bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Outcomes, Food Accessibility, and the Social Determinants of Health: Visualizing Disparities in South Carolina Using an Active Learning Approach With Interactive Dashboards
Authors: Borders Stephen
Published: March 2023

The COVID-19 pandemic created mass disruptions throughout the world that continue to reverberate today. Among those are increasing demands for how public health information is delivered and consumed. Interactive dashboards such as the iconic Johns Hopkins University Center for Systems Science and Engineering dashboard have become a staple of the pandemic. Today, public health departments in all 50 states, many universities, school systems, and cities maintain active COVID-19 dashboards driving demand for those with skills and expertise to create new and innovative solutions to communicate critical public health information. This article describes a data visualization curriculum, learning objectives, and course activities using an active learning approach in a fully online, asynchronous undergraduate setting. The activities utilize publicly available data whereby students assemble the requisite data and develop an interactive dashboard in Tableau to analyze the intersection of food accessibility, the social determinants of health, and health outcomes in select South Carolina counties. The lesson resulted in an improved student understanding of the factors associated with dietary-related illness while enhancing data literacy and dashboard design skills.
Nurse Leadership Post COVID Pandemic—A Framework for Digital Healthcare Innovation and Transformation
Authors: Fletcher Monica , Read Carol , D-Adderio Luciana
Published: March 2023

Background

The COVID-19 pandemic generated a series of profound and unprecedented challenges for health and social care systems and those frontline clinicians responsible for delivering services including nurses. One consequence has been the rapid and widespread introduction of a range of digital tools, solutions, and initiatives. In the United Kingdom, this has required clinical leadership to drive implementation and adoption of digital innovations across the system, ranging from those in senior executive board level positions to those on the frontline.

Findings

This commentary presents a framework highlighting the breadth of digital transformations which emerged as a consequence of the U.K. health and social care systems’ response to the COVID-19 crisis. The framework outlines the different levels of digital transformation, ranging from what we have termed “ceremonial adoption” to isolated automation, organizational integration, and full systems integration. We reflect on the nursing leadership practices that need to be in place to support these changes.

Conclusion

Whilst acknowledging the extraordinary results achieved by the COVID-19 driven tsunami of digital transformation, we reflect on the essential steps required to translate these nascent, isolated efforts into fully integrated, long-term solutions. We also offer recommendations for clinical digital leaders and suggest steps that will be crucial to translate the temporary and/or limited interventions into effective, permanent features of our health and social care systems, while also providing a platform on which to build future digital capabilities. We will inevitably continue to see an increase in the use of technology in everyday clinical practice, and nurses are well positioned to take a lead in its widespread adoption.
Marielle’s seeds: Contesting the emotional life of corruption talk in Bolsonaro’s Brazil
Authors: Tucker Jennifer L , Granero de Melo Thainara
Published: March 2023

In this paper, we argue the emotional life of corruption narratives underwrite the rise of the extreme Right in Brazil. Further, we argue that the talk of corruption is pervasive, polysemic, contested, racialized and emotional. It is deeply entwined with social struggles over the form, content and ends of political life. Drawing on this perspective, we analyze discourses of corruption in the wake of a seismic corruption scandal, Operation Lava Jato. We identify two competing narratives of corruption. The hegemonic form uses emotions to create political enemies, promote anti-Black punitivism and uphold social hierarchies. In contrast, a counternarrative of corruption rooted in Black feminist epistemology centers racialized spatial inequality as Brazil’s central challenge and offers pathways to reclaim political life from punitive neoliberalism. We contribute by specifying how the emotional life of corruption talk helps build support for Jair Bolsonaro’s cross-class project of revanchist populism. Ultimately, we argue that the Right has successfully mobilized corruption talk in the service of necropolitics.
Evolving Treatment Patterns in Diabetic Macular Edema Between 2015 and 2020
Authors: Sodhi Guneet S. , Haq Zeeshan , Aggarwal Nitika , Boucher Nick , Emerson Geoffrey G. , Hahn Paul
Published: March 2023

Purpose: To explore the recent evolution of diabetic macular edema (DME) treatment practice patterns over 5 years among retina specialists in the United States. Methods: This retrospective analysis assessed 306 700 eyes with newly diagnosed DME from the Vestrum Health database between January 2015 and October 2020. The year-over-year and cumulative 5-year distributions of eyes treated with antivascular endothelial growth factor (anti-VEGF) agents, steroids, focal laser, or any combination and those of untreated eyes were calculated. Changes from baseline visual acuity were assessed. Results: Yearly treatment patterns changed significantly from 2015 (n = 18056) to 2020 (n = 11042). The proportion of untreated patients declined over time (32.7% vs 27.7%; P < .001), the use of anti-VEGF monotherapy increased (43.5% vs 61.8%; P < .001), the use of focal laser monotherapy declined (9.7% vs 3.0%; P < .001), and the use of steroid monotherapy remained stable (0.9% vs 0.7%; P = 1.000). Of eyes that maintained follow-up for 5 years (from 2015 to 2020), 16.3% were untreated while 77.5% were treated with anti-VEGF agents (as monotherapy or combination therapy). Vision gains in treated patients remained approximately stable from 2015 (3.6 letters) to 2020 (3.5 letters). Conclusions: From 2015 to 2020, treatment patterns for DME evolved toward greater anti-VEGF monotherapy, stable steroid monotherapy, less laser monotherapy, and fewer untreated eyes.
Smart energopower: Energy, work and waste within a UK smart grid trial
Authors: Angel James
Published: March 2023

