bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Laterality Matter? The Effect of Unilateral v. Bilateral Sacroiliac Screw Fixation on Personal Hygiene
Authors: Deckey David G. , Gulbrandsen Matthew T. , Hinckley Nathaniel B. , Lara Nina , Mayfield Cory K. , Makovicka Justin L. , Adeniyi Biodun , Chang Michael S.
Published: May 2021

Study Design:

Retrospective comparative analysis of prospective cohort.

Objective:

To determine whether sacroiliac (SI) screw fixation ipsilateral to hand dominance compared to bilateral fixation impacts personal hygiene (wiping) after toileting.

Methods:

Inclusion criteria were adult spinal deformity (ASD) patients with long arthrodesis (≥T12-pelvis) who had undergone primary unilateral or bilateral SI fixation with a minimum of 2-years-follow-up.

Results:

117 consecutive patients were included and separated into 2 groups: bilateral SI fixation (BL, n = 61) and unilateral SI fixation (UNI, n = 56), with no difference in age. Of UNI patients, 10.7% (6) performed personal hygiene with a different hand after surgery, compared to 6.6% (4) of patients who received BL fixation ( P = 0.422). All UNI patients who switched hands were right-hand dominant, and 5/6 received right-sided fixation. There was no statistical difference found between number of levels fused (<8, 9-11, or >11 levels) and changes in personal hygiene habits. Over a third of patients from both groups had difficulty performing personal hygiene after fusion (UNI = 39.3% BL = 36.1%, P = 0.719).

Conclusion:

SI screws increase the difficulty of performing personal hygiene; yet, the side of unilateral screws does not significantly change personal hygiene habits when compared to bilateral screw placement. Moreover, the length of the construct does not have a significant impact on ability to perform personal hygiene, cause changes in habits, or require the assistance of another individual. However, among our sample of individuals, bilateral fixation did result in a higher rate of revision instrumentation.
Fatal Acute Hemorrhagic Leukoencephalitis Following Immunization Against Human Papillomavirus in a 14-Year-Old Boy
Authors: Wellnitz Kari , Sato Yutaka , Bonthius Daniel J.
Published: May 2021

Human papilloma virus (HPV) is a prevalent pathogen whose persistent infection can lead to a variety of cancers. To protect against this threat, an HPV vaccine has been developed and is routinely administered to adolescents. The HPV vaccine has a reassuring safety profile, but reports have emerged of acute disseminated encephalomyelitis following its administration. Acute hemorrhagic leukoencephalitis (AHLE) is a severe inflammatory disease of the central nervous system and the most fulminant form of ADEM. We report a previously healthy 14-year-old boy who developed headache, fatigue, focal weakness, and confusion 3 weeks after receiving the HPV vaccine. Neuroimaging demonstrated multifocal demyelination. Despite treatment with high-dose steroids, his encephalopathy worsened. He developed severe cerebral edema and died of cerebral herniation. Postmortem histology revealed perivenular sleeves of tissue damage, myelin loss surrounding small parenchymal vessels, and diffuse hemorrhagic necrosis, consistent with AHLE. This is the first report of AHLE following HPV vaccination.
Cognitive and linguistic effects of narrative-based language intervention in children with Developmental Language Disorder
Authors: Pauls Laura J , Archibald Lisa MD
Published: May 2021

Background and aims

Narrative-based language intervention provides a naturalistic context for targeting overall story structure and specific syntactic goals in children with Developmental Language Disorder (DLD). Given the cognitive demands of narratives, narrative-based language intervention also has the potential to positively impact related abilities such as working memory and academic skills.

Methods

Ten children (8–11 years old) with DLD completed 15 sessions of narrative-based language intervention.

Results

Results of single subject data revealed gains in language for five participants, four of whom improved on a probe tapping working memory. An additional four participants improved on a working memory probe only. On standardized measures, clinically significant gains were noted for one additional participant on a language measure and one additional participant on a visuospatial working memory. Carry over to reading was noted for three participants and to math for one participant. Across measures, gains in both verbal and visuospatial working memory were common. A responder analysis revealed that improvement in language may be associated with higher verbal short-term memory and receptive language at baseline. Those with working memory impairments were among those showing the fewest improvements across measures.

Conclusions

Narrative-based language intervention impacted verbal skills in different ways across individual children with DLD. Implications: Further research is needed to gain an understanding of who benefits most from narrative-based language intervention.
The Paleolithic imagination:Nature, science, and race in Anthropocene fitness cultures
Authors: Weedon Gavin , Patchin Paige Marie
Published: May 2021

The widespread uptake of the Anthropocene concept over the past two decades has seen a concomitant rise in cultural forms that trade on nostalgia for Paleolithic life. Mud running, CrossFit, and the Paleo diet exemplify this trend, with the Paleolithic hunter-gatherer at the center of their popular prescriptions for healthy living. In this article, we identify these practices as embodying the anxieties of the Anthropocene as well as its historical and racial elisions. By focusing on the oblique and subtle racializations of Anthropocene health and fitness cultures, we contribute to understandings of the cultural significance of the human body in the Anthropocene and the relationship between the biopolitics of health and geological life, arguing that the body is a key site through which the tensions and inequalities of the Anthropocene are played out. And by unraveling how the Paleolithic imagination is rooted in a distinctly capitalist, Euro-American attitude to the body in nature, we show the Anthropocene to be defined by uneven distributions of health as self-optimization, and health as environmental risk. The Paleolithic imagination demonstrates the tangled politics of race, science, and nature in the twenty-first century, in which global ecological instability, the biopolitics of health, the shadows of colonialism, and consumer capitalism converge.
Development and Evaluation of a Prediabetes Decision Aid in Primary Care: Examining Patient-Reported Outcomes by Language Preference and Educational Attainment
Authors: Bandi Keerthi , Vargas Maria C. , Lopez Azucena , Cameron Kenzie A. , Ackermann Ronald T. , Mohr Loretta , Williams Geoffrey C. , Fagerlin Angela , Kirley Kate , Hodge Heather , Kandula Namratha R. , O’Brien Matthew J.
Published: May 2021

