bluuebunny/crossref_metadata_2025 huggingface dataset:
Go Green Textiles: A Case of Social Entrepreneurship in India
Authors: Vikas Sona , Mathur Ashish
Published: November 2022

This case outlines the journey of this new-age young social entrepreneur, Akhilesh Taparia, whose mantra has been social welfare coupled with organisational success. The case traces how he fought against all odds to take his enterprise to greater heights and deliberates around these questions: What did he do to achieve success in such a short period of time? What was his thought process? How did he grow? What were the main elements of his strategy to have a sustainable enterprise? What were his main hurdles? The case attempts to identify the challenges of social entrepreneurs in emerging economies like India, especially when the required resources are not easily available. Being an entrepreneur and resolving problems can be tough but being in the social space can be even more hard. Nonetheless at a time when the textile industry was caught amongst stiff competition, Go Green created a niche for itself as a textile supplier of organic fabrics. A personal interview of Akhilesh Taparia and a personal visit to his factory gave the authors a complete understanding of the manufacturing and packing process. The primary objective of this case is to understand concepts related to social entrepreneurship and deliberate upon Taparia’s entrepreneurial characteristics, motivations, expertise and effectiveness, and how these supported his company’s growth.
City regions and decent work: Politics, pluralism and policy making in Greater Manchester
Authors: Johnson Mathew , Martínez Lucio Miguel , Mustchin Stephen , Grimshaw Damian , Cartwright Jo , Rodriguez Jenny K. , Dundon Tony
Published: November 2022

Despite a growing body of literature examining the politics of city-regionalism, the question of how local actors engage with, and challenge each other in the subnational regulatory space requires greater attention if we are to develop a more comprehensive understanding of supposedly pluralist approaches to policy making. This paper critically evaluates policy innovations in Greater Manchester (GM) that seek to steer the behaviour of economic actors towards a mutually reinforcing model of decent work and social inclusion. We argue that underneath the expansive political agenda of the GM metro mayor, what has emerged so far is a relatively shallow form of consensus-based neo-pluralism that allows for elite consultation over issues of inclusive growth and responsible business rather than more radically redistributive or participatory policies. The implications for our understanding of the changing and often contradictory role of the state in shaping subnational regulation and governance are discussed.
The Use of Advanced Semiautomated Bone Segmentation in Hallux Rigidus
Authors: Carvalho Kepler Alencar Mendes de , Mallavarapu Vineel , Ehret Amanda , Dibbern Kevin , Lee Hee Young , Barbachan Mansur Nacime Salomao , Laleveé Matthieu , de Cesar Netto Cesar
Published: November 2022

Background:

Weightbearing computed tomography (WBCT) measurements allow evaluation of several anatomical points for a correct clinical-radiographic diagnosis of pathologies, such as hallux rigidus (HR). In addition, a new semiautomatic segmentation software obtains automated 3D measurements from WBCT scan data sets, minimizing errors in reading angular measurements. The study’s objective was (1) to evaluate the reliability of WBCT semiautomatic imaging measures in HR, (2) to evaluate correlation and agreement between manual and semiautomatic measures in the setting of HR, and (3) to compare semiautomatic measurements between pathologic (HR) and standard control groups.

Methods:

A retrospective study of HR patients was performed including 20 feet with HR. WBCT manual and semiautomatic 3D measurements were performed using the following parameters: (1) first metatarsal-proximal phalanx angle (1stMPP), (2) hallux valgus angle (HVA), (3) first to second intermetatarsal angle (IMA), (4) hallux interphalangeal angle (IPA), (5) first metatarsal length (1stML), (6) second metatarsal length (2ndML), (7) first metatarsal declination angle (1stMD), (8) second metatarsal declination angles (2ndMD), and (9) metatarsus primus elevatus (MPE). The differences between pathologic and control cases were assessed with a Wilcoxon test.

Results:

Interobserver and intraobserver agreement for manual vs semiautomatic WBCT measurements demonstrated excellent reliability. According to the Pearson coefficient, there was a strong positive linear correlation between both methods for the following parameters evaluated: HVA (ρ = 0.96), IMA (ρ = 0.86), IPA (ρ = 0.89), 1stML (ρ = 0.96), 2ndML (ρ = 0.91), 1stMD (ρ = 0.86), 2ndMD (ρ = 0.95), and MPE (ρ = 0.87). Comparison between the pathologic group with HR and the control (standard) group allowed for the differentiating of the pathologic (HR) from the non-pathologic conditions for MPE (p < 0.05).

Conclusion:

Semiautomatic measurements are reproducible and comparable to measurements performed manually, showing excellent interobserver and intraobserver agreement. The software used differentiated pathologic from nonpathologic conditions when submitted to semiautomatic MPE measurements.

