bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategic universality in the making of global guidelines for mental health
Authors: Mills China
Published: January 2022

Based on interviews with members of the Guideline Development Group (GDG) of the World Health Organization’s (WHO) Mental Health Gap Action Programme (mhGAP) Guidelines for Mental, Neurological and Substance Use Disorders, this article adds empirical depth to understanding the contingent and strategic nature of universality in relation to mental health. Differently from debating whether or not mental health is global, the article outlines the people, ideas, and processes involved in making it global. Thematic analysis of interviews carried out with nine (out of 21) members of the original mhGAP GDG identified six intersecting strategies that enable the construction of universality in global mental health (GMH): 1) processes and practices of assembling expertise; 2) decisions on what counts as evidence; 3) framing cultural relativism as nihilistic; 4) the delaying of complexity to prioritize action; 5) the narration of tensions as technical rather than epistemological; and 6) the ascription of messiness to local contexts rather than to processes of standardization. Interviews showed that differently from the public-facing consensus often presented in GMH, GDG members hold contrasting and contingent understandings of the nature of universality in relation to mental health diagnoses and interventions. Thus, the universality of mental health achieved through the mhGAP Guidelines is partial and temporary, requiring continuous (re)iteration. The article uses empirical data to show nuance, complexity, and multi-dimensionality where binary thinking sometimes dominates, and to make links across arguments ‘for’ and ‘against’ global mental health.
Hemispheric involvement in the comprehension of conventional metaphors in Arabic–Hebrew speakers
Authors: Ershaid Hadeel , Mashal Nira , Borodkin Katy
Published: January 2022

Aims and objectives/purpose/research questions:

Previous studies in pairs of typologically distant languages showed that hemispheric processing of metaphoric expressions differs in a native versus second language. The current research explored this finding in a pair of typologically close languages, Arabic and Hebrew.

Design/methodology/approach:

Forty-six Arabic native speakers who were proficient in Hebrew (second language; 30 women, aged 19–28) participated in a divided visual field (DVF) experiment. They were presented with conventional metaphors, literal expressions, and unrelated word pairs and asked to indicate whether the word pairs formed a meaningful expression. Participants were tested in spoken Arabic, literary Arabic, and Hebrew in separate blocks.

Data and analysis:

Mean reaction times and accuracy were analyzed using repeated-measures three-way analysis of variance, with language, visual field, and expression type as independent variables.

Findings/conclusions:

In contrast to previously reported findings, a left-hemisphere advantage or a bilateral pattern of processing was observed for conventional metaphors in both varieties of Arabic and in Hebrew, suggesting similar hemispheric processing in native and second language.

Originality:

Metaphor processing is examined in a pair of typologically close languages.

Significance/implications:

Our findings (in a pair of typologically close languages) differ from those previously reported in pairs of less similar languages, suggesting a modulatory role of language similarity in hemispheric processing of second-language metaphors.
Bilingual children acting as language brokers in Italy: Their affective and cognitive attitudes about the practice
Authors: Ceccoli Federica
Published: January 2022

Aims and objectives:

This paper sets out to examine Italian bilingual children’ attitudes about Child Language Brokering (CLB), with a focus on the perceived feelings (affective component of attitudes) and benefits (cognitive component of attitudes) related to CLB. The aim is to study the presence of any relationship between the affective and cognitive components of child language brokers’ attitudes, since they can affect the outcomes of CLB and their analysis can provide tools to reduce the stressors related to it.

Methodology:

A survey was carried out among 150 immigrant students attending vocational high schools in the Northern and Central regions of Italy. Demographic and linguistic data were processed by means of a descriptive analysis, while attitudinal scales were processed by means of both descriptive and inferential analysis.

Findings:

The results will show that the child language brokers who perceive stronger positive feelings about CLB also report stronger attitudes towards the benefits of the practice.

Originality:

Considering the lack of research examining child language brokers’ attitudes in Italy by means of attitude scales, and the lack of attention to the affective and cognitive dimensions of such attitudes, this study addresses this gap by investigating these two dimensions of CLB.
Spatiotemporal distribution of negative air ion and PM2.5 in urban residential areas
Authors: Wang Wei , Xia Sihan , Zhu Zhenying , Wang Tian , Cheng Xinyue
Published: January 2022

Urban environments are characterised by high pollution levels, which adversely affect the physiology, psychology and behaviour of the urban residents. In this study, on-site measurements and air quality evaluations were performed in urban residential areas. The negative air ion (NAI) concentration, fine particulate matter (PM2.5) concentration, temperature and relative humidity were measured in different seasons. Both PM2.5 and the NAI concentrations changed significantly with seasons. The PM2.5 concentration was the highest in winter, intermediate in autumn and the lowest in summer, while the NAI concentration showed an opposite trend. The overall changes in NAI and PM2.5 concentrations showed a trend of double peaks and double valleys, and there was a substantial difference between rainy days versus sunny days. The NAI concentration was positively correlated with temperature and relative humidity, and the influence of relative humidity on NAI was greater than that of temperature. There were notable spatial differences in the intensity of impact by different pollution sources. Based on these results, suggestions were made for optimising the layout of residential buildings and the rationalisation of traffic networks, with the aim of increasing NAI concentrations and reducing PM2.5 concentrations. This would help reduce the pollution levels in urban residential areas.
Investigation of the joinability of single- and multi-layered AA6014 sheets produced by accumulative roll bonding in the shear-clinching process
Authors: Zettl Bastian , Wiesenmayer Sebastian , Kraus Martin , Merklein Marion
Published: January 2022

