bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospective Radiographic Assessment of Intraoperative Range of Motion with Total Ankle Replacement
Authors: Gagné Oliver , Bitar Rogerio C. , Kim Jaeyoung , Caolo Kristin C. , Saito Guilherme H. , Cody Elizabeth , Deland Jonathan T. , Ellis Scott J. , Demetracopoulos Constantine A.
Published: January 2022

Category:

Ankle Arthritis

Introduction/Purpose:

One of the proposed benefits of total ankle replacement, when compared to ankle fusion is the preservation of range of motion (ROM) of the ankle. Preservation of ankle motion may improve quality of life as evidenced by patient-reported outcome measures (PROMs). However, despite improving dorsiflexion intraoperatively during TAR, studies have not demonstrated large improvements in dorsiflexion (DF) at final followup after TAR. The objective of this study was to radiographically evaluate and quantify preoperative, intraoperative ankle dorsiflexion and plantarflexion (PF), compare it to post- operative ankle ROM, and determine the effect of Achilles lengthening (TAL) on preserving dorsiflexion motion that is gained during surgery.

Methods:

This prospective study compared 111 patients with an average age of 62.3 years who underwent primary total ankle replacement with one of four different implants between March and December 2019. A total of 71 patients (64%) had an associated TAL based on the surgeon's decision. Intraoperative fluoroscopy was utilized by the primary surgeon to document the maximal dorsiflexion and plantar flexion at the end of the case. This was completed after the TAL on a perfect lateral. Standardized weight bearing at maximum ROM positions lateral radiographs were obtained twelve months postoperatively. The change in range of motion was analyzed using a paired t-test with a significance level of 0.05.

Results:

The cohort's preoperative range was 22.0° (8.1°DF, 14°PF) and was increased to 38.5° intraoperatively (12.7°DF, 25.8°PF) as described in Table 1. Postoperative ROM is 24.9° (11.7°DF, 13.2°PF) which means that 65% of the intraoperative ROM is preserved. Preoperative and intraoperative range of motion was not different between the group that had a TAL compared to no TAL. At the year postoperatively, the dorsiflexion was similar between both groups. The group who did not have a TAL went from 12.8 intraoperatively to 12.2° postoperatively whereas the group who had a TAL went from 12.2° to 11.3° which was statistically equivalent.

Conclusion:

This study is the first to assess how much ankle range of motion is retained after TAR. Overall, we observed that 65% of dorsiflexion was retained after TAR. TAL as a concomitant procedure did not effect the proportion of dorsiflexion motion that was retained. Additional studies are needed to determine how to best optimize and increase ROM after TAR.
The Adelaide Experience: Short Term Results with the Use of Cartiva Implant
Authors: Genuth Gil , Stavrou Peter , Brown Christopher H.
Published: January 2022

Category:

Midfoot/Forefoot

Introduction/Purpose:

Hallux rigidus is the most common arthritic condition of the foot. There are only few surgical options that does not require fusing the 1st MTPJ thus allowing motion in the joint. A new first metatarsophalangeal (MTP) joint hemiarthroplasty with a polyvinyl alcohol (PVA) hydrogel implant (Cartiva) has demonstrated pain relief and functional outcomes equivalent to first MTP arthrodesis at 2 and 5 years postoperation in few studies done in North America. We would like to present the Adelaide short term result with the use of this implant.

Methods:

40 Patients who underwent first PVA hydrogel MTP hemiarthroplasty in Adelaide by two senior foot and ankle surgeons (C.B and P.S) and by two international foot and ankle fellow (G.G and J.P) between 2017 and 2019 were included in this study. The follow up period was 24 months postoperation. Patients underwent physical examination and radiographic evaluation and completed a pain VAS, the Short-Form-36 (SF-36), and the Foot and Ankle Ability Measure (FAAM) sports subscale and activities of daily living (ADL) subscale. At the time of this study, 40 patients had reached 2 year follow-up.

Results:

There were no lost to follow up, leaving 40 patients with mean age 63.4 (range, 40.1-79.9) years. Mean follow-up was 24 months (range, 6-30 months). Postoperative active MTP natural joint dorsiflexion and peak MTP dorsiflexion were mean 18.2 (range, 10.0- 30.0) and 29.7 (range, 10.0-45.0) degrees, respectively. Pain VAS, SF-36, FAAM ADL, and FAAM Sports scores demonstrated clinically and statistically significant improvements. Radiographically, no patient demonstrated changes in implant position, implant loosening or subsidence, or implant wear. One implant was removed because of persistent pain 7 months post surgery and was converted to fusion 3 months after the removal of the Cartiva implant.

