bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the value of three-dimensional printing and virtualization in paediatric healthcare: A multi-case quality improvement study
Authors: Jacob John , Stunden Chelsea , Zakani Sima
Published: February 2023

Background

Three-dimensional printing is being utilized in clinical medicine to support activities including surgical planning, education, and medical device fabrication. To better understand the impacts of this technology, a survey was implemented with radiologists, specialist physicians, and surgeons at a tertiary care hospital in Canada, examining multidimensional value and considerations for uptake.

Objectives

To examine how three-dimensional printing can be integrated into the paediatric context and highlight areas of impact and value to the healthcare system using Kirkpatrick's Model. Secondarily, to explore the perspective of clinicians utilizing three-dimensional models and how they make decisions about whether or not to use the technology in patient care.

Methods

A post-case survey. Descriptive statistics are provided for Likert-style questions, and a thematic analysis was conducted to identify common patterns in open-ended responses.

Results

In total, 37 respondents were surveyed across 19 clinical cases, providing their perspectives on model reaction, learning, behaviour, and results. We found surgeons and specialists to consider the models more beneficial than radiologists. Results further showed that the models were more helpful when used to assess the likelihood of success or failure of clinical management strategies, and for intraoperative orientation. We demonstrate that three-dimensional printed models could improve perioperative metrics, including a reduction in operating room time, but with a reciprocal effect on pre-procedural planning time. Clinicians who shared the models with patients and families thought it increased understanding of the disease and surgical procedure, and had no effect on their consultation time.

Conclusions

Three-dimensional printing and virtualization were used in preoperative planning and for communication among the clinical care team, trainees, patients, and families. Three-dimensional models provide multidimensional value to clinical teams, patients, and the health system. Further investigation is warranted to assess value in other clinical areas, across disciplines, and from a health economics and outcomes perspective.
How Mass Public Shooters Use Social Media: Exploring Themes and Future Directions
Authors: Peterson Jillian , Densley James , Spaulding Jamie , Higgins Stasia
Published: February 2023

This mixed-methods study examines social media use among public mass shooters in the United States as an extension of a comprehensive database of 170 mass shooters from 1966 to 2021. Here, we report findings from a systematic content analysis of public data and detailed timelines that were constructed for 44 mass shooters’ social media habits and changes to those habits during the period of time leading up to their shooting. The paper also presents as a case study, a sentiment analysis, and term-linkage network for one perpetrator’s total 3,000 tweets. Several themes were found in the data—there were shooters who changed their posting habits and in some cases, stopped using social media entirely in the lead up to their crime; shooters who used hate speech and were “radicalized” to violence online; shooters with a demonstrable interest in violence, who referenced past mass shooters in their own communications; shooters who exhibited signs of mental illness and suicidality; shooters who were already known to authorities; and shooters who like those described above, actively posted while shooting, presumably to boost their own celebrity status. The findings from this study provide insight into commonalities among mass shooters in terms of their social media usage, which could lead to new pathways for prevention and intervention.
The Use of TikTok for Political Campaigning in Canada: The Case of Jagmeet Singh
Authors: Moir Aidan
Published: February 2023

TikTok is a critical platform for political campaigns seeking to engage with new publics through digital advocacy. Jagmeet Singh, the leader of Canada’s New Democratic Party, has emerged as a TikTok celebrity since establishing his profile in 2019. At the time of writing, he is the only Canadian federal party leader using TikTok with his interactions greatly surpassing those on his other social media profiles. Strategically utilizing TikTok to promote his social justice-oriented political platform and to build momentum in preparation for a snap election, his digital campaign has received extensive attention from the Canadian press. Through qualitative content analysis of his videos and news media coverage of Singh’s activity on TikTok, this article questions how his TikTok profile thematically engages with social democratic politics within the context of the permanent campaign. Attention is directed toward how Singh employs TikTok’s features to establish his brand of left-wing populism and advocate against systematic social inequality to appeal to TikTok’s youthful demographic.
Taking Humor Seriously on TikTok
Authors: Matamoros-Fernández Ariadna
Published: February 2023

Humor and play are at the center of TikTok culture. Through the platform’s unique functionalities such as the “Use this Sound” and “Duet” features, people use and repurpose sounds in combination with dance and other performative “challenges” that invite imitation and transformation in novel and creative ways. Users have found on TikTok an ideal site to engage in memetic culture for a wide variety of prosocial aims: from calling out China’s treatment of Uighurs to “memeing” politicians for their poor commitments to matters of concern like climate change. All too often, though, users on TikTok also participate in practices that can advertently and inadvertently be harmful, such as viral trends trivializing police brutality and domestic violence and racist parodies. In a moment where various countries are discussing new regulations to push platforms to address, consistently and transparently, illegal and lawful harmful content and conduct, this commentary argues that humor should be taken seriously for online safety.
How do Adults With Congenital Heart Disease Evaluate Their Clinical Care?
Authors: Wijayarathne Pasangi M. , Ng Alexandrea , Menahem Samuel
Published: February 2023

Background

Almost 90% of patients with congenital heart disease (CHD) now reach adulthood. How do they evaluate the care they received?

