bluuebunny/crossref_metadata_2025 huggingface dataset:
“Will You Work with Me?”: Visual Worksheets as Facilitators of Inclusive, Collaborative, and Empowering Interviews with Vulnerable Populations
Authors: Čanigová Kateřina
Published: March 2022

Vulnerable populations are often excluded from research interviews, as they are considered too difficult to reach. If included, they often face barriers that obstruct active participation and collaboration among participants, such as low literacy levels, a lack of confidence, and mistrust. Based on a body of texts that deal with the inclusion of vulnerable participants, I have developed a methodology aimed at promoting substantive social impact on researched communities. I propose visually based worksheets as a tool to give voice to often silenced individuals, to contribute to social change and justice. In this article, I explore the possibilities of visual methods to facilitate interviews and encourage greater levels of participation. With the use of selected visual methods—image elicitation, drawings, diagrams, and card-based games incorporated into graphic worksheets—I demonstrate how to address low levels of participant cooperation and understanding of interview tasks. This article is based on extensive fieldwork in the form of interviews with people living in poverty in the Czech Republic. Through the example of five of the 17 worksheets I designed, I illustrate the motivations and thought processes that stand behind their creation. The worksheets are aimed at the inclusion of vulnerable populations and bringing their voices into the research while focusing on crucial topics such as housing history, debts and obligations, debt repayment, and financial distress.
Analysis of the influence of groundwater seepage on the deformation of deep foundation pit with suspended impervious curtain
Authors: Shi Jinjiang , Wu Bo , Liu Yi , Xu Shixiang , Hou Jianlin , Wang Yong , Sun Qingwen , Meng Guowang , Nong Zhongjian , Qiu Hongbin , Li Xiang
Published: March 2022

Taking the deep foundation pit of a metro station with rich water environment as the research background, a three-dimensional model of seepage-stress coupling is established. Numerical simulation is used to study the deformation process and influencing factors of deep foundation pit dewatering and excavation of the station, and the influence of dfferent pre-dewatering conditions and different depths of the water-stop curtain on the deformation of the foundation pit is analyzed. The results show that during the dewatering and excavation of foundation pits, seepage-stress has an obvious coupling effect in dewatering and excavation. The stress concentration position of retaining structure and the maximum displacement of lateral displacement are about 0.5–0.6 excavation depth of pile body. With the depth of precipitation increases, the seepage effect in the soil layer is obviously enhanced, which is not conducive to the stability of the foundation pit.
COVID-19-associated Isolated Cortical Vein Thrombosis: Detection of SARS‐CoV‐2 in CSF
Authors: Oktar Ayla Çulha , Göçgün Nurdan , Yaşgüçlükal Miray Atacan , Bayar Muhammet Duran , Alaçam Sema , Karabulut Nuran , Duman Ezgi Bakırcıoğlu , Şişman Büşra , Baştan Birgül , Balcı Belgin Petek , Çokar Özlem
Published: March 2022

COVID-19 has been associated with central nervous system manifestations; however, cerebral venous thrombosis is rarely reported. A 34-year-old woman was admitted to the hospital with headache and recurrent seizures; she was recently discharged after COVID-19 pneumonia. Cranial magnetic resonance imaging and magnetic resonance venography showed cortical vein thrombosis in the right frontal lobe. SARS-CoV-2 RNA was detected in cerebrospinal fluid analysis. The patient was anticoagulated and put on antiepileptics. The most probable mechanism underlying the venous thrombosis is COVID-19-associated hypercoagulability. However, the relation between the viral RNA in cerebrospinal fluid analysis and the thrombosis is controversial.
Innovative impact testing machine for enhancing impact related research in Australia
Authors: Asad Mohammad , Zahra Tatheer , Thambiratnam David P , Chan Tommy HT , Liu Xuemei , Zhuge Yan , Hayne Mark , Morris Anthony , Nguyen Christina
Published: March 2022

This paper summarises the development of a state-of-art impact testing machine for simulating impacts such as vehicular crashes or debris impacts onto structures. The machine has a 200 kg pneumatically powered projectile which can travel horizontally within the barrel of the machine with a maximum velocity of 50 m/s to impact the target structure. The maximum kinetic energy that can be generated by the projectile is 125 kJ by using different combinations of mass and velocity. The diameter of the projectile is 214 mm, and its impacting face can be changed to different shapes, such as flat circle, flat square or an elliptical nose to suit different impact scenarios. An innovative braking mechanism incorporating a crush tube is attached within the barrel to ensure safety when the projectile fails to be restrained by the impact. The crush tube can absorb the maximum imparted by the moving projectile. An advanced data acquisition system is installed to collect quantitative and qualitative test data during a period of 50 ms to 1 s. Two high-speed digital image correlation (DIC) cameras are attached and synchronised with the operation of the impact testing machine to record the images at the rate of 50,000 frames per second. Outputs in terms of strains, deformations, accelerations of the target structure with a record of damage history can be analysed using this 3D DIC technique. The paper also briefly presents the first application of this machine for impact testing masonry wall structures.
Incidental diagnosis of squamous cell carcinoma transformation in mature cystic teratoma of the ovary: A case report and review of literature
Authors: Dorji Namkha , Choden Sonam , Tshering Sangay
Published: March 2022

