bluuebunny/crossref_metadata_2025 huggingface dataset:
The artist and the automaton in digital game production
Authors: Chia Aleena
Published: February 2022

This article analyses discourses around procedural content generation (PCG) as automation of creativity in the games industry. PCG refers to techniques for creating game content algorithmically, by manipulating data through sets of computational operations and parameters. By producing scalable results with combinatorial diversity, procedural generation is touted as the future of content, yet flouted as the harbinger of technological unemployment in game art production. Critical scholarship on automation suggests that the real danger is not job loss per se, but the constitution of an underclass of artists whose vital work of conditioning algorithmic outputs is denigrated as derivative and ‘manual’. Framed by liberal humanist ideas of agency, PCG naturalizes trade-offs where the autonomy of generative machines is contingent upon the automatism of its human conditioners. This qualitative analyses of talks on PCG at the Game Developers Conference (2015–2020) shows how procedural systems bifurcate the creative work of algorithmic cultural production into affective and mechanical forms of conditioning that map onto stratifications of racial capitalism. Affective tuning resists documentation and is reserved for artists with technomasculine forms of cultural capital; mechanical tuning is relegated to automatable and outsourced labour and relies on replicable technique that is considered artistic but not creative. This article argues that PCG’s reclassification of creativity through racialised dialectics of human agency and machine automaticity overlooks the autonomy of procedural systems. PCG pipelines are organised less around the agency of human toolmakers and more around the autonomy of systems that assimilate tasks in the management of complex networks of dependencies. Instead of pitting artists against machines, this analysis politicises automation’s racial stratifications by examining the momentum of more-than-human systems in which toolmakers and tool users negotiate granularities of control and degrees of concession.
Effectiveness of eHealth mindfulness-based interventions on cancer-related symptoms among cancer patients and survivors: A systematic review and meta-analysis
Authors: Fung Jonathan Ying Ting , Lim Helen , Vongsirimas Nopporn , Klainin-Yobas Piyanee
Published: February 2022

Objectives

This review aimed to synthesize the best available evidence concerning the effectiveness of electronic health, mindfulness-based interventions (eHealth-MBIs) on anxiety, depression, mindfulness and quality of life (QoL) among cancer patients/survivors.

Methods

Published and unpublished studies were retrieved from 10 electronic databases. Two independent authors screened and selected articles, extracted data using a standardized form and appraised the studies with the Cochrane risk of bias assessment tool. Meta-analyses were performed using a random-effect model with Review Manager (REVMAN). Standardized mean differences (SMDs) were used to determine intervention effects. Narrative syntheses were conducted for studies not suitable for meta-analyses. Heterogeneity was identified through I2 and chi-square statistics. Subgroup analyses were performed based on types of controls, age groups and gender. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess overall quality.

Results

In total, 18 studies were included. The eHealth-MBIs improved primary outcomes of anxiety (SMD = −0.28) and depression (SMD = −0.24), among cancer patients/survivors with small effect sizes. Effects for the secondary outcomes of QoL (SMD = 0.25) and mindfulness (SMD = 0.29) were observed at short-term follow-up assessments but not at post-intervention. Overall quality was rated as low for the primary and very low for the secondary outcomes.

Conclusion

The eHealth-MBIs can be offered as a cost-effective and accessible alternative for cancer patients and survivors in healthcare settings. Future research may further explore the effectiveness of eHealth-MBIs based on different types of MBIs, cancer types, modes of delivery and other outcomes such as stress and post-traumatic growth.
Language perceptions and use among (TV) journalists in multilingual Belgium: how pragmatic realities affect the idealized benchmark of bilingualism
Authors: Vandendaele Astrid , Standaert Olivier , Bouko Catherine
Published: February 2022

Building on previous research, we investigate how TV reporters at the French- and Dutch-speaking public television networks deal with each other’s language when preparing and producing news reports. Through analysis of 31 semi-structured interviews with journalists from both networks, our study provides both insights into the news production process in a multilingual country, and the individual reporters’ perception of the French- and Dutch-speaking Belgians’ language. By delineating how the idealized benchmark of bilingualism is restrained by pragmatic realities (format, time and language proficiency), we demonstrate how ‘coping strategies’, including collective translation processes, play a role in news production.
Endovascular Aneurysm Repair With AFX Stent-Grafts or Tube Grafts for Sacciform Infrarenal Pathologies in a Narrow Aortic Anatomy
Authors: Lescan Mario , Andic Mateja , Serban Denisa , Artzner Christoph , Grözinger Gerd , Schlensak Christian , Estler Arne , Mustafi Migdat
Published: February 2022

Purpose:

The objective of this study was to compare the outcomes of patients treated with tube grafts and AFX stent-graft in the narrow infrarenal aortic anatomy.

Materials and Methods:

Patients with penetrating aortic ulcers (PAUs) or sacciform aneurysms of the infrarenal aorta and an aortic bifurcation diameter ≤20 mm who underwent endovascular aneurysm repair (EVAR) with bifurcated AFX or tube stent-grafts (TUBE) between 2012 and 2020 were included. Demographic data and the outcome of the AFX group were compared with the TUBE group. All morphological measurements in the preoperative and postoperative computed tomography scans were performed in the aortic centerline.

