bluuebunny/crossref_metadata_2025 huggingface dataset:
Autism Spectrum Disorder and Obesity in Children: A Systematic Review and Meta-Analysis
Authors: Sammels Olivia , Karjalainen Louise , Dahlgren Jovanna , Wentz Elisabet
Published: March 2022

Introduction: Children and adolescents with autism spectrum disorder (ASD) appear to be at greater risk of excess weight gain. The aim of this systematic review and meta-analysis was to examine whether children with ASD have a greater prevalence of obesity and whether the prevalence of ASD is higher in children with obesity. Methods: We conducted a systematic search on PubMed, Scopus, and PsychINFO until May 21, 2021. We used the meta package in the R in order to calculate the pooled prevalence and relative risk of obesity in children with ASD. Results: We found 20 eligible studies investigating the prevalence of obesity in children with ASD, with the prevalence ranging from 7.9 to 31.8% and from 1.4 to 23.6% among controls. All but three studies originated from the USA. The proportion of children with obesity in ASD populations was 17% (95% confidence interval [CI]: 13–22). The relative risk of obesity in children with ASD compared with control children was 1.58 (95% CI: 1.34–1.86). There were no controlled studies reporting on the prevalence of ASD in children with obesity. Conclusion: Children and adolescents with ASD have a higher prevalence of obesity than healthy controls. There is a need for further prevalence studies of obesity in children with ASD, especially outside the USA, since the few European studies carried out have failed to show a significant difference between obesity prevalence in children with and without ASD. There is no knowledge at all regarding the prevalence of ASD among children with obesity.
Magnolia: a construção imagética de uma muxe por Graciela Iturbide
Authors: Kons Luiza Possamai
Published: March 2022

Este artigo pretende analisar a construção imagética das fotografias Magnolia I e Magnolia II, capturadas no ano de 1986 na cidade de Juchitán de Zaragoza, no Istmo de Tehuantepec, Sul do México, e presentes no livro fotodocumental Juchitán de Las Mujeres, de Graciela Iturbide. Partiremos de uma contextualização das características presentes no trabalho da fotógrafa, bem como das singularidades presentes na formação identitária das muxes, buscando entender se os retratos de Magnolia constituem uma visão essencialista, entendendo que os sistemas conotativos fazem parte da interpretação da linguagem fotográfica.
Judith Scott: a tessitura do devir
Authors: Oliveira Solange de
Published: March 2022

Este artigo aborda o fiar como devir nas obras de Judith Scott (1943-2005), artista trissômica, iletrada e inábil para a linguagem verbal. O intento é examinar a índole intuitiva e a temporalidade – a formatividade prioriza o processo ao produto. A temporalidade será abordada a partir da filosofia bergsoniana. Frequentemente, expressões ínsitas são sufocadas pelo conhecimento teórico, por “ideias muito possuídas”, em termos pontyanos. Deduzir aleatoriedade é um equívoco, orientado pela generalidade. Considerando o ineditismo da pesquisa sobre a estadunidense no Brasil, esta reflexão contribui com a diversidade de perspectivas sobre processos de saber artístico e com a consolidação da fortuna crítica, além de proporcionar uma discussão sobre a possibilidade de pensar a arte a partir de uma perspectiva fenomenológica.
Registros de absenteísmo-doença: o que os conteúdos revelam sobre a funcionalidade de trabalhadores da higienização?
Authors: Santos Bárbara Cordeiro , Lopes Jaqueline do Carmo Machado , Scharan Karoleen Oswald , Moser Auristela Duarte de Lima
Published: March 2022

Objetivo: Utilizar os registros de absenteísmo-doença de trabalhadores de limpeza do setor de higienização de uma instituição de ensino superior para estabelecer um subsídio inicial de conteúdo com as categorias da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Método: Estudo quantitativo, descritivo e retrospectivo. Foram analisados 2.881 atestados médicos, de trabalhadores de limpeza durante o período de 2010 a 2014, classificados de acordo com a CID-10. Variáveis estudadas: sexo, data admissional e demissional, início e fim do atestado, número de dias de afastamento e códigos da CID-10. A partir das regras propostas por Cieza et al. 2016, em um processo efetuado por três pesquisadoras, estabeleceu-se o conteúdo dos registros de absenteísmo-doença com a CIF. Os dados foram tratados pelo programa IBM SPSS Statistics 2.0. Resultados: Foram identificados 29 conceitos significativos da CID-10, referentes aos 6 capítulos mais frequentes. Vinte e seis deles foram relacionados a 17 categorias da CIF, majoritariamente às funções e estruturas do Corpo, seguido de 1 categoria de Atividades e Participação. Um conceito foi classificado como condição de saúde e 2 como não cobertos pela CIF. Os dados disponíveis não evidenciaram categorias do componente Fatores Ambientais. Conclusão: O conteúdo dos registros de absenteísmo-doença permitiu subsidiar a seleção de categorias da CIF, refletindo os aspectos biofísicos contemplados na CID-10. Porém, para considerar os aspectos biopsicossociais da CIF e da política de saúde do trabalhador, será importante contemplar nos registros de absenteísmo-doença conteúdos referentes as Atividades e Participação e, Fatores Ambientais, nos quais os trabalhadores experenciam sua funcionalidade.
Quedas em idosos comunitários atendidos por uma estratégia de saúde da família do município de São Leopoldo: prevalência e fatores associados
Authors: Carvalho Murilo Santos de , Martins Patricia , Santos Franciele Souza , Queiroz Débora Taís Seifert
Published: March 2022

