bluuebunny/crossref_metadata_2025 huggingface dataset:
Isolated Gastrocnemius Recession for Flexible Adult Acquired Flatfoot Deformity
Authors: Michalski Max , Chiodo Christopher P. , Greene Brady D. , Broughton Kimberly K. , Bluman Eric M. , Smith Jeremy T.
Published: January 2022

Category:

Hindfoot; Midfoot/Forefoot

Introduction/Purpose:

Adult acquired flatfoot deformity (AAFD) frequently has an associated gastrocnemius contracture, which is a primary focus of most non-operative treatment protocols. When conservative measures fail, AAFD reconstruction often includes a gastrocnemius recession. Most reconstruction procedures involve a period of post-operative non-weight-bearing, which can be difficult for elderly patients. Beginning in 2011, patients with flexible AAFD patients and at risk of non-compliance with weight-bearing restrictions, were offered a staged approach with initial isolated gastrocnemius recession followed by reconstruction, if required. Gastrocnemius recession may allow passive correction of the deformity, improve orthotic fit and obviate the need reconstruction (Figure). The goal of this study was to retrospectively evaluate patient reported outcomes following an isolated gastrocnemius recession for flexible AAFD.

Methods:

A total of 49 patients met the inclusion criteria: isolated gastrocnemius recession for flexible AAFD, no previous ipsilateral surgery and >6 months follow-up. Of 49 eligible patients, 29 (31 feet) participated. Pre-operative and post-operative outcomes were compared for Foot and Ankle Ability Measure activities of daily living subscale (FAAM-ADL), visual analog scale (VAS), and the PROMIS Physical Function Short Form 10a (PROMIS PF SF 10a). Additionally, patients were asked about satisfaction, willingness to undergo the procedure again and whether orthotic provided better relief. Mean and standard deviation were compared using a two-tailed paired t-test with significance.

Results:

FAAM-ADL and PROMIS PF SF 10a significantly improved from 55.9 and 37.3 pre-operatively to 71.6 and 42.0 (p=0.01, p=0.046) respectively. 70% of patients were either satisfied or very satisfied, 67% would undergo the procedure again, and 64.5% of patients had improved relief with use of orthotics post-operatively.

Conclusion:

A staged approach with initial isolated gastrocnemius recession for the management of flexible AAFD in elderly patients can be effective. These results for patient recorded outcomes, patient satisfaction, willingness to undergo the procedure again and improvement in orthotic relief may guide the shared decision-making process with elderly patients when offered a reconstruction versus staged approach.
AirPods and the earth: Digital technologies, planned obsolescence and the Capitalocene
Authors: Taffel Sy
Published: January 2022

Apple's AirPods have helped forge a multibillion-dollar market for true wireless hearable devices. The article employs media geology and political ecology to argue that AirPods exemplify the Capitalocene, a time where a planetary sociotechnical system based on ecologically unequal exchange benefits a privileged minority of humans while inflicting significant harms to humans and ecosystems that will persist across inhuman temporalities. These harms are inequitably distributed and are not typically experienced by those who can afford luxury items such as AirPods. While digital technologies are often mistaken for dematerialised objects that will enable infinite economic growth on a materially finite planet, examining the flows of energy, matter, labour and knowledge required for the production and maintenance of these devices comprehensively refutes these claims. AirPods are designed to function for just eighteen to thirty-six months of daily use before planned obsolescence renders AirPods as long-lived, toxic, electronic waste. Pending ‘right to repair’ legislation should prohibit the production of irreparable digital devices such as AirPods, as the right to repair an irreparable device is effectively meaningless.
Roles of Wnt Signaling Pathway and ROR2 Receptor in Embryonic Development: An Update Review Article
Authors: Guo Rui , Xing Quan Sheng
Published: January 2022

The Wnt family is a large class of highly conserved cysteine-rich secretory glycoproteins that play a vital role in various cellular and physiological courses through different signaling pathways during embryogenesis and tissue homeostasis 3. Wnt5a is a secreted glycoprotein that belongs to the noncanonical Wnt family and is involved in a wide range of developmental and tissue homeostasis. A growing body of evidence suggests that Wnt5a affects embryonic development, signaling through various receptors, starting with the activation of β-catenin by Wnt5a. In addition to affecting planar cell polarity and Ca2+ pathways, β-catenin also includes multiple signaling cascades that regulate various cell functions. Secondly, Wnt5a can bind to Ror receptors to mediate noncanonical Wnt signaling and a significant ligand for Ror2 in vertebrates. Consistent with the multiple functions of Wnt5A/Ror2 signaling, Wnt5A knockout mice exhibited various phenotypic defects, including an inability to extend the anterior and posterior axes of the embryo. Numerous essential roles of Wnt5a/Ror2 in development have been demonstrated. Therefore, Ror signaling pathway become a necessary target for diagnosing and treating human diseases. The Wnt5a- Ror2 signaling pathway as a critical factor has attracted extensive attention.
Developing theory-based text messages to support retention in clinical trials: A mixed methods approach
Authors: Green Sophie M C , Raine Erin , Hall Louise H , Collinson Michelle , Mason Ellen , Gillies Katie , French David P , Bartlett Yvonne Kiera , Hartley Suzanne , Foy Robbie , Farrin Amanda , Smith Samuel G ,   on behalf of the ROSETA investigators
Published: January 2022