Accumulative roll bonding belongs to the severe plastic deformation processes and is suitable for producing multi-layered as well as high-strength sheets through repeated rolling. After four accumulative roll bonding-cycles, the strength of the investigated AA6014-T4 alloy is elevated due to strain and fine grain hardening by 170% in yield strength and by 37% in ultimate tensile strength. This is accompanied by a significant decrease in material ductility which is disadvantageous for joining processes based on forming operations. Shear-clinching, however, can be used to join high-strength and low-ductile materials on the die side. Thus, it is a promising method for the mechanical joining of accumulative roll bonding components. The multi-layered and more brittle material is located on the die side whereas the single-layered base material with higher ductility is positioned on the punch side. At present, there is no scientific knowledge how the multi-layered material behaves in the shear-clinching process. Since the material is cut in the process, delamination effects could occur at the interfaces produced via accumulative roll bonding. Additionally, the investigation aims at the influence of the accumulative roll bonding process on the properties of the joints. They are expected to depend on the number of process cycles and thus on the change of mechanical properties of the multi-layered material. The bond strength of the shear-clinched joints is determined by shear and tensile tests. The areas of material failure are analysed via metallographic methods. From the failure behaviour and load-bearing capacity it is determined which number of accumulative roll bonding cycles is ideal for joining multi-layered sheets via shear-clinching.
Phosphaturic Mesenchymal Tumor Along the Hallux side Inducing a Chronic non-Healing Wound: A Case Report with Literature Review
Authors: Sun Xiaofang , Ni Pengwen , Xie Ting , Wu Shaohan
Published: January 2022

Phosphaturic mesenchymal tumor (PMT) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, hypophosphatemia, and bone calcification disorders. Complete surgical resection of the tumor is believed to be the most effective treatment measure. However, the diagnosis of PMT is very difficult because of its insidious and small size, especially, when it appears in subcutaneous tissue with a chronic non-healing wound. We report a rare case of a 38-year-old man with a chronic non-healing wound on the left hallux for approximately eight months. Plain radiographic images and magnetic resonance imaging (MRI) revealed a cystic radiolucent shadow in the left distal phalanx. Bone scan observations also showed increased uptake in the same location. Histologically, this tumor was composed of numerous spindle cells with clusters of giant cells. The serum FGF23 level was significantly higher before surgery, with higher FGF23 levels closer to the tumor. Reverse transcription polymerase chain reaction and immunohistochemistry further confirmed the high expression of FGF23 in tumors. These data suggest that FGF23 may be a potential causative factor of PMT. The serum FGF23 levels might be useful for the diagnosis of PMT and localization of the tumor. The tumor was CD56- and D2 to 40-positive and CD31-negative. The non-healing wound caused by PMT might be attributed to the invasive growth of the tumor, destruction of intercellular junctions, and decrease in the number of endothelial cells.
Innovative approaches for treatment of osteosarcoma
Authors: Rothzerg Emel , Pfaff Abigail L , Koks Sulev
Published: January 2022

Osteosarcoma (OS) is the most common primary malignant bone tumor, which usually occurs in children and adolescents. It is generally a high-grade malignancy presenting with extreme metastases to the lungs or other bones. The etiology of the disease is multifaceted and still remains obscure. A combination of surgery and chemotherapy has played a major role in the treatment of OS over the past three decades, and consequently, the overall survival rates for the disease have remained unchanged. Therefore, there is an urgent need to employ new comprehensive analyses and technologies to develop significantly more informative classification systems, with the aim of developing more effective and less toxic therapies for OS patients. This review discusses the existing knowledge of OS therapy and potential methods to develop novel therapeutic agents for the disease.
Predicting the tensile strength of bleach washed denim garments by using fuzzy logic modeling
Authors: Sarkar Joy , Rifat Niaz Morshed , Al Faruque Md Abdullah
Published: January 2022

The prime intention of this study is to develop and validate the efficiency of a fuzzy logic model to predict the tensile strength of bleach washed denim garments. Denim washing is nowadays a widely used technology to give a worn-out appearance to denim garments and thus add esthetic to that garments’ appearance and outlook. In the case of regular overall fading of denim, bleach washing is very popular. At the same time, it is also a matter of concern that the process optimization of bleach washing is critical as bleaching agents have an adverse effect on the fabrics. Among others, bleach concentration, time, and temperature are the primary process parameters in bleach washing, which directly impact the final strength of the treated denim garments. Though their relationship is nonlinear, a fuzzy expert-based system has been constructed to model and illustrate the complex relationship among bleach concentration, time, and temperature in the input side, whereas tensile strength is the output. Strength is the most critical parameter of the final denim product, as it dominates the serviceability of that garments. Therefore, predicting the tensile strength without the trial-and-error method, which is being practiced now, can be a blessing for industrial practitioners. With the help of a laboratory trial, the developed model has been evaluated, and it has been found that the mean relative error was 2.82 and 3.92 for warp and weft direction tensile strength, respectively. On the other hand, the comparison exhibited a coefficient of determination ( R2) of 0.99 for both warp and weft direction tensile strengths. The authors found that the performance of the developed model is satisfactory enough to predict the tensile strength of the bleach washed denim garments.
Analysis and selection of eigenvalues of vibration signals in cutting tool milling
Authors: Wang Liqiang , Li Xiao , Shi Bo , Munochiveyi Munyaradzi
Published: January 2022

