bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress shielding following stemless anatomic total shoulder arthroplasty
Authors: Aibinder William R , Uddin Fares , Bicknell Ryan T , Krupp Ryan , Scheibel Markus , Athwal George S
Published: November 2021

Background

Finite element analysis has suggested that stemless implants may theoretically decrease stress shielding. The purpose of this study was to assess the radiographic proximal humeral bone adaptations seen following stemless anatomic total shoulder arthroplasty.

Methods

A retrospective review of 152 prospectively followed stemless total shoulder arthroplasty utilizing a single implant design was performed. Anteroposterior and lateral radiographs were reviewed at standard time points. Stress shielding was graded as mild, moderate, and severe. The effect of stress shielding on clinical and functional outcomes was assessed. Also, the influence of subscapularis management on the occurrence of stress shielding was determined.

Results

At 2 years postoperatively, stress shielding was noted in 61 (41%) shoulders. A total of 11 (7%) shoulders demonstrated severe stress shielding with 6 occurring along the medial calcar. There was one instance of greater tuberosity resorption. At the final follow-up, no humeral implants were radiographically loose or migrated. There was no statistically significant difference in clinical and functional outcomes between shoulders with and without stress shielding. Patients undergoing a lesser tuberosity osteotomy had lower rates of stress shielding, which was statistically significant ( p = 0.021)

Discussion

Stress shielding does occur at higher rates than anticipated following stemless total shoulder arthroplasty, but was not associated with implant migration or failure at 2 years follow-up.

Level of evidence

IV, Case series.
The Use of Extreme Value Statistics to Characterize Blood Glucose Curves and Patient Level Risk Assessment of Patients With Type I Diabetes
Authors: Szigeti Mátyás , Ferenci Tamás , Kovács Levente
Published: November 2021

Objective:

Characterizing blood glucose curves and providing precise patient level risk assessment of hyperglycemia using extreme value statistics and comparing these assessments with traditional indicators of glycemic variability which are not designed to specifically capture the risk of hyperglycemia.

Research Design and Methods:

One year return level (blood glucose level exceeded exactly once every year on average) and probability of exceeding and expected time spent above certain thresholds (600 and 400 mg/dL) per year were calculated. As a comparison, traditional metrics for glycemic variability were determined too. The effect of body mass index on extremes was also investigated using non-stationary models. Metrics were calculated on a dataset containing 170.8 patient-years of measurements of 226 patients.

Results:

Nine high-risk patients were identified with the novel metrics: their estimated time spent above 600 mg/dL per year were above 2 hours. These patients were at moderate risk according to the traditional metrics. Higher body mass index was associated with more extreme glucose levels.

Conclusions:

Through these estimates it is possible to assess each patient’s individual clinical risk of hyperglycemia even beyond the observed blood glucose levels and detection limits. Additionally, it allows the assessment of the impact of clinical characteristics and treatments on blood glucose control in a novel, mathematically well-founded and potentially clinically more useful way than the already existing indicators.
Youth Political Talk in the Changing Media Environment: A Cross-National Typology
Authors: Kligler-Vilenchik Neta , Tenenboim-Weinblatt Keren , Boczkowski Pablo J. , Hayashi Kaori , Mitchelstein Eugenia , Villi Mikko
Published: November 2021

While political communication scholarship has long underscored the importance of political talk—casual conversations about news and politics that occur in everyday situations—as a way for citizens to clarify their opinions and as a precursor for political engagement, much of this literature tends to depict political talk as uncomfortable and difficult for citizens. Yet, this focus on the challenging aspects of political talk has been informed predominantly by the US context. To what extent may a different picture emerge when looking across different cultural contexts? And how are these dynamics shaped by the affordances of the multi-platform social media environment? This paper explores these questions through a unique dataset of 122 qualitative interviews conducted between 2016 and 2019 with young people (ages 18–29) from five countries: Argentina, Finland, Israel, Japan, and the United States. Rather than solidifying the avoidance of controversial political talk as the key strategy at the disposal of young people, our findings point at a five-pronged typology of young people, with each type representing a different approach toward political talk. Our typology thus contributes to a more comprehensive and nuanced picture of various approaches towards political talk employed by young people across different countries and in relation to different digital media affordances.
Social Media Use and Pathways to Protest Participation: Evidence From the 2019 Chilean Social Outburst
Authors: Scherman Andrés , Rivera Sebastian
Published: November 2021

In this article, we explore the relationship between social media use and participation in protests in Chile. In October 2019, Chile faced the most massive protests since the country’s return to democracy. Due to its magnitude, the media and analysts refer to this process as the “social outburst.” Although these protests engaged broad sectors of the population, most of the protesters were young people. Using a probabilistic and face-to-face survey applied to young people aged 18-29 years, we find that the only social media platform associated with participation in protests was Facebook. Our analysis also shows the importance of the specific activities that people engage in social media. Taking part in political activities on social media is strongly associated with attending protests but using social media platforms to get information or share common interests with other users is not. Furthermore, we examine whether social media has an indirect impact on participation through interpersonal conversation. The results show that Instagram—one of the most popular social media platforms among young Chileans—spurs interpersonal conversation, which in turn increases the likelihood of participating in protests. Our findings suggest that social media still plays a role in shaping people’s political behavior despite changes in the social media environment and in social media consumption patterns.
Does Delayed Retirement Crowd Out Workforce Welfare? Evidence in China
Authors: Hu Zhen , Yang James
Published: November 2021

