bluuebunny/crossref_metadata_2025 huggingface dataset:
The Antecedents of Consumer Satisfaction Toward OTT Platforms During COVID-19 Lockdown in India
Authors: Verma Saurabh , Yadav Sunil Kumar
Published: May 2023

The outbreak of COVID-19 has emerged as the biggest threat to human life. It has changed the entire lifestyle of human beings concerning their emotional stability and cognitive development. Enjoyment is one of the emotions and acts as a positive stimulus that a consumer used to feel and seeks for a balanced life. Since the nationwide lockdown was implemented on March 25, 2020, people have turned restless about how to enjoy themselves at home, as all of their options of going out were being shattered. It was the time when continuous innovations in the form of digital content through over-the-top (OTT) platforms flourished and provided an affordable and diversified entertainment source to consumers. These OTT services help consumers to view the contents via the Internet directly. Furthermore, it has drastically changed people’s preferences toward diversified content based on their choices. This study aims to explore the various determinants affecting consumer satisfaction toward the OTT platforms amid COVID-19 crisis in India. The study’s main findings revealed that among the demographic variables, age group of the consumer largely influences their satisfaction toward OTT platforms. Moreover, work from home, affordability, convenience, and content quality are the significant determinants affecting consumer satisfaction levels toward OTT platforms. The study is relevant to the current marketing scenario, as it provides useful insights for the content developers of the major OTT platforms such as Amazon Prime, Netflix, Disney+ Hotstar, Voot, and many others to enhance the consumer satisfaction in the terms of digital content consumption.
The New Haven School Matters: An Inquiry into Insights of the Policy-oriented Jurisprudence for the Pedagogy of International Law in Iran
Authors: Dadmehr Hadi
Published: May 2023

While the scope of the theories of international law has expanded over the past decades, the formalist rule-oriented approaches are still dominant scholarly traditions in Iranian legal studies. Describing the internal structure of the New Haven School of international law, the author suggests that the Iranian community of international law may embrace the methodological frame of policy-oriented jurisprudence in doctrinal legal research. It is an irrefutable fact that the rule-oriented schools (including positivism and natural law) could provide compelling insights into some features of international law; however, a profound understanding of the dynamic and changing process of international lawmaking requires moving beyond a set of supposedly fair and neutral legal rules. The policy-oriented perspective has provided a variety of intellectual tools and concepts (including the elements of the world constitutive process: participants, perspectives, arenas of decisions, bases of power, strategies and outcomes) to identify and influence the comprehensive process of authoritative decisions.
Teaching Race After the Genome: An Approach to Challenging Biological Understandings of Race in the Classroom
Authors: Romero Luis A. , Zarrugh Amina
Published: May 2023

As a billion-dollar industry with millions of consumers, DNA-based ancestry testing has become a highly sought out tool for people seeking knowledge of their ancestry and, recently, their family health history. As sociologists have emphasized, however, these DNA-based technologies have also risked reinvigorating dubious connections between biology and race. In this article, we outline a class assignment utilizing YouTube videos that feature consumers narrating the results of their DNA-based ancestry testing. The assignment invites students to interrogate the claims of consumers, who often seamlessly connect their ancestry results to particular racial and ethnic identities. As a result, students are poised to better understand how race and ethnicity are social constructions rather than individual biological traits.
Child Victims’ Interactions with Criminal Justice: An Observational Study in West Bengal
Authors: Dube Dipa , Shaw Rohini Kumari
Published: May 2023

Crime occurrence has a serious impact on its victims; the toll is even greater when it concerns children. They have to undergo severe physical, psychological and emotional trauma in the aftermath of a crime. When children interact with the criminal justice system, they are put through the gruelling processes of the police investigation, recording statements, medical examination, appearance in courts, cross-examination and so on. Each component has its own impact on the children, with studies suggesting that participation of children in the ‘adult’ criminal justice process can be confusing, distressing and even re-traumatizing.

With international efforts to put victims as salient to the criminal justice discourse, things have changed. Recognizing the ineptness of the adult processes in their application towards justice to child victims, States have modified the complexities and attempted to establish a parallel system of justice dispensation that is more ‘child-friendly’. India, on its part, has passed the Protection of Children from Sexual Offences Act, 2012, to redefine the processes in its application to children, especially in matters of child sexual abuse. Thus, special courts are set up, incorporating special measures to ensure the privacy, confidentiality and comfort of the child victims who appear before them.

Based on an observational study of ‘special’ and ‘designated’ courts in the State of West Bengal, the present article indicates that Protection of Children from Sexual Offences Act (POCSO Act) directives are still not in place. The insufficient number of fast-track courts, unavailability of dedicated personnel, infrastructural inadequacies and inappropriate processes still mar the justice system. The article forwards suggestions that are imperative to improve the overall experience of child victims.
Embracing difference and cultivating hope: The transformative potential of Possibility Studies
Authors: Ross Wendy
Published: May 2023

This ending commentary on this inaugural issue of Possibility Studies and Society surveys the papers submitted by over 30 scholars from diverse fields and backgrounds that explore the emerging field of Possibility Studies through the lens of their respective disciplines and theoretical perspectives. It draws out the complexities of the really and ideally possible, the future and the past, and reality and imagination before moving to examine the purpose of Possibility Studies with a focus on political change, education, and hope. It calls for an embrace of non-dualistic attitudes across all domains and an engagement with the energy generated by collaborative difference.
Understanding patient experience of chronic cough in interstitial lung disease
Authors: Mann Jennifer M.V. , Holland Anne E. , Goh Nicole S.L. , Khor Yet H.
Published: May 2023

Rationale

Chronic cough is a common symptom in patients with interstitial lung disease (ILD), negatively contributing to health-related quality of life. Despite this, there is limited information and understanding on the experience of this group of patients with chronic cough. This study aimed to explore the symptom experiences for chronic cough in patients with ILD to identify its characteristics and impacts.

