bluuebunny/crossref_metadata_2025 huggingface dataset:
Zero knowledge and high interest in the use of long-acting injectable pre-exposure prophylaxis (PrEP) among adolescent men who have sex with men and transgender women in two capital cities in Brazil
Authors: Pedrana Leo , Magno Laio , Zucchi Eliana Miura , da Silva Luís Augusto Vasconcelos , Ferraz Dulce , Grangeiro Alexandre , Castellanos Marcelo , Brasil Sandra Assis , Dourado Inês
Published: September 2022

Background

Adolescent men who have sex with men (aMSM) and transgender women (aTGW) are affected disproportionately by human immunodeficiency virus (HIV) infection. Although new methods of pre-exposure prophylaxis (PrEP), such as long-acting injectable (LAI-PrEP), have been approved by the Food and Drug Administration, their acceptability among aMSM/aTGW is not well known.

Methods

Forty-eight semi-structured interviews were conducted to assess the knowledge and interest in LAI-PrEP among aMSM/aTGW enrolled in a daily oral PrEP cohort from two capital cities of Brazil since 2019.

Results

Previous knowledge of LAI-PrEP remains scarce, but the high interest regarding its use has been reported. Interest in the use of LAI-PrEP is associated with eliminating the burden of daily responsibility or the risk of missing the necessary medications, lowering the costs of this method, increasing confidentiality, and decreasing the frequency of visiting PrEP clinics. The reported barriers to uptake included fear of injection, doubts on its effectiveness, side effects, and greater dependence on a health provider.

Conclusions

There is an urgent need to strengthen the preventive strategies against HIV infection among the youth, enhance their knowledge and those of healthcare providers, and offer safe and new options.
Treatment of inferior pole fracture of the patella with tension-free external immobilization
Authors: Pu Shaoquan , Chen Yanling , Liang Jinlong , Xu Yongqing , Zhao Yonghui
Published: September 2022

Background

Inferior pole fracture of the patella (IPFP) has small and comminuted fracture blocks that are hard to immobilize, and early mobilization may lead to loss of fracture reduction and immobilization failure. Therefore, a difficulty of treatment is to achieve rigid immobilization with early functional exercise. Here, a new treatment method of tension-free external immobilization is put forward.

Methods

The clinical data of 11 IPFP patients treated with tension-free external immobilization from May 2016 to June 2019 were retrospectively analyzed. There were six males and five females aged 39.0 ± 12.8 years (range 18–53 years). IPFP was caused by traffic accidents in five cases and falls in six cases. All cases had unilateral closed injuries, including four in the left knee and seven in the right knee. The preoperative range of motion of the knee was 22.0 ± 7.5° (10–30°). The time from injury to operation was 4.5 ± 1.3 d (3–7 d). The operation-related indices were recorded, and the function of the affected knee was assessed by the Böstman score.

Results

All operations were successful. The operation time was 56.4 ± 8.4 mi (45–70 min), the intraoperative blood loss was 54.1 ± 14.6 mL (40–80 mL), and the length of hospital stay was 7.5 ± 1.9 d (5–11 d). The mean follow-up time was 20.4 ± 7.6 months (12–36 months), the duration of fracture healing was 8.9 ± 1.5 weeks (7–12 weeks), and the removal time of the external immobilization device was 10.4 ± 0.9 weeks (9–12 weeks). At the last follow-up, the range of motion had no significant difference between the affected knee (129.7 ± 3.3°, range 125–135°) and the unaffected knee (130.8 ± 3.8°, range 126–137°) (t = 0.718, p < 0.05). The Böstman score of the knee was 29.2 ± 1.0 points (27–30 points), including 10 excellent cases (90.9%) and one good case (9.1%).

Conclusion

Tension-free external immobilization is a feasible treatment for IPFP. It can help with early functional exercise and achieve a satisfactory clinical effect.
Influence of diabetes on response to ultrasound guided hydrodistension treatment of adhesive capsulitis: a retrospective study
Authors: Dimitri-Pinheiro Sofia , Pinto Beatriz Serpa , Pimenta Madalena , Neves João Sérgio , Carvalho Davide
Published: September 2022

Background

Diabetes is associated with microvascular and macrovascular complications. Although it is less recognized, diabetes also has an important role in the development of musculoskeletal disorders. Our objective was to evaluate the effect of type 2 diabetes (T2D) on the severity of adhesive capsulitis of the shoulder (AC) and on the efficacy of ultrasound guided hydrodistension treatment.

Methods

We conducted a retrospective longitudinal observational study, of patients with AC who underwent ultrasound guided hydrodistension at our Centre. Severity was measured with DASH (Disabilities of Arm, Shoulder and Hand) score and pain was evaluated with a score between 0 and 10. The association of T2D with baseline characteristics of AC, and with outcomes at 6–12 months was analyzed using linear and logistic regression models.

Results

We evaluated 120 ultrasound guided hydrodistension treatments of AC, 85 in patients without diabetes and 35 in patients with T2D. Patients with diabetes had a higher prevalence of dyslipidemia, hypertension and higher HbA1c values. The average duration of diabetes was 4.8 years (2.0, 7.9). The baseline characteristics of AC were not significantly different between patients with and without diabetes. Patients with T2D relapsed more frequently and required more reinterventions than patients without diabetes (20.0% vs 4.7%, p = 0.008), had higher post-intervention pain scale values [4.0 (0.0–5.0) vs 0.0 (0.0–5.0), p = 0.022] and higher post-intervention DASH score [0.8 (0.0–1.8) vs 0.0 (0.0–0.8), p = 0.038].