This paper designs an experimental scheme to monitor the tool wear state by extracting the vibration signal of tool wear. The data acquisition and signal processing hardware includes a T-type cutting tool, a vibration sensor, an amplifier, a data acquisition card, and a computer. In the time domain, the vibration signal is analyzed by statistical analysis method, and it is concluded that the variance of vibration signal of X-axis wear is positively correlated with the degree of tool wear. Moreover, the vibration signal is converted from time domain to frequency domain by Fourier transform, and the characteristic frequency bands of vibration signal are 2–4 kHz and 7–9 kHz in frequency domain. In addition, in time-frequency domain, the vibration signal is decomposed by wavelet packet decomposition technology, and the energy statistics of the decomposed frequency band is carried out. It is further judged that the energy percentage of 2.5–3.75 kHz and 7.5–8.25 kHz is closely related to tool wear, so the energy percentage of the two characteristic frequency bands is selected as the characteristic value of tool wear monitoring.
Brief overview: cemiplimab for the treatment of advanced basal cell carcinoma: PD-1 strikes again
Authors: Davis Christina M. , Lewis Karl D.
Published: January 2022

Basal cell carcinoma (BCC) is the most common malignancy worldwide. Fortunately, most tumors are localized and easily amenable to surgical resection or locally destructive treatments. However, a subset of BCCs can become locally advanced or metastatic. The development of small-molecule inhibitors of smoothened, a protein in the hedgehog pathway, which is almost universally activated in BCCs, was a breakthrough in the treatment of patients with advanced BCC. However, these agents are associated with primary and secondary resistance and have a toxicity profile that makes long-term use difficult. The recent approval of cemiplimab for patients with advanced BCC who are resistant to or are intolerant of hedgehog inhibitor therapy fills a significant unmet need as these patients now have a viable, second-line systemic therapeutic option. This article summarizes the rationale and data leading to the approval for cemiplimab in advanced BCC.
The poverty of power in the Green Keynesian turn
Authors: Brown Keith Brower
Published: January 2022

This August marked the arrival of a modest step away from climate neoliberalism toward a “green Keynesianism” in the United States. Legislation advanced by the Biden administration shifted away from austerity and carbon market creation, toward patching up public infrastructure and direct industrial subsidies. However, the new program included next to zero labor terms for the private work it would generously subsidize, let alone more active steps to advance public ownership or worker power. The apparent defeat of the novel measures of this Keynesian strategy, by a united corporate front, demonstrates the political peril of a climate transition strategy based on avoiding confrontation with capital. This is especially due to the present confluence of renewable and fossil energy capital, which will have an enduring drive to make use of the enormous remaining fossil reserves worldwide. Political breakthroughs stemming from California's climate transition provide an instructive alternative to Biden's Keynesian indifference to worker power. Through the joint work of scholars, rank-and-file workers, and broader social movements, the racialized and gendered repression of green construction labor must be overcome, if we are to build the power needed for a climate transition that lasts.
Comparison of Teriparatide and Combination of Cissus Quadrangularis and Dalbergia Sissoo on Bone Healing Against the Control Group in Maxillofacial Fractures: A Randomized Open-label Control Trial
Authors: PG Gigi , Chugh Ankita , Chaudhry Kirti , Kaur Amanjot , Kumar Pravin , Gaur Shubham , Kumar Shailendra , Singh Surjit
Published: January 2022

Study Design

Randomized Control Trial.

Objective

A randomized control trial was planned to aim to assess whether subcutaneous Injection of Teriparatide and Tablet Reunion (combination of Cissus Quadrangularis and Dalbergia sissoo) improves maxillofacial fracture healing as compared to the control group.

Methods

24 patients of mandibular fracture with or without concomitant maxillofacial fractures were randomly divided into 3 equal groups (Group 1- Control, Group 2- Tablet Reunion, and Group 3- Injection Teriparatide) and the treatment duration was 4 weeks. Pain, fracture site mobility, bite force, serum markers, and radiographic healing were assessed preoperatively and postoperatively at regular intervals till 12 weeks.

Results

Group 2 showed early pain relief, although it was insignificant. Group 3 showed the highest anterior bite force at all the time points. Change in mean posterior bite force (PBF) showed a statistically significant increase at 8th week and 12th week in intergroup comparison; however, at 12th week, Group 3 was significantly better than Group 1 and reported the highest posterior bite force compared to other groups. Serum calcium and PTH level showed no significant difference, whereas Serum ALP showed a statistically significant increase in Group 3. The radiographic assessment showed no significant difference among the 3 groups.

