bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatocellular Adenoma in an Infant With Burn-McKeown Syndrome: Report of a Case
Authors: González Iván A. , Surrey Lea F. , Russo Pierre
Published: October 2022

Hepatocellular adenomas (HCA) in infants are exceedingly rare with only 5 cases reported to the best of our knowledge, all of them preceding the classification of HCA. Here we present an autopsy case of a 9-month-old girl with Burn-McKeown syndrome with an incidental liver nodule in the right lobe measuring 1.5 cm in greatest dimension. The lesion was composed of an unencapsulated proliferation of hepatocytes with multiple unaccompanied arteries without well-formed portal tracts, and an intact reticulin framework without thickened hepatic plates, findings consistent with an HCA. Glutamine synthetase (GS), lipid fatty acid-binding protein (LFABP), c-reactive protein (CRP), serum amyloid-a (SAA), beta-catenin and CD34 immunostains were performed. GS was diffusely and strongly positive in the lesion, CD34 showed heterogenous staining of sinusoids within the lesion without a well-formed rim from the background liver and beta-catenin was negative for nuclear staining. CRP and SAA were considered negative, and LFABP was retained. Molecular testing showed no CTNNB1 variants and found two tier 3 variants involving CHEK2 and PTEN genes. These findings are consistent with an unclassified HCA (U-HCA) per the 2019 WHO Classification of Tumors, representing the youngest patient reported. This raises the possibility that some HCAs are congenital or develop very early in life, remaining undiagnosed until later in life.
A narrative review of history, advantages, future developments of the distal radial access
Authors: Korotkikh Alexander Vladimirovich , Babunashvili Avtandil Mikhailovich , Kazantsev Anton Nikolaevich , Annaev Zinat Shavkatovich
Published: October 2022

This article presents a historical excursus and a review of modern literature on distal radial access for interventional surgery, discussing the anatomical and physiological substantiation of the use of this access point in endovascular surgery, its advantages and disadvantages. The main considerations directly related to distal puncture, choice of instrumentation, hemostasis, possible complications, and prevention are analyzed. The major areas of interventional surgery (coronary, vascular, oncological, and neurointerventional), where the distal radial approach is actively used, are reflected and their characteristics are highlighted. In general, it has been shown that with the development of technology, improved manual skills, the widespread use of hydrophilic introducers, and modern sheathless guiding catheters, the vessel diameter, and puncture site are not decisive factors when choosing access for any type of intervention.
Professional education toward protean careers in music? Bigenerational Finnish composers’ pathways and livelihoods in changing ecosystems
Authors: Westerlund Heidi , López-Íñiguez Guadalupe
Published: October 2022

Contemporary professional landscapes in classical music fields are rapidly changing and younger generations of musicians are confronting their creative careers, more often than not in connection to self-employment and freelancing. This narrative inquiry investigates the pathways and livelihoods of composers in a changing professional ecosystem through interviews with 10 bigenerational composers in Finland. The analysis is presented in three “factional stories,” in which the empirical material is crafted into “fictional form” by an anonymous first-person narrator. The stories depict how the secure, traditional careers of the older generation are found to be bound to traditional orchestras and ensembles, whereas the protean careers of the younger generation of composers involve passionate pathfinding amid pluralizing ecosystems, within but also beyond traditional contexts and through various collaborations. The younger composers are expanding significantly, or consciously distancing themselves from, the traditional model and values of a contemporary composer. Competition is found to be increasing and professional education described as too short and insufficient in its concentration on technique—this does not provide new understandings and skills beyond traditional composing craft needed for navigating the profession and securing livelihoods. Although similarities are found in the pathways of both composers’ generations, such as strong career callings and experiences of luck, the “struggle” for a composer to find a place in society is more strongly experienced by the younger generation, for which the development of an ongoing “learner identity” is required to embrace—and not resist—such a challenge. As a whole, the study provides a new understanding of composers’ pathfinding through changing ecosystems and suggests that traditional and protean music careers co-exist—even within a single person—while they can also be clearly separated from each other. The study informs higher music education programs in Western countries.
Single-number values versus subjective judgment of airborne sound insulation in dwellings
Authors: Rauscher Thomas , Neubauer Reinhard O. , Zaglauer Maria , Leistner Philip
Published: October 2022

There is a long history of adapting airborne sound insulation in buildings to the actual needs. A first pan-European work was published with COST Action TU0901: Integrating and Harmonizing Sound Insulation Aspects in Sustainable Urban Housing Constructions in which the differences between the sound insulation measure and the standard sound level difference were documented. Furthermore, ISO 16283-1: Field measurement of sound insulation in buildings and of building elements—Part 1: Airborne sound insulation states: Compared to DnT, R’ has a weaker connection to the subjective impression of airborne sound insulation. To investigate this relationship a simplified listening test and a computer-simulated variation studies of a synthesized airborne sound insulation were carried out. A test sound was generated from a speech, a music, and a noise signal, each of which was filtered by six frequency responses of solid structures. In a paired comparison task, 16 participants judged the loudness of the resulting 18 sounds. The results of the listening test show that perceived loudness is significantly correlated to the single number quantity DnT,w but less to the single number quantity R’w. This finding was confirmed across all signal types. Thus, the results confirm the statement in ISO 16283-1, that the single number quantity DnT,w has a stronger connection to the subjective impression of airborne sound insulation as the quantity R’w.
Time after death: Material afterlives in the work of estate administration
Authors: Pinedo-Padoch Sofia
Published: October 2022

