bluuebunny/crossref_metadata_2025 huggingface dataset:
Three-dimensional Analysis of the Temporal Bone Morphology in Patients with Craniofacial Microsomia
Authors: Li Xiyuan , Liu Wei , Tang Xiaojun , Li Chuan , Zhang Zhiyong
Published: January 2023

Objective

To characterise the morphology of temporal bone in patients with craniofacial microsomia (CFM).

Design

A retrospective study.

Setting

A craniofacial centre.

Patients

Ninety-four patients with unilateral craniofacial microsomia.

Interventions

Mimics 21.0 (Materialise Inc., Belgium) was used to locate temporal bone landmarks on preoperative computed tomography data. The spatial Cartesian coordinate system was established in 3-matic 13.0 (Materialise Inc., Belgium). The coordinates of each landmark and the distances and angles between the landmarks were calculated. A classification system was used to quantify the severity of the zygomatic arch deformity.

Main outcome measure(s)

The bilateral differences in coordinates, linear and angular measurements, and the severity of temporal bone deformity (TTL δ, Psag δ, Paxiδ, and Tsag δ) among the groups were compared using the paired t-test and Kruskal-Wallis test, respectively.

Results

Compared to those of the unaffected side, the landmarks of the inner ear and petrous part on the affected side showed a decrease in the Z-coordinate or an increase in the X-coordinate. A superolateral rotation tendency of the temporal bone on the affected side was found. There were no significant differences in the linear and angular measurements between the groups. The degree of zygomatic arch deformation was lower in the mild group; however, no significant difference was found between the moderate and severe groups.

Conclusions

In patients with CFM, asymmetry of the temporal bone and its inner organs (vestibulocochlear organ, facial nerve, and vessels) exists in multiple dimensions; its severity is not completely consistent with the degree of mandibular involvement.
Managing Outpatient Cycle Times in Hospitals Using Integrated Closed-Loop Approaches
Authors: Subburaman Ganesh-Babu B , Munavalli Jyoti R , Ravilla Thulasiraj , Mertens Helen , Webers Carroll , Vasudeva Rao Shyam , van Merode Frits
Published: January 2023

Long waiting times in outpatient clinics have multiple adverse effects on patients and their attendants, staff and hospital management. Several approaches practiced to manage the cycle time have been proposed. The purpose of this study was to evaluate the impact of implementing closed-loop based multiple approaches together. This study was conducted in Aravind Eye Hospital (AEH), Madurai, India where several approaches to manage cycle times have been implemented over the years. Scheduling system was introduced to manage COVID-19 specific norms. We compared the cycle times in general outpatient clinics in a regime in which multiple approaches were practiced together before and after introducing scheduling to regimes in which individual approaches were practiced. We analysed how the cycle time varied by patient load. Cycle time for all patient days when the combined approach was used was 19% lower than baseline, and better than under each of the individual approaches. The outcome sustained even during the COVID-19 pandemic that necessitated additional processes and procedures. Therefore, implementing multiple approaches can be more effective to reduce the cycle time than implementing individual approaches
Family physician services and blood pressure control in China: A population-based retrospective cohort study
Authors: Jing Rize , Eggleston Karen , Lai Xiaozhen , Fang Hai
Published: January 2023

Objective

Given the importance of continuous family physician (FP) care in the management of hypertension, we explored the effects of such care among hypertensive patients in China, a country where such care is generally underutilized. We examined the longitudinal association between the use and continuity of FP services and health outcomes including blood pressure (BP) control rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP).

Methods

We conducted a population-based cohort study using data from the retrospective regional electronic health record database in Xiamen City, China. The study considered 18,119 hypertensive patients aged over 18 years who had at least two visits to a health center in the preceding 12 months. The generalized estimating equation model was adopted to estimate the longitudinal association between FP service utilization and health outcomes.

Results

Hypertensive patients treated by their own FPs had a higher BP control rate (OR = 1.14, 95% CI: 1.02–1.28) and lower DBP (−0.36 mmHg, 95% CI: −0.52 to −0.20) than those without a FP or those with a FP but treated by a general community physician (GCP). Compared with hypertensive patients treated exclusively by GCPs, patients treated continuously and exclusively by a FP were 45% more likely to have their BP under control (OR = 1.45, 95% CI: 1.32–1.60), and their SBP and DBP were lower by 0.6 mmHg (95% CI: −0.78 to −0.39) and 0.6 mmHg (95% CI: −0.79 to −0.47), respectively.

Conclusions

Hypertensive patients continuously treated by their own FPs performed better in terms of BP control rate, SBP and DBP values. In addition, the number and continuity of FP visits were associated with better BP control.
Language and communication skills in multilingual children on the autism spectrum: A systematic review
Authors: Gilhuber Christina Sophia , Raulston Tracy Jane , Galley Kasie
Published: January 2023

More than half the global population is estimated to be multilingual, yet research on autistic children who grow up in multilingual environments remains scant. We conducted a systematic review of peer-reviewed studies on multilingualism in autistic children and its impact on children’s language and communication skills. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, our search identified 22 group comparison studies published from 2011 to 2022. The current review addressed two main questions: (a) Which language and communication skills of multilingual autistic children were assessed and how; and (b) how the skills of multilingual autistic children compared with their peers. Semantic-related skills were most frequently reported, while phonology and pragmatics were the most underreported dimensions of language. Most reviewed studies used a combination of direct and indirect language assessments. Available research provides no indication that being exposed to more than one language has adverse effects on the communication skills of autistic children. Although multilingual autistic children often have common autism characteristics, such as pragmatic difficulties affecting their communication skills, preliminary findings also indicate that they may share some advantages of multilingualism with their multilingual nonautistic peers. Studies often excluded participants with co-occurring diagnoses, which may have impacted the generalizability of the findings.

