bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of Functional Coating Films on Glass Substrates for Photovoltaic Modules According to the Coating Method Used
Authors: Trang Ma Minh , Lee Changyeon , Kim Jung Hyun , Park Young , Joung Yeon-Ho , Choi Wonseok
Published: February 2021

This study analyzes characteristics of anti-pollution functional coating films on glass substrates for PV modules that were coated using different methods and annealed using hot air fans. For the purpose of this study, antipollution functional coating films were applied on glass substrates
made of the same material as the cover glass for PV modules. Each one of the following three coating methods: brushing, fabric and dipping was applied into separate specimens. Afterwards, all the films were rest in room temperature for 20 minutes and then annealed using hot air fans at 300
°C for 2 minutes. Specimens undergone both coating and annealing process were analyzed for their anti-pollution properties, contact angle, optical characteristics and other mechanical properties such as hardness and adhesion. Contact angle was analyzed using a contact-angle analyzer, and
light transmittance was analyzed using UV-visible which is capable of utilizing the integrating sphere. Based on the results of this study, the most suitable coating method for hot-fan-annealed film was found. If the coating process proposed in this study is applied to PV modules production,
improvement in anti-pollution characteristics as well as energy generation efficiency can be expected.
Dynamics of East Asian Spring Rainband and Spring–Autumn Contrast: Environmental Forcings of Large-Scale Circulation
Authors: Wang Shi-Xin , Zuo Hong-Chao , Sun Fen , Wu Li-Yang , Yin Yixing , Luo Jing-Jia
Published: February 2021

Dynamics of the East Asian spring rainband are investigated with a reanalysis dataset and station observations. Here, it is revealed that the rainband is anchored by external forcings. The midtropospheric jet core stays quasi-stationary around Japan. It has two branches in its entry region, which originate from the south and north flanks of the Tibetan Plateau and then run northeastward and southeastward, respectively. The southern branch advects warm air from the Tibetan–Hengduan Plateau northeastward, forming a rainband over southern China through causing adiabatic ascent motion and triggering diabatic feedback. The rainband is much stronger in spring than in autumn due to the stronger diabatic heating over the Tibetan–Hengduan Plateau, a more southward-displaced midtropospheric jet, and the resulting stronger warm advection over southern China. The northern jet branch forms a zonally elongated cold advection belt, which reaches a maximum around northern China, and then weakens and extends eastward to east of Japan. The westerly jet also steers strong disturbance activities roughly collocated with the cold advection belt via baroclinic instability. The high disturbance activities belt causes large cumulative warm advection (CWA) through drastically increasing extremely warm advection days on its eastern and south flanks, where weak cold advection prevails. CWA is more essential for monthly/seasonally rainfall than conventionally used time-average temperature advection because it is shown that strengthened warm advection can increase rainfall through positive diabatic feedback, while cold advection cannot cause negative rainfall. Thus, the rainband is collocated with the large CWA belt instead of the warm advection south of it. This rainband is jointed to the rainband over southern China, forming the long southwest–northeast-oriented East Asian spring rainband. Increasing moisture slightly displaces the rainband southeastward.
Influence of female cuticular hydrocarbon (CHC) profile on male courtship behavior in two hybridizing field crickets Gryllus firmus and Gryllus pennsylvanicus
Authors: Heggeseth Brianna , Sim Danielle , Partida Laura , Maroja Luana S.
Published: February 2021

Background

The hybridizing field crickets,Gryllus firmusandGryllus pennsylvanicushave several barriers that prevent gene flow between species. The behavioral pre-zygotic mating barrier, where males court conspecifics more intensely than heterospecifics, is important because by acting earlier in the life cycle it has the potential to prevent a larger fraction of hybridization. The mechanism behind such male mate preference is unknown. Here we investigate if the female cuticular hydrocarbon (CHC) profile could be the signal behind male courtship.

Results

While males of the two species display nearly identical CHC profiles, females have different, albeit overlapping profiles and some females (between 15 and 45%) of both species display a male-like profile distinct from profiles of typical females. We classified CHC females profile into three categories:G. firmus-like (F; including mainlyG. firmusfemales),G. pennsylvanicus-like (P; including mainlyG. pennsylvanicusfemales), and male-like (ML; including females of both species).Gryllus firmusmales courted ML and F females more often and faster than they courted P females (p < 0.05).Gryllus pennsylvanicusmales were slower to court thanG. firmusmales, but courted ML females more often (p < 0.05) than their own conspecific P females (no difference between P and F). Both males courted heterospecific ML females more often than other heterospecific females (p < 0.05, significant only forG. firmusmales).

Conclusions

Our results suggest that male mate preference is at least partially informed by female CHC profile and that ML females elicit high courtship behavior in both species. Since ML females exist in both species and are preferred over other heterospecific females, it is likely that this female type is responsible for most hybrid offspring production.
Effects of low versus standard pressure pneumoperitoneum on renal syndecan-1 shedding and VEGF receptor-2 expression in living-donor nephrectomy: a randomized controlled study
Authors: Aditianingsih Dita , Mochtar Chaidir Arif , Lydia Aida , Siregar Nuryati Chairani , Margyaningsih Nur Ita , Madjid Amir Sjarifuddin , Suwarto Suhendro
Published: February 2021

Background

Laparoscopic nephrectomy is a preferred technique for living kidney donation. However, positive-pressure pneumoperitoneum may have an unfavorable effect on the remaining kidney and other distant organs due to inflamed vascular endothelium and renal tubular cell injury in response to increased systemic inflammation. Early detection of vascular endothelial and renal tubular response is needed to prevent further kidney injury due to increased intraabdominal pressure induced by pneumoperitoneum. Transperitoneal laparoscopic living donor nephrectomy represented a human model of mild increasing intraabdominal pressure. This study aimed to assess the effect of increased intraabdominal pressure on vascular endothelium and renal tubular cells by comparing the effects of low and standard pressure pneumoperitoneum on vascular endothelial growth factor receptor-2 (VEGFR-2) expression and the shedding of syndecan-1 as the early markers to a systemic inflammation.

