bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of goals scored in open play at the 2017 and 2018 Australian national cerebral palsy football championship
Authors: Goh Alvin M , Drinkwater Eric J , Harms Craig A , Scanlan Mark , Newton Robert U , Ma’ayah Fadi
Published: May 2022

Despite increasing popularity of cerebral palsy (CP) football (para football) worldwide, there are limited data available describing effective attacking strategies that lead to goals. The purpose of this research was to investigate the most frequent methods of ball repossession, distribution and movement patterns that successfully led to goals scored in open play of CP football. Video footage of all goals (n = 167) during the Australian National CP Football Championships in 2017 and 2018 were analysed using SportsCode software. Most goals (89.8%) were scored from open play, with the most effective mode of ball delivery identified as being direct play, of four or less passes, to create an opportunity to score. More goals were scored during the first half of games (54.9%), with a majority of goals (67.1%) scored from a region that encompasses the entire penalty area (Zone 1). The findings from the research conclude that tactically, coaches could capitalise on restarts by moving the ball quickly in four or less passes into the middle of the penalty area, to increase their chances of scoring goals in CP football.
The assessment and selection of suppliers using AHP and MABAC with type-2 fuzzy numbers in automotive industry
Authors: Komatina Nikola , Tadić Danijela , Aleksić Aleksandar , Jovanović Aleksandar D
Published: May 2022

The selection of appropriate suppliers in an uncertain environment influences the sustainability and the competitive advantage of the automotive industry and hence presents one of the significant management problems. In the literature, it is suggested that an acceptable supplier may be determined concerning many criteria. In this manuscript, criteria selection is based on the relevant literature. Handling of different uncertainties is performed by using the type-2 fuzzy sets that have the capability of handling more considered impreciseness and uncertainties. In the presented research, the two-state model is proposed. In the first stage, the relative importance of criteria and sub-criteria are described by pre-defined linguistic expressions which are modeled by the interval type-2 triangular fuzzy numbers (IT2TFNs). The fuzzy weights vectors are given by using the fuzzy Analytic Hierarchical Process with IT2TFNs (IT2FAHP). After that, the ranking of suppliers is based on the modified Multi-Attributive Border Approximation area Comparison method (MABAC) with IT2TFNs (IT2FMABAC). The extension of the conventional MABAC includes: (a) modeling of sub-criteria values of IT2TFNs, (b) the fuzzy criteria values are calculated by using fuzzy algebra rules, (c) belonging of each supplier to border approximation areas (BAAs) is given by using procedure, and (d) the distance of suppliers to BAAs is determined by using the normalized Euclidean distance formulas. The proposed model is tested on the real-life data from the automotive supply chain. Through the presented research, it is shown that the proposed IT2FMABAC is a useful and reliable tool for the rational purchasing decision-making process.
Immune-related dissociated response as a specific atypical response pattern in solid tumors with immune checkpoint blockade
Authors: Guan Yaping , Feng Dongfeng , Yin Beibei , Li Kun , Wang Jun
Published: May 2022

Immune checkpoint blockade using immune checkpoint inhibitors, including cytotoxic T-lymphocyte-associated antigen–4 and programmed cell death protein-1/programmed cell death ligand–1 inhibitors, has revolutionized systematic treatment for advanced solid tumors, with unprecedented survival benefit and tolerable toxicity. Nivolumab, pembrolizumab, cemiplimab, avelumab, durvalumab, atezolizumab, and ipilimumab are currently approved standard treatment options for various human cancer types. The response rate to immune checkpoint inhibitors, however, is unsatisfactory, and unexpectedly, atypical radiological responses, including delayed responses, pseudoprogression, hyperprogression, and dissociated responses (DRs), are observed in a small subgroup of patients. The benefit of immunotherapy for advanced patients who exhibit atypical responses is underestimated according to the conventional response evaluation criteria in solid tumors (RECIST). In particular, DR is considered a mixed radiological or heterogeneous response pattern when responding and nonresponding lesions or new lesions coexist simultaneously. The rate of DR reported in different studies encompass a wide range of 3.3–47.8% based on diverse definition of DR. Although DR is also associated with treatment efficacy and a favorable prognosis, it is different from pseudoprogression, which has concordant progressive lesions and can be regularly captured by immune RECIST. This review article aims to comprehensively determine the frequency, definition, radiological evaluation, probable molecular mechanisms, prognosis, and clinical management of immune-related DR and help clinicians and radiologists objectively and correctly interpret this specific atypical response and better understand and manage cancer patients with immunotherapy and guarantee their best clinical benefit.
Implementation of the Hanyu Shuiping Kaoshi and its Home Edition During the Covid-19 Pandemic: A Survey of European Test Centres
Authors: Chen Julie Yu-Wen
Published: May 2022

The Hanyu Shuiping Kaoshi (HSK) test is a standardized Chinese language proficiency test targeting non-native speakers. Compared with other Chinese proficiency tests, the HSK has the largest test population in the world and has attracted the most academic research. This article examines how the HSK was carried out during the Covid-19 pandemic and the issues facing home-based HSK test, the so-called HSK Home Edition. The results of a primary survey showed that the majority of test centres in Europe opted to implement the traditional paper-based format of the HSK during the Covid-19 pandemic, despite the availability of the HSK Home Edition. Concerns related to technical and security issues were among the major factors that hindered successful implementation of the Home Edition. Of the test centres that utilised the Home Edition, they rated their overall experience as satisfactory. This finding suggests that concerns relating to technical and security issues associated with the adoption of the Home Edition may be less daunting than anticipated. Additional training for test centre staff could improve the implementation of the Home Edition.
Outcomes After Medial Ulnar Collateral Ligament Graft Repair in Professional Baseball Pitchers With Minimum 2-Year Follow-up
Authors: Steffes Matthew J. , Heaps Braiden M. , ElAttrache Neal S. , Haselman William Tyler
Published: May 2022

Background:

Rerupture of the reconstructed ulnar collateral ligament (UCL) is becoming more frequent at the professional level of baseball. However, there is no literature describing outcomes after UCL graft repair.

