bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypoplastic Left Heart Syndrome Palliation: Technical Aspects and Common Pitfalls of the Hybrid Approach
Authors: Akintürk Hakan , Yörüker Uygar , Schranz Dietmar
Published: September 2022

The Giessen hybrid strategy is used for initial palliation of HLHS and variants when the intent is to pursue further staged palliative reconstruction toward Fontan circulation. It is also used for initial palliation of HLHC and other anomalies with potential for eventual biventricular repair. From June 1998 - October 2021, 197 patients with HLHS and related variants underwent hybrid stage 1. Follow-up is complete (median 8.3 [range 0-23.3] years). Operative mortality for hybrid stage I was 3.6% (7/197); reduced to 2.8% since 2010 (4/141). Interstage mortality was 4.1% (8/197). Operative mortality for comprehensive stage II was 5.8% (10/172), and since 2010 was 1.8% (2/113 patients). Fontan completion has been accomplished in 117 patients, and 33 are still awaiting stage III. Twelve patients underwent heart transplantation. Over 23 years, overall survival is 77.7% and transplant-free survival is 73.6%.
Imaging of Left Ventricular Hypoplasia
Authors: Cohen Meryl S.
Published: September 2022

Left ventricular hypoplasia is a common finding in various forms of congenital heart disease. Echocardiography in the setting of left ventricular hypoplasia must comprehensively assess the size and function of all left-sided structures including the mitral valve, left ventricular outflow tract, aortic valve and aortic arch. Of most importance in any variation of left ventricular hypoplasia is the left ventricular inlet. In neonates, the left ventricular inlet often determines the adequacy of the left ventricle and is the most difficult component to treat surgically.
Pneumococcal Vaccine Recommendations for Old-Age Home Indian Residents: A Literature Review
Authors: Ghia Canna Jagdish , Rambhad Gautam
Published: September 2022

Advancing age is accompanied by decreased immunity, poor health, and physiological changes, which render the elderly population highly susceptible to infectious diseases. We aim to identify the guidelines for pneumococcal vaccines in old-age facilities in India. We performed an extensive review of Indian literature (indexed and non-indexed publications) from 2010 to 2020 using search strings “Pneumococcal vaccine AND Recommendations AND India,” “Pneumococcal vaccine AND Guidelines AND India,” followed by a hand search to identify the most updated versions of recommendations. We reviewed immunization guidelines recommended by nine medical associations and societies in India—Association of Physicians of India (API), Geriatric Society of India (GSI), Indian Society of Nephrology (ISN), Mass Gathering Advisory Board Consensus Recommendation, Indian Medical Association (IMA), Indian Chest Society and National College of Chest Physicians (ICS-NCCP), Research Society for Study of Diabetes in India (RSSDI), Indian Association of Occupational Health Guidelines for Working Adults (IAOH), and API guidelines for immunization during COVID19 pandemic. All bodies recommend pneumococcal vaccines, sequence and preference of which depend on factors such as age, underlying conditions, and immune status. Integration of society recommendations and their implementation into public and private vaccination programs are required to promote adult immunization.
Predictive kappa (κ) models for Turkey: Regional effects and uncertainty analysis
Authors: Altindal Abdullah , Askan Aysegul
Published: September 2022

High-frequency attenuation of ground motions is commonly characterized by the κ parameter. κ and its value at zero distance, [Formula: see text], are critical parameters for site characterization, ground motion simulations, and adjustment of ground motion models for different site conditions. In this study, we derive regional κ models for Eastern, Western, and Northwestern Turkey, using a ground motion data set of 3212 strong ground motion records with 9636 components from 1053 earthquakes, recorded at 178 stations with varying site conditions. Initially, models with linear functional forms are derived with distance and site conditions as predictor variables. Residual analyses showed that these models have non-normal residuals with heterogeneous variances (heteroscedasticity). Box–Cox transformations on κ values are performed to address these two issues. Models using these transformations resulted in normal residuals with homogeneous variances (homoscedasticity). Effects of earthquake magnitude on the κ value are also investigated, and a linear adjustment for magnitudes is proposed. A constant vertical-to-horizontal ratio of 0.78 is proposed to estimate the vertical κ values instead of deriving separate models for the vertical component. This approach does not result in significant decreases in accuracy and is preferred due to its simplicity. Next, the physical implications of logarithmic transformations for the κ values are discussed. Finally, regional differences in κ models are highlighted.
Shear wave velocity and site period measurements for the western portion of the Mexico City Basin following the Mw7.1 2017 Puebla–Morelos, Mexico, earthquake
Authors: Wood Clinton M , Woodfield Landon J , Rahimi Salman , Rosado-Fuentes Alejandro , Sánchez-Sesma Francisco J , Cruz-Jiménez Hugo , Mayoral Juan M , de la Rosa Daniel
Published: September 2022