Methods

We conducted a prospective randomized study on 44 patients undergoing laparoscopic donor nephrectomy. Subjects were assigned to standard (12 mmHg) or low pressure (8 mmHg) groups. Baseline, intraoperative, and postoperative plasma interleukin-6, syndecan-1, and sVEGFR-2 were quantified by ELISA. Syndecan-1 and VEGFR-2 expression were assessed immunohistochemically in renal cortex tissue. Renal tubule and peritubular capillary ultrastructures were examined using electron microscopy. Perioperative hemodynamic changes, end-tidal CO2, serum creatinine, blood urea nitrogen, and urinary KIM-1 were recorded.

Results

The low pressure group showed lower intra- and postoperative heart rate, intraoperative plasma IL-6, sVEGFR-2 levels and plasma syndecan-1 than standard pressure group. Proximal tubule syndecan-1 expression was higher in the low pressure group. Proximal-distal tubules and peritubular capillary endothelium VEGFR-2 expression were lower in low pressure group. The low pressure group showed renal tubule and peritubular capillary ultrastructure with intact cell membranes, clear cell boundaries, and intact brush borders, while standard pressure group showed swollen nuclei, tenuous cell membrane, distant boundaries, vacuolizations, and detached brush borders.

Conclusion

The low pressure pneumoperitoneum attenuated the inflammatory response and resulted in reduction of syndecan-1 shedding and VEGFR-2 expression as the renal tubular and vascular endothelial proinflammatory markers to injury due to a systemic inflammation in laparoscopic nephrectomy.

Trial registration

ClinicalTrials.gov NCT:03219398, prospectively registered on July 17th, 2017.
Frequency of the requirement of inappropriate uncuffed tracheal tube size for pediatric patients: a retrospective observational analysis
Authors: Hanamoto Hiroshi , Nakagawa Hikaru , Niwa Hitoshi
Published: February 2021

Background

The insertion of inappropriately sized uncuffed endotracheal tubes (ETTs) with a tight seal or presence of air leakage may be necessary in children. This study aimed to analyze the frequency of the requirement of inappropriately sized uncuffed ETT insertion, air leakage after the ETT was replaced with one of a larger size, and factors associated with air leakage after ETT replacement.

Methods

Patients under 2 years of age who underwent oral surgery under general anesthesia with uncuffed ETTs between December 2013 and May 2015 were enrolled. The ETT size was selected at the discretion of the attending anesthesiologists. A leak test was performed after intubation. The ETT was replaced when considered necessary. Data regarding the leak pressure (PLeak) and inspiratory and expiratory tidal volumes were extracted from anesthesia records. We considered a PLeak of 10 < PLeak ≤ 30 cmH2O to be appropriate. The frequencies of the requirement of inappropriately sized ETTs, absence of leakage after ETT replacement, ETT size difference, and leak rate were calculated. A logistic regression was performed, with PLeak, leak rate, and size difference included as explanatory variables and presence of leakage after replacement as the outcome variable.

Results

Out of the 156 patients enrolled, 109 underwent ETT replacement, with the requirement of inappropriately sized ETTs being observed in 25 patients (23%). ETT replacement was performed in patients with PLeak ≤ 10 cmH2O; leakage was absent after replacement (PLeak < 30 cmH2O) in 52% of patients (25/48). In the multivariate logistic model, the leak rate before ETT replacement was significantly associated with the presence of leakage after replacement (p = 0.021).

Conclusions

Inappropriately sized ETTs were inserted in approximately 23% of the patients. The leak rate may be useful to guide ETT replacement.
The prevalence, reasons and attitudes for the practice of informal medicine
Authors: Amran Menashe Meni , Kopit Avital Bilitzky , Kranc Hannan Ariel , Peleg Roni
Published: February 2021

Background

Informal medicine, entailing undocumented medical advice, has been described in diverse medical disciplines and geographical regions. We assessed the current prevalence and characteristics of informal medical consulting, the reasons physicians provide it, and their attitudes toward it.

Methods

We conducted a survey among family physicians in Israel, a country with a national health insurance system. A questionnaire was emailed to all primary care physicians in the two largest HMOs in southern Israel. Fifteen questions addressed the prevalence, practice and attitudes to informal medical consulting. Ten questions assessed demographics and professional experience.

Results

Of 143 respondents (mean age 41 years), 55% were women. Ninety-five percent of the respondents reported requesting informal medical consulting from other physicians. Fifty-four percent reported often providing informal consulting to family and friends; and an additional 27% reported doing so under exceptional circumstances. The main reasons given for informal consulting requests were availability and accessibility (81% of respondents), and not financial savings. Only 17.5% stated being in favor of informal consulting for family and friends. Only 11% expressed feeling satisfaction after providing such consultation; 49% expressed discomfort. Sixty-six percent thought a position paper on informal consulting to family and friends is needed.

