transwell assays.

Results

The consequences displayed that TFAP2A-AS1 was upregulated in the TCGA datasets. The expression of TFAP2A-AS1 was higher in OSCC samples. Bioinformatics analysis shown that TFAP2A-AS1 might be associated with the P53 signaling pathway. Cell culture experiments indicated that deficiency of TFAP2A-AS1 inhibited cell growth, invasion, and migration, and overexpression of it could opposite results in SCC-25 cells.

Conclusion

The results suggested that TFAP2A-AS1 was overexpressed in OSCC cells, which could facilitate OSCC cell proliferation, migration, and invasion.
A cumulative prospect theory-based method for group medical emergency decision-making with interval uncertainty
Authors: Sun Jiayi , Zhou Xiang , Zhang Juan , Xiang Kemei , Zhang Xiaoxiong , Li Ling
Published: May 2022

Background

An emergency response to a medical situation is generally considered to be a risk decision-making problem. When an emergency event occurs, it makes sense to take into account more than one decision maker’s opinions and psychological behaviors. The existing research tends to ignore these multidimensional aspects. To fill this literature gap, we propose a multi-attribute model.

Methods

The model is based on cumulative prospect theory (CPT), considering multiple experts’ psychological factors. By not assuming full rationality, we extend existing models to allow multiple experts’ risk preferences to be incorporated into the decision-making process in the case of an emergency. Then, traditional CPT is extended by allowing for multiple attributes. In addition, rather than using crisp data, interval values are adopted to tackle the usual uncertainties in reality.

Results

The multi-attribute CPT based model proposed can deal with the selection of potential emergency alternatives. The model incorporates interval values to allow more uncertainty and the comparative studies show that the optimal solution changes under different scenarios.

Conclusions

Our illustrative example and comparative study show that considering multiple experts and multiple attributes is more reasonable, especially in complicated situations under an emergency. In addition, decision-makers’ risk preferences highly affect the selection outcomes, highlighting their importance in the medical decision-making process. Our proposed model can be applied to similar fields with appropriate modifications.
Comparison of Iran’s nursing education with developed and developing countries: a review on descriptive-comparative studies
Authors: Farsi Zahra , Nasiri Morteza , Sajadi Seyedeh Azam , Khavasi Mohammad
Published: May 2022

Background

Iran’s nursing education has undergone significant modifications in the last decades, especially following the Islamic revolution and the Iran-Iraq war. This review outlined changing trends in Iran’s nursing education and evaluate its status compared to other developing and developed countries.

Methods

Six international and two national electronic data sources were searched up to May 2021, using relevant keywords and terms. The studies were included if they addressed history, development, or evolutionary aspects of Iran’s nursing education or evaluated its status by comparing it with developing or developed countries, using Bereday's model. To obtain more relevant information, the organizational documents of the Iranian Ministry of Health and Medical Education and the Iranian Ministry of Culture and Higher Education were searched. Of 753 evidence found in the initial search, 73 were considered eligible for this review. A systematic and unbiased data synthesis was performed and a narrative and tabulated summary was presented.

Results

The evolution in Iran’s nursing education has resulted in the establishment of Bachelor, Master, and Ph.D. programs. Iran’s nursing education system plays an important role in fulfilling the healthcare system’s mission, and it does not hold a dissatisfactory position in comparison with other developed and developing countries. However, this system is expected to be more versatile for the upcoming changes and advancements.

Conclusion

Iran’s nursing education has a moderate rating despite recent changes. Hence, this system has to be modified in some aspects by adopting experiences of other countries, with an appropriate and successful education system, to prepare future highly competent nurses.
The anti-tumor effect of proteasome inhibitor MG132 for human adenoid cystic carcinoma: correlate with the emerging role of Nrf2/Keap1 signaling pathway
Authors: Xu Jiazhi , Wu Haiwei , Sun Jiatong , Gong Zhiyuan , Lu Xiaoya , Yang Enli , Chen Zhanwei , Huang Shengyun , Nong Xiaolin , Zhang Dongsheng
Published: May 2022

Background

Adenoid cystic carcinoma (ACC) is one of the most common malignant salivary gland tumors. Moreover, the unique biological characteristics and complex structures of ACC contribute to its poor survival rates. Recently, proteasome inhibitors have been shown to elicit satisfactory therapeutic effects in the treatment of certain solid tumors, but few studies have been implemented to investigate the effects of proteasome inhibitor therapy for ACC.