Conclusion

Although baseline characteristics of AC in patients with diabetes were similar to those without diabetes, patients with diabetes had a worse response to treatment, more frequent relapses and a greater need for new interventions.
Comparison of deep transfer learning algorithms and transferability measures for wearable sleep staging
Authors: Waters Samuel H. , Clifford Gari D.
Published: September 2022

Background

Obtaining medical data using wearable sensors is a potential replacement for in-hospital monitoring, but the lack of data for such sensors poses a challenge for development. One solution is using in-hospital recordings to boost performance via transfer learning. While there are many possible transfer learning algorithms, few have been tested in the domain of EEG-based sleep staging. Furthermore, there are few ways for determining which transfer learning method will work best besides exhaustive testing. Measures of transferability do exist, but are typically used for selection of pre-trained models rather than algorithms and few have been tested on medical signals. We tested several supervised transfer learning algorithms on a sleep staging task using a single channel of EEG (AF7-Fpz) captured from an in-home commercial system.

Results

Two neural networks—one bespoke and another state-of-art open-source architecture—were pre-trained on one of six source datasets comprising 11,561 subjects undergoing clinical polysomnograms (PSGs), then re-trained on a target dataset of 75 full-night recordings from 24 subjects. Several transferability measures were then tested to determine which is most effective for assessing performance on unseen target data. Performance on the target dataset was improved using transfer learning, with re-training the head layers being the most effective in the majority of cases (up to 63.9% of cases). Transferability measures generally provided significant correlations with accuracy (up to $$r = -0.53$$

r
=
-
0.53

).

Conclusion

Re-training the head layers provided the largest performance boost. Transferability measures are useful indicators of transfer learning effectiveness.
Shaping health: conducting a community health needs assessment in culturally diverse peripheral population groups
Authors: Rayan-Gharra Nosaiba , Ofir-Gutler Marganit , Spitzer Sivan
Published: September 2022

Introduction

The impact of social determinants on health status and outcomes has been widely established. However, it is recognized that health systems' ability to address community health needs may be limited. To better understand the interrelation between social determinants of health and health outcomes, health systems need to understand the health concerns and needs of populations. The aim of this study was to map the perceived health needs of Israel's northern periphery’s diverse ethnic and religious communities and regional clusters by conducting a community health needs assessment (CHNA).

Methods

The study employed a mixed-methods approach. We conducted a CHNA in the Galilee between November 2019 to January 2020 (n = 750). Additionally, we conducted focus groups using design thinking methodology to better understand the underlying causes of existing gaps between community and healthcare representatives (n = 42). Quantitative data was analyzed using multiple logistic regressions and qualitative data was analyzed using a content and thematic analysis.

Results

Galilee residents perceived sense of community (78%) as the major strength while cancer (53%) was perceived as the major health problem followed by heart disease and stroke (28.4%). The adjusted odds ratios for the association of each predictor with each perceived social and structural determinants of health among respondents indicated that Arab respondents were more likely to report race/ethnicity discrimination, domestic violence, lack of parks and recreation, neighborhood violence, limited places to exercise, school dropout and limited access to healthy food, as determinants affecting health than Jews. Conversely, Jews were more likely than Arabs to report access to mental health services, access to transportation, lack of job opportunities and access to a doctor's office as determinants affecting their health. Qualitative analysis revealed residents felt a 'lack of health security' as a result of problematic access to specialty and mental health services, especially for elderly populations.

Conclusions

CHNA can inform the design of tailored interventions that will improve health for Galilee residents addressing their socioeconomic-cultural–geographical characteristics. The study's findings raise the need to create such tailored approaches to address the lack of health security felt by residents and improve not only health services provision but the social determinants affecting their health.
Comparing swab- and different symptoms-based strategies to ascertain COVID-19 recovery in healthcare workers: a cost-effectiveness analysis
Authors: Benoni Roberto , Campagna Irene , Moretti Francesca , Tardivo Stefano
Published: September 2022

Objective

Given the human and economic cost of the COVID-19 pandemic, protecting healthcare workers (HCW) and ensuring continuity of care is critical. The aim of this study is to evaluate the cost-effectiveness of different strategies to ascertain COVID-19 recovery in HCWs.

Methods

Data were collected from the hospital health surveillance program on HCWs at the University Hospital of Verona between 29/02/2020 and 14/04/2021. The diagnosis of SARS-CoV-2 infection and the assessment of the recovery were made through RT-PCR on oro-nasopharyngeal swab-sample. Recovery time and probability were estimated through Kaplan–Meier estimate. For each recovery assessment strategy costs (laboratory diagnostics and human resources), expressed in local currency (euro—€), and working days saved (WDS—effectiveness) were estimated. A decision-tree was created where each knot was a time point scheduled by the different recovery assessment strategies. A Monte Carlo simulation method was used, and probabilistic sensitivity analysis assessed the effect of input uncertainty.

Results

In the study period 916 (9.9%) HCWs tested positive. Recovery time through symptom-based strategy (21 days 0.95 CI 16–24) was significantly lower compared to swab-based one (25 days 0.95 CI 23–28, p < 0.001). The swab-based strategy was dominated by all symptoms-based ones. Symptoms-based with a swab on days 14 and 17 had an ICER of 2 €/WDS and 27 €/WDS compared to the one scheduled on days 10 and 17 and with only one swab on the 17th day.