Purpose

The purpose of this study was to examine the development and preliminary effectiveness of a novel Prediabetes Decision Aid on adoption of intensive lifestyle interventions (ILIs) and metformin. Little research has focused on increasing uptake of these evidence-based treatments, especially among non-English speakers and those with low educational attainment.

Methods

Investigators developed an English and Spanish decision aid displaying information about type 2 diabetes (T2DM) risk and treatments to prevent T2DM and prompting patients to identify next steps for management. This pilot study was a single-arm, pretest-posttest trial of 40 adult patients with prediabetes, obesity, and ≥1 office visit within the prior 12 months. Participants reviewed this tool briefly with a study team member, and data were collected on 3 coprimary outcomes: knowledge about T2DM risk, decisional conflict, and intention to adopt treatment. Exploratory outcomes included subsequent documentation of prediabetes in chart notes and adoption of ILIs or metformin.

Results

Almost all participants were women, with nearly half expressing Spanish language preference and low educational attainment. A nonsignificant increase in knowledge was observed across all subgroups. Decisional conflict was significantly reduced from pretest to posttest and was similar between subgroups defined by language preference and educational attainment. While intention to adopt ILIs increased across all subgroups, this change was only significant among Spanish speakers and participants with low educational attainment. At 6 months, 17 participants had subsequent provider documentation of prediabetes, and 12 adopted ILIs or metformin.

Conclusions

The decision aid improved patient-reported outcomes and promoted treatment adoption in a diverse patient sample.
IMA–CNMNC approved mineral symbols
Authors: Warr Laurence N.
Published: May 2021

Several text symbol lists for common rock-forming minerals have been published over the last 40 years, but no internationally agreed standard has yet been established. This contribution presents the first International Mineralogical Association (IMA) Commission on New Minerals, Nomenclature and Classification (CNMNC) approved collection of 5744 mineral name abbreviations by combining four methods of nomenclature based on the Kretz symbol approach. The collection incorporates 991 previously defined abbreviations for mineral groups and species and presents a further 4753 new symbols that cover all currently listed IMA minerals. Adopting IMA–CNMNC approved symbols is considered a necessary step in standardising abbreviations by employing a system compatible with that used for symbolising the chemical elements.
Applied anatomy knowledge in gynaecology and obstetrics: the trainees’ perception
Authors: Asali Fida , Mahfouz Ismaiel Abu , Saleem Heba Abu , Mahfouz Salem Abu , Mohammad Maha T. , Al-Kuran Oqba
Published: May 2021

Background

Medical education has recognised the importance of anatomy teaching. Limitations in applied anatomy knowledge exist among obstetrics and gynaecology (O&G) trainees.

This study aims to evaluate the knowledge of O&G trainees in applied anatomy and study-associated factors.

Materials and methods

The questionnaire-based study involved O&G trainees between 1/8/2019 and 1/12/2019. Data collected included age, gender, evaluation of medical school anatomy course, attendance at applied anatomy workshops, operating theatre workload, and senior colleagues’ demonstration of anatomy during operating sessions.

Results

There were 271 trainees recruited with a mean age of 29.3 years, and 80.1% rated the value of medical school anatomy courses as average or above average. Furthermore, 90.8% never attended applied anatomy workshops. In addition, 9.6% and 62% of first- and fifth-year trainees rated their knowledge as either good or very good, and 41.7% reported that anatomy demonstrations by senior doctors happened sometimes. The overall score of applied anatomy knowledge was significantly higher in higher training years, with attendance at applied anatomy lectures, with more operating workloads, and when senior doctors demonstrate anatomy more often during operating sessions.

Conclusions

Deficiencies in knowledge existed. Factors which may improve knowledge include more applied undergraduate anatomy courses, more frequent operating sessions, attending anatomy workshops, and more senior colleagues’ demonstration of anatomy during surgeries.
Successful treatment of aortic valve endocarditis caused by Enterococcus casseliflavus: a case report
Authors: Okumura Nobumasa , Watanabe Takashi , Teranishi Satoshi , Suzuki Daisuke , Hashimoto Takahiko , Takahashi Kosuke , Hara Toru
Published: May 2021

Background

Enterococcus casseliflavus is rarely isolated from human specimens. To the best of our knowledge, there are no reports on its detailed treatment course and prognosis. Here, we present the first known case of E. casseliflavus endocarditis with a detailed treatment course.