In The Birth of Energy (2019), Cara New Daggett offers an incisive critique of the dominant thermodynamic concept of energy. ‘Energy’, Daggett shows, is inextricably tied to an exploitative productivist politics that extols the virtues of work and the sins of waste. In this paper, I seek to develop new conversations between Daggett's account in The Birth of Energy and an important empirical development within the energy industry that Daggett herself does not consider: the smart grid. The paper draws upon a mixed-methods research project, investigating a UK smart grid trial called ‘OpenDSR’ devised and implemented by Manchester-based co-operative Carbon Co-op, with funding from the UK government. I draw on my research within OpenDSR to make two interconnected arguments. Firstly, I argue that the smart grid sees an intensification of the energy-as-work logic that Daggett opposes, taking pre-existing preoccupations with calculation and measurement within the energy system to new extremes in pursuit of the maximisation of efficiency and the minimisation of waste. I then proceed to think through the political implications of this argument, contending that while the smart grid reproduces the dominant energy logic that Daggett critiques, it might still have a part to play within an emancipatory environmental politics. In making this claim, a second argument emerges, constituting a sympathetic critique of Daggett's account more broadly. Daggett offers an incisive and important contribution that does much to develop debates within the energy social sciences and humanities. However, I suggest that her account risks obscuring some important political differences between variegated forms of work and waste: while she makes a persuasive case for an anti-work conceptualisation of energy that portends liberation from waged labour, her analysis of the kinds of ‘efficiency’ that pertain to the energy system seems less compelling.
Early Findings of Segments of Delays Model Study: Delay in Seeking Treatment During Acute Coronary Syndrome and Stroke
Authors: Muraleedharan Manesh , Chandak Alaka Omprakash
Published: March 2023

Time management is critical during the acute stage of acute coronary syndrome (ACS) and stroke. To understand the segments of delays and underlying factors which affect the delay, we conducted a questionnaire survey utilizing the segments of delays model, which is still in progress to reach a higher sample size. Variables, including socio-demographic characteristics, diagnosis, symptoms and severity, awareness, and past medical history, are included in the survey. Descriptive analysis and mapping of the delays were conducted to understand the study’s early findings. A comparison of delays during ACS and stroke shows a higher delay in stroke, especially during decision-making of the victim or family members to seek treatment. Also, the socioeconomic difference between ACS and stroke and the severity of symptoms in stroke are associated with delay.
Giving can be meaningful: A two-part qualitative analysis to restore and decode professionals’ understandings of meaningfulness in dual recovery
Authors: Tønnessen Siw , Klevan Trude , Ness Ottar
Published: March 2023

Through a double interpretation of a focus group interview, the study explores how recovery-oriented professionals in a supported housing facility for people in dual recovery support the residents’ need for meaningfuless in everyday life, and how this work may also facilitate the professionals’ own need for meaningfuless. Findings suggest that professionals promote meaningful everyday life for residents by constructing (1) an open house (2) a house with a framework, and (3) a house of change, and for them self by constructing (4) a house of giving. The study proposes that a discourse is active in the data, namely, that the professional is usually in the position of giving and the person in recovery is usually in the position of receiving. We suggest that if professionals wish to promote recovery, they should provide opportunities for service users to give, not just to receive.
Why isn’t the addressing of intersectional discrimination and disadvantage a key leadership priority in English schools?
Authors: Trevenna Jo
Published: March 2023

This paper explores current accountability mechanisms for the leadership of equality, equity, diversity and inclusion in addressing intersectional discrimination faced by pupils in English schools. I draw on the work of Kimberlé Crenshaw and Patricia Hill Collins in the critical framing of intersectional discrimination and the work of UK-based academics, notably David Gillborn, in examining the impact of intersectional discrimination on pupils in the English education system. I argue that an intersectional approach can deepen understanding and acknowledge the complexities of human identity and therefore offer more sophisticated support systems for pupils. The dangers of diluting the recognition of the impact of singular, shared identity attributes are considered in the context of power hierarchies at the points of intersection and balanced against the recognition that a focus on single characteristics and a totalising view of identity may reduce understanding which can then limit equity action for equality.
Housing (de-)financialisation under state entrepreneurialism in China: The revival of affordable housing and Shanghai’s shared-ownership housing scheme
Authors: Shen Jie , Luo Xiang , Sun Zhe
Published: March 2023

While the emergent literature has clearly documented the unfolding of housing financialisation in urban China, a counter-trend occurring simultaneously has received little attention. Focusing on the revival of affordable housing and Shanghai’s shared-ownership housing (SOH) scheme, this study examines how housing financialisation is simultaneously facilitated and managed by the state. Rather than extending housing finance to low-income groups as in many Western societies, the statecraft in China is characterised by segmented housing (de-)financialisation. On the one hand, the strategy has included as many families as possible for housing financialisation; on the other hand, it has excluded low- to middle-income families to reduce financial risk and maintain social stability. SOH merges the two rationales into one by using financial capacity as an implicit eligibility criterion. While lower-middle-class families have been drawn into shared homeownership, they have been frustrated by constraints on assetisation and have become losing subjects of financialisation.
NPH Insulin Versus Insulin Glargine Versus NPH Insulin Plus Insulin Glargine for the Treatment of Dexamethasone-Induced Hyperglycemia in Patients With COVID-19: A Retrospective Cohort Study
Authors: Fornwald Courtney R. , Tuttle Natalie S. , Murphy Julie A.
Published: March 2023

Background:

Dexamethasone use in patients hospitalized with COVID-19 significantly reduces mortality; however, it commonly results in hyperglycemia. Optimal treatment of dexamethasone-induced hyperglycemia is not well established.

