bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literature
Authors: Lee Anselm Chi-Wai , Chui Chan Hon , Kwok Robert , Lee Kim Shang , Fong Chee Meng , Wong Wilfred Hing-Sang
Published: April 2023

Introduction:

In Europe and North America, the majority of children with high-risk neuroblastoma survive the disease. Elsewhere, the treatment outcomes are poor.

Methods:

A retrospective review of children treated for high-risk neuroblastoma in a single institution in Singapore from 2007 to 2019 was carried out. Treatment consisted of intensive chemotherapy, surgery aimed at gross total resection of residual disease after chemotherapy, consolidation with high-dose therapy followed by autologous stem cell rescue, and radiotherapy to the primary and metastatic sites followed by maintenance treatment with either cis-retinoic acid or anti-disialoganglioside monoclonal antibody therapy. Survival data were examined on certain clinical and laboratory factors.

Results:

There were 57 children (32 male) treated for high-risk neuroblastoma. Their mean age was 3.9 (range 0.7–14.9) years. The median follow-up time was 5.5 (range 1.8–13.0) years for the surviving patients. There were 31 survivors, with 27 patients surviving in first remission, and the five-year overall survival and event-free survival rates were 52.5% and 47.4%, respectively. On log-rank testing, only the group of 17 patients who were exclusively treated at our centre had a survival advantage. Their five-year overall survival rate compared to patients whose initial chemotherapy was done elsewhere was 81.6% versus 41.1% (P = 0.011), and that of event-free survival was 69.7% versus 36.1% (P = 0.032). Published treatment results were obtained from four countries in Southeast Asia with five-year overall survival rates from 13.5% to 28.2%.

Conclusion:

Intensified medical and surgical treatment for high-risk neuroblastoma proved to be effective, with superior survival rates compared to previous data from Southeast Asia.
Style, Function, and Design Influence in Early Classical Western Greece
Authors: Pope Spencer
Published: April 2023

This paper discusses the development of monumental temple building in Sicily and Magna Graecia in the early Classical Period in terms of style and design in relation to cult and political structures. It is demonstrated that there was a coherent style that defined a moment of rapid construction in Western Greece in 480 B.C., and that the noteworthy building in Sicily eventually influenced mainland Greek architecture. This moment of intense construction is one result of the victory over the Carthaginians in the Battle at Himera, which ushered in an exuberant political environment driven by ambitious tyrants that revised the urban built environment and cult distribution in Sicily.
The Mouthpiece of the Aulos Revisited
Authors: Wysłucha Kamila , Hagel Stefan
Published: April 2023

The precise nature of the aulos mouthpiece, especially in the Classical period and before, has been disputed: above all, was it a single or a double reed? A definitive answer to this question has the greatest consequences for the nature of aulos music regarding not only timbre but more importantly control of dynamics, phrasing, and microtonal adjustments. From a survey of iconographical, literary and archaeological evidence, it is argued that the instruments of higher cultural esteem were universally equipped with double reeds. Single reeds were known as well, but are almost completely eclipsed in our sources.
Tuber melanorufum and T. tomentellum, two new truffle species from China
Authors: FU HAO-YU , FAN LI
Published: April 2023

Tuber melanorufum and T. tomentellum spp. nov. are described and illustrated in this paper based on the morphological and phylogenetic data. Tuber melanorufum is diagnosed by the red-brown to blackish ascomata covered with distinctly fine warts and the ellipsoid to long ellipsoid ascospores ornamented with very crowded spine-reticulations. Tuber tomentellum is characterized by the large ascospores and two types of hairs arising from the outer cells of the peridium. Phylogenetic analyses place T. melanorufum and T. tomentellum in the Rufum and Puberulum clades, respectively.
A revision and nomenclator of the Cainozoic mudwhelks (Mollusca: Caenogastropoda: Batillariidae, Potamididae) of the Paratethys Sea (Europe, Asia)
Authors: HARZHAUSER MATHIAS , GUZHOV ALEKSANDR , LANDAU BERNARD
Published: April 2023

We present an in-depth revision of the Batillariidae and Potamididae from the Oligocene to the Pliocene of the Paratethys Sea, covering a geographic area of about 3 million km2 and a temporal frame of 23 Ma. A strong focus of this paper is laid on the consideration of rare and little known literature describing especially faunas from areas of the Eastern Paratethys Sea. The whereabouts of type material was evaluated and lectotypes are defined wherever necessary to clarify the status of most of the available names. In total, we traced 236 species-level names, which have been proposed for Paratethyan Batillariidae and Potamididae. After critical revision, only 28 of these names are accepted herein as valid species. This means that about 90% of the names found in the literature represent junior synonyms or misidentifications. Despite the tendency of several species to form convergent morphologies, the development of early teleoconch whorls allows a clear separation at the genus level. The Paratethyan Batillariidae and Potamididae are placed herein into 10 genera, of which Pustulosia nov. gen. (Batillariidae) and Theodisca nov. gen. (Potamididae) are introduced as new genera. Tiaracerithium Sacco, 1895 and Tiarapirenella Sacco, 1895 are reestablished as valid genera, which have been largely ignored or incorrectly applied in the literature. The second part of this paper comprises an annotated nomenclator of all species-level names used for Paratethyan mudwhelks. This nomenclator provides information on type material, type locality, stratigraphy and geographic distribution.
How Do Different Processes Shape Temperature Probability Distributions? A Percentile-Averaged Temperature Tendency Decomposition
Authors: Quan Heng , Zhang Boer , Bourguet Stephen , Linz Marianna , Chen Gang
Published: April 2023

