bluuebunny/crossref_metadata_2025 huggingface dataset:
Triglyceride-glucose index linked to all-cause mortality in critically ill patients: a cohort of 3026 patients
Authors: Liao Ying , Zhang Rongting , Shi Shanshan , Zhao Yukun , He Yibo , Liao Lihua , Lin Xueqin , Guo Qian , Wang Yani , Chen Liling , Li Weiguo , Li Shihai , Chen Kaihong , Fang Yong
Published: July 2022

Background

Triglyceride-glucose (TyG) index as a reliable surrogate of insulin resistance (IR) has been shown to be related to adverse clinical outcomes in patients with acute coronary syndrome, heart failure, ischemic stroke and so on. However, the relationship between TyG index and all-cause mortality in intensive care unit (ICU) patients remains unknown. The purpose of this study was to investigate the correlation between TyG index and all-cause mortality to evaluate the impact of IR on the prognosis of this population.

Methods

This was a retrospective observational study that included 3026 patients who had an initial triglyceride and glucose data on the first day of ICU admission, and all data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. These patients were grouped into quartiles (Q1–Q4) according to TyG index. The Kaplan–Meier analysis was used to compare all-cause mortality among the above four groups. Cox proportional hazards analyses were performed to examine the association between TyG index and all-cause mortality.

Results

During 10.46 years of follow-up, 1148 (37.9%) patients died, of which 350 (11.6%) occurred during the hospital stay and 258 (8.5%) occurred during the ICU stay. Kaplan–Meier analysis showed that the risk of all-cause mortality was significantly higher in patients with higher TyG index (log-rank P = 0.021). Multivariable Cox proportional hazards analyses showed that the TyG index was an independent risk predictor of ICU death (HR: 1.72, 95% CI 1.18–2.52, P = 0.005) and hospital death (HR: 2.19, 95% CI 1.59–3.03, P < 0.001), and each 1-unit increased in the TyG index, a 1.19-fold increase in the risk of death during the hospital stay.

Conclusions

TyG index is strongly related to the all-cause mortality increasing in critically ill patients. This finding indicates that the TyG index might be useful in identifying people at high risk of ICU death and hospital death.
“Raising the curtain on the equality theatre”: a study of recruitment to first healthcare job post-qualification in the UK National Health Service
Authors: Hammond John , Davies Nigel , Morrow Elizabeth , Ross Fiona , Vandrevala Tushna , Harris Ruth
Published: July 2022

Background

UK equality law and National Health Service (NHS) policy requires racial equality in job appointments and career opportunities. However, recent national workforce race equality standard (WRES) data show that nearly all NHS organisations in the UK are failing to appoint ethnically diverse candidates with equivalent training and qualifications as their white counterparts. This is problematic because workforce diversity is associated with improved patient outcomes and other benefits for staff and organisations.

Aim

To better understand the reasons behind underrepresentation of ethnically diverse candidates in first NHS healthcare jobs post-qualification and to identify any structural or systemic barriers to employment for such groups.

Methods

The study was informed by critical theory and the authors’ interdisciplinary perspectives as educators and researchers in the healthcare professions. Data collected from semi-structured face-to-face interviews with 12 nurse and physiotherapy recruiting managers from two NHS trusts in London were analysed using a healthcare workforce equity and diversity conceptual lens we developed from the literature. Using this lens, we devised questions to examine six dimensions of equity and diversity in the interview data from recruiting managers.

Results

Recruiting managers said they valued the benefits of an ethnically diverse workforce for patients and their unit/organisation. However, their adherence to organisational policies for recruitment and selection, which emphasise objectivity and standardisation, acted as constraints to recognising ethnicity as an important issue in recruitment and workforce diversity. Some recruiting managers sense that there are barriers for ethnically diverse candidates but lacked information about workforce diversity, systems for monitoring recruitment, or ways to engage with staff or candidates to talk about these issues. Without this information there was no apparent problem or reason to try alternative approaches.

Conclusion

These accounts from 12 recruiting managers give a ‘backstage’ view into the reasons behind ethnic inequalities in recruitment to first healthcare job in the UK NHS. Adherence to recruitment and selection policies, which aim to support equality through standardisation and anonymisation, appear to be limiting workforce diversity and creating barriers for ethnically diverse candidates to attain the jobs that they are trained and qualified for. The Healthcare Workforce Equity + Diversity Lens we have developed can help to ‘raise the curtain on the equality theatre’ and inform more inclusive approaches to recruitment such as contextualised recruitment or effective allyship between employers and universities.
Accessing Antenatal Care (ANC) services during the COVID-19 first wave: insights into decision-making in rural India
Authors: Bankar Shweta , Ghosh Deepika
Published: July 2022

Background

Antenatal care (ANC) services are a prime focus of the Government of India's National Health Mission (NHM), of which a key pillar is the promotion of maternal and child health. To ensure uninterrupted service delivery at the last mile, a cadre of Frontline Health Workers (FLHWs) has been appointed and health centres established at the village level. However, the onset of the COVID-19 pandemic and the nationwide lockdown from late March to June 2020 impacted pregnant women's access to institutional antenatal care services.

Methods

Using a qualitative research design, data was collected through 12 in-depth interviews (IDIs) with pregnant women and 17 IDIs with frontline health workers in the selected six districts under study. The narratives were analysed using inductive coding in Atlas.ti.

