bluuebunny/crossref_metadata_2025 huggingface dataset:
Key binding constraints, structural reform, and growth potential of Azerbaijan via economic diversification: A computable general equilibrium policy impact analysis
Authors: Das Gouranga , Ginting Edimon , Hampel Aimee , Horridge Mark
Published: May 2022

Being highly dependent on the oil sector, Azerbaijan suffered from economic downturn due to sharp fall in oil prices in 2015. However, such dependence creates development challenges for her. Simulated impact of prioritized economic reform policies—using a computable general equilibrium model (AZEORANI)—shows that, under the business-as-usual case with oil prices at 2011 level, it is projected to grow by 2.0% a year to 2030. However, consistent policy reforms enable enhanced growth by another 1.1 percentage points annually due to productivity boost and increased exports from non-oil sectors, viz., tourism and agriculture. In particular, following strategic roadmap, we consider baseline and policy shocks—10% improvement in productive efficiency, investment boost by 5% in non-mineral sector, and enhanced agricultural efficiency by 5%, and boost in tourism and transport by 10% via logistics-infrastructure, and technical progress in manufacturing over long run by 10–20% per annum. All these show that economic reforms have potentials to induce positive impact to overcome the binding constraints inhibiting growth and hence could promote economic development of Azerbaijan.
Post-traumatic headache: Pathophysiology and management - A review
Authors: Blumenfeld Andrew , McVige Jennifer , Knievel Kerry
Published: May 2022

Background

Post-traumatic headache (PTH) is a common secondary headache due to traumatic brain injury. In the past, significant research has been conducted to understand the pathophysiology and treatment options for PTH. However, PTH still lacks evidence-based treatment, and most of the management depends on the primary phenotype observed in the patient.

Objective

The main objective of this review is to provide a single reference that covers the current understanding of the pathophysiology and the treatment options available for PTH.

Methods

A detailed literature search on PubMed was performed, and a narrative review was prepared.

Results

The pathophysiology of PTH is multifactorial. Acute PTH may be attributed to increased peripheral pain sensitization with impaired pain inhibiting pathways. Chronic or persistent PTH may be due to a chronic inflammatory response and peripheral as well as central sensitization. The mechanism responsible for the transition of acute to persistent PTH is unknown. The migraine-like phenotype is reported to be the most prevalent headache type seen in PTH. New targets for preventive treatment have been identified in recent years, such as neuropeptides like calcitonin-gene-related peptide (CGRP), nitric oxide, and glutamate. The preventive pharmacological and non-pharmacological strategies employed for migraine (e.g. anti-CGRP monoclonal antibodies, onabotulinumtoxinA, physical therapy, cognitive and behavioral treatment, and neurostimulation techniques) have shown in preliminary studies that they are potentially efficacious, but large, randomized, double blind, placebo controlled trials are needed to further establish these as treatment options for PTH.

Conclusions

The lack of evidence-based treatment for PTH has created a need for future large trials to confirm the safety and efficacy of the currently employed treatments.
Supervision of School Counseling Leadership for School Counselors in Training
Authors: Li Hanyun , Peters Harvey Charles
Published: May 2022

Leadership is an integral component of the professional identity of school counselors. We build upon extant scholarship on school counseling leadership and supervision, supervision of counseling leadership, and the ASCA National Model to identify needs and strategies for the supervision of school counseling leadership. We investigate strategies for facilitating leadership development in school counselors in training within the framework of the ASCA National Model. We discuss implications for school counselor trainees, counselor educators, supervisors, and researchers.
Statistical Fragility of Single-Row Versus Double-Row Anchoring for Rotator Cuff Repair: A Systematic Review of Comparative Studies
Authors: Fackler Nathan P. , Ehlers Cooper B. , Callan Kylie T. , Amirhekmat Arya , Smith Eric J. , Parisien Robert L. , Wang Dean
Published: May 2022

Background:

Comparative studies and randomized controlled trials (RCTs) often use the P (probability) value to convey the statistical significance of their findings. P values are an imperfect measure, however, and are vulnerable to a small number of outcome reversals to alter statistical significance. The inclusion of a fragility index (FI) and fragility quotient (FQ) may aid in the interpretation of a study’s statistical strength.

Purpose/Hypothesis:

The purpose of this study was to examine the statistical stability of studies comparing single-row to double-row rotator cuff repair. It was hypothesized that the findings of these studies would be vulnerable to a small number of outcome event reversals, often fewer than the number of patients lost to follow-up.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

We analyzed comparative studies and RCTs on primary single-row versus double-row rotator cuff repair that were published between 2000 and 2021 in 10 leading orthopaedic journals. Statistical significance was defined as a P < .05. The FI for each outcome was determined by the number of event reversals necessary to alter significance. The FQ was calculated by dividing the FI by the respective sample size.

Results:

Of 4896 studies screened, 22 comparative studies, 10 of which were RCTs, were ultimately included for analysis. A total of 74 outcomes were examined. Overall, the median FI was 2 (interquartile range [IQR], 1-3), and the median FQ was 0.035 (IQR, 0.020-0.057). The mean FI was 2.55 ± 1.29, and the mean FQ was 0.043 ± 0.027. In 64% of outcomes, the FI was less than the number of patients lost to follow-up.) Additionally, 81% of significant outcomes needed just a single outcome reversal to lose their significance.

