bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Adjunctive Hyperbaric Oxygen Treatment Alone or with Surgery the Proper Management for Active and Persistent Osteoradionecrosis?
Authors: Jenwitheesuk Kamonwan , Mahakkanukrauh Ajanee , Punjaruk Wiyada , Vatanasapt Patravoot , Jenwitheesuk Kriangsak , Surakunprapha Palakorn , Jinaporntham Suthin , Uraiwan Krittinant , Limrattanapimpa Phasuk
Published: January 2021

This study enrolled patients with stage 3 osteoradionecrosis. There were three treatment modalities: antibiotics, hyperbaric oxygen therapy (HBOT), and surgery. Complete healing was the primary outcome. Multiple logistic regression analysis demonstrated that surgery with HBOT improved wound healing better than HBOT alone.
Twice-Daily Moisturizer Application for Skin Tear Prevention among Older Adults in Acute Care
Authors: Mornane Carolyn , Peck Blake , Terry Daniel , Ryan Michael
Published: January 2021

OBJECTIVE

To examine the effectiveness of twice-daily moisturizer application for patients admitted to an acute care setting on reducing the incidence of skin tear (ST) injuries.

DESIGN, SETTING, AND PARTICIPANTS

This prospective, nonrandomized, case-control study identified an experimental and control ward equivalent in demography and patient acuity in a large hospital in regional Victoria, Australia. Patients 70 years or older admitted to the wards were invited to participate.

INTERVENTION

Twice-daily application of a commercially available skin and body lotion to the arms and legs of participants.

MAIN OUTCOME MEASURES

The incidence of ST in the experimental and control settings in the pre-, intra-, and posttrial periods.

MAIN RESULTS

Although a decrease in ST incidence was observed over the study period (n = 128), this decrease was not significant pre- (median = 2.16, n = 73), intra- (median = 2.16, n = 73), or postintervention (median = 2.16, n = 69; χ[2, 152] = 0.502, P = .778). Similarly, there was no significant difference between wards (median = 9.86 [n = 152] vs median = 13.14 [n = 177]; U = 42.50, z = −1.198, r = 0.358, P = .231).

CONCLUSIONS

The moisturizer in this study did not have a direct influence on the frequency of STs in the study population, although the data would suggest an intermittent reduction in ST incidence. The authors postulate that this was correlated with behavior change effects from the study.
Semiautonomous Treatment Algorithm for the Management of Severe Hypertension in Pregnancy
Authors: Martin Courtney , Pappas James , Johns Kim , Figueroa Heather , Balli Kevin , Yao Ruofan
Published: January 2021

OBJECTIVE:

To evaluate whether implementation of a semiautonomous treatment algorithm was associated with improved compliance with American College of Obstetricians and Gynecologists guidelines for rapid administration of antihypertensive therapy in the setting of sustained severe hypertension.

METHODS:

This was a single-center retrospective cohort study of admitted pregnant and postpartum patients treated for severe hypertension between January 2017 and March 2020. The semiautonomous treatment algorithm, which included vital sign monitoring, blood pressure thresholds for diagnosis of severe hypertension, and automated order sets for recommended first-line antihypertensive therapy were implemented between May 2018 and March 2019. The primary outcomes were the administration of antihypertensive therapy within 15, 30 and 60 minutes of diagnosis of severe hypertension. Comparisons were made between the preimplementation, during implementation, and postimplementation groups using χ2. Analysis was limited to the first episode of severe hypertension treated. Statistical significance was defined as P<.05.

RESULTS:

In total, there were 959 obstetric patients treated for severe hypertension, with 373 (38.9%) treated preimplementation, 334 (34.8%) during implementation, and 252 (26.2%) after implementation. Treatment of severe hypertension within 15 minutes was 36.5% preimplementation, 45.8% during implementation, and 55.6% postimplementation (P=.001). Treatment within 30 minutes was 65.9% in the preimplementation group, 77.8% during implementation, and 79.0% in the postimplementation group (P=.004). There was no difference in percentage of patients treated within 60 minutes (86.3% before, 87.7% during and 92.9% after implementation, P=.12).

CONCLUSION:

Implementation of a semiautonomous treatment algorithm for severe hypertension was associated with a higher percentage of pregnant and postpartum patients receiving the first dose of antihypertensive therapy within 15 and 30 minutes. Implementation of similar algorithms for this and other obstetric indications may decrease time to appropriate therapy and help improve care equity.
Unilateral Breast Inflation Caused by Breastfeeding after Polyacrylamide Hydrogel Injection
Authors: Ebisudani Shogo , Inagawa Kiichi , Suzuki Yoshinori , Osugi Ikuko
Published: January 2021

Polyacrylamide hydrogel (PAAG) has been widely used in Russia and China as an injection material for cosmetic surgery. We report the case of a 36-year-old woman who noted breast enlargement subsequent to breastfeeding, after a PAAG injection. In 2016, a PAAG injection was administered to her under both mammary glands at a nearby cosmetic surgery clinic for breast augmentation. After she started breastfeeding following delivery in 2020, she was admitted to our hospital because of a rapid left breast enlargement and unbearable pain. Contrast-enhanced chest computed tomography revealed marked fluid retention in the left breast, and the mammary gland tissue had been pushed outward. A skin incision revealed a significant amount of yellowish-white odorless fluid accumulation. On surgery, a foreign body remained around the pectoralis major muscle, but complete removal was impossible. Currently, 3 months have passed since the operation; however, the patient has not experienced any further pain. There have been many reports on complications caused by PAAG injection. In our case, commencing breast feeding after receiving PAAG injections resulted in a rapid unilateral breast enlargement, and there is no similar report from Japan. In this case, suppressing lactation and rapid removal of the foreign body is the most important measure. It is difficult to completely remove PAAG once it has been injected. PAAG injections for breast augmentation should be avoided in all patients.
Machine learning: at the heart of failure diagnosis
Authors: Sanders William E. , Burton Tim , Khosousi Ali , Ramchandani Shyam
Published: January 2021

Purpose of review

Refinement in machine learning (ML) techniques and approaches has rapidly expanded artificial intelligence applications for the diagnosis and classification of heart failure (HF). This review is designed to provide the clinician with the basics of ML, as well as this technologies future utility in HF diagnosis and the potential impact on patient outcomes.

