bluuebunny/crossref_metadata_2025 huggingface dataset:
Why so Blue? (Or Should I Say Red?) Recognizing the Emotional Impact of Psoriasis on Patients and Family Members: A Qualitative Study
Authors: Snyder Ashley M. , Taliercio Vanina L. , Rich Bianca E. , Brandenberger Adelheid U. , Webber Lisa B. , Beshay Abram P. , Biber Joshua E. , Hess Rachel , Rhoads Jamie LW. , Secrest Aaron M.
Published: January 2022

Background: Psoriasis is a chronic skin condition with significant effects on quality of life, including impacts on emotional health. However, these experiences are not always addressed in clinic visits, despite their potential for significant effects on daily life. This study is part of a larger project on the effects of psoriasis on quality of life. The current information was analyzed separately because the amount of information on emotional impacts mentioned by participants was so significant that it warranted a separate analysis to thoroughly assess these experiences. Objective: To describe emotional consequences of psoriasis for patients and their family members. Methods: This project was conducted at an academic medical center in Utah. Experiences were discussed in interviews and focus groups with 25 patients and 11 family members. Thematic analysis was used to determine themes and subthemes. Results: This study sheds light on the damaging effects of psoriasis on emotional well-being, illustrating the challenges patients face from internal conflict, consequences for family members trying to cope with psoriasis in a loved one, and judgment from others who do not understand psoriasis and its challenges. Conclusion: Living with psoriasis leads to emotional consequences that may be left unaddressed in clinic visits, yet these experiences contribute significantly to quality of life. The stories told through this study can help clinicians understand how to identify and address emotional concerns to improve care for psoriasis patients and, as a result, improve quality of life for both patients and their families.
Tackling teachers’ low expectations of Black Caribbean students in English schools
Authors: Demie Feyisa
Published: January 2022

The underachievement of Black Caribbean students has been a persistent problem facing national policymakers in English schools for many years. Drawing on case study evidence, this article has looked into the experience and views of teachers, parents, governors and school staff about the effect of teachers’ low expectations on Black Caribbean students and the reasons for their underachievement in English schools. Evidence suggests teachers’ low expectation is one of the factors that hindered the achievement of Black Caribbean students. Low expectations manifest in several ways, including harsher reprimands, racist stereotyping, unconscious and conscious bias, as well as being overlooked to answer questions, and is set in low ability groups. The recommendations from this study are that schools should challenge teachers through training and the effective use of an inclusive curriculum that provides students with knowledge about the histories, cultures and contributions of diverse groups.
Prescribing Patterns of Antihypertensive Agents and Blood Pressure Control Among Patients With Incident Stage 2 Hypertension
Authors: Helms Micah V. , Edwards Ashley L. , Suszynsky Taylor H. , Hwang Andrew Y.
Published: January 2022

Background: Initiation of appropriate antihypertensive therapy is crucial, particularly among patients with stage 2 hypertension, whom initiation of dual antihypertensive agents is suggested. Little is known regarding real-world prescribing of antihypertensive agents for patients with incident stage 2 hypertension. Objective: The primary objective was to describe prescribing patterns of antihypertensive therapy among patients with incident stage 2 hypertension. The secondary objectives included determining association of blood pressure (BP) control with initial multiple antihypertensive agents. Methods: Retrospective cohort analysis was conducted using electronic medical records from 6 primary care clinics between January 2014 and June 2019. Included patients were ≥18 years with an initial diagnosis of stage 2 hypertension, defined as BP ≥160/100 mm Hg Primary analysis was characterizing prescribing patterns of antihypertensive agents among patients with incident stage 2 hypertension. Investigation of BP control (<140/90 mm Hg) at 3 months of diagnosis was also performed. Results: We identified 261 patients with incident stage 2 hypertension (mean age, 52 years; 53.2% males; mean baseline BP, 162.1/100.1 mm Hg). Approximately 72% of patients were initiated on single antihypertensive agent, with the most common being angiotensin receptor blockers (ARBs; 25.7%) and angiotensin-converting-enzyme (ACE) inhibitors (24.6%). Commonly initiated multiple antihypertensive agents were ACE-inhibitor + thiazide-like diuretic (52.7%), followed by an ARB + thiazide-like diuretic (21.6%). Multiple antihypertensive therapy was associated with improved BP control at 3 months (adjusted odds ratio [OR], 3.54; 95% confidence interval [CI], 1.55-8.06). Conclusion: Majority of patients with incident stage 2 hypertension were prescribed initial single antihypertensive therapy, though better BP control at 3 months was seen among those initiated on multi-antihypertensive therapy.
A relational database to support post-earthquake building damage and recovery assessment
Authors: Omoya Morolake , Ero Itohan , Zaker Esteghamati Mohsen , Burton Henry V , Brandenberg Scott , Sun Han , Yi Zhengxiang , Kang Hua , Nweke Chukuebuka C
Published: January 2022

Systematically collected and curated data sets from historical events provide a strong basis for simulating the physical and functional effects of natural hazards on the built environment. This article develops a relational database to support post-earthquake damage and recovery modeling of building portfolios. The current version of the database has been populated with information on the 3695 buildings affected by the 2014 South Napa, California, earthquake. The associated data categories include general building characteristics, site properties and shaking intensities, building damage and repair permitting (timing and type) information, and census-block-level sociodemographics. The Napa data set can be used to validate post-earthquake recovery simulation methodologies and explore the effectiveness of different modeling techniques in predicting damage. The database can be expanded to include other earthquakes and the overall framework can be adapted to other types of natural hazards (e.g. hurricanes, flooding).
Mathematical simulation of the calendering process for non-Newtonian polymers
Authors: Javed Muhammad Asif , Nasir Sarah , Ali Nasir , Arshad Sabeen
Published: January 2022

