bluuebunny/crossref_metadata_2025 huggingface dataset:
A comprehensive bibliometric analysis on opinion mining and sentiment analysis global research output
Authors: Musa Ibrahim Hussein , Zamit Ibrahim , Xu Kang , Boutouhami Khaoula , Qi Guilin
Published: September 2022

The rise of the Internet and social media (i.e. reviews, forum discussions, blogs and social networks) constituted an interesting source to detect user opinion trends. This study examines the global publication output on opinion mining and sentiment analysis from documents published in 2000 to 2020. Bibliometric indicators on the trends, most cited papers, authors, institutions, countries, funding agencies and research subject areas were independently screened and analysed using bibliometrix package in R. A total of 7603 eligible documents were identified from 2000 to 2020. The total number of citations for all publications was 129,251, with an average of 17.0 citations per publication. About 14,629 authors wrote those documents with 1.93 authors per document and a collaboration index of 1.98. The most prolific author was Cambria Erik, with 47 publications and h-index of 42. The leading countries for research were China with n = 824, India with n = 576 and the United States with n = 244 publications. Lecture Notes in Computer Science proceedings was the top-ranked venue for publications with n = 434, h-index of 32 and 4598 total citation scores. National Natural Science Foundation of China was the top-ranked funding agency for research, and most of the publications were computer science ( n = 6320) documents. The study provides an in-depth assessment of the landmark of the hot research topic and acknowledges the contribution of the most productive and active authors across different countries in the world. In addition, the findings could support the younger scholars in their future research direction and improve the efficiency in potential future research collaborations and projects.
An economy in the making: Negotiating capitalist and beyond-capitalist ontologies and relations in makerspaces
Authors: Vincent Olga
Published: September 2022

This paper critically examines how capitalist, alternative capitalist and non-capitalist ontologies and relations are negotiated in a hybrid makerspace that hosts both for-profit and non-profit entities and integrates community and commercial aspects. Despite a growing body of knowledge on the distinct characteristics of non-commercial makerspaces, few scholars have analysed them in relation to capitalism. This applies even more to commercial or hybrid makerspaces that remain so far under-researched in diverse economies literature. These spaces, however, can be of increasing interest given what we know about makerspaces as hubs of budding entrepreneurship and that some makers avidly pursue entrepreneurial objectives while others are reluctant to even consider commercialising their projects. In this paper, I employ an extended framework of diverse economies that understands capitalism as not only a form of socio-economic organisation but also a cultural and political architecture. Followed by an overview of existing literature that sheds light on beyond-capitalist dimensions of makerspaces, I explore a case study of the Keilewerf, a hybrid makerspace situated in Makers District in Rotterdam, the Netherlands, disentangling how capitalist, alternative capitalist and non-capitalist ontologies of sustainability-oriented makers co-exist and conflict with economic relations, knowledge production and relations with the state.
Perceived barriers to career progression in the headache field: A global web-based cross-sectional survey
Authors: de Boer Irene , Ambrosini Anna , Halker Singh Rashmi B , Baykan Betül , Buse Dawn C , Tassoreli Cristina , Jensen Rigmor H , Pozo-Rosich Patricia , Terwindt Gisela M ,   on behalf of the International Headache Society Women’s Leadership Forum
Published: September 2022

Background

It is well recognized that underrepresented and minoritized groups do not have the same career opportunities. However, there are limited data on the range and specifics of potential barriers that withhold people in headache medicine and science from reaching their full potential. Moreover, people from different geographical regions often perceive different challenges. We aimed to identify world-wide perceived career barriers and possibilities for promoting equality amongst professionals in the headache fields.

Methods

A cross-sectional online survey was conducted among professionals in the field of headache globally. The questions of the survey were aimed at assessing perceived career barriers in four domains: professional recognition, opportunities in scientific societies, clinical practice, and salary and compensation. Perceived mentorship was also assessed.

Results

In total 580 responders completed the survey (55.3% women). Gender was the most important perceived barrier in almost all domains. Additionally, country of birth emerged as an important barrier to participation in international scientific societies. Career barriers varied across world regions.

Conclusion

It is essential that longstanding and ongoing disparities by gender and country of origin for professionals in the headache field are globally acknowledged and addressed in areas of recruitment, retention, opportunities, mentor- and sponsorships, and advancement.
Management of the Failed First Revision ACL Reconstruction: Clinical Outcomes of Nonsurgical Management Versus Second Revision ACL Reconstruction From the SANTI Group
Authors: Fradin Thomas , Saithna Adnan , Haidar Ibrahim M. , Rayes Johnny , El Helou Abdo , Ngbilo Cedric , Pioger Charles , Vieira Thais Dutra , Hopper Graeme P. , Sonnery-Cottet Bertrand
Published: September 2022

Background:

The optimum management strategy after failure of revision anterior cruciate ligament reconstruction (RACLR) is not clearly defined. The literature evaluating differences in outcomes between surgical and nonsurgical management is sparse.

Purpose/Hypothesis:

The purpose was to evaluate the outcomes of surgical versus nonsurgical management of failed first RACLR. It was hypothesized that the long-term clinical outcomes of second RACLR would be superior with respect to knee stability, return to sport, and patient-reported outcome measures when compared with nonsurgical treatment.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who experienced failure of first RACLR were evaluated. All participants followed the same rehabilitation protocol regardless of whether they underwent nonsurgical treatment or a second RACLR. Follow-up comprised regular clinical review and a standardized telephone interview at the end of the study period. Patient-reported outcome measures were recorded at the final follow-up.