Idosos ocupam espaço significativo em nossa sociedade gerando uma modificação na estrutura de gastos em diversas áreas. Um dos fatores que mais colaboram para gastos em saúde é a queda acidental/recorrente, evento responsável por altas taxas de mortalidade e desenvolvimento de morbidades na terceira idade. Objetivo: Identificar a prevalência de quedas em idosos e realizar um rastreio epidemiológico dos fatores de risco encontrados nesta faixa etária. Método: Trata-se de estudo observacional do tipo descritivo transversal realizado com idosos pertencentes a uma Estratégia de Saúde da Família de São Leopoldo/RS, entre fevereiro e março de 2020. A coleta de dados se deu através de cinco instrumentos: questionário de histórico de quedas; Timed Up & Go (TUG); Teste de Alcance Funcional (TAF); Dinamometria de Preensão Palmar (DPP); e Mini Exame do Estado Mental (MEEM). Para análise de dados, utilizou-se teste Qui-Quadrado de Pearson, resíduos ajustados e Odds Ratio. Resultados: Amostra foi composta por 125 idosos comunitários, 66,4% do sexo feminino e com média de idade de 70,39±6,56 anos. Mais da metade sofreu queda no último ano, sendo as de tipo recorrentes as mais prevalentes (61,6%) e 53,4% destes fraturaram algum osso como resultado da queda. O histórico de quedas demonstrou associação positiva (p<0,05) ao sexo feminino, faixa etária mais elevada, viuvez, viver sozinho, polimedicação, medo de cair, ao TAF e à DPP. Conclusão: Idosos comunitários apresentam alta prevalência de quedas e diversos fatores causais associados. Reconhece-se a importância de uma avaliação multidimensional para rastrear os riscos e identificar idosos mais suscetíveis.
Effects of mental practice strategies associated with physical therapy on gait and risk of falls in Parkinson disease: experimental study
Authors: Silva Liliane Pereira da , Silva Taís Arcanjo Maropo da , Silva Kássia Maria Clemente da , Santos Suzana Pereira dos , Silva Douglas Monteiro da , Lins Carla Cabral dos Santos Accioly , Coriolano Maria das Graças Wanderley de Sales , Lins Otávio Gomes
Published: March 2022

Objective: To compare the effects of mental practice (MP) strategies associated with physical therapy on gait and risk of falls in people with Parkinson's disease (PD). Method: We included 35 people of both sexes with mild to moderate idiopathic PD allocated into four groups; 1- Control group (CG), 2- Image-guided mental practice group (IGMP), 3- Audio-guided mental practice group (AGMP) and 4- Unguided mental practice group (UMP). The subjects in the experimental groups underwent 15 sessions of motor physical therapy and mental practice, while the CG received only physical therapy. The sessions were held twice a week, 40 minutes for motor physical therapy and 1 minutes for the corresponding Mental Practice protocol. To evaluate the spatiotemporal parameters of the gait, the 10-meter Walking Test was used and the risk of falls using the Timed Up and Go (TUG). Results: The IGPM group presented significant results for the time (p= 0.027) and gait speed (p= 0.025) when compared to the results of the CG. Cadence and risk of falls had no major effect for the group. The UMP and AGMP groups did not present statistically significant results for TC10m and TUG when compared with CG. Conclusion: The results of this study suggest that image-guided mental practice training associated with motor physical therapy is more effective in increasing gait speed than other MP strategies.
O treinamento resistido reduz a dor em mulheres com fibromialgia
Authors: Andrade Alexandro , Sieczkowska Sofia Mendes , Silva Flávia Aguiar da , Vilarino Guilherme Torres
Published: March 2022

O treinamento resistido (TR) é uma estratégia de intervenção para o tratamento da fibromialgia (FM) que possui baixo custo, fácil acesso, fácil aplicação e efeito positivo na manutenção geral da saúde. Objetivo: Investigar o efeito de quatro semanas de TR na dor de pacientes com FM. Método: Trata-se de um ensaio clínico controlado não randomizado com cinquenta e quatro mulheres com FM (idade: 53,74 ± 8,54 anos). As pacientes foram alocadas no grupo intervenção (n= 33) e no grupo controle (n= 21). A intervenção consistiu em quatro semanas de um programa de TR supervisionado. Para a avaliação da dor foi utilizado um algômetro e a escala visual analógica. Para avaliar as diferenças após a intervenção, foi utilizada a ANOVA de dois fatores. Resultados: Os pacientes do grupo intervenção tiveram redução significativa da percepção da dor e aumento do limiar de dor, mas não houve diferença quando comparados ao grupo controle. Conclusão: A prática do TR por quatro semanas reduz a dor de pacientes com FM, entretanto, não foram encontradas diferenças significativas com o grupo controle. Por esse motivo, os resultados significativos deste estudo devem ser considerados com cautela, reforçando a necessidade de novos estudos.
Nãotradução: uma poiética tradutória perturbadora
Authors: Stradioto-Casolato Ana Magda
Published: March 2022

Este trabalho pretende analisar a nãotradução, termo proposto por Jacques Brault para definir uma de suas estratégias de criação poética. Segundo ele, a nãotradução é uma prática de escrita e não um sistema ou teoria tradutória. Apoiando-nos nos ensaios fundadores da nãotradução de autoria do próprio Brault, procuramos demonstrar que se trata de uma técnica de composição cujo resultado é uma reescrita criativa, nem poema original e nem tradução, mas uma nova intelegibilidade de ambos. Sem se emancipar do poema original e graças a virtuosidade do poeta nãotradutor, a nãotradução faz surgir um terceiro texto estabelecendo uma relação enunciativa tríplice que congrega três vozes: a do poeta do poema original, a do poeta nãotradutor e a que resulta da fusão de ambas.
Bento Aranha e a cidade da borracha: Manaus, 1904-1910
Authors: Pinheiro Luís Balkar Sá Peixoto
Published: March 2022