Conclusions

Our survey of primary care physicians shows very frequent informal medical consulting, despite high dissatisfaction with such, and an interest in receiving guidelines on this practice.
Characteristics and prognostic factors of COVID-19 among infected cases: a nationwide Tunisian analysis
Authors: Harizi Chahida , Cherif Ines , Najar Nourhene , Osman Molka , Mallekh Rym , Ayed Oumaima Ben , Ayedi Yosr , Dhaouadi Sonia , Hchaichi Aicha , Safer Mouna , Letaief Hejer , Bouaziz Ilhem , Derouiche Sondes , Gharbi Donia , Bouabid Leila , Bougatef Souha , Ben Salah Hamida , Fakhfakh Radhouane , Abid Salma , Ben Boubaker Ilhem Boutiba , Chahed Mohamed Kouni , Ben-Alaya Nissaf Bouafif
Published: February 2021

Background

The outbreak of coronavirus disease (COVID-19) continues to constitute an international public health concern. Few data are available on the duration and prognostic factors of the disease. We aimed to study the recovery time among a Tunisian cohort of COVID-19 confirmed patients and identify the prognostic factors.

Methods

A retrospective, nationwide study was conducted from March 2 to May 8, 2020, recruiting all patients who were diagnosed with COVID-19, by RT-PCR methods, in Tunisia. Data were collected via phone call interview. Kaplan-Meir Methods and Cox proportional hazards regression models were, respectively, used to study the recovery time and estimate its prognostic factors.

Results

One thousand and thirty patients with COVID-19 (aged 43.2 ± 18.2 years, 526 female (51.1%)) were enrolled. Among them 141 (14.8%) were healthcare professionals. Out of 173 patients (17.8%) admitted to the hospital, 47 were admitted in an intensive care unit. Among 827 patients who didn’t require specialized care, 55.5% were self-isolated at home, while the rest were in specialized centers. Six hundred and two patients were symptomatic. A total of 634 (61.6%) patients have recovered and 45 (4.4%) patients died. The median duration of illness was estimated to be 31 days (95% CI: [29–32]). Older age (HR = 0.66, CI:[0.46–0.96], P = 0.031) and symptoms (HR = 0.61, CI:[0.43–0.81], P = 0.021) were independently associated with a delay in recovery time. Being a healthcare professional (HR = 1.52, CI: [1.10–2.08], P = 0.011) and patients in home isolation compared to isolation centers (HR = 2.99, CI: [1.85–4.83], P < 10¯3) were independently associated with faster recovery time.

Conclusion

The duration of illness was estimated to be 1 month. However, this long estimated duration of illness may not equate to infectiousness. A particular attention must to be paid to elderly and symptomatic patients with closer monitoring.
An isolated ruptured spinal aneurysm presents with a thalamic Infarct: case report
Authors: Tenorio Alexander , Holmes Brandon B. , Abla Adib A. , Amans Matthew , Meisel Karl
Published: February 2021

Background

Isolated spinal artery aneurysms are extremely rare, and their pathogenesis, clinical presentation, and treatment strategies are poorly established. We report only the second case of a patient with an isolated posterior spinal aneurysm and concurrent left thalamic infarct and review the literature to help clarify treatment strategies of isolated spinal aneurysms.

Case presentation

A 49-year-old patient presented with acute onset walking difficulty followed by diaphoresis, back and abdominal pain, and paraplegia. Imaging was notable for a hemorrhagic spinal lesion with compression at T12 through L4 and an acute left thalamic infarct. Surgical exploration revealed an isolated posterior spinal artery aneurysm. The aneurysm was surgically resected and the patient had partial recovery six months post-operatively.

Conclusions

Isolated posterior spinal artery aneurysms of the thoracolumbar region are rare lesions that commonly present with abdominal pain, radiating back pain, and lower extremity weakness. Imaging may not provide a definitive diagnosis. The three primary treatment strategies are conservative management, endovascular treatment, or surgical resection. In patients with symptomatic cord compression, immediate surgical intervention is indicated to preserve neurologic function. In all other cases, the artery size, distal flow, morphology, and location may guide management.
Microarray analysis reveals an inflammatory transcriptomic signature in peripheral blood for sciatica
Authors: Wang Yi , Dai Guogang , Jiang Ling , Liao Shichuan , Xia Jiao
Published: February 2021

Background

Although the pathology of sciatica has been studied extensively, the transcriptional changes in the peripheral blood caused by sciatica have not been characterized. This study aimed to characterize the peripheral blood transcriptomic signature for sciatica.

Methods

We used a microarray to identify differentially expressed genes in the peripheral blood of patients with sciatica compared with that of healthy controls, performed a functional analysis to reveal the peripheral blood transcriptomic signature for sciatica, and conducted a network analysis to identify key genes that contribute to the observed transcriptional changes. The expression levels of these key genes were assessed by qRT-PCR.

Results

We found that 153 genes were differentially expressed in the peripheral blood of patients with sciatica compared with that of healthy controls, and 131 and 22 of these were upregulated and downregulated, respectively. A functional analysis revealed that these differentially expressed genes (DEGs) were strongly enriched for the inflammatory response or immunity. The network analysis revealed that a group of genes, most of which are related to the inflammatory response, played a key role in the dysregulation of these DEGs. These key genes are Toll-like receptor 4, matrix metallopeptidase 9, myeloperoxidase, cathelicidin antimicrobial peptide, resistin and Toll-like receptor 5, and a qRT-PCR analysis validated the higher transcript levels of these key genes in the peripheral blood of patients with sciatica than in that of healthy controls.