Case presentation

An 86-year-old Japanese woman was transferred to the emergency department with dyspnoea, wheezing, and lumbago. Her medical history included hypertension, chronic kidney disease, idiopathic interstitial pneumonia, and rectal carcinoma. Physical examination revealed expiratory wheezes and a diastolic murmur (Levine 2/6) at the 4th right sternal border. Chest radiography revealed bilateral interstitial opacities and slight cardiac dilatation. Transthoracic echocardiography demonstrated the presence of mobile vegetation with perforation, prolapse, and regurgitation of the aortic valve. With a suspicion of infective endocarditis, we started administering intravenous ampicillin/sulbactam. Thereafter, blood cultures identified E. casseliflavus through matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry. The antimicrobial treatment was then switched to ampicillin plus gentamicin. The patient underwent aortic valve replacement on the thirteenth hospital day. She was administered intravenous ampicillin and gentamicin for 6 weeks. The patient was discharged 8 weeks after admission.

Conclusions

Our case demonstrated that E. casseliflavus could cause infective endocarditis, which can be successfully treated with a 6-week regimen of ampicillin and gentamicin in combination with proper surgical treatment.
Primitive neuroectodermal tumor of the cervix diagnosed during pregnancy: a rare case report with discussion
Authors: Feng Xiang , Zhang Lina , Tan Yanling , Feng Aihua , Luo Fei , Xu Mengfan , Ye Hong , Zhu Hongyu , Zhou Peng , Li Hua
Published: May 2021

Background

Primitive neuroectodermal tumor (PNET) is a relatively rare malignant small round cell tumor, and the occurrence of cervical PNET during pregnancy is extremely rare.

Case presentation

A case of pregnancy complicated by PNET at our hospital was reported. A 19-year-old pregnant woman presented to the hospital due to multiple instances of vaginal bleeding during the first and second trimesters. She was initially considered for threatened abortion but was ultimately diagnosed with cervical PNET. No standard treatment plan has been developed for pregnant women with this tumor. After completing the necessary examinations, doctors cooperated with the patient and her family to develop a surgical treatment plan. The patient recovered well after surgery, but she refused radiotherapy and chemotherapy. After nearly 3 years of follow-up visits, the patient is alive with no signs of recurrence.

Conclusions

PNET during pregnancy is a rare but complex condition. It is necessary to devise an individualized treatment plan according to gestational age. Timely surgical treatment can significantly prolong the survival time of patients but may also lead to fetal loss and the inability to carry a pregnancy.
Genomic features of rapid versus late relapse in triple negative breast cancer
Authors: Zhang Yiqing , Asad Sarah , Weber Zachary , Tallman David , Nock William , Wyse Meghan , Bey Jerome F. , Dean Kristin L. , Adams Elizabeth J. , Stockard Sinclair , Singh Jasneet , Winer Eric P. , Lin Nancy U. , Jiang Yi-Zhou , Ma Ding , Wang Peng , Shi Leming , Huang Wei , Shao Zhi-Ming , Cherian Mathew , Lustberg Maryam B. , Ramaswamy Bhuvaneswari , Sardesai Sagar , VanDeusen Jeffrey , Williams Nicole , Wesolowski Robert , Obeng-Gyasi Samilia , Sizemore Gina M. , Sizemore Steven T. , Verschraegen Claire , Stover Daniel G.
Published: May 2021

Background

Triple-negative breast cancer (TNBC) is a heterogeneous disease and we have previously shown that rapid relapse of TNBC is associated with distinct sociodemographic features. We hypothesized that rapid versus late relapse in TNBC is also defined by distinct clinical and genomic features of primary tumors.

Methods

Using three publicly-available datasets, we identified 453 patients diagnosed with primary TNBC with adequate follow-up to be characterized as ‘rapid relapse’ (rrTNBC; distant relapse or death ≤2 years of diagnosis), ‘late relapse’ (lrTNBC; > 2 years) or ‘no relapse’ (nrTNBC: > 5 years no relapse/death). We explored basic clinical and primary tumor multi-omic data, including whole transcriptome (n = 453), and whole genome copy number and mutation data for 171 cancer-related genes (n = 317). Association of rapid relapse with clinical and genomic features were assessed using Pearson chi-squared tests, t-tests, ANOVA, and Fisher exact tests. We evaluated logistic regression models of clinical features with subtype versus two models that integrated significant genomic features.

Results

Relative to nrTNBC, both rrTNBC and lrTNBC had significantly lower immune signatures and immune signatures were highly correlated to anti-tumor CD8 T-cell, M1 macrophage, and gamma-delta T-cell CIBERSORT inferred immune subsets. Intriguingly, lrTNBCs were enriched for luminal signatures. There was no difference in tumor mutation burden or percent genome altered across groups. Logistic regression mModels that incorporate genomic features significantly outperformed standard clinical/subtype models in training (n = 63 patients), testing (n = 63) and independent validation (n = 34) cohorts, although performance of all models were overall modest.

Conclusions

We identify clinical and genomic features associated with rapid relapse TNBC for further study of this aggressive TNBC subset.
Translation, cross-cultural adaptation and psychometric validation of the Thai version of the STarT Back Screening Tool in patients with non-specific low back pain
Authors: Wiangkham Taweewat , Phungwattanakul Nattawan , Thongbai Natthathida , Situy Nisa , Polchaika Titipa , Kongmee Isara , Thongnoi Duangporn , Chaisang Rujirat , Suwanmongkhon Wanisara
Published: May 2021

Background

Low back pain (LBP) is a top musculoskeletal problem and a substantial cause of socioeconomic burden internationally. The STarT Back Screening Tool (SBST) is a useful screening tool to manage patients with LBP but it is unavailable in Thai. Therefore, the aims of this study were to translate and cross-culturally adapt the SBST into a Thai version (SBST-TH) and validate its psychometric properties (e.g., factor analysis, internal consistency, test-retest reliability, agreement, convergent validity and discriminative validity).

