bluuebunny/crossref_metadata_2025 huggingface dataset:
Osteosarcopenia and Long-COVID: a dangerous combination
Authors: Tarantino Umberto , Visconti Virginia V. , Bonanni Roberto , Gatti Andrea , Marcozzi Martina , Calabrò Davide , Cariati Ida
Published: October 2022

SARS-CoV-2 has caused a global pandemic and an unprecedented public health crisis, infecting more than 580 million people worldwide. Moreover, recent evidence has suggested the emergence of a new syndrome known as Long-COVID, a term used to describe a diverse set of physical and mental symptoms that persist after a diagnosed SARS-CoV-2 infection. Epidemiological data have identified myalgias, muscle and joint dysfunction, and bone fragility as common sequelae in patients with moderate and severe forms of this disease. Significant musculoskeletal dysfunction has also been detected in some healed patients, although knowledge about pathophysiological mechanisms of Long-COVID is still rather scarce. In this context, SARS-CoV-2 infection has been suggested to amplify the effects of aging on the musculoskeletal system by aggravating the osteosarcopenic state. Based on this evidence, our review focused on the muscle and bone tissue alterations induced by SARS-CoV-2 infection and Long-COVID, summarizing the current knowledge on the underlying biological mechanisms and highlighting the need for a multidisciplinary approach to predict the musculoskeletal targets and long-term consequences of COVID-19 disease.
Algorithmic precarity and metric power: Managing the affective measures and customers in the gig economy
Authors: Chan Ngai Keung
Published: October 2022

Drawing on a qualitative, multi-case study of three kinds of geographically tethered gig work—ride-hailing, delivery, and domestic services platforms—in the United States, I examine how workers anticipate the influences of metrics, live with metrics, and cope with algorithmic precarity. Data for this project include in-depth interviews with 50 gig workers about their efforts to interpret and manage metrics as part of their everyday work practices. The analysis reveals that participants were anxious about metrics primarily because of the disciplinary outcomes, that are, the threat of job loss and the valued job features. It also directs attention to how workers felt and experienced customer-sourced ratings and system-generated behavioral metrics variously across platforms. Information asymmetries and the perceived lack of control also intensified a sense of powerlessness among participants. While participants articulated strategies that aimed at managing the uncertainty of customer-sourced ratings—and more precisely, the work-related uncertainty created by “difficult customers”—throughout service interactions, their feelings of anxiety could not be resolved. Furthermore, the (in)visibility of metrics, the settings of platform-mediated worker–customer interactions, and workers’ platform dependence contributed to the varying disciplinary power of metrics. The study contributes to understanding how metrics as affective measures mediate the trilateral relationship between platforms, workers, and customers in the gig economy.
Big data and ICT solutions in the European Union and in China: A comparative analysis of policies in personalized medicine
Authors: Causio Francesco Andrea , Hoxhaj Ilda , Beccia Flavia , Marcantonio Marzia di , Strohäker Timo , Cadeddu Chiara , Ricciardi Walter , Boccia Stefania
Published: October 2022

Introduction

Several countries are either planning or implementing national strategies for the development and integration of Personalized Medicine (PM) into their healthcare systems. Personalized Medicine is an undisputed priority of the European Commission (EC), which has funded the project “Integrating China into the International Consortium for Personalized Medicine” (IC2PerMed), in order to ensure a common basis for Sino-European collaborations. By mapping the current PM landscape in the European Union (EU) and in China, IC2PerMed aims to provide key solutions toward a synergistic and coordinated approach in the field of PM.

Methods

An extensive desk research was conducted, aimed at identifying documents on PM-related policies, programs, and action plans in the EU and in China, published up to November 2020. The search was conducted by exploring scientific and gray literature, and official institutional repositories. A descriptive summary condensed the information retrieved for both.

Results

Since 2013, the year of publication of the first PM policy by the EC “Use of omics technologies in PM development,” several documents have been published. PM is a key element of the policy agenda also in China, which in 2016 integrated PM into the 13th National Five-Year Plan, followed by the publication of several policies on technology infrastructure and big data. Both in the EU and China, especially in recent years, these policies addressed in detail the issues of big data, data interoperability and exchange, while defining the standards of information and communication infrastructures.

Conclusions

In order to allow optimal collaboration, it is essential to understand similarities and differences between the respective policy strategies, with particular attention to data management and adopted infrastructures. The results of this project may enable the development of joint Sino-European research and innovation initiatives, promoting developments in the field of PM.
Thinking theologically about student success: Higher education with a higher calling
Authors: Cockle Theodore F , Vanderpool Sinda K , Hao David Q
Published: October 2022

Scholarly definitions of student success have become increasingly transactional and thereby reflect a specific form of modern utilitarianism. In this paper, we use a theological map to explore the terrain of contemporary student success scholarship and practice in an effort to re-imagine how the Christian faith might animate a vision of student success for scholar-practitioners. First, we review the current scholarly landscape, second, we show where it falls short. Third, we use the practical theological method to outline a theological vision of student success. Finally, we propose ways to bridge the gap between current practice and theological vision.
Photobiomodulation for modulation of neuropathic pain and improvement of scar tissue
Authors: Santiago Ronaldo , Gomes Shannon , Ozsarfati Jak , Zitney Michael
Published: October 2022

Background

This case-report explores the effects of photobiomodulation therapy (PBMT) on the healing of scar tissue. The patient was a 32-year old female two years post cholecystectomy resulting in a 15 cm linear scar that was causing severe pain.