Dynamic site characterization was performed at 25 sites located on the western portion of the Mexico City Basin that were severely damaged during the Mw7.1 2017 Puebla–Morelos, Mexico, earthquake. Testing was conducted using active and passive seismic surface wave methods and the microtremor horizontal-to-vertical spectral ratio method to determine site periods and develop one-dimensional (1D) shear wave velocity ( Vs) profiles for the first 60 m of the subsoil. The measured site periods were compared to site period maps developed in 2004 and 2020 along with values computed using the Design Seismic Actions System (SASID) software following the 2020 version of the Complementary Technical Norms for Seismic Design (NTC-DS). The most noticeable biases in the predictions from the 2004 site period map were observed between the boundary of Zone II and Zone IIIa, at which site periods are overestimated. These estimates were improved upon in the 2020 site period map and showed a close similarity with SASID computed site period values. The Vs, depth, and thickness of the lacustrine clay layer were also determined to be quite variable within the basin. The softest sites are located between the lakebeds with a Vs between 45 and 57 m/s. Sites located toward the outer rim of the North lakebed have a higher Vs between 80 and 100 m/s. The thickness of the clay layer varies significantly in the western side of the Basin with values ranging between approximately 3 and 34 m. Overall, the results of this study indicate good agreement with the model embedded in the SASID software. The results (1) emphasize the need to regularly monitor changes that occur over time in the lacustrine clay layer, (2) complement the development of models that improve our understanding of wave propagation within the Basin, and (3) update and improve Mexico City’s Norms.
Combined analysis of microstructures within an annual ring of Douglas fir (Pseudotsuga menziesii) by dynamic mechanical analysis and small angle X-ray scattering
Authors: Horiyama Hiroaki , Kojiro Keisuke , Okahisa Yoko , Imai Tomoya , Itoh Takafumi , Furuta Yuzo
Published: September 2022

Dynamic mechanical analysis (DMA) and small angle X-ray scattering (SAXS) measurements of water-saturated wood of Douglas fir (Pseudotsuga menziesii) in the temperature range of 0 ℃ to 100 ℃ were focused to clarify microstructural changes within an annual ring. The following results were obtained. Thermal softening behavior caused by micro-Brownian motion of lignin was observed in both earlywood and latewood. The peaks of tanδ were found at around 95 ℃ for earlywood and at around 90 ℃ for latewood. These results suggested that the structures of lignin in the cell wall were different between earlywood and latewood. SAXS measurements of water-saturated earlywood and latewood in water were performed with precise temperature control. The scattering intensity increased with increasing temperature, indicating that the density of the matrix was reduced at higher temperature. One-dimensional SAXS intensity at the equator, which approximately represents cellulose microfibrils arrangement in the matrix, was intensively analyzed using the WoodSAS model. The result of this model fitting showed that the cellulose microfibril diameter of latewood was higher than that of earlywood. In addition, the value of interfibrillar distance decreased monotonically in the earlywood, while it decreased rapidly in the latewood from 60 ℃ to 90 ℃. The changes in the cellulose microfibril (CMF) diameter and the interfibrillar distance with increasing temperature between earlywood and latewood by SAXS measurement were different. The differences in CMF diameter and inter-fibril distance between earlywood and latewood measured by SAXS also support the hypothesis that lignin structure differs between earlywood and latewood based on the results of DMA measurements.
High Sensing Performance Toward Acetone Vapor Using TiO2 Flower-Like Nanomaterials
Authors: Yang Weiye , Ou Quanhong , Yan Xueqian , Liu Lei , Liu Shaoyu , Chen Huohuo , Liu Yingkai
Published: September 2022

For real-application gas sensors, high performances (response, selectivity, response/recovery time and stability) are demanded. An effective strategy is applying nanomaterials in gas sensors. In this study, the anatase TiO2 flower-like nanomaterials (FLNMs) are prepared through a one-step hydrothermal method which exhibit high-performance toward acetone vapor. TiO2 FLNMs sensors property are characterized at optimal working temperature of 330 °C with selectivity (acetone), response (S = 33.72 toward 250 ppm acetone), linear dependence (R2 = 0.9913), response/recovery time (46/24 s toward 250 ppm acetone) and long-term stability (30 days). These demonstrate that TiO2 FLNMs get a high performance for acetone sensor. Moreover, the limit of detection of acetone is 0.65 ppm which is lower than that of exhaled air for diabetes (0.8 ppm), indicating that TiO2 FLNMs gas sensor gets potential application in medical diagnosis.
CNN-based two-branch multi-scale feature extraction network for retrosynthesis prediction
Authors: Yang Feng , Liu Juan , Zhang Qiang , Yang Zhihui , Zhang Xiaolei
Published: September 2022

Background

Retrosynthesis prediction is the task of deducing reactants from reaction products, which is of great importance for designing the synthesis routes of the target products. The product molecules are generally represented with some descriptors such as simplified molecular input line entry specification (SMILES) or molecular fingerprints in order to build the prediction models. However, most of the existing models utilize only one molecular descriptor and simply consider the molecular descriptors in a whole rather than further mining multi-scale features, which cannot fully and finely utilizes molecules and molecular descriptors features.

Results

We propose a novel model to address the above concerns. Firstly, we build a new convolutional neural network (CNN) based feature extraction network to extract multi-scale features from the molecular descriptors by utilizing several filters with different sizes. Then, we utilize a two-branch feature extraction layer to fusion the multi-scale features of several molecular descriptors to perform the retrosynthesis prediction without expert knowledge. The comparing result with other models on the benchmark USPTO-50k chemical dataset shows that our model surpasses the state-of-the-art model by 7.4%, 10.8%, 11.7% and 12.2% in terms of the top-1, top-3, top-5 and top-10 accuracies. Since there is no related work in the field of bioretrosynthesis prediction due to the fact that compounds in metabolic reactions are much more difficult to be featured than those in chemical reactions, we further test the feasibility of our model in task of bioretrosynthesis prediction by using the well-known MetaNetX metabolic dataset, and achieve top-1, top-3, top-5 and top-10 accuracies of 45.2%, 67.0%, 73.6% and 82.2%, respectively.

