bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears
Authors: Ward Patrick , Chang Peter , Radtke Logan , Brophy Robert H.
Published: July 2021

Background:

Anterior cruciate ligament (ACL) tears are common injuries; they are often associated with concomitant injuries to other structures in the knee, including bone bruises. While there is limited evidence that bone bruises are associated with slightly worse clinical outcomes, the implications of bone bruises for the articular cartilage and the risk of developing osteoarthritis (OA) in the knee are less clear. Recent studies suggest that the bone bruise pattern may be helpful in predicting the presence of meniscal ramp lesions.

Evidence Acquisition:

A literature review was performed in EMBASE using the keyword search phrase (acl OR (anterior AND cruciate AND ligament)) AND ((bone AND bruise) OR (bone AND contusion) OR (bone AND marrow AND edema) OR (bone AND marrow AND lesion) OR (subchondral AND edema)).

Study Design:

Clinical review.

Level of Evidence:

Level 4.

Results:

The literature search returned 93 articles of which 25 were ultimately included in this review. Most studies identified a high prevalence of bone bruises in the setting of acute ACL injury. Individual studies have found relationships between bone bruise volume and functional outcomes; however, these results were not supported by systematic review. Similarly, the literature has contradictory findings on the relationship between bone bruises and the progression of OA after ACL reconstruction. Investigations into concomitant injury found anterolateral ligament and meniscal ramp lesions to be associated with bone bruise presence on magnetic resonance imaging.

Conclusion:

Despite the ample literature identifying the prevalence of bone bruises in association with ACL injury, there is little evidence to correlate bone bruises to functional outcomes or progression of OA. Bone bruises may best be used as a marker for concomitant injury such as medial meniscal ramp lesions that are not always well visualized on magnetic resonance imaging. Further research is required to establish the longitudinal effects of bone bruises on ACL tear recovery.

Strength of Recommendation Taxonomy:

2.
Optimal treatment strategies for coronary artery disease in patients with advanced kidney disease: a meta-analysis
Authors: Yong Jingwen , Tian Jinfan , Zhao Xin , Yang Xueyao , Xing Haoran , He Yi , Song Xiantao
Published: July 2021

Background:

Coronary artery disease (CAD) is the leading cause of death in advanced kidney disease. However, its best treatment has not been determined.

Methods:

We searched PubMed and Cochrane databases and scanned references to related articles. Studies comparing the different treatments for patients with CAD and advanced CKD (estimated glomerular filtration rate <30 ml/min/1.73 m2 or dialysis) were selected. The primary result was all-cause death, classified according to the follow-up time: short-term (<1 month), medium-term (1 month-1 year), and long-term (>1 year).

Results:

A total of 32 studies were selected to enroll 84,498 patients with advanced kidney disease. Compared with medical therapy (MT) alone, percutaneous coronary intervention (PCI) was associated with low risk of short-, medium-term and long-term all-cause death (more than 3 years). For AMI patients, compared with MT, PCI was not associated with low risk of short- and medium-term all-cause death. For non-AMI patients, compared with MT, PCI was associated with low risk of long-term mortality (more than 3 years). Compared with MT, coronary artery bypass surgery (CABG) had no significant advantages in each follow-up period of all-cause death. Compared with PCI, CABG was associated with a high risk of short-term death, but low risk of long-term death: 1–3 years; more than 3 years. CABG could also reduce the risk of long-term risk of cardiac death, major adverse cardiovascular events (MACEs), myocardial infarction (MI), and repeat revascularization.

Conclusions:

In patients with advanced kidney disease and CAD, PCI reduced the risk of short-, medium- and long- term (more than 3 years) all-cause death compared with MT. Compared with PCI, CABG was associated with a high risk of short-term death and a low risk of long-term death and adverse events.
Toward a Quantitative Approach to the Specialness of Poetry: Taking Chang Hen Ge and Chang Hen Ge Zhuan as a Case Study
Authors: Zhang Cong , Yuan Rui
Published: July 2021

The differences of linguistic features between Chang Hen Ge ( Ge) and Chang Hen Ge Zhuan ( Zhuan) have rarely been mentioned in the relevant fields. Nevertheless, these differences can best highlight the specialness of poetry, for the two works were written contemporaneously by two friends on the same subject, in distinct styles. This article employs quantitative methods and indicators to provide empirical evidence for the specialness of Ge through comparisons between the two. The results show that, on the premise of expressing the same subject in different styles, Ge does have certain linguistic characteristics compared with Zhuan. Its particularity is reflected not only in fewer repeat characters and words but also in their richness, as well as in the use of more content words and fewer function words. Moreover, all of these characteristics have had a great influence on Ge’s artistic level and dissemination. Through this study, we hope that our methods provide a new perspective and shed some light on this area.
Inefficient Attentional Control Explains Verbal-Memory Deficits Among Military Veterans With Posttraumatic Reexperiencing Symptoms
Authors: Marquardt Craig A. , Pokorny Victor J. , Disner Seth G. , Nelson Nathaniel W. , McGuire Kathryn A. , Sponheim Scott R.
Published: July 2021