Methods

Treatment was initiated using the BIOFLEX® therapist device which consists of LED arrays and laser probes of a specific wavelength, power and frequency applied directly on the skin overlying the scar. The frequency and duration of treatment was every other day for six weeks in a clinic setting, followed by three times a week for two months at home. Then the patient continued to use the BIOFLEX® therapist home device on an as-needed basis.

Findings

The final result of this patient's treatment was significant flattening and decreased redness of her scar. Her self-reported pain decreased to a 6/10. At the one year follow up, the patient reported that she stopped taking her opioids, antidepressant and sleeping pills and that her pain decreased to a 4/10. At the last review her pain score was 1/10; and she had returned to work and took Tylenol (acetaminophen) occasionally for breakthrough pain.

Conclusions

We attribute the patient's improvement in scar appearance and pain symptoms to PBMT. Since pain is often associated with depressed mood and sleep disturbances, it cannot be determined whether PBMT was the direct or indirect cause of this patient's improved mood. For future studies, we propose the use of control subjects with similar scars treated with sham treatment compared to those who will receive the PBMT and observed for the same duration of time and compare the overall results.

Lay Summary

Dermatological applications, especially wound healing; are accepted indications for photobiomodulation therapy (PBMT). The expansion into other clinical applications, particularly neurological ones show potential benefit. We present a case of a patient with a hypertrophic scar associated with severe neuropathic pain and concurrent depression, all of which improved directly or indirectly with PBMT. Although the original focus of treatment was dermatological the improvement in pain plus the discontinuation of therapy (opioids, antidepressants and benzodiazepines) were considered to be due to the PBMT.
Control of Therapeutic Levels of Anticoagulation and Associated Factors: A Prospective Cohort Study
Authors: Reig-Garcia Glòria , Camara-Liebana David , Jiménez-Quiñones Raquel , Vilanó-Vives Jordi , Figa-Vaello Josep , Garre-Olmo Josep , Mantas-Jiménez Susana , Juvinyà-Canal Dolors , Suñer-Soler Rosa
Published: October 2022

Maintaining therapeutic levels of anticoagulation is essential to avoid health complications in people who take vitamin K antagonists. This study aimed to analyze the influence of people’s characteristics and the presence of changes in their lives in the control of therapeutic levels of anticoagulation. A longitudinal multicenter study with a 1-year follow-up of a cohort of 199 people receiving anticoagulant therapy was performed. The effect of biological, clinical, social, lifestyle, and changes in life on the international normalized ratio (INR) was analyzed. During the follow-up, 46.7% of participants presented good INR control. At baseline, a diagnosis of atrial fibrillation ( P = .00), the lack of comorbidities ( P = .03), absence of depression ( P = .04), and not following a pharmacological treatment with hypoglycemia drugs ( P = .01) were associated with good INR control. During the follow-up, the variable of making changes to the usual diet was associated with poor INR control ( P = .05). In the binary multiple regression model, factors associated with poor control were taking hypoglycemia drugs ( P = .02) and the presence of depression ( P = .04), and only the diagnosis of atrial fibrillation was associated with good control ( P = .03). People with a diagnosis of atrial fibrillation had good INR control. Having comorbidities, suffering depression, taking hypoglycemia drugs, and making changes to the diet have a negative effect on INR control.
The Adverse and Advantage Effects of Wearing a Facemask in Thai Children: A Survey During the COVID-19 Pandemic
Authors: Ratchatavech Kritchawan , Techasatian Leelawadee , Panombualert Sunee , Uppala Rattapon
Published: October 2022

Background:

There is little information on facemask use during the COVID-19 pandemic in the pediatric population. This became the main purpose of the present study to investigate demographic data of facemask wearing in children, types, and length of facemask, as well as the benefits, drawbacks, and negative consequences of facemask wearing in this population.

Methods:

A cross-sectional study was conducted using a structured questionnaire sent via Google Forms. Caregivers for consecutive convenience were asked in the survey (parents of children under the age of 18).

Results:

A total number of 706 children were enrolled. There were 320 boys (45.33%), and 386 girls (54.67%). The children’s ages range between 4 months and 18 years, with a median age of 9 years. A surgical mask (549, 77.76%) was the most frequent type of facemask in the study population, followed by a cloth mask (86, 12.18%). Facemasks have been shown to be beneficial in the pediatric population. When compared to a former time when facemasks were not used routinely, there were considerably fewer respiratory infections, reduced diarrhea symptoms, and a drop in hospital admissions. In 317 cases (44.9%), children were shown to have negative consequences from wearing facemasks. The most prevalent adverse effect observed in the study population was non-cutaneous (respiratory discomfort/breathing difficulty) which were found in 240 cases (33.99%). Double masking method (surgical + surgical) and wearing a facemask oversize revealed a higher risk in the presence of facemask adverse effects, whereas wearing a proper size facemask reduces the risk of adverse effects from facemask use in children (Adjusted OR [95% CI] = 0.55 [0.38-0.78], P .0003).