Methods

A qualitative study using semi-structured telephone interviews was undertaken in 16 adults with a diagnosis of ILD of any type and severity. Patients were recruited from a quaternary referral centre in Melbourne, Australia. Interviews were transcribed verbatim and coded by two researchers using thematic analysis.

Results

Patients (age range: 39–87 years, forced vital capacity: 53–107% predicted and diffusing capacity of the lung for carbon monoxide: 28–89% predicted) experienced a spectrum of cough severity and characteristics, including both dry and productive coughs. The impact of chronic cough included physical symptoms, social and emotional difficulties, and interference with work and vocational participation. Management strategies used to relieve cough included mucolytics, opiates, throat lozenges, warm drinks, pacing, breath control, relaxation exercises, movement, continuous positive airways pressure and supplemental oxygen. Patients expressed a need for further information and education regarding chronic cough, including its triggers and management.

Conclusions

This study highlights the experience and significance of chronic cough in patients with ILD. The nature and severity of chronic cough in patients with ILD appears to be more heterogeneous than previously described, with physical, social and emotional impacts contributing to symptom burden.
Patients’ acceptance of outcome and experience measurements during hospitalisation for COPD exacerbations: a CICERO Clinical Research Collaboration–European Lung Foundation online patient survey
Authors: Gyselinck Iwein , Ramakrishnan Sanjay , Vermeersch Kristina , Halner Andreas , Pott Hendrik , Dobbels Fabienne , Coleman Courtney , Collis Philip , Watz Henrik , Greulich Timm , Franssen Frits M.E. , Burgel Pierre-Régis , Bafadhel Mona , Janssens Wim ,   on behalf of the CICERO Consortium,   CICERO Clinical Research Collaboration members.Chairs:, Bafadhel Mona , Janssens Wim , Burgel Pierre-Régis , Contoli Marco , Franssen Frits , Greening Neil , Greulich Timm , Huerta Garcia Arturo , Quint Jennifer , Schmeck Bernd , Vanfleteren Lowie , Watz Henrik , Ramakrishnan Sanjay , Gyselinck Iwein , Halner Andreas , McAuley Hamish , Vermeersch Kristina , Beersaerts Amber , Abdo Mustafa , Pott Hendrik , Steven Cass , Albert Richard , Jenkins Christine , Vogelmeier Claus , Collis Philip , Bolsman Hilma , Roche
Published: May 2023

Background

The lack of standardised outcome assessments during hospitalisation and follow-up for acute COPD exacerbations has hampered scientific progress and clinical proficiency. The objective of the present study was to evaluate patients’ acceptance of selected outcome and experience measurements during hospitalisations for COPD exacerbations and follow-up.

Methods

An online survey was held amongst COPD patients in France, Belgium, The Netherlands, Germany and the UK. The European Lung Foundation COPD Patient Advisory Group was involved in the conceptualisation, development and dissemination of the survey. The survey was complementary to a previously obtained expert consensus. We assessed patients’ views and acceptance of selected patient-reported outcomes or experiences and corresponding measurement instruments (for dyspnoea, frequent productive cough, health status and hospitalisation experience), and of selected clinical investigations (blood draw, pulmonary function test, 6-min walk test, chest computed tomography, echocardiography).

Findings

200 patients completed the survey. All selected outcomes and experiences were deemed important, and acceptance of their methods of assessment was high. The modified Medical Research Council scale and a numerical rating scale to address dyspnoea, the COPD Assessment Test for quality of life and frequent productive cough, and the Hospital Consumer Assessment of Healthcare Providers and Systems for hospital experiences were the instruments preferred by patients. Consensus on importance of blood draw and spirometry was higher compared with the other investigations.

Interpretation

The survey results endorse the use of the selected outcome and experience measurements during hospitalisations for COPD exacerbations. They can be used to optimise standardised and patient-centred care and facilitate multicentric data collection.
Endobronchial optical coherence tomography or computed tomography for evaluating progression of bronchiectasis
Authors: Cheng Lin-ling , Guan Wei-jie , Zhong Chang-hao , Duan Chong-yang , Su Zhu-quan , Li Shi-yue , Zhong Nan-shan
Published: May 2023

Background

The early radiological signs of progression in bronchiectasis remain unclear. The objective of the present study was to compare endobronchial optical coherence tomography (EB-OCT) and chest computed tomography (CT) for the evaluation of radiological progression of bronchiectasisviastratification of the presence (TW+) or absence (TW−) of thickened-walled bronchioles surrounding dilated bronchi in patients with bronchiectasis based on CT, and determine the risk factors.