Methods

Adults with CHD (ACHD) recruited for an international multi-center study (APPROACH-IS II) were posed 3 additional “questions” to determine their perceptions of the positive, negative, and areas for improvement of their clinical care. The findings underwent a thematic analysis.

Results

Of the 210 recruited, 183 completed the questionnaire, 147 answered the 3 “questions.” Most appreciated open communication and support, a holistic approach, continuity of and readily accessible care conducted by experts, and with good outcomes. Less than half reported negative concerns which included loss of autonomy, distress from multiple and/or painful investigations, restricted lifestyles, medication side-effects, and anxiety about their CHD. Others found their reviews time-consuming with long travel times. Some complained of limited support, poor accessibility to services in rural areas, shortage of ACHD specialists, absence of tailored rehabilitation programs, and at times their own as well as their clinicians’ limited understanding of their CHD. Suggestions for improvement included better communication, further education about their CHD, availability of simplified written information, mental health and support services, support groups, seamless transition to adult care and providing better prognostications, financial assistance, flexible appointments, telehealth reviews, and greater access to rural specialist care.

Conclusions

In addition to providing optimal medical and surgical care for ACHD, clinicians need to be cognizant of their patients’ concerns and proactive in addressing them.
Outcomes of Treatment for Infective Endocarditis Following Transcatheter Pulmonary Valve Replacement
Authors: Fox J. Chancellor , Carvajal Horacio G. , Wan Fei , Canter Matthew W. , Merritt Taylor C. , Eghtesady Pirooz
Published: February 2023

Background

Recipients of transcatheter pulmonary valve replacement (TPVR) have shown increased risk of infective endocarditis (IE). Little is known about the outcomes of different management strategies, particularly surgery, for IE after TPVR.

Methods

We queried the Pediatric Health Information System database for cases of IE after TPVR performed from 2010-2020. We described patient demographics, hospital courses, admission complications, and treatment outcomes based on therapy offered, surgical or medical only. We compared outcomes of initial therapy. Data are expressed as median or percent.

Results

Sixty-nine cases of IE were identified, accounting for 98 related hospital admissions; 29% of patients recorded IE-related readmissions. Of those readmitted after initial medical therapy only, 33% had relapse IE. Rates of surgery were 22% during initial admission and 36% overall. Likelihood of surgical intervention increased with each subsequent admission. Renal and respiratory failure were more common in those given initial surgery. Mortality rate was 4.3% overall and 8% in the surgical cohort.

Conclusion

Initial medical therapy may result in relapses/readmissions and possible delay of surgical therapy, which appears to be most effective for treatment of IE. For those treated only medically, a more aggressive course of therapy may be more likely to prevent relapse. Mortality following surgical therapy for IE after TPVR appears higher than reported for surgical pulmonary valve replacement generally.
Effect of Postoperative Non-Weight-Bearing in Trochanteric Fracture of the Femur: A Retrospective Cohort Study Using Propensity Score Matching
Authors: Takemoto Naoki , Yoshitani Junya , Saiki Yoshitomo , Numata Hitoaki , Nambu Koshi
Published: February 2023

Introduction

The effects of postoperative early weight-bearing (WB) on walking ability, muscle mass, and sarcopenia have been investigated. Postoperative WB restriction is also reportedly associated with pneumonia and prolonged hospitalization; however, its effect on surgical failures has not been studied. This study aimed to assess whether WB restriction after surgery for trochanteric fracture of the femur (TFF) is useful in preventing surgical failure, considering the unstable fracture type, quality of intraoperative reduction, and tip-apex distance.

Patients and Methods

This retrospective analysis included 301 patients admitted to a single institution between January 2010 and December 2021, diagnosed with TFF, and who underwent femoral nail surgery. Eight patients were excluded, and finally 293 patients were included in the study. Propensity score (PS) matching yielded 123 cases; 41 patients in the non-WB (NWB) group and 82 patients in the WB group were included in the final analysis. The primary outcome was surgical failure (cutout, nonunion, osteonecrosis, and implant failure). The secondary outcomes were medical complications (pneumonia, urinary tract infection, stroke, and heart failure), change in walking ability, period of hospitalization, and sliding distance of the lag screw.

Results

Five surgical complications occurred in the NWB group and two in the WB group, with significantly more surgical complications in the NWB group ( P = .041). Cutout occurred in two cases, each in the NWB and WB groups. Two cases of nonunion and one case of implant failure occurred in the NWB group, but not in the WB group. Osteonecrosis did not occur in both groups. The secondary outcomes were not significantly different between the two groups.

