bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiences of African Americans Living With Sickle Cell Disease
Authors: Wickersham Karen E. , Dawson Robin M. , Becker Karen P. , Everhart Kayla C. , Miles Heather S. , Schultz Beth E. , Tucker Curisa M. , Wright Pamela J. , Jenerette Coretta M.
Published: January 2022

Introduction:

About 100,000 individuals in the United States live with sickle cell disease (SCD). Palliative care (PC) can improve symptom management for these individuals. The purpose of the study was to explore (a) the experiences of people living with SCD, and (b) their knowledge and perceptions of PC.

Method:

Using a qualitative, descriptive design, adults with SCD were recruited from a foundation in the southeastern United States. Data included social and SCD-related demographics and audio-recorded, semi-structured focus groups. Analysis took a thematic analysis approach.

Results:

Participants: There were 16 African Americans who participated in the study, 75% of whom were females, and aged 22 to 71 years. Five themes were identified: unique and unpredictable impact of SCD on daily life, the changing experience of SCD over time, stigmatization/marginalization in health care interactions, perceptions of support in managing SCD symptoms/crises, and PC: “What is it?”

Discussion:

Participants lacked PC knowledge. PC should be offered to individuals with SCD as part of comprehensive SCD management.
Comprehensive Evaluation and Unique Morphologic Features of Nonsteroidal Anti-Inflammatory Drug (NSAID) Enteropathy in the Terminal Ileum
Authors: Nguyen Jessica , Lee Sherry , Yang Guang-Yu
Published: January 2022

Differentiating NSAID enteropathy from Crohn disease can be challenging on terminal ileum biopsy. It is important to distinguish these two entities for management. In this study, clinical, radiographic, endoscopic, and histologic features of 30 patients diagnosed with NSAID enteropathy and 30 patients diagnosed with Crohn disease on terminal ileal biopsy were compared. None of the patients in the NSAID cohort demonstrated significant changes on imaging performed prior to biopsy. Depending on disease severity, patients with Crohn disease showed imaging findings ranging from minimal changes to significant bowel wall and/or luminal changes. Endoscopically, erythema, erosions, and/or ulcers in the terminal ileum were observed in a majority of NSAID cases. Patients with active Crohn disease were noted to have erythema, ulcers, strictures, and/or visible inflammation throughout the distal ileum and colon. Histologically, at least 80% of cases in each cohort showed ulceration/erosion and cryptitis/crypt abscesses. The Crohn disease cohort had significantly higher degree of lymphoplasmacytic inflammation in the lamina propria compared to the NSAID cohort. In contrast, a significantly higher percentage of the NSAID cohort had gland/crypt atrophy. A decrease in number of Paneth cells was found in the NSAID cohort. Decreased lamina propria lymphoplasmacytic inflammation was the most specific and the presence of gland atrophy the most sensitive feature favoring NSAID enteropathy. In summary, the combination of gland/crypt/Paneth cell atrophy with decreased lamina propria lymphoplasmacytic inflammation can aid in differentiating NSAID enteropathy from Crohn disease in terminal ileal biopsies; however, correlation with clinical, radiographic, and endoscopic findings is still required.
Analysis of an anti-plane crack in a one-dimensional orthorhombic quasicrystal strip
Authors: Hu Keqiang , Yang Weilin , Fu Jiawei , Chen Zengtao , Gao Cun-Fa
Published: January 2022

In this paper, a central crack in a one-dimensional (1D) orthorhombic quasicrystal strip under anti-plane loadings has been studied. Fourier transform is applied to reduce the mixed boundary value problem of the crack to solving a system of simultaneous singular integral equations. Asymptotic expressions of the phonon and the phason fields near the crack tips have been obtained. The crack-tip singularities of the anti-plane crack have been investigated, and the intensity factors of the stresses in the phonon and the phason fields are derived explicitly. The stress intensity factors (SIFs) and the hoop stress intensity factors (HSIFs) have been determined to investigate the effect of the geometric size and the crack skewing phenomenon. This crack skewing phenomenon is different from the mode-III crack problems in isotropic elastic materials and transversely isotropic elastic materials where the crack propagates along the original crack plane.
Post Myocardial Infarction Ventricular Septal Rupture Revealed By Acute Liver Failure Symptoms: A Case Report
Authors: Haddar Leila , Bouchlarhem Amine , Bouyaddid Salma , Kasimi Asmae , Oulali Noureddine , El ouafi Noha , Ismaili Nabila
Published: January 2022

Introduction:

The mechanical complications of acute myocardial infarction (AMI) still kill despite the evolution of medicine. Early diagnosis and adequate management are necessary to improve the prognosis, and this requires first, a good clinical examination that should raise the suspicion of a mechanical complication, then the echocardiography is performed to confirm the diagnosis.

Case Presentation:

We present a case of a 64-year-old patient admitted to the emergency room for jaundice with delayed ST-segment elevation myocardial infarction (STEMI). Physical examination revealed signs of right heart failure, which led us to associate jaundice with signs of acute liver failure secondary to right heart failure. Echocardiography confirmed the diagnosis of a ventricular septal rupture (VSR) with left-right shunt, and a significant dilation of the right ventricle. The patient underwent surgical closure of the VSR with fatal evolution.