Malignant transformation in a mature cystic teratoma of the ovary is a rare complication. Herein, we report a case of a 62-year-old woman who was diagnosed with squamous cell carcinoma in a mature cystic teratoma of the ovary in the histopathology examination. This case report highlights the importance of suspecting malignant transformation in an elderly woman with a large mature cystic teratoma of the ovary with a thickened wall so that proper surgical and adjuvant treatments are planned.
Review of Postoperative Delirium in Geriatric Patients After Hip Fracture Treatment
Authors: Albanese Anita M. , Ramazani Noyan , Greene Natasha , Bruse Laura
Published: March 2022

Introduction

Postoperative delirium (POD) is a serious complication occurring in 4–53.3% of geriatric patients undergoing surgeries for hip fracture. Incidence of hip fractures is projected to grow 11.9% from 258,000 in 2010 to 289,000 in 2030 based on 1990 to 2010 data. As prevalence of hip fractures is projected to increase, POD is also anticipated to increase.

Signficance

Postoperative delirium remains the most common complication of emergency hip fracture surgery leading to high morbidity and mortality rates despite significant research conducted regarding this topic. This study reviews literature from 1990 to 2021 regarding POD in geriatric hip fracture management.

Results

Potentially modifiable and non-modifiable risk factors for developing POD include, but are not limited to, male gender, older age, multiple comorbidities, specific comorbidities (dementia, cognitive impairment, diabetes, vision impairment, and abnormal blood pressure), low BMI, preoperative malnutrition, low albumin, low hematocrit, blunted preoperative cytokines, emergency surgery, time to admission and surgery, preoperative medical treatment, polypharmacy, delirium-inducing medications, fever, anesthesia time, and sedation depth and type. Although the pathophysiology remains unclear, the leading theories suggest neurotransmitter imbalance, inflammation, and electrolyte or metabolic derangements as the underlying cause of POD. POD is associated with increased length of hospital stay, cost, morbidity, and mortality. Prevention and early recognition are key factors in managing POD. Methods to reduce POD include utilizing interdisciplinary teams, educational programs for healthcare professionals, reducing narcotic use, avoiding delirium-inducing medications, and multimodal pain control.

Conclusion

While POD is a known complication after hip fracture surgery, further exploration in prevention is needed. Early identification of risk factors is imperative to prevent POD in geriatric patients. Early prevention will enhance delivery of health care both pre- and post-operatively leading to the best possible surgical outcome and better quality of life after hip fracture treatment.
Block Chain Application in Insurance Services: A Systematic Review of the Evidence
Authors: Shetty Ankitha , Shetty Adithya D. , Pai Rashmi Yogesh , Rao Rohini R. , Bhandary Rakshith , Shetty Jyothi , Nayak Santosh , Keerthi Dinesh Tantri , Dsouza Komal Jenifer
Published: March 2022

The Insurance industry participates in various processes that are characterized by data exchange, which is modified or updated by many parties. Hence, the insurance industry can benefit from the adoption of blockchain technology. However, there is a lack of understanding of the technology, the legal implications and the issues in implementing the technology. This paper aims at finding potential opportunities for the insurance sector on the implementation of blockchain technology. It also discusses issues and concerns for insurance companies wanting to adopt block chain technologies. A search was carried out for relevant electronic bibliographic databases (searched by means of keywords), articles published in scientific journals, websites of consultancy firms and blockchain developers, and reference lists of relevant review articles. Articles were screened and eligibility was based on participants, procedures, interventions comparisons, outcomes (PICO) model and criteria for PRISMA (Preferred Reporting Items for Systematic Reviews). A total of 23 papers were finalized after scrutiny for this study whereby the results disclose that blockchain, as a single source of reality, has the potential to improve productivity and mitigate the complexity of the insurance processes. Examples of real-world applications and insurance use cases are presented to demonstrate the strengths & capabilities of the technology. This study also considers the present-day issues, risks and concerns in the implementation of the blockchain technology. Finally, the challenges and obstacles in the application of Blockchain technology in the Insurance Sector is highlighted and presented.
Recommendations of ELT Students for Four Language Skills Development: A Study on Emergency Distance Education During the COVID-19 Pandemic
Authors: Tuncer Hülya , Karataş Tuçe Öztürk
Published: March 2022

The COVID-19 pandemic will not be easily forgotten as its contagious impact has penetrated education. In response to this, educational practices have moved online within various forms and terms, and Emergency Distance Education (EDE) is one of them. Within this frame, this qualitative study aimed to investigate the recommendations of 118 English Language Teaching (ELT) Department students for their teachers and for students themselves in developing four language skills—reading, writing, listening, and speaking—during EDE settings to improve the efficiency of the online courses. In doing so, Framework Method via NVivo 11 Plus was utilized. The participants’ recommendations for EDE included a total of 152 comments for reading, 141 for writing, 131 for listening, and 147 for speaking skills. The participants’ recommendations for four skills centered on a total of seven themes: for teachers, for students, for online platforms, for eliminating technical issues, satisfactory, no recommendation, and no answer. The data analysis demonstrated that the majority of the recommendations for each skill were given for teachers under two sub-themes: content and implementation. While content had the highest frequency for reading, writing, and listening skills, implementation was found to be the top concern for speaking skills. The results of the study presented valuable insights not only for ELT contexts but also for all language education settings.
Extensive Tracheal Injuries: A Reasoned Multistep Approach to Guarantee Mechanical Ventilatory Support Developed During the COVID‐19 Pandemic
Authors: Mattioli Francesco , Martone Andrea , Andreani Alessandro , Cappiello Gaia , Tonelli Roberto , Clini Enrico , Marchioni Alessandro
Published: March 2022