Conclusions

The results of this retrospective cohort study using a PS matching approach showed that WB restriction after TFF surgery could not decrease the incidence of surgical failures.
Leveraging from Home: A Qualitative Study Examining Indian Nurses’ Job Demand Management during the Pandemic
Authors: Sivarajan Rahul , Varma Aparna M , Narzary Moon , Siju Cini
Published: February 2023

In this qualitative study spread across three Indian states—Assam, Kerala and Maharashtra, we explore how 13 Indian staff nurses working full time in the first wave of the COVID pandemic cope with the increased job demands and perceived psychological contract breaches (PCB) from a work−home resources (W−HR) perspective. The study utilises the W−HR model as a theoretical lens to analyse the nurses’ lived experiences through a phenomenological approach. We could observe that a significant black swan event such as the pandemic can trigger resource depletion at work and home and materialise in PCB at work for the nurses. Nurses then resort to sensemaking to tide over the pandemic-affected work circumstances by balancing contextual demands and personal resources. By integrating PCB experienced by these nurses via a W−HR model framework, we address calls by researchers to understand how psychological contracts change over time.
Glenoid Bone Loss Pattern in Patients With Posterior Instability Versus Anterior Instability: A Matched Cohort Study
Authors: Livesey Michael G. , Bedrin Michael D. , Kolevar Matthew P. , Lundy Alexander E. , Weir Tristan B. , Kaveeshwar Samir , Kilcoyne Kelly G. , Dickens Jonathan F. , Hasan S. Ashfaq , Gilotra Mohit N.
Published: February 2023

Background:

The pattern of glenoid bone loss (GBL) in anterior glenohumeral instability is well described. It was recognized recently that posterior GBL after instability has a posteroinferior pattern.

Purpose/Hypothesis:

The purpose of this study was to compare GBL patterns in a matched cohort of patients with anterior versus posterior glenohumeral instability. The hypothesis was that the GBL pattern in posterior instability would be more inferior than the GBL pattern in anterior instability.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

In this multicenter retrospective study, 28 patients with posterior instability were matched with 28 patients with anterior instability by age, sex and number of instability events. GBL location was defined using a clockface model. Obliquity was defined as the angle between the long axis of the glenoid and a line tangent to the GBL. Superior and inferior GBL were measured as areas and defined relative to the equator. The primary outcome was the 2-dimensional characterization of posterior versus anterior GBL. The secondary outcome was a comparison of the posterior GBL patterns in traumatic and atraumatic instability mechanisms in an expanded cohort of 42 patients.

Results:

The mean age of the matched cohorts (n = 56) was 25.2 ± 9.87 years. The median obliquity of GBL was 27.53° (interquartile range [IQR], 18.83°-47.38°) in the posterior cohort and 9.28° (IQR, 6.68°-15.75°) in the anterior cohort ( P < .001). The mean superior-to-inferior bone loss ratio was 0.48 ± 0.51 in the posterior cohort and 0.80 ± 0.55 ( P = .032) in the anterior cohort. In the expanded posterior instability cohort (n = 42), patients with traumatic injury mechanism (n = 22), had a similar GBL obliquity compared to patients with an atraumatic injury mechanism (n = 20) (mean, 27.73° [95% CI, 20.26°-35.20°] vs 32.20° [95% CI, 21.27°-43.14°], respectively) ( P = .49).

Conclusion:

Posterior GBL occurred more inferiorly and at an increased obliquity compared with anterior GBL. This pattern is consistent for traumatic and atraumatic posterior GBL. Bone loss along the equator may not be the most reliable predictor of posterior instability, and critical bone loss may be reached more rapidly than a model of loss along the equator may predict.
Operative Versus Nonoperative Treatment of Acute Achilles Tendon Rupture: A Propensity Score–Matched Analysis of a Large National Dataset
Authors: Crook Bryan S. , Varshneya Kunal , Meyer Lucy E. , Anastasio Albert , Cullen Mark M. , Lau Brian C.
Published: February 2023

Background:

No consensus exists regarding the superiority of operative versus nonoperative management for Achilles tendon ruptures, as multiple randomized controlled trials conducted since the advent of early mobilization protocols have found outcomes for these 2 interventions to be more similar than were previously held.

Purpose:

To use a large national database to (1) compare reoperation and complication rates between operative and nonoperative treatment of acute Achilles tendon ruptures and (2) evaluate trends in treatment and cost over time.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The MarketScan Commercial Claims and Encounters database was used to identify an unmatched cohort of 31,515 patients who sustained primary Achilles tendon ruptures between 2007 and 2015. Patients were stratified into operative and nonoperative treatment groups, and a propensity score—a matching algorithm—was used to establish a matched cohort of 17,996 patients (n = 8993 per treatment group). Reoperation rates, complications, and aggregate treatment costs were compared between groups with an alpha level of .05. A number needed to harm (NNH) was calculated from the absolute risk difference in complications between cohorts.

Results:

The operative cohort experienced a significantly larger total number of complications within 30 days of injury (1026 vs 917; P = .0088). The absolute increase in cumulative risk was 1.2% with operative treatment, which resulted in an NNH of 83. Neither 1-year (1.1% [operative] vs 1.3% [nonoperative]; P = .1201) nor 2-year reoperation rates (1.9% [operative] vs 2% [nonoperative]; P = .2810) were significantly different. Operative care was more expensive than nonoperative care at 9 months and 2 years after injury; however, there was no difference in cost between treatments at 5 years. Before matching, the rate of surgical repair for Achilles tendon rupture remained stable, from 69.7% to 71.7% between 2007 and 2015, indicating little change in practice in the United States.

