bluuebunny/crossref_metadata_2025 huggingface dataset:
‘English-only’ English medium instruction: Mixed views in Thai and Vietnamese higher education
Authors: Sahan Kari , Galloway Nicola , McKinley Jim
Published: February 2022

Emerging from the growing body of work on English medium instruction (EMI) in higher education are challenges to policy implementation, particularly when it is implemented top-down without a careful needs analysis or when it fails to address problems associated with ‘English-only’ implementation and so-called ‘native speaker’ norms. Our study responds to this need by exploring the role of English in EMI classrooms. We draw on data collected from 17 universities in Thailand and Vietnam using questionnaires with 1,377 students, 83 teachers of English for academic purposes (EAP), and 148 content teachers, as well as interviews with 35 students, 31 EAP teachers, and 28 content teachers. We also draw on data from 14 focus groups with teachers and students at seven universities in Vietnam. Findings reveal differences in attitudes amongst stakeholders and highlight that the L1 in EMI classrooms in Thailand and Vietnam, albeit used sparingly, is a useful pedagogical tool. Overall, however, participants preferred native-accented teachers with experience abroad, and English-only instruction. This study calls for more research into raising awareness of Global Englishes and translanguaging practices to challenge such attitudes, university language policies, and teacher recruitment practices that seem to reflect native-speakerism and discourage bilingual instruction or L1 use in EMI classes.
Differentiating Preschoolers With(Out) Social-Emotional and Behavioral Problems: Do We Have a Useful Tool?
Authors: Major Sofia O. , Seabra-Santos Maria J. , Martin Roy P.
Published: February 2022

The early identification of social-emotional and behavioral problems of preschool children has become an important goal in research and clinical practice. A growing number of studies have been published in this field; however, most focus on behavior problems, or on social skills, but few on both. The present study aims to test the validity of the Portuguese version of the Preschool and Kindergarten Behavior Scales–Second Edition (PKBS-2) in differentiating two groups of preschoolers regarding their social skills and behavior problems: 41 children at risk for disruptive behavior (BP group) and 41 selected from the PKBS-2 normative sample (comparison group). Each child was rated with the PKBS-2 by parents and teachers. Results showed that children in the BP group were rated by their parents as having fewer social skills and more behavior problems than the comparison group ( p < .01, for the majority of the PKBS-2 scores). A similar pattern was found for teachers’ ratings. The discriminant functional analysis highlighted the Social Cooperation and the Externalizing Problem Behavior subscales as most accurate in differentiating the two groups. The usefulness of the PKBS-2 Portuguese version as a valid assessment tool available for practice and research with preschoolers was supported.
Low muscle mass determined by psoas muscle area does not correlate with dual-energy x-ray absorptiometry or total lumbar muscle mass scores: A prospective cohort study of patients undergoing vascular surgery
Authors: Thurston Benjamin E , Thomas Jolene M , Miller Michelle , Delaney Chris L
Published: February 2022

Background/Objective: Low muscle mass and sarcopenia have been explored as risk factors for poor outcomes following vascular surgery. The findings have been variable. The use of a diverse range of techniques to identify low muscle mass is a confounder in establishing the true relationship between low muscle mass, sarcopenia and outcomes. Our aim was to establish if different scoring methods identified the same patients as sarcopenic. We also explored which method best predicted outcomes. Method: 70 patients undergoing vascular surgery were prospectively assessed for sarcopenia using dual-energy x-ray absorptiometry (DEXA) scan, grip strength and gait speed. These patients underwent abdominal CT imaging as routine care. The muscle mass of each patient was determined using DEXA and by both psoas muscle and total skeletal muscle area on CT, normalised for patient height (PMI and CT-SMI, respectively). Low muscle mass was defined by published age- and sex-specific cut-offs. Grip strength data was combined with muscle mass to define sarcopenic patients. One- and 3-year mortality and time to readmission was recorded. Conclusion and Results: 10–22% of patients had low muscle mass and 4–10% of patients were sarcopenic, depending on the method employed. PMI did not correlate with DEXA or CT-SMI for low muscle mass, but CT-SMI correlated with DEXA ( p = 0.0007). For sarcopenia, CT-SMI and DEXA scoring correlated ( p = 0.002); PMI correlated with CT-SMI ( p = 0.0006) but not DEXA. Low muscle mass by PMI predicted 1-year mortality ( p = 0.02, X2 = 5.34, Effect size = 1.04) but the applicability of this finding is limited by the diverse pathologies explored. No other method predicted 1- or 3-year mortality or readmissions in this heterogenous cohort. The psoas area did not correlate with muscle mass defined by DEXA or total lumbar skeletal muscle area. Low psoas muscle index may be an independent marker of poor outcome, unrelated to generalised sarcopenia, and this warrants investigation in specific pathologies. A lower total number of patients were sarcopenic than had been expected, emphasising the need to use population-based pre-defined cut-offs.
The Benefits of Utilizing Continuous Glucose Monitoring of Diabetes Mellitus in Primary Care: A Systematic Review
Authors: Kieu Alexander , King Jeffrey , Govender Romona Devi , Östlundh Linda
Published: February 2022

Background:

Continuous glucose monitoring (CGM) and intermittently scanned CGM (is-CGM) have shown to effectively manage diabetes in the specialty setting, but their efficacy in the primary care setting remains unknown. Does CGM/is-CGM improve glycemic control, decrease rates of hypoglycemia, and improve staff/physician satisfaction in primary care? If so, what subgroups of patients with diabetes are most likely to benefit?