Recent findings

Recent studies applying ML methods to unique data sets available from electrocardiography, vectorcardiography, echocardiography, and electronic health records show significant promise for improving diagnosis, enhancing detection, and advancing treatment of HF. Innovations in both supervised and unsupervised methods have heightened the diagnostic accuracy of models developed to identify the presence of HF and further augmentation of model capabilities are likely utilizing ensembles of ML algorithms derived from different techniques.

This article is an overview of recent applications of ML to achieve improved diagnosis of HF and the resultant implications for patient management.
Acceptable Risk of Sudden Incapacitation Among Safety Critical Transportation Workers
Authors: Sinclair Donald C. , Hegmann Kurt T. , Holland John P.
Published: January 2021

Objective:

Identify a risk threshold for sudden incapacitation for safety critical positions in transportation industries supporting medical fitness for duty standards.

Methods:

Systematic literature searches were performed examining acceptable risk criteria for medically related incapacitation using PubMed Central and Google Scholar databases. Websites for professional societies and national and international governmental agencies were also accessed. Article abstracts were reviewed and exhaustive searches were performed.

Results:

International regulatory bodies have adopted definitions of acceptable risk typically with a threshold of 1% to 2% absolute risk of sudden incapacitation per annum. Several “risk-of-harm” models have been proposed that incorporate factors modulating an absolute risk constant derived from epidemiological studies.

Conclusion:

A 1% absolute annual risk of sudden incapacitation should be adopted as the threshold for determining medical fitness for duty among employees in safety critical positions in transportation industries.
Application effect of initiation of enteral nutrition at different time periods after surgery in neonates with complex congenital heart disease
Authors: Du Na , Cui Yanqin , Xie Wanhua , Yin Caixin , Gong Chen , Chen Xiuchun
Published: January 2021

Early enteral nutrition (EN) promotes the recovery of critically ill patients, but the initiation time for EN in neonates after cardiac surgery remains unclear.

This study aimed to investigate the effect of initiation time of EN after cardiac surgery in neonates with complex congenital heart disease (CHD).

Neonates with complex CHD admitted to the CICU from January 2015 to December 2017 were retrospectively analyzed. Patients were divided into the 24-hour Group (initiated at 24 hours after surgery in 2015) (n = 32) and 6-hour Group (initiated at 6 hours after surgery in 2016 and 2017) (n = 66). Data on the postoperative feeding intolerance, nutrition-related laboratory tests (albumin, prealbumin, retinol binding protein), and clinical outcomes (including duration of mechanical ventilation, CICU stay, and postoperative hospital stay) were collected.

The incidence of feeding intolerance was 56.3% in 24-hour Group and 39.4%, respectively (P = .116). As compared to 24-hour Group, prealbumin and retinol binding protein levels were higher (160.7 ± 64.3 vs 135.2 ± 28.9 mg/L, P = .043 for prealbumin; 30.7 ± 17.7 vs 23.0 ± 14.1 g/L P = .054 for retinol-binding protein). The duration of CICU stay (9.4 ± 4.5 vs 13.3 ± 10.4 day, P = .049) and hospital stay (11.6 ± 3.0 vs 15.8 ± 10.3 day, P = .028) were shorter in 6-hour Group.

Early EN improves nutritional status and clinical outcomes in neonates with complex CHD undergoing cardiac surgery, without significant feeding intolerance.
Differences in Methods of Suicide Death Among Transgender and Nontransgender Patients in the Veterans Health Administration, 1999–2016
Authors: Blosnich John R. , Boyer Taylor L. , Brown George R. , Kauth Michael R. , Shipherd Jillian C.
Published: January 2021

Background:

Limited research suggests that rates of suicide death among transgender people may be higher than their nontransgender peers.

Objective:

The objective of this study was to compare rates of suicide deaths by different means between transgender and nontransgender patients.

Research Design:

This secondary analysis used VHA administrative and electronic health record (EHR) data from October 1, 1999 through December 31, 2016.

Subjects:

Transgender patients (n=8981) were categorized as such based on a set of International Classification of Disease codes, and a comparison sample was selected by randomly choosing 3 nontransgender patients (n=26,924).

Measures and Analyses:

Cause and date of death data are from the National Death Index. Because of low frequencies amid different methods of suicide death, we combined categories into self-poisoning; hanging, strangulation and suffocation; discharge of firearms; and self-harm by all other and unspecified means. We conducted Cox regression analyses to model time-to-event for each method of suicide, adjusted for age, sex based on EHR, race, ethnicity, marital status, and whether patients had ever been diagnosed with depression.

Results:

Among transgender patients, 73 died by suicide (22 female EHR-based sex, 51 male EHR-based sex), and among nontransgender patients, 71 died by suicide (4 female EHR-based sex, 67 male EHR-based sex). In adjusted models, transgender patients had significantly greater hazards of death by self-poisoning and firearms than their nontransgender peers.

