bluuebunny/crossref_metadata_2025 huggingface dataset:
Land and Social Power Relations in Bihar: Tale of Two Villages
Authors: Mishra Rapti
Published: September 2022

There is a complex relationship between land and the network of social power in Bihar, which cannot be comprehended by a single lens. This article argues that depending upon the historical and local contexts of a place, various patterns of social power configurations evolve, which present an opportunity for theorists to move beyond the established set of narrations and broaden their lenses, thereby challenging the conformity and reposing trust in variations based on day-to-day experiences. To highlight this varied pattern of complex relations between the network of social power and its historical linkages, the article tries to look into the local narratives of land relations of two villages of Samastipur district in Bihar, namely Shri Kameshwar Nagar and Banda. Through critical discourse analysis (CDA), the article attempts to illustrate that the shifting politico-economic status is intrinsically related to complex land relations, which, in turn, reinforces and perpetuates social inequality in various ways, and therefore, there is a need to have greater insight on the local histories of the land-relations.
Learning from Error in Violence Prevention: A School Shooting as an Organizational Accident
Authors: Goodrum Sarah , Slepicka Jessie , Woodward William , Kingston Beverly
Published: September 2022

This article argues that the organizational structure and culture of schools may impede the prevention of violence in America’s schools, specifically threat assessment and management for students of concern. The data come from a qualitative case study of a school shooting where two students died; the data include deposition testimony from 12 school officials and more than 4,000 pages of school and law enforcement records. The findings illustrate the way the school’s organizational structure and culture shaped and hindered violence prevention practices. The tightly coupled guidelines for threat assessment created an institutional myth of safety and a false sense of security for the school and district, and the loosely coupled structure of the organization led educators to modify guidelines and make decisions about the student’s behavior problems and discipline without consulting others. The school’s culture of autonomy for staff and fresh start mentality for students created unintentional secrets about the history of the student’s difficulties, which gave educators little context for understanding the problem behaviors they observed and inhibited the threat assessment team’s ability to adequately evaluate and monitor those behaviors. Recommendations for building organizational structures and cultures that support violence prevention in schools are discussed.
Adverse Respiratory Events After Pediatric Endoscopic Airway Surgeries
Authors: Alshareef Waleed A. , Aldriweesh Bshair A. , Almutairi Nasser K. , Alsini Albaraa Y. , Zakzouk Abdulmajeed S. , Aljasser Abdullah I. , Alammar Ahmed Y.
Published: September 2022

Objective

Perioperative risk stratification of pediatric patients undergoing airway intervention remains crucial in identifying those at a higher risk of requiring postoperative intensive care unit (ICU) care. Here we determined the likelihood of and possible risk factors for developing perioperative adverse respiratory events (PAREs) requiring ICU care after various pediatric endoscopic airway surgeries (EASs).

Methods

We conducted a retrospective chart review of pediatric patients who were aged <18 years and underwent EAS between 2015 and 2021. Early postoperative adverse events within 24 h of surgery were recorded and analyzed.

Results

Overall, 99 patients who underwent EAS were included. The age at the time of the intervention ranged from 8 months to 18 years. Fifty-eight patients, median age was 4.83 years, underwent papilloma debulking with no high likelihood of PARE in this patient subgroup (OR = 0.48; 0.16–1.44). Twenty-five patients, median age was 9.72 years, underwent balloon dilation of laryngotracheal stenosis with no increase in the likelihood of PARE in this patient population (OR = 2.02; 0.65–6.28). Early postoperative respiratory events occurred in 16 patients (16.2%). Most of these events (75%) manifested within 4 h after surgery. In a univariate analysis, intervention at the level of the subglottis or 2 or more laryngeal subsites increased the risk of PARE (OR = 6.57; 1.11–12.52 and OR = 3.73; 1.93–22.34, respectively). In a multivariate analysis, only intervention in the subglottic area maintained its effect (OR = 6.84; 1.82–25.65).

Conclusion

Respiratory adverse events following pediatric EAS are not uncommon, and the majority are encountered shortly after surgery. Intervention in the subglottic area was an independent predictor of PARE.
Sentiment analysis of Indian Tweets about Covid-19 vaccines
Authors: Mir Aasif Ahmad , Sevukan Rathinam
Published: September 2022

People are becoming more reliant on social media networks to express their opinions about various topics and obtain health information. The study is intended to explore and analyse the sentiments of Indian people related to Covid-19 vaccines as well as to visualise the top most frequently occurring terms individuals have used to communicate their ideas on Twitter about Covid-19 vaccines in India. The Tweet Archiver was used to retrieve the Tweets against ‘Covid19vaccine’ and ‘Coronavirusvaccine’ hashtags for the period of 2 months 18 days (4 January 2021–22 March 2021). After collecting data, the Orange software and VOSviewer were used for further analysis. The Tweets were posted across the country, with an immense contribution from Maharashtra (223, 15.58%), followed by Delhi (220, 15.37%) and Tamil Nadu (73, 5.10%). The majority (639, 44.65%) of the Tweets reflect positive sentiments, followed by neutral (521, 38.50%) and negative (241, 16.84%) sentiments, respectively. This signifies that most Twitter users have a favourable opinion towards Covid vaccines in India. Based on the relevance score of the words, the words ‘Delhi heart’, ‘Lung institute’, ‘Gift’, ‘Unite2fightcorona’, and ‘Covid-19 Vaccine’ are the leading words appearing in Tweets. The study illustrates the sentiments of the Indian people towards ‘Covid-19 vaccines’, gains some insights into overall public communication about the topic and complements the existing literature. It can assist health policymakers and administrators in better understanding the polarity (positive, negative, and neutral) of Tweets about Covid-19 vaccines on Twitter to raise public awareness about health concerns and misinformation about the vaccine.
Locality sensitive blocking (LSB): A robust blocking technique for data deduplication
Authors: Sohail Asif , Qounain Waqar ul
Published: September 2022