Conclusion:

Results indicated no differences in reoperation rates between operative and nonoperative management of Achilles tendon ruptures. Operative management was associated with an increased risk of complications and higher initial costs, which dissipated over time. Between 2007 and 2015 the proportion of Achilles tendon ruptures managed operatively remained similar despite increasing evidence that nonoperative management of Achilles tendon rupture may provide equivalent outcomes.
Modified T2 Statistics for Improved Detection of Aided Cortical Auditory Evoked Potentials in Hearing-Impaired Infants
Authors: Chesnaye Michael Alexander , Bell Steven Lewis , Harte James Michael , Simonsen Lisbeth Birkelund , Visram Anisa Sadru , Stone Michael Anthony , Munro Kevin James , Simpson David Martin
Published: February 2023

The cortical auditory evoked potential (CAEP) is a change in neural activity in response to sound, and is of interest for audiological assessment of infants, especially those who use hearing aids. Within this population, CAEP waveforms are known to vary substantially across individuals, which makes detecting the CAEP through visual inspection a challenging task. It also means that some of the best automated CAEP detection methods used in adults are probably not suitable for this population. This study therefore evaluates and optimizes the performance of new and existing methods for aided (i.e., the stimuli are presented through subjects’ hearing aid(s)) CAEP detection in infants with hearing loss. Methods include the conventional Hotellings T2 test, various modified q-sample statistics, and two novel variants of T2 statistics, which were designed to exploit the correlation structure underlying the data. Various additional methods from the literature were also evaluated, including the previously best-performing methods for adult CAEP detection. Data for the assessment consisted of aided CAEPs recorded from 59 infant hearing aid users with mild to profound bilateral hearing loss, and simulated signals. The highest test sensitivities were observed for the modified T2 statistics, followed by the modified q-sample statistics, and lastly by the conventional Hotelling's T2 test, which showed low detection rates for ensemble sizes <80 epochs. The high test sensitivities at small ensemble sizes observed for the modified T2 and q-sample statistics are especially relevant for infant testing, as the time available for data collection tends to be limited in this population.
A Multisite Qualitative Analysis of Perceived Roles in Medication Safety: Older Adults’ Perspectives
Authors: Jallow Fatoumata , Stehling Elisa , Sajwani-Merchant Zara , Daniel Kathryn M , Fulda Kimberly G , Espinoza Anna M , Gurses Ayse P , Arbaje Alicia I , Xiao Yan
Published: February 2023

Older adults and caregivers play an essential role in medication safety; however, self-perception of their and health professionals’ roles in medication safety is not well-understood. The objective of our study was to identify the roles of patients, providers, and pharmacists in medication safety from the perspective of older adults. Semi-structured qualitative interviews were held with 28 community-dwelling older adults over 65 years who took five or more prescription medications daily. Results suggest that older adults’ self-perceptions of their role in medication safety varied widely. Older adults perceived that self-learning about their medications and securing them are critical to avoiding medication-related harm. Primary care providers were perceived as coordinators between older adults and specialists. Older adults expected pharmacists to inform them of any changes in the characteristics of medications to ensure medications were taken correctly. Our findings provide an in-depth analysis of older adults’ perceptions and expectations of their providers’ specific roles in medication safety. Educating providers and pharmacists about the role expectations of this population with complex needs can ultimately improve medication safety.
Information Provision for Informed Consent Procedures in Psychological Research Under the General Data Protection Regulation: A Practical Guide
Authors: Hallinan Dara , Boehm Franziska , Külpmann Annika , Elson Malte
Published: February 2023

Psychological research often involves the collection and processing of personal data from human research participants. The European General Data Protection Regulation (GDPR) applies, as a rule, to psychological research conducted on personal data in the European Economic Area (EEA)—and even, in certain cases, to psychological research conducted on personal data outside the EEA. The GDPR elaborates requirements concerning the forms of information that should be communicated to research participants whenever personal data are collected directly from them. There is a general norm that informed consent should be obtained before psychological research involving the collection of personal data directly from research participants is conducted. The information required to be provided under the GDPR is normally communicated in the context of an informed consent procedure. There is reason to believe, however, that the information required by the GDPR may not always be provided. Our aim in this tutorial is thus to provide general practical guidance to psychological researchers allowing them to understand the forms of information that must be provided to research participants under the GDPR in informed consent procedures.
A review of urban vitality research in the Chinese world
Authors: Jiang Yanxiao , Zhang Yuyang , Liu Yu , Huang Zhou
Published: February 2023

This paper is a systematic review of the contemporary research progresses of urban vitality in China. Through examining the most related and advanced Chinese academic literatures, this paper introduces the core definitions and concepts and summarizes the methodology and findings of current Chinese urban vitality research. The data sources and quantitative research methods and paradigms such as vitality index frameworks are listed and discussed in detail regarding their strengths and limitations. From studies in multiple Chinese cities, we synthesize the effects and the influence mechanisms of multi-faceted factors on different types of urban vitality. Finally, we not only summarize and extrapolate the policy implications of these literatures for improving urban vitality but also propose recommendations for future research.
Effectiveness of nirmatrelvir plus ritonavir treatment for patients with CLL during the Omicron Surge
Authors: Tadmor Tamar , Alapi Hillel , Rokach Lior
Published: February 2023