Does delayed retirement crowd out the welfare of the workforce? To answer this question, a dynamic optimization framework is established to simulate the impact of delayed retirement on the welfare of the working population over time. Simulations are conducted based on practical and feasible parameters. Delayed retirement was found to improve the welfare of the working population rather than crowding it out. Furthermore, the results are robust against changes in parameters and modes of supporting elderly individuals. In terms of policymaking, it is suggested that such facts be shared with the public and that a delayed retirement plan be introduced as soon as possible to manage the pension and retirement wave caused by post-1960s baby boomers. However, to ensure that the delayed retirement plan does not lead to a reduction in the welfare of the working population, increases in fertility costs and the pension replacement rate should be appropriately controlled.
Exploring the Interplay of Trait Emotional Intelligence and ESL Teacher Effectiveness: Is Self-Efficacy the Mechanism Linking Them?
Authors: Anwar Rahila Huma , Zaki Sajida , Memon Natasha , Thurasamy Ramayah
Published: November 2021

This study investigated the influence of trait emotional intelligence (EI) and self-efficacy (SE) on English as a Second Language (ESL) teachers’ effectiveness (TE). The study also explored the mediating role of teacher self-efficacy in augmenting the relationship between trait EI and teacher effectiveness. We adopted a quantitative survey design involving both public and private sector higher education institutions (HEIs) of Pakistan. The participants ( N = 243 ESL teachers) were selected via convenience sampling. Data were analyzed using Partial Least Squares-Structural Equation Modelling (PLS-SEM) via SmartPLS3 software. Analysis through standard bootstrapping procedure resulted in direct and indirect (mediation analysis) path coefficients. Trait EI predicted ESL teachers’ effectiveness and self-efficacy. However, teacher self-efficacy was found to be more important as it revealed a larger effect on teacher effectiveness than trait EI and also mediated the relationship between trait EI and teacher effectiveness. The findings support previous research that positions emotional intelligence at the core of teaching effectiveness and has highlighted the predominant role that self-efficacy can play in strengthening this relationship. This study is significant as it underscored the importance of trait EI and self-efficacy in facilitating teacher effectiveness at the tertiary level. Implications and directions for future research are discussed.
Tapping into Leadership in Early Childhood Development Centers: Learning from the Lived Experiences of Principals in South African Townships
Authors: Blose Sibonelo , Muteweri Evelyn
Published: November 2021

Leadership is one of the critical drivers of educational institutions and has been overwhelmingly researched across countries. However, there is little with regards to early childhood development centers in the scholarship of educational leadership. South Africa has an assortment of early childhood development centers (ECD) ranging from fully registered and well-resourced centers in affluent areas to less regulated and poorly resourced community-based centers in townships, informal settlements and rural areas. In these centers, there are individuals performing a pivotal role of leading and managing the institutions. In this paper, we hone in on these individuals, specifically in a township setting, whom we refer to as ECD center principals. By means of narrative inquiry methodology, we solicited and interpreted the lived experiences of selected ECD center principals to garner an understanding of what it means to lead an ECD center in a township setting. The paper makes two broad contributions, namely, ECD center principals’ self-cognitions and their experiences of leading centers in townships.
The effect of coffee and whitening systems on surface roughness and gloss of CAD/CAM lithium disilicate glass cermaics
Authors: Al-Angari Sarah S. , Meaigel Shahad , Almayouf Nouf , Quwayhis Shahad , Aldahash Abdulelah , Al-Angari Nadia S.
Published: November 2021

Objectives:

To investigate the effects of a coffee beverage and two whitening systems on the surface roughness and gloss of glazed Lithium Disilicate Glass-Ceramics (LDGC) for computer-aided design/computer-aided manufacturing (CAD/CAM) systems.

Methods:

Sixty-eight LDGC disks (12 × 10 × 2 mm) were prepared from blocks of CAD/CAM systems (IPS e.max CAD ceramic). Baseline measurements for surface roughness (Ra) and gloss (GU) were taken using a 3-D optical profilometer and a glossmeter, respectively; then specimens were randomized into four groups ( n = 17). All specimens were immersed in a coffee solution (24 h × 12 days) then subjected to two whitening systems. G1-negative control (kept moist × 7 days); G2-positive control (brushed with distilled water, 200 g/load, 2 min twice daily × 7 days); G3-whitening toothpaste (Colgate optic white; relative dentin abrasivity (RDA) = 100, 200 g/load, 2 min twice daily × 7 days); and G4-simulated at-home bleaching protocol (Opalescence,15% carbamide peroxide (CP), 6 h/day × 7 days). The study outcomes were measured at baseline and after the treatments. Data were analyzed using paired T-test and one-way ANOVA (α = 0.05).

Results:

The mean surface roughness significantly increased ( p ⩽ 0.002) for all groups after the designated treatment protocols. Among groups, the mean surface roughness of G2 and G3 were significantly higher ( p ⩽ 0.001) (Ra: 0.51 and 0.57 μm, respectively) compared to the control group (Ra: 0.23 μm), and were not significantly different from G4 (Ra: 0.46 μm). Surface gloss decreased with no significant change within or among groups after treatment.