Results

During the first wave of the COVID-19 pandemic, pregnant women, most of whom belonged to poor and marginalised groups, were left with limited access to health centres and FLHWs. Respondents from the study areas of rural Jharkhand, Madhya Pradesh and Uttar Pradesh extensively reported concerns stemming from the lockdown that influenced their decision to access ANC services. These included anxieties around meeting their families' daily needs due to a loss of livelihood (in particular, abject food insecurity), inability to access healthcare, and a sense of mistrust in public health systems and functionaries. All of these, coupled with the real threat to health posed by COVID-19, disrupted their plans for pregnancy and delivery, further compunding the risk to their health and wellbeing.

Conclusion

This study identified several social, behavioural and structural facets of the communities that contributed to the confusion, anxiety and helplessness experienced during the COVID-19 first wave by both groups, viz. pregnant women and FLHWs. In planning and implementing initiaves to ensure the delivery and uptake of ANC services in this and similar contexts during times of crisis, these facets must be considered.
Disrespect and abuse during labour and birth amongst 12,239 women in the Netherlands: a national survey
Authors: van der Pijl Marit S. G. , Verhoeven Corine J. M. , Verweij Rachel , van der Linden Tineke , Kingma Elselijn , Hollander Martine H. , de Jonge Ank
Published: July 2022

Background

Women experience disrespect and abuse during labour and birth all over the world. While the gravity of many forms of disrespect and abuse is evident, some of its more subtle forms may not always be experienced as upsetting by women. This study examines (1) how often women experience disrespect and abuse during labour and birth in the Netherlands and (2) how frequently they consider such experiences upsetting. We also examine (3) which respondent characteristics (age, ethnicity, educational level and parity) are associated with those experiences of disrespect and abuse that are upsetting, and (4) the associations between upsetting experiences of disrespect and abuse, and women’s labour and birth experiences.

Methods

Women who gave birth up to five years ago were recruited through social media platforms to participate in an online survey. The survey consisted of 37 questions about experiences of disrespect and abuse divided into seven categories, dichotomised in (1) not experienced, or experienced but not considered upsetting (2) experienced and considered upsetting. A multivariable logistic regression analysis was performed to examine associated characteristics with upsetting experiences of disrespect and abuse. A Chi-square test was used to investigate the association between upsetting experiences of disrespect and abuse and overall birth experience.

Results

13,359 respondents started the questionnaire, of whom 12,239 met the inclusion and exclusion criteria. Disrespect and abuse in terms of ‘lack of choices’ (39.8%) was reported most, followed by ‘lack of communication’ (29.9%), ‘lack of support’ (21.3%) and ‘harsh or rough treatment/physical violence’ (21.1%). Large variation was found in how frequently certain types of disrespect and abuse were considered upsetting, with 36.3% of women experiencing at least one situation of disrespect and abuse as upsetting. Primiparity and a migrant background were risk factors for experiencing upsetting disrespect and abuse in all categories. Experiencing more categories of upsetting disrespect and abuse was found to be associated with a more negative birth experience.

Conclusions

Disrespectful and abusive experiences during labour and birth are reported regularly in the Netherlands, and are often (but not always) experienced as upsetting. This emphasizes an urgent need to implement respectful maternity care, even in high income countries.
Axenfeld–Rieger syndrome: orthopedic and orthodontic management in a pediatric patient: a case report
Authors: Cazzolla Angela Pia , Testa Nunzio Francesco , Spirito Francesca , Di Cosola Michele , Campobasso Alessandra , Crincoli Vito , Ballini Andrea , Cantore Stefania , Ciavarella Domenico , Lo Muzio Lorenzo , Dioguardi Mario
Published: July 2022

Axenfeld–Rieger Syndrome (ARS) is a rare autosomal dominant genetic disease with considerable expressive variability, characterized by ocular and non-ocular manifestations, cardiovascular, mild craniofacial abnormalities and dental malformations. Current data report an incidence of Xenfeld-Rieger syndrome in the population of 1: 200,000.

The case described is that of a 14-year-old female patient whose ARS is suspected and investigated following a dental specialist visit for orthodontic reasons, acquired the patient’s family and clinical data following a medical approach multidisciplinary, we proceed to the orthodontic involved the use of the Rapid Palatal Expander (RPE) and a fixed orthodontic treatment.

The aim of this study is to report the case of the orthopaedic and orthodontic treatment in a patient affected by ARS and with facial dysmorphism and teeth anomalies associated to ocular anomalies.
Cord blood antimicrobial peptide LL37 levels in preterm neonates and association with preterm complications
Authors: Ren Zhuxiao , Mo Wenhui , Yang Liling , Wang Jianlan , Zhang Qi , Zhong Zhicheng , Wei Wei , Liu Zhipeng , Wu Zhiping , Yao Yao , Yang Jie
Published: July 2022

Background

Cathelicidin/LL-37 plays a significant role in the human immune defense reaction. Preterm human immature organs being exposed to inflammation-induced injury was the critical denominator leading to the common preterm associated complications. Previous study showed LL37 concentration in preterm neonates was lower in tracheal aspirates and breast milk as compared to term infants. An adults study showed decreased LL-37 levels was a risk factor for patients in developing severe chronic obstructive pulmonary disease (COPD). However, little is known about the regulation of human cord blood LL37 in preterm neonates and the association with preterm complications. This study was designed to investigate the concentration of LL37 in cord blood of preterm infants and correlation with preterm complications.