Data deduplication is process of discovering multiple representations of same entity in an information system. Blocking has been a benchmark technique for avoiding the pair-wise record comparisons in data deduplication. Standard blocking (SB) aims at putting the potential duplicate records in the same block on the basis of a blocking key. Afterwards, the detailed comparisons are made only among the records residing in the same block. The selection of blocking key is a tedious process that involves exponential alternatives. The outcome of SB varies considerably with a change in blocking key. To this end, we have proposed a robust blocking technique called Locality Sensitive Blocking (LSB) that does not require the selection of blocking key. The experimental results show an increase of up to 0.448 in F-score as compared with SB. Furthermore, it is found that LSB is more robust towards blocking parameters and data noise.
Novel Optimization Approach for Camera Calibration in Traffic Scenes
Authors: Tang Xinyao , Wang Wei , Song Huansheng , Li Ying
Published: September 2022

Currently, most camera calibration methods for traffic scenes are based on vanishing points and road geometry markings with simplified camera models, which can only be applied to scenes containing straight roads. However, in practical applications, cameras are usually installed with roll angles and scenes containing curved roads, to which existing methods are not applicable. To solve the above problems, we propose a novel optimization approach for camera calibration in traffic scenes, which can be applied to curved road scenes and predict camera roll angle. Firstly, a camera space model with a camera roll angle is established for image rotation. Secondly, vehicle trajectories are extracted for the best vanishing point by a parallel coordinate system and diamond space. Vehicle trajectories are also used to obtain calibration regions for extracting road markings and edges. The road markings, edges, and the best vanishing point obtained by the above two steps automatically are more accurate and stable, especially for curved road scenes. Based on the road markings and the best vanishing point, initial calibration can be conducted. Finally, by extracting redundant markings in the calibration region, the non-linear constraint of redundant markings on the road is proposed to obtain optimized calibration parameters and predict the camera roll angle. Through experimental validation on the public dataset BrnoCompSpeed and highway scenes, the proposed approach can achieve better calibration results in both straight and curved road scenes with the mean calibration error reduced by 30% compared with the previous calibration methods.
Adding a brake shoe temperature model into freight train longitudinal braking dynamics simulations
Authors: Wu Qing , Magelli Matteo , Zampieri Nicolò , Bernal Esteban
Published: September 2022

Published research about brake shoe temperature assessments and the influences of temperature dependent brake Coefficient of friction (CoF) on train braking performance do not consider detailed train dynamics. This paper addresses this research gap by combining a brake shoe temperature model with a detailed Longitudinal Train Dynamics (LTD) model. A simplified one-dimensional (1D) Finite Element brake shoe temperature model was developed. Studies were conducted to assess brake shoe temperatures during cyclic air brakes and single-occurrence air brakes. Results show brake shoe temperatures at different positions of the train can be very different due to brake characteristics variations. During case studies, temperature dependent brake CoF increases train braking distances by 10.2 and 6.6% on down grade and flat tracks respectively. Emergency brake cases have the highest increases of brake distances by 11.3% on down grade tracks.
High HIV/STI prevalence among cisgender men and transgender women sex workers attending community-based centres in Barcelona, Spain: The Sweetie Project
Authors: Ferrer Laia , González Victoria , Martró Elisa , Folch Cinta , Saludes Verónica , Muñoz Rafael , Rodríguez Vanesa , Morales Adriana , Meroño Mercè , Morey Francisca , Sanjosé Sílvia de , Casabona Jordi
Published: September 2022

Background

The aim of this study was to describe the socio-demographics, and the sexual and health-seeking behaviours of cisgender men and transgender women sex workers (M & TWSW) attending community-based organisations (CBOs) in Barcelona, Spain, as well as to estimate the prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), Chlamydia Trachomatis (CT) and Neisseria gonorrhoeae (NG) among them at different anatomical sites.

Methods

The Sweetie Project was a community-based cross-sectional study of 147 M & TWSW recruited in two CBOs in Barcelona between 2017 and 2018. A nurse collected biological samples from rectum, pharynx and urethra from the subjects at each CBO and the participants self-completed an epidemiological questionnaire.

Results

The highest prevalence observed was for HIV infection (25.3%) followed by bacterial STIs (NG 19.2% and CT 10.3%). The most prevalent anatomical site was pharyngeal (17.7%) followed by rectal (13.8%). More than half of participants who had a pharyngeal infection presented an isolated pharyngeal infection (57.7%) and half of those who had a rectal or urethral infection presented an isolated infection respectively. The seroprevalence of HCV and HBV was 2.4% and 34.2% respectively. There was a poor but statistically significant correlation between HIV and rectal CT infection ( r = 0.31), previous exposure to HCV ( r = 0.27) or self-reported STI ( r = 0.23), as well as between previous exposure to HCV and rectal CT ( r = 0.21) or self-reported STI ( r = 0.20).