Purpose:

To evaluate rerupture rate, return to play, performance upon return, and patient-reported outcomes after a novel UCL graft repair technique.

Study Design:

Case series; Level of evidence, 4.

Methods:

All included patients underwent UCL graft repair after a previous UCL reconstruction, pitched in at least 1 professional baseball game before repair, and were at least 2 years postprocedure within the same 10-year time period. The authors evaluated patient characteristics and performance metrics, including wins, losses, win percentage, earned run average, innings pitched, walks and hits per inning pitched, for the 2 seasons before and after the procedure. Patients were contacted to assess UCL rerupture, timing of return to sport, current level of competition, Conway score, and Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow Score.

Results:

Six players met the inclusion criteria. All had proximal UCL graft ruptures and underwent flexor-pronator tendon repair in combination with graft repair. At a mean (±SD) follow-up of 56.7 ± 37.8 months, no reruptures were encountered, and the mean KJOC score was 87.9 ± 14.6. Of the 6 pitchers who underwent UCL graft repair, 4 (67%) returned to professional pitching at a mean of 17 ± 6 months. Three of the 6 (50%) achieved an excellent Conway score, signifying a return to prior level of sport. There was no significant difference in demographic or preoperative pitching performance metrics between players who did and did not return to pitching. For those players who returned to professional pitching, there was no significant difference between preprocedure and postprocedure performance statistics.

Conclusion:

Repair of the UCL graft appears to yield comparable rates of return to play and performance with revision UCL reconstruction. This technique serves as a viable alternative for proximal avulsion ruptures of the UCL graft.
Visualizing green space accessibility for more than 4,000 cities across the globe
Authors: Long Xuejing , Chen Yijun , Zhang Yuheng , Zhou Qi
Published: May 2022

Green space accessibility has benefits for promoting physical and mental health of urban residents. Many studies have investigated this measure but used limited cities. To fill this gap, this study visualizes green space accessibility for 4353 cities across the globe. Three global open datasets and two different scales (city- and national-scales) were involved for the analysis. We found that most countries and cities have a relative high value in terms of the green space accessibility, and those with a relatively low value are mostly located in South American, African, and Asian countries and cities. The results may be useful not only for local governments to implement precise planning for reducing potential inequality in access to green space, but also for researchers to further investigate the relationship between green space accessibility and various issues related to urban built-up environment.
Cognitive flexibility moderates the association between maltreatment and emotion regulation in residential care children of the middle childhood period
Authors: Amédée Laetitia Mélissande , Cyr-Desautels Laurence , Bénard Houria , Pascuzzo Katherine , Dubois-Comtois Karine , Hébert Martine , Matte-Gagné Célia , Cyr Chantal
Published: May 2022

The purpose of this study was to examine, in a sample of residential care children, the moderating role of cognitive flexibility in the association between maltreatment and emotion regulation competencies. The sample included 69 children aged 8 to 12 and their group home educator as their primary caretaker. Educators completed questionnaires evaluating child emotion regulation competencies and cognitive flexibility. Child history of maltreatment and sociodemographic data were collected on the basis of the children’s child protective services files. Moderation analyses showed that the effect of child maltreatment on emotion regulation was only present for children with high levels of cognitive flexibility, such that the less children experienced severe maltreatment, the more they showed emotion regulation competencies. Children with low cognitive flexibility displayed lower levels of emotion regulation regardless of their maltreatment history. These results suggest that focusing on cognitive flexibility when intervening with children in residential care could help strengthen their emotion regulation competencies, which may prevent further maladaptive behaviors.
The electroretinogram b-wave amplitude: a differential physiological measure for Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder
Authors: Lee Irene O. , Skuse David H. , Constable Paul A. , Marmolejo-Ramos Fernando , Olsen Ludvig R. , Thompson Dorothy A.
Published: May 2022

Background

Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent childhood neurodevelopmental disorder. It shares some genetic risk with Autism Spectrum Disorder (ASD), and the conditions often occur together. Both are potentially associated with abnormal glutamate and GABA neurotransmission, which can be modelled by measuring the synaptic activity in the retina with an electroretinogram (ERG). Reduction of retinal responses in ASD has been reported, but little is known about retinal activity in ADHD. In this study, we compared the light-adapted ERGs of individuals with ADHD, ASD and controls to investigate whether retinal responses differ between these neurodevelopmental conditions.

Methods

Full field light-adapted ERGs were recorded from 15 ADHD, 57 ASD (without ADHD) and 59 control participants, aged from 5.4 to 27.3 years old. A Troland protocol was used with a random series of nine flash strengths from −0.367 to 1.204 log photopic cd.s.m−2. The time-to-peak and amplitude of the a- and b-waves and the parameters of the Photopic Negative Response (PhNR) were compared amongst the three groups of participants, using generalised estimating equations.

