bluuebunny/crossref_metadata_2025 huggingface dataset:
Unexpected Bare Metal Stent Migration Associated With Aortic Remodeling After PETTICOAT Technique for Aortic Dissection
Authors: Kobayashi Kimihiro , Yamashita Atsushi , Kuroda Yoshinori , Nakai Shingo , Arai Shusuke , Uchida Tetsuro
Published: February 2022

Purpose:

To report a unique case of bare metal stent migration in the overlapping zone and subsequent distal stent graft-induced new entry (SINE) after the Provisional Extension to Induce a Complete Attachment (PETTICOAT) technique for aortic dissection.

Case report:

A 67-year-old man underwent thoracic endovascular aortic repair (TEVAR) using the PETTICOAT technique for acute complicated type B aortic dissection. The postoperative course was uneventful, and follow-up computed tomography (CT) showed not only favorable aortic remodeling but also progressive bare metal stent migration in the overlapping zone between the stent graft and the bare metal stent. A 6-month postoperative CT revealed a distal SINE, and the patient underwent re-TEVAR to cover the new entry. Postoperative CT demonstrated successful repair of the distal SINE. The patient is currently in good health 2 years after the reintervention.

Conclusion:

Surgeons should consider the potential risk of device migration due to favorable aortic remodeling after TEVAR for aortic dissection, especially with the use of additional bare metal stents.
Novel weft-knitted spacer structure with silicone tube and foam inlays for cushioning insoles
Authors: Li Nga-wun , Yick Kit-lun , Yu Annie
Published: February 2022

A novel spacer fabric with a weft-knitted structure of silicone tube and foam inlays is proposed for use in insoles to alleviate in-shoe pressure, reduce moisture and enhance thermal comfort. The material variables, including the diameter of the spacer yarn, type of inlaid material and net wrap and spacer pattern have been systematically investigated. Their force reduction and thermal characteristics in terms of air and water vapour permeabilities, thermal conductivity and impact force reduction are determined and compared to those of traditional insole materials. The results show that the inlays can effectively enhance the impact force reduction of the 3D spacer fabrics. In comparison to traditional insole materials, the proposed spacer fabric with an inlaid structure can enhance air and moisture permeabilities and heat dissipation to provide greater wear comfort for prolonged use. The air permeability, thermal conductivity and impact force reduction of the inlaid spacer structure can be modified with changes to the diameter of the spacer yarn, type of inlay and net material used and spacer pattern, whilst its water vapour permeability can also be varied by using different types of inlays. Spacer fabric with a higher number of spacer yarn courses and spacer yarn with a large diameter not only exhibits good impact force reduction with uniform thickness, but also offers good thermal conductivity. The findings of this study will contribute toward an insole design with the use of alternative insole materials for optimal foot protection.
Framework and Analysis of Key Performance Indicators in Cuban Higher Education
Authors: Vinajera-Zamora Andrey , Gaus Nurdiana , Rodríguez-Martínez Yohandra
Published: February 2022

This article aims to examine how Cuban higher education has implemented and created frameworks for key performance indicators (KPIs) to enhance its higher education accountability and quality. Referring to the past 15 years of available data on the United Nations Educational, Scientific, and Cultural Organization’s website (2005–2020), this study shows that Cuba’s higher education system has improved, as indicated by the increasing rate of the gross graduation ratio (both sexes) as well as national and inbound student mobility.

Este manuscrito examinó como la educación superior cubana ha implementado y creado marcos de referencia de Indicadores de Ejecución Clave para mejorar su responsabilidad y calidad de educación superior. Refiriéndose a los últimos 15 años de información disponible en la red mundial (2005–2020) de la página de las Naciones Unidas sobre Enseñanza, Organizaciones Científicas y Culturales, este estudio demuestra que el sistema de educación superior ha mejorado, indicado por el incremento en la tasa de graduación bruta (ambos géneros) nacional, y de movilidad estudiantil interna
Anemia Severity and the Risks of Postoperative Complications and Extended Length of Stay Following Primary Total Elbow Arthroplasty
Authors: Gordon Adam M. , Ashraf Asad M. , Sheth Bhavya K. , Magruder Matthew L. , Conway Charles A. , Choueka Jack
Published: February 2022

Background:

Anemia is a modifiable risk factor that may influence postoperative complications following orthopedic surgical procedures. The objective was to determine the influence of preoperative anemia severity on postoperative complications and length of stay (LOS) following total elbow arthroplasty (TEA).

Methods:

The American College of Surgeons National Surgical Quality Improvement Program registry was queried from 2006 to 2019 for patients undergoing primary TEA. Using the World Health Organization definitions of anemia, patients undergoing TEA were stratified into 3 cohorts: nonanemia (hematocrit >36% for women, >39% for men), mild anemia (hematocrit 33%-36% for women, 33%-39% for men), and moderate-to-severe anemia (hematocrit <33% for both women and men). Patient demographics, surgical time, LOS, and postoperative complications were compared between the groups. A P value <.004 was considered significant.

Results:

After exclusion, 589 patients, of whom 369 (62.6%) did not have anemia, 129 (21.9%) had mild anemia, and 91 (15.5%) had moderate/severe anemia, were included. Increasing severity of anemia was associated with an increased average hospital LOS (2.30 vs 2.81 vs 4.91 days, P < .001). There was a statistically significant increase in blood transfusions (1.08% vs 7.75% vs 17.58%, P < .001), major complications (9.21% vs 17.83% vs 34.07%, P < .001), any complications (11.11% vs 23.26% vs 36.26%, P < .001), and extended LOS ≥6 days (6.23% vs 6.98% vs 31.87%, P < .001) with increasing severity of anemia. Multivariate analysis identified moderate-to-severe anemia was significantly associated with major complications and extended LOS ( P < .001).

