bluuebunny/crossref_metadata_2025 huggingface dataset:
An assessment of infection prevention and control preparedness of healthcare facilities in Nigeria in the early phase of the COVID-19 pandemic (February–May 2020)
Authors: Joy Okwor Tochi , Gatua Josephine , Umeokonkwo Chukwuma David , Abah Stephen , Ike Ifeanyi Franklin , Ogunniyi Abiodun , Ipadeola Oladipupo , Attah Timothy , Assad Hassan , Dooga Jerome , Olayinka Adebola , Abubakar Jafiya , Oladejo John , Aderinola Olaolu , Eneh Chibuzo , Ilori Elsie , Ibekwe Priscilla , Ochu Chinwe , Ihekweazu Chikwe
Published: February 2022

Background

Infection prevention and control (IPC) activities play a large role in preventing the transmission of SARS-CoV-2 in healthcare settings. This study describes the state of IPC preparedness within health facilities in Nigeria during the early phase of coronavirus disease (COVID-19) pandemic.

Methods

We carried out a cross sectional study of health facilities across Nigeria using a COVID-19 IPC checklist adapted from the U.S Centers for Disease Control and Prevention. The IPC aspects assessed were the existence of IPC committee and teams with terms of reference and workplans, IPC training, availability of personal protective equipment and having systems in place for screening, isolation and notification of COVID-19 patients. Existence of the assessed aspects was regarded as preparedness in that aspect.

Results

In total, 461 health facilities comprising, 350 (75.9%) private and 111 (24.1%) public health facilities participated. Only 19 (4.1%) health facilities were COVID-19 treatment centres with 68% of these being public health facilities. Public health facilities were better prepared in the areas of IPC programme with 69.7% of them having an IPC focal point versus 32.3% of private facilities. More public facilities (59.6%) had an IPC workplan versus 26.8% of private facilities. Neither the public nor the private facilities were adequately prepared for triaging, screening, and notifying suspected cases, as well as having trained staff and equipment to implement triaging.

Conclusions

The results highlight the need for government, organisations and policymakers to establish conducive IPC structures to reduce the risk of COVID-19 transmission in healthcare settings.
Decolonizing and re-theorizing radical democratic education: Toward a politics and practice of refusal
Authors: Zembylas Michalinos
Published: February 2022

The aim of this article is twofold: first, it seeks to discuss the relationship between democracy and colonization, and to examine the implications of this relationship for democratic education and, second, it turns to decolonial thinking as a resource for critiquing and reconstructing “radical democratic education.” A decolonial critique offers two crucial insights to radical democratic education that draws on Mouffe’s theory of radical democracy: first, it shows how Mouffe’s theory entails the risk of re-inscribing the hegemony of liberal democratic principles because this theory is insufficiently attentive to the harms caused by dispossessions of colonized peoples, especially the loss of their land and, second, a decolonial critique highlights the role of recent ethico-political movements such as “refusal” in resurrecting and rehabilitating the radical promise of democratic education. These insights have practical implications for those who are rethinking radical democratic education in terms of an expanded notion of democracy encompassing subaltern standpoints.
Complications of Locked Plating for Proximal Humeral Fractures in Active Patients in a Level One Trauma Center
Authors: Marsalli Michael , De La Paz Joaquín , Córdova Carlos , Fritis Diego , Errázuriz Juan De Dios
Published: February 2022

Background

The incidence of complications associated with locked plating of proximal humerus fractures (PHF) has been reported in up to 40% of surgeries. This study aimed to analyze the incidence and risk factors of complications and re-intervention associated with locked plating of PHF in a an young active working population.

Methods

This retrospective cohort study included patients indicated for locked plating of displaced PHF at a dedicated workers’ accident trauma center. The variables analyzed were patient comorbidities, fracture characteristics, and immediate radiologic surgical outcomes. Postoperative complications and risk factors were determined.

Results

A total of 127 patients with a median follow-up of 31 months and a median age of 52 years were included. The complication and reintervention rates were 13.4% and 12.6%, respectively. The main cause of reintervention was post-traumatic stiffness. The incidence of other complications was 4% screw protrusion, 1.6% avascular necrosis, 1.6% varus collapse. Complications were not associated with age, comorbidity, fracture classification, bone mineral density, Hertel's risk factors, presence of calcar comminution, reduction quality, and calcar screw position.

Discussion

The incidence of complications and reintervention was low. The main cause of reintervention was persistent stiffness, and no risk factors for complications were found in this study.
Minimally Invasive Chevron Akin: Locking The Metatarsal-Cuneiform Joint
Authors: Nunes Gustavo Araujo , Ferreira Gabriel Ferraz , Baumfeld Tiago , Filho Miguel Viana Pereira , Baumfeld Daniel , Lam Peter
Published: February 2022

Introduction

Minimally Invasive Chevron Akin (MICA) can be used to treat hallux valgus (HV) associated with a hypermobility of the first metatarsal-cuneiform joint (1MTCJ). The aim of this study was to perform a radiographic analysis of the MICA, focused on evaluating the 1MTCJ.