When someone dies without a will and with no close family willing to administer their estate in New York City and other large US cities, the Public Administrator (PA), a small state agency, steps in to take care of the deceased's estate. Because the subject of the PA's work—the deceased—is no longer present, the office relies on things—objects, homes, money, and documents—as legal markers of identity. The afterlife of a person, therefore, is a distinctly material afterlife. Though death may signify an end, it is in fact the beginning of a different kind of time that is orchestrated in stops and starts by the work of the law, people, and material objects. The ethnographic stories told in this essay demonstrate how two temporal categories—the legal and extralegal—come up against each other in tense and uncanny ways, and how this convergence of legal and extralegal temporalities produces the distinctive material afterlives of the dead.
A clinical alert: Oral glucose tolerance test triggering diabetic ketoacidosis in pregnancy
Authors: Mundkur Anjali , Roopa Padavagodu Shivananda , Narayan Pratap Kumar , Vasudeva Akhila , Jain Gazal , Adiga Prashanth K
Published: October 2022

Gestational diabetes mellitus is a common medical disorder of pregnancy. Diabetic ketoacidosis is a complication that may affect both maternal and perinatal wellbeing adversely. It is rare, most often involving women with type 1 or type 2 diabetes, but occasionally can be seen in gestational diabetes mellitus. Here are two cases of ketoacidosis seemingly triggered by glucose ingestion for the oral glucose tolerance test in previously normoglycemic women, posing a diagnostic and therapeutic challenge. Prevention of such complications must be considered when treating high-risk pregnant women> 40 years of age, pregnant as a result of assisted reproductive techniques. Fasting blood glucose checked before ingestion of the glucose in a selected group of women may be one way of avoiding this complication. This suggestion may put women at risk of prolonged fasting and stretching services. Glucose tolerance test is a diagnostic test, and these cases demonstrate a rare complication.
A new cell-free therapeutic strategy for liver regeneration: Human placental mesenchymal stem cell-derived extracellular vesicles
Authors: Li Ting , Fu Yu , Guo Zeyi , Zhu Honglei , Liao Hangyu , Niu Xiaoge , Zhou Lin , Fu Shunjun , Li Yang , Li Shao , Wang Lujia , Zheng Yizhou , Feng Lei , Gao Yi , He Guolin
Published: October 2022

Mesenchymal stem cells (MSCs) have potential role in organ regeneration therapy. Previous work indicating that MSCs confer protection against liver disease. Here, we aimed to determine the potential application in liver regeneration of human placenta-derived MSCs extracellular vesicles (hPMSCs-EVs) via experimental hepatectomy. hPMSCs-EVs were administered intravenously 24 h before 70% partial hepatectomy, the specific composition of hPMSCs-EVs was identified by sequencing and validated by the quantitative polymerase chain reaction, including circ-RBM23. The role of circ-RBM23 in L02 cell was evaluated and it was found that circ-RBM23 knockdown inhibited L02 cell proliferation both in vitro and in vivo. The competing endogenous RNA function of circ-RBM23 was evaluated by the RNA immunoprecipitation assay and found that circ-RBM23 shares miRNA response elements with RRM2. Overexpressed circ-RBM23 bound competitively to miR-139-5p, preventing the miRNA-mediated degradation of RRM2, activating the expression of eIF4G and AKT/mTOR, and facilitating liver regeneration. These results indicate that hPMSCs-EVs prevent hepatic dysfunction and improve liver regeneration in vivo and hepatocytes proliferation in vitro, potentially via circ-RBM23 delivery.
Internet-facilitated interventions for informal caregivers of patients with neurodegenerative disorders: Systematic review and meta-analysis
Authors: Boyt Neil , Ho Aileen K , Morris-Bankole Hannah , Sin Jacqueline
Published: October 2022

Objective

This systematic review explored the effectiveness of internet-delivered interventions in improving psychological outcomes of informal caregivers for neurodegenerative-disorder (ND) patients.

Methods

We searched seven databases for English-language papers published from 1999 to May 2021. Study-eligibility required that interventions used a minimum 50% internet-facilitation, targeting unpaid, adult informal caregivers of community-based ND-patients. We included randomised controlled trials (RCTs) and pre-post evaluative studies reporting outcomes for at least one-time point post-intervention. Independent quality checks on abstract and full-text screening were completed. Data extraction encompassed interventions’ features, approaches, theoretical bases and delivery-modes. The Integrated quality Criteria for the Review Of Multiple Study designs (ICROMS) framework assessed risk of bias. Alongside narrative synthesis, we calculated meta-analyses on post-intervention using outcome measures from at least two RCTs to assess effectiveness.

