bluuebunny/crossref_metadata_2025 huggingface dataset:
Struggling with Primary Infertility: Psychological Well-Being and Associated Factors in North Indian Women
Authors: Sharma Apoorva , Mahajan Chakraverti , Saraswathy K. N. , Puri Manju , Babu Nandita
Published: April 2022

The study aimed to understand the effect of primary infertility on the psychological well-being of women. In addition, the study has assessed the impact of socio-demographic variables, reproductive trajectories and lifestyle variables on psychological well-being independently and in light of their dynamic interaction among North Indian women. This study was conducted among 250 infertile women with primary infertility attending the Gynaecology OPD and 250 age-matched fertile women from Delhi. Pretested quantitative interview schedule and WHO-5 perceived well-being scale were used for data collection. The results depicted that infertile women were found to have higher prevalence of poor psychological well-being than fertile women. Of all the variables, education, duration of infertility, physical activity, exercise, sleep pattern and family structure were significantly associated with the psychological well-being of infertile women. Infertility is a major cause of the decline in psychological well-being in infertile women. In most hospitals and infertility clinics, women are treated for infertility, but their psychological well-being is often ignored. To improve the psychological well-being of women dealing with primary infertility, infertility education and awareness, physical activity and family counselling must be integrated into the infertility treatment.
Functional Outcomes and Subsequent Surgical Procedures After Arthroscopic Suture Versus Screw Fixation for ACL Tibial Avulsion Fractures: A Systematic Review and Meta-analysis
Authors: Chang Chao-Jui , Huang Tzu-Ching , Hoshino Yuichi , Wang Chi-Hsiu , Kuan Fa-Chuan , Su Wei-Ren , Hong Chih-Kai
Published: April 2022

Background:

Although arthroscopic screw fixation and suture fixation are mainstream interventions for displaced anterior cruciate ligament avulsion fractures of the tibia, the differences in clinical outcomes between them remain inconclusive.

Purpose:

To conduct a meta-analysis comparing the clinical and functional outcomes between arthroscopic screw fixation and suture fixation for tibial avulsion fractures.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and using the PubMed, Embase, and Cochrane Central Register of Controlled Trials databases. Inclusion criteria were English-language articles that compared functional outcomes after screw fixation versus suture fixation for tibial avulsion fractures and had at least 1-year follow-up. Relevant data were extracted and analyzed statistically using the Mantel-Haenszel method and variance-weighted means. Random-effects models were used to generate pooled relative risk (RR) estimates with confidence intervals (CIs).

Results:

Of 1395 articles initially identified, we included 5 studies with 184 patients (91 patients with screw fixations and 93 patients with suture fixations). The pooled results indicated similar postoperative outcomes for screw fixation and suture fixation: Lysholm score (mean difference [MD], −0.32 [95% CI, −6.08 to 5.44]; P = .91), proportion of International Knee Documentation Committee score grade A (74% vs 74%; RR, 0.63 [95% CI, 0.10-3.95]; P = .63), Tegner score (MD, 0.10 [95% CI: −1.73 to 1.92]; P = .92), and Lachman test results (stable knee joint, 82% vs 82%; RR, 0.99; 95% CI: 0.85-1.16; P = .90). Patients in the screw fixation group had a significantly higher overall subsequent surgery rate (46% vs 19%; RR, 2.33; 95% CI,1.51-3.60; P = .0001) and implant removal rate (44% vs 3%; RR, 8.52; 95% CI, 3.58-20.29; P < .00001) compared with those in the suture fixation group. Nonimplant-related subsequent surgery rates were similar for the 2 groups.

Conclusion:

The findings indicated a higher risk of subsequent surgery (RR, 2.33) and implant removal (RR, 8.52) after screw fixation when compared with suture fixation for tibial avulsion fractures. However, there were no significant differences in clinical outcome scores between the 2 techniques.
Measuring Business and Professional Communication Skills
Authors: Coffelt Tina , Cosgrove Samantha , Vance Bremen
Published: April 2022

Understanding the expectations of employers contributes to the relevancy of business and professional communication (BPC) courses. Studies that bridge the gap between course content and workplace expectations support this process. This article presents findings from a scale development procedure to analyze BPC skills using a multimodal perspective. Employers ( N = 260) were asked what skills they perceive to be communication and how proficient they expect a recent college graduate to be to better understand the expectations that graduates face when entering the job market. The findings have implications for course design, curriculum selection, and program organization.
Sustained Improvement in Patient Experience by Optimizing Patient Flow in Ambulatory Settings
Authors: Pashankar Dinesh S , Brown Troy , Votto Paul , Follo Marie , Formica Richard N , Schilsky Michael L , Mulligan David C , Khokhar Babar
Published: April 2022