Background: Returning a trial questionnaire is a behaviour affected by a range of psychological and contextual factors. Previously tested Short Message Service (SMS) messages to prompt questionnaire return have not addressed these factors, and have not been characterised by established taxonomies of behaviour change techniques (BCTs). Purpose: We aimed to develop acceptable theory-based SMS messages, with fidelity to four BCTs, to support participant understanding of the consequences of not returning trial questionnaires. Methods and Results: We initially developed 32 messages. Ten behaviour change experts assessed message fidelity to the intended BCT (Study 1a). All messages had appropriate fidelity to the intended BCT (mean ratings = 6.8/10 [SD = 0.6) to 7.5/10 [SD = 0.3]). Study 1b, a focus group with five patient representatives, recommended removing the BCT ‘comparative imagining of future outcomes’ (4 messages), two further messages be removed, and amendments to five messages. In Study 1c, 60 breast cancer survivors rated all remaining 26 messages as acceptable (mean = 3.8/5 [SD = 1.2] to 4.3/5 [SD = 0.8]). Twelve behaviour change experts rated the fidelity of the 26 messages to intended BCTs (Study 1d); all messages had appropriate fidelity (mean ratings = 6.1/10 [SD = 2.4] to 6.9/10 [SD = 1.4]). Conclusions: In these studies, we developed 26 SMS messages that were acceptable to the intended recipients and had sufficient fidelity to the intended BCTs. This approach could be taken to design interventions supporting behaviours needed for the successful delivery of clinical trials. The messages are available to research teams who can evaluate them in Studies within Trials.
Langerhans dendritic cell vaccine bearing mRNA-encoded tumor antigens induces antimyeloma immunity after autotransplant
Authors: Chung David J. , Sharma Sneh , Rangesa Madhumitha , DeWolf Susan , Elhanati Yuval , Perica Karlo , Young James W.
Published: January 2022

Posttransplant vaccination targeting residual disease is an immunotherapeutic strategy to improve antigen-specific immune responses and prolong disease-free survival after autologous stem cell transplantation (ASCT) for multiple myeloma (MM). We conducted a phase 1 vaccine trial to determine the safety, toxicity, and immunogenicity of autologous Langerhans-type dendritic cells (LCs) electroporated with CT7, MAGE-A3, and Wilms tumor 1 (WT1) messenger RNA (mRNA), after ASCT for MM. Ten patients received a priming immunization plus 2 boosters at 12, 30, and 90 days, respectively, after ASCT. Vaccines contained 9 × 106 mRNA-electroporated LCs. Ten additional patients did not receive LC vaccines but otherwise underwent identical ASCT and supportive care. At 3 months after ASCT, all patients started lenalidomide maintenance therapy. Vaccinated patients developed mild local delayed-type hypersensitivity reactions after booster vaccines, but no toxicities exceeded grade 1. At 1 and 3 months after vaccines, antigen-specific CD4 and CD8 T cells increased secretion of proinflammatory cytokines (interferon-γ, interleukin-2, and tumor necrosis factor-α) above prevaccine levels, and also upregulated the cytotoxicity marker CD107a. CD4 and CD8 T-cell repertoire analysis showed a trend for increased clonal expansion in the vaccine cohort, which was more pronounced in the CD4 compartment. Although not powered to assess clinical efficacy, treatment responses favored the vaccine arm. Triple antigen–bearing mRNA-electroporated autologous LC vaccination initiated at engraftment after ASCT, in conjunction with standard lenalidomide maintenance therapy for MM, is safe and induces antigen-specific immune reactivity. This trial was registered at www.clinicaltrials.gov as #NCT01995708.
Deleterious effect of bone marrow-resident macrophages on hematopoietic stem cells in response to total body irradiation
Authors: Chalot Marion , Barroca Vilma , Devanand Saiyirami , Hoffschir Françoise , Romeo Paul-Henri , Moreno Stéphanie G.
Published: January 2022

Bone marrow (BM) resident macrophages interact with a population of long-term hematopoietic stem cells (LT-HSCs) but their role on LT-HSC properties after stress is not well defined. Here, we show that a 2 Gy-total body irradiation (TBI)-mediated death of LT-HSCs is associated with increased percentages of LT-HSCs with reactive oxygen species (ROS) and of BM resident macrophages producing nitric oxide (NO), resulting in an increased percentage of LT-HSCs with endogenous cytotoxic peroxynitrites. Pharmacological or genetic depletion of BM resident macrophages impairs the radio-induced increases in the percentage of both ROS+ LT-HSCs and peroxynitrite+ LT-HSCs and results in a complete recovery of a functional pool of LT-HSCs. Finally, we show that after a 2 Gy-TBI, a specific decrease of NO production by BM resident macrophages improves the LT-HSC recovery, whereas an exogenous NO delivery decreases the LT-HSC compartment. Altogether, these results show that BM resident macrophages are involved in the response of LT-HSCs to a 2 Gy-TBI and suggest that regulation of NO production can be used to modulate some deleterious effects of a TBI on LT-HSCs.
The deep Basel-1 geothermal well: an attempt assessing the predrilling hydraulic and hydrochemical conditions in the basement of the Upper Rhine Graben
Authors: Stober Ingrid , Ladner Florentin , Hofer Moritz , Bucher Kurt
Published: January 2022