Conclusions

Both the intervention group drugs showed a promising effect on accelerating the fracture healing and improving bite force restoration with the osteoanabolic action; however, early radiographic healing and increased serum osteogenic markers in Group 3 indicate its possible optimistic role in maxillofacial fracture healing.
Analysis of Neoclassical Canons in Adult Kenyans of Indian Descent
Authors: Sarna Krishan , Osundwa Tom Mulama , Kamau Martin , Sonigra Khushboo Jayant
Published: January 2022

Study Design: Descriptive cross-sectional.

Objective: To establish anthropometric norms and test the validity of four neoclassical canons among Kenyans of Indian descent.

Methods: Using direct anthropometric landmarks, 3 vertical and 4 horizontal measurements were made on the faces of 130 adult Kenyans of Indian descent. The mean of each anthropometric measurement was calculated and a student t-test was used to identify significant gender differences. These results were compared to four neoclassical canons and the percentage of each canon and its variants were recorded. A chi-square test was then performed to assess any gender differences between these findings.

Results: When comparing sexes, the anthropometric means of males were larger than those of females except for eye fissure length. In addition, only the upper third displayed sexual dimorphism. As for the neoclassical canons, the orbital canon was found to apply to 20.0% of males and 21.6% of females, followed by the naso-oral canon found in 16.4% of males and 17.6% of females, and the orbito-nasal canon present in 14.5% of males and 18.9% of females. The vertical canon was not found to be applicable to any participant.

Conclusion: The facial morphometric measurements in this population differ from the described neoclassical canons since they do not apply to the majority of these individuals. Therefore surgeons should be guided by the observed population-specific differences during reconstructive and facial aesthetic surgery.
Utility of IgG4 immunohistochemistry detection in pemphigus diagnosis
Authors: García-Lechuga Maricela , Vega-Memije María Elisa , Montiel-Rangel Ana Isabel , Torres-González Andres , Rangel-Gamboa Lucia
Published: January 2022

Pemphigus includes a group of blistering autoimmune diseases that affect the skin and mucosa, characterized by the formation of epidermal bullous and the presence of antibodies against binding proteins. Pemphigus is classified according to clinical presentation, target molecule, and IgG production as pemphigus vulgaris, foliaceous, IgA-pemphigus, and paraneoplastic pemphigus. Thus, the identification of autoantibodies class and site of deposition is mandatory. The gold standard to identify the immune complex deposition is the direct immunofluorescences technique, performed in fresh tissue; unfortunately, this method is unavailable in the regional hospital at the Mexican provinces. Nevertheless, IgG subclass-4 is the prevalence of immunoglobulin in acantholysis. Therefore, this IgG subclass could be detected using IgG4 immunohistochemistry. Because direct immunofluorescences technique is absent in provinces or patients denied a new biopsy to confirm the diagnosis, this work presented pemphigus vulgaris confirmation using the IgG4 immunohistochemistry technique in patients with clinical lesions suggestive of pemphigus vulgaris and intraepidermal blister manifestation in histopathology.
VIPCare: Understanding the support needed to create affective interactions between new caregivers and residents with dementia
Authors: Ghafurian Moojan , Francis Linda , Tao Zhuofu , Step Mary , Hoey Jesse
Published: January 2022

Introduction

In this paper, we study the support needed by professional caregivers of those with dementia, and present a first step toward development of VIPCare, a novel application with the goal of assisting new caregivers at care-centres in interacting with residents with dementia.

Methods

A mixed-methods study including two questionnaires, two focus groups, and seven co-design sessions with 17 professional caregivers was conducted to (a) understand caregivers’ challenges/approaches used to reduce negative interactions with persons with dementia, (b) identify the existing gaps in supporting information for improving such interactions, and (c) co-design the user interface of an application that aims to help improve interactions between a new professional caregiver and persons with dementia. A pre-questionnaire assessed knowledge of smartphones and attitude toward technology. A post-questionnaire provided an initial evaluation of the designed user interface.

Results

Focus groups emphasized the importance of role-playing learned through trial and error. The layout/content of the application was then designed in four iterative paper-prototyping sessions with professional caregivers. An iOS/Android-based application was developed accordingly and was modified/improved in three iterative sessions. The initial results supported efficiency of VIPCare and suggested a low task load index.

Conclusions

We presented a first step toward understanding caregiver needs and developing an application that can help reduce negative interactions between professional caregivers and those with dementia.
The Dice Are Loaded: Schools’ Social Class Composition and Athletic Contests
Authors: Goldsmith Pat Rubio , Abel Richard
Published: January 2022

Research shows that social class differences in high school sports participation are large and growing. However, focusing on sports participation may obfuscate large social class differences in sports performance among participants. The authors develop theoretical predictions on the basis of exclusion (middle-class youth perform sports better) and inclusion (working-class youth perform sports better). To test these predictions, the authors analyze the relationship between high schools’ social class composition and success in high school athletics using data on more than 200,000 contests in school fixed-effects models. The findings indicate that predominantly middle-class schools beat economically integrated and predominantly working-class schools by large margins, supporting exclusivity perspectives. Also, predominantly working-class schools win as much as economically integrated schools, providing evidence of inclusion, but inclusion is much weaker than exclusion. The authors conclude that sports performance among youth is highly stratified by social class.
Pathophysiology of Reflux Following Bariatric Surgery
Authors: Ozeki Katharine A. , Gavini Sravanya
Published: January 2022