Objective:

The study purpose was to assess the difference in blood glucose (BG) control between insulin glargine, neutral protamine hagedorn (NPH) insulin, and insulin glargine plus NPH insulin for dexamethasone-induced hyperglycemia in patients with type 2 diabetes (T2DM) and COVID-19 infection.

Methods:

This retrospective study was conducted in adult inpatients with T2DM and COVID-19 infection who received 6 mg of dexamethasone once daily and insulin during the 5-day study period. The primary outcome was the difference in mean point-of-care (POC) BG levels between study insulins. Secondary outcomes included the incidence of hyperglycemia and hypoglycemia, length of stay, and the percent difference between the mean daily inpatient and home basal insulin doses (for patients who were receiving basal insulin prior to admission in the insulin glargine and insulin glargine and NPH insulin groups only).

Results:

Ninety-six patients were included in the analysis (67 insulin glargine, 10 NPH insulin, and 19 insulin glargine plus NPH insulin). The difference in mean POC BG level was not different among groups (254 ± 60 mg/dL vs 234 ± 39 mg/dL vs 250 ± 51 mg/dL, respectively; P = 0.548). There were no significant differences in the secondary outcomes.

Conclusions:

No difference in the mean POC BG level was observed. Dexamethasone-induced hyperglycemia was poorly controlled in patients with T2DM and COVID-19 infection.
Transcriptome and proteome analyses reveal the potential mechanism of seed dormancy release in Amomum tsaoko during warm stratification
Authors: Pan Chunliu , Yao Lixiang , Yu Liying , Qiao Zhu , Tang Meiqiong , Wei Fan , Huang Xueyan , Zhou Yunyi
Published: March 2023

Background

In Amomum tsaoko breeding, the low germination rate is the major limitation for their large-scale reproduction. We found that warm stratification was an effective treatment to break the seed dormancy of A. tsaoko prior to sowing and could be an important component of improving breeding programs. The mechanism of seed dormancy release during warm stratification remains unclear. Therefore, we studied the differences between transcripts and proteomes at 0, 30, 60, and 90 days of warm stratification, to identify some regulatory genes and functional proteins that may cause seed dormancy release in A. tsaoko and reveal their regulatory mechanism.

Results

RNA-seq was performed for the seed dormancy release process, and the number of differentially expressed genes (DEGs) was 3196 in three dormancy release periods. Using TMT-labelling quantitative proteome analysis, a total of 1414 proteins were defined as differentially expressed proteins (DEPs). Functional enrichment analyses revealed that the DEGs and DEPs were mainly involved in signal transduction pathways (MAPK signaling, hormone) and metabolism processes (cell wall, storage and energy reserves), suggesting that these differentially expressed genes and proteins are somehow involved in response to seed dormancy release process, including MAPK, PYR/PYL, PP2C, GID1, GH3, ARF, AUX/IAA, TPS, SPS, and SS. In addition, transcription factors ARF, bHLH, bZIP, MYB, SBP, and WRKY showed differential expression during the warm stratification stage, which may relate to dormancy release. Noteworthy, XTH, EXP, HSP and ASPG proteins may be involved in a complex network to regulate cell division and differentiation, chilling response and the seed germination status in A. tsaoko seed during warm stratification.

Conclusion

Our transcriptomic and proteomic analysis highlighted specific genes and proteins that warrant further study in fully grasping the precise molecular mechanisms that control the seed dormancy and germination of A. tsaoko. A hypothetical model of the genetic regulatory network provides a theoretical basis for overcoming the physiological dormancy in A. tsaoko in the future.
Genome-wide association study of 17 serum biochemical indicators in a chicken F2 resource population
Authors: Song Haijie , Li Wenting , Li Yuanfang , Zhai Bin , Guo Yujie , Chen Yi , Han Ruili , Sun Guirong , Jiang Ruirui , Li Zhuanjian , Yan Fengbin , Li Guoxi , Liu Xiaojun , Zhang Yanhua , Tian Yadong , Kang Xiangtao
Published: March 2023

Background

Serum biochemical indicators are often regarded as direct reflections of animal metabolism and health. The molecular mechanisms underlying serum biochemical indicators metabolism of chicken (Gallus Gallus) have not been elucidated. Herein, we performed a genome-wide association study (GWAS) to identify the variation associated with serum biochemical indicators. The aim of this research was to broaden the understanding of the serum biochemical indicators in chickens.