This paper mathematically studies calendering with a tangent hyperbolic model to simulate non-Newtonian polymers. The constitutive equations based on Lubrication Approximation Theory (LAT) are first non-dimensionalized and then simplified. The simplified equations describing the flow inside the calender are solved (a) analytically using the perturbation method and (b) numerically using MatLab built-in routine “BVP4c” method. The first case obtains an analytical expression for velocity, pressure gradient, and final sheet thickness with the help of the perturbation method, while BVP4c and Runge-Kutta methods are used to calculate the velocity, pressure, pressure gradient, and mechanical quantities numerically. The power-law index and Weissenberg number influence on pressure, pressure gradient, and velocity profiles of fluid being calendered are shown with graphs. The pressure inside the calender decreases as the power-law index and Weissenberg number increase. The force function and final sheet thickness decreases as the power-law index and Weissenberg number increases.
Antiplatelet medications and risk of intracranial hemorrhage in patients with metastatic brain tumors
Authors: Miller Eric J. , Patell Rushad , Uhlmann Erik J. , Ren Siyang , Southard Hannah , Elavalakanar Pavania , Weber Griffin M. , Neuberg Donna , Zwicker Jeffrey I.
Published: January 2022

Although intracranial hemorrhage (ICH) is frequent in the setting of brain metastases, there are limited data on the influence of antiplatelet agents on the development of brain tumor–associated ICH. To evaluate whether the administration of antiplatelet agents increases the risk of ICH, we performed a matched cohort analysis of patients with metastatic brain tumors with blinded radiology review. The study population included 392 patients with metastatic brain tumors (134 received antiplatelet agents and 258 acted as controls). Non–small cell lung cancer was the most common malignancy in the cohort (74.0%), followed by small cell lung cancer (9.9%), melanoma (4.6%), and renal cell cancer (4.3%). Among those who received an antiplatelet agent, 86.6% received aspirin alone and 23.1% received therapeutic anticoagulation during the study period. The cumulative incidence of any ICH at 1 year was 19.3% (95% CI, 14.1-24.4) in patients not receiving antiplatelet agents compared with 22.5% (95% CI, 15.2-29.8; P = .22, Gray test) in those receiving antiplatelet agents. The cumulative incidence of major ICH was 5.4% (95% CI, 2.6-8.3) among controls compared with 5.5% (95% CI, 1.5-9.5; P = .80) in those exposed to antiplatelet agents. The combination of anticoagulation plus antiplatelet agents did not increase the risk of major ICH. The use of antiplatelet agents was not associated with an increase in the incidence, size, or severity of ICH in the setting of brain metastases.
Allergen provocation tests in respiratory research: building on 50 years of experience
Authors: Gauvreau Gail M. , Davis Beth E. , Scadding Guy , Boulet Louis-Philippe , Bjermer Leif , Chaker Adam , Cockcroft Donald W. , Dahlén Barbro , Fokkens Wyste , Hellings Peter , Lazarinis Nikolaos , O'Byrne Paul M. , Tufvesson Ellen , Quirce Santiago , Van Maaren Maurits , de Jongh Frans H. , Diamant Zuzana
Published: January 2022

The allergen provocation test is an established model of allergic airway diseases, including asthma and allergic rhinitis, allowing the study of allergen-induced changes in respiratory physiology and inflammatory mechanisms in sensitised individuals as well as their associations. In the upper airways, allergen challenge is focused on the clinical and pathophysiological sequelae of the early allergic response, and is applied both as a diagnostic tool and in research settings. In contrast, bronchial allergen challenge has almost exclusively served as a research tool in specialised research settings with a focus on the late asthmatic response and the underlying type 2 inflammation. The allergen-induced late asthmatic response is also characterised by prolonged airway narrowing, increased nonspecific airway hyperresponsiveness and features of airway remodelling including the small airways, and hence allows the study of several key mechanisms and features of asthma. In line with these characteristics, allergen challenge has served as a valued tool to study the cross-talk of the upper and lower airways and in proof-of-mechanism studies of drug development. In recent years, several new insights into respiratory phenotypes and endotypes including the involvement of the upper and small airways, innovative biomarker sampling methods and detection techniques, refined lung function testing as well as targeted treatment options further shaped the applicability of the allergen provocation test in precision medicine. These topics, along with descriptions of subject populations and safety, in line with the updated Global Initiative for Asthma 2021 document, will be addressed in this review.
Pulmonary infection by SARS-CoV-2 induces senescence accompanied by an inflammatory phenotype in severe COVID-19: possible implications for viral mutagenesis
Authors: Evangelou Konstantinos , Veroutis Dimitris , Paschalaki Koralia , Foukas Periklis G. , Lagopati Nefeli , Dimitriou Marios , Papaspyropoulos Angelos , Konda Bindu , Hazapis Orsalia , Polyzou Aikaterini , Havaki Sophia , Kotsinas Athanassios , Kittas Christos , Tzioufas Athanasios G. , de Leval Laurence , Vassilakos Demetris , Tsiodras Sotirios , Stripp Barry R. , Papantonis Argyris , Blandino Giovanni , Karakasiliotis Ioannis , Barnes Peter J. , Gorgoulis Vassilis G.
Published: January 2022

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the respiratory system can progress to a multisystemic disease with aberrant inflammatory response. Cellular senescence promotes chronic inflammation, named senescence-associated secretory phenotype (SASP). We investigated whether coronavirus disease 2019 (COVID-19) is associated with cellular senescence and SASP.