Conclusions:

Wearing a proper-size facemask reduces the risk of adverse effects from facemask use in children. The future suggestion of an appropriate facemask size for a certain age will aid in the avoidance of facemask adverse effects in the pediatric population.
Treatment of Post-Coarctectomy Hypertension With Labetalol—A 9-Year Single-Center Experience
Authors: Siersma Carolien , Brouwer Carole N. M. , Sojak Vladimir , Ten Harkel Arend D. J. , Roeleveld Peter P.
Published: October 2022

Background

Although considering the pathophysiology of post-coarctectomy hypertension, β-blockers should be effective, experience with labetalol for treatment is limited in the literature.

Methods

Retrospective collection and analysis of data in children aged ≤6 years following coarctectomy in our tertiary care university medical center between January 2009 and June 2018.

Results

96 patients were included, 45 were treated with intravenous labetalol and 51 received no treatment. Median time to maximum dose received (median 1.1 mg/kg/h) was 2.7 h, and median time to the reduction of labetalol dose was 8.3 h. No antihypertensives had to be added. In one child, labetalol was switched to nitroprusside due to bronchoconstriction. Of patients receiving intravenous labetalol, 48% had been switched to oral labetalol at discharge.

Conclusions

Intravenous labetalol is a fast, effective, and safe drug to treat hypertension following aortic coarctation repair. Labetalol is easily converted to oral therapy when the continuation of treatment is considered necessary.
Coronary Revascularization in Patients With Cardiac Sequelae of Kawasaki Disease at a Single Center
Authors: Ramírez-Marroquín Edgar S. , Ortega-Zhindón Diego B. , Flores-Sarria Iris P. , Calderón-Colmenero Juan , García-Montes José A. , Cervantes-Salazar Jorge L.
Published: October 2022

Background: Kawasaki disease (KD) is a self-limited vasculitis that mainly affects infants and preschool-age children, characterized by coronary aneurysms and/or stenoses that may lead to the occurrence of ischemia, heart attack, and sudden death. This study aimed to evaluate the clinical and surgical results of pediatric patients with KD and cardiac sequelae who underwent coronary artery bypass grafting. Methods: A retrospective study was carried out. Patients with a diagnosis of KD and cardiac sequelae who underwent coronary artery bypass grafting from January 1, 2004, through March 31, 2021, were included: preoperative characteristics and conditions. Results: Ten patients were included, with a mean age of 6.4 ± 3.7 years; 80% males. Seven (70%) had the compromise of 2 coronary arteries, the most affected being the left anterior descendent artery (36.9%) with aneurysm and the right coronary artery (36.8%) with stenosis. 40% had preoperative moderate-to-severe ventricular dysfunction. The graft most frequently used was the right internal thoracic artery (47.6%), and the most frequent coronary bypass target vessel was the left anterior descending artery (38.1%). There was no early mortality or deaths during follow-up; 90% remained in functional class I. Among the cohort as a group, there was an overall improvement in postoperative ventricular function ( P = .03). This persisted, being unchanged at subsequent follow-up ( P = .95). Conclusions: Coronary artery bypass grafting is an appropriate treatment option for children with cardiac sequelae of KD, with excellent surgical results. Furthermore, this surgical procedure avoids the deterioration of left ventricular function in pediatric age.
Occlusion Pressure of the Thoracic Duct in Fontan Patients With Lymphatic Failure: Does Dilatation Challenge Contractility?
Authors: Savla Jill J. , Kelly Benjamin , Krogh Emil , Smith Christopher L. , Krishnamurthy Ganesh , Glatz Andrew C. , DeWitt Aaron G. , Pinto Erin M. , Ravishankar Chitra , Gillespie Matthew J. , O’Byrne Michael L. , Escobar Fernando A. , Rome Jonathan J. , Hjortdal Vibeke , Dori Yoav
Published: October 2022

Background

The Fontan circulation challenges the lymphatic system. Increasing production of lymphatic fluid and impeding lymphatic return, increased venous pressure may cause lymphatic dilatation and decrease lymphatic contractility. In-vitro studies have reported a lymphatic diameter-tension curve, with increasing passive stretch affecting the intrinsic contractile properties of each thoracic duct segment. We aimed to describe thoracic duct occlusion pressure and asses if thoracic duct dilation impairs contractility in individuals with a Fontan circulation and lymphatic failure.

Methods

Central venous pressure and thoracic duct measurements were retrospectively collected from 31 individuals with a Fontan circulation. Thoracic duct occlusion pressure was assessed during a period of external manual compression and used as an indicator of lymphatic vessel contractility. Measurements of pressure were correlated with measurements of the thoracic duct diameter in images obtained by dynamic contrast-enhanced MR lymphangiography.

Results

The average central venous pressure and average pressure of the thoracic duct were 17 mm Hg. During manual occlusion, the thoracic duct pressure significantly increased to 32 mm Hg. The average thoracic duct diameter was 3.3 mm. Thoracic duct diameter correlated closely with the central venous pressure. The rise in pressure following manual occlusion showed an inverse correlation with the diameter of the thoracic duct.