Level of Evidence:

Level III, retrospective comparative study.
Artificial colouration of smectite through adsorbing dyes from wastewater to make a hybrid pigment
Authors: Rodrigues Itamar A. , Anaissi Fauze J.
Published: November 2022

Artificially coloured smectites (smectite pigments) were prepared via the sorption of anionic dyes on smectite saturated with ferric ions (Fe-smectite). Fe-smectite has a surface charge and is capable of decolourizing aqueous solutions containing single-component anionic dyes (Amaranth, Brilliant blue FCF and Tartrazine) or multi-component dyes (dye mixtures). Kinetic and equilibrium models were used to describe the sorption of individual dyes, whereas the decolourization of the multi-component system was studied by monitoring the reduction in the intensity of the absorption bands in the visible light region. The Langmuir–Freundlich dual-site model presented the best fit to the experimental data, and the sorption kinetics followed the pseudo-second order model. The smectite pigments were dispersed in colourless paint (10%, w/w), acting as organic–inorganic hybrid pigments. Colorimetric measurements of the powdered smectite pigments dispersed in colourless real-estate paint showed chemical compatibility without the need for solvents as dispersants. These properties allow the application of coloured smectites as pigments in a sustainable circular economy.
Formulation and release kinetics of ibuprofen–bentonite tablets
Authors: Alyoussef Alkrad Jamal , Al-Sammarraie Sind , Dahmash Eman Zmaily , Qinna Nidal A. , Naser Abdallah Y.
Published: November 2022

Bentonite-based tablets offer multiple advantages over other types of formulated tablets, including being biocompatible and cost-effective, and they can be used to develop gel-like matrices that have potential for use in sustained-release formulations. Developing a high-load sustained-release formulation has been reported to be challenging; therefore, the aim of this study was to develop systematically bentonite-based sustained-release tablets for a high-load active agent (ibuprofen) and investigate their release kinetics. Ibuprofen-loaded tablets (800 mg) were prepared using wet and dry granulation followed by enteric coating of the tablets. Fourier-transform infrared spectroscopy, differential scanning calorimetry and X-ray powder diffraction were used to evaluate the compatibility of ibuprofen with bentonite. The results show that these tablets comply with compendial requirements. In addition, the release profile of the formulations reveals that the drug follows a non-Fickian release model. The present formulation demonstrates a new use of bentonite as a safe and cost-effective excipient with adequate binding and compaction for preparing sustained-release tablets.
Lncap-AI prostate cancer cell line establishment by Flutamide and androgen-free environment to promote cell adherent
Authors: Wang Huifeng , Wei Xihua , Zhang Die , Li Weidong , Hu Yanling
Published: November 2022

Background

To establish castration-resistant prostate cancer (CRPC) - Lncap androgen-independent (AI) cell line from Lncap androgen-dependent (AD) cell line, and explore the different molecular biological between these two cell lines.

Methods

The Lncap-AD cell line was cultured and passaged 60 times over 16 months. The morphology of the Lncap-AI cell line was observed. AR levels identification were detected in qRT-PCR and Western Blot assay. CCK-8, EdU assay, wound healing assay and cell adhesion assays were used to observe the ability of proliferation, migration, and adhesion. SEM and TEM were used to observe microculture structure. At last, the PSA secrete ability was evaluated by Elisa assay.

Results

The Lncap-AD cell line was cultured and passaged 60 times over 16 months. The Lncap-AI cell line showed a morphologic change at the end stage of culture, the cells turned slender and cell space turned separated compared to the Lncap-AD cell line. The relative levels of AR-related genes in the Lncap-AI cell line were up-regulation compared to the Lncap-AD cell line both in mRNA and protein levels. The expression of AR and HK2 proteins were influenced and down-regulation by Enzalutamide in the Lncap-AD cell line, but no obvious difference in Lncap-AI cell lines. Lncap-AI cell line showed strong viability of proliferation, migration, and adhesion by CCK-8, EdU assay, wound healing assay, and adhesion assay. The microstructure of Scanning Electron Microscopy (SEM) showed many synapses in the Lncap-AI cell line and PC3 cell line, but not in the Lncap-AD cell line. At last, the PSA secrete ability was evaluated by Elisa assay, and PCa cell lines showed no significant difference.

Conclusion

Simulation of CRPC progression, Lncap-AD cell line turned to Lncap-AI cell line with androgen deprivation therapy.
Airway microecology in rifampicin-resistant and rifampicin-sensitive pulmonary tuberculosis patients
Authors: Cai Xingshan , Luo Yang , Zhang Yuanliang , Lin Yuan , Wu Bitong , Cao Zhizhong , Hu Zuqiong , Wu Xingyi , Tan Shouyong
Published: November 2022

Background

Pulmonary tuberculosis is a chronic infectious disease of the respiratory system. It is still one of the leading causes of death from a single infectious disease, but it has been stuck in the study of a single pathogen. Recent studies have shown that many diseases are associated with disruption of the native microbiota. In this study we investigated the occurrence of tuberculosis and the correlation between drug resistance and respiratory flora. High-throughput 16 S rRNA gene sequencing was used to characterize the respiratory microbiota composition of 30 tuberculosis (TB) affected patients and compared with 30 healthy (H) controls. According to their Gene Xpert results, 30 pulmonary tuberculosis patients were divided into 12 persons in the drug-sensitive group (DS0) and 18 persons in the drug-resistant group (DR0). The microbial flora of the two were compared with the H group.

Results

The data generated by sequencing showed that Firmicutes, Proteus, Bacteroides, Actinomyces and Fusobacterium were the five main bacterial phyla detected, and they constituted more than 96% of the microbial community. The relative abundances of Fusobacterium, Haemophilus, Porphyromonas, Neisseria, TM7, Spirochetes, SR1, and Tenericutes in the TB group was lower than that of the H group, and Granulicatella was higher than the H group. The PcoA diagrams of the two groups had obvious clustering differences. The Alpha diversity of the TB group was lower than that of the H group, and the Beta diversity was higher than that of the H group (P < 0.05). The relative abundance of Streptococcus in the DS0 group was significantly higher than that in the DR0 group (P < 0.05).