Methods

Forty patients (50 feet) with moderate to severe HV underwent a MICA procedure. Radiographic analysis included hallux valgus angle (HVA), intermetatarsal angles between the first and second rays (IMA), the intermetatarsal angle between the proximal fragment of the osteotomy and the second ray (IAPF) and the distance between a point 3 cm distal from the base of the second metatarsal and a point located at the same height for the first metatarsal base (Dist 1-2). The IAPF was compared with the preoperative IMA, and the other parameters were compared preoperatively and postoperatively. The radiographic complications were also recorded.

Results

Most patients were female (92%). The mean age was 50.4 years (SD = 16.1) and the mean follow-up was 16.1 months (SD = 3.5). The average HVA improved from 32.5° to 7.3°, and the average IMA from 14.2° to 4.2°. The IAPF and Dist1-2 values showed an increase of 4.8° and 4.0 mm respectively. There were no radiographic complications. Conclusion. Minimally invasive Chevron Akin promotes a great correction of the moderate to severe HV conventional parameters and increase the transversal stability of the 1MTCJ fixing this joint as medial as possible.

Level of Evidence

Level IV, case series
Factors affecting telepractice use in COVID-19
Authors: Chua Christine H , Seow Ferlin CL , Tang Florence MA , Lim Li Mei
Published: February 2022

Background

The use of telepractice as an alternate method of delivering healthcare to people increased significantly after COVID-19 became a global pandemic.

Objectives

This study aimed to identify factors contributing to the accelerated adoption of telepractice during COVID-19 in Singapore. It also sought to examine whether there are differences in the perspectives of staff in nursing facilities and caregivers in personal homes towards telepractice.

Methods

A cross-sectional mixed method design was used. A survey with 20 items was adapted from the Telehealth Usability Questionnaire and translated into Mandarin. Anonymous responses were obtained from 70 patients and caregivers who had received speech therapy services via telepractice from a restructured hospital before and/or during Singapore’s Circuit Breaker period. Analyses were conducted using descriptive statistics and content analysis.

Results

Sociodemographic variables of age, gender, education level and language preference did not impact user satisfaction and the likelihood of using telepractice again. Service-related factors were more influential. Participants chose to use telepractice as it saved travelling time (24.0%), was easy to use (19.3%), improved healthcare access (17.5%) and reduced waiting time (17.5%). Although all respondents expressed satisfaction in telepractice, 35.5% from personal homes and 37.5% from nursing facilities were not keen to use it again. Amongst caregivers, 26.7% from personal homes and 37.5% from nursing facilities preferred not to continue telepractice use. Technical and logistical disruptions and the lack of ‘personal touch’ were contributing factors.

Conclusion

Improving technological infrastructure, providing training for users and developing guidelines would help sustain telepractice as a form of service delivery beyond COVID-19.
MRI interobserver reliability in rectal tumor angulation
Authors: Pedersen Malene RV , Otto Peter O , Precht Helle , Rafaelsen Søren R
Published: February 2022

Background

When rectal tumors are examined using magnetic resonance imaging (MRI) the perpendicular angulation of the axial T2-weighted image to the tumor axis is essential for a correct measure of the shortest distance between tumor and mesorectal facia.

Purpose

The purpose of this study was to determine the interobserver variability in rectal tumor angulation between a radiologist and a radiographer.

Material and Methods

Two observers performed the angulation independently. All MRI examinations were performed using an MRI 1.5 Tesla unit. A Bland–Altman plot was used to assess the interobserver variance and Intraclass correlation coefficient (ICC) statistic was used to assess the interobserver reliability.

Results

MRI was performed in 55 patients with rectal cancer during a one-year period (25 (45.5%) women and 30 (54.5%) men). The median age was 71 years (range 46–87 years). The rectal tumor mean length was 3.9 cm. The interobserver reliability was good (ICC = 0.83, 95% confidence interval 0.72–0.90).

Conclusion

Radiographers receiving training will be able to perform MRI rectal tumor angulation.
Applying for RAMP Using a Cohort Model: Overcoming Challenges
Authors: Taylor Julia V. , Goodman-Scott Emily , Walsh Robyn
Published: February 2022

Although comprehensive school counseling programs are implemented widely across the country, school counselors face myriad barriers to implementation. As such, we conducted a multilevel, descriptive case study to examine a school counseling cohort preparing to apply for the American School Counselor Association’s Recognized ASCA Model Program (RAMP) over a 2-year period. Due to the significant amount of data collected during the research process, this is the second article of a two-part study. Results of this study highlight the process of school counselors overcoming barriers to comprehensive program implementation via prolonged professional development and include the following themes: (a) overcoming a lack of training and knowledge on comprehensive school counseling programs and (b) advocating to overcome systemic barriers. We address considerations for counselor educators, school counseling professionals, and counseling organizations/associations.
Applying for RAMP Using a Cohort Model: Results of a Multilevel Case Study
Authors: Goodman-Scott Emily C. , Taylor Julia V. , Walsh Robyn
Published: February 2022