Methods

In this present study, cell counting kit-8 assay and flow cytometry assay were performed to examine the effects of proteasome inhibitor (MG132) on cell viability and apoptosis. We applied western blot and immunofluorescence staining to explore the expression of the Nrf2/Keap1 signaling pathway and P62, additionally Nrf2 inhibitor (ML385) was utilized to evaluate the role of Nrf2/Keap1 signaling pathway in MG132-induced cell apoptosis.

Results

Our data indicated that MG132 significantly suppressed the growth of ACC-83 cells(MG132 10µM P = 0.0046; 40µM P = 0.0033; 70µM P = 0.0007 versus control) and induced apoptosis (MG132 10µM P = 0.0458; 40µM P = 0.0018; 70µM P = 0.0087 versus control). The application of MG132 induced the up-regulation of Nrf2/Keap1 signaling pathway. Furthermore, inhibition of Nrf2 attenuated the therapeutic effects of MG132 for ACC (both ML385 + MG132 10µM P = 0.0013; 40µM P = 0.0057; 70µM P = 0.0003 versus MG132). P < 0.05 was considered statistically significant.

Conclusions

Our results revealed that proteasome inhibitors MG132 could inhibit the cell viability and induce the apoptosis of ACC through Nrf2/Keap1 signaling pathway.
Early intubation and decreased in-hospital mortality in patients with coronavirus disease 2019
Authors: Yamamoto Ryo , Kaito Daiki , Homma Koichiro , Endo Akira , Tagami Takashi , Suzuki Morio , Umetani Naoyuki , Yagi Masayuki , Nashiki Eisaku , Suhara Tomohiro , Nagata Hiromasa , Kabata Hiroki , Fukunaga Koichi , Yamakawa Kazuma , Hayakawa Mineji , Ogura Takayuki , Hirayama Atsushi , Yasunaga Hideo , Sasaki Junichi ,   the J-RECOVER study group
Published: May 2022

Background

Some academic organizations recommended that physicians intubate patients with COVID-19 with a relatively lower threshold of oxygen usage particularly in the early phase of pandemic. We aimed to elucidate whether early intubation is associated with decreased in-hospital mortality among patients with novel coronavirus disease 2019 (COVID-19) who required intubation.

Methods

A multicenter, retrospective, observational study was conducted at 66 hospitals in Japan where patients with moderate-to-severe COVID-19 were treated between January and September 2020. Patients who were diagnosed as COVID-19 with a positive reverse-transcription polymerase chain reaction test and intubated during admission were included. Early intubation was defined as intubation conducted in the setting of ≤ 6 L/min of oxygen usage. In-hospital mortality was compared between patients with early and non-early intubation. Inverse probability weighting analyses with propensity scores were performed to adjust patient demographics, comorbidities, hemodynamic status on admission and time at intubation, medications before intubation, severity of COVID-19, and institution characteristics. Subgroup analyses were conducted on the basis of age, severity of hypoxemia at intubation, and days from admission to intubation.

Results

Among 412 patients eligible for the study, 110 underwent early intubation. In-hospital mortality was lower in patients with early intubation than those with non-early intubation (18 [16.4%] vs. 88 [29.1%]; odds ratio, 0.48 [95% confidence interval 0.27–0.84];p = 0.009, and adjusted odds ratio, 0.28 [95% confidence interval 0.19–0.42];p < 0.001). The beneficial effects of early intubation were observed regardless of age and severity of hypoxemia at time of intubation; however, early intubation was associated with lower in-hospital mortality only among patients who were intubated later than 2 days after admission.

Conclusions

Early intubation in the setting of ≤ 6 L/min of oxygen usage was associated with decreased in-hospital mortality among patients with COVID-19 who required intubation.