Discussion

The Sweetie Project confirms the high burden of HIV and bacterial STIs among a sample of M&TWSW recruited in CBOs and reinforces the need to routinely screen them at all exposed anatomical sites.
COVID-19 Pandemic, Social Isolation, and Online Gaming Addiction: Evidence From Two Case Reports
Authors: Arya Sidharth , Sharma Manoj Kumar , Rathee Sunila , Singh Priya
Published: September 2022

In the background of COVID-19 restrictions, online games have positioned themselves as activities which promote adherence to precautionary measures, while allowing users to socially interact and entertain themselves. Emerging evidence suggest increase in viewership as well as gaming activity throughout the world. However, such rapid increase in initiation of gaming activities also puts vulnerable population at risk of developing problematic use and addiction. We provide 2 real world examples of how pandemic-related changes can contribute toward gaming disorder in those with previously recreational or minimal Internet gaming. Public health policymakers need to be mindful of potential fallout of gaming addiction secondary to increased changes brought by the pandemic.
Politics of Reservation: Implications for Social Justice
Authors: Veeresha Nayakara
Published: September 2022

The growing rise of demand for the reservation by some of the socially influential communities exerts pressure on the elected governments, especially at the state level. This will considerably reduce the reservation space available for the genuine communities who are facing jaati based discrimination and exclusion in socio-political governance. The reluctance of the Indian State to conduct a jaati (caste) census across the country is an indication of the use of reservations for the electoral gains rather than using it as a tool for achieving social equality and justice. The caste census is a kind of double-edged sword and has large political ramifications. The extension of reservation benefits without scientific basis/criteria is counterproductive as it pushes more and more dominant communities into the ambit of affirmative action, thereby depriving the benefits to the genuine communities who are at the bottom of the socio-political order.
Barriers to LGBTQIA-Inclusive Palliative Care
Authors: Lutz Gabriel , Ehrlich Martin
Published: September 2022

Along the continuum of care, the transition towards end of life often provokes anxiety and requires medical assistance from palliative care providers. Unfortunately, historical, legal and medical barriers often prevent lesbian, gay, bisexual, transgender, queer, intersex and asexual patients from receiving essential palliative services. This article seeks to explain currently known barriers faced by these patients in obtaining palliative care, and offer preliminary solutions that can be implemented by all providers.
Finding “Otherness” in Music and Pedagogy: A Critical Ontological Analysis of an Immersive International Music Education Exchange Program
Authors: McBride Nicholas R. , Nicholson George
Published: September 2022

This study sought to investigate how a cohort of American preservice graduate students in music education reconceptualize their pedagogical lens after participating in an immersive cultural music exchange program in China. By embracing a critical ontology framework, we interwove Western ways of knowing alongside local knowledge to examine the ways in which participants explored their cultural competence through self-reflection. Data indicated that participants in this study were receptive to non-Western social and musical experiences within learning environments that minimized power dynamics, such as peer-to-peer instruction and informal music making. This finding suggests that music teacher educators preparing a cultural immersion program could construct multiple types of learning opportunities in an effort to build preservice teachers’ cultural competence. In addition to careful research, design, and implementation of immersion programs, music teacher educators might also prepare students for the messiness of the cultural competence work, including cultural misunderstandings, issues of authenticity, and varying interpretations.
Research on the utilization of fuel cold energy for LNG powered container ships
Authors: Li Boyang , Li Yajing , Lin Yiqun , Cui Ying , Yang Hualin
Published: September 2022

Aiming at the problems that the fuel releases a lot of cold energy and the refrigerated containers consume a lot of electricity on large LNG powered container ships, a set of cold energy cascade utilization scheme that mainly uses LNG cold energy for refrigerated containers is designed. The simulation software Aspen HYSYS is used to establish and simulate the process of the ship’s cold energy cascade utilization system under five different working conditions, and the main parameters of the key nodes are obtained, according to the established exergy efficiency model, the exergy efficiency of the main equipment and the whole system is solved. Under the five working conditions, the maximum exergy efficiency of the refrigerated container system before optimization is 24.54%, at this time, the exergy efficiency of the entire cold energy utilization system is 24.86%. With the goal of improving the exergy efficiency of the entire system, using a hierarchical optimization method, the key parameters affecting the exergy efficiency of each cold energy utilization module are analyzed and optimized respectively, and the optimal operating parameters of different cold energy utilization module were determined. So as to realize the optimization of the whole cold energy cascade utilization system. The results show that the exergy efficiency of the optimized LNG cold energy cascade utilization system for ships under five working conditions is improved, under the 65% working condition, the exergy efficiency of the optimized refrigerated container system is 27.69%, and the exergy efficiency of the whole cold energy utilization system is 28.04%, which are increased by 3.15% and 3.18% respectively. Which proves that the LNG cold energy cascade utilization system can realize the effective utilization of LNG cold energy.
Venom induced consumption coagulopathy and performance of 20-min whole blood clotting test for its detection in viperid envenomation
Authors: Rajkumar Bayye , Vishwanath Vinod Kolar , Kar Rakhee , Ramasubramani Premkumar
Published: September 2022

Background:

Venom induced consumption coagulopathy (VICC) and its underlying mechanisms have not been fully elucidated in viperid envenomation (VE), especially among Indian patients. We evaluated for VICC in VE, assessed the performance of 20-min whole blood clotting test (20WBCT) for VICC detection and also studied predictors of VICC.