School counselors across the United States are implementing comprehensive school counseling programs, such as those following the American School Counselor Association (ASCA) National Model. ASCA awards a designation honoring exemplary school counseling programs: Recognized ASCA Model Program (RAMP). Although a growing number of studies have examined RAMP status through survey methods and student outcomes, the need remains to understand RAMP through the lens of each school’s unique context and experience. We present a multilevel, qualitative, participatory, descriptive case study to examine a school counseling cohort preparing over a 2-year period to apply for RAMP, utilizing a district–university partnership. Given the expansive data gleaned from the present study, the results are reported in two articles; this is the first of a two-part study. Results highlight this RAMP cohort process, including the following themes: (a) the push and pull of deciding to participate, (b) collaborative supports, (c) facilitators’ integral and complex role, and (d) next steps.
Pneumatic exoskeletons for orthopedic rehabilitation of the upper arm—An overview
Authors: Khose Ashna S
Published: February 2022

An exoskeleton is an external cast which can be used to maneuver, protect or even provide a greater magnitude of strength to the upper limb allowing for heightened efficiency and performance. The limb may be weakened due to so many diseases or reasons such as paralysis, stroke, muscular atrophy, and different kinds of injuries. Numerous designs and manufactured prototypes of pneumatic exoskeletons have been reviewed—their pros and cons weighed against each other. This paper covers the fundamental concepts of various prototypes that have been designed and developed over the years. The best mechanism has been highlighted, although the design of a fully efficient exoskeleton comes with its set of drawbacks. Types of energy used for the driver unit, types of actuators, materials used, design concepts, and overall weight and manufacturing cost of every prototype has been contrasted with the others to conclude what an ideal exoskeleton for rehabilitation purposes must look like and the principles and features of the prototype must be decided upon by keeping aesthetics and ergonomics in mind.
Infant Sleep as a Cornerstone for Cognitive Development
Authors: Seehagen Sabine
Published: February 2022

During infancy, humans typically spend most of their time asleep. It is intuitively plausible that this state is important for development and well-being. But there has been a surprising dearth of knowledge regarding the causal role of sleep for specific cognitive processes during this period. Recent experimental evidence has revealed a causal role of sleep for early memory processes. By supporting the consolidation and further processing of recently acquired memories, sleep shapes emerging knowledge networks. In addition, infants’ sleep patterns likely shape their learning environment by influencing caregiver sleep and behavior. Based on recent research, recommendations for policy and practice include (a) allowing individualized sleep schedules in child care settings, (b) providing easily accessible information on sleep and sleep promotion to caregivers, (c) integrating findings from sleep research in the training of early childhood educators, and (d) providing flexible parental leave arrangements that promote sufficient sleep in infants and caregivers.
How Infants Learn From a World of Faces: Implications for Racial Biases and Mask-Wearing
Authors: Bayet Laurie
Published: February 2022

Faces are special to infants from birth, and experiences with faces in infancy are critical to developing brain circuits that support face processing skills through adulthood. Infants learn to extract rich information from faces, including recognizing people, tracking their gaze and expressions, and lip-reading. As infants learn to interact with the people around them, their responses to and understanding of these communicative facial cues become more connected to their social understanding and reflect their developmental context. Infants’ face perception is particularly responsive to experience, with some degree of plasticity present through middle childhood. Opportunities to interact with people from diverse racial backgrounds in infancy may help prevent perceptual and social biases toward different groups. Variations in experience with faces beyond face race and gender, such as the use of face coverings, may impact how and what infants learn from faces.
Resilience: Within-Group Variations in the Impact of Racial Discrimination on Black Youth's Mental Health
Authors: Elisha Isabelle M. , Collins Rayven-Nikkita
Published: February 2022

Growing national concern about the increase in Black youth's suicide rates has led to calls for closer examinations of disparities in young people's mental health outcomes and their underlying causes, including differences in access to healthcare and willingness to use mental health services, and systemic inequities. The present research brief answers this call through a critical analysis of racial discrimination and other adverse mechanisms that perpetuate negative mental health outcomes for Black youth. Our approach draws from principles of developmental psychology and intersectional theory. We begin by arguing for a biopsychosocial consideration of the effects of discrimination on Black youth's development. Then, we review the multilevel impact of racism on mental health outcomes. Although examining global patterns for Black youth as a group has value, our paper will instead focus on within-group differences and the intersecting social factors that shape them. Finally, we end with research-based proposals for policies that prioritize Black youth's well-being.
From the Womb into the World: Protecting the Fetal Brain from Maternal Stress During Pregnancy
Authors: van den Heuvel Marion I.
Published: February 2022

No other period in a child's life matches the speed of brain development than the first nine months in the womb. Rapid growth goes hand in hand with enormous potential, but also with great vulnerability. This policy-focused review focuses on maternal mental health as a key factor for fetal brain development. Already during pregnancy, the fetal brain wires differently when exposed to maternal stress, and children prenatally exposed to stress have a higher risk of developing neurodevelopmental disorders. Maternal prenatal stress is preventable, treatable, and tractable by policy. Research-based, policy recommends: (1) screening for maternal mental health issues throughout pregnancy, (2) encourage talking about prenatal mental health, (3) evidence-based interventions for pregnant women with mental health issues, (4) avoiding stress-inducing communication towards pregnant women, and (5) stimulating positive postnatal parenting. Investing in healthy pregnancies will improve fetal brain growth, and, ultimately lead to a healthier next generation.
Emerging Adults’ Awareness and Perceptions of Mental Health Problems and Services in Nigeria
Authors: Ajike Patience Taiwo , Ariyo Esther Abimbola , Ariyo Adijat Motunrayo , Adubi Kikelomo
Published: February 2022