Lay Abstract

Both parents and service providers have voiced concerns about the potential negative impact of exposure to multiple languages on the language and communication skills of autistic children. The current literature review summarized research that assessed the language and communication skills of multilingual autistic children in comparison with their autistic and nonautistic peers. After a comprehensive search, 22 relevant publications were identified that met the inclusion criteria of the current review. Thirteen studies used both direct (directly administered screening/diagnostic tools) and indirect language assessments (e.g. parent questionnaires). Receptive and expressive vocabulary was the most frequently assessed language skill. Available research does not support the assumption that bilingualism has negative effects on the language and communication skills of autistic children. The language and communication skills of multilingual autistic children frequently resembled their monolingual autistic peers in both strengths and areas of growth. Preliminary findings indicate that multilingual autistic children may share some advantages of multilingualism with their multilingual nonautistic peers. Studies often excluded participants with intellectual disabilities or complex communication needs, which means that a large population of autistic children is not yet represented in research about the effects of multilingualism.
Environmentally persistent free radicals enhance SARS-CoV-2 replication in respiratory epithelium
Authors: Yamamoto Ayaho , Sly Peter D , Chew Keng Yih , Khachatryan Lavrent , Begum Nelufa , Yeo Abrey J , Vu Luan D , Short Kirsty R , Cormier Stephania A , Fantino Emmanuelle
Published: January 2023

Epidemiological evidence links lower air quality with increased incidence and severity of COVID-19; however, mechanistic data have yet to be published. We hypothesized air pollution-induced oxidative stress in the nasal epithelium increased viral replication and inflammation. Nasal epithelial cells (NECs), collected from healthy adults, were grown into a fully differentiated epithelium. NECs were infected with the ancestral strain of SARS-CoV-2. An oxidant combustion by-product found in air pollution, the environmentally persistent free radical (EPFR) DCB230, was used to mimic pollution exposure four hours prior to infection. Some wells were pretreated with antioxidant, astaxanthin, for 24 hours prior to EPFR-DCB230 exposure and/or SARS-CoV-2 infection. Outcomes included viral replication, epithelial integrity, surface receptor expression ( ACE2, TMPRSS2), cytokine mRNA expression ( TNF-α, IFN-β), intracellular signaling pathways, and oxidative defense enzymes. SARS-CoV-2 infection induced a mild phenotype in NECs, with some cell death, upregulation of the antiviral cytokine IFN-β, but had little effect on intracellular pathways or oxidative defense enzymes. Prior exposure to EPFR-DCB230 increased SARS-CoV-2 replication, upregulated TMPRSS2 expression, increased secretion of the proinflammatory cytokine TNF-α, inhibited expression of the mucus producing MUC5AC gene, upregulated expression of p21 (apoptosis pathway), PINK1 (mitophagy pathway), and reduced levels of antioxidant enzymes. Pretreatment with astaxanthin reduced SARS-CoV-2 replication, downregulated ACE2 expression, and prevented most, but not all EPFR-DCB230 effects. Our data suggest that oxidant damage to the respiratory epithelium may underly the link between poor air quality and increased COVID-19. The apparent protection by antioxidants warrants further research.
Source Localization and Spectrum Analyzing of EEG in Stuttering State upon Dysfluent Utterances
Authors: Bayat Masoumeh , Boostani Reza , Sabeti Malihe , Yadegari Fariba , Pirmoradi Mohammadreza , Rao KS , Nami Mohammad
Published: January 2023

Purpose: The present study which addressed adults who stutter (AWS) attempted to investigate power spectral dynamics in the stuttering state by answering the questions using quantitative electroencephalography (qEEG). Method: A 64-channel electroencephalography (EEG) setup was used for data acquisition at 20 AWS. Since the speech, especially stuttering, causes significant noise in the EEG, 2 conditions of speech preparation (SP) and imagined speech (IS) were considered. EEG signals were decomposed into 6 bands. The corresponding sources were localized using the standard low-resolution electromagnetic tomography (sLORETA) tool in both fluent and dysfluent states. Results: Significant differences were noted after analyzing the time-locked EEG signals in fluent and dysfluent utterances. Consistent with previous studies, poor alpha and beta suppression in SP and IS conditions were localized in the left frontotemporal areas in a dysfluent state. This was partly true for the right frontal regions. In the theta range, disfluency was concurrence with increased activation in the left and right motor areas. Increased delta power in the left and right motor areas as well as increased beta2 power over left parietal regions was notable EEG features upon fluent speech. Conclusion: Based on the present findings and those of earlier studies, explaining the neural circuitries involved in stuttering probably requires an examination of the entire frequency spectrum involved in speech.
Coronary Revascularization in Patients With Diabetes: A Meta-Analysis of Randomized Controlled Trials and Propensity-Matched Studies
Authors: Ahmed Adham , Varghese Kathryn S. , Fusco Peter J. , Mathew Dave M. , Mathew Serena M. , Ahmed Sarah , Rogando Dillon O. , Salazar Stephanie A. , Pandey Roshan , Awad Ahmed K. , Levy Kenneth H. , Hernandez Marisol , Calixte Rose
Published: January 2023