Methods

Translation and cross-cultural adaptation of the SBST into Thai version were conducted according to standard guidelines. A total of 200 participants with non-specific LBP were invited to complete the SBST, visual analogue scale for pain intensity, Roland-Morris disability questionnaire (RMDQ), fear-avoidance beliefs questionnaire, pain catastrophising scale, hospital anxiety and depression scale and the EuroQol five-dimensional questionnaire. Thirty participants completed the SBST-TH twice with an interval of 48 h to evaluate test-retest reliability.

Results

Factor analysis demonstrated two (physical and psychological) components for the SBST-TH (39.38% of the total variance). The Cronbach’s alpha (0.86 for total score and 0.76 for psychosocial subscore) represent satisfactory internal consistency. The acceptability of intraclass correlation coefficient was found in the total (0.73) and subscore (0.79). The areas under the curve (AUC) for the total score ranged 0.67–0.85 and 0.66–0.75 for subscore. The excellent discriminative validity was observed (AUC = 0.85, 95% confidence interval = 0.72, 0.97) between the total score of the SBST-TH and disability (RMDQ). Spearman’s correlation coefficients represented moderate to strong correlation (0.32–0.56) between the SBST-TH and all questionnaires. The findings suggest a good relationship between the SBST-TH and disability and quality of life. Owing to the results from the convergent and discriminative validity, construct validity of the SBST-TH can be supported. The minimal detectable changes of the total score and subscore were 2.04 and 1.60, respectively. Significant floor and ceiling effects were not found in the SBST-TH.

Conclusion

The SBST-TH was successfully translated and adapted. It is a valid and reliable tool to classify Thai patients with non-specific LBP into low, moderate and high risks for chronicity.

Trial registration

TCTR20191009005#.
Single-port thoracoscopic anatomic resection for chronic inflammatory lung disease
Authors: Wu Chen-Yu , Chen Ying-Yuan , Chang Chao-Chun , Yen Yi-Ting , Lai Wu-Wei , Huang Wei-Li , Tseng Yau-Lin
Published: May 2021

Background

It is challenging to proceed thoracoscopic anatomic resection when encountering severe pleural adhesion or calcified peribronchial lymphadenopathy. Compared with multiple-port video-assisted thoracoscopic surgery (MP-VATS), how to overcome these challenges in single-port (SP-) VATS is still an intractable problem. In the present study, we reported the surgical results of chronic inflammatory lung disease and shared some useful SP-VATS techniques.

Methods

We retrospectively assessed the surgical results of chronic inflammatory lung disease, primarily bronchiectasis, and mycobacterial infection, at our institution between 2010 and 2018. The patients who underwent SP-VATS anatomic resection were compared with those who underwent MP-VATS procedures. We analyzed the baseline characteristics, perioperative data, and postoperative outcomes, and illustrated four special techniques depending on the situation: flexible hook electrocautery, hilum-first technique, application of Satinsky vascular clamp, and staged closure of bronchial stump method.

Results

We classified 170 consecutive patients undergoing thoracoscopic anatomic resection into SP and MP groups, which had significant between-group differences in operation time and overall complication rate (P = 0.037 and 0.018, respectively). Compared to the MP-VATS group, the operation time of SP-VATS was shorter, and the conversion rate of SP-VATS was relatively lower (3.1% vs. 10.5%, P = 0.135). The most common complication was prolonged air leakage (SP-VATS, 10.8%; MP-VATS, 2.9%, P = 0.045).

Conclusions

For chronic inflammatory lung disease, certain surgical techniques render SP-VATS anatomic resection feasible and safe with a lower conversion rate.
The prevalence of uterine fundal pressure during the second stage of labour for women giving birth in health facilities: a systematic review and meta-analysis
Authors: Farrington Elise , Connolly Mairead , Phung Laura , Wilson Alyce N. , Comrie-Thomson Liz , Bohren Meghan A. , Homer Caroline S. E. , Vogel Joshua P.
Published: May 2021

Background

Uterine fundal pressure involves a birth attendant pushing on the woman’s uterine fundus to assist vaginal birth. It is used in some clinical settings, though guidelines recommend against it. This systematic review aimed to determine the prevalence of uterine fundal pressure during the second stage of labour for women giving birth vaginally at health facilities.

Methods

The population of interest were women who experienced labour in a health facility and in whom vaginal birth was anticipated. The primary outcome was the use of fundal pressure during second stage of labour. MEDLINE, EMBASE, CINAHL and Global Index Medicus databases were searched for eligible studies published from 1 January 2000 onwards. Meta-analysis was conducted to determine a pooled prevalence, with subgroup analyses to explore heterogeneity.

Results

Eighty data sets from 76 studies (n = 898,544 women) were included, reporting data from 22 countries. The prevalence of fundal pressure ranged from 0.6% to 69.2% between studies, with a pooled prevalence of 23.2% (95% CI 19.4–27.0, I2 = 99.97%). There were significant differences in prevalence between country income level (p < 0.001, prevalence highest in lower-middle income countries) and method of measuring use of fundal pressure (p = 0.001, prevalence highest in studies that measured fundal pressure based on women’s self-report).