Methods

Singleton infants born in June 2017 to August 2021 in the study hospital were enrolled. Maternal and neonatal clinical characteristics were collected. LL37 levels, pro-inflammatory factor interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-a) in cord blood and LL37 levels in serum 48–72 hours after birth were measured by enzyme-linked immunosorbent assay. The serum level of LL37 in preterm and term neonates were compared, the perinatal factors possibly affecting the LL37 levels were investigated and the relationship between LL37 level and preterm outcomes were analyzed.

Results

Cord blood LL37 levels in preterm infants were lower than that in term neonates. Cord blood LL37 level was positively correlated with gestational age in preterm. Prenatal steroid administration in preterm neonates decreased cord blood LL37 level. LL37 level was obviously lower in patients with bronchopulmonary dysplasia (BPD). Multiple line regression analysis showed higher LL37 level in cord blood was an independent protective factor for BPD. The concentration of pro-inflammatory factor IL-6 was negatively correlated with LL37.

Conclusion

Cord blood LL37 levels increased during gestation and decreased after perinatal steroid usage. Very preterm infants who displayed higher cord blood LL37 level had reduced risk of developing BPD. Regulation of pro-inflammatory cytokine IL-6 may be associated with the protective effect of LL37 on BPD.
The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis
Authors: Salari Nader , Rasoulpoor Shabnam , Rasoulpoor Shna , Shohaimi Shamarina , Jafarpour Sima , Abdoli Nasrin , Khaledi-Paveh Behnam , Mohammadi Masoud
Published: July 2022

Background

Autism spectrum disorder (ASD) is one of the serious developmental disorders that is usually diagnosed below the age of three years. Although the severity of the disease’s symptoms varies from patient to patient, the ability to communicate with others is affected in all forms of ASD. This study aimed to determine the prevalence of ASD in high-risk groups by continent.

Methods

The present study was conducted by systematic review and meta-analysis from 2008 to July 2021. Databases such as Science Direct, PubMed, Scopus, SID, Magiran, Web of Science (WoS), and Google Scholar from 2008 to July 2021 were searched to find related studies. Data were analysed using Comprehensive Meta-Analysis software (Version 2).

Results

A total of 74 studies with 30,212,757 participants were included in this study. The prevalence of ASD in the world was 0.6% (95% confidence interval: 0.4–1%). Subgroup analyses indicated that the prevalence of ASD in Asia, America, Europe, Africa and Australia was 0.4% (95% CI: 0.1–1), 1% (95% CI: 0.8–1.1), 0.5% (95% CI: 0.2–1), 1% (95% CI: 0.3–3.1), 1.7% (95% CI: 0.5–6.1) respectively.

Conclusion

ASD imposes a heavy health burden on communities around the world. Early detection of ASD can reduce the incidence of developmental disorders and improve patients’ communication skills. Therefore, health policymakers need to be aware of the prevalence and increasing trend of ASD to implement appropriate planning and interventions to reduce its consequences.
Plasmodium berghei Brca2 is required for normal development and differentiation in mice and mosquitoes
Authors: Yoshikawa Yasunaga , Kimura Shunta , Soga Akira , Sugiyama Makoto , Ueno Aki , Kondo Hiroki , Zhu Zida , Ochiai Kazuhiko , Nakayama Kazuhiko , Hakozaki Jun , Kusakisako Kodai , Haraguchi Asako , Kitano Taisuke , Orino Koichi , Fukumoto Shinya , Ikadai Hiromi
Published: July 2022

Background

Malaria is a major global parasitic disease caused by species of the genus Plasmodium. Zygotes of Plasmodium spp. undergo meiosis and develop into tetraploid ookinetes, which differentiate into oocysts that undergo sporogony. Homologous recombination (HR) occurs during meiosis and introduces genetic variation. However, the mechanisms of HR in Plasmodium are unclear. In humans, the recombinases DNA repair protein Rad51 homolog 1 (Rad51) and DNA meiotic recombinase 1 (Dmc1) are required for HR and are regulated by breast cancer susceptibility protein 2 (BRCA2). Most eukaryotes harbor BRCA2 homologs. Nevertheless, these have not been reported for Plasmodium.

Methods

A Brca2 candidate was salvaged from a database to identify Brca2 homologs in Plasmodium. To confirm that the candidate protein was Brca2, interaction activity between Plasmodium berghei (Pb) Brca2 (PbBrca2) and Rad51 (PbRad51) was investigated using a mammalian two-hybrid assay. To elucidate the functions of PbBrca2, PbBrca2 was knocked out and parasite proliferation and differentiation were assessed in mice and mosquitoes. Transmission electron microscopy was used to identify sporogony.

Results

The candidate protein was conserved among Plasmodium species, and it was indicated that it harbors critical BRCA2 domains including BRC repeats, tower, and oligonucleotide/oligosaccharide-binding-fold domains. The P. berghei BRC repeats interacted with PbRad51. Hence, the candidate was considered a Brca2 homolog. PbBrca2 knockout parasites were associated with reduced parasitemia with increased ring stage and decreased trophozoite stage counts, gametocytemia, female gametocyte ratio, oocyst number, and ookinete development in both mice and mosquitoes. Nevertheless, the morphology of the blood stages in mice and the ookinete stage was comparable to those of the wild type parasites. Transmission electron microscopy results showed that sporogony never progressed in Brca2-knockout parasites.