Objective:

Patients with diabetes have poorer outcomes with coronary artery disease (CAD) and pose a unique clinical population for revascularization. We performed a pairwise meta-analysis of randomized trials (RCTs) and propensity-matched observational studies (PMS) to compare the clinical outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with diabetes.

Methods:

A comprehensive literature search was performed to identify RCT and PMS studies comparing CABG with PCI in patients with diabetes with concurrent CAD. Studies were pooled using the random-effects model to perform a pairwise meta-analysis. Primary outcomes included long-term all-cause mortality, cardiac mortality, myocardial infarction (MI), major adverse cardiac and cerebrovascular events (MACCE), and repeat revascularization. Meta-regression was used to explore the effects of baseline risk factors on primary outcomes with moderate to high heterogeneity.

Results:

A total of 18 RCTs and 9 PMS with 28,846 patients were included. PCI was associated with increased long-term all-cause mortality (risk ratio [RR] = 1.34, P < 0.001), cardiac mortality (RR = 1.52, P < 0.001), MI (RR = 1.51, P = 0.009), MACCE (RR = 1.65, P < 0.001), and repeat revascularization (RR = 2.48, P < 0.001) compared with CABG. There was no difference in long-term stroke between the 2 groups (RR = 0.95, P = 0.82). At meta-regression, a greater proportion of female patients in studies was associated with a decreased protective benefit for CABG for long-term all-cause mortality but an increased protective benefit for long-term MI and repeat revascularization.

Conclusions:

Revascularization of patients with diabetes using CABG is associated with significantly reduced long-term mortality, MI, MACCE, and repeat revascularizations. Future studies exploring the influence of gender on revascularization outcomes are necessary to elucidate the ideal treatment modality in patients with diabetes.
Ruptured isolated spinal artery aneurysms: Case series of five patients and a review of the literature on management strategies
Authors: McGuire Laura Stone , Fuentes Angelica , Charbel Fady T , Alaraj Ali , Amin-Hanjani Sepideh
Published: January 2023

Background

Aneurysms of the spinal arteries are rare entities, the majority of which are associated with other vascular lesions, such as spinal vascular malformations. Isolated spinal artery aneurysms (SAAs) are even less frequently encountered, and their incidence is largely unknown, as the literature is limited to case reports and small series. The optimal management strategy for SAAs is not well defined.

Objective

To review the institutional experience of five patients with isolated SAAs.

Methods

Five cases of isolated SAAs were identified at our institution, including two cases with multiple simultaneous SAAs. Clinical presentation, imaging, and management strategies for each case were reviewed. A literature review of all SAAs reported between 1950 and 2020 was performed.

Results

A total of five patients with eight isolated SAAs presented to our institution: one aneurysm was lumbar in location, while the remaining seven were thoracic. Two patients were treated with glue embolization followed by laminectomy for hematoma evacuation; one was treated with only surgery; and the other two, which both had multiple lesions, were managed conservatively with interval complete regression of their aneurysms. All five patients had good neurological outcomes. Literature review found 124 patients with at least 137 isolated SAAs and revealed treatment strategies including conservative management, glue or coil embolization, muslin wrapping, and surgical resection or clipping.

Conclusion

Multiple management strategies exist for SAAs, and clinical consideration of patient presentation and lesion morphology determine appropriate strategy. Our case series demonstrates three of these treatment paradigms.
Phylogenetic analysis of Prevotella copri from fecal and mucosal microbiota of IBS and IBD patients
Authors: Lo Presti Alessandra , Del Chierico Federica , Altomare Annamaria , Zorzi Francesca , Monteleone Giovanni , Putignani Lorenza , Angeletti Silvia , Cicala Michele , Guarino Michele Pier Luca , Ciccozzi Massimo
Published: January 2023

Background:

Prevotella copri is the most abundant member of the genus Prevotella that inhabits the human large intestines. Evidences correlated the increase in Prevotella abundance to inflammatory disorders, suggesting a pathobiont role.

Objectives:

The aim of this study was to investigate the phylogenetic dynamics of P. copri in patients with irritable bowel syndrome (IBS), inflammatory bowel diseases (IBDs) and in healthy volunteers (CTRL).

Design:

A phylogenetic approach was used to characterize 64 P. copri 16S rRNA sequences, selected from a metagenomic database of fecal and mucosal samples from 52 patients affected by IBD, 44 by IBS and 59 healthy.

Methods:

Phylogenetic reconstructions were carried out using the maximum likelihood (ML) and Bayesian methods.