Patients with CLL, even in the omicron era and post-vaccination, suffer from persistent covid, higher complications and mortality compared to the general population. In the current study, we evaluated retrospectively the effectiveness of Nirmatrelvir plus ritonavir among 1,080 patients with CLL that were infected with SARS-CoV-2. Nirmatrelvir administration was associated with a reduction in Covid-19-related hospitalization or death by day 35. Specifically, the rate of Covid-19-related hospitalization or death in the treated group compared to the untreated group was 4.8% (14 out of 292) versus 10.2% (75 out of 733). Moreover, we report a 69% relative risk reduction in Covid-19-related hospitalization or death in patients with CLL at the age of 65 years or above. Multivariate analysis indicates that patients older than 65 years, heavily treated patients (>2 prior treatments), patients with recent hospitalizations, IVIG treatment and comorbidity had significant improvement outcomes following treatment with Nirmatrelvir.
A review of piezoelectric MEMS sensors and actuators for gas detection application
Authors: Ba Hashwan Saeed S. , Khir Mohd Haris Md. , Nawi Illani Mohd , Ahmad Mohamad Radzi , Hanif Mehwish , Zahoor Furqan , Al-Douri Y. , Algamili Abdullah Saleh , Bature Usman Isyaku , Alabsi Sami Sultan , Sabbea Mohammed O. Ba , Junaid Muhammad
Published: February 2023

Piezoelectric microelectromechanical system (piezo-MEMS)-based mass sensors including the piezoelectric microcantilevers, surface acoustic waves (SAW), quartz crystal microbalance (QCM), piezoelectric micromachined ultrasonic transducer (PMUT), and film bulk acoustic wave resonators (FBAR) are highlighted as suitable candidates for highly sensitive gas detection application. This paper presents the piezo-MEMS gas sensors’ characteristics such as their miniaturized structure, the capability of integration with readout circuit, and fabrication feasibility using multiuser technologies. The development of the piezoelectric MEMS gas sensors is investigated for the application of low-level concentration gas molecules detection. In this work, the various types of gas sensors based on piezoelectricity are investigated extensively including their operating principle, besides their material parameters as well as the critical design parameters, the device structures, and their sensing materials including the polymers, carbon, metal–organic framework, and graphene.
Comparative transcriptome analysis in peaberry and regular bean coffee to identify bean quality associated genes
Authors: Fu Xingfei , Li Guiping , Hu Faguang , Huang Jiaxiong , Lou Yuqiang , Li Yaqi , Li Yanan , He Hongyan , Lv YuLan , Cheng Jinhuan
Published: February 2023

Background

The peaberry bean in Arabica coffee has exceptional quality compared to the regular coffee bean. Understanding the molecular mechanism of bean quality is imperative to introduce superior coffee quality traits. Despite high economic importance, the regulatory aspects of bean quality are yet largely unknown in peaberry. A transcriptome analysis was performed by using peaberry and regular coffee beans in this study.

Results

The result of phenotypic analysis stated a difference in the physical attributes of both coffee beans. In addition, transcriptome analysis revealed low genetic differences. Only 139 differentially expressed genes were detected in which 54 genes exhibited up-regulation and 85 showed down-regulations in peaberry beans compared to regular beans. The majority of differentially expressed genes had functional annotation with cell wall modification, lipid binding, protein binding, oxidoreductase activity, and transmembrane transportation. Many fold lower expression of Ca25840-PMEs1, Ca30827-PMEs2, Ca30828-PMEs3, Ca25839-PMEs4, Ca36469-PGs. and Ca03656-Csl genes annotated with cell wall modification might play a critical role to develop different bean shape patterns in Arabica. The ERECTA family genes Ca15802-ERL1, Ca99619-ERL2, Ca07439-ERL3, Ca97226-ERL4, Ca89747-ERL5, Ca07056-ERL6, Ca01141-ERL7, and Ca32419-ERL8 along lipid metabolic pathway genes Ca06708-ACOX1, Ca29177-ACOX2, Ca01563-ACOX3, Ca34321-CPFA1, and Ca36201-CPFA2 are predicted to regulate different shaped bean development. In addition, flavonoid biosynthesis correlated genes Ca03809-F3H, Ca95013-CYP75A1, and Ca42029-CYP75A2 probably help to generate rarely formed peaberry beans.

Conclusion

Our results provide molecular insights into the formation of peaberry. The data resources will be important to identify candidate genes correlated with the different bean shape patterns in Arabica.
Combining a machine-learning derived 4-lncRNA signature with AFP and TNM stages in predicting early recurrence of hepatocellular carcinoma
Authors: Fu Yi , Si Anfeng , Wei Xindong , Lin Xinjie , Ma Yujie , Qiu Huimin , Guo Zhinan , Pan Yong , Zhang Yiru , Kong Xiaoni , Li Shibo , Shi Yanjun , Wu Hailong
Published: February 2023

Background

Near 70% of hepatocellular carcinoma (HCC) recurrence is early recurrence within 2-year post surgery. Long non-coding RNAs (lncRNAs) are intensively involved in HCC progression and serve as biomarkers for HCC prognosis. The aim of this study is to construct a lncRNA-based signature for predicting HCC early recurrence.