Conclusion

We revealed inflammatory characteristics that serve as a peripheral blood transcriptomic signature for sciatica and identified genes that are essential for mRNA dysregulation in the peripheral blood of patients with sciatica.
Comprehensive analysis of genomic mutation signature and tumor mutation burden for prognosis of intrahepatic cholangiocarcinoma
Authors: Zhang Rui , Li Qi , Fu Jialu , Jin Zhechuan , Su Jingbo , Zhang Jian , Chen Chen , Geng Zhimin , Zhang Dong
Published: February 2021

Background

Intrahepatic cholangiocarcinoma (iCCA) is a highly lethal malignancy of the biliary tract. Analysis of somatic mutational profiling can reveal new prognostic markers and actionable treatment targets. In this study, we explored the utility of genomic mutation signature and tumor mutation burden (TMB) in predicting prognosis in iCCA patients.

Methods

Whole-exome sequencing and corresponding clinical data were collected from the ICGC portal and cBioPortal database to detect the prognostic mutated genes and determine TMB values. To identify the hub prognostic mutant signature, we used Cox regression and Lasso feature selection. Mutation-related signature (MRS) was constructed using multivariate Cox regression. The predictive performances of MRS and TMB were assessed using Kaplan–Meier (KM) analysis and receiver operating characteristic (ROC). We performed a functional enrichment pathway analysis using gene set enrichment analysis (GSEA) for mutated genes. Based on the MRS, TMB, and the TNM stage, a nomogram was constructed to visualize prognosis in iCCA patients.

Results

The mutation landscape illustrated distributions of mutation frequencies and types in iCCA, and generated a list of most frequently mutated genes (such as Tp53, KRAS, ARID1A, and IDH1). Thirty-two mutated genes associated with overall survival (OS) were identified in iCCA patients. We obtained a six-gene signature using the Lasso and Cox method. AUCs for the MRS in the prediction of 1-, 3-, and 5-year OS were 0.759, 0.732, and 0.728, respectively. Kaplan–Meier analysis showed a significant difference in prognosis for patients with iCCA having a high and low MRS score (P < 0.001). GSEA was used to show that several signaling pathways, including MAPK, PI3K-AKT, and proteoglycan, were involved in cancer. Conversely, survival analysis indicated that TMB was significantly associated with prognosis. GSEA indicated that samples with high MRS or TMB also showed an upregulated expression of pathways involved in tumor signaling and the immune response. Finally, the predictive nomogram (that included MRS, TMB, and the TNM stage) demonstrated satisfactory performance in predicting survival in patients with iCCA.

Conclusions

Mutation-related signature and TMB were associated with prognosis in patients with iCCA. Our study provides a valuable prognostic predictor for determining outcomes in patients with iCCA.
Association of Photopic and Mesopic Contrast Sensitivity in older drivers with risk of motor vehicle collision using naturalistic driving data
Authors: Owsley Cynthia , Swain Thomas , Liu Rong , McGwin Gerald , Kwon Mi Young
Published: February 2021

Background

Older drivers have a crash rate nearly equal to that of young drivers whose crash rate is the highest among all age groups. Contrast sensitivity impairment is common in older adults. The purpose of this study is to examine whether parameters from the photopic and mesopic contrast sensitivity functions (CSF) are associated with incident motor vehicle crash involvement by older drivers.

Methods

This study utilized data from older drivers (ages ≥60 years) who participated in the Strategic Highway Research Program Naturalistic Driving Study, a prospective, population-based study. At baseline participants underwent photopic and mesopic contrast sensitivity testing for targets from 1.5–18 cycles per degree. Model fitting generated area under the log CSF (AULCSF) and peak log sensitivity. Participant vehicles were instrumented with sensors that captured continuous driving data when the vehicle was operating (accelerometers, global positioning system, forward radar, 4-channel video). They participated for 1–2 years. Crashes were coded from the video and other data streams by trained analysts.

Results

The photopic analysis was based on 844 drivers, and the mesopic on 854 drivers. Photopic AULCSF and peak log contrast sensitivity were not associated with crash rate, whether defined as all crashes or at-fault crashes only (all p > 0.05). Mesopic AULCSF and peak log sensitivity were associated with an increased crash rate when considered for all crashes (rate ratio (RR): 1.36, 95% CI: 1.06–1.72; RR: 1.28, 95% CI: 1.01–1.63, respectively) and at-fault crashes only (RR: 1.50, 95% CI: 1.16–1.93; RR: 1.38, 95% CI: 1.07–1.78, respectively).

Conclusions

Results suggest that photopic contrast sensitivity testing may not help us understand future crash risk at the older-driver population level. Results highlight a previously unappreciated association between older adults’ mesopic contrast sensitivity deficits and crash involvement regardless of the time of day. Given the wide variability of light levels encountered in both day and night driving, mesopic vision tests, with their reliance on both cone and rod vision, may be a more comprehensive assessment of the visual system’s ability to process the roadway environment.
Effect of CYP2D6 polymorphisms on plasma concentration and therapeutic effect of risperidone
Authors: Lu Jinjun , Yang Ye , Lu Jian , Wang Zuqing , He Yiping , Yan Yeliang , Fu Kai , Jiang Wenjuan , Xu Yunqing , Wu Renrong , Liu Wenqing , Zhao Jingping
Published: February 2021

Background

This study aimed to investigate the influence ofCYP2D6polymorphisms on risperidone plasma concentrations in patients with schizophrenia. Based on pharmacogenomics, we examined whether plasma concentration of risperidone is associated with clinical response and adverse side-effects.