Among individuals with posttraumatic stress disorder (PTSD), verbal learning and memory are areas of weakness compared with other cognitive domains (e.g., visuospatial memory). In this study, previously deployed military veterans completed clinical assessments of word memory and vocabulary ( n = 243) and a laboratory task measuring encoding, free recall, repetition priming, and recognition of words ( n = 147). Impaired verbal memory was selectively related to reexperiencing symptoms of PTSD but was not associated with other symptom groupings or blast-induced traumatic brain injury. Implicit priming of response times following word repetition was also unrelated to clinical symptoms. Instead, slowed response times during encoding explained associations between reexperiencing and memory performance. These findings are consistent with alterations in attentional control explaining PTSD-related verbal-memory deficits. Such findings have implications for understanding trauma-focused psychotherapy and recovery, which may depend on efficient attentional processing of words to alter posttraumatic reexperiencing symptoms.
Comparison of Denosumab and Zoledronic acid as neoadjuvant therapy in patients with giant cell tumor of bone
Authors: Kanwat Himanshu , Banjara Roshan , Kumar Venkatesan Sampath , Majeed Abdul , Gamnagatti Shivanand , Khan Shah Alam
Published: July 2021

Objectives:

Both Zoledronic acid and denosumab have been utilized in neo-adjuvant setting for facilitating surgery and downsizing the lesion in Giant cell tumor (GCT). This study is aimed at comparing Zoledronic acid and Denosumab, when used in neo-adjuvant setting, in terms of radiological and clinical outcomes in GCT undergoing surgical intervention.

Patients and Methods:

Patients undergoing surgical intervention for GCT who received either denosumab or Zoledronic acid as neoadjuvant agents were retrospectively analyzed for reduction in tumor load radiologically, change in surgical plan after therapy, facilitation of surgery, therapy related complications, cost of treatment, rate of local recurrence and clinical outcomes.

Results:

Twenty patients received denosumab and 19 patients received Zoledronic acid as neoadjuvant agent. There was no significant difference in radiological outcomes, facilitation of surgery and clinical outcomes at end of follow-up. Zoledronic acid group had lower number of recurrences, however, not statistically significant. Therapy with Zoledronic acid was significantly cheaper (p = 0.001).

Conclusion:

Zoledronic acid is a cheaper alternative to denosumab in terms of solidification of lesion, reducing recurrence rates and improving clinical outcomes. Larger prospective studies required to further delineate this outcome with Zoledronic acid.
Previsit Patient Instructional Video for the Virtual Orthopedic Foot and Ankle Examination
Authors: Noori Naudereh , Chien Bonnie , Zhang Zijun , Schon Jason , Hembree Walter , Schon Lew
Published: July 2021

Level of Evidence:

Level V, clinical tips.
Gene therapy for sickle cell disease: moving from the bench to the bedside
Authors: Abraham Allistair A. , Tisdale John F.
Published: July 2021

Gene therapy as a potential cure for sickle cell disease (SCD) has long been pursued, given that this hemoglobin (Hb) disorder results from a single point mutation. Advances in genomic sequencing have increased the understanding of Hb regulation, and discoveries of molecular tools for genome modification of hematopoietic stem cells have made gene therapy for SCD possible. Gene-addition strategies using gene transfer vectors have been optimized over the past few decades to increase expression of normal or antisickling globins as strategies to ameliorate SCD. Many hurdles had to be addressed before clinical translation, including collecting sufficient stem cells for gene modification, increasing expression of transferred genes to a therapeutic level, and conditioning patients in a safe manner that enabled adequate engraftment of gene-modified cells. The discovery of genome editors that make precise modifications has further advanced the safety and efficacy of gene therapy, and a rapid movement to clinical trial has undoubtedly been supported by lessons learned from optimizing gene-addition strategies. Current gene therapies being tested in clinical trial require significant infrastructure and expertise, given that cells must be harvested from and chemotherapy administered to patients who often have significant organ dysfunction and that gene-modification takes place ex vivo in specialized facilities. For these therapies to realize their full potential, they would have to be portable, safe, and efficient, to make an in vivo–based approach attractive. In addition, adequate resources for SCD screening and access to standardized care are critically important for gene therapy to be a viable treatment option for SCD.
Targeting the GPR119/incretin axis: a promising new therapy for metabolic-associated fatty liver disease
Authors: Zhao Jianan , Zhao Yu , Hu Yiyang , Peng Jinghua
Published: July 2021

In the past decade, G protein-coupled receptors have emerged as drug targets, and their physiological and pathological effects have been extensively studied. Among these receptors, GPR119 is expressed in multiple organs, including the liver. It can be activated by a variety of endogenous and exogenous ligands. After GPR119 is activated, the cell secretes a variety of incretins, including glucagon-like peptide-1 and glucagon-like peptide-2, which may attenuate the metabolic dysfunction associated with fatty liver disease, including improving glucose and lipid metabolism, inhibiting inflammation, reducing appetite, and regulating the intestinal microbial system. GPR119 has been a potential therapeutic target for diabetes mellitus type 2 for many years, but its role in metabolic dysfunction associated fatty liver disease deserves further attention. In this review, we discuss relevant research and current progress in the physiology and pharmacology of the GPR119/incretin axis and speculate on the potential therapeutic role of this axis in metabolic dysfunction associated with fatty liver disease, which provides guidance for transforming experimental research into clinical applications.
Genomic prediction with non-additive effects in beef cattle: stability of variance component and genetic effect estimates against population size
Authors: Onogi Akio , Watanabe Toshio , Ogino Atsushi , Kurogi Kazuhito , Togashi Kenji
Published: July 2021