Conclusions:

Preoperative anemia is a modifiable risk factor for medical and surgical complications within 30 days of TEA.
Increased aortic repair in Germany correlates with reduction of death caused by aortic aneurysms but not aortic dissections
Authors: Santosa Frans , Beckerath Olga von , Cremer Svenja , Katoh Marcus , Juntermanns Benjamin , Kröger Knut , Gäbel Gabor
Published: February 2022

Introduction

We asked if there is a significant correlation between the increasing trend in aortic repair (AR) and decreasing aortic aneurysm (AA) and aortic dissection (AD) mortality? Therefore, we retrospectively analyzed all aortic repairs in patients with AA and AD and its correlation with disease-specific death rates and hospitalizations for ruptured AA and AD in Germany.

Methods

We retrieved the number of cases hospitalized for AA and AD as well as the procedures in these cases from the Federal Bureau of Statistics (DRG statistics) and death rates from the national mortality statistic published by the Federal Statistical Office in Germany for the years 2006–2017.

Results

From 2006 to 2017, the total number of hospitalized cases admitted with principal diagnosis of AA increased by 25.8% and that of AD by 56.7%. That of cases with the principal diagnosis of ruptured AA (rAA) remained unchanged (−2.5%) and that with rAD increased by 54.6%. The number of (open and endovascular) procedures in cases hospitalized for AA increased by 39.4% and for AD by 126.4%. The age-adjusted death rates in Germany for AA decreased from 4.0 to 2.9 per 100,000 inhabitants and that for AD increased from 1.0 to 1.4. The decrease in death attributed to AA cases can be described by linear regression as y = −0.0003*y + 6.7076 ( p < 0.0001). Accepting this association between increased elective procedures and reduced AA mortality, each/all 1000 procedures save 0.3 lives per 100,000 inhabitants.

Conclusion

Despite increasing numbers of AR for AA and AD, only the mortality rate for all AAs decreased, while we did not observe a decrease in overall mortality of AD in Germany.
Quality of antenatal care and associated factors among pregnant women in East Africa using Demographic and Health Surveys: A multilevel analysis
Authors: Raru Temam Beshir , Mamo Ayana Galana , Bahiru Nebiyu , Deressa Alemayehu , Alemu Addisu , Birhanu Abdi , Yuya Mohammed , Taye Merga Bedasa , Negash Belay , Letta Shiferaw
Published: February 2022

Introduction:

Antenatal care offers a forum for critical healthcare functions, including health education, screening, and disease prevention. Several pocket studies carried out in specific localities of East African countries were investigated. However, these were neither representative of the country nor specific to the recommended minimum of four antenatal care visits. Therefore, this study aimed to identify factors associated with quality of antenatal care among pregnant women in East Africa.

Methods:

A secondary data analysis was done using Demographic and Health Survey data of six East African Countries from 2008 to 2018. A total of 46,656 women who gave birth in the 5 years preceding the survey were included in this study. A multilevel mixed-effect logistic regression model was fitted. Variables with a p-value < 0.05 were declared as significant factors associated with the quality of antenatal care.

Results:

The magnitude of quality of antenatal care in East Africa was 11.16% (95% confidence interval: 10.87–11.45). Women of age 35–49 (adjusted odds ratio = 1.51; 95% confidence interval: 1.25–1.80), primary education (adjusted odds ratio = 1.35; 95% confidence interval: 1.18–1.55), richest wealth index (adjusted odds ratio = 2.35; 95% confidence interval: 2.02–2.74), and rural resident (adjusted odds ratio = 0.62; 95% confidence interval: 0.55–0.69) were among factors significantly associated with quality of antenatal care.

Conclusion:

The magnitude of antenatal care quality was low in East Africa. Age, level of education, wealth index, birth order, husband/partners’ level of education, residence, and living countries were among the factors associated with the quality of antenatal care. It would be useful to increase financial support strategies that enable mothers from poor households to use health services and enhance women’s understanding of the significance of antenatal care utilization through health education targeting both women and partners with no education is very crucial.
Intra-Articular Injection of Rebamipide-Loaded Nanoparticles Attenuate Disease Progression and Joint Destruction in Osteoarthritis Rat Model: A Pilot Study
Authors: Kim Sung Eun , Choi Sung Jae , Park Kyeongsoon , Kim Hak-Jun , Song Gwan Gyu , Jung Jae Hyun
Published: February 2022

Objective

Rebamipide has antioxidant effects and is a drug with a local rather than systemic mechanism of action. Oxidative stress and inflammation in chondrocytes are the major factors contributing to the development and progression of osteoarthritis (OA). Since OA is mainly developed in weight bearing or overused joints, the locally sustained therapy is effective for targeting inflammatory component of OA. We investigated the effects of intra-articular injection of rebamipide loaded nanoparticles (NPs) in OA rat model.