Hydrogeological properties of fluid reservoirs in the brittle continental crust at 5 km have been deduced from hydraulic and chemical data provided by the Deep Heat Mining well Basel-1 in the south of the Upper Rhine rift valley (central Europe, Switzerland). The investigation was challenging because no direct temperature logs or fluid samples from the undisturbed reservoir exist. However, the properties of the undisturbed reservoir have been reliably reconstructed from short time hydraulic tests and the evolution of outflow water composition. The rock of the open hole sections (4629–5000 m) is predominantly coarse-grained undeformed poorly fractured quartz-monzodiorite. The permeability k = 5.8 × 10–18m2is characteristic for plutonic basement at 5 km depth. Fluid flow is restricted to few steeply dipping fracture zones in this section. Outflow water triggered by massive injection of river water contains predominantly NaCl. The total of dissolved solids (TDS) in the pristine reservoir at depth is about 45 g kg−1. The origin of the high salinity is probably fossil seawater. The water has been modified in the reservoir by desiccation reactions related to the partial and local hydration of the igneous reservoir rock. The estimated reservoir temperature of 185 °C using three different calibrations of standard fluid geothermometers is in excellent agreement with measured and extrapolated temperatures in the borehole. The consistent application of different fluid geothermometers confirms the rock control of the fluid composition.
Anatomy and kinematic evolution of an ancient passive margin involved into an orogenic wedge (Western Southern Alps, Varese area, Italy and Switzerland)
Authors: Scaramuzzo Emanuele , Livio Franz A. , Granado Pablo , Di Capua Andrea , Bitonte Raffaele
Published: January 2022

We make use of own geological mapping, interpretations of seismic reflection profiles and deep geophysical data to build a lithospheric-scale cross-section across the European Western Southern Alps (Varese area) and to model a progressive restoration from the end of Mesozoic rifting to present-day. Early phases of Alpine orogeny were characterized by Europe-directed thrusting, whereas post-Oligocene shortening led to basement-involving crustal accretion accompanied by backfolding, and consistent with the kinematics of the adjoining Ivrea Zone. Wedging was favored by a significant component of reactivation of the inherited Adriatic rifted margin. Our results also suggest that, during the collisional and post-collisional tectonics, lithosphere dynamics drove diachronically the onset of tectonic phases (i.e., wedging and slab retreat), from east to west, across the Western Southern Alps.
Characterisation of cold-induced mitochondrial fission in porcine aortic endothelial cells
Authors: Quiring Leonard , Walter Björn , Lohaus Niklas , Schwan Dhanusha , Rech Anja , Dlugos Andrea , Rauen Ursula
Published: January 2022

Background

Previously, we observed that hypothermia, widely used for organ preservation, elicits mitochondrial fission in different cell types. However, temperature dependence, mechanisms and consequences of this cold-induced mitochondrial fission are unknown. Therefore, we here study cold-induced mitochondrial fission in endothelial cells, a cell type generally displaying a high sensitivity to cold-induced injury.

Methods

Porcine aortic endothelial cells were incubated at 4–25 °C in modified Krebs–Henseleit buffer (plus glucose to provide substrate and deferoxamine to prevent iron-dependent hypothermic injury).

Results

Cold-induced mitochondrial fission occurred as early as after 3 h at 4 °C and at temperatures below 21 °C, and was more marked after longer cold incubation periods. It was accompanied by the formation of unusual mitochondrial morphologies such as donuts, blobs, and lassos. Under all conditions, re-fusion was observed after rewarming. Cellular ATP content dropped to 33% after 48 h incubation at 4 °C, recovering after rewarming. Drp1 protein levels showed no significant change during cold incubation, but increased phosphorylation at both phosphorylation sites, activating S616 and inactivating S637. Drp1 receptor protein levels were unchanged. Instead of increased mitochondrial accumulation of Drp1 decreased mitochondrial localization was observed during hypothermia. Moreover, the well-known Drp1 inhibitor Mdivi-1 showed only partial protection against cold-induced mitochondrial fission. The inner membrane fusion-mediating protein Opa1 showed a late shift from the long to the fusion-incompetent short isoform during prolonged cold incubation. Oma1 cleavage was not observed.

Conclusions

Cold-induced mitochondrial fission appears to occur over almost the whole temperature range relevant for organ preservation. Unusual morphologies appear to be related to fission/auto-fusion. Fission appears to be associated with lower mitochondrial function/ATP decline, mechanistically unusual, and after cold incubation in physiological solutions reversible at 37 °C.
RETRACTED ARTICLE: LINC01354/microRNA-216b/KRAS Axis Promotes the Occurrence and Metastasis of Endometrial Cancer
Authors: Zhang Yan , Zhao Wei , Na Fei , Li Meng , Tong Shengchun
Published: January 2022

Objective

LINC01354 has been defined as a tumor driver in several cancers. Nevertheless, whether LINC01354 involves in endometrial cancer (EC) has been little navigated. Thus, the mechanism of LINC01354 was explored in the disease.

Methods

Measurements of LINC01354, microRNA (miR)-216b and kirsten rat sarcoma viral oncogene (KRAS) levels in EC tissues and cells were performed. LINC01354 low expression and miR-216b overexpression vectors were introduced into EC cells (lshikawa), thereby their effects on cell viability, apoptosis, migration and invasion were manifested. Rescue experiments were also carried out by down-regulating LINC01354 and miR-216b spontaneously. Tumorigenesis in vivo was also assessed. The relationships of LINC01354/miR-216b/KRAS were analyzed.