Conclusion:

Over half of the studies currently used to guide clinical practice have a number of patients lost to follow-up greater than their FI. The results of these studies should be interpreted within the context of these limitations. Future analyses may benefit from the inclusion of the FI and the FQ in their statistical analyses.
Association Between Meeting Return-to-Sport Criteria and Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction
Authors: Ueda Yuya , Matsushita Takehiko , Shibata Yohei , Takiguchi Kohei , Ono Kumiko , Kida Akihiro , Ono Rei , Nagai Kanto , Hoshino Yuichi , Matsumoto Tomoyuki , Sakai Yoshitada , Kuroda Ryosuke
Published: May 2022

Background:

The relationship between meeting return-to-sport criteria and psychological readiness after anterior cruciate ligament (ACL) reconstruction is unknown.

Purposes:

To examine (1) whether patients who met 1 of the criteria for return to sport had higher psychological readiness than those who did not meet any of the criteria and (2) if those who met more criteria had higher psychological readiness.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

This study included 144 patients who underwent unilateral ACL reconstruction. All patients had regularly participated in some sport activities before an ACL rupture. At 12 months postoperatively, each patient completed 3 knee function tests (isokinetic quadriceps strength, isokinetic hamstring strength, and single-leg hop distance) and 2 self-reported measures (International Knee Documentation Committee [IKDC] 2000 subjective form and ACL–Return to Sport after Injury [ACL-RSI] scale); the ACL-RSI scale was used to measure psychological readiness to return to sport. The 4 criteria for return to sport were a limb symmetry index (LSI) ≥90% for each of the 3 function tests in addition to an IKDC score ≥90. Multivariate regression analysis was used to determine the association between meeting the individual criteria and the ACL-RSI score. In addition, the patients were divided into 5 groups according to the number of criteria met, and the Kruskal-Wallis and Steel-Dwass tests were used to compare the ACL-RSI scores among the groups.

Results:

Overall, 23 patients (16.0%) met none of the criteria for return to sport, 27 (18.7%) met 1 of the criteria, 34 (23.6%) met 2 criteria, 35 (24.3%) met 3 criteria, and 25 (17.4%) met all 4 criteria. Meeting the criteria for the hamstring strength LSI ( P = .002), single-leg hop distance LSI ( P = .004), and IKDC subjective score ( P < .001) was each associated with higher ACL-RSI scores. Significant differences in ACL-RSI scores were found between patients who met none versus 2, 3, and 4 of the return-to-sport criteria ( P < .001 for all) and between patients who met 1 versus 4 criteria ( P < .001).

Conclusion:

Meeting return-to-sport criteria was positively associated with psychological readiness, and the patients who met multiple criteria had higher psychological readiness.
Serious Mental Illness in the Nursing Home Literature: A Scoping Review
Authors: Bucy Taylor , Moeller Kelly , Bowblis John R , Shippee Nathan , Fashaw-Walters Shekinah , Winkelman Tyler , Shippee Tetyana
Published: May 2022

Nursing homes (NH) and other institutional-based long-term care settings are not considered an appropriate place for the care of those with serious mental illness, absent other medical conditions or functional impairment that warrants skilled care. Despite policy and regulatory efforts intended to curb the unnecessary placement of people with serious mental illness (SMI) in these settings, the number of adults with SMI who receive care in NHs has continued to rise. Through a scoping review, we sought to summarize the available literature describing NH care for adults with SMI from 2000 to 2020. We found that SMI was operationalized and measured using a variety of methods and diagnoses. Most articles focused on a national sample, with the main unit of analysis being at the NH resident-level and based on analysis of secondary data sets. Understanding current evidence about the use of NHs by older adults with SMI is important to policy and practice, especially as we continue to grapple as a nation with how to provide quality care for older adults with SMI.
Childhood MMR Vaccination Effectiveness Against Rubella: A Longitudinal Cohort Study
Authors: Geier David A. , Geier Mark R.
Published: May 2022

The vaccine effectiveness (VE) of childhood measles-mumps-rubella (MMR) vaccine to reduce childhood rubella infections in the US during the 1990s/2000s was undertaken in a retrospective longitudinal cohort study. SAS and StatsDirect software were utilized to examine non-identifiable linked eligibility and claim healthcare records prospectively generated from the Florida Medicaid system in the Independent Healthcare Research Database (IHRD). A total of 33 839 children received a single MMR vaccination (vaccinated) and 44 154 children never received a rubella-containing vaccine (unvaccinated) were continuously eligible from 1990 to 2009 for Florida Medicaid within the first 10 years following birth. Cox proportional hazards models determined VE against diagnosed rubella (ICD-9 code: 056.xx). Children receiving MMR were at significantly reduced risk of rubella in unadjusted (VE = 80.7%, 95% confidence interval = 73.7%-85.8%) and adjusted (VE = 78.6%, 95% confidence interval = 70.8%-84.3%) models as compared to unvaccinated children. Between 1991 and 2009, in the combined vaccinated-unvaccinated cohort examined on a yearly basis, a significant inverse correlation between increasing MMR vaccine population coverage and a decreasing incidence rate of diagnosed rubella was observed. This first large-scale population epidemiological study supports the routine use childhood MMR vaccination to significantly reduce childhood rubella infections and also supports its ability to induce “herd immunity.” This study, coupled with a recently published epidemiological study showing childhood MMR vaccination significantly reduced measles infections, provide powerful epidemiological evidence strongly supporting MMR vaccination as an effective tool to improve public health.
A Secondary Traumatic Stress Reduction Program in Emergency Room Nurses
Authors: Robinson Lauren K. , Sterling Laura , Jackson Joel , Gentry Eric , Araujo Fabiana , LaFond Cynthia , Jacobson Kristen C. , Lee Royce
Published: May 2022

Introduction

Secondary traumatic stress is highly prevalent among nurses, especially among nurses working within the emergency department (ED). Reducing healthcare worker secondary traumatic stress is important for ensuring the delivery of high quality, safe patient care. This paper reports on the development and implementation of a secondary traumatic stress reduction program.