Gastroesophageal reflux is one of the most common gastrointestinal disorders worldwide and is associated with central obesity. While bariatric surgery is the most effective means of achieving sustainable weight loss and should alleviate reflux, reflux can develop or worsen following bariatric surgery. We reviewed the available literature to summarize the potential pathophysiological mechanisms that can explain reflux outcomes following the 3 most common bariatric surgeries: laparoscopic adjustable gastric banding (LABG), laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (RYGB). Overall, LABG and LSG have been shown to predispose to reflux while RYGB is associated with improvement of GERD.
Diffusion of OXA-48 carbapenemase among urinary isolates of Klebsiella pneumoniae in non-hospitalized elderly patients
Authors: Šuto Sandra , Bedenić Branka , Likić Saša , Kibel Sara , Anušić Maja , Tičić Vladimira , Zarfel Gernot , Grisold Andrea , Barišić Ivan , Vraneš Jasmina
Published: January 2022

Background

Recently, a dramatic increase of Klebsiella pneumoniae positive for OXA-48 β-lactamases was observed first in the hospital setting and later in the long-term care facilities (LTCFs) and community in the Zagreb County, particularly, in urinary isolates. The aim of the study was to analyse the epidemiology and the mechanisms of antibiotic resistance of OXA-48 carbapenemase producing K. pneumoniae strains isolated from urine of non-hospitalized elderly patients.

Results

The isolates were classified into two groups: one originated from the LTCFs and the other from the community. Extended-spectrum β-lactamases (ESBLs) were detected by double disk-synergy (DDST) and combined disk tests in 55% of the isolates (51/92). The ESBL-positive isolates exhibited resistance to expanded-spectrum cephalosporins (ESC) and in majority of cases to gentamicin. LTCFs isolates showed a significantly lower rate of additional ESBLs and consequential resistance to ESC and a lower gentamicin resistance rate compared to the community isolates, similarly to hospital isolates in Zagreb, pointing out to the possible transmission from hospitals.ESBL production was associated with group 1 of CTX-M or SHV-12 β-lactamases. Ertapenem resistance was transferable from only 12 isolates. blaOXA-48 genes were carried by IncL plasmid in 42 isolates. In addition IncFII and IncFIB were identified in 18 and 2 isolates, respectively. Two new sequence types were reported: ST4870 and ST4781.

Conclusions

This study showed eruptive and extensive diffusion of OXA-48 carbapenemase to LTCFs and community population in Zagreb County, particularly affecting patients with UTIs and urinary catheters. On the basis of susceptibility testing, β-lactamase production, conjugation experiments, MLST and plasmid characterization it can be concluded that there was horizontal gene transfer between unrelated isolates, responsible for epidemic spread of OXA-48 carbapenemase in the LTCFs and the community The rapid spread of OXA-48 producing K. pneumoniae points out to the shortcomings in the infection control measures.
Effectiveness of clotting factor replacement therapy after antivenom treatment on coagulopathic envenomation following green pit viper bites: a retrospective observational study
Authors: Zeng Liangbo , Liang Qing , Liang Zijing , Han Jieyun , Wu Miaozhu , Liu Rong , Wang Xida
Published: January 2022

Background

Green pit vipers (GPVs), namely Trimeresurus albolabris and Trimeresurus stejnegeri accounts for most snakebites in Southern China. Green pit viper venom contains thrombin-like enzymes, resulting in defibrination syndrome. Using of clotting factor replacement after antivenom administration is controversial. The objective of this study was to investigate the effects of clotting factor replacement in coagulopathic patients with T. albolabris and T. stejnegeri bites after antivenom administration.

Methods

We retrospectively reviewed 123 patients who were bitten by T. albolabris and T. stejnegeri and were admitted to the Emergency Department of a hospital in Guangzhou, Southern China, from 2013 to 2019. Recovery of prothrombin time (PT) and fibrinogen level were compared among (1) fresh-frozen plasma (FFP) group; (2) cryoprecipitate (cryo) group; (3) FFP and cryo group; and (4) control group after antivenom administration.

Results

The incidence of coagulopathy was 31%. Persistent and late coagulopathy were the most common patterns among four groups. The median reduction in PT was 20.1 ± 31.2 s for FFP and cryo group. The median increase in fibrinogen level was very small: 0.05 ± 0.20 g/L for FFP group, 0.09 ± 0.37 g/L for cryo group and 0.07 ± 0.31 g/L for FFP and cryo group, respectively. The percentage of unimproved PT was markedly higher in the FFP and cryo group than the control group (P = 0.01 by log-rank test, P = 0.02 by Gehan-Breslow-Wilcoxon test). The percentage of unimproved fibrinogen level tended to be worse in the FFP and cryo group than the control group, but the different was marginal (P = 0.05 by Gehan-Breslow-Wilcoxon test, P = 0.07 by log-rank test). A total of 7.8% (7/90) of the patients in the clotting factor replacement groups developed anaphylaxis and heart failure.