Results:

A total of 41 patients with a mean follow-up of 104 ± 52.7 months (range, 40-140 months) were evaluated. Of these, 31 underwent a second RACLR, and 10 patients chose nonsurgical treatment. There was a high rate of return to sport in both groups, but patients undergoing second RACLR had significantly better Tegner (6.35 vs 4.8; P = .012), Lysholm (88.5 vs 78.3; P = .0353), Knee injury and Osteoarthritis Outcome Score (KOOS) Quality of Life (72.6 vs 56.3; P = .0490), and KOOS Sport and Recreation scores (81.4 vs 62.5; P = .0033). Significantly more patients undergoing second RACLR achieved the Patient Acceptable Symptom State for KOOS Sport and Recreation than those who underwent nonsurgical management (74.2% vs 30%; P = .015). The most important predictor of failure to achieve a good/excellent Lysholm score in multivariate analysis was nonsurgical management ( P = .0095).

Conclusion:

Both second RACLR and nonsurgical management of failed first RACLR were associated with high rates of return to sport. However, second RACLR was associated with significantly better functional outcome scores with respect to Tegner, Lysholm, KOOS Quality of Life, and KOOS Sport and Recreation scores compared to nonsurgical management. In addition, nonsurgical treatment was the only significant predictor of failure to achieve a good/excellent Lysholm score at the final follow-up, and this was likely a function of inferior knee stability in that group.
Neurotoxicity associated with oxidative stress and inflammasome gene expression induced by allethrin in SH-SY5Y cells
Authors: Castillo Giovana , Barrios-Arpi Luis , Ramos-Gonzalez Mariella , Vidal Paola , Gonzales-Irribarren Alejandro , Ramos-Cevallos Norma , Rodríguez José-Luis
Published: September 2022

Pyrethroids, including allethrin, have largely been used as commercial insecticides. The toxicity of allethrin is little known, but it is assumed that, as occurs with other pyrethroids, it could cause alterations of the nervous system and pose both occupational and non-occupational health hazards. To evaluate the neurotoxicity of allethrin we used the MTT assay of SH-SY5Y neuroblastoma cells to determine cell viability. Dose-dependent reductions of cell viability served to compare the vehicle-group and the IC50 for allethrin, which was 49.19 μM. ROS production increased significantly at concentrations of 10–200 μM of allethrin, and NO levels were significantly increased by the effect of allethrin at a minimum concentration of 50 μM. Lipid peroxidation increased by the effect of allethrin at concentrations of 25, 50, 100, and 200 μM. Caspase 3/7 activity was induced by allethrin concentrations of 50, 100, and 200 μM. Here, we suggest that allethrin might affect the inflammasome complex (Caspase-1, NLRP3, and PYDC1) and apoptosis (Bax and Bcl-2) gene expression by mRNA fold change expression levels shown in Caspase-1 (2.46-fold), NLRP3 (1.57-fold), PYDC1 (1.48-fold), and Bax (2.1-fold). These results demonstrated that allethrin induced neurotoxicity effects on SH-SY5Y cells through activation of inflammasome pathways, cell death, and oxidative stress.
Who is the Practitioner in Faculty-Staff Sexual Misconduct Work?: Views from the UK and US
Authors: Coy Maddy , Bull Anna , Libarkin Julie , Page Tiffany
Published: September 2022

This article maps and compares four universities’ policies and procedures for addressing faculty and staff sexual misconduct in higher education in the UK and US. While universities have engaged in significant work to grapple with student-student sexual misconduct, attention to misconduct perpetrated, and experienced, by higher education employees is relatively nascent. In this paper, we explore the maze of institutional processes and actors that victim-survivors of FASSM might encounter. We describe what is known about prevalence of FASSM in the US and UK and offer an overview of the policy landscape in both settings. Inspired by Patricia Yancey Martin, we analyze publicly available policy documents on FASSM from two US and two UK universities and map out visually the range of investigative, reporting, and sanctioning processes. We introduce an analytic distinction between an actor and a practitioner within the FASSM context, whereby actors are those tasked with administrative duties in handling sexual misconduct reports, while practitioners are those with specialized knowledge and training that enables them to prioritize victim-survivor needs. These illustrative diagrams suggest that while university employees are tasked to act on reports and disclosures of sexual misconduct, it is difficult to identify specialist practitioners with expertise to support victim-survivors of FASSM. Ultimately, this work provides a deeper understanding of what practice looks like in relation to higher education FASSM, and we outline implications for future research directions.
Prevalence of oral and anal human papillomavirus infection in Czech predominantly HIV-positive men having sex with men - data from a previously unreported population
Authors: Nemcova Jana , Riegert Jan , Cerna Katerina , Rob Filip , Smahelova Jana , Hercogova Jana Tresnak , Martinek Petr , Ondic Ondrej
Published: September 2022

Background:

HIV-positive men who have sex with men (MSM) are more likely to experience human papillomavirus (HPV) infection. The persistent HPV infection is the major factor in the development of anal and oropharyngeal neoplasms. Data on the prevalence of anal and oral HPV in MSM are almost absent from the countries of Central and Eastern Europe. We conducted a cross-sectional study focused on the prevalence of oral and anal HPV infections and the relationship between current anal and oral HPV intrapersonal infection in a Czech population of predominantly HIV-positive MSM.