Methods:

This hospital-based observational study enrolled 103 consecutive patients (age ⩾ 12 years) of snakebite admitted within 24 h of bite, with features of VE. They underwent 20WBCT, prothrombin time (PT)/international normalised ratio (INR), plasma fibrinogen and D-dimer testing during first 24 h after enrolment. Overt VICC (defined by overt bleeding), subclinical VICC (INR ⩾ 1.4 and/or fibrinogen < 2g/L, without overt bleeding), disseminated intravascular coagulation (DIC) (overt/non-overt, defined based on International Society on Thrombosis and Haemostasis (ISTH) DIC score) and primary defibrination (PDF) were evaluated among patients.

Results:

VICC overall was noted in 77 (≈75%) and overt VICC in 52 (≈50%). DIC (overt/non-overt) was noted in 59 (≈77%) and PDF in 2 (2.6%) patients with VICC. Sensitivity, specificity, positive predictive value and negative predictive value of 20WBCT for VICC detection were 98.7% (95%CI: 92.9–99.9%), 65.4% (95%CI: 44.3–82.8%), 89.4% (95%CI: 83.3–93.5%) and 94.4% (95%CI: 70.4–99.2%) respectively. Severe cellulitis in bitten limb predicted reduced VICC risk.

Discussion:

Majority (75%) of patients with VE had VICC and 68% with VICC had overt bleeding. DIC (overt/non-overt) was the predominant contributor to VICC. Though 20WBCT is a good screening test for VICC, false positive results should be kept in mind before deciding on snake antivenom treatment.
Screening of miRNAs in White Blood Cell as a Radiation Biomarkers for Rapid Assessment of Acute Radiation Injury
Authors: Li Jiaxun , Shen Zhefan , Chen Wei , Feng Zhenlan , Fang Lan , Zhao Jianpeng , Liu Cong , Du Jicong , Cheng Ying
Published: September 2022

Accidental radiation exposure is a threat to human health that necessitates effective clinical diagnosis. Suitable biomarkers are urgently needed for early assessment of exposure dose. Existing technologies being used to assess the extent of radiation have notable limitations. As a radiation biomarker, miRNA has the advantages of simple detection and high throughput. In this study, we screened for miRNAs with dose and time dependent responses in peripheral blood leukocytes via miRNA sequencing in establishing the animal model of acute radiation injury. Four radiation-sensitive and stably expressed miRNAs were selected out in the 24 h group of leukocyte miRNAs: mmu-miR-130b-5p, mmu-miR-148b-5p, mmu-miR-184-3p, mmu-miR-26a-2-3p, and five were screened in the 48 h group of leukocyte miRNAs: mmu-miR-130b-5p, mmu-miR-423-5p, mmu-miR-676-3p, mmu-miR-150-5p, mmu-miR-342-3p.The correlation curves between their expression and irradiation dose were plotted. Then, the results were validated by RT-qPCR in mouse peripheral blood. As a result, mmu-miR-150-5p and mmu-miR-342-3p showed the highest correlation at 48h after irradiation, and mmu-miR-130b-5p showed good correlation at both 24 h and 48 h after irradiation. In a conclusion, the miRNAs that are sensitive to ionizing radiation with dose dependent effects were selected out, which have the potential of forming a rapid assessment scheme for acute radiation injury.
Lifestyle Medicine Education: Medical School to Residency
Authors: Veazey Erica
Published: September 2022

This narrative work follows my experience as a medical school student and then Family Medicine resident trying to pursue education and training in the field of Lifestyle Medicine. As a newer specialty, it can be difficult for trainees to find mentors and opportunities to advance their education. In this essay, I hope not only to provide an example of my own experience but also to highlight the multitude of resources trainees can and should utilize from the Donald A. Pegg Student Leadership Award to the Walk with a Future Doc community to the Lifestyle Medicine Handbook and Lifestyle Medicine 101 Curriculum slides. I have seen first-hand the impact incorporating these resources has on medical school and residency training and I believe that by sharing our stories trainees can light the path for the next generation of graduates.
Comparison of bone formation mediated by bone morphogenetic protein delivered by nanoclay gels with clinical techniques (autograft and InductOs®) in an ovine bone model
Authors: Black Cameron , Gibbs David , McEwan Josephine , Kanczler Janos , Fernández Marta Peña , Tozzi Gianluca , Dawson Jonathan , Oreffo Richard
Published: September 2022