Conclusions

The use of uterine fundal pressure on women during vaginal birth in health facilities is widespread. Efforts to prevent this potentially unnecessary and harmful practice are needed.
A novel tumor suppressor ASMTL-AS1 regulates the miR-1228-3p/SOX17/β-catenin axis in triple‐negative breast cancer
Authors: Sun Jie , Li Xiaohua , Yu Enqiao , Liu Jianxia , Sun Liang , He Qin , Lu Qiran
Published: May 2021

Background

Triple-negative breast cancer (TNBC) is a special type of breast cancer that lacks effective therapeutic targets. There is a significant need to clarify its pathogenesis, so as to bring new targeted approaches for TNBC management. Here, we identified a long-non coding RNA (lncRNA) ASMTL-AS1 that linked to TNBC development and progression.

Methods

Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot assays were used to test gene and protein levels, respectively. The regulatory axis of miR-1228-3p/SOX17/β-catenin was determined by luciferase reporter and RNA pull-down assays. In vivo assay was conducted by using the nude mice model via subcutaneous transplantation of tumor cells.

Results

ASMTL-AS1 was significantly downregulated in TNBC tissues compared to normal tissues, which was closely associated with aggressive clinical features and unfavorable prognosis. Lentivirus-mediated ASMTL-AS1 overexpression evidently reduced the ability of TNBC cell colony formation, activity and invasion by more than 2.5 times. RNA pull-down and luciferase reporter assays revealed that miR-1228-3p directly bound to ASMTL-AS1, ASMTL-AS1 increased SOX17 expression via sponging and repressing miR-1228-3p. Subsequently, the upregulated SOX17 trans-suppressed β-catenin expression, resulting in the inactivation of carcinogenic Wnt/β-catenin signaling, thereby restraining TNBC cell growth and dissemination. Importantly, the xenograft tumor model showed that the ASMTL-AS1 overexpression significantly retarded tumor growth, and negatively regulated Wnt/β-catenin pathway.

Conclusions

Our data characterize a novel tumor suppressor in TNBC, restoration of ASMTL-AS1 may be a candidate therapeutic intervention for TNBC patients.
Biomarkers as therapy monitoring for postmenopausal osteoporosis: a systematic review
Authors: Migliorini Filippo , Maffulli Nicola , Spiezia Filippo , Tingart Markus , Maria Peretti Giuseppe , Riccardo Giorgino
Published: May 2021

Background

Biochemical markers of bone turnover (BTMs), such as bone alkaline phosphatase (bALP), procollagen type I N propeptide (PINP), serum cross-linked C-telopeptides of type I collagen (bCTx), and urinary cross-linked N-telopeptides of type I collagen (NTx), are commonly used for therapy monitoring purposes for osteoporotic patients. The present study evaluated the potential role of BTMs as therapy monitoring.

Methods

All randomized clinical trials (RCTs) comparing two or more pharmacological treatments for postmenopausal osteoporosis were accessed. Only studies that reported the value of bALP, PINP, bCTx, and NTx at last follow-up were included. A multivariate analysis was performed to assess associations between these biomarkers and clinical outcomes and rate of adverse events in patients with postmenopausal osteoporosis. A multiple linear model regression analysis through the Pearson product-moment correlation coefficient was used.

Results

A total of 16 RCTs (14,446 patients) were included. The median age was 67 years, and the median BMI 25.4 kg/m2. The median vertebral BMD was 0.82, hip BMD 0.79, and femur BMD 0.64 g/cm2. The ANOVA test found optimal within-group variance concerning mean age, body mass index, and BMD. Greater bALP was associated with lower femoral BMD (P = 0.01). Greater NTx was associated with a greater number of non-vertebral fractures (P = 0.02). Greater NTx was associated with greater rate of therapy discontinuation (P = 0.04). No other statistically significant associations were detected.

Conclusion

Our analysis supports the adoption of BTMs in therapy monitoring of osteoporotic patients.

Level of evidence

Level I, systematic review of RCTs.
Subjective cognitive complaints in patients with stress-related exhaustion disorder: a cross sectional study
Authors: Nelson Andreas , Gavelin Hanna Malmberg , Boraxbekk Carl-Johan , Eskilsson Therese , Josefsson Maria , Slunga Järvholm Lisbeth , Neely Anna Stigsdotter
Published: May 2021

Background

Stress-related exhaustion is associated with cognitive impairment as measured by both subjective cognitive complaints (SCCs) and objective cognitive test performance. This study aimed to examine how patients diagnosed with exhaustion disorder differ from healthy control participants in regard to levels and type of SCCs, and if SCCs are associated with cognitive test performance and psychological distress.

Methods

We compared a group of patients with stress-related exhaustion disorder (n = 103, female = 88) with matched healthy controls (n = 58, female = 47) cross-sectionally, concerning the type and magnitude of self-reported SCCs. We furthermore explored the association between SCCs and cognitive test performance as well as with self-reported depression, anxiety and burnout levels, in the patient and the control group, respectively.

Results

Patients reported considerably more cognitive failures and were more likely than controls to express memory failures in situations providing few external cues and reminders in the environment. In both groups, SCCs were associated with demographic and psychological factors, and not with cognitive test performance.

Conclusion

Our findings underline the high burden of cognitive problems experienced by patients with exhaustion disorder, particularly in executively demanding tasks without external cognitive support. From a clinical perspective, SCCs and objective cognitive test performance may measure different aspects of cognitive functioning, and external cognitive aids could be of value in stress rehabilitation.