Conclusion

Pulmonary tuberculosis can cause disorders of the respiratory tract microbial flora, in which the relative abundance of Streptococcus was significantly different between rifampicin-sensitive and rifampicin-resistant patients.
Analysis of CT signs, radiomic features and clinical characteristics for delta variant COVID-19 patients with different vaccination status
Authors: Wei Huanhuan , Shao Zehua , Tai Jianqing , Fu Fangfang , Lv Chuanjian , Guo Zhiping , Wu Yaping , Chen Lijuan , Bai Yan , Wu Qingxia , Yu Xuan , Mu Xinling , Shao Fengmin , Wang Meiyun
Published: November 2022

Objective

To explore the characteristics of peripheral blood, high resolution computed tomography (HRCT) imaging and the radiomics signature (RadScore) in patients infected with delta variant virus under different coronavirus disease (COVID-19) vaccination status.

Methods

123 patients with delta variant virus infection collected from November 1, 2021 to March 1, 2022 were analyzed retrospectively. According to COVID-19 vaccination Status, they were divided into three groups: Unvaccinated group, partially vaccinated group and full vaccination group. The peripheral blood, chest HRCT manifestations and RadScore of each group were analyzed and compared.

Results

The mean lymphocyte count 1.22 ± 0.49 × 10^9/L, CT score 7.29 ± 3.48, RadScore 0.75 ± 0.63 in the unvaccinated group; The mean lymphocyte count 1.55 ± 0.70 × 10^9/L, CT score 5.27 ± 2.72, RadScore 1.03 ± 0.46 in the partially vaccinated group; The mean lymphocyte count 1.87 ± 0.70 × 10^9/L, CT score 3.59 ± 3.14, RadScore 1.23 ± 0.29 in the fully vaccinated group. There were significant differences in lymphocyte count, CT score and RadScore among the three groups (all p < 0.05); Compared with the other two groups, the lung lesions in the unvaccinated group were more involved in multiple lobes, of which 26 cases involved the whole lung.

Conclusions

Through the analysis of clinical features, pulmonary imaging features and radiomics, we confirmed the positive effect of COVID-19 vaccine on pulmonary inflammatory symptoms and lymphocyte count (immune system) during delta mutant infection.
Artificial neural network - an effective tool for predicting the lupus nephritis outcome
Authors: Stojanowski Jakub , Konieczny Andrzej , Rydzyńska Klaudia , Kasenberg Izabela , Mikołajczak Aleksandra , Gołębiowski Tomasz , Krajewska Magdalena , Kusztal Mariusz
Published: November 2022

Background

Lupus nephropathy (LN) occurs in approximately 50% of patients with systemic lupus erythematosus (SLE), and 20% of them will eventually progress into end-stage renal disease (ESRD). A clinical tool predicting remission of proteinuria might be of utmost importance. In our work, we focused on predicting the chance of complete remission achievement in LN patients, using artificial intelligence models, especially an artificial neural network, called the multi-layer perceptron.

Methods

It was a single centre retrospective study, including 58 individuals, with diagnosed systemic lupus erythematous and biopsy proven lupus nephritis. Patients were assigned into the study cohort, between 1st January 2010 and 31st December 2020, and eventually randomly allocated either to the training set (N = 46) or testing set (N = 12). The end point was remission achievement. We have selected an array of variables, subsequently reduced to the optimal minimum set, providing the best performance.

Results

We have obtained satisfactory results creating predictive models allowing to assess, with accuracy of 91.67%, a chance of achieving a complete remission, with a high discriminant ability (AUROC 0.9375).

Conclusion

Our solution allows an accurate assessment of complete remission achievement and monitoring of patients from the group with a lower probability of complete remission. The obtained models are scalable and can be improved by introducing new patient records.
Granulocyte colony stimulating factor versus human chorionic gonadotropin for recurrent implantation failure in intra cytoplasmic sperm injection: a randomized clinical trial
Authors: Bakry Mohamed Sobhy , Eldesouky Elsayed , Alghazaly Moatazza Mahdy , farag Elsayed , Sultan Eslam Elsayed Kamal , Elazzazy Hossam , Mohamed Attia , Ali Soliman Mohamed Said , Anwar Assem , Elrashedy Asmaa Ahmed , Abdelmonem Mohamed , Abd-ElGawad Mohamed , Bosilah Almandouh H.
Published: November 2022

Background

Repeated implantation failure (RIF) is defined as the case whereby the transferred embryos fail to implant after several attempts of In vitro fertilization (IVF) which causes a profound impact on the quality of life and financial burden. Some clinical studies have confirmed that Granulocyte colony-stimulating factor (G-CSF) and human chorionic gonadotropin (HCG) can improve pregnancy outcomes and implantation rates. Hence, our study aims to compare the efficacy of G-CSF and HCG on pregnancy outcomes in RIF women who undergo intra-cytoplasmic sperm injection (ICSI).

Methods

This randomized, single-blinded study was conducted et al.-Azhar University Hospitals, Cairo, Egypt, between 10th October 2020 and 20th December 2020. The study included 100 women aged 20–43 years old undergoing ICSI cycles, with a history of RIF. Patients were divided randomly into two groups: group (1): included 50 patients injected with 500 IU of intrauterine HCG on embryo transfer day, and group (2): Included 50 patients injected with G-CSF on the embryo transfer day.