Despite the high prevalence of psychiatric disorders among Nigerian youths, mental health care access and usage in this population is extremely low. This review examines emerging adults’ awareness and perceptions of mental health problems and services in Nigeria. Specifically, we (1) provide background information about mental health perception, services, and challenges in Nigeria; (2) describe the current state of mental health among the emerging adult population in Nigeria; (3) discuss risk factors among emerging adults in Nigeria; (4) document emerging adults’ perception of mental health problems and services in Nigeria, and potential explanations for this mental health trend. We conclude with a discussion of practices and policies. In a nation like Nigeria, where mental health services are scarce and health gaps and disparities abound, the value of mental health awareness and realistic health policies cannot be overstated.
Supporting Healthy Brain and Behavioral Development During Infancy
Authors: Scott Lisa S. , Brito Natalie H.
Published: February 2022

Much of infant development occurs in the home and in the context of caregiving support. Babies learn through their everyday interactions with parents—from watching, listening, communicating, cuddling, and playing with them. Foundations for cognitive skills such as attention, perception, learning, and language are all built in the brain during the first year of life. Socioemotional development, including the ability to self-regulate behaviors and emotions, also begins during infancy. Recent advances have allowed researchers to answer questions about the developing brain and how it is impacted by experience and environmental systems, including parental sensitivity and consistency, the home environment, socio-cultural factors, community support systems, and public policies. Giving parents the opportunity to support healthy infant development through paid parental leave programs that are accessible, flexible, and equitable, will positively impact early trajectories of brain and behavioral development.
Milestones or Millstones: How Standard Assessments Mask Cultural Variation and Misinform Policies Aimed at Early Childhood Development
Authors: Karasik Lana B. , Robinson Scott R.
Published: February 2022

Traditionally, the study of motor development—rooted in Western populations and culture—has focused on establishing norms in the timing and sequence of motor skills, inspiring the widely used emphasis on motor milestones in standard assessments (e.g., crawling by 8 months). Motor milestones are only a perceived version of what is an important skill; they are cultural conventions, not universals. Some cultures allow infants floor time; others carry them constantly, limiting practice. Thus, milestones create millstones to considerations of culture and context. Cultural beliefs, practices, and expectations manifest in childrearing practices. The variability in childrearing—or differences in infants’ experiences—offer unique opportunities for posture, balance, and locomotion, which in turn generates variation in motor skills both within and between cultures. Cross-cultural comparisons best illustrate the enormous variability in infants’ everyday experiences and effects on motor skills. We offer suggestions from this cross-cultural perspective to inform policy when designing interventions to help infants and young children thrive.
A Case for Early Language and Behavior Screening: Implications for Policy and Child Development
Authors: Kaiser Ann P. , Chow Jason C. , Cunningham Jennifer E.
Published: February 2022

Early language skills and prosocial behavior contribute to positive outcomes across the lifespan. Screening has improved the identification and early intervention (EI) for children with hearing loss, autism spectrum disorders, and genetically based disabilities. However, many children with significant functional impairments in language and behavior are not identified before school entry. These children have missed a critical window for EI that might have prevented or mitigated persistent developmental language impairment and challenging behaviors. The critical need for early identification of children with delays in both language and social-emotional development by proposing a preventive, universal screening approach. This approach to early screening aims to reduce the number of children on a trajectory of academic failure and social difficulties as a result of these early developmental delays.
Design and Implementation of a Global Health and Underserved Care Track in an Otolaryngology Residency
Authors: Urban Matthew J. , Jagasia Ashok A. , Batra Pete S. , LoSavio Phillip
Published: February 2022

Despite widespread resident interest in global health and underserved care, few otolaryngology residency programs offer a formal global health experience. This article is the first to characterize a formal otolaryngology global health and underserved care track with a focus on how this curriculum integrates with and supplements resident education. Components of the track include longitudinal limited‐resource field experiences in domestic and abroad settings, a related quality improvement project, and completion of a formalized global health educational curriculum. In addition to delivering humanitarian aid, residents in this track obtain a unique educational experience in all 6 core competencies of the Accreditation Council for Graduate Medical Education. Early barriers to implementation included identifying mentorship, securing funding, and managing busy resident schedules. In this work, we detail track components, schedule by track year, keys to implementation, and potential educational pitfalls.
Perspectives of an international sample of adults with Trichotillomania on the acceptability and feasibility of an asynchronous qualitative email interview method
Authors: Roodt Chane Anne , Keeley Philip , Turner Mary , Edmondson Amanda , Kendal Sarah
Published: February 2022

Purpose

Trichotillomania (TTM) is characterised by the recurrent pulling out of one’s own hair, resulting in hair loss. It is a poorly understood disorder with no consensus on aetiology or epidemiology. Nested within a larger qualitative study exploring a wide range of TTM topics, the aim of this paper is to report and consider participant views on the acceptability and feasibility of the asynchronous email interview method.