Results

Increased LINC01354 and KRAS and reduced miR-216b levels were measured in EC. Silencing LINC01354 or overexpressing miR-216b retarded EC cellular development. LINC01354 counteracted with miR-216b to target KRAS. Suppression of miR-216b antagonized silenced LINC01354-induced impacts on EC cell development. LINC01354/miR-216b/KRAS axis enhanced tumorigenesis in mice with EC.

Conclusion

It is testified that silencing LINC01354 inhibits KRAS by up-regulating miR-216b, thereby discouraging cell malignant phenotype in EC.
The short term influence of right ventricular pacing burden on echocardiographic and spiroergometric parameters in patients with preserved left ventricular ejection fraction
Authors: Youssef Akram , Pfluecke Christian , Dawid Maciej , Ibrahim Karim , Günther Michael , Kolschmann Steffen , Richter Utz , Francke Alexander , Wunderlich Carsten , Christoph Marian
Published: January 2022

Background

The incidence of worsened clinical outcome due to high right ventricular (RV) pacing burden in patients with preserved left ventricular function remains controversial.

Objective

To investigate the impact of RV pacing on several echocardiographic and spiroergometric parameters.

Methods

In 60 pacemaker patients with preserved left ventricular ejection fraction (LVEF) serial echocardiographies and spiroergometries were performed over a time course of 12 months. Additionally, in 48 patients retrospective echocardiographic analyses of the LV- and RV function were carried out up to 24 months after pacemaker implantation.

Results

The patients were divided into two groups: The high RV pacing burden group (hRVP: ≥ 40%) and the low RV pacing group (lRVP < 40%) according to the definitions in previous randomized MOST and DAVID trials. After a period of 12-month pacemaker therapy no changes to left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), LVEF, E/A-ratio; E/E′-ratio and tricuspid annular plane systolic excursion (TAPSE) could be revealed, independently of the RV pacing burden. Additionally, after 24-month long term follow-up there were no differences in LVEF and TAPSE in both groups. Accordingly, no relevant changes of peak exercise capacity, ventilatory anaerobic threshold or maximal oxygen consumption could be demonstrated independently of the RV pacing.

Conclusions

In pacemaker patients with preserved LVEF the burden of RV pacing has no adverse influence on several echocardiographic and spiroergometric surrogate parameters of pacemaker-induced cardiomyopathy after a follow-up of 12 to 24 month. Despite this, screening for pacemaker induced cardiomyopathy should be performed especially in the presence of new heart failure symptoms.
Tuberculosis burden caused by migrant population in Eastern China: evidence from notification records in Zhejiang Province during 2013–2017
Authors: Liu Kui , Chen Songhua , Zhang Yu , Li Tao , Xie Bo , Wang Wei , Wang Fei , Peng Ying , Ai Liyun , Chen Bin , Wang Xiaomeng , Jiang Jianmin
Published: January 2022

Background

Internal migrants have an enormous impact on tuberculosis (TB) epidemic in China. Zhejiang Province, as one of the developed areas, also had a heavy burden caused by TB.

Methods

In this study, we collected all cases in Zhejiang Province through the TB Management Information System from 2013 to 2017. Description analysis and Spatio-temporal analysis using R software and ArcGIS were performed to identify the epidemiological characteristics and clusterings, respectively.

Results

48,756 individuals in total were notified with TB among the migrant population (TBMP), accounting for one-third of all cases identified. The primary sources of TB from migrants outside the province were from Guizhou, Sichuan, and Anhui. Wenzhou, Taizhou, and Lishui were the three mainly outflowing cities among the intra-provincial TBMP and Hangzhou as the primarily inflowing city. Also, results implied that the inconsistency of the TBMP in spatial analysis and the border area of Quzhou and Lishui city had the highest risk of TB occurrence among the migrants. Additionally, one most likely cluster and four secondary clusters were identified by the spatial–temporal analysis.

Conclusion

The effective control of TB in extra-provincial MP was critical to lowering the TB burden of MP in Zhejiang Province. Also, it is suggested that active TB screening for migrant employees outflowed from high epidemic regions should be strengthened, and further traceability analysis needs to be investigated to clarify the mechanism of TB transmission in clustered areas.
Working mothers’ breastfeeding experience: a phenomenology qualitative approach
Authors: Ahmad Rita Surianee , Sulaiman Zaharah , Nik Hussain Nik Hazlina , Mohd Noor Norhayati
Published: January 2022

Background

Breastfeeding practice is influenced by the mother’s attitude toward and knowledge of breastfeeding. Working mothers face many challenges and need support to maintain breastfeeding. This study aimed to explore working mothers’ breastfeeding experiences and challenges that can influenced their practices.

Methods

The qualitative phenomenological approach involving working mothers in Kota Bharu who fulfilled the inclusion criteria and consented to participate in the study were recruited using purposive sampling. Sixteen participants aged 24 to 46 years were interviewed using semi-structured in-depth interviews in the study. All interviews were recorded in digital audio, transcribed verbatim and analyzed using thematic analysis.