Design

We fabricated rebamipide-loaded methoxy poly(ethylene glycol)-b-poly(D,L-lactide) (mPEG-PDLLA) and poly(D, L-lactide- co-glycolide) (PLGA) NPs that allow the sustained release of rebamipide. In vitro, chondrocytes from rat were used to investigate the cytotoxicity and anti-inflammatory effect of rebamipide-loaded NPs. In vivo, monosodium iodoacetate (MIA)-induced OA rats were divided into 7 groups, consisting of healthy control rats and rats injected with MIA alone or in combination with NPs, rebamipide (1 mg)/NPs, rebamipide (10 mg)/NPs, rebamipide (10 mg) solution, or oral administration.

Results

In vitro, rebamipide/NPs dose-dependently suppressed the mRNA levels of pro-inflammatory mediators, including interleukin (IL)-1β, IL-6, tumor necrosis factor-α, matrix metalloproteinase (MMP)-3, MMP-13, and cyclo-oxygenase-2. In vivo, the mRNA levels of pro-inflammatory components most markedly decreased in the intra-articularly injected rebamipide (10 mg)/NP group compared to other groups. Macroscopic, radiographic, and histological evaluations showed that the intra-articular injection of rebamipide/NPs inhibited cartilage degeneration more than rebamipide solution or rebamipide administration.

Conclusions

Using a chemically induced rat model of OA, intra-articular delivery of rebamipide was associated with decreased local and systemic inflammatory response decreased joint degradation and arthritic progression.
Neural diffusion tensor imaging metrics correlate with clinical measures in people with relapsing-remitting MS
Authors: Alshehri Abdulaziz , Al-iedani Oun , Arm Jameen , Gholizadeh Neda , Billiet Thibo , Lea Rodney , Lechner-Scott Jeannette , Ramadan Saadallah
Published: February 2022

Background and purpose

Diffusion tensor imaging (DTI) can detect microstructural changes of white matter in multiple sclerosis (MS) and might clarify mechanisms responsible for disability. Thus, we aimed to compare DTI metrics in relapsing-remitting MS patients (RRMS) with healthy controls (HCs), and explore the correlations between DTI metrics, total brain white matter (TBWM) and white matter lesion (WML) with clinical parameters compared to volumetric measures.

Material and methods

37 RRMS patients and 19 age/sex-matched HCs were included. All participants had clinical assessments, structural and diffusion scans on a 3T MRI. Volumetric and white matter DTI metrics; fractional anisotropy (FA), mean, radial and axial diffusivities (MD, RD and AD) were estimated and correlated with clinical parameters. The mean group differences were calculated using t-tests, and univariate correlations with Pearson correlation coefficients.

Results

Compared to HCs, statistically significant increases in MD (+3.6%), RD (+4.8%), AD (+2.7%) and a decrease in FA (−4.3%) for TBWM in RRMS was observed ( p < .01). MD and RD in TBWM and AD in WML correlated moderately with disability status. Volumetric segmentation indicated a decrease in the total brain volume, GM and WM(−5%) with a reciprocal increase in CSF(+26%) in RRMS( p < .01). Importantly, DTI parameters showed a medium correlation with cognitive domains in contrast to white matter-related volumetric measurements in RRMS(Pearson correlation, p < .05).

Conclusions

Our study shows a correlation of DTI metrics with clinical symptoms of MS, in particular cognition. More generally, these findings indicated that DTI is a useful and unique technique for evaluating the clinical features of white matter disease and warrants further investigation into its clinical role.
Social media-based intervention to promote HBV screening and liver cancer prevention among Korean Americans: Results of a pilot study
Authors: Hong Y. Alicia , Yee Soo , Bagchi Pramita , Juon Hee-soon , Kim Sojung Claire , Le Daisy
Published: February 2022

Objective

In United States, Asian Americans are 10 times more likely to have hepatitis B virus (HBV) infection than Whites. Asian immigrants with limited English proficiency face extra barriers to HBV screening and many are unaware of the infectious status. This study aimed to evaluate a social media-based intervention to promote HBV screening and liver cancer prevention among Korean Americans (KA) with limited English proficiency.

Methods

Our community-academia partnership developed the “Lets talk about liver cancer” mHealth program by adapting a CDC media campaign. The program consisted of culturally tailored short video clips and pictorial messages and was delivered over 4 weeks to the participants via the popular Korean social media app, Kakao Talk. A total 100 KA living in greater Washington DC metropolitan were recruited via social media networks and completed this pre-post pilot study.

Results

Out of the 100 participants of KA, 56 were female, mean age was 60, and most have lived in the U.S. for more than 20 years, 84% had limited English proficiency, and 21% had a family history of HBV infection or liver cancer. After 4-week intervention, 95% completed the follow-up survey. Participants reported significant improvements in HBV-related knowledge, liver cancer prevention knowledge, perceived benefits of HBV testing, perceived risks of HBV infection, injunctive norms of HBV testing, and self-efficacy of HBV testing.