Background

Genomic prediction is now an essential technology for genetic improvement in animal and plant breeding. Whereas emphasis has been placed on predicting the breeding values, the prediction of non-additive genetic effects has also been of interest. In this study, we assessed the potential of genomic prediction using non-additive effects for phenotypic prediction in Japanese Black, a beef cattle breed. In addition, we examined the stability of variance component and genetic effect estimates against population size by subsampling with different sample sizes.

Results

Records of six carcass traits, namely, carcass weight, rib eye area, rib thickness, subcutaneous fat thickness, yield rate and beef marbling score, for 9850 animals were used for analyses. As the non-additive genetic effects, dominance, additive-by-additive, additive-by-dominance and dominance-by-dominance effects were considered. The covariance structures of these genetic effects were defined using genome-wide SNPs. Using single-trait animal models with different combinations of genetic effects, it was found that 12.6–19.5 % of phenotypic variance were occupied by the additive-by-additive variance, whereas little dominance variance was observed. In cross-validation, adding the additive-by-additive effects had little influence on predictive accuracy and bias. Subsampling analyses showed that estimation of the additive-by-additive effects was highly variable when phenotypes were not available. On the other hand, the estimates of the additive-by-additive variance components were less affected by reduction of the population size.

Conclusions

The six carcass traits of Japanese Black cattle showed moderate or relatively high levels of additive-by-additive variance components, although incorporating the additive-by-additive effects did not improve the predictive accuracy. Subsampling analysis suggested that estimation of the additive-by-additive effects was highly reliant on the phenotypic values of the animals to be estimated, as supported by low off-diagonal values of the relationship matrix. On the other hand, estimates of the additive-by-additive variance components were relatively stable against reduction of the population size compared with the estimates of the corresponding genetic effects.
Transcriptomic analysis of temporal shifts in berry development between two grapevine cultivars of the Pinot family reveals potential genes controlling ripening time
Authors: Theine Jens , Holtgräwe Daniela , Herzog Katja , Schwander Florian , Kicherer Anna , Hausmann  Ludger , Viehöver Prisca , Töpfer Reinhard , Weisshaar Bernd
Published: July 2021

Background

Grapevine cultivars of the Pinot family represent clonally propagated mutants with major phenotypic and physiological differences, such as different colour or shifted ripening time, as well as changes in important viticultural traits. Specifically, the cultivars ‘Pinot Noir’ (PN) and ‘Pinot Noir Precoce’ (PNP, early ripening) flower at the same time, but vary in the beginning of berry ripening (veraison) and, consequently, harvest time. In addition to genotype, seasonal climatic conditions (i.e. high temperatures) also affect ripening times. To reveal possible regulatory genes that affect the timing of veraison onset, we investigated differences in gene expression profiles between PN and PNP throughout berry development with a closely meshed time series and over two separate years.

Results

The difference in the duration of berry formation between PN and PNP was quantified to be approximately two weeks under the growth conditions applied, using plant material with a proven PN and PNP clonal relationship. Clusters of co-expressed genes and differentially expressed genes (DEGs) were detected which reflect the shift in the timing of veraison onset. Functional annotation of these DEGs fit to observed phenotypic and physiological changes during berry development. In total, we observed 3,342 DEGs in 2014 and 2,745 DEGs in 2017 between PN and PNP, with 1,923 DEGs across both years. Among these, 388 DEGs were identified as veraison-specific and 12 were considered as berry ripening time regulatory candidates. The expression profiles revealed two candidate genes for ripening time control which we designated VviRTIC1 and VviRTIC2 (VIT_210s0071g01145 and VIT_200s0366g00020, respectively). These genes likely contribute the phenotypic differences observed between PN and PNP.

Conclusions

Many of the 1,923 DEGs show highly similar expression profiles in both cultivars if the patterns are aligned according to developmental stage. In our work, putative genes differentially expressed between PNP and PN which could control ripening time as well as veraison-specific genes were identified. We point out connections of these genes to molecular events during berry development and discuss potential candidate genes which may control ripening time. Two of these candidates were observed to be differentially expressed in the early berry development phase. Several down-regulated genes during berry ripening are annotated as auxin response factors / ARFs. Conceivably, general changes in auxin signaling may cause the earlier ripening phenotype of PNP.
Study of C-reactive protein, procalcitonin, and immunocyte ratios in 194 patients with sepsis
Authors: Tian Tian , Wei Bing , Wang Junyu
Published: July 2021

Background

Evidence suggests that C-reactive protein (CRP), procalcitonin (PCT), and immune cells can predict sepsis severity in adult patients. However, the specific values of these indicators are not consistent in predicting prognosis.