Conclusion:

Short term results for the use of Cartiva implant in Adelaide show that functional outcomes improved significantly, pain was reduced significantly, and the implant demonstrated excellent survivorship. Our results are similar for those described in the North American literature
Deep Learning Improves the Accuracy of Weightbearing CT Scan in Detecting Subtle Syndesmotic Instability
Authors: Guss Daniel , Mojahed-Yazdi Reza , Ashkani-Esfahani Soheil , Bhimani Rohan , Waryasz Gregory R. , Kerkhoffs Gino , Lubberts Bart , DiGiovanni Christopher W.
Published: January 2022

Category:

Ankle; Trauma

Introduction/Purpose:

Weightbearing CT (WBCT) scan provides an ability to compare the ankle joints bilaterally in a 3D manner under physiologic load. According to our recent investigations, 3D volume measurement of the syndesmosis, if measured up to 5cm proximal to the tibial plafond, can detect the instability with an accuracy of 90%, sensitivity of 95.8%, and specificity of 83.3%. However, these values can differ based on the knowledge and experience of the human interpreter. Deep learning, as a subset of machine learning, has shown promising potentials in processing and analyzing images and detecting abnormalities within the images using deep convolutional neural networks (DCNN). Herein, we aimed to assess the accuracy, sensitivity, and specificity of 3D volume WBCT evaluation using DCNN algorithms in patients with subtle syndesmotic instability.

Methods:

In this study 140 bilateral ankle WBCT scans of patients with subtle syndesmotic instability who were diagnosed intraoperatively were allocated to the patient group. The control group comprised 140 bilateral ankle WBCT images of healthy individuals. We utilized inception V3 model for our DCNN. Data augmentation and transfer learning were used; however, the images were not preprocessed in terms of change in size and resolution. The data were divided as 80:10:10 for training, validation, and test subsets, respectively. The outcome of the study was expressed as sensitivity, specificity, F-score, and the area under the curve (AUC).

Results:

The performance of our DCNN algorithm showed a sensitivity of 99.41%, specificity of 99.34%, F-score of 99.37%, and 99.99% AUC ( Figure 1 ). The change in loss value of the train data was plateaued after 40 iterations. Axial images were the most appropriate images that were used by the algorithm to detect the instability.

Conclusion:

In this study we observed that using DCNN in the process of WBCT image interpretation for diagnosis of syndesmotic instability, particularly in subtle cases, makes this modality almost perfect with a very small chance of missing a case. Training a DCNN using a greater number of inputs is still recommended to improve the validity and reliability of this method. Providing a heat map will also help clinicians discover the process of decision-making by these algorithms as DCNNs are sometimes called 'black box'.
Radiographic Evaluation of Isolated Continuous Compression Staples for Akin Osteotomy Fixation
Authors: Horner Kevin , Fiala Kyle , Summerhays Benjamin , Schweser Kyle M.
Published: January 2022

Category:

Bunion; Other

Introduction/Purpose:

The use of continuous compression implants (nitinol staples) in orthopaedic surgery has increased secondary to advances in metal alloy engineering. Biomechanical studies provide useful data supporting the theoretical use of nitinol staples in the foot and ankle. However, clinical data is limited. The purpose of this study was to determine the overall effectiveness, both clinically and radiographically, of continuous compression implants (nitinol staples) to achieve bony healing in the medially based, closing-wedge osteotomy of the proximal phalanx of the great toe (Akin osteotomy).

Methods:

A retrospective chart review was performed on 104 patients (107 feet) who underwent an Akin osteotomy using nitinol staples between January 1st, 2018 and February 20th, 2020. The primary outcome variable was radiographic evidence of healing on x-ray. X-rays were independently reviewed by three board-certified foot and ankle surgeons. All investigators were blinded towards the x-rays, and x-rays were randomized in terms of timing from surgery. Each investigator reviewed digital radiographs independently and recorded their radiographic finding responses. Osteotomies were deemed healed if greater than 50% of the osteotomy contained bridging bone. A partially healed osteotomy was defined as some bridging bone, but less than 50% of the overall osteotomy site, and a nonunion was defined as no healing seen radiographically, broken hardware, or loss of reduction.

Results:

Radiographic union (partial or full) was seen in 95% of Akin osteotomies (96/101) based on our parameters, with no loss of initial reduction. Only 2.8% (3/107) of the patient population had unplanned return to the operating room for reasons associated with the Akin osteotomy: one infection (0.9%), one irritable hardware removal (0.9%), and one traumatic disruption of fixation (0.9%). None of the eligible staples (0/106) were found to be fractured upon radiographic analysis. Smokers and diabetics represented 4.8 and 8.7 percent of the patient population, respectively.

Conclusion:

Since its inception in 1925, the Akin osteotomy has been described using several types of fixation methods. The results of this retrospective study show that continuous compression implants (nitinol staples) are a viable option for Akin osteotomy fixation, with low rates of complications (2.8%, 3/107) and high healing rates (95%, 96/101). Staples are lower profile, eliminating hardware irritation and potential secondary surgeries, are technically less demanding, and time of application is decreased when compared to other fixation methods. They offer the benefit of continuous compression of the fusion site, as well, and are rigid enough to maintain reduction.
Diagnosis of the Achilles Insertional Tendinopathies by Algometry
Authors: Mansur Nacime S. , Pereira Vinícius F. , Monteiro Cunha Henrique C. , Yamada André F. , Matsunaga Fabio Teruo , Sugawara Tamaoki Marcel J.
Published: January 2022

Category:

Ankle; Hindfoot

Introduction/Purpose:

Diagnosis of Achilles insertional tendinopathies (AIT) is based on pain by tendon palpation. However, there is no consensus or standard regarding the amount of force to be used during the evaluation. The algometry is a method of measuring the pressure applied in a specific region and can be a method for determining diagnosis values. Goal: To determine a cut-off value for Pain Threshold (PT) in the assessment of AIT.