Findings

Three main themes emerged from the data analysis: perception of breastfeeding, challenges in breastfeeding, and support for breastfeeding. Two subthemes for perceptions were perception towards breastfeeding and towards infant formula. Challenges had two subthemes too which were related to perceived insufficient milk and breastfeeding difficulty. Where else, two subthemes for support were internal support (spouse and family) and external support (friends, employer, and healthcare staff).

Conclusions

Maintaining breastfeeding after return to work is challenging for working mothers and majority of them need support to continue breastfeeding practice. Support from their spouses and families’ influences working mothers’ decision to breastfeed. Employers play a role in providing a support system and facilities in the workplace for mothers to express and store breast milk. Both internal and external support are essential for mothers to overcome challenges in order to achieve success in breastfeeding.
Network analyses of internet gaming disorder symptoms and their links with different types of motivation
Authors: Gomez Rapson , Stavropoulos Vasileios , Tullett-Prado Deon , Schivinski Bruno , Chen Wai
Published: January 2022

The study used regularized partial correlation network analysis (EBICglasso) to examine the structure of DSM-5 internet gaming disorder (IGD) symptoms (network 1); and the associations of the IGD symptoms in the network with different types of motivation as defined in the self-determination theory i.e., intrinsic motivation (engaging in an activity for something unrelated to the activity), identified regulation (engaging in the activity because it aligns with one’s values and/or goals), external regulation (engagement in activity being driven by external rewards and/or approval), and amotivation (engaging in an activity without often understanding why) (network 2). Participants were 968 adults from the general community. They completed self-rating questionnaires covering IGD symptoms and different types of motivation. The findings for network 1 showed mostly positive connections between the symptoms within the IGD network. The most central symptom was loss of control, followed by continuation, withdrawal symptoms, and tolerance. In general, these symptoms were more strongly connected with each other than with the rest of the IGD symptoms. The findings for network 2 showed that the different types of motivation were connected differently with the different IGD symptoms. For instance, the likeliest motivation for the preoccupation and escape symptoms is intrinsic motivation, and for negative consequences, it is low identified regulation. Overall, the findings showed a novel understanding of the structure of the IGD symptoms, and the motivations underlying them. The clinical implications of the findings for assessment and treatment of IGD are discussed.
Prospective associations between alcohol consumption and psychological well-being in midlife
Authors: Grønkjær Marie , Wimmelmann Cathrine Lawaetz , Mortensen Erik Lykke , Flensborg-Madsen Trine
Published: January 2022

Background

Alcohol consumption potentially influences psychological well-being in beneficial and harmful ways, but prospective studies on the association show mixed results. Our main purpose was to examine prospective associations between alcohol consumption and psychological well-being in middle-aged men and women.

Methods

The study sample included 4148 middle-aged individuals (80% men) from the Copenhagen Aging and Midlife Biobank who reported their alcohol consumption (average weekly consumption and frequency of binge drinking) at baseline in 2004 or 2006 and reported their psychological well-being (satisfaction with life and vitality) at follow-up in 2009–2011. Analyses were adjusted for sociodemographic factors, lifestyle, social relations, and morbidity.

Results

For satisfaction with life at follow-up, lower scores were observed in men and women who were alcohol abstinent at baseline as well as in men with heavy alcohol consumption compared with moderate alcohol consumption at baseline. Moreover, men with weekly binge drinking at baseline had lower satisfaction with life scores at follow-up than men with moderate frequency of binge drinking (1–3 times/month). In relation to vitality at follow-up, alcohol abstinence at baseline in men and women and heavy alcohol consumption at baseline in men were associated with lower scores compared with moderate alcohol consumption (yet in men these findings were not robust to adjustment for covariates).

Conclusions

Alcohol abstinence seems to be prospectively associated with adverse psychological well-being (vitality and life satisfaction) in men and women, while heavy alcohol consumption seems to be prospectively associated with adverse satisfaction with life in men. Finally, a prospective association between weekly binge drinking and lower life satisfaction was observed in men.
Food shortages, stockpiling and panic buying ahead of Brexit as reported by the British media: a mixed methods content analysis
Authors: Coleman Paul C. , Dhaif Fatima , Oyebode Oyinlola
Published: January 2022

Background

On 23 June 2016, the United Kingdom voted to leave the European Union. From that date until the UK left the EU in January 2021, there were frequent warnings from industry and government sources of potential disruption to the food supply chain and possible food shortages. Over this period, the media had an important role in communicating on the potential impacts of Brexit. This study examines how food supply and demand, in the context of Brexit, was portrayed by the British media.

Methods

The study consisted of two components: (1) a quantitative analysis measuring frequency of reporting and information sources for articles on food supply and demand in the context of Brexit, in three daily newspapers, between January 2015 and January 2020; and (2) a content analysis exploring key themes and media framing of relevant issues in a subset of articles.

Results

Reports by the media about the impact of Brexit on the UK food system were largely absent in the six months before the UK voted to leave the EU in June 2016, increasing in frequency from mid-2018 onward, peaking in mid-2019 following the appointment of Boris Johnson as prime minister. Five themes were developed from included articles: food shortages/panic buying (appearing in 96% of articles); food chain disruption (86%); economic impacts (80%); preparation and stockpiling by the government/food sector (63%) and preparation and stockpiling by individuals (22%).