Methods

A retrospective study analyzed the medical records of 194 patients based on the concept of sepsis in 2016 (Sepsis 3.0) from January 2017 to December 2019. A comparative analysis of inflammatory factors associated with patients in the sepsis survival and the non-survival group was performed. The concentrations of CRP and PCT, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were measured. ROC curve was used to assess the diagnosis and analysis of the selected indices of sepsis. According to each index’s cut-off value of the ROC curve, the patients were divided into two groups, and the prognosis was calculated.

Results

Among the 194 patients, 32 died (16.49%), the median age of the patients was 79 (66.0, 83.3) years, and 118 were male (60.8%). Analysis of related inflammatory indicators showed that CRP, NLR, MLR, PLR, and CRP*PCT in the non-survival group were statistically higher than those in the survival group (allpvalues were < 0.05). Regression analysis showed that PCT, CRP, NLR, PLR, and CRP*PCT were all independent prognostic factors for patients. The ROC curve results showed that CRP*PCT had the best diagnostic value (AUC = 0.915). The cut-off values of PCT, CRP, NLR, PLR, MLR, and CRP*PCT were 0.25 ng/mL, 85.00 mg/L, 8.66, 275.51, 0.74%, and 5.85 (mg/L)2, respectively. Kaplan-Meier survival estimate showed that patient prognosis between the CRP, PCT, NLR, PLR, and CRP*PCT was statistically different (all valuesP < 0.05, respectively). However, there was no statistically significant difference in gender and MLR (all valuesP > 0.05, respectively), grouping based on diagnostic cut-off values.

Conclusions

In this study, inflammation-related markers PCT, CRP, NLR, MLR, PLR, and CRP*PCT can be used as independent risk factors affecting the prognosis of patients with sepsis. Furthermore, except for MRL, these indicators have cut-off values for predicting patient death.
Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes
Authors: Maas Veronique Y.F. , Poels Marjolein , Lamain-de Ruiter Marije , Kwee Anneke , Bekker Mireille N. , Franx Arie , Koster Maria P.H.
Published: July 2021

Background

While the potential adverse outcomes of prenatal exposure to unhealthy lifestyle are widely evidenced, little is known about these exposures in the periconception period. We investigated the associations between lifestyle behaviours and adverse pregnancy outcomes with a unique distinction between preconceptional- and prenatal lifestyle behaviours.

Methods

A secondary analysis took place within a prospective multicentre cohort study in the Netherlands, including 3,684 pregnant women. Baseline characteristics and preconceptional and first trimester lifestyle behaviours were assessed through a self-administered questionnaire in the first trimester. Adverse pregnancy outcomes (hypertensive disorders in pregnancy (HDP), small for gestational age (SGA), gestational diabetes (GDM) and spontaneous preterm birth (sPTB)) were reported by healthcare professionals. Data were collected between 2012 and 2014 and analysed using multivariate logistic regression.

Results

Women who are overweight, and especially obese, have the highest odds of developing any adverse pregnancy outcome (adjusted odds ratio (aOR) 1.61 (95 % Confidence Interval (CI) 1.31–1.99) and aOR 2.85 (95 %CI 2.20–3.68), respectively), particularly HDP and GDM. Women who prenatally continued smoking attained higher odds for SGA (aOR 1.91 (95 %CI 1.05–1.15)) compared to the reference group, but these odds decreased when women prenatally quit smoking (aOR 1.14 (95 %CI 0.59–2.21)). Women who did not use folic acid supplements tended to have a higher odds of developing adverse pregnancy outcomes (aOR 1.28 (95 %CI 0.97–1.69)), while women who prenatally started folic acid supplements did not (aOR 1.01 (95 %CI 0.82–1.25)).

Conclusions

Our results indicate that smoking cessation, having a normal body mass index (BMI) and initiating folic acid supplements preconceptionally may decrease the risk of adverse pregnancy outcomes. Therefore, intervening as early as the preconception period could benefit the health of future generations.
Determination of neonatal case-specific fatality rates in a tertiary health institution in North Central Nigeria
Authors: Audu L. I. , Otuneye A. T. , Mairami A. B. , Mukhtar-Yola M. , Mshelia L. J.
Published: July 2021

Background

The current neonatal mortality rate in Nigeria (37/1000) is among the highest in the world and the major causes have consistently been reported as sepsis, perinatal asphyxia and prematurity. However, case-specific fatality which defines the risk of dying from these and other neonatal morbidities is rarely emphasized. Determination of case-specific fatality rates (CSFR) may inform a change in our current approach to neonatal care interventions which may eventually bring about the much-needed reduction in our neonatal mortality rate. Our aim was to determine the case-specific fatality rates for the common causes of mortality among hospitalized neonates at the National Hospital Abuja (NHA).

Methods

Relevant demographic and clinical data on all neonates admitted into the NICU at the NHA over a period of 13 months (January 2017 to February 2018) were extracted from the Neonatal Registry database and analyzed using appropriate statistical methods with the SPSS version 20 software. The case-specific fatality rates were computed for the predominant morbidities in addition to determination of the neonatal mortality rates and associated risk factors.