Results

Searches yielded 51 eligible studies with 3180 participants. In 48 studies, caregivers supported a dementia-diagnosed individual. Intervention-durations encompassed four weeks to 12 months, with usage-frequency either prescribed or participant-determined. The most frequently-used approach was education, followed by social support. We calculated meta-analyses using data from 16 RCTs. Internet-delivered interventions were superior in improving mastery (g  =  1.17 [95% CI; 0.1 to 2.24], p  =  0.03) and reducing anxiety (g = -1.29 [95% CI; −1.56 to −1.01], p < 0.01), compared to all controls. Findings were equivocal for caregivers’ quality of life, burden and other outcomes. High heterogeneity reflected the multifarious combinations of approaches and delivery-modes, precluding assessment of the most efficacious intervention features. Analyses using burden and self-efficacy outcomes’ follow-up data were also non-significant compared to all comparator-types. Although 32 studies met the ICROMS threshold scores, we rated most studies’ evidence quality as ‘very-low’.

Conclusions

This review demonstrated some evidence for the efficacy of internet-delivered interventions targeting informal ND-caregivers. However, more rigorous studies, with longer follow-ups across outcomes and involving NDs other than dementia, are imperative to enhance the knowledge-base.
Nexus Between Financial Crises, Corporate Governance and Future Stock Price Crash Risk
Authors: Zulfiqar Faiza , Sahar Najam Us , Jalal Raja Nabeel-Ud-Din , Akhtar Muhammad , Fayyaz Um-E-Roman , Venditti Michelina
Published: October 2022

We aim to investigate the impact of corporate governance attributes on future stock price crash risk in stable and crisis periods. We used Dynamic Panel Generalized Method of Movements (DPGMM) and Principal Component Analysis (PCA) to generate the factors for the individual attribute to capture the accuracy of the results. Ownership concentration and board structure have a significant negative while audit quality has no association with the stock price crash risk. However, the financial crisis has a positive association with stock crash risk. Furthermore, the study provides a potential screening methodology for investors to mitigate future risk as to price crash risk for portfolios that cannot be dealt with diversification.
Readability and Quality of Online Health Information Regarding Parathyroidectomy
Authors: Byrne Jim , Keogh Samuel , Cullinane Carolyn , Razzaq Zeeshan , Redmond Henry Paul
Published: October 2022

Objective

Assessment of the readability and quality of online health information regarding parathyroidectomy.

Study Design

Cross‐sectional analysis.

Setting

Websites providing patient‐oriented health information regarding parathyroidectomy obtained via the Google search engine.

Methods

The top 75 Google search results for “parathyroidectomy,”“parathyroid surgery,” and “parathyroid gland removal” were reviewed. Websites were categorized by website type and country of origin. Readability was assessed by Flesch‐Kincaid Grade Level and Simple Measure of Gobbledygook. Website quality was assessed per JAMA benchmark criteria and the DISCERN instrument.

Results

A total of 74 unique websites were evaluated. The mean readability of the assessed websites exceeded the recommended sixth‐grade reading level on the Flesch‐Kincaid Grade Level and Simple Measure of Gobbledygook (P <. 001). Readability did not vary significantly by website type. Websites originating from the United Kingdom were significantly more readable than those from the United States. The majority of assessed websites were of poor quality (n = 42, 56.8%) on assessment based on the DISCERN instrument. Quality varied significantly by website category on the JAMA benchmark criteria (P <. 001) and DISCERN score (P =. 049) with commercial websites receiving the highest scores. DISCERN score also varied significantly by country of origin (P =. 036) with UK sites receiving highest mean DISCERN scores.

Conclusion

Online health information regarding parathyroidectomy is largely of poor quality and is poorly readable for many patients. Institutions utilizing well‐defined guidelines for development of patient educational resources may provide online health information of greater quality and readability.
An innovative approach based on real-world big data mining for calculating the sample size of the reference interval established using transformed parametric and non-parametric methods
Authors: Ma Chaochao , Hou Li’an , Zou Yutong , Ma Xiaoli , Wang Danchen , Hu Yingying , Song Ailing , Cheng Xinqi , Qiu Ling
Published: October 2022

Background

Currently, the direct method is the main approach for establishment of reference interval (RI). However, only a handful of studies have described the effects of sample size on establishment of RI and estimation of sample size. We describe a novel approach for estimation of the sample size when establishing RIs using the transformed parametric and non-parametric methods.

Methods

A total of 3,697 healthy participants were enrolled in this study. We adopted a two-layer nested loop sample size estimation method to determine the effects of sample size on RI, using thyroid-related hormone as an example. The sample size was selected as the calculation result when the width of the confidence interval (CI) of the upper and lower limit of the RI were both stably < 0.2 times the width of RI. Then, we calculated the sample size for establishing RIs via transformed parametric and non-parametric methods for thyroid-related hormones.

Results

Sample sizes for thyroid stimulating hormone (TSH), as required by parametric and non-parametric methods to establish RIs were 239 and 850, respectively. Sample sizes required by the transformed parametric method for free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3) and total thyroxine (TT4) were all less than 120, while those required by the non-parametric method were more than 120.