Studying temperature probability distributions and the physical processes that shape them is important for understanding extreme temperature events. Previous work has used a conditional mean temperature framework to reveal whether horizontal temperature advection drives temperature to extreme or median values at a specific location as a method to dynamically interpret temperature probability distributions. In this paper, we generalize this method to study how other processes shape temperature probability distributions and explore the diverse effects of horizontal temperature advection on temperature probability distributions at different locations and different temperature percentiles. We apply this generalized method to several representative regions to demonstrate its use. We find that temperature advection drives temperatures toward more extreme values over most land in the midlatitudes (i.e., cold air advection occurs during cold anomalies and warm air advection occurs during warm anomalies). In contrast, we find that horizontal temperature advection dampens temperature anomalies in some coastal summer monsoon regions, where extreme temperatures result from other processes, such as horizontal humidity advection and vertical temperature advection. By calculating the mean of processes conditioned on the temperature percentile, this method enables composite analysis of processes that contribute to events for all percentiles and a range of processes. We show examples of composites at different percentiles for certain processes and regions to illustrate the conditional mean analysis. This general approach may benefit future studies related to temperature probability distributions and extreme events.
Quality-related batch process monitoring based on multi-way orthogonal signal correction enhanced total principal component regression
Authors: Zhang Yan , Zhao Xiaoqiang , Hui Yongyong , Cao Jie
Published: April 2023

Batch process quality-related fault detection is necessary for keeping operation safety and quality consistency. However, the process variables have a weak ability to explain the quality variables makes the batch process quality-related fault detection a difficult task. In this work, a multi-way orthogonal signal correction enhanced total principal component regression (MOSC-ETPCR) is proposed to achieve the nonlinear quality-related fault detection of the batch process. First, after batch process data expansion, the orthogonal signal correction algorithm is used to filter out the quality-irrelevant information in process variables and avoid the influence of quality-irrelevant data on process modeling. Secondly, the nonlinear characteristics of the process are extracted by the maximum information coefficient matrix, and the quality-related nonlinear regression model is constructed to ensure the maximum correlation between the extracted features and quality variables. Thirdly, the statistics and corresponding control limits are established based on the obtained regression model. Finally, the effectiveness of the MOSC-ETPCR algorithm was verified by numerical simulation and the penicillin fermentation process.
How Social Roles Affect Sleep Health during Midlife
Authors: Frazier Cleothia , Brown Tyson H.
Published: April 2023

This study draws on role theory and the life course perspective to examine how sleep health (duration, quality, and latency) is shaped by social role accumulation (number of roles), role repertoires (role combinations), and role contexts among middle-aged adults. We also examine how the relationships between social roles and sleep health are gendered. We use data from the National Longitudinal Survey of Youth 1979 Cohort (N = 7,628). Results show that role accumulation is associated with less sleep and decreased insomnia symptoms, and that role repertoires also impact sleep (e.g., parenthood leads to diminished sleep quantity and quality). There is also evidence that contextual factors related to employment history, marital quality, and parenthood affect sleep health. Furthermore, results reveal that several of the relationships between social roles and sleep are gendered. Taken together, findings demonstrate the utility of examining links between multiple dimensions of social roles and sleep health.
Primary sphincter repair after fistulectomy: A simple and safe option for complex fistula-in-ano
Authors: Saraf M. , Thakur D. S. , Mahant R. , Verma A. , Somashekar U. , Sharma D.
Published: April 2023

Complete tract excision for complex fistula-in-ano, where the sphincter, is divided is increasingly being followed by immediate sphincter repair. We concluded, by a prospective study conducted on 60 consecutive patients, that this procedure is feasible and safe, and polydioxanone and polyglactin 910 in repair result in a comparable outcome.
Hierarchical coordinated control of multi-axle steering for heavy-duty vehicle based on tire lateral and longitudinal forces optimization
Authors: Du Heng , Zhu Xiaowei , Liu Qihui , Ren Tianyu , Wang Yunchao
Published: April 2023

Traditional multi-axle steering vehicle often adopts linear state feedback control, which is difficult to ensure high-precision trajectory tracking under all working conditions. Moreover, due to the failure to consider the optimal distribution of tire lateral and longitudinal forces, tires are prone to problems such as uneven load rates and wear. In this paper, considering the over-redundant and nonlinear characteristics of three-axle vehicle, a hierarchical coordinated control strategy is proposed. In the upper layer, the trajectory tracking controller is designed based on the robust nonlinear sliding mode control theory. In the middle layer, based on the optimization conditions of tire load rate and dissipative energy, the lateral and longitudinal forces optimal distribution controller is constructed under the constraint of friction circle. In the lower layer, the lateral and longitudinal forces are finally converted into tire angles and torques with the tire inverse model. The results show that the hierarchical coordinated control strategy can ensure that the multi-axle vehicle can achieve high-precision trajectory tracking under all-terrain load conditions, and the load rate and wear of each tire are relatively uniform. The coordinated control strategy proposed in this paper considers the influence of nonlinear characteristic of vehicle and tire lateral and longitudinal forces distribution on steering coordination, which can provide an important theoretical basis for the further improvement of steering coordination of multi-axle vehicle.
Hegel, History, Hostility: The Persistence of War in Hegel’s Political Philosophy
Authors: Clarkson Joseph
Published: April 2023

