bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the experience of viewing extreme real-world violence online: Naturalistic evidence from an online discussion forum
Authors: Stubbs Joshua Edward , Nicklin Laura Louise , Wilsdon Luke , Lloyd Joanne
Published: July 2022

This study investigates the psychological impact of viewing user-generated content depicting extreme real-world violence. Eight threads were harvested from a publicly accessible online discussion forum in which people discussed their experiences of witnessing real-world torture, maiming or death online. Reflexive thematic analysis was used to systematically analyse these threads. The themes capture the contradictory ways in which people react to viewing extreme real-world violence online, with some finding it intensely distressing and others using it as a resource for psychological grounding or (perceived) strengthening. Based on this analysis, we highlight pathways that may lead to the cessation or continuation of viewing such content and argue that greater research on this seemingly common but under-studied experience is warranted.
Working conditions and well-being in UK social care and social work during COVID-19
Authors: Ravalier Jermaine , McFadden Paula , Gillen Patricia , Mallett John , Nicholl Patricia , Neill Ruth , Manthorpe Jill , Moriarty John , Schroder Heike , Curry Denise
Published: July 2022

Stress and mental health are among the biggest causes of sickness absence in the UK, with the Social Work and Social Care sectors having among the highest levels of stress and mental health sickness absence of all professions in the UK. Chronically poor working conditions are known to impact employees' psychological and physiological health. The spread of the COVID-19 pandemic has affected both the mode and method of work in Social Care and Social Work. Through a series of cross-sectional online surveys, completed by a total of 4,950 UK Social Care and Social Workers, this study reports the changing working conditions and well-being of UK Social Care and Social Workers at two time points (phases) during the COVID-19 pandemic.

All working conditions and well-being measures were found to be significantly worse during Phase 2 (November–January 2021) than Phase 1 (May–July 2020), with worse psychological well-being than the UK average in Phase 2. Furthermore, our findings indicate that in January 2021, feelings about general well-being, control at work, and working conditions predicted worsened psychological well-being.

Our findings highlight the importance of understanding and addressing the impact of the pandemic on the Social Care and Social Work workforce, thus highlighting that individuals, organizations, and governments need to develop mechanisms to support these employees during and beyond the pandemic.
Enhancing participatory research with young children through comic-illustrated ethnographic field notes
Authors: Tatham-Fashanu Christina
Published: July 2022

Conducting research with young participants presents numerous challenges, particularly in terms of representation as the researcher endeavours to listen to children’s voices in order to understand and portray their perspectives accurately. Since the 1989 United Nations Convention on the Rights of a Child established children have the right to express their views and have these taken seriously in matters that affect them, researchers have developed a variety of multimodal methods to capture the children’s perspectives. The aim of this paper is to describe an innovative methodological approach to recording ethnographic observations of young children (aged four to six) through a visual mode: the cartoon. The article describes the methodology of a specific research project that explored young children’s communicative practices in a super-diverse environment. Adopting a flexible approach to research and putting children’s suggestions into practice led to the co-production cartoons that used the participants’ self-portraits to visually portray the researcher’s written observations of the children. The paper presents vignettes, evidencing how the use of self-portraits meant the cartoons were more engaging, held greater personal significance and opened up spaces for dialogue, leading the researcher to uncover deeper insights. This has important implications for any research that endeavours to listen to the participants’ perspectives, but where verbal or written forms of communication are impeded.
Making a “Hate-Watch”: Netflix’s Indian Matchmaking and the Stickiness of “Cringe Binge TV”
Authors: Guha Suryansu
Published: July 2022

Netflix’s 2020 release Indian Matchmaking drew a massive backlash particularly from South Asian and diasporic audiences who felt it normalized the experiences associated with arranged marriages. Audiences took to the internet to express how much they loved hating the show but at the same time also continued to obsessively watch despite their reservations. My paper takes up this paradox of simultaneously loving and hating a media product. By drawing from interviews with the showrunner, members of the production team and a close reading of the show’s texts and paratexts, I argue that “hatewatching” or “cringe-binge” as a mode of spectatorship only seems an oppositional form of viewing or an act of resistance to the reification of dominant hegemonic values. Far from being a function of spectatorial agency, I demonstrate how the platforms utilize “hatewatching” as a lucrative form of viewership and consumer habit to cultivate stickiness for their content.
Do Political Beliefs Drive Environment Selection?
Authors: Santoro Lauren Ratliff
Published: July 2022

Scholars interested in understanding if and to what extent social environments influence individual political behavior are plagued by the reality that individuals construct their social environments. Though there is acknowledgement that this construction is determined by homophily – likes associating with likes – the extent to which political beliefs drive environment selection is yet untested. This paper seeks to understand the extent to which political beliefs inform individuals’ decisions on which social environments to select into. To do so, I follow individuals as they select into social environments across their first year in a university setting – first contacting them before they are embedded in a new social environment, tracking their selections into friendships and groups, and observing how their attitudes change over a year and a half period. Results demonstrate that political beliefs can be significant predictors of selection into non-political social contexts, especially for those with the strongest beliefs about politics.
Extensor Tendon Integrity After Percutaneous Placement of Intramedullary Metacarpal Screws: A Cadaveric Study
Authors: Powers Robert , Lynch Thomas , Bates Taylor , Rask Dawn , Achay Jennifer A. , Plucknette Benjamin , Wilson David
Published: July 2022

Background:

Intramedullary implants are an increasingly common method for fixation of metacarpal fractures. Numerous techniques for instrumentation have been described with varied consideration for the risk of extensor tendon injury. The current cadaveric study evaluates the prevalence and degree of extensor tendon injury and compares percutaneous approaches with different drilling techniques.