Methods

We used an adaption of a 5-week intervention based on the Accelerated Recovery Program to test whether there would be a reduction in secondary traumatic stress in a pilot sample of nine ED nurses. Outcomes were assessed using the Secondary Traumatic Stress Scale (STSS), Somatic Symptoms Scale (SSS), and Compassion Satisfaction subscale (CSS) measures.

Results

Eight of nine nurses were able to complete at least three of the five sessions. Results indicate significant change in STSS (F[5,23]  =  4.22, p  =  .007) and SSS (F[3,15]  =  4.42, p  =  .02) scores, but not CSS (F[5,23]  =  0.83, p  =  .54) scores. Pairwise comparisons revealed that the beneficial effects of the program happened early. For both STSS and SSS, scores at sessions 1 and 2 were generally higher than subsequent sessions. We also found a trend for continued effects on STSS at a four-month follow-up (t23  =  1.95, p  =  .064).

Conclusion

Overall, results indicate the 5-week program was associated with a significant reduction in secondary traumatic stress and related somatic symptoms in healthcare workers.
Tracing the Contours of Hate Speech in India in the Pandemic Year: The Curious Case of Online Hate Speech against Muslims and Dalits During the Pandemic
Authors: Binny Malavika
Published: May 2022

Though India is no stranger to either epidemics or hate speech, the COVID-19 crisis brought to the surface many of the pre-existing schisms and prejudices that subsequently led to both the Muslim minority community and the Dalit community being cast as miasmic and constant agitators against the central government. In the case of hate speech against the Muslim community, it has led to a peculiar situation wherein the invisible but pervasive Islamophobia that has been plaguing the country from the colonial times has risen it ugly head particularly across regional news channels and social media networks, making the phenomena hyper-visible. The Hindutva 1 politicians from the extreme right parties have been indulging in spreading anti-Muslim propaganda, moulding the image of the Muslim community as not only disease-bearers and super-spreaders of COVID-19 virus but also as being anti-national, as the central government has proclaimed ‘a war against the COVID virus’ ( The Print, 2020, 26 April).

During the initial spread of the virus throughout the country, there was an increasing tendency to show the Muslim community as intentionally spreading the disease or as being ignorant of current medical practices, with multiple TV channels airing the views that the Tablighi Jamaat event (a religious congregation held in March 2020) was marked as a super-spreader event, and with multiple politicians engaging in rumour-mongering and hate-speech against the Muslims, framing the community as a miasmic community that needs to be cleared from India.

On the other hand, the hate speech against Dalits in India is much more nuanced, indirect and layered. It began as WhatsApp and Facebook messages extolling the caste system and justifying the discriminatory practice of untouchability 2 using the logic of social distancing and progressed to painting Dalits and Dalit spaces as unhygienic disease-scapes. This consequently led to the denial of livelihoods to thousands of domestic workers and unskilled workers who belonged to lower caste groups as they found themselves without jobs as most middle caste upper caste families and business owners fired their employees without notice. The study involves a hermeneutical analysis of news reports of the spread of COVID from newspapers and electronic media in English as well as interviews with at least 100 members of groups on social media (WhatsApp and Facebook) that propagate extremely communal and casteist material.
A Retrospective Analysis of q12hr and q8hr Heparin for DVT/PE Prophylaxis in an Inpatient Rehabilitation Setting
Authors: Dashner Adam , Siders, PharmD Erin
Published: May 2022

Purpose: There is little clinical evidence comparing the safety and efficacy of prophylactic subcutaneous heparin given every 8 hours and every 12 hours. We performed a retrospective analysis incorporating these dosing intervals in an inpatient rehabilitation setting. Methods: Heparin usage data was collected and patient charts were analyzed for both therapeutic failure and bleeding events. A 2-tailed Fisher’s exact test was performed for both outcomes, with a P-value of less than 0.05 being considered significant. Odds ratios were also calculated with P-values less than 0.05 being considered significant. Study Population: A Cerner report was run to identify patients ordered prophylactic heparin in an inpatient rehabilitation setting from April 7, 2020, to October 27, 2021. One hundred patients receiving heparin every 8 hours and every 12 hours were randomly selected for chart review. These study groups were further stratified by Padua risk scores. Results: In both groups, 4 (4.0%) patients were identified as having a documented bleeding event and 2 (2.0%) patients from each group were identified as having a therapy failure. Conclusion: For both endpoints, no significant differences in bleeding rates or therapy failure rates were detected in any of the population stratifications.
Management of femoral head fracture by Ganz surgical dislocation of the hip
Authors: Hosny Hossam , Mousa Shazly , Salama Wael
Published: May 2022

Introduction

Posterior hip dislocation is the commonest type of hip dislocation. It is associated with femoral head fracture in 7% of cases. Urgent and congruent hip reduction is mandatory to improve clinical outcomes and avoid irreversible complications. The purpose of this study is to assess the safety and functional and radiological outcomes of surgical hip dislocation by Ganz technique for treatment of femoral head fracture.