Conclusions

Scheduling swabs on days 14 and 17 in a symptom-based strategy was the most cost-effective, saving 7.5 more working days than the standard one with swabs on days 10 and 17.
What is the global prevalence of depression among men who have sex with men? A systematic review and meta-analysis
Authors: Nouri Elham , Moradi Yousef , Moradi Ghobad
Published: September 2022

Background

Depression due to stigma resulting from their sexual identity, isolation, social exclusion, and insufficient access to care and counseling services has become a health problem among men who have sex with men (MSM).

Objectives

This study aimed to determine the global prevalence of depression among MSM as a systematic review and meta-analysis.

Methods

This study was a systematic review and meta-analysis performed in five steps of search strategy, screening and selecting articles, data extraction, evaluation of the risk of bias, and meta-analysis. In this study, the determined keywords were searched in the databases of PubMed, Scopus, Embase, and Web of Science from January 1913 to July 2021 to find the initial articles, from which data were extracted according to the set checklist in the data extraction stage. Finally, the studies were included in the present meta-analysis according to the inclusion and exclusion criteria, to be evaluated using the Newcastle Ottawa scale checklist. I Square and Q Cochrane were also used to assess the degree of heterogeneity. The analyses were performed using the random-effects model in STATA 16.

Results

The results showed the quality score of the majority of cross-sectional studies included in the meta-analysis (62 studies) was equal to six or seven (moderate), and five ones had a high-quality score. After combining these studies, the pooled prevalence of depression among MSM in the world was 35% (95% CI 31%–39%, I square; 98.95%, P-value < 0.001). Population subgroup analysis showed the pooled prevalence of depression among MSM living with HIV was 47% (95% CI 39%-55%, I square; 95.76%, P-value < 0.001). Continent subgroup analysis showed the highest pooled prevalence of depression among Asian MSM at 37% (95% CI 31%-43%, I square; 99.07%, P-value < 0.001). Also, in the subgroup analysis of the sampling method, the pooled prevalence in the studies which used the respondent-driven sampling method was equal to 34% (95% CI 25%-43%, I square; 99.32%, P-value < 0.001). Sensitivity analysis revealed the pooled prevalence of depression in studies included in the meta-analysis was near or around the pooled estimate.

Conclusion

The pooled prevalence of depression among MSM was almost three times higher than the general male population. Therefore, particular and therapeutic interventions such as screening, and harm reduction programs for mental disorders, especially depression, are suggested to be considered in service packages.
MiRNA expression deregulation correlates with the Oncotype DX® DCIS score
Authors: Loudig Olivier , Mitchell Megan I. , Ben-Dov Iddo Z. , Liu Christina , Fineberg Susan
Published: September 2022

Background

Current clinical criteria do not discriminate well between women who will or those who will not develop ipsilateral invasive breast cancer (IBC), or a DCIS recurrence after a ductal carcinoma in situ (DCIS) diagnosis. The 12-gene Oncotype DX® DCIS assay (RT qPCR gene-based scoring system) was established and shown to predict the risk of subsequent ipsilateral IBC or DCIS recurrence. Recent studies have shown that microRNA (miRNA) expression deregulation can contribute to the development of IBC, but very few have evaluated miRNA deregulation in DCIS lesions. In this study, we sought to determine whether specific miRNA expression changes may correlate with Oncotype DX® DCIS scores.

Methods

For this study, we used archived formalin-fixed, paraffin-embedded (FFPE) specimens from 41 women diagnosed with DCIS between 2012 and 2018. The DCIS lesions were stratified into low (n = 26), intermediate (n = 10), and high (n = 5) risk score groups using the Oncotype DX® DCIS assay. Total RNA was extracted from DCIS lesions by macro-dissection of unstained FFPE sections, and next-generation small-RNA sequencing was performed. We evaluated the correlation between miRNA expression data and Oncotype score, as well as patient age. RT-qPCR validations were performed to validate the topmost differentially expressed miRNAs identified between the different risk score groups.

Results

MiRNA sequencing of 32 FFPE DCIS specimens from the three different risk group scores identified a correlation between expression deregulation of 17 miRNAs and Oncotype scores. Our analyses also revealed a correlation between the expression deregulation of 9 miRNAs and the patient’s age. Based on these results, a total of 15 miRNAs were selected for RT-qPCR validation. Of these, miR-190b (p = 0.043), miR-135a (p = 0.05), miR-205 (p = 0.00056), miR-30c (p = 0.011), and miR-744 (p = 0.038) showed a decreased expression in the intermediate/high Oncotype group when compared to the low-risk score group. A composite risk score was established using these 5 miRNAs and indicated a significant association between miRNA expression deregulation and the Oncotype DX® DCIS Score (p < 0.0021), between high/intermediate and low risk groups.

Conclusions

Our analyses identified a subset of 5 miRNAs able to discriminate between Oncotype DX® DCIS score subgroups. Together, our data suggest that miRNA expression analysis may add value to the predictive and prognostic evaluation of DCIS lesions.
Prenatal exposure to tobacco and adverse birth outcomes: effect modification by folate intake during pregnancy
Authors: Hoyt Adrienne T. , Wilkinson Anna V. , Langlois Peter H. , Galeener Carol E. , Ranjit Nalini , Sauder Katherine A. , Dabelea Dana M. , Moore Brianna F.
Published: September 2022

Background

Fetal exposure to tobacco increases the risk for many adverse birth outcomes, but whether diet mitigates these risks has yet to be explored. Here, we examined whether maternal folate intake (from foods and supplements) during pregnancy modified the association between prenatal exposure to tobacco and with preterm delivery, small-for-gestational age (SGA) births, or neonatal adiposity.