The COVID‐19 pandemic has notably increased the need for prolonged mechanical ventilation (MV) in patients with respiratory failure. This has increased the risk of extensive tracheal injury (ETI) associated with life‐threatening complications in complex cases. Furthermore, tracheal injury treatment in patients with COVID‐19 has not been described yet. Three patients with COVID‐19 and ETI who required MV between April and November 2020 were included. A multistep approach was performed to restore tracheal integrity with a custom‐remodeled stent and tracheostomy tube placement to allow ventilatory support. Efficient MV with no residual air leaks was obtained in all cases. One patient died 6 weeks after the procedure due to COVID‐19 lung damage. Two patients have completely been weaned from MV. This multistep procedure could be used to maintain ventilatory support in the case of ETI, working as a bridge to subsequent surgery when clinical conditions improve.
Multimodal knowledge building in a Japanese secondary English as a foreign language class
Authors: Amundrud Thomas
Published: March 2022

Multimodal analysis examines how different modes, such as space, gesture, and language, instantiate meaning together. In this paper, a Systemic Functional-Multimodal Discourse Analysis demonstrates how teachers enact their pedagogy with their students across modes through what is represented experientially, how relationships between people are construed interpersonally, and how coherent texts are realized textually. This paper is a preliminary study of classroom data from a larger project looking at the multimodal pedagogy of Japanese secondary school teachers of English through the paired lenses of Systemic Functional-Multimodal Discourse Analysis and Legitimation Code Theory. It demonstrates how methods from these perspectives may be productively combined. How this teacher builds cumulative knowledge multimodally can be uncovered through the analysis of pedagogic register (Rose, 2018) and exchange (Berry, 1981; Martin and Rose, 2007), as well as classroom space and representing and textual action (Amundrud, 2017; Martin and Zappavigna, 2019). How both gesture and dialogic exchange between the teacher and students modulate the contextual relation of the knowledge construed in class is also explored via semantic gravity, which looks at how closely connected knowledge practices are to their context (Maton, 2014). As a preliminary study, the paper closes with limitations and future directions for this pedagogic multimodality research.
Identifying Subjective Perspectives on Managing Underground Risks at Schiphol Airport
Authors: Biersteker Erwin , van Marrewijk Alfons , Koppenjan Joop
Published: March 2022

Recently, scholars have called for a focus on subjective aspects of risk management as a suitable lens for understanding how it functions. In line with this lens, this study focuses on project actors’ viewpoints on risk management in the context of construction projects to provide novel insights in risk management. Drawing on Renn's model and following a Q methodology, we identify four risk management approaches among asset managers and project managers working at the Dutch Schiphol Airport. The action-oriented and future-oriented viewpoints are dominant, while the expert input and stakeholder-centric viewpoints are in the minority. Our findings extend the risk management debate by showing that (1) there are various approaches to risk management that have been identified independently from the formal risk management; (2) these approaches cannot be explained by a project actor's role or objective within the project; and (3) that project actors have a dominant focus on managing complexity-induced risks at the expense of managing other types of risks.
Task-driven knowledge graph filtering improves prioritizing drugs for repurposing
Authors: Ratajczak Florin , Joblin Mitchell , Ringsquandl Martin , Hildebrandt Marcel
Published: March 2022

Background

Drug repurposing aims at finding new targets for already developed drugs. It becomes more relevant as the cost of discovering new drugs steadily increases. To find new potential targets for a drug, an abundance of methods and existing biomedical knowledge from different domains can be leveraged. Recently, knowledge graphs have emerged in the biomedical domain that integrate information about genes, drugs, diseases and other biological domains. Knowledge graphs can be used to predict new connections between compounds and diseases, leveraging the interconnected biomedical data around them. While real world use cases such as drug repurposing are only interested in one specific relation type, widely used knowledge graph embedding models simultaneously optimize over all relation types in the graph. This can lead the models to underfit the data that is most relevant for the desired relation type. For example, if we want to learn embeddings to predict links between compounds and diseases but almost the entirety of relations in the graph is incident to other pairs of entity types, then the resulting embeddings are likely not optimised to predict links between compounds and diseases. We propose a method that leverages domain knowledge in the form of metapaths and use them to filter two biomedical knowledge graphs (Hetionet and DRKG) for the purpose of improving performance on the prediction task of drug repurposing while simultaneously increasing computational efficiency.

Results

We find that our method reduces the number of entities by 60% on Hetionet and 26% on DRKG, while leading to an improvement in prediction performance of up to 40.8% on Hetionet and 14.2% on DRKG, with an average improvement of 20.6% on Hetionet and 8.9% on DRKG. Additionally, prioritization of antiviral compounds for SARS CoV-2 improves after task-driven filtering is applied.