Methods:

Oral gargle and anal swab samples from 205 predominantly HIV-positive MSM from the Czech Republic were analysed for HPV infection using PCR. Selected sociodemographic and clinical data were correlated with HPV detection using generalized linear models and multivariate analysis.

Results:

HPV infection was detected in 183 (96.8%) anal and 48 (23.6%) oral samples. The most common type of HR-HPV was HPV16 in both anal (25.4%) and oral (2.5%) samples. Multiple anal HPV infections and the presence of vaccine-targeted HR-HPV types were significantly correlated with abnormal anal cytology and HIV status.

Conclusion:

The prevalence of anal HPV infection in Czech predominantly HIV-positive MSM ranks among the highest reported, while oral HPV prevalence is consistent with MSM populations. Minimal overlap of oral and anal HPV types within a patient was observed.
Facilitated trailing haptic externalization technique for intrascleral intraocular lens fixation
Authors: Ucar Fikret
Published: September 2022

Purpose

To describe the facilitated trailing haptic externalization technique for intrascleral intraocular lens (IOL) fixation.

Methods

In this technique, first the direction of the 4–5 mm tip of the trailing haptic is straightened with the help of forceps. After the second needle enters the posterior chamber, the edge of the IOL optic is pushed towards the opposite scleral tunnel with the needle. The trailing haptic approaching the center from the periphery and the straightened distal part of the haptic towards the direction of the needle facilitate the relatively easily and gently placing of the haptic into the lumen with a one-time use of forceps.

Results

This technique was performed on 65 eyes of 58 patients, with a mean patient age of 53.0 ± 14.6 years (range, 22–78). No complications such as endothelial touch, vitreous loss, iris or ciliary body damage, and hyphema were encountered during surgery. The mean operation duration was 14.8 ± 2.3 min (range, 12−20). In the postoperative period, there was only mild postoperative anterior chamber reaction in all eyes. Postoperative transient intraocular pressure (IOP) elevation that responded well to topical antiglucomatous therapy was observed in only two cases (3%). No patient developed haptic exposure, IOL dislocation, iris capture, postoperative hypotony, vitreous hemorrhage, choroidal effusion, cystoid macular edema, or retinal detachment.

Conclusion

The facilitated trailing haptic externalization technique provides a safer, simpler, and minimally invasive surgery without significant complications while easing the surgical difficulties of the Yamane technique.
Describing (pre)linguistic oral productions in 3- to 5-year-old autistic children: A cluster analysis
Authors: Maes Pauline , Weyland Marielle , Kissine Mikhail
Published: September 2022

In many autistic children, speech onset is delayed and expressive language emerges after 3 years of age. We qualitatively and quantitatively describe oral productions of autistic preschoolers, including many non- or minimally speaking, recorded during interactions with a caregiver and with an experimenter. Data clustering on manually coded oral production samples indicates five validated linguistic profiles of oral production in this diverse and inclusive sample ( n = 59) of 3- to 5-year-old autistic children with highly variable expressive language abilities. These profiles are then compared on a series of demographic (age, socioeconomic status) and psychometric (autism severity, nonverbal and verbal IQ) measures, as well as on additional measures of language (expressive vocabulary, phonetic inventories). Two clusters are composed of speaking autistic children, while the three others comprise non- or minimally speaking children with qualitatively different patterns of vocal productions. The five-profile division suggests that traditional binary division of speaking vs nonspeaking children does not do justice to the complexity of early expressive language in autism.

Lay abstract

For most autistic children, spoken language emergence and development happen after the age of 3. Once they start developing and using spoken language, some eventually manage to reach typical levels of language abilities, while others remain minimally speaking into adulthood. It is therefore difficult to consider young autistic preschoolers as a homogeneous group in terms of spoken language levels. In our study, we breakdown a representative and inclusive group of children on the spectrum aged from 3 to 5 into five subgroups that correspond to different linguistic profiles. To do so, we qualitatively described children’s (pre)verbal productions elicited during interactions with a parent and with an experimenter. We then used a type of statistical analysis called cluster analysis to group together the children that had a similar expressive (pre)linguistic behavior. Using this analysis, we were able to delineate five linguistic profiles with qualitatively different patterns of vocal production. Two of these profiles are composed of speaking children; the three others are composed of non- or minimally speaking children. Our findings show that traditional binary division of speaking versus nonspeaking autistic children is not precise enough to describe the heterogeneity of early spoken language in young autistic children. They also support the use of qualitative descriptions of vocal productions and speech to accurately document children’s level of language, which could, in turn, help design very finely tailored language intervention specific to each child.
Staged treatment for pancreaticoduodenal artery aneurysm with coeliac artery revascularisation: Case report and systematic review
Authors: Ghoneim Baker , Nash Connor , Akmenkalne Liga , Cremen Sinead , Canning Catriona , Colgan Mary P , O’Neill Sean , Martin Zenia , Madhavan Prakash , O’Callaghan Adrian
Published: September 2022

Background

Despite being rare, pancreaticoduodenal artery aneurysms (PDAAs) carry a risk of rupture of up to 50% and are frequently associated with coeliac artery occlusion.