Methods

Mother–child pairs (n = 701) fromHealthy Startwere included in this analysis. Urinary cotinine was measured at ~ 27 weeks gestation. Diet was assessed using repeated 24-h dietary recalls. Neonatal adiposity (fat mass percentage) was measured via air displacement plethysmography. Interaction was assessed by including a product term between cotinine (< / ≥ limit of detection [LOD]) and folate (< / ≥ 25thpercentile [1077 µg/day]) in separate logistic or linear regression models, adjusting for maternal age, race, ethnicity, education, pre-pregnancy body mass index, and infant sex.

Results

Approximately 26% of women had detectable levels of cotinine. Folate intake was significantly lower among women with cotinine ≥ LOD as compared to those with cotinine < LOD (1293 µg/day vs. 1418 µg/day;p = 0.01). Folate modified the association between fetal exposure to tobacco with neonatal adiposity (p for interaction = 0.07) and SGA (p for interaction = 0.07). Among those with lower folate intake, fetal exposure to tobacco was associated with lower neonatal adiposity (mean difference: -2.09%; 95% CI: -3.44, -0.74) and increased SGA risk (OR: 4.99; 95% CI: 1.55, 16.14). Conversely, among those with higher folate intake, there was no difference in neonatal adiposity (mean difference: -0.17%; 95% CI: -1.13, 0.79) or SGA risk (OR: 1.15; 95% CI: 0.57, 2.31).

Conclusions

Increased folate intake during pregnancy (from foods and/or supplements) may mitigate the risk of fetal growth restriction among those who are unable to quit smoking or cannot avoid secondhand smoke during pregnancy.
Nitrogen deposition experiment mimicked with NH4NO3 overestimates the effect on soil microbial community composition and functional potential in the Eurasian steppe
Authors: Li Tingting , Zhang Zijia , Ma Yiping , Song Yuqian , Yang Guojiao , Han Xingguo , Zhang Ximei
Published: September 2022

Background

The nitrogenous compound deposited from the atmosphere to the soil is complex, but most field experiments mimic nitrogen deposition with the acid NH4NO3alone. Thus, whether the acid and non-acid nitrogenous compounds have similar effects on biodiversity and ecosystem functions remains understudied. We mimicked nitrogen deposition with acidic NH4NO3and (NH4)2SO4, and non-acidic urea, slow-released urea and NH4HCO3in a temperate steppe, and quantified soil microbial taxonomic and functional gene composition with amplicon sequencing and shotgun metagenomics, respectively.

Results

While NH4NO3and (NH4)2SO4significantly altered the soil microbial taxonomic and functional composition as well as their carbon decomposition potential, the other three compounds had smaller effects.

Conclusion

Our results suggested that previous nitrogen deposition experiments mimicked with NH4NO3or (NH4)2SO4alone may have overestimated the effect on biodiversity and ecosystem functions in the Eurasian steppe and similar ecosystems affected by mainly nonacidic nitrogen deposition.
Contested skills and constrained mobilities: migrant carework skill regimes in Taiwan and Japan
Authors: Lan Pei-Chia
Published: September 2022

This article compares the paradoxical conditions of migrant care workers in two major receiving countries in Asia: Taiwan’s policy regime has positioned live-in care workers as “unskilled” foreigners, who nevertheless have gained increasing desirability and mobility in the labor market. By contrast, Japan has maintained the regime of skilled migration but the recent expansion of the trainee program reinforces paternalistic control over migrant caregivers, who are considered culturally inadequate. Contesting the assumption that skills indicate desirability and mobility in the labor market, I argue that we must examine the context-dependent constitution of skills at the intersection of migration, care, and skill regimes. I propose a multifaced framework to examine how the state and intermediary agencies co-produce the skill regime of care migration, including the following dimensions: migrant skills as a political language and structure of governance, care work skills as social and cultural constructions, the infrastructure of recruitment and training, and the consequence of labor market mobility.
Antagonistic role of barley against bioaccumulation and oxidative stress of aflatoxin B1 in male rats
Authors: Elgohary Mohamed Ramadan , Abdel-Fattah Shaaban Mostafa , Abu-Sree Yehia Hassan , Morsy Gamal Mohamed , Ali Atef Abdel-Moneem
Published: September 2022

Background

This study aims to evaluate the protective effect of barley against the bioaccumulation and oxidative stress of aflatoxin B1 (AFB1) in male rats. The lethality percentile doses (LDs: LD1 to LD99 at 24, 48, 72, and 96 h) were measured. To achieve these goals during subacute treatments, one hundred rats were divided into five groups, each with twenty rats. The groups I, II, III, IV, and V throughout 21 days were daily given drinking water, DMSO, 2.0 g of barley/kg, and 7.49 mg/kg of AFB1 alone or in combination with 2.0 g of barley/kg, respectively.

Results

The results revealed that AFB1 was detected only in the liver, kidney, and serum of groups IV, in which the accumulated AFB1 exhibited a significant direct relationship with the experimental periods with a marked positive correlation coefficient. Additionally, the concentrations of AFB1 residue in the serum of rats given AFB1 alone exhibited a significant inverse relationship with the levels of GSH, activity of CAT, SOD, and GR, whereas the levels of MDA showed a significant positive relationship. In the serum of rats given AFB1 plus barley, all parameters were mostly recovered and didn’t correlate with either the experimental periods or AFB1 in the serum.