Methods

In this prospective cohort study, we performed both chest CT and EB-OCT at baseline and 5-year follow-up, to compare changes in airway calibre metrics. We evaluated bacterial microbiology, sputum matrix metalloproteinase-9 levels and free neutrophil elastase activity at baseline. We compared clinical characteristics and airway calibre metrics between the TW+and TW−groups. We ascertained radiological progression at 5 yearsviaCT and EB-OCT.

Results

We recruited 75 patients between 2014 and 2017. At baseline, EB-OCT metrics (mean luminal diameter (p=0.017), inner airway area (p=0.005) and airway wall area (p=0.009) of seventh- to ninth-generation bronchioles) were significantly greater in the TW+group than in the TW−group. Meanwhile, EB-OCT did not reveal bronchiole dilatation (compared with the same segment of normal bronchioles) surrounding nondilated bronchi on CT in the TW−group. At 5 years, 53.1% of patients in the TW+group progressed to have bronchiectasis measured with EB-OCT, compared with only 3.3% in TW−group (p<0.05). 34 patients in the TW+group demonstrated marked dilatation of medium-sized and small airways. Higher baseline neutrophil elastase activity and TW+bronchioles on CT predicted progression of bronchiectasis.

Conclusion

Thickened-walled bronchioles surrounding the dilated bronchi, identified with EB-OCT, indicates progression of bronchiectasis.
A Phase 2 randomised study to establish efficacy, safety and dosing of a novel oral cathepsin C inhibitor, BI 1291583, in adults with bronchiectasis: Airleaf
Authors: Chalmers James D. , Gupta Abhya , Chotirmall Sanjay H. , Armstrong April , Eickholz Peter , Hasegawa Naoki , McShane Pamela J. , O'Donnell Anne E. , Shteinberg Michal , Watz Henrik , Eleftheraki Anastasia , Diefenbach Claudia , Sauter Wiebke
Published: May 2023

New therapies are needed to prevent exacerbations, improve quality of life and slow disease progression in bronchiectasis. Inhibition of cathepsin C (CatC) activity has the potential to decrease activation of neutrophil-derived serine proteases in patients with bronchiectasis, thereby reducing airway inflammation, improving symptoms, reducing exacerbations and preventing further airway damage. Here we present the design of a phase 2 trial (Airleaf™;NCT05238675) assessing the efficacy and safety of a novel CatC inhibitor, BI 1291583, in adult patients with bronchiectasis. This multinational, randomised, double-blind, placebo-controlled, parallel-group, dose-finding study has a screening period of at least 6 weeks, a treatment period of 24–48 weeks and a follow-up period of 4 weeks. ∼240 adults with bronchiectasis of multiple aetiologies will be randomised to placebo once daily, or BI 1291583 1 mg once daily, 2.5 mg once daily or 5 mg once daily in a 2:1:1:2 ratio, stratified byPseudomonas aeruginosainfection and maintenance use of macrolides. The primary efficacy objective is to evaluate the dose–response relationship for the three oral doses of BI 1291583versusplacebo on time to first pulmonary exacerbation up to Week 48 (the primary end-point). Efficacy will be assessed using exacerbations, patient-reported outcomes, measures of symptoms, sputum neutrophil elastase activity and pulmonary function testing. Safety assessment will include adverse event reporting, physical examination, monitoring of vital signs, safety laboratory parameters, 12-lead electrocardiogram, and periodontal and dermatological assessments. If efficacy and safety are demonstrated, results will support further investigation of BI 1291583 in phase 3 trials.
Arthroscopic rotator cuff repair in fibromyalgia patients had comparable outcomes to a matched control group
Authors: Gurel Ron , Vidra Matias , Elbaz Etay , Factor Shai , Kazum Efi , Bivas Assaf , Maman Eran , Chechik Ofir , Rotman Dani
Published: May 2023

Background

Although fibromyalgia is associated with poor outcomes following orthopedic surgeries, several studies show some benefit from surgical intervention and nevertheless recommend operative treatment when indicated. There is sparse evidence of the effect of fibromyalgia on the outcomes of shoulder surgery. The purpose of this study was to investigate the effect of fibromyalgia on patient-reported outcomes of arthroscopic rotator cuff repair (ARCR).

Methods

All patients with a confirmed diagnosis of fibromyalgia who underwent ARCR in one institution between 2010 and 2021 were included. Data retrieved from medical records included demographics, characteristics of the cuff tear and the surgical procedure, and preoperative and last follow-up (minimum 1 year) postoperative Disabilities of the Arm, Shoulder and Hand (DASH) score, Subjective Shoulder score (SSV), and Numeric Pain Rating Scale (NPRS). A matched controlled group of patients without fibromyalgia who had undergone ARCR was selected according to age, sex, and preoperative DASH, SSV, and NPRS scores.

Results

There were no significant differences in demographics, cuff tear and surgical procedure characteristics, and preoperative scores between the fibromyalgia and control groups. The fibromyalgia patients’ postoperative scores for all 3 measurements showed significant improvement: SSV by 32.1 (P = 0.004), DASH by 20.3 (P = 0.016), and NPRS by 2.33 (P = 0.017). There were no significant differences in the postoperative DASH, SSV, and NPRS between the fibromyalgia and control groups.