Discussion:

VSR is a rare life-threatening mechanical complication of AMI. The clinical signs depend on the left-right shunt and the onset of heart failure, which are 2 major determinants of the therapeutic strategy and the timing of the surgery. Despite surgical closure of the VSR, the mortality remains high, but the prognosis is better in patients treated with surgery than in patients who are treated medically only.

Conclusion:

The clinical presentation of VSR may differ from a patient to another. Good clinical sense and echocardiography are essential to set early diagnosis, and thus decide on the adequate management at the right time.
Indirect discrimination and substantive equality in Nitisha: Easier said than done under Indian constitutional jurisprudence
Authors: Khanna Vandita
Published: January 2022

This note analyses the recent landmark case of Lt Col Nitisha v Union of India, dated 25 March 2021, where the Supreme Court of India formally recognised the concept of indirect discrimination under Articles 14 and 15(1) of the Indian Constitution. Despite the favourable outcome and conceptual leaps in acknowledging that indirect discrimination is closely tied to substantive equality, the reasoning in the judgment does not fully cohere with these conceptual insights. This note critically examines how Nitisha poses barriers to addressing indirect discrimination with a substantive equality lens, particularly because of an intent-based divide between direct and indirect discrimination, a causal requirement between the norm and disparate impact, adoption of mirror comparators and the lack of clarity on justifications.
Sudden Rupture of Abdominal Aortic Aneurysm in COVID19 Patients
Authors: Bozzani Antonio , Arici Vittorio , Ticozzelli Giulia , Franciscone Mila Maria , Sterpetti Antonio V. , Ragni Franco
Published: January 2022

Purpose:

The purpose of the paper is to report the clinical outcomes of 4 patients with ruptured abdominal aortic aneurysm (AAA) during (3 patients) or immediately after (1 patient) moderate-severe SARS-CoV-2 infection. We discuss COVID-19-related mechanisms which could impact AAA rupture.

Patients and Methods:

During the period of the pandemic (March 2020—May 2021), we performed surgery in 18 patients with ruptured AAA. Four patients were affected by moderate or severe SARS-CoV-2 infection (in 3 patients the rupture occurred during the infection and in 1 patient 3. months after discharge from the hospital). Two patients underwent open repair and 2 endovascular surgery.

Results:

No postoperative mortality and no major complication occurred. Rapid growth of the AAA in comparison with a previous Duplex scan was evident in all 4 patients.

Conclusions:

Family doctors and vascular surgeons should be aware about the possibility of AAA degeneration in patients with moderate-severe COVID19 infection. The risk is increased by steroid therapy which is essential in more advanced stages of the infection. In this clinical setting, endovascular repair is a valid choice.
Long-term Results of Angulated Versus Hyperangulated Neck in Endovascular Aneurysm Repair With Endurant Endoprosthesis
Authors: Özdemir-van Brunschot Denise M. D. , Torsello Giovanni Battista , Bernardini Giulia , Litterscheid Sarah , Torsello Giovanni Frederico , Beropoulis Efthymios
Published: January 2022

Purpose:

Patients with a hyperangulated (>60°) proximal aortic neck and at high risk of open surgery have been treated with endovascular aortic repair (EVAR). However, long-term outcomes are not well reported. The aim of this study is to compare the technical and clinical success of EVAR in angulated (45°-60°) and hyperangulated (>60°) proximal neck angulation.

Materials and Methods:

The data of all consecutive patients undergoing EVAR treated between November 2007 and February 2020 were collected. A retrospective analysis of this prospective database was performed. The primary measure outcome was technical and clinical success. In addition, we evaluated sack evolution, type IA endoleak, secondary procedures, aneurysm rupture, mortality, aneurysm-related mortality, and migration.

Results:

In all, 246 of 1353 EVAR patients presented with an angulation of the proximal neck >45°, 130 patients presented with an infrarenal angulation >60°, while 116 patients had an angulation between 45° and 60°. Patients with a hyperangulated infrarenal aortic neck were significantly more often women (8.6% vs 26.9%), older (73.9 vs 76.7 years), and had less often diabetes mellitus (20.7% vs 10.8%). Suprarenal neck angulation and reversed tapered neck were significantly more frequent in the hyperangulated group so that propensity scores were generated using these anatomical parameters to create a matched cohort group. No significant differences in technical (87.9% vs 94.8%) and clinical success (66.4% vs 69.8%) were observed. After a mean clinical follow-up of 58.9 months significantly more secondary procedures were performed in the hyperangulated group (23.3% vs 12.9% p=0.04); however, neck-related secondary procedures were comparable (1.7% vs 6.0%; p=0.09). Also, all-cause and aneurysm-related mortality, sack evolution, type IA endoleak, aneurysm rupture, and migration were comparable for both groups.

Conclusion:

Compared with less angulated proximal aortic neck, hyperangulated neck anatomy did not reduce the technical and clinical success of EVAR but increased the risk of secondary procedures. In patients who are not good candidates for open surgery, EVAR is a reasonable alternative.
Intravenous thrombolysis in ischemic stroke patients with a prior intracranial hemorrhage: a meta-analysis
Authors: Dolatshahi Mahsa , Sabahi Mohammadmahdi , Shahjouei Shima , Koza Eric , Abedi Vida , Zand Ramin
Published: January 2022

Background:

The history of intracranial hemorrhage (ICrH) is considered a contraindication for intravenous thrombolysis (IVT) among patients with acute ischemic stroke (AIS).