Conclusions

The present data concluded that barley accelerated the biotransformation of AFB1 to a hydrophilic metabolite that is easily eliminated outside the body, leading to the recovery of all studied parameters to normal levels.
Liver resection of hepatocellular carcinoma in HIV-HCV co-infected patients: a retrospective case series
Authors: Cammarata Francesco , Benuzzi Laura , Crespi Michele , Troci Albert , Pennacchi Luca , Schiavini Monica , Foschi Diego
Published: September 2022

Introduction

Despite the effectiveness of new therapies and awareness campaigns, the number of seropositive patients is increasing every year. Recently, other causes of death, not directly related to HIV, have emerged, such as chronic liver disease. The risk of hepatocellular carcinoma (HCC) is seven times greater in HIV patients than in noninfected patients, and it is especially attributable to HCV infection. The aim of our study was to evaluate clinical outcomes of HCC in HIV-HCV co-infected patients after liver resection (LR).

Materials and methods

The current study was conducted on a prospective database and reviewed retrospectively. All consecutive patients with HCC treated by LR from January 2013 to March 2019 at the Luigi Sacco University Hospital in Milan were enrolled. We included patients older than 18 years of age with HCV-related HCC, and in this set of patients, we identified two groups based on the presence of HIV infection.

Results

We identified 16 patients with HCV infection and precisely five with HIV-HCV co-infection and eleven with HCV infection alone. All HIV patients were male against 72.7% in the non-HIV group (p = 0.509). All patients had optimal HIV virologic control and a normal CD4 T-cell count. The mean diagnosis-to-treatment interval was statistically different between the two groups (HIV versus non-HIV: 1.2 ± 0.55 months versus 2.39 ± 1.09 months, p = 0.039).

No other significant differences were found between HIV-HCV co-infected patients and HCV-infected patients. Long-term outcomes in terms of OS and RFS were similar between the two groups.

Conclusions

With a multidisciplinary approach and intensive support, LR can be a safe and efficacious procedure in HIV-HCV patients. For these reasons, we should not exclude potential patients merely on the basis of their HIV seropositivity.
Effect of entecavir and tenofovir disoproxil fumarate on hepatocellular carcinoma in subjects with chronic hepatitis B: a meta-analysis
Authors: Tony Sara M. , Shaaban Mohamed E. A. , Mohamed Ahmed I. M. , Abdelrahim Mohamed E. A.
Published: September 2022

Background

A meta-analysis was made to assess the impact of entecavir comparison with tenofovir disoproxil fumarate as nucleos(t)ide analogue on hepatic cellular carcinoma (HCC). The study had subjects with chronic hepatitis B virus (HBV). Systemic research was done for all studies concerned with our topic till the date (March 2022). We included 19 studies in which 27,618 subjects participated. All subjects included were diagnosed with chronic HBV at the beginning of the study. A total of 15,734 subjects from the overall 27,618 were medicated with entecavir; however, 11,884 subjects were on tenofovir disoproxil fumarate. We calculated the odds ratio (OR) with confidence intervals (CIs) of 95% to evaluate the impact of entecavir and tenofovir disoproxil fumarate on HCC in subjects with chronic HBV by applying a dichotomous approach with a random or fixed-effect model.

Results

Chronic HBV subjects treated with entecavir showed a higher significant biochemical response than those treated with tenofovir disoproxil fumarate (OR 1.39; 95% CI 1.21–1.60, at p < 0.001). Also, no significant difference was detected with entecavir compared to tenofovir disoproxil fumarate concerning the occurrence of hepatic cells cancer (OR 1.26; 95% CI 0.96–1.67, p = 0.10), virological response (OR 0.89; 95% CI 0.63–1.25, p = 0.49), and seroconversion (OR 1.27; 95% CI 0.76–2.14, p = 0.37).

Conclusions

The use of entecavir resulted in a significantly higher biochemical response; nevertheless, it did not show any significant variation concerning the occurrence of hepatic cancer, virological response, or serological conversion compared to tenofovir disoproxil fumarate in chronic HBV subjects. So, results interpretation needs to be carried out carefully owing to the limited number of studies included in specific comparisons, e.g., serological conversion.
Low presence of potentially toxic elements in Singapore urban garden soils
Authors: Goh Tiong Ann , Ramchunder Sorain J. , Ziegler Alan D.
Published: September 2022

Background

Urban agriculture is potentially an important piece of the food security puzzle for a rapidly growing urban world population. Community gardening is also promoted as a safe and viable form of exercise for aging populations in crowded settings where opportunities to participate in other action activities may be limited. Knowledge of potential site-specific health risks to environmental contaminants is important in dialogues promoting urban farming.

Methods

We assess the pseudo-total concentrations of selected potentially toxic elements (PTEs) in the soils of community gardens, public parks, and woodlands in the tropical urban island nation of Singapore. We compare concentrations of cadmium, copper, lead, and zinc with amalgamated risk guidelines to form a baseline understanding of the level of contamination in these spaces. We also perform providence tracking with lead isotopes to identify potential sources of contaminants.