Methods:

A comprehensive search in seven databases was performed in June 2021 for primary studies examining any continuous glucose monitoring system in primary care. We excluded studies with fewer than 20 participants, specialty care only, or hospitalized participants. The National Heart, Lung and Blood Institute and Grading of Recommendations Assessment, Development and Evaluation were used for the quality assessment. The weighted mean difference (WMD) of HbA1c between CGM/is-CGM and usual care with 95% confidence interval was calculated. A narrative synthesis was conducted for change of time in, above, or below range (TIR, TAR, and TBR) hypoglycemic events and staff/patient satisfaction.

Results:

From ten studies and 4006 participants reviewed, CGM was more effective at reducing HbA1c compared with usual care (WMD −0.43%). There is low certainty of evidence that CGM/is-CGM improves TIR, TAR, or TBR over usual care. The CGM can reduce hypoglycemic events and staff/patient satisfaction is high. Patients with intensive insulin therapy may benefit more from CGM/is-CGM.

Conclusions:

Compared with usual care, CGM/is-CGM can reduce HbA1c, but most studies had notable biases, were short duration, unmasked, and were sponsored by industry. Further research needs to confirm the long-term benefits of CGM/is-CGM in primary care.
Three-year trajectories in functional limitations and cognitive decline among Dutch 75+ year olds, using nine-month intervals
Authors: Gardeniers Maura Kyra Maria , van Groenou Marjolein Irene Broese , Meijboom Erik Jan , Huisman Martijn
Published: February 2022

Background

Using longitudinal panel data, we aimed to identify three-year trajectories in cognitive and physical functioning among Dutch older adults, and the characteristics associated with these trajectories.

Methods

We used Group-based Trajectory Modelling with mortality jointly estimated to identify trajectories, using a scale composed of 6 Activities of Daily Living (ADL) as a measure of physical functioning, and the short mini mental status examination (sMMSE) or the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a measure of cognitive functioning. Data came from 574 Dutch adults aged 75+, collected in five nine-month measurement waves (2015–2018) for the Longitudinal Aging Study Amsterdam.

Results

For physical functioning five trajectories were identified: ‘high’, ‘moderate’, ‘steeply declining’, ‘gradually declining’, and ‘continuously low’; and for cognitive functioning: ‘high’, ‘moderate’, ‘declining’, and ‘low’. Living in an institution, and being lower educated increased the probability of the two continuously low functioning trajectories, whereas old age and multimorbidity increased the probability of low physical functioning, but multimorbidity decreased the probability of low cognitive functioning. Associations for steeply declining physical functioning were absent. Being older and having multimorbidity increased the probability of gradually declining physical functioning and declining cognitive functioning. A higher prevalence of lung- and heart disease, cancer, and rheumatic disease was found in the gradually declining physical functioning group; and a higher prevalence of diabetes, cerebrovascular accidents, and cancer was found in the declining cognitive functioning group. High and moderate physical functioning and high cognitive functioning were characterized by being younger, community-dwelling, and higher educated. Having multimorbidity negatively predicted high and moderate physical functioning, but was not associated with high and moderate cognitive functioning.

Conclusions

This study identified trajectories comparable to studies that used longer time intervals, showing the consistent presence of heterogeneity in both physical and cognitive trajectories. Co-modelling mortality resulted in bigger group sizes for the more adverse trajectories. The favourable trajectories, containing most of the participants, were mostly characterized by absence of disease. The prevalence of chronic diseases differed between the declining trajectories, suggesting that certain diseases tend to induce cognitive decline rather than physical decline, and vice versa.
Current practice in benzodiazepine receptor agonists deprescribing on acute geriatric wards: a cohort study
Authors: Sibille François-Xavier , Spinewine Anne , Zerah Lorène , Maljean Laurentine , Schoevaerdts Didier , de Saint-Hubert Marie
Published: February 2022

Background

Benzodiazepine receptor agonist (BZRA) use is highly prevalent in hospitalised older people although these drugs are associated with numerous and serious adverse events. Deprescribing can reduce risks associated with chronic BZRA use. The aim of this study was to measure the prevalence of, and factors associated with, BZRA deprescribing in acute geriatric units.

Methods

During a one-year period, this multicentre retrospective study included patients aged ≥70 years, hospitalised in acute geriatric units, and using ≥1 BZRA on admission. BZRA deprescribing at discharge was defined as: ≥25% decrease in lorazepam-equivalent admission dose; discontinuation of all BZRAs; or cessation of a rescue prescription at discharge. BZRA cessation was defined as discontinuation of all BZRAs at discharge. We identified social, medical, geriatric and medication factors associated with BZRA deprescribing using logistic regression.

Results

In total, 561 patients were included (mean age: 85.3±5.9 years, 70% of women). BZRA deprescribing occurred in 240 (42.8%), including 85 with BZRA cessation (15.2%). Deprescribing occurred more frequently in patients with a BZRA-related adverse event on admission or during hospital stay (odds ratio (OR) 4.5; 95% confidence interval [2.6; 7.9]), with an antidepressant (1.6 [1.1; 2.4]) and a higher lorazepam-equivalent dosage on admission (OR 1.2 [1; 1.4]), and less frequently in patients with antipsychotic drug (OR 0.5 [0.3; 0.8]). BZRA cessation was more likely in patients with a BZRA-related adverse event (OR 2.2 [1.2; 4.3]) and a lower lorazepam-equivalent dosage on admission (OR 0.5 [0.3; 0.6]).