Objective:

This study aimed at comparing the safety of IVT among patients with and without a history of ICrH.

Methods:

We performed a systematic review of the literature. Data regarding all AIS patients with prior ICrH who received IVT were retrieved. Meta-analysis was performed to compare the rate of symptomatic hemorrhagic transformation (sHT), death within 90 days, and favorable and unfavorable 90-day functional outcomes based on modified Rankin Scale (mRS) among stroke patients with and without prior ICrH.

Results:

Out of 13,032 reviewed records, 7 studies were included in the systematic review and meta-analysis. Quantitative synthesis of data regarding the rate of sHT (5068 patients) revealed no significant difference between the two groups [odds ratio, OR: 1.55 (0.77, 3.12); p = 0.22]. However, a significantly higher risk of death within 90 days [OR: 3.91 (2.16, 7.08); p < 0.00001] and a significantly higher 90-day poor functional outcomes (mRS, 4–6) [OR: 1.57 (1.07, 2.30); p = 0.02] were observed among patients with prior ICrH. Likewise, the percentage of 90-day good functional outcomes (mRS, 0–1) was lower in the prior ICrH group [OR: 0.54 (0.35, 0.84); p = 0.06]. Subgroup analyses in patients with a history of ICrH (based on both patients’ medical history and imaging confirmation) revealed no significant between-group differences in rates of sHT. Also, sensitivity analysis consisting of only studies using standard-dose IVT showed no difference in sHT rates and 90-day outcomes between the two groups. There was no evidence of heterogeneity ( I2 >50%) among included studies.

Conclusion:

The results of this study indicated that prior history of ICrH does not increase the risk of sHT post-IVT, but it is associated with a higher risk of death and poor functional outcomes in 90 days.
Intra-articular placebo effect in the treatment of knee osteoarthritis: a survey of the current clinical evidence
Authors: Fazeli Mir Sohail , McIntyre Louis , Huang Yili , Chevalier Xavier
Published: January 2022

Knee osteoarthritis (KOA) is a debilitating disease characterized by chronic pain, stiffness, and decreased mobility. Intra-articular injectable therapies show good clinical efficacy in improving symptoms; however, these therapies and their comparators (intra-articular saline) have been associated with a large underlying placebo effect. We aimed to describe the existing evidence on the challenges, hypotheses, and potential solutions to mitigate the intra-articular placebo effect in clinical trials in KOA. A targeted literature review was conducted by searching Embase, MEDLINE®, and CENTRAL using predefined study selection criteria. All eligible studies identified were extracted for relevant data, and results were narratively summarized. Forty-three studies were included following screening. Challenges associated with the intra-articular placebo effect included its ability to mask the comparative efficacy of active treatments in trials ( n = 7 studies), long-lasting effects (up to 6 months; n = 3), and substantial variation of placebo effect sizes across populations ( n = 3). Hypotheses for the mechanism of the placebo effect included aspiration of synovial fluid during administration ( n = 6) and dilution of inflammatory mediators ( n = 2). Factors affecting the placebo effect size were more invasive routes of administration (e.g., injection versus oral; n = 4) and patient expectations ( n = 2). Proposed solutions included the suggestion for readers to weigh the relevance of clinical trial evidence against the presence of large underlying placebo effects ( n = 9), discontinuation of intra-articular saline as an appropriate placebo ( n = 5), and inclusion of ‘no treatment’ or sham injection as a control ( n = 4). The intra-articular placebo effect is a well-documented occurrence in KOA clinical trials, and it is suggested that it be accounted for when designing randomized controlled trials. Awareness and understanding of the intra-articular placebo effect in KOA are required for fair interpretation of clinical trial evidence.
Designing an App for Immunosuppression Adherence and Communication: A Qualitative Approach
Authors: Schick-Makaroff Kara , Lagendyk Laura , Foster Bethany , Lam Ngan N. , Braam Branko , Bello Aminu , Shojai Soroush , Wen Kevin
Published: January 2022

Background:

Immunosuppression nonadherence may be the most important factor limiting long-term allograft survival.

Objective:

Following user-centered design, we explored the essential priorities and preferences of kidney transplant recipients and healthcare providers (HCP) to inform development of a smartphone app to improve immunosuppression adherence and communication.

Design:

A qualitative descriptive research design was used.

Setting:

The University of Alberta Hospital adult kidney transplant program in Edmonton, Canada.

Participants:

Participants were recruited by convenience sampling and included 32 kidney transplant recipients and 11 HCPs.

Methods:

Seven focus groups (5 with recipients and 2 with HCPs) were conducted to inform app development. Sessions were recorded, and transcripts were coded to elucidate themes.

Results:

App development to improve adherence was not a priority for HCP. Recipients prioritized choice: that all features be optional. Recipients preferred support while traveling; access to laboratory results; and use by younger or newly transplanted recipients. Both recipients and HCP preferred linkage to pharmacy; and self-management and accountability. For the app to improve communication, HCPs believed the priorities to be addressed included: clarity on scope of app; legal, ethical, and professional obligations; and charting. Both recipients and HCP prioritized HCP workload, and broader medication and health concerns. Healthcare providers preferred tech support; both recipients and HCPs preferred app access for nontransplant HCP.

Limitations:

Limitations include underrepresentation of physicians, recipients with racial/ethnic diversity, and potential selection bias of transplant recipients who perceived themselves to be adhering to immunosuppression medications.