Methods

We recruited patients with chronic schizophrenia who were then treated with risperidone. TheCYP2D6genotypes were determined using targeted sequencing. All high-frequency mutation sites of the nine exons of the gene were assayed in the present study. Plasma concentrations of risperidone and 9-hydroxyrisperidone (9-OH-RIS) were measured using high-performance liquid chromatography (HPLC). Psychiatric symptoms were monitored using The Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), and Clinical Global Impression (CGI). Adverse effects were evaluated using the Barnes Akathisia Scale (BAS) and Extrapyramidal Symptom Rating Scale (ESRS). Follow-up visits were scheduled at weeks 2,4, and 8 after treatment initiation.

Results

Among the 76 patients, 100 C > T (rs1065852), 1038 C > T (rs1081003), 1662 G > C (rs1058164), 2851 C > T (rs16947), and 4181G > C (rs1135840) variants were detected. The most common allele wasCYP2D6*10(81.6%), whereasCYP2D6*2(9.2%) andCYP2D6*5 (17.1%) were relatively rare. Plasma levels of risperidone and the risperidone/9-OH risperidone ratio (R/9-OH) were significantly increased in individuals withCYP2D6*10(P < 0.05). The change in PANSS score, weight, high-density lipoprotein (HDL) level, prolactin (PRL) level, and ESRS were significantly different from baseline, between the different genotypes (P < 0.01). Moreover, individuals withCYP2D6*10homozygous (TT) mutations were associated with higher risperidone concentration and R/9-OH ratio than those with heterozygous mutations (CT) (P < 0.01). A change from baseline in BPRS scores was observed only during week 8 and was different between heterozygous and homozygous mutations. As for the C2851T polymorphism, the incidence of adverse metabolic effects was significantly different between the C/C and C/T genotypes (P < 0.01). Regarding theG4181Cpolymorphisms, the changes from baseline in GLU and TG, were different between the C/C and C/G genotypes (P < 0.01).

Conclusions

The genotype ofCYP2D6significantly influences the plasma concentration of risperidone and may subsequently influence the adverse side-effects following risperidone treatment, while also exerting a slight influence on clinical outcomes.
Small airway dysfunction in patients with cough variant asthma: a retrospective cohort study
Authors: Gao Jie , Wu Haigui , Wu Feng
Published: February 2021

Background

Cough variant asthma (CVA) is one of the special populations of asthma. The aim of the study was to compare small airways, the degree of bronchial hyperresponsiveness (BHR) and airway inflammatory subtypes between CVA and classic asthma (CA), and investigate the relationship between these markers to determine the accuracy as indicators of CVA.

Methods

A total of 825 asthmatic patients participated in the study and 614 were included. 614 patients underwent spirometry and a bronchial challenge with methacholine and 459 patients performed induction sputum cell test.

Results

The number of CVA patients showed less small airway dysfunction than those of CA patients (p < 0.005). The degree of small airways dysfunction was higher in the CA group compared with the CVA group (p < 0.001). Small airways dysfunction was severer in the eosinophilic airway inflammatory subtype compared with other subtypes (p < 0.05).The area under curve of MMEF, FEF50 and FEF75 (% predicted) was 0.615, 0.621, 0.606, respectively. 0.17mcg of PD20 and 4.7% of sputum eosinophils was the best diagnostic value for CVA with an AUC of 0.582 and 0.575 (p = 0.001 and p = 0.005, respectively).

Conclusions

The eosinophilic airway inflammatory subtype may be increased small airway dysfunction. The value of small airways, BHR and induction sputum cells in CVA prediction, which reflected significant, but not enough to be clinically useful.
Functional improvement in hip pathology is related to improvement in anxiety, depression, and pain catastrophizing: an intricate link between physical and mental well-being
Authors: Gudmundsson Paul , Nakonezny Paul A. , Lin Jason , Owhonda Rebisi , Richard Heather , Wells Joel
Published: February 2021

Background

Pain catastrophizing, anxiety, and depression are risk factors for poor functional outcomes and worse post-treatment pain that can be treated alongside physical care given to orthopedic patients. While these factors have been shown to be common in patients with hip pathology, there is limited literature that follows these conditions throughout treatment. The purpose of this study was to track psychological factors in patients with various hip pathology to determine if they improved alongside functional measures following treatment.

Methods

Patients presenting to a specialist hip clinic were prospectively evaluated for outcomes of pain catastrophizing, anxiety, depression, and hip function. Pre- and post-treatment assessments were undertaken: Pain Catastrophizing Scale, the Hospital Anxiety Depression Scale, the Hip Outcome Survey, and Hip Disability and Osteoarthritis Outcome Score (HOOS). Patient characteristics were recorded. A correlation analysis, using the Spearman partial correlation coefficient (rs), was conducted to evaluate the relationship between change in psychological factors with change in functional outcomes.

Results

A total of 201 patients (78 male, 123 female) with a mean age of 53.75 ± 18.97 years were included, with diagnoses of hip dysplasia (n = 35), femoroacetabular impingement (n = 35), lateral trochanteric pain syndrome (n = 9), osteoarthrosis (n = 109), and avascular necrosis of the hip (n = 13). Statistical analysis revealed a significant negative relationship between change in function level (as measured by HOOS ADL) and change in pain catastrophizing (rs = − 0.373,p < 0.0001), depression (rs = − 0.363, p < 0.0001), and anxiety (rs = − 0.264,p = 0.0002). Pain catastrophizing, depression, and anxiety improved with function. Spearman correlation coefficients also revealed that pain catastrophizing, HADS anxiety, and HADS depression improved with improvement in other patient-reported functional outcomes.