The return of war in Europe has renewed the urgency of understanding war’s role in the interstate system. Although many theorists take a progressive view in which war is withering away, others argue war remains a recurrent feature of political life. This article contributes to theoretical debates about war’s ongoing significance by systematically reconstructing Hegel’s theory of war and its relevance for understanding war’s persistence. Historically, Hegel thinks war has taken increasingly rational forms over time, though, contrary to optimistic interpretations, this points to enmity’s distillation rather than its elimination. Causally, Hegel suggests war occurs because the lack of a power above states capable of adjudicating conflicting rights and the consequent struggle to enforce one’s formally valid claims against those who could substantively deny them. Ethically, Hegel holds war is a necessary evil which, abstractly, ought to end. However, since war teaches citizens that their good is tied to the good of the community as a whole, thereby restraining civil society’s encroachments on the political, Hegel denies the end of war would be an absolute ethical good. By systematically reconstructing Hegel’s views on war, this article sheds new light on war’s role in the system of European states.
The role of evanescent modes in global-local analysis of ultrasonic guided waves in plates with varying local zone-scatterer relations
Authors: Spada Antonino , Zhang Mingyue , Lanza di Scalea Francesco , Capriotti Margherita
Published: April 2023

In order to provide a reliable and robust SHM performance, Ultrasonic Guided Waves (UGWs) need to be analyzed and understood. Numerical modeling of UGW propagation and scattering by hybrid methods offers the possibility of simulating UGW interaction with waveguides of arbitrary cross-sections and discontinuities. Maximizing the accuracy of such methods is important to perform quantitative SHM, while maintaining minimum computational cost. This work investigates the role of evanescent modes in the numerical analysis of UGWs in aluminum and composite plates with defects, by the hybrid Global-Local method. The complex solutions to the UGW eigenvalue problem are found and the scattering spectra for A0 and S0 incident modes are calculated. The accuracy of the numerical solution is then studied by computing the error in terms of energy balance.

Parametric studies with respect to the local zone size, defect dimensions and shape are conducted including and excluding evanescent modes in the analysis. Considerations are provided to obtain a solution with error no greater than 5%, in terms of varying local zone – scatterer relations within plate waveguides.
New insights in the multimodal imaging of retinitis pigmentosa
Authors: Berni Alessandro , Arrigo Alessandro , Bianco Lorenzo , Antropoli Alessio , Saladino Andrea , Mansour Ahmad M. , Vilela Manuel , Bandello Francesco , Parodi Maurizio Battaglia
Published: April 2023

Retinitis pigmentosa (RP) is a group of inherited rod-cone dystrophies, noted for a high genotypical and phenotypical heterogeneity.

Traditionally, VA, visual field, and electroretinography have been used to assess RP progression. However, visual acuity and visual field tests are essentially subjective and, especially in the late stages of the disease, are unable to confidently reveal minor progression. Therefore, there is a need for novel examination modalities that rely on quantitative, structural measurements. In this regard, several non-invasive imaging techniques have been studied, including spectral-domain optical coherence tomography, optical coherence tomography angiography, and fundus autofluorescence. By correlating surrogate biomarkers with functional measurements of the disease, these techniques may be able to develop reliable outcome meters that can be used to gain a deeper understanding of the underlying causes of the disease and to assess the effectiveness of therapy even before an actual loss of vision occurs.

In this review, we will summarize the recent imaging findings and biomarkers that have been identified in RP patients. Our goal is to provide information that can promptly aid in selecting patients for clinical trials and new gene therapies, monitoring the disease progression, and evaluating treatment outcomes.
Experiences with recruitment and retention of adolescents and emerging adults in a weight loss intervention trial
Authors: Horst Gilbert , Miller Hailey , Peeler Anna , Charleston Jeanne , Dell Thomas , Juraschek Stephen P , Brady Tammy M
Published: April 2023

Background/Aims:

Efficient and effective participant recruitment is key for successful clinical research. Adolescent and emerging adult recruitment into clinical trials can be particularly challenging, especially when targeting underrepresented groups. This study aimed to determine the most successful recruitment strategies from those employed during a pediatric trial testing the efficacy of a behavioral intervention on adiposity and cardiovascular disease risk.

Methods:

We determined the effectiveness, cost, and diversity of the final research population by each recruitment method utilized in the EMPower trial, a randomized clinical trial designed to test the effect of a technology-delivered behavioral Healthy Lifestyle intervention on adiposity, blood pressure, and left ventricular mass among adolescents and emerging adults with overweight or obesity. Effectiveness was determined by respondent yield (RY; number of respondents/number contacted), scheduled yield (SY; number scheduled for a baseline visit/number of respondents), enrollment yield (EY; number enrolled/number of respondents), and retention (number completed/number enrolled). Cost-effectiveness of each recruitment method was calculated and demographics of participants recruited via each method was determined.