Conclusion

We describe a novel approach for estimating sample sizes for establishment of RI. A corresponding open-source code has been developed and is available for applications. The established method is suitable for most analytes, with evidence based on thyroid-related hormones indicating that different sample sizes are required to establish RIs using different methods for analytes with different variations.
Patient experience with non-invasive prenatal testing (NIPT) as a primary screen for aneuploidy in the Netherlands
Authors: Kristalijn Syanni A. , White Karen , Eerbeek Deanna , Kostenko Emilia , Grati Francesca Romana , Bilardo Caterina M.
Published: October 2022

Background

Non-invasive prenatal testing (NIPT) as a screening method for trisomy 21 and other chromosomal abnormalities has been adopted widely across the globe. However, while many clinical validation studies have been performed, less is known regarding the patient experience with NIPT. This study explored how individuals experience NIPT in a pre- and post-test setting, where NIPT is broadly available as a primary screening method with the option of reporting beyond common trisomies.

Methods

Participants were recruited using social media with a strategy designed to select individuals who had the option to have NIPT as part of the TRIDENT-2 study (In the Netherlands, NIPT is only available within the TRIDENT studies executed by the NIPT consortium. This research was done independently from the NIPT consortium.) in the Netherlands. The study used online questionnaires and semi-structured interviews. Both were developed around a patient experience framework consisting of seven themes: information, patient as active participant, responsiveness of services, lived experience, continuity of care and relationships, communication, and support.

Results

Overall, 4539 questionnaire responses were analyzed and 60% of the respondents had experienced NIPT. Of those, 1.7% received a high-risk result for trisomy or another chromosomal copy number variant (referred to as an “additional finding”). Overall, participants felt they had received sufficient information and had control over their decision regarding whether or not to choose NIPT. The vast majority of respondents who had NIPT were positive about their experience and would use it again. Those with results showing an increased probability for trisomy or additional findings were more likely to report negative feelings such as tension and anxiety, and less likely to feel that they had been sufficiently prepared for the implications of their results.

Conclusions

The patient experience with first-tier NIPT in the Netherlands was largely positive. Areas for improvement included counseling on the implications of screening and the different possible outcomes of NIPT, including additional findings that may be uncovered by expanding NIPT beyond the common trisomies. The experiences reported in this study may be useful for other countries intending to implement NIPT.
Mortality from diseases of the circulatory system in Brazil and its relationship with social determinants focusing on vulnerability: an ecological study
Authors: Bastos Luiz A. V. M. , Bichara Jose L. P. , Nascimento Gabriela S. , Villela Paolo B. , de Oliveira Glaucia M. M.
Published: October 2022

Background

Deaths from diseases of the circulatory system and ischemic heart diseases are declining, but slowly in developing countries, emphasizing its probable relationship with determinants of social vulnerability.

Objectives

To analyze the temporal progression of mortality rates of diseases of the circulatory system and ischemic heart diseases from 1980 to 2019 and the association of the rates with the Municipal Human Development Index and Social Vulnerability Index in Brazil.

Methods

We estimated the crude and standardized mortality rates of diseases of the circulatory system and ischemic heart diseases and analyzed the relationship between the obtained data and the Municipal Human Development Index and Social Vulnerability Index. Data on deaths and population were obtained from the DATASUS. The Municipal Human Development Index and the Social Vulnerability Index of each federative unit were extracted from the websites Atlas Brazil and Atlas of Social Vulnerability, respectively.

Results

The age-standardized mortality rates of diseases of the circulatory system and ischemic heart diseases showed a downward trend nationwide, which was unequal across the federative units. There was an inversely proportional relationship between the standardized mortality rates of diseases of the circulatory system and ischemic heart diseases and the Municipal Human Development Index. The downward mortality trend was observed when the indices were greater than 0.70 and 0.75, respectively. The Social Vulnerability Index was directly proportional to the standardized mortality rates of diseases of the circulatory system and ischemic heart diseases. An upward mortality trend was observed with a Social Vulnerability Index greater than 0.35.

Conclusions

Social determinants represented by the Municipal Human Development Index and the Social Vulnerability Index were related to mortality from diseases of the circulatory system and ischemic heart diseases across the Brazilian federative units. The units with most development and least social inequalities had the lowest mortality from these causes. The most vulnerable die the most.
Innovative approach to monitor performance of integrated disease surveillance and response after the Ebola outbreak in Sierra Leone: lessons from the field
Authors: Njuguna Charles , Vandi Mohamed , Squire James Sylvester , Kanu Joseph Sam , Gachari Wilson , Liyosi Evans , Githuku Jane , Chimbaru Alexander , Njeru Ian , Caulker Victor , Mugagga Malimbo , Sesay Stephen , Yahaya Ali Ahmed , Talisuna Ambrose , Yoti Zabulon , Fall Ibrahima Socé
Published: October 2022

Background

Supervision of healthcare workers improves performance if done in a supportive and objective manner. Regular supervision is a support function of Integrated Disease Surveillance and Response (IDSR) strategy and allows systematic monitoring of IDSR implementation. Starting 2015, WHO and other development partners supported the Ministry of Health and Sanitation (MoHS) to revitalize IDSR in Sierra Leone and to monitor progress through supportive supervision assessments. We report on the findings of these assessments.