Conclusions:

Differences in methods of suicide death suggest that firearms and self-poisoning may be specific areas of concern for transgender individuals experiencing suicidal crisis, which underscore needs for examining effective delivery of evidence-based care.
Culture-Independent Genotyping Revealed 3 Strain Clusters in a Potential Neisseria gonorrhoeae Outbreak in Young Heterosexuals (<25 Years), the Netherlands, October 2017 to March 2019
Authors: van der Veer Brian M.J.W. , Wolffs Petra F.G. , Hoebe Christian J.P.A. , Wijers Juliën N.A.P. , van Liere Gènevieve A.F.S. , Werner Marita I.L.S. , Verhaegh Amanja , Dukers-Muijrers Nicole H.T.M. , van Alphen Lieke B.
Published: January 2021

Background

Investigation was undertaken to determine the genetic relatedness of Neisseria gonorrhoeae (NG) isolates of young (<25 years) heterosexuals of a potential outbreak from October 2017 to March 2019 in South-Limburg, the Netherlands.

Methods

Data and residual sample material of routine diagnostics were retrieved for outbreak cases (78/81), young heterosexuals at baseline (January 2016 to September 2017, n = 30), and men who have sex with men (2018, n = 47). Total DNA was isolated, and NG was genotyped using culture-free NG multiantigen sequence typing. Sanger sequence data were used to construct a phylogenetic tree. Cases of outbreak clusters were geographically mapped, and descriptive analyses were performed on patient characteristics, comparing these clusters.

Results

Outbreak investigation showed 81 cases of young heterosexuals between October 2017 and March 2019 (4.5 per month) compared with 30 between January 2016 and September 2017 (1.4 per month), which was considered as baseline. Culture-independent genotyping of NG was performed to assess the genetic relatedness, as only 21 outbreak cases were culture confirmed. This revealed 3 independent outbreak clusters G2 (n = 18), G13113 (n = 11), and GNewST (n = 24). None of the clusters were geographically linked or introduced by bridging with men who have sex with men networks. Number of sex partners reported by men and Chlamydia trachomatis coinfection were associated with clusters G2 and GNewST, respectively.

Conclusions

Culture-independent typing proved to be essential to identify the 3 outbreak clusters. However, targeted interventions were difficult because information on sex partners was limited. Therefore, prospective culture-independent typing could be used for early outbreak detection and aid in transmission prevention.
Big Carotid Body Paraganglioma
Authors: Lai Yen-Shuo , Tseng Wan-Ling , Pan Shin-Chen
Published: January 2021

Background

Carotid body paragangliomas are rare and therapeutically challenging. Shamblin I or II carotid body paraganglioma can be removed en bloc. This operation is sometimes combined with preoperative transarterial embolization to control bleeding. However, Shamblin III carotid body paraganglioma, which is encased with carotid vessels, is difficult to remove without carotid artery ligation for excision. Sometimes, not all tumor tissues are removed during operation and residual tumor tissues remain. Here, we review a case of Shamblin III carotid body paraganglioma removal without preoperative transarterial embolization or ligation of the carotid artery. We present a successful technique for Shamblin III carotid body paraganglioma resection that reduces bleeding during the operation.

Material and Methods

A 74-year-old male patient who had an enlarged left neck mass for more than 20 years underwent tumor excision. The final pathology was carotid body paraganglioma. During the operation, the tumor was discovered to be encased in the bifurcation of the common carotid artery. We carefully isolated and temporarily clamped the common carotid artery to enable application of the finger dissection method to completely free the tumor from the carotid artery in a safe and bloodless plane.

Results

Neither intraoperative massive bleeding nor postoperative cranial nerve deficit occurred. Favorable wound status was noted during outpatient department follow-up.

Conclusions

We describe a successful case of Shamblin III carotid body paraganglioma removal using temporary clamping of the common carotid artery and the finger dissection method.
A Comparative Study of Three-Dimensional Simulation in Nonsurgical Rhinoplasty With Hyaluronic Acid Fillers
Authors: Chen Chuhsin , He Junjun , Xiong Zhezhen , Xue Ke , Liu Kai
Published: January 2021

Background

The use of 3-dimensional computer imaging has grown steadily over the past decade, especially with cosmetic facial surgery. The technological advance has influenced how we counsel patients, perform procedures, and assess outcomes. The purpose of this study was to analyze the feasibility of quantifying simulated versus actual outcomes for nonsurgical rhinoplasty with hyaluronic acid.

Methods

A retrospective review of 3-dimensional images (LifeViz Inc, France) for rhinoplasty patients was performed. Randomized preoperative, simulated, and actual images were rated by a blinded panel of physicians (1 = poor, 5 = excellent). In addition, a quantitative assessment of nasofrontal angle and nasolabial angle was conducted where paired and 2-sample t tests were performed (P < 0.05 as significant).

Results

Twenty-five patients were included in this comparison study. Fifty-six percent of preoperative images were rated as poor (mean, 1.7). The simulation received a mean score of 3.4 (good in 60% of cases), and 80% of actual cases were rated good to excellent (mean, 3.7). Mean nasofrontal angle decreased from 147.1 ± 1.2° preinjection to 143.3 ± 1.6° posttreatment, a mean change of 3.8 ± 2.0°. The mean nasolabial angle decreased from 125.5 ± 1.6° pretreatment to 117.5 ± 1.5° posttreatment. Average volume of actual dosage was 1.74 ± 0.18 mL.