Methods:

Ninety-six metacarpals (thumbs excluded) from 24 fresh-frozen cadaveric upper extremities were used to compare 2 percutaneous approaches and 2 drilling techniques. This resulted in 4 subgroups available for comparison: oscillate to bone (OB), forward to bone (FB), oscillating through the skin (OS), and forward through the skin (FS). After instrumentation, the extensor tendons were dissected and disruption was characterized. The main outcome measures were tendon “hit rate” and relative extensor tendon defect width.

Results:

Tendon hit rate was significantly higher in the long finger (LF), that is, 79.2%, compared with other metacarpals: index finger, 20.8%; ring finger, 12.5%; and small finger 25%. The mean relative tendon disruption was significantly less in the OB group (16.05%) compared with the other groups: FB (31.84%), FS (31.50%), and OS (29.85%).

Conclusion:

Retrograde intramedullary screw fixation of metacarpal fractures can be performed using percutaneous approaches without a significant disruption of the extensor mechanism. Instrumentation through a longitudinal stab incision down to the metacarpal head and the use of drill oscillation minimize injury to the extensor tendons. The LF extensor tendon is most at risk with retrograde intramedullary implant placement.
Is Personalized Dietary Therapy Effective for Individuals With Irritable Bowel Syndrome?
Authors: Zarini Gustavo G. , McLean Michael A. , Delgado Savina I.
Published: July 2022

Introduction: Adverse reactions to foods and food additives have a critical role in clinical manifestations of irritable bowel syndrome (IBS). Personalized dietary modifications conducted under the supervision of a qualified health practitioner could considerably impact the clinical care and course of the condition. Objective: To investigate the clinical effectiveness of the Lifestyle Eating and Performance (LEAP) program based on the Leukocyte Activation Assay-MRT (LAA-MRT®) results in improving IBS symptoms and quality of life. Methods: The retrospective study included de-identified client records (n = 146) from private group practices seen by registered dietitians. The eligibility criteria were adults aged > 18 years old with an established diagnosis of IBS. Results: Participants were 46.7 ± 12.6 years old and had a BMI of 26.7 ± 6.1 kg/m2; the majority were female (87.0%) and followed-up by a registered dietitian for 10.1 ± 6.4 weeks. There was a significant reduction post-dietary intervention in overall Global Gastrointestinal Symptom Survey Scores (P < 0.001) and improvement in quality of life (P < 0.001). Conclusion: This study generates real-world evidence of an alternative treatment option for IBS using a personalized dietary approach. A more precise understanding of the effect of food intake reactions is vital for clinical improvements and enhancing health outcomes in IBS.
Survey of Australian clinicians’ antenatal care and management practices in pregnant women with a history of bariatric surgery
Authors: Elder-Robinson Elaina C , de Jersey Susan , Porteous Helen , Huxtable Shannon L , Palmer Michelle A
Published: July 2022

Background

Pregnancy following bariatric surgery requires tailored care. The current Australian care provision and its alignment with consensus guidelines is unclear.

Methods

Antenatal care clinicians were invited to complete a web-based survey assessing multidisciplinary referral, gestational diabetes mellitus (GDM) and micronutrient management practices.

Results

Respondents (n = 100) cared for pregnant women with a history of bariatric surgery at least monthly (63%) with most (54%) not using a specific guideline to direct care. GDM screening methods included one-week of home blood glucose monitoring (43%) or the oral glucose tolerance test (42%). Pregnancy multivitamin supplementation changes (59%) with bariatric surgery type were common. Half (54%) screened for micronutrient deficiencies every trimester and conducted additional growth ultrasounds (50%).

Conclusion

The care clinicians report providing may not align with current international consensus guidelines. Further studies with increased obstetric clinician response may aid increased understanding of current practices. The development of workplace management guidelines for pregnancy in women with a history of bariatric surgery may assist with providing consistent evidence-based care.
A featural account for own-face processing? Looking for support from face inversion, composite face, and part-whole tasks
Authors: Lee Jasmine K. W. , Janssen Steve M. J. , Estudillo Alejandro J.
Published: July 2022

It is widely accepted that face perception relies on holistic processing. However, this holistic advantage is not always found in the processing of the own face. Our study aimed to explore the role of holistic and featural processing in the identification of the own face, using three standard, but largely independent measures of holistic face processing: the face inversion task, the composite face task, and the part-whole task. Participants were asked to identify their face, a friend’s face, and an unfamiliar face in three different experimental blocks: (a) inverted versus upright; (b) top and bottom halves of the face aligned versus misaligned; and (c) facial features presented in isolation versus whole foil face context. Inverting a face impaired its identification, regardless of the identity. However, alignment effects were only found when identifying a friend or an unfamiliar face. In addition, a stronger feature advantage (i.e., better recognition for isolated features compared to in a whole-face context) was observed for the own face compared to the friend and unfamiliar faces. Altogether, these findings suggest that the own face is processed in a more featural manner but also relies on holistic processing. This work also highlights the importance of taking into consideration that different holistic processing paradigms could tap different forms of holistic processing.
Outpatient portal use among pregnant individuals: Cross-sectional, temporal, and cluster analysis of use
Authors: Morgan Evan , Schnell Patrick , Singh Priti , Fareed Naleef
Published: July 2022

Background

Outpatient portal technology can improve patient engagement. For pregnant individuals, the level of engagement could have important implications for maternal and infant outcomes.