Results

In 100 RIF women, we found a significant improvement in pregnancy outcomes favoring G-CSF over HCG including implantation rate, chemical pregnancy, and clinical pregnancy (P < 0.0001, P = 0.0003, and P = 0.0006, respectively).

Conclusion

For the first time, we demonstrated a significant improvement in pregnancy outcomes favoring G-CSF over HCG in terms of implantation rate, chemical pregnancy, and clinical pregnancy.

Trial registration

The study was registered on Pan African Clinical Trials Registry with the following number: PACTR202010482774275 and was approved on 2nd October 2020.
Prevalence of immune-related adverse events and anti-tumor efficacy following immune checkpoint inhibitor therapy in Japanese patients with various solid tumors
Authors: Yoshikawa Yuki , Imamura Michio , Yamauchi Masami , Hayes C. Nelson , Aikata Hiroshi , Okamoto Wataru , Miyata Yoshihiro , Okada Morihito , Hattori Noboru , Sugiyama Kazuhiko , Yoshioka Yukio , Toratani Shigeaki , Takechi Masaaki , Ichinohe Tatsuo , Ueda Tsutomu , Takeno Sachio , Kobayashi Tsuyoshi , Ohdan Hideki , Teishima Jun , Hide Michihiro , Nagata Yasushi , Kudo Yoshiki , Iida Koji , Chayama Kazuaki
Published: November 2022

Background

While immune checkpoint inhibitors (ICIs) occasionally cause immune-related adverse events (irAEs) in various organs, the prevalence of irAEs and potential risk factors have not been clarified. We identified irAE predictive factors and examined the relationship between the effect of ICIs and irAEs for patients with malignancies.

Methods

A total of 533 cases treated with ICIs, including programmed death 1 (PD-1), PD-ligand 1 (PD-L1), and cytotoxic T-lymphocyte antigen 4 (CTLA-4), for various malignancies were included retrospectively. We recorded irAEs from medical records and graded them using the Common Terminology Criteria for Adverse Events version 5. Prevalence and predictive factors associated with immune-related liver injury and the relationship between irAE and treatment response were analyzed.

Results

During a median of 10 (1–103) cycles with a median follow-up after several ICI initiations of 384 (21–1715) days, irAEs with all grades and with grade ≥ 3 developed in 144 (27.0%) and 57 (10.7%) cases. Cumulative irAE development rates were 21.9, 33.5, and 43.0% in all grades and 8.8, 14.9, and 20.7% in grade ≥ 3 at 5, 10, and 20 cycles, respectively. Patients who received anti-CTLA4 therapy were more likely to develop irAEs compared to those who received anti-PD-1 or anti-PD-L1 monotherapy. Liver injury was the most common irAE. Multivariate analysis identified the combination of PD-1 and anti-CTL-4 antibodies (hazard ratio [HR], 17.04; P < 0.0001) and baseline eosinophil count ≥130/μL (HR, 3.01 for < 130; P = 0.012) as independent risk factors for the incidence of immune-related liver injury with grade ≥ 2. Patients who developed irAEs had a higher disease control rate (P < 0.0001) and an increased overall survival rate compared to those without irAEs (P < 0.0001).

Conclusion

Combination therapy with anti-PD-1 and anti-CTL-4 antibodies resulted in higher a frequency of irAEs. Baseline absolute eosinophil count was found to be a predictive factor for immune-related liver injury. Occurrence of irAEs may be associated with higher efficacy of ICI treatment and longer survival among patients who receive ICI therapy.
Associations between data-driven lifestyle profiles and cognitive function in the AusDiab study
Authors: Dingle Sara E , Bowe Steven J , Bujtor Melissa , Milte Catherine M , Daly Robin M , Anstey Kaarin J , Shaw Jonathan E , Torres Susan J
Published: November 2022

Background

Mounting evidence highlights the importance of combined modifiable lifestyle factors in reducing risk of cognitive decline and dementia. Several a priori additive scoring approaches have been established; however, limited research has employed advanced data-driven approaches to explore this association. This study aimed to examine the association between data-driven lifestyle profiles and cognitive function in community-dwelling Australian adults.

Methods

A cross-sectional study of 4561 Australian adults (55.3% female, mean age 60.9 ± 11.3 years) was conducted. Questionnaires were used to collect self-reported data on diet, physical activity, sedentary time, smoking status, and alcohol consumption. Cognitive testing was undertaken to assess memory, processing speed, and vocabulary and verbal knowledge. Latent Profile Analysis (LPA) was conducted to identify subgroups characterised by similar patterns of lifestyle behaviours. The resultant subgroups, or profiles, were then used to further explore associations with cognitive function using linear regression models and an automatic Bolck, Croon & Hagenaars (BCH) approach.

Results

Three profiles were identified: (1) “Inactive, poor diet” (76.3%); (2) “Moderate activity, non-smokers” (18.7%); and (3) “Highly active, unhealthy drinkers” (5.0%). Profile 2 “Moderate activity, non-smokers” exhibited better processing speed than Profile 1 “Inactive, poor diet”. There was also some evidence to suggest Profile 3 “Highly active, unhealthy drinkers” exhibited poorer vocabulary and verbal knowledge compared to Profile 1 and poorer processing speed and memory scores compared to Profile 2.