Explorando a rica produção jornalística legada por Bento de Figueiredo Tenreiro Aranha, intelectual e político paraense, o artigo aborda as crônicas escritas por ele no Jornal do Commercio, de Manaus (AM), entre os anos de 1904 e 1910, momento que coincide com a expansão da economia de exportação da borracha no Norte do Brasil e com o processo de urbanização modernizadora da capital amazonense. Transferindo-se para Manaus, cidade onde morou por cerca de quatro décadas, Bento Aranha participou ativamente do círculo letrado e político da cidade, logo se tornando um personagem de grande expressão e influência. Lançando mãos de diferentes estratégias distintivas, destacou-se no interior da elite cultural de Manaus, transformando-se num intelectual mediador de suma importância. Sua trajetória foi, em muitos aspectos, singular no Norte do país, em especial pela radicalidade e contundência de suas posições, tendo ali abraçado, de forma pioneira, o abolicionismo e o republicanismo. Contraditando o discurso apologético do urbanismo modernizador, então em voga, dedicou dezenas de crônicas aos problemas estruturais da cidade de Manaus, sempre com atenção aos populares e aos deserdados do látex. A leitura crítica desses escritos, revela uma cidade pelo avesso, rica em contraste e prenhe de problemas e contradições.
Impact of Antihypertensive Drug Class on Outcomes in SPRINT
Authors: DeCarolis Douglas D. , Gravely Amy , Olney Christine M. , Ishani Areef
Published: March 2022

Background:

The primary objective of this analysis is to assess if greater exposure to any major antihypertensive drug class was associated with reduced primary composite outcome events in SPRINT (Systolic Blood Pressure Intervention Trial).

Methods:

This is a secondary analysis of the SPRINT trial evaluating whether longitudinal, time varying exposure to any major antihypertensive drug class had any impact on primary outcome events, after adjusting for effects of randomization arm, time varying achieved systolic blood pressure, other drug class exposure, and baseline characteristics.

Results:

Nine thousand two hundred fifty-two participants were included. After adjustments, exposure of one year or greater to thiazide-type diuretics or renin-angiotensin system blockers was associated with significantly fewer primary events than exposure of less than one year (hazard ratio, 0.78 [95% CI, 0.64–0.94]). There was no significant difference with longer versus shorter exposure to calcium channel blockers. Greater exposure to beta-blockers was associated with an increase in primary events compared with exposure of <1 year (hazard ratio, 1.35 [95% CI, 1.13–1.62]). Furthermore, thiazide-type diuretics were associated with a reduction in heart failure events and renin-angiotensin system blockers with reduced myocardial infarction. Both were associated with less cardiovascular deaths.

Conclusions:

The SPRINT trial demonstrated a lower target blood pressure led to reductions in adverse cardiovascular events. This analysis suggests greater exposure to thiazide-type diuretics and renin-angiotensin system blockers also contributed to reduced adverse cardiovascular events. Greater exposure to beta-blockers was associated with increased cardiovascular events.
Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction
Authors: Saito Yuichi , Tateishi Kazuya , Kanda Masato , Shiko Yuki , Kawasaki Yohei , Kobayashi Yoshio , Inoue Takahiro
Published: March 2022

Background

Lower primary percutaneous coronary intervention (PCI) volume is known to be associated with worse outcomes in patients with acute myocardial infarction (MI) at hospital level. The present study aimed to evaluate the relations of primary, elective, and total PCI volume and primary/total PCI volume ratio per hospital to in‐hospital mortality in patients with acute MI undergoing primary PCI.

Methods and Results

Using a large nationwide administrative database, we included a total of 83 076 patients from 154 hospitals in Japan undergoing PCI for either acute MI or elective cases. Relations of annual procedural volumes for primary, elective, and total PCI to in‐hospital mortality after acute MI at hospital level were evaluated. The ratio of primary to total PCI volume per hospital was also assessed. The primary end point was the ratio of observed to predicted mortality. Of 83 076 patients, 26 913 (32.4%) underwent primary PCI for acute MI, among whom 1561 (5.8%) died during hospitalization. Overall, observed in‐hospital mortality after acute MI and observed/predicted mortality ratio were higher in hospitals with lower primary, elective, and total PCI volumes. Observed/predicted in‐hospital mortality ratio was higher in hospitals with low primary/total PCI volume ratio, even in those with high total PCI volume.

Conclusions

Primary, elective, and total PCI volume at hospitals were inversely associated with in‐hospital mortality in patients with acute MI undergoing primary PCI. Lower ratio of primary to total PCI volume were related to higher in‐hospital mortality, suggesting primary/total PCI volume ratio as an institutional indicator of quality of care for acute MI.
Atrial Structural Remodeling in Patients With Atrial Fibrillation Is a Diffuse Fibrotic Process: Evidence From High‐Density Voltage Mapping and Atrial Biopsy
Authors: Yamaguchi Takanori , Otsubo Toyokazu , Takahashi Yuya , Nakashima Kana , Fukui Akira , Hirota Kei , Ishii Yumi , Shinzato Kodai , Osako Ryosuke , Tahara Mai , Kawano Yuki , Kawaguchi Atsushi , Aishima Shinichi , Takahashi Naohiko , Node Koichi
Published: March 2022

Background

Low‐voltage areas (LVAs) in the atria of patients with atrial fibrillation are considered local fibrosis. We hypothesized that voltage reduction in the atria is a diffuse process associated with fibrosis and that the presence of LVAs reflects a global voltage reduction.