Conclusion:

Future research is needed for the app to become a comprehensive, secure platform for broader communication between recipients and HCP, pharmacies, and nontransplant clinicians while streamlining HCP workload.
A Practical Clinical Protocol for Monitoring Patients with Severe Uncontrolled Chronic Rhinosinusitis with Nasal Polyposis Treated with Biologics
Authors: Millarelli Stefano , Loperfido Antonella , Mammarella Fulvio , Giorgione Cristina , Celebrini Alessandra , Del Ninno Massimiliano , Bellocchi Gianluca
Published: January 2022

Objectives:

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a pathological condition which leads to high healthcare-related costs and low quality of life for patients. The introduction of new biological therapies (monoclonal antibodies, MAbs) in CRSwNP patients has allowed new therapeutic options for non-responders to conventional therapies and Dupilumab represents the first approved biological agent. The aim of this paper is to provide a practical clinical multidisciplinary protocol which might help clinicians involved in this field to monitor the clinical outcomes.

Methods:

Our centre of Rhinology and Rhino-Allergology has developed a dedicated collection form to observe the outcomes of patients treated with Dupilumab. Our research started from the indications given in EPOS 2020 as main reference. We then implemented these references in an electronic database trying to apply Evidence Based Medicine (EBM) in current clinical practice.

Results:

The result consists of three parts: an anamnestic collection data, a clinician reported outcome and two patient reported outcomes (PROMs) questionnaire, the visual analogue scale (VAS) and the Sino-Nasal Outcome Test-22 (SNOT-22). The tables we propose should provide an adequate correlation with the patients’ adherence to therapy and their treatment outcomes. Such periodical evaluation (after a month, after 3 months, after 6 months and at one year) should quickly allow to monitor if the patient is correctly assuming the therapy and the eventual objective improvements.

Conclusions:

We propose a practical monitoring protocol formulated to analyse both objective and subjective aspects of patients with severe uncontrolled CRSwNP treated with MAbs, thus helping to define in future a better comparison between the clinical results of different institutes.
Achieving Fulfilment in Life: Cultivating the Mindset of Gratitude Among Thai Adolescents
Authors: Balthip Karnsunaphat , Suwanphahu Bunrome , McSherry Wilfred
Published: January 2022

Gratitude plays a significant role in nurturing holistic health and wellbeing in adolescent. However, cultivating the mindset of gratitude is associated with several factors, in particular, culture and religion. Therefore, an opportunity exists for studies to be undertaken, exploring gratitude specifically within the Thai culture. This grounded theory study aimed to understand how Thai adolescents cultivated a mindset of gratitude. Data were gathered from 27 participants, aged 15 to 19 years. Purposeful and theoretical sampling techniques were used to select participants. Data were collected through in-depth interviews, written stories, and drawn pictures. Data analysis was guided by Strauss and Corbin’s grounded theory. The core category of “Achieving Fulfilment in Life”—reflecting the process of cultivating the mindset of gratitude among Thai adolescents—comprised three categories: (a) condition: appreciating the value of oneself and others; (b) strategies: committing to live life on a positive life path; and (c) consequence: attaining true happiness. The findings illustrated the processes involved in cultivating the mindset of gratitude, highlighting how this may help in the development of a holistic health promotion program using the concept of gratitude to enhance the health and wellbeing of adolescents.
Good Tech and Social Good: Value Creation by Korean Social and High-Tech Oriented Start-Ups
Authors: Berg Su-Hyun , Mitra Jay
Published: January 2022

Through an exploration of Korean high-tech social enterprises, we aim to identify and explore critically (a) how socially engaged, early stage, high technology firms combine social and economic objectives with which to scale up their ventures; and (b) how socially engaged firms seek entrepreneurial opportunity development, including the internationalisation process and the support of stake holding institutions to help scale up the value creation process. We highlight ‘people’, ‘organisations’ and the ‘environment’ dimensions, enabling an understanding of the drivers of socially entrepreneurial activity both from individual and societal perspectives. The analytical framework of our study is based on empirical data acquired from individual in-depth interviews, group interviews, active participatory observations and survey data from 2018 to 2021. We found that social motivation and objectives of the entrepreneurs are equally strong drivers and that they are the principal factors for the scaling up process. The motivation is strengthened by the proactive role of government initiatives which also attract other key stakeholders in the growth process. A combination of digital technology with a high degree of social motivation of the entrepreneurs tends to lead to the development of international market opportunities and attract the interests of international foundations.
The applicability research of the diagnostic criteria for 6.7.2 angiography headache in the international classification of headache disorders-3rd edition
Authors: Lu Chenglong , Zhang Leyi , Wang Jun , Cao Xiangyu , Jia Xin , Ma Xiaohui , Zhang Ran , Wang Lin , Yang Ying , Meng Fanchao , Yu Shengyuan , Liu Ruozhuo
Published: January 2022

Background

Angiography headache (AH) is common but not negligible, and the criteria for AH have been based on only a few studies. The purpose of this study was to investigate the incidence, risk factors and possible mechanism of AH and reappraise the diagnostic criteria for AH in the International Classification of Headache Disorders 3 (ICHD-3).

Methods

Two hundred and seventy-nine patients completed this prospective, non-randomized study, including 107 patients who underwent cerebral angiography, 101 patients who underwent coronary intervention and 71 patients who underwent extremities arterial intervention. Patients were followed up with questionnaires immediately after the procedure and 24 h, 72 h, 1 week and 2 weeks after the procedure.