Results

Statistically significant elevations of the ERG b-wave amplitudes, PhNR responses and faster timings of the b-wave time-to-peak were found in those with ADHD compared with both the control and ASD groups. The greatest elevation in the b-wave amplitudes associated with ADHD were observed at 1.204 log phot cd.s.m−2flash strength (p< .0001), at which the b-wave amplitude in ASD was significantly lower than that in the controls. Using this measure, ADHD could be distinguished from ASD with an area under the curve of 0.88.

Conclusions

The ERG b-wave amplitude appears to be a distinctive differential feature for both ADHD and ASD, which produced a reversed pattern of b-wave responses. These findings imply imbalances between glutamate and GABA neurotransmission which primarily regulate the b-wave formation. Abnormalities in the b-wave amplitude could provisionally serve as a biomarker for both neurodevelopmental conditions.
RSNET: inferring gene regulatory networks by a redundancy silencing and network enhancement technique
Authors: Jiang Xiaohan , Zhang Xiujun
Published: May 2022

Background

Current gene regulatory network (GRN) inference methods are notorious for a great number of indirect interactions hidden in the predictions. Filtering out the indirect interactions from direct ones remains an important challenge in the reconstruction of GRNs. To address this issue, we developed a redundancy silencing and network enhancement technique (RSNET) for inferring GRNs.

Results

To assess the performance of RSNET method, we implemented the experiments on several gold-standard networks by using simulation study, DREAM challenge dataset and Escherichia coli network. The results show that RSNET method performed better than the compared methods in sensitivity and accuracy. As a case of study, we used RSNET to construct functional GRN for apple fruit ripening from gene expression data.

Conclusions

In the proposed method, the redundant interactions including weak and indirect connections are silenced by recursive optimization adaptively, and the highly dependent nodes are constrained in the model to keep the real interactions. This study provides a useful tool for inferring clean networks.
Auditory steady state responses elicited by silent gaps embedded within a broadband noise
Authors: Kadowaki Seiichi , Morimoto Takashi , Okamoto Hidehiko
Published: May 2022

Background

Auditory temporal processing plays an important role in speech comprehension. Usually, behavioral tests that require subjects to detect silent gaps embedded within a continuous sound are used to assess the ability of auditory temporal processing in humans. To evaluate auditory temporal processing objectively, the present study aimed to measure the auditory steady state responses (ASSRs) elicited by silent gaps of different lengths embedded within a broadband noise. We presented a broadband noise with 40-Hz silent gaps of 3.125, 6.25, and 12.5 ms.

Results

The 40-Hz silent gaps of 3.125, 6.25, and 12.5 ms elicited clear ASSRs. Longer silent gaps elicited larger ASSR amplitudes and ASSR phases significantly differed between conditions.

Conclusion

The 40 Hz gap-evoked ASSR contributes to our understanding of the neural mechanisms underlying auditory temporal processing and may lead to the development of objective measures of auditory temporal acuity in humans.
A systematic review of HIV screening programs conducted in pediatric emergency departments in the United States
Authors: Bi Lynn , Solnick Rachel E. , Merchant Roland C.
Published: May 2022

Background

We conducted a systematic review of studies published in peer-reviewed journals on HIV screening programs conducted in pediatric emergency departments (PEDs) in the United States (US) with the objective of describing the methods, testing yields and challenges in these programs.

Methods

We searched for full-text, English-language, original research articles focused on the conduct, development, initiation or implementation of any HIV screening program in a US PED through eight online databases (Pubmed (MEDLINE), Scopus, Embase, Cochrane, Web of Science, CINAHL, PsycInfo and Google Scholar) from their inception through July 2020. We also searched for articles on the websites of thirteen emergency medicine journals, 24 pediatric and adolescent health journals, and ten HIV research journals, and using the references of articles found through these searches. Data on HIV testing program components and yield of testing was extracted by one investigator independently and verified by a second investigator. Each program was summarized and critiqued.

Results

Of the eight articles that met inclusion criteria, most involved descriptions of their HIV testing program, except for one that was focused on quality improvement of their program. Five described an opt-in and three an opt-out approach to HIV screening. Programs differed greatly by type of HIV test utilized and who initiated or performed testing. There were large variations in the percentage of patients offered (4.0% to 96.7%) and accepting (42.7% to 86.7%) HIV testing, and HIV seropositivity in the studies ranged from 0 to 0.6%. Five of the eight studies reported an HIV seropositivity greater than 0.1%, above Centers for Disease Control and Prevention recommended threshold for testing in a healthcare setting.

Conclusions

The studies illustrate opportunities to further optimize the integration of HIV screening programs within US PEDs and reduce barriers to testing, improve efficiency of testing results and increase effectiveness of programs to identify cases. Future research should focus on advancing the methodology of screening programs beyond feasibility studies as well as conducting investigations on their implementation and longer-term sustainability.
Reliability and validity of the Chinese version of a short form of the family health scale
Authors: Wang Fei , Wu Yunchou , Sun Xiaonan , Wang Dong , Ming Wai-Kit , Sun Xinying , Wu Yibo
Published: May 2022

Background

With the release of the Health China Action (2019–2030), family health is receiving increasing attention from experts and scholars. But at present, there is no family health scale in China that involves multidimensional and interdisciplinary commonality.