Results:

Maximum likelihood phylogenetic tree applied onto reference and data sets, assigned all the reads to P. copri clade, in agreement with the taxonomic classification previously obtained. The longer mean genetic distances were observed for both the couples IBD and CTRL and IBD and IBS, respect to the distance between IBS and CTRL, for fecal samples. The intra-group mean genetic distance increased going from IBS to CTRLs to IBD, indicating elevated genetic variability within IBD of P. copri sequences. None clustering based on the tissue inflammation or on the disease status was evidenced, leading to infer that the variability seemed to not be influenced by concomitant diseases, disease phenotypes or tissue inflammation. Moreover, patients with IBS appeared colonized by different strains of P. copri. In IBS, a correlation between isolates and disease grading was observed.

Conclusion:

The characterization of P. copri phylogeny is relevant to better understand the interactions between microbiota and pathophysiology of IBD and IBS, especially for future development of therapies based on microbes (e.g. probiotics and synbiotics), to restore the microbiota in these bowel diseases.
Investigation of the relationship between rational drug use and healthy lifestyle behaviours of university students
Authors: Aslan Sinan , Çinar Ercan , Ertürk Nuriye EFE , Baysal Peyda
Published: January 2023

Aim:

the aim of this research is to investigate the relationship between rational drug use and healthy lifestyle behaviours of university students.

Method:

this descriptive and cross-sectional study consisted of 1115 students from a university in the Southeast-East Anatolia Region in the autumn semester of the 2019–2020 academic year. In the collection of data, ‘Student Introduction Form’, ‘The Rational Drug Use Scale’ and ‘The Health-Promoting Lifestyle Profile II’ were used. Ethical approval was obtained from the Batman University Ethics Committee. In addition, necessary legal permissions were obtained from the institution where the study was conducted and from the students. Descriptive statistics, number, percentage, independent t-test, ANOVA test and Spearman’s rank correlation were used in the Statistical Package for Social Science (SPSS) 22.0 package software to analyse the data.

Results:

the average age of the students was 21.31 ± 2.37 years, and their monthly drug expenditure was 142.63 ± 157.200 Turkish Lira. Some 28.1% of them were third-year students, 59% had graduated from Anatolian high school, 59.6% were living with their nuclear family, 49.1% had an equal level of income and expenditure, 7.7% had no chronic disease, and 9% had regular medication. Some 57.8% of them had health insurance. The Health-Promoting Lifestyle Profile II scale mean score of the students was 124.12 ± 21.37 and the Rational Drug Use Scale mean score was 33.65 ± 6.75. A statistically significant difference was found between the students’ class, income, and the total mean scores of the health-promoting lifestyle profile II scale ( p < 0.05). A statistically significant difference was found between the school type, family type and income status of the students and the total mean scores of the rational drug use scale ( p < 0.05).

Conclusion:

a strong positive correlation was found between rational drug use scale and the health-promoting lifestyle profile II scales.
Stress and Mood Associations With Smartphone Use in University Students: A 12-Week Longitudinal Study
Authors: Bradley Abigail H. M. , Howard Andrea L.
Published: January 2023

The current study used device-logged screen-time records to measure week-to-week within-person associations between stress and smartphone use in undergraduate students ( N = 187; mean age = 20.1 years). The study was conducted during fall 2020 and focused on differences across types of app used and whether accumulated screen use each week predicted end-of-week mood states. Participants uploaded weekly screenshots from their iPhone “Screen Time” settings display and completed surveys measuring stress, mood, and COVID-19 experiences. Results of multilevel models showed no week-to-week change in smartphone hours of use or device pickups. Higher stress levels were not concurrently associated with heavier smartphone use, either overall or by type of app. Heavier smartphone use in a given week did not predict end-of-week mood states, but students who tended to spend more time on their phones in general reported slightly worse moods—a between-persons effect potentially reflecting deficits in well-being that are present in students’ off-line lives as well. Our findings contribute to a growing scholarly consensus that time spent on smartphones tells us little about young people’s well-being.
Closing-Wedge Posterior Tibial Slope–Reducing Osteotomy in Complex Revision ACL Reconstruction
Authors: Vivacqua Thiago , Thomassen Stephan , Winkler Philipp W. , Lucidi Gian A. , Rousseau-Saine Alexis , Firth Andrew D. , Heard Mark , Musahl Volker , Getgood Alan M.J.
Published: January 2023

Background:

A posterior tibial slope (PTS) >12° has been shown to correlate with failure of anterior cruciate ligament (ACL) reconstruction (ACLR). PTS-reducing osteotomy has been described to correct the PTS in patients with a deficient ACL, mostly after failure of primary ACLR.

Purpose:

To report radiologic indices, clinical outcomes, and postoperative complications after PTS-reducing osteotomy performed concurrently with revision ACLR (R-ACLR).

Study Design:

Case series; Level of evidence, 4.

Methods:

A review of medical records at 3 institutions was performed of patients who had undergone PTS-reducing osteotomy concurrently with R-ACLR between August 2010 and October 2020. Radiologic parameters recorded included the PTS, patellar height according to the Caton-Deschamps Index (CDI), and anterior tibial translation (ATT). Patient-reported outcomes (International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS]), reoperations, and complications were evaluated.