Development of a growth factor delivery vehicle providing appropriate temporal-spatial release together with an appropriate preclinical large animal model to evaluate bone formation is critical in the development of delivery strategies for bone tissue regeneration. Smectite nanoclays such as LAPONITE™ possess unique thixotropic and protein retention properties offering promise for use in growth factor delivery in bone repair and regeneration. This study has examined bone formation mediated by a clinically approved growth factor delivery system (InductOs®) in combination with Laponite gel in an aged female ovine femoral condyle defect preclinical model (10 weeks). Two different designs, one containing a low volume of Laponite gel (LLG) in combination with the InductOs® absorbable collagen sponge (ACS), the other in which Laponite gel formed the implant (HLG), were compared against InductOs® alone and an autograft positive control. Thus, five groups: (i) empty defect, (ii) autograft, (iii) BMP2 + ACS, (iv) BMP2 + ACS + LLG and (v) BMP2 + HLG + ACS were examined in 9 mm × 12 mm defects performed bilaterally in the medial femoral condyles of 24 aged (>5 years) sheep. Bone formation within the defect was assessed using micro-computed tomography (micro-CT), digital volume correlation (DVC) for biomechanical characterisation as well as histology. The autograft and InductOs® mediated enhanced bone formation ( p < 0001) compared to blank controls, while no significant differences were observed between the Laponite/Collagen/BMP delivery vehicles. However, the current study illustrated the excellent biocompatibility of Laponite and its ability to deliver localised active BMP-2, with the opportunity for improved efficacy with further optimisation. Interestingly, DVC-computed strain distributions indicated that the regenerated bone structure is mechanically adapted to bear external loads from the early remodelling stages of the bone reparation cascade. The current studies of selected nanoclay delivery platforms for BMP, assessed in a clinically relevant large animal model auger well for the development of bone fracture therapeutics for an ageing population.
Differential Racialization and Police Interactions among Young Adults of Asian Descent
Authors: Baluran Darwin A.
Published: September 2022

This qualitative study examined how inclusion or exclusion from the boundaries of “Asian-ness” shaped how young adults of Asian origin experienced and navigated police encounters. Respondents’ accounts suggest that being racialized as Asian guarded against aggression and disrespectful tone and behaviors from the police, attributing neutral police treatment to generalizations about Asians as docile, law-abiding, and non-threatening. However, those who described being racialized as something other than Asian reported more negative police treatment. I argue that the differential racialization of these young adults led to divergent policing experiences via status construction. How individuals interact with each other is partly shaped by their perceived racial-ethnic status. However, how others classify one’s racial-ethnic status does not necessarily follow the ethno-racial pentagon. Thus, these findings elucidate how racialization processes reproduce inequality within—not merely between—existing monolithic racial-ethnic categories.
Child Trafficking in India and Procedures for Prevention and Protection of Children’s Rights: An Analysis
Authors: Neha  , Kumar Raj
Published: September 2022

The present study on the research topic is done to find out the menace of child trafficking, its extent and how we can combat it by effectively enforcing the existing laws in India. The main reason of child trafficking, extent, area, historical background, national and international legal framework, existing laws, schemes and tradition in India to know the effectiveness or drawbacks regarding child trafficking in India have been studied.

It has been observed that there is lack of effective implementation of the already existing laws and of awareness among the people about their rights. As a result the society shows indifference towards the problems of child trafficking for begging, child prostitution, child labour, organ trade, drug trafficking and smuggling.
R306X Mutation in the MECP2 Gene Causes an Atypical Rett Syndrome in a Moroccan Patient: A Case Report
Authors: Bouzroud Wafaa , Tazzite Amal , Berrada Sarah , Gazzaz Bouchaïb , Dehbi Hind
Published: September 2022

Rett syndrome (RTT) is a rare X-linked syndrome that predominantly affects girls. It is characterized by a severe and progressive neurodevelopmental disorder with neurological regression and autism spectrum features. The Rett syndrome is associated with a broad phenotypic spectrum. It ranges from a classical Rett syndrome defined by well-established criteria to atypical cases with symptoms similar to other syndromes, such as Angelman syndrome. The first case of a Moroccan female child carrying a R306X mutation in the MECP2 (Methyl-CpG-Binding Protein 2) gene, with an unusual manifestation of Rett syndrome, is presented here. She showed autistic regression, behavioral stagnation, epilepsy, unmotivated laughter, and craniofacial dysmorphia. Whole exome sequencing revealed a nonsense mutation (R306X), resulting in a truncated, nonfunctional MECP2 protein. The overlapping phenotypic spectrums between Rett and Angelman syndromes have been described, and an interaction between the MECP2 gene and the UBE3A (Ubiquitin Protein Ligase E3A) gene pathways is possible but has not yet been proven. An extensive genetic analysis is highly recommended in atypical cases to ensure an accurate diagnosis and to improve patient management and genetic counseling.
Characteristics and outcomes of asthmatic outpatients with COVID-19 who receive home telesurveillance
Authors: Beurnier Antoine , Yordanov Youri , Dechartres Agnès , Dinh Aurélien , Debuc Erwan , Lescure François-Xavier , Jourdain Patrick , Jaulmes Luc , Humbert Marc
Published: September 2022

Background

The prognosis of asthmatic outpatients with COVID-19 needs to be clarified. The objectives of this study were: 1) to investigate the characteristics and outcomes of asthmatic patients receiving initial ambulatory care and home monitoring for COVID-19 with Covidom, a telesurveillance solution; and 2) to compare the characteristics and outcomes between asthmatic and non-asthmatic patients.

Methods

Inclusion criteria were age ≥18 years, suspected or confirmed COVID-19 diagnosis allowing initial ambulatory care, registration in Covidom between March 2020 and April 2021 and completion of the initial medical questionnaire. We compared clinical characteristics and outcomes between asthmatic and non-asthmatic patients, and we evaluated whether asthma was independently associated with clinical worsening (hospitalisation or death) within 30 days follow-up using a multivariate logistic regression model.