Conclusions

During hospitalisation in the acute geriatric units of our hospital, BZRA deprescribing occurred in 42.8% of the patients. Identification of an BZRA-related adverse event by the treating physician appears to be a major factor: this reactive deprescribing accounted for 74% of cases in our study. Further prospective studies are needed to measure long-term persistence of in-hospital deprescribing and encourage proactive management.
Loneliness and social isolation among the older person in a Swiss secure institution: a qualitative study
Authors: Pageau Félix , Seaward Helene , Habermeyer Elmar , Elger Bernice , Wangmo Tenzin
Published: February 2022

Background

A pandemic of loneliness is hitting the aging population. As COVID19 forced us to isolate ourselves, we are in a better position to understand consequences of social distancing. The recent literature showed that older incarcerated adults are particularly at risk of health-related complications due to isolation in the prison environment, reducing their social capital. Mental and physical health can be severely affected by loneliness and social isolation, especially in prison.

Methods

Our qualitative study investigates the view of older persons deprieved of their liberty on loneliness and social isolation pertaining to their mental health. We interviewed 57 older participants, including imprisoned individuals and forensic patients, following a semi-structured interview guide. During the data management and data analysis process, we excluded 7 interviews which were of poorer quality. Thereafter, we analyzed the remainders following a thematic approach.

Results

Most interviewees experience loneliness following lack of significant human relationships in prison. Making friends appears to be a challenge for all the participants, because, for one thing, they do not find people with similar interests. Also, secure institution setting aggravates isolation due to the restrictions of movement placed such as rules concerning movement between floors, hindering intimate relationship, and separation between friends. Moreover, contact with prison personnel is limited and lack social capital (e.g. trust).

Conclusion

To our knowledge, this study is one of the first to present incarcerated persons’ perspective on loneliness, social isolation and poor social capital in the Swiss prison setting. These has been reported to cause health problems both somatic and psychological. Our participants experience these deleterious factors in detention. As prisons have the possibility to become a health-promoting environment through connectedness, friendship, and trust promotion, stakeholders need to better their social capital.
Role of the T2Dx magnetic resonance assay in patients with suspected bloodstream infection: a single-centre real-world experience
Authors: Quirino Angela , Scaglione Vincenzo , Marascio Nadia , Mazzitelli Maria , Garofalo Eugenio , Divenuto Francesca , Serapide Francesca , Bruni Andrea , Lionello Rosaria , Pavia Grazia , Costa Chiara , Giancotti Aida , Peronace Cinzia , Longhini Federico , Russo Alessandro , Liberto Maria Carla , Matera Giovanni , Torti Carlo , Trecarichi Enrico Maria
Published: February 2022

Background

T2Dx was approved by the US Food and Drug Administration for the rapid detection of a modified panel of ESKAPE bacterial species or Candida spp. causing bloodstream infection (BSI).

Patients and methods

We performed a retrospective, observational study from January 1, 2018 to December 31, 2019 of all hospitalised patients with suspected BSI who underwent assessment using T2Dx in addition to standard blood culture (BC). T2-positive patients (cases) were compared to a matched group of patients with BSI documented only by BC (1:2 ratio) to investigate the possible impact of T2Dx on the appropriateness of empirical antimicrobial therapy and 21-day mortality.

Results

In total, 78 T2Dx-analysed samples (49 patients) were analysed. The T2Dx assay result was positive for18 patients and negative for 31 patients. The concordance rates of the T2Bacteria Panel and T2Candida Panel results with those of standard BC were 74.4% and 91.4%, respectively. In the matched analysis, inappropriate empiric antimicrobial therapy administration was significantly less frequent in cases than in comparators (5.5% vs. 38.8%). The 21-day mortality rate was twofold lower in cases than in comparators (22.2% vs. 44.4%), although the difference was not significant. No other analysed variables were significantly different between the two groups.

Conclusions

This study illustrated that T2Dx might be associated with an increase in the appropriateness of empiric antimicrobial therapy in patients with BSI. Further studies are needed to evaluate whether the T2Dx assay can improve patient outcomes.
Pregnancy outcomes and associated factors for uterine rupture: an 8 years population-based retrospective study
Authors: Wan Sheng , Yang Mengnan , Pei Jindan , Zhao Xiaobo , Zhou Chenchen , Wu Yuelin , Sun Qianqian , Wu Guizhu , Hua Xiaolin
Published: February 2022

Background

Uterine rupture is an obstetrical emergency with serious undesired complications for laboring mothers resulting in fatal maternal and neonatal outcomes. The aim of this study was to assess the incidence of uterine rupture, its association with previous uterine surgery and vaginal birth after caesarean section (VBAC), and the maternal and perinatal implications.

Methods

This is a population-based retrospective study. All pregnant women treated for ruptured uterus in one center between 2013 and 2020 were included. Their information retrieved from the medical records department were reviewed retrospectively.

Results

A total of 209,112 deliveries were included and 41 cases of uterine rupture were identified. The incidence of uterine rupture was 1.96/10000 births. Among the 41 cases, 16 (39.0%) had maternal and fetal complications. There were no maternal deaths secondary to uterine rupture, while perinatal fatality related to uterine rupture was 7.3%. Among all cases, 38 (92.7%) were scarred uterus and 3 (7.3%) were unscarred uterus. The most common cause of uterine rupture was previous cesarean section, while cases with a history of laparoscopic myomectomy were more likely to have serious adverse outcomes, such as fetal death. 24 (59.0%) of the ruptures occurred in anterior lower uterine segment. Changes in Fetal heart rate monitoring were the most reliable signs for rupture.