Methods and Results

We examined 140 patients with atrial fibrillation and 13 patients with a left accessory pathway (controls). High‐density bipolar voltage mapping was performed using a grid‐mapping catheter during high right atrial pacing. Global left atrial (LA) voltage (V
GLA
) in the whole LA and regional LA voltage (V
RLA
) in 6 anatomic regions were evaluated with the mean of the highest voltage at a sampling density of 1 cm
2
. Patients with atrial fibrillation were categorized into quartiles by V
GLA
. LVAs were evaluated at voltage cutoffs of 0.1, 0.5, 1.0, and 1.5 mV. Twenty‐eight patients with atrial fibrillation also underwent right atrial septum biopsy, and the fibrosis extent was quantified. Voltage at the biopsy site (V
biopsy
) was recorded. V
GLA
results by category were Q1 (<4.2 mV), Q2 (4.2–5.6 mV), Q3 (5.7–7.0 mV), and Q4 (≥7.1 mV). V
RLA
at any region was reduced as V
GLA
decreased. V
GLA
and V
RLA
did not differ between Q4 and controls. The presence of LVAs increased as V
GLA
decreased at any voltage cutoff. Biopsies revealed 11±6% fibrosis, which was inversely correlated with both V
biopsy
and V
GLA
(
r
=–0.71 and –0.72, respectively). V
biopsy
was correlated with V
GLA
(
r
=0.82).

Conclusions

Voltage reduction in the LA is a diffuse process associated with fibrosis. Presence of LVAs reflects diffuse voltage reduction of the LA.
Endangered Blue Whale Survival in the North Atlantic: Lagging Scientific and Governance Responses, Charting Future Courses
Authors: Koubrak Olga , VanderZwaag David L. , Worm Boris
Published: March 2022

Populations of blue whales were heavily depleted across the globe by industrial whaling and are still considered globally endangered today. In the Northwest Atlantic, an estimated 400–600 individuals remain, but these numbers are highly uncertain. Ship strikes, fishing gear entanglement, and marine debris are thought to be leading causes of contemporary human-caused mortality in blue whales, with anthropogenic noise possibly causing sublethal stress and injury. Climate change is recognised as an emerging and intensifying threat that is likely to affect food supply and could limit the capacity of the population to recover. Both Canada and the United States have protected blue whales through their domestic legislation. This article reviews law and policy responses in the two countries, as well as bilateral, regional and international frameworks that address anthropogenic threats to blue whales. Future scientific directions, as well as recommendations for improvements to domestic legislation and multilevel cooperation are outlined.
Pierre Bayle’s Erasmus
Authors: Regier Willis Goth
Published: March 2022

Desiderius Erasmus (1466?-1536) and Pierre Bayle (1647–1706) are two of the most respected figures in the Republic of Letters. Their names are often joined due to similarities in their thinking and concerns, their ties to Rotterdam, their coincidental circumstances, and Bayle’s own praise of Erasmus. Bayle read Erasmus carefully, quoted him often, cited him more often still, and noted his flaws. This paper tracks Bayle’s explicit references to Erasmus in his journalism, books, and letters. It indicates what he read and what he apparently preferred among Erasmus’ writings. It observes Bayle’s rare ensemble of Erasmian affinities, his contributions to Erasmus scholarship, and his uses of Erasmus in his own work.
Ettore Romagnoli traduttore delle Baccanti
Authors: Troiani Sara
Published: March 2022

At the beginning of the Twentieth Century the Italian philologist Ettore Romagnoli popularised ancient classical culture through his work as translator and director of performances of Greek and Roman dramas. In his plays he attempted to reproduce the unity of the arts that belonged to the mousikē technē and to achieve a modern recreation of ancient sounds and rhythms. The paper aims to analyse the translation of Euripides’ Bacchae by Romagnoli (1912), comparing it with his studies on Greek music and tragedy and with operas. On the one hand, Romagnoli’s translation in Italian verses is based on the musicological theories about the close relationship between music and metrics in ancient Greek poetry; on the other, the adoption of operatic language to translate specific lines of Euripides’ drama is probably oriented to the Italian audience, which would have recognised conventional expressions from the libretti or from famous arias.
Two Auloi from Megara
Authors: Terzḗs Chrḗstos , Hagel Stefan
Published: March 2022

Two aulos pairs (Δ1965 and Δ1964), unearthed in 1980 and 2005 respectively at Megara (Attica), are exhibited in the city’s Archaeological Museum. Both are associated with metal sliding keys (resembling the keys on the well-known Pergamon aulos model), either mounted on the pipes (Δ1964) or displayed next to them (Δ1965). The present paper describes the parts, proposes a meaningful re-assemblage of the bone sections, and gives a detailed account of the sliding mechanism, which is here for the first time attested on finds of actual musical instruments, including an entirely new technology of speaker hole keys. A musical analysis, based on determining plausible reed configurations using software modelling, suggests that the finds represent a partially standardised design of professional modulating auloi, playing attested harmoníai while hovering between the enharmonic and chromatic.
Re-Stringing the Daphnē Harp?
Authors: Hagel Stefan
Published: March 2022