Objective

This study: (1) cross-sectionally and temporally characterized the outpatient portal use among pregnant individuals seen at our academic medical center; and (2) identified clusters of the outpatient portal user groups based on the cross-sectional and temporal patterns of use.

Methods

We used outpatient portal server-side log files to execute a hierarchical clustering algorithm to group 7663 pregnant individuals based on proportions of outpatient portal function use. Post-hoc analyses were performed to further assess outpatient portal use on key encounter characteristics.

Results

The most frequently used functions were MyRecord (access personal health information), Visits (manage appointments), Messaging (send/receive messages), and Billing (view bills, insurance information). Median outpatient portal function use plateaued by the third trimester. Four distinct clusters were identified among all pregnant individuals: “Schedulers,” “Resulters,” “Intense Digital Engagers,” and “Average Users.” Post-hoc analyses revealed that the use of the Visits function increased and the use of the MyRecord function decreased over time among clusters.

Conclusions

Our identification of distinct cluster groups of outpatient portal users among pregnant individuals underscores the importance of avoiding the use of generalizations when describing how such patients might engage with patient-facing technologies such as an outpatient portal. These results can be used to improve user experience and training with outpatient portal functions and may educate maternal health providers on patient engagement with the outpatient portal.
Advanced Practice Registered Nurse Transition to Practice in the Long-Term Care Setting: An Ethnography
Authors: Johnson Alisha Harvey , Harrison Tracie Culp
Published: July 2022

Advanced practice registered nurses are successful in improving quality outcomes and filling provider care gaps in long-term care. However, little is known about the nurse’s transition to practice in this setting. A 12-month ethnography was conducted via participant-observation with nine advanced practice registered nurses in five long-term care facilities to understand practice environment influence on the nurses’ transition and on the reciprocal influence of the nurse on the practice environment. Transition was fraught with uncertainty as documented by five themes: where’s my authority, institutional acceptance, personal role fulfillment, provider relationships, and individual versus organizational care. These findings suggest that transition in this setting is complex, characterized by insecurity whether the individual is new to advanced practice or experienced. Transition in long-term care could be strengthened by formal programs that include clinical practice, reconceived mentorship for advanced practice registered nurses, and education designed to improve comfort and expertise with indirect care.
A Systematic Review of Horticultural Therapy’s Influence on Chinese Older Adults’ Psychosocial Wellbeing
Authors: Lin Peilin , Morris Paul G. , Ma Jingni , Williams Joanne M.
Published: July 2022

Aim: This systematic review aims to evaluate changes in Chinese older adults’ psychosocial wellbeing after receiving horticultural therapy, and examine existing evidence regarding horticultural therapy’s effectiveness in a Chinese setting. Method: Intervention studies measuring relevant outcomes amongst older adults and conducted in China were identified from ASSIA, CIHAHL Plus, PsycINFO, EMBASE, MEDLINE, SCOPUS, Web of Science Core Collection and CNKI. Cochrane risk of bias assessment tools were used to appraise study quality. Result: 16 studies were selected, among which four were published in English and 12 in Chinese. Findings suggested that after receiving horticultural therapy, older adults’ psychosocial wellbeing is generally improved, but causal relationships between improvements and horticulture therapy were less clear. Conclusion: Features of horticultural therapy conducted in China is with its cultural and social uniqueness. Existing evidence supports the post-intervention benefits on completion of horticultural therapies, but the limitations in programme design, sample representativeness and methodological robustness limited the quality of the evidence.
Unfolding time, race and class inequalities to access leisure
Authors: Tomasiello Diego Bogado , Giannotti Mariana
Published: July 2022

The access to leisure activities is an important element to understand the potential participation and integration of individuals in the society. Despite its importance, urban planners in large urban centers in developing countries seek to prioritize access to mandatory activities. This study quantifies the accessibility to leisure and its inequalities in the municipality of São Paulo, considering the opening hours of leisure opportunities and racial and class population groups. Tracking data from buses and TomTom speed profile were used in the public and the private transport networks, respectively, to analyze and compare accessibility to parks and cultural equipment. A multitemporal analysis was performed to better understand the fluctuation of accessibility to leisure through different hours considering the opening hours of parks and cultural equipment. The population was stratified into four groups according to race and class (higher black, higher white, lower black, and lower white) to perform accessibility inequalities analysis. Results show that accessibility to leisure is higher for private transport users, it decreases from the central to the peripheral areas, and it changes significantly during the day due to traffic conditions, transit supply, and leisure opportunities opening hours. The Lorenz curves, Gini, and the Palma coefficients showed a highly unequal level of accessibility to leisure for different population groups, with the low-black population having the lowest level of leisure accessibility. Our findings may support policy makers in designing strategies to provide more spatial equity in the access to leisure opportunities.
Lymph node excisions provide more precise lymphoma diagnoses than core biopsies: a French Lymphopath network survey
Authors: Syrykh Charlotte , Chaouat Charlotte , Poullot Elsa , Amara Nadia , Fataccioli Virginie , Parrens Marie , Traverse-Glehen Alexandra , Molina Thierry-Jo , Xerri Luc , Martin Laurent , Dubois Romain , Lacheretz-Szablewski Vanessa , Copin Marie-Christine , Moreau Anne , Chenard Marie-Pierre , Cabarrou Bastien , Lusque Amélie , Gaulard Philippe , Brousset Pierre , Laurent Camille
Published: July 2022