Methods

Autopsy lung tissue samples from 11 COVID-19 patients and 43 age-matched non-COVID-19 controls with similar comorbidities were analysed by immunohistochemistry for SARS-CoV-2, markers of senescence and key SASP cytokines. Virally induced senescence was functionally recapitulated in vitro, by infecting epithelial Vero-E6 cells and a three-dimensional alveosphere system of alveolar type 2 (AT2) cells with SARS-CoV-2 strains isolated from COVID-19 patients.

Results

SARS-CoV-2 was detected by immunocytochemistry and electron microscopy predominantly in AT2 cells. Infected AT2 cells expressed angiotensin-converting enzyme 2 and exhibited increased senescence (p16INK4A and SenTraGor positivity) and interleukin (IL)-1β and IL-6 expression. In vitro, infection of Vero-E6 cells with SARS-CoV-2 induced senescence (SenTraGor), DNA damage (γ-H2AX) and increased cytokine (IL-1β, IL-6, CXCL8) and apolipoprotein B mRNA-editing (APOBEC) enzyme expression. Next-generation sequencing analysis of progenies obtained from infected/senescent Vero-E6 cells demonstrated APOBEC-mediated SARS-CoV-2 mutations. Dissemination of the SARS-CoV-2-infection and senescence was confirmed in extrapulmonary sites (kidney and liver) of a COVID-19 patient.

Conclusions

We demonstrate that in severe COVID-19, AT2 cells infected by SARS-CoV-2 exhibit senescence and a proinflammatory phenotype. In vitro, SARS-CoV-2 infection induces senescence and inflammation. Importantly, infected senescent cells may act as a source of SARS-CoV-2 mutagenesis mediated by APOBEC enzymes. Therefore, SARS-CoV-2-induced senescence may be an important molecular mechanism of severe COVID-19, disease persistence and mutagenesis.
Arterial blood gas analysis: as safe as we think? A multicentre historical cohort study
Authors: Rowling Sacha C. , Fløjstrup Marianne , Henriksen Daniel Pilsgaard , Viberg Bjarke , Hallenberg Christian , Lindholt Jes Sanddal , Alberg-Fløjborg Andreas , Nanayakkara Prabath W.B. , Brabrand Mikkel
Published: January 2022

Purpose

Arterial punctures (APs) for arterial blood gas (ABG) analyses are much-used medical procedures. To date, no large studies have been conducted on the major complication rate of APs. We aimed to describe the risk of major complications within 7 days after puncture and investigate whether using antithrombotic medication affected this.

Methods

We included all APs performed for ABG analysis at three Danish hospitals from January 1, 1993 to February 25, 2013. We excluded APs ordered by the anaesthesiology department, intensive care unit (ICU) or in patients <18 years old. Data on the patient level were extracted from the Danish National Patient Registry, Danish Civil Registration System and Odense Pharmaco-Epidemiologic Database (OPED), the latter providing us with information on antithrombotic medication. Initially, two clinicians compiled a list with all procedures and diagnoses that could possibly be a consequence of APs. The selected procedures and diagnoses were further categorised independently by three surgeons and used to indicate the complication rate.

Results

We analysed 473 327 APs and found 669 (0.14%, 95% CI 0.13–0.15) APs led to major complications: embolisms or thrombosis (49.0%), aneurysms (15.4%), nerve damage (1.5%), arteriovenous fistulas (0.6%) or of another kind (33.5%). The identified major complication rates in patients on antithrombotic medication were increased (OR 1.31, 95% CI 1.07–1.61).

Conclusion

APs for ABG analyses are safe procedures. The major complication rate within 7 days was 0.14% (95% CI 0.13–0.15). Patients on antithrombotic medication carry an increased risk of developing major complications.
Mortality and survival in idiopathic pulmonary fibrosis: a systematic review and meta-analysis
Authors: Zheng Qiang , Cox Ingrid A. , Campbell Julie A. , Xia Qing , Otahal Petr , de Graaff Barbara , Corte Tamera J. , Teoh Alan K.Y. , Walters E. Haydn , Palmer Andrew J.
Published: January 2022

Background

There are substantial advances in diagnosis and treatment for idiopathic pulmonary fibrosis (IPF), but without much evidence available on recent mortality and survival trends.

Methods

A narrative synthesis approach was used to investigate the mortality trends, then meta-analyses for survival trends were carried out based on various time periods.

Results

Six studies reported the mortality data for IPF in 22 countries, and 62 studies (covering 63 307 patients from 20 countries) reported survival data for IPF. Age-standardised mortality for IPF varied from ∼0.5 to ∼12 per 100 000 population per year after year 2000. There were increased mortality trends for IPF in Australia, Brazil, Belgium, Canada, Czech Republic, Finland, France, Germany, Hungary, Italy, Lithuania, the Netherlands, Poland, Portugal, Spain, Sweden and UK, while Austria, Croatia, Denmark, Romania and the USA showed decreased mortality trends. The overall 3-year and 5-year cumulative survival rates (CSRs) were 61.8% (95% CI 58.7–64.9; I2=97.1%) and 45.6% (95% CI 41.5–49.7; I2=97.7%), respectively. Prior to 2010, the pooled 3-year CSR was 59.9% (95% CI 55.8–64.1; I2=95.8%), then not significantly (p=0.067) increased to 66.2% (95% CI 62.9–69.5; I2=92.6%) in the 2010s decade. After excluding three studies in which no patients received antifibrotics after year 2010, the pooled 3-year CSRs significantly (p=0.039) increased to 67.4% (95% CI 63.9–70.9; I2=93.1%) in the 2010s decade.