Results

The incidence of headache was 22.4% (24/107) in cerebral angiography group, 23.8% (24/101) in coronary intervention group, and 16.9% (12/71) in extremities arterial intervention group. Headache still occurred in 12.1% (13/107), 14.9% (15/101) and 11.3% (8/71) of patients 24 h after the procedure in the three groups, respectively. Two types of headache were observed in cerebral angiography group and coronary intervention group, one during and one after the procedure, while only postoperative headache was observed in extremities arterial intervention group. Previous headache history was a risk factor for headache in the three groups (p = 0.003 in cerebral angiography group, p = 0.006 in coronary intervention group, and p = 0.016 in extremities arterial intervention group). In addition, female (p = 0.008) was a risk factor for cerebral angiography group. Headache characteristics were described in detail.

Conclusions

The diagnostic criteria for 6.7.2 angiography headache in ICHD-3 may miss a number of cerebral AH with onset later than 24 h after the procedure. Therefore, it is recommended to revise it according to the literature and further studies. The incidence of headache was high during and after angiography and interventional procedure. It was suggested that the definition of headache due to coronary intervention and headache due to extremities arterial intervention should be added in ICHD.
CBMOS: a GPU-enabled Python framework for the numerical study of center-based models
Authors: Mathias Sonja , Coulier Adrien , Hellander Andreas
Published: January 2022

Background

Cell-based models are becoming increasingly popular for applications in developmental biology. However, the impact of numerical choices on the accuracy and efficiency of the simulation of these models is rarely meticulously tested. Without concrete studies to differentiate between solid model conclusions and numerical artifacts, modelers are at risk of being misled by their experiments’ results. Most cell-based modeling frameworks offer a feature-rich environment, providing a wide range of biological components, but are less suitable for numerical studies. There is thus a need for software specifically targeted at this use case.

Results

We present CBMOS, a Python framework for the simulation of the center-based or cell-centered model. Contrary to other implementations, CBMOS’ focus is on facilitating numerical study of center-based models by providing access to multiple ordinary differential equation solvers and force functions through a flexible, user-friendly interface and by enabling rapid testing through graphics processing unit (GPU) acceleration. We show-case its potential by illustrating two common workflows: (1) comparison of the numerical properties of two solvers within a Jupyter notebook and (2) measuring average wall times of both solvers on a high performance computing cluster. More specifically, we confirm that although for moderate accuracy levels the backward Euler method allows for larger time step sizes than the commonly used forward Euler method, its additional computational cost due to being an implicit method prohibits its use for practical test cases.

Conclusions

CBMOS is a flexible, easy-to-use Python implementation of the center-based model, exposing both basic model assumptions and numerical components to the user. It is available on GitHub and PyPI under an MIT license. CBMOS allows for fast prototyping on a central processing unit for small systems through the use of NumPy. Using CuPy on a GPU, cell populations of up to 10,000 cells can be simulated within a few seconds. As such, it will substantially lower the time investment for any modeler to check the crucial assumption that model conclusions are independent of numerical issues.
Bacterial co-infections in community-acquired pneumonia caused by SARS-CoV-2, influenza virus and respiratory syncytial virus
Authors: Hedberg Pontus , Johansson Niclas , Ternhag Anders , Abdel-Halim Lina , Hedlund Jonas , Nauclér Pontus
Published: January 2022

Background

A mismatch between a widespread use of broad-spectrum antibiotic agents and a low prevalence of reported bacterial co-infections in patients with SARS-CoV-2 infections has been observed. Herein, we sought to characterize and compare bacterial co-infections at admission in hospitalized patients with SARS-CoV-2, influenza or respiratory syncytial virus (RSV) positive community-acquired pneumonia (CAP).

Methods

A retrospective cohort study of bacterial co-infections at admission in SARS-CoV-2, influenza or RSV-positive adult patients with CAP admitted to Karolinska University Hospital in Stockholm, Sweden, from year 2011 to 2020. The prevalence of bacterial co-infections was investigated and compared between the three virus groups. In each virus group, length of stay, ICU-admission and 30-day mortality was compared in patients with and without bacterial co-infection, adjusting for age, sex and co-morbidities. In the SARS-CoV-2 group, risk factors for bacterial co-infection, were assessed using logistic regression models and creation of two scoring systems based on disease severity, age, co-morbidities and inflammatory markers with assessment of concordance statistics.

Results

Compared to influenza and RSV, the bacterial co-infection testing frequency in SARS-CoV-2 was lower for all included test modalities. Four percent [46/1243 (95% CI 3–5)] of all SARS-CoV-2 patients had a bacterial co-infection at admission, whereas the proportion was 27% [209/775 (95% CI 24–30)] and 29% [69/242 (95% CI 23–35)] in influenza and RSV, respectively. S. pneumoniae and S. aureus constituted the most common bacterial findings for all three virus groups. Comparing SARS-CoV-2 positive patients with and without bacterial co-infection at admission, a relevant association could not be demonstrated nor excluded with regards to risk of ICU-admission (aHR 1.53, 95% CI 0.87–2.69) or 30-day mortality (aHR 1.28, 95% CI 0.66–2.46) in adjusted analyses. Bacterial co-infection was associated with increased inflammatory markers, but the diagnostic accuracy was not substantially different in a scoring system based on disease severity, age, co-morbidities and inflammatory parameters [C statistic 0.66 (95% CI 0.59–0.74)], compared to using disease severity, age and co-morbidities only [C statistic 0.63 (95% CI 0.56–0.70)].