Conclusion

Higher central venous pressures are associated with increasing diameters of the thoracic duct. When challenged by manual occlusion, dilated thoracic ducts display a decreased ability to increase pressure. Dilatation and a resulting decreased contractility may partly explain the challenged lymphatic system in individuals with a Fontan circulation.
Effective Interventions to Prevent Repeat Pregnancies in Adolescents: A Systematic Review
Authors: Manjarres-Posada Natalia Isabel , Benavides-Torres Raquel A. , Pérez Baleón Guadalupe Fabiola , Urrutia Soto María Teresa , Onofre-Rodríguez Dora Julia , Barbosa-Martínez Rosalva del Carmen , Márquez-Vega María Aracely
Published: October 2022

Repeat adolescent pregnancy is a public health problem worldwide. Different interventions aimed at increasing the use of contraception and preventing repeat pregnancies have been implemented and their effectiveness has been evaluated. This systematic review evaluates the results of the efficacy of diverse interventions for contraceptive use and prevention of repeat pregnancies in adolescents. A search was conducted for articles published from 1985 to 2018 in the PubMed, Scopus, EBSCOhost, Web of Science, and ProQuest databases, including interventions with adolescents 15 to 19 years of age who were pregnant, postpartum or had a history of pregnancy. Significant results were found for an increase in contraceptive use and prevention of repeat adolescent pregnancy, leading to the conclusion that there are reports of high methodological quality multicomponent interventions for the prevention of repeat adolescent pregnancy that could be tested in other socio-economic and cultural contexts.
Mobile Learning in Education: Inevitable Substitute during COVID-19 Era
Authors: Khan Raja Muhammad Ishtiaq , Ali Ashraf , Alouraini Abdullah
Published: October 2022

The incorporation of mobile phones is persistent in the development of language learning, particularly in the EFL context. The present investigation aims to determine the impact of mobile-assisted language learning (MALL) applications on developing “learners” grammar proficiency. The current study employed a quantitative research method to explore MALL-assisted feedback in a WhatsApp group during the group chat. 60 Saudi male EFL learners, randomly assigned to the control and experimental group. Participants in the Experimental group practiced grammar in WhatsApp chat, whereas the same material was sent to the control group on Blackboard. The data was gathered by administering pre and post-test of grammar proficiency. Descriptive statistics and ANCOVA were used to analyze the data. The study’s findings exhibited that WhatsApp group practice and feedback positively impacted learners’ performance.
Sustainable Development Trend of Chinese Advertising Design from 1992 to 2020: A Bibliometric and Content Analysis
Authors: Zhang Rui-zhi , Hur Joon-young
Published: October 2022

By using the methods of bibliometric and content analysis, this paper conducted data mining and content research on the articles of advertising design research in China from 1992 to 2020 and analyzed the evolution context, hotspots, and sustainable development trends of advertising design research in recent 30 years. It was found that advertising design research has experienced four stages: embryonic, exploration, prosperous, integration and innovation. It mainly focused on four hotspots: collaborative research on relevant factors of advertising design, research on advertising design centered on plane media, renewal of concept and method of advertising design education, and research on advertising design and communication in the new media environment. This paper analyzed and predicted five future sustainable research directions: research on the profound transformation of advertising media in the digital age, research on nationalization theory and localization practice of advertising design, international academic dialog in the field of advertising design, research on advertising design education under the background of interdisciplinary, and sustainable social value innovation.
Diffuse Idiopathic Skeletal Hyperostosis Prevalence, Characteristics, and Associated Comorbidities: A Cross-Sectional Study of 1815 Whole Spine CT Scans
Authors: Ahmed Owais , Ramachandran Karthik , Patel Yogin , Dhanapaul Sindhiya , Meena Jalaj , Shetty Ajoy P. , Bhari Thippeswamy Pushpa , Kanna Rishi Mugesh , Rajasekaran Shanmuganathan
Published: October 2022

Study Design

A Retrospective Study

Objective

To determine the prevalence and characteristics of DISH using whole spine CT scans and to evaluate the association of DISH with co-morbidities and other ossified lesions.

Method

A retrospective study of whole-spine CT scans of polytrauma patients from 2018-2021 above the age of 20 years. The screening was done using modified Resnick criteria. Overall and age-specific prevalence, characteristics, and associations with obesity, diabetes mellitus (DM), ischemic heart disease (IHD), aortic calcification (AC), ossified posterior longitudinal ligament (OPLL), and ossified ligamentum flavum (OLF) were evaluated.

Results

Out of 1815 patients, 347 had DISH, with a prevalence rate of 19.1% and a mean age of 61.7 years. The highest prevalence of DISH was seen in individuals over 80 years of age (45.5%). The prevalence among males (20.2%) was higher than for females (14.9%). The most commonly involved level was T8-T9 (95.4%), followed by T9-T10 (91.9%), and the most common vertebra involved was T9 (96%). All the cases involving T9 had ossification on the right anterior aspect of the vertebral body. The presence of DM, high BMI, and IHD was found to be significantly higher in patients with DISH (P value < .001). The incidence of aortic calcification was 22.5%, OPLL was 13.3%, and OLF was 4.9% in patients with DISH.