Method

Cross-cultural qualitative research on TTM is sparse; therefore, an international qualitative study with a geographically diverse sample was conducted using an asynchronous email interview method.

Results

Participant perspectives highlighted three themes related to the study method: the value in creating personal connections, cathartic reflections, and perceived strengths and weaknesses. This paper highlights the potential of the asynchronous email interview method for sustaining remote research across multiple locations, using a sample of 20 adults with TTM (18–55 years) from 15 different countries.

Conclusions

This was an acceptable and feasible method for data collection, facilitating remote access while yielding rich data from an often hidden and hard-to-reach population.
Residual Vibration Reduction of High-Speed Pick-and-Place Parallel Robot Using Input Shaping
Authors: Shan Xianlei , Li Yuhang , Liu Haitao , Huang Tian
Published: February 2022

Because of their elastic links and joints, high-speed parallel robots for pick-and-place operations inevitably suffer from residual vibrations that significantly degrade their positioning accuracy. An effective approach based on the input shaping technique is presented in this paper for suppressing the residual vibration in these parallel robots. After addressing the design principle of an input shaper for a parallel robot with flexible actuated joints, a robust optimal input shaper is developed by considering the configuration-dependent flexible modes and minimizing the maximum percentage of residual vibration at the end-effector. The input shaper allows a good overall performance to be achieved throughout the entire workspace. Experimental results on a 4-DOF SCARA-type parallel robot show that the residual vibration of the end-effector is dramatically reduced and the dynamic positioning accuracy of the robot significantly improved.
Genome-wide identification of Tomato Golden 2-Like transcription factors and abiotic stress related members screening
Authors: Wang Zi-yu , Zhao Shuang , Liu Jun-fang , Zhao Hai-yan , Sun Xu-ying , Wu Tai-ru , Pei Tong , Wang Yue , Liu Qi-feng , Yang Huan-huan , Zhang He , Jiang Jing-bin , Li Jing-fu , Zhao Ting-ting , Xu Xiang-yang
Published: February 2022

Background

Golden 2-Like (G2-like) transcription factors play an important role in plant development. However, the roles of theseG2-likeregulatory genes in response to abiotic stresses in tomato are not well understood.

Results

In this study, we identified 66 putativeG2-likegenes in tomato (Solanum lycopersicum)and classified them into 5 groups (I to V) according to gene structure, motif composition and phylogenetic analysis. TheG2-likegenes were unevenly distributed across all 12 chromosomes. There were nine pairs of duplicated gene segments and four tandem duplicatedSlGlkgenes. Analysis of the cis-regulatory elements (CREs) showed that the promoter regions ofSlGlks contain many kinds of stress- and hormone-related CREs. Based on RNA-seq,SlGlks were expressed in response to three abiotic stresses. Thirty-six differentially expressedSlGlks were identified; these genes have multiple functions according to Gene Ontology (GO) analysis and are enriched mainly in the zeatin biosynthesis pathway. Further studies exhibited that silencingSlGlk16in tomato would reduce drought stress tolerance by earlier wilted, lower superoxide dismutase (SOD), peroxidase (POD) activities, less Pro contents and more MDA contents.

Conclusions

Overall, the results of this study provide comprehensive information on G2-like transcription factors andG2-likegenes that may be expressed in response to abiotic stresses.
Increase in surgical fixation of pediatric midshaft clavicle fractures since 2008
Authors: Sassi Elina , Hannonen Juuli , Serlo Willy , Sinikumpu Juha-Jaakko
Published: February 2022

Background

Clavicle fractures in children have traditionally been treated non-operatively. In adults, a great increase in operative treatment has been reported. We aimed to analyze the respective trend and potential explanatory factors in children.

Methods

This is a single-institution retrospective study in a subregion in Northern Finland. The ICD-code S42.0 was used to identify the cases in the hospital registry. Altogether, 214 children, aged < 16, with consecutive clavicle fractures were first enrolled in the area during 2008–2019. Hospital journals and radiographs were reviewed. After lateral and medial fractures and patients living outside the area were excluded, final study population was 172. The respective population at risk was extracted by Statistics Finland. Predictive factors and annual rates of operative treatment as adjusted for 100,000 children at risk were determined.

Results

The rate of the surgical treatment of clavicle fractures increased from zero in 2008 to 10.8 in 2019 per 100,000 age-adjusted children (β = 0.864, 95% confidential intervals (CI) 0.4 to 1.4). There was a rise in the rate of surgery from 2.6% (2014–16) to 16.1% (2017–19) (diff. 13.5, 95% CI 1.7 to 23.3%). A displacement > 15 mm and a shortening of > 15 mm were associated with the increased risk of surgery but did not change during the study period. Age > 9 years increased the risk of surgery; the mean age increased from 5.5 years (2008–10) to 8.5 years (2017–19). There was a 3.6-fold increase in sports-related fractures (95% CI 7.4 to 26.4). The severity of the fractures did not change.

