bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Text Message Reminders on Attendance at Cervical Cancer Screening Appointments in a Predominantly Hispanic Population
Authors: Molokwu Jennifer C. , Dwivedi Alok , Alomari Adam , Guzman Jesus , Shokar Navkiran
Published: May 2022

Hispanic women have the highest rates of incident cervical cancer in the United States (U.S.) and are 1.9 times more likely to die from cervical cancer than non-Hispanic Whites. Objective: Assess the impact of text message reminders on cervical cancer screening attendance and completion. Design: Pragmatic non-randomized study design using propensity matched analysis. Setting: Community-dwelling low-income females in the U.S./Mexico border community. A total of 2,255 mainly Hispanic females aged 21–65. Methods: Text message reminders in addition to usual care (telephone call reminders). Results: After adjusting for significant factors and propensity score matching, individuals in the text reminder group had 11% lower screening incidence than individuals without text reminders (risk difference [RD] = −0.11, 95% CI: −0.16, −0.05; p < .001). Conclusion: Participants with text reminders were less likely to complete cervical screening than usual practice in a predominantly Hispanic population. Our study demonstrates that reminders’ content rather than method may be vital to improving our population's cancer screening rates.
Screening of Prognostic Biomarkers for Stereotactic Body Radiation Therapy in Primary Liver Cancer
Authors: Liang Zhenzhen , Xue Chang , Chen Qing , Li Mengke , Li Guanghui , Feng Hao , Liu Yi , Liu Xiaodong , Ma Shumei
Published: May 2022

Objective

So far there are still no effective immediate-early markers for assessing the efficacy of Stereotactic Body Radiation Therapy (SBRT). To find effective biomarkers for accurate assessment of the efficacy of SBRT in patients with primary liver cancer, we conducted this study including retrospective part and prospective part.

Material and Methods

589 patients with primary liver cancer were included at Ruikang Hospital affiliated to Guangxi Medical University from January 2012 to December 2018. Follow-up was conducted, clinical information and a total of 17 patients with 51 blood samples (before SBRT, before discharge and 2 months after SBRT) were collected. mRNAs profiles on 2 patients with 6 blood samples were detected by high-throughput sequencing, followed by qPCR verification on 15 patients with 45 blood samples.

Results

The commonly used serum biomarkers such as AFP, CEA, and CA125 shown low prognostic value in distinguishing survival group and death group, indicated by low AUC (less than .7) and Youden indexes (less than .5). Based on high-throughput sequencing of test group and qPCR detection of another verification group, we found 16 up-regulated and 12 downregulated genes after SBRT. Among them, ADIPOR1 and EPB42 showed significantly different between effective and ineffective group after SBRT, ROC suggested that based on the optimal threshold of .5838, ADIPOR1 shown a sensitivity of 100% and a specificity of 83.33% to distinguish effective from ineffective group. And EPB42 had a sensitivity of 75% and a specificity of 100% at the optimal threshold of 1.3817. In addition, GSEA showed that high expression of ADIPOR1 was mainly related to Mismatch repair, Circadian rhythm, Protein processing in endoplasmic reticulum, DNA replication, and Fanconi anemia pathways.

Conclusion

ADIPOR1 in whole blood is a promising candidate to act as prognostic biomarker for predication of SBRT outcomes in primary liver cancer patients.
The effects of turbulent air streams and corrugated surfaces on the output of a wind turbine
Authors: Al-Shnynat Nidal , Duwairi Hamzeh
Published: May 2022

It is challenging to select the area that best fit the installation of wind turbines within complex and forestry terrains. This study aims to highlight the effects of corrugated surfaces on the characteristics of a turbulent wind flow, and on the performance of a wind turbine installed within this topography. It is hypothesized that a sinusoidal wave can be utilized to describe a corrugated surface. The physical stance was analytically modeled based on conservation principles of mass and mechanical energy. Model’s mathematical equation was then solved, by adopting finite difference method and MATLAB’s Bvp4c algorithm. The results show that wind and turbine related parameters are affected by the evolved atmospheric Boundary Layer (ABL) and differed according to the location within the boundary layer (BL) from the leading part to the edge, where BL’s retarding effects diminishes. The study also proves that velocity and turbine harvested power are inversely proportional to the corrugated surface’s amplitude, and to the wind’s turbulence ratio. On the other hand, it demonstrates a direct proportion between boundary layer thickness (BLT) and corrugated surfaces-related parameters. To the contrary of previous works, this study concentrated on capturing interaction effects between wind turbine, atmospheric inflow, and complex terrains.
Beyond the humanitarian savior logics? UNHCR's public communication strategies for the Syrian and Central African crises
Authors: Ongenaert David , Joye Stijn , Machin David
Published: May 2022