Aim

To translate a Short Form of the Family Health Scale (FHS-SF) and to test the reliability and validity of the Chinese version of the FHS-SF.

Method

A Short Form of the Family Health Scale was Chinese translated with the consent of the original author. A total of 8912 residents were surveyed in 120 cities across China using a multistage sampling method, with gender, ethnicity, and education level as quota variables. Seven hundred fifty participants were selected to participate in this study, and 44 participants were randomly selected to be retested 1 month later.

Results

The Cronbach’s alpha of the Chinese version of a Short Form the Family Health Scale was 0.83,the Cronbach’s alphas of the four subscales ranged from 0.70 to 0.90, the retest reliability of the scale was 0.75, the standardized factor loadings of the validation factor analysis were above 0.50, GFI = 0.98; NFI = 0.97; RFI = 0.95; RMSEA = 0.07, all within acceptable limits.

Conclusion

The Chinese version of a Short Form the Family Health Scale has good reliability and validity and can be used to assess the level of family health of Chinese residents.
Long-term cardio-vascular risk assessment in chronic kidney disease and kidney transplanted patients following SARS-COV-2 disease: protocol for multi-center observational match controlled trial
Authors: Tapoi Laura , Apetrii Mugurel , Dodi Gianina , Nistor Ionut , Voroneanu Luminita , Siriteanu Lucian , Onofriescu Mihai , Kanbay Mehmet , Covic Adrian
Published: May 2022

Background

The coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) produced a pandemic since March 2020 by affecting more than 243 million people with more than 5 million deaths globally. SARS-CoV-2 infection is produced by binding to angiotensin-converting enzyme, which among other sites is highly expressed in the endothelial cells of the blood vessels, pericytes and the heart, as well as in renal podocytes and proximal tubular epithelial cells. SARS-CoV-2 and cardiovascular disease (CVD) are interconnected by risk factors association with an increased incidence of the disease and by determining de novo cardiac complications. At the same time, COVID-19 disease can lead to acute kidney injury directly, or due to sepsis, multi-organ failure and shock. Therefore, the pre-existence of both CVD and chronic kidney disease (CKD) is linked with a higher risk of severe disease and worse prognosis.

Methods

The main aim of this study is to assess the CV risk in a CKD (stage 3 to 5), dialysis and kidney transplanted population, following SARS-CoV-2 infection, with focus on the endothelial dysfunction as compared to a control group of matched patients. By using clinical evaluation, flow-mediated dilatation, carotid-femoral pulse wave velocity, intima-media thickness, echocardiographic parameters, lung ultrasound, bioimpedance spectroscopy and a series of novel biomarkers, the investigators will determine the long-term impact of this disease on CV and renal outcomes.

Discussion

This study will address the challenges and implications in long-term CV sequeale of COVID-19 and focus on a better understanding of the underlying mechanisms and possible therapeutic options.

Trial registration

Patient enrolment in the trial started in January 2021 and is expected to finish at the end of 2022. The study can be found on ClinicalTrials.gov database with NCT05125913 identifier.

Registered on 18 November 2021 - Retrospectively registered.
The identification of miRNA and mRNA expression profiles associated with pediatric atypical teratoid/rhabdoid tumor
Authors: Xu Xinke , Yuan Hongyao , Pan Junping , Chen Wei , Chen Cheng , Li Yang , Li Fangcheng
Published: May 2022

Background

Atypical teratoid/rhabdoid tumor (AT/RT) is a malignant pediatric tumor of the central nervous system (CNS) with high recurrence and low survival rates that is often misdiagnosed. MicroRNAs (miRNAs) are involved in the tumorigenesis of numerous pediatric cancers, but their roles in AT/RT remain unclear.

Methods

In this study, we used miRNA sequencing and gene expression microarrays from patient tissue to study both the miRNAome and transcriptome traits of AT/RT.

Results

Our findings demonstrate that 5 miRNAs were up-regulated, 16 miRNAs were down-regulated, 179 mRNAs were up-regulated and 402 mRNAs were down-regulated in AT/RT. qPCR revealed that hsa-miR-17-5p and MAP7 mRNA were the most significantly differentially expressed miRNA and mRNA in AT/RT tissues. Furthermore, the results from analyses using the miRTarBase database identified MAP7 mRNA as a target gene of hsa-miR-17-5p.

Conclusions

Our findings suggest that the dysregulation of hsa-miR-17-5p may be a pivotal event in AT/RT and miRNAs that may represent potential therapeutic targets and diagnostic biomarkers.
The prognostic value of weight loss during radiotherapy among patients with nasopharyngeal carcinoma: a large-scale cohort study
Authors: Jin Ya-Nan , Xia Tian-Liang , Mai Dong-Mei , Yao Ji-Jin , Jiang Chang , He Wen-Zhuo , Xia Liang-Ping
Published: May 2022

Background

We aim to investigate the prognostic value of weight loss during radiotherapy (RT) among patients with nasopharyngeal carcinoma (NPC).

Methods

A total of 1149 NPC patients who received radical RT were retrospectively analyzed. Patients’ weight were measured at initiation of RT (WPre-RT) and every week during RT (WRT1,2,3,4,5,6,7). Percentage of weight loss (PWL) at 1st, 2nd, 3rd, 4th, 5th, 6th, and 7th week of RT (RT-PWL1,2,3,4,5,6,7) were calculated using the following equation: (WPre-RT –WRT1,2,3,4,5,6,7)/WPre-RT × 100%. The optimal threshold of RT-PWL7 was determined by recursive partitioning analyses (RPAs). Our endpoints included disease-free survival (DFS), overall survival (OS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRRFS).