Methods

This was a cross-sectional study where six longitudinal assessments were conducted in randomly selected health facilities. Health facilities assessed were 71 in February 2016, 99 in July 2016, 101 in May 2017, 126 in August 2018, 139 in February 2019 and 156 in August 2021. An electronic checklist based on selected core functions of IDSR was developed and uploaded onto tablets using the Open Data Kit (ODK) platform. Supervision teams interviewed health care workers, reviewed documents and made observations in health facilities. Supervision books were used to record feedback and corrective actions. Data from the supervisory visits was downloaded from ODK platform, cleaned and analysed. Categorical data was summarized using frequencies and proportions while means and medians were used for continuous variables. Z test was used to test for differences in proportions.

Results

Completeness of IDSR reporting improved from 84.5% in 2016 to 96% in 2021 (11.5% points; 95% CI 3.6, 21.9; P-value 0.003). Timeliness of IDSR reports improved from 80.3 to 92% (11.7% points; 95% CI 2.4, 22.9; P-value 0.01). There was significant improvement in health worker knowledge of IDSR concepts and tools, in availability of IDSR standard case definition posters and reporting tools and in data analysis practices. Availability of vaccines and temperature monitoring tools in health facilities also improved significantly but some indicators dropped such as availability of IDSR technical guidelines and malaria testing kits and drugs.

Conclusion

Supervision using electronic tool contributed to health systems strengthening through longitudinal tracking of core IDSR indicators and other program indicators such as essential malaria commodities and availability and status of routine vaccines. Supervision using electronic tools should be extended to other programs.
Global burden and trends of rotavirus infection-associated deaths from 1990 to 2019: an observational trend study
Authors: Du Yuxia , Chen Can , Zhang Xiaobao , Yan Danying , Jiang Daixi , Liu Xiaoxiao , Yang Mengya , Ding Cheng , Lan Lei , Hecht Robert , Zhu Changtai , Yang Shigui
Published: October 2022

Background

Rotavirus is the leading global pathogen of diarrhea-associated mortality and poses a great threat to public health in all age groups. This study aimed to explore the global burden and 30-year change patterns of rotavirus infection-associated deaths.

Methods

Based on the Global Burden of Disease 2019 Study (GBD 2019), we analyzed the age-standardized death rate (ASDR) of rotavirus infection by sex, geographical region, and sociodemographic index (SDI) from 1990 to 2019. A Joinpoint regression model was used to analyze the global trends in rotavirus infection over the 30 years, SaTScan software was used to detect the spatial and temporal aggregations, and a generalized linear model to explore the relationship between sociodemographic factors and death rates of rotavirus infection.

Results

Globally, rotavirus infection was the leading cause of diarrheal deaths, accounting for 19.11% of deaths from diarrhea in 2019. Rotavirus caused a higher death burden in African, Oceanian, and South Asian countries in the past three decades. The ASDR of rotavirus declined from 11.39 (95% uncertainty interval [95% UI] 5.46–19.48) per 100,000 people in 1990 to 3.41 (95% UI 1.60–6.01) per 100,000 people in 2019, with an average annual percentage change (AAPC) (− 4.07%, P < 0.05). However, a significant uptrend was found in high-income North America (AAPC = 1.79%, P < 0.05). The death rate was the highest among children under 5 years worldwide. However, the death rates of elderly individuals over 70 years were higher than those of children under 5 years in 2019 among high, high-middle, middle, and low-middle SDI regions. Current health expenditure, gross domestic product per capita, and the number of physicians per 1000 people were significantly negatively correlated with death rates of rotavirus.

Conclusions

Although the global trends in the rotavirus burden have decreased substantially over the past three decades, the burden of rotavirus remained high in Africa, Oceania, and South Asia. Children under 5 years and elderly individuals over 70 years were the populations most at risk for rotavirus infection-associated deaths, especially elderly individuals over 70 years in relatively high SDI regions. More attention should be paid to these areas and populations, and effective public health policies should be implemented in the future.
Simultaneous femoral head reduction osteotomy (FHRO) combined with periacetabular osteotomy (PAO) for the treatment of severe femoral head asphericity in Perthes disease
Authors: Gharanizadeh Kaveh , Ravanbod Hadi , Aminian Amir , Mirghaderi Seyed Peyman
Published: October 2022

Background

The purpose of this study is to describe the midterm clinical and radiologic outcomes of concurrent femoral head reduction osteotomy (FHRO) and periacetabular osteotomy (PAO) in Legg–Calvé–Perthes disease (LCPD) patients with major aspherical femoral head deformities.

Methods

The study included four Perthes patients in Stage IV of Waldenstrom’s classification with a mean age of 10.5 and severe femoral head asphericity. They were treated with a combination of FHRO + PAO and followed for at least 2 years. An evaluation of the radiological outcome of the surgery was carried out based on the lateral center to edge angle (LCEA), the anterior center to edge angle (ACEA), the Tönnis angle, the head sphericity index, the Stulberg classification, the extrusion index, and Shenton’s line integrity. An evaluation of the clinical outcome was made by evaluating hip range of motion (ROM), Harris hip score (HHS), and Merle d’Aubigne´-Postel score.