Forcibly displaced people often face restrictive migration policies and stereotypical discourses. Therefore, this study analyzes UNHCR's public communication strategies towards the Syrian and Central African crises. Through a comparative-synchronic multimodal critical discourse analysis (MCDA) of UNHCR's (international) press releases (N = 28), news stories (N = 233), photos (N = 462) and videos (N = 50) of 2015, we examined its main representation and argumentation strategies. First, we found that UNHCR primarily represents forcibly displaced people in its press releases and news as victimized and/or voiceless masses, reproducing humanitarian savior and deservingness logics. However, stories, photos, and videos frequently portray them also as empowered individuals. This can be partially explained by media logics and political and private sector discourses and agenda-building opportunities. Moreover, UNHCR mainly voices pity-based and post-humanitarian Self-oriented solidarity discourses, and links protection to states’ (perceived) interests. Finally, these discursive strategies respond to dominant migration management paradigms and the increasingly neoliberalized, political realist international refugee regime (IRR).
Soluble CD163 is produced by monocyte-derived and alveolar macrophages, and is not associated with the severity of idiopathic pulmonary fibrosis
Authors: Chauvin Pierre , Morzadec Claudie , de Latour Bertrand , Llamas-Gutierrez Francisco , Luque-Paz David , Jouneau Stéphane , Vernhet Laurent
Published: May 2022

The soluble form of the membrane hemoglobin scavenger receptor CD163 (sCD163), released by shedding, is a strong marker for macrophage activation. Serum sCD163 levels rise in several acute inflammatory states and some fibrosing diseases. Monocyte-derived macrophages (MoDM) differentiated by macrophage colony-stimulating factor (M-MoDM) contribute to the pathophysiology of idiopathic pulmonary fibrosis (IPF), an irreversible and rapidly fatal interstitial lung disease. Since M-MoDM express high membrane CD163 levels, we thus postulated that sCD163 could be a relevant biomarker for macrophage activation in IPF. We found that M-MoDM constitutively released higher amounts of sCD163 (49.5 ± 24.5 ng/ml) than monocytes (0.45 ± 0.32 ng/ml) or MoDM differentiated with granulocyte macrophage-stimulating factor (2.24 ± 0.98 ng/ml). The basal production of sCD163 by M-MoDM was increased following stimulation with lipopolysaccharide (123.4 ± 54.9 ng/ml) or ATP (168.9 ± 41.8 ng/ml). The sCD163 release was controlled by metalloproteases but not through ADAM17 activation. Moreover, CD163-positive macrophages and sCD163 were detected in pulmonary tissues and alveolar fluids of Caucasian patients with IPF, respectively. IPF alveolar macrophages constitutively secreted sCD163 amounts (67.6 ± 44.6 ng/µg RNA) which were significantly higher than those released by alveolar macrophages isolated from controls (19.2 ± 7.6 ng/µg RNA) or patients with other interstitial lung disease (31.5 ± 16.6 ng/µg RNA). However, the concentrations of sCD163 in blood serum collected from 155 patients with IPF did not correlate with the severity of their disease. In conclusion, our results show that M-MoDM constituted a pertinent model to study the regulation of sCD163 production. Yet, serum sCD163 values could not provide a prognostic biomarker for IPF in our cohort.
Anti-skin Aging Activities of Sideritis scardica and 3 Flavonoids With an Uncommon 8-Hydroxyl Moiety
Authors: Sato Fumiaki , Wong Chin Piow , Furuya Kaito , Kuzu Chikako , Kimura Ryosuke , Udo Tomoha , Honda Haruno , Yang Jinwei
Published: May 2022

The skin plays various crucial biological functions and gradually degenerates due to the process of skin aging. Hence, the development of new ingredients for delaying or even reversing skin aging is an essential subject that needs to be addressed. Our screening effort for anti-skin aging ingredients has led to the discovery that Sideritis scardica extract (SSE) possesses collagenase inhibition, advanced glycation end product (AGE) formation inhibition, antioxidative, and antiallergic activities, as well as ultraviolet B (UVB)-induced matrix metalloproteinase-1 (MMP-1) expression inhibition activity. However, the effect of S. scardica, commonly known as a mountain herb, on skin aging is unknown and needs additional study. Further studies on SSE have led to the isolation of 3 flavonoids with an uncommon 8-hydroxyl moiety, isoscutellarein (1), 4′- O-methylhypolaetin (2), and 4′- O-methylisoscutellarein (3). Biological evaluations also revealed that 1-3 possess SSE collagenase inhibition, AGE formation inhibition, antioxidative, and antiallergic activities, while 3 was identified to possess SSE UVB-induced MMP-1 expression inhibition activity. Moreover, the AGE formation inhibition activity and antiallergic activity of 1-3 were speculated to be derived from their antioxidative activity, while direct inhibition of the collagenase enzyme led to their observed collagenase inhibition activity. Regarding the inhibition activity of 1-3 on UVB-induced MMP-1 expression, further studies are necessary to reveal their possible mechanism of action. Collectively, the biological activities of SSE and the isolated flavonoids 1-3 highlight the potential of S. scardica to be further developed as an agent to delay or reverse skin aging.
Therapeutic Potential of Berberine for Osteoporosis and its Underlying Mechanisms: A Bioinformatics, Network Pharmacology, Molecular Dynamics Simulation Study
Authors: Yu Jin-Ling , Wang Bo-Wei , Zhang Hui-Li , Yang Liu-Qing , Yao Jing-Jing , Huang Han-Dan , Tao Lu , Gao Ying , Liu Zhi-Hui
Published: May 2022