Conclusions

Incidence of uterine rupture in the study area, Shanghai, China was consistent with developed countries. Further improvements in obstetric care and enhanced collaboration with referring health facilities were needed to ensure maternal and perinatal safety.
Baseline blood count levels increase odds of cytopenia among CML patients in Kenya: a case control study
Authors: McLigeyo Angela , Rajab Jamilla , Oyiro Peter , Ezzi Mohammed , Bett Yatich , Ong’ondi Matilda , Odhiambo Andrew , Mwanzi Sitna , Othieno-Abinya Nicholas
Published: February 2022

Background

Imatinib is the gold standard for the treatment of all phases of Philadelphia positive Chronic Myeloid Leukemia (CML). During treatment, patients may develop cytopenia. We aimed to study the baseline characteristics and factors associated with cytopenia at a Nairobi Hospital.

Methods

This was a retrospective case-control study of patients aged ≥18 years on follow-up at the Glivec International Patient Access Program (GIPAP) clinic from 2007 to 2015. The cases consisted of CML patients on imatinib who developed cytopenia. The controls were CML patients on imatinib who did not develop cytopenia. Baseline socio – demographic, clinical, hematologic, and molecular data were retrieved from patients’ files. Chi square or fishers’ exact tests were used to analyze for differences between cytopenia and no cytopenia. Binary logistic regressions were employed to identify relationships. Univariate and multivariate analyses were done to identify independent predictors of cytopenia. Odds ratios (OR) were presented including the 95% confidence intervals and respective p values.

Results

A total of 201 patients were studied consisting of ninety-four (94) patients with cytopenia and 107 with no cytopenia. Among the entire population, males were 52, and 42% were aged 36–50 years. Sex, age, marital status, occupation and education level were similar between the cytopenia and no cytopenia groups.

Among the 201 patients, 70% had symptoms for > 12 months before diagnosis, 78.6% had B symptoms at baseline, 80% had a moderate splenomegaly at baseline.

Among patients with cytopenia, 40 and 37.4% developed cytopenia within 3 months and 3–6 months respectively after imatinib initiation. Baseline neutrophilia, neutropenia, anaemia, thrombocytosis, thrombocytopenia was found in 68, 11, 11, 23.5 and 11% respectively. Baseline hemoglobin, neutrophil and platelet level were significantly different between the cytopenia and the no cytopenia group. On univariable analysis, baseline anemia with hb < 7.9 g/dL (p = 0.002), neutropenia (p = 0.001), neutrophilia > 100,000/mm3 (p = 0.002) and thrombocytopenia (p = 0.001) increased the odds of developing cytopenia. On multivariable analysis, baseline anaemia (p value < 0.002), neutropenia (p value < 0.001), thrombocytopenia (p value, < 0.001) and thrombocytosis (p value, 0.033) increased the odds of developing cytopenia.

Conclusion

Odds of cytopenia were higher in presence of baseline cytopenia and thrombocytosis. Clinicians should have a high index of suspicion for these patients.
Nutrient intake, dietary patterns, and anthropometric variables of children with ADHD in comparison to healthy controls: a case-control study
Authors: Salvat Habibeh , Mohammadi Mehriar Nader , Molavi Parviz , Mostafavi Seyed Ali , Rostami Reza , Salehinejad Mohammad Ali
Published: February 2022

Background

Poor health behaviors and variables are recently more documented in attention-deficit hyperactivity disorder (ADHD) lifestyle which might be relevant to the pathophysiology of this disorder. The objective of this case-control study was to assess the nutrient intake, dietary patterns, and anthropometric variables in children with ADHD compared to normal peers.

Method

One hundred children diagnosed with ADHD were included and compared to 100 healthy, sex-matched normal children as the control group. Anthropometric indices, macronutrients, and micronutrients were measured and compared in both groups.

Results

ADHD children were significantly consuming more simple sugars, tea, ready-made meals but less protein, vitamin B1, vitamin B2, vitamin C, zinc and calcium compared to the control group. The body mass index (BMI) and waist circumference of children with ADHD were significantly higher and were related to the severity and type of the disease.

Conclusion

Unhealthy eating behavior is more frequent in children with ADHD, compared to normal children which might warrant lifestyle intervention in this disorder.
Cognitive, emotional, and social functioning of preschoolers with attention deficit hyperactivity problems
Authors: Biele Guido , Overgaard Kristin R. , Friis Svein , Zeiner Pal , Aase Heidi
Published: February 2022

Background

Attention Deficit Hyperactivity Disorder (ADHD) is associated with deficits in different functional domains. It remains unclear if deficits in different domains are equally strong in early childhood, and which deficits are specific to ADHD. Here, we describe functional domains in preschoolers and assess deficits in children with ADHD problems, by comparing them to preschoolers with other mental health problems or who develop typically.

Methods

The ADHD Study assessed 1195 ca. 3.5 years old preschoolers through a semi-structured parent interview, parent questionnaires, and with neuropsychological tests. We determined functional domains by applying factor analytic methods to a broad set of questionnaire- and test-scales. Using resulting factor scores, we employed a Bayesian hierarchical regression to estimate functional deficits in children with ADHD.