Methods:

Design: This is a prospective case-control study of diagnostic accuracy, to develop a diagnostic criterion. Methods: Forty asymptomatic individuals and forty patients with insertional Achilles tendinopathy, matched by age and sex, were evaluated, and submitted to algometry for PT and for Visual Analogical Scale (VAS) levels with 3kg/f at the insertion of the calcaneal tendon by two different evaluators. Inter-observer reproducibility was accessed through the interclass correlation index (ICC). Sensitivity and specificity calculation of PT and of VAS were calculated and plotted on a ROC (Receiver Operator Characteristic) curve.

Results:

The lowest ICC found was 0.788. Regarding the diagnosis through TP, the 4.08 kg/f mark showed the best relation between sensitivity and specificity (92.5% and 92.5%, respectively). Algometry values lower than 4.08 were considered positive for disease. For the diagnosis of TIA through VAS with 3kg/f, the value of 2.98 was determined (sensitivity of 92.5% and specificity of 97.5%).

Conclusion:

This study showed that algometry is a reliable method in the assessment of Achilles insertional tendinopathies, having a high intra-observer reproducibility. The painful threshold for establishing the diagnosis of Achilles insertional tendinopathies was 4.08 kg/, with values below this number considered altered.
Clinical and Radiological Outcomes of Autologous Osteochondral Transplantation with and without Micronized Allograft Cartilage Matrix Augmentation for Osteochondral Lesions of the Talus
Authors: Mercer Nathaniel P. , Samsonov Alan , Dankert John , Kennedy John G.
Published: January 2022

Category:

Ankle; Basic Sciences/Biologics; Trauma

Introduction/Purpose:

Autologous osteochondral transplantation (AOT) using a cylindrical graft, in the treatment of osteochondral lesions of the talus (OLT) is typically indicated for patients with larger lesions. However, with lesions that are irregular in shape, the AOT graft may not completely replace the lesion. For these lesions, we utilize Extracellular Matrix Cartilage Allograft (EMCA) augmentation in AOT to act as a physiologic grout between the host and graft interface. The purpose of this study was to evaluate the clinical and radiological outcomes of AOT with concentrated bone marrow aspirate (CBMA) and EMCA augmentation in the treatment of OLT.

Methods:

A retrospective analysis comparing patients treated with AOT/CBMA alone and AOT with CBMA/EMCA was performed. Clinical outcomes were evaluated with the use of the Foot and Ankle Outcome Score (FAOS). Magnetic resonance imaging (MRI) was evaluated with the use of the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. Cyst formation was also evaluated on postoperative MRI.

Results:

Twenty-six patients were included in the AOT + CBMA/EMCA group, with 10 males and 16 females. Thirty-four patients were included in the AOT/CBMA group, with 17 males and 17 females. The mean symptoms, pain, ADL, sports activities, and QOL scores in FAOS significantly improved in both groups (p<0.001), but there was no significant difference between groups at final follow-up. There was no significant difference between the mean MOCART scores between groups (p=0.118). In the AOT/CBMA group, 2 patients (7.7%) complained of knee pain and 5 patients (19.2%) required additional surgery (2 hardware removals and 3 arthroscopic debridements of scar tissue in the ankle). In the AOT + CBMA/EMCA group, 3 patients (8.8%) complained of knee pain, and one patient (2.9%) required hardware removal.

Conclusion:

The current study demonstrated that AOT combined with CBMA and EMCA was an effective surgical treatment for OLT, providing good clinical and radiological outcomes. However, the benefit of combining ECMA with CBMA in small chondral defects at the host graft interface may be marginal as the biologic effect is induced by the CBMA and the mechanical scaffold effect of ECMA may not be required in such small defects.
Music Therapy for Children with Oncology & Hematological Conditions and Their Families: Advancing the Standards of Psychosocial Care
Authors: Knott David , Krater Caitlin , MacLean Jessica , Robertson Kim , Stegenga Kristin , Robb Sheri L.
Published: January 2022

Background: Diagnosis and treatment of cancer and blood disorders in childhood, adolescence and young adulthood has a significant impact on patients and families. The Psychosocial Standards of Care project, initiated in 2012, resulted in 15 Psychosocial Standards (PSS) that guide the care patients and families receive throughout treatment. As members of the multidisciplinary psychosocial care team, music therapists play an important role in the advancing the PSS. Most surveys have focused on other commonly provided services (e.g., social work, child life), leaving gaps in our understanding about the availability and use of music therapy services to advance PSS. This paper offers an initial description of how music therapy services contribute to the provision of care under these Standards. Methods: We analyze how music therapy services promote PSS through synthesis of a music therapy clinical practice survey, published literature, and scope of practice documents. A brief overview of music therapy services structure, PSS that music therapy services currently address, and two clinical program descriptions are included. Results: Music therapy services address 9 of the 15 PSS and are well integrated within the larger program of psychosocial care. Findings suggest integration of music therapy services can help ensure personalized, comprehensive care and efficient use of often-limited psychosocial care resources. Discussion: Nurses, as members of the psychosocial and medical teams are uniquely positioned to identify patient and family care needs and refer patients for services. Understanding how music therapy services address PSS and most importantly, the needs of patients and families, will optimize their care.
A Pilot Randomized Control Trial of Teens Taking Charge: A Web-based Self-management Program for Adolescents with Cancer
Authors: Breakey Vicky R. , Gupta Abha , Johnston Donna L. , Portwine Carol , Laverdiere Caroline , May Sylvie Le , Dick Bruce , Hundert Amos , Nishat Fareha , Killackey Tieghan , Nguyen Cynthia , Lalloo Chitra , Stinson Jennifer
Published: January 2022