Patient experience has become a priority for healthcare institutions as it affects clinical quality of care, financial reimbursement, provider, and patient satisfaction. We report our experience of improving patient experience measured by Press Ganey surveys in a busy multidisciplinary clinic over 65 months. We optimized patient flow in the clinic by technology-facilitated communication among the clinic staff and by a modest space redesign. We noted a significant improvement in “clinic visit” scores from baseline of 82.1 to 84.6 at year 1, 86.1 at year 2, 88.7 at year 3, and 88.9 at year 4 ( P < .001). In comparison with previous short-term studies, we were able to sustain improvement in patient experience scores over 4 years due to optimized patient flow and monitoring of clinic operations. A similar approach can be implemented in other ambulatory settings and is likely to cause a long-term positive impact on patient experience.
Walk this way: Visualizing accessibility and mobility in metro station areas on a 3D pedestrian network
Authors: Xu Yingying , Chan Ho-Yin , Chen Anthony , Liu Xintao
Published: April 2022

Accessibility and mobility are positioned differently at the heart of transportation planning; whilst a transportation system with high accessibility will not necessarily be able to support high mobility. In this short article, we evaluate and visualize the accessibility and mobility of pedestrian networks around the metro station areas in a transit-oriented city – Hong Kong. By using the newly released 3D pedestrian network for the whole of Hong Kong under the Open and Big Data Plans, we have created visualizations to compare the 500-m walking coverage area and reachable area with a 10-min walking distance that reflects the accessibility and mobility around metro station areas, respectively. We find that there are significant differences between accessibility and mobility for some stations. We illustrate the potential underlying causes by comparing three representative pairs of stations as examples.
Book review: Judith Misrahi-Barak, K. Satyanarayana and Nicole Thiara (Eds.), Dalit Text: Aesthetics and Politics Re-Imagined
Authors: Mondal Sristi
Published: April 2022

Judith Misrahi-Barak, K. Satyanarayana and Nicole Thiara (Eds.), Dalit Text: Aesthetics and Politics Re-Imagined. New York: Routledge, 2020, xxiv + 238 pp., ₹641 (paperback). ISBN: 978-0-367-21841-6.
Kinematic Calibration of a Six-Legged Walking Machine Tool
Authors: Liu Jimu , Chen Zhijun , Gao Feng
Published: April 2022

This paper presents the kinematic calibration of a novel six-legged walking machine tool comprising a six-legged mobile robot integrated with a parallel manipulator on the body. Each leg of the robot is a 2-universal-prismatic-spherical (UPS) and UP parallel mechanism, and the manipulator is a 6-PSU parallel mechanism. The error models of both subsystems are derived according to their inverse kinematics. The objective function for each kinematic limb is formulated as the inverse kinematic residual, i.e., the deviation between the actual and computed joint coordinates. The hip center of each leg is first identified via sphere fitting, and the other kinematic parameters are identified by solving the objective function for each limb individually using the least-squares method. Thus, the kinematic parameters are partially decoupled, and the complexities of the error models are reduced. A calibration method is proposed for the legged robot to overcome the lack of a fixed base on the ground. A calibration experiment is conducted to validate the proposed method, where a laser tracker is used as the measurement equipment. The kinematic parameters of the entire robot are identified, and the motion accuracy of each leg and that of the manipulator are significantly improved after calibration. Validation experiments are performed to evaluate the positioning and trajectory errors of the six-legged walking machine tool. The results indicate that the kinematic calibration of the legs and manipulator improves not only the motion accuracy of each individual subsystem but also the cooperative motion accuracy among the subsystems.
Metal Electrode Polarization in Triboelectric Nanogenerator Probed by Surface Charge Neutralization
Authors: Jeong Jiwon , Yoo Byungsoo , Jang Eunji , Choi Inje , Lee Jongjin
Published: April 2022

Triboelectric nanogenerator (TENG) uses charge transfer between two asymmetric charge affinity materials such as metal and dielectrics. Metal electrode acts as charge collector from dielectrics and acts as charge transfer path to an external load, which model deals with only a net charge of metal electrode concerning electrical output. In this work, we found that metal electrode in triboelectric generator has non-negligible surface charge polarization causing open-circuit voltage difference in the model TENG system. The output voltage depends on the initial preparation conditions of the TENG for I–V measurements, even for the same measured charge densities. The measured output voltage difference with the same charge density implies that electric charges of TENG are composed of movable charges that affect current and voltage output and the bounded fixed charges that only affect open-circuit voltage.
Selection and demography drive range-wide patterns of MHC-DRB variation in mule deer
Authors: Cook Rachel M. , Suttner Brittany , Giglio Rachael M. , Haines Margaret L. , Latch Emily K.
Published: April 2022

Background

Standing genetic variation is important especially in immune response-related genes because of threats to wild populations like the emergence of novel pathogens. Genetic variation at the major histocompatibility complex (MHC), which is crucial in activating the adaptive immune response, is influenced by both natural selection and historical population demography, and their relative roles can be difficult to disentangle. To provide insight into the influences of natural selection and demography on MHC evolution in large populations, we analyzed geographic patterns of variation at the MHC class II DRB exon 2 locus in mule deer (Odocoileus hemionus) using sequence data collected across their entire broad range.