Results

We found that preschoolers’ functioning could be described along the seven relatively independent dimensions activity level and regulation, executive function, cognition, language, emotion regulation, introversion, and sociability. Compared to typically developing preschoolers, those with ADHD had deficits in all domains except introversion and sociability. Only deficits in activity level regulation and executive functions were larger than 0.5 standardised mean deviations and larger than deficits of children with other mental health problems.

Conclusions

Preschoolers with ADHD have deficits in multiple functional domains, but only impairments in activity level and regulation and executive functions are specific for ADHD and large enough to be clinically significant. Research on functioning in these domains will be important for understanding the development of ADHD, and for improving treatment and prevention approaches.
Hip, vertebral, and wrist fracture risks and schizophrenia: a nationwide longitudinal study
Authors: Chu Yu-Wen , Chen Wen-Pin , Yang Albert C. , Tsai Shih-Jen , Hu Li-Yu , Lee Shyh-Chyang , Lee Yao-Tung , Shen Cheng-Che
Published: February 2022

Background

Fractures are a great health issue associated with morbidity, quality of life, life span, and health care expenditure. Fractures are correlated with cardiovascular disease, type 2 diabetes mellitus, cerebrovascular disease, and some psychiatric disorders. However, representative national data are few, and longitudinal cohort studies on the association between schizophrenia and the subsequent fracture risk are scant. We designed a nationwide population-based cohort study to investigate the association of schizophrenia with hip, vertebral, and wrist fractures over a 10-year follow-up.

Methods

Data of patients with schizophrenia (International Classification of Diseases, Ninth Revision, Clinical Modification code 295) and matched over January 2000–December 2009) were extracted from Taiwan National Health Insurance Research Database. A Cox proportional-hazards regression model was constructed to calculate hazard ratios (HRs) for fractures between the schizophrenia and control cohorts.

Results

Of 2028 people with schizophrenia (mean age: 36.3 years, 49.4% female), 89 (4.4%) reported newly diagnosed fractures—significantly higher than the proportion in the control population (257, 3.2%; P = 0.007). The incidences of hip (1.2%, P = 0.009) and vertebral (2.6%, P = 0.011) fractures were significantly higher in the schizophrenia cohort than in the control cohort. In Cox regression analysis, hip (adjusted HR: 1.78, 95% confidence interval [CI]: 1.08–2.93) and vertebral (adjusted HR: 1.40, 95% CI: 1.01–1.95) fracture risks were significantly higher in patients with schizophrenia. Furthermore, a sex-based subgroup analysis revealed that the risk of hip fracture remained significantly higher in female patients with schizophrenia (HR: 2.68, 95% CI: 1.32–5.44) than in female controls. On the other hand, there was no significant interaction between effects of sex and schizophrenia on the risk of fractures.

Conclusions

Over a 10-year follow-up, hip and vertebral fracture risks were higher in the people with schizophrenia than in the controls. The risk of fractures in patients with schizophrenia does not differ between female and male.
A retrospective comparative study of clinical efficacy of percutaneous short segment pedicle screw fixation with or without screwing of the fractured vertebra with O-arm navigation
Authors: Shao Xiaofeng , Peng Peng , Yang Peng , Xu Tian , Liu Zixiang , Hua Xi , Zhu Xiaoyu , Qian Zhonglai , Yang Huilin , Mao Haiqing , Chen Kangwu
Published: February 2022

Objective

To retrospectively analyze the short and long-term efficacies of O-arm-navigated percutaneous short segment pedicle screw fixation, with or without screwing of the fractured vertebra.

Methods

A total of 42 patients who underwent O-arm-navigated percutaneous short segment pedicle screw fixation for the treatment of thoracolumbar fractures from February 2015 to December 2018 were selected for analysis. The patients were divided into two groups according to the surgical intervention they received: Group A received percutaneous short segment pedicle screw fixation with screwing of the fractured vertebra and Group B received percutaneous short segment pedicle screw fixation without screwing of the fractured vertebra. Radiographic analysis included Cobb angles and percentage of anterior vertebral height (AVH%). Clinical functional outcomes were assessed using the visual analog scale (VAS) for back pain and the oswestry disability index (ODI) scores.

Results

No significant differences were observed in the operation time and intraoperative blood loss between the two groups (P > 0.05). The length of incision was statistically significantly different between the two groups (P < 0.05). There was no significant difference in Cobb angle and AVH% between the two groups before and after the surgery (P > 0.05). However, the Cobb angle and AVH% were both significantly larger in Group A than Group B at the final follow-up (P < 0.05). In terms of clinical outcomes, there were no statistically significant differences in VAS and ODI scores between the two groups (P > 0.05).

Conclusion

In the short term, both minimally invasive treatments were safe and effective in treating thoracolumbar fracture. Although there was significant difference between the two groups in Cobb angle and vertebral body height at the last follow-up, the difference was small. Therefore, these specific parameters will be an important outcome measure in further investigations.
Active methodologies association with online learning fatigue among medical students
Authors: de Oliveira Kubrusly Sobral Juliana Barros , Lima Danilo Lopes Ferreira , Lima Rocha Hermano Alexandre , de Brito Elias Silveira , Duarte Lara Hannyella Goveia , Bento Loren Beatriz Bastos Braga , Kubrusly Marcos
Published: February 2022

Background

Due to the current scenario of the COVID-19 pandemic and the social distancing issues, distance learning was implemented in many medical schools. Educational institutions faced the challenge of continuing to promote teaching and learning while keeping teachers and students in their homes, aiming to reduce the spread of the virus. This change compromised the students’ mental health, due to the degree of exhaustion or fatigue attributed to the involvement in videoconferences, called “zoom fatigue”. Despite the importance of zoom fatigue for medical education, it can be observed that there have not been studies on the role of the online teaching and learning process through active methodologies in the genesis of this fatigue. We aimed to assess the association of the teaching method used and the prevalence of zoom fatigue.