Conclusion

Fibromyalgia patients with rotator cuff tears who undergo ARCR do not have inferior patient-reported outcomes compared with non-fibromyalgia controls. Fibromyalgia should not be a considered a contraindication for ARCR.

Level of evidence: III
Pan-cancer analysis of SYNGR2 with a focus on clinical implications and immune landscape in liver hepatocellular carcinoma
Authors: Liu Chunxun , Qu Zhaowei , Zhao Haoran , Wang Peng , Zhan Chao , Zhang Yubao
Published: May 2023

Background

Synaptogyrin-2 (SYNGR2), as a member of synaptogyrin gene family, is overexpressed in several types of cancer. However, the role of SYNGR2 in pan-cancer is largely unexplored.

Methods

From the TCGA and GEO databases, we obtained bulk transcriptomes, and clinical information. We examined the expression patterns, prognostic values, and diagnostic value of SYNGR2 in pan-cancer, and investigated the relationship of SYNGR2 expression with tumor mutation burden (TMB), microsatellite instability (MSI), immune infiltration, and immune checkpoint (ICP) genes. The gene set enrichment analysis (GSEA) software was used to perform pathway analysis. Besides, we built a nomogram of liver hepatocellular carcinoma patients (LIHC) and validated its prediction accuracy.

Results

SYNGR2 was highly expressed in most cancers. The high expression of SYNGR2 significantly reduced the overall survival (OS), disease-specific survival (DSS), disease-free interval (DFI), and progression-free interval (PFI) in multiple types of cancer. Also, receiver operating characteristic (ROC) curve analysis demonstrated that SYNGR2 showed high accuracy in distinguishing cancerous tissues from normal ones. Moreover, SYNGR2 expression was correlated with TMB, MSI, immune scores, and immune cell infiltrations. We also analyzed the association of SYNGR2 with immunotherapy response in LIHC. Finally, a nomogram including SYNGR2 and pathologic T, N, M stage was built and exhibited good predictive power for the OS, DSS, and PFI of LIHC patients.

Conclusion

Overall, SYNGR2 is a critical oncogene in various tumors. SYNGR2 participates in the carcinogenic progression, and may contribute to the immune infiltration in tumor microenvironment. Our study suggests that SYNGR2 can serve as a predictor related to prognosis in pan-cancer, especially LIHC.
Cis-regulatory atlas of primary human CD4+ T cells
Authors: Stefan Kurtis , Barski Artem
Published: May 2023

Cis-regulatory elements (CRE) are critical for coordinating gene expression programs that dictate cell-specific differentiation and homeostasis. Recently developed self-transcribing active regulatory region sequencing (STARR-Seq) has allowed for genome-wide annotation of functional CREs. Despite this, STARR-Seq assays are only employed in cell lines, in part, due to difficulties in delivering reporter constructs. Herein, we implemented and validated a STARR-Seq–based screen in human CD4+ T cells using a non-integrating lentiviral transduction system. Lenti-STARR-Seq is the first example of a genome-wide assay of CRE function in human primary cells, identifying thousands of functional enhancers and negative regulatory elements (NREs) in human CD4+ T cells. We find an unexpected difference in nucleosome organization between enhancers and NRE: enhancers are located between nucleosomes, whereas NRE are occupied by nucleosomes in their endogenous locations. We also describe chromatin modification, eRNA production, and transcription factor binding at both enhancers and NREs. Our findings support the idea of silencer repurposing as enhancers in alternate cell types. Collectively, these data suggest that Lenti-STARR-Seq is a successful approach for CRE screening in primary human cell types, and provides an atlas of functional CREs in human CD4+ T cells.
Exploring flexible polynomial regression as a method to align routine clinical outcomes with daily data capture through remote technologies
Authors: Filipow Nicole , Main Eleanor , Tanriver Gizem , Raywood Emma , Davies Gwyneth , Douglas Helen , Laverty Aidan , Stanojevic Sanja
Published: May 2023

Background

Clinical outcomes are normally captured less frequently than data from remote technologies, leaving a disparity in volumes of data from these different sources. To align these data, flexible polynomial regression was investigated to estimate personalised trends for a continuous outcome over time.

Methods

Using electronic health records, flexible polynomial regression models inclusive of a 1st up to a 4th order were calculated to predict forced expiratory volume in 1 s (FEV1) over time in children with cystic fibrosis. The model with the lowest AIC for each individual was selected as the best fit. The optimal parameters for using flexible polynomials were investigated by comparing the measured FEV1 values to the values given by the individualised polynomial.

Results

There were 8,549 FEV1 measurements from 267 individuals. For individuals with > 15 measurements (n = 178), the polynomial predictions worked well; however, with < 15 measurements (n = 89), the polynomial models were conditional on the number of measurements and time between measurements. The method was validated using BMI in the same population of children.