Results:

Fifty-one patients (female: 12/51; 29%; median age: 72 years [63, 77]) with a median follow-up of 10 (3, 39) months, were included, of whom 35/51 (69%) had PAUs and 11/51 were symptomatic (22%). The aortic bifurcation diameter was 17 mm (15, 18) with severe calcifications in 25/51 (49%). The distal aortic landing zone was longer in the TUBE group (9 mm vs 24 mm; p<0.001). The technical success was 96% with a median aneurysm shrinkage of 8% (3, 13), which was comparable between the groups (p=0.264). Periprocedural mortality, conversion to open surgery, myocardial infarction, and stroke were not observed. Two type Ia endoleaks (EL) and 2 type Ib EL occurred, all in the TUBE group (Type 1 EL; 19 vs 0%; p=0.013). The limb patency in the AFX group was 100%. One patient with a tube graft developed an infrarenal aortic thrombosis 40 months after the intervention. The reintervention rate in the TUBE group was higher (14 vs 0%; p=0.032) and included 3 aortic cuff implantations and 1 covered endovascular aortic reconstruction of aortic bifurcation (CERAB).

Conclusion:

AFX stent-graft showed a lower rate of type I endoleaks and reinterventions in sacciform infrarenal aortic pathologies during the early and midterm follow-up.
“There Will Be an End, But We Don’t Know When”: Preserving Diverse COVID-19 Pandemic Experiences Through Oral History
Authors: Nyitray Kristen J. , Reijerkerk Dana , Kretz Chris
Published: February 2022

In March 2020, Stony Brook University Libraries began documenting campus communications and the events locally unfolding as the COVID-19 pandemic emerged across the world. These efforts evolved into a larger rapid-response collecting project planned and managed remotely. Documenting COVID-19: Stony Brook University Experiences was developed to preserve institutional history and experiences. With a collecting scope of personal narratives, photographs, and oral histories, the initiative presented new opportunities and challenges for Stony Brook University Libraries. This study discusses the oral history methods for the project from concept to implementation. It describes the planning and managing processes for the oral histories and considers the ethics of recording trauma experiences contemporaneously during the pandemic. The authors offer practical guidance for developing and processing a rapid-response collection of oral histories in a remote environment.
Cefepime Dosing Requirements in Elderly Patients Attended in the Emergency Rooms
Authors: Ruiz-Ramos Jesus , Herrera-Mateo Sergio , López-Vinardell Laia , Juanes-Borrego Ana , Puig-Campmany Mireia , Mangues-Bafalluy Maria Antonia
Published: February 2022

Objective

This study aimed to assess the probability of reaching an adequate pharmacokinetic/pharmacodynamic (pK/pD) index for different cefepime dosages in frail patients with bacteremia treated in the emergency room.

Methods

Simulation study based on Gram-negative bacterial strains that cause bacteremia. The probability of reaching a time above the minimum inhibitory concentration (MIC) at 50% and 100% dosing intervals (fT > 50 and fT > 80% MIC) was assessed for two different renal clearance intervals.

Results

One hundred twenty nine strains were collected, the predominant species being Escherichia coli (n = 83 [64.3%]). In patients with a ClCr of 30 mL/min, an fT > 50% MIC was reached in more than 90% of the simulations. However, a dose of at least 1 g every 12 h must be administered to reach an fT > 80% MIC. In patients with a ClCr of 30–60 mL/min, the probability of reaching an fT > 50% MIC was higher than 90% with doses of 1 g every 8 h or more, but this value was not reached in > 90% simulations for any of the doses tested in this study.

Conclusions

Standard cefepime dosing can reach an adequate PK/PD index in frail patients. Nevertheless, a high dose or extended infusion is necessary to reach an fT > 80% MIC in patients with a ClCr > 60 mL/min.
TEHL analysis of VH-CATT cylindrical gear transmission in elliptical contact considering time-varying parameters
Authors: Luo Pei , Wu Yang , Liang Shuang , Hou Li , Fan Qingwen , Wei Yongqiao
Published: February 2022

The lubrication characteristics of a cylindrical gear transmission with a variable hyperbolic circular-arc-tooth-trace (VH-CATT) are important theoretical bases for the tribology design of the gear and its fatigue life prediction. Existing lubrication characteristics studies of it are based on simplified linear contact models, which are limited to one specific meshing position only. Therefore, the mathematical models for tooth contact analysis (TCA) and loaded tooth contact analysis (LTCA) are established to calculate most time-varying parameters in a meshing period, such as the kinematic parameters, spatial geometric parameters, and contact parameters, are calculated. Accordingly, a thermo-elastohydrodynamic lubrication (TEHL) model of an elliptical contact of this gear transmission is presented. Using all the proposed mathematical models, the TEHL results with smooth and rough tooth surfaces in a meshing period are analyzed. The obtained results reveal that these models can be used to predict the distribution of the film thickness, pressure, and temperature rise on the smooth and rough tooth surfaces of VH-CATT cylindrical gear transmission in each contact area of a meshing period. And it shows that the time-varying parameters have great influences on lubrication performance. Furthermore, the lubrication mechanism in a meshing period is investigated systematically in VH-CATT cylindrical gear transmission.
Thromboembolectomy for acute lower limb ischemia: Contemporary outcomes of two surgical methods from a single tertiary center
Authors: Chahrour Mohamad A , Berri Nabih , Jaafar Rola , Sfeir Roger , Haddad Fady , Hoballah Jamal J
Published: February 2022

Objectives

The current treatment of acute lower limb ischemia (ALLI) includes open surgical and percutaneous pharmaco-mechanical thromboembolectomy (TE). We hereby report our results with open surgical TE over a 10-year period and compare our outcomes using routine fluoroscopic assisted TE (FATE) with blind and selective on demand fluoroscopic-assisted TE (BSTE).