Conclusion

This study reports a prevalence rate of 19.1% for DISH, with the highest prevalence among individuals above 80 years of age (45.5%). DISH has a higher propensity to affect the right anterior aspect of the vertebral body in the thoracic spine and is strongly associated with obesity, DM, IHD, and AC.
Telephone Clinics During the Covid-19 Pandemic—The Experiences of Interstitial Lung Disease Patients and Their Carers
Authors: Gillett Mia , Hope-Gill Ben
Published: October 2022

The COVID-19 pandemic has resulted in a widespread move towards virtual consultations within secondary care due to infection concerns. This service evaluation undertaken in a Welsh Interstitial Lung Disease (ILD) specialist center looks at the experiences of unselected ILD patients and their careers with telephone consultations and aims to identify the role of telephone consultations in future practice for this patient group. A mixed methods approach was used with an initial postal questionnaire followed by a virtual focus group. From the 84 patient and 26 carer questionnaire responses, there was broad support for telephone consultations from both groups. The main perceived benefit was reduced infection risk, although face-to-face consultations were seen as holding more value. Themes identified in the virtual focus group of 6 participants recognized the need to balance quality of care against practical considerations. In conclusion, there was support for future telephone consultations if patients and clinicians have flexibility in determining when this occurs, instead of a face-to-face consultation.
Connectivity and centrality: Geovisualization of express networks in China
Authors: Sun Wenjie , Zhang Jin , Shen Hao , Li Guoqi , Wang Hongjian , He Feng , Bi Feng
Published: October 2022

Express delivery volume is an important indicator of intercity e-commerce trading activities, offering a new vision for glimpsing the intercity linkages. However, it has been a challenge to reveal the spatial distribution of intercity express flows due to the limitations on the use of express parcel data by most companies. The study maps the spatial pattern of intercity express connection intensity and identifies the urban centrality, supported by waybill data from China. Intercity express connections form a triangular corridor centred on the ‘Pearl River Delta–Yangtze River Delta–Beijing-Tianjin-Hebei’ urban agglomerations. Shenzhen, Guangzhou, Jinhua, Shanghai, Beijing, Quanzhou, Xingtai, etc., exhibit higher centrality for their strong consumption power or commodity production capacity. These cities also develop relatively strong connections with national central cities (Chengdu, Chongqing, Wuhan, Tianjin, etc.) and provincial capitals (Changsha, Urumqi, Hulun Buir, etc.). The cities on the western side of the Hu-line present low centrality and weak connections with the eastern cities and form sub-network with the provincial capital cities as the core.
Molecular Determinants of Clinical Outcomes In a Real-World Diffuse Large B-cell Lymphoma Population
Authors: Alduaij Waleed , Collinge Brett J , Ben-Neriah Susana , Jiang Aixiang , Hilton Laura K , Boyle Merrill , Meissner Barbara , Chong Lauren C. , Miyata-Takata Tomoko , Slack Graham W. , Farinha Pedro , Craig Jeffrey W , Lytle Andrew , Savage Kerry J. , Villa Diego , Gerrie Alina S. , Freeman Ciara L. , Gascoyne Randy D. , Connors Joseph M , Morin Ryan D , Sehn Laurie H. , Mungall Andrew J , Steidl Christian , Scott David W.
Published: October 2022

Molecular heterogeneity of diffuse large B-cell lymphoma (DLBCL) underlies the variable outcomes achieved with immunochemotherapy. However, outcomes of gene expression profiling (GEP)-defined molecular subgroups in a real-world DLBCL population remain unknown. Here we examined the prevalence and outcomes of molecular subgroups in an unselected population of 1149 patients with de novo DLBCL in British Columbia, Canada. Evaluable biopsies were profiled by fluorescence in situ hybridization (FISH), immunohistochemistry and digital GEP to assign cell-of-origin (COO) and the so-called "double-hit signature" (DHITsig) - a signature originally described as being characteristic for high-grade B-cell lymphoma with MYC and BCL2 rearrangements (HGBCL-DH-BCL2). DHITsig was expressed in 21% of 431 germinal center B-cell-like (GCB)-DLBCL and all 55 Burkitt lymphomas examined. Reflecting this latter finding, DHITsig has been renamed the "dark zone signature" (DZsig). DZsigpos-DLBCL, non-DZsigpos GCB-DLBCL and activated B-cell-like (ABC)-DLBCL were associated with a 2-year overall survival of 57%, 89% and 71%, respectively. 62% of DZsigpos tumors were negative for HGBCL-DH-BCL2 by FISH, but were associated with outcomes similar to HGBCL-DH-BCL2. A small group of HGBCL-DH-BCL2 that lacked DZsig expression had different molecular features compared to DZsig-expressing HGBCL-DH-BCL2, and were associated with favorable outcomes comparable DLBCL, not otherwise specified. DZsigpos and ABC-DLBCL had shorter diagnosis-to-treatment interval (DTI) than GCB-DLBCL, with this metric being associated with outcome. In conclusion, DZsig expression extends beyond HGBCL-DH-BCL2 and captures a poor-prognosis DLBCL subgroup with short DTI, including patients unidentifiable by routine FISH testing, that should be considered for treatment intensification or novel therapies in prospective trials.
Genetic counselling and testing in pulmonary arterial hypertension: a consensus statement on behalf of the International Consortium for Genetic Studies in PAH
Authors: Eichstaedt Christina A. , Belge Catharina , Chung Wendy K. , Gräf Stefan , Grünig Ekkehard , Montani David , Quarck Rozenn , Tenorio-Castano Jair A. , Soubrier Florent , Trembath Richard C. , Morrell Nicholas W.
Published: October 2022