Conclusion

Flexible polynomials can be used to extrapolate clinical outcome measures at frequent time intervals to align with daily data captured through remote technologies.
Causes and risk factors of death among people who inject drugs in Indonesia, Ukraine and Vietnam: findings from HPTN 074 randomized trial
Authors: Dumchev Kostyantyn , Guo Xu , Ha Tran Viet , Djoerban Zubairi , Zeziulin Oleksandr , Go Vivian F. , Sarasvita Riza , Metzger David S. , Latkin Carl A. , Rose Scott M. , Piwowar-Manning Estelle , Richardson Paul , Hanscom Brett , Lancaster Kathryn E. , Miller William C. , Hoffman Irving F.
Published: May 2023

Introduction

The HIV Prevention Trials Network (HPTN) 074 study demonstrated a positive effect of an integrated systems navigation and psychosocial counseling intervention on HIV treatment initiation, viral suppression, medication assisted treatment (MAT) enrollment, and risk of death among people who inject drugs (PWID). In this sub-study, we analyzed the incidence, causes, and predictors of death among HIV-infected and uninfected participants.

Methods

The HPTN 074 randomized clinical trial was conducted in Indonesia, Ukraine, and Vietnam. HIV-infected PWID with unsuppressed viral load (indexes) were recruited together with at least one of their HIV-negative injection partners. Indexes were randomized in a 1:3 ratio to the intervention or standard of care.

Results

The trial enrolled 502 index and 806 partner participants. Overall, 13% (66/502) of indexes and 3% (19/806) of partners died during follow-up (crude mortality rates 10.4 [95% CI 8.1–13.3] and 2.1 [1.3–3.3], respectively). These mortality rates were for indexes nearly 30 times and for partners 6 times higher than expected in a population of the same country, age, and gender (standardized mortality ratios 30.7 [23.7–39.0] and 5.8 [3.5–9.1], respectively). HIV-related causes, including a recent CD4 < 200 cells/μL, accounted for 50% of deaths among indexes. Among partners, medical conditions were the most common cause of death (47%). In the multivariable Cox model, the mortality among indexes was associated with sex (male versus female aHR = 4.2 [1.5–17.9]), CD4 count (≥ 200 versus < 200 cells/μL aHR = 0.3 [0.2–0.5]), depression (moderate-to-severe versus no/mild aHR = 2.6 [1.2–5.0]) and study arm (intervention versus control aHR = 0.4 [0.2–0.9]). Among partners, the study arm of the index remained the only significant predictor (intervention versus control aHR = 0.2 [0.0–0.9]) while controlling for the effect of MAT (never versus ever receiving MAT aHR = 2.4 [0.9–7.4]).

Conclusions

The results confirm that both HIV-infected and uninfected PWID remain at a starkly elevated risk of death compared to general population. Mortality related to HIV and other causes can be significantly reduced by scaling-up ART and MAT. Access to these life-saving treatments can be effectively improved by flexible integrated interventions, such as the one developed and tested in HPTN 074.
Incidence of HIV disclosure among HIV affected heterosexual partners using a community health worker led mechanism in rural Uganda; a quasi-experimental study
Authors: Lukyamuzi Zubair , Ssuna Bashir , Mirembe Ruth Nabisere , Mawanda Denis , Maena Joel , Nakalega Rita , Atuhaire Patience , Musoke Philippa , Butler Lisa M.
Published: May 2023

Background

HIV disclosure is vital in HIV management. Community Health Workers (CHW) were reported to support partner disclosure among HIV affected heterosexual partners with disclosure difficulties. However, time to disclosure attributed to use of CHW led disclosure support mechanism was not documented. This study compared the incidence of sexual partner disclosure among adults living with HIV (ALHIV) with CHW support and those without in the greater Luwero region, Uganda.

Methods

We conducted a quasi-experimental study with two arms allocated by geographically determined clusters and adjusted for between-group differences; among ALHIV in the greater Luwero region of Uganda who had never disclosed to their current primary sexual partners. We allocated study clusters to either a CHW-led intervention or control arm. In both arms, we consecutively recruited participants; those in the intervention arm received CHW disclosure support in addition to routine care. The overall follow-up was six months, and the primary outcome was disclosure to the partner. We used survival analysis with proportional hazard ratios to determine the time to partner disclosure in both arms.

Results

A total of 245 participants were enrolled, and 230 (93.9%) completed the study; of these, 112 (48.7%) were in the intervention and 118 (51.3%) in the control arm. The mean age was 31 ± 8 years with a range of 18 to 55 years; the majority were females, 176 (76.5%). The cumulative incidence of disclosure was higher in the intervention arm, 8.76 [95% CI: 7.20–10.67] per 1,000 person-days versus 5.15 [95%CI: 4.85–6.48] per 1,000 person-days in the control arm, log-rank test, X2 = 12.93, P < 0.001.

Male gender, aHR = 1.82, tertiary education, aHR = 1.51, and relationship duration of > six months, aHR = 1.19 predicted disclosure. Prior disclosure to a relative, aHR = 0.55, and having more than one sexual partner in the past three months, aHR = 0.74, predicted non-disclosure.

Conclusion

CHW-led support mechanism increased the rate of sexual partner disclosure among ALHIV with disclosure difficulties. Therefore, to achieve the global targets of ending HIV, near location CHW-led disclosure support mechanism may be used to hasten HIV disclosure in rural settings.
Subsequent fertility after cesarean scar pregnancy: a retrospective analysis
Authors: Jin Xiaoxiao , Liu Manman , Zhang Panxi , Zheng Lingzhi , Qi Feng
Published: May 2023

Background

Cesarean scar pregnancy (CSP) refers to the implantation and growth of the gestational sac at a uterine scarring site due to a previous cesarean section. The effects of CSP on subsequent fertility have emerged as a clinical issue of importance in gynecology and obstetrics in China owing to the increasing rate of cesarean section over the past 30 years in combination with the abolition of the national family planning policy, allowing for subsequent pregnancies. Therefore, we aimed to investigate the effects of CSP treatment on subsequent fertility and pregnancy outcomes.