Methods

Data of RNA expression and associated clinical information were accessed from The Cancer Genome Atlas Liver Hepatocellular Carcinoma (TCGA-LIHC) database. Recurrence associated differentially expressed lncRNAs (DELncs) were determined by three DEG methods and two survival analyses methods. DELncs involved in the signature were selected by three machine learning methods and multivariate Cox analysis. Additionally, the signature was validated in a cohort of HCC patients from an external source. In order to gain insight into the biological functions of this signature, gene sets enrichment analyses, immune infiltration analyses, as well as immune and drug therapy prediction analyses were conducted.

Results

A 4-lncRNA signature consisting of AC108463.1, AF131217.1, CMB9-22P13.1, TMCC1-AS1 was constructed. Patients in the high-risk group showed significantly higher early recurrence rate compared to those in the low-risk group. Combination of the signature, AFP and TNM further improved the early HCC recurrence predictive performance. Several molecular pathways and gene sets associated with HCC pathogenesis are enriched in the high-risk group. Antitumor immune cells, such as activated B cell, type 1 T helper cell, natural killer cell and effective memory CD8 T cell are enriched in patients with low-risk HCCs. HCC patients in the low- and high-risk group had differential sensitivities to various antitumor drugs. Finally, predictive performance of this signature was validated in an external cohort of patients with HCC.

Conclusion

Combined with TNM and AFP, the 4-lncRNA signature presents excellent predictability of HCC early recurrence.
The effect and safety of dexmedetomidine as an adjuvant to local anesthetics in erector spinae plane block: a systematic review and meta-analysis of randomized controlled trials
Authors: Yu Liang , Shen Xiaojuan , Liu He
Published: February 2023

Background

Dexmedetomidine (DEX) has been thought to be an effective adjuvant to local anesthetics (LAs) in erector spinae plane block (ESPB), however, this method of use is not recorded in the drug instructions. Hence, our meta-analysis will evaluate its efficacy and safety for the first time.

Methods

A systematic search of published articles was conducted in the PubMed, Embase, Web of science, and Cochrane Library databases up to July 17, 2022, using specific keywords related to our aims. The time first to request rescue analgesia, number of patient controlled intravenous analgesia (PCIA) presses, rate of rescue analgesia use, postoperative nausea and vomiting (PONV), arrhythmia, and hypotension were calculated by using random-effect models. This systematic review and meta-analysis was registered with PROSPERO (registration number: CRD42022345488).

Results

Numerous electronic databases were searched and finally 8 studies with a total of 570 patients, 303 in the DEX arm, 267 in the control arm were included. As an adjuvant to LAs, DEX significantly increased the time to first request of rescue analgesia (mean difference [MD] = 8.40, 95% confidence interval [CI] = 4.70–12.10, P < 0.00001), reduced the number of PCIA presses (MD = -4.12, 95% CI = -7.79 to -0.45, P = 0.03) and the rate of rescue analgesia (odds ratio [OR] = 0.33, 95% CI = 0.17–0.65, P = 0.002). Moreover, the combination reduced the risk of PONV (OR = 0.57, 95% CI = 0.36–0.91, P = 0.02). In addition, there was no difference in the incidence of hypotension (OR = 1.01, 95% CI = 0.37–2.74, P = 0.99) and arrhythmia (OR = 0.76, 95% CI = 0.19–3.07, P = 0.70).

Conclusion

DEX can reduce analgesic requirements after various surgical procedures when used as an adjuvant to LAs for ESPB. Moreover, there was no significant difference between the two groups in terms of safety indicators (arrhythmia, hypotension).
Family physicians’ responses to personal protective equipment shortages in four regions in Canada: a qualitative study
Authors: Mathews Maria , Ryan Dana , Hedden Lindsay , Lukewich Julia , Marshall Emily Gard , Asghari Shabnam , Terry Amanda Lee , Buote Richard , Meredith Leslie , Moritz Lauren , Spencer Sarah , Brown Judith B. , Christian Erin , Freeman Thomas R. , Gill Paul S. , Sibbald Shannon L. , Wong Eric
Published: February 2023

Background

Despite well-documented increased demands and shortages of personal protective equipment (PPE) during previous disease outbreaks, health systems in Canada were poorly prepared to meet the need for PPE during the COVID-19 pandemic. In the primary care sector, PPE shortages impacted the delivery of health services and contributed to increased workload, fear, and anxiety among primary care providers. This study examines family physicians’ (FPs) response to PPE shortages during the first year of the COVID-19 pandemic to inform future pandemic planning.

Methods

As part of a multiple case study, we conducted semi-structured qualitative interviews with FPs across four regions in Canada. During the interviews, FPs were asked to describe the pandemic-related roles they performed over different stages of the pandemic, facilitators and barriers they experienced in performing these roles, and potential roles they could have filled. Interviews were transcribed and a thematic analysis approach was employed to identify recurring themes. For the current study, we examined themes related to PPE.