Methods

A cross-sectional, quantitative, analytical study was carried out in Medical Schools of Ceará, Brazil. Problem-Based Learning (PBL) teaching methodology is the only methodology used in the first semester and PBL together with traditional teaching, i.e., hybrid teaching, is used in the other ones. The Zoom Exhaustion & Fatigue Scale (ZEF) was used, with the questions currently validated for Brazilian Portuguese. Chi-square tests were used to verify the statistical association between the measured variables and the teaching methodology.

Results

The prevalence of zoom fatigue reached 56% in students using the hybrid model, versus 41% in those using the PBL methodology, with a statistically significant difference (p value = 0.027). The mean prevalence of overall zoom fatigue was 48%. Students using the hybrid methodology differed from PBL students by having a significantly higher frequency of feelings of wanting to be alone after a videoconference (16.9 vs. 7.1%, respectively) and needing time to be alone after a video conference (10.2 vs. 3.6%, respectively).

Conclusions

Considering that zoom fatigue may stay with us for years beyond the COVID-19 pandemic, it is important to know and provide instructions on how to reduce video conferencing fatigue. The present study suggests that the active participation of students and the number of activities are important factors to be considered.
Personalised treatment for cognitive impairment in dementia: development and validation of an artificial intelligence model
Authors: Liu Qiang , Vaci Nemanja , Koychev Ivan , Kormilitzin Andrey , Li Zhenpeng , Cipriani Andrea , Nevado-Holgado Alejo
Published: February 2022

Background

Donepezil, galantamine, rivastigmine and memantine are potentially effective interventions for cognitive impairment in dementia, but the use of these drugs has not been personalised to individual patients yet. We examined whether artificial intelligence-based recommendations can identify the best treatment using routinely collected patient-level information.

Methods

Six thousand eight hundred four patients aged 59–102 years with a diagnosis of dementia from two National Health Service (NHS) Foundation Trusts in the UK were used for model training/internal validation and external validation, respectively. A personalised prescription model based on the Recurrent Neural Network machine learning architecture was developed to predict the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores post-drug initiation. The drug that resulted in the smallest decline in cognitive scores between prescription and the next visit was selected as the treatment of choice. Change of cognitive scores up to 2 years after treatment initiation was compared for model evaluation.

Results

Overall, 1343 patients with MMSE scores were identified for internal validation and 285 [21.22%] took the drug recommended. After 2 years, the reduction of mean [standard deviation] MMSE score in this group was significantly smaller than the remaining 1058 [78.78%] patients (0.60 [0.26] vs 2.80 [0.28]; P = 0.02). In the external validation cohort (N = 1772), 222 [12.53%] patients took the drug recommended and reported a smaller MMSE reduction compared to the 1550 [87.47%] patients who did not (1.01 [0.49] vs 4.23 [0.60]; P = 0.01). A similar performance gap was seen when testing the model on patients prescribed with AChEIs only.

Conclusions

It was possible to identify the most effective drug for the real-world treatment of cognitive impairment in dementia at an individual patient level. Routine care patients whose prescribed medications were the best fit according to the model had better cognitive performance after 2 years.
Variability of adiposity indices and incident heart failure among adults with type 2 diabetes
Authors: Kaze Arnaud D. , Erqou Sebhat , Santhanam Prasanna , Bertoni Alain G. , Ahima Rexford S. , Fonarow Gregg C. , Echouffo-Tcheugui Justin B.
Published: February 2022

Background

It remains unclear how the variability of adiposity indices relates to incident HF. This study evaluated the associations of the variability in several adiposity indices with incident heart failure (HF) in individuals with type 2 diabetes (T2DM).

Methods

We included 4073 participants from the Look AHEAD (Action for Health in Diabetes) study. We assessed variability of body mass index (BMI), waist circumference (WC), and body weight across four annual visits using three variability metrics, the variability independent of the mean (VIM), coefficient of variation (CV), and intraindividual standard deviation (SD). Multivariable Cox regression models were used to generate adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for incident HF.

Results

Over a median of 6.7 years, 120 participants developed incident HF. After adjusting for relevant confounders including baseline adiposity levels, the aHR for the highest (Q4) versus lowest quartile (Q1) of VIM of BMI was 3.61 (95% CI 1.91–6.80). The corresponding aHRs for CV and SD of BMI were 2.48 (95% CI 1.36–4.53) and 2.88 (1.52–5.46), respectively. Regarding WC variability, the equivalent aHRs were 1.90 (95% CI 1.11–3.26), 1.79 (95% CI 1.07–3.01), and 1.73 (1.01–2.95) for Q4 versus Q1 of VIM, CV and SD of WC, respectively.

Conclusions

In a large sample of adults with T2DM, a greater variability of adiposity indices was associated with higher risks of incident HF, independently of traditional risk factors and baseline adiposity levels.