Results

A GWAS of serum biochemical indicators was carried out on 734 samples from an F2 Gushi× Anka chicken population. All chickens were genotyped by sequencing, 734 chickens and 321,314 variants were obtained after quality control. Based on these variants, a total of 236 single-nucleotide polymorphisms (SNPs) on 9 chicken chromosomes (GGAs) were identified to be significantly (-log10(P) > 5.72) associated with eight of seventeen serum biochemical indicators. Ten novel quantitative trait locis (QTLs) were identified for the 8 serum biochemical indicator traits of the F2 population. Literature mining revealed that the ALPL, BCHE, GGT2/GGT5 genes at loci GGA24, GGA9 and GGA15 might affect the alkaline phosphatase (AKP), cholinesterase (CHE) and γ-glutamyl transpeptidase (GGT) traits, respectively.

Conclusion

The findings of the present study may contribute to a better understanding of the molecular mechanisms of chicken serum biochemical indicator regulation and provide a theoretical basis for chicken breeding programs.
Influence of opioid analgesia type on circulating tumor cells in open colorectal cancer surgery (POACC-1): study protocol for a prospective randomized multicenter controlled trial
Authors: Berta Emil , Srovnal Josef , Dytrych Petr , Bruthans Jan , Ulrichova Jitka , Prasil Petr , Vecera Lubomir , Gabrhelik Tomas , Tolmaci Benjamin , Dusa Josef , Maca Jan , Mazancova Michelle , Haiduk Filip , Kutej Martin , Ihnat Peter , Michalek Pavel , Hajduch Marian
Published: March 2023

Background

Opioids and epidural analgesia are a mainstay of perioperative analgesia but their influence on cancer recurrence remains unclear. Based on retrospective data, we found that cancer recurrence following colorectal cancer surgery correlates with the number of circulating tumor cells (CTCs) in the early postoperative period. Also, morphine- but not piritramide-based postoperative analgesia increases the presence of CTCs and shortens cancer-specific survival. The influence of epidural analgesia on CTCs has not been studied yet.

Methods

We intend to enroll 120 patients in four centers in this prospective randomized controlled trial. The study protocol has been approved by Ethics Committees in all participating centers. Patients undergoing radical open colorectal cancer surgery are randomized into epidural, morphine, and piritramide groups for perioperative analgesia. The primary outcome is the difference in the number of CTCs in the peripheral blood before surgery, on the second postoperative day, and 2–4 weeks after surgery. The number of CTCs is measured using molecular biology methods. Perioperative care is standardized, and relevant data is recorded. A secondary outcome, if feasible, would be the expression and activity of various receptor subtypes in cancer tissue. We intend to perform a 5-year follow-up with regard to metastasis development.

Discussion

The mode of perioperative analgesia favorably affecting cancer recurrence would decrease morbidity/mortality. To identify such techniques, trials with long-term follow-up periods seem suboptimal. Given complex oncological therapeutic strategies, such trials likely disable the separation of perioperative analgesia effects from other factors. We believe that early postoperative CTCs presence/dynamics may serve as a sensitive marker of various perioperative interventions´ influences on cancer recurrence. Importantly, it is unbiased to the influence of long-term factors and minimally invasive. Analysis of opioid/cannabinoid receptor subtypes in cancer tissue would improve understanding of underlying mechanisms and promote personalization of treatment. We are not aware of any similar ongoing studies.

Trial registration number

NCT03700411, registration date: October 3, 2018. Study status: recruiting.
Computed tomography derived cervical fat-free muscle fraction as an imaging-based outcome marker in patients with acute ischemic stroke: a pilot study
Authors: Mesropyan Narine , Khorsandian Louisa , Faron Anton , Sprinkart Alois M. , Dorn Franziska , Paech Daniel , Isaak Alexander , Kuetting Daniel , Pieper Claus C. , Radbruch Alexander , Attenberger Ulrike I. , Reimann Jens , Bode Felix J. , Kornblum Cornelia , Luetkens Julian A.
Published: March 2023

Background

Outcome assessment in stroke patients is essential for evidence-based stroke care planning. Computed tomography (CT) is the mainstay of diagnosis in acute stroke. This study aimed to investigate whether CT-derived cervical fat-free muscle fraction (FFMF) as a biomarker of muscle quality is associated with outcome parameters after acute ischemic stroke.

Methods

In this retrospective study, 66 patients (mean age: 76 ± 13 years, 30 female) with acute ischemic stroke in the anterior circulation who underwent CT, including CT-angiography, and endovascular mechanical thrombectomy of the middle cerebral artery between August 2016 and January 2020 were identified. Based on densitometric thresholds, cervical paraspinal muscles covered on CT-angiography were separated into areas of fatty and lean muscle and FFMF was calculated. The study cohort was binarized based on median FFMF (cutoff value: < 71.6%) to compare clinical variables and outcome data between two groups. Unpaired t test and Mann-Whitney U test were used for statistical analysis.

Results

National Institute of Health Stroke Scale (NIHSS) (12.2 ± 4.4 vs. 13.6 ± 4.5, P = 0.297) and modified Rankin scale (mRS) (4.3 ± 0.9 vs. 4.4 ± 0.9, P = 0.475) at admission, and pre-stroke mRS (1 ± 1.3 vs. 0.9 ± 1.4, P = 0.489) were similar between groups with high and low FFMF. NIHSS and mRS at discharge were significantly better in patients with high FFMF compared to patients with low FFMF (NIHSS: 4.5 ± 4.4 vs. 9.5 ± 6.7; P = 0.004 and mRS: 2.9 ± 2.1 vs.3.9 ± 1.8; P = 0.049). 90-day mRS was significantly better in patients with high FFMF compared to patients with low FFMF (3.3 ± 2.2 vs. 4.3 ± 1.9, P = 0.045).