Methods

PubMed and Embase databases were searched using appropriate terms. The systematic review was conducted according to PRISMA guidelines.

Results

We present the case of a 2 cm pancreaticoduodenal artery aneurysm pre-operative angiography demonstrated that the coeliac artery was occluded and the pancreaticoduodenal artery was providing collateral blood supply to the liver. Treatment was a staged hybrid intervention inclusive of an aorto-hepatic bypass using a 6 mm graft, followed by coil embolisation of the aneurysm. We also present a systematic review of the management of PDAAs. Two hundred and ninety-two publications were identified initially with 81 publications included in the final review. Of the 258 peripancreatic aneurysms included, 175 (61%) were associated with coeliac artery disease either occlusion or stenosis. Abdominal pain was the main presentation in 158 cases. Rupture occurred in 111 (40%) of patients with only ten (3.8%) cases being unstable on presentation. Fifty (18%) cases were detected incidentally while investigating another pathology. Over half the cases ( n=141/54.6%) were treated by trans arterial embolisation (TAE) alone, while 37 cases had open surgery only. Twenty-one cases needed TAE and a coeliac stent. Seventeen cases underwent hybrid treatment (open and endovascular). Sixteen cases were treated conservatively and in 26 cases, treatment was not specified.

Conclusion

PDAAs are commonly associated with coeliac artery disease. The most common presentation is pain followed by rupture. The scarcity of literature about true peripancreatic artery aneurysms associated with CA occlusive disease makes it difficult to assess the natural history or the appropriate treatment. Revascularisation of hepatic artery is better done with bypass in setting of median arcuate ligament compression and occluded celiac trunk.
Index pollicization: an evolution of ideas and techniques from a paediatric orthopaedic institution
Authors: Carter Peter R. , Ezaki Marybeth , Oishi Scott
Published: September 2022

Pollicization has been a very successful procedure in the treatment of specific types of hypoplastic thumb. Although much has remained the same since early descriptions of the procedure in the 1800s and 1900s, refinements over the years have made it safer and more predictable. Over the years at our institution we have studied, modified and refined our incisions to produce a new thumb that is aesthetically pleasing with excellent function. We present our technique for pollicization along with pearls and pitfalls we have discovered.
Falls Incidence Compared Between a Multibedded Ward Hospital and a 100% Single-Occupancy Room Hospital: An Uncontrolled Before-After Study
Authors: Hussain Fozia , van Dijk Monique , Oudshoorn Christian , Ista Erwin
Published: September 2022

Background:

Single-occupancy patient rooms in hospitals have become popular because of the privacy they offer. A downside, however, is the lack of social control from other patients, which might increase the risk of falls and undetected delirium.

Aim:

To study whether the incidence of falls in single-occupancy patient rooms differs from that in multibedded patient rooms. Secondary aims were to establish differences in the context of falls and differences in delirium incidence.

Methods:

An uncontrolled observational before-after study was performed during 16 months before and 16 after moving to a hospital with 100% single-occupancy patient rooms. Fall data were retrieved from the hospital incident reporting system. The Delirium Observation Screening Scale (DOSS) was retrieved from the hospital electronic patient data system. Main outcomes were the number of falls per 1,000 patient days, assessed with a Poisson regression analysis, and delirium incidence in fallers.

Results:

The incidence of falls was not significantly different between the before period (1.39 falls/1,000 patient days) and the after period (1.38 falls/1,000 patient days; p = .924). In the after period, falls in the bathroom were significantly more frequent than in the before period, respectively, 17.2% and 9.4% ( p = .003). In both periods, one quarter of the patients who fell had been assessed for delirium. In the before period, 57/73 (78%) of those were suspected for delirium (DOSS ≥ 3) versus 37/55 (67%) in the after period ( p = .225).

Conclusions:

In this study, we observed no change in incidence of falls after moving to a hospital with 100% single-occupancy bed rooms.
Identifying Optimal Locations for Potential Temporary Community Clinics During Public Health Emergencies
Authors: Mohagheghi Salman , Gharipour Mohammad , DeClercq Caitlin , Bui Andrew , Tyne Intisar Ameen
Published: September 2022

Objectives:

This article argues that community healthcare clinics managed by dedicated medical professionals who are familiar with the special needs of the local community may serve as effective alternatives to centralized hospitals and medical facilities, which may be disconnected from these local communities.

Background:

The literature indicates that socioeconomic factors that affect an individual’s ability to seek medical help when needed can cause vulnerability to public health emergencies. These factors include belonging to lower income populations, being African American, being dependent due to age (below 18 or above 65) or disability, being an immigrant, English-language ability, access to transportation means, and the strength of an individual’s social network.

Method:

This study aims at developing a multifaceted methodology to identify optimal locations for deployment of temporary healthcare clinics to address health disparity issues among socially vulnerable populations, especially during pandemics and public health crises. This case study looks at the Health Enterprise Zone (HEZ) in Baltimore and ranks Census tracts based on their vulnerability, using two novel health vulnerability indices and considering their locations.

Results:

Using the proposed methodology, the optimal tracts within the HEZ are identified as potential locations for deploying temporary healthcare clinics.