Results:

Included were 23 patients with a mean follow-up of 26.7 months (range, 6-84 months; median, 22.5 months). Statistically significant differences from preoperative to postoperative values were found in PTS (median [range], 14.0° [12°-18°] vs 4.0° [0°-15°], respectively; P < .001), CDI (median, 1.00 vs 1.10, respectively; P = .04) and ATT (median, 8.5 vs 3.6 mm, respectively; P = .001). At the final follow-up, the IKDC score was 52.4 ± 19.2 and the KOOS subscale scores were 81.5 ± 9.5 (Pain), 74 ± 21.6 (Symptoms), 88.5 ± 8 (Activities of Daily Living); 52.5 ± 21.6 (Sport and Recreation), and 48.8 ± 15.8 (Quality of Life). A traumatic ACL graft failure occurred in 2 patients (8.7%). Reoperations were necessary for 6 patients (26.1%) because of symptomatic hardware, and atraumatic recurrent knee instability was diagnosed in 1 patient (4.3%).

Conclusion:

Tibial slope–reducing osteotomy resulted in a significant decrease of ATT and can be considered in patients with a preoperative PTS ≥12° and ≥1 ACLR failure. In highly complex patients with multiple prior surgeries, the authors found a reasonably low graft failure rate (8.7%) when utilizing PTS-reducing osteotomy. Surgeons must be aware of potential complications in patients with multiple previous failed ACLRs.
Optimization of Sound Coding Strategies to Make Singing Music More Accessible for Cochlear Implant Users
Authors: Tahmasebi Sina , Segovia-Martinez Manuel , Nogueira Waldo
Published: January 2023

Cochlear implants (CIs) are implantable medical devices that can partially restore hearing to people suffering from profound sensorineural hearing loss. While these devices provide good speech understanding in quiet, many CI users face difficulties when listening to music. Reasons include poor spatial specificity of electric stimulation, limited transmission of spectral and temporal fine structure of acoustic signals, and restrictions in the dynamic range that can be conveyed via electric stimulation of the auditory nerve. The coding strategies currently used in CIs are typically designed for speech rather than music. This work investigates the optimization of CI coding strategies to make singing music more accessible to CI users. The aim is to reduce the spectral complexity of music by selecting fewer bands for stimulation, attenuating the background instruments by strengthening a noise reduction algorithm, and optimizing the electric dynamic range through a back-end compressor. The optimizations were evaluated through both objective and perceptual measures of speech understanding and melody identification of singing voice with and without background instruments, as well as music appreciation questionnaires. Consistent with the objective measures, results gathered from the perceptual evaluations indicated that reducing the number of selected bands and optimizing the electric dynamic range significantly improved speech understanding in music. Moreover, results obtained from questionnaires show that the new music back-end compressor significantly improved music enjoyment. These results have potential as a new CI program for improved singing music perception.
Does social desirability of entrepreneurship matter for early-stage entrepreneurs’ internationalization? The moderating role of economic freedom
Authors: Capelleras Joan-Lluís , Martin-Sanchez Victor , Zhang Chao
Published: January 2023

Based on an institutional perspective, this study examines the influence of the social desirability of entrepreneurship on early-stage entrepreneurs’ internationalization and the moderating role of home country economic freedom. Using data from 45,454 early-stage entrepreneurs in 48 countries for the period 2005–2016, we find that the social desirability of entrepreneurship negatively affects early-stage entrepreneurs’ internationalization, and that economic freedom positively moderates this relationship. The study contributes to the literature by showing how the home country institutional context affects the level of early-stage entrepreneurs’ internationalization across countries.

JEL CLASSIFICATION: F23; L26; O17
Ambiguous Expectations of Parent Caregiving for the Child and Adolescent With Cancer at the Hospital and at Home—An Ethnographic Study
Authors: Roug Louise Ingerslev , Jarden Mary , Wahlberg Ayo , Hjalgrim Lisa Lyngsie , Hansson Helena
Published: January 2023

Background: Over the past three decades, complex care and treatment have increasingly become the responsibility of parents as home-based care providers, yet little is known about parents’ caregiving experiences when considering the variety of care tasks. It is imperative to gain insight into the challenges parents face when managing treatment and care of their child with cancer to ensure optimal parental support and prior to further expansion of home-based parent caregiving. This study aimed to explore the experiences of children and adolescents with cancer, who had received treatment through a portable infusion pump, and their parents in managing different care tasks. It is the first study and forms the basis of the research project INTACTatHome, that develops and tests interventions of home-based intravenous anti-cancer treatment. Methods: Ethnographic fieldwork comprising participant observation and semi-structured interviewing analyzed using qualitative thematic analysis. Thirteen families participated in the study. Results: Three main themes were identified: (1) being a “mini-nurse”; (2) dividing care; and (3) managing anxiety and fear, each based on separate sub-themes. These themes were bound together by an overarching theme: “Ambiguous expectations of parent caregiving.” Discussion: This study contributes to a deeper understanding of the varying experiences of children and adolescents and their parents in managing different care tasks for a child or adolescent with cancer. It underscores the need to establish clear expectations of parents as caregivers throughout the cancer treatment trajectory. This perspective is crucial when developing and implementing future home-based care services.
SBNO2 is a critical mediator of STAT3-driven hematological malignancies
Authors: Brandstoetter Tania , Schmoellerl Johannes , Grausenburger Reinhard , Kollmann Sebastian , Doma Eszter , Huuhtanen Jani , Klampfl Thorsten , Eder Thomas , Grebien Florian , Hoermann Gregor , Zuber Johannes , Mustjoki Satu , Maurer Barbara , Sexl Veronika
Published: January 2023