Trial registration

Participants were recruited as part of the Rehabilitation for Improved Cognition (RECO) study (ClinicalTrials.gov: NCT03073772). Date of registration: 8 March 2017
Vitamin D receptor gene polymorphisms and its interactions with environmental factors on renal cell carcinoma risk
Authors: Jianhai Tian , Jian Lv , Long Zhang , Wei Wang , Shumao Zhang , Yiming Wang , Xiaojuan Li
Published: May 2021

Aims

We designed a case-control study to investigate the effect of vitamin D receptor gene (VDR) gene single nucleotide polymorphisms (SNPs) and possible gene- environment interaction on the susceptibility of renal cell carcinoma (RCC).

Methods

Generalized multifactor dimensionality reduction (GMDR) was used to find out the interaction combinations between SNPs and environmental factors, including gene- gene synergy and gene environment synergy effect. Logistic regression was used to analyze the correlation between the four SNPs in VDR gene and RCC, and the significant interaction combinations found by GMDR model were analyzed by hierarchical analysis.

Results

The genotype distribution of the control group was in accordance with Hardy- Weinberg equilibrium. Logistic regression analysis showed that the risk of RCC in VDR-rs7975232 A allele carriers was significantly higher than that of CC genotype carriers (CA + AA vs. CC), adjusted OR (95 % CI) = 1.75 (1.26–2.28). We used GMDR model to screen the best synergistic model between the four SNPs of VDR gene and smoking and drinking. We found a significant two locus model (P = 0.0010) involving rs7975232 and smoking. The cross- validation consistency of the two- locus model was 10/ 10, and the accuracy was 60.72 %. Compared with non-smokers with rs7975232 -CA or AA genotype, smokers with rs7975232 -CC genotype had the highest risk of RCC, or (95 % CI) = 2.23 (1.42–3.09), after adjustment for covariates.

Conclusions

We found that the A allele of rs7975232 within VDR gene, interaction between rs7975232 and smoking were all associated with increased RCC risk.
Platelet-rich plasma for tendinopathy and osteoarthritis: a narrative review
Authors: Shala Rilind
Published: May 2021

Background

Musculoskeletal disorders include a wide range of degenerative and inflammatory problems, which can affect any part of the muscular and skeletal system. Platelet-rich plasma (PRP) has been a breakthrough in musculoskeletal medicine, especially with its effects to speed up soft tissue, cartilage, and bone healing. It is now thought that stem cells are able to reverse the degenerative process and promote rapid healing. Platelet-rich plasma (PRP) has received special attention in treating tendinopathy and osteoarthritis. This review aims to do a comprehensive review of the scientific evidence for the efficiency of PRP application in tendinopathy and osteoarthritis.

Main body of the abstract

In osteoarthritis treatment, platelet-rich plasma is thought to influence the whole joint environment by increasing chondrocyte proliferation. The injection of autologous PRP into the joint space and surrounding soft tissues delivers a concentrated dose of these growth factors, which accelerate the healing process and reduce pain.

Short conclusion

Many studies report some benefits in regard to pain and functionality, especially in tendinopathy, but further investigations are needed to incorporate PRP into clinical practice and be a common form of therapy for tendinopathy and osteoarthritis. Caution should be applied with any treatment we use in clinical practice, especially with PRP and other forms of injections.
Revisiting vitamin D status and supplementation for in-patients with intellectual and developmental disability in the North of England, UK
Authors: Dudley Bethany , Ostrowski Marcin , Ciausu Vlad , Ince Chris , McKinnon Iain
Published: May 2021

Aims and method

To re-evaluate vitamin D testing and supplementation among in-patients with intellectual and developmental disability (IDD) and examine any correlates with physical health conditions, including COVID-19. Records of all in-patients between January 2019 and July 2020 (n = 78) were examined for 25-hydroxyvitamin D (25(OH)D) level, ward area, supplementation status, test seasonality, medication and health status.

Results

The mean 25(OH)D level for supplemented (800 IU/day) patients was 75 nmol/L (s.d. = 20), compared with 40 nmol/L (s.d. = 19) in the non-supplemented group (P < 0.001). Thirty-eight percent of those who were in-patients during the first wave of the COVID-19 pandemic developed symptoms, but the small sample size could not establish vitamin D levels as a predictor of outcome.

Clinical implications

Vitamin D (800 IU/day) supplementation is effective but the adequacy of the nationally recommended dose of 400 IU/day is unclear. Links to COVID-19 merit further research.
Psychological distress among people with probable COVID-19 infection: analysis of the UK Household Longitudinal Study
Authors: Niedzwiedz Claire L. , Benzeval Michaela , Hainey Kirsten , Leyland Alastair H. , Katikireddi Srinivasa Vittal
Published: May 2021

Studies exploring the longer-term effects of experiencing coronavirus disease-2019 (COVID-19) on mental health are lacking. We explored the relationship between reporting probable COVID-19 symptoms in April 2020 and psychological distress (measured using the General Health Questionnaire) 1, 2, 3, 5 and 7 months later. Data were taken from the UK Household Longitudinal Study, a nationally representative household panel survey of UK adults. Elevated levels of psychological distress were found up to 7 months after probable COVID-19, compared with participants with no likely infection. Associations were stronger among younger age groups and men. Further research into the psychological sequalae of COVID-19 is urgently needed.
Updated Standardized Definitions for Efficacy End Points (STEEP) in Adjuvant Breast Cancer Clinical Trials: STEEP Version 2.0
Authors: Tolaney Sara M. , Garrett-Mayer Elizabeth , White Julia , Blinder Victoria S. , Foster Jared C. , Amiri-Kordestani Laleh , Hwang E. Shelley , Bliss Judith M. , Rakovitch Eileen , Perlmutter Jane , Spears Patricia A. , Frank Elizabeth , Tung Nadine M. , Elias Anthony D. , Cameron David , Denduluri Neelima , Best Ana F. , DiLeo Angelo , Baizer Lawrence , Butler Lynn Pearson , Schwartz Elena , Winer Eric P. , Korde Larissa A.
Published: May 2021

PURPOSE

The Standardized Definitions for Efficacy End Points (STEEP) criteria, established in 2007, provide standardized definitions of adjuvant breast cancer clinical trial end points. Given the evolution of breast cancer clinical trials and improvements in outcomes, a panel of experts reviewed the STEEP criteria to determine whether modifications are needed.