Conclusions

Brca2 is implicated in nearly all Plasmodium life cycle stages, and especially in sporogony. PbBrca2 contributes to HR during meiosis.

Graphical Abstract
The role of LCN2 and LCN2-MMP9 in spondylitis radiographic development: gender and HLA-B27 status differences
Authors: Tsui Florence W. L. , Lin Aifeng , Sari Ismail , Zhang Zhenbo , Pritzker Kenneth P. H. , Tsui Hing Wo , Inman Robert D.
Published: July 2022

Background

Male HLA-B27-positive radiographic-axial spondyloarthritis (r-axSpA) patients are prone to have severe spinal radiographic progression, but the underlying mechanisms are unclear. We recently showed that persistently elevated Lipocalin 2 (LCN2; L) reflects sacroiliac joint (SIJ) inflammation. LCN2 binds to MMP9. Concomitant elevation of L and LCN2-MMP9 (LM) was detected in many inflammatory diseases. We asked whether L and LM play similar roles in r-axSpA pathogenesis.

Methods

We analyzed 190 axSpA patients (123 radiographic and 67 non-radiographic axSpA) who had no detectable circulating Oncostatin M, to avoid complications due to cross-talk between pathways. L and LM levels from a single blood sample of each patient were measured and were correlated with MRI and modified stoke AS (mSASS) scoring. Association of elevated L (L+) or concurrent L+ and elevated LM (LM+) patterns with B27 status and gender were assessed.

Results

In L+LM+ axSpA patients, both L and LM levels correlated with MRI SPARCC SIJ scores, but only LM levels correlated with MRI Berlin Spine Scores, suggesting LM is a biomarker for both SIJ and spinal inflammation. Among patients with minimal spinal ankylosis (mSASSS < 10), 65% of male r-axSpA patients are L+LM+, while 30% and 64% of female patients are L+LM+ and L+, respectively, supporting the role of LM with disease progression. In B27+ L+LM+ male patients, both L and LM (but not CRP) levels correlate with mSASSS. B27 positivity and maleness have additive effects on spondylitis progression, suggesting concurrent high L and LM elevations are associated with B27+ male patients having more significant radiographic damage. L+ B27-negative male patients or L+ female patients are more likely to have milder disease.

Conclusion

L and LM are informative biomarkers for SIJ and spinal inflammation, as well as for ankylosing development in r-axSpA patients. Distinctive L+LM+ or L+ patterns not only could distinguish clinically aggressive vs milder course of disease, respectively, but also provide an explanation for B27-positive male patients being the most susceptible to severe ankylosis.
TCP post-radioembolization and TCP post-EBRT in HCC are similar and can be predicted using the in vitro radiosensitivity
Authors: d’Abadie Philippe , Walrand Stephan , Hesse Michel , Borbath Ivan , Lhommel Renaud , Jamar François
Published: July 2022

Background

Tumor equivalent uniform dose (EUD) is proposed as a predictor of patient outcome after liver radioembolization (RE) of hepatocellular carcinoma (HCC) and can be evaluated with 90Y-TOF-PET. The aim is to evaluate the correlation between PET-based tumors EUD and the clinical response evaluated with dual molecular tracer (11C-acetate and 18F-FDG) PET/CT post-RE.

Methods

34 HCC tumors in 22 patients were prospectively evaluated. The metabolic response was characterized by the total lesion metabolism variation (ΔTLM) between baseline and follow-up. This response allowed to compute a tumor control probability (TCP) as a function of the tumor EUD.

Results

The absorbed dose response correlation was highly significant (R = 0.72, P < 0.001). With an absorbed dose threshold of 40 Gy, the metabolic response was strongly different in both groups (median response 35% versus 100%, P < 0.001). Post-RE TCP as a function of the EUD was very similar to that observed in external beam radiation therapy (EBRT), with TCP values equal to 0.5 and 0.95 for a EUD of 51 Gy and 100 Gy, respectively. The TCP was perfectly predicted by the Poisson model assuming an inter tumor radiosensitivity variation of 30% around the HCC cell in vitro value.

Conclusions

EUD-based 90Y TOF-PET/CT predicts the metabolic response post-RE in HCC assessed using dual molecular PET tracers and provides a similar TCP curve to that observed in EBRT. In vivo and in vitro HCC radiosensitivities are similar. Both TCPs show that a EUD of 100 Gy is needed to control HCC for the three devices (resin spheres, glass spheres, EBRT). Observed absorbed doses achieving this 100 Gy-EUD ranged from 190 to 1800 Gy!
Bacillus licheniformis PF9 improves barrier function and alleviates inflammatory responses against enterotoxigenic Escherichia coli F4 infection in the porcine intestinal epithelial cells
Authors: Li Qiao , Li Linyan , Chen Yanhong , Yu Changning , Azevedo Paula , Gong Joshua , Yang Chengbo
Published: July 2022

Background

Enterotoxigenic Escherichia coli (ETEC) F4 commonly colonizes the small intestine and releases enterotoxins that impair the intestinal barrier function and trigger inflammatory responses. Although Bacillus licheniformis (B. licheniformis) has been reported to enhance intestinal health, it remains to be seen whether there is a functional role of B. licheniformis in intestinal inflammatory response in intestinal porcine epithelial cell line (IPEC-J2) when stimulated with ETEC F4.