Results

33 815 patients met the inclusion criteria. Asthma was reported in 4276 (12.6%). The main comorbidities among asthmatic patients were obesity (23.1%), hypertension (12.7%) and diabetes (4.5%). As compared with non-asthmatic patients, asthmatic patients were more often female (70.0versus62.1%, p<0.001), of younger age (42.2versus43.8 years, p<0.001) and obese (23.1versus17.6%, p<0.001). The rate of hospitalisation did not differ significantly (4.7versus4.2%, p=0.203) and no asthmatic patient died during follow-up (versus25 non-asthmatic patients, 0.1%; p=0.109). In multivariate analysis, asthma was independently associated with higher risk of clinical worsening (OR 1.23, 95% CI 1.04–1.44, p=0.013).

Conclusion

In a large French cohort of patients receiving initial ambulatory care and home monitoring for COVID-19, asthma was independently associated with higher risk of clinical worsening although no asthmatic patient died within the 30 days follow-up.
Prevalence and genetic basis of first-line drug resistance ofMycobacterium tuberculosisin Ca Mau, Vietnam
Authors: Callum Jack , Nguyen Phuong T.B. , Martinez Elena , Nguyen Van-Anh T. , Garden Frances , Nguyen Nhung V. , Nguyen Thu-Anh , Nguyen Hoa B. , Nguyen Son V. , Luu Khanh B. , Ho Jennifer , Linh Nguyen N. , Britton Warwick J. , Sintchenko Vitali , Fox Greg J. , Marks Guy B.
Published: September 2022

Background and objective

Data on the prevalence of anti-tuberculous drug resistance and its association with genetic mutations inMycobacterium tuberculosisare limited. Our study explores the genomics of tuberculosis in Ca Mau, Vietnam.

Methods

Patients ≥15 years in Ca Mau Province, Vietnam, were screened annually for tuberculosis between 2014 and 2017. Isolates underwent drug susceptibility testing (DST) using the breakpoint method. DNA was extracted and whole genome sequencing (WGS) was performed.

Results

We identified 365 positive sputum cultures forM. tuberculosisand processed 237 for DST and 265 for WGS. Resistance to isoniazid was present in 19.8% (95% CI 14.7 to 24.9%), rifampicin in 3.5% (1.1 to 5.7%) and ethambutol in 2.5% (0.9 to 5.4%) of isolates. Relevant mutations inrpoBgene were detected in 3.8% (1.8 to 6.8%).katG, inhAorfabG1mutations were found in 19.6% (15.0 to 24.9%) withKatGbeing most common at 12.8% (9.1–17.5%). We found 38.4% of isolates were of Beijing lineage, 49.4% East-African-Indian lineage and 8.4% European-American lineage. There were no associations between resistance profiles and clinical features.

Conclusion

The high burden of isoniazid resistance and thekatGmutation highlights the challenges facing Vietnam in its efforts to achieve its EndTB goals.
Investigation of the frequency of obstructive sleep apnoea syndrome in patients with subclinical hypothyroidism
Authors: Gencer Aysegul , Atahan Ersan , Kadioglu Pinar , Mutlu Birsen
Published: September 2022

Background

The aim of this study is to determine the frequency of obstructive sleep apnoea syndrome (OSAS) in a study group with the diagnosis of subclinical hypothyroidism and in a control group without the diagnosis of subclinical hypothyroidism. This study compares these two groups in terms of demographic characteristics, chronic diseases and especially polysomnographic data.

Methods

A total of 120 patients were included in this study. They consisted of 60 patients with newly diagnosed subclinical hypothyroidism and a control group of 60 patients with normal thyroid functions. Demographic, anthropometric, polysomnography data and Epworth Sleepiness Scale scores of the patients were recorded and compared.

Results

Any significant difference in the frequency and severity of OSAS was not detected. A significant difference was found in the oxygen desaturation index (ODI), the apnoea–hypopnoea index (AHI) in rapid eye movement sleep, the AHI in supine sleep position and the arousal index of the group experiencing subclinical hypothyroidism with OSAS.

Conclusion

This study showed that there was no increase in OSAS frequency in patients with subclinical hypothyroidism, but it demonstrated that the ODI and the arousal index were significantly increased in OSAS patients diagnosed with subclinical hypothyroidism. It is thought that the diagnosis and treatment of OSAS in these patients may be important in preventing cardiovascular complications.
COVID-19 therapies for inpatients: a review and quality assessment of clinical guidelines
Authors: Wohl David A. , Espinueva Aprille A. , Dau Lauren , Wang Chen-Yu , Lachmann Alexandra , Bam Rujuta A. , Rawal Aaditya , Chappell-Smith Kerris , Rockstroh Juergen K.
Published: September 2022

Owing to condensed development processes, expanding evidence and differences in healthcare system characteristics, many COVID-19 guidelines differ in their quality and treatment recommendations, which has consequences for clinical practice. This review aimed to identify COVID-19 treatment guidelines, assess their quality and summarise their recommendations. Guidelines were identified for five therapies most commonly used among inpatients with COVID-19 (remdesivir, dexamethasone, tocilizumab, baricitinib and casirivimab/imdevimab) from 11 countries. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool. Full details of recommendations and supporting evidence were analysed for high-quality guidelines, defined as those scoring ≥50% in Domain 3 (Rigour of Development) of AGREE-II. Overall, guidelines differed substantially in their quality and, even among high-quality guidelines using the same evidence, recommendations regarding specific therapeutics varied. Potential reasons for this heterogeneity, including the availability and consistency of clinical data, visibility of trial end-points and context-specific factors, are discussed.
Heterogeneity in the use of biologics for severe asthma in Europe: a SHARP ERS study
Authors: Frix Anne-Noelle , Heaney Liam G. , Dahlén Barbro , Mihaltan Florin , Sergejeva Svetlana , Popović-Grle Sanja , Sedlak Vratislav , Lehtimäki Lauri , Bourdin Arnaud , Korn Stephanie , Zervas Eleftherios , Csoma Zsuzsanna , Lúðvíksdóttir Dora , Butler Marcus , Canonica Giorgio Walter , Grisle Ineta , Bieksiene Kristina , Ten Brinke Anneke , Kuna Piotr , Chaves Loureiro Claudia , Nenasheva Natalia M. , Lazic Zorica , Škrgat Sabina , Ramos-Barbon David , Leuppi Joerg , Gemicioglu Bilun , Bossios Apostolos , Porsbjerg Celeste M. , Bel Elisabeth H. , Djukanovic Ratko , Louis Renaud
Published: September 2022