Patients and methods

In this retrospective study, 18 cases of femoral head fracture were included. Six cases had Pipkin type I and 12 had Pipkin type II fracture. They were treated through surgical hip dislocation. All cases were followed up for at least 24 months. Matta’s criteria were used for radiological evaluation (plain radiographs). Functional evaluation was done using Harris Hip Score and modified Merle d’Aubigne and Postel score at final follow-up.

Results

No patients were lost during the follow-up period. No signs of infection or wound dehiscence were noted in this study. There was one case of osteonecrosis. All cases had labral injury, which was debrided. None of our cases needed suture anchor repair of the labrum. Radiographical evaluation according to Matta’s criteria yielded anatomic fracture reduction in 17 patients but imperfect in 1 patient. According to Harris Hip Score, four Pipkin type I cases were rated as excellent and two as good. Among cases of Pipkin type II fracture, six were rated as excellent, four as good, one as fair, and one as poor. According to modified Merle d’Aubigne and Postel score, 11 cases had excellent results, 5 cases were rated as good, one as fair, while one case had poor results.

Conclusion

Open reduction and internal fixation of femoral head fracture using surgical hip dislocation through Ganz approach is a viable treatment option and provides satisfactory results with low complication rate.
Transcriptomic and metabolomic landscape of quinoa during seed germination
Authors: Hao Yuqiong , Hong Yechun , Guo Huimin , Qin Peiyou , Huang Ancheng , Yang Xiushi , Ren Guixing
Published: May 2022

Background

Quinoa (Chenopodium quinoa), a dicotyledonous species native to Andean region, is an emerging crop worldwide nowadays due to its high nutritional value and resistance to extreme abiotic stresses. Although it is well known that seed germination is an important and multiple physiological process, the network regulation of quinoa seed germination is largely unknown.

Results

Here, we performed transcriptomic study in five stages during transition from quinoa dry seed to seedling. Together with the GC–MS based metabolome analysis, we found that seed metabolism is reprogrammed with significant alteration of multiple phytohormones (especially abscisic acid) and other nutrients during the elongation of radicels. Cell-wall remodeling is another main active process happening in the early period of quinoa seed germination. Photosynthesis was fully activated at the final stage, promoting the biosynthesis of amino acids and protein to allow seedling growth. The multi-omics analysis revealed global changes in metabolic pathways and phenotype during quinoa seed germination.

Conclusion

The transcriptomic and metabolomic landscape depicted here pave ways for further gene function elucidation and quinoa development in the future.
Combined morpho-physiological, ionomic and transcriptomic analyses reveal adaptive responses of allohexaploid wheat (Triticum aestivum L.) to iron deficiency
Authors: Hua Ying-peng , Wang Yue , Zhou Ting , Huang Jin-yong , Yue Cai-peng
Published: May 2022

Background

Plants worldwide are often stressed by low Fe availability around the world, especially in aerobic soils. Therefore, the plant growth, seed yield, and quality of crop species are severely inhibited under Fe deficiency. Fe metabolism in plants is controlled by a series of complex transport, storage, and regulatory mechanisms in cells. Allohexaploid wheat (Triticum aestivum L.) is a staple upland crop species that is highly sensitive to low Fe stresses. Although some studies have been previously conducted on the responses of wheat plants to Fe deficiency, the key mechanisms underlying adaptive responses are still unclear in wheat due to its large and complex genome.

Results

Transmission electron microscopy showed that the chloroplast structure was severely damaged under Fe deficiency. Paraffin sectioning revealed that the division rates of meristematic cells were reduced, and the sizes of elongated cells were diminished. ICP-MS-assisted ionmics analysis showed that low-Fe stress significantly limited the absorption of nutrients, including N, P, K, Ca, Mg, Fe, Mn, Cu, Zn, and B nutrients. High-throughput transcriptome sequencing identified 378 and 2,619 genome-wide differentially expressed genes (DEGs) were identified in the shoots and roots between high-Fe and low-Fe conditions, respectively. These DEGs were mainly involved in the Fe chelator biosynthesis, ion transport, photosynthesis, amino acid metabolism, and protein synthesis. Gene coexpression network diagrams indicated that TaIRT1b-4A, TaNAS2-6D, TaNAS1a-6A, TaNAS1-6B, and TaNAAT1b-1D might function as key regulators in the adaptive responses of wheat plants to Fe deficiency.

Conclusions

These results might help us fully understand the morpho-physiological and molecular responses of wheat plants to low-Fe stress, and provide elite genetic resources for the genetic modification of efficient Fe use.
Propofol total intravenous anaesthesia versus inhalational anaesthesia for acute postoperative pain in patients with morphine patient-controlled analgesia: a large-scale retrospective study with covariate adjustment
Authors: Wong Stanley Sau Ching , Choi Edward Kwok Yiu , Chan Wing Shing , Cheung Chi Wai
Published: May 2022

Background

To compare the postoperative analgesic effect of propofol total intravenous anaesthesia (TIVA) versus inhalational anaesthesia (GAS) in patients using morphine patient-controlled analgesia (PCA).