Results:

A minimum of 109,314 adolescents and emerging adults were contacted by at least one recruitment method (clinic, web-based, postal mailing, electronic medical record (EMR) messaging) leading to 429 respondents. The most successful strategies in terms of RY were clinic-based recruitment (n = 47, 61% RY), community web-postings (n = 109, 5.33% RY), and EMR messaging (n = 163, 0.99% RY); however, website, postal mailings, and EMR recruitment led to more successful SY and EY. Postal mailings were the most costly strategy to employ (US$3261/completed participant) with EMR messaging the second most costly (US$69/completed participant). Community web-postings were free of charge. Clinic-based recruitment did not add additional costs, per se, but did require a substantial amount of personnel time (63.6 h/completed participant). Final cohort diversity primarily came from postal mailings (57% Black) and EMR messages (50% female).

Conclusion:

Electronic medical record messaging and web-based recruitment were highly successful and cost-effective strategies in a pediatric clinical trial targeting adolescents and emerging adults, but was less successful in recruiting a diverse cohort. Clinic recruitment and postal mailings, despite being costly and time-consuming, were the strategies that enrolled a greater proportion of underrepresented groups. While online forms of trial recruitment are growing in popularity, clinic-based recruitment and non-web-based strategies may be required to ensure participant diversity and representation.
Social representations on the environment and socio-metabolic regimes: The case of the Spanish state
Authors: Requena-i-Mora Marina
Published: April 2023

This article investigates the relationship between the socio-historical representation of the environment and socio-metabolic regimes in the case of the Spanish state. For this purpose, 70 interviews and three focus groups were conducted with different social actors. This qualitative study has been complemented by reconstructing per capita trends in the material footprint. The results show three differentiated regimes. First, before the 1960s, we found an era predominantly characterized by an agricultural economy, and the environment was understood as a source of livelihood. Material use was between 3 and 6 tons/capita/year. After the 1960s, economic modernization started, and natural resources were considered unlimited. The transition from an agrarian to an industrial socio-metabolic regime was inherently linked to a surge in material use per capita. In the 1980s, political modernization began, and the consumption of materials on average is currently between 14 and 27 tons/capita/year. However, when the material footprint has reached the highest amount, the environment is considered a product of economic growth and a post-material value. Post-materialism's historical and social specifics promote a social representation of the environment that hinges on separating lived practices from the environmental impacts these practices have produced. The resulting environmental concern may not benefit the environment. Conclusions highlight a need to rescue social representations of the environment that relate to the environmental impact of lifestyles.
High-performance Sustainable Work Practices for Corporate ESG Outcomes: Sustainable HRM Perspective
Authors: Makhecha Upam Pushpak , Mariappanadar Sugumar
Published: April 2023

Today, companies are inclined to contribute to sustainability by focusing on corporate sustainability (CS) strategies which lead to environment, social and governance (ESG) outcomes. In order to implement the CS strategies, companies have to design practices across domains such as finance, operations, marketing and human resources to facilitate the ESG outcomes. Using the sustainable HRM perspective, in this brief article, we introduce the role of high-performance sustainable work practices in implementing CS strategy to achieve ESG outcomes.
Symptoms Evaluation After Anti-Reflux Surgery—GI Perspective
Authors: Chandra Subhash , Reddymasu Savio
Published: April 2023

Gastrointestinal symptoms related to antireflux surgery are result of either an incompetent gastroesophageal valve, a supra-therapeutic valve or other complications of anti-reflux surgery such as decreased gastric accommodation, rapid gastric emptying, gastroparesis, paraesophageal hernia, or exacerbation of another undiagnosed motility disorder. Here, we reviewed a diagnostic approach for these symptoms which starts with detailed history and a tailored approach in use of diagnostic tests and empirical treatment to aid in diagnosis. In treatment for these symptoms, a conservative approach with lifestyle modifications should be employed first and repeat surgical procedure should be reserved as the last option. Of the emerging endoscopic therapies for symptoms refractory to medical therapy, gastric per-oral endoscopic myotomy is effective in improving gastric emptying and related symptoms.
E. urophylla × E. grandis high-quality genome and comparative genomics provide insights on evolution and diversification of eucalyptus
Authors: Shen Chao , Li Limei , Ouyang Lejun , Su Min , Guo Kexin
Published: April 2023

Background

Eucalyptus urophylla × Eucalyptus grandis, an economically important forest tree, provides important raw material for energy and reduces damage to native forests. However, the absence of a high-qualityE. urophylla × E. grandisreference genome has significantly hindered its evolution and genetic analysis.

Results

We successfully presented a high-quality reference genome ofE. urophylla × E. grandis(545.75 Mb; scaffold N50, 51.62 Mb) using a combination of the Illumina, PacBio HiFi, and Hi-C sequencing platforms. A total of 34,502 genes and 58.56% of the repetitive sequences in this genome were annotated. Using genome evolution analyses, we identified a recent whole-genome duplication (WGD) event inE. urophylla × E. grandis. We further found that gene families associated with starch and sucrose metabolism, flavonoid biosynthesis, and plant–pathogen interaction were significantly expanded inE. urophylla × E. grandis. Moreover, comparative genomic and evolutionary analyses showed large structural variations among the different chromosomes of the 34 Eucalyptus accessions, which were divided into six clades.