Background: There is a lack of self-management tools for adolescents with cancer (AWC). This study evaluated the feasibility of Teens Taking Charge Cancer, a web-based self-management program. Methods: A pilot randomized control trial (RCT) was conducted across 4 pediatric oncology clinics. AWC (12–18 years) and their caregivers were randomized to either the intervention or control group. All were asked to complete 12 website modules over 12 weeks (at their own pace) and received monthly calls from health coaches. The intervention website was based on cognitive behavioral principals, designed as an interactive self-guided online program, while the control consisted of education and included links to 12 general cancer websites. Outcome assessments occurred at enrollment and 12 weeks post-intervention. The primary outcomes included rate of accrual and retention, adherence to the protocol, acceptability and satisfaction with intervention using questionnaire and semi-structured interviews, adverse events and engagement with the intervention. Results: Eighty-one teen-caregiver dyads were enrolled with a retention rate of 33%. In the intervention group 46% ( n = 18) logged in at least once over the 12-week period. A mean of 2.4 of 12 modules ( SD 3.0) were completed; and no one completed the program. Thirty-three percent of caregivers in the intervention logged into the website at least once and none completed the full program. Discussion: The results from this pilot study suggest that the current design of the Teens Taking Charge Cancer RCT lacks feasiblity. Future web-based interventions for this group should include additional features to promote uptake and engagement with the program.
Effects of sand burial depth on Xanthium spinosum seed germination and seedling growth
Authors: Tao Yuan-yuan , Shang Tian-cui , Yan Jun-jie , Hu Yun-xia , Zhao Yu , Liu Ying
Published: January 2022

In desert habitats, sand burial is an important factor affecting germination of plant seeds and seedling growth.Xanthium spinosumhas strong adaptability in arid desert areas, and is a common malignant invasive plant in Xinjiang, China. The effects of different sand burial depths on seed germination, seedling emergence, growth and biomass allocation were studied to provide a scientific basis for further control ofX. spinosum. Six sand burial depths (1, 2, 3, 5, 7 and 9 cm) were established to explore the response ofX. spinosumseed germination and seedling growth to sand burial. The first emergence time, peak emergence time, emergence rate, seedling growth height, biomass and biomass distribution ofX. spinosumseeds was significantly different at sand burial depths (P< 0.05). TheX. spinosumseeds had the highest emergence rate (71.5%) at 1 cm sand burial and the maximum seedling height (7.1 cm). As sand burial depth increased, the emergence rate and seedling height gradually decreased. Emergence rate (12.25%) and seedling height (2.9 cm) were lowest at 9 cm sand burial. The root length at 9 cm depth (13.6 cm) was significantly higher than that at other sand depths (P< 0.05). The sand burial depth affected the biomass accumulation and distribution ofX. spinosum. As sand burial depth increased, the root biomass and rhizome ratio increased, and the most deeply buried seedlings allocated more biomass for root growth. The optimal sand burial depth for seed germination and seedling growth ofX. spinosumwas 1–3 cm, and high burial depth (5–9 cm) was not conducive to the germination and growth ofX. spinosumseedlings. For prevention and control ofX. spinosum, we suggest deeply ploughing crops before sowing to ensureX. spinosumseeds are ploughed into a deep soil layer.
Assessing the quality of patient handovers between ambulance services and emergency department – development and validation of the emergency department human factors in handover tool
Authors: Golling Marina , Behringer Wilhelm , Schwarzkopf Daniel
Published: January 2022

Background

Patient handover between prehospital care and the emergency department plays a key role in patient safety. Therefore, we aimed to create a validated tool for measuring quality of communication and interprofessional relations during handover in this specific setting.

Methods

Based on a theoretical framework a comprehensive item pool on information transfer and human factors in emergency department handovers was created and refined in a modified Delphi survey involving clinical experts. Based on a pre-test, items were again revised. The resulting Emergency Department Human Factors in Handover tool (ED-HFH) was validated in a field test at the emergency department of a German university hospital from July to December 2017. The ED-HFH was completed by emergency department and ambulance service staff participating in handovers and by an external observer. Description of item characteristics, exploratory factor analysis, analyses on internal consistency and interrater reliability by intraclass-correlation. Construct validity was analysed by correlation with an overall rating on quality of the handover.

Results

The draft of the ED-HFH contained 24 items, 90 of 102 eligible staff members participated in the field test completing 133 questionnaires on 38 observed handovers. Four items were deleted after analysis of item characteristics. Factor analysis supported a single factor explaining 39% of variance in the items. Therefore, a sum-score was calculated with a possible range between 14 and 70. The median value of the sum-score in the sample was 61.5, Cronbach’s α was 0.83, intraclass-correlation was 0.52, the correlation with the overall rating of hand-over quality was ρ = 0.83 (p ≤ 0.001).