Results

The median RT-PWLs were 0, 0, 1.5, 2.9, 4.1, 5.5, 6.6% at 1st, 2nd, 3rd, 4th, 5th, 6th, and 7th week of RT, respectively. RT-PWL7 optimal threshold with respect to DFS was 5.3% based on RPAs. Therefore, a consistent threshold of 5% (<5% vs > ≥5%) was selected to classify NPC patients into low RT-PWL7 and high RT-PWL7 groups for survival analysis. Compared to high RT-PWL7 (≥5%), patients with low RT-PWL7 (< 5%) had significantly better ten-year DFS (61.2% vs 78.8%; P < 0.001), OS (70.1% vs 86.6%; P < 0.001), and DMFS (80.2% vs 88.5%; P = 0.007). However, no difference was observed between LRRFS groups (91.7% vs 94.3%; P = 0.173). In multivariate analysis, high RT-PWL7 was an independent risk factor for DFS (HR, 1.56; 95%CI, 1.19-2.03; P = 0.001), OS (HR, 1.54; 95%CI, 1.11-2.15; P = 0.011), and DMFS (HR, 1.47; 95%CI, 1.03-2.10; P = 0.033) in patients with NPC. In addition, treatment strategy, plasma Epstein-Barr virus DNA, and N stage were associated with weight loss.

Conclusions

High RT-PWL7 was significantly associated with decreased DFS, OS, and DMFS for NPC patients. Clinicians should continuously inform patients on the health impact of minimizing RT-PWL7 under 5% during radiotherapy.
Gestational trophoblastic neoplasia with extrauterine metastasis but lacked uterine primary lesions: a single center experience and literature review
Authors: Li Jingnan , Wang Yu , Lu Bingjian , Lu Weiguo , Xie Xing , Shen Yuanming
Published: May 2022

Background

To investigate the clinicopathological characteristics, diagnoses, treatments, and outcomes of a special type of gestational trophoblastic neoplasia (GTN) which only has extrauterine metastases without uterine primary lesions.

Methods

The medical records and pathological sections of the patients who were pathologically diagnosed as GTN, only had extrauterine metastatic lesions but lacked uterine primary lesions, in Women’s Hospital of Zhejiang University School of Medicine from February 2014 to March 2021 were collected and reviewed.

Results

Thirteen patients with pathologically confirmed GTN presenting with extrauterine metastases from a missing primary site were included in the past 7 years. The median age was 31.2 years old. 76.9% of patients had a non-hydatidiform pregnancy last time. The intervals between the antecedent pregnancy were > 12 months in 61.5% of patients. Pretreatment serum human chorionic gonadotropin(hCG) levels ranged from 118.7 to 807,270 IU/L. Six patients were misdiagnosed as ectopic pregnancy at initial diagnosis, and 4 as primary tumors at metastatic sites. All of them were diagnosed definitely by surgical pathology including 8 choriocarcinomas (CC), 4 epithelioid trophoblastic tumors (ETTs), and 1 mixed GTN (CC mixed with ETT). All patients achieved complete remission (CR) after treatments. Three patients relapsed; no patient died by the end of follow-up.

Conclusion

GTN presenting with extrauterine metastases from a missing primary site is easily misdiagnosed. Detection of serum hCG in these patients can reduce misdiagnosis. Chemotherapy combined with individualized surgery should be considered for these special GTN patients. Immune checkpoint inhibitors might be potential remedial measures for refractory and recurrent patients.
Impact of keratoconus stage on outcome after corneal crosslinking
Authors: Gassel Caroline Julia , Röck Daniel , Konrad Eva-Maria , Blumenstock Gunnar , Bartz-Schmidt Karl Ulrich , Röck Tobias
Published: May 2022

Background

This study aimed to analyze if the outcome after corneal crosslinking (CXL) in progressive keratoconus patients depends on the stage at which the procedure is performed. This knowledge would help to improve success of CXL and to define surgery indications in those patients.

Methods

In this retrospective study, 124 consecutive eyes of 100 patients with progressive keratoconus undergoing corneal CXL at the University Eye Hospital Tübingen were included. The eyes were graded according to modified Krumeich stages depending on induced myopia or astigmatism, corneal radii, minimum corneal thickness, and morphological changes. The observation period covered November 2008 to September 2018. Preoperatively, 12 and 24 months after CXL, the best corrected visual acuity (BCVA) was determined and astigmatism as well as tomographic parameters (Kmax, Kmin, central corneal thickness (CCT), minimum corneal thickness (MCT)) were measured by means of a Scheimpflug camera system.

Results

BCVA results showed significant differences between the modified Krumeich stages at 12 months (p = 0.014) and at 24 months postoperatively (p = 0.032). Also, astigmatism differed significantly among the stages at 24 months after CXL (p = 0.023). However, no significant differences regarding astigmatism were detectable after 12 months. In terms of Kmax, Kmin, CCT, and MCT, no significant differences between the Krumeich stages were observed.