Conclusion

Knowledge graphs contain facts that are counter productive for specific tasks, in our case drug repurposing. We also demonstrate that these facts can be removed, resulting in an improved performance in that task and a more efficient learning process.
Geographical inequalities in the decreasing 28-day mortality following incident acute myocardial infarction: a Danish register-based cohort study, 1987–2016
Authors: Fuglsang Niels Asp , Zinck Elisabeth , Ersbøll Annette Kjær , Ersbøll Bjarne Kjær , Gislason Gunnar Hilmar , Kjærulff Thora Majlund , Bihrmann Kristine
Published: March 2022

Background

Mortality following acute myocardial infarction (AMI) has decreased in western countries for decades; however, it remains unknown whether the decrease is distributed equally across the population independently of residential location. This study investigated whether the observed decreasing 28-day mortality following an incident AMI in Denmark from 1987 to 2016 varied geographically at municipality level after accounting for sociodemographic characteristics.

Methods

A register-based cohort study design was used to investigate 28-day mortality among individuals with an incident AMI. Global spatial autocorrelation (within sub-periods) was analysed at municipality level using Moran's I. Analysis of spatio-temporal autocorrelation before and after adjusting for sociodemographic characteristics was performed using logistic regression and conditional autoregressive models with inference in a Bayesian setting.

Results

In total, 368,839 individuals with incident AMI were registered between 1987 and 2016 in Denmark; 128,957 incident AMIs were fatal. The 28-day mortality decreased over time at national level with an odds ratio of 0.788 (95% credible interval (0.784, 0.792)) per 5-year period after adjusting for sociodemographic characteristics. The decrease in the 28-day mortality was geographically unequally distributed across the country and in a geographical region in northern Jutland, the 28-day mortality decreased significantly slower (4–12%) than at national level.

Conclusions

During the period from 1987 to 2016, the 28-day mortality following an incident AMI decreased substantially in Denmark. However, in a local geographical region, the 28-day mortality decreased significantly slower than in the rest of the country both before and after adjusting for sociodemographic differences. Efforts should be made to keep geographical trend inequalities in the 28-day mortality to a minimum.
Isolated IgG4-related cholecystitis with localized gallbladder wall thickening mimicking gallbladder cancer: a case report and literature review
Authors: Harada Yuko , Mihara Kisyo , Amemiya Ryusuke , Nakagawa Masashi , Hanada Ryota , Inoue Kentaro , Shito Masaya , Orikasa Hideki , Aiura Koichi
Published: March 2022

Background

IgG4-related cholecystitis, which is a manifestation of IgG4-related disease in the gallbladder, is associated with autoimmune pancreatitis or IgG4-related sclerosing cholangitis in most cases; isolated gallbladder lesions without systemic manifestations are very rare. Gallbladder wall thickening is often diffuse, but sometimes localized, in which case, differentiation from gallbladder cancer becomes difficult. The characteristic features of IgG4-related cholecystitis on imaging that would enable differentiation from gallbladder cancer remain poorly described.

Case presentation

We present a rare case of isolated IgG4-related cholecystitis with localized gallbladder wall thickening that was clinically difficult to distinguish from malignancy before resection. An 82-year-old man was referred to our hospital because of gallbladder wall thickening on abdominal ultrasonography without any symptoms. Dynamic computed tomography of the abdomen showed localized wall thickening from the body to the fundus of the gallbladder that was enhanced from an early stage with a prolonged contrast effect. There were no other findings, such as pancreatic enlargement and bile duct dilatation. Magnetic resonance cholangiopancreatography revealed neither dilatation nor stenosis of the bile duct and pancreatic duct. Endoscopic ultrasonography (EUS) showed a smooth layered thickening of the gallbladder wall with a maximum thickness of 6 mm and a well-preserved outermost hyperechoic layer in the same area. Laparoscopic cholecystectomy was performed because malignancy could not be completely ruled out. Pathological examination of a resected specimen revealed IgG4-positive plasma cell infiltration, fibrosis, and phlebitis. Although the serum IgG4 level measured after resection was normal, the condition was ultimately diagnosed as probable IgG4-related cholecystitis according to the 2020 revised comprehensive diagnostic criteria for IgG4-related disease. The EUS images reflected the pathological findings, in which lymphocytic infiltration was distributed in a laminar fashion in the gallbladder wall.

Conclusions

Although rare, isolated IgG4-related cholecystitis with localized wall thickening mimicking gallbladder cancer remains a clinical problem. A smooth laminar thickening of the gallbladder wall on EUS imaging could be one of the most informative characteristics for differentiating IgG4-related cholecystitis from gallbladder cancer.
The monocyte to lymphocyte ratio not only at baseline but also at relapse predicts poor outcomes in patients with hepatocellular carcinoma receiving locoregional therapy
Authors: Wang Qi , Qiao Wenying , Liu Biyu , Li Jianjun , Yuan Chunwang , Long Jiang , Hu Caixia , Zang Chaoran , Zheng Jiasheng , Zhang Yonghong
Published: March 2022

Background

Monocyte to lymphocyte ratio (MLR) represents a pro-inflammatory immune microenvironment. The aim of this study was to elucidate the effect of MLR and subsequent MLR when relapse occurred (R-MLR) on prognosis for hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) combined with ablation.

Methods

A prospective analysis was conducted on 606 patients with HCC who were treated with TACE combined with local ablation in Beijing You’an Hospital affiliated to Capital Medical University from January 1, 2012 to December 31, 2016. MLR or R-MLR were stratified according to the optimal cut-off values. The cumulative recurrence-free survival (RFS), overall survival (OS) , and recurrence-death survival (RDS) rates were calculated by Kaplan–Meier method. The Cox proportion hazard model and logistic regression analysis was conducted to screen for independent predictive factors for indicating early relapse and long-term prognosis.