Conclusion

Three-dimensional simulation for patients undergoing nonsurgical rhinoplasty is helpful for surgical planning and patient communications. It provides a mechanism for critical self-evaluation and helps set patients with realistic expectations about rhinoplasty.
Application of Conchal Cartilage Grafts in Nasal Tip Plasty
Authors: Zhang Ce , Jin Ting-ting , Li Jing-yu , Yan Sheng , Zhao Ye , Pan Lei , Sun Yi
Published: January 2021

Introduction

The autologous conchal cartilage of good elasticity is easy to harvest, thus is often used in nasal tip plasty of East Asians. However, the operation techniques vary a lot among different surgeons. This article aims to introduce 3 techniques commonly used in clinical practice.

Methods

One hundred three patients were included in this study and divided into 3 groups according to the shape of the nasal tip during 2017 to 2019. The patients were followed up for at least 6 months. All patients were measured with Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS). ImageJ software was used to measure and calculate the projection ratio for lateral position standard image, and columella-labial angle (CLA) was measured.

Results

In group 1, SCHNOS for nasal obstruction (SCHNOS-O) score were 13.23 ± 7.61 and 14.49 ± 10.55 (P > 0.05); SCHNOS for nasal cosmesis (SCHNOS-C) score were 66.55 ± 31.23 and 21.73 ± 18.91 (P < 0.001); projection ratio were 0.51 ± 0.04 and 0.57 ± 0.05 (P < 0.001); CLA were 91.02° ± 5.67° and 93.55° ± 4.64° (P > 0.05), preoperative and postoperative, respectively. In group 2, SCHNOS-O score were 16.76 ± 13.44 and 15.44 ± 9.26 (P > 0.05); SCHNOS-C score were 61.87 ± 44.14 and 19.16 ± 29.37 (P < 0.001); projection ratio were 0.50 ± 0.05 and 0.58 ± 0.03 (P < 0.001); CLA were 92.32° ± 6.39° and 94.86° ± 5.96°(P > 0.05), preoperative and postoperative, respectively. In group 3, SCHNOS-O score were 15.25 ± 7.83 and 17.73 ± 11.66 (P > 0.05); SCHNOS-C score were 52.03 ± 33.38 and 17.73 ± 11.66 (P < 0.001); projection ratio were 0.53 ± 0.05 and 0.57 ± 0.02 (P < 0.001); CLA were 91.65° ± 5.75° and 93.21° ± 5.38° (P > 0.05), preoperational and postoperational, respectively.

Conclusions

None of these 3 techniques cause or aggravate nasal obstruction, and all of them can achieve high cosmetic satisfaction. Technique 1 and technique 2 are suitable for the patients with moderate and moderate to severe short nose that is common in East Asia, which can better increase the protrusion of the tip and length of the nose. Technique 3 is suitable for the patients with better shape of the nose, who need to slightly increase the protrusion of the nasal tip and increase the upward rotation.
Rhabdomyolysis is Associated with In-Hospital Mortality in Patients with COVID-19
Authors: Geng Yan , Ma Qiang , Du Yong-sheng , Peng Na , Yang Ting , Zhang Shi-yu , Wu Feng-fu , Lin Hua-liang , Su Lei
Published: January 2021

Purpose:

Rhabdomyolysis (RM) has been associated with many viral infectious diseases, and associated with poor outcomes. We aim to evaluate the clinical features and outcomes of RM in patients with coronavirus disease 2019 (COVID-19).

Method:

This was a single-center, retrospective, cohort study of 1,014 consecutive hospitalized patients with confirmed COVID-19 at the Huoshenshan Hospital in Wuhan, China, between February 17 and April 12, 2020.

Results:

The overall incidence of RM was 2.2%. Compared with patients without RM, those with RM tended to have a higher risk of deterioration. Patients with RM also constituted a greater percentage of patients admitted to the intensive care unit (90.9% vs. 5.3%, P < 0.001) and a greater percentage of patients undergoing mechanical ventilation (86.4% vs. 2.7% P < 0.001). Moreover, patients with RM had laboratory test abnormalities, including the presence of markers of inflammation, activation of coagulation, and kidney injury. Patients with RM also had a higher risk of in-hospital death (P < 0.001). Cox's proportional hazard regression model analysis confirmed that RM indicators, including peak creatine kinase levels > 1,000 IU/L (HR = 6.46, 95% CI: 3.02–13.86) and peak serum myoglobin concentrations > 1,000 ng/mL (HR = 9.85, 95% CI: 5.04–19.28), were independent risk factors for in-hospital death. Additionally, patients with COVID-19 that developed RM tended to have delayed viral clearance.

Conclusion:

RM might be an important contributing factor to adverse outcomes in COVID-19 patients. The early detection and effective intervention of RM may help reduce mortality among COVID-19 patients.
Exploring Emotional Responses After Postoperative Complications
Authors: Vitous C. Ann , Byrnes Mary E. , De Roo Ana , Jafri Sara M. , Suwanabol Pasithorn A.
Published: January 2021

Objective:

This qualitative study explored the impact of postoperative complications on surgeons and their well-being.

Background:

Complications are an inherent component of surgical practice. Although there have been extensive efforts to reduce postoperative complications, the impact of complications on surgeons have not been well-studied. Surgeons are often left to process their own emotional responses to these complications, the effects of which are not well characterized.