Results

All radiographic measures improved; three patients were classified as Stulberg class II and one as class III. The LCEA, ACEA, and Tönnis angle improved by 29° (from 3° to 32°), 16° (from 14° to 30°), and − 10° (from 18° to 8°), respectively. The mean femoral head sphericity index and extrusion index improved by 12% (from 83 to 95%) and − 33% (from 40 to 7%). No disruption was observed in the postoperative Shenton’s line. According to HHS, all patients have shown excellent hip function, which improved by 27 points (from 69 to 96). Moreover, the hip ROM was increased from 222° to 267°. The follow-up period did not reveal any serious postoperative complications, such as osteonecrosis or conversion to arthroplasty.

Conclusions

Combined FHRO with PAO may improve the hip joint’s morphology and function in patients with residual femoral head deformity and acetabular dysplasia due to LCPD. Despite being considered a complex and demanding hip surgery, these results suggest a more widespread implication of the salvage procedure.
Using genetically encoded fluorescent biosensors to interrogate ovarian cancer metabolism
Authors: Bose Shree , Yao Haipei , Huang Qiang , Whitaker Regina , Kontos Christopher D. , Previs Rebecca A. , Shen Xiling
Published: October 2022

Background

Epithelial ovarian cancer (OC) is the most lethal gynecological malignancy and patients present with significant metastatic burden, particularly to the adipose-rich microenvironment of the omentum. Recent evidence has highlighted the importance of metabolic adaptations in enabling this metastasis, leading to significant interest in evolving the arsenal of tools used to study OC metabolism. In this study, we demonstrate the capability of genetically encoded fluorescent biosensors to study OC, with a focus on 3D organoid models that better recapitulate in vivo tumor microenvironments.

Materials and methods

Plasmids encoding the metabolic biosensors HyPer, iNap, Peredox, and Perceval were transfected into 15 ovarian cancer cell lines to assay oxidative stress, NADPH/NADP+, NADH/NAD+, and ATP/ADP, respectively. Fluorescence readings were used to assay dynamic metabolic responses to omental conditioned media (OCM) and 100 μM carboplatin treatment. SKOV3 cells expressing HyPer were imaged as 2D monolayers, 3D organoids, and as in vivo metastases via an intravital omental window. We further established organoids from ascites collected from Stage III/IV OC patients with carboplatin-resistant or carboplatin-sensitive tumors (n = 8 total). These patient-derived organoids (PDOs) were engineered to express HyPer, and metabolic readings of oxidative stress were performed during treatment with 100 μM carboplatin.

Results

Exposure to OCM or carboplatin induced heterogenous metabolic changes in 15 OC cell lines, as measured using metabolic sensors. Oxidative stress of in vivo omental metastases, measured via intravital imaging of metastasizing SKOV3-HyPer cells, was more closely recapitulated by SKOV3-HyPer organoids than by 2D monolayers. Finally, carboplatin treatment of HyPer-expressing PDOs induced higher oxidative stress in organoids derived from carboplatin-resistant patients than from those derived from carboplatin-sensitive patients.

Conclusions

Our study showed that biosensors provide a useful method of studying dynamic metabolic changes in preclinical models of OC, including 3D organoids and intravital imaging. As 3D models of OC continue to evolve, the repertoire of biosensors will likely serve as valuable tools to probe the metabolic changes of clinical importance in OC.
Male partners involvement in human immune deficiency virus testing and counseling during prenatal care visits in Bichena town Westcentral Ethiopia: a cross-sectional study
Authors: Gessesse Nigusu Ayalew , Gela Getahun Belay , Aweke Amlaku Mulat , Balcha Wondu Feyisa
Published: October 2022

Objective

Transmission of the Human immune deficiency virus (HIV) from mother to child remains a significant problem in developing countries. Male partners’ involvement in HIV testing and counseling is a major entry point for the prevention of mother-to-child transmission (PMTCT) of HIV. This study aimed to assess male partners’ involvement in HIV testing and counseling during prenatal care visits in Bichena town, Westcentral Ethiopia.

Results

A community-based cross-sectional study design was conducted from October 1/2018 to June 15/2019 among 406 male partners. Less than half (41.38%) [95% CI: 36.20–46.10%] of the male partners were involved in HIV testing and counseling. In multivariable analysis male partners who are found in the age group of 20–29 years, secondary, and diploma and above educational level, good knowledge of the services provided in the prenatal care visits, male partners whose wife had ≥ 4 prenatal care visits, good knowledge of mother to child transmission (MTCT) and PMTCT of HIV, entering the prenatal care room together with his wife, discussing maternal health issue with health care providers, and travel < 15 min to reach a nearby health facility were associated with male partners involvement in HIV testing and counseling.
The role of models in the covid-19 pandemic
Authors: Steinberg David M. , Balicer Ran D. , Benjamini Yoav , De-Leon Hilla , Gazit Doron , Rossman Hagai , Sprecher Eli
Published: October 2022