Conclusion

The comparison result on USPTO-50k indicates that our proposed model surpasses the existing state-of-the-art model. The evaluation result on MetaNetX dataset indicates that the models used for retrosynthesis prediction can also be used for bioretrosynthesis prediction.
Building resilience in German primary care practices: a qualitative study
Authors: Litke Nicola , Weis Aline , Koetsenruijter Jan , Fehrer Valeska , Koeppen Martina , Kuemmel Stephanie , Szecsenyi Joachim , Wensing Michel
Published: September 2022

Background

In recent years, healthcare has faced many different crises around the world such as HIV-, Ebola- or H1N1-outbrakes, opioid addiction, natural disasters and terrorism attacks). In particular, the current pandemic of Covid-19 has challenged the resilience of health systems. In many healthcare systems, primary care practices play a crucial role in the management of crises as they are often the first point of contact and main health care provider for patients. Therefore, this study explored which situations are perceived as crises by primary care practice teams and potential strategies for crisis management.

Methods

A qualitative observational study was conducted. Data were collected in interviews and focus groups with experts from primary care practices and stakeholders focusing on primary care practices in Germany such as physicians, medical assistants, practice managers, quality managers, hygiene managers and institutions on health system level (politics, research and health insurance). All interviews and focus groups were audio-recorded and transcribed verbatim. A qualitative content analysis was performed using a rapid qualitative analysis approach first, followed by a thematic analysis.

Results

Two focus groups and 26 interviews including 40 participating experts were conducted. Many different situations were perceived as crises, varying from issues in the practice organization to problems on health system level and international disasters. Distinct aspects associated with the perception of a crisis situation by interviewees were the presence of emotional reactions, a need for organizational changes and a lack of necessary resources. A broad spectrum of possible strategies was discussed that could help to cope with or even prevent the emergence of an actual crisis. In particular, strengthening communication within practice teams and resilience among employees was perceived to be fundamental for improving responses to crises or preventing them.

Conclusions

The study provides perspectives of primary health care workers on crises in health, that could inform health policy regarding prevention and management of future crises in primary care facilities.
Frailty and risks of all-cause and cause-specific death in community-dwelling adults: a systematic review and meta-analysis
Authors: Peng Yang , Zhong Guo-Chao , Zhou Xiaoli , Guan Lijuan , Zhou Lihua
Published: September 2022

Background

The associations of frailty with all-cause and cause-specific mortality remain unclear. Therefore, we performed this meta-analysis to fill this gap.

Methods

We searched the PubMed and Embase databases through June 2022. Prospective cohort studies or clinical trials examining frailty were evaluated, and the multiple adjusted risk estimates of all-cause and cause-specific mortality, such as death from cardiovascular disease (CVD), cancer, respiratory illness, dementia, infection, and coronavirus disease 2019 (COVID-19), were included. A random effects model was used to calculate the summary hazard ratio (HR).

Results

Fifty-eight studies were included for the qualitative systematic review, of which fifty-six studies were eligible for the quantitative meta-analysis, and the studies included a total of 1,852,951 individuals and more than 145,276 deaths. Compared with healthy adults, frail adults had a significantly higher risk of mortality from all causes (HR 2.40; 95% CI 2.17–2.65), CVD (HR 2.64; 95% CI 2.20–3.17), respiratory illness (HR 4.91; 95% CI 2.97–8.12), and cancer (HR 1.97; 95% CI 1.50–2.57). Similar results were found for the association between prefrail adults and mortality risk. In addition, based on the studies that have reported the HRs of the mortality risk per 0.1 and per 0.01 increase in the frailty index, we obtained consistent results.

Conclusions

The present study demonstrated that frailty was not only significantly related to an increased risk of all-cause mortality but was also a strong predictor of cause-specific mortality from CVD, cancer, and respiratory illness in community-dwelling adults. More studies are warranted to clarify the relationship between frailty and cause-specific mortality from dementia, infection, and COVID-19.

Trial registration

PROSPERO (CRD42021276021).
Effects of continuity of care on hospitalizations and healthcare costs in older adults with dementia
Authors: Chao Yung-Hsiang , Huang Wen-Yen , Tang Chia-Hong , Pan Yu-An , Chiou Jeng-Yuan , Ku Li-Jung Elizabeth , Wei James Cheng-Chung
Published: September 2022

Introduction

People with dementia have high rates of hospitalization, and a share of these hospitalizations might be avoidable with appropriate ambulatory care, also known as potentially preventable hospitalization (PAH). This study investigates the associations between continuity of care and healthcare outcomes in the following year, including all-cause hospitalization, PAHs, and healthcare costs in patients with dementia.