Results

All pseudo-total concentrations of Cd, Cu, Pb, and Zn in the soil were below threshold concentrations considered to represent substantial risk. Further, PTE concentrations in gardens were largely equivalent to those found in community parks and woodlands, but the geographical distribution varied. Provenance tracking with Pb isotopes indicated Pb in gardens was both anthropogenic and natural, but spatially variable. The lack of strong spatial clustering of areas with the highest PTE concentrations was inconsistent with a common point source of contamination. However, the correlation between Cu and Zn suggest a common source for these elements, such as road/trafficking or atmospheric deposition.

Conclusion

We find limited risk of urban gardeners to exposure to Cd, Cu, Pb, and Zn—elements that are commonly abundant in urban settings with dense transportation networks and substantial industrial activities. The low levels of PTEs are encouraging for the promotion of urban farming for food production and leisure in this dense urban setting. However, as concentrations were low, we did not assess bioavailability and bioaccessibility of the PTEs. These assessments would need to be determined in cases of with higher levels of contamination to provide a more thorough consideration of actual human risk.
Does Concurrent Cholestasis Alter the Prognostic Value of Preoperatively Elevated CA19-9 Serum Levels in Patients with Pancreatic Head Adenocarcinoma?
Authors: Anger Friedrich , Lock Johan Friso , Klein Ingo , Hartlapp Ingo , Wiegering Armin , Germer Christoph-Thomas , Kunzmann Volker , Löb Stefan
Published: September 2022

Background

Pancreatic adenocarcinoma (PDAC) patients with preoperative carbohydrate antigen 19-9 (CA19-9) serum levels higher than 500 U/ml are classified as biologically borderline resectable (BR-B). To date, the impact of cholestasis on preoperative CA19-9 serum levels in these patients has remained unquantified.

Methods

Data on 3079 oncologic pancreatic resections due to PDAC that were prospectively acquired by the German Study, Documentation and Quality (StuDoQ) registry were analyzed in relation to preoperative CA19-9 and bilirubin serum values. Preoperative CA19-9 values were adjusted according to the results of a multivariable linear regression analysis of pathologic parameters, bilirubin, and CA19-9 values.

Results

Of 1703 PDAC patients with tumor located in the pancreatic head, 420 (24.5 %) presented with a preoperative CA19-9 level higher than 500 U/ml. Although receiver operating characteristics (ROC) analysis failed to determine exact CA19-9 cut-off values for prognostic indicators (R and N status), the T, N, and G status; the UICC stage; and the number of simultaneous vein resections increased with the level of preoperative CA19-9, independently of concurrent cholestasis. After adjustment of preoperative CA19-9 values, 18.5 % of patients initially staged as BR-B showed CA19-9 values below 500 U/ml. However, the postoperative pathologic results for these patients did not change compared with the patients who had CA19-9 levels higher than 500 U/ml after bilirubin adjustment.

Conclusions

In this multicenter dataset of PDAC patients, elevation of preoperative CA19-9 correlated with well-defined prognostic pathologic parameters. Bilirubin adjustment of CA19-9 is feasible but does not affect the prognostic value of CA19-9 in jaundiced patients.
Accounting for Dynamic Changes in the Power–Duration Relationship Improves the Accuracy of W′ Balance Modeling
Authors: BLACK MATTHEW I. , SKIBA PHILIP F. , WYLIE LEE J. , LEWIS JAMES , JONES ANDREW M. , VANHATALO ANNI
Published: September 2022

Purpose

This study aimed 1) to examine the accuracy with which W′ reconstitution (W′REC) is estimated by the W′ balance (W′BAL) models after a 3-min all-out cycling test (3MT), 2) to determine the effects of a 3MT on the power–duration relationship, and 3) to assess whether accounting for changes in the power–duration relationship during exercise improved estimates of W′REC.

Methods

The power–duration relationship and the actual and estimated W′REC were determined for 12 data sets extracted from our laboratory database where participants had completed two 3MT separated by 1-min recovery (i.e., control [C-3MT] and fatigued [F-3MT]).

Results

Actual W′REC (6.3 ± 1.4 kJ) was significantly overestimated by the W′BAL·ODE (9.8 ± 1.3 kJ; P < 0.001) and the W′BAL·MORTON (16.9 ± 2.6 kJ; P < 0.001) models but was not significantly different to the estimate provided by the W′BAL·INT (7.5 ± 1.5 kJ; P > 0.05) model. End power (EP) was 7% lower in the F-3MT (263 ± 40 W) compared with the C-3MT (282 ± 44 W; P < 0.001), and work done above EP (WEP) was 61% lower in the F-3MT (6.3 ± 1.4 kJ) compared with the C-3MT (16.9 ± 3.2 kJ). The size of the error in the estimated W′REC was correlated with the reduction in WEP for the W′BAL·INT and W′BAL·ODE models (both r > −0.74, P < 0.01) but not the W′BAL·MORTON model (r = −0.18, P > 0.05). Accounting for the changes in the power–duration relationship improved the accuracy of the W′BAL·ODE and W′BAL·MORTON, but they remained significantly different to actual W′REC.