Conclusion:

All glazed LDGC had a significant increase in surface roughness after being subjected to simulated 1 year of coffee drinking and whitening systems (15% CP and whitening toothpaste), and the greatest change was associated with brushing (simulating 8 months). However, coffee beverages and whitening systems had no significant effect on the surface gloss.
Measurement of Collusion in Open Ascending Price Auctions in Agricultural Commodity Markets
Authors: Das Dipankar , Kapoor Sanjeev
Published: November 2021

This paper derives a method of measuring the degree of collusion among the bidders in an open ascending repetitive price auction in agricultural commodity markets in India. This paper first derives the bidders’ behaviour’s theoretical structure and then a measure of collusion formation. Finally, the degree of the cartel has been computed using time series wholesale price data of potato and onion crops. This research’s findings are helpful for the study of the link between the supply of the agriculture commodity and the degree of collusion. Using the proposed method in this research, if the Agricultural Produce Market Committee (APMC) measures cartel for each market and publish periodically, it will help farmers choose the right market to sell the produce. The farmers would select the market where the degree of collusion is relatively lower. Identifying different small cartel groups at different times with respective to the supply of the agriculture commodity would help avoid the incidence of distress selling by farmers, which is the main hindrance in developing the farming community in India.

JEL Classifications: C7,D44,L1,L4,Q1
Book review: Christoph Brumann and David Berliner (Eds.), World Heritage on the Ground: Ethnographic Perspectives
Authors: Peterson John Allen
Published: November 2021

Christoph Brumann and David Berliner (Eds.), World Heritage on the Ground: Ethnographic Perspectives, EASA Series (European Association of Social Anthropologists). New York: Berghahn Books, 2016, 336 pp., $135.00/£99.00. ISBN 978-1-78533-091-9.
Temporal Sequencing of Mental Health Symptom Severity and Suicidal Ideation in Post-9/11 Men and Women Veterans Who Recently Separated from the Military
Authors: Lawrence Karen A. , Vogt Dawne , Nigam Shawn , Dugan Adam J. , Slade Emily , Smith Brian N.
Published: November 2021

Background

Despite some evidence for gender differences in associations between military veterans’ mental health and suicidal ideation (SI), gender-specific prospective studies are lacking. The aims of this prospective study were to: (1) examine gender differences in veterans’ initial status and trajectories of mental health severity and SI status and (2) identify temporal sequencing of mental health predictors of SI.

Methods

Surveys of 1035 US veterans were administered at 3 time-points (T1, T2, T3) over a 7-year period following military separation, with an initial assessment within 2 years of military separation.

Results

Men reported higher baseline PTSD and alcohol misuse severity than women. No baseline gender difference in SI prevalence was detected. Baseline gender differences in mental health severity were maintained over time. For both men and women, remittance of SI was more likely from T1 to T2 than from T2 to T3 while chronic SI was more likely from T2 to T3. The strongest predictors of T3 SI were prior SI followed by alcohol misuse, depression, and PTSD severity with stronger effects for T2 predictors than T1.

Conclusion

The maintenance of baseline gender differences throughout trajectories of mental health predictors of SI supports the need for ongoing gender-specific mental health services. Current governmental interorganizational efforts are focused on suicide prevention during the first year after military service completion. Our findings indicate a need to extend mental health screening and treatment beyond the early post-military period to reduce risk and recurrence of SI for both men and women.
Lentiviral-Mediated Gene Therapy for the Treatment of Adenosine Deaminase 2 Deficiency
Authors: Mortellaro Alessandra , Zoccolillo Matteo , Mesa Nuñez Cristina , Brix Alessia , Brigida Immacolata , Barzaghi Federica , Scala Serena , Jofra Hernández Raisa , Basso-Ricci Luca , Colantuoni Mariasilvia , Cesaro Simone , Conti Francesca , Pession Andrea , Benedetti Fabio , Gattorno Marco , Naldini Luigi , Cicalese Maria Pia , Pistocchi Anna , Aiuti Alessandro
Published: November 2021

Adenosine deaminase 2 deficiency (DADA2) is a recently defined inborn error of immunity caused by loss-of-function mutations in the ADA2 gene. Patients suffer from severe manifestations, including early-onset lacunar strokes, intracranial hemorrhages, vasculitis/vasculopathy, systemic inflammation, immunodeficiency, and hematologic abnormalities. The therapeutic benefit of the current treatments is unsatisfactory. Anti-tumor necrosis factor therapy reduces strokes and systemic inflammation but does not correct cytopenia and bone marrow failure. Allogeneic hematopoietic stem/progenitor cell (HSPC) transplantation can ameliorate most disease manifestations, but patients are at risk for complications. Therefore, we proposed that autologous HSPC gene therapy may be an alternative curative option for patients who has no compatible donor or cannot receive intense chemotherapy.