Conclusions

BCVA showed a significantly higher improvement after CXL in the early stage of keratoconus compared to a higher stage. However, the postinterventional tomographic values did not differ significantly between the different modified Krumeich stages. The significantly higher improvement in BCVA after CXL in the early stage might indicate that earlier intervention provides a higher subjective benefit to the individual. Further studies with larger sample sizes are needed to confirm these findings.
Association between perceived harm of tobacco and intention to quit: a cross-sectional analysis of the Vietnam Global Adult Tobacco Survey
Authors: Tran Thi Phuong Thao , Park Jinju , Nguyen Thi Ngoc Phuong , Hoang Van Minh , Lim Min Kyung
Published: May 2022

Background

Perception of harm plays an important role in predicting intention to quit—an integral part of the cessation process. Perception on harm from bamboo waterpipe tobacco was unknown, even the predominant of this type of tobacco use. This study investigated the effects of perceived harm from cigarette and bamboo waterpipe tobacco on intention to quit among adult male Vietnamese tobacco users.

Methods

From the nationally-representative 2015 Global Adult Tobacco Survey, we included 1,351 adult males (≥ 18 years old) who used cigarettes, bamboo waterpipes, or both. Demographic characteristics, tobacco use behaviors, perceived harm from tobacco use, and regulation/policy exposure were measured. Effects of perceived harm from cigarette and bamboo waterpipe tobacco on intention to quit were assessed by logistic regression.

Results

Intention to quit prevalence was 59.0%, 55.0%, and 58.4% for cigarette, waterpipe, and dual users, respectively. Tobacco users who perceived that “using cigarettes and/or waterpipe could cause severe illness” and “waterpipe use is less harmful than cigarette smoking”, had tobacco use bans at home, or were exposed to anti-smoking campaigns or encouragement to quit information were more likely to intend to quit. When analyzed by tobacco users, intention to quit was more likely for those users who perceived their tobacco product as more harmful than the other product type, although statistical significance was only observed for cigarette users.

Conclusions

Misperceptions regarding harm from tobacco use could negatively affect intention to quit. Dissemination of accurate information on the risks from all forms of tobacco use and enforcement of tobacco control policies are important for encouraging intention to quit.
Efficacy and safety of anlotinib with and without EGFR-TKIs or immunotherapy in the treatment of elder patients with non-small-cell lung cancer: a retrospective study
Authors: Wang Wenxian , Shao Lan , Xu Yibing , Song Zhengbo , Lou Guangyuan , Zhang Yiping , Chen Ming
Published: May 2022

Background

Anlotinib is a multitarget tyrosine kinase inhibitor for treating patients with advanced non-small cell lung cancer (NSCLC). We aimed to assess the efficacy and safety of anlotinib in elder patients with advanced NSCLC.

Methods

Elder patients with advanced NSCLC who received anlotinib were enrolled. They were all age ≥ 65 years and with demonstrated records of EGFR gene status. All patients had received treatment with anlotinib or immune checkpoint inhibitors (ICIs)/EGFR-TKIs. The efficacy was evaluated according to the efficacy evaluation criteria for solid tumors (RECIST 1.1). Common Adverse Events Evaluation Criteria (CTCAE 4.03) were used to evaluate adverse drug reactions.

Results

A total of 91 patients were included in this study. We divided the patients into two groups (EGFR wild type: 60 patients; EGFR mutation: 31 patients). Among EGFR negative patients, the progression-free survival (PFS) for anlotinib monotherapy and anlotinib combination ICI therapy was 3.2 months and 5.0 months, respectively (P = 0.012). The difference in overall survival (OS) between monotherapy and combination therapy was also significant (9.5 vs. 18.4 months, respectively P = 0.010). Interestingly, we further analyzed differences between patients with hypertension and without hypertension, and found that hypertension was associated with better prognosis (5.7 vs. 1.4 months, P < 0.0001). In the EGFR mutation group, the PFS for anlotinib and EGFR-TKI combination treatment indicated better efficacy than that of anlotinib monotherapy (1.83 months vs. 7.03 months, respectively, P = 0.001). The median OS for monotherapy and combination therapy in the EGFR mutation group showed no statistical difference (28.34 months vs. 31.37 months, P = 0.223). The most common adverse reactions were hypertension, fatigue, and hand-foot syndrome, mainly of grade 1 or 2. No significant increase in adverse reactions was observed in patients  ≥ 70 years of age.

Conclusions

Anlotinib treatment and combination regimens resulted in good efficacy and controllable adverse reactions in elder patients with advanced NSCLC.
Clinical and pathological features of immune-mediated necrotising myopathies in a single-centre muscle biopsy cohort
Authors: Yang Hongxia , Tian Xiaolan , Zhang Lining , Li Wenli , Liu Qingyan , Jiang Wei , Peng Qinglin , Wang Guochun , Lu Xin
Published: May 2022

Objective

Immune-mediated necrotising myopathy (IMNM) is a subset of idiopathic inflammatory myopathies (IIM) characterized by significantly elevated creatine kinase level, muscle weakness and predominant muscle fibre necrosis in muscle biopsy. This study aimed to investigate the clinical and pathological characteristics of patients with IMNM in a single-centre muscle biopsy cohort.

Methods

A total of 860 patients who had muscle biopsy reports in our centre from May 2008 to December 2017 were enrolled in this study. IMNM was diagnosed according to the 2018 European Neuromuscular Centre (ENMC) clinicopathological diagnostic criteria for IMNM.