Methods:

We conducted 46 semi-structured interviews with a diverse range of surgeons practicing across Michigan to explore their responses to postoperative complications and the effect on overall well-being. The data were analyzed iteratively, through steps informed by thematic analysis.

Results:

Participants described feelings of sadness, anxiety, frustration, grief, failure, and disappointment after postoperative complications. When asked to elaborate on these responses, participants described internal processes such as feelings of personal responsibility and failure, self-doubt, and failing the patient and family. Participants also described external pressures influencing the responses, which included potential impact to reputation and medicolegal issues. Experience level, type of complication, and the surgeon's individual personality were specific factors that influenced the intensity of these responses.

Conclusion:

Surgeons’ emotional responses after postoperative complications may negatively impact individual well-being, and may represent a threat to the profession altogether if these issues remain inadequately recognized and addressed. Knowledge of the impact of unwanted or unexpected outcomes on surgeons is critical in developing and implementing strategies to cope with the challenges frequently encountered in the surgical profession.
Role of pollution and weather indicators in the COVID-19 outbreak: A brief study on Delhi, India
Authors: Singh Kuldeep , Agarwal Aryan
Published: January 2021

The present study examines the impact of environment pollution indicators and weather indicators on the COVID-19 outbreak in the capital city of India. In this study, we hypothesize that certain weather conditions with an atmosphere having high content of air pollutants, might impact the transmission of COVID-19, in addition to the direct human to human diffusion. The Kendall and Spearman rank correlation tests were chosen as an empirical methodology to conduct the statistical analysis. In this regard, we compiled a daily dataset of COVID-19 cases (Confirmed, Recovered, Deceased), Weather indicators (Temperature and relative humidity) and pollution indicators (PM 2.5, PM 10, NO2, CO, and SO2) in Delhi state of India. The effects of each parameter within three time frames of same day, 7 days ago, and 14 days ago are evaluated. This study reveal a significant correlation between the transmission of COVID-19 outbreaks and the atmospheric pollutants with a combination of specific climatic conditions. The findings of this research will help the policymakers to identify risky geographic areas and enforce timely preventive measures.
Altered kidney function and acute kidney damage markers predict survival outcomes of COVID-19 patients: A prospective pilot study
Authors: Temiz Mustafa Zafer , Hacibey Ibrahim , Yazar Ramazan Omer , Sevdi Mehmet Salih , Kucuk Suat Hayri , Alkurt Gizem , Doganay Levent , Doganay Gizem Dinler , Dincer Muhammet Murat , Yuruk Emrah , Erkalp Kerem , Muslumanoglu Ahmet Yaser
Published: January 2021

Background

The central role in the pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), called as coronavirus disease 2019 (COVID-19), infection is attributed to angiotensin-converting enzyme 2 (ACE-2). ACE-2 expressing respiratory system involvement is the main clinical manifestation of the infection. However, literature about the association between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and higher ACE-2 expressing kidney is very limited. In this study, we primarily aimed to investigate whether there is a kidney injury during the course of SARS-CoV-2 infection. The predictive value of kidney injury for survival was also determined.

Methods

A total of 47 participants who met the inclusion criteria were included in the study. The participants were classified as ‘‘COVID-19 patients before treatment’’ ‘‘COVID-19 patients after treatment’’, ‘‘COVID-19 patients under treatment in ICU’’ and ‘‘controls’’. The parameters comorbidity, serum creatinine and cystatin C levels, CKD-EPI eGFR levels, KIM-1 and NGAL levels, urine KIM-1/creatinine and NGAL/creatinine ratios were statistically compared between the groups. The associations between covariates including kidney disease indicators and death from COVID-19 were examined using Cox proportional hazard regression analysis.

Results

Serum creatinine and cystatin C levels, urine KIM-1/creatinine levels, and CKD-EPI, CKD-EPI cystatin C and CKD-EPI creatinine-cystatin C eGFR levels exhibited significant difference in the groups. The causes of the difference were more altered kidney function and increased acute kidney damage in COVID-19 patients before treatment and under treatment in ICU. Additionally, incidences of comorbidity and proteinuria in the urine analysis were higher in the COVID-19 patients under treatment in ICU group. Urine KIM-1/creatinine ratio and proteinuria were associated with COVID-19 specific death.

Conclusions

We found that COVID-19 patients under treatment in ICU exhibited extremely higher levels of serum cystatin C, and urine KIM-1/creatinine and urine NGAL/creatinine ratios. These results clearly described the acute kidney damage by COVID-19 using molecular kidney damage markers for the first time in the literature. Lowered CKD-EPI, CKD-EPI cystatin C and CKD-EPI creatinine-cystatin C eGFR levels were determined in them, as well. Urine KIM-1/creatinine ratio and proteinuria were associated with COVID-19 specific death. In this regard, considering kidney function and kidney damage markers must not be ignored in the COVID-19 patients, and serial monitoring of them should be considered.
Using excess deaths and testing statistics to improve estimates of COVID-19 mortalities
Authors: Böttcher Lucas , D’Orsogna Maria R. , Chou Tom
Published: January 2021

Factors such as non-uniform definitions of mortality, uncertainty in disease prevalence, and biased sampling complicate the quantification of fatality during an epidemic. Regardless of the employed fatality measure, the infected population and the number of infection-caused deaths need to be consistently estimated for comparing mortality across regions. We combine historical and current mortality data, a statistical testing model, and an SIR epidemic model, to improve estimation of mortality. We find that the average excess death across the entire US is 13% higher than the number of reported COVID-19 deaths. In some areas, such as New York City, the number of weekly deaths is about eight times higher than in previous years. Other countries such as Peru, Ecuador, Mexico, and Spain exhibit excess deaths significantly higher than their reported COVID-19 deaths. Conversely, we find negligible or negative excess deaths for part and all of 2020 for Denmark, Germany, and Norway.
A journey from Rio to Paris via Kyoto to facilitate technology transfer to the LDCs under the UNFCCC
Authors: Azam Monirul
Published: January 2021

Purpose

The purpose of this study is to evaluate to what extent the Paris Agreement and the United Nations Framework Convention on Climate Change (UNFCCC) have supported (or could support) the least developed countries (LDCs) particularly for accessing the climate technologies and thereby to meet the objectives of the Paris Agreement.