D. Najock has criticised a tentatively proposed diatonic-chromatic tuning for the triangular frame harp found at Daphnē and suggested a different enharmonic-diatonic stringing. While his criticism may well be justified, it is argued that his alternative proposal is physically problematic and historically implausible. A possible compromise is discussed.
Ancient ‘Solmisation’ and the Meaning of Notes
Authors: Hagel Stefan
Published: March 2022

When contextualising the ancient Greek solmisation system, known from Aristides Quintilianus and one of Bellermann’s Anonymi, within its musical and linguistic environment, it emerges that it hardly predates the Roman Imperial period, an important part of whose musical schooling it appears to have formed. The system seems based on a combination of the various vowels’ intrinsic F2 pitch and intensity and reflects the harmonic hierarchies of contemporary music, shedding a much more favourable light on the music-psychological relevance of Aristides’ gendered musical notes than is conventionally assumed.
Phylum Nematoda: trends in species descriptions, the documentation of diversity, systematics, and the species concept
Authors: HODDA M.
Published: March 2022

This paper summarizes the trends in nematode species description and systematics emerging from a comparison of the latest comprehensive classification and census of Phylum Nematoda (Hodda 2022a, b) with earlier classifications (listed in Hodda 2007).   It also offers some general observations on trends in nematode systematics emerging from the review of the voluminous literature used to produce the classification.   The trends in nematodes can be compared with developments in the systematics of other organisms to shed light on many of the general issues confronting systematists now and into the future.
The Time-Dependent Response of a Two-Basin Ocean to a Sudden Surface Temperature Change
Authors: Chang Chiung-Yin , Jansen Malte F.
Published: March 2022

Building on previous work using single-basin models, we here explore the time-dependent response of the Atlantic meridional overturning circulation (AMOC) to a sudden global temperature change in a two-basin ocean–ice model. We find that the previously identified mechanisms remain qualitatively useful to explain the transient and the long-term time-mean responses of the AMOC in our simulations. Specifically, we find an initial weakening of the AMOC in response to warming (and vice versa for cooling), controlled by the mid-depth meridional temperature contrast across the Atlantic basin. The long-term mean response instead is controlled primarily by changes in the abyssal stratification within the basin. In contrast to previous studies we find that for small-amplitude surface temperature changes, the equilibrium AMOC is almost unchanged, as the abyssal stratification remains similar due to a substantial compensation between the effects of salinity and temperature changes. The temperature-driven stratification change results from the differential warming/cooling between North Atlantic Deep Water and Antarctic Bottom Water, while the salinity change is driven by changes in Antarctic sea ice formation. Another distinct feature of our simulations is the emergence of AMOC variability in the much colder and much warmer climates. We discuss how this variability is related to variations in deep-ocean heat content, surface salinity, and sea ice in the deep convective regions, both in the North Atlantic and in the Southern Ocean, and its potential relevance to past and future climates.
Distal radial artery as an alternative approach to forearm radial artery for perioperative blood pressure monitoring: a randomized, controlled, noninferiority trial
Authors: Xiong Jingwei , Hui Kangli , Xu Miaomiao , Zhou Jiejie , Zhang Jie , Duan Manlin
Published: March 2022

Background

The novel distal radial artery (dRA) approach is a popular arterial access route for interventional cardiology and neurointerventions. We explored the dRA as an alternative site to the classic forearm radial artery (RA) for perioperative blood pressure monitoring. We hypothesized that dRA catheterization is noninferior to RA for the first attempt success rate.

Methods

This was a single-center, prospective, randomized controlled, noninferiority study. Adult patients who underwent elective surgery at the Jinling Hospital from May 2021 to August 2021 were enrolled. The primary endpoint was to test the noninferiority of the first attempt success rate between the groups. Secondary endpoints included anatomical characteristics, catheterization time, arterial posterior wall puncture rate, postoperative compression time, dampened arterial pressure waveforms, and complications.

Results

Totally, 161 patients who received either dRA (n = 81) or RA (n = 80) catheterization were analyzed. The first attempt success rates were 87.7 and 91.3% in the dRA and RA groups, respectively, with a mean difference of − 3.6% (95% CI, − 13.1 to 5.9%). The dRA diameter and cross-sectional area were significantly smaller than those of the RA (P < 0.001). The subcutaneous depth of dRA was significantly greater than that of the RA (P < 0.001). The dRA had a longer catheterization time (P = 0.008) but a shorter postoperative compression time (P < 0.001). The arterial posterior wall puncture rate of dRA was significantly higher than that of the RA (P = 0.006). The dRA had fewer dampened arterial waveforms than RA (P = 0.030) perioperatively.

Conclusions

The dRA is a rational alternative approach to RA for perioperative arterial pressure monitoring and provides a noninferior first attempt success rate.

Trial registration

This study is registered in the Chinese Clinical Trials Registry (registration number: ChiCTR2100043714, registration date: 27/02/2021).
Lived experiences of Palestinian patients with COVID-19: a multi-center descriptive phenomenological study of recovery journey
Authors: Alkaissi Aidah , Zaben Fadi , Abu-Rajab Mohammad , Alkony Mahdia
Published: March 2022

Background

Exploring lived experiences of recovered COVID-19 patients might have scientific, social, and policy relevance that can apply to the healthcare infrastructure. This multi-center descriptive phenomenological study was conducted to explore lived experiences of Palestinian patients who recovered from COVID-19. 