Gain-of-function mutations in the signal transducer and activator of transcription 3 (STAT3) gene are recurrently identified in patients with large granular lymphocytic leukemia (LGLL) and in some cases of natural killer (NK)/T-cell and adult T-cell leukemia/lymphoma. To understand the consequences and molecular mechanisms contributing to disease development and oncogenic transformation, we developed murine hematopoietic stem and progenitor cell models that express mutated STAT3Y640F. These cells show accelerated proliferation and enhanced self-renewal potential. We integrated gene expression analyses and chromatin occupancy profiling of STAT3Y640F-transformed cells with data from patients with T-LGLL. This approach uncovered a conserved set of direct transcriptional targets of STAT3Y640F. Among these, strawberry notch homolog 2 (SBNO2) represents an essential transcriptional target, which was identified by a comparative genome-wide CRISPR/Cas9-based loss-of-function screen. The STAT3-SBNO2 axis is also present in NK-cell leukemia, T-cell non-Hodgkin lymphoma, and NPM-ALK-rearranged T-cell anaplastic large cell lymphoma (T-ALCL), which are driven by STAT3-hyperactivation/mutation. In patients with NPM-ALK+ T-ALCL, high SBNO2 expression correlates with shorter relapse-free and overall survival. Our findings identify SBNO2 as a potential therapeutic intervention site for STAT3-driven hematopoietic malignancies.
A scoping review on the risk of tuberculosis in specific population groups: can we expand the World Health Organization recommendations?
Authors: Bigio Jacob , Viscardi Angelo , Gore Genevieve , Matteelli Alberto , Sulis Giorgia
Published: January 2023

Since 2015, the World Health Organization (WHO) has recommended prioritising testing and treatment of tuberculosis (TB) infection (TBI) in 11 high-risk groups. With new options emerging for TB preventive treatment, we conducted a scoping review, in consultation with the WHO's Global Tuberculosis Programme, to explore the evidence for other population groups at potentially high risk of progression to active TB. We searched six databases for preprints and articles published between 2000 and August 2022. 18 out of 33 668 screened records were included (six meta-analyses and 12 original research studies). Most were observational studies reporting the incidence of active TB in a risk groupversuscontrol. Glomerular diseases had the strongest association with active TB (standardised incidence ratio 23.36, 95% CI 16.76–31.68) based on an unpublished study. Other conditions associated with increased risk of active TB included hepatitis C, malignancies, diabetes mellitus, rheumatoid arthritis and vitamin D deficiency. Corticosteroid use was also associated with increased risk in several studies, although heterogeneous definitions of exposure and indications for use challenge interpretation. Despite methodological limitations of the identified studies, expanding the recommendations for TBI screening and treatment to new risk groups such as those reported here should be considered. Further group-specific systematic reviews may provide additional data for decision-making.
Lockdown stringency and employment formality: evidence from the COVID-19 pandemic in South Africa
Authors: Köhler Timothy , Bhorat Haroon , Hill Robert , Stanwix Benjamin
Published: January 2023

In response to COVID-19 most governments used some form of lockdown policy to manage the pandemic. This required making iterative policy decisions in a rapidly changing epidemiological environment resulting in varying levels of lockdown stringency over time. While studies estimating the labour market effects of lockdown policies exist in both developed and developing countries, there is limited evidence on the impact of variation in lockdown stringency, particularly in developing countries. Such variation may have large heterogenous effects both on aggregate and between worker groups. In this paper, we estimate the causal effect of lockdown stringency on employment probabilities, adopting a quasi-experimental design on unique labour force panel data from South Africa. South Africa is a useful case study given its upper-middle-income status and relatively small informal sector, thus serving as an example to a variety of developing and developed country economies. We find that the negative employment effects of the country’s lockdown policy were driven by effects on the informal sector. Furthermore, we observe important effect heterogeneity by employment formality as the stringency of the country’s lockdown regulations changed over time. We find that more stringent lockdown levels negatively affected informal, but not formal sector employment, while less stringent levels negatively affected formal, but not informal sector employment. From a policy perspective, evidence of such heterogeneity can inform decisions around the optimal targeting of support as the pandemic progresses and lockdown policies are reconsidered.
Causes of endoscopic misdiagnosis of gastrointestinal cyst as solid lesion
Authors: Gao Fei , Li Huikai , Du Chen , Han Ke , Linghu Enqiang
Published: January 2023

Background

To explore the causes of endoscopic misdiagnosis of gastrointestinal cyst as solid lesion and the diagnostic value and limitations of EUS, guide clinicians to develop appropriate treatment strategies and improve the ability to identify SMT.