Results

We identified 31 new MHC-DRB alleles which were phylogenetically similar to other cervid MHC alleles, and one allele that was shared with white-tailed deer (Odocoileus virginianus). We found evidence for selection on the MHC including high dN/dS ratios, positive neutrality tests, deviations from Hardy–Weinberg Equilibrium (HWE) and a stronger pattern of isolation-by-distance (IBD) than expected under neutrality. Historical demography also shaped variation at the MHC, as indicated by similar spatial patterns of variation between MHC and microsatellite loci and a lack of association between genetic variation at either locus type and environmental variables.

Conclusions

Our results show that both natural selection and historical demography are important drivers in the evolution of the MHC in mule deer and work together to shape functional variation and the evolution of the adaptive immune response in large, well-connected populations.
Explore potential disease related metabolites based on latent factor model
Authors: Wang Yongtian , Juan Liran , Peng Jiajie , Wang Tao , Zang Tianyi , Wang Yadong
Published: April 2022

Background

In biological systems, metabolomics can not only contribute to the discovery of metabolic signatures for disease diagnosis, but is very helpful to illustrate the underlying molecular disease-causing mechanism. Therefore, identification of disease-related metabolites is of great significance for comprehensively understanding the pathogenesis of diseases and improving clinical medicine.

Results

In the paper, we propose a disease and literature driven metabolism prediction model (DLMPM) to identify the potential associations between metabolites and diseases based on latent factor model. We build the disease glossary with disease terms from different databases and an association matrix based on the mapping between diseases and metabolites. The similarity of diseases and metabolites is used to complete the association matrix. Finally, we predict potential associations between metabolites and diseases based on the matrix decomposition method. In total, 1,406 direct associations between diseases and metabolites are found. There are 119,206 unknown associations between diseases and metabolites predicted with a coverage rate of 80.88%. Subsequently, we extract training sets and testing sets based on data increment from the database of disease-related metabolites and assess the performance of DLMPM on 19 diseases. As a result, DLMPM is proven to be successful in predicting potential metabolic signatures for human diseases with an average AUC value of 82.33%.

Conclusion

In this paper, a computational model is proposed for exploring metabolite-disease pairs and has good performance in predicting potential metabolites related to diseases through adequate validation. The results show that DLMPM has a better performance in prioritizing candidate diseases-related metabolites compared with the previous methods and would be helpful for researchers to reveal more information about human diseases.
Characterization of Escherichia coli isolated from urinary tract infection and association between virulence expression and antimicrobial susceptibility
Authors: Derakhshan Safoura , Ahmadi Sanaz , Ahmadi Erfan , Nasseri Sherko , Aghaei Abbas
Published: April 2022

Background

The capacity of antibiotics to modulate bacterial virulence has raised concerns over the appropriateness of antibiotic therapies, including when dosing strategies fall below sub-therapeutic levels. In this work, we investigated the ability of antibiotics to influence virulence in Escherichia coli isolated from urinary tract infection (UTI).

Results

Out of 120 isolates, 32.5% carried pap, 21.7% carried hlyA, and 17.5% carried cnf. The predominant B2 phylogroup was significantly associated with the quinolone-resistant isolates. A significant association was seen between the presence of hlyA hemolysin and susceptibility to ceftriaxone and ciprofloxacin (P < 0.05). Sub-inhibitory concentrations of both antibiotics reduced the levels of hlyA expression and hemolysis in isolates treated with antibiotics compared to untreated isolates (P < 0.05). Growth rate assay showed that the decrease in hlyA expression was not an effect of decreased growth rate.

Conclusion

Our study indicated the inhibitory effect of ciprofloxacin and ceftriaxone on the level of hemolysis, suggesting that the sub-inhibitory concentrations of these antibiotics may affect the outcome of infections. Further studies, including animal models may elucidate the outcome of virulence modulation by these antibiotics in UTI pathogenesis.
Study and QTL mapping of reproductive and morphological traits implicated in the autofertility of faba bean
Authors: Aguilar-Benitez David , Casimiro-Soriguer Inés , Ferrandiz Cristina , Torres Ana M.
Published: April 2022

Autofertility describes the ability of faba bean flowers to self-fertilize thereby ensuring the productivity of this crop in the absence of pollinators or mechanical disturbance. In the legume crop faba bean (Vicia faba L.), lack of autofertility in a context of insufficient pollination can lead to a severe decrease in grain yield. Here we performed the first QTL analysis aimed at identifying the genomic regions controlling autofertility in this crop. We combined pod and seed setting scores from a recombinant inbred population (RIL) segregating for autofertility in different environments and years with measurements of morphological floral traits and pollen production and viability. This approach revealed 19 QTLs co-localizing in six genomic regions. Extensive co-localization was evident for various floral features whose QTLs clustered in chrs. I, II and V, while other QTLs in chrs. III, IV and VI revealed co-localization of flower characteristics and pod and seed set data. The percentage of phenotypic variation explained by the QTLs ranged from 8.9 for style length to 25.7 for stigma angle. In the three QTLs explaining the highest phenotypic variation (R2 > 20), the marker alleles derived from the autofertile line Vf27. We further inspected positional candidates identified by these QTLs which represent a valuable resource for further validation. Our results advance the understanding of autofertility in faba bean and will aid the identification of responsible genes for genomic-assisted breeding in this crop.
Non-intubated video-assisted thoracoscopic surgery under combination of erector spinae plane block and thoracic paravertebral block
Authors: Alagoz Ali , Findik Gokturk , Sazak Hilal , Demiroz Sevki Mustafa , Baldemir Ramazan , Ulger Gulay , Zengin Musa
Published: April 2022

Background

The use of anesthetics and analgesic drugs and techniques in combination yields a multimodal effect with increased efficiency. In this case series, we aimed to evaluate the anesthetic effect of the thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) combination in patients, who underwent non-intubated video-assisted thoracoscopic surgery (NIVATS).