Mathematical and statistical models have played an important role in the analysis of data from COVID-19. They are important for tracking the progress of the pandemic, for understanding its spread in the population, and perhaps most significantly for forecasting the future course of the pandemic and evaluating potential policy options. This article describes the types of models that were used by research teams in Israel, presents their assumptions and basic elements, and illustrates how they were used, and how they influenced decisions. The article grew out of a “modelists’ dialog” organized by the Israel National Institute for Health Policy Research with participation from some of the leaders in the local modeling effort.
Reciprocal migration: the coloniality of recent two-way migration links between Angola and Portugal
Authors: Augusto Asaf , Alves Elisa , King Russell , Malheiros Jorge
Published: October 2022

Reciprocal migration—which we define as the mutual exchange of origin and destination by two different migrating groups—is hardly acknowledged in the migration literature. In terms of the temporalities of migration, which are usually seen as sequences or transitions, reciprocal migrations are simultaneous. We analyse the reciprocal migrations between Angola and Portugal over the time-frame of the past 10–15 years. In-depth interviews were carried out with Portuguese migrants in Angola, most of whom moved there in the wake of the post-2008 financial crisis, and with Angolan third-level students and recent graduates in Portugal. A key operational concept in our analysis is the plastic notion of skill and its differential racialisation. Portuguese migrants in Angola are automatically regarded as ‘skilled’ even when they are not, whereas Angolan students and graduates in Portugal, when they seek work, are often viewed as ‘unskilled African migrant workers’. We thus distinguish and deconstruct the geographical binary between transnational origin and destination spaces and the social binary between ‘skilled white bodies’ and ‘unskilled black bodies’. These racialised embodied tropes draw on histories of Portuguese colonisation and the contested notion of ‘Lusotropicalism’, as well as the so-called Lusophone migration system involving complex transnational relations and two-way migration flows. Theoretically we frame this asymmetrical system of reciprocal migration within a modified version of core–periphery relations, as well as the coloniality of power and its enduring influence over the racialisation of skill, education, culture and language across the Portuguese–Angolan transnational space.
Factors associated with mothers’ health care-seeking behaviours for childhood fever in Burkina Faso: findings from repeated cross-sectional household surveys
Authors: Badolo Hermann , Bado Aristide R. , Hien Hervé , Méda Nicolas , Susuman A. Sathiya
Published: October 2022

Introduction

Fever is one of the most frequent reasons for paediatric consultations in Burkina Faso, but health care-seeking behaviours and the factors associated with health care-seeking in the event of childhood fever are poorly documented. This study aims to analyse the health care-seeking behaviours and the factors associated with health care-seeking for childhood fever in Burkina Faso.

Methods

This study used the data from the baseline and endline surveys conducted to evaluate the impact of the Performance-Based Financing program in Burkina Faso. Univariate and multivariate binary logistic regression analyses were used to identify the factors associated with appropriate healthcare-seeking for childhood fever. Odds ratios were estimated to assess the strength of associations and 95% confidence intervals (CIs) were used for significance tests. Data were cleaned, coded and analysed using Stata software version 16.1.

Results

Among the children under five who had a fever, 75.19% and 79.76% sought appropriate health care in 2013 and 2017, respectively. Being 24–59 months old (AOR: 0.344, 95% CI 0.182–0.649 in 2013 and AOR: 0. 208, 95% CI 0.115–0.376 in 2017), living in a very wealthy household (AOR: 2.014, 95% CI 1.149–3.531 in 2013 and AOR: 2.165, 95% CI 1.223–3.834 in 2017), having a mother with a secondary or higher level of education or having made at least four antenatal care visits were significantly associated with seeking appropriate health care for childhood fever. Living in an area where the health facility is safe was also significantly associated with seeking appropriate care for childhood fevers.

Conclusions

The findings underscore the need to concentrate efforts aiming at sensitizing the population (especially women of childbearing age) to improve sanitation and the use of family planning (household composition), skilled antenatal care and postnatal care to help reduce the prevalence of fever in children under five and improve the use of medical healthcare for childhood fever.
Key factors to establish the ovalbumin-induced atopic dermatitis minipig model: age and body weight
Authors: Kim Young Kyu , Lee JuKyung , Kim Hyeon-Young , Kim Sung-Hwan , Hwang Jeong Ho , Suh Han Na
Published: October 2022

Background

Given its similar structure and immune response to the human skin, porcine is a good model for dermal studies. Here, we sensitized ovalbumin (Ova) on minipig back skin for 2–4 weeks to induce chronic atopic dermatitis (AD).

Results

Gross observation, serum cytokine level, epidermal thickness, and epidermal integrity did not change after 4 weeks of Ova induction compared with the control, indicating AD modeling failure. Only the neutrophils in the blood and macrophages in bronchoalveolar lavage fluid changed slightly until 3 or 2 weeks after Ova sensitization, respectively. The successful and failed Ova-induced AD minipig models only differ in age and body weight of the minipigs. The minipigs, 12 months old with a 30-kg median weight, had a two-fold thicker dermis than minipigs 8–10 months old, with an 18.97-kg median weight, resulting in impaired Ova permeability and immune response.