Results

High MLR was significantly associated with relapse, early recurrence, and overall survival. After a median follow-up of 59.4 months, The cumulative 1-, 3-, 5-year RFS rates of low MLR were 74.6%, 43.8%, and 34.0%; while 66.1%, 32.2%, and 22.6% for high group (P < 0.001). There were also significant differences in corresponding OS rates of the two groups (P = 0.003). The cumulative 1-, 3-, 5-year OS rates of low R-MLR were 99.5%, 87.2%, 75.5%; while 98.3%, 78.3%, 61.7% for high group (P < 0.001). There were also significant differences in corresponding RDS rates in the two groups (P = 0.008). 436 patients were divided into four groups on the base of cut-off values of MLR and R-MLR (low-low, low–high, high-low, and high-high). The low-low group has shown better outcomes including the cumulative 1-, 3-, 5-year OS, and RDS rates(P < 0.001).

Conclusions

High MLR was related to unfavorable outcome. Subsequent change of MLR between baseline and HCC relapse could indicate poor long-term survival after relapse.
Validating the agreement between the geriatric trauma frailty index and four published frailty scores in the Chinese geriatric trauma population
Authors: Zhao Fangjie , Tang Bihan , Liu Xu , Zhang Zhifeng , Zhang Lulu
Published: March 2022

Background

In the geriatric patient population, frailty significantly affects a patient’s prognostic outcome. This study aimed to compare the consistency of our constructed geriatric trauma frailty index with previously published indexes.

Methods

The geriatric trauma frailty index (GTFI) was compared with four previously published frailty indexes, i.e., the hospital frailty risk score (HFRS), Fried index, trauma-specific frailty index (TSFI), and 11-item modified frailty index (mFI) using the Bland-Altman method, intraclass correlation coefficient (ICC), and kappa consistency test. The indexes were calculated based on data collected from 101 questionnaires and medical records from 101 geriatric trauma patients at a tertiary hospital in Shanghai.

Results

Among the 101 geriatric trauma patients, 64 (63.4%) were women, with a mean age of 71.18 (SD = 9.89) years and mean length of stay (LOS) of 7.51 (SD = 3.89) days. The mean scores of GTFI score(≥ 1.3045 as frail), Fried index score(≥3 items as frail), TSFI score(≥ 4 as frail), and mFI (≥ 3 as frail),were 0.86 (SD = 1.51), 0.76 (SD = 1.07), 1.76 (SD = 1.96), and 1.29 (SD = 1.17). respectively. The GTFI score had good consistency with the HFRS (ICC: 0.716, 95% confidence interval [CI]: 0.596, 0.799, kappa: 0.608, 95% CI: 0.449, 0.766), fair consistency with the TSFI (ICC: 0.407, 95% CI: 0.227, 0.562, kappa: 0.460, 95% CI: 0.239, 0.672), and poor consistency with the mFI (ICC: 0.286, 95% CI: 0.097, 0.455, kappa: 0.305, 95% CI: 0.069, 0.525) and Fried index score (ICC: 0.256, 95% CI: 0.063, 0.426, kappa: 0.188, 95% CI: − 0.028, 0.408).

Conclusions

Different frailty indexes are based on different concepts of frailty and cannot be assumed to be interchangeable. There is still no gold standard for the current assessment methods of frailty, but it can be compared based on the understanding in terms of the concepts and measures used in each.
Investigating the intention to receive the COVID-19 vaccination in Macao: implications for vaccination strategies
Authors: Ung Carolina Oi Lam , Hu Yuanjia , Hu Hao , Bian Ying
Published: March 2022

Background

Understanding the intention of receiving COVID-19 vaccines is important to inform effective vaccination strategies. This study aimed to investigate such intention, identify the key influencing factors, and determine the most important intention predictors using a theoretically principled model.

Methods

An online, cross-sectional survey method was implemented in Macao in May 2021. People aged 18 years or above and residing in Macao for 12 months prior to the study were recruited through social media. Intention to receive COVID-19 vaccines and the main constructs of the protection motivation theory and the health belief model were the main measures encompassing threat appraisal, intrapersonal characteristics, cues to action, coping appraisal, past experiences and information seeking behavior. Descriptive statistics, Pearson correlation and multiple linear regression were used for data analysis.

Results

A total of 552 valid responses were received. Among the respondents, 79.5% aged between 25 and 54 years old, 59.4% were female, and 88% had a bachelor degree or above; 62.3% of the respondents indicated their intention to receive COVID-19 vaccination while 19.2% were hesitant and 18.5% did not have any intention. While 67.0% believed COVID-19 infection was life-threatening, only 19.0% thought they were at risk of getting infected. Control variables such as age, gender, education level, and having travel plans were significantly correlated with intention. Significant associations between intention with perceived severity, perceived susceptibility, maladaptive response reward, self-efficacy, response-efficacy, response cost, social attitude, social norm, past experience and information seeking behavior were identified (P < 0.05). The most important positive predictors of intention were “being able to make arrangement to receive the vaccine” (β = 0.333, P < 0.001), “a sense of social responsibility” (β = 0.326, P < 0.001), and “time off from work after vaccination” (β = 0.169, P < 0.001), whereas “concerns over vaccine safety” (β = − 0.124, P < 0.001) and “relying on online resources for vaccine information” (β = − 0.065, P < 0.05) were negative predictors. Perceived severity in terms of COVID-19 being a life threatening illness was not a predictor of intention.