Conclusions

Overall, our findings provide a valuable resource for expanding our understanding of theE. urophylla × E. grandisgenome evolution, genetic improvement, and its comparative biology.
Identification of an individualized therapy prognostic signature for head and neck squamous cell carcinoma
Authors: Lin Cheng , Chen Yuebing , Pan Jianji , Lu Qiongjiao , Ji Pengjie , Lin Shuiqin , Liu Chunfeng , Lin Shaojun , Li Meifang , Zong Jingfeng
Published: April 2023

Background

Head and neck squamous cell carcinoma (HNSCC) are the most common cancers in the head and neck. Therapeutic response-related genes (TRRGs) are closely associated with carcinogenesis and prognosis in HNSCC. However, the clinical value and prognostic significance of TRRGs are still unclear. We aimed to construct a prognostic risk model to predict therapy response and prognosis in TRRGs-defined subgroups of HNSCC.

Methods

The multiomics data and clinical information of HNSCC patients were downloaded from The Cancer Genome Atlas (TCGA). The profile data GSE65858 and GSE67614 chip was downloaded from public functional genomics data Gene Expression Omnibus (GEO). Based on TCGA-HNSC database, patients were divided into a remission group and a non-remission group according to therapy response, and differentially expressed TRRGs between those two groups were screened. Using Cox regression analysis and Least absolute shrinkage and selection operator (LASSO) analysis, candidate TRRGs that can predict the prognosis of HNSCC were identified and used to construct a TRRGs-based signature and a prognostic nomogram.

Result

A total of 1896 differentially expressed TRRGs were screened, including 1530 upregulated genes and 366 downregulated genes. Then, 206 differently expressed TRRGs that was significantly associated with the survival were chosen using univariate Cox regression analysis. Finally, a total of 20 candidate TRRGs genes were identified by LASSO analysis to establish a signature for risk prediction, and the risk score of each patient was calculated. Patients were divided into a high-risk group (Risk-H) and a low-risk group (Risk-L) based on the risk score. Results showed that the Risk-L patients had better overall survival (OS) than Risk-H patients. Receiver operating characteristic (ROC) curve analysis revealed great predictive performance for 1-, 3-, and 5-year OS in TCGA-HNSC and GEO databases. Moreover, for patients treated with post-operative radiotherapy, Risk-L patients had longer OS and lower recurrence than Risk-H patients. The nomogram involves risk score and other clinical factors had good performance in predicting survival probability.

Conclusions

The proposed risk prognostic signature and Nomogram based on TRRGs are novel promising tools for predicting therapy response and overall survival in HNSCC patients.
Selenium uptake, translocation, subcellular distribution and speciation in winter wheat in response to phosphorus application combined with three types of selenium fertilizer
Authors: Hu Caixia , Nie Zhaojun , Shi Huazhong , Peng Hongyu , Li Guangxin , Liu Haiyang , Li Chang , Liu Hongen
Published: April 2023

Background

Selenium (Se) deficiency causes a series of health disorders in humans, and Se concentrations in the edible parts of crops can be improved by altering exogenous Se species. However, the uptake, transport, subcellular distribution and metabolism of selenite, selenate and SeMet (selenomethionine) under the influence of phosphorus (P) has not been well characterized.

Results

The results showed that increasing the P application rate enhanced photosynthesis and then increased the dry matter weight of shoots with selenite and SeMet treatment, and an appropriate amount of P combined with selenite treatment increased the dry matter weight of roots by enhancing root growth. With selenite treatment, increasing the P application rate significantly decreased the concentration and accumulation of Se in roots and shoots. P1 decreased the Se migration coefficient, which could be attributed to the inhibited distribution of Se in the root cell wall, but increased distribution of Se in the root soluble fraction, as well as the promoted proportion of SeMet and MeSeCys (Se-methyl-selenocysteine) in roots. With selenate treatment, P0.1 and P1 significantly increased the Se concentration and distribution in shoots and the Se migration coefficient, which could be attributed to the enhanced proportion of Se (IV) in roots but decreased proportion of SeMet in roots. With SeMet treatment, increasing the P application rate significantly decreased the Se concentration in shoots and roots but increased the proportion of SeCys2 (selenocystine) in roots.

Conclusion

Compared with selenate or SeMet treatment, treatment with an appropriate amount of P combined with selenite could promote plant growth, reduce Se uptake, alter Se subcellular distribution and speciation, and affect Se bioavailability in wheat.
Barotrauma in COVID-19 acute respiratory distress syndrome: retrospective analysis of the COVADIS prospective multicenter observational database
Authors: Serck Nicolas , Piagnerelli Michael , Augy Jean Loup , Annoni Filippo , Ottavy Gregoire , Courcelle Romain , Carbutti Giuseppe , Lejeune Francois , Vinsonneau Christophe , Sauneuf Bertrand , Lefebvre Laurent , Higny Julien , Grimaldi David , Lascarrou Jean-Baptiste
Published: April 2023

Background

Despite evidence suggesting a higher risk of barotrauma during COVID-19-related acute respiratory distress syndrome (ARDS) compared to ARDS due to other causes, data are limited about possible associations with patient characteristics, ventilation strategy, and survival.