Conclusion

There is no improvement in coagulopathy profile in patients with T. albolabris and T. stejnegeri bites who received clotting factor replacement after antivenom administration. But the results from GPVs may not be generalized to other species of venomous snakes.
Prenatal detection of chromosomal abnormalities and copy number variants in fetuses with congenital gastrointestinal obstruction
Authors: Meng Xinyue , Jiang Lili
Published: January 2022

Background

Congenital gastrointestinal obstruction (CGIO) mainly refers to the stenosis or atresia of any part from the esophagus to the anus and is one of the most common surgical causes in the neonatal period. The concept of genetic factors as an etiology of CGIO has been accepted, but investigations about CGIO have mainly focused on aneuploidy, and the focus has been on duodenal obstruction. The objective of this study was to evaluate the risk of chromosome aberrations (including numeric and structural aberrations) in different types of CGIO. A second objective was to assess the risk of abnormal CNVs detected by copy number variation sequencing (CNV-seq) in fetuses with different types of CGIO.

Methods

Data from pregnancies referred for invasive testing and CNV-seq due to sonographic diagnosis of fetal CGIO from 2015 to 2020 were obtained retrospectively from the computerized database. The rates of chromosome aberrations and abnormal CNV-seq findings for isolated CGIOs and complicated CGIOs and different types of CGIOs were calculated.

Results

Of the 240 fetuses with CGIO that underwent karyotyping, the detection rate of karyotype abnormalities in complicated CGIO was significantly higher than that of the isolated group (33.8% vs. 10.8%, p < 0.01). Ninety-three cases with normal karyotypes further underwent CNV-seq, and CNV-seq revealed an incremental diagnostic value of 9.7% over conventional karyotyping. In addition, the incremental diagnostic yield of CNV-seq analysis in complicated CGIOs (20%) was higher than that in isolated CGIOs (4.8%), and the highest prevalence of pathogenic CNVs/likely pathogenic CNVs was found in the duodenal stenosis/atresia group (17.5%), followed by the anorectal malformation group (15.4%). The 13q deletion, 10q26 deletion, 4q24 deletion, and 2p24 might be additional genetic etiologies of duodenal stenosis/atresia.

Conclusions

The risk of pathogenic chromosomal abnormalities and CNVs increased in the complicated CGIO group compared to that in the isolated CGIO group, especially when fetuses presented duodenal obstruction (DO) and anorectal malformation. CNV-seq was recommended to detect submicroscopic chromosomal aberrations for DO and anorectal malformation when the karyotype was normal. The relationship between genotypes and phenotypes needs to be explored in the future to facilitate prenatal diagnosis of fetal CGIO and yield new clues into their etiologies.
Modulation of chemoimmunotherapy efficacy in non-small cell lung cancer by sex and histology: a real-world, patient-level analysis
Authors: Tuminello Stephanie , Alpert Naomi , Veluswamy Rajwanth R. , Kumar Arvind , Gomez Jorge E. , Flores Raja , Taioli Emanuela
Published: January 2022

Background

It has been postulated that patient’s sex impacts response to immunotherapy. Sex modulation of immunotherapy benefit, however, has not yet been explored using patient-level data, where potential confounders, as well as histologic type, can be accounted for. Here we investigated the association between sex and chemoimmunotherapy efficacy for non-small cell lung cancer (NSCLC) using a large, nation-wide dataset.

Patients & methods

Stage IV NSCLC patients diagnosed in 2015 were identified in the National Cancer Database (NCDB). Patients were treated with either chemoimmunotherapy or chemotherapy alone. The efficacy of the addition of immunotherapy treatment by sex was investigated using both an adjusted Cox proportional hazards model and propensity-score matching, in both the overall cohort and stratified by histological subtype.

Results

2064 (16%) patients received chemoimmunotherapy and10,733 (84%) received chemotherapy alone. Adjusted survival analysis in the overall cohort showed that both males (hazards ratio (HR)adj: 0.80, 95% CI: 0.74–0.87) and females (HRadj: 0.83, 95% CI: 0.76–0.90) had better OS when treated with chemoimmunotherapy than chemotherapy alone, with no statistically significant interaction between sex and receipt of immunotherapy (p = 0.63). Propensity matching confirmed these results. However, for those with squamous cell histology, male patients derived more benefit from chemoimmunotherapy treatment than females (HRadj: 0.73, 95% CI: 0.58–0.91 vs HRadj: 1.03, 95% CI: 0.76–1.38; p for interaction = 0.07).

Conclusion

Male patients with squamous cell carcinoma may derive more benefit from chemoimmunotherapy treatment. Histology likely plays an important role in how sex modulates immunotherapy efficacy.
Vitamin D and the risk of latent tuberculosis infection: a systematic review and meta-analysis
Authors: Cao Yan , Wang Xinjing , Liu Ping , Su Yue , Yu Haotian , Du Jingli
Published: January 2022

Objective

Latent tuberculosis infection (LTBI) may be a risk of developing tuberculosis (TB) and thus a health hazard. The aim of this meta-analysis is to explore the association between vitamin D and LTBI.

Methods

Databases including PubMed, Embase, Scopus, and ProQuest were electronically searched to identify observational or interventional studies that reported the association between vitamin D and LTBI. The retrieval time is limited from inception to 30 September 2021. Two reviewers independently screened literature, extracted data, and assessed risk bias of included studies. Meta-analysis was performed by using STATA 12.0 software.