METHODS

We conducted systematic searches of ClinicalTrials.gov for adjuvant systemic and local-regional therapy trials for breast cancer to investigate if the primary end points reported met STEEP criteria. On the basis of common STEEP deviations, we performed a series of simulations to evaluate the effect of excluding non–breast cancer deaths and new nonbreast primary cancers from the invasive disease–free survival end point.

RESULTS

Among 11 phase III breast cancer trials with primary efficacy end points, three had primary end points that followed STEEP criteria, four used STEEP definitions but not the corresponding end point names, and four used end points that were not included in the original STEEP manuscript. Simulation modeling demonstrated that inclusion of second nonbreast primary cancer can increase the probability of incorrect inferences, can decrease power to detect clinically relevant efficacy effects, and may mask differences in recurrence rates, especially when recurrence rates are low.

CONCLUSION

We recommend an additional end point, invasive breast cancer–free survival, which includes all invasive disease–free survival events except second nonbreast primary cancers. This end point should be considered for trials in which the toxicities of agents are well-known and where the risk of second primary cancer is small. Additionally, we provide end point recommendations for local therapy trials, low-risk populations, noninferiority trials, and trials incorporating patient-reported outcomes.
On a contextual model refuting Bell's theorem
Authors: Muchowski Eugen
Published: May 2021

Bell's theorem is refuted by presenting a counterexample that correctly predicts the expectation values of QM. As Bell only ruled out non-contextual models, a contextual model with hidden variables can refute his theorem. Such a model, which is able to explain the spin measurement results with entangled photons or electrons, is presented herein. It is not ruled out by the Kochen-Specker theorem. A physical justification for the contextual behaviour of entangled systems is provided. Consequences for the feasibility of quantum computers are discussed.
A Host of Possibilities
Authors: Min Susette
Published: May 2021

In 2012, Okwui Enwezor was appointed artistic director of the third iteration of La Triennale, which he titled Intense Proximité (IP). While Enwezor had the credentials to legitimize the French art scene, he was also keenly aware of his own revolving roles as guest and host. This article considers his exhibition-making practice within the context of hospitality. Conventionally, hospitality entails warmly welcoming guests to make themselves at home. This interaction between guest and host involves not only implicit codes of etiquette and manners but also an economy of exchange that revolves around constant transaction and negotiation. In general, a curator’s duties are similar to those of a host in setting up the conditions to welcome a diverse array of artists, ideas, and viewers into a designated space. Keeping in mind how curating, in the words of Erica Lehrer and Cynthia Milton, is also “a kind of intimate, intersubjective, interrelational obligation,” Enwezor never presumed his role as positionality to be sovereign. The first half of the article introduces the concept of hospitality and sets up Enwezor’s curatorial premise of IP. The second half mobilizes his curatorial practice as a means to open up ways to reconceive hospitality as a site of interruption, absolution, and abolition, and it reaffirms scholarship that conceives Enwezor’s exhibition making as a decolonial practice.
Smokers’ support for the ban on sale of slim cigarettes in six European countries: findings from the EUREST-PLUS ITC Europe surveys
Authors: Mechili Enkeleint A. , Przewoźniak Krzysztof , Driezen Pete , Kyriakos Christina N , Girvalaki Charis , Mons Ute , Quah Anne CK , Fernández Esteve , Trofor Antigona C , Demjén Tibor , Katsaounou Paraskevi A , Zatoński Witold , Fong Geoffrey T , Vardavas Constantine I
Published: May 2021

Background: Efforts to regulate tobacco products and reduce consumption in the European Union (EU) include the European Tobacco Products Directive (TPD), which went into force in May 2016. Despite the initial discussion to include a ban on sale of slim cigarettes, it was excluded in the final TPD. The main goal of this study was to examine support for a ban on slim cigarettes among smokers in six European Countries.

Methods: Data from the 2018 (Wave 2) International Tobacco Control Policy Evaluation Project 6 European Country (ITC 6E) EUREST-PLUS project survey, a cross sectional study of adult smokers (n=5592) from Germany, Greece, Hungary, Poland, Romania, and Spain, was analysed. Descriptive statistics were used to estimate support for a ban on slim cigarettes by sociodemographic characteristics and smoking behaviors. Logistic regression analysis was used to examine factors associated with support for a ban on slim cigarettes and perceptions of harm.

Results: Support for a ban on slims varied across countries, with highest support in Romania (33.8%), and lowest in Greece (18.0%). Female smokers (OR=0.77; 95%CI=0.66-0.90, daily smokers (OR=0.59; 95%CI=0.42-0.83), menthol smokers (OR=0.56; 95%CI=0.36-0.87), and smokers who did not have plans to quit within next six months (OR=0.45; 95%CI=0.36-0.57) had significantly lower odds of supporting a ban on slim cigarettes. Overall, 20% of smokers perceived slim cigarettes as less harmful than regular cigarettes.