Results and conclusion

A total of 730 neonates were admitted, out of which 391 (53.6%) were females, 396 (54.5%) were inborn and 396 (54.2%) were term. The three most prevalent morbidities were prematurity 272(37.2%), neonatal Jaundice 208(28.4%) and perinatal asphyxia 91(12.5%) while the most common causes of mortality were prematurity 47/113(41.6%), congenital malformations 27/113(23.9%) and perinatal asphyxia 26/113(23%). Congenital malformations had the highest case-specific fatality 27/83(32.5%) followed by Perinatal Asphyxia 26/91(28.6%) and prematurity 47/272(20.7%). The mortality pattern differed between inborn and out born babies. Implications of these case-specific fatality rates for targeted interventions are discussed.
Predictors of mortality among newborns admitted with perinatal asphyxia at public hospitals in Ethiopia: a prospective cohort study
Authors: Dessu Samuel , Dawit Zinabu , Timerga Abebe , Bafa Muluken
Published: July 2021

Introduction

Perinatal asphyxia is a complicated newborn health problem and applies a high contribution to the increased proportion of newborn mortality. It occurs in newborns due to altered breathing or inadequate inhalation and exhalation resulting in reduced oxygen perfusion to certain body tissues and organs. Irrespective of the increased progress in health care towards newborns and implementations in reductions in under-five, infant, and neonatal mortality in the past 10 years, perinatal asphyxia remained as the most common severe newborn health challenge that causes a high number of morbidity and mortality.

Methods

A prospective cohort longitudinal study was implemented among 573 newborns admitted with perinatal asphyxia at public hospitals in Southern Ethiopia from 1st March 2018 to 28th February 2020. The perinatal survival time was determined using Kaplan Meier survival curve together with a log-rank test. The dependent variable was time to death and the independent variables were classified as socio-demographic factors, obstetrics related factors, newborn related factors and maternal medical related factors. The study subjects were entered in to the cohort during admission with perinatal asphyxia in the hospital and followed until 7 days of life.

Results

The cumulative proportion of survival among the newborns admitted with perinatal asphyxia was 95.21% (95%CI:91.00,97.48), 92.82% (95%CI:87.95,95.77), 92.02%(95%CI:86.84,95.22) and 90.78%(95%CI:84.82,94.48) at the end of first, second, third and fourth follow-up days respectively. The mean survival date was 6.55(95%CI: 6.33, 6.77) and cord prolapse (AHR:6.5;95%CI:1.18,36.01), pregnancy induced hypertension (AHR:25.4;95%CI:3.68,175.0), maternal iron deficiency anemia (AHR:5.9;95%CI:1.19,29.5) and having convulsion of the newborn (AHR:10.23;95%CI:2.24,46.54) were statistically significant in multivariable cox proportional hazard model.

Conclusion

The survival status among newborns with perinatal asphyxia was low during the early follow-up periods after admission to the hospital and the survival status increased after fourth follow up days. In addition, cord prolapse, history of PIH, maternal iron deficiency anemia and newborns history of convulsion were the independent predictors of mortality.
Childhood vaccination coverage in Australia: an equity perspective
Authors: Arat Arzu , Moore Hannah C. , Goldfeld Sharon , Östberg Viveca , Sheppeard Vicky , Gidding Heather F.
Published: July 2021

Background

This study describes trends in social inequities in first dose measles-mumps-rubella (MMR1) vaccination coverage in Western Australia (WA) and New South Wales (NSW). Using probabilistically-linked administrative data for 1.2 million children born between 2002 and 2011, we compared levels and trends in MMR1 vaccination coverage measured at age 24 months by maternal country of birth, Aboriginal status, maternal age at delivery, socio-economic status, and remoteness in two states.

Results

Vaccination coverage was 3–4% points lower among children of mothers who gave birth before the age of 20 years, mothers born overseas, mothers with an Aboriginal background, and parents with a low socio-economic status compared to children that did not belong to these social groups. In both states, between 2007 and 2011 there was a decline of 2.1% points in MMR1 vaccination coverage for children whose mothers were born overseas. In 2011, WA had lower coverage among the Aboriginal population (89.5%) and children of young mothers (89.3%) compared to NSW (92.2 and 92.1% respectively).

Conclusion

Despite overall high coverage of MMR1 vaccination, coverage inequalities increased especially for children of mothers born overseas. Strategic immunisation plans and policy interventions are important for equitable vaccination levels. Future policy should target children of mothers born overseas and Aboriginal children.
Socio-economic inequality in anaemia among men in India: a study based on cross-sectional data
Authors: Kumar Pradeep , Sharma Himani , Sinha Debashree
Published: July 2021

Background

Undernutrition is a serious matter of public health concern in India. Existing studies, policies and programs focus on women and children thereby ignoring men in policymaking. This study examines the socio-economic inequality in anaemia levels among men in India and tries to decompose the factors behind it.

Methods

The fourth round of National Family Health Survey is used to fulfill the study objectives. The outcome variable of the study is men having anaemia or not. The study uses bivariate and multivariate techniques to identify the factors associated with the outcome variable. Further, concentration index and concentration curve are calculated to measure the socio-economic inequality in anaemia among men in India.