Methods

The study consecutively enrolled 499 women treated for CSP at Taizhou Hospital between January 2009 and December 2018. The study outcomes were the rate of secondary infertility and pregnancy outcomes. Clinical information was collected at the time of admission for CSP treatment. Information on subsequent fertility and pregnancy outcomes was collected via telephonic follow-up.

Results

Among the 499 women who met the inclusion criteria for CSP, 48 were lost to follow-up. Most women (74.9%, 338/451) did not express the desire for a subsequent pregnancy after CSP treatment. Among the 113 women who initially desired a subsequent pregnancy, 62 finally abandoned fertility plans. Among the 51 women who pursued pregnancy, 48 pregnancies were recorded in 43 women, infertility secondary to CSP treatment was identified in 15.7% (8/51) of women, and 60.8% (31/51) of women achieved full-term pregnancy, with placenta accreta spectrum identified in two women, one requiring a hysterectomy during cesarean section due to massive bleeding. Among the 16 women treated with uterine artery embolization combined with uterine aspiration and 18 women treated by ultrasound-guided local lauromacrogol injection combined with uterine aspiration, a successful full-term pregnancy rate of 68.8% (11/16) and 88.9% (16/18), respectively, was achieved. There were five cases of recurrent CSP among all 76 pregnancies (6.6%).

Conclusion

Over a long-term follow-up of women after CSP treatment, a high successful fertility rate was identified, with also an increased CSP recurrence rate. Uterine artery embolization combined with uterine aspiration and ultrasound-guided local lauromacrogol injection combined with uterine aspiration showed high rates of successful post-treatment fertility and pregnancy.
The association between viewing cigarette health warning labels and intention to quit smoking among Chinese adult smokers: support for including health outcome content and culturally specific messages
Authors: Nian Qinghua , Hardesty Jeffrey J , Cohen Joanna E , Kennedy Ryan D
Published: May 2023

Background

Tailored themes of pictorial health warning labels (HWLs) that considers specific cultural dimensions and within a specific policy/historical context can motivate behavior change, such as provoking smokers to think about quitting. Currently in China, the HWLs on cigarettes are text-only. This study designed pictorial HWLs using different themes to explore and examine the association between viewing pictorial HWLs and participants’ intention to quit smoking. The themes included: (1) Self-harm from using cigarettes, (2) Harming family or children with secondhand smoke, (3) Complying with existing smoke-free policies, and (4) Cigarette gift giving practices.

Methods

A cross-sectional randomized experimental survey was conducted among 1,625 smokers in Beijing (n = 545), Shanghai (n = 541), and Shenzhen (n = 539) during 2017. Before and after viewing eight pictorial HWLs of one theme, participants were asked if they had plans to quit smoking within the next month, within the next 6 months, beyond the next 6 months, or not at all. Ordinal logistic regression, Wilcoxon and Chi-square tests were used to analyze the data.

Results

After viewing the HWLs, 434 participants (26.9%) reported an intention to quit smoking sooner, 987 (61.2%) reported the same intention to quit, and 191 (11.8%) reported an intention to quit later. The pre-post change in intention to quit was statistically significant among all participants and participants under each theme (p > 0.05). Participants who rated the effectiveness of the HWL communicating how secondhand smoke harms children had 1.13 (95% CI 1.01–1.27) greater odds of reporting an intention to quit sooner compared to those viewing labels from the other themes, adjusting for covariates. Female participants and participants with annual household income more than 100,000RMB had 1.39 (95% CI 1.14–1.69) and 1.29 (95% CI 1.04–1.60) greater odds of reporting an intention to quit sooner compared to their counterparts across the entire sample.

Conclusions

Findings of this study provide evidence of an association between all four pictorial HWL themes and smokers’ intention to quit smoking. These findings can help inform what HWL themes might be appropriate when China implements pictorial health warning labels.
Novel external reinforcement device for gastrointestinal anastomosis in an experimental study
Authors: Hasegawa Hiro , Takeshita Nobuyoshi , Hyon Woogi , Hyon Suong-Hyu , Ito Masaaki
Published: May 2023

Background

Anastomotic leakage has been reported to occur when the load on the anastomotic site exceeds the resistance created by sutures, staples, and early scars. It may be possible to avoid anastomotic leakage by covering and reinforcing the anastomotic site with a biocompatible material. The aim of this study was to evaluate the safety and feasibility of a novel external reinforcement device for gastrointestinal anastomosis in an experimental model.

Methods

A single pig was used in this non-survival study, and end-to-end anastomoses were created in six small bowel loops by a single-stapling technique using a circular stapler. Three of the six anastomoses were covered with a novel external reinforcement device. Air was injected, a pressure test of each anastomosis was performed, and the bursting pressure was measured.