Conclusions

The ED-HFH showed its feasibility, reliability and validity as a measure of quality of information transfer and human factors in handovers between ambulance services  and the emergency department. It promises to be a useful tool for quality assurance and staff training.
Serum creatinine/cystatin C ratio as a surrogate marker for sarcopenia in patients with gastric cancer
Authors: Sun Jing , Yang Hui , Cai Wentao , Zheng Jingwei , Shen Ningzhe , Yang Xinxin , Pan Bujian , Zhang Weiteng , Chen Xiaodong , Shen Xian
Published: January 2022

Background

Sarcopenia is an age-related syndrome that may have negative impact on surgical outcomes and long-term survival of patients with gastric cancer. Serum creatinine/cystatin C (Cr/CysC) ratio has attracted attention as a surrogate marker for sarcopenia but has not been adequately studied in patients with gastric cancer. The purpose of this study was to investigate the validity of serum Cr/CysC ratio as a predictor of sarcopenia, evaluate a statistical cut-off value, and assess the relationship between Cr/CysC ratio and prognosis of patients with gastric cancer.

Methods

We retrospectively studied 327 patients who underwent surgery for gastric cancer from June 2009 to October 2021. The skeletal muscle mass index was calculated using computed tomography (CT). We determined the relevance of serum Cr/CysC ratio as a surrogate maker for sarcopenia by comparing it with various biomarkers. The Concordance index (C-index) was calculted to measure whether the Cr/CysC ratio can prognosis of patients with gastric cancer.

Results

Serum Cr/CysC was significantly correlated with with Skeletal Muscle Index (SMI) (r = 0.221, p < 0.001) and Skeletal Muscle Area (SMA) (r = 0.258, p < 0.001). The area under the curve for sarcopenia was significantly larger for serum Cr/CysC ratio than for other biomarkers (Cr/CysC: 0.644, CysC: 0.535, Cr: 0.556). Patients in the high-Cr/CysC group have longer survival time than that in low-Cr/CysC group, defined by the cutoff value 0.67. The C-index of both Cr/CysC ratio and SMI with OS was 0.63.

Conclusions

Serum Cr/CysC ratio can be used accurately, inexpensively, and easily to evaluate sarcopenia in male patients with gastric cancer. Our study shows that patients with Cr/CysC below 0.67 had possibility of sarcopenia and would be poor prognosis.
Effects of an oral mucosa protective formulation on chemotherapy- and/or radiotherapy-induced oral mucositis: a prospective study
Authors: Ueno Takao , Yatsuoka Wakako , Ishiki Hiroto , Miyano Kanako , Uezono Yasuhito
Published: January 2022

Background

Oral mucositis (OM) associated with cancer treatment not only impairs patients’ quality of life but also causes treatment delays or changes. This prospective exploratory study was conducted to evaluate the efficacy of Episil® oral liquid, which is an approved protective formulation for the oral mucosa in patients with OM. The extent of the pain-relieving effect, feeling during use, and adverse events or problems were evaluated.

Methods

In total, 10 Japanese cancer patients with OM receiving chemotherapy, pretreatment therapy for hematopoietic stem cell transplantation, or radiation therapy for head and neck cancer were enrolled.

Results

A numerical rating scale (NRS) was used to assess oral pain intensity due to OM. Compared to baseline, the mean NRS began to decrease at 5 min after using Episil® (7.1 ± 1.4 to 4.6 ± 2.87; p = 0.264). A significant decrease was observed in the pain score after using Episil® compared with that before using Episil®, and this effect lasted up to 120 min. The protective effects of Episil® were observed 3–5 min after application. Some patients felt slight soreness or discomfort when applying Episil®. However, this discomfort due to Episil®’s stimulation was within the allowable range and transient. No adverse events were observed in any of the cases.

Conclusions

The results of this prospective study showed that Episil® could be an effective treatment to relieve oral pain in Japanese patients with moderate to severe OM, and this newly approved product might adequately support patients’ oral intake.

Trial registration

University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) (UMIN000031921).
Metabolic phenotypes and risk of colorectal cancer: a systematic review and meta-analysis of cohort studies
Authors: Goodarzi Golnoosh , Mozaffari Hadis , Raeisi Tahereh , Mehravar Fatemeh , Razi Bahman , Ghazi Maryam Lafzi , Garousi Nazila , Alizadeh Shahab , Janmohammadi Parisa
Published: January 2022

Background

The association of obesity with colorectal cancer (CRC) may vary depending on metabolic status.

Objective

This meta-analysis aimed to investigate the combined impacts of obesity and metabolic status on CRC risk.

Methods

The Scopus, PubMed, and web of sciences databases were systematically searched up to Jun 2021 to find all eligible publications examining CRC risk in individuals with metabolically unhealthy normal-weight (MUHNW), metabolically healthy obesity (MHO), and metabolically unhealthy obesity (MUHO) phenotypes.