Results

A total of 68 FPs were interviewed across the four regions. Four overarching themes were identified: 1) factors associated with good PPE access, 2) managing PPE shortages, 3) impact of PPE shortages on practice and providers, and 4) symbolism of PPE in primary care. There was a wide discrepancy in access to PPE both within and across regions, and integration with hospital or regional health authorities often resulted in better access than community-based practices. When PPE was limited, FPs described rationing and reusing these resources in an effort to conserve, which often resulted in anxiety and personal safety concerns. Many FPs expressed that PPE shortages had come to symbolize neglect and a lack of concern for the primary care sector in the pandemic response.

Conclusions

During the COVID-19 pandemic response, hospital-centric plans and a lack of prioritization for primary care led to shortages of PPE for family physicians. This study highlights the need to consider primary care in PPE conservation and allocation strategies and to examine the influence of the underlying organization of primary care on PPE distribution during the pandemic.
Predictors of outcome after endovascular treatment for tandem occlusions: a single center retrospective analysis
Authors: Enriquez Brian Anthony B. , Nome Terje , Nome Cecilie G. , Tennøe Bjørn , Lund Christian G. , Beyer Mona K. , Skjelland Mona , Aamodt Anne Hege
Published: February 2023

Background

The endovascular treatment procedure in tandem occlusions (TO) is complex compared to single occlusion (SO) and optimal management remains uncertain. The aim of this study was to identify clinical and procedural factors that may be associated to efficacy and safety in the management of TO and compare functional outcome in TO and SO stroke patients.

Methods

This is a retrospective single center study of medium (MeVO) and large vessel occlusion (LVO) of the anterior circulation. Clinical, imaging, and interventional data were analyzed to identify predictive factors for symptomatic intracranial hemorrhage (sICH) and functional outcome after endovascular treatment (EVT) in TO. Functional outcome in TO and SO patients was compared.

Results

Of 662 anterior circulation stroke patients with MeVO and LVO stroke, 90 (14%) had TO. Stenting was performed in 73 (81%) of TO patients. Stent thromboses occurred in 8 (11%) patients. Successful reperfusion with modified thrombolysis in cerebral infarction (mTICI) ≥ 2b was achieved in 82 (91%). SICH occurred in seven (8%). The strongest predictors for sICH were diabetes mellitus and number of stent retriever passes. Good functional clinical outcome (mRS ≤ 2) at 90-day follow up was similar in TO and SO patients (58% vs 59% respectively). General anesthesia (GA) was associated with good functional outcome whereas hemorrhage in the infarcted tissue, lower mTICI score and history of smoking were associated with poor outcome.

Conclusions

The risk of sICH was increased in patients with diabetes mellitus and those with extra stent-retriever attempts. Functional clinical outcomes in patients with TO were comparable to patients with SO.
Retraction Note: The effect of uterine artery ligation in patients with central placenta pevia: a randomized controlled trial
Authors: Sanad Ahmad Sameer , Mahran Ahmad E. , Aboulfotouh Mahmoud Elmorsi , Kamel Hany Hassan , Mohammed Hashem Fares , Bahaa Haitham A. , Elkateeb Reham R. , Abdelazim Alaa Gamal , El-Din Mohamed Ahmed Zeen , Shawki Hossam El-Din
Published: February 2023

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12884-018-1989-5.
Association between Nocturnal Sleep Duration and Insomnia symptoms with depressive symptoms among 44,900 Chinese Han adults aged 30–79 in Southwest China
Authors: Gao Yang , Tang Wenge , Mao Deqiang , Chen Liling , Ding Xianbin
Published: February 2023

Background

Although there are several cross-sectional and prospective studies on the relationship between sleep duration /insomnia symptoms and depression symptoms, the results of these studies are still not conclusive, and few studies have further analyzed the association between sleep duration and depressive symptoms in adults by gender and age. Thus, this study aimed to investigate the relationship between nocturnal sleep duration and insomnia symptoms with depression symptoms, and further examine whether the association was impacted by age and gender in a large-scale Han Chinese population in southwest China.

Methods

A cross-sectional study was performed that included 44,900 participants from 18 districts in southwest China from September 2018 to January 2019. The study comprised 42,242 individuals in the final analysis. Depressive symptoms were investigated using the PHQ-2 questionnaires. Multivariate logistic regression analysis was performed to investigate the relationship between nocturnal sleep duration and insomnia symptoms with depression symptoms as well as the influence of age and gender.

Results

After adjusting for multiple variables, those with nocturnal sleep duration < 7 h had a higher odds ratio for depression (OR:1.47, 95%CI 1.31–1.65) compared to participants whose nocturnal sleep duration was in the range of 7-8 h. Notably, there is a higher association in those aged below 45 years (OR:1.91, 95%CI 1.52–2.41) and in female participants (OR:1.57, 95%CI 1.35–1.82). However, nocturnal sleep duration longer than 9 h was not associated with depression symptoms in either the whole population analysis or the subgroup analysis. Insomniacs had a higher odds ratio for depression(OR:1.87, 95%CI 1.84–2.36, respectively) compared to non-insomniacs. There is a higher association in those aged 45–60 years (OR:2.23, 95%CI 1.82–2.73) and in female participants (OR:2.17, 95%CI 1.84–2.56). Further subgroup analysis by age and gender at the same time showed the association between sleep deprivation and depression was highest among women aged below 45 years, while the association between insomnia and depression was the highest among men aged 45–59 years.