Conclusions

The Kakao Talk-based liver cancer prevention program for KAs was feasible and effective. We advocate for community-academia partnership to develop and implement culturally appropriate and social media-based interventions for underserved immigrants.
The theoretical origin of the knowledge-sharing mode of open access: From knowledge communism to academic capitalism
Authors: Ding Dawei , Li Zhengfeng
Published: February 2022

This paper adopts the science and technology studies perspective to explore the theoretical origin of open access to knowledge against the historical background of the interaction between science and society, as well as to clarify the benefit allocation and adjustment relations of different actors in the implementation process of the open-access mode. Focusing on the theoretical origin and realistic influence of open access, this paper investigates the historical changes of scientific knowledge from the common good to profitability and discusses different interpretations held by knowledge communism and academic capitalism concerning the property rights and social functions of scientific information. It also examines the role of commercial capital in commercializing academic resources and the substance of that commercialization. As a knowledge-sharing mode, open access is inevitable and rational. However, this mode involves many social problems, and there is a need to provide appropriate policies and systems.
Challenges in Emerging Adulthood Related to the Impact of Childhood Bullying Victimization
Authors: Lidberg Johan , Berne Sofia , Frisén Ann
Published: February 2022

Findings from interviews with 15 emerging adults ( M age = 29.00, SD = .37) subjected to bullying victimization as children and suffering from poor psychological health in emerging adulthood revealed experiences of a very long duration of victimization, coping through adaptation to the bullying, and experiences of not receiving help from school personnel. Many participants described experiences of depression, anxiety, and even suicidal thoughts during the school-years victimization. They perceived several direct long-term consequences of the victimization in emerging adulthood: feelings of insecurity; actively avoiding social situations; an identity formed into viewing oneself as worthless; and body-image problems. Additionally, many of them still felt anger towards school personnel who they remembered as not stopping the victimization. A longitudinal and prospective design enabled insights into victims’ experiences of both the childhood victimization as well as perceived long-term consequences on their emerging adulthood – and into how the victims experience that these aspects might be related.
Donor-Site Morbidity After Autologous Fascia Lata Harvest for Arthroscopic Superior Capsular Reconstruction: A Midterm Follow-up Evaluation
Authors: Ângelo Ana Catarina Leiria Pires Gago , de Campos Azevedo Clara Isabel
Published: February 2022

Background:

Autologous fascia lata (AFL) graft use in arthroscopic superior capsular reconstruction (ASCR) is effective for the treatment of irreparable rotator cuff tears (RCTs). Although donor-site morbidity (DSM) is a recurrent argument against AFL graft use, scientific evidence for this argument is lacking.

Purpose:

To report the midterm clinical follow-up evaluation of DSM in ASCR using minimally invasively harvested AFL grafts and compare thigh function and patient satisfaction with those of an unharvested control group.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Of 66 consecutive patients who underwent ASCR using a minimally invasively harvested AFL graft, 39 patients with a minimum follow-up of 24 months were retrospectively evaluated (ASCR group) and compared with 39 randomly selected patients who underwent arthroscopic RCT repair by the same surgeons (control group). The functional outcomes of both thighs were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patient satisfaction was evaluated using the Patient Scar Assessment Questionnaire (PSAQ) and a subjective questionnaire. Pain was quantified using a visual analog scale (VAS).

Results:

The ASCR group had a mean age of 65 years (range, 51-77 years) and a mean follow-up of 47 months (range, 24-66 months). The WOMAC score in the harvested thigh differed by 0.8% from that in the contralateral thigh ( P = .002). The mean PSAQ score differed by 6 points from the minimum PSAQ score ( P < .001). Overall, 95% of the patients indicated that they would undergo the same surgery again and that the shoulder outcome compensated for the thigh symptoms. There was no significant association between the presence of residual thigh symptoms and the willingness to undergo the same surgery again ( P = .354). The mean VAS score in the harvested thigh was 0.6 (range, 0-5). There was no significant difference in the average WOMAC score or VAS score between groups ( P = .684 and P = .148, respectively).

Conclusion:

Despite the proportion of residual symptoms, the associated functional effects were small and not clinically significant, and the vast majority of patients were accepting of the harvest symptoms given the improvement in shoulder function.
Perceived Social Support and its Effects on Treatment Compliance and Quality of Life in Cardiac Patients
Authors: Wenn Peter , Meshoyrer Daniel , Barber Megan , Ghaffar Atif , Razka Marisha , Jose Stephanie , Zeltser Roman , Makaryus Amgad N.
Published: February 2022

Background: The benefits of social support are often overlooked in common management components of cardiovascular diseases. The Multidimensional Scale of Perceived Social Support (MSPSS) is self-administered and scores perceived social support (PSS). We sought to identify PSS among cardiovascular patients and the effects it may have on quality of life (QoL) and treatment compliance. Methods: A total of 96 patients were evaluated using the MSPSS in 3 categories: significant other (SO), family, and friends using a 7-point Likert scale. A supplemental lifestyle survey assessed various demographics, subjective QoL, and compliance with treatment plans. Results: Patients with high QoL reported a higher PSS Likert score in the family support category. Patients who were compliant with appointments and had high substance use avoidance (tobacco, alcohol, illicit drugs) had a higher PSS Likert score in the friend support and higher PSS Likert score in support from SO and family categories, respectively. No difference in PSS was found in compliance with medications, diet, and exercise. Conclusion: Various social support categories are directly associated with higher QoL, adherence to appointments, and substance abuse avoidance.
Mechanical thrombectomy in stroke patients of working age: Real-world outcomes in Sweden
Authors: Roland Mihae , Markaki Ioanna , Andersson Tommy , Arnberg Fabian , Sjöstrand Christina
Published: February 2022

Introduction

Outcomes after mechanical thrombectomy (MT) in young stroke patients remain elusive due to small patient cohorts. We sought to determine outcomes after MT in stroke patients between ages 18 and 64 years and compare with outcomes in older patients in a large national stroke cohort.

Patients and methods

We used the Swedish National Stroke Registry and the Swedish National Endovascular Thrombectomy Registry to identify all patients treated with MT for anterior circulation occlusions. We examined outcome measures in terms of functional independence at 90 days (modified Rankin Scale score of 0–2), symptomatic intracerebral hemorrhage (sICH), and mortality at 90 days with multivariable logistic regression analysis.