Methods

This is a retrospective analysis of all patients who underwent open surgical TE for acute lower limb ischemia at a single tertiary center between 2008 and 2018. Patients were divided into a group who underwent BSTE and another who underwent routine FATE. Data on presentation, medical history, surgery performed, and short-term outcomes were retrieved from medical record. Comparison between baseline characteristics and outcomes of both groups were made using t-test and chi-square analysis.

Results

Over 10 years, 108 patients underwent surgical TE. Thirty-day mortality rate and 30-day major lower extremity amputation rate in the cohort were 12.0% and 6.5%, respectively. On subgroup analysis, 53 patients were treated by BSTE and 55 patients by FATE. There was no significant difference in 30-day mortality rate (11.3% vs 12.7%, p-value = .82) and 30-day major amputation rate (9.4% vs 3.6%, p-value = .454) between the two groups. Local anesthesia was more frequently performed in patients undergoing FATE (58.2% vs 24.5%, p-value < .001). More than one arteriotomy was more frequently required in patients undergoing BSTE (2.6% vs 45.5%, p-value < .001). Patients with infrapopliteal involvement undergoing FATE required less further interventions such as patch angioplasty (2.6% vs 36.4%, p-value < .001) and bypass (2.6% vs 22.7%, p-value = .01).

Conclusion

ALLI remains a disease of high morbidity and mortality. Open surgical TE offers an effective approach to treat ALLI. The addition of fluoroscopy to the conduction of TE could be associated with valuable benefits, especially in patients with infra-popliteal involvement. Randomized controlled trials are needed to objectively assess the therapeutic potential of FATE.
Incidence and mortality of cerebrovascular disease in Spain: 1,600,000 hospital admissions between 2001 and 2015
Authors: Pérez Hernández Azuquahe , Rodríguez Pérez Mª del Cristo , Marcelino Rodríguez Itahisa , Cuevas Fernández Francisco J , Domínguez Coello Santiago , Almeida González Delia , Calleja Puerta Sergio , Cabrera de León Antonio
Published: February 2022

Background:

To analyze the incidence and mortality of cerebrovascular diseases (CeVD) in Spain from 2001 to 2015.

Methods:

Retrospective study of hospital incidence, hospital case fatality and population mortality, with records from the Spanish Government Statistics. Days of hospital stay and risk of death (RD) during admission were estimated adjusting for age, sex, first stroke (FS), atrial fibrillation (AF), diabetes, hypertension, and smoking.

Results:

There were 1,662,487 stroke cases older than 15 years of age admitted to hospital (1,096,748 FS), with a national incidence = 291/105 in this period (Murcia maximum (367/105), Canary Islands minimum (238/105)). Population mortality (−50%) decreased while case fatality remained stable (−3%), despite the increase in the age of patients (+2.29 years) and the incidence (+25%). Canary Islands had the youngest patients (−3.5 years for men and −6 years for women) and the longest hospital stay (+5.1 days). Andalusia (odds ratio (OR) = 1.21 (1.19; 1.22)) and the Canaries (OR = 1.18 (1.15; 1.21)) had the highest RD. The factors associated to the highest increases in RD were FS (OR = 1.34 (95% confidence interval (CI) = 1.33–1.35)) and AF (OR = 1.30 (95% CI = 1.29–1.31)).

Conclusion:

Population mortality due to CeVD was reduced by half in Spain between 2001 and 2015, but hospital incidence increased. Andalusia and the Canary Islands had the highest RD in the country. These islands presented the lowest incidence, but their patients were younger, and their hospital stay longer. FS and AF were the factors associated with a higher RD.
Extraskeletal myxoid chondrosarcoma: A case series and review of the literature
Authors: Fice Michael P , Lee Linus , Kottamasu Pavan , Almajnooni Abdullah , Cohn Matthew R , Gusho Charles A , Gitelis Steven , Blank Alan T
Published: February 2022

Background

Extraskeletal myxoid chondrosarcoma (EMC) is a rare malignant soft tissue sarcoma (STS) that accounts for less than 3% of all soft tissue tumors. The conventional treatment for primary EMC is wide local excision with or without radiation therapy.

Materials and Methods

This study was a retrospective review of all EMC cases treated within a single institution between 1992 and 2019. EMC was diagnosed using a combination of histologic morphology and immunostaining, with confirmatory fluorescent in situ hybridization. Overall survival (OS) and disease-specific survival (DSS) were defined using Kaplan–Meier analysis.

Results

Fifteen patients were evaluated, including 11 males and four females. The average age at presentation was 51.7 ± 20.4 years and the mean follow-up time was 61.5 months (range, 5–286 months). The average resected tumor size at largest dimension was 7.14 cm (range, 2.4–18.7). Twelve of fifteen (80%) patients underwent wide local excision, and nine of the twelve (75%) underwent local radiation therapy. The 1-, 5-, and 10-year OS was 80% (95% CI, 59.8–100), 72% (95% CI, 48.5–95.5), and 72% (95% CI, 48.5–95.5), respectively. The 1-, 5-, and 10-year DSS was 92.3% (95% CI, 77.8–100), 83.1% (95% CI, 61.5–100), and 83.1% (95% CI, 61.5–100), respectively. At last follow-up, 11 patients were alive and ten (90.9%) were disease free.