Methods

This is a longitudinal retrospective cohort study of 69,658 patients with dementia obtained from the Taiwan National Health Insurance Research Database. The Continuity of Care Index (COCI) was calculated to measure the continuity of dementia-related visits across physicians. The PAHs were classified into five types as defined by the Medicare Ambulatory Care Indicators for the Elderly (MACIEs). Logistic regression models were used to examine the effect of COCI on all-cause hospitalizations and PAHs, while generalized linear models were used to analyze the effect of COCI on outpatient, hospitalization, and total healthcare costs.

Results

The high COCI group was significantly associated with a lower likelihood of all-cause hospitalization than the low COCI group (OR = 0.848, 95%CI: 0.821–0.875). The COCI had no significant effect on PAHs but was associated with lower outpatient costs (exp(β) = 0.960, 95%CI: 0.941 ~ 0.979), hospitalization costs (exp(β) = 0.663, 95%CI: 0.614 ~ 0.717), total healthcare costs (exp(β) = 0.962, 95%CI: 0.945–0.980).

Conclusion

Improving continuity of care for dementia-related outpatient visits is recommended to reduce hospitalization and healthcare costs, although there was no statistically significant effect of continuity of care found on PAHs.
Association between oral function and physical pre-frailty in community-dwelling older people: a cross-sectional study
Authors: Tani Asuka , Mizutani Shinsuke , Oku Saori , Yatsugi Harukaze , Chu Tianshu , Liu Xin , Iyota Kiyomi , Kishimoto Hiro , Kashiwazaki Haruhiko
Published: September 2022

Background

Few studies have examined the relationship between oral functions and the physical pre-frailty status, classified using physical function tests. This cross-sectional study aimed to clarify this association among community-dwelling older people from the Itoshima Frail Study in Itoshima Fukuoka Prefecture.

Methods

Of the 1,555 individuals invited to join the study, 381 (188 males and 193 females) enrolled. Their physical pre-frailty was assessed with a classification system consisting of two physical indicators (fatigue and unintentional weight loss, determined with a questionnaire), two functional components (declined walking speed and muscle weakness, determined using a body function measuring instrument), and declined physical activity (examined using a triaxial accelerometer). Subsequently, the individuals were classified into three groups: robust, pre-frailty, and frailty. Along with the number of teeth remaining, oral functions, such as masticatory performance, tongue pressure strength, and oral diadochokinesis (ODK), were examined. Data regarding social activity and exercise habits were collected, and the individuals’ body compositions were measured. Odds ratios (ORs) and 95% confidence intervals (CIs) for the physical pre-frailty were calculated using logistic regression models.

Results

In this study, 126 (33%) participants presented with physical pre-frailty. The participants in the robust group were younger, had stronger maximum handgrip strength, and walked faster than those in the physical pre-frailty group (p < 0.001). The robust group presented with better oral functions (masticatory performance,p = 0.015; oral ODK /ta/,p = 0.004). The physical pre-frailty status was significantly associated with age (OR, 1.111; 95% CI, 1.048–1.178;p < 0.001), masticatory performance (OR, 0.819; 95% CI, 0.680–0.986;p = 0.035), low ODK/ta/ (OR, 1.864; 95% CI, 1.069–3.250;p = 0.028), and low social activity (OR, 2.273; 95% CI, 1.308–3.951;p = 0.004).

Conclusion

This study indicated that older people with higher age, lower anterior tongue movement, lower masticatory performance, and lower social activity are positively associated with physical pre-frailty.
Factors associated with COVID-19 vaccine intentions during the COVID-19 pandemic; a systematic review and meta-analysis of cross-sectional studies
Authors: Terry Emily , Cartledge Sapphire , Damery Sarah , Greenfield Sheila
Published: September 2022

Background

A high COVID-19 vaccine uptake is essential to achieve herd immunity to combat the current strain of COVID-19 and potential future variants. This review aimed to identify factors associated with public intention to receive COVID-19 vaccines until February 2021 to provide accessible data to policymakers to inform framing and targeting of messages designed to optimise vaccine uptake.

Methods

Medline, Embase, CINAHL, PsycINFO, PsycARTICLES, Sociological Abstracts and Applied Social Sciences Index and Abstracts were searched for cross-sectional studies reporting data regarding COVID-19 vaccine intentions, published between 01/01/2020 and 12/02/2021. Title/abstract and full-text screening were performed independently by two authors. The Appraisal Tool for Cross-sectional Studies (AXIS) was used to assess bias and quality. Both random-effects meta-analysis and narrative synthesis were used to describe vaccine intentions and associated factors. A subgroup analysis assessing the impact of sex, sampling method and time of survey on COVID-19 vaccine intention was performed.

Results

Searches identified 4739 studies, and 23 cross-sectional studies were deemed eligible for the review; 22 used online surveys and one used a mixed-methods study design. Eighteen surveys were conducted in the first half of 2020 and five were conducted in the latter half of 2020. Fifteen countries were represented, with the most common being the United States (n = 4) and the United Kingdom (n = 4) sampling 41,403 participants across all surveys. Most studies employed convenience sampling and 11 non-responder rates raised concerns over non-response bias. From the 18 studies included in the meta-analysis, the pooled proportion of survey participants willing to receive the COVID-19 vaccine was 73.3% (n = 18, 95% Confidence Interval 64.2 to 81.5%, I2 = 99.7%). Factors associated with a higher COVID-19 vaccine acceptance included greater perceived risk of COVID-19, lower level of perceived vaccine harm, higher educational attainment and household income, older age, being of White ethnicity and male sex.