Osteoporosis is a systemic skeletal disease that can easily lead to bone fractures. Berberine has been shown to be effective in treating osteoporosis. This study was conducted to identify the potential mechanism of berberine in treating this complaint. We screened potential targets of berberine and identified the osteoporosis-related differentially expressed genes (DEGs) in the microarray dataset GSE56815. Protein–protein interaction (PPI) network construction, hub targets identification, and pathway enrichment were carried out to find the potential targets. Molecular docking and molecular dynamics studies were performed to verify the combination of berberine with its treatment-related central targets. In addition, SwissADME preliminarily evaluated the physicochemical properties of berberine. Through data mining, 23 osteoporosis-related targets of berberine were selected. PPI and module analyses suggested that AKT1, MAPK1, ESR1, AR, TP53, and PTGS2 are the core targets of berberine. Docking and molecular dynamics studies showed that berberine could stably bind to core proteins to form a protein–ligand complex. The enrichment analysis showed that the estrogen signaling pathway and thyroid hormone signaling pathway play important roles in curing osteoporosis. To sum up, berberine primarily acts on AKT1, MAPK1, ESR1, AR, TP53, and PTGS2, mainly regulating the estrogen and thyroid hormone signaling pathways to treat osteoporosis in a multi-target, multi-pathway, and multi-system manner.
Using Network Pharmacology and Molecular Docking Technology to Explore the Mechanism of Modified Pulsatilla Decoction in the Treatment of Ulcerative Colitis
Authors: Wu Tingting , Yang Xin , Xu Bo , Zhu Huiping , Guo Jinwei , Zhou Yu , Liang Guoqiang , Sun Hongwen
Published: May 2022

Objective: Using network pharmacology and molecular docking technology, our aim was to clarify the biological activity, key targets, and potential pharmacological mechanisms of modified Pulsatilla decoction (MPD) in the treatment of ulcerative colitis (UC). Materials and Methods: The main active ingredients of MPD were screened using the traditional Chinese medicine systems pharmacology platform. UC targets were obtained from the GeneCard, OMIM, DisGeNET, PharmGkb, and DrugBank databases. The common genes of MPD in the treatment of UC were identified by Venn diagram. The visual interactive network diagram of “active ingredient-target-disease” was constructed using the software Cytoscape. We used the STRING database to construct a protein–protein interaction network and analyze the correlation in protein interaction. We conducted gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis for common genes using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) database and R software. Subsequently, the molecular docking verification of ingredients and targets was conducted through Discovery Studio. Last, in vivo experiments were conducted to further verify the findings. Results: A total of 51 active ingredients were screened, involving 141 common genes. The top 5 ingredients in MPD were quercetin, β-sitosterol, luteolin, kaempferol, and stigmasterol. Pathways involved in the treatment of UC include the advanced glycation end products-receptor for advanced glycation end products (AGE-RAGE) signaling pathway, the interleukin-17 (IL-17) signaling pathway, the tumor necrosis factor (TNF) signaling pathway, viral infection-related signaling pathways, and some cancer pathways. Molecular docking showed that the important ingredients of MPD were well docked with mitogen-activated protein kinase 1 (MAPK1), mitogen-activated protein kinase 8 (MAPK8), RAC-alpha serine (AKT1), vascular endothelial growth factor-A (VEGFA), transcription factor AP-1 (JUN), and interleukin-6 (IL-6). Animal experiments showed that MPD could ameliorate the injury and colitis in dextran sulfate sodium (DSS)-induced colitic rats. MPD inhibited the expression of p-p38A and p-MLC in UC rats. Conclusions: MPD has the characteristics of a multisystem, multi-ingredient, and multitarget in the treatment of UC. The possible mechanisms include inhibition of inflammation, apoptosis, oxidation, and tumor gene transcription. MPD may have a protective effect in the treatment of UC.
Neurological and Inflammatory Effects of Radio Frequency and Cryoablation in a Rat Sciatic Nerve Model of Submucosal Nerve Ablation
Authors: Lett Kawasi , Zhang Yuying , Nishimura Nozomi
Published: May 2022

Background

Minimally-invasive ablation with radio frequency (RF) and cryoablation have been widely adopted to treat conditions with aberrant neural activity such as excessive mucus production in rhinitis, but neurological and inflammatory effects on treated tissues are poorly understood.

Objective

To gain an understanding of the physiological changes caused by nerve ablation using RF and cryoablation devices.

Methods

Using clinical devices for rhinitis treatment that ablate nerves with access from the nasal cavity, we applied temperature-controlled RF and cryoablation to rat sciatic nerves. To model the ablation through mucosal tissue similarly to the rhinitis procedure, RF ablation and cryoablation were applied through a layer of muscle.

Results

Both ablation techniques induced acute and sustained neurodegeneration visualized with histological sections at two days and one month after treatment. After both treatments, rats showed a change in muscle tone, but small increases in sensitivity measured by a von Frey test were only observed 2 days after cryoablation and one month after the RF ablation. Both treatments caused reductions in nerve conduction velocity at one month after treatment. Inflammation in treated nerves and surrounding tissues that persisted to one month.