Conclusions

Extraskeletal myxoid chondrosarcoma is a very rare STS most often seen in males and in the extremities. Our cohort was too small to provide meaningful statistical analysis; however, we observed lower rates of local recurrence in patients treated with radiation.
Refractory MOG-Associated Demyelinating Disease in a Pediatric Patient
Authors: Kroenke Eve , Ankar Alex , Malani Shukla Nikita
Published: February 2022

Background: MOG antibody associated demyelinating disease (MOGAD) is a newly described autoimmune disorder that presents with monophasic or multiphasic demyelination in children. Case: We report a case of MOGAD that was refractory to current treatment algorithms and required rapid escalation of immunotherapy to achieve disease control. Conclusion: This case helps to further expand the phenotype of MOGAD and emphasizes the need to consider MOGAD in patients presenting with focal neurologic deficits, altered mental status, and/or seizures.
Association of Clinical Signs, Host Biomarkers and Etiology With Radiological Pneumonia in Bhutanese Children
Authors: Jullien Sophie , Richard-Greenblatt Melissa , Casellas Aina , Tshering Kinley , Ribó Jose Luis , Sharma Ragunath , Tshering Tashi , Pradhan Dinesh , Dema Kumbu , Ngai Michelle , Muñoz-Almagro Carmen , Kain Kevin C. , Bassat Quique
Published: February 2022

Diagnosing pneumonia and identifying those requiring antibiotherapy remain challenging. Chest radiographs (CXR) are often used as the reference standard. We aimed to describe clinical characteristics, host-response biomarkers and etiology, and assess their relationship to CXR findings in children with pneumonia in Thimphu, Bhutan. Children between 2 and 59 months hospitalized with WHO-defined pneumonia were prospectively enrolled and classified into radiological endpoint and non-endpoint pneumonia. Blood and nasopharyngeal washing were collected for microbiological analyses and plasma levels of 11 host-response biomarkers were measured. Among 149 children with readable CXR, 39 (26.2%) presented with endpoint pneumonia. Identification of respiratory viruses was common, with no significant differences by radiological outcomes. No clinical sign was suggestive of radiological pneumonia, but children with radiological pneumonia presented higher erythrocyte sedimentation rate, C-reactive protein and procalcitonin. Markers of endothelial and immune activation had little accuracy for the reliable identification of radiological pneumonia.
Challenges in the Diagnosis and Management of Nephrotic Syndrome in a Child With Multisystemic Tuberculosis
Authors: Nassih Houda , El Qadiry Rabiy , Bourrahouat Aicha , Ait Sab Imane
Published: February 2022

We report the case of a child who had tuberculosis associated with nephrotic syndrome. In this case, it was difficult to identify if the renal involvement was due to renal infection with mycobacterium tuberculosis, the consequence of nephrotoxicity of anti-bacillary drugs, or due to new onset of nephrosis. Management was complex as the use of high-dose steroids can disseminate the infection.
Factors Associated With Pre-Lacteal Feeding Practices Among Mothers Having Children Aged 0-36 Months in Bangladesh: Evidence From Bangladesh Demographic and Health Survey 2017-18
Authors: Sultana Faojia , Sheba Israt Tahira
Published: February 2022

Despite being a known barrier to optimal breast-feeding indicators, the practice of Pre-lacteal Feeding (PLF) remains a key challenge in Bangladesh. This study examines the prevalence and underlying factors associated with PLF, for which data from a weighted sample of 4982 Bangladeshi mothers with children aged 0 to 36 months from the 2017-18 Bangladesh Demographic and Health Survey was used. Step-by-step multivariate logistic regression was performed to identify the association of significant determinants of PLF practices. Nearly 29% newborns received PLF before breastmilk and timely initiation of breastfeeding did not happen in case of 20.5% babies. The odds of PLF were significantly higher among the inhabitants of Dhaka division compared to other regions. In addition, birth-related factors such as optimal ANC visits ( P < .01), home delivery ( P < .01) and delivered by cesarean section ( P < .01) showed significantly higher odds of introducing PLF to the newborns. Our results demonstrated the need for developing targeted policies and actions to prevent such practices of PLF in order to improve optimal breastfeeding behavior in Bangladesh.
Effects of veverimer on serum bicarbonate and physical function in women with chronic kidney disease and metabolic acidosis: a subgroup analysis from a randomised, controlled trial
Authors: Mathur Vandana S. , Wesson Donald E. , Tangri Navdeep , Li Elizabeth , Bushinsky David A.
Published: February 2022

Background

Globally, the prevalence of chronic kidney disease (CKD) is higher in women than in men; however, women have been historically under-represented in nephrology clinical trials. Metabolic acidosis increases risk of progressive loss of kidney function, causes bone demineralization and muscle protein catabolism, and may be more consequential in women given their lower bone and muscle mass. Veverimer, an investigational, non-absorbed polymer that binds and removes gastrointestinal hydrochloric acid, is being developed as treatment for metabolic acidosis.

Methods

This was a Phase 3, multicenter, randomised, blinded, placebo-controlled trial in 196 patients with CKD (eGFR: 20–40 mL/min/1.73 m2) and metabolic acidosis who were treated for up to 1 year with veverimer or placebo. We present the findings from a pre-specified subgroup analysis evaluating the effects of veverimer on metabolic acidosis and physical function among women (N = 77) enrolled in this trial.