Conclusions

There was a high willingness to receive the COVID-19 vaccine which was influenced by sociodemographic factors and risk perceptions. The findings suggest future research should explore reasoning behind vaccine intentions for different sociodemographic groups to allow targeted communication strategies to be formulated by public health agencies.

Registration

PROSPERO Registration Number: CRD42021239134.
Intersectoral collaboration in the management of non-communicable disease’s risk factors in Iran: stakeholders and social network analysis
Authors: Bakhtiari Ahad , Takian Amirhossein , Majdzadeh Reza , Ostovar Afshin , Afkar Mehdi , Rostamigooran Narges
Published: September 2022

Introduction

As the major cause of premature death worldwide, noncommunicable diseases (NCDs) are complex and multidimensional, prevention and control of which need global, national, local, and multisectoral collaboration. Governmental stakeholder analysis and social network analysis (SNA) are among the recognized techniques to understand and improve collaboration. Through stakeholder analysis, social network analysis, and identifying the leverage points, we investigated the intersectoral collaboration (ISC) in preventing and controlling NCDs-related risk factors in Iran.

Methods

This is a mixed-methods study based on semi-structured interviews and reviewing of the legal documents and acts to identify and assess the interest, position, and power of collective decision-making centers on NCDs, followed by the social network analysis of related councils and the risk factors of NCDs. We used Gephi software version 0.9.2 to facilitate SNA. We determined the supreme councils' interest, position, power, and influence on NCDs and related risk factors. The Intervention Level Framework (ILF) and expert opinion were utilized to identify interventions to enhance inter-sectoral collaboration.

Results

We identified 113 national collective decision-making centers. Five councils had the highest evaluation score for the four criteria (Interest, Position, Power, and Influence), including the Supreme Council for Health and Food Security (SCHFS), Supreme Council for Standards (SCS), Supreme Council for Environmental Protection (SCIP), Supreme Council for Health Insurance (SCHI) and Supreme Council of the Centers of Excellence for Medical Sciences. We calculated degree, in degree, out-degree, weighted out-degree, closeness centrality, betweenness centrality, and Eigenvector centrality for all councils. Supreme Council for Standards and SCHFS have the highest betweenness centrality, showing Node's higher importance in information flow. Interventions to facilitate inter-sectoral collaboration were identified and reported based on Intervention Level Framework's five levels (ILF).

Conclusion

A variety of stakeholders influences the risk factors of non-communicable diseases. Through an investigation of stakeholders and their social networks, we determined the primary actors for each risk factor. Through the different (levels and types) of interventions identified in this study, the MoHME can leverage the ability of identified stakeholders to improve risk factors management. The proposed interventions for identified stakeholders could facilitate intersectoral collaboration, which is critical for more effective prevention and control of modifiable risk factors for NCDs in Iran. Supreme councils and their members could serve as key hubs for implementing targeted inter-sectoral approaches to address NCDs' risk factors.
Strategies for understanding the role of cellular heterogeneity in the pathogenesis of lung cancer: a cell model for chronic exposure to cigarette smoke extract
Authors: Xia Dong , Liu Jieyi , Yong Juanjuan , Li Xiang , Ji Weidong , Zhao Zhiqiang , Wang Xiaohui , Xiao Chen , Wu Sai , Liu Huaixiang , Zhao Heping , He Yun
Published: September 2022

Background

Human tumors are highly heterogeneous at the cellular, molecular, genetic and functional levels. Tumor heterogeneity has tremendous impact on cancer progression and treatment responses. However, the mechanisms for tumor heterogeneity have been poorly understood due to the lack of experimental models.

Methods

This study provides a novel exploration and analysis of the impacts of cellular and molecular heterogeneity of human lung epithelial cells on their malignant transformation following chronic exposure to cigarette smoke extracts.

Results

The ability of cigarette smoke extract (CSE) to cause malignant transformation of the human bronchial epithelial cells (16HBE) is dependent on the sizes of the cells. Epithelial-mesenchymal transition (EMT) plays an important role in this process. Mechanistically, CSE-induced malignant transformation of 16HBE cells was closely linked to the reduced relative telomere length of the larger 16HBE cells, thereby up-regulation of the expression of stemness genes.

Conclusions

These findings provide novel insights for understanding the impact of cellular heterogeneity in lung cancer development. The in vitro transformation model described in this study could be extrapolated to studying the pathogenesis of other malignancies, as well as for mechanistic studies that are not feasible in vivo.
A comparative analysis of histologic types of thyroid cancer between career firefighters and other occupational groups in Florida
Authors: Ogunsina Kemi , Koru-Sengul Tulay , Rodriguez Valentina , Caban-Martinez Alberto J. , Schaefer-Solle Natasha , Ahn Soyeon , Kobetz Erin N. , Hernandez Monique N. , Lee David J.
Published: September 2022

Background

Florida Firefighters experience a higher risk of thyroid cancer than non-firefighters. This study examines whether the histologic types and tumor stage of thyroid cancer is different among firefighters compared to other occupational groups.