Introduction

Treatment with biologics for severe asthma is informed by international and national guidelines and defined by national regulating bodies, but how these drugs are used in real-life is unknown.

Materials and methods

The European Respiratory Society (ERS) SHARP Clinical Research Collaboration conducted a three-step survey collecting information on asthma biologics use in Europe. Five geographically distant countries defined the survey questions, focusing on seven end-points: biologics availability and financial issues, prescription and administration modalities, inclusion criteria, continuation criteria, switching biologics, combining biologics and evaluation of corticosteroid toxicity. The survey was then sent to SHARP National Leads of 28 European countries. Finally, selected questions were submitted to a broad group of 263 asthma experts identified by national societies.

Results

Availability of biologics varied between countries, with 17 out of 28 countries having all five existing biologics. Authorised prescribers (pulmonologists and other specialists) also differed. In-hospital administration was the preferred deliverance modality. While exacerbation rate was used as an inclusion criterion in all countries, forced expiratory volume in 1 s was used in 46%. Blood eosinophils were an inclusion criterion in all countries for interleukin-5 (IL-5)-targeted and IL-4/IL-13-targeted biologics, with varying thresholds. There were no formally established criteria for continuing biologics. Reduction in exacerbations represented the most important benchmark, followed by improvement in asthma control and quality of life. Only 73% (191 out of 263) of surveyed clinicians assessed their patients for corticosteroid-induced toxicity.

Conclusion

Our study reveals important heterogeneity in the use of asthma biologics across Europe. To what extent this impacts on clinical outcomes relevant to patients and healthcare services needs further investigation.
Validation of the cough phenotype TBQ among elderly Finnish subjects
Authors: Koskela Heikki O. , Kaulamo Johanna T. , Selander Tuomas A. , Lätti Anne M.
Published: September 2022

Background

Phenotypes can be utilised in the clinical management of disorders. Approaches to phenotype disorders have evolved from subjective expert opinion to data-driven methodologies. A previous cluster analysis among working-age subjects with cough revealed a phenotype TBQ (triggers, background disorders, quality-of-life impairment), which included 38% of the subjects with cough. The present study was carried out to validate this phenotyping among elderly, retired subjects with cough.

Methods

This was an observational cross-sectional study conductedviaemail among the members of the Finnish Pensioners’ Federation (n=26 205, 23.6% responded). The analysis included 1109 subjects with current cough (mean±sdage 72.9±5.3 years; 67.7% female). All filled in a comprehensive 86-item questionnaire including the Leicester Cough Questionnaire. Phenotypes were identified utilising k-means partitional clustering.

Results

Two clusters were identified. Cluster A included 75.2% of the subjects and cluster B 24.8% of the subjects. The three most important variables to separate the clusters were the number of cough triggers (mean±sd2.47±2.34versus7.08±3.16, respectively; p<0.001), Leicester Cough Questionnaire physical domain (5.38±0.68versus4.21±0.81, respectively; p<0.001) and the number of cough background disorders (0.82±0.78versus1.99±0.89 respectively; p<0.001).

Conclusion

The phenotype TBQ could be identified also among elderly, retired subjects with cough, thus validating the previous phenotyping among working-age subjects. The main underlying pathophysiological feature separating the phenotype TBQ from the common cough phenotype is probably hypersensitivity of the cough reflex arc.
Which serum markers predict the success of reimplantation after periprosthetic joint infection?
Authors: Shao Hongyi , Bian Tao , Zhou Yixin , Huang Yong , Song Yang , Yang Dejin
Published: September 2022

Purpose

In clinical practice, serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels are routinely used to screen for periprosthetic joint infection (PJI), but the effectiveness of predicting the success of reimplantation is variable. This study aimed to evaluate the diagnostic effectiveness of serum CRP, ESR, plasma D-dimer, and fibrinogen values in groups achieving treatment success or failure for PJI.

Methods

A total of 119 PJI cases between January 2012 and January 2017 were identified and included in this study. The most recent serum CRP, ESR, plasma D-dimer, and fibrinogen values obtained prior to performing second-stage revision or spacer exchange were collected for analysis. Treatment failure was defined as having been unable to undergo reimplantation due to clinically persistent infection or reinfection after reimplantation.