Conclusion

Government messaging sought to reassure the public that even under a worst-case scenario there would be no food shortages. These messages, however, contradicted warnings in the media of disruption to the food supply chain and food shortages. The media further reinforced this narrative of potential food shortages by reporting on the experiences of those preparing for Brexit by stockpiling food. The media must consider the impact of their messaging on public behaviour, as even imagined food shortages can instigate stockpiling and panic buying behaviour, as observed during the COVID-19 pandemic.
Surgical stabilization of the ipsilateral scapula and rib fractures using the mirror Judet approach: a preliminary result
Authors: Chuang Chang-Han , Huang Chin-Kai , Li Chia-Ying , Hu Ming-Hsien , Lee Pei-Yuan , Wu Po-Ting
Published: January 2022

Background

We report our preliminary results using a single approach, the mirror Judet approach, for patients with both ipsilateral scapula and multiple rib fractures.

Methods

Five consecutive patients [median age: 56 years (range: 44 ~ 60)] with ipsilateral scapula and multiple rib fractures that met the surgical indications were retrospectively reviewed. A single approach, the mirror Judet approach, was used for surgical stabilization of the scapula and targeted rib fractures. Thoracoscopic surgery was performed first for management of associated lung lesions and marking the targeted rib. All patients received the same rehabilitation protocol and a minimum 12-month follow-up.

Results

All surgically-fixed fractures eventually united without malunion. No complaints of intercostal neuralgia, infection, or other complications were seen. The mean range of motion in the injured shoulder returned to at least 90% of the contralateral side range. The mean Disabilities of the Arm, Shoulder, and Hand score at the 12th month was 2.0 (range: 0-7). All patients were able to return to their previous work.

Conclusion

The mirror Judet approach allows for the surgical stabilization of the ipsilateral scapula and multiple rib fractures using the same approach and provides acceptable functional outcomes in well-selected patients.

Level of evidence

Level IV.
The challenge of measuring spinopelvic parameters: inter-rater reliability before and after minimally invasive lumbar spondylodesis
Authors: Hohenhaus Marc , Volz Florian , Merz Yorn , Watzlawick Ralf , Scholz Christoph , Hubbe Ulrich , Klingler Jan-Helge
Published: January 2022

Background

The common manual measurement technique of spinal sagittal alignment on X-rays is susceptible to rater-dependent variability, which has not been adequately considered in previous publications. This study investigates the effect of those variations in the characterization of patients receiving lumbar spondylodesis.

Methods

General alignment parameters on pre- and postoperative X-rays were evaluated by four raters in 43 prospectively sampled patients undergoing monolevel spondylodesis. The Intra-class Correlation Coefficient (ICC) for each rater pair and all raters together was calculated for inter-rater reliability. For the operation-induced change of the sagittal alignment in every patient the Wilcoxon test was applied to compare for each rater separately.

Results

The ICCs were “good” (>0.75) to “excellent” (>0.9) for all raters together and for 45 of the 48 single rater pairs (93.75%). All revealed a significant increase of the addressed segmental lordosis and disc height and no significant change for spinopelvic parameters and sagittal vertical axis from pre- to postoperative. The lumbar lordosis showed a significant increase through the operation of +2.5° (p = 0.014) and +3.7° (p = 0.015) in two raters and no difference for the other ones (+2.1°, p = 0.171; -2.2°, p = 0.522).

Conclusions

The pre- to postoperative change of lumbar lordosis revealed different significance levels for different raters, although the ICCs were formally good. Accordingly, the evaluation by only one rater would lead to different conclusions. Due to this susceptibility of alignment measurements to rater-dependent variability, the exact evaluation process should be described in every publication and the consistency of significant results be validated through multiple raters.

Trials registration

The trial was approved by the local ethics committee and listed at the national clinical trials register (DRKS00004514, date of registration: 08/11/2012).
Does segmental artery occlusion cause intravertebral cleft following osteoporotic vertebral fracture: a prospective magnetic resonance angiography study
Authors: Zhang Tianyu , Kang Yu , Wang Yanhua , Zhang Peixun , Zhang Dianying , Xue Feng
Published: January 2022

Background

The avascular necrosis (AVN) hypothesis of intravertebral cleft (IVC) formation in osteoporotic vertebral fracture (OVCF) has received increasing attention. The aim of this article is to detect whether the segmental artery occlusion causes the IVC following OVCF.

Methods

Between December 2019 and April 2020, 44 OVCF patients with 46 fracture levels were prospectively enrolled and the vertebral segmental arteries were evaluated by magnetic resonance angiography (MRA). The artery conditions were divided into patent, narrow and occluded. The lesion segmental occlusion rate (LSOR) and the total occlusion rate (TOR) were calculated. The association of segmental artery occlusion and IVC formation was assessed.

Results

LOSR was 15.34% and TOR was 15.12%. The segmental arteries of the unfractured vertebrae had a higher occlusion rate at thoracolumbar levels than at non-thoracolumbar levels. There was no significant difference between the IVC group and the non-IVC group in the fractured levels artery occlusion rate (20.24 ± 28.08 vs 9.78 ± 19.56, P = 0.156) or the total segmental arteries occlusion rate (13.83 ± 12.04 vs 11.57 ± 9.25, P = 0.476).