Conclusions

The prevalence of bacterial co-infections was significantly lower in patients with community-acquired SARS-CoV-2 positive pneumonia as compared to influenza and RSV positive pneumonia.
Repression of lncRNA PART1 attenuates ovarian cancer cell viability, migration and invasion through the miR-503-5p/FOXK1 axis
Authors: Li Bing , Lou Ge , Zhang Jiahui , Cao Ning , Yu Xi
Published: January 2022

Background

Ovarian cancer (OC) is a female malignant tumor with a high fatality rate. Long non-coding RNAs (lncRNAs) are deeply involved in OC progression. The aim of this study is to explore the specific mechanism of lncRNA prostate androgen-regulated transcript 1 (PART1) in OC.

Methods

Quantitative real time PCR was utilized to determine the expression levels of PART1, microRNA (miR)-503-5p and forkhead-box k1 (FOXK1) in OC tissues and/or cells. The cell viability, migration, and invasion in OC were evaluated by 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-h-tetrazolium bromide assay, wound healing assay and transwell invasion assay, respectively. Flow cytometry was used to analyze the cell apoptosis. The xenograft tumor was conducted in nude mice to verify the effect of PART1 knockdown on OC in vivo. The target relationships among PART1, miR-503-5p and FOXK1 were predicted by StarBase, and verified by luciferase reporter assay. The level of FOXK1 was assessed by western blot.

Results

Increased expression of PART1 and FOXK1 was observed in OC tissues or cells, whereas miR-503-5p was downregulated. PART1 silencing or miR-503-5p overexpression repressed the cell viability, migration and invasion, and protomed apoptosis. Meanwhile, miR-503-5p was a target of PART1, and FOXK1 was a direct target gene of miR-503-5p. Both downregulation of miR-503-5p and upregulation of FOXK1 partly relieved the suppressive effects of PART1 knockdown on the oncogenicity of OC in vitro.

Conclusion

Decreased PART1 represses the cell viability, migration and invasion of OC via regulating the miR-503-5p/FOXK1 axis, which provided an underlying target for treating OC.
Profile of primary childhood glaucoma at a child eye health tertiary facility in Malawi
Authors: Mdala Shaffi , Zungu Thokozani , Manda Chatonda , Namate Chinsisi , Fernando Elizabeth , Twabi Halima Sumayya , Msukwa Gerald , Kayange Petros Cyrus
Published: January 2022

Background

To describe the clinical characteristics and treatment of primary childhood glaucoma at Queen Elizabeth Central Hospital in Blantyre, Malawi.

Methods

A retrospective case notes review was undertaken of all medical records of patients aged less than 16 years with a diagnosis of primary glaucoma according to the Childhood Glaucoma Research Network Classification (CGRN) who presented from January 2016 to December 2018. The parameters extracted from the case files included age at presentation, sex, type of glaucoma, presenting complaints, laterality of ocular involvement, examination findings and the treatment modality instituted. The Mann-Whitney test was used to investigate factors associated with the intraocular pressure (IOP) in eyes that had a higher presenting IOP value compared to contralateral eyes.

Results

A total of 45 subjects (80 eyes) were identified, 42 with primary congenital glaucoma (PCG) and 3 with juvenile open angle glaucoma (JOAG). The mean age for the population was 2.6 years (S.D ± 3.7) and most of the patients were male, with a male-female ratio of 2:1. The majority of patients had bilateral disease (n = 35, 77.8%) with the commonest presenting complaint being a whitish appearance of the eye (57.5%). The eyes studied had a mean IOP of 30.1 mmHg (CI 27.4–32.9), a mean horizontal corneal diameter (HCD) of 13.6 mm (CI 13.1–14.2) and a mean cup-disc-ratio `(CDR) of 0.73 (CI 0.66–0.79). In addition, 62 eyes (77.5%) had corneal haze on examination. Most patients (n = 59, 73.8%) underwent a combined trabeculotomy – trabeculectomy surgery within the study period. The median presenting IOP was significantly higher with JOAG compared to PCG (P = 0.02).

Conclusion

PCG was the most common primary childhood glaucoma at Queen Elizabeth Central Hospital and most patients presented with bilateral eye involvement. Most of the eyes had corneal haze and JOAG was associated with a higher presenting IOP compared to PCG. Further studies to investigate the outcomes of combined trabeculotomy – trabeculectomy surgery in primary childhood glaucoma in Malawi are recommended.
Development and initial validation of the Chinese Version of the Noise Exposure Questionnaire (C-NEQ)
Authors: Han Kun , Wang Qixuan , Yang Lu , Xu Sijia , Li Chen , Lin James , Wu Hao , Huang Zhiwu
Published: January 2022

Background

With a high prevalence of noise-induced hearing loss (NIHL), the noise survey tools for identifying individuals with high risk of NIHL are still limited. This study was aimed to translate and develop a Chinese version of noise exposure questionnaire (C-NEQ), and validate its reliability and reproducibility.