Pulmonary arterial hypertension (PAH) is a rare disease that can be caused by (likely) pathogenic germline genomic variants. In addition to the most prevalent disease gene,BMPR2(bone morphogenetic protein receptor 2), several genes, some belonging to distinct functional classes, are also now known to predispose to the development of PAH. As a consequence, specialist and non-specialist clinicians and healthcare professionals are increasingly faced with a range of questions regarding the need for, approaches to and benefits/risks of genetic testing for PAH patients and/or related family members. We provide a consensus-based approach to recommendations for genetic counselling and assessment of current best practice for disease gene testing. We provide a framework and the type of information to be provided to patients and relatives through the process of genetic counselling, and describe the presently known disease causal genes to be analysed. Benefits of including molecular genetic testing within the management protocol of patients with PAH include the identification of individuals misclassified by other diagnostic approaches, the optimisation of phenotypic characterisation for aggregation of outcome data, including in clinical trials, and importantly through cascade screening, the detection of healthy causal variant carriers, to whom regular assessment should be offered.
Sputum neutrophil counts in healthy subjects: relationship with age
Authors: Beech Augusta , Singh Dave
Published: October 2022

A threshold of ∼60% has commonly been used in asthma and COPD studies to define the presence of neutrophilic airway inflammation. This threshold is based on relatively young healthy subject datasets. However, age-related increases in sputum neutrophils have been observed previously. We used a healthy cohort, with a comparatively wider age range, to re-evaluate the age-related increase in sputum neutrophils, analysing changes by decade. We also studied the long-term repeatability of sputum neutrophil counts.

Differential sputum cell count data for healthy subjects (n=121) was retrospectively analysed. Subjects with a repeated count (mean interval 4.8 years) were included in longitudinal analysis.

There was a significant positive association between age and sputum neutrophil % (rho=0.24, p<0.01), with 51.2% of subjects having a sputum neutrophil count >60%. Sputum neutrophil counts increased with each decade until ∼60 years where a plateau was observed. The baseline sputum neutrophil % increased significantly at repeated sampling (p=0.02), with excellent long-term repeatability (intraclass correlation coefficient=0.80).

We confirm previous reports of an age-related increase in sputum neutrophil % in healthy individuals and identified a plateau which occurs at age ∼60 years. There was an increase in sputum neutrophil % during longitudinal follow-up, indicating that age-related neutrophilia is a progressive phenomenon. These findings question the use of an unadjusted threshold, in relation to age, to identify the presence of neutrophilic airway inflammation.
A Discrete Multi-Objective Artificial Bee Colony Algorithm for a Real-World Electronic Device Testing Machine Allocation Problem
Authors: Xie Jin , Li Xinyu , Gao Liang
Published: October 2022

With the continuous development of science and technology, electronic devices have begun to enter all aspects of human life, becoming increasingly closely related to human life. Users have higher quality requirements for electronic devices. Electronic device testing has gradually become an irreplaceable engineering process in modern manufacturing enterprises to guarantee the quality of products while preventing inferior products from entering the market. Considering the large output of electronic devices, improving the testing efficiency while reducing the testing cost has become an urgent problem to be solved. This study investigates the electronic device testing machine allocation problem (EDTMAP), aiming to improve the production of electronic devices and reduce the scheduling distance among testing machines through reasonable machine allocation. First, a mathematical model was formulated for the EDTMAP to maximize both production and the scheduling distance among testing machines. Second, we developed a discrete multi-objective artificial bee colony (DMOABC) algorithm to solve EDTMAP. A crossover operator and local search operator were designed to improve the exploration and exploitation of the algorithm, respectively. Numerical experiments were conducted to evaluate the performance of the proposed algorithm. The experimental results demonstrate the superiority of the proposed algorithm compared with the non-dominated sorting genetic algorithm II (NSGA-II) and strength Pareto evolutionary algorithm 2 (SPEA2). Finally, the mathematical model and DMOABC algorithm were applied to a real-world factory that tests radio-frequency modules. The results verify that our method can significantly improve production and reduce the scheduling distance among testing machines.
Leiomyosarcoma presenting as unilateral painless testicular mass in a septuagenarian: a case report with review of the literature
Authors: Joshi Brijmohan , Goel Ritesh , Kumar Anant , Maheshwari Ruchir , Chaturvedi Samit , Ranjan Satish Kumar
Published: October 2022

Background

Primary testicular leiomyosarcoma has a rare occurrence and the diagnosis is uncertain on pre-operative assessment. It is often seen in the background of chronic inflammation, radiotherapy, and the use of high-dose anabolic steroids.

Case presentation

We report a case of a painless testicular lump in a septuagenarian with pre-existing diabetes mellitus and hypertension but without any oncological risk factors. The primary workup did not reveal any elevation of serum tumour markers or any signs of metastatic disease on contrast imaging. The patient underwent a high inguinal orchiectomy due to a suspicion of germ cell tumor, and histopathology and immunohistochemistry confirmed the diagnosis of leiomyosarcoma.