Results

At week 52, women treated with veverimer had a greater increase in mean (± standard error) serum bicarbonate than the placebo group (5.4 [0.5] vs. 2.2 [0.6] mmol/L; P < 0.0001). Physical Function reported by patients on the Kidney Disease and Quality of Life – Physical Function Domain, a measure that includes items related to walking, stair climbing, carrying groceries and other activities improved significantly in women randomized to veverimer vs placebo (+ 13.2 vs. -5.2, respectively, P < 0.0031). Objectively measured performance time on the repeated chair stand test also improved significantly in the veverimer group vs. placebo (P = 0.0002).

Conclusions

Veverimer was effective in treating metabolic acidosis in women with CKD, and significantly improved how they felt and functioned.

Trial registration

ClinicalTrials.gov Identifier: NCT03390842. Registered on January 4, 2018.
Urban-rural differences in China’s crude death rate changes
Authors: Xiao Fan , Mei Li , Jiang Quanbao
Published: February 2022

Background

From 1982 to 2010, the country’s crude death rate (CDR) dropped sharply, fluctuated, and finally slightly declined. There is a big difference in CDR between urban and rural areas. From 1982 to 1990, the CDR in the country and the countryside declined, and the CDR in cities and towns rose. After 1990, the CDR in cities gradually decreased, the CDR in towns first fell and then rose, and the CDR in the countryside steadily increased. The CDR is affected by changes in the age-specific death rate (ASDR) and age structure.

Methods

This paper decomposes CDR changes into the influence of declines in ASDR and the impact of age structure changes based on 1982, 1990, 2000, and 2010 census data.

Results

The decline in ASDR reduces the CDR, and the aging population increases the CDR (including cities, towns, and the countryside). At the same time, decomposing the difference between the countryside and cities (or the countryside and towns) CDRs found that after 1990, the influence of ASDR differences and age structure differences increased with time. Our results revealed a more significant effect of ASDR differences. The combined effect of two factors (ASDR and age structure) makes the 0, 1–14, 15–64 age groups reduce the CDR, and the 65+ age group increases the CDR. In addition, the 0-year-old group has a not negligible impact on the changes in CDR, although it accounts for a small proportion of the total population.

Conclusions

The influence of ASDR and age structure differs over time (1982 to 1990, 1990 to 2000, and 2000 to 2010) and across regions (cities, towns, the countryside). Considering the slow decline in ASDR and the accelerated aging population, we can infer that the CDR in 2020 will stabilize or even rise slightly instead of dropping significantly (compared with the CDR in 2010). This study provides a basis for the formulation of relevant public health policies.
Correlation analysis of coronary artery tortuosity and calcification score
Authors: Li Min , Wang Zhen-Wei , Fang Li-Juan , Cheng Shou-Quan , Wang Xin , Liu Nai-Feng
Published: February 2022

Background

Coronary artery tortuosity (CAT) is regarded as a variation of vascular anatomy, and its relationship with coronary artery calcification (CAC) score is still not well clarified. Studying the correlation between coronary artery calcification scores and CAT to determine specific prevention and intervention populations seems to have more meaningful.

Methods

The study is a cross-sectional retrospective study, including 1280 patients. CAT is defined as the presence of at least three consecutive curvatures of more than 45°measured during systole or diastole of a major epicardial coronary artery. Multivariable regression analysis was used to adjust the clinical parameters directly affecting CAT.

Results

Of these individuals, 445 (35%) were evaluated having CAT, of which females are higher than males (59.1% vs. 40.9%). Moderate CAC score (101–400) (odds ratio (OR) 1.49, 95% confidence interval [95%CI] 1.05–2.10, P = 0.025) revealed significantly associated with CAT on univariable analysis. However, multivariable analysis after adjusting for confounding factors only indicated that CAT was positively correlated with female (OR 1.68, 95%CI 1.30–2.17, P < 0.001), hypertension (OR 1.35, 95% CI 1.04–1.75, P = 0.024), and age (OR 1.02, 95% CI 1.01–1.03, P = 0.001), while was negatively associated with body mass index (BMI) 24–27.9(OR 0.76, 95% CI 0.58–1.00, P = 0.044), and BMI > 28 (OR 0.46, 95% CI 0.31–0.68, P < 0.001). Further analysis stratified by gender showed that compared with non-CAT, CAT was significantly linked with moderate CAC score (OR 1.79, 95% CI 1.00–3.20, P = 0.048), hypertension (OR 1.54, 95% CI 1.07–2.22, P = 0.021), and high-density lipoprotein (HDL) (OR 1.86, 95% CI 1.07–3.24, P = 0.028), while was negatively related to BMI > 28 (OR 0.51, 95% CI 0.31–0.84, P = 0.008) in female patients.

Conclusions

CAT is more likely to be found in females, connected with hypertension, age, and BMI. No significant correlation is found between the presence of tortuosity and calcium score or diameter stenosis on multivariable analysis. Whereas the CAT is associated with moderate CAC score in correlation analysis when women are selected as the main group.
Single-site laparoscopic high ligation of the extraperitoneal hernia sac with an epidural needle for incarcerated ovarian hernia in infants
Authors: Wang Yun-jin , Chen Liu , Zhang Qi-liang , Zhang Jian-qin , Cui Xu , Zhou Chao-ming
Published: February 2022

Background

The purpose of this study was to evaluate the safety and efficacy of single-site laparoscopic extraperitoneal hernia sac ligation with an epidural needle for incarcerated ovarian hernias in infants and young children.

Methods

The clinical data of 38 infants with incarcerated ovarian hernias who underwent single-site laparoscopic extradural needle extraperitoneal hernia sac ligation from January 2015 to January 2018 were retrospectively analysed.