Results

A total of 7 cohort studies with a total of 759,066 participants were included in this meta-analysis. Compared with healthy normal-weight people, MUHNW, MHO, and MUHO individuals indicated an increased risk for CRC with a pooled odds ratio of 1.19 (95% CI = 1.09–1.31) in MUHNW, 1.14 (95% CI = 1.06–1.22) in MHO, and 1.24 (95% CI = 1.19–1.29) in MUHO subjects. When analyses were stratified based on gender, associations remained significant for males. However, the elevated risk of CRC associated with MHO and MUHO was not significant in female participants.

Conclusions

The individuals with metabolic abnormality, although at a normal weight, have an increased risk for CRC. Moreover, obesity is associated with CRC irrespective of metabolic status.
Diet and nutritional status among hospitalised children in Hawassa, Southern Ethiopia
Authors: Hjellbakk Vilde K. , Hailemariam Hailu , Reta Fikadu , Engebretsen Ingunn M. S.
Published: January 2022

Background

Undernutrition constitutes a major problem among children in Hawassa, Ethiopia, and the literature on nutritional status in hospitalised children is scarce. The aim of this study was to investigate dietary diversity, nutritional practices, and the frequencies of undernutrition and the factors associated with severe acute malnutrition (SAM) in a hospitalised paediatric population in Hawassa, Southern Ethiopia.

Methods

A hospital-based cross-sectional study was carried out among hospitalised children in Hawassa, Southern Ethiopia. Children aged 6 to 59 months and their caregivers admitted for >24 hours from two public hospitals in Hawassa between November 2019 and January 2020 were included. Dietary diversity was assessed using World Health Organization (WHO) guidelines. Weight and height/length of the children were measured, and z-scores were calculated using the WHO growth standards. The definition of SAM was a weight-for-height z-score (WHZ) less than –3 or a clinically confirmed SAM diagnosis with higher WHZ.

Results

A total of 188 caregiver-child pairs were assessed in the two public hospitals. The majority of the patients were admitted with SAM (N = 70/188, 37%) or respiratory tract infections (N = 44/188, 23%). There was a similar number of boys and girls with SAM. Of all the children, 59% reported to have consumed foods from fewer than four food groups, while 40% reported eating foods from four or more food groups. The rate of malnutrition was high, and 35.8% of the children were classified as wasted (WHZ < –2) and 41% were stunted (height-for-age z-score < –2). Nearly 30% of the SAM patients were also stunted.

Conclusion

This study revealed that hospitalised children in this setting had poor dietary diversity and nutritional status, a high degree of morbidity, and extreme poverty. There is thus a need to focus on nutrition patterns in clinical settings.
Barriers and facilitators to program directors’ use of the medical education literature: a qualitative study
Authors: Doja Asif , Lavin Venegas Carolina , Cowley Lindsay , Wiesenfeld Lorne , Writer Hilary , Clarkin Chantalle
Published: January 2022

Background

It is unclear how often frontline clinical teachers are using this literature and its evidence base in teaching and assessment. Our study purpose was to examine postgraduate program director perspectives on the utilization and integration of evidence-based medical education literature in their teaching and assessment practices.

Methods

The authors conducted semi-structured telephone interviews with a convenience sample of current and former program directors from across Canada. Interviews were transcribed and analyzed inductively to distil pertinent themes.

Results

In 2017, 11 former and current program directors participated in interviews. Major themes uncovered included the desire for time-efficient and easily adaptable teaching and assessment tools. Participants reported insufficient time to examine the medical education literature, and preferred that it be ‘synthesized for them’. (i.e., Best evidence guidelines). Participants recognised continuing professional development and peer to peer sharing as useful means of education about evidence-based tools. Barriers to the integration of the literature in practice included inadequate time, lack of financial compensation for teaching and assessment, and the perception that teaching and assessment of trainees was not valued in academic promotion.

Discussion

Faculty development offices should consider the time constraints of clinical teachers when planning programming on teaching and assessment. To enhance uptake, medical education publications need to consider approaches that best meet the needs of a targeted audiences, including frontline clinical teachers. This may involve novel methods and formats that render evidence and findings from their studies more easily ‘digestible’ by clinical teachers to narrow the knowledge to practice gap.
The effect of the online flipped classroom on self-directed learning readiness and metacognitive awareness in nursing students during the COVID-19 pandemic
Authors: Khodaei Safoura , Hasanvand Shirin , Gholami Mohammad , Mokhayeri Yaser , Amini Mitra
Published: January 2022

Background

The COVID-19 pandemic has initiated digital developments in higher education while closing in-person university classes. As this crisis continues, the need to revive virtual learning opportunities was seriously felt. The present study was conducted to determine the online flipped classroom’s effect on nursing students’ self-directed learning readiness and metacognitive awareness.

Methods

This quasi-experimental single-group study with pretest-posttest design recruited 34 sophomore students of a nursing school in Lorestan province, Western Iran selected by census according to the inclusion criteria. Online asynchronous learning and online flipped classrooms were used during the semester’s first and second eight weeks, respectively. Students filled out self-directed learning readiness scale and metacognitive awareness inventory online before, in the middle of, and at the end of the semester. Data were analyzed using paired t-test in Stata-14 software.