Methods

This was a descriptive phenomenological study. A purposive sampling technique was used to recruit the study participants. Semi-structured qualitative interviews were conducted with patients who recovered from COVID-19 (n = 20). The interviews were transcribed verbatim. The transcripts were analyzed using Colaizzi’s phenomenological approach which consisted of the following steps: 1) familiarization, 2) identification of significant statements, 3) formulation of the meanings, 4) clustering the themes, 5) development of an exhaustive description of the phenomenon, 6) production of the fundamental structure, and 7) verification of the fundamental structure.

Results

Semi-structured interviews were conducted with 14 male and 6 female patients who recovered from COVID-19. The total duration of the interview time was 998 min (16.6 h). The qualitative data collected during the interviews were categorized into 5 major themes and 16 subthemes that exhaustively described the phenomenon. The major themes were relevant to: 1) emotions after learning about the infection, 2) experiencing social exclusion and stigma, 3) the experienced symptoms, 4) supportive treatments, herbs, rituals, and social support, 5) and life after recovery.

Conclusion

The interviewees recounted experiencing negative emotions, social exclusion, and stigma because of their infection. It may be important for mental health promotion to be an integral part of the care plan for patients with COVID-19. More studies are still needed to investigate if introducing mental healthcare providers to the care team of patients with COVID-19 can improve the experiences of the patients.
Fat infiltration of paraspinal muscles as an independent risk for bone nonunion after posterior lumbar interbody fusion
Authors: Han Gengyu , Zou Da , Liu Zexiang , Zhang Bo , Gong Chunjie , Zhou Siyu , Li Wei , Sun Zhuoran , Li Weishi
Published: March 2022

Background

The prognosis value of paraspinal muscle degeneration on clinical outcomes has been revealed. However no study has investigated the effect of the fat infiltration (FI) of paraspinal muscles on bone nonunion after posterior lumbar interbody fusion (PLIF).

Methods

Three hundred fifty-one patients undergoing PLIF for lumbar spinal stenosis with 1-year follow-up were retrospectively identified. Patients were categorized into bone union (n = 301) and bone nonunion (n = 50) groups based on dynamic X-ray at 1-year follow-up. The relative total cross-sectional area (rTCSA) and FI of multifidus (MF) and erector spinae (ES), and the relative functional CSA (rFCSA) of psoas major (PS) were measured on preoperative magnetic resonance imaging.

Results

The nonunion group had a significantly higher MF FI and a higher ES FI and a smaller MF rTCSA than the union group (p = 0.001, 0.038, 0.026, respectively). Binary logistic regression revealed that MF FI (p = 0.029, odds ratio [OR] = 1.04), lumbosacral fusion (p = 0.026, OR = 2193) and length of fusion (p = 0.001, OR = 1.99) were independent factors of bone nonunion. In subgroup analysis, in one or two-level fusion group, the patients with nonunion had a higher MF FI and a higher ES FI than those of the patients with union (all p < 0.05). Similarly, in lumbosacral fusion group, the patients with nonunion had a higher MF FI and a higher ES FI than those of the patients with union (all p < 0.05). The logistic regressions showed that MF FI remained an independent factor of bone nonunion both in the patients with one or two-level fusion (p = 0.003, OR = 1.074) and in the patients with lumbosacral fusion (p = 0.006, OR = 1.073).

Conclusions

Higher fatty degeneration was strongly associated with bone nonunion after PLIF. Surgeons should pay attention to the FI of paraspinal muscles when performing posterior surgery for patients, especially those who need short-segment fusion or to extend fusion to S1.
Incidence of upper extremity deep vein thrombosis in the retrosternal reconstruction after esophagectomy
Authors: Yamada Leo , Saito Motonobu , Suzuki Hiroya , Mochizuki Shotaro , Endo Eisei , Kase Koji , Ito Misato , Nakano Hiroshi , Yamauchi Naoto , Matsumoto Takuro , Kaneta Akinao , Kanke Yasuyuki , Onozawa Hisashi , Hanayama Hiroyuki , Okayama Hirokazu , Fujita Shotaro , Sakamoto Wataru , Watanabe Yohei , Hayase Suguru , Saze Zenichiro , Momma Tomoyuki , Ohki Shinji , Kono Koji
Published: March 2022

Background

Upper extremity deep vein thrombosis (UEDVT) is relatively rare but cannot be negligible because it can cause fatal complications. Although it is reported that the occurrence rate of UEDVT has increased due to central venous catheter (CVC), cancer, and surgical invasion, there is still limited information for esophagectomy. The aim of this study was to evaluate the clinical factors, including CVC placement and thromboprophylaxis approach, as well as retrosternal space’s width as a predictive factor for UEDVT in patients receiving esophagectomy.

Methods

This study included 66 patients who underwent esophagectomy with retrosternal reconstruction using a gastric tube. All patients routinely underwent contrast-enhanced computed tomography (CT) on the 4th postoperative day. Low-molecular-weight-heparin (LMWH) was routinely administered by the 2nd postoperative day. To evaluate retrosternal space’s width, (a) The distance from sternum to brachiocephalic artery and (b) the distance from sternum to vertebra were measured by preoperative CT, and the ratio of (a) to (b) was defined as the width of retrosternal space.

Results

Among all patients, 11 (16.7%) suffered from UEDVT, and none was preoperatively received CVC placement, while 7 were inserted in non-UEDVT cases. Retrosternal space’s width in patients with UEDVT was significantly smaller than that in patients without UEDVT (0.17 vs. 0.26; P < 0.0001). A cutoff value of the width was 0.21, which has high sensitivity (87%) and specificity (82%) for UEDVT prediction, respectively.