Methods

Eligible cases were firefighters (n = 120) identified in a linkage of Florida Cancer Data System (FCDS) registry records (1981–2014) and Florida State Fire Marshal’s Office employment and certification records, and non-firefighters classified into: blue-collar (n = 655), service (n = 834), white-collar (n = 4,893), and other (n = 1,789). Differences in thyroid histologic type (papillary, follicular, and rare/other less common forms of thyroid cancer), tumor stage, and age at diagnosis were evaluated using multinomial logistic regression models comparing blue-collar, service, white-collar, and other occupational groups with firefighters. Univariate odds ratios as well as odds ratios adjusted for age, gender, race, tumor stage, and year of diagnosis (aOR) and 95% confidence intervals (95%CI) were reported.

Results

Service (aOR = 4.12; 95%CI: 1.25—13.65), white-collar (aOR = 3.51; 95%CI: 1.08—11.36), and blue-collar (aOR = 4.59; 95%CI: 1.40—15.07) workers had significantly higher odds of being diagnosed with rare histologic types of thyroid cancer vs papillary type compared to firefighters. Service (aOR = 0.42; 95%CI: 0.27—0.66), white-collar (aOR = 0.39; 95%CI: 0.26—0.59), blue-collar (aOR = 0.36; 95%CI: 0.23—0.56), and other (aOR = 0.34; 95%CI: 0.22—0.53) occupational groups have a significantly lower odds of being diagnosed with rare vs papillary type at a younger age (30—49 years) vs 50—69 years compared to firefighters. However, stage at diagnosis was not significantly different among occupational groups.

Conclusion

Firefighters diagnosed with thyroid cancer experience a higher odds of papillary compared to rare histologic types of thyroid cancer relative to other workers; there is no evidence of an increased odds of late-stage diagnosis in firefighters relative to other worker groups. Firefighters may benefit from routine screening and active surveillance of suspected thyroid tumors especially given the excellent treatment outcomes available for those diagnosed with early-stage papillary thyroid tumors.
Association between smoking habits and dental care utilization and cost using administrative claims database and specific medical check-up data
Authors: Kawamura Kahori , Doi Takashi , Kano Keita , Matsui Masanori , Hattori Yuka , Onishi Fukutaro , Fukata Hirotsuka , Miyake Tatsuro
Published: September 2022

Background

This study aims to evaluate the association between smoking habits and dental care utilization and cost in individuals registered with the Japan Health Insurance Association, Osaka branch.

Methods

We used the administrative claims database and specific medical check-up data and included 226,359 participants, who visited dental institutions, underwent dental examinations, and underwent specific medical checkups, with smoking data from April 2016 to March 2017. We calculated propensity scores with age, gender, exercise, eating habits, alcohol intake, and sleep. We also compared dental care utilization with the total cost of each procedure.

Results

According to propensity score matching, 62,692 participants were selected for each group. Compared to non-smokers, smokers were younger, and a higher proportion were men. Smokers tended to skip breakfast, have dinner just before bed, and drink alcohol. After adjusting for potential confounding factors with propensity score matching, the mean annual dental cost among smokers was significantly higher than non-smokers. The prevalence of pulpitis, missing teeth, and apical periodontitis were higher among smokers than non-smokers, while inlay detachment, caries, and dentine hypersensitivity were higher among non-smokers.

Conclusion

This study suggests that smokers have higher dental cost consisted of progressive dental caries, missing teeth, and uncontrolled acute inflammation that necessitated the use of medications. It is suggested that smokers tend to visit the dentist after their symptoms become severe.
Translation and validation of the Hungarian Version of the infection control standardized questionnaire: a cross-sectional study
Authors: Hammoud Sahar , Amer Faten , Khatatbeh Haitham , Alfatafta Huda , Zrínyi Miklós , Kocsis Béla
Published: September 2022

Background

To our knowledge, there is currently no psychometrically validated Hungarian scale to evaluate nurses’ knowledge about infection prevention and control (IPC) practices. Thus, we aim in this study to assess the validity and reliability of the infection control standardized questionnaire Hungarian version (ICSQ-H).

Methods

A cross-sectional, multisite study was conducted among 591 nurses in Hungary. The original ICSQ included 25 questions. First, the questionnaire was translated into Hungarian. Then, content validity was assessed by a committee of four specialists. This was done by calculating the item content validity index and scale content validity index. Afterward, structural validity was evaluated in a two-step process using principal component analysis and confirmatory factor analysis. The goodness of fit for the model was measured through fit indices. Convergent validity was assessed by calculating the average variance extracted. Additionally, discriminant validity was evaluated by computing the Spearman correlation coefficient between the factors. Finally, the interitem correlations, the corrected item-total correlations, and the internal consistency were calculated.

Results

The content validity of the questionnaire was established with 23 items. The final four-factor ICSQ-H including 10 items showed a good fit model. Convergent validity was met except for the alcohol-based hand rub (ABHR) factor, while discriminant validity was met for all factors. The interitem correlations and the corrected item-total correlations were met for all factors, but the internal consistency of ABHR was unsatisfactory due to the low number of items.