Trial RegistrationNone.
Stage-specific regulation of signalling pathways to differentiate pluripotent stem cells to cardiomyocytes with ventricular lineage
Authors: Satthenapalli Ramakanth , Lee Scott , Bellae Papannarao Jayanthi , Hore Timothy A. , Chakraborty Akash , Jones Peter P. , Lamberts Regis R. , Katare Rajesh
Published: May 2022

Background

Pluripotent stem cells (PSCs) can be an ideal source of differentiation of cardiomyocytes in vitro and during transplantation to induce cardiac regeneration. However, differentiation of PSCs into a heterogeneous population is associated with an increased incidence of arrhythmia following transplantation. We aimed to design a protocol to drive PSCs to a ventricular lineage by regulating Wnt and retinoic acid (RA) signalling pathways.

Methods

Mouse embryonic stem cells were cultured either in monolayers or three-dimensional hanging drop method to form embryonic bodies (EBs) and exposed to different treatments acting on Wnt and retinoic acid signalling. Samples were collected at different time points to analyse cardiomyocyte-specific markers by RT-PCR, flow cytometry and immunofluorescence.

Results

Treatment of monolayer and EBs with Wnt and RA signalling pathways and ascorbic acid, as a cardiac programming enhancer, resulted in the formation of an immature non-contractile cardiac population that expressed many of the putative markers of cardiac differentiation. The population exhibited upregulation of ventricular specific markers while suppressing the expression of pro-atrial and pro-sinoatrial markers. Differentiation of EBs resulted in early foetal like non-contractile ventricular cardiomyocytes with an inherent propensity to contract when stimulated.

Conclusion

Our results provide the first evidence of in vitro differentiation that mimics the embryonic morphogenesis towards ventricular specific cardiomyocytes through regulation of Wnt and RA signalling pathways.
European public health best practice portal - process and criteria for best practice assessment
Authors: Stepien Magdalena , Keller Ingrid , Takki Marianne , Caldeira Sandra
Published: May 2022

Background

Non-communicable diseases (NCDs) are major and growing burden on population health and the use and cost of healthcare in EU Member States and beyond. Different countries face many common challenges in public health and can learn from each other. The exchange of ‘best practices’ is one way to tackle the observed disparities in health sector. To address the United Nations Sustainable Development Goals, the European Commission developed the EU Public Health Best Practice Portal to facilitate the exchange of best practices and facilitate their implementation in other EU countries or regions. The ultimate aim of the portal is to reduce NCDs burden and the prevalence of their risk factors by promoting implementation and scale up of evidence-based effective interventions in the areas of health promotion, disease prevention and management of NCDs.

Results

This article presents the rationale and the process, ranging from best practice assessment to their transfer to interested Member States, applied in the EU Public Health Best Practice Portal. The portal selects best practices using rigorously defined criteria for best practice assessment. This article further provides an overview of other similar initiatives in Europe and internationally that collect and disseminate information on interventions and actions to combat NCDs.

Conclusion

Exchange of best practices is a promising tool in tackling NCDs. Transfer and scaling up of policies and interventions between countries may contribute to tackle disparities observed between countries in regards to the prevalence of risk factors and associated diseases.
A case series of group-based ketamine-assisted psychotherapy for patients in residential treatment for eating disorders with comorbid depression and anxiety disorders
Authors: Robison Reid , Lafrance Adele , Brendle Madeline , Smith Michelle , Moore Claire , Ahuja Sachin , Richards Scott , Hawkins Nicole , Strahan Erin
Published: May 2022

Background

Depression and anxiety outcome measures, safety/tolerability, patient satisfaction, and ease of implementation of group-based ketamine-assisted psychotherapy (G-KAP) delivered to patients in intensive residential eating disorder (ED) treatment were assessed.

Case presentation

This study reports on five participants with a diagnosis of an ED and comorbid mood and anxiety disorders who received weekly intramuscular ketamine injections in a group setting over 4 weeks. Measures of anxiety (GAD-7) and depression (PHQ-9) were administered pre-dose, 4-h post-dose, and 24-h post dose. Four of the 5 participants experienced clinically significant improvements on the PHQ-9 score (i.e., change greater than 5) while 2 of the 5 participants experienced clinically significant improvements on the GAD-7 score (i.e., change greater than 4) from pre-dose to 24-h post-dose after the last ketamine session. Dosing sessions were well tolerated, and no serious adverse events were reported. Clinical observations and participant reports corroborated improvements in depression and anxiety symptoms, good tolerability of ketamine treatment, and practical implementation of the G-KAP protocol in a residential ED treatment center.