Results

Of 2143 patients, 565 were between 18 and 64 years (26.4%) and 1179 (55.0%) were males. Analysis showed that patient aged 18–64 achieved higher rate of functional independence at 90 days (46.2% vs 28.4%, p < .001), had less often sICH (5.5% vs 6.8%, p = .008), and lower 90-day mortality rate (6.9% vs 17.7%, p < .001). Increasing age was associated with a lesser probability of functional independence at 90 days (adjusted odds ratio (aOR), 0.94; [95% confidence intervals (CIs) 0.93–0.95]), higher odds of mortality at 90 days (aOR, 1.05; [95% CIs 1.03–1.06]), and of sICH (aOR 1.03; [95% CIs 1.01–1.05]).

Conclusion

Patients aged 18–64 years demonstrated better outcome after thrombectomy regarding functional independence, sICH, and mortality at 90 days when compared to older ages.
Fuel cell drive for urban freight transport in comparison to diesel and battery electric drives: a case study of the food retailing industry in Berlin
Authors: Winkler John Kenneth , Grahle Alexander , Syré Anne Magdalene , Martins-Turner Kai , Göhlich Dietmar
Published: February 2022

The option of decarbonizing urban freight transport using battery electric vehicle (BEV) seems promising. However, there is currently a strong debate whether fuel cell electric vehicle (FCEV) might be the better solution. The question arises as to how a fleet of FCEV influences the operating cost, the greenhouse gas (GHG) emissions and primary energy demand in comparison to BEVs and to Internal Combustion Engine Vehicle (ICEV). To investigate this, we simulate the urban food retailing as a representative share of urban freight transport using a multi-agent transport simulation software. Synthetic routes as well as fleet size and composition are determined by solving a vehicle routing problem. We compute the operating costs using a total cost of ownership analysis and the use phase emissions as well as primary energy demand using the well to wheel approach. While a change to BEV results in 17–23% higher costs compared to ICEV, using FCEVs leads to 22–57% higher costs. Assuming today’s electricity mix, we show a GHG emission reduction of 25% compared to the ICEV base case when using BEV. Current hydrogen production leads to a GHG reduction of 33% when using FCEV which however cannot be scaled to larger fleets. Using current electricity in electrolysis will increase GHG emission by 60% compared to the base case. Assuming 100% renewable electricity for charging and hydrogen production, the reduction from FCEVs rises to 73% and from BEV to 92%. The primary energy requirement for BEV is in all cases lower and for higher compared to the base case. We conclude that while FCEV have a slightly higher GHG savings potential with current hydrogen, BEV are the favored technology for urban freight transport from an economic and ecological point of view, considering the increasing shares of renewable energies in the grid mix.
Complete genome sequence of the kiwifruit bacterial canker pathogen Pseudomonas savastanoi strain MHT1
Authors: Zhong Mingzhao , Sun Yunhao , Zhang Xianzhi , Liang Hong , Xiong Lina , Han Qunxin
Published: February 2022

Background

Pseudomonas savastanoi is an important plant pathogen that infects and causes symptoms in a variety of economically important crops, causing considerable loss of yield and quality. Because there has been no research reported to date on bacterial canker of kiwifruit (Actinidia chinensis) plants caused by P. savastanoi and, in particular, no in-depth studies of the complete genome sequence or pathogenic mechanism, long-lasting and environmentally friendly control measures against this pathogen in kiwifruit are lacking. This study therefore has both theoretical value and practical significance.

Results

We report the complete genome sequence of P. savastanoi strain MHT1, which was first reported as the pathogen causing bacterial canker in kiwifruit plants. The genome consists of a 6.00-Mb chromosome with 58.5% GC content and 5008 predicted genes. Comparative genome analysis of four sequenced genomes of representative P. savastanoi strains revealed that 230 genes are unique to the MHT1 strain and that these genes are enriched in antibiotic metabolic processes and metabolic pathways, which may be associated with the drug resistance and host range observed in this strain. MHT1 showed high syntenic relationships with different P. savastanoi strains. Furthermore, MHT1 has eight conserved effectors that are highly homologous to effectors from P. syringae, Pseudomonas amygdali, and Ralstonia solanacearum strains. The MHT1 genome contains six genomic islands and two prophage sequences. In addition, 380 genes were annotated as antibiotic resistance genes and another 734 as encoding carbohydrate-active enzymes.

Conclusion

The whole-genome sequence of this kiwifruit bacterial canker pathogen extends our knowledge of the P. savastanoi genome, sets the stage for further studies of the interaction between kiwifruit and P. savastanoi, and provides an important theoretical foundation for the prevention and control of bacterial canker.
Immunoglobulin G4-related constrictive pericarditis and the importance of a thorough workup: a case report
Authors: Maltês Sérgio , Cabral Margarida , Freitas Pedro , Albuquerque Catarina , Fernandes Carolina , Moura Diana , Santos Beatriz , Mendes Miguel , Neves José
Published: February 2022

Background

Constrictive pericarditis remains a problematic diagnosis and a thorough investigation is critical. Among possible aetiologies, immunoglobulin-G4 (IgG4)-related pericardial disease is an unusual cause of pericardial constriction. We report a challenging diagnostic case of pericardial constriction due to IgG4-related disease.