Conclusion

This study reaffirmed that intention to receive COVID-19 vaccination is an ongoing concern in the combat of the pandemic. Multi-component strategies to enhance health literacy that supports well-informed decision-making, increase vaccination convenience, promote social responsibility, and provide time-off incentives are among the key considerations in designing and improve vaccination campaigns in Macao.
Isaacs’ syndrome as the initial presentation of malignant thymoma and associated with double-positive voltage-gated potassium channel complex antibodies, a case report
Authors: Li Kuan-Ching , Liao Ming-Feng , Wu Yih-Ru , Lyu Rong-Kuo
Published: March 2022

Background

Isaacs’ syndrome is a peripheral nerve hyperexcitability (PNH) syndrome due to peripheral motor nerve instability. Acquired Isaacs’ syndrome is recognized as a paraneoplastic autoimmune disease with possible pathogenic voltage-gated potassium channel (VGKC) complex antibodies. However, the longitudinal correlation between clinical symptoms, VGKC antibodies level, and drug response is still unclear.

Case presentation

A 45-year-old man had progressive four limbs soreness, muscle twitching, cramps, and pain 4 months before admission. Electromyography (EMG) studies showed myokymic discharges, neuromyotonia, and an incremental response in the high-rate (50 Hz) repetitive nerve stimulation (RNS) test. Isaacs’ syndrome was diagnosed based on clinical presentations and EMG reports. Serum studies showed positive VGKC complex antibodies, including leucine-rich glioma-inactivated 1 (LGI1) and contactin-associated protein-like 2 (CASPR2) antibodies. The acetylcholine receptor antibody was negative. Whole-body computed tomography (CT) and positron emission tomography revealed a mediastinal tumor with the great vessels encasement, right pleura, and diaphragm seeding. Biopsy confirmed a World Health Organization type B2 thymoma, with Masaoka stage IVa. His symptoms gradually improved and both LGI1 and CASPR2 antibodies titer became undetectable after concurrent chemoradiotherapy (CCRT) and high dose steroid treatment. However, his Isaacs’ syndrome recurred after the steroid was reduced 5 months later. Follow-up chest CT showed probable thymoma progression. LGI1 antibody turned positive again while CASPR2 antibody remained undetectable.

Conclusions

Our patient demonstrates that Isaacs’ syndrome could be the initial and only neuromuscular manifestation of malignant thymoma. His Isaacs’ syndrome is correlated well with the LGI1 antibody level. With an unresectable thymoma, long-term immunosuppressant therapy may be necessary for the management of Isaacs’ syndrome in addition to CCRT for thymoma.
Spotlight on MuSK positive myasthenia gravis: clinical characteristics, treatment and outcomes
Authors: Huang Qi , Li Feng , Zhao Song
Published: March 2022

Background

To investigate the clinical characteristics, treatments and outcomes of patients with myasthenia gravis with antibodies to muscle-specific tyrosine kinase (MuSK-MG).

Methods

We retrospectively reviewed the cases of 21 patients with confirmed MuSK-MG between January 2012 and January 2020 in our centre. Detailed clinical data and long-term follow-up information were summarized.

Results

Females (17/21, 81%) predominated among these MuSK-MG patients, and the mean age of onset in this group was 51.86 ± 16.16 years. MuSK-MG patients were divided into three subgroups according to the symptoms of muscle weakness at onset: ocular myasthenia gravis (OMG, 47.6%), bulbar myasthenia gravis (BMG, 42.9%), and generalized myasthenia gravis (GMG, 9.5%). The mean progression time from symptom onset to other muscle group involvement in OMG patients was 4.38 ± 2.54 months. Pyridostigmine bromide was adopted in 81.0% of patients, and 90.5% of patients received corticosteroids. Compared to usage in hospitals, the median daily dose of corticosteroids decreased significantly at the last follow-up. A total of 85.7% of patients received a long-term follow-up, with an average time of 1202.17 ± 976.73 days. At the end of the follow-up period, 4.8% of patients had achieved complete stable remission, 42.9% of patients had minimal manifestations, 19.0% had improved, the condition of 4.8% of patients remained unchanged, and 9.5% of patients died.

Conclusion

Female patients were more prevalent in this study, and MuSK-MG patients rapidly progressed to a generalized state. Although approximately 50% of MuSK-MG patients can achieve a favourable outcome with conventional immunosuppressants, complete stable remission is rare, and approximately 15% respond poorly. More effective medications should be explored in these patients.
Circular RNA hsa_circ_0000277 promotes tumor progression and DDP resistance in esophageal squamous cell carcinoma
Authors: Cheng Jiwei , Zhang Ruixiang , Yan Ming , Li Yin
Published: March 2022

Background

Circular RNAs (circRNAs) are well-known regulators of cancer progression and chemoresistance in various types of cancers. This study was performed to investigate the function of hsa_circ_0000277 in esophageal squamous cell carcinoma (ESCC).