Results

There was no significant difference between the mean score of metacognitive awareness before and after Online asynchronous learning (P=0.15), but the mean score of self-directed learning readiness increased significantly after OA (P=0.0004). After applying online flipped classrooms, students’ mean (SD) scores of metacognitive awareness and self-directed learning readiness were 272.03 (53.03) and 162.03 (21.77), respectively, which confirmed their significant improvement compared to before the intervention. A comparison of the mean score changes of both methods indicated that their implementation did not lead to significant differences between the mean total score of metacognitive awareness (P=0.15) and the mean total score of self-directed learning readiness (P=0.07).

Discussion

Online flipped classroom approach can be used as an effective method in nursing education by improving self-directed learning and metacognitive awareness, which are essential in online education for nursing students.
Regenerating zebrafish scales express a subset of evolutionary conserved genes involved in human skeletal disease
Authors: Bergen Dylan J. M. , Tong Qiao , Shukla Ankit , Newham Elis , Zethof Jan , Lundberg Mischa , Ryan Rebecca , Youlten Scott E. , Frysz Monika , Croucher Peter I. , Flik Gert , Richardson Rebecca J. , Kemp John P. , Hammond Chrissy L. , Metz Juriaan R.
Published: January 2022

Background

Scales are mineralised exoskeletal structures that are part of the dermal skeleton. Scales have been mostly lost during evolution of terrestrial vertebrates whilst bony fish have retained a mineralised dermal skeleton in the form of fin rays and scales. Each scale is a mineralised collagen plate that is decorated with both matrix-building and resorbing cells. When removed, an ontogenetic scale is quickly replaced following differentiation of the scale pocket-lining cells that regenerate a scale. Processes promotingde novomatrix formation and mineralisation initiated during scale regeneration are poorly understood. Therefore, we performed transcriptomic analysis to determine gene networks and their pathways involved in dermal scale regeneration.

Results

We defined the transcriptomic profiles of ontogenetic and regenerating scales of zebrafish and identified 604 differentially expressed genes (DEGs). These were enriched for extracellular matrix, ossification, and cell adhesion pathways, but not in enamel or dentin formation processes indicating that scales are reminiscent to bone. Hypergeometric tests involving monogenetic skeletal disorders showed that DEGs were strongly enriched for human orthologues that are mutated in low bone mass and abnormal bone mineralisation diseases (P< 2× 10−3). The DEGs were also enriched for human orthologues associated with polygenetic skeletal traits, including height (P< 6× 10−4), and estimated bone mineral density (eBMD,P< 2× 10−5). Zebrafish mutants of two human orthologues that were robustly associated with height (COL11A2,P=6× 10−24) or eBMD (SPP1,P=6× 10−20) showed both exo- and endo- skeletal abnormalities as predicted by our genetic association analyses;col11a2Y228X/Y228Xmutants showed exoskeletal and endoskeletal features consistent with abnormal growth, whereasspp1P160X/P160Xmutants predominantly showed mineralisation defects.

Conclusion

We show that scales have a strong osteogenic expression profile comparable to other elements of the dermal skeleton, enriched in genes that favour collagen matrix growth. Despite the many differences between scale and endoskeletal developmental processes, we also show that zebrafish scales express an evolutionarily conserved sub-population of genes that are relevant to human skeletal disease.
Effects of different artificial diets on commercial honey bee colony performance, health biomarkers, and gut microbiota
Authors: Ricigliano Vincent A. , Williams Steven T. , Oliver Randy
Published: January 2022

Background

Honey bee colonies managed for agricultural pollination are highly dependent on human inputs, especially for disease control and supplemental nutrition. Hives are routinely fed artificial “pollen substitute” diets to compensate for insufficient nutritional forage in the environment. The aim of this study was to investigate the effects of different artificial diets in a northern California, US commercial beekeeping operation from August through February. This time period represents an extended forage dearth when supplemental nutrition is used to stimulate late winter colony growth prior to almond pollination in the early spring. A total of 144 honey bee colonies were divided into 8 feeding groups that were replicated at three apiary sites. Feeding groups received commercial diets (Global, Ultra Bee, Bulk Soft, MegaBee, AP23, Healthy Bees), a beekeeper-formulated diet (Homebrew), or a sugar negative control. Diets were analyzed for macronutrient and amino acid content then evaluated with respect to honey bee colony population size, average bee weight, nutrition-related gene expression, gut microbiota abundance, and pathogen levels.

Results

Replicated at three apiary sites, two pollen-containing diets (Global and Homebrew) produced the largest colonies and the heaviest bees per colony. Two diets (Bulk Soft and AP23) that did not contain pollen led to significantly larger colonies than a sugar negative control diet. Diet macronutrient content was not correlated with colony size or health biomarkers. The sum of dietary essential amino acid deficiencies relative to leucine content were correlated with average bee weight in November and colony size used for almond pollination in February. Nutrition-related gene expression, gut microbiota, and pathogen levels were influenced by apiary site, which overrode some diet effects. Regarding microbiota, diet had a significant impact on the abundance of Bifidobacterium and Gilliamella and trended towards effects on other prominent bee gut taxa.