We performed an in-depth study, using multiparametric flow cytometry, of the bone marrow (BM) cell composition of three adult patients with the hematological phenotype of DADA2. Compared with healthy donors (HDs), patients' BM exhibited a reduced number of mature and immature populations belonging to different hematopoietic lineages. Patients exhibited a substantial reduction in circulating neutrophils and hematopoietic stem cells and progenitor pools in the BM. Severe neutropenia and HSPC defects are direct causes of DADA2. Indeed, ADA2 knock-down in zebrafish - as rodents do not harbor an ADA2 orthologue gene - caused a significant decrease in neutrophil and HSPC numbers, reminiscent of patients' phenotype. Administration of human recombinant ADA2 effectively corrected both neutropenia and defective hematopoiesis in the zebrafish embryo.

We used a third-generation LV to restore constitutive ADA2 expression in HSPCs. Transduction of healthy donors' HSPCs allowed efficient delivery of the functional ADA2 enzyme with no toxicity. Supranormal ADA2 expression in healthy donors' and patients' HSPCs was well-tolerated and did not impact HSPC multilineage differentiation potential in vitro and in vivo. We also assessed whether LV-derived ADA2 could correct the hyperinflammatory M1 macrophage phenotype characteristic of DADA2. ADA2 reconstitution in patients' macrophages led to the normalization of IL-6 and TNF release. Similar results were obtained using M1 macrophages differentiated from ADA2-transduced HSPCs. Altogether, our findings indicate that HSPC gene therapy is a promising approach to re-establish stable ADA2 activity and correct the hematological and inflammatory manifestations in patients with DADA2.

Disclosures

Aiuti: Orchard Therapeutics: Other: PI of clinical trials sponsored by company.
Eye movement characteristics in male patients with deficit and non-deficit schizophrenia and their relationships with psychiatric symptoms and cognitive function
Authors: Zhang Lin , Zhang Xiangrong , Fang Xinyu , Zhou Chao , Wen Lu , Pan Xinming , Zhang Fuquan , Chen Jiu
Published: November 2021

Background

The cognitive impairment pattern of deficit schizophrenia (DS) is centered on an impaired attention function. Previous studies have suggested that the exploratory eye movement (EEM) tests reflect attention deficits in patients with schizophrenia. However, no study has investigated the characteristics of eye movement in DS in the Chinese Han population. This study aimed to investigate the pattern of eye movement characteristics in DS patients and to examine whether eye movement characteristic is associated with serious negative symptoms and cognitive decline in this schizophrenia subtype.

Methods

A total of 86 male patients [37 DS and 49 non-deficit schizophrenia (NDS)] and 80 healthy controls (HC) participated in this study. Clinical symptoms were assessed using the Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS). Cognitive function was assessed using the Mattis Dementia Rating Scale (MDRS-2). Eye movement data of subjects were collected using an eye movement tracking analyzer.

Results

There were significant differences in the overall eye movement data and cognitive test scores among the three groups (all P < 0.001). Both DS and NDS schizophrenia subgroups showed more severe eye movement and cognitive impairment compared with the control group. The number of eye fixations (NEF), total of eye scanning length (TESL), and cognitive function in DS patients were significantly lower than those in NDS patients. The discriminant analysis (D score) was higher than that of the control group (P < 0.001). In the DS group, the inattention factor of SANS was negatively correlated with the attention factor (r = − 0.545, P = 0.001) and structure factor of cognitive (r = − 0.389, P = 0.023), the affective flattening factor of SANS was negatively correlated with TESL (r = − 0.353, P = 0.041) and initiation/retention factor of cognitive (r = − 0.376,P = 0.028). TESL was found to positively correlate with the MDRS-2 total score (r = 0.427, P = 0.012), attention factor (r = 0.354, P = 0.040), and memory factor (r = 0.349, P = 0.043) in the DS group, whereas the mean of eye scanning length (MESL) positively correlated with cognitive impairments in the NDS group. The negative symptoms showed no significant correlation with cognition in the NDS group.

Conclusions

Total of eye scanning length may be a characteristic eye movement symptom in DS patients, which is associated with serious negative symptoms and cognitive impairment in this schizophrenia subtype.
Perfusion CT detects alterations in local cerebral flow of glioma related to IDH, MGMT and TERT status
Authors: Wang Ke , Li Yeming , Cheng Haiyang , Li Shenjie , Xiang Wei , Ming Yang , Chen Ligang , Zhou Jie
Published: November 2021

Background

The aim of this study was to investigate the relationship between tumor biology and values of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), time to peak (TTP), permeability surface (PS) of tumor in patients with glioma.

Methods

Forty-six patients with glioma were involved in the study. Histopathologic and molecular pathology diagnoses were obtained by tumor resection, and all patients accepted perfusion computed tomography (PCT) before operation. Regions of interests were placed manually at tumor and contralateral normal-appearing thalamus. The parameters of tumor were divided by those of contralateral normal-appearing thalamus to normalize at tumor (relative [r] CBV, rCBF, rMTT, rTTP, rPS). The relationships of the parameters, world health organization (WHO) grade, molecular pathological findings were analysed.