Methods

RNA levels were analyzed via the reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Cell Counting Kit-8 (CCK-8) assay was applied to determine cell proliferation and half maximal inhibitory concentration (IC50) of cisplatin (DDP). Colony formation ability was evaluated by colony formation assay. Cell cycle and apoptosis were measured using flow cytometry. RNA immunoprecipitation (RIP), pull-down assay and dual-luciferase reporter assays were performed for target interaction analysis. The protein levels were determined through western blot. Xenograft models were established for researching hsa_circ_0000277 function in vivo.

Results

Hsa_circ_0000277 expression was increased in ESCC cells and tissues, and it had important clinical significance. Downregulation of hsa_circ_0000277 repressed ESCC cell proliferation, colony formation, cell cycle, and DDP resistance. Hsa_circ_0000277 acted as a microRNA-873-5p (miR-873-5p) sponge and Sry-related high-mobility group box 4 (SOX4) was validated as a target of miR-873-5p. Moreover, hsa_circ_0000277/miR-873-5p axis and miR-873-5p/SOX4 axis regulated ESCC cell progression and DDP resistance. Hsa_circ_0000277/miR-873-5p axis activated SOX4/Wnt/β-catenin signaling pathway. Hsa_circ_0000277 facilitated tumorigenesis and DDP resistance by miR-873-5p/SOX4 axis in vivo.

Conclusion

These findings unraveled that hsa_circ_0000277 promoted ESCC progression and DDP resistance via miR-873-5p/SOX4/Wnt/β-catenin axis, showing a specific molecular mechanism of carcinogenesis and chemoresistance in ESCC.
Predicting biochemical-recurrence-free survival using a three-metabolic-gene risk score model in prostate cancer patients
Authors: Zhao Yiqiao , Tao Zijia , Li Lei , Zheng Jianyi , Chen Xiaonan
Published: March 2022

Background

Biochemical recurrence (BCR) after initial treatment, such as radical prostatectomy, is the most frequently adopted prognostic factor for patients who suffer from prostate cancer (PCa). In this study, we aimed to construct a prognostic model consisting of gene expression profiles to predict BCR-free survival.

Methods

We analyzed 70 metabolic pathways in 152 normal prostate samples and 494 PCa samples from the UCSC Xena dataset (training set) via gene set enrichment analysis (GSEA) to select BCR-related genes and constructed a BCR-related gene risk score (RS) model. We tested the power of our model using Kaplan–Meier (K–M) plots and receiver operator characteristic (ROC) curves. We performed univariate and multivariate analyses of RS using other clinicopathological features and established a nomogram model, which has stronger prediction ability. We used GSE70770 and DFKZ 2018 datasets to validate the results. Finally, we performed differential expression and quantitative real-time polymerase chain reaction analyses of the UCSC data for further verification of the findings.

Results

A total of 194 core enriched genes were obtained through GSEA, among which 16 BCR-related genes were selected and a three-gene RS model based on the expression levels of CA14, LRAT, and MGAT5B was constructed. The outcomes of the K–M plots and ROC curves verified the accuracy of the RS model. We identified the Gleason score, pathologic T stage, and RS model as independent predictors through univariate and multivariate Cox analyses and constructed a nomogram model that presented better predictability than the RS model. The outcomes of the validation set were consistent with those of the training set. Finally, the results of differential expression analyses support the effectiveness of our model.

Conclusion

We constructed an RS model based on metabolic genes that could predict the prognosis of PCa patients. The model can be easily used in clinical applications and provide important insights into future research on the underlying mechanism of PCa.
Assessment of the national and subnational completeness of death registration in Nepal
Authors: Pandey Surender Prasad , Adair Tim
Published: March 2022

Background

Reliable and timely mortality data from a civil registration and vital statistics (CRVS) system are of crucial importance for generating evidence for policy and monitoring the progress towards national and global development goals. In Nepal, however, the death registration system is not used to produce mortality statistics, because it does not providing data on age at death and only reporting deaths by year of registration. This study assesses the completeness of death registration in Nepal – both the existing offline system and the newer online system – as well as the completeness of death reporting from a CRVS Survey, and assesses differences by year, sex, ecological belt, and province.

Methods

The empirical completeness method is used to estimate completeness at all ages from the offline (paper-based) registration system (2013-17), the online registration system (2017-19) and the CRVS Survey (2014-15).

Results

Completeness of the offline death registration system was 69% in 2017, not increasing since 2013 and being higher for males (73%) than females (65%). Completeness of online registration was only 32% in 2019, but almost double the 2017 figure. Completeness of death reporting in the CRVS Survey was 75% in 2015. The largest subnational differentials in completeness exist for the offline registration system, ranging from 90% in Gandaki to just 39% in Karnali.

Conclusions

Improvement in the utility of the Nepalese death registration system for mortality statistics is dependent on continued roll-out of the online death registration system (which reports age at death and deaths by year of occurrence) throughout the country, focusing on areas with low registration, building a strong coordination mechanism among CRVS stakeholders and implementing public awareness programs about death registration.
Association of China’s two-child policy with changes in number of births and birth defects rate, 2008–2017
Authors: Chen Hanyi , Wei Ting , Wang Haiyin , Zhou Yi , Chen Hua , Sun Lianghong , Xiao Shaotan , Ma Wuren , Zhao Huijuan , Chen Guanghua , Liang Xinlei , Zhang Donglan , Zheng Weiwei , Zhou Yixin , Yu Zhangsheng
Published: March 2022

Background

In October 2015, China’s one-child policy was universally replaced by a so-called two-child policy. This study investigated the association between the enactment of the new policy and changes in the number of births, and health-related birth outcomes.