Conclusion:

The analysis of vulnerabilities to public health emergencies based on socioeconomic factors can assist in identifying potential locations for setting up temporary healthcare clinics with the goal of assisting socially vulnerable populations during outbreaks and pandemics.
A qualitative meta-synthesis examining spirituality as experienced by individuals living with terminal cancer
Authors: Hayden Lucy , Byrne Emma , Deegan Avril , Dunne Simon , Gallagher Pamela
Published: September 2022

This review aimed to examine and synthesise literature on spirituality as experienced by individuals living with terminal cancer. Six databases were systematically searched for studies with qualitative findings relevant to spirituality and terminal cancer. Thirty-seven studies were included and thematic synthesis was used to identify themes. Analytical themes included: making sense of dying; living with dying; feeling connected; and being reflective. This review highlights how the experience of spirituality can positively impact the lives of terminal cancer patients. Further, these findings suggest that spirituality can be a transformative experience that allows individuals to experience peace at end of life.
Fine-grained petalite and spodumene dykes in the Stankuvatske Li-deposit, Ukrainian Shield: products of tectono–metamorphic recrystallisation
Authors: Kurylo Sergii , Uher Pavel , Broska Igor , Lyzhachenko Nataliia , Bondarenko Sergii , Gieré Reto
Published: September 2022

The Palaeoproterozoic (~2.0−1.8 Ga) Stankuvatske Li deposit (Ukrainian Shield, Central Ukraine) represents an uncommon case of recrystallised, fine-grained petalite ± spodumene meta-pegmatite dykes with LCT affinity hosted in amphibolites and meta-ultrabasic rocks. The meta-pegmatite dykes show remnants of primary, pre-metamorphic zoning, with dominant magmatic albite, K-feldspar, quartz, Li-phases (petalite, spodumene, rarely triphylite and montebrasite), and accessory muscovite, fluorapatite, columbite-(Fe), tantalite-(Fe), cassiterite, Ta-rich rutile, zinco- and ferronigerite, gahnite, pyrite, sphalerite and zircon. The parental magma of the meta-pegmatites was peraluminous, and enriched in Li and P, though relatively poor in B and F during the late-magmatic stage. Metasomatic reactions between residual pegmatite magma and (ultra)basic country rocks resulted in the precipitation of holmquistite, triphylite, fluorapatite, tourmaline and Rb–Cs-rich biotite. Secondary generations of fine-grained petalite, spodumene, albite and K-feldspar were formed during post-magmatic stages, i.e. during hydrothermal–metasomatic alteration and/or subsequent tectono–metamorphic recrystallisation of the primary pegmatites. The initial subsolidus metasomatism of primary feldspars took place in alkaline conditions as a result of Na (partly K) for Li exchange.

The presence of fibrolitic sillimanite and chrysoberyl, together with the scarcity of muscovite and (OH,F)-bearing minerals, point to metamorphic recrystallisation of the former Li-rich granitic pegmatites at relatively high-temperature and medium-pressure (~600±50°C; ~0.3−0.4 GPa) conditions.
Impact of D-dimer for pathologic differentiation on transesophageal echocardiography in embolic stroke of undetermined source: a single-center experience
Authors: Hira Kenichiro , Ueno Yuji , Watanabe Masao , Shimura Hideki , Kurita Naohide , Miyamoto Nobukazu , Haginiwa Haruna , Yamashiro Kazuo , Hattori Nobutaka , Urabe Takao
Published: September 2022

Background

Embolic stroke of undetermined source (ESUS) encompasses diverse embologenic mechanisms, which transesophageal echocardiography (TEE) is critical to detect. Specific markers related to each embolic source in ESUS is not fully studied. We focused on D-dimer levels, and explored the association of D-dimer with potential embolic sources (PES) identified on TEE in ESUS.

Methods

Consecutive patients with ESUS were included in this study. Clinical characteristics including D-dimer levels were compared between ESUS patients with and without TEE, and among none of, one, and at least two PES in ESUS patients undergoing TEE. Factors related to elevation of D-dimer were analyzed.

Results

A total of 211 patients (age, 69.3 ± 13.2 years; 149 males) with ESUS were enrolled. Of these, 115 received TEE, displaying significantly younger age and lower D-dimer levels than patients without TEE (P < 0.05), and 20 (17%), 61 (53%), and 34 (30%) patients were classified into none of, one, and ≥ two PES, respectively. On multiple logistic regression analysis, D-dimer levels were related to one PES (odds ratio [OR]: 9.01; 95% confidence interval [CI]: 1.00–81.51; P = 0.050) and PES ≥ two (OR: 9.76; 95% CI: 1.07–88.97; P = 0.043). Right-to-left shunt (RLS) with deep venous thrombosis (DVT)(OR: 13.94; 95% CI: 1.77–109.99; P = 0.012) and without DVT (OR: 3.90; 95% CI: 1.20–12.70; P = 0.024) were associated with elevation of D-dimer.

Conclusions

D-dimer levels were higher in patients with PES. Among PES, RLS, with and without DVT, were associated with increase of D-dimer in ESUS.
Preoperative serum CA19-9 should be routinely measured in the colorectal patients with preoperative normal serum CEA: a multicenter retrospective cohort study
Authors: Li Zhenhui , Zhu Haibin , Pang Xiaolin , Mao Yun , Yi Xiaoping , Li Chunxia , Lei Ming , Cheng Xianshuo , Liang Lei , Wu Jiamei , Ding Yingying , Yang Jun , Sun Yingshi , Zhang Tao , You Dingyun , Liu Zaiyi
Published: September 2022

Objective

Whether preoperative serum carbohydrate antigen 19–9 (CA19-9) is an independent prognostic factor and there are interactions of serum CA19-9 with carcinoembryonic antigen (CEA) on the risk of recurrence in colorectal cancer (CRC) patients are still not clarified.