Results

The muscle biopsy cohort consisted of 531 patients with IIM (61.7%), 253 patients with non-IIM (29.4%), and 76 undiagnosed patients (8.8%). IIM cases were classified as IMNM (68[7.9%]), dermatomyositis (346[40.2%]), anti-synthetase syndrome (82[9.5%]), polymyositis (32[3.7%]), and sporadic inclusion body myositis (3[0.3%]). Limb girdle muscular dystrophy (LGMD) 2B and lipid storage myopathy (LSM) are the two most common non-IIM disorders in our muscle biopsy cohort. IMNM patients had a higher onset age (41.57 ± 14.45 vs 21.66 ± 7.86 and 24.56 ± 10.78, p < .0001), shorter duration (21.79 ± 26.01 vs 66.69 ± 67.67 and 24.56 ± 10.78, p < .0001), and more frequent dysphagia (35.3% vs. 3.4 and 6.3%, p = .001) than LGMD 2B and LSM patients. Muscle biopsy from IMNM showed more frequent muscle fibre necrosis (95.6% vs 72.4 and 56.3%, p < .0001), overexpression of major histocompatibility complex-I on sarcolemma (83.8% vs 37.9 and 12.9%, p < .0001), and CD4+ T cell endomysia infiltration (89.7% vs 53.6 and 50%, p < .0001) compared with those from LGMD 2B and LSM patients.

Conclusions

It is easy to distinguish IMNM from other IIM subtypes according to clinical symptoms and myositis specific antibodies profiles. However, distinguishing IMNM from disorders clinically similar to non-IIM needs combined clinical, serological and pathological features.
Automatic segmentation model of intercondylar fossa based on deep learning: a novel and effective assessment method for the notch volume
Authors: Li Mifang , Bai Hanhua , Zhang Feiyuan , Zhou Yujia , Lin Qiuyu , Zhou Quan , Feng Qianjin , Zhang Lingyan
Published: May 2022

Background

Notch volume is associated with anterior cruciate ligament (ACL) injury. Manual tracking of intercondylar notch on MR images is time-consuming and laborious. Deep learning has become a powerful tool for processing medical images. This study aims to develop an MRI segmentation model of intercondylar fossa based on deep learning to automatically measure notch volume, and explore its correlation with ACL injury.

Methods

The MRI data of 363 subjects (311 males and 52 females) with ACL injuries incurred during non-contact sports and 232 subjects (147 males and 85 females) with intact ACL were retrospectively analyzed. Each layer of intercondylar fossa was manually traced by radiologists on axial MR images. Notch volume was then calculated. We constructed an automatic segmentation system based on the architecture of Res-UNet for intercondylar fossa and used dice similarity coefficient (DSC) to compare the performance of segmentation systems by different networks. Unpaired t-test was performed to determine differences in notch volume between ACL-injured and intact groups, and between males and females.

Results

The DSCs of intercondylar fossa based on different networks were all more than 0.90, and Res-UNet showed the best performance. The notch volume was significantly lower in the ACL-injured group than in the control group (6.12 ± 1.34 cm3 vs. 6.95 ± 1.75 cm3, P < 0.001). Females had lower notch volume than males (5.41 ± 1.30 cm3 vs. 6.76 ± 1.51 cm3, P < 0.001). Males and females who had ACL injuries had smaller notch than those with intact ACL (p < 0.001 and p < 0.005). Men had larger notches than women, regardless of the ACL injuries (p < 0.001).

Conclusion

Using a deep neural network to segment intercondylar fossa automatically provides a technical support for the clinical prediction and prevention of ACL injury and re-injury after surgery.
Radiomics nomogram based on dual-energy spectral CT imaging to diagnose low bone mineral density
Authors: Yao Qianqian , Liu Mengke , Yuan Kemei , Xin Yue , Qiu Xiaoqian , Zheng Xiuzhu , Li Changqin , Duan Shaofeng , Qin Jian
Published: May 2022

Background

Osteoporosis is associated with a decrease of bone mineralized component as well as a increase of bone marrow fat. At present, there are few studies using radiomics nomogram based fat-water material decomposition (MD) images of dual-energy spectral CT as an evaluation method of abnormally low Bone Mineral Density (BMD). This study aims to establish and validate a radiomics nomogram based the fat-water imaging of dual-energy spectral CT in diagnosing low BMD.

Methods

Ninety-five patients who underwent dual-energy spectral CT included T11-L2 and dual x-ray absorptiometry (DXA) were collected. The patients were divided into two groups according to T-score, normal BMD(T ≥ -1) and abnormally low BMD (T < -1). Radiomic features were selected from fat-water imaging of the dual-energy spectral CT. Radscore was calculated by summing the selected features weighted by their coefficients. A nomogram combining the radiomics signature and significant clinical variables was built. The ROC curve was performed to evaluate the performance of the model. Finally, we used decision curve analysis (DCA) to evaluate the clinical usefulness of the model.

Results

Five radiomic features based on fat-water imaging of dual-energy spectral CT were constructed to distinguish abnormally low BMD from normal BMD, and its differential performance was high with an area under the curve (AUC) of 0.95 (95% CI, 0.89–1.00) in the training cohort and 0.97 (95% CI, 0.91–1.00) in the test cohort. The radiomics nomogram showed excellent differential ability with AUC of 0.96 (95%CI, 0.91–1.00) in the training cohort and 0.98 (95%CI, 0.93–1.00) in the test cohort, which performed better than the radiomics model and clinics model only. The DCA showed that the radiomics nomogram had a higher benefit in differentiating abnormally low BMD from normal BMD than the clinical model alone.