Methods

This prospective observational multicenter study included consecutive patients with moderate-to-severe COVID-19 ARDS requiring invasive mechanical ventilation and managed at any of 12 centers in France and Belgium between March and December 2020. The primary objective was to determine whether barotrauma was associated with ICU mortality (censored on day 90), and the secondary objective was to identify factors associated with barotrauma.

Results

Of 586 patients, 48 (8.2%) experienced barotrauma, including 35 with pneumothorax, 23 with pneumomediastinum, 1 with pneumoperitoneum, and 6 with subcutaneous emphysema. Median time from mechanical ventilation initiation to barotrauma detection was 3 [0–17] days. All patients received protective ventilation and nearly half (23/48) were in volume-controlled mode. Barotrauma was associated with higher hospital mortality (P < 0.001) even after adjustment on age, sex, comorbidities, PaO2/FiO2 at intubation, plateau pressure at intubation, and center (P < 0.05). The group with barotrauma had a lower mean body mass index (28.6 ± 5.8 vs. 30.3 ± 5.9, P = 0.03) and a higher proportion of patients given corticosteroids (87.5% vs. 63.4%, P = 0.001).

Conclusion

Barotrauma during mechanical ventilation for COVID-19 ARDS was associated with higher hospital mortality.
Effect of anesthesia administration method on apgar scores of infants born to women undergoing elective cesarean section
Authors: Gwanzura Chipo , Gavi Samuel , Mangiza Marcia , Moyo Faith Vhenekai , Lohman Matthew C. , Nhemachena Taazadza , Chipato Tsungai
Published: April 2023

Background

Neonatal health at delivery as measured by apgar scores is an important outcome. This study was done to assess the impact of anesthesia on Apgar 1-minute and 5-minute scores of infants delivered through elective cesarean section in Zimbabwe.

Methods

We carried out a secondary analysis of data from the Efficacy of Tranexamic Acid in Preventing Postpartum Hemorrhage (ETAPPH) clinical trial in Zimbabwe. Outcomes measured were infant Apgar scores at 1 and 5 min, exposure was the administration of either a general (intravenous propofol/ketamine/sodium thiopental) or spinal (hyperbaric bupivacaine 0.5%) anesthesia for anesthesia during the elective cesarean section procedure. Marginal Structural Logistic Modelling (MSM) using an unstabilized Inverse Probability Treatment Weight (IPTW) estimator was used to assess the relationship between anesthetic administration method and infant Apgar scores.

Results

Four hundred and twenty-one (421) women who had an elective caesarean section in the ETAPPH study had their infants assessed for Apgar scores. Comparing general anesthesia to spinal anesthesia, spinal anesthesia was related to good Apgar scores at 1-minute (adjusted odds ratio [aOR] = 4.0, 95% Confidence Interval = 1.5–10.7, sensitivity analysis E-value = 3.41). Spinal anesthetic administration was also related to good Apgar scores at 5 min (adjusted odds ratio [aOR] = 6.2, 95% Confidence Interval = 1.6–23.1, sensitivity analysis E-value = 4.42).

Conclusions

When providing anesthesia for patients undergoing elective cesarean section, care should be taken on the method of administration of anesthetic agents. General anesthesia tends to depress Apgar scores at 1 min, although most neonates recover and have better scores at 5 min. Spinal anesthesia should be the first choice whenever possible.

Trial registration

The clinical trial from which data of this study was abstracted was registered under clinical trials registration number NCT04733157.
Characteristics, prognostic determinants of monocytes, macrophages and T cells in acute coronary syndrome: protocol for a multicenter, prospective cohort study
Authors: Lin Muzhi , Wang Bing , Wei Bo , Li Chao , Tu Lin , Zhu Xiaohan , Wu Zheyi , Huang Guangwei , Lu Xiyang , Xiong Guobao , Lu Shanglin , Yang Xinglin , Li Peng , Liu Xingde , Li Wei , Lu Yuming , Zhou Haiyan
Published: April 2023

Background

Acute coronary syndrome(ACS) is the leading cause of mortality and disability worldwide. Immune response has been confirmed to play a vital role in the occurrence and development of ACS. The objective of this prospective, multicenter, observational study is to define immune response and their relationship to the occurrence and progressive of ACS.

Methods

This is a multicenter, prospective, observational longitudinal cohort study. The primary outcome is the incidence of major adverse cardiovascular events (MACE) including in-stent restenosis, severe ventricular arrhythmia, heart failure, recurrent angina pectoris, and sudden cardiac death, and stroke one year later after ACS. Demographic characteristics, clinical data, treatments, and outcomes are collected by local investigators. Furthermore, freshly processed samples will be stained and assessed by flow cytometry. The expression of S100A4, CD47, SIRPα and Tim-3 on monocytes, macrophages and T cells in ACS patients were collected. Follow-up: during hospitalization, 3, 6 and 12 months after discharge.

Discussion

It is expected that this study will reveal the possible targets to improve the prognosis or prevent from occurrence of MACE in ACS patients. Since it’s a multicenter study, the enrollment rate of participants will be accelerated and it can ensure that the collected data are more symbolic and improve the richness and credibility of the test basis.