Methods

We enrolled patients diagnosed with gastrointestinal SMT between January 2001 and December 2021 who underwent endoscopic resection with postoperative pathological diagnosis of cyst. Age, sex, maximum lesion diameter, judge the texture of lesion, origin and echo are potential factors affecting the diagnostic accuracy of cysts.

Results

The diagnostic accuracy of EUS assessment 39.3% higher than that without EUS assessment (6.7%). The error rate was 60.7%, lower than that without EUS assessment (93.3%), suggesting that preoperative EUS assessment improved the diagnostic accuracy of gastrointestinal cyst (Fisher's accurate test, P = 0.033). The diagnostic accuracy of “judge the texture of lesion” was higher than that of no touch (P = 0.031). When the lesion size increased by 1 cm, the diagnostic accuracy decreased by about 21%. Hypoechoic lesions were less likely to be diagnosed correctly than anechoic lesions (P = 0.003).

Conclusions

The main cause of misdiagnosing gastrointestinal cyst as solid lesion is that no EUS assessment was performed before endoscopic resection or anechoic lesion was judged as hypoechoic lesion by preoperative EUS assessment.
SPATS2 is correlated with cell cycle progression and immune cells infiltration in hepatocellular carcinoma
Authors: Lin Jing , Yan Jia , Deng Xiu ling , Wang Chang shan , Wang Hai sheng
Published: January 2023

The spermatogenesis associated serine rich 2 (SPATS2) is a member of RNA-binding protein in which the abnormal expression is linked with carcinogenesis in serval types of cancer. However, there is no systematic study on the differential expression, prognostic significance, epigenetic regulation, immune infiltration of SPATS2 in hepatocellular carcinoma (HCC). In the present study, we investigated the expression, prognosis, epigenetic regulation, and immune cell infiltration of SPATS2 in HCC. We found that the elevated expression of SPATS2 was unfavorably associated with the clinical pathological stage and prognosis. Functional enrichment analysis revealed that SPATS2 is associated with cell cycle, apoptosis and cancer cell metastasis processes in HCC. Our results confirmed that knockdown of SPATS2 will affect cell cycle, apoptosis and invasion of HCC cell lines. Moreover, the expression of SPATS2 is upregulated by epigenetic regulation, including DNA methylation, m6A and histone modification in HCC. In addition, SPATS2 expression was positively correlated with immune cell infiltration or expression of immune related gene markers in HCC. Taken together, our data demonstrated that SPATS2 is associated with progression and immune infiltration, and could serve as a prognostic biomarker for HCC. In conclusion, these results highlight the potential of SPATS2 to be used as a therapeutic target for HCC.
Short and long-term follow-up and clinical outcomes in patients with celiac disease in a large private practice setting
Authors: Khurana Akash , Leffler Daniel A. , Gomez Kayeromi , Thukral Chandrashekhar
Published: January 2023

Background

Celiac disease (CD) is caused by an immune response to gluten and treatment is adherence to a gluten-free diet. Guidelines from studies in large academic settings recommend registered dietitian (RD) referrals at time of diagnosis and periodic testing for micronutrient deficiencies. There is limited data to guide follow-up parameters in a large, community-based practice. The purpose of this study was to evaluate guideline adherence in this setting.

Methods

This retrospective study conducted in 2019 assessed CD care based on follow-up rates, micronutrient testing, symptoms, and serology results in cohorts with and without RD referrals. Patients in this study were followed at Rockford Gastroenterology Associates (RGA): a large, private GI practice. Patients were included if they had a diagnosis of CD from 1/2014 through 12/2018, based on positive serology and/or duodenal biopsy. Patient data was collected by chart review and analyzed through Microsoft Excel. Fisher’s exact and Chi-square tests were used for the statistical analysis and were calculated through the Statistical Product and Service Solutions (SPSS) software.

Results

320 patients were initially reviewed and a cohort of 126 patients met inclusion criteria. 69.8% had a RD referral. 65.9% had at least one lab test order for any of the 6 micronutrients. Of 63 patients tested for iron, 11 were iron deficient (8 with RD referral). Of 64 patients tested for vitamin D, 21 were deficient (17 with referral). 80.2% attended at least one follow-up appointment, but 34.9% had only one follow-up visit over a mean follow up duration of 5.82 months. 79 patients had follow-up data for symptoms or serology and were separated into 4 categories (with vs. without RD referral): (1) asymptomatic and negative serology (32% vs. 26%), (2) symptomatic and negative serology (28% vs. 16%), (3) asymptomatic and positive serology (27% vs. 32%), (4) symptomatic and positive serology (13% vs. 26%). Category 1 yielded a fisher exact test value of 2.62 (p = 0.466).

Conclusions

RD referral, micronutrient testing, and close follow-up are important parameters that affect outcomes in patients with CD. Rates for dietitian referral, some micronutrient testing and follow-up visits were higher than 50%, though results from this study were not statistically significant. Further standardization of follow-up testing and monitoring for CD will help minimize discrepancies between community-based and large, academic GI practices.
Transradial versus transfemoral approach for TACE: a retrospective study
Authors: You Ke , Guo Tao , Sun Da , Song Hao , Liu Zuojin
Published: January 2023

Objective

Transcatheter arterial chemoembolization (TACE) has been widely applied in the treatment of hepatocellular carcinoma (HCC). Our study aimed to investigate the feasibility and efficacy of transradial access as an alternative to transfemoral access for TACE.