Conclusions

Patients with hip pathology often exhibit pain catastrophizing, anxiety, and depression, but improvements in hip functionality are associated with decreased severity of these psychological comorbidities. Exploring this connection demonstrates the correlation between musculoskeletal impairment and psychosocial outcomes and mental health. Perioperative multidisciplinary assessment may be a beneficial part of comprehensive orthopaedic hip care.
Electromagnetic navigation reduces radiation exposure for retrograde drilling in osteochondrosis dissecans of the talus
Authors: Jungesblut Oliver D , Berger-Groch Josephine , Hoffmann Michael , Schroeder Malte , Krajewski Kara L. , Stuecker Ralf , Rupprecht Martin
Published: February 2021

Background

Retrograde drilling in osteochondrosis dissecans (OCD) is a widely used surgical intervention. A radiation-free electromagnetic navigation system (ENS)-based method was compared with the standard freehand fluoroscopic (SFF) method regarding clinical applicability.

Methods

We performed a clinical cohort study at a department of Orthopaedics in a Level 1 children’s hospital with 40 patients (20 SFF and 20 ENS). Retrograde drilling of the talar dome was used in patients with unstable medial OCD (MRI stage 2 according to Hepple’s revised classification; stage 2 according to the International Cartilage Repair Society). The outcome measurements were: (a) Intraoperative fluoroscopy exposure and length of surgery and (b) Postoperative serial follow-up MRIs every 6 months.

Results

22 female and 18 male patients aged 13.8 ± 1.6 years (range: 11–17 years) were included. Using the ENS technique, length of surgery was significantly reduced to 20.2 ± 6.4 min compared to 36.1 ± 11.8 min (p < 0.01) for the SFF technique. The average x-ray radiation time for the SFF technique was 23.5 ± 13.5 sec and 1.9 ± 1.7 sec for the ENS technique (p < 0.01). Radiation exposure was significantly reduced from 44.6 ± 19.7 mSv (SFF technique) to 5.6 ± 2.8 mSv (ENS technique) (p < 0.01). Intraoperative perforation of cartilage occurred once in the SFF group. Correct placement of the drilling channel was verified in all patients on follow-up MRI after six months and a timely healing was seen after two years.

Conclusions

The ENS method provides for a significant reduction in length of surgery and radiation exposure. ENS was without intraoperative cartilage perforation. The clinical and radiological follow-up parameters are comparable for SFF- and ENS-guided retrograde drilling.

Trial registration

WF – 085/20, 05/2020 “retrospectively registered” https://www.aerztekammer-hamburg.org/ethik_kommission.html.
AGLR is a novel index for the prognosis of hepatocellular carcinoma patients: a retrospective study
Authors: Liao Yan , Wei Rongyu , Yao Renzhi , Qin Liling , Li Jun , Yu Junxiong , Liao Weijia
Published: February 2021

Background

Most hepatocellular carcinoma (HCC) patients’ liver function indexes are abnormal. We aimed to investigate the relationship between (alkaline phosphatase + gamma-glutamyl transpeptidase)/lymphocyte ratio (AGLR) and the progression as well as the prognosis of HCC.

Methods

A total of 495 HCC patients undergoing radical hepatectomy were retrospectively analyzed. We randomly divided these patients into the training cohort (n = 248) and the validation cohort (n = 247). In the training cohort, receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of AGLR for predicting postoperative survival of HCC patients, and the predictive value of AGLR was evaluated by concordance index (C-index). Further analysis of clinical and biochemical data of patients and the correlation analysis between AGLR and other clinicopathological factors were finished. Univariate and multivariate analyses were performed to identify prognostic factors for HCC patients. Survival curves were analyzed using the Kaplan–Meier method.

Results

According to the ROC curve analysis, the optimal predictive cut-off value of AGLR was 90. The C-index of AGLR was 0.637 in the training cohort and 0.654 in the validation cohort, respectively. Based on this value, the HCC patients were divided into the low-AGLR group (AGLR ≤ 90) and the high-AGLR group (AGLR > 90). Preoperative AGLR level was positively correlated with alpha-fetoprotein (AFP), tumor size, tumor-node-metastasis (TNM) stage, and microvascular invasion (MVI) (allp < 0.05). In the training and validation cohorts, patients with AGLR > 90 had significantly shorter OS than patients with AGLR ≤ 90 (p < 0.001). Univariate and multivariate analyses of the training cohort (HR, 1.79; 95% CI 1.21–2.69;p < 0.001) and validation cohort (HR, 1.82; 95% CI 1.35–2.57;p < 0.001) had identified AGLR as an independent prognostic factor. A new prognostic scoring model was established based on the independent predictors determined in multivariate analysis.

Conclusions

The elevated preoperative AGLR level indicated poor prognosis for patients with HCC; the novel prognostic scoring model had favorable predictive capability for postoperative prognosis of HCC patients, which may bring convenience for clinical management.
Splenogonadal fusion: a case report and review of the literature
Authors: Chen Guangjie , Wang Xiaohao , Zhao Yijun , Zhu Linfeng , Tang Daxing
Published: February 2021

Background

Splenogondal fusion (SGF) is a rare congenital anomaly characterized by abnormal association between the splenic tissue and the gonads or mesonephric remnants. SGF that requires separate two-stage laparoscopic staged Fowler-Stephen orchiopexy on both the left and right sides is extremely rare. SGF could be misdiagnosed as testicular malignancy and leads to unnecessary orchiectomy.