Conclusions

There has been an increasing trend in the surgical fixation of pediatric middle shaft clavicle fractures since 2008. The available literature does not support the trend.
Short-term outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma in older patients: a propensity score matching analysis
Authors: Monden Kazuteru , Sadamori Hiroshi , Hioki Masayoshi , Ohno Satoshi , Takakura Norihisa
Published: February 2022

Background

The incidence of hepatocellular carcinoma (HCC) requiring surgical treatment in older patients has been continuously increasing. This study aimed to examine the safety and feasibility of performing laparoscopic liver resection (LLR) versus open liver resection (OLR) for HCC in older patients at a Japanese institution.

Methods

Between January 2010 and June 2021, 133 and 145 older patients (aged ≥ 70 years) who were diagnosed with HCC underwent LLR and OLR, respectively. Propensity score matching (PSM) analysis with covariates of baseline characteristics was performed. The intraoperative and postoperative data were evaluated in both groups.

Results

After PSM, 75 patients each for LLR and OLR were selected and the data compared. No significant differences in demographic characteristics, clinical data, and operative times were observed between the groups, although less than 10% of cases in each group underwent a major resection. Blood loss (OLR: 370 mL, LLR: 50 mL; P < 0.001) was lower, and the length of postoperative hospital stay (OLR: 12 days, LLR: 7 days; P < 0.001) and time to start of oral intake (OLR: 2 days, LLR: 1 day; P < 0.001) were shorter in the LLR group than in the OLR group. The incidence of complications ≥ Clavien–Dindo class IIIa was similar between the two groups.

Conclusions

LLR, especially minor resections, is safely performed and feasible for selected older patients with HCC.
Low calf circumference can predict nutritional risk and mortality in adults with metabolic syndrome aged over 80 years
Authors: Ren Chenxi , Zhang Xiaoyan , Zhu Yunxia , Xu Jun , Xie Ying
Published: February 2022

Background

Metabolic disorders and malnutrition are a double burden worldwide. The aim was to determine whether low calf circumference (CC) could predict nutritional risk and the cut-off values of CC for predicting nutritional risk in metabolic syndrome (MetS) patients aged over 80 years. We aimed to evaluate the risk factors for predicting mortality in MetS.

Methods

A total of 514 patients aged over 80 years with MetS were enrolled and followed for 2.5 years. On admission, demographic data, CC, and laboratory parameters were obtained. Patients with a Nutritional Risk Screening 2002 (NRS 2002) total score ≥ 3 were considered to have nutritional risk.

Results

The CC level was significantly lower in the nutritional risk group than in the non-nutritional risk with MetS group (27.1 ± 4.0 cm vs. 30.8 ± 3.9 cm). Logistic regression analysis of nutritional risk revealed that increasing CC (adjusted OR, 0.81; 95% CI, 0.74–0.88) was an independent protective factor against nutrition risk. The best CC cut-off value for predicting nutritional risk according to the NRS 2002 was 28.8 cm. Cox regression multivariate models showed nutritional risk (HR, 2.48; 95% CI, 1.22–5.04) and decreased CC (HR, 2.78; 95% CI, 1.27–5.98) remained independent risk factors for mortality.

Conclusion

Decreased CC could predict not only nutritional risk but also mortality in MetS patients aged over 80 years. The elderly who had MetS with nutritional risk should be discovered early, early intervention and early treatment. CC may be a valuable index to screen out this population.
In-vitro characterization and evaluation of mesoporous titanium dioxide composite hydroxyapatite and its effectiveness in occluding dentine tubules
Authors: Yin Lu , Xu Xuehong , Chu Chienyu , Lin Pingting , Huang Honglan , Luo Bizhu , Yang Changwei
Published: February 2022

Background

To synthesize mesoporous titanium dioxide composite hydroxyapatite (TiO2–HAP) and to evaluate its effectiveness in sealing of occluding dentine tubules.

Methods

TiO2–HAP was synthesized by chemical precipitation method and characterized using infrared absorption spectrometer, X-ray diffraction, scanning electron microscope, and specific surface area detector. Forty completely extracted molars were prepared and randomly assigned into Control group, Gluma group, HAP group and TiO2–HAP group according to different treatments. The characteristics of HAP and TiO2–HAP and the sealing effectiveness of dentine tubules in these four groups, including infrared spectrum, surface contact angle, pore size distribution, and re-mineralized enamel surface profiles, were analyzed by suitable characterized techniques. The cytotoxicity of the synthesized TiO2–HAP was tested and compared using 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide (MTT) colorimetry.

Results

Our results showed TiO2–HAP group had significantly lower contact angle, higher specific surface area, and wider range of pore size distribution than other groups. The majority of dentinal tubules in the TiO2–HAP group were blocked by white matter in a uniformed manner, and the crystals arranged in order grew along the axial direction. In addition, no significant difference in optical density (OD) value was found between control group and TiO2–HAP group (P > 0.05), and cell growth was good in TiO2–HAP group, indicating no cytotoxicity of TiO2–HAP.