Case presentation

A 68-year old male with a history of inferior myocardial infarction with right ventricle (RV) involvement was thrice-hospitalized due to marked ascites and peripheral oedema. Systemic congestion was initially attributed to RV dysfunction due to previous infarction. Yet, at the final admission, a re-assessment echocardiogram followed by cardiac computed tomography, magnetic resonance and right heart catheterization raised a possible diagnosis of constrictive pericarditis with a finding of abnormal pulmonary venous return. Patient therefore underwent pericardiectomy and surgical correction of pulmonary venous return. Pericardium histology revealed an IgG4-related pericardial constriction. Patient was later discharged on corticosteroids with marked symptomatic improvement.

Conclusion

IgG4-related disease remains a rare cause of pericardium constriction while also presenting a challenging diagnosis in everyday clinical practice. This case exemplifies the difficulties faced by clinicians when reviewing a possible case of constrictive pericarditis, while highlighting the importance of a multimodality assessment.
Emergency department visits and trends related to cocaine, psychostimulants, and opioids in the United States, 2008–2018
Authors: Suen Leslie W. , Davy-Mendez Thibaut , LeSaint Kathy T. , Riley Elise D. , Coffin Phillip O.
Published: February 2022

Background

Drug-related emergency department (ED) visits are escalating, especially for stimulant use (i.e., cocaine and psychostimulants such as methamphetamine). We sought to characterize rates, presentation, and management of ED visits related to cocaine and psychostimulant use, compared to opioid use, in the United States (US).

Methods

We used 2008–2018 National Hospital Ambulatory Medical Care Survey data to identify a nationally representative sample of ED visits related to cocaine and psychostimulant use, with opioids as the comparator. To make visits mutually exclusive for analysis, we excluded visits related to 2 or more of the three possible drug categories. We estimated annual rate trends using unadjusted Poisson regression; described demographics, presenting concerns, and management; and determined associations between drug-type and presenting concerns (categorized as psychiatric, neurologic, cardiopulmonary, and drug toxicity/withdrawal) using logistic regression, adjusting for age, sex, race/ethnicity, and homelessness.

Results

Cocaine-related ED visits did not significantly increase, while psychostimulant-related ED visits increased from 2008 to 2018 (2.2 visits per 10,000 population to 12.9 visits per 10,000 population; p < 0.001). Cocaine-related ED visits had higher usage of cardiac testing, while psychostimulant-related ED visits had higher usage of chemical restraints than opioid-related ED visits. Cocaine- and psychostimulant-related ED visits had greater odds of presenting with cardiopulmonary concerns (cocaine adjusted odds ratio [aOR] 2.95, 95% CI 1.70–5.13; psychostimulant aOR 2.46, 95% CI 1.42–4.26), while psychostimulant-related visits had greater odds of presenting with psychiatric concerns (aOR 2.69, 95% CI 1.83–3.95) and lower odds of presenting with drug toxicity/withdrawal concerns (aOR 0.47, 95%CI 0.30–0.73) compared to opioid-related ED visits.

Conclusion

Presentations for stimulant-related ED visits differ from opioid-related ED visits: compared to opioids, ED presentations related to cocaine and psychostimulants are less often identified as related to drug toxicity/withdrawal and more often require interventions to address acute cardiopulmonary and psychiatric complications.
Quantifying population level hypertension care cascades in India: a cross-sectional analysis of risk factors and disease linkages
Authors: Kothavale Ajinkya , Puri Parul , Sangani Purvi G.
Published: February 2022

Background

Hypertension is associated with higher morbidity and mortality burden, and is reported to pose severe repercussions on those above the age of 60 years. Despite the growing concern, empirical evidence providing nationally representative estimates of hypertension care cascades for the elderly population are inadequate in India. Therefore, the present study aims to quantify the magnitude of hypertension care cascades, identify the co-morbidities attributed to hypertension and recognize lifestyle modifications to reduce the instances of uncontrolled blood pressure among the elderly population in India.

Method

This study employed data on 28,109 elderly individuals from the Longitudinal Ageing Study in India, 2017-18. Descriptive and multivariable analyses were performed to identify the burden and correlates of hypertension and uncontrolled blood pressure levels. Population Attributable Risk was computed to identify deteriorating health implications and recognize viable solutions to improve the situation.

Results

The findings suggest that elderly experiences loss at all stages of hypertension care, namely, at the level of measured hypertension (72.5%), diagnosis/awareness (57.3%), treatment (50.5%), and control (27.5%). The highest dip was observed at the level of blood pressure control. The findings hint towards the linkages between socio-economic, demographic, and lifestyle factors with hypertension and uncontrolled blood pressure levels. Caste, religion, living arrangement, MPCE quintile, residence, family history of hypertension, working status, and alcohol consumption were the significant predictors of uncontrolled hypertension. The findings quantified the proportion of diseased cases attributed to hypertension, and highlighted essential contributors of overall and uncontrolled hypertension.

Conclusions

There is an urgent need to improve access to cost-effective anti-hypertensive prescriptions to curtail the increasing burden of uncontrolled blood pressure and some other co-morbid diseases. Thus, if apprehended cautiously, findings from this study can serve to design practical approaches aimed at control, prevention, and management of hypertension among the elderly population of India.
Trends in utilisation of plain X-rays by older Australians (2010–2019)
Authors: Gaget Virginie , Inacio Maria C. , Tivey David R. , Jorissen Robert N. , Babidge Wendy , Visvanathan Renuka , Maddern Guy J.
Published: February 2022

Background

Older Australians are major health service users and early diagnosis is key in the management of their health. Radiological services are an important component of diagnosis and disease management planning in older Australians, but their national utilisation of diagnostic services has never been investigated in Australia.