Design/methodology/approach

This study adopted legal dogmatism to evaluate the gradual development of technology transfer issues to support the LDCs under the international climate regime.

Findings

This study suggested a few potential measures to facilitate meaningful technology transfer to LDCs – such as clarifying and linking the role of the technology and financial mechanism, a more robust role of capacity building, using the sustainable development mechanism with a technology transfer focus, improving the transparency and reporting mechanism to particularly indicate support regarding technology transfer requested and received by the LDCs linking it with the nationally determined contributions, and adapting a pragmatic approach to intellectual property.

Originality/value

This study is an original contribution as it identified concern over technology transfer under the UNFCCC since 1992 with a focus on the LDCs and indicated required actions that need to be taken to support the LDCs in the context of climate-related technology transfer and beyond.
Invariant natural killer T cells: Not to be ignored in liver disease
Authors: Gan Jian , Mao Xiao Rong , Zheng Su Jun , Li Jun Feng
Published: January 2021

The liver is an important immune organ. Hepatocellular injury can be caused by many factors, which further leads to chronic liver diseases by activating the immune system. Multiple immune cells, such as T lymphocytes, B lymphocytes, natural killer cells (NKs), natural killer T cells (NKTs), and γδT cells, accumulate and participate in the immune regulation of the liver. NKTs are an indispensable component of immune cells in the liver, and invariant natural killer T cells (iNKTs) are the main subpopulation of NKTs. iNKTs activated by glycolipid antigen presented on CD1d secrete a series of cytokines and also act on other immune cells through cell‐to‐cell contact. Studies on the relationship between iNKTs and liver immunity have provided clues to uncover the pathogenesis of liver diseases and develop a promising strategy for the diagnosis and treatment of liver diseases.
Pressure effects on sulfur‐oxidizing activity of Thiobacillus thioparus
Authors: Osman Jorge R. , Cardon Hervé , Montagnac Gilles , Picard Aude , Daniel Isabelle
Published: January 2021

Carbon capture and storage technologies are crucial for reducing carbon emission from power plants as a response to global climate change. The CarbFix project (Iceland) aims at examining the geochemical response of injected CO2 into subsurface reservoirs. The potential role of the subsurface biosphere has been little investigated up to now. Here, we used Thiobacillus thioparus that became abundant at the CarbFix1 pilot site after injection of CO2 and purified geothermal gases in basaltic aquifer at 400–800 m depth (4–8 MPa). The capacity of T. thioparus to produce sulfate, through oxidation of thiosulfate, was measured by Raman spectroscopy as a function of pressure up to 10 MPa. The results show that the growth and metabolic activity of T. thioparus are influenced by the initial concentration of the electron donor thiosulfate. It grows best at low initial concentration of thiosulfate (here 5 g.l−1 or 31.6 mM) and best oxidizes thiosulfate into sulfate at 0.1 MPa with a yield of 14.7 ± 0.5%. Sulfur oxidation stops at 4.3 ± 0.1 MPa (43 bar). This autotrophic specie can thereby react to CO2 and H2S injection down to 430 m depth and may contribute to induced biogeochemical cycles during subsurface energy operations.
Molecular expression and functional features of Kv7 channels in human prostate smooth muscle
Authors: Choi Joongwon , Han Deok H. , Chae Mee R. , Sung Hyun H. , Kang Su J. , Shin Jimin , Lee Sung W.
Published: January 2021

Background

Relaxation of prostate smooth muscle tone is a key strategy for the medical treatment of lower urinary tract symptoms (LUTS) in men. However, potassium channel's physiological role inhuman prostatic smooth muscle (HPrSM) has yet to be determined.

Objectives

In this study, we examined the molecular characteristics and physiological roles of Kv7 channels in HPrSM.

Materials and methods

The expressions of KCNQ1–5 (Kv7 channel pore‐forming α‐subunits) and KCNE1‐5 (β‐regulatory subunits) isoforms in HPrSM were examined using real‐time PCR. The relaxation effect of ML213 was investigated by cumulatively adding ML213 to the prostate strips. Kv7 currents were recorded using an amphotericin‐B perforated patch‐clamp technique.

Results

In HPrSM cells, KCNQ4, KCNQ5, and KCNE4 isoforms were predominantly expressed, while KCNQ1, KCNQ5, and KCNE3 isoforms were the most abundantly expressed in human prostatic tissues. Western blot analysis revealed the protein expression of the Kv7.1, 7.4, and 7.5 channel subtypes in human prostate tissues (n = 3). ML213 (an activator of Kv7.2/7.4/7.5) induced the concentration‐dependent relaxation of HPrSM strips (n = 15, p = 0.001), and this effect was attenuated by pretreatment with XE991 (a Kv7.1–7.5 blocker). In electrophysiology studies, ML213 significantly increased the amplitude of whole‐cell Kv7 currents in HPrSM cells. ML213‐induced outward currents were greater than retigabine (a Kv7.2–7.5 channel activator). The subsequent addition of XE991 completely inhibited the ML213‐induced currents (n = 9, p < 0.01 vs. ML213). ML213 hyperpolarized the HPrSM cell membrane potential and was fully reversed by XE991. In situ PLA revealed the colocalization of heteromeric KV7.4/KV7.5 channels in HPrSM cells.