Results

All procedures were successfully performed using laparoscopy with no need for conversion to open surgery. The time of hospital stay was 1.30 ± 0.39 days. During hospitalization and follow-up, there were no complications, such as intestinal or bladder injury, abdominal wall vascular injury, ovarian atrophy, hernia recurrence or contralateral indirect hernia. However, three patients experienced complications, including two cases of poor healing of the umbilical incision and one case of suture granuloma.

Conclusions

Single-site laparoscopic high ligation of the extraperitoneal hernia sac with an epidural needle is a safe and feasible method for the treatment of incarcerated ovarian hernias in infants and young children. It has the advantages of minimal trauma, no scarring and good cosmetic effects.
In vitro inactivation of SARS-CoV-2 using a povidone-iodine oral rinse
Authors: Shet Manjunath , Westover Jonna , Hong Rosa , Igo David , Cataldo Marc , Bhaskar Sailaja
Published: February 2022

Background

Healthcare professionals, especially dentists and dental hygienists, are at increased risk for contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through air-borne particles and splatter. This study assessed the in vitro virucidal activity of 0.5% (w/v) povidone-iodine (PVP-I) oral rinse against SARS-CoV-2 to demonstrate its utility as a professional oral rinse.

Methods

A 0.5% (w/v) PVP-I oral rinse formulation, placebo oral rinse, and positive (70% [v/v] ethanol and water) and negative (water) controls were assessed using the time-kill method. SARS-CoV-2 was propagated in Vero 76 host cells. Following neutralization validation, triplicate tests were performed for each test formulation and virucidal activity measured at 15, 30, and 60 s and 5 min.

Results

The 0.5% (w/v) PVP-I oral rinse demonstrated effective in vitro virucidal activity against SARS-CoV-2 as early as 15 s after exposure; viral titer was reduced to < 0.67 log1050% cell culture infectious dose (CCID50)/0.1 mL (log10reduction of > 4.0) at 30 s, whereas the placebo oral rinse reduced the SARS-CoV-2 viral titer to 4.67 and 4.5 log10CCID50/0.1 mL at the 15- and 30-s time points, with a log10reduction of 0.63 and 0.17, respectively. No toxicity or cytotoxic effects against Vero 76 host cells were observed with the 0.5% (w/v) PVP-I oral rinse; positive and negative controls performed as expected.

Conclusions

In vitro virucidal activity of 0.5% (w/v) PVP-I oral rinse against SARS-CoV-2 was demonstrated. Rapid inactivation of SARS-CoV-2 was observed with 0.5% (w/v) formulation with a contact duration of 15 s. Clinical investigations are needed to assess the effectiveness of PVP-I oral rinse against SARS-CoV-2 in dental practice.
Development and validation of an instrument to measure pediatric nurses' adherence to ethical codes
Authors: Beykmirza Raziyeh , Nikfarid Lida , Negarandeh Reza , Sarkhani Naeimeh , Moradi Cherati Mahboube
Published: February 2022

Background and aim

The nature of pediatric settings may encounter nurses with more complicated ethical issues. A code of ethics guides nurses to act and decide ethically as a profession. Also, there is always a need to evaluate amount nurses adhere to this code of ethics, using valid and reliable instruments. This study aimed to develop a questionnaire and assess its psychometric properties to measure pediatric nurses' adherence to the code of ethics.

Methods

In this methodological research study, firstly, the questionnaire was developed based on an extensive review of the related literature and the theoretical framework of nursing ethics. A panel of experts (n = 12) reviewed the preliminary questionnaire qualitatively and quantitatively (using CVI and CVR). A conveniently selected sample of 156 nurses working in pediatric wards in three hospitals filled out the questionnaire. The psychometric process included determining sample size and data adequacy using KMO and Bartlette's test of sphericity; exploratory factor analysis (principal component method with Promax rotation); item analysis; and Cronbach's alpha coefficient. Also, the Interclass Correlation Index (ICC) value was determined using a two-week interval test–retest method on 30 eligible nurses.

Results

The CVI and CVR for the entire questionnaire were 0.85 and 0.78, respectively. The CVI and CVR of all items were reported higher than 0.59 and 0.8, respectively. Cronbach's alpha of the 28-items instrument was 0.92. Extracted six factors explained 65.31% of the total variance, and the values of the item correlations with the total questionnaire showed good internal consistency (0.52 to 0.90). The items of each factor were evaluated to determine the values they represent. Accordingly, the factors were named beneficence, nonmaleficence, human dignity, autonomy, informed consent, and honesty. The ICC value was 0.99.

Conclusions

The developed instrument is acceptable and has good reliability and validity. It can be used to assess the amount of pediatric nurses' adherence to the code of ethics by managers, teachers, and researchers.
The social determinants of health associated with cardiometabolic diseases among Asian American subgroups: a systematic review
Authors: Min Lucy Y. , Islam Rehnuma B. , Gandrakota Nikhila , Shah Megha K.
Published: February 2022

Background

Asian Americans represent one of the fastest-growing immigrant groups in the U.S. and are at high risk for cardiometabolic diseases (CMDs), including type 2 diabetes, hypertension, coronary artery disease, and stroke. Despite the growth of Asians in the U. S, there is a gap in understanding the heterogeneity of CMDs across Asian subgroups and how these might be affected by the social determinants of health (SDOH), or the environment in which people live and work.