Case presentation

This is a case of an 8-month old male infant presented with bilateral cryptorchidism, B-mode ultrasound visualized the left and right testes in the lower abdominal cavity and the upper margin of the left testicle as a hypoechoic mass extending to the spleen, indicating an undescended right testis and possible SGF on the left side. Single-site laparoscopic examination confirmed the diagnosis of SGF on the left side and an undescended right testis. As both testes were high and the right spermatic vessel was poorly developed and short, a routine single stage orchiopexy would be difficult and risky, therefore, separate two-stage laparoscopic staged Fowler-Stephen orchiopexies for both sides were implemented. Stage 1 of the staged Fowler-Stephen orchiopexy for the right side was performed first without treating the left side, Stage 2 for the right side, separation of the left testis from the spleen as well as Stage 1 for the left side were performed 7 months later, and Stage 2 for the left side was performed 7 months after that. Follow-up ultrasound 1 year after the surgery revealed no obvious abnormalities in the shapes of the testes or their blood supply. This treatment strategy prevented unnecessary orchiectomy.

Conclusions

We reported a rare case of SGF that needed separate two-stage laparoscopic staged Fowler-Stephen orchiopexies for both sides, and a review of the recent literature. SGF is a rare congenital anomaly often diagnosed incidentally during exploration/surgery for scrotal swelling/mass, cryptorchidism or inguinal hernia in young patients. Surgeons, especially pediatric surgeons should be aware of this rare condition to avoid unnecessary, life-altering radical orchiectomy. When routine single stage orchiopexy is not feasible or risky for either side, separate two-stage laparoscopic staged Fowler-Stephen orchiopexies could be performed on both the left and right sides to avoid unnecessary orchiectomy.
Association between 20q12 rs13041247 polymorphism and risk of nonsyndromic cleft lip with or without cleft palate: a meta-analysis
Authors: Huang Liheng , Liang Xinglong , Ou Yangzhan , Tang Shijie , He Yunpu
Published: February 2021

Background

Previous genome-wide association studies have identified a link between the rs13041247 single nucleotide polymorphisms (SNPs) in the chromosome 20q12 locus and the development of the congenital malformation known as nonsyndromic cleft lip with or without cleft palate (NSCL/P). The present meta-analysis was therefore designed to formally assess the relationship between rs13041247 and NSCL/P.

Methods

We searched Embase, Web of Science, PubMed, the China National Knowledge Internet (CNKI), and the China Wanfang database in order to identify relevant published through 25 June 2019. This allowed us to identify 13 studies incorporating 4914 patients and 5981 controls for whom rs13041247 genotyping had been conducted, with STATA 12.0 then being used to conduct a meta-analysis of these pooled results. The I2statistic was used to compare heterogeneity among studies.

Results

In total this analysis incorporated 13 case-control studies. No association between the rs13041247 polymorphism and NSCL/P risk was detected in individuals of Asian ethnicity (C vs T: OR = 0.847, 95% CI = 0.702–1.021; CC vs TT: OR = 0.725, 95% CI = 0.494–1.063; CC vs CT: OR = 0.837, 95% CI = 0.657–1.067; CT + TT vs CC: OR = 1.265, 95% CI = 0.951–1.684; CC + CT vs TT: OR = 0.805, 95% CI = 0.630–1.029) or Caucasian ethnicity (C vs T: OR = 0.936, 95% CI = 0.786–1.114; CC vs TT: OR = 0.988, 95% CI = 0.674–1.446; CC vs CT: OR = 1.197, 95% CI = 0.816–1.757; CT + TT vs CC: OR = 0.918, 95% CI = 0.639–1.318; CC + CT vs TT: OR = 0.855, 95% CI = 0.677–1.081). However, an overall analysis of all participants in these studies revealed the rs13041247 C allele, the CT genotype, and the CC + CT model to be linked to a reduced NSCL/P risk (C vs T: OR = 0.897, 95% CI: 0.723–1.114,P = 0.048; CT vs TT: OR = 0.839, 95% CI: 0.734–0.959,P = 0.01; CC + CT vs TT: OR = 0.824, 95% CI: 0.701–0.968,P = 0.019).

Conclusion

These results suggest that the rs13041247 SNP located at the 20q12 chromosomal locus is associated with NSCL/P risk in an overall pooled study population, although this association was not significant in East Asian or Caucasian populations.
The pattern of change in opioid and adjuvant prescriptions for cancer pain before and after referral to a comprehensive program in the Palliative Care Center in Kuwait
Authors: Al-Ansari Ameena Mohammed , Abd-El-Gawad Wafaa Mostafa , AboSerea Sobhi Mostafa , ElShereafy Eman El Sayed , Ali Fatma Abdel Shakor , ElSayed Mohammed Abd Elaziz
Published: February 2021

Background

Cancer-related pain is a complicated symptom that often coincides with fatigue, depression, and anxiety. Although many safe treatments are available, inadequate control of Cancer-related pain continues to lead to suffering in cancer patients. This study’s aim is to describe pain control, and the pattern of change in opioid and adjuvant medication prescriptions, before and after referral to the Palliative Care Center.

Methods

We conducted a prospective cohort study in adult cancer patients the Palliative Care Center between January 1, 2016 and December 30, 2017. We measured pain intensity and other associated symptoms via the Revised Edmonton Symptom Assessment System (ESAS-r) and documented detailed analgesics and adjuvant medication history before starting any palliative care and on days 0, 3, 6, and 14.