Methods

A retrospective cohort study was performed in a single tertiary university hospital. Adult patients who used PCA morphine after general anaesthesia across 15 types of surgeries were included. Patients who received propofol TIVA were compared to those who had inhalational anaesthesia. Primary outcomes assessed were postoperative numerical rating scale (NRS) pain scores and postoperative opioid consumption.

Results

Data from 4202 patients were analysed. The overall adjusted NRS pain scores were significantly lower in patients who received propofol TIVA at rest (GEE: β estimate of the mean on a 0 to 10 scale = -0.56, 95% CI = (-0.74 to -0.38), p < 0.001; GAS as reference group) and with movement (β estimate = -0.89, 95% CI = (-1.1 to -0.69), p < 0.001) from postoperative days (POD) 1–3. Propofol TIVA was associated with lower overall adjusted postoperative morphine consumption (β estimate = -3.45, 95% CI = (-4.46 to -2.44), p < 0.001). Patients with propofol TIVA had lower adjusted NRS pain scores with movement for hepatobiliary/pancreatic (p < 0.001), upper gastrointestinal (p < 0.001) and urological surgeries (p = 0.005); and less adjusted postoperative morphine consumption for hepatobiliary/pancreatic (p < 0.001), upper gastrointestinal (p = 0.006) and urological surgeries (p = 0.002). There were no differences for other types of surgeries.

Conclusion

Propofol TIVA was associated with statistically significant, but small reduction in pain scores and opioid consumption in patients using PCA morphine. Subgroup analysis suggests clinically meaningful analgesia possibly for hepatobiliary/pancreatic and upper gastrointestinal surgeries.

Trial registration

This study is registered at ClinicalTrials.gov (NCT03875872).
Diagnostic and prognostic significance of lncRNA SOX2-OT in patients with carotid atherosclerosis
Authors: Tao Jianping , Hu Yu
Published: May 2022

Background

This paper aimed to analyze IncRNA SOX2-OT expression in patients with carotid atherosclerosis and to elucidate the predictive significance of SOX2-OT on carotid atherosclerosis.

Methods

The levels of SOX2-OT from 185 participants were tested. The relationship between CIMT levels and SOX2-OT expression was examined by Pearson analysis. The clinical value of SOX2-OT was investigated by the ROC curve, K–M curve, and COX regression analysis. The comparison of SOX2-OT expression between patients with good prognosis and poor prognosis was also performed.

Results

The expression of SOX2-OT was augmented in the patients with carotid atherosclerosis and was correlated with the level of CIMT. The high level of SOX2-OT might be a risk factor for carotid atherosclerosis. An enhancement of SOX2-OT expression was found in patients with poor prognosis. SOX2-OT might be an independent prognostic biomarker.

Conclusions

SOX2-OT was upregulated in patients with carotid atherosclerosis and might be a predictive indicator in the progression of carotid atherosclerosis.
Effect of resveratrol supplementation on hepatic steatosis and cardiovascular indices in overweight subjects with type 2 diabetes: a double-blind, randomized controlled trial
Authors: Ali Sangouni Abbas , Abdollahi Shima , Mozaffari-Khosravi Hassan
Published: May 2022

Background

Patients with type 2 diabetes mellitus (T2DM) are prone to develop non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD). We aimed to investigate whether the resveratrol supplementation improves novel hepatic and cardiovascular indices in these patients.

Methods

We conducted a double-blind, randomized controlled trial for 8 weeks. Seventy-six patients with T2DM were randomly assigned to receive 1000 mg/day resveratrol or placebo. Levels of lipid accumulation product (LAP), visceral adiposity index (VAI), Castelli risk index I (CRI-I), CRI-II and atherogenic coefficient (AC) were measured at the beginning and after intervention.

Results

A total of 71 participants completed the trial. After adjusting for confounding factors including medications, diabetes duration, energy intake and physical activity, no significant difference was found between the intervention group and the control group in LAP (mean change: − 2.46 ± 23.3 vs. 1.43 ± 14.3; P = 0.43), VAI (mean change: − 0.25 ± 1.1 vs. − 0.02 ± 0.6; P = 0.47), CRI-I (mean change: − 0.25 ± 0.9 vs. − 0.09 ± 0.5; P = 0.79), CRI-II (mean change: − 0.23 ± 0.7 vs. − 0.06 ± 0.6; P = 0.38) and AC (mean change: − 0.25 ± 0.9 vs. − 0.09 ± 0.5; P = 0.79).

Conclusions

Resveratrol supplementation had no effect on hepatic steatosis and cardiovascular indices. Further clinical trials, especially among subjects with dyslipidemia are needed to reach a firm conclusion. In addition, taking all medications should be controlled in future studies.

Trial registration The protocol was registered on 29/12/2017 at the Iranian clinical trials website (IRCT20171118037528N1) with URL: https://en.irct.ir/trial/27734.
Mortality after transcatheter aortic valve replacement for aortic stenosis among patients with malignancy: a systematic review and meta-analysis
Authors: Siddiqui Muhammad Umer , Yacob Omar , Junarta Joey , Pasha Ahmed K. , Mookadam Farouk , Mamas Mamas A. , Fischman David L.
Published: May 2022

Background

With advancements in cancer treatment, the life expectancy of oncology patients has improved. Thus, transcatheter aortic valve replacement (TAVR) may be considered as a feasible option for oncology patients with severe symptomatic aortic stenosis (AS). We aim to evaluate the difference in short- and long-term all-cause mortality in cancer and non-cancer patients treated with TAVR for severe AS.