Objective

The purpose of this systematic review is to examine the current literature on CMDs among Asian Americans and identify the SDOH that are associated with the incidence and/or prevalence of CMDs among specific Asian subgroups.

Methods

PubMed, Embase, Web of Science were searched for articles published in Jan 2000-Nov 2020. The reproducible strategy yielded 2732 articles. The articles were reviewed based on the following inclusion criteria: (1) observational study published in the U.S., (2) adult population includes specific Asian subgroups, (3) exposures include SDOH, and (4) outcomes include a CMD, defined as type 2 diabetes, hypertension, coronary artery disease, or stroke.

Results

In this review, 14 studies were identified and organized into four key themes: acculturation (n = 9), socioeconomic status (SES) (n = 6), social context (n = 2), and health literacy (n = 1). The most represented Asian subgroups in the literature were Chinese, Filipino, and South Asians. Acculturation was the most described social factor in the included reviews. Seven studies found associations between higher acculturation levels and higher prevalence of CMD. However, the measure of acculturation varied by study and included various combinations of the country of birth, number of years residing in the U.S., and English proficiency. The effects of SES, measured as income level and educational attainment, varied by racial subgroups. One study found that higher levels of education were associated with CMD among South Asians.

Conclusion

Acculturation, SES, social context, and health literacy impact the risk of CMD among Asian Americans; these vary across subgroups. Future research disentangling SDOHs on the risk of CMDs by Asian subgroup is necessary to provide better informed preventive practices and interventions.
Toddler foods and milks don’t stack up against regular foods and milks
Authors: McCann Jennifer , Beckford Kelsey , Beswick Holly , Chisholm Melanie , Woods Julie
Published: February 2022

Aim

To compare the cost and nutritional profiles of toddler-specific foods and milks to ‘regular’ foods and milks.

Methods

Cross-sectional audit of non-toddler specific (‘regular’) foods and milks and secondary analysis of existing audit data of toddler specific (12-36 months) foods and milks in Australia.

Main findings

The cost of all toddler-specific foods and milks was higher than the regular non-toddler foods. Foods varied in nutritional content, but toddler foods were mostly of poorer nutritional profile than regular foods. Fresh milk cost, on average, $0.22 less per 100 mL than toddler milk. Toddler milks had higher mean sugar and carbohydrate levels and lower mean protein, fat, saturated fat, sodium and calcium levels per 100 mL, when compared to fresh full fat cow’s milk.

Conclusions

Toddler specific foods and milks cost more and do not represent value for money or good nutrition for young children.
How do naloxone-based interventions work to reduce overdose deaths: a realist review
Authors: Miller Nicole M. , Waterhouse-Bradley Bethany , Campbell Claire , Shorter Gillian W.
Published: February 2022

Background

Naloxone-based interventions as part of health systems can reverse an opioid overdose. Previous systematic reviews have identified the effectiveness of naloxone; however, the role of context and mechanisms for its use has not been explored. This realist systematic review aims to identify a theory of how naloxone works based on the contexts and mechanisms that contribute to the success of the intervention for improved outcomes.

Methods

Pre-registered at PROSPERO, this realist review followed RAMESES standards of reporting. Keywords included 'naloxone' and ' opioid overdose'. All study designs were included. Data extraction using 55 relevant outputs based on realist logic produced evidence of two middle-range theories: Naloxone Bystander Intervention Theory and Skills Transfer Theory.

Results

Harm reduction and/or low threshold contexts provide a non-judgemental approach which support in-group norms of helping and empower the social identity of the trained and untrained bystander. This context also creates the conditions necessary for skills transfer and diffusion of the intervention into social networks. Stigma and negative attitudes held by first responders and stakeholders involved in the implementation process, such as police or GPs, can prohibit the bystander response by inducing fear in responding. This interferes with skills transfer, naloxone use and carriage of naloxone kits.

Conclusions

The findings provide theoretically informed guidance regarding the harm reduction contexts that are essential for the successful implementation of naloxone-based interventions. Peer-to-peer models of training are helpful as it reinforces social identity and successful skills transfer between bystanders. Health systems may want to assess the prevalence of, and take steps to reduce opioid-related stigma with key stakeholders in contexts using a low threshold training approach to build an environment  to support positive naloxone outcomes.

Trial Registration

PROSPERO 2019 CRD42019141003.
Intimate partner violence and unmet need for family planning in Afghan women: the implication for policy and practice
Authors: Dadras Omid , Nakayama Takeo , Kihara Masahiro , Ono-Kihara Masako , Dadras Fateme
Published: February 2022

Background

Intimate Partner Violence (IPV) is a serious public health issue and has been linked to a range of adverse health outcomes. This study explored the prevalence of IPV and its relationship with the unmet need for family planning among a sample of married Afghan women aged 18–49 years.

Methods

This study used the data from Afghanistan Demographic and Health Survey (DHS) conducted in 2015. The data relating to IPV, unmet need for family planning, and sociodemographic characteristics of Afghan women aged 18–49 (n = 20,593) were extracted and analyzed accounting for the sampling weights and survey design in bivariate and multivariate analyses using the STATA software version 14.