Conclusions

The two neurolytic devices used in the clinic work similarly by axonal disintegration and which leads to disruption of electrical signals. The data suggest that these methods are effective methods of nerve ablation that could be used to treat diseases related to elevated neuron activity such as rhinitis.
Longitudinal CT evaluation of transdermal scopolamine for aspiration pneumonia with sialorrhea in severe chronic brain injury: A case series
Authors: Yamaki Tomohiro , Takahashi Kyoko , Azuhata Osamu , Itou Daisuke , Yakufujiang Madinum , Oka Nobuo , Odaki Masaru , Kobayashi Shigeki
Published: May 2022

Sialorrhea is a major cause of recurrent aspiration pneumonia in severe chronic brain injury. Previous reports have shown that transdermal scopolamine can decrease saliva production. We present four patients with severe chronic brain injury who experienced repeat aspiration pneumonia with sialorrhea. Longitudinal computed tomography examinations to assess the therapeutic effect were performed in all four cases before and after transdermal scopolamine. Transdermal scopolamine was applied as a patch (0.1 g/2.5 cm2) behind the earlobe every 24 h after confirming the absence of glaucoma. Patches were formulated as an in-hospital preparation (scopolamine butylbromide 0.25 g and hydrophilic cream 4.75 g) under the approval of our institutional review board. Longitudinal computed tomography after transdermal scopolamine use showed a decrease in pleural effusions associated with continuous aspiration pneumonia in all four cases. The data from repeat computed tomography suggest that long-term transdermal scopolamine for reducing saliva production may be a reasonable option for appropriate palliative care in severe chronic brain injury patients.
Network Analysis of Depressive Symptomatology in Underweight and Obese Adults
Authors: Ramos-Vera Cristian , Serpa Barrientos Antonio , Vallejos-Saldarriaga José , Saintila Jacksaint
Published: May 2022

Background:

Depressive symptoms can affect people’s quality of life and social environment. In addition, in severe situations, they can lead to suicidal behaviors.

Objective:

This study aimed to analyze the differences in depressive symptoms in underweight and obese Peruvian adults.

Methods:

A cross-sectional study was carried out based on secondary data obtained from the Instituto Nacional de Estadística e Informática (INEI), Lima, Peru. A sample of 10 053 participants was considered, of which 55.96% were women. Two Gaussian plot models were estimated and the levels of depressive symptomatology were compared between the 2 groups (adults with underweight and obese).

Results:

A total of 1510 (15.02%) were underweight adults and 8543 (84.98%) were obese adults. There were differences in the reporting of depressive symptoms in the underweight group; the most central items were “Depressed mood” (PH2), “Tiredness/low energy” (PH4), and “Psychomotor difficulties” (PH8).

Conclusion:

This study provides new evidence on the dynamic relationship between depressive symptoms according to the body mass index categories (underweight and obese) assessed.
Perceived Principal’s Authentic Leadership Impact on the Organizational Citizenship Behavior and Well-Being of Teachers
Authors: Shie Er-Huei , Chang Shu-Hsuan
Published: May 2022

As teacher well-being is impacted by the leadership ability of school management, which helps establish trust and cooperation among the teaching faculty, it is an important subject of research. Therefore, this study aims to explore how the authentic leadership of school principals impacts (1) the teacher-school relationship (based on organizational trust, organizational identification, and organizational commitment), and (2) teachers’ organizational citizenship behavior. In addition, mediating effects of the teacher-school relationship and organizational citizenship are investigated. For data collection, senior high/vocational school teachers in central Taiwan were recruited to participate in a self-reported questionnaire survey. Specifically, 783 valid responses were retrieved. The empirical findings are as follows. First, the principals’ authentic leadership had a direct effect on teachers’ organizational trust, organizational identification, organizational commitment, and organizational citizenship behavior. Second, organizational identification and organizational commitment directly affected organizational citizenship behavior. Third, organizational trust, organizational commitment, and organizational citizenship behavior directly affected teachers’ well-being. Finally, organizational trust, organizational commitment, and organizational identification had a mediating effect on the relationship between authentic leadership, organizational citizenship behavior, and teacher well-being. The academic and practical implications, as well as contributions of the study, are discussed, and suggestions for future research and management are proposed.
The effect of multimedia and temporal contiguity principles on students’ attitude and retention in learning Japanese language
Authors: Ge Shigang , Hai Leng Chin , Baharudin Siti Mastura
Published: May 2022

Nowadays many schools take the Japanese language as the second language, although there are similarities in the writing of the Japanese and Chinese language, the student’s learning outcomes are a challenge for the teacher. This study is to explore the effect of multimedia principles (multimedia, temporal contiguity) in slides on students’ attitude and retention towards Japanese vocabulary among 10-grade students in Chinese rural areas. Using quasi-experimental research to form an experiment group and control group for 10 weeks. 90 participants have randomly selected sampling from Wucuan town, Zunyi city, Guizhou province. 5 Likert-scale questionnaire was used to collect the students’ attitudes and binary tests for the students’ retention. All the data were sorted out and input into the SPSS 26 version for description and inferential analysis. The results showed the students’ attitude and retention in EG are significantly different than the CG. Reveal the multimedia and temporal contiguity principles are a benefit to the students. Multimedia and contiguity principles used in the slides can change attitudes toward learning Japanese vocabulary and improve students’ retention.
Risk Factors for Femoral Cortical Button Malposition in Posterior Cruciate Ligament Reconstruction
Authors: Yuanjie Zeng , Xing Xie , Jing Wang , Xi Gong , Yanbin Pi , Yu Mei
Published: May 2022

Background:

Femoral cortical button suspension fixation is a popular and reliable technique for posterior cruciate ligament reconstruction (PCLR). Button malposition during graft fixation can lead to postoperative graft loosening.