Methods

Medical records of 16 patients, who underwent NIVATS for wedge resection under the combination of ESPB and TPVB were reviewed retrospectively. Demographic data of patients, duration of the sensory block, amount of the anesthetic agent used for premedication and sedo-analgesia, any presence of perioperative cough, operative times, postoperative visual analog scale (VAS) scores in the postoperative follow-up period, the need for additional analgesia, and patient satisfaction were reviewed.

Results

Of the patients included in the study, 12 were men and 4 were women. The mean age was 48.6 years and the mean BMI was 24.7 kg/m2. The mean time needed for the achievement of the sensorial block was 14 min and the mean skin-to-skin operative time was 21.4 min. During the procedure, patients received 81.5 ± 27.7 mg of propofol and 30 ± 13.6 micrograms of remifentanil infusions, respectively. The mean dose of ketamine administered in total was 58.1 ± 12.2 mg. Only 2 patients needed an extra dose of remifentanil because of recurrent cough. No patients developed postoperative nausea vomiting. During the first 24 h, the VAS static scores of the patients were 3 and below, while VAS dynamic scores were 4 and below. Morphine consumption in the first postoperative 24 h was 13.2 mg.

Conclusions

In conclusion, combined ESPB and TPVB with added intravenous sedo-analgesia in the presence of good cooperation between the surgical team and the anesthesiologist in the perioperative period can provide optimal surgical conditions including the prevention of cough in NIVATS. It is not sufficient to state that this combination is superior to alone ESPB or alone TPVB, as it is a preliminary study with a limited number of cases.
Idiopathic posterior papillary muscle rupture; a case report
Authors: Milioglou Ioannis , Janko Matthew R. , Hassan Hafeez ul , ElHaq Mohammed , Filby Steven J. , Pelletier Marc P.
Published: April 2022

Background

Papillary muscle rupture is a rare condition. Its clinical presentation, diagnosis and management can be very challenging for the clinician.

Case presentation

A 73-year-old woman with hypertension presented with chest pain, ST-segment changes, and elevated serum troponin levels. Coronary angiography was normal. Echocardiography revealed normal ventricular function, flail posterior mitral leaflet, and severe mitral regurgitation. She underwent emergent mitral valve replacement.

Conclusion

The diagnostic and management strategies of this uncommon presentation are discussed.
Evaluation of multiple imputation approaches for handling missing covariate information in a case-cohort study with a binary outcome
Authors: Middleton Melissa , Nguyen Cattram , Moreno-Betancur Margarita , Carlin John B. , Lee Katherine J.
Published: April 2022

Background

In case-cohort studies a random subcohort is selected from the inception cohort and acts as the sample of controls for several outcome investigations. Analysis is conducted using only the cases and the subcohort, with inverse probability weighting (IPW) used to account for the unequal sampling probabilities resulting from the study design. Like all epidemiological studies, case-cohort studies are susceptible to missing data. Multiple imputation (MI) has become increasingly popular for addressing missing data in epidemiological studies. It is currently unclear how best to incorporate the weights from a case-cohort analysis in MI procedures used to address missing covariate data.

Method

A simulation study was conducted with missingness in two covariates, motivated by a case study within the Barwon Infant Study. MI methods considered were: using the outcome, a proxy for weights in the simple case-cohort design considered, as a predictor in the imputation model, with and without exposure and covariate interactions; imputing separately within each weight category; and using a weighted imputation model. These methods were compared to a complete case analysis (CCA) within the context of a standard IPW analysis model estimating either the risk or odds ratio. The strength of associations, missing data mechanism, proportion of observations with incomplete covariate data, and subcohort selection probability varied across the simulation scenarios. Methods were also applied to the case study.

Results

There was similar performance in terms of relative bias and precision with all MI methods across the scenarios considered, with expected improvements compared with the CCA. Slight underestimation of the standard error was seen throughout but the nominal level of coverage (95%) was generally achieved. All MI methods showed a similar increase in precision as the subcohort selection probability increased, irrespective of the scenario. A similar pattern of results was seen in the case study.

Conclusions

How weights were incorporated into the imputation model had minimal effect on the performance of MI; this may be due to case-cohort studies only having two weight categories. In this context, inclusion of the outcome in the imputation model was sufficient to account for the unequal sampling probabilities in the analysis model.
BivRec: an R package for the nonparametric and semiparametric analysis of bivariate alternating recurrent events
Authors: Castro-Pearson Sandra , Sur Aparajita , Lee Chi Hyun , Huang Chiung-Yu , Luo Xianghua
Published: April 2022

Background

Bivariate alternating recurrent event data can arise in longitudinal studies where patients with chronic diseases go through two states that occur repeatedly, e.g., care periods and break periods. However, there was no statistical software that provided tools for the analysis of such data. To meet this software need, we developed , a package for R that contains a set of tools for exploratory, nonparametric and semiparametric regression analysis of bivariate alternating recurrent events.