Discussion

IPF is a diagnosis associated with high mortality. There was no observed increasing survival trend for patients with IPF before year 2010, with then a switch to an improvement, which is probably multifactorial.
ERS International Congress 2021: highlights from the Paediatric Assembly
Authors: Ardura-Garcia Cristina , Abellan Alicia , Cuevas-Ocaña Sara , Freitag Nadine , Lam Yin Ting , Makrinioti Heidi , Slaats Monique , Storti Matteo , Williams Emma E. , Dassios Theodore , Duijts Liesbeth , Ersu Refika H. , Fustik Stojka , Morty Rory E. , Proesmans Marijke , Schramm Dirk , Saglani Sejal , Moeller Alexander , Pijnenburg Marielle W.
Published: January 2022

In this review, Early Career Members of the European Respiratory Society (ERS) and the Chairs of the ERS Assembly 7: Paediatrics present the highlights in paediatric respiratory medicine from the ERS International Congress 2021. The eight scientific Groups of this Assembly cover respiratory physiology and sleep, asthma and allergy, cystic fibrosis (CF), respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology, bronchology, and lung and airway development. We here describe new developments in lung function testing and sleep-disordered breathing diagnosis, early life exposures affecting pulmonary function in children and effect of COVID-19 on sleep and lung function. In paediatric asthma, we present the important role of the exposome in asthma development, and how biologics can provide better outcomes. We discuss new methods to assess distal airways in children with CF, as some details remain blind when using the lung clearance index. Moreover, we summarise the new ERS guidelines for bronchiectasis management in children and adolescents. We present interventions to reduce morbidity and monitor pulmonary function in newborns at risk of bronchopulmonary dysplasia and long-term chronic respiratory morbidity of this disease. In respiratory epidemiology, we characterise primary ciliary dyskinesia, identify early life determinants of respiratory health and describe the effect of COVID-19 preventive measures on respiratory symptoms. Also, we describe the epidemiology of interstitial lung diseases, possible consequences of tracheomalacia and a classification of diffuse alveolar haemorrhage in children. Finally, we highlight that the characterisation of genes and pathways involved in the development of a disease is essential to identify new biomarkers and therapeutic targets.
Study on the strength of glued laminated timber beams with round holes: proposal of the design formula for the splitting strength
Authors: Okamoto Shigefumi , Akiyama Nobuhiko , Araki Yasuhiro , Aoki Kenji , Inayama Masahiro
Published: January 2022

When a glued laminated timber (GLT) beam with a round hole is subjected to a shear force and bending moment, the hole will crack and fail due to a large tensile stress perpendicular to the grain and shear stresses. If the stresses acting on the hole are known, it is possible to estimate the fracture load. However, it is necessary to obtain the stresses acting on the hole by finite element analysis, which is very time consuming. In this study, to easily estimate the fracture load, we proposed a formula to estimate the bearing capacity at the time of a hole fracture by obtaining the stress acting on the hole through finite element analysis and an approximate formula. The validity of the proposed formula was verified using the existing experimental data of a GLT beam. As a result, it was confirmed that the proposed equation can estimate the fracture load of GLT beams in Japan and that the proposed equation can estimate the fracture load of GLT beams in countries other than Japan with some accuracy.
Unifying the analysis of continuous and categorical measures of weight loss and incorporating group effect: a secondary re-analysis of a large cluster randomized clinical trial using Bayesian approach
Authors: Tang Fengming , Befort Christie A. , Wick Jo , Gajewski Byron J.
Published: January 2022

Background

Although frequentist paradigm has been the predominant approach to clinical studies for decades, some limitations associated with the frequentist null hypothesis significance testing have been recognized. Bayesian approaches can provide additional insights into data interpretation and inference by deriving posterior distributions of model parameters reflecting the clinical interest. In this article, we sought to demonstrate how Bayesian approaches can improve the data interpretation by reanalyzing the Rural Engagement in Primary Care for Optimizing Weight Reduction (REPOWER).

Methods

REPOWER is a cluster randomized clinical trial comparing three care delivery models: in-clinic individual visits, in-clinic group visits, and phone-based group visits. The primary endpoint was weight loss at 24 months and the secondary endpoints included the proportions of achieving 5 and 10% weight loss at 24 months. We reanalyzed the data using a three-level Bayesian hierarchical model. The posterior distributions of weight loss at 24 months for each arm were obtained using Hamiltonian Monte Carlo. We then estimated the probability of having a higher weight loss and the probability of having greater proportion achieving 5 and 10% weight loss between groups. Additionally, a four-level hierarchical model was used to assess the partially nested intervention group effect which was not investigated in the original REPOWER analyses.

Results

The Bayesian analyses estimated 99.5% probability that in-clinic group visits, compared with in-clinic individual visits, resulted in a higher percent weight loss (posterior mean difference: 1.8%[95% CrI: 0.5,3.2%]), a greater probability of achieving 5% threshold (posterior mean difference: 9.2% [95% CrI: 2.4, 16.0%]) and 10% threshold (posterior mean difference: 6.6% [95% CrI: 1.7, 11.5%]). The phone-based group visits had similar result. We also concluded that including intervention group did not impact model fit significantly.