Results

The results indicate that majority of the socio-economic related inequality is explained by wealth quintile followed by geographical regions of India, body mass index and educational attainment. The results also emphasize that older men belong to the high-risk groups. Moreover, the likelihood of anaemia is 40% more likely among men who belonged to East region and 25%, 13% and 7 % less likely among those who belonged to Northeast, West and South region compared to those who belonged in the North region of the country.

Conclusion

Existing policies on anaemia should include men to achieve an anaemia free India. Individual education and awareness should be encouraged to improve nutritional status.
Solitary vaginal paraganglioma with mature sacrococcygeal teratoma: a rare case report
Authors: Wang Zhan , Fan Hua , Fan Jinghua , Seery Samuel , Wang Wenda , Zhang Yushi
Published: July 2021

Background

Vaginal paraganglioma are rare, atypical, solitary tumors which originate from the female genital tract. Sacrococcygeal teratoma are also rare neoplasms which derive from one (or more) primordial germ cell layers. Here we report a unique case of vaginal paraganglioma with sacrococcygeal teratoma.

Case presentation

A 44-year-old female experienced paroxysmal hypertension, palpitations and dizziness for almost six years. Enhanced CT and MRI highlighted two abnormal soft tissue lesions located in the left vaginal wall and coccyx anteriorly, and Iodine-131 metaiodobenzylguanidine (131I-MIBG) demonstrated abnormal radioactive uptake in perineum area. Endocrine tests showed elevated plasma normetanephrine (NMN) and 24 h urine norepinephrine. There was a well-circumscribed soft tissue lesion of approximately 3.5 cm in the left lateral vaginal wall which could be palpated during bimanual examination, together with a 1.5 cm tumor in the posterior wall of the rectum. We completely resected the two lesions in stages with the support of a senior gynecologist and general surgeons. Postoperative histopathological examinations suggested the vaginal paraganglioma and mature sacrococcygeal teratoma. Targeted sanger sequencing for the 36 mostly common paraganglioma-related genes, with a depth of 1000x, revealed no mutations. Post-operatively, plasma NMN and 24 h urine norepinephrine returned to the normal range and her symptoms completely disappeared.

Conclusions

We reported an extremely rare case and the successful treatment of functional vaginal paraganglioma coexisting with adult sacrococcygeal teratoma.
Correction to: Periodontal health in an indigenous Sámi population in Northern Norway: a cross-sectional study
Authors: Bongo Ann-Kristine Sara , Brustad Magritt , Oscarson Nils , Jönsson Birgitta
Published: July 2021

An amendment to this paper has been published and can be accessed via the original article.
Health professionals’ perceptions of palliative care for end-stage cardiac and respiratory conditions: a qualitative interview study
Authors: Fairlamb Hannah J. , Murtagh Fliss E. M.
Published: July 2021

Background

End-stage cardiac and respiratory diseases are common in the UK. People with these end-stage conditions experience similar, or even worse, symptomatic suffering to cancer patients but are less likely to receive specialist palliative care services. The objective of this study is to explore health professional perceptions and current practices in relation to specialist palliative care for patients with end-stage cardiac and respiratory disease.

Methods

Qualitative study using in-depth interviews with health professionals, audio recorded and transcribed verbatim for thematic analysis. The study was conducted with doctors and nurses from cardiology, respiratory, and palliative care specialities in the UK. The participants had to be involved clinically in providing care to people with end-stage cardiac or respiratory diseases.

Results

A total of 16 health professionals participated (5 cardiology, 5 respiratory, and 6 palliative care). Participants reported variable disease trajectories in these diseases making deciding on timing of palliative care involvement difficult. This was complicated by lack of advance care planning discussions, attributed to poor communication, and lack of health professional time and confidence. Participants reported poor interdepartmental education and limited specialist palliative care involvement in multidisciplinary teams.

Conclusions

Palliative care for end-stage cardiac and respiratory diseases needs more attention in research and practice. Better integration of advance care planning discussions and early patient education/professional awareness are needed to enable timely referral to palliative care. Moreover, increased interdepartmental working for health professionals via joint educational and clinical meetings is perceived as likely to support earlier and increased referral to specialist palliative care services.
Late presentation of extrauterine adenomyomas after laparoscopic morcellation at hysterectomy: a case report
Authors: Zaki Mohammed Nagdi , Gheewale Aafia Mohammed Farooq , Ibrahim Nada , Elrahman Ibrahim Abd
Published: July 2021

Background

An adenomyoma is a well circumscribed form of adenomyosis and can be located within the myometrium, in the endometrium as a polyp, or extrauterine with the last being the rarest presentation amongst the three. With the ongoing advancement in gynecological surgery, the use of electromechanical morcellators have made the removal of large and dense specimens possible with minimally invasive techniques. However, it has also caused an increase in complications which were previously rare. Whilst the tissue is being grinded within the abdominal cavity, residual tissue can spread and remain inside, allowing for implantation to occur and thereby giving rise to recurrence of uterine tissue as a new late postoperative complication.