Conclusion

Cervical FFMF obtained from routine clinical CT might be a new imaging-based muscle quality biomarker for outcome prediction in stroke patients.
A rare case of H3K27-altered diffuse midline glioma with multiple osseous and spinal metastases at the time of diagnosis
Authors: Aftahy A. Kaywan , Butenschoen Vicki M. , Hoenikl Lisa , Liesche-Starnecker Friederike , Wiestler Benedikt , Schmidt-Graf Friederike , Meyer Bernhard , Gempt Jens
Published: March 2023

Background

H3K27-altered diffuse midline gliomas are uncommon central nervous system tumors with extremely poor prognoses.

Case presentation

We report the case of a 24-year-old man patient with multiple, inter alia osseous metastases who presented with back pain, hemi-hypoesthesia, and hemi-hyperhidrosis. The patient underwent combined radio-chemotherapy and demonstrated temporary improvement before deteriorating.

Conclusions

H3K27-altered diffuse midline glioma presents an infrequent but crucial differential diagnosis and should be considered in cases with rapid neurological deterioration and multiple intracranial and intramedullary tumor lesions in children and young adults. Combined radio-chemotherapy delayed the neurological deterioration, but unfortunately, progression occurred three months after the diagnosis.
The mothers’ breastfeeding behaviour within six weeks postpartum: new scale development and psychometric validation study
Authors: Wu Jing-Ling , Pang Shu-Qin , Jiang Xiu-Min , Lin Yan , Zheng Qing-Xiang
Published: March 2023

Background

The evaluation of mothers’ breastfeeding behaviour within 6 weeks postpartum could help health workers comprehensively identify maternal breastfeeding shortcomings, clarify nursing problems, and provide targeted interventions. However, no prior study was found, therefore this study aimed to develop and validate the reliability and validity of the mothers’ breastfeeding behaviour scale within 6 weeks postpartum.

Methods

A main two-step approach was used: (1) a qualitative pilot study using the purposive sampling method was adopted to test the fitness, simplicity, and clarity of items with 30 mothers; (2) a cross-sectional survey using the convenient sampling method was conducted for item analysis and psychometric validation with 600 mothers.

Results

The final version of the scale consisted of 36 items with seven dimensions, explaining 68.852% of the total variance. The Cronbach’s α, split-half, and retest coefficients were 0.958, 0.843, and 0.753, respectively. The validity of the scale: (1) Content validity: content validity index (CVI) range of items was between 0.882 and 1.000. The scale-level-CVI was 0.990. (2) Structure validity: The fitting indices were as follows: χ2/ⅆf =2.239, RMR = 0.049, RMSEA = 0.069, TLI = 0.893, CFI = 0.903, IFI = 0.904, PGFI = 0.674, and PNFI = 0.763. (3) Convergent validity: The composite reliability and average variance extracted (AVE) of the seven dimensions were between 0.876 and 0.920 and between 0.594 and 0.696. (4) Distinguish validity: The correlation coefficients were less than the square root of the AVE, except for self-decision behaviour, self-coping behaviour, and self-control behaviour. However, the fit index of the original three-factor model was better than that of the other new models, with significant differences (P < 0.001). (5) Calibration validity: The area under the curve was 0.860 or 0.898 when the scale was used to predict exclusive or any breastfeeding at 42 days. The correlation coefficients of the maternal breasting feeding evaluation scale, breastfeeding self-efficacy short-form scale, and the scale were 0.569 and 0.674, respectively.

Conclusion

The newly developed mothers’ breastfeeding behaviour scale within 6 weeks postpartum consists of 36 items belonging to seven dimensions with good reliability and validity and is a reliable and valid instrument to be used in future maternal breastfeeding behaviour assessments and interventions.
Comparison of aneuploidy rate in spontaneous abortion chorionic villus between D6 and D5 thawed-frozen blastocyst transfer
Authors: Zhao Weie , Chen Panyu , Liu Xiaoping , Li Yujie , Liang Xiaoyan , Li Jingjie
Published: March 2023

Background

To compare the aneuploidy rate in spontaneous abortion chorionic villus (SA-CV) after D5 and D6 thawed-frozen blastocyst transfer(TBT).

Methods

This retrospective cohort study recruited 522 patients with early spontaneous abortion from March 2012 to January 2020 in the our center. The aneuploidy rate of SA-CV was compared according to the blastocyst development stage: D5 group (n = 398) and D6 group (n = 124).

Results

Patients’ characteristics, including age, body mass index, follicle-stimulating hormone, fertilization methods, type of infertility, infertility duration, and gestational age when abortion, did not differ between the two groups (all P > 0.05). Although the mean number of embryos was significantly higher in D6 than in the D5 group (P < 0.001), the mean number of high-quality embryos was similar (P = 0.773). In the D5 group, 46.5% of SA-CV showed aneuploidy, which was comparable to 41.1% in the D6 group (P = 0.296). After further grouping according to age (> 35 years or ≤ 35 years), the difference between the D5 and D6 groups remained not statistically significant (P = 0.247 and P = 0.690). Multivariate logistic analysis showed that women’s age was independently associated with the aneuploidy rate (OR = 0.891; 95% CI: [0.854–0.930]; P < 0.001). The rate of chromosomal aneuploidy was significantly higher in the age > 35 years group than in the age ≤ 35 years group (61.0% vs. 39.4%, P < 0.001). Other factors, including blastocyst formation speed, were not significant predictors of aneuploidy rate.