Conclusions

This study suggests the potential utility of G-KAP as an adjunct to intensive, specialized ED treatment. Overall, this novel, cross-diagnostic intervention warrants future research to further explore its appropriateness in a treatment setting.
Machine Learning to Predict Risk of Relapse Using Cytologic Image Markers in Patients With Acute Myeloid Leukemia Posthematopoietic Cell Transplantation
Authors: Arabyarmohammadi Sara , Leo Patrick , Viswanathan Vidya Sankar , Janowczyk Andrew , Corredor German , Fu Pingfu , Meyerson Howard , Metheny Leland , Madabhushi Anant
Published: May 2022

PURPOSE

Allogenic hematopoietic stem-cell transplant (HCT) is a curative therapy for acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Relapse post-HCT is the most common cause of treatment failure and is associated with a poor prognosis. Pathologist-based visual assessment of aspirate images and the manual myeloblast counting have shown to be predictive of relapse post-HCT. However, this approach is time-intensive and subjective. The premise of this study was to explore whether computer-extracted morphology and texture features from myeloblasts' chromatin patterns could help predict relapse and prognosticate relapse-free survival (RFS) after HCT.

MATERIALS AND METHODS

In this study, Wright-Giemsa–stained post-HCT aspirate images were collected from 92 patients with AML/MDS who were randomly assigned into a training set ( S t = 52) and a validation set ( S v = 40). First, a deep learning–based model was developed to segment myeloblasts. A total of 214 texture and shape descriptors were then extracted from the segmented myeloblasts on aspirate slide images. A risk score on the basis of texture features of myeloblast chromatin patterns was generated by using the least absolute shrinkage and selection operator with a Cox regression model.

RESULTS

The risk score was associated with RFS in S t (hazard ratio = 2.38; 95% CI, 1.4 to 3.95; P = .0008) and S v (hazard ratio = 1.57; 95% CI, 1.01 to 2.45; P = .044). We also demonstrate that this resulting signature was predictive of AML relapse with an area under the receiver operating characteristic curve of 0.71 within S v. All the relevant code is available at GitHub.

CONCLUSION

The texture features extracted from chromatin patterns of myeloblasts can predict post-HCT relapse and prognosticate RFS of patients with AML/MDS.
The GIST of Advances in Treatment of Advanced Gastrointestinal Stromal Tumor
Authors: Schaefer Inga-Marie , DeMatteo Ronald P. , Serrano César
Published: May 2022

Gastrointestinal stromal tumor (GIST) is the most common malignant neoplasm of mesenchymal origin and a compelling clinical and biologic model for the rational development of molecularly targeted agents. This is because the majority of GISTs are driven by gain-of-function mutations in KIT or PDGFRA receptor tyrosine kinases. Specific GIST mutations circumscribe well-defined molecular subgroups that must be determined during the diagnostic work-up to guide clinical management, including therapeutic decisions. Surgery is the cornerstone treatment in localized disease and can also be clinically relevant in the metastatic setting. The correct combination and sequence of targeted agents and surgical procedures improves outcomes for patients with GIST and should be discussed individually within multidisciplinary expert teams. All currently approved agents for the treatment of GIST are based on orally available tyrosine kinase inhibitors targeting KIT and PDGFRA oncogenic activation. Although first-line imatinib achieves remarkable prolonged disease control, the benefit of subsequent lines of treatment is more modest. Novel therapeutic strategies focus on overcoming the heterogeneity of KIT or PDGFRA secondary mutations and providing more potent inhibition of specific challenging mutations. This article reviews the current understanding and treatment of GIST, with an emphasis on recent advances.
Grief Aesthetics
Authors: Ife Fahima
Published: May 2022