Conclusions

We unified the analyses of continuous (the primary endpoint) and categorical measures (the secondary endpoints) of weight loss with one single Bayesian hierarchical model. This approach gained statistical power for the dichotomized endpoints by leveraging the information in the continuous data. Furthermore, the Bayesian analysis enabled additional insights into data interpretation and inference by providing posterior distributions for parameters of interest and posterior probabilities of different hypotheses that were not available with the frequentist approach.

Trial registration

ClinicalTrials.gov Identifier NCT02456636; date of registry: May 28, 2015.
Improved U-Net3+ with stage residual for brain tumor segmentation
Authors: Qin Chuanbo , Wu Yujie , Liao Wenbin , Zeng Junying , Liang Shufen , Zhang Xiaozhi
Published: January 2022

Background

For the encoding part of U-Net3+,the ability of brain tumor feature extraction is insufficient, as a result, the features can not be fused well during up-sampling, and the accuracy of segmentation will reduce.

Methods

In this study, we put forward an improved U-Net3+ segmentation network based on stage residual. In the encoder part, the encoder based on the stage residual structure is used to solve the vanishing gradient problem caused by the increasing in network depth, and enhances the feature extraction ability of the encoder which is instrumental in full feature fusion when up-sampling in the network. What’s more, we replaced batch normalization (BN) layer with filter response normalization (FRN) layer to eliminate batch size impact on the network. Based on the improved U-Net3+ two-dimensional (2D) model with stage residual, IResUnet3+ three-dimensional (3D) model is constructed. We propose appropriate methods to deal with 3D data, which achieve accurate segmentation of the 3D network.

Results

The experimental results showed that: the sensitivity of WT, TC, and ET increased by 1.34%, 4.6%, and 8.44%, respectively. And the Dice coefficients of ET and WT were further increased by 3.43% and 1.03%, respectively. To facilitate further research, source code can be found at: https://github.com/YuOnlyLookOne/IResUnet3Plus.

Conclusion

The improved network has a significant improvement in the segmentation task of the brain tumor BraTS2018 dataset, compared with the classical networks u-net, v-net, resunet and u-net3+, the proposed network has smaller parameters and significantly improved accuracy.
The social media response to twice-weekly mass asymptomatic testing in England
Authors: Dennis Amelia , Robin Charlotte , Carter Holly
Published: January 2022

Background

From 9th April 2021, everyone in England has been encouraged to take two COVID-19 tests per week. This is the first time that national mass asymptomatic testing has been introduced in the UK and the effectiveness of the policy depends on uptake with testing and willingness to self-isolate following a positive test result. This paper examines attitudes towards twice-weekly testing, as well as barriers and facilitators to engaging in testing.

Methods

Between 5th April and 28th May 2021 we searched Twitter, Facebook, and online news articles with publicly available comment sections to identify comments relating to twice-weekly testing. We identified 5783 comments which were then analysed using a framework analysis.

Results

We identified nine main themes. Five themes related to barriers to engaging in testing: low perceived risk from COVID-19; mistrust in the government; concern about taking a test; perceived ineffectiveness of twice-weekly testing policy; and perceived negative impact of twice-weekly testing policy. Four themes related to facilitators to engaging in testing: wanting to protect others; positive perceptions of tests; a desire to return to normal; and perceived efficacy for reducing asymptomatic transmission.

Conclusions

Overall, the comments identified indicated predominately negative attitudes towards the twice weekly testing policy. Several recommendations can be made to improve engagement with twice weekly testing, including: 1) communicate openly and honestly about the purpose of testing; 2) provide information about the accuracy of tests; 3) provide financial support for those required to self-isolate, and; 4) emphasise accessibility of testing.
A reliable and robust method for the upper thigh muscle quantification on computed tomography: toward a quantitative biomarker for sarcopenia
Authors: Ko Yousun , Shin Youngbin , Sung Yu Sub , Lee Jiwoo , Lee Jei Hee , Kim Jai Keun , Park Jisuk , Ko Hye Sun , Kim Kyung Won , Huh Jimi
Published: January 2022

Background

We aimed to evaluate the feasibility of the upper thigh level as a landmark to measure muscle area for sarcopenia assessment on computed tomography (CT).

Methods

In the 116 healthy subjects who performed CT scans covering from mid-abdomen to feet, the skeletal muscle area in the upper thigh level at the inferior tip of ischial tuberosity (SMAUT), the mid-thigh level (SMAMT), and L3 inferior endplate level (SMAL3) were measured by two independent readers. Pearson correlation coefficients between SMAUT, SMAMT, and SMAL3 were calculated. Inter-reader agreement between the two readers were evaluated using intraclass correlation coefficient (ICC) and Bland-Altman plots with 95% limit of agreement (LOA).

Results

In readers 1 and 2, very high positive correlations were observed between SMAUT and SMAMT (r = 0.91 and 0.92, respectively) and between SMAUT and SMAL3 (r = 0.90 and 0.91, respectively), while high positive correlation were observed between SMAMT and SMAL3 (r = 0.87 and 0.87, respectively). Based on ICC values, the inter-reader agreement was the best in the SMAUT (0.999), followed by the SMAL3 (0.990) and SMAMT (0.956). The 95% LOAs in the Bland-Altman plots indicated that the inter-reader agreement of the SMAUT (− 0.462 to 1.513) was the best, followed by the SMAL3 (− 9.949 to 7.636) and SMAMT (− 12.105 to 14.605).