Methods

Consecutive patients with CRC who underwent curative resection for stage II-III colorectal adenocarcinoma at five hospitals were collected. Based on Cox models, associations of preoperative CA19-9 with recurrence-free survival (RFS) and overall survival (OS) were evaluated in patients with or without elevated CEA, and interactions between CEA and CA19-9 were also calculated. Restricted cubic spline (RCS) curves were used to evaluate the associations between preoperative CA19-9 and CRC outcomes on a continuous scale.

Results

A total of 5048 patients (3029 [60.0%] men; median [interquartile range, IQR] age, 61.0 [51.0, 68.0] years; median [IQR] follow-up duration 46.8 [36.5–62.4] months) were included. The risk of recurrence increased with the elevated level of preoperative CA19-9, with the slope steeper in patients with normal CEA than those with elevated CEA. Worse RFS was observed for elevated preoperative CA19-9 (> 37 U/mL) (n = 738) versus normal preoperative CA19-9 (≤ 37 U/mL) (n = 4310) (3-year RFS rate: 59.4% versus 78.0%; unadjusted hazard ratio [HR]: 2.02; 95% confidence interval [CI]:1.79 to 2.28), and significant interaction was found between CA19-9 and CEA (P for interaction = 0.001). Increased risk and interaction with CEA were also observed for OS. In the Cox multivariable analysis, elevated CA19-9 was associated with shorter RFS and OS regardless of preoperative CEA level, even after adjustment for other prognostic factors (HR: 2.08, 95% CI:1.75 to 2.47; HR: 2.25, 95% CI:1.80 to 2.81). Subgroup analyses and sensitivity analyses yielded largely similar results. These associations were maintained in patients with stage II disease (n = 2724).

Conclusions

Preoperative CA19-9 is an independent prognostic factor in CRC patients. Preoperative CA19-9 can be clinically used as a routine biomarker for CRC patients, especially with preoperative normal serum CEA.
Perceived knowledge of scheme members and their satisfaction with their medical schemes: a cross-sectional study in South Africa
Authors: M’bouaffou Francis , Buch Eric , Olorunju Steve , Thsehla Evelyn
Published: September 2022

Background

South Africa has a dual healthcare system comprising of private and public sectors covering 16% and 84% of the population, respectively. Medical schemes are the primary source of health insurance in the private sector. The aim of this study was to assess members of medical schemes' perceived knowledge and satisfaction with their medical schemes.

Methods

A cross-sectional survey was conducted using a stratified systematic sample of members of 22 open medical schemes. Medical schemes members completed an online questionnaire on knowledge and satisfaction with their medical schemes. We calculated a composite perceived knowledge and satisfaction score. Descriptive, bivariate and multivariate analysis was conducted.

Results

A total of 336 members of medical schemes participated in this study. Respondents generally perceived themselves to have good knowledge of their medical schemes. Eighty-one percent of participants were satisfied with the quality of services received from their designated service providers (DSPs), however, only 9% were satisfied with accessibility of doctors under their DSP arrangement. Twenty-five percent of respondents were satisfied with scheme contributions and only 46% were satisfied with the prescribed minimum benefit package.

Conclusion

Medical schemes remain a key element of private healthcare in South Africa. The analysis shows that medical schemes, should put more effort into the accessibility of general practitioner under their designated service providers. Furthermore, the prescribed minimum benefits should be reviewed to provide a comprehensive benefits basket without co-payment for members as recommended by the Medical Schemes Act Amendment Bill of 2018.
Effect of trochanter displacement on impingement and bone contact in total hip arthroplasty performed after curved intertrochanteric varus osteotomy for osteonecrosis of the femoral head: a simulation study
Authors: Okamoto Masanori , Seki Taisuke , Takegami Yasuhiko , Osawa Yusuke , Imagama Shiro
Published: September 2022

Background

Curved intertrochanteric varus osteotomy (CVO) is a useful treatment option for osteonecrosis of the femoral head (ONFH). However, the effect of proximal femoral deformity in cases of CVO converted to total hip arthroplasty (THA) remains unclear. The aim of this study was to evaluate the effect of trochanter displacement on impingement and the contact state of the implant and femur in THA.

Methods

Thirty-eight hips that had undergone CVO for ONFH were reviewed and compared with a control group of 30 contralateral hips that had not undergone surgery. The range of motion (ROM) and impingement patterns and the percentage of cortical bone in the stem placement within the femur were measured by simulation using CT-based three-dimensional template software. We also measured the ROM and the number of joints that achieved the ROM required for activities of daily living when the upward displaced apex of the greater trochanter with osteotomy was resected and compared the findings with those obtained when the apex was not resected.