Registration-URL:https://clinicaltrials.gov/ct2/show/NCT00000620.
Prognostic usefulness of a modified risk model for solitary fibrous tumor that includes the Ki-67 labeling index
Authors: Sugita Shintaro , Segawa Keiko , Kikuchi Noriaki , Takenami Tomoko , Kido Tomomi , Emori Makoto , Akiyama Yukinori , Takada Kohichi , Hinotsu Shiro , Hasegawa Tadashi
Published: February 2022

Background

Predicting the prognosis of patients with solitary fibrous tumor (SFT) is often difficult. The prognostic risk models developed by Demicco et al. are now the standard for evaluating the risk of SFT metastasis in the current World Health Organization classification of soft tissue and bone tumors.

Methods

In this study, we examined the prognostic usefulness of a modified version of the Demicco risk models that replaces the mitotic count with the Ki-67 labeling index. We compared the three-variable and four-variable Demicco risk models with our modified risk models using Kaplan–Meier curves based on data for 43 patients with SFT.

Results

We found a significant difference in metastasis-free survival when patients were classified into low-risk and intermediate/high-risk groups using the three-variable (P = 0.022) and four-variable (P = 0.046) Demicco models. There was also a significant difference in metastasis-free survival between the low-risk and intermediate/high-risk groups when the modified three-variable (P = 0.006) and four-variable (P = 0.022) models were used.

Conclusion

Modified risk models that include the Ki-67 labeling index are effective for prediction of the prognosis in patients with SFT.
The Aβ1–42/Aβ1–40 ratio in CSF is more strongly associated to tau markers and clinical progression than Aβ1–42 alone
Authors: Delaby Constance , Estellés Teresa , Zhu Nuole , Arranz Javier , Barroeta Isabel , Carmona-Iragui María , Illán-Gala Ignacio , Santos-Santos Miguel Ángel , Altuna Miren , Sala Isabel , Sánchez-Saudinós M. Belén , Videla Laura , Valldeneu Sílvia , Subirana Andrea , Tondo Mireia , Blanco-Vaca Francisco , Lehmann Sylvain , Belbin Olivia , Blesa Rafael , Fortea Juan , Lleó Alberto , Alcolea Daniel
Published: February 2022

Background

Cerebrospinal fluid (CSF) Aβ1–42 levels and the Aβ1–42/Aβ1–40 ratio are markers of amyloid pathology, but previous studies suggest that their levels might be influenced by additional pathophysiological processes.

Aims

To compare Aβ1–42 and the Aβ1–42/Aβ1–40 ratio in CSF in different neurodegenerative disorders and study their association with other biomarkers (tTau, pTau181, and NfL) and with cognitive and functional progression.

Methods

We included all participants from the Sant Pau Initiative on Neurodegeneration (SPIN) with CSF Aβ1–42 and Aβ1–42/Aβ1–40. Participants had diagnoses of Alzheimer’s disease (AD), dementia with Lewy bodies, frontotemporal lobar degeneration-related syndromes, non-neurodegenerative conditions, or were cognitively normal. We classified participants as “positive” or “negative” according to each marker. We compared CSF levels of tTau, pTau181, and NfL between concordant and discordant groups through ANCOVA and assessed differences in cognitive (MMSE, FCSRT) and functional (GDS, CDR-SOB) progression using Cox regression and linear-mixed models.

Results

In the 1791 participants, the agreement between Aβ1–42 and Aβ1–42/Aβ1–40 was 78.3%. The Aβ1–42/Aβ1–40 ratio showed a stronger correlation with tTau and pTau181 than Aβ1–42 and an agreement with tTau and pTau181 of 73.1% and 77.1%, respectively. Participants with a low Aβ1–42/Aβ1–40 ratio showed higher tTau and pTau181 and worse cognitive and functional prognosis, regardless of whether they were positive or negative for Aβ1–42. The results were consistent across stages, diagnostic categories, and use of different cutoffs.

Conclusion

Although Aβ1–42 and Aβ1–42/Aβ1–40 are considered markers of the same pathophysiological pathway, our findings provide evidence favoring the use of the Aβ1–42/Aβ1–40 ratio in clinical laboratories in the context of AD.
Anaplastic thyroid carcinoma with unusual long-term survival: a case report
Authors: Moreno Fany , Reyes Clarisa , Pineda César Alas , Castellanos Gustavo , Cálix Flory , Calderón Jorge , Vasquez-Bonilla Walter O.
Published: February 2022

Background

Anaplastic thyroid carcinoma is a rare, rapidly progressive, and highly aggressive tumor. It has a global annual incidence of 1–2 per million people. It mostly affects older adults and women. The median survival duration after diagnosis does not exceed 6–8 months.

Case presentation

A 60-year-old female patient of mixed race (Honduran) presented to the local medical service with dysphonia that had started approximately 2 months earlier, accompanied by orthopnea that had started 1 month earlier. On physical examination, a soft mass was palpated within the anterior neck region; it was approximately 4 cm in diameter, painless, and mobile on swallowing, and had irregular margins. Ultrasound and computed tomography of the neck were performed. Subsequently, fine needle aspiration biopsy was performed. The histological diagnosis was anaplastic thyroid carcinoma (stage IVB). She underwent total thyroidectomy and chemotherapy. She is currently in her fifth year of remission after diagnosis and remains under oncologic surveillance.