Conclusions

These findings demonstrate that the power–duration relationship is altered after a 3MT, and accounting for these changes improves the accuracy of the W′BAL·ODE and the W′BAL·MORTON, but not W′BAL·INT models. These results have important implications for the design and use of mathematical models describing the energetics of exercise performance.
GNOSIS: an R Shiny app supporting cancer genomics survival analysis with cBioPortal
Authors: King Lydia , Flaus Andrew , Coughlan Simone , Holian Emma , Golden Aaron
Published: September 2022

Exploratory analysis of cancer consortia data curated by the cBioPortal repository typically requires advanced programming skills and expertise to identify novel genomic prognostic markers that have the potential for both diagnostic and therapeutic exploitation. We developed GNOSIS (GeNomics explOrer using StatistIcal and Survival analysis in R), an R Shiny App incorporating a range of R packages enabling users to efficiently explore and visualise such clinical and genomic data. GNOSIS provides an intuitive graphical user interface and multiple tab panels supporting a range of functionalities, including data upload and initial exploration, data recoding and subsetting, data visualisations, statistical analysis, mutation analysis and, in particular, survival analysis to identify prognostic markers. GNOSIS also facilitates reproducible research by providing downloadable input logs and R scripts from each session, and so offers an excellent means of supporting clinician-researchers in developing their statistical computing skills.
Osteoarthritis of the knee - a condemnation of a prosthesis for a young person? ATLAS Knee System as an effective method of relieving the medial compartment of the knee
Authors: Sygacz Oliwer , Walawski Jacek , Żelazny Przemysław , Filipczak Joanna , Swora Aleksandra , Borowik Joanna , Bróż Sebastian , Dankiewicz Sara , Brodowski Wojciech , Pawłowski Piotr , Basta-Arciszewska Katarzyna
Published: September 2022

Introduction: Osteoarthritis of the knee is one of the more common causes of disability in the elderly. In the United States, one in four adults suffers from the condition, half of whom are under the age of 65. The most commonly affected joint is the knee. A significant proportion of people in the 35-65 age range have degeneration in one compartment of the knee joint. Among the younger population, when non-operative methods are already failing and it is too early for surgery, there is a place for the ATLAS Knee System.
Aim of the study:  The purpose of our work is to present a new and innovative form of treatment for single-compartment osteoarthritis of the knee. Based on the available literature, to show the advantages, disadvantages and results of treatment with the ATLAS Knee System.
Methods and materials: A literature review was conducted in the PubMed database, using the keywords: "Atlas Knee System"; "osteoarthritis"; "knee osteoarthritis".
Results: The ATLAS system is built with an absorber that, as the knee is stretched, absorbs the forces acting on the medial compartment, while not putting stress on the rest of the knee joint. After patients use the implant, a significant reduction in pain and improvement in knee function is observed.
Conclusion: Osteoarthritis is a significant health problem increasingly prevalent even among the younger population. The ATLAS system provides an alternative for younger people in whom conservative treatment has failed, while more invasive methods such as osteotomies and total or single-unit prosthetics are impossible or rejected by the patient. More studies are needed, on a larger number of people to accurately evaluate this system.
The management and diagnosis of rhabdomyolysis-induced acute kidney injury: a case study
Authors: Torr Leah , Mortimore Gerri
Published: September 2022

Rhabdomyolysis is characterised by a rapid dissolution of damaged or injured skeletal muscle that can be the result of a multitude of mechanisms. It can range in severity from mild to severe, leading to multi-organ failure and death. Rhabdomyolysis causes muscular cellular breakdown, which can cause fatal electrolyte imbalances and metabolic acidosis, as myoglobin, creatine phosphokinase, lactate dehydrogenase and other electrolytes move into the circulation; acute kidney injury can follow as a severe complication. This article reflects on the case of a person who was diagnosed with rhabdomyolysis and acute kidney injury after a fall at home. Understanding the underpinning mechanism of rhabdomyolysis and the associated severity of symptoms may improve early diagnosis and treatment initiation.
End-of-term reports on clinical negligence claims
Authors: Tingle John
Published: September 2022

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses the annual reports of NHS Resolution and the Medical Defence Union
Using restorative practice in health care
Authors: Foster Sam
Published: September 2022

Sam Foster, Chief Nurse, Oxford University Hospitals, considers whether the principles of restorative practice can help in the process of dealing with the aftermath of patient safety incidents
PENTHROX
Authors: Rees Sharon
Published: September 2022

In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #penthrox
Consultation in out-of-hours practice: a clinical review of Lyme disease
Authors: Brydon Sharon , MacVicar Sonya
Published: September 2022

In recent times, telephone triage and virtual consultation have been expedited in the out-of-hours urgent primary care setting. This brings challenges concerning gaining a comprehensive history and building a therapeutic relationship between nurse prescriber and patient. This article presents a clinical review of Lyme disease to explore consultation models and how implementing a hybrid consultation approach may support the practitioner to develop safe prescribing practices and optimise patient expectations. This review of Lyme disease management highlights the sparse, low-quality evidence available, with national guidance indicating antimicrobial treatment for those who present with an erythema migrans rash prior to laboratory testing confirmation. This reinforces the importance of reaching a shared decision with the patient understanding of the perceived risk and benefits of treatment. The factors discussed include Lyme disease prevention and how the practitioner ensures safety netting in the out-of-hours setting.
Constant amplitude modulation heterodyne interferometry
Authors: Liu Heshan , Wang Juan , Gao Ruihong , Luo Ziren
Published: September 2022

Laser interferometer with picometer precision is a key technology in the space gravitational wave detection. Many interferometry strategies have been put forward for the multiple purposes in the past 10 yr. We propose a new interferometry method, called constant amplitude modulation (CAM) heterodyne interferometry. Differently, the CAM provides an optical pilot tone (OPT) for the noise correction theme. Compared with the analog pilot tone, the OPT can record and correct more noises, such as the analog to digital converter sampling jitter, the photodetector noise and the analog front-end noise. From the discussion, the modulated depth