Conclusion

The radiomics nomogram incorporated radiomics features and clinical factor based the fat-water imaging of dual-energy spectral CT may serve as an efficient tool to identify abnormally low BMD from normal BMD well.
Chylous ascites with lymphatic leakage localization: technical aspects and clinical applications
Authors: Lu Chaoxiang , Wang Lei , Gao Qi
Published: May 2022

Background

Carbon nanoparticle suspension (CNS) was applied to locate the lymphatic leakage in chylous ascites (CA). However, the flow speed and distance of the CNS were particularly decreased in the following two cases (patient 5 and 6). This study aimed to investigate and improve the flow speed and distance of the CNS via a rat model.

Methods

Seven patients with CA were accepted for surgery in the past two years. Clinical data were recorded. Rats were divided into two groups to confirm the hypothesis regarding whether accepting milk or orally administered food before surgery was the key factor in CA surgery with CNS. The animals were divided into 2 groups: experimental group of 5 rats receiving fat emulsion injection (2 g/kg) 30 min before the operation and control group of 5 rats receiving saline. We analyzed flow speed and distance of the CNS in two groups of rats. The hypothesis established was that CNS movements pattern differ depending on the degree of capillary lymph duct filling. Finally, the late case reconfirmed the hypothesis again.

Results

In animal experiments, the CNS in the preoperative high-fat feeding group moved faster and over a longer distance than that in the control group (0.51 ± 0.09 cm vs. 0.19 ± 0.10 cm, respectively; p < 0.05). Based on this, the CNS was applied to the seventh patient, who had been given a diet with a slightly higher fat content 3 days before the operation, and marked improvement with a complete cure was recorded.

Conclusions

The capillary lymph duct was beginning to swell after dietary intake. The dilation of the lymph vessel could make it easier for the CNS to move and reach the leakage.
Oral lichen planus: comparative efficacy and treatment costs—a systematic review
Authors: Sandhu Shaiba , Klein Brittany A. , Al-Hadlaq Malak , Chirravur Prazwala , Bajonaid Amal , Xu Yuanming , Intini Rossella , Hussein Mai , Vacharotayangul Piamkamon , Sroussi Herve , Treister Nathaniel , Sonis Stephen
Published: May 2022

Objective

To compare the reported efficacy and costs of available interventions used for the management of oral lichen planus (OLP).

Materials and methods

A systematic literature search was performed from database inception until March 2021 in MEDLINE via PubMed and the Cochrane library following PRISMA guidelines. Only randomized controlled trials (RCT) comparing an active intervention with placebo or different active interventions for OLP management were considered.

Results

Seventy (70) RCTs were included. The majority of evidence suggested efficacy of topical steroids (dexamethasone, clobetasol, fluocinonide, triamcinolone), topical calcineurin inhibitors (tacrolimus, pimecrolimus, cyclosporine), topical retinoids, intra-lesional triamcinolone, aloe-vera gel, photodynamic therapy, and low-level laser therapies for OLP management. Based on the estimated cost per month and evidence for efficacy and side-effects, topical steroids (fluocinonide > dexamethasone > clobetasol > triamcinolone) appear to be more cost-effective than topical calcineurin inhibitors (tacrolimus > pimecrolimus > cyclosporine) followed by intra-lesional triamcinolone.

Conclusion

Of common treatment regimens for OLP, topical steroids appear to be the most economical and efficacious option followed by topical calcineurin inhibitors. Large-scale multi-modality, prospective trials in which head-to-head comparisons interventions are compared are required to definitely assess the cost-effectiveness of OLP treatments.
Oral health knowledge and oral hygiene practice among visually impaired subjects in Addis Ababa, Ethiopia
Authors: Fantaye Wondwossen , Nur Abdela , Kifle Getachew , Engida Fasikawit
Published: May 2022

Background

Oral health is a global issue. It has an enormous impact on the overall health and well-being of an individual. In addition, many studies indicate visual impairment as one of the constraints for proper maintenance of oral hygiene. However, little is known about visually impaired individuals' oral health knowledge and behavior in Ethiopia, specifically in Addis Ababa. Therefore, this study is conducted to assess the oral health knowledge and related behaviors among participants with visual impairment in Addis Ababa, Ethiopia.

Aim

This study aimed to assess the oral health knowledge and oral hygiene practice among visually impaired participants in Addis Ababa, Ethiopia. It is initially imperative to recognize the deficiency of data regarding the dental health care and needs of such visually impaired individuals in Ethiopia.

Methods

It is a quantitative cross-section study design carried out at the Ethiopian National Association for the blind, located in Addis Ababa, the capital city of Ethiopia. A survey was conducted by convenience sampling of visually impaired library attendees' at the blind association. Sixty-five individuals, of which 46 males and 19 females, agreed to take part in the study. Of these, 30.8% had partial and 69.2% total visual impairment.

Results

61.3% with totally and 72% with partially visually impaired scored high in the knowledge of caries causes respectively. The use of tooth brushing was confirmed by 42.2% with totally and 25% with partially visually impaired. The use of Traditional chewing sticks was confirmed by 57.7% with totally and 30% with partially visually impaired individuals. Moreover, both (Toothbrush and Traditional chewing stick) was used by 35.5% totally and 55% partially visually impaired individuals, respectively.

Conclusions

The study showed the awareness about the causes of dental caries among the visually impaired was high. However, the majority of them had a significant misconception about the causes of dental caries.