Case presentation

A 45-year-old woman presented with worsening constipation and right iliac fossa pain. Her past surgical history consists of laparoscopic supra-cervical hysterectomy that was indicated due to uterine fibroids. Computerized tomography and magnetic resonance imaging were done, which showed an irregular lobulated heterogeneous mass seen in the presacral space to the right, located on the right lateral aspect of the recto-sigmoid, measuring 4.5 × 4.3 × 4.3 cm in size. A transvaginal ultrasound revealed a cyst in the left ovary. The patient had a treatment course over several months that included Dienogest (progestin) and Goserelin (GnRH analogue) with add-back therapy. In line with the declining response to medications, the patient was advised for a laparoscopic ovarian cystectomy. During the surgery, an additional lesion was found as a suspected fibroid and the left ovarian cyst was identified as pockets of peritoneal fluid which was sent for cytology. The surgical pathology report confirmed adenomyosis in both specimens, namely the right mass and the initially suspected fibroid.

Conclusion

In this case report, we showcase a rare occurrence of an extrauterine adenomyoma presenting two years post laparoscopic morcellation at hysterectomy. This poses questions regarding the benefits versus risks of power morcellation in laparoscopic hysterectomy.
The relationship between empathy and altruistic motivations in nursing studies: a multi-method study
Authors: Messineo Linda , Seta Luciano , Allegra Mario
Published: July 2021

Background

The efficient management of relational competences in healthcare professionals is crucial to ensuring that a patient’s treatment and care process is conducted positively. Empathy is a major component of the relational skills expected of health professionals. Knowledge of undergraduate healthcare students’ empathic abilities is important for educators in designing specific and efficient educational programmes aimed at supporting or enhancing such competences. In this study, we measured first-year undergraduate nursing students’ attitudes towards professional empathy in clinical encounters. The students’ motivations for entering nursing education were also evaluated. This study takes a multi-method approach based on the use of qualitative and quantitative tools to examine the association between students’ positive attitudes towards the value of empathy in health professionals and their prosocial and altruistic motivations in choosing to engage in nursing studies.

Methods

A multi-method study was performed with 77 first-year nursing students. The Jefferson Scale of Empathy (JSE) – Health Professions Student Version was administered. Students’ motivations for choosing nursing studies were detected through an open question and thematically analysed. Using explorative factor analysis and principal component analysis, a dimensional reduction was conducted to identify subjects with prosocial and altruistic motivations. Finally, linear models were tested to examine specific associations between motivation and empathy.

Results

Seven distinct themes distinguishing internal and external motivational factors were identified through a thematic analysis of students’ answers regarding their decision to enter a nursing degree course. Female students gained higher scores on the empathy scale than male ones. When students’ age was considered, this difference was only observed for younger students, with young females’ total scores being higher than young males'. High empathy scores were positively associated with altruistic motivational factors. A negative correlation was found between external motivational factors and the scores of the Compassionate Care subscale of the JSE.

Conclusions

Knowing the level of nursing students’ empathy and their motivational factors for entering nursing studies is important for educators to implement training paths that enhance students’ relational attitudes and skills and promote the positive motivational aspects that are central to this profession.
Fear of future workplace violence and its influencing factors among nurses in Shandong, China: a cross-sectional study
Authors: Fu Chang , Ren Yaru , Wang Guowen , Shi Xiuxin , Cao Fenglin
Published: July 2021

Background

Fear of workplace violence has become a critical issue worldwide, which can lead to burnout, low levels of job satisfaction, and turnover. However, to date, little attention has been directed toward fear of workplace violence among nurses. Accordingly, this study investigated the level of fear of future workplace violence and its influencing factors among nurses in Shandong, China.

Methods

A cross-sectional study was conducted from July 30 through September 30, 2020 in Shandong Province, China. A total of 1898 nurses were enrolled from 12 tertiary hospitals. Fear of future workplace violence was measured using the Fear of Future Violence at Work scale. Demographic information, employment characteristics, social support, and experience of workplace violence were assessed. Multiple linear regression analysis was used to explore the influencing factors of fear of future workplace violence.

Results

The average score of fear of future violence at work was 67.43 ± 17.20 among nurses. Multiple linear regression analysis showed that higher fear of future violence at work scores were reported among nurses who were female (B = 7.10,p < 0.001), married (B = 3.50,p = 0.028), with a monthly income ≥5000 Chinese yuan (CNY) (B = 3.14,p = 0.007), working in the department of internal medicine (B = 2.90,p = 0.032), surgery (B = 5.03,p < 0.001), pediatrics (B = 5.38,p = 0.003), or emergency department (B = 4.50,p = 0.010), working as a contract employee (B = 2.41,p = 0.042), or who had experienced workplace violence (B = 7.02,p < 0.001). Lower fear of future violence at work scores were found among nurses who took vacations (1–14 days: B = − 2.52,p = 0.047; ≥15 days: B = − 3.69,p = 0.007) and had a high-level of social support (B = − 2.03,p = 0.020).