Results

The rCBV, rMTT and rPS of patients are positively related to the pathological classification (P < 0.05). The values of rCBV and rPS in IDH mutated patients were lower than those IDH wild-type. The values of rCBF in patients with MGMT methylation were lower than those MGMT unmethylation (P < 0.05). The MVD of TERT wild-type group was lower than TERT mutated group (P < 0.05). The values of rCBV were significant difference in the four molecular groups divided by the combined IDH/TERT classification (P < 0.05). The progression free survival (PFS) and overall survival (OS) were significant difference in the four molecular groups divided by the combined IDH/TERT classification (P < 0.05).

Conclusions

Our study introduces and supports the changes of glioma flow perfusion may be closely related to its biological characteristics.
A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania
Authors: Jeremiah Rohan D. , Patel Dhruvi R. , Chirwa Ellen , Kapito Esnath , Mei Xiaohan , McCreary Linda L. , Norr Kathleen F. , Liu Li , Patil Crystal L.
Published: November 2021

Background

HIV testing at antenatal care (ANC) is critical to achieving zero new infections in sub-Saharan Africa. Although most women are tested at ANC, they remain at risk for HIV exposure and transmission to their infant when their partners are not tested. This study evaluates how an HIV-enhanced and Centering-based group ANC model-Group ANC+ that uses interactive learning to practice partner communication is associated with improvements in partner HIV testing during pregnancy.

Methods

A randomized pilot study conducted in Malawi and Tanzania found multiple positive outcomes for pregnant women (n = 218) assigned to Group ANC+ versus individual ANC. This analysis adds previously unpublished results for two late pregnancy outcomes: communication with partner about three reproductive health topics (safer sex, HIV testing, and family planning) and partner HIV testing since the first antenatal care visit. Multivariate logistic regression models were used to assess the effect of type of ANC on partner communication and partner testing. We also conducted a mediation analysis to assess whether partner communication mediated the effect of type of care on partner HIV testing.

Results

Nearly 70% of women in Group ANC+ reported communicating about reproductive health with their partner, compared to 45% of women in individual ANC. After controlling for significant covariates, women in group ANC were twice as likely as those in individual ANC to report that their partner got an HIV test (OR 1.99; 95% CI: 1.08, 3.66). The positive effect of the Group ANC + model on partner HIV testing was fully mediated by increased partner communication.

Conclusions

HIV prevention was included in group ANC health promotion without compromising services and coverage of standard ANC topics, demonstrating that local high-priority health promotion needs can be integrated into ANC using a Group ANC+. These findings provide evidence that greater partner communication can promote healthy reproductive behaviors, including HIV prevention. Additional research is needed to understand the processes by which group ANC allowed women to discuss sensitive topics with partners and how these communications led to partner HIV testing.
Machine learning-based Radiomics analysis for differentiation degree and lymphatic node metastasis of extrahepatic cholangiocarcinoma
Authors: Tang Yong , Yang Chun Mei , Su Song , Wang Wei Jia , Fan Li Ping , Shu Jian
Published: November 2021

Background

Radiomics may provide more objective and accurate predictions for extrahepatic cholangiocarcinoma (ECC). In this study, we developed radiomics models based on magnetic resonance imaging (MRI) and machine learning to preoperatively predict differentiation degree (DD) and lymph node metastasis (LNM) of ECC.

Methods

A group of 100 patients diagnosed with ECC was included. The ECC status of all patients was confirmed by pathology. A total of 1200 radiomics features were extracted from axial T1 weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), and apparent diffusion coefficient (ADC) images. A systematical framework considering combinations of five feature selection methods and ten machine learning classification algorithms (classifiers) was developed and investigated. The predictive capabilities for DD and LNM were evaluated in terms of area under precision recall curve (AUPRC), area under the receiver operating characteristic (ROC) curve (AUC), negative predictive value (NPV), accuracy (ACC), sensitivity, and specificity. The prediction performance among models was statistically compared using DeLong test.

Results

For DD prediction, the feature selection method joint mutual information (JMI) and Bagging Classifier achieved the best performance (AUPRC = 0.65, AUC = 0.90 (95% CI 0.75–1.00), ACC = 0.85 (95% CI 0.69–1.00), sensitivity = 0.75 (95% CI 0.30–0.95), and specificity = 0.88 (95% CI 0.64–0.97)), and the radiomics signature was composed of 5 selected features. For LNM prediction, the feature selection method minimum redundancy maximum relevance and classifier eXtreme Gradient Boosting achieved the best performance (AUPRC = 0.95, AUC = 0.98 (95% CI 0.94–1.00), ACC = 0.90 (95% CI 0.77–1.00), sensitivity = 0.75 (95% CI 0.30–0.95), and specificity = 0.94 (95% CI 0.72–0.99)), and the radiomics signature was composed of 30 selected features. However, these two chosen models were not significantly different to other models of higher AUC values in DeLong test, though they were significantly different to most of all models.

Conclusion

MRI radiomics analysis based on machine learning demonstrated good predictive accuracies for DD and LNM of ECC. This shed new light on the noninvasive diagnosis of ECC.
Identification of a novel metabolism-related gene signature associated with the survival of bladder cancer
Authors: Li Xiaotao , Fu Shi , Huang Yinglong , Luan Ting , Wang Haifeng , Wang Jiansong
Published: November 2021

Background

Bladder cancer (BC) is one of the most common malignancies and has a relatively poor outcome worldwide. In this study, we attempted to construct a novel metabolism-related gene (MRG) signature for predicting the survival probability of BC patients.