According to expert guidelines, lymph node surgical excision is the standard of care for lymphoma diagnosis. However, core needle biopsy (CNB) has become widely accepted as part of the lymphoma diagnostic workup over the past decades. The aim of this study was to present the largest multicenter inventory of lymph nodes sampled either by CNB or surgical excision in patients with suspected lymphoma and to compare their diagnostic performance in routine pathologic practice. We reviewed 32 285 cases registered in the French Lymphopath network, which provides a systematic expert review of all lymphoma diagnoses in France, and evaluated the percentage of CNB and surgical excision cases accurately diagnosed according to the World Health Organization classification. Although CNB provided a definitive diagnosis in 92.3% and seemed to be a reliable method of investigation for most patients with suspected lymphoma, it remained less conclusive than surgical excision, which provided a definitive diagnosis in 98.1%. Discordance rates between referral and expert diagnoses were higher on CNB (23.1%) than on surgical excision (21.2%; P = .004), and referral pathologists provided more cases with unclassified lymphoma or equivocal lesion through CNB. In such cases, expert review improved the diagnostic workup by classifying ∼90% of cases, with higher efficacy on surgical excision (93.3%) than CNB (81.4%; P < 10−6). Moreover, diagnostic concordance for reactive lesions was higher on surgical excision than CNB (P = .009). Overall, although CNB accurately diagnoses lymphoma in most instances, it increases the risk of erroneous or nondefinitive conclusions. This large-scale survey also emphasizes the need for systematic expert review in cases of lymphoma suspicion, especially in those sampled by using CNB.
Race, rituximab, and relapse in TTP
Authors: Chaturvedi Shruti , Antun Ana G. , Farland Andrew M. , Woods Ryan , Metjian Ara , Park Yara A. , de Ridder Gustaaf , Gibson Briana , Kasthuri Raj S. , Liles Darla K. , Akwaa Frank , Clover Todd , Baumann Kreuziger Lisa , Sadler J. Evan , Sridharan Meera , Go Ronald S. , McCrae Keith R. , Upreti Harsh Vardhan , Liu Angela , Lim Ming Y. , Gangaraju Radhika , Zheng X. Long , Raval Jay S. , Masias Camila , Cataland Spero R. , Johnson Andrew , Davis Elizabeth , Evans Michael D. , Mazepa Marshall A. ,   for the United States Thrombotic Microangiopathies Consortium
Published: July 2022

Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is characterized by recurring episodes of thrombotic microangiopathy, causing ischemic organ impairment. Black patients are overrepresented in iTTP cohorts in the United States, but racial disparities in iTTP outcome and response to therapy have not been studied. Using the United States Thrombotic Microangiopathies Consortium iTTP Registry, we evaluated the impact of race on mortality and relapse-free survival (RFS) in confirmed iTTP in the United States from 1995 to 2020. We separately examined the impact of rituximab therapy and presentation with newly diagnosed (de novo) or relapsed iTTP on RFS by race. A total of 645 participants with 1308 iTTP episodes were available for analysis. Acute iTTP mortality did not differ by race. When all episodes of iTTP were included, Black race was associated with shorter RFS (hazard ratio [HR], 1.60; 95% CI, 1.16-2.21); the addition of rituximab to corticosteroids improved RFS in White (HR, 0.37; 95% CI, 0.18-0.73) but not Black patients (HR, 0.96; 95% CI, 0.71-1.31). In de novo iTTP, rituximab delayed relapse, but Black patients had shorter RFS than White patients, regardless of treatment. In relapsed iTTP, rituximab significantly improved RFS in White but not Black patients. Race affects overall relapse risk and response to rituximab in iTTP. Black patients may require closer monitoring, earlier retreatment, and alternative immunosuppression after rituximab treatment. How race, racism, and social determinants of health contribute to the disparity in relapse risk in iTTP deserves further study.
HMGA2 expression defines a subset of human AML with immature transcriptional signature and vulnerability to G2/M inhibition
Authors: Moison Céline , Spinella Jean-François , Chagraoui Jalila , Lavallée Vincent-Philippe , Lehnertz Bernhard , Thiollier Clarisse , Boivin Isabel , Mayotte Nadine , MacRae Tara , Marinier Anne , Hébert Josée , Sauvageau Guy
Published: July 2022