Conclusions

The rate of chromosomal aneuploidy in SB-CV after D6 TBT was comparable to that after D5 TBT. Chromosomal aneuploidy may not be a main factor contributing to the high prevalence early pregnancy loss at D6 group.
Association of maternal risk factors with fetal aneuploidy and the accuracy of prenatal aneuploidy screening: a correlation analysis based on 12,186 karyotype reports
Authors: Wei Lun , Zhang Jiakai , Shi Ningxian , Luo Chao , Bo Le , Lu Xuanping , Gao Shasha , Mao Caiping
Published: March 2023

Background

NIPT is becoming increasingly important as its use becomes more widespread in China. More details are urgently needed on the correlation between maternal risk factors and fetal aneuploidy, and how these factors affect the accuracy of prenatal aneuploidy screening.

Methods

Information on the pregnant women was collected, including maternal age, gestational age, specific medical history and results of prenatal aneuploidy screening. Additionally, the OR, validity and predictive value were also calculated.

Results

A total of 12,186 analysable karyotype reports were collected with 372 (3.05%) fetal aneuploidies, including 161 (1.32%) T21, 81 (0.66%) T18, 41 (0.34%) T13 and 89 (0.73%) SCAs. The OR was highest for maternal age less than 20 years (6.65), followed by over 40 years (3.59) and 35–39 years (2.48). T13 (16.95) and T18 (9.40) were more frequent in the over-40 group (P < 0.01); T13 (3.62/5.76) and SCAs (2.49/3.95) in the 35–39 group (P < 0.01). Cases with a history of fetal malformation had the highest OR (35.94), followed by RSA (13.08): the former was more likely to have T13 (50.65) (P < 0.01) and the latter more likely to have T18 (20.50) (P < 0.01). The sensitivity of primary screening was 73.24% and the NPV was 98.23%. The TPR for NIPT was 100.00% and the respective PPVs for T21, T18, T13 and SCAs were 89.92, 69.77, 53.49 and 43.24%, respectively. The accuracy of NIPT increased with increasing gestational age (0.81). In contrast, the accuracy of NIPT decreased with maternal age (1.12) and IVF-ET history (4.15).

Conclusions

①Pregnant patients with maternal age below 20 years had higher risk of aneuploidy, especially in T13; ②A history of fetal malformations is more risky than RSA, with the former more likely to have T13 and the latter more likely to have T18; ③Primary screening essentially achieves the goal of identifying a normal karyotype, and NIPT can accurately screen for fetal aneuploidy; ④A number of maternal risk factors may influence the accuracy of NIPT diagnosis, including older age, premature testing, or a history of IVF-ET. In conclusion, this study provides a reliable theoretical basis for optimizing prenatal aneuploidy screening strategies and improving population quality.
HELLP syndrome, intracerebral hemorrhage, and hemophagocytic syndrome after cesarean section in a pregnant patient with severe preeclampsia: a case report
Authors: Tan Minghe , Wang Siqi , Li Qingshu , Yuan Ruixue , Zhao Maoji , Cao Jun
Published: March 2023

Background

Pregnancy-related intracranial hemorrhage (ICH) is a rare but potentially life-threatening event with complex and varied cause, such as HELLP syndrome and hemophagocytic syndrome.

Case presentation

A 33-year-old patient underwent a cesarean section with a preliminary diagnosis of "severe preeclampsia and class3 HELLP syndrome ". The patient had poor response to language before surgery, and the catheter drainage fluid was hematuria. Later, the surgeon reported severe bleeding in the operation. Following thromboelastography (TEG) result and postoperative laboratory tests confirmed class1 HELLP syndrome and ICH occurred on the second day after the surgery, and hemophagocytic syndrome was diagnosed during subsequent treatments.

Conclusion

For patients with HELLP syndrome, we should pay attention to their coagulation condition. The coagulation tests and platelet counts should be repeated if their clinical presentation changed. Those with neurological alarm signs should receive CT or MRI scan. If a pregnant woman had prolonged hemocytopenia and thrombocytopenia, not only the HELLP but also the hemophagocytic syndrome should be considered.
Optimal therapy for concomitant EGFR and TP53 mutated non-small cell lung cancer: a real-world study
Authors: Sun Haiyan , Ren Peng , Chen Yongzi , Lan Lan , Yan Zhuchen , Yang Yinli , Wang Bin , Wang Cong , Li Yanwei , Li Ling , Zhang Yu , Li Yanyang , Wang Zuolin , Pan Zhanyu , Jiang Zhansheng
Published: March 2023

Background

Non-small cell cancer (NSCLC) patients with concomitant epidermal growth factor receptor (EGFR) and TP53 mutations have a poor prognosis with the treatment of tyrosine kinase inhibitors (TKIs), and may benefit from a combination regimen preferentially. The present study aims to compare the benefits of EGFR-TKIs and its combination with antiangiogenic drugs or chemotherapy in patients with NSCLC harboring EGFR and TP53 co-mutation in a real-life setting.