Conclusion

The existence of CVC may not affect the development of UEDVT, but preoperative evaluation of retrosternal ratio may predict the occurrence of UEDVT.
Infliximab therapy in refractory sarcoidosis: a multicenter real-world analysis
Authors: Sakkat Abdullah , Cox Gerard , Khalidi Nader , Larche Maggie , Beattie Karen , Renzoni Elisabetta A. , Morar Nilesh , Kouranos Vasilis , Kolb Martin , Hambly Nathan
Published: March 2022

Background

Infliximab is a monoclonal antibody that binds and neutralizes circulating tumor necrosis factor-alpha, a key inflammatory cytokine in the pathophysiology of sarcoidosis. Despite the paucity of randomized clinical trials, infliximab is often considered a therapeutic option for refractory disease. Our study aimed to investigate the effectiveness of infliximab in patients with refractory sarcoidosis.

Methods

Sarcoidosis patients from three tertiary centres were retrospectively identified by pharmacy records based on treatment with infliximab. Treatment with Infliximab was initiated in patients who failed first and second line immunomodulators as determined by a multidisciplinary team of Respirologists, Dermatologists, ENT specialists, Rheumatologists, and Neurologists. Participants were characterized by the primary organ for which infliximab was initiated and the total number of organs involved. Clinical outcomes were categorized as treatment success versus failure. We defined treatment success as (A) improvement of cutaneous, upper airway, lymph node, gastrointestinal, eye, or joint manifestations; or (B) improvement or no change in central nervous system (CNS) or pulmonary manifestations.

Results

33 patients with refractory sarcoidosis were identified. The proportion of treatment success was 100% (95% CI 54.1–100) in CNS, 91.7% (95% CI 61.5–99.8) in cutaneous, 78.6% (95% CI 49.2–95.3) in pulmonary and 71.5% (95% CI 29.0–96.3) in upper airway disease. The use of infliximab was associated with a reduction prednisone dose by 50%.

Conclusion

Infliximab is possibly an effective therapy for refractory sarcoidosis, with the greatest value in neurologic and cutaneous manifestations. Across all disease presentations, infliximab facilitated a clinically relevant reduction in corticosteroid dose. Relapse is common after discontinuation of infliximab.
Ameliorating role of microRNA-378 carried by umbilical cord mesenchymal stem cells-released extracellular vesicles in mesangial proliferative glomerulonephritis
Authors: Chen Wenbiao , Zhang Feng , Hou Xianliang , Xu Huixuan , Tang Donge
Published: March 2022

Background

Mesenchymal stem cells (MSCs) and their released extracellular vesicles (Evs) have shown protective effects against kidney diseases. This study aims to study the functions of umbilical cord MSCs-released Evs (ucMSC-Evs) and their implicated molecules in mesangial proliferative glomerulonephritis (MsPGN).

Methods

A rat model of MsPGN was induced by anti-Thy-1.1, and rat mesangial cells (rMCs) HBZY-1 were treated with PDGF-BB/DD to mimic MsPGN condition in vitro. Rats and cells were treated with different doses of ucMSC-Evs, and then the pathological changes in renal tissues and proliferation of rMCs were determined. Differentially expressed microRNAs (miRNAs) after Evs treatment were screened by microarray analysis. The interactions among miR-378, PSMD14, and TGFBR1 were analyzed. Gain- and loss-of function studies of miR-378 and PSMD14 were performed to explore their effects on tissue hyperplasia and rMC proliferation and their interactions with the TGF-β1/Smad2/3 signaling pathway.

Results

The ucMSC-Evs treatment ameliorated mesangial hyperplasia and fibrosis in rat renal tissues and suppressed the aberrant proliferation of rMCs in a dose-dependent manner. miR-378 was the most upregulated miRNA in tissues and cells after ucMSC-Evs treatment. miR-378 directly targeted PSMD14, and PSMD14 maintained the stability of TGFBR1 through deubiquitination modification, which led to TGF-β1/Smad2/3 activation. Either miR-378 knockdown or PSMD14 overexpression diminished the protective functions of ucMSC-Evs by activating the TGF-β1/Smad2/3 signaling pathway.

Conclusion

UcMSC-Evs ameliorate pathological process in MsPGN through the delivery of miR-378, which suppresses PSMD14-mediated TGFBR1 stability and inactivates the TGF-β1/Smad2/3 signaling pathway to reduce tissue hyperplasia and rMC proliferation.

Graphical Abstract
Biomechanical effects of fixed-bearing femoral prostheses with different coronal positions in medial unicompartmental knee arthroplasty
Authors: Ma Pengcheng , Muheremu Aikeremujiang , Zhang Siping , Zheng Qian , Wang Wei , Jiang Kan
Published: March 2022

Background

To study the biomechanical effects of femoral prostheses at different coronal positions using finite element analysis and provide a clinical reference for unicompartmental knee arthroplasty (UKA).

Methods

A normal knee joint model was established and verified, establishing 13 working conditions for the femoral prosthesis: the standard position, varus and valgus angles of 3°, 6° and 9° and medial and lateral translations of 1 mm, 3 mm and 5 mm. The stress changes at different positions were analysed, including the polyethylene (PE) insert upper surface, the surface of lateral compartment cartilage and the surface of cancellous bone under tibial prosthesis.