Results

Reinforcement of the anastomotic site with the device was successfully performed in all anastomoses. The bursting pressure was 76.1 ± 5.7 mmHg in the control group, and 126.8 ± 6.8 mmHg in the device group, respectively. The bursting pressure in the device group was significantly higher than that in the control group (p = 0.0006).

Conclusions

The novel external reinforcement device was safe and feasible for reinforcing the anastomoses in the experimental model.
Long-term outcomes of surgical repair of isolated coarctation of the aorta in different age groups
Authors: Al-Dairy Alwaleed
Published: May 2023

Background

Coarctation of the aorta (CoA) is one of the most common congenital heart defects (5–8% of all CHD). Treatment of native CoA may be accomplished surgically, or through an interventional approach. Surgical repair of CoA remains an important option for treatment of aortic coarctation during childhood, although it is mostly performed in neonates and young infants.

Objectives

In this retrospective study, we sought to share the long-term outcomes of different surgical techniques for repair of coarctation of the aorta in different age groups.

Materials and methods

This is a retrospective single-center clinical study that included 228 consecutive patients (age: 1 day- 41years) in whom surgical repair of isolated native coarctation of the aorta was performed with different surgical techniques.

Results

Immediate results were excellent; however, the mortality rate were higher in the infants. Complications rate and incidence of recoarctation, both were comparable between different age groups and different surgical techniques.

Conclusions

Surgical repair of CoA remains an important option for treatment of aortic coarctation in different age groups with low morbidity and mortality. We did not find any significant difference between different surgical techniques regarding the development of recoarctation.
Successful management of 30 kg Gigantic para-testicular liposarcoma
Authors: Aksoy Cem , Karschuck Philipp , Derigs Marcus , Sevinc Selim , Groeben Christer , Zacharis Aristeidis , Flegar Luka , Pehl Anika , Huber Johannes , Mandal Subhajit
Published: May 2023

We report the successful management of a paratesticular liposarcoma, which, to the best of our knowledge, is the largest known of its type. A 62-year-old male presented with a painless, gradually progressive left testicular “giant” mass measuring 60 × 40 cm, weighing 30 kg and growing over a period of three 3 years. Additionally, a 5 × 5 cm trophic ulcer could be seen at the bottom of the scrotum. The ultrasound of the left testis revealed the testis having been completely replaced with a cystic and solid tumour. Preoperative serum testicular tumour markers (STM) were within normal limits. The markers included Alpha Feto Protein, Beta Human Chorionic Gonadotropin and Lactose Dehydrogenase. A left sided high inguino-scrotal approach with a huge skin resection including the trophic ulcer with complete removal of the tumour and a primary complex closure of the wound was performed. The post-operative period was uneventful, and histopathology revealed a dedifferentiated liposarcoma. We believe social taboo and fear of disfigurement impart a sense of shame in patients which led to the delayed presentation in a hospital in the index patient. The absence of metastases even with a protracted course is surprising.
Immunohistochemical expression of the hepatocyte growth factor in chromophobe renal cell carcinoma
Authors: Erlmeier Maximilian , Mikuteit Marie , Zschäbitz Stefanie , Autenrieth Michael , Weichert Wilko , Hartmann Arndt , Steffens Sandra , Erlmeier Franziska
Published: May 2023

Background

The prognostic value of Hepatocyte growth factor (HGF) in non-clear cell renal cell carcinoma (RCC) is still unclear. The aim of this study is to evaluate the prognostic impact of HGF expression in a large cohort of chromophobe RCC (chRCC).

Methods

Patients who underwent renal surgery due to chRCC were recruited. Clinical data was retrospectively evaluated. Tumor specimen were analyzed for HGF expression by immunohistochemistry.

Results

81 chRCC patients were eligible for analysis, thereof 37 (45.7%) patients were positive for HGF. No significant associations were found for HGF expression and clinical attributes in patients with chRCC. Kaplan-Meier analysis revealed no differences in 5-year overall survival (OS) for patients with HGF− compared to HGF+ tumors (95.0% versus 90.9%; p = 0.410).

Conclusions

In chRCC HGF expression is not associated with parameters of aggressiveness or survival.
Wear behaviour of lithography ceramic manufactured dental zirconia
Authors: Patil Ashwini , D Davidson Jebaseelan , Bomze Daniel , Gopal Vasanth
Published: May 2023

Objective

The study aims to evaluate the wear surface using 3D surface roughness and other material characterization of zirconia fabricated using photopolymerization based Lithography-based Ceramic Manufacturing (LCM).

Method

LCM technology was used to fabricate zirconia specimens of size 10 × 10 × 2mm3. Scanning Electron Microscope, 3D–profilometer, X-ray Diffraction, and hardness test characterized the samples before and after wear and Coefficient of friction (COF) was monitored.

Result

The COF was around 0.7 and did not differ much between the horizontally and vertically printed specimens. However, the surface roughness after wear for horizontally printed specimen was 0.567 ± 0.139 μm, while that for vertically printed specimen was 0.379 ± 0.080 μm. The reduced valley depth and the dale void volume were low for the vertically printed zirconia specimen, indicating lesser voids and low fluid retention. In addition, it was observed that the hardness value of the vertically printed sample was better. The scanning electron microscopic images and 3D surface profiles of the zirconia specimens depicted the surface topography and revealed the wear track.