Conclusions

The MTT assay identified that TiO2–HAP had little effect on the L929 cell line. We showed TiO2–HAP might be used as a remineralization agent in enamel caries-like lesions.
Methodological quality of systematic reviews on Chinese herbal medicine: a methodological survey
Authors: Cheung Andy K. L. , Wong Charlene H. L. , Ho Leonard , Wu Irene X. Y. , Ke Fiona Y. T. , Chung Vincent C. H.
Published: February 2022

Background

Systematic reviews (SRs) synthesise the best evidence of effectiveness and safety on Chinese herbal medicine (CHM). Decision-making should be supported by the high-quality evidence of prudently conducted SRs, but the trustworthiness of conclusions may be limited by poor methodological rigour.

Methods

This survey aimed to examine the methodological quality of a representative sample of SRs on CHM published during January 2018 to March 2020. We conducted literature search in Cochrane Database of Systematic Reviews, MEDLINE via Ovid, and EMBASE via Ovid. Eligible SRs must be in Chinese or English with at least one meta-analysis on the treatment effect of any CHM documented in the 2015 Chinese Pharmacopoeia. Two reviewers extracted the bibliographical characteristics of SRs and appraised their methodological quality using AMSTAR 2 (Assessing the Methodological Quality of Systematic Reviews 2). The associations between bibliographical characteristics and methodological quality were investigated using Kruskal-Wallis tests and Spearman’s rank correlation coefficients.

Results

We sampled and appraised one hundred forty-eight SRs. Overall, one (0.7%) was of high methodological quality; zero (0%), four (2.7%), and one-hundred forty-three (96.6%) SRs were of moderate, low, and critically-low quality. Only thirteen SRs (8.8%) provided a pre-defined protocol; none (0%) provided justifications for including particular primary study designs; six (4.1%) conducted a comprehensive literature search; two (1.4%) provided a list of excluded studies; nine (6.1%) undertook meta-analysis with appropriate methods; and seven (4.7%) reported funding sources of included primary studies. Cochrane reviews had higher overall quality than non-Cochrane reviews (P < 0.001). SRs with European funding support were less likely to have critically-low quality when compared with their counterparts (P = 0.020). SRs conducted by more authors (rs = 0.23; P = 0.006) and published in higher impact factor journals (rs = 0.20; P = 0.044) were associated with higher methodological quality.

Conclusions

Our results indicated that the methodological quality of SRs on CHM is low. Future authors should enhance the methodological quality through registering a priori protocols, justifying selection of study designs, conducting comprehensive literature search, providing a list of excluded studies with rationales, using appropriate method for meta-analyses, and reporting funding sources among primary studies.
The University of Padua salivary-based SARS-CoV-2 surveillance program minimized viral transmission during the second and third pandemic wave
Authors: Basso Daniela , Aita Ada , Navaglia Filippo , Mason Paola , Moz Stefania , Pinato Alessio , Melloni Barbara , Iannelli Luca , Padoan Andrea , Cosma Chiara , Moretto Angelo , Scuttari Alberto , Mapelli Daniela , Rizzuto Rosario , Plebani Mario
Published: February 2022

Background

The active surveillance of students is proposed as an effective strategy to contain SARS-CoV-2 spread and prevent schools’ closure. Saliva for molecular testing is as sensitive as naso-pharyngeal swab (NPS), self-collected and well accepted by participants. This prospective study aimed to verify whether the active surveillance of the Padua University employees by molecular testing of self-collected saliva is an effective and affordable strategy for limiting SARS-CoV-2 spread.

Methods

A surveillance program based on self-collection of saliva every 2 weeks (October 2020–June 2021) was conducted. Among 8183 employees of the Padua University, a total of 6284 subjects voluntarily took part in the program. Eight collection points guaranteed the daily distribution and collection of barcoded salivary collection devices, which were delivered to the laboratory by a transport service for molecular testing. Quarantine of positive cases and contact tracing were promptly activated.

Results

Among 6284 subjects, 206 individuals were SARS-CoV-2 positive (99 by salivary testing; 107 by NPS performed for contact tracing or symptoms). The cumulative SARS-CoV-2 incidence in this cohort was 3.1%, significantly lower than that of employees not in surveillance (8.0%), in Padua (7.1%) and in the Veneto region (7.2%). Employees with positive saliva results were asymptomatic or had mild symptoms. The levels of serum antibodies after 3 months from the infection were correlated with age and Ct values, being higher in older subjects with greater viral loads.