Results

A total of 5 studies involving 2 case–control studies and 3 cohort studies were included. The meta-analysis result showed that the risk of LTBI among individuals was not associated with high vitamin D level (OR 0.51, 95% CI 0.05–5.65, P = 0.58). The result from cohort studies also suggested that relatively high vitamin D level was not a protective factor for LTBI (RR = 0.56, 95%CI 0.19–1.67, P = 0.300).

Conclusions

Our meta-analysis suggested that serum vitamin D levels were not associated with incidence of LTBI, and relatively high serum vitamin D level was not a protective factor for LTBI. Further RCTs are needed to verify whether sufficient vitamin D levels and vitamin D supplementation reduces the risk of LTBI.
Finite element stress analysis of the bearing component and bone resected surfaces for total ankle replacement with different implant material combinations
Authors: Yu Jian , Zhao Dahang , Chen Wen-Ming , Chu Pengfei , Wang Shuo , Zhang Chao , Huang Jiazhang , Wang Xu , Ma Xin
Published: January 2022

Background

A proper combination of implant materials for Total Ankle Replacement (TAR) may reduce stress at the bearing component and the resected surfaces of the tibia and talus, thus avoiding implant failure of the bearing component or aseptic loosening at the bone-implant interface.

Methods

A comprehensive finite element foot model implanted with the INBONE II implant system was created and the loading at the second peak of ground reaction force was simulated. Twelve material combinations including four materials for tibial and talar components (Ceramic, CoCrMo, Ti6Al4V, CFR-PEEK) and three materials for bearing components (CFR-PEEK, PEEK, and UHMWPE) were analyzed. Von Mises stress at the top and articular surfaces of the bearing component and the resected surfaces of the tibia and talus were recorded.

Results

The stress at both the top and articular surfaces of the bearing component could be greatly reduced with more compliant bearing materials (44.76 to 72.77% difference of peak stress value), and to a lesser extent with more compliant materials for the tibial and talar components (0.94 to 28.09% difference of peak stress value). Peak stresses at both the tibial and talar bone-implant interface could be reduced more strongly by using tibial and talar component materials with smaller material stiffness (7.31 to 66.95% difference of peak stress value) compared with bearing materials with smaller material stiffness (1.11 to 24.77% difference of peak stress value).

Conclusions

Implant components with smaller material stiffness provided a stress reduction at the bearing component and resected surfaces of the tibia and talus. The selection of CFR-PEEK as the material of tibial and talar components and UHMWPE as the material of the bearing component seemed to be a promising material combination for TAR implants. Wear testing and long-term failure analysis of TAR implants with these materials should be included in future studies.
Open reduction and locked compression plate fixation, with or without allograft strut, for periprosthetic fractures in patients who had a well-fixed femoral stem: a retrospective study with an average 2-year follow-up
Authors: Lv Hui , Guo Xing , Wang Yuan Hui , Zhang Zhong Jie , Zou Long Fei , Xue Hao , Huang Deng Hua , Tan Mei Yun
Published: January 2022

Background

The use of cortical strut allograft has not been determined for Vancouver type B1 or C fracture. This study aimed to evaluate the short-term efficacy of locking compression plating with or without cortical strut allograft in managing these types of fractures.

Methods

We retrospectively assessed 32 patients (17 males, 15 females; 23–88 years, mean: 67.2 years) with Vancouver type B1 or C fractures. Seventeen patients (Group A; B1 fractures in 15 hips, C fractures in 2 hips) were treated with open reduction and internal fixation with locking compression plates (group A). The other 15 patients (Group B; B1 in 14 hips, C in 1 hip) were fixed by locking compression plating combined with cortical strut allografting (group B). The fracture healing rate, healing time, complications and function were compared between these two groups.

Results

The mean follow-up time was 32.4 months (12 to 66), and the overall fracture union rate of the 32 patients was 96.9%. Group B had a higher fracture union rate than Group A, but the difference was not statistically significant. Group A had one case of nonunion of type B1 fracture and one case of malunion; the mean time to fracture healing was 5.3 months (3 to 9). In group B, all patients reached bony union without malunion, with a mean time of fracture healing of 5.1 months (3 to 8).

Conclusion

Treatment of Vancouver type B1 or C fractures by locking compression plating, with or without cortical strut allografting, resulted in similar union rates in these patients. This suggest that, the use of cortical strut allografting should be decided cautiously.
High prevalence of acetabular rim osteophytes after hip arthroscopy for treatment of FAI
Authors: Gao Guanying , Liu Rongge , Dong Hanmei , Ao Yingfang , Wang Jianquan , Xu Yan
Published: January 2022

Background

Few studies mentioned acetabular rim osteophytes (ARO) after arthroscopy for femoroacetabular impingement (FAI) in follow-up after primary hip arthroscopy. We found that many patients had postoperative ARO, which may lead to recurrent or secondary pincer-type deformity after primary hip arthroscopy for FAI and postoperative ARO sometimes even led to revision surgery. It is necessary to carry out related research on ARO.

Methods

We respectively evaluated consecutive cases who underwent hip arthroscopy in our hospital between January 2008 and January 2020. Radiographic examination was obtained for all patients preoperatively and postoperatively. Another CT scan was performed at least 6 months after surgery at final follow-up. Preoperative patient-reported outcomes (PROs) and PROs at final follow-up were obtained, including visual analog scale (VAS) for pain and modified Harris Hip Score (mHHS). The volume of ARO was calculated using mimics 21.0 software. According to the material of anchors and whether the anchors were used, patients were divided into absorbable group, non-absorbable group and no anchor group.