Ethics and dissemination

This study has been registered in Chinese Clinical Trial Registry Center. Ethical approval was obtained from the Affiliated Hospital of Guizhou Medical University. The dissemination will occur through the publication of articles in international peer-reviewed journals.

Trial Registration

Chinese Clinical Trial Registry: ChiCTR2200066382.
Comparison of valvuloplasty and replacement for surgical treatment of tricuspid infective endocarditis
Authors: Xie Linfeng , Chen Xiaodong , He Jian , Lin Sixian , Chen Xingfeng , Wu Qingsong , Chen Ling , Zhuang Jingxiang , Qiu Zhihuang , Chen Liangwan
Published: April 2023

Background

Owing to the increase in both intravenous drug injections and intracardiac and vascular interventional treatments among drug users, the incidence of infective endocarditis (IE) involving the tricuspid valve, which sits between the two right heart chambers, has gradually increased. This study aimed to compare the clinical outcomes of different surgical procedures for tricuspid infective endocarditis (TIE).

Methods

We retrospectively analyzed fifty-six patients who underwent tricuspid valve surgery at our hospital from January 2006 to August 2019. All patients were diagnosed with TIE and indicated a need for surgery. Perioperative and follow-up data were collected to summarize and analyze the clinical outcomes of different surgical approaches, including tricuspid valvuloplasty (TVP) and tricuspid valve replacement (TVR) for TIE.

Results

Cardiopulmonary bypass (CPB) time, aortic cross-clamp (ACC) time, postoperative mechanical ventilation time, and intensive care unit (ICU) stay time were shorter in the TVP group than in the TVR group. Additionally, the incidence of red blood cell transfusion and postoperative complications was lower in the TVP group than in the TVR group. The postoperative 30-day mortality rates were similar between both the groups. Fifty-two patients were followed up for an average of 5.50 ± 3.79 years. The postoperative 3-, 5-, and 7-year survival rates were 100%, 100%, and 95.5% in the TVP group and 96.7%, 96.7%, and 96.7% in the TVR group, respectively. The 5-year and 10-year reoperation rates were 0% and 0% in the TVP group and 6.7% and 20% in the TVR group, respectively.

Conclusion

Both TVR and TVP for TIE significantly improved the functional status of the heart with satisfactory efficacy. TVP was found to be superior to TVR in reducing the need for postoperative blood transfusions, reducing the risk of postoperative complications, and reducing the need for long-term reoperations.
An Australian aged care home for people subject to homelessness: health, wellbeing and cost–benefit
Authors: O’Connor Claire M. C. , Poulos Roslyn G. , Sharma Anurag , Preti Costanza , Reynolds Najwa L. , Rowlands Allison C. , Flakelar Kyall , Raguz Angela , Valpiani Peter , Faux Steven G. , Boyer Michael , Close Jacqueline C. T. , Gupta Leena , Poulos Christopher J.
Published: April 2023

Background

Older people subject to homelessness face many challenges including poor health status, geriatric syndromes, and depression, coupled with barriers in accessing health and aged care services. Many are in need of formal aged care at a younger age than the general population, yet, in Australia, specialised aged-care services to support this vulnerable cohort are limited.

Methods

This study was an evaluation of a new purpose-built aged care home for people with high care needs and who are homeless or at risk of homelessness. Over the first 12 months post-admission, the study examined: (1) changes in residents’ physical, mental, psychological and social health, and (2) the costs incurred by the study cohort, including any cost benefit derived.

Results

Thirty-five residents enrolled in the study between March 2020 – April 2021. At admission, almost half of residents were within the range for dementia, the majority were frail, at high risk for falls, and had scores indicative of depression. Over time, linear mixed-effect models showed significant improvement in personal wellbeing scores, with clinically significant improvements in overall health related quality of life. Levels of physical functional independence, frailty, and global cognition were stable, but cognitive functional ability declined over time. Comparison of 12 month pre- and post- admission cost utility data for a smaller cohort (n = 13) for whom complete data were available, suggested an average per resident saving of approximately AU$32,000, while the QALY indicators remained stable post-admission.

Conclusion

While this was a small study with no control group, these preliminary positive outcomes add to the growing body of evidence that supports the need for dedicated services to support older people subject to homelessness.
Maternal pre-pregnancy BMI, MTHFR polymorphisms, and the risk of adverse pregnancy outcomes in pregnant women from South China: a retrospective cohort study
Authors: Gu Chunming , Wu Weixiang , Lai Kefeng , Li Huan , Wu Lihong , Lu Weiming , Ruan Xiaolin , Luo Mingyong
Published: April 2023

Background

Increasing evidence suggests an association between maternal pre-pregnancy body mass index (pre-BMI) and adverse pregnancy outcomes. However, the effects of methylenetetrahydrofolate reductase (MTHFR) polymorphisms on these relationships require further investigation. This study aimed to investigate whether the relationship between pre-BMI and the risk of adverse pregnancy outcomes was influenced byMTHFRgene polymorphisms.

Methods

A total of 5614 mother-fetus pairs were included in the study. The odds ratios (OR) of adverse pregnancy complications, including gestational diabetes mellitus (GDM), gestational hypertension (GHT), cesarean delivery (CS), and premature rupture of membranes (PROM), were estimated using adjusted logistic regression models and subgroup analysis.