Methods

In the present study, the effects of B. licheniformis PF9 on the release of pro-inflammation cytokines, cell integrity and nuclear factor-κB (NF-κB) activation were evaluated in ETEC F4-induced IPEC-J2 cells.

Results

B. licheniformis PF9 treatment was capable of remarkably attenuating the expression levels of inflammation cytokines tumor necrosis factor-α (TNF-α), interleukin (IL)-8, and IL-6 during ETEC F4 infection. Furthermore, the gene expression of Toll-like receptor 4 (TLR4)-mediated upstream related genes of NF-κB signaling pathway has been significantly inhibited. These changes were accompanied by significantly decreased phosphorylation of p65 NF-κB during ETEC F4 infection with B. licheniformis PF9 treatment. The immunofluorescence and western blotting analysis revealed that B. licheniformis PF9 increased the expression levels of zona occludens 1 (ZO-1) and occludin (OCLN) in ETEC F4-infected IPEC-J2 cells. Meanwhile, the B. licheniformis PF9 could alleviate the injury of epithelial barrier function assessed by the trans-epithelial electrical resistance (TEER) and cell permeability assay. Interestingly, B. licheniformis PF9 protect IPEC-J2 cells against ETEC F4 infection by decreasing the gene expressions of virulence-related factors (including luxS, estA, estB, and elt) in ETEC F4.

Conclusions

Collectively, our results suggest that B. licheniformis PF9 might reduce inflammation-related cytokines through blocking the NF-κB signaling pathways. Besides, B. licheniformis PF9 displayed a significant role in the enhancement of IPEC-J2 cell integrity.
Transplantation of bacteriophages from ulcerative colitis patients shifts the gut bacteriome and exacerbates the severity of DSS colitis
Authors: Sinha Anshul , Li Yue , Mirzaei Mohammadali Khan , Shamash Michael , Samadfam Rana , King Irah L. , Maurice Corinne F.
Published: July 2022

Background

Inflammatory bowel diseases (IBDs) including Crohn’s disease (CD) and ulcerative colitis (UC) are characterized by chronic and debilitating gut inflammation. Altered bacterial communities of the intestine are strongly associated with IBD initiation and progression. The gut virome, which is primarily composed of bacterial viruses (bacteriophages, phages), is thought to be an important factor regulating and shaping microbial communities in the gut. While alterations in the gut virome have been observed in IBD patients, the contribution of these viruses to alterations in the bacterial community and heightened inflammatory responses associated with IBD patients remains largely unknown.

Results

Here, we performed in vivo microbial cross-infection experiments to follow the effects of fecal virus-like particles (VLPs) isolated from UC patients and healthy controls on bacterial diversity and severity of experimental colitis in human microbiota-associated (HMA) mice. Shotgun metagenomics confirmed that several phages were transferred to HMA mice, resulting in treatment-specific alterations in the gut virome. VLPs from healthy and UC patients also shifted gut bacterial diversity of these mice, an effect that was amplified during experimental colitis. VLPs isolated from UC patients specifically altered the relative abundance of several bacterial taxa previously implicated in IBD progression. Additionally, UC VLP administration heightened colitis severity in HMA mice, as indicated by shortened colon length and increased pro-inflammatory cytokine production. Importantly, this effect was dependent on intact VLPs.

Conclusions

Our findings build on recent literature indicating that phages are dynamic regulators of bacterial communities in the gut and implicate the intestinal virome in modulating intestinal inflammation and disease.
Axillary lymphangioma that developed following COVID-19 vaccination: a case report
Authors: Sasa Soichiro , Inoue Hiroaki , Inui Tomohiro , Miyamoto Naoki , Aoyama Mariko , Okumura Kazumasa , Toba Hiroaki , Yoshida Takahiro , Tezuka Miki , Hirose Chieko , Saijo Yasuyo , Uehara Hisanori , Izumori Ayumi , Takahashi Masako , Sasa Mitsunori , Takizawa Hiromitsu
Published: July 2022

Background

Extensive vaccination programs are being implemented worldwide for coronavirus disease 2019 (COVID-19). With the spread of vaccination, swelling of the lymph nodes after vaccination is frequently seen. We encountered a patient who developed left axillary lymphadenoma following vaccine administration.

Case presentation

The patient was a Japanese woman in her 80 s who had previously undergone surgery for right breast cancer. She received two injections of the Pfizer-BioNTech COVID-19 vaccine in her left arm. Approximately 3 months later, she complained of left axillary swelling, and imaging resulted in a diagnosis of left axillary lymphangioma. In accordance with the patient’s wishes, we performed axillary mass resection. The pathological diagnosis was lymphangioma.

Conclusion

Our examination findings indicated that congestion of the axillary lymph vessels might have been caused by upper-arm injections of the COVID-19 vaccine.
Time to readmission and associated factors after post treatment discharge of severe acute malnourished under-five children in Pawe General Hospital
Authors: Kebede Fassikaw
Published: July 2022

Background

Relapse or repeated episodes is the admission of a child with the diagnosis of severe acute malnutrition (SAM) after being discharged to a status of treated and cured from a stabilizing center. A child may experience more than one episode of SAM depending on the improvement of the underlying comorbidity. Thus, this study aimed to estimate the time to readmission of SAM and associated factors for under-five children in North West Ethiopia.