Conclusions

Salivary-based surveillance with contact tracing effectively allowed to limit SARS-CoV-2 contagion, also in a population with a high incidence.
Use of nCounter mRNA profiling to identify at-arrival gene expression patterns for predicting bovine respiratory disease in beef cattle
Authors: Scott Matthew A. , Woolums Amelia R. , Swiderski Cyprianna E. , Thompson Alexis C. , Perkins Andy D. , Nanduri Bindu , Karisch Brandi B. , Goehl Dan R.
Published: February 2022

Background

Transcriptomics has identified at-arrival differentially expressed genes associated with bovine respiratory disease (BRD) development; however, their use as prediction molecules necessitates further evaluation. Therefore, we aimed to selectively analyze and corroborate at-arrival mRNA expression from multiple independent populations of beef cattle. In a nested case-control study, we evaluated the expression of 56 mRNA molecules from at-arrival blood samples of 234 cattle across seven populations via NanoString nCounter gene expression profiling. Analysis of mRNA was performed with nSolver Advanced Analysis software (p < 0.05), comparing cattle groups based on the diagnosis of clinical BRD within 28 days of facility arrival (n = 115 Healthy; n = 119 BRD); BRD was further stratified for severity based on frequency of treatment and/or mortality (Treated_1, n = 89; Treated_2+, n = 30). Gene expression homogeneity of variance, receiver operator characteristic (ROC) curve, and decision tree analyses were performed between severity cohorts.

Results

Increased expression of mRNAs involved in specialized pro-resolving mediator synthesis (ALOX15, HPGD), leukocyte differentiation (LOC100297044, GCSAML, KLF17), and antimicrobial peptide production (CATHL3, GZMB, LTF) were identified in Healthy cattle. BRD cattle possessed increased expression of CFB, and mRNA related to granulocytic processes (DSG1, LRG1, MCF2L) and type-I interferon activity (HERC6, IFI6, ISG15, MX1). Healthy and Treated_1 cattle were similar in terms of gene expression, while Treated_2+ cattle were the most distinct. ROC cutoffs were used to generate an at-arrival treatment decision tree, which classified 90% of Treated_2+ individuals.

Conclusions

Increased expression of complement factor B, pro-inflammatory, and type I interferon-associated mRNA hallmark the at-arrival expression patterns of cattle that develop severe clinical BRD. Here, we corroborate at-arrival mRNA markers identified in previous transcriptome studies and generate a prediction model to be evaluated in future studies. Further research is necessary to evaluate these expression patterns in a prospective manner.
Multiple intestinal hemangioma concurrent with low-grade appendiceal mucinous neoplasm presenting as intussusception—a case report and literature review
Authors: Yang Yanhua , Jia Dongmei , Jiang Chen
Published: February 2022

Background

Cases with intussusception caused by either intestinal hemangiomas or appendiceal mucinous neoplasms are extremely rare.

Case presentation

In this study, we reported a 47-year-old male presented with paroxysmal abdominal pain and postprandial bloating for 3 days. CT results indicated a high possibility of secondary intussusception in ascending colon. Histopathology indicated a mixed type of cavernous and capillary hemangioma, combined with low-grade appendiceal mucinous neoplasms (LAMNs) and intestinal obstruction. The patient underwent laparotomy and right hemicolectomy. Finally, the patient was followed up for 4 months with no disease progression.

Conclusions

Rare studies reported the intestine hemangiomas coincided with appendix low-grade mucinous tumor. Its manifestations are not specific, which is a challenge in the preoperative diagnosis. For cases with intussusception that was not observed in time, it may lead to intestinal necrosis and diffuse peritonitis. Additionally, the ruptured mucinous tumor in the appendix may lead to pathogenesis of pseudomyxoma peritonei. Therefore, accurate diagnosis and appropriate surgery-based treatment contribute to the improvement of prognosis and severe outcomes among these patients.
Pediatric antiphospholipid syndrome: clinical features and therapeutic interventions in a single center retrospective case series
Authors: Madison Jacqueline A. , Gockman Kelsey , Hoy Claire , Tambralli Ajay , Zuo Yu , Knight Jason S.
Published: February 2022

Background/purpose

Pediatric antiphospholipid syndrome (APS) is a thromboinflammatory disease characterized by the presence of circulating antiphospholipid antibodies and either thrombotic events or pregnancy morbidity. The objective of this study was to review a large institution’s experience to better understand the characteristics of children with APS.

Methods

We conducted a retrospective review of pediatric APS at a tertiary referral center. The electronic medical record system was queried from 2000 through 2019, and 21 cases were included based on meeting the revised Sapporo Classification criteria by age 18 or younger. Comparisons between primary and secondary APS patients were made with two-tailed t-tests.

Results

Twenty-one patients were included with a median age at diagnosis of 16 years and median follow-up of 5.8 years. Secondary APS was slightly more common than primary APS (11 vs. 10 cases) and was primarily diagnosed in the context of systemic lupus erythematosus. Two thirds of patients (67%) also had “non-criteria” manifestations of APS including thrombocytopenia, autoimmune hemolytic anemia, and livedo reticularis/racemosa. Almost half of patients (43%) had recurrent thrombosis, typically when patients were subtherapeutic or non-adherent with anticoagulation. Damage Index in Patients with Thrombotic APS (DIAPS) scores indicated a chronic burden of disease in both primary and secondary APS patients.

Conclusion

This case series of pediatric APS provides important context regarding disease phenotypes displayed by children with APS. High prevalence of non-criteria clinical manifestations highlights the need to consider these characteristics when developing pediatric-specific classification criteria and when considering this relatively rare diagnosis in pediatric practice.