Methods

Medline, PubMed, and Cochrane Central Register of Controlled Trials were searched for relevant studies. Patients with cancer who underwent treatment with TAVR for severe AS were included and compared to an identical population without cancer. The primary endpoints were short- and long-term all-cause mortality.

Results

Of 899 studies included, 8 met inclusion criteria. Cancer patients had significantly higher long-term all-cause mortality after TAVR when compared to patients without cancer (risk ratio [RR] 1.43; 95% confidence interval (CI) 1.26–1.62;P < 0.01). Four studies evaluated short-term mortality after TAVR and demonstrated no difference in it in patients with and without cancer (RR 0.72; 95% CI 0.47–1.08;P = 0.11).

Conclusion

Patients with cancer and severe AS have higher long-term all-cause mortality after TAVR. However, we found no difference in short-term all-cause mortality when comparing patients with and without cancer. The decision to perform TAVR in cancer patients should be individualized based on life expectancy and existing co-morbidities.
The International Guideline Evaluation Screening Tool (IGEST): development and validation
Authors: D’angelo Daniela , Coclite Daniela , Napoletano Antonello , Gianola Silvia , Castellini Greta , Latina Roberto , Iacorossi Laura , Fauci Alice Josephine , Iannone Primiano
Published: May 2022

Background

Guideline adaptation provides an important alternative to de novo guideline development by making the process more efficient and reducing unnecessary duplication. The quality evaluation of international guidelines is an essential part of the adaptation process.

The study aims at describing the development and validation of a new tool to screen trustworthy Clinical Practice Guidelines (CPGs) for their adoption/adaption: the International Guideline Evaluation Screening Tool (IGEST).

Methods

The process of developing the IGEST involved two main phases: 1) tool development and 2) content validation. The tool development phase comprised three stages, where the scope of the IGEST was defined and the item pool was generated and refined. The content validation was performed through the computation of a content validity index (CVI) based on the opinions of an expert panel.

Results

All the items obtained a CVI >0.78, which resulted in the validation of the instrument. The final instrument comprised four preliminary conditions and 12 criteria organised into three dimensions: (i) the management of conflict of interest; (ii) the quality of evidence and the coherence between evidence and recommendations; and (iii) the panel composition.

Conclusion

The IGEST showed good content validity for assessing the quality of international guidelines. Using the new tool to select trustworthy guidelines might increase the likelihood that international clinical practice guidelines will be adopted/adapted to the local context by allowing a quick screening of existing guidelines trustworthiness and providing an acceptability threshold that supports the decision-making process.
Combination of serological biomarkers and clinical features to predict mucosal healing in Crohn’s disease: a multicenter cohort study
Authors: Tang Nana , Chen Han , Chen Ruidong , Tang Wen , Zhang Hongjie
Published: May 2022

Purpose

Mucosal healing (MH) has become the treatment goal of patients with Crohn’s disease (CD). This study aims to develop a noninvasive and reliable clinical tool for individual evaluation of mucosal healing in patients with Crohn’s disease.

Methods

A multicenter retrospective cohort was established. Clinical and serological variables were collected. Separate risk factors were incorporated into a binary logistic regression model. A primary model and a simple model were established, respectively. The model performance was evaluated with C-index, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Internal validation was performed in patients with small intestinal lesions.

Results

A total of 348 consecutive patients diagnosed with CD who underwent endoscopic examination and review after treatment from January 2010 to June 2021 were composed in the derivation cohort, and 112 patients with small intestinal lesions were included in the validation cohort. The following variables were independently associated with the MH and were subsequently included into the primary prediction model: PLR (platelet to lymphocyte ratio), CAR (C-reactive protein to albumin ratio), ESR (erythrocyte sedimentation rate), HBI (Harvey-Bradshaw Index) score and infliximab treatment. The simple model only included factors of PLR, CAR and ESR. The primary model performed better than the simple one in C-index (87.5% vs. 83.0%,p = 0.004). There was no statistical significance between these two models in sensitivity (70.43% vs. 62.61%,p = 0.467), specificity (87.12% vs. 80.69%,p = 0.448), PPV (72.97% vs. 61.54%,p = 0.292), NPV (85.65% vs. 81.39%,p = 0.614), and accuracy (81.61% vs. 74.71%,p = 0.303). The primary model had good calibration and high levels of explained variation and discrimination in validation cohort.

Conclusions

This model can be used to predict MH in post-treatment patients with CD. It can also be used as an indication of endoscopic surveillance to evaluate mucosal healing in patients with CD after treatment.
RETRACTED ARTICLE: Analysis of antiviral efficacy after switching from brand to generic entecavir in patients with treatment-naïve chronic hepatitis B
Authors: Hsu Po-Ke , Su Pei-Yuan , Wu Chia-Lin
Published: May 2022

Background/Aims

Entecavir (ETV) can suppress chronic hepatitis B (CHB) virus replication as a standard of treatment drugs. For the treatment of CHB, affordable generic drugs may be more widely used in developing and undeveloped countries. However, there is little real-world data regarding the clinical efficacy of switching from entecavir-brand-name drugs (ETV-Brand) to entecavir generic drugs (ETV-Generic) with 0.5 mg once daily. The aim of the study was to evaluate the antiviral activity and safety of ETV-Generic in comparison to ETV-Brand in CHB-patients.