Conclusion

In this population of community-dwelling Australian adults, a sub-group characterised by moderate activity levels and higher rates of non-smoking had better cognitive function compared to two other identified sub-groups. This study demonstrates how LPA can be used to highlight sub-groups of a population that may be at increased risk of dementia and benefit most from lifestyle-based multidomain intervention strategies.
Beliefs associated with cancer screening behaviors among African Americans and Sub-Saharan African immigrant adults: a cross-sectional study
Authors: Adegboyega A. , Wiggins A.T. , Obielodan O. , Dignan M. , Schoenberg N.
Published: November 2022

Background

Beliefs influence cancer screening. However, there are conflicting findings about how belief influence cancer screening among Black adults. The aim of this study was to evaluate the relationships between beliefs (religiosity, fatalism, temporal orientation, and acculturation) and cervical, breast, and colorectal cancer screening behaviors among African Americans and sub-Saharan African immigrants.

Methods

We conducted a cross-sectional survey of 73 African American and 59 English speaking Sub-Saharan immigrant adults recruited from Lexington and surrounding cities in Kentucky. Data collected included sociodemographic variables, cancer screening behaviors, and several instruments that characterize beliefs, including religiosity, fatalism, temporal orientation, and acculturation.

Results

Participants’ mean age was 43.73 years (SD = 14.0), 83% were females, and 45% self-identified as sub-Saharan immigrants. Based on eligibility for each screening modality, 64% reported having ever had a Pap test, 82% reported ever having mammogram, and 71% reported ever having a colonoscopy. Higher education (OR = 2.62, 95% CI = 1.43—4.80) and being insured (OR = 4.09, 95% CI = 1.10 – 15.18) were associated with increased odds of cervical cancer screening (pap test), while cancer fatalism (OR = 0.24, 95% CI = 0.07 – 0.88) was associated with decreased odds. Increased age (OR = 1.57, 95% CI = 1.06 – 2.32) and reduced present orientation (OR = 0.42, 95% CI = 0.22 – 0.80) were associated with receipt of a mammogram. Nativity was the only factor associated with colonoscopy screening. Compared to African Americans, sub-Saharan African immigrants were 90% less likely to have had a colonoscopy (OR = 0.10, 95% CI = 0.02 – 0.66).

Conclusion

This study contributes to the existing literature by confirming that beliefs are important in cancer screening behaviors among African American and sub-Saharan African immigrants. These findings should inform the development of cancer control and prevention programs for Black adults.

Trial registration

US National Library of Science identifier NCT04927494. Registered June 16, 2021,www.clinicaltrials.gov
Validation studies of verbal autopsy methods: a systematic review
Authors: Mahesh Buddhika P. K. , Hart John D. , Acharya Ajay , Chowdhury Hafizur Rahman , Joshi Rohina , Adair Tim , Hazard Riley H.
Published: November 2022

Background

Verbal autopsy (VA) has emerged as an increasingly popular technique to assign cause of death in parts of the world where the majority of deaths occur without proper medical certification. The purpose of this study was to examine the key characteristics of studies that have attempted to validate VA cause of death against an established cause of death.

Methods

A systematic review was conducted by searching the MEDLINE, EMBASE, Cochrane-library, and Scopus electronic databases. Included studies contained 1) a VA component, 2) a validation component, and 3) original analysis or re-analysis. Characteristics of VA studies were extracted. A total of 527 studies were assessed, and 481 studies screened to give 66 studies selected for data extraction.

Results

Sixty-six studies were included from multiple countries. Ten studies used an existing database. Sixteen studies used the World Health Organization VA questionnaire and 5 studies used the Population Health Metrics Research Consortium VA questionnaire. Physician certification was used in 36 studies and computer coded methods were used in 14 studies. Thirty-seven studies used high level comparator data with detailed laboratory investigations.

Conclusion

Most studies found VA to be an effective cause of death assignment method and compared VA cause of death to a high-quality established cause of death. Nonetheless, there were inconsistencies in the methodologies of the validation studies, and many used poor quality comparison cause of death data. Future VA validation studies should adhere to consistent methodological criteria so that policymakers can easily interpret the findings to select the most appropriate VA method.

Prospero Registration

CRD42020186886.
Analysis of molecular pathologic and clinical features of 36 patients with pulmonary sarcomatoid carcinoma
Authors: Yu Yingying , Duan Xiumei , Wang Shuai , He Hua , Lan Shijie , Guo Zhen , Wu Di
Published: November 2022

Background

Pulmonary sarcomatoid carcinoma (PSC) is a heterogeneous disease with poor prognosis. It is essential to understand the molecular basis of its progression in order to devise novel therapeutic strategies. The aim of this study was to identify the pathological mutations in PSC through next generation sequencing technology (NGS), and provide reference for the diagnosis and molecular targeted therapy.

Materials and methods

Thirty-sex patients with pathologically confirmed PSC who underwent surgical tumor resection at The First Hospital of Jilin University and Jilin Cancer Hospital from June 2011 to June 2017 were enrolled. Thirteen patients were successfully followed up and detailed clinical data were obtained. NGS was performed for the exons of entire oncogenes. Kaplan–Meier method was used for the univariate analysis, and the Cox proportional risk regression model was used for multivariate analysis.

Results

A total of 19 highly frequent mutations were identified, of which the KRAS, BRCA1 and ALK mutations were significantly correlated with the overall survival (OS). Multivariate analysis showed that KRAS mutation was an independent factor affecting the OS of PSC patients.