Methods

An institution-based retrospective cohort study was employed in 760 files of under-five children spanning from 2014/15 to 2019/20. The data extraction tool was developed from SAM treatment guidelines and medical history sheets. Epi Data version 3.2 and STATA version 14 were used for data entry and final analysis, respectively. After checking all assumptions, the multivariable Cox Proportional Hazard model was fitted to the isolated independent predictors for time to readmission. A categorical variable with p < 0.05 was considered a risk factor for the relapse of SAM.

Result

The mean (± SD) age of participant children was 27.8 (± 16.5) months with mean (± SD) time to relapse of SAM cases were 30.4(± 21.39) weeks posttreatment discharge. The overall incidence density rate of relapse was determined as 10.8% (95% CI 8.3; 12.6). The average time (± SD) for treatment recovery from the first admission of the SAM case was 28.8(± 18.7) days. Time of readmission was significantly associated with living in rural resident (AHR 5⋅3 = 95% CI, 2⋅95, 13⋅87, p = 0.021), having HIV infection (AHR6⋅8 = 95%CI; 4.1–11.9 p = 0.001), and first admission with edema (AHR = 3.5 = 95% CI; 1.92, 6.2, p = 0.018).

Conclusion

Nearly one in every ten severely acute malnourished under-five children relapsed within a mean time to relapse 30.4(± 21.39) weeks posttreatment discharge. Time to relapse was significantly associated with being a rural resident for children, having edema during the first admission, and being HIV-infected cases. A protocol ought to be drafted for extending Supplementary Nutrition in Acute Malnutrition management program following discharge is highly needed.
COVID-19: positive experience with differentiated tactics of mechanical ventilation of the lungs for different phenotypes (L-phenotype)
Authors: Piacherski Valery , Muzyka Lidziya , Zhylynski Dzyanis
Published: July 2022

Relevance

Studies have previously been published on a possible differential approach to respiratory therapy in patients with COVID-19 depending on the L- or H-phenotype.

The authors believe that early tracheal intubation reduces the risk of lung injury. The use of deep sedation and low PEEP (6–8 cmH2O) and early intubation may prevent transition to type H.

Method and results

Eleven patients with COVID-19 type L pneumonia received respiratory support based on the proposed guidelines. Eight women and three men (ages 45 to 84) with COVID-19 type L pneumonia were treated in the intensive care unit. Did they all receive oxygen therapy up to 15 L/min. high-flow oxygen therapy up to 60 L/ min, non-invasive ventilation of the lungs. If it was impossible to reduce FiO2 from 100 to 75% within 2–3 h or if the patient was intolerant to NIV, early tracheal intubation was used.

The minute ventilation volume was set to
maintain CO2 <60 mmHg. and pH>7.25 in venous blood. Sedation
was performed by intravenous titration of fentanyl and propofol. If deeper
sedation was required to synchronize the patient to the ventilator, intravenous
muscle relaxants were used over 24-48 hours (bolus or intravenous titration)
instead of sedation.

Conclusion

All 11 patients were successfully weaned from
the mechanical ventilation of the lungs. A differentiated approach to
respiratory therapy for COVID-19 L-type pneumonia proved to be an effective
approach in these patients.

It is probably worth avoiding deep sedation of
patients on mechanical ventilation with L-type pneumonia, which would reduce
the time spent on mechanical ventilation and reduce the risk of mortality from
nosocomial bacterial infection.

The new MVL strategy for L-type pneumonia and
the problem of deep sedation require more research. But the available data
suggests that it probably has benefits.
Researchers, animal support and regulatory staff: symbiosis or antagonism?
Authors: Tsang Benjamin , Gerlai Robert
Published: July 2022

Animals are studied en masse by biologists around the world in a variety of biomedical and basic research studies. All this research benefits humankind and animals alike as it tackles a wide variety of problems ranging from those of conservation biology to medicine. Research with animal subjects is a complex endeavor that requires the cooperation and collaboration of a large number of experts, from the principal investigator through technicians and vivarium staff to regulatory experts. The research must be conducted in a humane manner that adheres to acceptable practices regulated by local, state and federal guidelines, rules and the law. In this short opinion article, we examine the current state of affairs regarding how researchers, animal support staff and regulatory experts work together. We pay particular attention to potential conflicts that may arise from the occasionally distinct roles played by those involved in animal research, and we provide some suggestions as short- and long-term remedies that have not been previously discussed in the literature.
Direct anterior approach in total hip arthroplasty: more indications and advantages than we found
Authors: Xu Zhonghua , Zhang Jun , Li Jie , Zhang Yuan
Published: July 2022