Methods

In this single-center, retrospective, 175 treatment-naïve—CHB-patients were assigned to receive 0.5 mg of ETV-Brand per day for a least 2 years and then switched to ETV-Generic for 6 months for analysis. The primary efficacy endpoint was a sustained virological response in comparison of the rate of undetectable serum Hepatitis B deoxyribonucleic acid (HBV DNA) as the sustained virologic response at baseline and 6 months after switching. Secondary efficacy endpoints were the comparison of the alanine aminotransferase (ALT) levels between before and after switching and ALT normalization. Renal safety consideration was reported on changing the estimated glomerular filtration rate.

Results

From baseline to 6 months, the rate of undetectable HBV DNA and ALT levels remained stable as compared ETV-Brand period with ETV-Generic for 6 months. The rate of undetectable HBV DNA were 81.1%in ETV-Brand versus 88.0%in ETV-Generic (p = 0.05 CI 0.1–13.5%). ALT levels were 27.2 IU/L (CI 24.8–29.6 IU/L) in ETV-Brand versus 26.2 IU/L (CI 24.0–28.4 IU/L) in ETV-Generic (p = 0.55). Both endpoints were not significantly different between ETV-Brand and ETV-Generic treatments. Kidney function did not significantly differ from ETV-Brand (80.8, interquartile range [IQR]: 66.6–95.3 mL/min/1.73 m2) to ETV-Generic treatment period (80.3, IQR: 65.6–93.5 mL/min/1.73 m2).

Conclusion

In treatment-naïve CHB-patients, the efficacy and safety profiles of switching from ETV-Brand to ETV-Generic showed no difference. Concluding the ETV-Generic comes to exciting virologic responses and rare adverse events.
Comprehensive quality of elderly rehabilitation nursing staff in medical and health care institutions in Liaoning Province, China: a cross-sectional study
Authors: Zhou Yunru , Sun Longfeng , Liang Yanting , Mao Guoju , Xu Pei
Published: May 2022

Background

With the global aging problem is becoming increasingly severe, the elderly care has become an important issue that needs attention. Chinese government attaches great importance to the development of medical and health care institutions, and is committed to improving the comprehensive quality of elderly rehabilitation nursing staff in medical and health care institutions.

Methods

From June to September 2019, a cross-sectional study among 193 elderly rehabilitation nursing staff was conducted in Liaoning Province, China. Using a self-designed questionnaire, the comprehensive quality of elderly rehabilitation nursing staff in medical and health care institutions was investigated by face to face. The multiple linear regression model was explored to analyze the influencing factors.

Results

A total of 193 questionnaires were distributed, and 189 (97.93%) valid questionnaires were recovered. Age was from 19 to 65 years old, with an average age of (38.34 ± 9.76) years old. Bachelor degree or above accounted for 54.00%. 57.10% have engaged in elderly rehabilitation nursing for more than one year. There were 163 nurses with qualification certificates, accounting for 86.20%. The total score of comprehensive quality was 118.52 ± 22.90. The total Cronbach ' s α coefficient of the questionnaire was 0.967, and the content validity index was 0.991. Only 61 (32.30%) elderly rehabilitation nurses received professional training in elderly rehabilitation nursing. The results of multiple linear regression analysis showed that the educational level of elderly rehabilitation nursing staff (P = 0.002) and the number of years engaged in elderly rehabilitation nursing (P = 0.005) were the main influencing factors of comprehensive quality.

Conclusions

The comprehensive quality of elderly rehabilitation nursing staff is at a medium level in Liaoning Province's medical and health care institutions. However, the professional nursing talents were very short, and the education level and years of experience in elderly care were the main influencing factors of the comprehensive quality.
Skin infection by Mycobacterium farcinogenes–senegalense group in an immunocompetent patient: a case report
Authors: Cheng An-Yu , Lee Chih-Hung
Published: May 2022

Background

Mycobacterium farcinogenes–senegalense group mostly cause bovine farcy, which rarely infect human beings. We reported one case of cutaneous Mycobacterium farcinogenes–senegalense group infection in an immunocompetent victim.

Case presentation

A 66-year-old Taiwanese woman with hypertension developed tender nodules on her left dorsal foot for 2 months. Tissue culture identified Mycobacterium farcinogenes–senegalense group. The lesion was treated successfully with clarithromycin and sulfamethoxazole/trimethoprim, followed by surgical excision.

Conclusions

Mycobacterium farcinogenes–senegalense group infection should be considered as a potential pathogen of skin infection in immunocompetent patients.
An endorectal ultrasound-based radiomics signature for preoperative prediction of lymphovascular invasion of rectal cancer
Authors: Wu Yu-quan , Gao Rui-zhi , Lin Peng , Wen Rong , Li Hai-yuan , Mou Mei-yan , Chen Feng-huan , Huang Fen , Zhou Wei-jie , Yang Hong , He Yun , Wu Ji
Published: May 2022

Objective

To investigate whether radiomics based on ultrasound images can predict lymphovascular invasion (LVI) of rectal cancer (RC) before surgery.