Discussion

Anaplastic thyroid carcinoma demonstrates a lethal behavior. Approximately 18% survive for more than a year after diagnosis, and 0–10% survive for 5 years. Different pretherapeutic prognostic factors may affect survival, including age < 70 years, the absence of distant metastases, and complete local resection.

Conclusion

Conventional treatment improves the quality of life of the patient, but the results are not encouraging for the medium and long term. Only a few patients manage to exceed the average life expectancy of 3–6 months, despite undergoing the currently available therapeutic regimen.
Response and resilience of anammox consortia to nutrient starvation
Authors: Wang Dou , Wang Yulin , Liu Lei , Chen Yiqiang , Wang Chunxiao , Li Yu-You , Zhang Tong
Published: February 2022

Background

It is of critical importance to understand how anammox consortia respond to disturbance events and fluctuations in the wastewater treatment reactors. Although the responses of anammox consortia to operational parameters (e.g., temperature, dissolved oxygen, nutrient concentrations) have frequently been reported in previous studies, less is known about their responses and resilience when they suffer from nutrient interruption.

Results

Here, we investigated the anammox community states and transcriptional patterns before and after a short-term nutrient starvation (3 days) to determine how anammox consortia respond to and recover from such stress. The results demonstrated that the remarkable changes in transcriptional patterns, rather than the community compositions were associated with the nutritional stress. The divergent expression of genes involved in anammox reactions, especially the hydrazine synthase complex (HZS), and nutrient transportation might function as part of a starvation response mechanism in anammox bacteria. In addition, effective energy conservation and substrate supply strategies (ATP accumulation, upregulated amino acid biosynthesis, and enhanced protein degradation) and synergistic interactions between anammox bacteria and heterotrophs might benefit their survival during starvation and the ensuing recovery of the anammox process. Compared with abundant heterotrophs in the anammox system, the overall transcription pattern of the core autotrophic producers (i.e., anammox bacteria) was highly resilient and quickly returned to its pre-starvation state, further contributing to the prompt recovery when the feeding was resumed.

Conclusions

These findings provide important insights into nutritional stress-induced changes in transcriptional activities in the anammox consortia and would be beneficial for the understanding of the capacity of anammox consortia in response to stress and process stability in the engineered ecosystems.
The cellular response to plasma membrane disruption for nanomaterial delivery
Authors: Houthaeve Gaëlle , De Smedt Stefaan C. , Braeckmans Kevin , De Vos Winnok H.
Published: February 2022

Delivery of nanomaterials into cells is of interest for fundamental cell biological research as well as for therapeutic and diagnostic purposes. One way of doing so is by physically disrupting the plasma membrane (PM). Several methods that exploit electrical, mechanical or optical cues have been conceived to temporarily disrupt the PM for intracellular delivery, with variable effects on cell viability. However, apart from acute cytotoxicity, subtler effects on cell physiology may occur as well. Their nature and timing vary with the severity of the insult and the efficiency of repair, but some may provoke permanent phenotypic alterations. With the growing palette of nanoscale delivery methods and applications, comes a need for an in-depth understanding of this cellular response. In this review, we summarize current knowledge about the chronology of cellular events that take place upon PM injury inflicted by different delivery methods. We also elaborate on their significance for cell homeostasis and cell fate. Based on the crucial nodes that govern cell fitness and functionality, we give directions for fine-tuning nano-delivery conditions.
Factors affecting consumer acceptance of electronic cash in China: an empirical study
Authors: Qu Bo , Wei Li , Zhang Yujia
Published: February 2022

This paper proposes and validates a comprehensive model of consumer acceptance in the context of offline e-cash payment. It modifies the unified theory of acceptance and the use of technology model (UTAUT) with constructs of perceived security, cost of use, and government policy. Data collected from 4428 questionnaires about users’ attitudes toward e-cash is used to apply a structural equation model which, in turn, assesses the predictive model. The empirical results indicate that perceived security and cost of use are beneficial extensions to the traditional UTAUT model, and intention is a key antecedent to users’ actual utilization of e-cash. In addition, the demographic moderators are found to have significant effects on the relations among the variables. These results are useful to e-cash development and significant to the issue of Digital Currency Electronic Payment.
Best practices for the development and fit-for-purpose validation of biomarker methods: a conference report
Authors: Mathews Joel , Amaravadi Lakshmi , Eck Steven , Stevenson Lauren , Wang Yow-Ming C. , Devanarayan Viswanath , Allinson John , Lundsten Kelly , Gunsior Michele , Ni Yan G. , Pepin Marc-Olivier , Gagnon Audrey , Sheldon Curtis , Trampont Paul C. , Litwin Virginia
Published: February 2022

This conference report summarized a full-day workshop, “best practices for the development and fit-for-purpose validation of biomarker methods,” which was held prior to the American Association of Pharmaceutical Scientists (AAPS) PharmSci360 Congress, San Antonio, TX, November 2019. The purpose of the workshop was to bring together thought leaders in biomarker assay development in order to identify which assay parameters and key statistical measures need to be considered when developing a biomarker assay. A diverse group of more than 40 scientists participated in the workshop. The workshop and subsequent working dinner stimulated robust discussion. While a consensus on best practices was not achieved, some common themes and major points to consider for biomarker assay development have been identified and agreed on. The focus of this conference report is to summarize the presentations and discussions which occurred at the workshop. Biomarker assay validation is a complex and an evolving area with discussions ongoing.