An excerpt from an experimental series, “Grief Aesthetics” is a lyrical essay on intimacy and writing. The essay participates in the double black study of eroding and composing a new sentence, a new sentence sounded in refusal (of the social pact of writing, of grammar), a new sentence forged in friendship (of thinking with, of writing with). On one level, “Grief Aesthetics” is concerned with inherited grief, the remains of stolen life, the residual desire for romance in contemporary black art. The essay considers the loss of romantic love in conversation with Terence Nance's feature and short films An Oversimplification of Her Beauty and Swimming in Your Skin Again, in conversation with a single recurring line from a poem in Taylor Johnson's Inheritance. At another level, “Grief Aesthetics” is a sort of ars poetica on the process of writing and at this level is preoccupied with the poetic line, the sentence (thinking about sentences), the space in writing, the mundane moments in between the emergence of a line or series of lines and declension as it occurs in the gaps. At every turn “Grief Aesthetics” practices creating in “commonsense” (a shared feeling, a shared aesthetics) among contemporary artists whose works evoke a sense of grief, (dis)placement, loss, loneliness, homelessness, desire, tenderness, friendship, bliss.
The role of Lrp6-mediated Wnt/β-catenin signaling in the development and intervention of spinal neural tube defects in mice
Authors: Zhao Tianyu , McMahon Moira , Reynolds Kurt , Saha Subbroto Kumar , Stokes Arjun , Zhou Chengji J.
Published: May 2022

Neural tube defects (NTDs) are among the common and severe birth defects with poorly understood etiology. Mutations in the Wnt co-receptor LRP6 are associated with NTDs in humans. Either gain-of-function (GOF) or loss-of-function (LOF) mutations of Lrp6 can cause NTDs in mice. NTDs in Lrp6-GOF mutants may be attributed to altered β-catenin-independent noncanonical Wnt signaling. However, the mechanisms underlying NTDs in Lrp6-LOF mutants and the role of Lrp6-mediated canonical Wnt/β-catenin signaling in neural tube closure remain unresolved. We previously demonstrated that β-catenin signaling is required for posterior neuropore (PNP) closure. In the current study, conditional ablation of Lrp6 in dorsal PNP caused spinal NTDs with diminished activities of Wnt/β-catenin signaling and its downstream target gene Pax3, which is required for PNP closure. β-catenin-GOF rescued NTDs in Lrp6-LOF mutants. Moreover, maternal supplementation of a Wnt/β-catenin signaling agonist reduced the frequency and severity of spinal NTDs in Lrp6-LOF mutants by restoring Pax3 expression. Together, these results demonstrate the essential role of Lrp6-mediated Wnt/β-catenin signaling in PNP closure, which could also provide a therapeutic target for NTD intervention through manipulation of canonical Wnt/β-catenin signaling activities.
Inter-Spin Interactions of 1D Chains of Different-Sized Nitroxide Radicals Incorporated in the Organic 1D Nanochannels of Tris(o-phenylenedioxy)cyclotriphosphazene
Authors: Kobayashi Hirokazu , Takeuchi Kanae , Morinaga Yuka , Honda Hidehiko , Yamamoto Masato , Odanaka Yuki , Inagaki Masahiro
Published: May 2022

Variable-temperature electron spin resonance (ESR) was measured for one-dimensional (1D) molecular chains formed using different-sized organic radicals incorporated into the 1D nanochannels of tris(o-phenylenedioxy)cyclotriphosphazene (TPP). The ESR spectra for the molecular chains of 4-oxo-2,2,6,6-tetramethyl-1-piperidinyl-1-oxyl (TEMPONE) incorporated in the TPP nanochannels ([TPP-TEMPONE]) exhibited anisotropic three-dimensional (3D) spin diffusion at temperatures close to room temperature. In contrast, 1D spin diffusion was observed even at low temperatures indicating a longer rotational diffusion correlation time or the termination of molecular motion of the guest radicals dispersed in the TPP nanochannels. The temperature range for 1D spin diffusion in [TPP-TEMPONE] was higher and wider than that of TPP inclusion compounds incorporating smaller nitroxide radicals, such as di-t-butyl nitroxide (DTBN), or 2,2,6,6-tetramethyl-1-piperidinyl-1-oxyl (TEMPO) radicals, as previously reported. Thus, inter-spin interactions of the organic-radical 1D molecular chains formed in size-adjustable nanochannels, such as TPP, are influenced by the molecular size and dynamics of guest radicals, and temperature.
Targeting Physical Inactivity Using Behavioral Theory in Chronic, Disabling Diseases
Authors: Pekmezi Dori , Motl Robert
Published: May 2022