Conclusion

The KRAS mutation is an independent prognostic factor for PSC, and patients harboring the KRAS mutation had significantly shorter OS compared to patients with wild type KRAS. The characteristic mutation landscape of PSC may guide clinical targeted therapy.
Comparison of denosumab and oral bisphosphonates for the treatment of glucocorticoid-induced osteoporosis: a systematic review and meta-analysis
Authors: Jiang Lianghai , Dong Jian , Wei Jianwei , Liu Lantao
Published: November 2022

Background

Both denosumab and bisphosphonates have been demonstrated effective for glucocorticoid-induced osteoporosis. However, evidence-based medicine is still lacking to prove the clinical results between denosumab and bisphosphonates. This meta-analysis aims to compare the efficacy and safety between denosumab and oral bisphosphonates for the treatment of glucocorticoid-induced osteoporosis through evidence-based medicine.

Methods

MEDLINE, EMBASE, and the Cochrane library databases were searched up to June 2022 for randomized controlled trials that compared denosumab and oral bisphosphonates in the treatment of glucocorticoid-induced osteoporosis. The following outcomes were extracted for comparison: percentage change in bone mineral density from baseline at the lumbar spine, total hip, femoral neck, and ultra-distal radius; percentage change from baseline in serum concentration of bone turnover markers; and incidence of treatment-emergent adverse events.

Results

Four randomized controlled trials involving 714 patients were included. The pooled results showed that denosumab was superior to bisphosphonates in improving bone mineral density in lumbar spine (mean difference (MD) 1.70; 95% confidence interval (CI) 1.11–2.30;P < 0.001) and ultra-distal radius (MD 0.87; 95% CI 0.29–1.45;P = 0.003), and in suppressing C-terminal telopeptide of type 1 collagen (MD -34.83; 95% CI -67.37--2.28;P = 0.04) and procollagen type 1 N-terminal propeptide (MD -14.29; 95% CI -23.65- -4.94;P = 0.003) at 12 months. No significant differences were found in percentage change in total hip or femoral neck bone mineral density at 12 months, or in the incidence of treatment-emergent adverse events or osteoporosis-related fracture.

Conclusions

Compared with bisphosphonates, denosumab is superior in improving bone mineral density in lumbar spine and ultra-distal radius for glucocorticoid-induced osteoporosis. Further studies are needed to prove the efficacy of denosumab.
Evaluation of tibial eminence morphology using magnetic resonance imaging (MRI) in juvenile patients with complete discoid lateral meniscus
Authors: Liu Wei , Fu Chunxu , Kang Kai , Huang Teng , Jiang Shigang , Gu Juyuan , Gao Shijun
Published: November 2022

Background

Many studies have shown that hypoplasia of knee bone morphology is related to the morphological features of the discoid lateral meniscus (DLM). However, few studies have focused on hypoplasia of tibial eminence morphology in juvenile patients with complete DLM. The purpose of this study was to determine the relationship between tibial eminence morphology characteristics and complete DLM in juvenile patients.

Methods

The DLM group comprised 34 juvenile patients with complete DLM, and the control group comprised 34 juvenile individuals, each with a normal lateral meniscus based on magnetic resonance imaging (MRI) findings. All parameters, including tibial width (TW), tibial eminence width (TEW), the height of the lateral tibial spine (HLTS), the height of the medial tibial spine (HMTS), lateral slope angle of the lateral tibial eminence (LSALTE), lateral slope angle of the medial tibial eminence (LSAMTE), tibial eminence width ratio (TEWR), height of the lateral tibial spine ratio (HLTSR), and the height of the medial tibial spine ratio (HMTSR), were recorded using coronal MR images. Statistical analyses were used to determine the differences between the two groups and whether differences were significant.

Results

The TEW and TEWR were significantly greater (P < 0.05), and LSALTE and LSAMTE were significantly smaller (P < 0.05) in patients in the DLM group than in participants in the control group. Receiver operating characteristic (ROC) analysis revealed that a larger TEW, above 13.4 mm, was associated with complete DLM, with a sensitivity of 77.0% and specificity of 88.2%, and a larger TEWR, above 19.7%, was associated with complete DLM, with a sensitivity of 76.5% and specificity of 91.2%.

Conclusions

MR imaging can be used to diagnose tibial eminence hypoplasia in juvenile patients with complete DLM. Additionally, TEW and TEWR could help clinicians screen for complete DLM in juvenile patients.
Effectiveness of Hypnosis for the Prevention of Anxiety During Coronary Angiography (HYPCOR study): a prospective randomized study
Authors: Abensur Vuillaume Laure , Gentilhomme Charles , Weber Sandrine , Ouamara Nadia , Bayard Julien , Valla Mathieu , Khalife Khalife , Goetz Christophe , Guler Nazmine
Published: November 2022

Background

Coronary angiography is the gold standard for the diagnosis of coronary artery disease. This intervention is nevertheless a source of anxiety for the patient both by its discomfort and by the consequences linked to the discovery of potential diseases.

Objectives

The aim of this study was to determine the effectiveness of hypnosis in reducing anxiety in patients undergoing coronary angiography.

Methods

One hundred sixty-nine patients with planned coronary angiography and no history of coronary angiography were randomized to a hypnosis or control group. Patients in the hypnosis group underwent a hypnosis session with self-hypnosis posthypnotic suggestions, while those in the control group had a conversational interview with the hypnotherapist. The primary endpoint was pre-exam anxiety level assessed by the Spielberger State-Trait Anxiety Inventory (STAI-Y A).