Methods

A total of 203 patients with RC were enrolled retrospectively, and they were divided into a training set (143 patients) and a validation set (60 patients). We extracted the radiomic features from the largest gray ultrasound image of the RC lesion. The intraclass correlation coefficient (ICC) was applied to test the repeatability of the radiomic features. The least absolute shrinkage and selection operator (LASSO) was used to reduce the data dimension and select significant features. Logistic regression (LR) analysis was applied to establish the radiomics model. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the comprehensive performance of the model.

Results

Among the 203 patients, 33 (16.7%) were LVI positive and 170 (83.7%) were LVI negative. A total of 5350 (90.1%) radiomic features with ICC values of ≥ 0.75 were reported, which were subsequently subjected to hypothesis testing and LASSO regression dimension reduction analysis. Finally, 15 selected features were used to construct the radiomics model. The area under the curve (AUC) of the training set was 0.849, and the AUC of the validation set was 0.781. The calibration curve indicated that the radiomics model had good calibration, and DCA demonstrated that the model had clinical benefits.

Conclusion

The proposed endorectal ultrasound-based radiomics model has the potential to predict LVI preoperatively in RC.
Recurrence of IgA nephropathy after kidney transplantation: experience from the Swiss transplant cohort study
Authors: Jäger Cédric , Stampf Susanne , Molyneux Karen , Barratt Jonathan , Golshayan Déla , Hadaya Karine , Huynh-Do Uyen , Binet Francoise-Isabelle , Mueller Thomas F , Koller Michael , Kim Min Jeong
Published: May 2022

Background

Recurrence of IgA nephropathy (IgAN) after kidney transplantation occurs in about 30% of patients. The relevance of recurrence for the long-term graft survival is expected to increase, since graft survival continues to improve.

Methods

In a nested study within the Swiss Transplant Cohort Study the incidence of IgAN recurrence, predictive factors, graft function and graft and patient survival were evaluated. Serum concentration of total IgA, total IgG, Gd-IgA1 and IgA-IgG immune complex were measured using ELISA-based immunologic assays.

Results

Between May 2008 and December 2016, 28 women and 133 men received their kidney allograft for end-stage kidney disease due to IgAN in Switzerland. Over a median follow-up time of 7 years after transplantation, 43 out of 161 patients (26.7%) developed an IgAN recurrence, of which six (13.9%) had an allograft failure afterwards and further four patients (9.3%) died. During the same follow-up period, 6 out of 118 patients (5%) each experienced allograft failure or died without prior IgAN recurrence. After 11 years the risk for IgAN recurrence was 27.7% (95%-CI: 20.6–35.3%). Renal function was similar in patients with and without recurrence up to 7 years after transplantation, but worsened thereafter in patients with recurrence (eGFR median (interquartile range) at 8 years: 49 ml/min/1.73m2(29–68) vs. 60 ml/min/1.73m2(38–78)). Serum concentration of total IgA, total IgG, Gd-IgA1 and IgA-IgG immune complex within the first year posttransplant showed no significant effect on the recurrence of IgAN. Younger recipients and women had a higher risk of recurrence, but the latter only in the short term.

Conclusions

Our study showed a recurrence risk of 28% at 11 years after transplantation, which is consistent with previous literature. However, the predictive value of known biomarkers, such as serum Gd-IgA1 and IgA-IgG IC, for IgAN recurrence could not be confirmed.
Effectiveness and safety of KunXian capsule for the treatment of IgA nephropathy
Authors: Le Wei-Bo , Shi Jin-Song , Gong Si-Wen , Yang Fan
Published: May 2022

Background

Tripterygium Wilfordii Hook F (TwHF) preparation has been widely used in the treatments of IgA nephropathy (IgAN) in China. However, the effectiveness and safety of the new generation of TwHF preparation, KuxXian capsule, on the treatment of IgAN remains unknown.

Methods

Here, we retrospectively describe our experience treating 55 consecutive IgAN patients with KunXian. We defined complete remission as proteinuria < 0.5 g/24 h and partial remission as proteinuria < 1 g/24 h, each also having > 50% reduction in proteinuria from baseline.

Results

At first follow-up after KunXian treatment (5.7 weeks, IQR 4.7–7.9), all but two patients (96%) showed a reduction in proteinuria. The overall median proteinuria decreased from 2.23 g/day at baseline to 0.94 g/day (P < 0.001) at the first follow-up. During a median follow-up of 28 weeks after KunXian administration, 25(45.5%) patients achieved complete remission, 34 (61.8%) patients achieved complete/partial remission. Of the 12 patients discontinued KunXian treatment during the follow-up, the median proteinuria was increased from 0.97 g/24 h to 2.74 g/24 h after a median of 10.9 weeks (P = 0.004). Multivariable Cox models showed that female, treatment switching from previous generation of TwHF preparation, lower initial KunXian dosage, and higher proteinuria at baseline were independently associated proteinuria remission. Of the 20 pre-menopausal females, 12 of them developed oligomenorrhea or menstrual irregularity and ten of them developed amenorrhea.

Conclusion

KunXian is effectiveness and safety for the treatment of IgA nephropathy. Woman of childbearing age to be informed of the risk of ovarian failure after being treated with TwHF preparations.