ϕ

m
o
d
u
l
a
t
e

=
1.375

rad and the power ratio of the beam split

n
=

0.432

are the best choice for the CAM-modulated parameter. Moreover, a simulated case has been implemented for the verification of the CAM strategy. Therefore, the CAM gives us another excellent choice in the optical design of the interferometer.
532-nm-modulated pulse generation based on a time-delay loop and polarization rotation
Authors: Xu Zhen , Liu Xinyu , Liao Yingqi , Yang Suhui
Published: September 2022

A simple and low-cost scheme of generating 532 nm modulated pulses is investigated both theoretically and experimentally. The modulator is an external cavity based on a temporal delay loop and polarization rotation that is realized by two half-wave plates. Propagating in the temporal delay loop multiple times and being outputted partially after each round trip, the intensity of the initial green laser pulse is modulated. By analyzing the polarization of the pulse in each round trip, the pulse train is modeled to simulate the waveform of the modulated pulse. This modulator is coupled with a sub-nanosecond 532-nm-laser source to verify the model of intensity modulation. In the experiment, by rotating the HWPs, modulated pulses with various temporal profiles are obtained. The fundamental modulation frequency is calculated to be 520 MHz, and the frequency of the second harmonic also exceeds 1 GHz. Such a scheme of intensity modulation can be applied in underwater detection and ranging.
760  Mbps ultraviolet wireless communication based on a transmitter with AlGaN/InGaN MQWs
Authors: Li Xin , Chen Meipeng , Wang Xu , Hu Fangchen , Han Mingyu , Li Yun , Wang Yongjin
Published: September 2022

III-nitride LEDs offer a solution for ultraviolet (UV) high-speed communication as a transmitter with high performance. This paper focuses on a transmitter with AlGaN/InGaN multi-quantum wells (MQWs) for UV communication. The transmitter is realized on a GaN-on-silicon platform by a double etching process. The emission region of the transmitter with a small area is beneficial for improving the data rate of UV communication. The emission peak keeps stable at 376.48 nm in the UVA band. The transmission with 300 Mbps is obtained in a UV communication system setup with on-off keying (OOK) modulation. We realize a digital signal transmission up to 760 Mbps by bit-loading discrete multi-audio (DMT) modulation.
High sensitivity and enhanced measurement range biosensing based on defective photonic crystal microring resonators
Authors: Su Jin-Yue , Huang Xun-Qiang , Xu Han-Lei , Zhou Jin-Yun , Meng Zi-Ming
Published: September 2022

In this paper, we propose a defective photonic crystal microring resonator (DPhCMRR) by introducing a point defect into a conventional photonic crystal microring resonator (PhCMRR). The defective resonant wavelength within the photonic mode gap and the location of the defect mode distribution can be readily controlled. Unlike conventional PhCMRR, where the free spectral range (FSR) is limited by the dispersive band structure, our DPhCMRR can take advantage of the tunability of the defect mode within the photonic mode gap, leading to a significant increase of the measurement range. Moreover, the bulk refractive index sensitivity can reach 200 nm/RIU (refractive index unit) and the local refractive index sensitivity is about 5 to 10 times larger than that of the conventional PhCMRR. For sensing applications, our DPhCMRR can possess high sensitivity and wide measurement range simultaneously. As proof of principle, it is demonstrated that our proposed DPhCMRR can perform as a sensitive virus biosensor, which can detect a single virus and a concentration of viruses quantitatively. Therefore, our DPhCMRRs can provide a new platform for achieving high sensitivity and wide measurement range biosensing.
Optimizing switching of non-linear properties with hyperbolic metamaterials
Authors: Ethridge James A. , Jones John G. , Ferdinandus Manuel R. , Havrilla Michael J. , Marciniak Michael A.
Published: September 2022

Hyperbolic metamaterials have been demonstrated to have special potential in their linear response, but the extent of their non-linear response has not been extensively modeled or measured. In this work, novel non-linear behavior of an ITO/SiO2 layered hyperbolic metamaterial is modeled and experimentally confirmed, specifically a change in the sign of the non-linear absorption with intensity. This behavior is tunable and can be achieved with a simple one-dimensional layered design. Fabrication was performed with physical vapor deposition, and measurements were conducted using the Z-scan technique. Potential applications include tunable optical switches, optical limiters, and tunable components of laser sources.
Quantum random number generator based on polarization switching in gain-switched VCSELs
Authors: Valle-Miñón Marcos , Quirce Ana , Valle Angel , Gutiérrez Jaime
Published: September 2022

We experimentally study a quantum random number generator based on the random excitation of the linearly polarized modes of a gain-switched vertical-cavity surface-emitting laser (VCSEL). Our device is characterized by having polarization switching under continuous wave operation. By measuring the linear polarization mode that is excited in each pulse we collect a sufficient number of bits to evaluate if a standard statistical test suite is passed. We consider linear and Von Neumann post-processing methods in order to reduce the bias with different levels of bits rejection. The post-processed bit strings pass all tests in the standard test suite for random number generators provided by the National Institute of Standards and Technology (NIST). We finally compare the results obtained with different post-processing functions, including several [n, k, d] linear BCH codes. We show that large values of n and k are the best choice to obtain simultaneously improved throughput and randomness.