Conclusions

There was a high level of fear of future workplace violence among nurses in Shandong, China. This should be considered an important issue by hospital administrators and government officials. Effective interventions need to be enacted to address the influencing factors of fear of future workplace violence.
Managing pneumonia through facility-based integrated management of childhood management (IMCI) services: an analysis of the service availability and readiness among public health facilities in Bangladesh
Authors: Rahman Ahmed Ehsanur , Mhajabin Shema , Dockrell David , Nair Harish , El Arifeen Shams , Campbell Harry
Published: July 2021

Background

With an estimated 24,000 deaths per year, pneumonia is the single largest cause of death among young children in Bangladesh, accounting for 18% of all under-5 deaths. The Government of Bangladesh adopted the WHO recommended Integrated Management of Childhood Illness (IMCI)-strategy in 1998 for outpatient management of pneumonia, which was scaled-up nationally by 2014. This paper reports the service availability and readiness related to IMCI-based pneumonia management in Bangladesh. We conducted a secondary analysis of the Bangladesh Health Facility Survey-2017, which was conducted with a nationally representative sample including all administrative divisions and types of health facilities. We limited our analysis to District Hospitals (DHs), Maternal and Child Welfare Centres (MCWCs), Upazila (sub-district) Health Complexes (UHCs), and Union Health and Family Welfare Centres (UH&FWCs), which are mandated to provide IMCI services. Readiness was reported based on 10 items identified by national experts as ‘essential’ for pneumonia management.

Results

More than 90% of DHs and UHCs, and three-fourths of UH&FWCs and MCWCs provide IMCI-based pneumonia management services. Less than two-third of the staff had ever received IMCI-based pneumonia training. Only one-third of the facilities had a functional ARI timer or a watch able to record seconds on the day of the visit. Pulse oximetry was available in 27% of the district hospitals, 18% of the UHCs and none of the UH&FWCs. Although more than 80% of the facilities had amoxicillin syrup or dispersible tablets, only 16% had injectable gentamicin. IMCI service registers were not available in nearly one-third of the facilities and monthly reporting forms were not available in around 10% of the facilities. Only 18% of facilities had a high-readiness (score 8–10), whereas 20% had a low-readiness (score 0–4). The readiness was significantly poorer among rural and lower level facilities (p < 0.001). Seventy-two percent of the UHCs had availability of one of any of the four oxygen sources (oxygen concentrators, filled oxygen cylinder with flowmeter, filled oxygen cylinder without flowmeter, and oxygen distribution system) followed by DHs (66%) and MCWCs (59%).

Conclusion

There are substantial gaps in the readiness related to IMCI-based pneumonia management in public health facilities in Bangladesh. Since pneumonia remains a major cause of child death nationally, Bangladesh should make a substantial effort in programme planning, implementation and monitoring to address these critical gaps to ensure better provision of essential care for children suffering from pneumonia.
The expression of miR-513c and miR-3163 was downregulated in tumor tissues compared with normal adjacent tissue of patients with breast cancer
Authors: Delgir Soheila , Ilkhani Khandan , Safi Asma , Rahmati Yazdan , Montazari Vahid , Zaynali-Khasraghi Zahra , Seif Farhad , Bastami Milad , Alivand Mohammad Reza
Published: July 2021

Background

Breast cancer (BC) is the most invasive cancer with different subtypes that its metabolism is unique compared with normal cells. Glutamine is considered critical nutrition that many cancer cells, particularly BC cells, are dependent on it for growth and proliferation. Therefore, targeting glutamine metabolism, especially enzymes that are related to this pathway, can be beneficial to design anti-cancer agents. Recent evidence has shown that microRNAs (miRNAs), with a short length and single-strand properties, play a prominent role in regulating the genes related to glutamine metabolism, which may control the development of cancer.

Methods

In silico analysis confirmed that miR-513c and miR-3163 might be involved in glutamine metabolism. The expression level of these two miRNAs was evaluated in eighty BC tissues and normal adjacent tissues. Furthermore, GSE38167, GSE38867, GSE42128, GSE45666, and GSE53179 were employed from gene expression omnibus (GEO). The Limma package was utilized to identify differentially expressed miRNAs (DEMs) of mentioned datasets to evaluate miR-513c and miR-3163 expression. Further, in silico analysis was utilized to predict the potential biological processes and molecular pathways of miR-513c and miR-3163, based on their target genes.

Results

In silico studies revealed top categories of biological processes and cellular pathways that might play a critical role in metabolism reprogramming and cancer development and were target genes for miR-513c and miR-3163. The current study showed that miR-513c (p value = 0.02062 and FC =  − 2.3801) and miR-3163 (p value = 0.02034 and FC =  − 2.3792) were downregulated in tumor tissues compared to normal adjacent tissues. The analysis of GEO microarray datasets showed that miR-513c was downregulated in GSE38167, GSE38867, GSE42128, GSE45666 and GSE53179, whereas there was a significant downregulation of miR-3163 in only two studies, including GSE38867 and GSE42128 that they were in accordance with our experimental results. Furthermore, the subgroup analysis did not show any substantial relationship between expression levels of these two miRNAs and factors such as age, family history of cancer, and abortion history.

Conclusion

MiR-513c and miR-3163 were downregulated in BC tissues, which might serve as tumor suppressors. They are suggested as potential therapeutic targets for patients with BC.