Conclusions

In patients with vertebral osteoporotic fracture, segmental artery occlusion is not associated with the development of intravertebral cleft.
Does surgical technique influence the burden of lung metastases in patients with pathologic long bone fractures?
Authors: Kendal Joseph K. , Heard Bryan J. , Abbott Annalise G. , Moorman Scott W. , Saini Raghav , Puloski Shannon K. T. , Monument Michael J.
Published: January 2022

Background

The aims of this study are to (1) determine whether fixation of metastatic long bone fractures with an intramedullary nail (IMN) influences the incidence of lung metastasis in comparison to arthroplasty or ORIF (Arthro/ORIF); and (2) assess this relationship in primary tumor types; and (3) to assess survival implications of lung metastasis after surgery.

Methods

Retrospective cohort study investigating 184 patients (107 IMN, and 77 Arthro/ORIF) surgically treated for metastatic long bone fractures. Patients were required to have a single surgically treated impending or established pathologic fracture of a long bone, pre-operative lung imaging (lung radiograph or computed tomography) and post-operative lung imaging within 6 months of surgery. Primary cancer types included were breast (n = 70), lung (n = 43), prostate (n = 34), renal cell (n = 37). Statistical analyses were conducted using two-tailed Fisher’s exact tests, and Kaplan-Meier survival analyses.

Results

Patients treated with IMN and Arthro/ORIF developed new or progressive lung metastases following surgery at an incidence of 34 and 26%, respectively. Surgical method did not significantly influence lung metastasis (p = 0.33). Furthermore, an analysis of primary cancer subgroups did not yield any differences between IMN vs Arthro/ORIF. Median survival for the entire cohort was 11 months and 1-year overall survival was 42.7% (95% CI: 35.4–49.8). Regardless of fixation method, the presence of new or progressive lung metastatic disease at follow up imaging study was found to have a negative impact on patient survival (p < 0.001).

Conclusions

In this study, development or progression of metastatic lung disease was not affected by long bone stabilization strategy. IM manipulation of metastatic long bone fractures therefore may not result in a clinically relevant increase in metastatic lung burden. The results of this study also suggest that lung metastasis within 6 months of surgery for metastatic long bone lesions is negatively associated with patient survival.

Level of evidence

III, therapeutic study
Effect of Cinnamaldehyde on C. albicans cell wall and (1,3)- β – D-glucans in vivo
Authors: Deng Jie-Hua , Zhang Xiao-Guang , Wang Gang-Sheng , Luo Jing-Na , Wang Jia , Qi Xiao-Ming , Li Yan-Ling
Published: January 2022

Background

The incidence rate of invasive candidiasis is high, its treatment is difficult, and the prognosis is poor. In this study, an immunosuppressive mouse model of invasive Candida albicans (C. albicans) infection was constructed to observe the effects of cinnamaldehyde (CA) on the C. albicans cell wall structure and cell wall (1,3)-β-D-glucan contents. This study provides a theoretical basis for CA treatment to target invasive C. albicans infection.

Methods

Immunosuppressed mice with invasive C. albicans infection were given an oral dosage of CA (240 mg.kg− 1.d− 1) for 14 days. Then, mouse lung tissue samples were collected for detection of the levels of (1,3)-β-D-glucan and transmission electron microscopy observations, using fluconazole as a positive control and 2% Tween 80 saline as a negative control.

Results

The immunosuppressive mouse model of invasive C. albicans infection was successfully established. The levels of (1,3)-β-D-glucan in the CA treatment group, fluconazole positive control group, invasive C. albicans infection immunosuppressive mouse model group, and 2% Tween 80 normal saline control group were 86.55 ± 126.73 pg/ml, 1985.13 ± 203.56 pg/ml, 5930.57 ± 398.67 pg/ml and 83.36 ± 26.35 pg/ml, respectively. Statistically, the CA treatment group, fluconazole positive control group and invasive C. albicans infection immunosuppressive mouse model group were compared with each other (P < 0.01) and compared with the 2% Tween 80 saline group (P < 0.01), showing that the differences were very significant. Comparison of the CA treatment group with the fluconazole positive control group (P < 0.05) displayed a difference as well. Electron microscopy showed that CA destroyed the cell wall of C. albicans, where the outer layer of the cell wall fell off and became thinner and the nuclei and organelles dissolved, but the cell membrane remained clear and intact.

Conclusion

CA destroys the cell wall structure of C. albicans by interfering with the synthesis of (1,3)-β-D-glucan to kill C. albicans. However, CA does not affect the cell membrane. This study provides a theoretical basis for CA treatment to target invasive C. albicans infection.
Efficacy prediction of noninvasive ventilation failure based on the stacking ensemble algorithm and autoencoder
Authors: Liang Na , Wang Chengliang , Duan Jun , Xie Xin , Wang Yu
Published: January 2022

Background

Early prediction of noninvasive ventilation failure is of great significance for critically ill ICU patients to escalate or change treatment. Because clinically collected data are highly time-series correlated and have imbalanced classes, it is difficult to accurately predict the efficacy of noninvasive ventilation for severe patients. This paper aims to precisely predict the failure probability of noninvasive ventilation before or in the early stage (1–2 h) of using it on patients and to explain the correlation of the predicted results.

Methods

In this paper, we proposed a SMSN model (stacking and modified SMOTE algorithm of prediction of noninvasive ventilation failure). In the feature generation stage, we used an autoencoder algorithm based on long short-term memory (LSTM) to automatically extract time series features. In the modelling stage, we adopted a modified SMOTE algorithm to address imbalanced classes, and three classifiers (logistic regression, random forests, and Catboost) were combined with the stacking ensemble algorithm to achieve high prediction accuracy.