Conclusions

Our findings suggest that Kv7.4 and 7.5 channels in prostatic smooth muscle play a critical role in the regulation of HPrSM tone and that Kv7 channel subtypes may be novel therapeutic targets for the treatment of LUTS associated with BPH.
Primary antibody deficiency: The impact on the quality of life and mental health of affected children and their parents
Authors: Berg Annika Klungland , Diseth Trond H. , Abrahamsen Tore Gunnar , Halvorsen Kathleen , Reinfjell Trude , Erichsen Hans Christian
Published: January 2021

Aim

To evaluate health‐related quality of life, mental health and treatment‐related stress responses in children with primary antibody deficiency and both their parents.

Methods

Children and their parents completed the standardised questionnaires Pediatric Quality of life Inventory, Strength and Difficulties Questionnaire and Impact of Event Scale. Parents also completed standardised questionnaires regarding their own mental health and quality of life. The results were compared to those of healthy children, kidney transplanted children and children in remission from acute lymphoblastic leukaemia.

Results

Children with primary antibody deficiency reported a poorer health‐related quality of life compared to healthy children and children in remission from acute lymphoblastic leukaemia. They reported poorer mental health compared with healthy children. Mothers of children with primary antibody deficiency reported poorer mental health compared to mothers of healthy children but comparable to mothers of chronically ill children. Parents reported a similar quality of life as the general Norwegian population. Treatment with subcutaneous immunoglobulin infusions at home is generally well tolerated, but some report severe treatment‐related stress.

Conclusion

Primary antibody deficiency has a significant impact on quality of life and mental health of affected children. Patients and parents with severe treatment‐related stress should be identified and helped.
Lessons learnt from the variation across 6741 family/general practices in England in the use of treatments for hypogonadism
Authors: Heald Adrian H. , Stedman Michael , Whyte Martin , Livingston Mark , Albanese Marco , Ramachandran Sud , Hackett Geoff
Published: January 2021

Introduction

We have previously reported rates of diagnosis of male hypogonadism in United Kingdom (UK) general practices. We aimed to identify factors associated with testosterone prescribing in UK general practice.

Methods

We determined for 6741 general practices in England, the level of testosterone prescribing in men and the relation between volume of testosterone prescribing and (1) demographic characteristics of the practice, (2) % patients with specific comorbidities and (3) national GP patient survey results.

Results

The largest volume (by prescribing volume) agents were injectable preparations at a total cost in the 12‐month period 2018/19 of £8,172,519 with gel preparations in second place: total cost £4,795,057. Transdermal patches, once the only alternative to testosterone injections or implants, were little prescribed: total cost £222,022. The analysis accounted for 0.27 of the variance in testosterone prescribing between general practices. Thus, most of this variance was not accounted for by the analysis. There was a strong univariant relation (r = .95, P < .001) between PDE5‐I prescribing and testosterone prescribing. Other multivariant factors independently linked with more testosterone prescribing were as follows: HIGHER proportion of men with type 2 diabetes(T2DM) on target control (HbA1c ≤ 58 mmol/mol) and HIGHER overall practice rating on the National Patient Survey for good experience, while non‐white ethnicity and socio‐economic deprivation were associated with less testosterone prescribing. There were a number of comorbidity factors associated with less prescribing of testosterone (such as T2DM, hypertension and stroke/TIA).

Conclusion

Our analysis has indicated that variation between general practices in testosterone prescribing in a well developed health economy is only related to small degree (r2 = 0.27) to factors that we can define. This suggests that variation in amount of testosterone prescribed is largely related to general practitioner choice/other factors not studied and may be amenable to measures to increase knowledge/awareness of male hypogonadism, with implications for men's health.
Glycaemic efficacy and safety of mealtime faster‐acting insulin aspart administered by injection as compared to insulin aspart in people with diabetes mellitus: A meta‐analysis of randomized controlled trials
Authors: Pal Rimesh , Banerjee Mainak , Bhadada Sanjay Kumar
Published: January 2021

Aims

To summarize all relevant randomized controlled trials (RCTs) and provide precise effect estimates of glycaemic efficacy/safety of faster‐acting insulin aspart administered by injection as compared to insulin aspart in people with diabetes mellitus.

Methods

PubMed/Cochrane Library were systematically searched till October 10, 2020, to identify RCTs with duration ≥16 weeks, evaluating efficacy/safety of mealtime injections of faster aspart compared to insulin aspart in people with type 1 diabetes mellitus and type 2 diabetes mellitus. Studies using faster aspart as continuous subcutaneous insulin infusion were excluded. Continuous and dichotomous outcome variables (expressed as estimated treatment difference and rate ratio in RCTs, respectively) were pooled using generic inverse variance method with fixed/random‐effects model. For each outcome variable, subgroup analysis between type 1 diabetes mellitus and type 2 diabetes mellitus was performed.