Physical inactivity and comorbidities (e.g., hypertension) result in poor prognoses among persons with chronic, disabling conditions including multiple sclerosis, Parkinson disease, and stroke. Theory can guide the design of behavior change interventions that can be delivered remotely for broad scale implementation. We hypothesize that theory-based behavior change interventions can increase physical activity and reduce comorbidities and associated consequences among persons with chronic, disabling conditions.
Meniscus Root Tears: A Clinical Review
Authors: Randazzo Elena , Duerr Robert , Baria Michael R.
Published: May 2022

Meniscus root tears are important to recognize early given their potentially devastating consequences on joint health. This injury results in the lost ability of the meniscus to transfer axial loads into hoop stress; therefore, it is functionally equivalent to a complete meniscectomy. This causes rapid progression of osteoarthritis and increased need to total knee arthroplasty in a previously healthy joint. Despite these consequences, root tears have only been discussed in the orthopedic literature in the last 10 to 15 years and have not been routinely integrated into nonoperative sports medicine education. It is important for all nonoperative sports medicine providers to properly diagnose and triage this injury early in its course to maximize joint preservation efforts. The goal of this manuscript is to review the anatomy, presentation, natural history, imaging, and treatment options for meniscal root tears.
Perfusion imaging techniques in lower extremity peripheral arterial disease
Authors: Galanakis Nikolaos , Maris Thomas G , Kontopodis Nikolaos , Tsetis Konstantinos , Kehagias Elias , Tsetis Dimitrios
Published: May 2022

Lower limb peripheral arterial disease (PAD) characterizes the impairment of blood flow to extremities caused by arterial stenoses or occlusions. Evaluation of PAD is based on clinical examination, calculation of ankle-brachial index and imaging studies such as ultrasound, CT, MRI and digital subtraction angiography. These modalities provide significant information about location, extension and severity of macrovasular lesions in lower extremity arterial system. However, they can be also used to evaluate limb perfusion, using appropriate techniques and protocols. This information may be valuable for assessment of the severity of ischemia and detection of hypoperfused areas. Moreover, they can be used for planning of revascularization strategy in patients with severe PAD and evaluation of therapeutic outcome. These techniques may also determine prognosis and amputation risk in patients with PAD. This review gives a basic overview of the perfusion techniques for lower limbs provided by imaging modalities such as ultrasound, CT, MRI, digital subtraction angiography and scintigraphy and their clinical applications for evaluation of PAD and revascularization outcome.
Bilateral symmetrical stress fractures of femoral neck in HIV patient: case report and brief review of literature
Authors: Narra Ramakrishna , Varra Sravan Kumar , Jukuri Naganarasimha Raju
Published: May 2022

Osseous changes in HIV positive patients receiving ART are three times greater than in normal individuals. These changes include osteopaenia/osteoporosis, stress fractures, fragility fractures and osteonecrosis. On an average, bone mineral density reduces by 2–6% in the first 2 years after commencement of antiretroviral therapy. High risk for stress fractures is observed in these patients. In present article, we report a case of bilateral femoral neck stress fractures in a known HIV patient.
Revisão sistemática internacional sobre agravos à saúde mental de professores
Authors: Ródio Trevisan Karen Rayany , Moraes Cruz Roberto , Dalagasperina Patricia , Ornellas Ariño Daniela , Valéria Steil Andrea
Published: May 2022