Conclusion

Testicular leiomyosarcoma in the elderly is a rare malignancy and usually occur without any pre-existing risk factors. Early treatment provides long-term curative oncological control.
Conditional wealth to estimate association of wealth mobility with health and human capital in low- and middle-income country cohorts
Authors: Varghese Jithin Sam , Osmond Clive , Stein Aryeh D.
Published: October 2022

Temporally harmonized asset indices allow the study of changes in relative wealth (mean, variance, social mobility) over time and its association with adult health and human capital in cohort studies. Conditional measures are the unexplained residuals of an indicator regressed on its past values. Using such measures, previously used to study the relative importance of key life stages for anthropometric growth, we can identify specific life stages during which changes in relative wealth are important for adult health in longitudinal studies. We discuss the assumptions, strengths and limitations of this methodology as applied to relative wealth. We provide an illustrative example using a publicly-available longitudinal dataset and show how relative wealth changes at different life stages are differentially associated with body mass index in adulthood.
The altruistic elderly, a valuable but unrecognised kidney donor group. A case report of an 85-year-old unspecified kidney donor
Authors: Okidi Okechukwu , Sharma Videha , Piscoran Oana , Biggins Fiona , Singh Rajinder , Augustine Titus
Published: October 2022

Background

Kidney transplantation is the definitive treatment for end stage renal disease (ESRD), offering improved quality of life and survival benefit over remaining on dialysis. There is, however, a prevailing significant mismatch between patients awaiting transplantation and available donor kidneys. Over time, initial stringent donor criteria have broadened and organs from extended criteria donors (ECDs) and older donors are now being accepted for transplantation. The spectrum of living donors has also undergone a change from close family members to an increasingly non-related, non-directed altruistic donors, newly classified as ‘unspecified’ donors. Unspecified elderly donors could be a potential untapped resource to expanding the kidney donor pool globally.

Case Presentation

We present a case of an 85 year and 8 months old individual, who donated to an unrelated non-directed matched recipient in the national deceased donor transplant waiting list with excellent donor and recipient outcomes at 7 years.

Conclusion

To our knowledge she is one of the oldest reported unspecified living kidney donors in the world to date. This case illustrates that elderly donors in good health can come forward to donate, knowing that it is safe and valuable. Once the immediate perioperative challenges after kidney donation are managed, elderly donors rarely encounter long term sequelae. We therefore report this case to increase awareness and refocus attention of transplant teams on elderly donors as a potential untapped group to help address the organ shortage problem in renal transplantation.
Use of regional citrate anticoagulation with medium cut-off membrane: pilot report
Authors: Vrečko Marija Malgaj , Pajek Jernej , Buturović-Ponikvar Jadranka
Published: October 2022

Background

Regional citrate anticoagulation during hemodialysis provides an immediate and complete anticoagulant effect, which is limited to the extracorporeal circuit. Citrate has become the standard anticoagulant in acute renal replacement therapy and is widely used in various intermittent hemodialysis modalities, especially for patients with contraindications for heparin. With the increased adoption of medium cut-off membranes, experience with regional citrate anticoagulation is needed. To our knowledge, this is the first report to assess the feasibility of regional citrate anticoagulation in expanded hemodialysis.

Methods

We prospectively analyzed 5 expanded hemodialysis procedures in 5 patients in which a medium cut-off membrane (Theranova®) was used. We followed our standard citrate protocol developed and tested for high-flux membrane. Anticoagulation was performed with a continuous infusion of 8% trisodium citrate into the arterial line and supplementation of 1 M calcium chloride into the venous line. We monitored ionized calcium and magnesium, sodium and blood gas analysis. Anticoagulation effectiveness was assessed by post-filter ionized calcium and by visual inspection of the anticoagulation in the circuit.

Results

There were no prematurely terminated procedures due to anticoagulation-related complications. With a blood flow of 250 mL/min and a dialysate flow of 500 mL/min, we were able to maintain serum ionized calcium in the range of 0.89–1.29 mmol/L and serum sodium in the range of 136–144 mmol/L. The mean pre- and post-dialysis arterial circuit pH was 7.42 (± 0.04) and 7.53 (± 0.23), respectively. The mean pre- and post-dialysis serum ionized magnesium was 0.54 (± 0.04) mmol/L and 0.43 (± 0.03) mmol/L, respectively (measurements were done on a point-of-care ionometer with a lower normal range for ionized magnesium).

Conclusion

We have shown that our standard citrate protocol for high-flux hemodialysis membrane could be successfully adopted for use in expanded hemodialysis with a medium cut-off membrane. Overall, electrolyte and acid-base balances were relatively well-controlled and anticoagulation effectiveness was excellent.

Trial registration

This is a pilot report with results taken from a larger ongoing trial (registered at ClinicalTrials.gov on October 25, 2019 under number NCT04139525) comparing citrate and heparin anticoagulation during expanded hemodialysis.
Routine laboratory testing in hemodialysis: how frequently is it needed?
Authors: Chidiac Claudia , Chelala Dania , Nassar Dany , Beaini Chadia , Azar Hiba , Finianos Serge , Boueri Celine , Hawi Jenny , Abdo Ibrahim , Aoun Mabel
Published: October 2022

Background:

Hemodialysis patients are followed by routine laboratory testing. There is uncertainty whether these tests always lead to a change in decision-making. This study aims to discover the number of yearly interventions/changes in prescription based on these tests and depict the group of patients who would benefit from reduced or increased laboratory blood tests.