Methods

This study was conducted from May 2020 to March 2021 in China. The questionnaire was translated from the original NEQ and adapted into Chinese culture using the method according to the International Test Committee. Content validity was evaluated by our expert group. Construct validity and reliability of the C-NEQ was determined through estimating the confirmatory factor analysis and Cronbach’s alpha in a cross-sectional analysis among 641 Chinese speaking adults, respectively. The retest reproducibility of the C-NEQ was analyzed by using the intra-group correlation coefficient (ICC) in a follow-up analysis among 151 participants.

Results

The C-NEQ comprises ten items covering four domains: occupational, housework, transport and recreational noise exposure. The annual noise exposure (ANE) was calculated as the protocol of original NEQ. A total of 641 adult participants (aged 26.9 ± 10.1 years, 53.4% males) completed the C-NEQ. The average time for completing the C-NEQ was 4.4 ± 3.0 min. Content validity indicated high relevance of the C-NEQ. The confirmatory factor analysis indices illustrated that the items of the C-NEQ were suitable with the data in the study. For the internal reliability, the Cronbach’s α coefficients of the total items and four domains (occupational, housework, transport, and recreational noise exposure) were 0.799, 0.959, 0.837, 0.825, and 0.803, respectively. Among them, 151 participants (aged 36.1 ± 11.1 years, 65.6% males) completed the retest of the C-NEQ 1 month after the first test. The ICC value of total ANEs between the first test and the second test was 0.911 (P < 0.001).

Conclusions

In this study, we have validated the C-NEQ with adequate reliability and reproducibility for quantifying an individual’s annual daily noise exposure, which provides an effective fast-screen tool for researches and clinics to identify those individuals with high risks of NIHL within the short time duration (no more than five minutes) among Chinese population.
The additional value of lung cancer screening program in identifying unrecognized diseases
Authors: Finamore Panaiotis , Tanese Luigi , Longo Filippo , De Stefano Domenico , Pedone Claudio , Angelici Laura , Agabiti Nera , Cascini Silvia , Davoli Marina , Zobel Bruno Beomonte , Incalzi Raffaele Antonelli , Crucitti Pierfilippo
Published: January 2022

Background

A systematic examination of low-dose CT (LDCT) scan, beside lung nodules, may disclose the presence of undiagnosed diseases, improving the efficacy and the cost/efficacy of these programs. The study was aimed at evaluating the association between LDCT scan findings and non-oncologic and oncologic diseases.

Methods

The LDCT scan of participants to the “Un Respiro per la vita”® lung cancer screening program were checked and abnormal findings, beside lung nodules, recorded. First admission to the acute care because of cardiovascular (CD), respiratory (RD) and oncological diseases (OD) in the following three years were retrieved. The association of LDCT scan abnormal findings with CD, RD and OD was assessed through univariable and multivariable logistic regression models.

Results

Mean age of 746 participants was 62 years (SD:5), 62% were male. 11 (1.5%) received a diagnosis of lung cancer. 16.1% participants were admitted to the acute care in the following three years: 8.6% for CD, 4.3% for RD and 5.2% for OD. Valve calcification (OR 2.02, p:0.02) and mucus plugs (OR 3.37, p:0.04) were positively associated with CD, while sub-pleural fibrosis had a protective role (OR 0.47, p:0.01). Lung nodules > 8 mm (OR 5.54, p: < 0.01), tracheal deviation (OR 6.04, p:0.01) and mucus plugs (OR 4.00, p:0.04) were positively associated with OD admissions. Centrilobular emphysema OR for RD admissions was 1.97 (p:0.06).

Conclusions

The observed association between selected LDCT findings and ensuing CD, RD and OD suggests that the information potential of LCDT goes beyond the screening of lung cancer.
Radiographic results on acetabular cup placement with the SuperPath technique: a retrospective study of 756 cases
Authors: Di Maro Agostino , Creaco Santo , Albini Mattia , Latiff Mahfuz , Merlo Marco
Published: January 2022

Background

The Supercapsular percutaneously assisted total hip (SuperPath) technique is a relatively new minimally invasive approach for total hip arthroplasty (THA). Good clinical outcomes related to its use are reported in the literature. Nonetheless, there are still uncertainties about its validity in terms of radiographic outcomes.

Main purpose of the study is to evaluate the effectiveness of the SuperPath in acetabular cup positioning through radiographic evaluation of acetabular inclination angle (IA) and acetabular anteversion (AA) angle within the safe zone described by Lewinnek. The leg length discrepancy (LLD), femoral offset (FO), and acetabular offset (AO) were also measured to ascertain the radiographic effectiveness of SuperPath in the acetabular cup placement.

Methods

Between January 2016 and December 2019, all SuperPath cases eligible for the study were included. They were operated by three orthopaedic surgeons with long-standing experience in THA via conventional posterolateral approach and who have performed SuperPath training fellowship. The Mann-Whitney U test was used for statistical assessments (p-value < 0.05). Means ± standard deviation (SD) of the radiographic IA and AA were calculated for each year.

Results

A retrospective analysis of 756 THAs was performed. The average percentage of IA within the Lewinnek’s safe zone was from 80 to 85%, while the average percentage of AA was from 76 to 79%. Both IA and AA showed no statistically significant difference between two consecutive years. Good results, in the ranges of normal values, were also obtained for LLD, FO and AO, with homogeneous outcomes between 1 year and the following one.