Results

The CVO group showed a significantly greater bony impingement in external rotation (68.4% vs. 43.3%, p = 0.033) and abduction (78.9% vs. 33.3%, p < 0.001) than in the control group. The CVO group showed a significantly smaller range of external rotation (19.0° [interquartile range; 4.0–28.8] vs. 38.0° [interquartile range; 36.0–41.8], p < 0.001) and abduction (23.0° [interquartile range; 8.5–38.8] vs. 56.0° [interquartile range; 50.3–60.0], p < 0.001) than in the control group. Significantly more joints achieved the ROM necessary for activities of daily living when the apex was resected than when it was not (10.5% vs. 63.2%, p < 0.001). The percentage of cortical bone in the stem placement position was significantly higher in the CVO group than in the control group in the proximal portion of the stem (25.5% vs. 0.0%, p < 0.001).

Conclusion

In cases requiring conversion to THA, we recommend resecting the upward displaced apex to achieve a sufficient ROM and carefully resecting the bone to avoid malignment of the stem.
Development of a cost of illness inventory questionnaire for children with autism spectrum disorder in South Asia
Authors: Chaudhary Divya , Bhat Bhargav , Shields Gemma E. , Davies Linda M. , Green Jonathan , Verghis Tara , Roy Reetabrata , Kumar Divya , Kakra Minal , Vajaratkar Vivek , Lall Gitanjali , Pandey Sonakshi , Johri Sanchita , Shakeel Saani , Patel Vikram , Juneja Monica , Gulati Sheffali , Divan Gauri
Published: September 2022

Background

The economic burden of autism is substantial and includes a range of costs, including healthcare, education, productivity losses, informal care and respite care, among others. In India, approximately, 2 million children aged 2–9 years have autism. Given the likely substantial burden of illness and the need to identify effective and cost-effective interventions, this research aimed to produce a comprehensive cost of illness inventory (COII) suitable for children with autism in South Asia (India) to support future research.

Methods

A structured and iterative design process was followed to create the COII, including literature reviews, interviews with caregivers, pilot testing and translation. Across the development of the COII, thirty-two families were involved in the design and piloting of the tool. The COII was forward translated (from English to Hindi) and back translated. Each stage of the process of development of the COII resulted in the further refinement of the tool.

Results

Domains covered in the final COII include education, childcare, relocation, healthcare contacts (outpatient, inpatient, medical emergencies, investigations and medication), religious retreats and rituals, specialist equipment, workshops and training, special diet, support and care, certification, occupational adjustments and government rebates/schemes. Administration and completion of the COII determined it to be feasible to complete in 35 minutes by qualified and trained researchers. The final COII is hosted by REDCap Cloud and is a bilingual instrument (Hindi and English).

Conclusions

The COII was developed using experiences gathered from an iterative process in a metropolitan area within the context of one low- and middle-income country (LMIC) setting, India. Compared to COII tools used for children with autism in high-income country settings, additional domains were required, such as complimentary medication (e.g. religious retreats and homeopathy). The COII will allow future research to quantify the cost of illness of autism in India from a broad perspective and will support relevant economic evaluations. Understanding the process of developing the questionnaire will help researchers working in LMICs needing to adapt the current COII or developing similar questionnaires.
The molecular mechanisms and therapeutic strategies of EMT in tumor progression and metastasis
Authors: Huang Yuhe , Hong Weiqi , Wei Xiawei
Published: September 2022

Epithelial–mesenchymal transition (EMT) is an essential process in normal embryonic development and tissue regeneration. However, aberrant reactivation of EMT is associated with malignant properties of tumor cells during cancer progression and metastasis, including promoted migration and invasiveness, increased tumor stemness, and enhanced resistance to chemotherapy and immunotherapy. EMT is tightly regulated by a complex network which is orchestrated with several intrinsic and extrinsic factors, including multiple transcription factors, post-translational control, epigenetic modifications, and noncoding RNA-mediated regulation. In this review, we described the molecular mechanisms, signaling pathways, and the stages of tumorigenesis involved in the EMT process and discussed the dynamic non-binary process of EMT and its role in tumor metastasis. Finally, we summarized the challenges of chemotherapy and immunotherapy in EMT and proposed strategies for tumor therapy targeting EMT.
Plasminogen activator inhibitor 1 and gestational diabetes: the causal relationship
Authors: Batiha Gaber El-Saber , Al-kuraishy Hayder M. , Al-Maiahy Thabat J. , Al-Buhadily Ali K. , Saad Hebatallah M. , Al-Gareeb Ali I. , Simal-Gandara Jesus
Published: September 2022

Plasminogen activator inhibitor 1 (PAI-1) also known as serpin E1 or endothelial plasminogen activator inhibitor, is produced from endothelial cells and adipose tissue. PAI-1 inhibits tissue plasminogen activator (tPA) and urokinase (uPA) preventing activation of plasminogen and fibrinolysis. Gestational diabetes mellitus (GDM) is defined as glucose intolerance and hyperglycemia during pregnancy. The underlying mechanism of GDM is due to the reduction of insulin secretion or the development of insulin resistance (IR). Normal PAI-1 is a crucial mediator for maintaining pregnancy, though aberrantly high PAI-1 promotes inflammation and thrombosis with increased risk of pregnancy loss. Increasing PAI-1 level had been shown to be an early feature of cardio-metabolic derangement in women with GDM. As well, GDM is regarded as an independent predictor for increasing PAI-1 levels compared to normal pregnancy. Taken together, GDM seems to be the causal factor in the increase of PAI-1 via induction of IR, hyperglycemia and hypertriglyceridemia. In conclusion, GDM triggers expression and release of PAI-1 which linked with GDM severity due to exaggerated pro-inflammatory and inflammatory cytokines with the development of IR. High PAI-1 levels in GDM may induce hypofibrinolysis and thrombotic complications.
N-acetylcysteine regulates dental follicle stem cell osteogenesis and alveolar bone repair via ROS scavenging
Authors: Meng Zhaosong , Liu Jiacheng , Feng Zhipeng , Guo Shuling , Wang Mingzhe , Wang Zheng , Li Zhe , Li Hongjie , Sui Lei
Published: September 2022