Mounting attention has been oriented to the direct anterior approach (DAA) in total hip arthroplasty (THA) because of alleged advantages in terms of tissue-sparing and minimal invasiveness, as well as fast recovery after surgery in the past decades. Doubt has also been raised by critics regarding learning curve, indications, technical feasibility, intraoperative risks and complications, and unconfirmed long-term consequences of the approach. The controversies were elaborately reviewed and discussed in a recent publication in Arthroplasty by Realyvasquez et al. from the perspective of American surgeons. This inclusive review covered the current status, technical issues, outcome evaluation, and developmental concerns of DAA in modern THA. As one of the pioneers of DAA in hip surgery communities in China, Prof. Y. Z., the corresponding author of the paper, has his own understanding and manipulation of DAA on the basis of thousands of DAA procedures he has performed. The purpose of this article was to respond to the pivotal issues discussed in the article by Realyvasquez et al., and to present our own view of points about the indications/contraindications and advantages as different from existing ideas. In particular, we proposed a Xinqiao Predictive Algorithm to quantitatively assess the indications for and feasibility of DAA for the first time. The algorithm was constructed on multiple factors derived from Chinese patients. Our study concluded that the potential advantages of DAA could be achieved by personalizing the pelvic functional position and placing the component into the real safe zone, by means of adapting to the spaciotemporal change of the hip-spine coordination.
Micro-elimination of hepatitis C in patients with chronic kidney disease: an Egyptian single-center study
Authors: George Michael Tari , Anwar Christina A. , Ahmed Ossama A. , Sarhan Iman , Elshazly Yehia , Shaker Mohammed K. , Eltabbakh Mohammed , Hashem Walaa , Tawfic Safaa R. , Kamel Shimaa Y. , Kandil Doaa M. , Naguib Gina G. , Khedr Abdelrahman , Ghanem Eman A. , Dabbous Hany , Doss Wahid , El-Sayed Manal H.
Published: July 2022

Background and aims

Micro-elimination of hepatitis C in renal patients is crucial. This study aims to assess the efficacy and safety of directly acting antivirals in chronic kidney disease patients and the effect of treatment on kidney functions.

Results

This prospective cohort study included 77 chronic HCV-infected patients with chronic kidney disease. Patients were consented and treated for 12 weeks with either sofosbuvir and daclatasvir ± ribavirin if glomerular filtration rate was > 30 mL/min per 1.73m2 or ritonavir-boosted paritaprevir-ombitasvir-ribavirin if it was < 30 mL/min per 1.73m2. Patients were divided into two categories (responders versus non-responders). Predictors of response to treatment were statistically analyzed through logistic regression analysis. Sixty-two patients received ritonavir-boosted paritaprevir-ombitasvir-ribavirin, 3 received sofosbuvir and daclatasvir, and 12 received sofosbuvir and daclatasvir plus ribavirin. Most patients were on hemodialysis (n = 36) while 31 were stage 3 kidney disease. All patients completed their treatment course; ribavirin doses were adjusted or stopped in patients who developed anemia (40%). Seventy-two patients (93.5%) achieved sustained virological response 12 weeks following end-of-treatment. Five patients (6.5%) were non-responders, 4 of whom were on hemodialysis (p = 0.179). All non-responders were on ritonavir-boosted paritaprevir-ombitasvir-ribavirin. The mean serum creatinine level at weeks 4 and 8 of treatment demonstrated significant improvement compared to pretreatment values (p < 0.001) in patients on conservative therapy.

Conclusion

Treatment of chronic kidney disease patients for chronic hepatitis C with directly acting antivirals is safe, efficacious with high response rates and likely to improve renal functions if started early in the course of kidney disease.
Control of climate events caused by the volcano on organic matter enrichment in the lacustrine source rocks of the Ordos Basin, central China
Authors: Zhang Bin , Mao Zhi-Guo , Yuan Yi-Lin , Yu Cong , Zhang Zhong-Yi , Tang Xuan , Shi Yu-Xin , Chen Xiao-Liang
Published: July 2022

We systematically analyze the geochemical characteristics of source rocks of the Yan Chang Formation in the Ordos Basin to reveal the influence mechanisms of the volcano on lacustrine organic matter enrichment. Organic matter enrichment is not synchronous with the volcanic eruption in time, but it has a “hysteresis” effect. The evidence of volcanic activity mainly includes two aspects: one is a large amount of volcanic ash in black shale, and the other is a negative shift of organic carbon isotopes of source rocks and finding that black shale was affected by climate events caused by the volcano. The climate event caused by the volcano has three effects on organic matter enrichment in black shale: (1) it brought nutrients for the growth of organisms and released a large amount of greenhouse gases, such as CO2, to accelerate photosynthesis and promote the growth of organisms; (2) a large amount of toxic gases, such as SO2 and H2S, were released and O2 was consumed and diluted in the air, forming a severe anoxic environment and accelerating the preservation of organic matter; and (3) it caused extremely hot weather, resulting in long-time surface runoff and other climate events, increasing input of terrestrial organic matter, and forming light components of hydrocarbons.
Management of a Girl With Delayed Puberty and Elevated Gonadotropins
Authors: McGlacken-Byrne Sinéad M , Achermann John C , Conway Gerard S
Published: July 2022

A girl presenting with delayed puberty and elevated gonadotropins may have a range of conditions such as Turner syndrome (TS), primary ovarian insufficiency (POI), and 46,XY disorders of sexual development (DSD). An organized and measured approach to investigation can help reach a timely diagnosis. Management of young people often requires specialist multidisciplinary input to address the endocrine and nonendocrine features of these complex conditions, as well as the psychological challenges posed by their diagnosis. Next-generation sequencing within the research setting has revealed several genetic causes of POI and 46,XY DSD, which may further facilitate an individualized approach to care of these young people in the future. Pubertal induction is required in many and the timing of this may need to be balanced with other issues specific to the condition (eg, allowing time for information-sharing in 46,XY DSD, optimizing growth in TS). Shared decision-making and sign-posting to relevant support groups from the outset can help empower young people and their families to manage these conditions. We describe 3 clinical vignettes of girls presenting with delayed puberty and hypergonadotropic amenorrhea and discuss their clinical management in the context of current literature and guidelines.
Today We Fly, Tomorrow We Fall: William Faulkner’sPylonin Fascist Italy
Authors: Tydal Fredrik
Published: July 2022