Purpose

This study aims to evaluate the utilisation of major plain X-rays by Australians ≥ 65 years old.

Methods

A population-based epidemiological evaluation and yearly cross-sectional analyses of X-ray examinations per 1,000 Australians aged ≥ 65 years old between 2009 and 2019 were conducted using publicly available Medicare Benefits Schedule and Australian Bureau of Statistics data sources. Age and sex specific incidence rate (IR) of plain X-rays per 1,000 Australians, adjusted incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated using a negative binomial regression model.

Results

During the study period, the Australian population over 65 years old increased by 39% while the crude plain X-ray utilisation by this population increased by 63%. Most X-rays were conducted on extremities or the chest. Men used chest radiography more than women, and particularly for lungs, where the incidence increased the most in those ≥ 85 years old. There was an increase in X-rays of extremities and the hip joint between 2009–10 and 2013–14 in people ≥ 85 years old.

Conclusion

The utilisation of plain X-rays of the chest, the gastro-intestinal tract and extremities was high and has increased among older Australians between 2009–10 and 2018–19. Plain X-rays remain a commonly used diagnostic tool for conditions affecting the older population.
Performance and utility of more highly sensitive malaria rapid diagnostic tests
Authors: Slater Hannah C. , Ding Xavier C. , Knudson Sophia , Bridges Daniel J. , Moonga Hawela , Saad Neil J. , De Smet Martin , Bennett Adam , Dittrich Sabine , Slutsker Laurence , Domingo Gonzalo J.
Published: February 2022

Background

A new more highly sensitive rapid diagnostic test (HS-RDT) forPlasmodium falciparummalaria (Alere™/Abbott Malaria Ag P.f RDT [05FK140], now calledNxTek™Eliminate Malaria Ag Pf) was launched in 2017. The test has already been used in many research studies in a wide range of geographies and use cases.

Methods

In this study, we collate all published and available unpublished studies that use the HS-RDT and assess its performance in (i) prevalence surveys, (ii) clinical diagnosis, (iii) screening pregnant women, and (iv) active case detection. Two individual-level data sets from asymptomatic populations are used to fit logistic regression models to estimate the probability of HS-RDT positivity based on histidine-rich protein 2 (HRP2) concentration and parasite density. The performance of the HS-RDT in prevalence surveys is estimated by calculating the sensitivity and positive proportion in comparison to polymerase chain reaction (PCR) and conventional malaria RDTs.

Results

We find that across 18 studies, in prevalence surveys, the mean sensitivity of the HS-RDT is estimated to be 56.1% (95% confidence interval [CI] 46.9–65.4%) compared to 44.3% (95% CI 32.6–56.0%) for a conventional RDT (co-RDT) when using nucleic acid amplification techniques as the reference standard. In studies where prevalence was estimated using both the HS-RDT and a co-RDT, we found that prevalence was on average 46% higher using a HS-RDT compared to a co-RDT. For use in clinical diagnosis and screening pregnant women, the HS-RDT was not significantly more sensitive than a co-RDT.

Conclusions

Overall, the evidence presented here suggests that the HS-RDT is more sensitive in asymptomatic populations and could provide a marginal improvement in clinical diagnosis and screening pregnant women. Although the HS-RDT has limited temperature stability and shelf-life claims compared to co-RDTs, there is no evidence to suggest, given this test has the same cost as current RDTs, it would have any negative impacts in terms of malaria misdiagnosis if it were widely used in all four population groups explored here.
Associations between daily steps and cognitive function among inpatients with schizophrenia
Authors: Chen Li-Jung , Stubbs Brendon , Chien I-Chia , Lan Tsuo-Hung , Chung Ming-Shun , Lee Hui-Ling , Hsu Wan-Chi , Ku Po-Wen
Published: February 2022

Background

Walking is the fundamental component of taking steps and is the main form of physical activity among individuals with schizophrenia; it also offers a range of health benefits. This study aimed to examine the associations between daily steps and cognitive function and further explored how many steps were related to better cognitive function among inpatients with schizophrenia.

Methods

Inpatients with schizophrenia were recruited from long-stay psychiatric wards across two hospitals (n=199 at site 1 and n=195 at site 2). Daily steps were collected with an accelerometer for 7 days. Four cognitive domains (attention, processing speed, reaction time, and motor speed) were tested at site 1, and two cognitive domains (attention and processing speed) were tested at site 2. The associations of daily steps and levels of steps/day with cognitive function were tested using multivariable linear regressions separated by site. Covariates included demographic variables, weight status, metabolic parameters, and clinical state.

Results

Participants took an average of 7445 (±3442) steps/day. More steps were related to better attention, processing speed, reaction time, and motor speed after multivariable adjustments. Compared with participants taking <5000 steps/day, those taking ≥5000 steps/day showed significantly better processing speed. Participants taking ≥7500 steps/day were associated with better attention, better reaction time, and better motor speed than those taking <5000 steps/day.

Conclusion

Daily steps are associated with better cognitive function among inpatients with schizophrenia. The optimal benefit for cognitive function among this clinical population is achieving 7500 steps/day or more.
Tick bites in different professions and regions: pooled cross-sectional study in the focus area Bavaria, Germany
Authors: Schielein Louisa , Tizek Linda , Biedermann Tilo , Zink Alexander
Published: February 2022

Background

As the vector-borne diseases tick-borne encephalitis (TBE) and Lyme borreliosis (LB) are common in Germany and transmitted by tick bites, the aim of this study was to assess differences in the number of tick bites in various professions and regions across southern Germany to evaluate the differences in tick-associated risk.