Conclusions

The results did not support the original three-factor structure of the ICSQ. However, the four-factor ICSQ-H demonstrated an adequate degree of good fit and was found to be reliable. Based on our findings, we believe that the ICSQ-H could pave the way for more research regarding nurses’ IPC knowledge to be conducted in Hungary. Nevertheless, its validation among other healthcare workers is important to tailor effective interventions to enhance knowledge and awareness.
linc00958/miR-185-5p/RSF-1 modulates cisplatin resistance and angiogenesis through AKT1/GSK3β/VEGFA pathway in cervical cancer
Authors: Tian Jing , Cheng Lei , Kong Enqi , Gu Wenjin , Jiang Yuanyuan , Hao Quan , Kong Beihua , Sun Li
Published: September 2022

Background

Chemoresistance is one of the major obstacles that lead to poor prognosis in cervical cancer. linc00958 was reported to be an oncogene in cervical cancer. However, its role in mediating chemoresistance remains to be revealed.

Purpose

To explore the regulatory mechanisms of linc00958 in cisplatin-resistant cervical cancer cells and further validate in xenograft mice.

Methods

Online bioinformatic tools were used to conduct the pre-investigation of linc00958/miR-185-5p/RSF-1 and predict the associations between RSF-1 and AKT1/GSK3β/VEGFA in cervical cancer. RT-qPCR measured the RNA expression levels of linc00958/miR-185-5p/RSF-1 in SiHa and SiHa/DDP. Cell survival rates were evaluated by CCK8 methods after cells were exposed to differential concentrations of DDP. Dual-luciferase reporter methods were used to measure luciferase activity. Western blot measured RSF-1 protein and phosphorylated changes of AKT1/GSK3β. Immunofluorescence was employed to observe VEGFA secretion in vitro. Tube formation was applied to evaluate the in-vitro changes of angiogenesis. The SiHa/DDP cells stably transfected with pLKO-sh-NC or pLKO-sh-linc00958 plasmids, were injected into mice, establishing xenograft models. The changes in mice weight and tumor volumes were recorded. H&E staining and Immunohistochemistry (IHC) method was further performed.

Results

linc00958 expression was higher in SiHa/DDP cells. High linc00958 expression was associated with low overall survival. In SiHa/DDP cells linc00958/miR-185-5p/RSF-1 axis inhibited the cellular resistance to cisplatin and suppressed VEGFA and the tube formation through AKT1/GSK3β/VEGFA pathway. The knockdown of linc00958 inhibited RSF-1 and Ki67, curbing tumor growth; it also inhibited VEGFA and CD34, decreasing angiogenesis in mice.

Conclusion

linc00958/miR-185-5p/RSF-1 modulates cisplatin resistance and angiogenesis through AKT1/GSK3β/VEGFA pathway in cervical cancer.
The immune system as a driver of mitochondrial disease pathogenesis: a review of evidence
Authors: Hanaford Allison , Johnson Simon C.
Published: September 2022

Background

Genetic mitochondrial diseases represent a significant challenge to human health. These diseases are extraordinarily heterogeneous in clinical presentation and genetic origin, and often involve multi-system disease with severe progressive symptoms. Mitochondrial diseases represent the most common cause of inherited metabolic disorders and one of the most common causes of inherited neurologic diseases, yet no proven therapeutic strategies yet exist. The basic cell and molecular mechanisms underlying the pathogenesis of mitochondrial diseases have not been resolved, hampering efforts to develop therapeutic agents.

Main body

In recent pre-clinical work, we have shown that pharmacologic agents targeting the immune system can prevent disease in theNdufs4(KO) model of Leigh syndrome, indicating that the immune system plays a causal role in the pathogenesis of at least this form of mitochondrial disease. Intriguingly, a number of case reports have indicated that immune-targeting therapeutics may be beneficial in the setting of genetic mitochondrial disease. Here, we summarize clinical and pre-clinical evidence suggesting a key role for the immune system in mediating the pathogenesis of at least some forms of genetic mitochondrial disease.

Conclusions

Significant clinical and pre-clinical evidence indicates a key role for the immune system as a significant in the pathogenesis of at least some forms of genetic mitochondrial disease.
Effectiveness of rib fixation compared to pain medication alone on pain control in patients with uncomplicated rib fractures: study protocol of a pragmatic multicenter randomized controlled trial—the PAROS study (Pain After Rib OSteosynthesis)
Authors: Perentes Jean Yaniss , Christodoulou Michel , Abdelnour-Berchtold Etienne , Karenovics Wolfram , Gayet-Ageron Angèle , Gonzalez Michel , Krueger Thorsten , Triponez Frédéric , Terrier Philippe , Bédat Benoît
Published: September 2022

Background

Persistent pain and disability following rib fractures result in a large psycho-socio-economic impact for health-care system. Benefits of rib osteosynthesis are well documented in patients with flail chest that necessitates invasive ventilation. In patients with uncomplicated and simple rib fractures, indication for rib osteosynthesis is not clear. The aim of this trial is to compare pain at 2 months after rib osteosynthesis versus medical therapy.