A docência é a segunda categoria profissional, em nível mundial, a manifestar mais doenças de caráter ocupacional. O objetivo deste estudo foi caracterizar o perfil epidemiológico de agravos à saúde mental em professores no âmbito nacional e internacional. Foram conduzidas buscas nas bases de dados Scopus, Web Of Science, PsycNet, PubMed e no portal BVS, considerando publicações dos últimos 10 anos (2008-2017), em inglês, espanhol e português. Foram incluídos estudos originais e empíricos, nos quais agravos à saúde mental foram abordados como variáveis dependentes em pesquisas com professores, totalizando 28 artigos. Os resultados indicam a sobrecarga de trabalho como um fator de risco psicossocial, e que os professores mais vulneráveis ao adoecimento, são do sexo feminino, não possuem companheiro, apresentam altos níveis de escolaridade e histórico familiar de transtorno mental.
The role of the district nurse in screening and assessment for frailty
Authors: Horner Ruth Louise
Published: May 2022

An ageing population is leading to greater demands on healthcare services; investments are being made to allow complex care to be given in patient's homes by community care staff, as highlighted in the NHS Long Term Plan (2019) . Frailty is often identified in secondary care when acute crisis is hit; frailty does not suddenly occur and will happen over time. This article aims to explore community screening, the assessment processes of frailty and the role the district nurse has. It also addresses how working collaboratively with the wider multidisciplinary team to earlier identify service users with frailty can assist in improving patient outcomes by empowering and supporting service users to remain at home. Recognising continual improvement to service users' care and changes in practice should be considered and disseminated. based upon best available evidence.
The importance of management's response to staff speaking up in the healthcare setting
Authors: Ghorbankhani Melika , Jones Aled
Published: May 2022

Melika Ghorbankhani and Aled Jones highlight the role of the ‘recipient’ of concerns raised by healthcare staff, and discuss ways that managers can create a culture of psychological safety that promotes speaking up.
Patient preferences regarding communication of minor surgery results: who and how?
Authors: Senaratne Radha , Casey Máire-Caitlín , Balakrishnan Theogren , Hussey Alan , Jones Deirdre , McInerney Niall , Regan Padraic J , Kelly Jack L
Published: May 2022

Background/Aims

The excision of skin lesions is one of the most common procedures in plastic surgery. Following the disruptions associated with the COVID-19 pandemic, this study investigated patient preferences communicating the results of skin lesion excision surgery.

Methods

A retrospective analysis was conducted with patients who had undergone elective minor surgical procedures over a 30-day period. A questionnaire was distributed to 103 patients to assess their preferences regarding delivery of the outcomes of their procedure in terms of which healthcare professional contacted them and whether this occurred in person or remotely. The outcomes of this were used to adapt the service and a repeat analysis was conducted 3 months later.

Results

If the lesion was benign, 45.0% of participants preferred to be contacted via email, letter or text, while 38.8% preferred either a telephone call or in-person appointment with their GP, and only 16.3% preferred direct contact from their hospital doctor. If the lesion was malignant, 55.0% preferred to be contacted by their GP, 30.0% by their hospital doctor and 15.0% via letter, email or text. The repeat analysis saw the proportion of patients who received their results via remote consultation with a hospital clinician increase from 12.8% to 16.1%, while the proportion of patients who received their results at an in-person outpatients appointment decreased from 14.5% to 9.3%.

Conclusions

This study shows that a substantial proportion of patients would prefer to receive the results of skin lesion surgery from their GP over the telephone, suggesting that this would be a better means of delivering results than an in-person hospital appointment. This method could also reduce the number of patients returning to the clinic in person, helping to streamline follow up and improve clinic efficiency.
How best can faculty development support teachers in clinical settings?
Authors: Gagnon Nathalie , Bernier Carolle , Houde Sylvie
Published: May 2022

Faculty development is key to ensuring quality clinical teaching, but standardising teaching practices in multiple settings is a challenge. This article presents an example of a 3-year faculty development programme for teaching clinical reasoning skills, implemented by the Faculty of Medicine and Health Sciences, University of Sherbrooke, Quebec, Canada for its faculty members at multiple teaching sites. A follow-up study 1–5 months after the final workshop, using a self-assessment questionnaire, indicates that almost half of the participants transferred some of their newly acquired knowledge into their teaching practices. This article discusses factors to consider when developing a faculty development culture, at both a programme and faculty level, to support quality teaching and learning.