Materials and methods

The analysis is based on three cross-sectional studies that were conducted in 2016 and 2017 in two real-life settings and in one medical setting in Bavaria. All participants filled in a paper-based questionnaire about their history with tick bites. Only adult participants (≥ 18 years) were included in this study.

Results

Overall, 3503 individuals (mean age 50.8 ± 15.2 years, median age 53.0 ± 12.2 years, 54.0% female) were included. Of these, 50% worked in an outdoor profession and 56% lived in environs. Around 70% of participants reported at least one previous tick bite. In comparison to indoor workers, forestry workers (OR = 2.50; 95% CI: 1.10–5.68) had the highest risk for a tick bite followed by farmers (OR = 1.22; 95% CI: 1.01–1.47). Furthermore, people living in rural areas (OR = 1.97, 95% CI:1.49–2.59) and environs (OR = 1.98, 95% CI: 1.54–2.55) were twice as likely to have a previous tick bite than people living in urban areas. In general, slightly more tick bites were reported by people living in eastern Bavaria.

Conclusion

Rising numbers of TBE and LB indicate the need for further prevention strategies, which should focus on outdoor professions with a higher risk and people living in environs and rural areas.
Impact of the Norwegian Agreement for a More Inclusive Working Life on diagnosis-specific sickness absence in young adults: a difference-in-difference analysis
Authors: Hasting Rachel L. , Merkus Suzanne L. , Hanvold Therese N. , Kristensen Petter , Gran Jon Michael , Mehlum Ingrid S.
Published: February 2022

Background

The Norwegian Agreement for a More Inclusive Working Life (the IA Agreement) aims to reduce sickness absence (SA) and increase work participation. Potential impacts of the IA Agreement have not been thoroughly evaluated. The study aimed to estimate the impact of the IA Agreement on musculoskeletal and psychological SA prevalence and duration among young adult men and women, and to identify whether the impact was modified by economic activity or SA grade.

Methods

Data from national registries were combined for 372,199 individuals born in Norway 1967–1976. ICPC-2 codes identified musculoskeletal (L) and psychological (P) diagnoses. A difference-in-difference method compared prevalence and mean duration of first SA > 16 days between 2000 and 2005 separately for men and women working in IA companies relative to non-IA companies. Analyses were adjusted for mean company size and stratified by economic activity and SA grade (full/graded). Average marginal change was calculated with 95% confidence intervals (CI).

Results

The impacts of the IA Agreement on SA prevalence were mixed as the direction and size of marginal changes varied according to diagnosis, gender, and economic activity. However, there was a general tendency towards reduced mean SA duration for both diagnosis groups, and in particular men with musculoskeletal SA (− 16.6 days, 95% CI -25.3, − 7.9). Individuals with full SA in IA companies had greater reductions in mean SA duration. Only the wholesale and retail economic activity indicated a beneficial contribution of the IA Agreement for both SA prevalence and duration, in both diagnoses and genders.

Conclusions

Potential impacts of the IA Agreement on SA in young men and women varied according to diagnosis and economic activity. However, results indicated that the IA Agreement could reduce SA duration. Further research should identify reasons for gender and economic activity differences.
Trajectories of hypoxemia and pulmonary mechanics of COVID-19 ARDS in the NorthCARDS dataset
Authors: Jafari Daniel , Gandomi Amir , Makhnevich Alex , Qiu Michael , Rolston Daniel M. , Gottesman Eric P. , Tsegaye Adey , Mayo Paul H. , Stewart Molly E. , Zhang Meng , Hajizadeh Negin
Published: February 2022

Background

Understanding heterogeneity seen in patients with COVIDARDS and comparing to non-COVIDARDS may inform tailored treatments.

Methods

A multidisciplinary team of frontline clinicians and data scientists worked to create the Northwell COVIDARDS dataset (NorthCARDS) leveraging over 11,542 COVID-19 hospital admissions. The data was then summarized to examine descriptive differences based on clinically meaningful categories of lung compliance, and to examine trends in oxygenation.

Findings

Of the 1536 COVIDARDS patients in the NorthCARDS dataset, there were 531 (34.6%) who had very low lung compliance (< 20 ml/cmH2O), 970 (63.2%) with low-normal compliance (20–50 ml/cmH2O), and 35 (2.2%) with high lung compliance (> 50 ml/cmH2O). The very low compliance group had double the median time to intubation compared to the low-normal group (107.3 h (IQR 25.8, 239.2) vs. 39.5 h (IQR 5.4, 91.6)). Overall, 68.8% (n = 1057) of the patients died during hospitalization. In comparison to non-COVIDARDS reports, there were less patients in the high compliance category (2.2% vs. 12%, compliance ≥ 50 mL/cmH20), and more patients with P/F ≤ 150 (59.8% vs. 45.6%). There is a statistically significant correlation between compliance and P/F ratio. The Oxygenation Index is the highest in the very low compliance group (12.51, SD(6.15)), and lowest in high compliance group (8.78, SD(4.93)).

Conclusions

The respiratory system compliance distribution of COVIDARDS is similar to non-COVIDARDS. In some patients, there may be a relation between time to intubation and duration of high levels of supplemental oxygen treatment on trajectory of lung compliance.