Methods

First, differentially expressed MRGs between BC and normal samples were identified and used to construct a protein-protein interaction (PPI) network and perform mutation analysis. Next, univariate Cox regression analysis was utilized to select prognostic genes, and multivariate Cox regression analysis was applied to establish an MRG signature for predicting the survival probability of BC patients. Moreover, Kaplan-Meier (KM) survival analysis and receiver operating characteristic (ROC) analysis were performed to evaluate the predictive capability of the MRG signature. Finally, a nomogram based on the MRG signature was established to better predict the survival of BC.

Results

In the present study, 27 differentially expressed MRGs were identified, most of which presented mutations in BC patients, and LRP1 showed the highest mutation rate. Next, an MRG signature, including MAOB, FASN and LRP1, was established by using univariate and multivariate Cox regression analysis. Furthermore, survival analysis indicated that BC patients in the high-risk group had a dramatically lower survival probability than those in the low-risk group. Finally, Cox regression analysis showed that the risk score was an independent prognostic factor, and a nomogram integrating age, pathological tumor stage and risk score was established and presented good predictive ability.

Conclusion

We successfully constructed a novel MRG signature to predict the prognosis of BC patients, which might contribute to the clinical treatment of BC.
Burnout and job satisfaction of psychiatrists in China: a nationwide survey
Authors: Yao Hao , Wang Peicheng , Tang Yi-Lang , Liu Yuanli , Liu Tingfang , Liu Huanzhong , Chen Yanhua , Jiang Feng , Zhu Jiming
Published: November 2021

Background

Despite a significant shortage of psychiatrists in China, an ever-increasing number of psychiatrists in China are experiencing burnout and job dissatisfaction and considering leaving their jobs. Yet, to our knowledge, there have been no nationwide studies to date that examined both burnout and job dissatisfaction of psychiatrists in China. Therefore, this study evaluated burnout and job dissatisfaction of psychiatrists in China, and identified relevant characteristics.

Methods

We conducted a nationwide, cross-sectional survey in March 2019. Psychiatrists from all tertiary psychiatric hospitals in China were invited to participate. The Maslach Burnout Inventory-Human Service Survey and the short version of the Minnesota Satisfaction Questionnaire were used to measure burnout and job satisfaction. Data on socio-demographic and occupational characteristics were collected. Multivariate logistic regression was conducted to identify socio-demographic and occupational characteristics associated with burnout and job satisfaction.

Results

In total, 4520 psychiatrists from tertiary psychiatric hospitals in China completed the questionnaire. Overall, 38.4% of respondents met the criteria for burnout and 35.6% were dissatisfied with their jobs. Being male, more years of practice, having no leadership role, and longer working hours per week were significantly associated with burnout and job dissatisfaction. Lower monthly pay was significantly associated with job dissatisfaction but not burnout. Moreover, burnout was significantly associated with job dissatisfaction.

Conclusions

Our data suggest a high rate of burnout and job dissatisfaction among psychiatrists in China. In order to preserve and strengthen the mental health workforce, proactive measures are urgently needed to mitigate burnout and job dissatisfaction among psychiatrists in China.
Prevalence and risk factors of food insecurity among Libyan migrant families in Australia
Authors: Mansour Reima , John James Rufus , Liamputtong Pranee , Arora Amit
Published: November 2021

Background

The burden of food insecurity remains a public health challenge even in high income countries, such as Australia, and especially among culturally and linguistically diverse (CALD) communities. While research has been undertaken among several migrant communities in Australia, there is a knowledge gap about food security within some ethnic minorities such as migrants from the Middle East and North Africa (MENA). This study aims to determine the prevalence and correlates of food insecurity among Libyan migrant families in Australia.

Methods

A cross-sectional design utilising an online survey and convenience sampling was used to recruit 271 participants, each representing a family, who had migrated from Libya to Australia. Food security was measured using the single-item measure taken from the Australian Health Survey (AHS) and the 18-item measure from the United States Department of Agriculture Household Food Security Survey Module (USDA HFSSM). Multivariable logistic regression was used to identify independent correlates associated with food insecurity.

Results

Using the single-item measure, the prevalence of food insecurity was 13.7% whereas when the 18-item questionnaire was used, more than three out of five families (72.3%) reported being food insecure. In the multivariable logistic regression analysis for the single-item measure, those living alone or with others reported higher odds of being food insecure (AOR = 2.55, 95% CI 1.05, 6.21) compared to those living with their spouse, whereas higher annual income (≥AUD 40,000) was associated with lower odds of food insecurity (AOR = 0.30, 95% CI 0.11, 0.84). Higher annual income was also associated with lower odds of food insecurity (AOR = 0.49, 95% CI 0.25, 0.94) on the 18-item measure. On both single and 18-item measures, larger family size (AOR = 1.27, 95% CI 1.07, 1.49 and AOR = 1.21, 95% CI 1.01, 1.47 respectively) was associated with increased odds of food insecurity.