Methods

We used difference-in-difference model to analyse the birth record data in Pudong New Area, Shanghai.The design is descriptive before-and-after comparative study.

Results

The data covered three policy periods: the one-child policy period (January 2008 to November 2014); the partial two-child policy period (December 2014 to June 2016); the universal two-child policy period (July 2016 to December 2017). There was an estimate of 7656 additional births during the 18 months of the implementation of the universal two-child policy. The trend of monthly percentage of births to mothers aged ≥35 increased by 0.24 percentage points (95% confidence interval 0.19 to 0.28,p < 0.001) during the same period. Being a baby boy, preterm birth, low birth weight, parents with lower educational attainment, and assisted delivery were associated with a higher risk of birth defects.

Conclusions

The universal two-child policy was associated with an increase in the number of births and maternal age. Preterm birth, low birth weight, and assisted delivery were associated with a higher risk of birth defects, which suggested that these infants needed additional attention in the future.
Fragile X premutation carrier screening in Pakistani preconception women in primary care consultation
Authors: Meraj Neelam , Yasin Muhammad , Rehman Zia Ur , Tahir Haleema , Jadoon Humaira , Khan Niamat , Shahid Rabia , Zubair Maria , Zulfiqar Irba , Jabeen Musarrat , Neelam Shahzadi , Hameed Abdul , Saleha Shamim
Published: March 2022

Purpose

Women of reproductive age who carry fragile X premutation (PM) alleles have 56 to 200 CGG repeats in the 5′-untranslated region ofFMR1gene are at increased risk for producing children with intellectual disabilities (ID) or autism spectrum disorders (ASD) due to expansion of PM alleles to full mutation alleles (> 200 repeats) during maternal transmission.

Methods

In present study fragile X PM carrier screening was performed in total 808 women who were consulting primary health care centers for preconception care in Khyber Pakhtunkhwa region of Pakistan between April, 2018 and December, 2020. Polymerase chain reaction (PCR) was performed for detection of PM carrier women and the CGG repeats number was confirmed by Southern blotting and capillary electrophoresis.

Results

The prevalence rate for PM carriers among preconception women was found to be 0.7% that was contributed by 0.5% women in risk group (RG1) with family history of ID and 0.2% in risk group 2 (RG2) with family history of ASD. PM carrier women had at least one affected child or sibling. In addition, the preconception women withFMR1PM alleles were found to be at increased risk for primary ovary insufficiency (RG1:P = 0.0265, RG2:P = 0.0389), postpartum depression (RG1:P = 0.0240, RG2:P = 0.0501) and neuropsychiatric disorders (RG1:P = 0.0389, RG2:P = 0.0432).

Conclusions

Current study provides first evidence of fragile X PM carrier screening in Pakistani preconception women in primary care consultation. Findings of current study may help to improve preconception care and to reduce burden of fragile X associated disorders in our population.
Clinical analysis of 44 cases of atypical polypoid adenomyoma of the uterus
Authors: Wang Xin , Guo Yinshu
Published: March 2022

Background

Atypical polypoid adenomyoma (APA) is a rare intrauterine polypoid lesion that occurs predominantly in premenopausal women. Although APA was previously considered a benign lesion and treated conservatively, an increasing number of cases show that APA has a high rate of recurrence or residual disease and that it precedes the development of carcinoma. The clinical management of APA remains to be established. The aim of this study was to analyse the clinicopathological features of APA and discuss its diagnosis and prognosis.

Methods

Forty-four patients with APA were admitted to Beijing Obstetrics and Gynecology Hospital from 2005 to 2019, and their clinical and histopathologic features were evaluated. B-ultrasound was performed, and all the patients (n = 44) underwent hysteroscopy. Endometrium excision was performed by means of the four-step diagnosis and treatment method. Hysteroscopic transcervical resection (TCR) was performed in 5 patients with APA-H and 11 with APA-L. Except for one patient who underwent transcervical endometrial resection, all the patients underwent hysterectomy and salpingectomy or salpingo-oophorectomy. Data from a median follow-up of 42 months (ranging from 3 to 174 months) were available for these patients.

Results

Pathological diagnosis were made according to the degree of abnormality of the APA surface glands, resulting in APA-L in 36 patients and APA-H in 8 patients. Among these patients, 28 (25 APA-L and 3 APA-H) were treated conservatively. The effect of the four-step diagnosis and treatment method as an APA therapy was excellent. During the follow-up, no evidence of recurrence was found.

Conclusions

For patients with intracavitary lesions > 1 cm, the hysteroscopic four-step diagnosis and treatment method and pathological diagnosis are the basis of clinical treatment. More than 30% of APA surface glands have complex structures characterized by branching and budding or other high-risk factors, such as endometrial hyperplasia, which are indications for hysterectomy. For patients who desire to become pregnant or to preserve the uterus, hysteroscopy with complete excision of the lesions should be the preferred treatment method. The patients should be treated and followed up closely with regular hysteroscopy and endometrial biopsy.