Results

The package provides functions for nonparametric estimations for the joint distribution of bivariate gap times () and semiparametric regression methods for evaluating covariate effects on the two types of gap times under the accelerated failure time model framework (). The package also provides exploratory data analysis tools such as a visualization of the gap times by groups. We utilize a subset of the South Verona Psychiatric Case Register (PCR) data to illustrate the use of the package for the reviewed methods.

Conclusions

We demonstrate ’s capability for data visualization, nonparametric and regression based analysis, as well as data simulation. The package has default methods with satisfactory performance despite the complexity of calculations and fills a gap in software for statistical analysis of bivariate alternating recurrent events. is accessible under the GPL-3 General Public License through CRAN, facilitating its installation.
Identification of tools used to assess the external validity of randomized controlled trials in reviews: a systematic review of measurement properties
Authors: Jung Andres , Balzer Julia , Braun Tobias , Luedtke Kerstin
Published: April 2022

Background

Internal and external validity are the most relevant components when critically appraising randomized controlled trials (RCTs) for systematic reviews. However, there is no gold standard to assess external validity. This might be related to the heterogeneity of the terminology as well as to unclear evidence of the measurement properties of available tools. The aim of this review was to identify tools to assess the external validity of RCTs. It was further, to evaluate the quality of identified tools and to recommend the use of individual tools to assess the external validity of RCTs in future systematic reviews.

Methods

A two-phase systematic literature search was performed in four databases: PubMed, Scopus, PsycINFO via OVID, and CINAHL via EBSCO. First, tools to assess the external validity of RCTs were identified. Second, studies investigating the measurement properties of these tools were selected. The measurement properties of each included tool were appraised using an adapted version of the COnsensus based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.

Results

38 publications reporting on the development or validation of 28 included tools were included. For 61% (17/28) of the included tools, there was no evidence for measurement properties. For the remaining tools, reliability was the most frequently assessed property. Reliability was judged as “sufficient” for three tools (very low certainty of evidence). Content validity was rated as “sufficient” for one tool (moderate certainty of evidence).

Conclusions

Based on these results, no available tool can be fully recommended to assess the external validity of RCTs in systematic reviews. Several steps are required to overcome the identified difficulties to either adapt and validate available tools or to develop a better suitable tool.

Trial registration

Prospective registration at Open Science Framework (OSF): 10.17605/OSF.IO/PTG4D.
Design of a new Z-test for the uncertainty of Covid-19 events under Neutrosophic statistics
Authors: Aslam Muhammad
Published: April 2022

Background

The existing Z-test for uncertainty events does not give information about the measure of indeterminacy/uncertainty associated with the test.

Methods

This paper introduces the Z-test for uncertainty events under neutrosophic statistics. The test statistic of the existing test is modified under the philosophy of the Neutrosophy. The testing process is introduced and applied to the Covid-19 data.

Results

Based on the information, the proposed test is interpreted as the probability that there is no reduction in uncertainty of Covid-19 is accepted with a probability of 0.95, committing a type-I error is 0.05 with the measure of an indeterminacy 0.10. Based on the analysis, it is concluded that the proposed test is informative than the existing test. The proposed test is also better than the Z-test for uncertainty under fuzzy-logic as the test using fuzz-logic gives the value of the statistic from 2.20 to 2.42 without any information about the measure of indeterminacy. The test under interval statistic only considers the values within the interval rather than the crisp value.

Conclusions

From the Covid-19 data analysis, it is found that the proposed Z-test for uncertainty events under the neutrosophic statistics is efficient than the existing tests under classical statistics, fuzzy approach, and interval statistics in terms of information, flexibility, power of the test, and adequacy.
Measuring demand and supply of community care services for older people healthy ageing in rural Zhejiang Province
Authors: Zhou Wusi , Jiang Biya , Yu Liujun , Dai Weidong
Published: April 2022

Background

A consequence of demographic trends and economic prosperous is the increasing diversity in needs for care services. However, the traditional family support for older people has been largely supplanted by the wider provision of community care services. This study aims to investigate the current status of demand and supply in community care services across different villages of Zhejiang province and assess service effectiveness for healthy ageing.

Methods

A questionnaire survey was carried out towards 207 rural villages across 9 cities in Zhejiang province. One hundred eighty-six valid responses were received, representing a response rate of around 89.9%. Descriptive statistics were employed to identify older villagers’ care needs and available community services. Comparative analysis examined the balance between the demand and supply of community care services. Correlation analysis were applied to determine key factors that impacted the supply of social services in rural communities.