Conclusion

The study shows that zirconia fabricated using LCM technology possesses surface roughness of about 0.5 μm with no machining scars that are usually associated with CAD/CAM dentistry and also indicating agreement with clinically acceptable values for minimal surface roughness of dental restorations. Dental restorations using LCM fabricated zirconia redues the requirement of post-processing work flow that is part of CAD/CAM dentistry.
Explaining the intention and behaviours of interinstitutional collaboration in chronic disease management among health care personnel: a cross-sectional study from Fujian Province, China
Authors: Teng Li , Dai Yue , Peng Tao , Su Yuan , Pan Lingyi , Li Yueping
Published: May 2023

Background

The increasing number of chronic diseases consumes a large amount of health resources and puts a huge burden on health service system. The integrated management of chronic diseases in Sanming City aims to improve the efficiency and quality of chronic disease management through the collaboration between different levels of medical institutions.

Aim

The aim of the present study was to use the theory of planned behaviour (TPB) to examine the intention and behaviours of interinstitutional collaboration in chronic disease management (ICCDM) among healthcare personnel.

Methods

A cross-sectional study of 274 health care personnel was conducted in medical institutions in Fujian Province, China, from March 2022 to April 2022. A self-administered questionnaire based on TPB theory was applied to measure the participants’ ICCDM behaviours.

Results

The proposed TPB model revealed that attitude was significantly and positively associated with behaviour intention, and behaviour intention and perceived behavioural control were significant predictors of ICCDM behaviour.

Conclusion

TPB provides insights into ICCDM behaviour. Due to the fact that attitude, perceived behavioural control, and behavioural intention towards ICCDM behaviour were demonstrated to be significant predictors of ICCDM behaviour, these factors may be a promising focus of ICCDM interventions in the integrated management of chronic diseases in China.
Machine learning-enhanced echocardiography for screening coronary artery disease
Authors: Guo Ying , Xia Chenxi , Zhong You , Wei Yiliang , Zhu Huolan , Ma Jianqiang , Li Guang , Meng Xuyang , Yang Chenguang , Wang Xiang , Wang Fang
Published: May 2023

Background

Since myocardial work (MW) and left atrial strain are valuable for screening coronary artery disease (CAD), this study aimed to develop a novel CAD screening approach based on machine learning-enhanced echocardiography.

Methods

This prospective study used data from patients undergoing coronary angiography, in which the novel echocardiography features were extracted by a machine learning algorithm. A total of 818 patients were enrolled and randomly divided into training (80%) and testing (20%) groups. An additional 115 patients were also enrolled in the validation group.

Results

The superior diagnosis model of CAD was optimized using 59 echocardiographic features in a gradient-boosting classifier. This model showed that the value of the receiver operating characteristic area under the curve (AUC) was 0.852 in the test group and 0.834 in the validation group, with high sensitivity (0.952) and low specificity (0.691), suggesting that this model is very sensitive for detecting CAD, but its low specificity may increase the high false-positive rate. We also determined that the false-positive cases were more susceptible to suffering cardiac events than the true-negative cases.

Conclusions

Machine learning-enhanced echocardiography can improve CAD detection based on the MW and left atrial strain features. Our developed model is valuable for estimating the pre-test probability of CAD and screening CAD patients in clinical practice.

Trial registration: Registered as NCT03905200 at ClinicalTrials.gov. Registered on 5 April 2019.
Referral rate, profile and degree of control of patients with familial hypercholesterolemia: data from a single lipid unit from a Mediterranean area
Authors: Serra-Planas Enric
Published: May 2023

Background

The challenging rigorous management of hypercholesterolemia promotes referral to specialized units. This study explored the need, based on referral rate and cardiovascular (CV) risk factor control in patients evaluated for familial hypercholesterolemia (FH), for a lipid unit (LU).

Methods

Over a four-year period, 340 referrals to our unit were analyzed to establish the lipid disorder referral rate. Moreover, 118 patients referred for potential FH during the period 2010–2018 (52.4 ± 13.9 years, 47.5% male, Caucasian, 26.3% obese, 33.1% smokers and 51.7% with some glycaemic alteration) were investigated. The Dutch Lipid Clinic Network (DLCN) score, type and dose of lipid-lowering drugs, lipid profile including lipoprotein (a) (Lp(a)) and the presence of plaques with carotid ultrasound (CU) were recorded.

Results

Lipids represented 6.2% of referrals (38 patient-years) requiring a 2–3 h weekly monographic outpatient consultation. The potential FH sample displayed a DLCN score ≥ 6 in 78% and modifiable CV risk factors in 51%. Only 22% achieved tight disease control despite intensive treatment. The statin-ezetimibe combination treatment group achieved better goals (73.0% vs. 45.5%, P = 0.003), and the rosuvastatin group had a higher proportion of prediabetes (60.9% vs. 39.1%, P = 0.037). Neither CU plaque presence nor Lp(a) > 50 mg/dL was linked with established CV disease patients, but higher Lp(a) concentrations were detected between them (102.5 (26.3–145.8) vs. 25.0 (13.0–52.0) mg/dL, P = 0.012).

Conclusions

The referral rate, degree of control, and proportion of modifiable CV risk factors in FH patients demonstrate the need for LU in our area as well as optimize control and treatment.