Conclusion

Age and body weight are key factors that should be considered when developing an Ova-induced AD minipig model.
Methylphenidate for prison inmates with ADHD: yes or no?
Authors: Cortese Samuele
Published: October 2022

In a double-blind randomised controlled trial by Asherson et al., involving prisoners with attention-deficit hyperactivity disorder (ADHD), the rates of response to osmotic-release oral system methylphenidate (OROS-methylphenidate) and placebo were very similar (~50%). I critically discuss this trial against other international literature, highlighting the key issues in the field in terms of clinical practice and research.
Development and Validation of a Machine Learning Approach Leveraging Real-World Clinical Narratives as a Predictor of Survival in Advanced Cancer
Authors: Lin Frank Po-Yen , Salih Osama S.M. , Scott Nina , Jameson Michael B. , Epstein Richard J.
Published: October 2022

PURPOSE

Predicting short-term mortality in patients with advanced cancer remains challenging. Whether digitalized clinical text can be used to build models to enhance survival prediction in this population is unclear.

MATERIALS AND METHODS

We conducted a single-centered retrospective cohort study in patients with advanced solid tumors. Clinical correspondence authored by oncologists at the first patient encounter was extracted from the electronic medical records. Machine learning (ML) models were trained using narratives from the derivation cohort, before being tested on a temporal validation cohort at the same site. Performance was benchmarked against Eastern Cooperative Oncology Group performance status (PS), comparing ML models alone (comparison 1) or in combination with PS (comparison 2), assessed by areas under receiver operating characteristic curves (AUCs) for predicting vital status at 11 time points from 2 to 52 weeks.

RESULTS

ML models were built on the derivation cohort (4,791 patients from 2001 to April 2017) and tested on the validation cohort of 726 patients (May 2017-June 2019). In 441 patients (61%) where clinical narratives were available and PS was documented, ML models outperformed the predictivity of PS (mean AUC improvement, 0.039, P < .001, comparison 1). Inclusion of both clinical text and PS in ML models resulted in further improvement in prediction accuracy over PS with a mean AUC improvement of 0.050 ( P < .001, comparison 2); the AUC was > 0.80 at all assessed time points for models incorporating clinical text. Exploratory analysis of oncologist's narratives revealed recurring descriptors correlating with survival, including referral patterns, mobility, physical functions, and concomitant medications.

CONCLUSION

Applying ML to oncologists' narratives with or without including patient's PS significantly improved survival prediction to 12 months, suggesting the utility of clinical text in building prognostic support tools.
Germline Testing and Somatic Tumor Testing forBRCA1/2Pathogenic Variants in Ovarian Cancer: What Is the Optimal Sequence of Testing?
Authors: Kwon Janice S. , Tinker Anna V. , Santos Jennifer , Compton Katie , Sun Sophie , Schrader Kasmintan A. , Karsan Aly
Published: October 2022

PURPOSE

In 2020, ASCO recommended that all women with epithelial ovarian cancer have germline testing for BRCA1/2 mutations, and those without a germline pathogenic variant (PV) should have somatic tumor testing to determine eligibility for a poly (ADP-ribose) polymerase inhibitor. Consequently, the majority of patients with ovarian cancer will have both germline testing and somatic testing. An alternate strategy is tumor testing first and then germline testing if there is a PV in the tumor and/or significant family history. The objective was to conduct a cost-effectiveness analysis comparing the two testing strategies.

METHODS

The Markov model compared the costs (US dollars) and benefits of two testing strategies for newly diagnosed ovarian cancer: (1) ASCO strategy and (2) tumor testing triage for germline testing. Data were applied from SOLO-1, and costs were from wholesale acquisition prices, Medicare, and published sources. Sensitivity analyses accounted for uncertainty around various parameters. Monte Carlo simulation estimated the number tested and identified with germline and somatic BRCA PV for olaparib maintenance treatment annually in the US population.

RESULTS

The ASCO strategy was more effective but more costly than tumor testing triage in identifying patients for olaparib, with an incremental cost-effectiveness ratio of $281,296 US dollars per progression-free life year gained. Assuming 10,000 eligible patients with ovarian cancer annually, Monte Carlo simulation yielded comparable numbers of patients with BRCA PV in the germline and tumor with the ASCO and tumor testing triage strategies (2,080 v 2,062, respectively), but substantially higher number of patients tested using the ASCO strategy (8,052 v 3,076).

CONCLUSION

The ASCO strategy may identify more BRCA PVs but is not cost-effective. Tumor testing in epithelial ovarian cancer as triage for germline testing is the favored strategy in this health care system.
Insidious Concern
Authors: Elster Mikey
Published: October 2022

This article examines media that couches criticism of trans medicine, pediatrics, and activism in terms of “care” or “concern” for trans people and youth in particular. It identifies these as “insidious concerns,” speech acts, utterances, and proclamations that would harm that which they claim to care for or about. It proceeds to argue that this type of discourse is endemic to a wider crisis of social reproduction exacerbated by neoliberal economic restructuring. Through historical contextualization, cultural analysis, and ethnography, this article highlights the racist, nationalist, and reactionary undercurrents motivating the current trans panic in the United States. It concludes that theoretical attention to social reproduction might offer new insights for trans studies that can act as counterdiscourse to “insidious concern.”