Results

We included five RCTs; three of type 1 diabetes mellitus (n = 1963) and two of type 2 diabetes mellitus (n = 1780). All had low risk of bias. Faster aspart was associated with small but significant improvement in HbA1c than insulin aspart (MD: −0.06%, 95% CI: −0.10, −0.02, p = 0.005, I2 = 19%). HbA1c reduction was statistically significant only in type 1 diabetes mellitus on subgroup analysis (MD: −0.08%, 95% CI: −0.14, −0.02, p = 0.005, I2 = 47%). Besides, faster aspart was associated with reduced postprandial plasma glucose (PPG) increment at 1 h/2 h after meal test and increased 1,5‐anhydroglucitol compared to insulin aspart. Early postprandial hypoglycaemic episodes were higher with faster aspart; however, overall and nocturnal hypoglycaemic episodes were not different from insulin aspart.

Conclusions

Faster aspart is associated with reduced HbA1c, PPG increment and comparable overall hypoglycaemic episodes with regard to insulin aspart.
Governing through non‐enforcement: Regulatory forbearance as industrial policy in advanced economies
Authors: Dewey Matías , Di Carlo Donato
Published: January 2021

Political economy scholarship generally assumes that governments are interested in enforcing economic regulations. Cases of non‐enforcement are predominantly studied in the context of developing countries and are chiefly associated with states' deficient institutional capacity. This article casts doubts on these assumptions by showing how governments in advanced democracies manipulate the regulatory regime and generate selective non‐enforcement of economic regulations to shape markets at their discretion. We argue that regulatory forbearance becomes an attractive form of industrial policy when governments are prevented from intervening discretionally in markets due to legal obstacles, which they cannot overcome; or when the productive structure of the country makes alternative forms of intervention unviable. Drawing on the study of tax non‐enforcement in two most‐different cases of strong and weak state capacity such as Germany and Italy, the article theorizes three techniques through which governments manipulate regulatory regimes: legal and organizational sabotage and shirking. By shedding light on the economic logic of forbearance, the article points at non‐enforcement as an overlooked mode of regulatory governance and suggests the need to inquire further into governments' strategic agency behind regulatory regimes.
Foreword
Authors: Grayling A.C.
Published: January 2021

The landscape for considerations about nations, nationality, and ethnicity is a confusing one. It cannot be mapped without the kind of engagement exemplified by the papers presented in this Special Issue: examination of specific matters and illumination of the individual jigsaw puzzle pieces out of which the bigger and far more complicated picture will develop. Particularity produces clarity, and it is only through careful examination of each piece in the puzzle, one by one, that it becomes possible to discern the true contours of these concepts.
Men in Women’s Clothes
Authors: Jones Ward E.
Published: January 2021

The descriptive phrase that comprises my title can refer both to a pervasive comic trope and a mode of self‐expression. There is a tension here, insofar as the comic trope leads us not to take cross‐dressing, or drag, seriously. The first half of the comic film Some Like It Hot (1959), with its cross‐gender plot and its (sophisticated but) straightforward use of the comic trope of men‐in‐women’s clothes, appears to fall foul of this tension and to be susceptible to criticism in this regard. However, the film rectifies itself, portraying the cross‐dressing relationship which develops through the second half of the film as a potentially meaningful one for both partners. In this article, I interpret the film as inviting its viewers to adopt a (particular kind of) skeptical ironic (that is, Pyrrhonian) attitude toward gender‐presentation practices. While the film in no way attempts to discourage us from participating in such practices, it does invite us—through our partiality toward the characters Osgood and Jerry/Daphne, as we follow their budding, transgressive relationship—to acknowledge that a violation of gender‐presentation practices can be a meaningful feature of sincere relationships.
The effect of a video‐supported assessment to increase the accuracy of self‐reported physical activity
Authors: Ullrich Antje , Voigt Lisa , Siewert‐Markus Ulrike , Meyer Christian , Dörr Marcus , Ulbricht Sabina
Published: January 2021

Self‐reported physical activity differs from activity levels measured by device. We tested the effect of a video that visualizes the intensity levels of physical activity to increase the agreement between self‐reported and accelerometer‐based moderate‐to‐vigorous physical activity (MVPA) within a single‐blinded, randomized study. Participants (N = 378, 40‐75 years) wore an accelerometer for seven days. Prior to the collection of self‐reported data by the IPAQ‐SF, participants were randomly assigned (1:1) to a control group (CG) or a video group (VG). The outcome was the absolute difference between self‐reported and accelerometer‐based time spent in MVPA (Δ MVPAIPAQ−Accelerometry). To examine the agreement, we used Spearman correlation coefficients and Bland‐Altman analysis. To test the video effect, we used Wilcoxon signed‐rank test, Bayes factor, and simultaneous‐quantile regression. In total, 302 participants fulfilled the accelerometer wear time criteria (≥10 hours/day; ≥6 days) and completed self‐reports within three days after the wearing period. The median of Δ MVPAIPAQ−Accelerometry was −9.0 min/day (IQR: −32.0 to 66.6) for CG and −11.5 min/day (IQR: −29.9 to 14.3) for VG. Wilcoxon signed‐rank test revealed no differences in Δ MVPAIPAQ−Accelerometry between study groups whereas Bayes factor indicated insensitivity of the data. Simultaneous‐quantile regression revealed no relationship between video presentation and Δ MVPAIPAQ−Accelerometry in the 25th percentile. In the 50th (b = −12.4 [95% CI = −23.2 to −1.5] and 75th percentile (b = −45.7 [95% CI = −70.5 to −20.9]), Δ MVPAIPAQ−Accelerometry was negatively associated with video presentation. To conclude, video‐supported assessment may increase the accuracy of self‐reported MVPA among individuals who slightly underestimated and those who overestimated their MVPA.