Results

Performing a hypnosis session did not result in a significant decrease in anxiety before the intervention. Age, high trait anxiety, high state anxiety the day before, and belief that hypnosis works in general were associated with increased anxiety before the procedure. No adverse events were reported after hypnosis. There was no statistically significant difference between the 2 groups for the occurrence of complications of the intervention.

Conclusion

In this study, performing a hypnosis session before coronary angiography did not reduce the state of anxiety measured just before the intervention. In all cases, the hypnotic experience appears to be positive for the patient, encouraging further research efforts.

Trial registration

The research protocol has been registered on the ClinicalTrials.gov registry (NCT02818101; 29/06/2016) and with the ANSM (IDRCB 2016-A00205-46; 02/02/2016).
A 4-factor perspective of the patient-practitioner orientation scale (PPOS): a deeper understanding of patient-centredness
Authors: Jiang Yinan , Wei Jing , Shi Lili , Cao Jinya , Zhu Boheng , Hong Xia
Published: November 2022

Background

Although patient-centred medical services are widely recognized and accepted, how to define and evaluate them remains a controversial topic.

Objectives

This study attempts to evaluate the underlying structure of the Patient-Practitioner Orientation Scale (PPOS) with a homogenous population and clarify the connotation of patient-centredness.

Methods

In this cross-sectional study, 279 7th year Chinese medical students in were selected to examine the internal structure of the PPOS by means of internal consistency, exploratory, and confirmatory factor analyses.

Results

Both the two-factor model and the four-factor model showed acceptable internal consistency and structural validity. The four-factor model that endorsed the implicit attitude towards the doctor–patient relationship outperformed the two-factor model in terms of adaptability.

Conclusions

The PPOS has good psychometric attributes, as evaluated by Chinese medical students. This article attempts to explore patient-centredness from the perspective of implicit attitudes that affect the doctor–patient relationship and resummarizes the four factors. These four dimensions may suggest a deeper attitude towards the doctor–patient relationship, while “sharing information” or “caring about” the “patient” is the behaviour and preference expressed on the basis of these four attitudes, which is the result rather than the cause.

Practice implications

Understanding the underlying attitudes towards the doctor–patient relationship can help to construct a patient-centred medical service concept and improve the doctor–patient relationship in medical education courses and the system design of medical activities.
Canadian critical care nurses experiences on the front lines of the COVID-19 pandemic: a qualitative descriptive study
Authors: Gamble Kathleen , Murthy Srinivas , Silverberg Sarah L. , Gobat Nina , Puchalski Ritchie Lisa M.
Published: November 2022

Background

Recent pandemics have provided important lessons to inform planning for public health emergencies. Despite these lessons, gaps in implementation during the COVID-19 pandemic are evident. Additionally, research to inform interventions to support the needs of front-line nurses during a prolonged pandemic are lacking. We aimed to gain an understanding of critical care nurses’ perspectives of the ongoing pandemic, including their opinions of their organization and governments response to the pandemic, to inform interventions to improve the response to the current and future pandemics.

Methods

This sub-study is part of a cross-sectional online survey distributed to Canadian critical care nurses at two time points during the pandemic (March–May 2020; April–May 2021). We employed a qualitative descriptive design comprised of three open-ended questions to provide an opportunity for participants to share perspectives not specifically addressed in the main survey. Responses were analyzed using conventional content analysis.

Results

One hundred nine of the 168 (64.9%) participants in the second survey responded to the open-ended questions. While perspectives about effectiveness of both their organization’s and the government’s responses to the pandemic were mixed, most noted that inconsistent and unclear communication made it difficult to trust the information provided. Several participants who had worked during previous pandemics noted that their organization’s COVID-19 response failed to incorporate lessons from these past experiences. Many respondents reported high levels of burnout and moral distress that negatively affected both their professional and personal lives. Despite these experiences, several respondents noted that support from co-workers had helped them to cope with the stress and challenges.

Conclusion

One year into the pandemic, critical care nurses’ lived experiences continue to reflect previously identified challenges and opportunities for improvement in pandemic preparedness and response. These findings suggest that lessons from the current and prior pandemics have been inadequately considered in the COVID-19 response. Incorporation of these perspectives into interventions to improve the health system response, and support the needs of critical care nurses is essential to fostering a resilient health workforce. Research to understand the experience of other front-line workers and to learn from more and less successful interventions, and leaders, is needed.
Patient safety culture as a space of social struggle: understanding infection prevention practice and patient safety culture within hospital isolation settings - a qualitative study
Authors: Hunt Julian , Gammon John , Williams Sharon , Daniel Sharon , Rees Sue , Matthewson Sian
Published: November 2022

Background

In recent times, infection prevention and patient safety have become a global health policy priority with thought being given to understanding organisational culture within healthcare, and of its significance in initiating sustained quality improvement within infection prevention and patient safety. This paper seeks to explore the ways in which engagement of healthcare workers with infection prevention principles and practices, shape and inform patient safety culture within the context of hospital isolation settings; and vice-versa.

Research methods

In this paper, we utilise focus group interviews at two hospital sites within one health board in order to engage healthcare staff in elaborating on their understandings of infection prevention practices and patient safety culture within isolation settings in their organisation. Focus group transcripts were analysed inductively using thematic analysis in order to identify and develop emerging empirical themes.