Results

The research found that rural older residents normally lived with their children or spouse with limited literacy and income. On average the categories of community care services is substantially small in comparison with the increasingly diverse demands of older people in rural areas. There was an obvious mismatch between service demand and service supply in rural communities, which often caused the waste of public resources. Moving forward, the uppermost priority is given to infrastructure construction service and daily life service, while little attention is paid to mental health service and specialized nursing service.

Conclusion

There needs to be an improvement in the socio-economic capacity of rural communities and in the diversity of social care services. Policies and strategies are also needed to encourage private sectors’ involvement in providing care services for rural older people. Local government should have a clear vision of the potential demands for community care services, practical guidelines will be useful in guaranteeing better service quality.
Prediction of gestational diabetes mellitus by different obesity indices
Authors: Song Zhimin , Cheng Yan , Li Tingting , Fan Yongfang , Zhang Qingying , Cheng Haidong
Published: April 2022

Background

The incidence rates of obesity and gestational diabetes mellitus (GDM) are increasing in parallel. This study aimed to evaluate the relationship between different obesity indices, including prepregnancy body mass index (preBMI), the first-trimester abdominal circumference (AC), and first-trimester abdominal circumference/height ratio (ACHtR), and GDM, and the efficacy of these three indices in predicting GDM was assessed.

Methods

A total of 15,472 pregnant women gave birth to a singleton at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. Prepregnancy weight was self-reported by study participants, body height and AC were measured by nurses at the first prenatal visit during weeks 11 to 13+6 of pregnancy. GDM was diagnosed through a 75-g oral glucose tolerance test at 24–28 gestational weeks. Using receiver operator characteristic (ROC) curve analysis, we evaluated the association between obesity indices and GDM.

Results

A total of 1912 women (12.4%) were diagnosed with GDM. Logistic regression analysis showed that AC, ACHtR, and preBMI (P < 0.001) were all independent risk factors for the development of GDM. In the normal BMI population, the higher the AC or ACHtR was, the more likely the pregnant woman was to develop GDM. The area under the ROC curve (AUC) was 0.63 (95% CI: 0.62–0.64) for the AC, 0.64 (95% CI: 0.62–0.65) for the ACHtR and 0.63 (95% CI: 0.62–0.64) for the preBMI. An AC ≥ 80.3 cm (sensitivity: 61.6%; specificity: 57.9%), an ACHtR of ≥ 0.49 (sensitivity: 67.3%; specificity: 54.0%), and a preBMI ≥ 22.7 (sensitivity: 48.4%; specificity: 71.8%) were determined to be the best cut-off levels for identifying subjects with GDM.

Conclusions

An increase in ACHtR may be an independent risk factor for GDM in the first trimester of pregnancy. Even in the normal BMI population, the higher the AC and ACHtR are, the more likely a pregnant woman is to develop GDM. AC, ACHtR in the first trimester and preBMI might be anthropometric indices for predicting GDM, but a single obesity index had limited predictive value for GDM.
A cross-sectional international study shows confidence in public health scientists predicts use of COVID-19 non-pharmaceutical interventions
Authors: Goldfinch Shaun , Taplin Ross
Published: April 2022

Background

We examine the antecedents of COVID-19 phone tracking applications use, social distancing, and mask use, in the United States, Hong Kong and Japan.

Methods

We draw on online panel surveys of over 1000 respondents each in the USA, Hong Kong and Japan, using broadly representative quota sample selections. Results are tested by ordinal logistic regression for the two ordinal dependent variables and logistic regression for phone app use.

Results

Confidence in public health scientists predicts use of phone tracking applications, social distancing, and mask use, albeit statistically insignificant for tracer phone application use in Hong Kong. Trust in government predicts the use of a phone tracking application. Counterintuitively, trust in government is negatively and significantly associated with mask use and social distancing in Hong Kong and Japan. Women are more likely to wear masks and practice social distancing. Government employees are more likely to use a phone tracking application, but less likely to mask and social distance. Voting and civic participation are positively associated with trust in government and confidence in public health scientists, in all three countries. There are interesting variations across all three countries on other antecedents and controls.

Conclusions

Building and maintaining confidence in public health scientists provides a key tool to manage pandemics. Credible, effectively communicative – and independent – medical and scientific leaders may be central to pandemic control success. For digital measures, trust in government and privacy protection is central. Political and social factors are important to understand successful public health policy implementation.
Accuracy and safety of robot-assisted cortical bone trajectory screw placement: a comparison of robot-assisted technique with fluoroscopy-assisted approach
Authors: Li Yue , Chen Long , Liu Yuzeng , Ding Hongtao , Lu Hongyi , Pan Aixing , Zhang Xinuo , Hai Yong , Guan Li
Published: April 2022

Objective

To compare the safety and accuracy of cortical bone trajectory screw placement between the robot-assisted and fluoroscopy-assisted approaches.