Conclusion

Short nocturnal sleep duration and insomnia symptoms were positively associated with the risk of depressive symptoms among Chinese Han adults aged 30–79 in Southwest China, especially the middle-aged population and females should be more concerned.
Interrupting the intergenerational cycle of violence: protocol for a three-generational longitudinal mixed-methods study in South Africa (INTERRUPT_VIOLENCE)
Authors: Meinck Franziska , Woollett Nataly , Franchino-Olsen Hannabeth , Silima Mpho , Thurston Christina , Fouché Ansie , Monaisa Kopano , Christofides Nicola
Published: February 2023

Background

Violence is a global social and human rights issue with serious public health implications across the life-course. Interpersonal violence is transmitted across generations and there is an urgent need to understand the mechanisms of this transmission to identify and inform interventions and policies for prevention and response. We lack an evidence-base for understanding the underlying mechanisms of the intra- and intergenerational transmission of violence as well as potential for intervention, particularly in regions with high rates of interpersonal violence such as sub-Saharan Africa. The study has four aims: 1) to identify mechanisms of violence transmission across generations and by gender through quantitative and qualitative methods; 2) to examine the effect of multiple violence experience on health outcomes, victimisation and perpetration; 3) to investigate the effect of structural risk factors on violence transmission; and 4) to examine protective interventions and policies to reduce violence and improve health outcomes.

Methods

INTERRUPT_VIOLENCE is a mixed-methods three-generational longitudinal study. It builds on a two-wave existing cohort study of 1665 adolescents in South Africa interviewed in 2010/11 and 2011/12. For wave three and possible future waves, the original participants (now young adults), their oldest child (aged 6+), and their former primary caregiver will be recruited. Quantitative surveys will be carried out followed by qualitative in-depth interviews with a subset of 30 survey families. Adults will provide informed consent, while children will be invited to assent following adult consent for child participation. Stringent distress and referral protocols will be in place for the study. Triangulation will be used to deepen interpretation of findings. Qualitative data will be analysed thematically, quantitative data using advanced longitudinal modelling. Ethical approval was granted by the University of Edinburgh, University of the Witwatersrand, North-West University, and the Provincial Department of Health Mpumalanga. Results will be published in peer-reviewed journals, policy briefs, and at scientific meetings.

Discussion

The proposed study represents a major scientific advance in understanding the transmission and prevention of violence and associated health outcomes and will impact a critically important societal and public health challenge of our time.
Ethnic disparities in COVID-19 outcomes: a multinational cohort study of 20 million individuals from England and Canada
Authors: Zaccardi Francesco , Tan Pui San , Shah Baiju R. , Everett Karl , Clift Ash Kieran , Patone Martina , Saatci Defne , Coupland Carol , Griffin Simon J. , Khunti Kamlesh , Dambha-Miller Hajira , Hippisley-Cox Julia
Published: February 2023

Background

Heterogeneous studies have demonstrated ethnic inequalities in the risk of SARS-CoV-2 infection and adverse COVID-19 outcomes. This study evaluates the association between ethnicity and COVID-19 outcomes in two large population-based cohorts from England and Canada and investigates potential explanatory factors for ethnic patterning of severe outcomes.

Methods

We identified adults aged 18 to 99 years in the QResearch primary care (England) and Ontario (Canada) healthcare administrative population-based datasets (start of follow-up: 24th and 25th Jan 2020 in England and Canada, respectively; end of follow-up: 31st Oct and 30th Sept 2020, respectively). We harmonised the definitions and the design of two cohorts to investigate associations between ethnicity and COVID-19-related death, hospitalisation, and intensive care (ICU) admission, adjusted for confounders, and combined the estimates obtained from survival analyses. We calculated the ‘percentage of excess risk mediated’ by these risk factors in the QResearch cohort.

Results

There were 9.83 million adults in the QResearch cohort (11,597 deaths; 21,917 hospitalisations; 2932 ICU admissions) and 10.27 million adults in the Ontario cohort (951 deaths; 5132 hospitalisations; 1191 ICU admissions). Compared to the general population, pooled random-effects estimates showed that South Asian ethnicity was associated with an increased risk of COVID-19 death (hazard ratio: 1.63, 95% CI: 1.09-2.44), hospitalisation (1.53; 1.32-1.76), and ICU admission (1.67; 1.23-2.28). Associations with ethnic groups were consistent across levels of deprivation. In QResearch, sociodemographic, lifestyle, and clinical factors accounted for 42.9% (South Asian) and 39.4% (Black) of the excess risk of COVID-19 death.

Conclusion

International population-level analyses demonstrate clear ethnic inequalities in COVID-19 risks. Policymakers should be cognisant of the increased risks in some ethnic populations and design equitable health policy as the pandemic continues.