Results

Pregnant women with higher pre-BMI values were positively related to the risk of GDM, GHT, and CS. In the subgroup analysis, underweight BMI was associated with a decreased risk of CS and GDM in pregnant women with theMTHFRA1298C AA or C677T CC genotype, while overweight/obese BMI was associated with an increased risk of GDM and CS in differentMTHFRvariants. Moreover, pregnant women withMTHFRA1298C AC + CC or C667T CC were found to have an increased risk of GHT in theMTHFRA1298C AA or C667T CT + TT genotype. A remarkable association was observed between the obesity group withMTHFRA1298C AC + CC (OR = 6.49, CI: 2.67–15.79) and the overweight group with the C667T CC genotype (OR = 4.72, CI: 2.13–10.45).

Conclusions

MTHFRgene polymorphisms exert a modifying effect on the association between maternal pre-BMI and the risk of GHT, CS, and GDM. Pregnant women with a high pre-BMI with specificMTHFRgenotypes should be considered for GHT development.
A case report of interstitial keratitis and secondary glaucoma after cataract surgery that may be related to late congenital syphilis
Authors: Li Xingying , Zhou Yu , Ma Huafeng , Wu Mingxing
Published: April 2023

Background

The destruction of blood eye barrier and the administration of corticosteroid eyedrops after phacoemulsification surgery can lead to the replication of the local potential pathogens. With the rapid increase and popularization of cataract surgery, all kinds of rare postoperative complications have appeared. Here, we report a case of interstitial keratitis and secondary glaucoma after cataract surgery, which may be related to late congenital syphilis, which eventually led to blindness in the right eye. We hope that the timely report of this case will enable doctors to pay more attention to the possibility of potential pathogen replication after cataract surgery, and enable more patients to receive reasonable and effective treatment.

Case presentation

A 63-year-old female was referred to our clinic for investigation with a 1-week history of moderate pain in the right eye and ipsilateral headache in January 2020. She had cataract surgery on her right eye two years ago and on her left eye one year ago. The intraocular pressure (IOP) in the right eye was 43.2 mmHg and that in the left eye was 28.5 mmHg. Her right eye underwent medication, trabeculectomy and finally was subjected to ciliary body photocoagulation to control the IOP. The IOP of the left eye was well controlled by regular use of eye drops. In addition to the elevated IOP, the inflammation of the anterior segment and corneal stroma was found. Before cataract surgery, bilateral corneal opacities was revealed, but after cataract surgery, interstitial keratitis in both eyes was gradually aggravated, during the follow-up period from 2019 to 2021. She informed us that she had suffered from decreased vision in both eyes and was diagnosed with bilateral keratitis and congenital syphilis at the age of 20. In 2018, the serologic test for syphilis was positive in blood (Chemiluminescence analysis (CLIA): + ; Toluidine red unheated serum test (TRUST): + , titer was 1:1). However, four tests for TRUST were negative in 2019 and 2020, so she was not treated for syphilis.

Conclusion

This case of glaucoma and interstitial keratitis might be secondary to ocular inflammation caused by late congenital syphilis. The ocular inflammation and the activation of syphilis may be related to cataract surgery.
Prevalence and risk factors of keratoconus (including oxidative stress biomarkers) in a cohort study of Shiraz university of medical science employees in Iran
Authors: Mohaghegh Sahar , Kangari Haleh , Masoumi Seyed Jalil , Bamdad Shahram , Rahmani Saeed , Abdi Saeed , Fazil Nagham , Shahbazi Saeedeh
Published: April 2023

Background

To determine the prevalence of keratoconus in Shiraz University of Medical Sciences Employees and the related risk factors including oxidative stress biomarkers.

Methods

2546 subjects’ mean age ± SD, 40.35 ± 6.70 (46% male) were recruited. All participants underwent objective refraction using auto-refractometer and retinoscopy, followed by subjective refraction, and bio-microscopy. Pentacam imaging was performed for the detected keratoconus patients. The prevalence of keratoconus and frequency of the visual impairment among keratoconus cases were evaluated. Potential risk factors of sex, age, family history of keratoconus, body mass index ≥ 30 kg/m2, serum levels of glucose ≥ 100 mg/d, low-density-lipoprotein-cholesterol (LDL) ≥ 110 mg/dL, high-density-lipoprotein-cholesterol ≤ 40 mg/d, and triglycerides ≥ 150 mg/dL in the blood were evaluated.

Results

The prevalence of keratoconus at least in one eye was 0.98% (95% CI: 0.6- 1.4%). The best corrected visual acuity in the keratoconus group was 0.06 ± 0.1 and the rest of the population was 0.01 ± 0.07 logMAR (p < 0.001). The frequency of visual impairment in the keratoconus group was zero. Odds ratios of the family history of keratoconus (21.00, 95% CI: 9.00–48.00, p < 0.001) and LDL ≥ 110 mg/dL (3.00, 95% CI: 1.20–6.40, p = 0.01) were significant.

Conclusions

Keratoconus is rare and is not considered a risk factor for visual impairment. A family history of keratoconus and elevated serum LDL levels are contributing risk factors, suggesting an inflammatory background for the disease. Serum levels of LDL ≥ 110 mg/dL in the blood increased the risk of keratoconus three folds.