Methods

This retrospective study was conducted between November 2018 and June 2020, including 81 patients who underwent cortical bone trajectory (CBT) surgery for degenerative lumbar spine disease. CBT was performed by the same team of experienced surgeons. The patients were randomly divided into two groups—the fluoroscopy-assisted group (FA, 44 patients) and the robot-assisted group (RA, 37 patients). Robots for orthopedic surgery were used in the robot-assisted group, whereas conventional fluoroscopy-guided screw placement was used in the fluoroscopy-assisted group. The accuracy of screw placement and rate of superior facet joint violation were assessed using postoperative computed tomography (CT). The time of single screw placement, intraoperative blood loss, and radiation exposure to the surgical team were also recorded. The χ2 test and Student’s t-test were used to analyze the significance of the variables (P < 0.05).

Results

A total of 376 screws were inserted in 81 patients, including 172 screws in the robot-assisted group and 204 pedicle screws in the fluoroscopy-assisted group. Screw placement accuracy was higher in the RA group (160, 93%) than in the FA group (169, 83%) (P = 0.003). The RA group had a lower violation of the superior facet joint than the FA group. The number of screws reaching grade 0 in the RA group (58, 78%) was more than that in the FA group (56, 64%) (P = 0.041). Screw placement time was longer in the FA group (7.25 ± 0.84 min) than in the RA group (5.58 ± 1.22 min, P < 0.001). The FA group had more intraoperative bleeding (273.41 ± 118.20 ml) than the RA group (248.65 ± 97.53 ml, P = 0.313). The radiation time of the FA group (0.43 ± 0.07 min) was longer than the RA group (0.37 ± 0.10 min, P = 0.001). Furthermore, the overall learning curve tended to decrease.

Conclusions

Robot-assisted screw placement improves screw placement accuracy, shortens screw placement time, effectively improves surgical safety and efficiency, and reduces radiation exposure to the surgical team. In addition, the learning curve of robot-assisted screw placement is smooth and easy to operate.
In Vivo three-dimensional kinematics of normal knees during sitting sideways on the floor
Authors: Kono Kenichi , Yamazaki Takaharu , Konda Shoji , Inui Hiroshi , Tanaka Sakae , Sugamoto Kazuomi , Tomita Tetsuya
Published: April 2022

Background

The normal knee kinematics during asymmetrical kneeling such as the sitting sideways remains unknown. This study aimed to clarify in vivo kinematics during sitting sideways of normal knees.

Methods

Twelve knees from six volunteers were examined. Under fluoroscopy, each volunteer performed a sitting sideways. A two-dimensional/three-dimensional registration technique was used. The rotation angle, varus-valgus angle, anteroposterior translation of the medial and lateral sides of the femur relative to the tibia, and kinematic pathway in each flexion angle was evaluated.

Results

Bilateral knees during sitting sideways showed a femoral external rotation relative to the tibia with flexion (ipsilateral: 13.7 ± 3.5°, contralateral: 5.8 ± 6.8°). Whereas the ipsilateral knees showed valgus movement of 4.6 ± 2.5° from 130° to 150° of flexion, and the contralateral knees showed varus movement of -3.1 ± 4.4° from 110° to 150° of flexion. The medial side of the contralateral knees was more posteriorly located than that of the ipsilateral knees beyond 110° of flexion. The lateral side of the contralateral knees was more anteriorly located than that of the ipsilateral knees from 120° to 150° of flexion. In the ipsilateral knees, a medial pivot pattern followed by a bicondylar rollback was observed. In the contralateral knees, no significant movement followed by a bicondylar rollback was observed.

Conclusion

Even though the asymmetrical kneeling such as sitting sideways, the knees did not display asymmetrical movement.
First report of a gallbladder hemangioma coexisting with gallstones: a case report and literature review of a rare finding
Authors: Trucco Giulia , Chiusa Luigi , Tandoi Francesco , Bertero Luca
Published: April 2022

Background

Gallbladder hemangioma is an exceptionally rare entity, with only ten cases reported in literature hitherto. The here described case is the first report of a gallbladder hemangioma coexisting with gallstones.

Case presentation

A 76-year-old male was hospitalized following repeated episodes of epigastric pain. Patient’s medical history included primary hypertension, type 2 diabetes mellitus, dyslipidemia, obesity and hyperuricemia. Physical examination revealed marked pain in the right hypochondriac region, and laboratory workup was notable for mildly elevated glycemia (125 mg/dL) and pancreatic amylase (60 IU/L). Abdominal ultrasound showed multiple gallstones, a thickened gallbladder wall and mild edema of the perivisceral adipose tissue as well as a hepatic angioma. During surgery, an incidental subserosal nodule of about 1 cm was detected within the gallbladder fundus. After surgery, the clinical course was uneventful and the patient was discharged. Histopathological examination of the subserosal nodule showed multiple dilated vascular channels within a sclerosing matrix, a finding consistent with a cavernous hemangioma. Diffuse chronic cholecystitis was also present.

Conclusions

Gallbladder hemangiomas represent a rare, likely underdiagnosed condition which can be undetected during the preoperative workup.
Pursuing impact in research: towards an ethical approach
Authors: Bærøe Kristine , Kerasidou Angeliki , Dunn Michael , Teig Inger Lise
Published: April 2022

Background

Research proactively and deliberately aims to bring about specific changes to how societies function and individual lives fare. However, in the ever-expanding field of ethical regulations and guidance for researchers, one ethical consideration seems to have passed under the radar: How should researchers act when pursuing actual, societal changes based on their academic work?