In 1937, two years following the American original, Pylon became the first novel by William Faulkner to be translated into Italian. The choice, however, is unexpected, given the critique of technology in Faulkner’s cautionary tale, which would seem to oppose the fascist ideology of Mussolini’s regime, then at its height. Like the futurists, whose ideas they appropriated, the fascists idealized technological progress, committing themselves to what Faulkner’s novel calls into question. The translation of foreign literature under fascism was a complex and dynamic field, as theorized by Cesare Pavese, who argued that American novels in Italian translation played a role in the domestic intellectual resistance. Against this background, the Italian translation of Faulkner’s novel may thus appear as an antifascist act. Indeed, the translator’s introduction to the work foregrounds the theme of technological critique and implicitly asserts its relevance for contemporary Italy. A closer examination of publisher and translator complicates the picture, revealing contradictory intentions and casting subversive aims into doubt. Nevertheless, an ambitious publishing project in the immediate postwar period, which sought to mobilize the novel for the purposes of national reconstruction, confirms the inherent antifascist potential of the translation.
The Elusiveness of Commonality: Late Twentieth-Century Sinology and the Search for a Shared Lyric Language
Authors: Varsano Paula
Published: July 2022

As the study of what we now call “premodern” China gained traction among students in the postwar United States, the question of how it should be approached emerged as a divisive issue among interested scholars, perhaps nowhere as much as it did among those with a particular interest in Chinese poetry. From the 1960s to the 1980s, the stakes seemed high as scholars confronted their passionate disagreements about things as fundamental as the proper subject of study and the most fruitful methodology. Is China a coherent and self-sufficient subject of study? Can it be rightly and accurately characterized as a civilization so separate from the West, and so perfectly integrated within itself, as to render impossible—and even damaging—an approach to any aspect of its civilization that enables comparison? What is lost and what is gained if one chooses to focus more on Chinese poetry as poetry and less on Chinese poetry as Chinese? Is it really necessary—or possible—to choose? Or is it possible to find balance along a continuum? Of particular interest is the discourse of scholars who saw in the rise of formalist studies of literature either an opportunity or a threat. This article traces just some of the lines of resistance and exploration, convergence, and bifurcation that developed in this period, observing that the disagreements that were exercising these camps, while quite real, were not as absolute as their rhetoric would suggest.
Mouvance in Medieval Chinese Textual Culture: Lunyu 論語 in a Dunhuang Florilegium
Authors: Nugent Christopher M. B.
Published: July 2022

This essay applies the approaches of the “new medievalism,” mouvance or “mutability” in particular, to medieval textual materials purporting to contain parts of the classics, focusing on Lunyu 論語 (Analects), Shangshu 尚書 (Documents), and Xiaojing 孝經 (Classic of Filial Piety). Using Dunhuang manuscripts of the florilegium titled Xinji wenci jiujing chao 新集文詞九經抄 (New Compilation of Phrases Excerpted from the Nine Classics), the essay shows that the texts of these classics presented by such compilations differed substantially from the “official” texts of the time as represented by the versions carved in stone during the Kaicheng reign period (836–841). The essay further argues that such florilegia as Xinji wenci jiujing chao were likely widely used, implying that many readers in the period may have had a different conception of the contents of the classics from what we might assume they had. This has implications for our understanding of intertextuality in literary works from the period.
Theories of Spatiality and the Study of Medieval China
Authors: Luo Manling
Published: July 2022

Space is a ubiquitous and essential dimension of human existence, so much so that it is often taken for granted. In what has been dubbed the “spatial turn,” Western scholars in geography, philosophy, history, literature, and other disciplines have tried to reorient critical perspectives in order to account for the importance of space to humanity. Meanwhile, space/place has been a fairly prominent subject in the study of medieval China. This essay contrasts Western general and local theories and Sinological studies to show their divergent and overlapping concerns. The juxtaposition illustrates how Western theories of spatiality can help open up new possibilities for Sinological studies of medieval China. Meanwhile, such engagements can also enhance the relevance of Sinological studies of medieval China to the developments in broader academia and beyond.
Synthesis of Cationic Sandwich-type Ruthenium Complexes with η6-Arene Ligands Bearing Long Alkyl Chains and Their Behavior in Water
Authors: Nakamura Yushi , Wakabayashi Misato , Sadakane Koichiro , Ohta Tetsuo , Oe Yohei
Published: July 2022

Novel sandwich-type ruthenium complexes [Ru(η6-arene)(p-cymene)](BF4)2, in which the η6-arene ligands have long alkyl chains, were prepared. These complexes were dispersed in water to form corresponding micelles. Alkoxy moieties on the η6-arene ligands were reacted with OH− to afford the corresponding phenolic species. Thus, [Ru(p-undecyloxyanisole)(p-cymene)]2+ was converted to [Ru(η6-p-methoxyphenolate)(p-cymene)]+ through the unexpected demethylation by treatment with Na2CO3 with the micelle remaining. The micelle collapsed when similar ruthenium complex bearing dodecyl 2-(4-methoxyphenoxy)acetate as an arene ligand was treated with Na2CO3 aq.