Purpose:

To determine the risk factors of femoral cortical button malposition in PCLR when neither direct visualization nor intraoperative fluoroscopy is used.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Of the 206 consecutive patients who underwent PCLR without direct visualization or intraoperative radiographs in 2019 at a single institution, 182 met the selection criteria and were included in the study. The distance from the suspension button to the femoral cortex was measured on postoperative computed tomography scans. The button was considered malpositioned if its distance to the femoral cortex was ≥2 mm. We evaluated patient-related and surgery-related variables, including age, sex, concomitant ligament reconstruction, button type, and surgeon experience. Multivariate logistic regression was conducted to evaluate the risk factors for button malposition.

Results:

The overall prevalence of button malposition was approximately 17.0% (31/182), and the mean distance from the button to the femoral cortex was 6.11 ± 5.82 mm in the malposition group. Male sex was the most significant risk factor for button malposition (odds ratio [OR], 13.86; 95% confidence interval [CI], 1.73-111.17; P = .013). Other independent risk factors were low surgical volume (completing ≤3 procedures; OR, 6.41; 95% CI, 1.89-21.72; P = .003), concomitant ligament reconstruction (OR, 5.56; 95% CI, 2.12-14.58; P < .001), and fixed-loop button (OR, 3.96; 95% CI, 1.11-14.18; P = .034).

Conclusion:

Male sex, low surgical volume, concomitant ligament reconstruction, and fixed-loop button were independent risk factors for femoral cortical button malposition during PCLR.
Three-Dimensional Quantification of Cam Resection Using MRI Bone Models: A Comparison of 2 Techniques
Authors: Alter Thomas D. , Knapik Derrick M. , Guidetti Martina , Espinoza Alejandro , Chahla Jorge , Nho Shane J. , Malloy Philip
Published: May 2022

Background:

The current clinical standard for the evaluation of cam deformity in femoroacetabular impingement syndrome is based on radiographic measurements, which limit the ability to quantify the complex 3-dimensional (3D) morphology of the proximal femur.

Purpose:

To compare magnetic resonance imaging (MRI)–based metrics for the quantification of cam resection as derived using a best-fit sphere alpha angle (BFS-AA) method and using 3D preoperative-postoperative surface model subtraction (PP-SMS).

Study Design:

Descriptive laboratory study.

Methods:

Seven cadaveric hemipelvises underwent 1.5-T MRI before and after arthroscopic femoral osteochondroplasty, and 3D bone models of the proximal femur were reconstructed from the MRI scans. The alpha angles were measured radially along clockfaces using a BFS-AA method from the literature and plotted as continuous curves for the pre- and postoperative models. The difference between the areas under the curve for the pre- and postoperative models was then introduced in the current study as the BFS-AA–based metric to quantify the cam resection. The cam resection was also quantified using a 3D PP-SMS method, previously described in the literature using the metrics of surface area (FSA), volume (FV), and height (maximum [FHmax] and mean [FHmean]). Bivariate correlation analyses were performed to compare the metrics quantifying the cam resection as derived from the BFS-AA and PP-SMS methods.

Results:

The mean ± standard deviation maximum pre- and postoperative alpha angle measurements were 59.73° ± 15.38° and 48.02° ± 13.14°, respectively. The mean for each metric quantifying the cam resection with the PP-SMS method was as follows: FSA, 540.9 ± 150.7 mm2; FV, 1019.2 ± 486.2 mm3; FHmax , 3.6 ± 1.0 mm; and FHmean, 1.8 ± 0.5 mm. Bivariate correlations between the BFS-AA–based and PP-SMS–based metrics were strong: FSA ( r = 0.817, P = .012), FV ( r = 0.888, P = .004), FHmax ( r = 0.786, P = .018), and FHmean ( r = 0.679, P = .047).

Conclusion:

Strong positive correlations were appreciated between the BFS-AA and PP-SMS methods quantifying the cam resection.

Clinical Relevance:

The utility of the BFS-AA technique is primarily during preoperative planning. The utility of the PP-SMS technique is in the postoperative setting when evaluating the adequacy of resection or in patients with persistent hip pain with suspected residual impingement. In combination, the techniques allow surgeons to develop a planned resection while providing a means to evaluate the depth of resection postoperatively.
European Stroke Organisation (ESO) guideline on screening for subclinical atrial fibrillation after stroke or transient ischaemic attack of undetermined origin
Authors: Rubiera Marta , Aires Ana , Antonenko Kateryna , Lémeret Sabrina , Nolte Christian H , Putaala Jukka , Schnabel Renate B , Tuladhar Anil M , Werring David J , Zeraatkar Dena , Paciaroni Maurizio
Published: May 2022