Methods

This retrospective analysis included 124 patients with advanced NSCLC having concomitant EGFR and TP53 mutations, who underwent next-generation sequencing prior to treatment. Patients were classified into the EGFR-TKI group and combination therapy group. The primary end point of this study was progression-free survival (PFS). The Kaplan–Meier (KM) curve was drawn to analyze PFS, and the differences between the groups were compared using the logarithmic rank test. Univariate and multivariate cox regression analysis was performed on the risk factors associated with survival.

Results

The combination group included 72 patients who received the regimen of EGFR-TKIs combined with antiangiogenic drugs or chemotherapy, while the EGFR-TKI monotherapy group included 52 patients treated with TKI only. The median PFS was significantly longer in the combination group than in the EGFR-TKI group (18.0 months; 95% confidence interval [CI]: 12.1–23.9 vs. 7.0 months; 95% CI: 6.1–7.9; p < 0.001) with greater PFS benefit in TP53 exon 4 or 7 mutations subgroup. Subgroup analysis showed a similar trend. The median duration of response was significantly longer in the combination group than in the EGFR-TKI group. Patients with 19 deletions or L858R mutations both achieved a significant PFS benefit with combination therapy versus EGFR-TKI alone.

Conclusion

Combination therapy had a higher efficacy than EGFR-TKI alone for patients with NSCLC having concomitant EGFR and TP53 mutations. Future prospective clinical trials are needed to determine the role of combination therapy for this patient population.
Machine learning to predict occult metastatic lymph nodes along the recurrent laryngeal nerves in thoracic esophageal squamous cell carcinoma
Authors: Zhang Yiliang , Zhang Longfu , Li Bin , Ye Ting , Zhang Yang , Yu Yongfu , Ma Yuan , Sun Yihua , Xiang Jiaqing , Li Yike , Chen Haiquan
Published: March 2023

Purpose

Esophageal squamous cell carcinoma (ESCC) metastasizes in an unpredictable fashion to adjacent lymph nodes, including those along the recurrent laryngeal nerves (RLNs). This study is to apply machine learning (ML) for prediction of RLN node metastasis in ESCC.

Methods

The dataset contained 3352 surgically treated ESCC patients whose RLN lymph nodes were removed and pathologically evaluated. Using their baseline and pathological features, ML models were established to predict RLN node metastasis on each side with or without the node status of the contralateral side. Models were trained to achieve at least 90% negative predictive value (NPV) in fivefold cross-validation. The importance of each feature was measured by the permutation score.

Results

Tumor metastases were found in 17.0% RLN lymph nodes on the right and 10.8% on the left. In both tasks, the performance of each model was comparable, with a mean area under the curve ranging from 0.731 to 0.739 (without contralateral RLN node status) and from 0.744 to 0.748 (with contralateral status). All models showed approximately 90% NPV scores, suggesting proper generalizability. The pathology status of chest paraesophgeal nodes and tumor depth had the highest impacts on the risk of RLN node metastasis in both models.

Conclusion

This study demonstrated the feasibility of ML in predicting RLN node metastasis in ESCC. These models may potentially be used intraoperatively to spare RLN node dissection in low-risk patients, thereby minimizing adverse events associated with RLN injuries.
Association between vitamin D level in mother’s serum and the level of vitamin D in the serum of pre-term infants
Authors: Motlagh Alireza Jashni , Davoodvandi Ahmadreza , Saeieh Sara Esmaelzadeh
Published: March 2023

Background

Vitamin D deficiency and insufficiency is common in mothers and infants. The present study was conducted with the aim of association between the level of vitamin D in the mother’s serum and the level of vitamin D in the serum of preterm infants.

Method

The present descriptive – analytical study was performed on 140 mothers and preterm infants referred to the Kamali hospital in Alborz University of Medical Sciences. Sampling was done from available mothers after hospitalization for delivery and their infants during the first 72 hours after delivery. Information from mothers and infants were collected with researcher made check list, including age, type of delivery, number of pregnancies, vitamin D during this pregnancy, infants birth age, gender, and birth weight. Data analysis was performed using SPSS version 24 software.

Results

The average age of mothers was 28 ± 5 years and the average age of infants at the time of birth was 30 ± 1 weeks. Forty two infants (67%) were boys and 23 infants (33%) were girls. The results showed a high rate of vitamin D insufficiency and deficiency in mother (44, 49%) and preterm infants (49, 38%). The results of the Pearson correlation test showed that there is a strong and significant relationship between the serum vitamin D level of mothers and preterm infants (P = 0.001). Logistic regression tests showed that mother’s vitamin D level had an effect on the infant’s vitamin D level.

Conclusion

Considering high rate of vitamin D deficiency and insufficiency and relationship between vitamin D in preterm infants serum and mothers, diagnostic screenings are recommended to investigate vitamin D disorders in pregnant mothers, which should be planned, implemented and followed up in the form of a therapeutic program to prevent the occurrence of complications caused by this disorder in the mother and infant.
Successful treatment of Henoch-Schönlein purpura-associated hematochezia in a child with hemophilia A: a case report
Authors: Feng Kai , Liu Chang , Zhang Keqing , Hao Jing
Published: March 2023

Background

Henoch-Schönlein purpura (HSP) is a common form of immunological vasculitis in children. Hemophilia A is a genetic disorder and characterized by spontaneous hemorrhage or prolonged bleeding due to factor VIII deficiency. Both diseases increase the risk of bleeding, but they have different mechanisms. How should we treat patients with both diseases?