Main text

When researchers engage in the process of bringing about societal impact to tackle local or global challenges important concerns arise: cultural, social and political values and institutions can be put at risk, transformed or even hampered if researchers lack awareness of how their ‘acting to impact’ influences the social world. With today’s strong focus on research impacts, addressing such ethical challenges has become urgent within in all fields of research involved in finding solutions to the challenges societies are facing. Due to the overall goal of doing something good that is often inherent in ethical approaches, boundaries to researchers’ impact of something good is neither obvious, nor easy to detect. We suggest that it is time for the field of bioethics to explore normative boundaries for researchers’ pursuit of impact and to consider, in detail, the ethical obligations that ought to shape this process, and we provide a four-step framework of fair conditions for such an approach. Our suggested approach within this field can be useful for other fields of research as well.

Conclusion

With this paper, we draw attention to how the transition from pursuing impact within the Academy to trying to initiate and achieve impact beyond the Academy ought to be configured, and the ethical challenges inherent in this transition. We suggest a stepwise strategy to identify, discuss and constitute consensus-based boundaries to this academic activity. This strategy calls for efforts from a multi-disciplinary team of researchers, advisors from the humanities and social sciences, as well as discussants from funding institutions, ethical committees, politics and the society in general. Such efforts should be able to offer new and useful assistance to researchers, as well as research funding agencies, in choosing ethically acceptable, impact-pursuing projects.
The use of electronic health records to inform cancer surveillance efforts: a scoping review and test of indicators for public health surveillance of cancer prevention and control
Authors: Conderino Sarah , Bendik Stefanie , Richards Thomas B. , Pulgarin Claudia , Chan Pui Ying , Townsend Julie , Lim Sungwoo , Roberts Timothy R. , Thorpe Lorna E.
Published: April 2022

Introduction

State cancer prevention and control programs rely on public health surveillance data to set objectives to improve cancer prevention and control, plan interventions, and evaluate state-level progress towards achieving those objectives. The goal of this project was to evaluate the validity of using electronic health records (EHRs) based on common data model variables to generate indicators for surveillance of cancer prevention and control for these public health programs.

Methods

Following the methodological guidance from the PRISMA Extension for Scoping Reviews, we conducted a literature scoping review to assess how EHRs are used to inform cancer surveillance. We then developed 26 indicators along the continuum of the cascade of care, including cancer risk factors, immunizations to prevent cancer, cancer screenings, quality of initial care after abnormal screening results, and cancer burden. Indicators were calculated within a sample of patients from the New York City (NYC) INSIGHT Clinical Research Network using common data model EHR data and were weighted to the NYC population using post-stratification. We used prevalence ratios to compare these estimates to estimates from the raw EHR of NYU Langone Health to assess quality of information within INSIGHT, and we compared estimates to results from existing surveillance sources to assess validity.

Results

Of the 401 identified articles, 15% had a study purpose related to surveillance. Our indicator comparisons found that INSIGHT EHR-based measures for risk factor indicators were similar to estimates from external sources. In contrast, cancer screening and vaccination indicators were substantially underestimated as compared to estimates from external sources. Cancer screenings and vaccinations were often recorded in sections of the EHR that were not captured by the common data model. INSIGHT estimates for many quality-of-care indicators were higher than those calculated using a raw EHR.

Conclusion

Common data model EHR data can provide rich information for certain indicators related to the cascade of care but may have substantial biases for others that limit their use in informing surveillance efforts for cancer prevention and control programs.
A novel nomogram to predict mortality in patients with stroke: a survival analysis based on the MIMIC-III clinical database
Authors: Li Xiao-Dan , Li Min-Min
Published: April 2022

Background

Stroke is a disease characterized by sudden cerebral ischemia and is the second leading cause of death worldwide. We aimed to develop and validate a nomogram model to predict mortality in intensive care unit patients with stroke.

Methods

All data involved in this study were extracted from the Medical Information Mart for Intensive Care III database (MIMIC-III). The data were analyzed using multivariate Cox regression, and the performance of the novel nomogram, which assessed the patient’s overall survival at 30, 180, and 360 days after stroke, was evaluated using Harrell’s concordance index (C-index) and the area under the receiver operating characteristic curve. A calibration curve and decision curve were introduced to test the clinical value and effectiveness of our prediction model.

Results

A total of 767 patients with stroke were randomly divided into derivation (n = 536) and validation (n = 231) cohorts at a 7:3 ratio. Multivariate Cox regression showed that 12 independent predictors, including age, weight, ventilation, cardiac arrhythmia, metastatic cancer, explicit sepsis, Oxford Acute Severity of Illness Score or OASIS score, diastolic blood pressure, bicarbonate, chloride, red blood cell and white blood cell counts, played a significant role in the survival of individuals with stroke. The nomogram model was validated based on the C-indices, calibration plots, and decision curve analysis results.

Conclusions

The plotted nomogram accurately predicted stroke outcomes and, thus may contribute to clinical decision-making and treatment as well as consultation services for patients.