Conclusion

Muscle area measurement at the upper thigh level correlates well with those with the mid-thigh and L3 inferior endpoint level and shows the highest inter-reader agreement. Thus, the upper thigh level might be an excellent landmark enabling SMAUT as a reliable and robust biomarker for muscle area measurement for sarcopenia assessment.
Transanal endoluminal repair for anastomotic leakage after low anterior resection
Authors: Chen Yi-Chang , Tsai Yuan-Yao , Ke Tao-Wei , Fingerhut Abe , Chen William Tzu-Liang
Published: January 2022

Background

There is still no consensus on the management of colorectal anastomotic leakage after low anterior resection. The goal was to evaluate the outcomes of patients who underwent transanal endoluminal repair + laparoscopic drainage ± stoma vs. drainage only ± stoma.

Methods

Retrospective chart review of patients sustaining anastomotic leakage after laparoscopic low anterior resection between January 2013 and September 2020 who required laparoscopic reoperation.

Results

Forty-nine patients were included, 22 patients underwent combined laparoscopy and transanal endoluminal repair and 27 patients had drainage with a stoma (n = 16) or drainage alone (n = 11), without direct anastomotic repair. The overall morbidity rate was 30.6% and the mortality rate was 2%. Combined laparoscopic lavage/drainage and transanal endoluminal repair of anastomotic leakage was associated with a lower complication rate (13.6% vs. 44.4%, p = 0.03) and fewer intraabdominal infections (4.5% vs. 29.6%, p = 0.03) compared with no repair.

Conclusions

Combined laparoscopic lavage/drainage and transanal endoluminal repair is effective in the management of colorectal anastomosis leakage and was associated with lower morbidity—in particular intraabdominal infection—compared with no repair. However, our results need to be confirmed in larger, and ideally randomized, studies.
Tunnel versus medial approach in laparoscopic radical right hemicolectomy for right colon cancer: a retrospective cohort study
Authors: Zhang Xijie , Zhang Junli , Ma Pengfei , Cao Yanghui , Liu Chenyu , Li Sen , Li Zhi , Zhao Yuzhou
Published: January 2022

Purpose

This study aimed to explore the feasibility and safety of the tunnel approach in laparoscopic radical right hemicolectomy for colon cancer.

Methods

From July 2016 to October 2018, a total of 106 consecutive patients with colon cancer who underwent laparoscopic radical right hemicolectomy at the Affiliated Cancer Hospital of Zhengzhou University were enrolled. The patients were stratified into either a tunnel approach (TA) (n = 56) group or traditional medial approach (MA) (n = 50) group according to the surgical technique performed. The baseline demographics, perioperative outcomes and oncologic outcomes were compared between the two groups.

Results

The baseline characteristics did not differ between groups. The TA group had significantly less blood loss [20.0 (10.0–40.0) vs. 100 (100.0–150.0) ml, p < 0.001] and a shorter operation time [128.4 ± 16.7 vs. 145.6 ± 20.3 min, p < 0.001] than the MA group. The time to first flatus and postoperative hospital stay were similar [3.0 (2.0–4.0) vs. 3.0 (3–4.0) days, p = 0.329; 10.4 ± 2.6 vs. 10.7 ± 3.0 days, p = 0.506] between the two groups. The conversion to laparotomy and complication rates were similar between groups (0 vs. 6.0%, p = 0.203; 14.3% vs. 18.0%, p = 0.603, respectively). No treatment-related deaths occurred in either group. The TA group did not have significantly better survival outcomes than the MA group (p = 0.372).

Conclusions

The TA seems to allow for more favourable results in terms of blood loss and operative time than the MA, with similar results regarding time to first flatus, hospital stay, postoperative complication rate, conversion rate and oncologic outcomes; moreover, the TA is easier for beginners to master.
A survey on knowledge and attitudes towards molar-incisor hypomineralization among undergraduate and postgraduate students at the School of Stomatology, Wuhan University
Authors: Liu Yanchen , He Miao
Published: January 2022

Background

Molar incisor hypomineralization (MIH) is a developmental dental disease, and its clinical management challenges dentists. This study aimed to investigate the knowledge about MIH and the attitudes towards learning more about MIH among undergraduate and postgraduate students attending the School of Stomatology, Wuhan University.

Methods

This survey was based on a questionnaire modified based on previous studies. The questionnaire was sent to 540 undergraduate and postgraduate students from the School of Stomatology, Wuhan University. The questions covered their clinical experience, perceptions, clinical management, and preferences for further training. Data were analysed with the Chi-square test.

Results

We collected 368 questionnaires (response rate: 68%). Among them, 89% (328/368) were eligible for analysis. Most respondents (80%) had heard of MIH, primarily from classroom teaching. However, only 40% of the students had observed the disease clinically, and a relatively low proportion of students were familiar with the aetiology, prevalence, differential diagnosis, and treatment of MIH. Most respondents were highly enthusiastic and had great expectations about further systematic teaching about MIH.

Conclusion

Most students in this study had heard of MIH, but few were familiar with the principles of its differential diagnosis. Systematic teaching about MIH is warranted.
HPLC-DAD phenolics analysis, α-glucosidase, α-amylase inhibitory, molecular docking and nutritional profiles of Persicaria hydropiper L.
Authors: Mahnashi Mater H. , Alqahtani Yahya S. , Alyami Bandar A. , Alqarni Ali O. , Alqahl Sultan A. , Ullah Farhat , Sadiq Abdul , Zeb Alam , Ghufran Mehreen , Kuraev Alexey , Nawaz Asif , Ayaz Muhammad
Published: January 2022

Background

Natural phenolic compounds and Phenolics-rich medicinal plants are also of great interest in the management of diabetes. The current study was aimed to analyze phenolics inP. hydropieprL extracts via HPLC-DAD analysis and assess their anti-diabetic potentials using in-vitro and in-silico approaches.