Results

An estimated 55.89% experienced some type of IPV during the last 12 months. Unmet need for family planning was documented in less than a third of the population. Illiterate employed women from poorer families who were living in the rural areas were more likely to suffer from any type of IPV. Moreover, those from Pashtun, Tajik, and Pashai ethnic groups had a higher odds of any type of violence compared to the reference group (Turkmen). Illiterate women (OR = 1.37, 95% CI 1.02–1.83) with more than 5 pregnancy experiences (OR = 1.44, 95% CI 1.19–1.74) had more unmet needs for family planning compared to the reference group. The unmet needs were almost 40% and 30% less likely to be observed among women from Pashtun and Tajik ethnic backgrounds compared to the reference group (Turkmen), respectively. The likelihood of having unmet needs was 30% less in those women who suffered from any type of violence.

Conclusion

IPV is an important predictor of several adverse health outcomes. The findings portray the disastrous situation of Afghan women’s rights violation and violence against them and communicate an important message to the international communities and human rights advocate to take immediate actions in order to mitigate the current situation and prevent the violence against Afghan women to improve the integrity of their reproductive health.
The systematic development of attributes and levels for a discrete choice experiment of HIV patient preferences for long-acting antiretroviral therapies in the United States
Authors: Brah Aaron T. , Barthold Douglas , Hauber Brett , Collier Ann C. , Ho Rodney J. Y. , Marconi Vincent C. , Simoni Jane M. , Graham Susan M.
Published: February 2022

Introduction

Patient preferences for long-acting antiretroviral therapies (LA-ART) should inform development of regimens with optimal adherence and acceptability. We describe a systematic process used to identify attributes and levels for a discrete choice experiment (DCE) designed to elicit preferences for potential LA-ART options in the US.

Methods

Our approach was conducted in four stages: data collection, data reduction, removing inappropriate attributes, and optimizing wording. We started with 8 attributes defining potential LA-ART products based on existing literature and knowledge of products in development. We conducted 12 key informant interviews with experts in HIV treatment. The list of attributes, the set of plausible levels for each attribute, and restrictions on combinations of attribute levels were updated iteratively.

Results

Despite uncertainty about which products will become available, key informant discussions converged on 4 delivery modes (infusions and patches were not considered immediately feasible) and 6 additional attributes. Treatment effectiveness and frequency of clinical monitoring were dropped. Oral lead-in therapy was split into two attributes: pre-treatment time undetectable and pre-treatment negative reaction testing. We omitted product-specific systemic and local side effects. In addition to mode, the final set of attributes included: frequency of dosing; location of treatment; pain; pre-treatment time undetectable; pre-treatment negative reaction testing; and late-dose leeway.

Conclusions

A systematic process successfully captured elements that are both feasible and relevant to evaluating the acceptability of potential LA-ART alternatives to patients.
Controlled human exposure to diesel exhaust: a method for understanding health effects of traffic-related air pollution
Authors: Long Erin , Schwartz Carley , Carlsten Christopher
Published: February 2022

Diesel exhaust (DE) is a major component of air pollution in urban centers. Controlled human exposure (CHE) experiments are commonly used to investigate the acute effects of DE inhalation specifically and also as a paradigm for investigating responses to traffic-related air pollution (TRAP) more generally. Given the critical role this model plays in our understanding of TRAP’s health effects mechanistically and in support of associated policy and regulation, we review the methodology of CHE to DE (CHE–DE) in detail to distill critical elements so that the results of these studies can be understood in context. From 104 eligible publications, we identified 79 CHE–DE studies and extracted information on DE generation, exposure session characteristics, pollutant and particulate composition of exposures, and participant demographics. Virtually all studies had a crossover design, and most studies involved a single DE exposure per participant. Exposure sessions were typically 1 or 2 h in duration, with participants alternating between exercise and rest. Most CHE–DE targeted a PM concentration of 300 μg/m3. There was a wide range in commonly measured co-pollutants including nitrogen oxides, carbon monoxide, and total organic compounds. Reporting of detailed parameters of aerosol composition, including particle diameter, was inconsistent between studies, and older studies from a given lab were often citedin lieuof repeating measurements for new experiments. There was a male predominance in participants, and over half of studies involved healthy participants only. Other populations studied include those with asthma, atopy, or metabolic syndrome. Standardization in reporting exposure conditions, potentially using current versions of engines with modern emissions control technology, will allow for more valid comparisons between studies of CHE–DE, while recognizing that diesel engines in much of the world remain old and heterogeneous. Inclusion of female participants as well as populations more susceptible to TRAP will broaden the applicability of results from CHE–DE studies.
Unconventional protein post-translational modifications: the helmsmen in breast cancer
Authors: Liu Jiena , Wang Qin , Kang Yujuan , Xu Shouping , Pang Da
Published: February 2022

Breast cancer is the most prevalent malignant tumor and a leading cause of mortality among females worldwide. The tumorigenesis and progression of breast cancer involve complex pathophysiological processes, which may be mediated by post-translational modifications (PTMs) of proteins, stimulated by various genes and signaling pathways. Studies into PTMs have long been dominated by the investigation of protein phosphorylation and histone epigenetic modifications. However, with great advances in proteomic techniques, several other PTMs, such as acetylation, glycosylation, sumoylation, methylation, ubiquitination, citrullination, and palmitoylation have been confirmed in breast cancer. Nevertheless, the mechanisms, effects, and inhibitors of these unconventional PTMs (particularly, the non-histone modifications other than phosphorylation) received comparatively little attention. Therefore, in this review, we illustrate the functions of these PTMs and highlight their impact on the oncogenesis and progression of breast cancer. Identification of novel potential therapeutic drugs targeting PTMs and development of biological markers for the detection of breast cancer would be significantly valuable for the efficient selection of therapeutic regimens and prediction of disease prognosis in patients with breast cancer.