Conclusion

It is possible to achieve good radiographic values of acetabular cup orientation through the SuperPath within the Lewinnek’s safe zone. These results are similar to those reported in the literature by authors using SuperPath. Low rate (0,3%) of hip dislocations were reported. Therefore, the SuperPath technique represents a good alternative THA approach. Nevertheless, there is not a statistically significant improvement in these radiographic parameters over a four-year time.

Level of evidence

Level IV, retrospective study.
Retrospective analysis of bladder cancer morphology and depth of invasion under cystoscopy
Authors: Chen Hu , Hong Yang , Yu Bai , Ruiqian Li , Jun Li , Hongyi Wu , Ziyong Wang , Haiyang Jiang , Chongjian Zhang , Ying Bi , Qilin Wang
Published: January 2022

Background

The pathological diagnosis of bladder cancer workup relies on cystoscopy, however, due to sampling restriction, the depth of local invasion is often understaged.

Methods

A total of 386 patients with bladder urothelial carcinoma underwent follow-up. The data collected included age, sex, tumor size, surgical options, histologic grade, invasive depth, lymph node metastasis, and oncological outcomes, and the patients were divided into coral-like and crumb-like groups. These data were analyzed with the chi-square test, binary logistic regression, Kaplan–Meier analysis, univariable and multivariable logistic regression and Spearman correlation test.

Results

Bladder tumor morphology was moderately correlated with invasion depth (ρ = 0.492, p < 0.001; Spearman correlation), which was associated with invasion status (HR = 8.27; 95% CI 4.3–15.79, p < 0.001). Tumor morphology was not an independent factor for OS but was associated with PFS. Outer invasion depth was an independent factor that was significantly associated with inferior OS and PFS.

Conclusions

Tumor morphology (coral-like and crumb-like) under cystoscopy was related to the depth of invasion. The outer invasive depth of BC was an independent factor that was significantly associated with inferior OS and PFS.
Endovascular coil embolization of inferior mesenteric artery to ileal-conduit fistula: a case report
Authors: Altaha Mustafa A. , Tarulli Massimo , Bajwa Jaspreet , Mafeld Sebastian , Jaberi Arash
Published: January 2022

Background

Uretero-arterial fistulas (UAFs) are uncommon and pose a diagnostic dilemma, making them life threatening if not recognized and treated expediently. UAFs to small arteries such as a branch of the inferior mesenteric artery (IMA) are very uncommon and present a further diagnostic and treatment challenge. There should be a high index of suspicion for UAFs when intervening on patients with history of treated pelvic cancers and long-standing ureteric stents experiencing hematuria not attributable to another cause.

Case presentation

We present a case of a fistula formed between a distal branch of the IMA—superior rectal artery—and an ileal-conduit in a patient with a long-standing reverse nephroureterostomy (Hobbs) catheter presenting with abdominal pain and hematuria through the conduit. During a tube exchange, contrast injection demonstrated a fistula with the superior rectal artery, multiple ileal intraluminal blood clots, and active extravasation. The patient became tachycardic and hypotensive, actively bleeding through the ileal-conduit, prompting a massive transfusion protocol. Successful endovascular coiling of the superior rectal artery was performed with resolution of active extravasation and stabilization of the patient. The patient recovered and was discharged in stable condition 10 days later.

Conclusions

Although UAFs are uncommon, our case demonstrated key predisposing risk factors to fistula development; pelvic cancer surgery, pelvic radiation, and a prolonged ureteric stent through the ileal-conduit. Typically, UAFs arise from communication with the iliac arterial system, however in this instance we have demonstrated that fistulization to other arterial vessels is also possible. Endovascular management has become the preferred method of therapy, typically involving the placement of covered stents when involving the iliac arterial system. In this instance stent grafting was not possible due to the small caliber vessel and therefore had to be embolized.
Evaluation of primary care responsiveness by people with mental illness in Spain
Authors: Coronado-Vázquez Valle , Gil-de-Gómez María Josefa , Rodríguez-Eguizábal Eva , Oliván-Blázquez Bárbara , Gómez-Salgado Juan , Magallón-Botaya Rosa , Sánchez-Calavera María Antonia
Published: January 2022

Background

The health system responsiveness is a concept developed by the World Health Organization that measures patients’ expectations for the non-medical care they receive. The aim of this study is to assess primary care responsiveness as seen by people with mental illness and to analyse the factors associated with poor responsiveness.

Methods

Cross-sectional descriptive study on 426 people with mental illness who had attended primary care consultations at least once in the previous 12 months. The responsiveness of the health system was determined through the short questionnaire “Multi-country Survey Study on Health and Health Systems Responsiveness”. Differences in responsiveness by sociodemographic characteristics were compared through the Chi-squared test. Logistic regression identified the factors associated with poor responsiveness.

Results

Overall responsiveness was measured as good by 77.4% of patients, being this probability higher in the domains: dignity, confidentiality, and communication. The most valued domains by people with mental illness were prompt attention (42.4%), dignity (30.1%), and communication (17%). Only prompt attention scored high importance and poor responsiveness. In patients with an income lower than 900 euros per month and low level of studies, the probability of poor confidentiality responsiveness was multiplied by 3 and 2.7 respectively.

Conclusions

People with mental illness perceive good responsiveness from primary care in terms of dignity, confidentiality, and communication. Prompt attention, as the domain of greatest importance and worst valuation, should be prioritised through the implementation of organisational measures in health centres to reduce waiting times, especially in urban areas.