Conclusions: Support for a ban of slim cigarettes was relatively low among smokers, while misperceptions that slim cigarettes are less harmful is high, particularly among countries where slim cigarette use is more prevalent. Findings support a ban on slim cigarettes to reduce misperceptions around slim cigarettes being less harmful.
A tool for assessing the climate change mitigation and health impacts of environmental policies: the Cities Rapid Assessment Framework for Transformation (CRAFT)
Authors: Symonds Phil , Milner James , Mohajeri Nahid , Aplin Juliette , Hale Joanna , J Lloyd Simon , Fremont Henry , Younkin Sam , Shrubsole Clive , Robertson Lawrie , Taylor Jonathon , Zimmermann Nici , Wilkinson Paul , Davies Mike
Published: May 2021

Background: A growing number of cities, including Greater London, have set ambitious targets, including detailed policies and implementation plans, to reach global goals on sustainability, health, and climate change. Here we present a tool for a rapid assessment of the magnitude of impact of specific policy initiatives to reach these targets. The decision-support tool simultaneously quantifies the environmental and health impacts of specified selected policies.

Methods: The ‘Cities Rapid Assessment Framework for Transformation (CRAFT)’ tool was applied to Greater London. CRAFT quantifies the effects of ten environmental policies on changes in (1) greenhouse gas (GHG) emissions, (2) exposures to environmental hazards, (3) travel-related physical activity, and (4) mortality (the number of attributable deaths avoided in one typical year). Publicly available data and epidemiological evidence were used to make rapid quantitative estimates of these effects based on proportional reductions in GHG emissions and environmental exposures from current baseline levels and to compute the mortality impacts.

Results: The CRAFT tool estimates that, of roughly 50,000 annual deaths in Greater London, the modelled hazards (PM2.5 (from indoor and outdoor sources), outdoor NO2, indoor radon, cold, overheating) and low travel-related physical activity are responsible for approximately 10,000 premature environment-related deaths. Implementing the selected polices could reduce the annual mortality number by about 20% (~1,900 deaths) by 2050. The majority of these deaths (1,700) may be avoided through increased uptake in active travel. Thus, out of ten environmental policies, the ‘active travel’ policy provides the greatest health benefit. Also, implementing the ten policies results in a GHG reduction of around 90%.

Conclusions: The CRAFT tool quantifies the effects of city policies on reducing GHG emissions, decreasing environmental health hazards, and improving public health. The tool has potential value for policy makers through providing quantitative estimates of health impacts to support and prioritise policy options.
Development of an Express Method for Studying the Toxicity of Modern Cable Compounds’ Combustion Products
Authors: Anikin N. , Mel'nikov N. , Monahov A. , Garmashov A.
Published: May 2021

In case of fire, combustible materials and products made on their basis have a decisive role in the development of combustion, formation and spread of foreground risks. Normative legal documents restrict the use of fire hazardous materials, but it is impossible to exclude their use completely. In case of fire, in addition to flame and high temperatures are formed smoke and toxic gaseous products of combustion. The basis of the most common products is polyvinyl chloride - one of the most common fire hazardous materials, whose production volumes have only increased in recent years. In the course of this work, an express method has been developed and tested for the qualitative and quantitative determination of toxic substances contained in combustion products of plastic compounds based on polyvinyl chloride.
The invisible pandemic: Antimicrobial resistance
Authors: Cope Graham
Published: May 2021

Graham Cope looks at how antibiotic resistant bacteria have fared during the coronavirus pandemic
Latest clinical research
Authors: Greener Mark
Published: May 2021

Mark Greener summarises the latest studies relevant to primary care nurses
Updating your partnership deeds
Authors: Cumberlege Justin
Published: May 2021

Justin Cumberlege, a partner in the healthcare law firm Hempsons, highlights what needs updating in partnership deeds
Equine Review
Authors: Fiske-Jackson Andy
Published: May 2021

Introduction:

This edition of the Equine Review looks at an interesting study on straight and distal sesamoidean ligament injuries, the use of ethanol in distal limb antiseptic protocols and the detection time of tiludronic acid.
Multilevel symmetrized Toeplitz structures and spectral distribution results for the related matrix sequences
Authors: Ferrari Paola , Furci Isabella , Serra-Capizzano Stefano
Published: May 2021

In recent years,  motivated by computational purposes, the singular value and spectral features of the symmetrization of Toeplitz matrices generated by a Lebesgue integrable function have been studied. Indeed, under the assumptions that $f$ belongs to $L^1([-\pi,\pi])$ and it has real Fourier coefficients, the spectral and singular value distribution of the matrix-sequence $\{Y_nT_n[f]\}_n$ has been identified, where $n$ is the matrix size, $Y_n$ is the anti-identity matrix, and $T_n[f]$ is the Toeplitz matrix generated by $f$. In this note, the authors consider the multilevel Toeplitz matrix $T_{\bf n}[f]$ generated by $f\in L^1([-\pi,\pi]^k)$, $\bf n$ being a multi-index identifying the matrix-size, and they prove spectral and singular value distribution results for the matrix-sequence $\{Y_{\bf n}T_{\bf n}[f]\}_{\bf n}$ with $Y_{\bf n}$ being the corresponding tensorization of the anti-identity matrix.