Methods

Patients undergoing TACE were divided into the radial artery (RA) route group or the femoral artery (FA) route group according to the operation approach, namely, transradial or transfemoral access. We retrospectively analysed the clinical characteristics, technical outcomes, clinical efficacy and incidence of adverse events to compare the two technologies for intervention for HCC.

Results

Transradial access was found to achieve superior technical outcomes and clinical efficacy, as the patients in the RA group had a lower rate of hepatic arterial spasm, a higher partial response rate and a lower progression rate than the patients in the FA group according to the mRECIST evaluations. In contrast, the liver function indices and VAS (visual analogue scale) pain scores were consistent across the two groups. Moreover, patients in the RA group had a shorter length of stay than those in the FA group, despite similar hospitalization expenses. The total adverse events were significantly reduced by transradial access for TACE (72.5% vs. 84.1%, P = 0.027).

Conclusion

Our study suggested that transradial access is an effective and feasible alternative to transfemoral access for TACE. Large-scale prospective randomized controlled studies are expected.
Lethality risk markers by sex and age-group for COVID-19 in Mexico: a cross-sectional study based on machine learning approach
Authors: Rojas-García Mariano , Vázquez Blanca , Torres-Poveda Kirvis , Madrid-Marina Vicente
Published: January 2023

Background

Mexico ranks fifth worldwide in the number of deaths due to COVID-19. Identifying risk markers through easily accessible clinical data could help in the initial triage of COVID-19 patients and anticipate a fatal outcome, especially in the most socioeconomically disadvantaged regions. This study aims to identify markers that increase lethality risk in patients diagnosed with COVID-19, based on machine learning (ML) methods. Markers were differentiated by sex and age-group.

Methods

A total of 11,564 cases of COVID-19 in Mexico were extracted from the Epidemiological Surveillance System for Viral Respiratory Disease. Four ML classification methods were trained to predict lethality, and an interpretability approach was used to identify those markers.

Results

Models based on Extreme Gradient Boosting (XGBoost) yielded the best performance in a test set. This model achieved a sensitivity of 0.91, a specificity of 0.69, a positive predictive value of 0.344, and a negative predictive value of 0.965. For female patients, the leading markers are diabetes and arthralgia. For males, the main markers are chronic kidney disease (CKD) and chest pain. Dyspnea, hypertension, and polypnea increased the risk of death in both sexes.

Conclusions

ML-based models using an interpretability approach successfully identified risk markers for lethality by sex and age. Our results indicate that age is the strongest demographic factor for a fatal outcome, while all other markers were consistent with previous clinical trials conducted in a Mexican population. The markers identified here could be used as an initial triage, especially in geographic areas with limited resources.
Epidemiology of TB in prisoners: a metanalysis of the prevalence of active and latent TB
Authors: Placeres Aline Ferreira , de Almeida Soares Débora , Delpino Felipe Mendes , Moura Heriederson Sávio Dias , Scholze Alessandro Rolim , dos Santos Márcio Souza , Arcêncio Ricardo Alexandre , Fronteira Inês
Published: January 2023

Background

Tuberculosis (TB) in prisons usually occurs at higher rates than in the general population, especially in developing countries. TB has been reported as the most common cause of death among prisoners. Studies have shown limitations for early detection of TB in prisons that seem to result from mistaken concepts about TB, delayed diagnosis mainly due to the naturalization of lack of healthcare for this population

Methods

A scoping review was performed using the methodology of the Joanna Briggs Institute to assess “What are the scientific evidences on the epidemiology of TB in the prison system?”. Then, a meta-analysis was performed to assess the prevalence of TB (active and latent) TB in prisoners. The results are presented as prevalence, in percentage, through random effects models, with a confidence interval of 95%.

Results

Regarding active TB, the results of the metanalysis showed that countries with a high burden of TB had a prevalence of 3.54% [2.71; 4.63], countries not considered to be high burden TB countries had a prevalence of 1.43% [0.86; 2.37]. Latent TB had a prevalence of 51.61% [39.46; 63.58] in high TB burden countries and a prevalence of 40.24% [23.51; 59.61] in countries with low TB burden. In terms of development, in low- and lower-middle-income countries, the prevalence of active TB was 3.13% [1.84; 5.29] and in high- and upper-middle income countries the prevalence was 2.25% [1.70; 2.99]. The prevalence of latent TB in high- and middle-income countries was 43.77% [28.61; 60.18] and of 49.42% [45.91; 52.94] in low and lower middle-income countries.

Conclusion

Our analysis suggests that TB, and probably other infectious diseases, find fertile ground in prisons where previous acquire social disadvantages seem to thrive—therefore, TB in prisons is a global public health problem and effective strategies are needed to control the disease are needed targeting the prison environment, including rapid health assessments to understand each context and to implement tailored and precision interventions.