Methods

This trial is a pragmatic multicenter, randomized, superiority, controlled, two-arm, not-blinded, trial that compares pain evolution between rib fixation and standard pain medication versus standard pain medication alone in patients with uncomplicated rib fractures. The study takes place in three hospitals of Thoracic Surgery of Western Switzerland. Primary outcome is pain measured by the brief pain inventory (BPI) questionnaire at 2 months post-surgery. The study includes follow-up assessments at 1, 2, 3, 6, and 12 months after discharge. To be able to detect at least 2 point-difference on the BPI between both groups (standard deviation 2) with 90% power and two-sided 5% type I error, 46 patients per group are required. Adjusting for 10% drop-outs leads to 51 patients per group.

Discussion

Uncomplicated rib fractures have a significant medico-economic impact. Surgical treatment with rib fixation could result in better clinical recovery of patients with uncomplicated rib fractures. These improved outcomes could include less acute and chronic pain, improved pulmonary function and quality of life, and shorter return to work. Finally, surgical treatment could then result in less financial costs.

Trial registration

ClinicalTrials.govNCT04745520. Registered on 8 February 2021.
Enhancing COVID Rehabilitation with Technology (ECORT): protocol for an open-label, single-site randomized controlled trial evaluating the effectiveness of electronic case management for individuals with persistent COVID-19 symptoms
Authors: Hatcher Simon , Werier Joel , Edgar Nicole E. , Booth James , Cameron D. William J. , Corrales-Medina Vicente , Corsi Daniel , Cowan Juthaporn , Giguère Pierre , Kaluzienski Mark , Marshall Shawn , Mestre Tiago , Mulligan Bryce , Orpana Heather , Pontefract Amanda , Stafford Darlene , Thavorn Kednapa , Trudel Guy
Published: September 2022

Background

As of May 2022, Ontario has seen more than 1.3 million cases of COVID-19. While the majority of individuals will recover from infection within 4 weeks, a significant subset experience persistent and often debilitating symptoms, known as “post-COVID syndrome” or “Long COVID.” Those with Long COVID experience a wide array of symptoms, with variable severity, including fatigue, cognitive impairment, and shortness of breath. Further, the prevalence and duration of Long COVID is not clear, nor is there evidence on the best course of rehabilitation for individuals to return to their desired level of function. Previous work with chronic conditions has suggested that the addition of electronic case management (ECM) may help to improve outcomes. These platforms provide enhanced connection with care providers, detailed symptom tracking and goal setting, and access to relevant resources. In this study, our primary aim is to determine if the addition of ECM with health coaching improves Long COVID outcomes at 3 months compared to health coaching alone.

Methods

The trial is an open-label, single-site, randomized controlled trial of ECM with health coaching (ECM+) compared to health coaching alone (HC). Both groups will continue to receive usual care. Participants will be randomized equally to receive health coaching (± ECM) for a period of 8 weeks and a 12-week follow-up. Our primary outcome is the WHO Disability Assessment Scale (WHODAS), 36-item self-report total score. Participants will also complete measures of cognition, fatigue, breathlessness, and mental health. Participants and care providers will be asked to complete a brief qualitative interview at the end of the study to evaluate acceptability and implementation of the intervention.

Discussion

There is currently little evidence about the optimal treatment of Long COVID patients or the use of digital health platforms in this population. The results of this trial could result in rapid, scalable, and personalized care for people with Long COVID which will decrease morbidity after an acute infection. Results from this study will also inform decision making in Long COVID and treatment guidelines at provincial and national levels.

Trial registration

ClinicalTrials.gov NCT05019963. Registered on 25 August 2021.
Effects of physical training on physical and functional fitness, physical activity level, endothelial function, hemodynamic variables, bone metabolism, and quality of life of post-bariatric patients: study protocol for a randomized controlled trial
Authors: Lopes Karynne Grutter , das Graças Coelho de Souza Maria , da Costa Tavares Bezerra Michelle , Bessa Lucas Miranda , Farinatti Paulo , Bouskela Eliete , Madeira Miguel , Kraemer-Aguiar Luiz Guilherme
Published: September 2022

Background

Evidence of the benefits induced from resistance exercise on health markers of post-bariatric patients is limited. The study will investigate the effects of a resistance training (RT) program on muscle mass and strength, bone metabolism biomarkers, bone mineral density (BMD), bone microarchitecture, and endothelial function of patients subjected to Roux-en-Y gastric bypass.

Methods/design

This randomized controlled trial will include 60 post-bariatric patients, physically inactive, aging 18 to 50 years, with a post-surgery period ≥ 12 months. They will be randomly assigned into two groups: (i) the non-exercised control group, which will receive the standard clinical follow-up, or (ii) the intervention group which will consist of RT (60 min/session; 3 times/week, for 6 months). The primary outcomes will include muscle mass and strength, bone metabolism biomarkers, BMD, and bone microarchitecture. The secondary outcomes will be anthropometry, hemodynamic measurements, cardiovascular risk factors, health-related quality of life (QoL), and endothelial function. Outcomes will be assessed by blood biomarkers of bone formation and reabsorption, dual X-ray absorptiometry, repetition maximum and handgrip strength tests, high-resolution peripheral quantitative computed tomography, 36-Item Short-Form Health Survey, venous occlusion plethysmography, and nailfold videocapillaroscopy.

Discussion

It is expected that there are greater benefits from the RT program, possibly improving muscle mass and strength, bone metabolism, density and microarchitecture, QoL, and cardiovascular risk.

Trial registration

ClinicalTrials.gov NCT04193397. Registered on 7 December 2019.