Conclusion

This study provides evidence that food insecurity amongst Libyan migrants in Australia is a widespread problem and is associated with a number of sociodemographic and socio-economic factors. The findings of this study serve to contribute to the depth and breadth of food security research among vulnerable communities, in this instance Libyan migrant families.
A full-factorial randomized controlled trial of adjunct couples HIV testing and counseling components addressing drug use and communication skills among sexual minority male couples
Authors: Starks Tyrel J. , D. Kyre Kory , B. Cowles Christine , Castiblanco Juan , Washington Catherine , N. Parker Jayelin , M. Kahle Erin , Stephenson Rob
Published: November 2021

Background

The past decade has seen increasing attention directed to the development of HIV prevention interventions for male couples, driven by epidemiological data indicating that main or primary – rather than causal – partnerships account for a substantial number of HIV infections in this population. Couples HIV testing and counseling (CHTC) has emerged as a standard of care in the US. This protocol describes a study that aims to evaluate the efficacy of two adjunct components to CHTC – communication training (CT) videos and a substance use module (SUM) – to reduce drug use and sexual HIV transmission risk behavior.

Methods

Eligible couples must include one participant who is aged 17-29, HIV-negative, and reports recent drug use. Both partners must be aged 17 or older, identify as cismale (assigned male sex at birth and currently identify as male gender), and communicate in English. Couples are randomized post-baseline to one of four conditions (CHTC as usual, CHTC plus CT video; CHTC + SUM and CHTC + CT video + SUM) in a full-factorial design. Follow up assessments are completed at 3-, 6-, 9- and 12-months post baseline.

Discussion

Results of this trial will enhance the application of CHTC. If found effective, adjunct components would comprise a brief and scalable drug use intervention that could be readily integrated into existing HIV testing settings.

Trial registration

ClinicalTrials.gov Protocol Registration; NCT05000866; completed August 3, 2021; https://register.clinicaltrials.gov/

Protocol version 1.0; September 1, 2021.
Cementation of a dual mobility cup in a well-fixed acetabular component- a reliable option in revision total hip arthroplasty?
Authors: Bellova Petri , Koch Fiona , Stiehler Maik , Hartmann Albrecht , Fritzsche Hagen , Günther Klaus-Peter , Goronzy Jens
Published: November 2021

Background

The “cup-in-cup” technique allows for revision of failed total hip arthroplasty (THA) when the cementless cup is well fixed. Furthermore, it can be used for liner wear or mechanical failure where liner replacement may be impossible or impractical. Recently, the “cup-in-cup” technique in combination with dual mobility cups (DMC) has drawn increased attention. Our aim was to report on the clinical and radiographic outcomes following this surgery.

Methods

From 2015 to 2020, 33 patients treated with the DMC- “cup in cup” technique were retrospectively reviewed. Fourteen patients had died while 19 were available for the final follow-up (FU), of which 15 underwent both a radiograph and a FU visit, 2 underwent a radiograph only and 2 underwent a telephone interview only. Patient-related outcome measures included the HHS and the WOMAC. Radiographs were assessed for implant loosening and positioning. Primary endpoint was revision of any cause and secondary endpoint was loosening of the DMC at the latest FU. The survival analysis was conducted using the Kaplan-Meier method.

Results

The mean age at surgery was 78.6 ± 7.1 (63–93) years and the mean surgery duration was 124.4 ± 52.0 (60–245) minutes. Recurrent dislocation (42.4%), periprosthetic fracture (39.4%) and polyethylene wear (6.1%) were the most frequent reasons for surgery. The mean FU duration (n = 19) was 28.5 ± 17.3 (3–64) months. The mean HHS score at FU was 59.4 ± 22.2 (29–91) and the mean WOMAC score was 59.7 ± 25.6 (15.6–93.8).

Two cups were revised due to instability and one revision was performed due to periprosthetic joint infection, accounting for an overall cup survival rate of 86.8% after a mean FU of 22.9 ± 18.0 (1.5–64.6) months. The survival rate free of loosening was 90.9% after a mean FU of 22.3 ± 18.5 (1.5–64.7) months.

Conclusions

We found that the cementation of a DMC in a well-fixed cup is a promising short- to mid-term treatment addressing THA instability especially in elderly and frail patients, who benefit from a reduced operation time. Proper cementation technique, adequate cup positioning as well as selection of a sufficiently large DMC are crucial for treatment success. Longer FUs will be needed in the future in order to further prove the benefit of this technique.
Correlation between parity and metabolic syndrome in Chinese women aged 40 years and older: the Reaction study
Authors: Xie Qian , Xu Haoran , Wan Qin
Published: November 2021

Aims

The purpose of the present study was to investigate the correlation between the number of live-birth pregnancies and metabolic syndrome (MetS) in Chinese women according to menstruation history.

Methods

Registry data for all pregnancies in a cohort of 6157 Chinese women aged 40 years or older were obtained and the number of live-birth pregnancies were enumerated. We defined MetS using five criteria: impaired insulin metabolism and glucose tolerance, obesity in the abdominal area, dyslipidemia, and hypertension. Multivariate logistic regression analysis was conducted to assess potential risk factors for MetS. Postmenopausal women with three or more of live-birth pregnancies had the highest prevalence of MetS (P < 0.05).