Conclusions

Multiple colony and individual bee measures are necessary to test diet efficacy since honey bee nutritional responses are complex to evaluate. Balancing essential amino acid content relative to leucine instead of tryptophan may improve diet protein efficiency ratios. Optimization of bee diets could improve feed sustainability and agricultural pollination efficiency by supporting larger, healthier honey bee colonies.
Prognostic implication of serum glycated albumin for patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention
Authors: Liu Chi , Zhao Qi , Ma Xiaoteng , Cheng Yujing , Sun Yan , Zhang Dai , Liu Xiaoli , Zhou Yujie
Published: January 2022

Background

It has been demonstrated that glycated albumin (GA) is significantly associated with diabetes complications and mortality. However, among patients diagnosed with non-ST-elevation acute coronary syndrome (NSTE-ACS) administered percutaneous coronary intervention (PCI), the predictive value of GA for poor prognosis is unclear.

Methods

This study eventually included 2247 NSTE-ACS patients in Beijing Anzhen Hospital, Capital Medical University in January-December 2015 who received PCI. All patients were followed up until death or for 48 months post-discharge. The primary endpoint was major adverse cardio-cerebral events (MACCEs), including all-cause death, non-fatal myocardial infarction, ischemia-induced revascularization and non-fatal ischemic stroke.

Results

In total, 547 (24.3%) MACCEs were recorded during the follow-up period. Upon adjusting for potential confounders, GA remained an important risk predictor of MACCEs (As nominal variate: hazard ratio [HR] 1.527, 95% confidence interval [CI] 1.236–1.886, P < 0.001; As continuous variate: HR 1.053, 95% CI 1.027–1.079, P < 0.001). GA addition significantly enhanced the predictive ability of the traditional risk model (Harrell’s C-index, GA vs. Baseline model, 0.694 vs. 0.684, comparison P = 0.002; continuous net reclassification improvement (continuous-NRI) 0.085, P = 0.053; integrated discrimination improvement (IDI) 0.007, P = 0.020).

Conclusion

GA is highly correlated with poor prognosis in NSTE-ACS patients undergoing PCI, suggesting that it may be a major predictive factor of adverse events among these individuals.
Towards application of CRISPR-Cas12a in the design of modern viral DNA detection tools (Review)
Authors: Dronina Julija , Samukaite-Bubniene Urte , Ramanavicius Arunas
Published: January 2022

Early detection of viral pathogens by DNA-sensors in clinical samples, contaminated foods, soil or water can dramatically improve clinical outcomes and reduce the socioeconomic impact of diseases such as COVID-19. Clustered regularly interspaced short palindromic repeat (CRISPR) and its associated protein Cas12a (previously known as CRISPR-Cpf1) technology is an innovative new-generation genomic engineering tool, also known as ‘genetic scissors’, that has demonstrated the accuracy and has recently been effectively applied as appropriate (E-CRISPR) DNA-sensor to detect the nucleic acid of interest. The CRISPR-Cas12a fromPrevotella and Francisella 1are guided by a short CRISPR RNA (gRNA). The unique simultaneouscis-andtrans-DNA cleavage after target sequence recognition at the PAM site, sticky-end (5–7 bp) employment, and ssDNA/dsDNA hybrid cleavage strategies to manipulate the attractive nature of CRISPR–Cas12a are reviewed. DNA-sensors based on the CRISPR-Cas12a technology for rapid, robust, sensitive, inexpensive, and selective detection of virus DNA without additional sample purification, amplification, fluorescent-agent- and/or quencher-labeling are relevant and becoming increasingly important in industrial and medical applications. In addition, CRISPR-Cas12a system shows great potential in the field of E-CRISPR-based bioassay research technologies. Therefore, we are highlighting insights in this research direction.

Graphical Abstract
Peptide-based semiconducting polymer nanoparticles for osteosarcoma-targeted NIR-II fluorescence/NIR-I photoacoustic dual-model imaging and photothermal/photodynamic therapies
Authors: Yuan Ying , Diao Shanchao , Ni Xiaoyue , Zhang Dong , Yi Wanrong , Jian Chao , Hu Xiang , Li Daifeng , Yu Aixi , Zhou Wen , Fan Quli
Published: January 2022

Background

The overall survival rate of osteosarcoma (OS) patients has not been improved for 30 years, and the diagnosis and treatment of OS is still a critical issue. To improve OS treatment and prognosis, novel kinds of theranostic modalities are required. Molecular optical imaging and phototherapy, including photothermal therapy (PTT) and photodynamic therapy (PDT), are promising strategies for cancer theranostics that exhibit high imaging sensitivity as well as favorable therapeutic efficacy with minimal side effect. In this study, semiconducting polymer nanoparticles (SPN-PT) for OS-targeted PTT/PDT are designed and prepared, using a semiconducting polymer (PCPDTBT), providing fluorescent emission in the second near-infrared window (NIR-II, 1000 - 1700 nm) and photoacoustic (PA) signal in the first near-infrared window (NIR-I, 650 - 900 nm), served as the photosensitizer, and a polyethylene glycolylated (PEGylated) peptide PT, providing targeting ability to OS.

Results

The results showed that SPN-PT nanoparticles significantly accelerated OS-specific cellular uptake and enhanced therapeutic efficiency of PTT and PDT effects in OS cell lines and xenograft mouse models. SPN-PT carried out significant anti-tumor activities against OS both in vitro and in vivo.

Conclusions

Peptide-based semiconducting polymer nanoparticles permit efficient NIR-II fluorescence/NIR-I PA dual-modal imaging and targeted PTT/PDT for OS.

Graphic Abstract