Results

Positioned against a background of healthcare restructuring and ever-increasing uncertainty, our study found two very different hospitals in regard to patient safety culture and infection prevention practice. While one hospital site embodies a mixed picture in regard to patient safety culture, the second hospital is best characterised as being highly fragmented. The utilisation of focus group interviews revealed themes that capture the ways in which interviewees position and understand the work they perform within the broader structural, political and cultural context, and what that means for infection prevention practice and patient safety culture.

Conclusion

Drawing on the insights of Bourdieu, this paper theorises the field of patient safety as a space of social struggle. Patient safety is thus positioned within its structural, cultural and political context, rather than as merely an epidemiological dilemma.
Understanding patient preferences for emergency care for lower triage acuity presentations during GP hours: a qualitative study in Australia
Authors: Korczak Viola , Yakubu Kenneth , Angell Blake , Middleton Paul , Dinh Michael , Lung Thomas , Jan Stephen
Published: November 2022

Background

Low acuity presentations to Australian emergency departments drive long wait times, higher costs and may be better treated in primary care settings. This study sought to understand factors leading these patients to present to emergency departments.

Methods

Semi-structured interviews were carried out with patients at two tertiary emergency departments in Sydney during general practitioner opening hours. Nvivo was used to code the interviews and a thematic analysis was carried out to capture the main themes from the interviews.

Results

Forty-four interviews were included in the analysis across the two sites. They represented a diverse population in terms of ethnicity, education and socioeconomic background. Patient preferences for emergency care were organised into four main themes: (i) patients were referred (either by another health service, work, friend, or family), (ii) emergency department factors (convenience of investigations and severity of symptoms requiring emergency care), (iii) GP factors (does not have a GP, cannot find an appointment with a GP or has previously had a negative experience with a GP) and (iv) personal factors such as their connection to the hospital.

Conclusion

Multiple factors led patients to seek ED care for low acuity presentations during GP hours. Some of these factors could be addressed to meet patient needs in the community, however this is currently not the case. Addressing these factors to improve access to GP clinics and the availability of services outside the hospital setting could reduce ED presentations and likely improve patient experience.
Plant-based dietary patterns defined by a priori indices and colorectal cancer risk by sex and race/ethnicity: the Multiethnic Cohort Study
Authors: Kim Jihye , Boushey Carol J. , Wilkens Lynne R. , Haiman Christopher A. , Le Marchand Loïc , Park Song-Yi
Published: November 2022

Background

Plant-based diets assessed by a priori indices are associated with health outcomes. This study investigated the associations between pre-defined indices of plant-based diets and risk of colorectal cancer (CRC) and evaluated whether the association varies by sex, race and ethnicity, and anatomic subsite of tumors.

Methods

A total of 79,952 men and 93,475 women who participated in the Multiethnic Cohort Study were included. Primary outcome was incidence of invasive CRC. Cox models were used to estimate the risk of CRC across quintiles of three plant-based diet scores: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI).

Results

During a mean follow-up of 19.2 years, 4976 incident CRC were identified. Among men, multivariable-adjusted HR (95% CI) for the highest vs. lowest quintiles was 0.77 (0.67–0.88) for PDI, and 0.80 (0.70–0.91) for hPDI, while no significant association was found for uPDI among men and for all indices among women. In men, the inverse association for PDI was stronger in Japanese American, Native Hawaiian, and White groups than African American or Latino group (P for heterogeneity = 0.01) and for left colon and rectal tumors than right tumors (P for heterogeneity = 0.005), whereas the decreased risk with hPDI was found consistently across racial and ethnic groups and subsites.

Conclusions

Greater adherence to plant-based diets rich in healthy plant foods and low in less healthy plant foods is associated with a reduced risk of CRC in men, but not in women. The strength of the association among men may vary by race and ethnicity and anatomic subsite of tumors.
Pathogenicity, colonization, and innate immune response to Pasteurella multocida in rabbits
Authors: Yang Wenhao , Li Mingtao , Zhang Chengcheng , Zhang Xiaorong , Guo Mengjiao , Wu Yantao
Published: November 2022

Background

Pasteurella multocida (P. multocida) infection can cause a series of diseases in different animals and cause huge economic losses to the breeding industry. P. multocida is considered to be one of the most significant pathogens in rabbits. In order to elucidate the pathogenic mechanism and innate immune response of P. multocida, an infection experiment was carried out in this study.

Results

Our results showed that the clinical symptoms of rabbits were severe dyspnoea and serous nasal fluid. During the course of the disease, the deaths peaked at 2 days post infection (dpi) and mortality rate was 60%. The pathological changes of the lung, trachea, and thymus were observed. In particular, consolidation and abscesses appeared in lung. Histopathologic changes in rabbits showed edema, hemorrhage, and neutrophil infiltration in the lung. P. multocida can rapidly replicate in a variety of tissues, and the colonization in most of the tested tissues reached the maximum at 2 dpi and then decreased at 3 dpi. The number of P. multocida in lung and thymus remained high level at 3 dpi. Toll-like receptors 2 and 4 signaling pathways were activated after P. multocida infection. The expression of Il1β, Il6, Il8, and Tnf-α was significantly increased. The expression of most proinflammatory cytokines peaked at 2 dpi and decreased at 3 dpi, and the expression trend of cytokines was consistent with the colonization of P. multocida in rabbit tissues.

Conclusions

The P. multocida can rapidly replicate in various tissues of rabbit and cause bacteremia after infection. TLRs signaling pathways were activated after P. multocida infection, significantly inducing the expression of proinflammatory cytokines, which is might the main cause of respiratory inflammation and septicemia.