Results

Among the 6157 females aged 40 years or older in Luzhou city, 2143 (34.8%) participants had incident MetS. The number of live-birth pregnancies was significantly correlated with age and fasting blood glucose (FBG) level (P < 0.05). The prevalence of MetS increased with the number of live-birth pregnancies (P < 0.01), and the frequency in postmenopausal women was significantly higher than that in premenopausal women (P < 0.001). In the binary logistic regression model, menopausal status [OR = 0.343 (0.153–0.769), P < 0.001] were significantly associated with an increased risk of MetS.

Conclusions

The number of live-birth pregnancies is correlated with an increased risk of MetS in Chinese women aged 40 years and over, especially in postmenopausal women. Greater attention should be paid to postmenopausal women who have had multiple live-birth pregnancies with a view to intervening early to prevent related diseases.
Anti-inflammatory effect of lavender (Lavandula angustifolia Mill.) essential oil prepared during different plant phenophases on THP-1 macrophages
Authors: Pandur Edina , Balatinácz Alex , Micalizzi Giuseppe , Mondello Luigi , Horváth Adrienn , Sipos Katalin , Horváth Györgyi
Published: November 2021

Background

Pseudomonas aeruginosa is the most common Gram-negative bacterium associated with nosocomial respiratory infections. Lavender essential oil is mainly used in aromatherapy, but it has several pharmacological and therapeutic properties. Furthermore, it possesses antifungal and antibacterial activities. The anti-inflammatory activity of essential oils may depend on the composition and the ratio of the compounds. The constitution of the essential oils extracted from the different stages of flowering period varies, which makes it plausible that the collection time of the flowers influences the anti-inflammatory effects. Different types of essential oils reduce inflammation acting similarly by modulating the activity and action of the NFκB signalling pathway, which is the major regulator of the transcription of pro-inflammatory cytokines.

Methods

Lavender essential oils were distilled from lavender plant cultivated in Hungary and the flowers were harvested at the beginning and at the end of flowering period. The experiments were carried out on THP-1 human monocyte/macrophage cell line as in vitro cell culture model for monitoring the effects of lavender essential oils and the main compound linalool on P. aeruginosa LPS stimulated inflammation. The mRNA and protein levels of four pro-inflammatory cytokines, IL-6, IL-1β, IL-8 and TNFα were determined by Real Time PCR and ELISA measurements. The effects of essential oils were compared to the response to two NFκB inhibitors, luteolin and ACHP.

Results

Linalool and lavender essential oil extracted from plants at the beginning of flowering period were successful in decreasing pro-inflammatory cytokine production following LPS pretreatment. In case of IL-8 and IL-1β lavender oil showed stronger effect compared to linalool and both of them acted similarly to NFκB inhibitors. Pretreatments with linalool and lavender essential oil/beginning of flowering period prevented pro-inflammatory cytokine production compared to LPS treatment alone. Although lavender essential oil/end of flowering period decreased IL-6, IL-1β and IL-8 mRNA expression in case of LPS pretreatment, it was not capable to reduce cytokine secretion.

Conclusion

Based on our results it has been proven that lavender essential oil extracted at the beginning of flowering period is a potent inhibitor of the synthesis of four pro-inflammatory cytokines IL-6, IL-8, IL-β and TNFα of THP-1 cells. This supports the relevance of the collection of the lavender flowers from early blooming period for essential oil production and for the utilization as an anti-inflammatory treatment.
A systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure
Authors: Daw Paulina , Withers Thomas M. , van Zanten Jet J. C. S. Veldhuijzen , Harrison Alexander , Greaves Colin J.
Published: November 2021

Background

There is a longstanding research-to-practice gap in the delivery of cardiac rehabilitation for patients with heart failure. Despite adequate evidence confirming that comprehensive cardiac rehabilitation can improve quality of life and decrease morbidity and mortality in heart failure patients, only a fraction of eligible patients receives it. Many studies and reviews have identified patient-level barriers that might contribute to this disparity, yet little is known about provider- and system-level influences.

Methods

A systematic review using narrative synthesis. The aims of the systematic review were to a) determine provider- and system-level barriers and enablers that affect the delivery of cardiac rehabilitation for heart failure and b) juxtapose identified barriers with possible solutions reported in the literature. A comprehensive search strategy was applied to the MEDLINE, Embase, PsycINFO, CINAHL Plus, EThoS and ProQuest databases. Articles were included if they were empirical, peer-reviewed, conducted in any setting, using any study design and describing factors influencing the delivery of cardiac rehabilitation for heart failure patients. Data were synthesised using inductive thematic analysis and a triangulation protocol to identify convergence/contradiction between different data sources.

Results

Seven eligible studies were identified. Thematic analysis identified nine overarching categories of barriers and enablers which were classified into 24 and 26 themes respectively. The most prevalent categories were ‘the organisation of healthcare system’, ‘the organisation of cardiac rehabilitation programmes’, ‘healthcare professional’ factors and ‘guidelines’. The most frequent themes included ‘lack of resources: time, staff, facilities and equipment’ and ‘professional’s knowledge, awareness and attitude’.

Conclusions

Our systematic review identified a wide range of provider- and system-level barriers impacting the delivery of cardiac rehabilitation for heart failure, along with a range of potential solutions. This information may be useful for healthcare professionals to deliver, plan or commission cardiac rehabilitation services, as well as future research.