Results

All these tests showed significantly lower values in the treatment success group than in the treatment failure group. The optimal cutoff serum CRP, ESR, plasma D-dimer, and fibrinogen levels for predicting the success of reimplantation were 9.4 mg/L, 29 mm/h, 1740 ng/mL, and 365.6 mg/dL, respectively. All tests had the same sensitivity (72.7%) except for ESR (63.6%), while their specificities were 92.6%, 88.0%, 72.3%, and 83.2%, respectively. Plasma fibrinogen had the highest AUC value of 0.831 [95% confidence interval (CI), 0.685 to 0.978], followed by serum CRP (0.829) and ESR (0.795); plasma D-dimer had the lowest AUC value of 0.716 (95% CI, 0.573 to 0.859).

Conclusion

Plasma CRP and fibrinogen are good tests for predicting reimplantation success after two-stage revision procedures for patients with PJI.
Assessment of survivin and p27 expression as potential prognostic markers in urothelial cell carcinoma of urinary bladder in Egyptian patients
Authors: Helal Noha Said , Omran Zeinab , Moussa Mona
Published: September 2022

Background

Bladder cancer (BC) is the tenth most common cancer worldwide with urothelial carcinoma (UC) being the main histologic subtype. Survivin is an apoptosis inhibitor that is associated with tumor proliferation and invasion. P27 is a cyclin-dependent kinase inhibitor that negatively regulates cell proliferation. The expression of both proteins was variable among different solid tumors including UC.

Methods

We aimed to investigate the expression of survivin and P27 in UC of urinary bladder and correlate their expressions with histopathological parameters in an attempt at studying the possibility of their use as targeted therapies. The investigation was performed through immunohistochemical staining for both proteins on sections belonging to 60 UCs and 12 mild chronic cystitis cases (controls). Immunopositivity (number of positive cases) and expression score (percentage of positive urothelial cells) were evaluated.

Results

Both survivin and P27 were absent in urothelial cells of mild chronic cystitis lesions while expressed in 60% and 43.3% of UCs, respectively. High score of survivin and low score of P27 were associated with poor prognostic factors of UC (solid pattern, high grade, and deep tumors). By logistic regression test, survivin expression can be a predictive risk factor associated with solid pattern and high-grade UC, while P27 expression can be a predictive risk factor associated low-grade UC.

Conclusion

High survivin and low P27 expression scores were associated with the studied prognostic factors of UC. Both proteins may play a role in UC progression and can have a value as prognostic and/or diagnostic markers of UC, as well as targeted therapies.
The dynamic interaction between COVID-19 and shipping freight rates: a quantile on quantile analysis
Authors: Khan Khalid , Su Chi Wei , Khurshid Adnan , Umar Muhammad
Published: September 2022

This study determines the impact of the coronavirus disease (COVID-19) that has been prevalent since the year 2019, on the shipping freights. This task has been undertaken by using the wavelet quantile on the quantile approach. The results of the study affirm that the pandemic has in fact affected the shipping freight costs, primarily due to the lower demand for energy and raw materials, and the unavailability of the vessels. In addition to this, the spread of COVID-19 has had a positive impact on the Baltic Dry Index in the high quantiles and is deemed to be more responsive in the long run. Also, the COVID-19 infection has had a negative effect on the Baltic Dry Tanker Index and the Baltic Clean Tanker Index in the medium to high quantiles, particularly in the short and the medium run. The positive impact of COVID-19 on the Baltic Clean Tanker Index has been recognized in the long term in the high quantiles. These findings support the theoretical model which states that the spread of COVID-19 and the shipping freights are closely related. The results suggest that the degree of the effect is more causal in the short. Therefore, the shipping industry must ideally pay special attention to the detection of abrupt changes in the freight rate dynamics, and the specific regulations regarding these intricacies are critical.
Thymic epithelial tumors: examining the GTF2I mutation and developing a novel prognostic signature with LncRNA pairs to predict tumor recurrence
Authors: Liu Wei , Yang Hao-Shuai , Zheng Shao-Yi , Weng Jian-Hao , Luo Hong-He , Lei Yi-Yan , Feng Yan-Fen
Published: September 2022

Background

General transcription factor IIi (GTF2I) mutations are very common in thymic epithelial tumors (TETs) and are related to a more favorable prognosis in TET patients. However, limited research has been conducted on the role of GTF2I in the tumor immune microenvironment (TIME). Further, long non-coding RNAs (lncRNAs) have been associated with the survival of patients with TETs. Therefore, this study aimed to explore the relationship between GTF2I mutations and TIME and build a new potential signature for predicting tumor recurrence in the TETs. Research data was downloaded from The Cancer Genome Atlas database and the CIBERSORT algorithm was used to evaluate TIME differences between GTF2I mutant and wild-type TETs. Relevant differentially expressed lncRNAs based on differentially expressed immune-related genes were identified to establish lncRNA pairs. We constructed a signature using univariate and multivariate Cox regression analyses.

Results

GTF2I is the most commonly mutated gene in TETs, and is associated with an increased number of early-stage pathological types, as well as no history of myasthenia gravis or radiotherapy treatment. In the GTF2I wild-type group, immune score and immune cell infiltrations with M2 macrophages, activated mast cells, neutrophils, plasma, T helper follicular cells, and activated memory CD4 T cells were higher than the GTF2I mutant group. A risk model was built using five lncRNA pairs, and the 1-, 3-, and 5-year area under the curves were 0.782, 0.873, and 0.895, respectively. A higher risk score was related to more advanced histologic type.

Conclusion

We can define the GTF2I mutant-type TET as an immune stable type and the GTF2I wild-type as an immune stressed type. A signature based on lncRNA pairs was also constructed to effectively predict tumor recurrence.