Results

The stresses on the PE insert upper surface and the cancellous bone surface increased with increasing femoral prosthesis valgus/varus, and the stress increased gradually during medial to lateral translation. The stress change is more significant during valgus and lateral translation. However, the stress on the cartilage surface decreases in the process of varus to valgus and medial translation to lateral translation.

Conclusion

The fixed-bearing femoral prosthesis of the medial UKA should avoid translation or varus/valgus tilt on the coronal plane as much as possible. The obvious misalignment of the femoral prosthesis will significantly affect the stress on the internal structure of the knee joint, especially the PE insert and cartilage surface. A femoral prosthesis coronal tilt of more than 6° may significantly increase the stress on the PE surface, and varus of more than 6° may significantly increase the stress on the cartilage surface. For the femoral prosthesis position at the distal end of the femoral condyle, it is recommended to be placed in the centre.
The comparison of catastrophic health expenditure and its inequality between urban and rural households in China
Authors: Fu Xian-zhi
Published: March 2022

Background

In recent years, the goal of universal coverage of the basic medical insurance schemes has been basically achieved in China, but the heavy economic burden of diseases is still the main cause of poverty in many households. Exploring catastrophic health expenditure (CHE) and its inequality are highly important for forward-looking policymaking. This study aims to compare the incidence, intensity and inequality of CHE between urban and rural households in China.

Methods

This study was based on a national representative household survey—the China Family Panel Studies (CFPS)—that was conducted from 2012 to 2018. Concentration index (CI) was employed to measure the inequality of CHE incidence and overshoot, while the decomposition method of the CI was used to estimate the main influencing factors affecting inequality of CHE incidence.

Results

From 2012 to 2018, the CHE incidence of urban households increased from 11.01 to 11.88%, while the CHE incidence of rural households decreased from 18.42 to 18.31%. During the same period, the CI of CHE incidence for urban households decreased from − 0.1480 to − 0.1693, while that for rural households declined from − 0.1062 to − 0.1501. The major contribution to the pro-poor inequality in CHE incidence was associated with socioeconomic status, lagged CHE, receiving inpatient services, having elderly members, education of household head, and self-assessed health status of household head.

Conclusions

Rural households had higher risk of incurring CHE than urban households. The strong pro-poor inequality for CHE incidence and overshoot could be found in both two groups. The problem of poverty due to illness was more severe among low-income groups in rural areas than in urban areas. The relevant policy interventions should further focus on encouraging the development of supplementary medical insurance and increasing the reimbursement rate for hospitalization expenses in the medical assistance system.
Back to basics: measuring the impact of interventions to limit the spread of COVID-19 in Europe
Authors: Cortis Dominic , Vella King Fiona
Published: March 2022

Background

Following the emergence of the COVID-19 pandemic in Europe at the start of 2020, most countries had implemented various measures in an attempt to control the spread of the virus. This study analyses the main non-pharmaceutical interventions and their impact on the rate by which cumulative cases and deaths were growing in Europe during the first wave of this pandemic.

Methods

The interventions analysed are the school closures, restrictions on travel, cancellation of events, restrictions on gatherings, partial and full lockdowns. Data was collected on the implementation date of these interventions, and the number of daily cases and deaths during the first wave of the pandemic for every country and territory geographically located in Europe. The study uses growth rates to calculate the increase in cumulative cases and deaths in Europe before, during, and after these interventions were implemented.

Results

The results show that decisions to close schools, cancel events, and restrict travel were taken during the same time period, whereas the decisions for the other interventions were taken when the growth rates were similar. The most effective interventions at lowering the rate by which cumulative cases were increasing were the travel restrictions, school closures, and the partial lockdown, while most effective against cumulative deaths were the partial lockdown, travel restrictions, and full lockdown.

Conclusion

All the interventions reduced the rate by which cumulative cases and deaths were increasing with the partial lockdowns being the most effective from the other interventions, during the first wave of the pandemic in Europe.
Anticipation of recovery of native renal function and liberation from renal replacement therapy in critically ill patients with severe acute kidney injury
Authors: Schiffl Helmut
Published: March 2022

Background

Renal replacement therapy (RRT) is used to manage critically ill patients with severe acute kidney injury (AKI-D), and it is undoubtedly life-sustaining for most patients. However, the prolonged unnecessary use of these techniques may be harmful. At present, no consensus guidelines provide specific recommendations for clinicians on when (optimal timing of discontinuation) and how (liberation or weaning) to stop RRT in intensive care unit (ICU) patients with recovering native kidney function.

Methods and results

Numerous variables such as clinical parameters, classical surrogate markers for glomerular filtration rate, novel biomarkers of kidney function and damage, and new imaging techniques in AKI-D have been described to predict successful discontinuation of RRT. Most available studies are limited by study design, heterogeneity of variable assessment and thresholds of biomarkers, and lack of prospective validation. At present, the decision on discontinuation of RRT in ICU patients is based on three clinical scenarios: (a) intrinsic kidney function (defined as spontaneous urine output > 500 ml/24 h, timed creatinine clearance > 15 to 20 ml/min) has adequately improved to match the demands and continued RRT is no longer consistent with goals of care (transition to intermittent RRT); (b) the acute illness that prompted RRT has improved; (c) the clinical practice of switching haemodynamic stable patients with persistent AKI-D from continuous RRTs to intermittent RRTs is variable, but de-escalation of RRT (frequency, dose) may facilitate mobilization and discharge of ICU patients.

Conclusions

The predictive ability of novel kidney biomarkers, surrogate markers of kidney function, and direct measurements of kidney function should be evaluated in future studies.