Case presentation

An 8-year-old male with hemophilia A was diagnosed with HSP while receiving coagulation factor VIII replacement therapy in our hospital. Hematochezia occurred 6 days after the diagnosis of HSP. And he treated with coagulation FVIII, methylprednisolone and hemostatic drugs.

Conclusions

There is no causal relationship between hemophilia A and HSP, but both diseases can cause bleeding. This child's hematochezia was caused by HSP, but hemophilia could not be ignored during the treatment. Our case report adds to the present body of knowledge about the treatment of HSP associated hematochezia in a child with hemophilia A.
Hashtag fitspiration: credibility screening and content analysis of Instagram fitness accounts
Authors: Curtis Rachel G , Prichard Ivanka , Gosse Georgia , Stankevicius Anna , Maher Carol A
Published: March 2023

Background

Fitspiration is a social media phenomenon purported to inspire viewers to lead healthier lifestyles but can result in negative psychological outcomes such as body dissatisfaction. This study aimed to develop a tool to audit Instagram fitspiration accounts and screen for content that could have potentially negative psychological effects.

Methods

This study developed and implemented an audit tool to (1) identify credible fitspiration accounts (i.e., accounts that do not portray potentially harmful or unhealthy content) and (2) describe the content of identified accounts. The most recent 15 posts of 100 leading Instagram fitspiration accounts were audited. Accounts were deemed non-credible and were excluded if they contained fewer than four fitness-related posts or portrayed nudity or inappropriate clothing, sexualisation or objectification, extreme body types, “thinspiration”, or negative messages.

Results

Many accounts contained fewer than four fitness-related posts (n = 41), sexualisation or objectification (n = 26), nudity or inappropriate clothing (n = 22), and/or extreme body types (n = 15). Three accounts failed on all four criteria, while 13, 10 and 33 failed on three, two, or one criterion, respectively. Therefore, only 41% of accounts were considered credible. Inter-rater reliability (percentage agreement and Brennan and Prediger’s coefficient κq) was high (Stage 1: 92% agreement [95% CI 87, 97], κq 0.84 [95% CI 0.73, 0.95]; Stage 2: 93% agreement [95% CI 83, 100], κq 0.85 [95% CI 0.67, 1.00]). Account holders of credible fitspiration accounts were predominantly female (59%), aged 25–34 (54%), Caucasian (62%), and from the United States (79%). Half held a qualification related to physical activity or physical health (e.g., personal trainer, physiotherapy; 54%). Most included accounts included an exercise video (93%) and example workout (76%).

Conclusion

While many popular Instagram fitspiration accounts offered credible content such as example workouts, many accounts contained sexualisation, objectification or promotion of unhealthy or unrealistic body shapes. The audit tool could be used by Instagram users to ensure the accounts they follow do not portray potentially harmful or unhealthy content. Future research could use the audit tool to identify credible fitspiration accounts and examine whether exposure to these accounts positively influences physical activity.
Individual and area-level socioeconomic correlates of hypertension prevalence, awareness, treatment, and control in uMgungundlovu, KwaZulu-Natal, South Africa
Authors: Madela SLM , Harriman NW , Sewpaul R , Mbewu AD , Williams DR , Sifunda S , Manyaapelo T , Nyembezi A , Reddy SP
Published: March 2023

Background

Hypertension is the second leading risk factor for death in South Africa, and rates have steadily increased since the end of Apartheid. Research on the determinants of hypertension in South Africa has received considerable attention due to South Africa’s rapid urbanization and epidemiological transition. However, scant work has been conducted to investigate how various segments of the Black South African population experience this transition. Identifying the correlates of hypertension in this population is critical to the development of policies and targeted interventions to strengthen equitable public health efforts.

Methods

This analysis explores the relationship between individual and area-level socioeconomic status and hypertension prevalence, awareness, treatment, and control within a sample of 7,303 Black South Africans in three municipalities of the uMgungundlovu district in KwaZulu-Natal province: the Msunduzi, uMshwathi, and Mkhambathini. Cross-sectional data were collected on participants from February 2017 to February 2018. Individual-level socioeconomic status was measured by employment status and educational attainment. Ward-level area deprivation was operationalized by the most recent (2011 and 2001) South African Multidimensional Poverty Index scores. Covariates included age, sex, BMI, and diabetes diagnosis.

Results

The prevalence of hypertension in the sample was 44.4% (n = 3,240). Of those, 2,324 were aware of their diagnosis, 1,928 were receiving treatment, and 1,051 had their hypertension controlled. Educational attainment was negatively associated with hypertension prevalence and positively associated with its control. Employment status was negatively associated with hypertension control. Black South Africans living in more deprived wards had higher odds of being hypertensive and lower odds of having their hypertension controlled. Those residing in wards that became more deprived from 2001 to 2011 had higher odds of being aware of their hypertension, yet lower odds of receiving treatment for it.

Conclusions

Results from this study can assist policymakers and practitioners in identifying groups within the Black South African population that should be prioritized for public health interventions. Black South Africans who have and continue to face barriers to care, including those with low educational attainment or living in deprived wards had worse hypertension outcomes. Potential interventions include community-based programs that deliver medication to households, workplaces, or community centers.