High-mobility group AT-hook 2 (HMGA2) is a nonhistone chromatin-binding protein that is normally expressed in stem cells of various tissues and aberrantly detected in several tumor types. We recently observed that one-fourth of human acute myeloid leukemia (AML) specimens express HMGA2, which associates with a very poor prognosis. We present results indicating that HMGA2+ AMLs share a distinct transcriptional signature representing an immature phenotype. Using single-cell analyses, we showed that HMGA2 is expressed in CD34+ subsets of stem cells and early progenitors, whether normal or derived from AML specimens. Of interest, we found that one of the strongest gene expression signatures associated with HMGA2 in AML is the upregulation of G2/M checkpoint genes. Whole-genome CRISPR/Cas9 screening in HMGA2 overexpressing cells further revealed a synthetic lethal interaction with several G2/M checkpoint genes. Accordingly, small molecules that target G2/M proteins were preferentially active in vitro and in vivo on HMGA2+ AML specimens. Together, our findings suggest that HMGA2 is a key functional determinant in AML and is associated with stem cell features, G2/M status, and related drug sensitivity.
Interaction of von Willebrand factor with blood cells in flow models: a systematic review
Authors: Arisz Ryanne A. , de Vries Judith J. , Schols Saskia E. M. , Eikenboom Jeroen C. J. , de Maat, Moniek P. M.
Published: July 2022

The presence of blood flow influences the interaction between von Willebrand factor (VWF) and blood cells, affecting characteristics of forming blood clots. The interactions between coagulation and inflammation have mainly been studied in thrombosis models, but it remains unclear whether these interactions might also play a role in reduced bleeding in patients with bleeding disorders. In this systematic review, we provide an overview of the literature investigating the interactions between VWF and blood cells in flow models. For article selection, a systematic search was performed in Embase, Medline-Ovid, Cochrane Library, Web of Science databases, and Google Scholar. After selection, 24 articles were included. These articles describe direct or platelet-dependent interactions between VWF and neutrophils, monocytes, erythrocytes, or lymphocytes under different flow conditions. Almost all the described interactions required the presence of activated platelets. Only erythrocytes, monocytes, and natural killer cells were capable of directly binding the VWF multimers. Overall, interactions between VWF and blood cells mainly occurred in the presence of platelets. Because of the large variation in study design and used flow rates, further research is necessary to compare the results between studies and draw firm conclusions on when and under what conditions these interactions can occur. After our findings, many questions remained unanswered. This review might provide a starting point for future research. Extended knowledge on the influence of blood flow on VWF and blood cell interactions can contribute to improved understanding of the variation in bleeding in patients with bleeding disorders.
BMX kinase mediates gilteritinib resistance inFLT3-mutated AML through microenvironmental factors
Authors: Buelow Daelynn R. , Bhatnagar Bhavana , Orwick Shelley J. , Jeon Jae Yoon , Eisenmann Eric D. , Stromatt Jack C. , Pabla Navjot Singh , Blachly James S. , Baker Sharyn D. , Blaser Bradley W.
Published: July 2022

Despite the clinical benefit associated with gilteritinib in relapsed/refractory acute myeloid leukemia (AML), most patients eventually develop resistance through unknown mechanisms. To delineate the mechanistic basis of resistance to gilteritinib, we performed targeted sequencing and scRNASeq on primary FLT3-ITD-mutated AML samples. Co-occurring mutations in RAS pathway genes were the most common genetic abnormalities, and unresponsiveness to gilteritinib was associated with increased expression of bone marrow-derived hematopoietic cytokines and chemokines. In particular, we found elevated expression of the TEK-family kinase, BMX, in gilteritinib-unresponsive patients pre- and post-treatment. BMX contributed to gilteritinib resistance in FLT3-mutant cell lines in a hypoxia-dependent manner by promoting pSTAT5 signaling, and these phenotypes could be reversed with pharmacological inhibition and genetic knockout. We also observed that inhibition of BMX in primary FLT3-mutated AML samples decreased chemokine secretion and enhanced the activity of gilteritinib. Collectively, these findings indicate a crucial role for microenvironment-mediated factors modulated by BMX in the escape from targeted therapy and have implications for the development of novel therapeutic interventions to restore sensitivity to gilteritinib.
Idiopathic pleuroparenchymal fibroelastosis: three-dimensional computed tomography assessment of upper-lobe lung volume
Authors: Fukada Atsuki , Suzuki Yuzo , Mori Kazutaka , Kono Masato , Hasegawa Hirotsugu , Hashimoto Dai , Yokomura Koshi , Imokawa Shiro , Tanaka Yuko , Inoue Yusuke , Hozumi Hironao , Karayama Masato , Furuhashi Kazuki , Enomoto Noriyuki , Fujisawa Tomoyuki , Nakamura Yutaro , Inui Naoki , Fujino Yoshihisa , Nakamura Hidenori , Suda Takafumi
Published: July 2022

Background

Idiopathic pleuroparenchymal fibroelastosis (iPPFE) is a rare interstitial lung disease characterised by predominant upper-lobe fibrosis involving the pleura and subpleural lung parenchyma. Despite its poor prognosis, there is no consensus on prognostic determinants of iPPFE to date. Because volume loss in the upper lobe is a distinct feature of iPPFE, we hypothesised that the lung volume of the bilateral upper lobes (upper-lobe volume) accurately indicates disease severity and mortality risk in iPPFE patients.