Results

A total of 71 patients were finally included in this study. Patients with postoperative ARO had higher VAS at final follow-up (P<0.05). Patients without postoperative ARO had higher mean mHHS at final follow-up (P = 0.08) and higher percentage of passing minimal clinical important difference. The percentage and volume of postoperative ARO was significantly higher in patients who underwent acetabuloplasty and labral repair (P<0.05). The percentage and volume of postoperative ARO in absorbable group were significantly higher than the other groups (P<0.05).

Conclusion

There is a high percentage of ARO after hip arthroscopy for treatment of FAI and patients who have undergone labral repair and acetabuloplasty are more likely to have postoperative ARO. Using of absorbable anchors may increase the possibility and volume of postoperative ARO. Postoperative ARO may predict a worse clinical outcome.
Effect of type 2 diabetes on coronary artery ectasia: smaller lesion diameter and shorter lesion length but similar adverse cardiovascular events
Authors: Cai Zhongxing , Li Luqi , Wang Haoyu , Yuan Sheng , Yin Dong , Song Weihua , Dou Kefei
Published: January 2022

Background

Coronary artery ectasia (CAE) is a rare finding in coronary angiography and associated with poor clinical outcomes. Unlike atherosclerosis, diabetes mellitus (DM) is not commonly associated with CAE. This study aims to investigate the effect of type 2 diabetes mellitus (DM2) on coronary artery ectasia, especially the differences in angiographic characteristics and clinical outcomes.

Methods

Patients with angiographically confirmed CAE from 2009 to 2015 were included. Quantitative coronary angiography (QCA) was performed to measure the diameter and length of the dilated lesion. The primary endpoint was the maximum diameter and maximum length of the dilated lesion at baseline coronary angiography. The secondary endpoint was 5-year major adverse cardiovascular events (MACE), which was a component of cardiovascular death and nonfatal myocardial infarction (MI). Propensity score weighting (PSW) and propensity score matching (PSM) were used to balance covariates. Kaplan–Meier method and Cox regression were performed to assess the clinical outcomes.

Results

A total of 1128 patients were included and 258 were combined with DM2. In the DM2 group, the maximum diameter of dilated lesion was significantly lower (5.26 mm vs. 5.47 mm, P  = 0.004) and the maximum length of the dilated lesion was significantly shorter (25.20 mm vs. 31.34 mm, P  = 0.002). This reduction in dilated lesion diameter (5.26 mm vs. 5.41 mm, P  = 0.050 in PSW; 5.26 mm vs. 5.46 mm, P  = 0.007 in PSM, respectively) and length (25.17 mm vs. 30.17 mm, P  = 0.010 in PSW; 25.20 mm vs. 30.81 mm, P  = 0.012 in PSM, respectively) was consistently observed in the propensity score analysis. A total of 27 cardiovascular deaths and 41 myocardial infarctions occurred at 5-year follow-up. Compared with non-DM group, there were similar risks of MACE (6.02% vs. 6.27%; HR 0.96, 95% CI 0.54–1.71, P  = 0.894), cardiovascular death (2.05% vs. 2.61%; HR 0.78, 95% CI 0.29–2.05, P  = 0.605) and MI (4.07% vs. 3.72%; HR 1.11, 95% CI 0.54–2.26, P  = 0.782) in patients with DM2. Consistent result was observed in multivariable regression.

Conclusions

Compared to non-DM patients, patients with CAE and type 2 diabetes were associated with a smaller diameter and shorter length of dilated vessels, suggesting the important effect of DM2 on the pathophysiological process of CAE. Similar risks of MACE were found during 5-year follow up among diabetic and non-DM patients.
Malignancies in patients with cystic fibrosis: a case series
Authors: Appelt Dorothea , Fuchs Teresa , Steinkamp Gratiana , Ellemunter Helmut
Published: January 2022

Background

Previous reports have shown an increased number of colorectal cancers in patients with cystic fibrosis. We assessed the database of our cystic fibrosis center to identify patients with all kinds of cancer retrospectively. All patients visiting the Cystic Fibrosis Centre Innsbruck between 1995 and 2019 were included.

Case presentation

Among 229 patients with cystic fibrosis treated at the Cystic Fibrosis Centre in Innsbruck between 1995 and 2019, 11 subjects were diagnosed with a malignant disease. The median age at diagnosis was 25.2 years (mean 24.3 years). There were four gynecological malignancies (cervical intraepithelial neoplasia and cervical cancer), two hematological malignancies (acute lymphocytic leukemia), one gastrointestinal malignancy (peritoneal mesothelioma), and four malignancies from other origins (malignant melanoma, neuroblastoma, adrenocortical carcinoma, and thyroid cancer). One malignancy occurred after lung transplantation. There was a strong preponderance of females, with 10 of the 11 cases occurring in women. Six deaths were attributed to cancer.

Conclusions

Most diagnoses were made below 30 years of age, and half of the subjects died from the malignant disease. Awareness of a possible malignancy is needed in patients with atypical symptoms. Regular screenings for cancer should also be considered, not only for gastrointestinal tumors.