Background

Dental follicle stem cells (DFSCs) show mesenchymal stem cell properties with the potential for alveolar bone regeneration. Stem cell properties can be impaired by reactive oxygen species (ROS), prompting us to examine the importance of scavenging ROS for stem cell-based tissue regeneration. This study aimed to investigate the effect and mechanism ofN-acetylcysteine (NAC), a promising antioxidant, on the properties of DFSCs and DFSC-based alveolar bone regeneration.

Methods

DFSCs were cultured in media supplemented with different concentrations of NAC (0–10 mM). Cytologic experiments, RNA-sequencing and antioxidant assays were performed in vitro in human DFSCs (hDFSCs). Rat maxillary first molar extraction models were constructed, histological and radiological examinations were performed at day 7 post-surgery to investigate alveolar bone regeneration in tooth extraction sockets after local transplantation of NAC, rat DFSCs (rDFSCs) or NAC-treated rDFSCs.

Results

5 mM NAC-treated hDFSCs exhibited better proliferation, less senescent rate, higher stem cell-specific marker and immune-related factor expression with the strongest osteogenic differentiation; other concentrations were also beneficial for maintaining stem cell properties. RNA-sequencing identified 803 differentially expressed genes between hDFSCs with and without 5 mM NAC. “Developmental process (GO:0032502)” was prominent, bioinformatic analysis of 394 involved genes revealed functional and pathway enrichment of ossification and PI3K/AKT pathway, respectively. Furthermore, after NAC treatment, the reduction of ROS levels (ROS, superoxide, hydrogen peroxide), the induction of antioxidant levels (glutathione, catalase, superoxide dismutase), the upregulation of PI3K/AKT signaling (PI3K-p110, PI3K-p85, AKT, phosphorylated-PI3K-p85, phosphorylated-AKT) and the rebound of ROS level upon PI3K/AKT inhibition were showed. Local transplantation of NAC, rDFSCs or NAC-treated rDFSCs was safe and promoted oral socket bone formation after tooth extraction, with application of NAC-treated rDFSCs possessing the best effect.

Conclusions

The proper concentration of NAC enhances DFSC properties, especially osteogenesis, via PI3K/AKT/ROS signaling, and offers clinical potential for stem cell-based alveolar bone regeneration.
Pathling: analytics on FHIR
Authors: Grimes John , Szul Piotr , Metke-Jimenez Alejandro , Lawley Michael , Loi Kylynn
Published: September 2022

Background

Health data analytics is an area that is facing rapid change due to the acceleration of digitization of the health sector, and the changing landscape of health data and clinical terminology standards. Our research has identified a need for improved tooling to support analytics users in the task of analyzing Fast Healthcare Interoperability Resources (FHIR®) data and associated clinical terminology.

Results

A server implementation was developed, featuring a FHIR API with new operations designed to support exploratory data analysis (EDA), advanced patient cohort selection and data preparation tasks. Integration with a FHIR Terminology Service is also supported, allowing users to incorporate knowledge from rich terminologies such as SNOMED CT within their queries. A prototype user interface for EDA was developed, along with visualizations in support of a health data analysis project.

Conclusions

Experience with applying this technology within research projects and towards the development of analytics-enabled applications provides a preliminary indication that the FHIR Analytics API pattern implemented by Pathling is a valuable abstraction for data scientists and software developers within the health care domain. Pathling contributes towards the value proposition for the use of FHIR within health data analytics, and assists with the use of complex clinical terminologies in that context.
Therapeutic potential of chrysin nanoparticle-mediation inhibition of succinate dehydrogenase and ubiquinone oxidoreductase in pancreatic and lung adenocarcinoma
Authors: Ragab Eman M. , El Gamal Doaa M. , Mohamed Tarek M. , Khamis Abeer A.
Published: September 2022

Pancreatic adenocarcinoma (PDAC) and lung cancer are expected to represent the most common cancer types worldwide until 2030. Under typical conditions, mitochondria provide the bulk of the energy needed to sustain cell life. For that inhibition of mitochondrial complex ΙΙ (CΙΙ) and ubiquinone oxidoreductase with natural treatments may represent a promising cancer treatment option. A naturally occurring flavonoid with biological anti-cancer effects is chyrsin. Due to their improved bioavailability, penetrative power, and efficacy, chitosan–chrysin nano-formulations (CCNPs) are being used in medicine with increasing frequency. Chitosan (cs) is also regarded as a highly versatile and adaptable polymer. The cationic properties of Cs, together with its biodegradability, high adsorption capacity, biocompatibility, effect on permeability, ability to form films, and adhesive properties, are advantages. In addition, Cs is thought to be both safe and economical. CCNPs may indeed be therapeutic candidates in the treatment of pancreatic adenocarcinoma (PDAC) and lung cancer by blocking succinate ubiquinone oxidoreductase.