Results

The analysis included 240 patients whose cancer-related pain, anxiety, and depression scores meaningfully improved by day 6. The changes in the median (interquartile ranges) of Cancer-related pain, anxiety, and depression scores from day 0 to day 6 were: 6 (4–8) to 3 (1–4); 6 (4–9) to 2 (1–4); and 3 (2–6) to 2 (1–4), respectively, withp < 0.001 for all. Morphine was the most common opioid administered; the percentage using it increased from 20.4% (n = 49) before referral to 49.6% (n = 119) on day 6 (p < 0.001). The median morphine equivalent daily dose decreased from a median (interquartile ranges) of 60(31–93) mg/day before referral to 34(22–66) mg/day on day 6 (p < 0.001). There was also a statistically significant increase in the percentage of patients taking adjuvant medications, from 38.8% before referral to 84.2% on day 6 (p < 0.001). Comparing D0 to D6, the number of patients using Gabapentinoids significantly increased from 57(23.75%) to 79(32.9%) (p < 0.001), amitriptyline dramatically increased from 14 (5.8%) to 44 (18.3%) (p < 0.001), and other antidepressant drugs increased from 15 (6.2%) to 34 (14.1%) (p < 0.001).

Conclusion

After referral to the Palliative Care Center, patients’ pain and other symptoms scores decreased significantly, even with lower median morphine equivalent daily doses, arguably through more appropriately directed opioid use. This is evidence for the effectiveness of the comprehensive program at the Palliative Care Center in Kuwait.
Correction to: Three novel circRNAs upregulated in tissue and plasma from hepatocellular carcinoma patients and their regulatory network
Authors: Wang Lianghai , Zhou Lisha , Hou Jun , Meng Jin , Lin Ke , Wu Xiangwei , Chen Xueling
Published: February 2021

An amendment to this paper has been published and can be accessed via the original article.
An intersectional analysis providing more precise information on inequities in self-rated health
Authors: Wemrell Maria , Karlsson Nadja , Perez Vicente Raquel , Merlo Juan
Published: February 2021

Background

Intersectionality theory combined with an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) can facilitate our understanding of health disparities. This enables the application of proportionate universalism for resource allocation in public health. Analyzing self-rated health (SRH) in Sweden, we show how an intersectional perspective allows for a detailed mapping of health inequalities while avoiding simplification and stigmatization based on indiscriminate interpretations of differences between group averages.

Methods

We analyzed participants (n=133,244) in 14 consecutive National Public Health Surveys conducted in Sweden in 2004–2016 and 2018. Applying AIHDA, we investigated the risk of bad SRH across 12 intersectional strata defined by gender, income and migration status, adjusted by age and survey year. We calculated odds ratios (with 95% confidence intervals) to evaluate between-strata differences, using native-born men with high income as the comparison reference. We calculated the area under the receiver operating characteristic curve (AU-ROC) to evaluate the discriminatory accuracy of the intersectional strata for identifying individuals according to their SRH status.

Results

The analysis of intersectional strata showed clear average differences in the risk of bad SRH. For instance, the risk was seven times higher for immigrated women with low income (OR 7.00 [95% CI 6.14–7.97]) than for native men with high income. However, the discriminatory accuracy of the intersectional strata was small (AU-ROC=0.67).

Conclusions

The intersectional AIHDA approach provides more precise information on the existence (or the absence) of health inequalities, and can guide public health interventions according to the principle of proportionate universalism. The low discriminatory accuracy of the intersectional strata found in this study warrants universal interventions rather than interventions exclusively focused on strata with a higher average risk of bad SRH.
Adolescent, caregiver and community experiences with a gender transformative, social emotional learning intervention
Authors: Cherewick Megan , Lebu Sarah , Su Christine , Richards Lisa , Njau Prosper F. , Dahl Ronald E.
Published: February 2021

Background

Inequitable gender norms, beliefs and behaviors, are shaped by learning experiences during key developmental stages in an individual’s life course, and can have negative impacts on health and well-being outcomes. Very early adolescence represents one stage when formative learning experiences about gender inequity can have the potential to support or hinder more equitable gender norms, beliefs and behaviors. The aim of this qualitative study was to evaluate the effect of a gender transformative, social emotional learning intervention for very young adolescents (VYAs) that included experiential learning with peers, parents/caregivers and community members.

Methods

This study examined the effects of an intervention designed to provide social emotional learning opportunities for adolescents ages 10–11 in Dar es Salaam, Tanzania. The qualitative sample included 279 participants. Qualitative methods included 102 in-depth interviews with VYAs, 22 focus groups with 117 VYAs, 60 in-depth interviews with parents/caregivers and 54 participant observations. A grounded theory approach was used to identify emergent themes.

Results

Participants reported growth in targeted areas of social emotional mindsets and skills, including a shift in gender norms, beliefs and behaviors. VYAs reported that experiential learning in mixed gender teams provided opportunities to actively practice and reflect on gender norms, beliefs and behaviors. VYAs also reported active practice of social emotional mindsets and skills with peers, parents/caregivers and the community. Parents/caregivers reported changes in VYAs’ social emotional mindsets and skills within the home, with the community and with siblings and peers. Both adolescents and parent/caregivers reported positive change towards more equitable gender norms, beliefs and behaviors through participation in experiential learning activities and reflective discussions.

Conclusions

These findings suggest that an intervention providing social and emotional experiential learning opportunities during the developmental window of very young adolescence can be effective in transforming gender norms, beliefs and behaviors. Involvement of peers, parents/caregivers and community members was effective at supporting learning social emotional mindsets and skills in VYAs. Findings encourage local and global adolescent programming to include gender transformative content paired with social emotional experiential learning with peers, family and the community and can stimulate positive change in gender norms, beliefs and behaviors to promote gender equity.