We aimed to provide practical recommendations for the screening of subclinical atrial fibrillation (AF) in patients with ischaemic stroke or transient ischaemic attack (TIA) of undetermined origin. These guidelines are based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. Five relevant Population, Intervention, Comparator, Outcome questions were defined by a multidisciplinary module working group (MWG). Longer duration of cardiac rhythm monitoring increases the detection of subclinical AF, but the optimal monitoring length is yet to be defined. We advise longer monitoring to increase the rate of anticoagulation, but whether longer monitoring improves clinical outcomes needs to be addressed. AF detection does not differ from in- or out-patient ECG-monitoring with similar monitoring duration, so we consider it reasonable to initiate in-hospital monitoring as soon as possible and continue with outpatient monitoring for more than 48 h. Although insertable loop recorders (ILR) increase AF detection based on their longer monitoring duration, comparison with non-implantable ECG devices for similar monitoring time is lacking. We suggest the use of implantable devices, if feasible, for AF detection instead of non-implantable devices to increase the detection of subclinical AF. There is weak evidence of a useful role for blood, ECG and brain imaging biomarkers for the identification of patients at high risk of AF. In patients with patent foramen ovale, we found insufficient evidence from RCT, but prolonged cardiac monitoring in patients >55 years is advisable for subclinical AF detection. To conclude, in adult patients with ischaemic stroke or TIA of undetermined origin, we recommend longer duration of cardiac rhythm monitoring of more than 48 h and if feasible with IRL to increase the detection of subclinical AF.
Does Age Impact Risk of Morbidity and Mortality for Elective Paraesophageal Hernia Repair in the Era of Minimally-Invasive Repair?
Authors: Mack Shale J. , Till Brian M. , Thosani Darshak , Rahman Uzma , Worrell Stephanie G. , Grenda Tyler , Evans Nathaniel R. , Okusanya Olugbenga T.
Published: May 2022

Purpose:

Patients with paraesophageal hernias (PEHs) typically present in the sixth and seventh decades of life. Frequently, elderly patients are not offered elective repair due to historical data on high operative risk. Given the broad adoption of minimally-invasive (MIS) techniques, we hypothesized that risk would be more acceptable in elderly patients.

Methods:

A retrospective study of the National Inpatient Sample (NIS) from 2016 to 2018 was performed. Patients were divided by age (50–79 and ≥80 years) and compared using Pearson’s Chi-squared and Student’s t-tests. Propensity score-match using age, race, gastroesophageal reflux disease, frailty, and 11 comorbidities was performed.

Results:

10 456 patients were included, 90.4% 50–79 (9,454) and 9.6% ≥ 80 (1002). The cohort was predominantly female (76.3%). Younger patients had fewer overall comorbidities and lower likelihood of frailty (2.5% vs. 9.3%, P < .01). Younger patients had shorter lengths of stay (2 days vs. 3 days, P < .01), fewer overall complications (26% vs. 36.8%, P < .01), and major complications (20.8% vs. 29.2%, P < .01). In-hospital mortality was higher for those over 80 (0.3% vs. 2.3%, P < .01). Propensity matching selected 942 pairs. Age remained associated with more frequent minor complications (23% vs. 28.7%, P < .01), major complications (12.1% vs. 16.1%, P < 0.01), and in-hospital mortality (0.5% vs. 2.3%, P < .01).

Conclusions:

There remains a significant association between age and risk of minor complication, major complication, and in-hospital mortality for elective repair of PEH despite the broad adoption of MIS techniques. This data may support the elective repair of PEHs at a younger age.
CircMiMi: a stand-alone software for constructing circular RNA-microRNA-mRNA interactions across species
Authors: Chiang Tai-Wei , Mai Te-Lun , Chuang Trees-Juen
Published: May 2022

Background

Circular RNAs (circRNAs) are a class of non-coding RNAs formed by pre-mRNA back-splicing, which are widely expressed in animal/plant cells and often play an important role in regulating microRNA (miRNA) activities. While numerous databases have collected a large amount of predicted circRNA candidates and provided the corresponding circRNA-regulated interactions, a stand-alone package for constructing circRNA-miRNA-mRNA interactions based on user-identified circRNAs across species is lacking.

Results

We present CircMiMi (circRNA-miRNA-mRNA interactions), a modular, Python-based software to identify circRNA-miRNA-mRNA interactions across 18 species (including 16 animals and 2 plants) with the given coordinates of circRNA junctions. The CircMiMi-constructed circRNA-miRNA-mRNA interactions are derived from circRNA-miRNA and miRNA-mRNA axes with the support of computational predictions and/or experimental data. CircMiMi also allows users to examine alignment ambiguity of back-splice junctions for checking circRNA reliability and examine reverse complementary sequences residing in the sequences flanking the circularized exons for investigating circRNA formation. We further employ CircMiMi to identify circRNA-miRNA-mRNA interactions based on the circRNAs collected in NeuroCirc, a large-scale database of circRNAs in the human brain. We construct circRNA-miRNA-mRNA interactions comprising differentially expressed circRNAs, and miRNAs in autism spectrum disorder (ASD) and cross-species analyze the relevance of the targets to ASD. We thus provide a rich set of ASD-associated circRNA-miRNA-mRNA axes and a useful starting point for investigation of regulatory mechanisms in ASD pathophysiology.