Results

Data from 2495 patients were used to train the SMSN model. Among them, 80% of 2495 patients (1996 patients) were randomly selected as the training set, and 20% of these patients (499 patients) were chosen as the testing set. The F1 of the proposed SMSN model was 79.4%, and the accuracy was 88.2%. Compared with the traditional logistic regression algorithm, the F1 and accuracy were improved by 4.7% and 1.3%, respectively.

Conclusions

Through SHAP analysis, oxygenation index, pH and H1FIO2 collected after 1 h of noninvasive ventilation were the most relevant features affecting the prediction.
Hand hygiene knowledge, perception, and self-reported performance among nurses in Kelantan, Malaysia: a cross-sectional study
Authors: Abd Rahim Mohamad Hazni , Ibrahim Mohd Ismail
Published: January 2022

Background

Nurses interact with patients 24 hours a day, and this connection has the potential to raise the risk of infection transmission to patients. Nursing plays a vital role in pre-venting healthcare-associated infections (HCAIs) by ensuring that hand hygiene (HH) practises are followed and maintained. The purpose of this study was to evaluate nurses’ knowledge, perceptions, and self-reported HH performance scores, as well as their correlation, in tertiary care hospitals in Kelantan, Malaysia.

Methods

A cross-sectional study was undertaken in all four Kelantan tertiary care hospitals from December 2019 to February 2020. A stratified random selection method was used to obtain a sample of 438 registered nurses. A validated WHO self-administered HH knowledge and perception questionnaire for healthcare personnel was used to measure HH knowledge, perception, and self-reported HH performance.

Results

The mean (SD) score of knowledge was 15.08 (1.96) out of the total 25. The score of perception participants towards HH was 68.02 (10.14) out of the total 81 and the average self-reported HH performance was 87.58 (12.03) out of 100. Pearson’s correlation analysis showed significant positive correlations between perception and knowledge scores; r (436) =0.17,p<0.001 and Perception and self-reported HH performance scores; r (436) =0.27,p<0.001.

Conclusions

There is a strong link between knowledge and perception scores. Lack of understanding of HH during patient care might lead to a negative perception, which can affect overall self-reported HH performance. The need of monitoring and maintaining HH knowledge among nurses was established in this study.
Investigating the effect of sexual behaviour on oropharyngeal cancer risk: a methodological assessment of Mendelian randomization
Authors: Gormley Mark , Dudding Tom , Kachuri Linda , Burrows Kimberley , Chong Amanda H. W. , Martin Richard M. , Thomas Steven J. , Tyrrell Jessica , Ness Andrew R. , Brennan Paul , Munafò Marcus R. , Pring Miranda , Boccia Stefania , Olshan Andrew F. , Diergaarde Brenda , Hung Rayjean J. , Liu Geoffrey , Tajara Eloiza H. , Severino Patricia , Toporcov Tatiana N. , Lacko Martin , Waterboer Tim , Brenner Nicole , Smith George Davey , Vincent Emma E. , Richmond Rebecca C.
Published: January 2022

Background

Human papilloma virus infection is known to influence oropharyngeal cancer (OPC) risk, likely via sexual transmission. However, sexual behaviour has been correlated with other risk factors including smoking and alcohol, meaning independent effects are difficult to establish. We aimed to evaluate the causal effect of sexual behaviour on the risk of OPC using Mendelian randomization (MR).

Methods

Genetic variants robustly associated with age at first sex (AFS) and the number of sexual partners (NSP) were used to perform both univariable and multivariable MR analyses with summary data on 2641 OPC cases and 6585 controls, obtained from the largest available genome-wide association studies (GWAS). Given the potential for genetic pleiotropy, we performed a number of sensitivity analyses: (i) MR methods to account for horizontal pleiotropy, (ii) MR of sexual behaviours on positive (cervical cancer and seropositivity for Chlamydia trachomatis) and negative control outcomes (lung and oral cancer), (iii) Causal Analysis Using Summary Effect estimates (CAUSE), to account for correlated and uncorrelated horizontal pleiotropic effects, (iv) multivariable MR analysis to account for the effects of smoking, alcohol, risk tolerance and educational attainment.

Results

In univariable MR, we found evidence supportive of an effect of both later AFS (IVW OR = 0.4, 95%CI (0.3, 0.7), per standard deviation (SD), p = < 0.001) and increasing NSP (IVW OR = 2.2, 95%CI (1.3, 3.8) per SD, p = < 0.001) on OPC risk. These effects were largely robust to sensitivity analyses accounting for horizontal pleiotropy. However, negative control analysis suggested potential violation of the core MR assumptions and subsequent CAUSE analysis implicated pleiotropy of the genetic instruments used to proxy sexual behaviours. Finally, there was some attenuation of the univariable MR results in the multivariable models (AFS IVW OR = 0.7, 95%CI (0.4, 1.2), p = 0.21; NSP IVW OR = 0.9, 95%CI (0.5 1.7), p = 0.76).

Conclusions

Despite using genetic variants strongly related sexual behaviour traits in large-scale GWAS, we found evidence for correlated pleiotropy. This emphasizes a need for multivariable approaches and the triangulation of evidence when performing MR of complex behavioural traits.