Methods

This retrospective study assessed two cohorts of 132 patients with iPPFE (69 in Hamamatsu cohort; 63 in Seirei cohort) and 45 controls. Each lobe volume was quantitatively measured using three-dimensional computed tomography at the time of iPPFE diagnosis and standardised using predicted forced vital capacity.

Results

The standardised upper-lobe volume in iPPFE patients was less than half that of controls, whereas the lower-lobe volume did not decrease. iPPFE patients with lower standardised upper-lobe volume had significantly shorter survival rates than those with higher volume (median survival: 6.08versus2.48 years, p<0.001). In multivariate analysis, the lower standardised upper-lobe volume was significantly associated with increased mortality adjusting for age, sex and forced vital capacity (HR 0.939). A composite scoring model, including age, sex and standardised upper-lobe volume, better predicted risk of death than the gender-age-physiology model.

Conclusion

Assessment of upper-lobe volume provides useful information for managing iPPFE by evaluating disease severity and mortality risk in clinical practice.
Plasma cell but not CD20-mediated B-cell depletion protects from bleomycin-induced lung fibrosis
Authors: Prêle Cecilia M. , Miles Tylah , Pearce David R. , O'Donoghue Robert J. , Grainge Chris , Barrett Lucy , Birnie Kimberly , Lucas Andrew D. , Baltic Svetlana , Ernst Matthias , Rinaldi Catherine , Laurent Geoffrey J. , Knight Darryl A. , Fear Mark , Hoyne Gerard , McAnulty Robin J. , Mutsaers Steven E.
Published: July 2022

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease associated with chronic inflammation and tissue remodelling leading to fibrosis, reduced pulmonary function, respiratory failure and death. Bleomycin (Blm)-induced lung fibrosis in mice replicates several clinical features of human IPF, including prominent lymphoid aggregates of predominantly B-cells that accumulate in the lung adjacent to areas of active fibrosis. We have shown previously a requirement for B-cells in the development of Blm-induced lung fibrosis in mice. To determine the therapeutic potential of inhibiting B-cell function in pulmonary fibrosis, we examined the effects of anti-CD20 B-cell ablation therapy to selectively remove mature B-cells from the immune system and inhibit Blm-induced lung fibrosis. Anti-CD20 B-cell ablation did not reduce fibrosis in this model; however, immune phenotyping of peripheral blood and lung resident cells revealed that anti-CD20-treated mice retained a high frequency of CD19+CD138+plasma cells. Interestingly, high levels of CD138+cells were also identified in the lung tissue of patients with IPF, consistent with the mouse model. Treatment of mice with bortezomib, which depletes plasma cells, reduced the level of Blm-induced lung fibrosis, implicating plasma cells as important effector cells in the development and progression of pulmonary fibrosis.
Impact of establishing a level-1 trauma center for lower extremity trauma: a 4-year experience
Authors: Kim Min Ji , Yang Kyung Min , Hahn Hyung Min , Lim Hyoseob , Lee Il Jae
Published: July 2022

Purpose

A multidisciplinary approach is essential for trauma patients’ treatment, particularly for cases with open lower extremity fractures, which are considered major traumas requiring a comprehensive approach. Recently, the social demand for severe-trauma centers has increased. This study analyzed the clinical impact of establishing a trauma center for the treatment of open lower extremity fractures.

Methods

A retrospective chart review was conducted for trauma patients admitted to our hospital. Patients were classified into two groups: before (January 2014–December 2015, 178 patients) and after establishment of a Level-1 trauma center (January 2017–December 2018, 125 patients). We included patients with open fracture below the knee level and Gustilo type II/III, but excluded those with life-threatening trauma that affected the treatment choice.

Results

Total 273 patient were included in this study, initial infection was significantly more common and external fixator application significantly less in post-center establishment group. The time to emergency operation decreased significantly from 13.89 ± 17.48 to 11.65 ± 19.33 h post-center setup. By multivariate analysis, the decreased primary amputation and increased limb salvage was attributed to establishment of the trauma center.

Conclusion

With the establishment of the Level-1 trauma center, limbs of patients with open lower extremity fractures could be salvaged, and the need for primary amputation was decreased. Early control of initial open wound infection and minimizing external fixator use allowed early soft tissue reconstruction. The existence of the center ensured a shorter interval to emergency operation and facilitated interdepartmental cooperation, which promoted active limb salvage and contributed to patients’ quality of life.
The impact of serum thyroid-stimulation hormone levels on the outcome of hepatitis B virus related acute-on-chronic liver failure: an observational study
Authors: Chen Jun-feng , Weng Wei-zhen , Huang Miao , Peng Xiao-hua , Zhang Jing , Xiong Jing , He Jian-rong , Zhang Shao-quan , Cao Hui-juan , Gao Bin , Lin Deng-na , Gao Juan , Gao Zhi-liang , Lin Bing-liang
Published: July 2022

Background

Thyroid dysfunction has been reported in severe liver diseases. The aim of this study was to analyze the impact of serum thyroid-stimulation hormone (TSH) levels on the prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF).