Methods

Plant crude methanolic extract (Ph.Cme) was evaluated for the presence of phenolic compounds using HPLC-DAD analysis. Subsequently, samples including crude (Ph.Cr), hexane (Ph.Hex), chloroform (Ph.Chf), ethyl acetate (Ph.EtAc), butanol (Ph.Bt), aqueous (Ph.Aq) and saponins (Ph.Sp) were tested for α-glucsidase and α-amylase inhibitory potentials and identified compounds were docked against these target enzymes using Molecular Operating Environment (MOE) software. Fractions were also analyzed for the nutritional contents and acute toxicity was performed in animals.

Results

In HPLC-DAD analysis of Ph.Cme, 24 compounds were indentfied and quantified. Among these, Kaemferol-3-(p-coumaroyl-diglucoside)-7-glucoside (275.4 mg g− 1), p-Coumaroylhexose-4-hexoside (96.5 mg g− 1), Quercetin-3-glucoronide (76.0 mg g− 1), 4-Caffeoylquinic acid (58.1 mg g− 1), Quercetin (57.9 mg g− 1), 5,7,3′-Trihydroxy-3,6,4′,5′-tetramethoxyflavone (55.5 mg g− 1), 5-Feruloylquinic acid (45.8 mg g− 1), Cyanidin-3-glucoside (26.8 mg g− 1), Delphinidin-3-glucoside (24 mg g− 1), Quercetin-3-hexoside (20.7 mg g− 1) were highly abundant compounds. In α-glucosidase inhibition assay, Ph.Sp were most effective with IC50value of 100 μg mL-1. Likewise in α-amylase inhibition assay, Ph.Chf, Ph.Sp and Ph.Cme were most potent fractions displayed IC50values of 90, 100 and 200 μg mL-1 respectively. Docking with the α-glucosidase enzyme revealed top ranked conformations for majority of the compounds with Kaemferol-3-(p-coumaroyl-diglucoside)-7-glucoside as the most active compound with docking score of − 19.80899, forming 14 hydrogen bonds, two pi-H and two pi-pi linkages with the Tyr 71, Phe 158, Phe 177, Gln 181, Arg 212, Asp 214, Glu 276, Phe 300, Val 303, Tyr 344, Asp 349, Gln 350, Arg 439, and Asp 408 residues of the enzyme. Likewise, docking with α-amylase revealed that most of the compounds are well accommodated in the active site residues (Trp 59, Tyr 62, Thr 163, Leu 165, Arg 195, Asp 197, Glu 240, Asp 300, His 305, Asp 356) of the enzyme and Cyanidin-3-rutinoside displayed most active compound with docking score of − 15.03757.

Conclusions

Phytochemical studies revealed the presence of highly valuable phenolic compounds, which might be responsible for the anti-diabetic potentials of the plant samples.
Who’s afraid of genetic tests?: An assessment of Singapore’s public attitudes and changes in attitudes after taking a genetic test
Authors: Cheung Ross , Jolly Shreshtha , Vimal Manoj , Kim Hie Lim , McGonigle Ian
Published: January 2022

Background

As a consequence of precision medicine initiatives, genomic technologies have rapidly spread around the world, raising questions about genetic privacy and the ethics of data sharing. Previous scholarship in bioethics and science and technology studies has made clear that different nations have varying expectations about trust, transparency, and public reason in relation to emerging technologies and their governance. The key aims of this article are to assess genetic literacy, perceptions of genetic testing, privacy concerns, and governing norms amongst the Singapore population by collecting surveys.

Methods

This study investigated genetic literacy and broad public attitudes toward genetic tests in Singapore with an online public survey (n = 560). To assess potential changes in attitudes following receipt of results from a genetic test, we also surveyed undergraduate students who underwent a genetic screen as part of a university class before and after they received their test results (n = 25).

Results

Public participants showed broad support for the use of genetic tests; scored an average of 48.9% in genetic literacy; and expressed privacy concerns over data sharing and a desire for control over their genetic data. After taking a genetic test and receiving genetic test results, students reported less fear of genetic tests while other attitudes did not change significantly.

Conclusion

These findings highlight the potential of genetic education and active engagement with genetic testing to increase support and participation in genomic projects, PM, and biobanking initiatives; and they suggest that data privacy protections could potentially reduce discrimination by giving participants control over who can access their data. More specifically, these findings and the dataset we provide may be helpful in formulating culturally sensitive education programs and regulations concerning genomic technologies and data privacy.
Embedded ethics: a proposal for integrating ethics into the development of medical AI
Authors: McLennan Stuart , Fiske Amelia , Tigard Daniel , Müller Ruth , Haddadin Sami , Buyx Alena
Published: January 2022