Conclusions

CircMiMi allows users to identify circRNA-mediated interactions in multiple species, shedding light on regulatory roles of circRNAs. The software package and web interface are freely available at https://github.com/TreesLab/CircMiMi and http://circmimi.genomics.sinica.edu.tw/, respectively.
SPINNAKER: an R-based tool to highlight key RNA interactions in complex biological networks
Authors: Paci Paola , Fiscon Giulia
Published: May 2022

Background

Recently, we developed a mathematical model for identifying putative competing endogenous RNA (ceRNA) interactions. This methodology has aroused a broad acknowledgment within the scientific community thanks to the encouraging results achieved when applied to breast invasive carcinoma, leading to the identification of PVT1, a long non-coding RNA functioning as ceRNA for the miR-200 family. The main shortcoming of the model is that it is no freely available and implemented in MATLAB®, a proprietary programming platform requiring a paid license for installing, operating, manipulating, and running the software.

Results

Breaking through these model limitations demands to distribute it in an open-source, freely accessible environment, such as R, designed for an ordinary audience of users that are not able to afford a proprietary solution. Here, we present SPINNAKER (SPongeINteractionNetworkmAKER), the open-source version of our widely established mathematical model for predicting ceRNAs crosstalk, that is released as an exhaustive collection of R functions. SPINNAKER has been even designed for providing many additional features that facilitate its usability, make it more efficient in terms of further implementation and extension, and less intense in terms of computational execution time.

Conclusions

SPINNAKER source code is freely available at https://github.com/sportingCode/SPINNAKER.git together with a thoroughgoing PPT-based guideline. In order to help users get the key points more conveniently, also a practical R-styled plain-text guideline is provided. Finally, a short movie is available to help the user to set the own directory, properly.
A predictive ambulance dispatch algorithm to the scene of a motor vehicle crash: the search for optimal over and under triage rates
Authors: Ceklic Ellen , Tohira Hideo , Ball Stephen , Brown Elizabeth , Brink Deon , Bailey Paul , Brits Rudolph , Finn Judith
Published: May 2022

Background

Calls for emergency medical assistance at the scene of a motor vehicle crash (MVC) substantially contribute to the demand on ambulance services. Triage by emergency medical dispatch systems is therefore important, to ensure the right care is provided to the right patient, in the right amount of time. A lights and sirens (L&S) response is the highest priority ambulance response, also known as a priority one or hot response. In this context, over triage is defined as dispatching an ambulance with lights and sirens (L&S) to a low acuity MVC and under triage is not dispatching an ambulance with L&S to those who require urgent medical care. We explored the potential for crash characteristics to be used during emergency ambulance calls to identify those MVCs that required a L&S response.

Methods

We conducted a retrospective cohort study using ambulance and police data from 2014 to 2016. The predictor variables were crash characteristics (e.g. road surface), and Medical Priority Dispatch System (MPDS) dispatch codes. The outcome variable was the need for a L&S ambulance response. A Chi-square Automatic Interaction Detector technique was used to develop decision trees, with over/under triage rates determined for each tree. The model with an under/over triage rate closest to that prescribed by the American College of Surgeons Committee on Trauma (ACS COT) will be deemed to be the best model (under triage rate of ≤ 5% and over triage rate of between 25–35%.

Results

The decision tree with a 2.7% under triage rate was closest to that specified by the ACS COT, had as predictors—MPDS codes, trapped, vulnerable road user, anyone aged 75 + , day of the week, single versus multiple vehicles, airbag deployment, atmosphere, surface, lighting and accident type. This model had an over triage rate of 84.8%.

Conclusions

We were able to derive a model with a reasonable under triage rate, however this model also had a high over triage rate. Individual EMS may apply the findings here to their own jurisdictions when dispatching to the scene of a MVC.
Workplace violence against emergency health care workers: What Strategies do Workers use?
Authors: Spelten Evelien , van Vuuren Julia , O’Meara Peter , Thomas Brodie , Grenier Mathieu , Ferron Richard , Helmer Jennie , Agarwal Gina
Published: May 2022

Background

Workplace violence by patients and bystanders against health care workers, is a major problem, for workers, organizations, patients, and society. It is estimated to affect up to 95% of health care workers. Emergency health care workers experience very high levels of workplace violence, with one study finding that paramedics had nearly triple the odds of experiencing physical and verbal violence.

Many interventions have been developed, ranging from zero-tolerance approaches to engaging with the violent perpetrator. Unfortunately, as a recent Cochrane review showed, there is no evidence that any of these interventions work in reducing or minimizing violence.

To design better interventions to prevent and minimize workplace violence, more information is needed on those strategies emergency health care workers currently use to prevent or minimize violence.

The objective of the study was to identify and discuss strategies used by prehospital emergency health care workers, in response to violence and aggression from patients and bystanders. Mapping the strategies used and their perceived usefulness will inform the development of tailored interventions to reduce the risk of serious harm to health care workers.

In this study the following research questions were addressed: (1) What strategies do prehospital emergency health care workers utilize against workplace violence from patients or bystanders? (2) What is their experience with these strategies?

Methods

Five focus groups with paramedics and dispatchers were held at different urban and rural locations in Canada. The focus group responses were transcribed verbatim and analyzed using thematic analysis.

Results

It became apparent that emergency healthcare workers use a variety of strategies when dealing with violent patients or bystanders. Most strategies, other than generic de-escalation techniques, reflect a reliance on the systems the workers work with and within.