Methods

This retrospective cohort study included 1,862 patients with HBV-related ACLF. Risk factors associated with 30-day and 90-day survival, hazard ratios (HRs), and 95% confidence intervals (CIs) for TSH were estimated using Cox proportional hazards regression. The Area Under the ROC curve (AUROC) analysis was carried out, and the cut-off values were calculated. After grouping by the cut-off value, survival was compared between the groups using the log-rank test. This study data is from the “Survival Cohort Study (SCS)”, which has been registered at ClinicalTrials.gov (NCT03992898).

Results

Multivariate analysis indicated that an elevated TSH level was a highly significant predictor for 30-day survival (HR = 0.743, 95% CI: 0.629–0.878, P < 0.001) and 90-day survival (HR = 0.807, 95% CI: 0.717–0.909, P < 0.001). The AUROC of TSH level for 30-day and 90-day mortality were 0.655 and 0.620, respectively, with the same best cut-off values of 0.261 µIU/mL. Log-rank test showed that the group with higher TSH level had higher 30-day (78.5%, 95% CI: 76.1%-80.9% vs. 56.9%, 95% CI: 53.4%-60.4%; P < 0.001) and 90-day survival rate (61.5%, 95% CI: 58.6%-64.4% vs. 42.8%, 95% CI: 39.3%-46.3%; P < 0.001). Similar findings were observed in subgroups analysis. After adjusting for age and other risk factors, the higher level of TSH remained associated with 30-day survival (HR = 0.602, 95% CI: 0.502–0.721, P < 0.001) and 90-day survival (HR = 0.704, 95% CI, 0.609–0.814, P < 0.001).

Conclusions

Serum TSH level significantly correlate with HBV-related ACLF patients’ survival and may be of value for predicting 30-day and 90-day survival of patients with HBV-related ACLF.
Comparison of mortality and clinical failure rates between vancomycin and teicoplanin in patients with methicillin-resistant Staphylococcus aureus pneumonia
Authors: Lee Jang Ho , Choi Myeong Geun , Park Hyung Jun , Kim Ho Cheol , Choi Chang-Min
Published: July 2022

Background

Very few studies have compared the effects and side effects of vancomycin and teicoplanin in patients with methicillin-resistant Staphylococcus aureus pneumonia. This study aimed to compare the efficacy and safety of vancomycin and teicoplanin in patients with methicillin-resistant Staphylococcus aureus pneumonia.

Methods

This study examined 116 patients with methicillin-resistant Staphylococcus aureus pneumonia who met the inclusion criteria and were treated with either vancomycin (n = 54) or teicoplanin (n = 62). The primary (i.e., clinical failure during treatment) and secondary outcomes (i.e., mortality rates, discontinuation of study drugs due to treatment failure, side effects, and clinical cure) were evaluated.

Results

The vancomycin group presented lower clinical failure rates (25.9% vs. 61.3%, p < 0.001), discontinuation due to treatment failure (22.2% vs. 41.9%, p = 0.024), and mortality rates (3.7% vs 19.4%, p = 0.010). The Cox proportional hazard model revealed that teicoplanin was a significant clinical failure predictor compared with vancomycin (adjusted odds ratio, 2.198; 95% confidence interval 1.163–4.154). The rates of drug change due to side effects were higher in the vancomycin group than in the teicoplanin group (24.1% vs. 1.6%, p < 0.001).

Conclusions

Vancomycin presented favorable treatment outcomes and more side effects compared with teicoplanin, which suggests that clinicians would need to consider the efficacy and potential side effects of these drugs before prescription.
Prevalence and geo-clinicodemographic factors associated with hepatitis B vaccination among healthcare workers in five developing countries
Authors: Duodu Precious Adade , Darkwah Ernest , Agbadi Pascal , Duah Henry Ofori , Nutor Jerry John
Published: July 2022

Background

There is a four-fold risk for hepatitis B infection among healthcare workers compared to the general population. Due to limited access to diagnosis and treatment of hepatitis B in many resource-constrained settings, there is a real risk that only few healthcare workers with viral hepatitis may get screened or diagnosed and treated. Studies on hepatitis B vaccination among healthcare workers in developing countries are sparse and this bodes ill for intervention and support. The aim of the study was to estimate the prevalence and explored the associated factors that predicted the uptake of the required, full dosage of hepatitis B vaccination among healthcare workers (HCWs) in five developing countries using nationally representative data.

Methods

We used recent datasets from the Demographic and Health Surveys Program’s Service Provision Assessment Survey. Descriptive summary statistics and logistic regressions were used to produce the results. Statistical significance was pegged at p < 0.05.

Results

The proportion of HCWs who received the required doses of hepatitis B vaccine in Afghanistan, Haiti, Malawi, Nepal, and Senegal were 69.1%, 11.3%, 15.4%, 46.5%, and 17.6%, respectively. Gender, occupational qualification, and years of education were significant correlates of receiving the required doses of hepatitis B among HCWs.