The emergence of ethical concerns surrounding artificial intelligence (AI) has led to an explosion of high-level ethical principles being published by a wide range of public and private organizations. However, there is a need to consider how AI developers can be practically assisted to anticipate, identify and address ethical issues regarding AI technologies. This is particularly important in the development of AI intended for healthcare settings, where applications will often interact directly with patients in various states of vulnerability. In this paper, we propose that an ‘embedded ethics’ approach, in which ethicists and developers together address ethical issues via an iterative and continuous process from the outset of development, could be an effective means of integrating robust ethical considerations into the practical development of medical AI.
The impact of improving haemophilia A management within the Spanish National Healthcare System: a social return on investment analysis
Authors: Soto Inmaculada , Mateo José , García-Diego Daniel-Aníbal , Gil Beatriz , Ruiz-Beato Elena , Ivanova Yoana , Martín Lorenzo Teresa , Maravilla-Herrera Paulina , Hidalgo-Vega Álvaro , Merino María
Published: January 2022

Background

Haemophilia A (HA) has been associated with poor health-related quality of life and a large economic burden, accentuated by severity, arthropathy, and inhibitors. To meet global standards of care, the management of HA should align with the principles of care outlined by the World Federation of Haemophilia. The aims of the present study were to establish a set of proposals to improve HA management within the Spanish National Health System (SNHS) and to estimate the impact its hypothetical implementation would generate from a clinical, healthcare, economic, and social perspective.

Methods

A multidisciplinary group of experts agreed on a set of 15 proposals to improve HA management within the SNHS. Thereafter, a forecast-type Social Return on Investment analysis was carried out to estimate the impact of implementing this set of proposals within the SNHS over a one-year timeframe, in relation to the required investment.

Results

This study estimated that the implementation of the complete set of 15 proposals would require a total investment of 2.34 M€ and have a total impact of 14.60 M€. Accordingly, every euro invested in the complete set of 15 proposals would yield a social return of €6.23 (€3.37 in the worst-case scenario and €9.69 in the best-case scenario) of both tangible and intangible nature in similar proportions (45.71 and 54.29%, respectively).

Conclusions

These results can be used to inform policy and practice such that interventions that may potentially improve current public health challenges associated with the management of HA may be implemented.
Spatial distribution and factors associated with adolescent pregnancy in Nigeria: a multi-level analysis
Authors: Bolarinwa Obasanjo Afolabi , Tessema Zemenu Tadesse , Frimpong James Boadu , Babalola Taiwo Oladapo , Ahinkorah Bright Opoku , Seidu Abdul-Aziz
Published: January 2022

Background

Adolescent pregnancy is a global public health and social phenomenon. However, the prevalence of adolescent pregnancy varies between and within countries. This study, therefore, sought to investigate the spatial distribution and factors associated with adolescent pregnancy in Nigeria.

Methods

Using data from the women’s recode file, a sample of 9448 adolescents aged 15-19 were considered as the sample size for this study. We employed a multilevel and spatial analyses to ascertain the factors associated with adolescent pregnancy and its spatial clustering.

Results

The spatial distribution of adolescent pregnancy in Nigeria ranges from 0 to 66.67%. A high proportion of adolescent pregnancy was located in the Northern parts of Nigeria. The likelihood of adolescent pregnancy in Nigeria was high among those who had sexual debut between 15 to 19 years [aOR = 1.49; 95%(CI = 1.16-1.92)], those who were currently married [aOR = 67.00; 95%(CI = 41.27-108.76)], and adolescents whose ethnicity were Igbo [aOR = 3.73; 95%(CI = 1.04-13.30)], while adolescents who were currently working [aOR = 0.69; 95%(CI = 0.55-0.88)] were less likely to have adolescent pregnancy.

Conclusion

A high proportion of adolescent pregnancy was located in the Northern parts of Nigeria. In addition, age at sexual debut, educational level, marital status, ethnicity, and working status were associated with adolescent pregnancy. Therefore, it is vital to take cognizant of these factors in designing adolescent pregnancy prevention programs or strengthening existing efforts in Nigeria.
Breast MRI in patients after breast conserving surgery with sentinel node procedure using a superparamagnetic tracer
Authors: Christenhusz Anke , Pouw Joost J. , Simonis Frank F. J. , Douek Michael , Ahmed Muneer , Klaase Joost M. , Dassen Anneriet E. , Klazen Caroline A. H. , van der Schaaf Margreet C. , ten Haken Bernard , Alic Lejla
Published: January 2022

Background

A procedure for sentinel lymph node biopsy (SLNB) using superparamagnetic iron-oxide (SPIO) nanoparticles and intraoperative sentinel lymph node (SLN) detection was developed to overcome drawbacks associated with the current standard-of-care SLNB. However, residual SPIO nanoparticles can result in void artefacts at follow-up magnetic resonance imaging (MRI) scans. We present a grading protocol to quantitatively assess the severity of these artefacts and offer an option to minimise the impact of SPIO nanoparticles on diagnostic imaging.

Methods

Follow-up mammography and MRI of two patient groups after a magnetic SLNB were included in the study. They received a 2-mL subareolar dose of SPIO (high-dose, HD) or a 0.1-mL intratumoural dose of SPIO (low-dose, LD). Follow-up mammography and MRI after magnetic SLNB were acquired within 4 years after breast conserving surgery (BCS). Two radiologists with over 10-year experience in breast imaging assessed the images and analysed the void artefacts and their impact on diagnostic follow-up.

Results

A total of 19 patients were included (HD, n = 13; LD, n = 6). In the HD group, 9/13 patients displayed an artefact on T1-weighted images up to 3.6 years after the procedure, while no impact of the SPIO remnants was observed in the LD group.

Conclusions

SLNB using a 2-mL subareolar dose of magnetic tracer in patients undergoing BCS resulted in residual artefacts in the breast in the majority of patients, which may hamper follow-up MRI. This can be avoided by using a 0.1-mL intratumoural dose.