Conclusion

The study results support the move away from focusing on the individual worker, who is the victim, to a systems-based approach to help reduce and minimize violence against health care workers. For this to be effective, system-based strategies need to be implemented and supported in healthcare organizations and legitimized through professional bodies, unions, public policies, and regulations.
Assessing research self-efficacy among primary health care physicians: a snapshot from Qatar
Authors: Bougmiza Iheb , Naja Sarah , Alchawa Mohamad , Alah Muna Abed , Al Kaabi Noora , Al Kubaisi Noora , Selim Nagah
Published: May 2022

Background

Research self-efficacy is one of the crucial predictors of productively engaging in research activities emphasized by the Qatar National Vision 2030. Nevertheless, studies typically focus on research self-efficacy among students, neglecting physicians, despite the importance of research as competency in continuous professional development. Therefore, the objective of our study is to understand the level of research self-efficacy among physicians and its determinants. 

Methods

An analytical cross-sectional design was employed. We utilized an open survey through DACIMA Software that included questions related to Self-Efficacy in Research Measure (SERM) and possible determinants. One-hundred-twenty-two completed answers, and the response rate was 19.2%. Following descriptive analyses, a chi-square test was used to uncover the associations among variables, with significance set to p ≤ 0.05. Next, a logistic regression model was conducted to identify the predictors of a low research self-efficacy level. Finally, reliability and principal component analysis were applied on the SERM scale.

Results

Three-quarters of the sample reported insufficient research self-efficacy. The sociodemographic and professional factors did not significantly associate with insufficient research self-efficacy. However, participation in clinical guidelines proved to be a determinant of sufficient research self-efficacy.

Conclusions

Physicians must be encouraged to participate in clinical guidelines to improve their research self-efficacy level.
Study protocol for ‘the effects of multimodal training of cognitive and/or physical functions on cognition and physical fitness of older adults: a cluster randomized controlled trial’
Authors: Chow Bik-Chu , Jiao Jiao , Man David , Lippke Sonia
Published: May 2022

Background

The elderly population worldwide is increasing exponentially which will be associated with more people suffering from cognition and fitness declines. The well-established benefits of exercise training for the elderly’s cognitive and physical functioning have been observed. However, the amalgamated effect of combining cognitive and physical exercises on the older adults’ cognitive functions, physical fitness, or psycho-related health remains unclear. Thus, this study protocol was planned to conduct different combinations of cognitive and/or physical training interventions to community-dwelling older adults and expected to see the multifaceted effects of the varied combination of training on their health.

Methods

This study is a cluster randomized controlled trial (CRCT). A total of 285 older adults (age ≥ 60) from twenty elderly centres as clusters will be randomly selected and assigned to intervention groups (IGs, n = 16) or control groups (CGs, n = 4). Each IG will be randomly assigned to one of the four combinations of three training modes that include cognitive (A), physical (B), and combined cognitive and physical training (CCPT, i.e. C), namely Mixed ABC, A + B, C + A, B + C. The intervention will last for 4 months in which the training is conducted for 16 sessions, 2 sessions per week, and 60 min per session. Four repeated assessments (pre-test, two post-training tests after 2 months and 4 months, and a follow-up test) will be conducted. The CG will only receive the four repeated assessments but no intervention. The outcome measures include cognitive tests (tests of execution, memory, and psych-social status), physical fitness, and dynamic balance tests.

Discussion

This study will provide substantial evidence that the integrated format of cognitive and physical exercises training will have higher cognition and fitness impact than the single training modes, and all these mixed modalities will have greater positive outcomes than the control condition. If the effectiveness is proven, the intervention can be further explored and extended to the nation so that many more elderly would be benefited.

Trial registration

The trial has been registered in the ClinicalTrials.gov in U.S. NIH (ID: NCT04727450, date: January 27, 2021).
Visual impairment as a predictor for deterioration in functioning: the Leiden 85-plus Study
Authors: Verbeek ERJ , Drewes YM , Gussekloo J
Published: May 2022

Background

Visual impairment frequently occurs amongst older people. Therefore, the aim of this study was to investigate the predictive value of visual impairment on functioning, quality of life and mortality in people aged 85 years.

Methods

From the Leiden 85-plus Study, 548 people aged 85 years were eligible for this study. Visual acuity was measured at baseline by Early Treatment Diabetic Retinopathy Study charts (ETDRS). According to the visual acuity (VA) three groups were made, defined as no (VA > 0.7), moderate (0.5 ≤ VA ≤ 0.7) or severe visual impairment (VA < 0.5). Quality of life, physical, cognitive, psychological and social functioning were measured annually for 5 years. For mortality, participants were followed until the age of 95.

Results

At baseline, participants with visual impairment scored lower on physical, cognitive, psychological and social functioning and quality of life (p < 0.001). Compared to participants with no visual impairment, participants with moderate and severe visual impairment had an accelerated deterioration in basic activities of daily living (respectively 0.27-point (p = 0.017) and 0.35 point (p = 0.018)). In addition, compared to participants with no visual impairment, the mortality risk was 1.83 (95% CI 1.43, 2.35) for participants with severe visual impairment.

Discussion

In very older adults, visual impairment predicts accelerated deterioration in physical functioning. In addition, severely visually impaired adults had an increased mortality risk. A pro-active attitude, focussing on preventing and treating visual impairment could possibly contribute to the improvement of physical independence, wellbeing and successful aging in very old age.