Conclusions

Given the increased risk of hepatitis B infection among healthcare workers, policymakers in developing countries should intensify education campaigns among HCWs and, perhaps, must take it a step further by making hepatitis B vaccination compulsory and a key requirement for employment, especially among those workers who regularly encounter bodily fluids of patients.
Risk factors for mortality in kidney transplant recipients with COVID‐19: a single centre experience and case–control study
Authors: Choudhary Devprakash , Kenwar Deepesh , Sharma Ajay , Bhalla Ashish , Singh Sarbpreet , Singh Mini P , Kumar Vivek , Sharma Ashish
Published: July 2022

Background

COVID-19 infection is considered to cause high mortality in kidney transplant recipients (KTR). Old age, comorbidities and acute kidney injury are known risk factors for increased mortality in KTR. Nevertheless, mortality rates have varied across different regions. Differences in age, comorbidities and varying standards of care across geographies may explain some variations. However, it is still unclear whether post-transplant duration, induction therapy, antirejection therapy and co-infections contribute to increased mortality in KTR with COVID-19. The present study assessed risk factors in a large cohort from India.

Methods

A matched case–control study was performed to analyze risk factors for death in KTR (N = 218) diagnosed with COVID-19 between April 2020 to July 2021 at the study centre. Cases were KTR who died (non-survivors, N = 30), whereas those who survived were taken as controls (survivors, N = 188).

Results

A high death-to-case ratio of 13.8% was observed amongst study group KTR infected with COVID-19. There was a high incidence (12.4%) of co-infections, with cytomegalovirus being the most common co-infection among non-survivors. Diarrhea, co-infection, high oxygen requirement, and need for mechanical ventilation were significantly associated with mortality on regression analyses. Antirejection therapy, lymphopenia and requirement for renal replacement therapy were associated with worse outcomes.

Conclusions

The mortality was much higher in KTR who required mechanical ventilation and had co-infections. Mortality did not vary with the type of transplant, post-transplant duration and usage of depletion induction therapy. An aggressive approach has to be taken for an early diagnosis and therapeutic intervention of associated infections.
Page kidney following spontaneous subcapsular hematoma immediately after kidney transplantation: a case report
Authors: Lee Tae Won , Bae Wooram , Choi Jungyoon , Bae Eunjin , Jang Ha Nee , Chang Se-Ho , Park Dong Jun
Published: July 2022

Background

Page kidney (PK) is the occurrence of kidney hypoperfusion and ischemia due to pressure on the kidney by a subcapsular hematoma (SH), a mass, or fluid collection. SH after renal transplantation may result in kidney ischemia and graft loss.

Case presentation

We present a rare case of early spontaneous SH in an allograft kidney that led to a decrease in renal function. A 56-year-old male patient underwent deceased donor kidney transplantation. After declamping, appropriate renal perfusion and immediate diuresis were observed, with no evidence of SH. However, his urinary output abruptly decreased 6 h postoperatively. Abdominal ultrasonography showed 28 mm deep SH on transplant and the resistive index (RI) increased to 0.98–1 and diastolic flow reversal was observed. Surgical interventions were performed 2 days after transplantation, following a further decrease in urinary output. Serum creatinine decreased to 2.2 mg/dL, urinary output increased to an average of 200 cc per hour and the RI value was decreased to 0.7 on POD 7.

Conclusion

In patients with abrupt decreased renal function after transplantation, SH should be suspected and the presence of PK should be determined using Doppler USG. In these cases, surgical intervention may avoid allograft dysfunction.
rhG-CSF is associated with an increased risk of metastasis in NSCLC patients following postoperative chemotherapy
Authors: Wang Yong , Fang Chen , Chen Renfang , Yuan Shangkun , Chen Lin , Qiu Xiaotong , Qian Xiaoying , Zhang Xinwei , Xiao Zhehao , Wang Qian , Fu Biqi , Song Xiaoling , Li Yong
Published: July 2022

Background

Recombinant human granulocyte colony-stimulating factor (rhG-CSF) reduces neutropenia events and is widely used in cancer patients receiving chemotherapy. However, the effects of rhG-CSF on distant organ metastasis (DOM) in non-small-cell lung cancer (NSCLC) patients following postoperative chemotherapy are not clear.

Methods

A retrospective cohort study was performed on NSCLC patients who underwent complete surgical resection and postoperative systemic chemotherapy at The First Affiliated Hospital of Nanchang University between 1 January 2012 and 31 December 2017. The effect of rhG-CSF on DOM was assessed with other confounding factors using Cox regression analyses.

Results

We identified 307 NSCLC patients who received postoperative systemic chemotherapy (n = 246 in the rhG-CSF group,n = 61 in the No rhG-CSF group). The incidence of DOM in postoperative NSCLC patients with rhG-CSF treatment was observably higher than in patients without rhG-CSF treatment (48.3% vs. 27.9%,p < 0.05). Univariate regression analysis revealed that rhG-CSF and pathological stage were independent risk factors for metastasis-free survival (MFS) (p < 0.05). RhG-CSF users had a higher risk of DOM (adjusted HR: 2.33, 95% CI: 1.31–4.15) than nonusers of rhG-CSF. The association between rhG-CSF and the risk of DOM was significant only in patients presenting with myelosuppression (HR: 3.34, 95% CI: 1.86–6.02) and not in patients without myelosuppression (HR: 0.71, 95% CI: 0.17–2.94, Interactionp-value< 0.01). The risk increased with higher dose density of rhG-CSF compared to rhG-CSF versus no users (pfor trend< 0.001).

Conclusion

These analyses indicate that rhG-CSF use is related to DOM following postoperative chemotherapy in NSCLC.