Methods:

This is a multi-center retrospective study that included patients on hemodialysis for more than one year. Laboratory data collected included yearly average of hemoglobin, urea reduction ratio (URR), serum phosphate, calcium, potassium, parathormone (PTH), ferritin and transferrin saturation (TSAT); changes in prescription of erythropoietin-stimulating agents (ESAs), intravenous (IV) iron, alfacalcidol, phosphate binders and dialysis parameters were retrieved from medical records. A multivariate regression analysis assessed factors associated with high number of interventions.

Results:

A total of 210 hemodialysis patients were included: 62.4% males, 47.1% diabetics. Their median age was 72 (62,78.5) years. Their laboratory parameters were within KDIGO targets. The median number of yearly interventions was 5 (3,7) for ESAs, 4 (2,6) for IV iron, 1 (0,2.25) for phosphate binders, 0 (0,1) for alfacalcidol. Based on the multivariate analysis, patients with higher ferritin, frequent changes in ESA, more changes in alfacalcidol and higher PTH had higher number of prescription’s changes in ESA, IV iron, phosphate binders and alfacalcidol respectively.

Conclusion:

While maintaining KDIGO targets, therapeutic interventions following routine laboratory testing did not exceed six times yearly for all parameters. This suggests that a reduced testing frequency in hemodialysis patients is possible without any impact on quality of care. A personalized approach remains safe for hemodialysis patients while reducing the cost. This is very relevant in low-resource settings and during economic crises and needs to be evaluated in prospective studies.
Relationship between energy balance-related behaviors and personal and family factors in overweight/obese primary school students aged 10–12 years in China: a cross-sectional study
Authors: Zhang Shicheng , Gao Haining , Cui Ying , Wang Xin , Cao Wenshuo , Ding Qian , Chang Bo
Published: October 2022

Background

Increasing rates of childhood obesity worldwide are a serious threat to the health of school-aged children. Unhealthy behavioral habits are modifiable factors in the control of childhood obesity, and personal and family factors are key influencing factors of behavioral habits in school-aged children. This study assessed the relationship between overweight/obesity, energy balance-related behaviors (EBRB), and their influencing factors in school-aged children.

Methods

This cross-sectional survey included 4412 primary school-aged (10–12 years) students who underwent body tests and were selected through stratified sampling in the Northeast, North, Northwest, and Southwest regions of China from March to July 2021. Independent sample t test was used to compare differences between behaviors and influencing factors of energy balance among overweight/obesity and normal weight students. Logistic regression analysis was used to assess the influence of EBRB on body shape. Multiple linear regression was used to assess the influence of personal and family factors on EBRB effects.

Results

Compared with normal-weight students, number of breakfasts consumed per week by overweight/obese students was significantly lower (p < 0.01), and weekly screen-viewing time was significantly longer (p < 0.01). Overweight/obese students’ health beliefs, parental subjective norms, parental modelling, parental practices, and home availability scores increased significantly in terms of beverage consumption behavior (p < 0.01 or p < 0.05). Attitude, health beliefs, self-efficacy, parental subjective norms, and parental support scores decreased significantly in terms of breakfast consumption (p < 0.01 or p < 0.05). Health belief scores on physical activity increased significantly (p < 0.01), while preference and autonomy scores decreased significantly (p < 0.01). Health beliefs, parental subjective norms, and parental practices scores of screen-viewing activities increased significantly (p < 0.01 or p < 0.05). Breakfast consumption (odds ratio [OR]: 0.911; 95% confidence interval [CI]: 0.870–0.954) and screen-viewing activities (OR:1.055; 95% CI: 1.030–1.080) correlated negatively and positively with overweight/obesity, respectively. The main influencing factors of breakfast behavior in overweight/obese students were self-efficacy (0.14), preference (0.11), attitude (0.07), home availability (0.18), and parent modelling (0.09); those for screen-viewing behavior were preference (0.19), self-efficacy (− 0.15), parental practices (0.13), and parental subjective norm (0.12).

Conclusions

Irregular breakfast consumption and excessive screen-viewing time are key EBRB associated with overweight/obesity among these Chinese participants. Their unhealthy breakfast consumption and screen-viewing activities result from a combination of personal and family factors.
Sleepless in inequality: findings from the 2018 behavioral risk factor surveillance system, a cross-sectional study
Authors: Pabayo Roman , Patel Priya , Liu Sze Y. , Molnar Beth E.
Published: October 2022

Background

Despite the large body of research on the adverse effects of income inequality, to date, few studies have examined its impact on sleep. The objective of this investigation is to examine the association between US state income inequality and the odds for regularly obtaining inadequate (< 7 h) and very inadequate (< 5 h) of sleep in the last 24 h.

Methods

We analysed data from 350,929 adults participating in the US 2018 Behavioral Risk Factor Surveillance System (BRFSS). Multilevel modeling was used to determine the association between state-level income inequality, as measured by the Gini coefficient, and the odds for obtaining inadequate and very inadequate sleep. We also determined if associations were heterogeneous across gender.

Results

A standard deviation increase in the Gini coefficient was associated with increased odds for inadequate (OR = 1.06, 95% CI: 1.00, 1.13) and very inadequate sleep (OR = 1.11, 95% CI: 1.03,1.20). Also, a cross-level Gini Coefficient X Gender interaction term was significant (OR = 1.07, 95% CI:1.01,1.13), indicating that increasing income inequality was more detrimental to women’s sleep behavior.

Conclusion

Future work should be conducted to determine whether decreasing the wide gap between incomes can alleviate the burden of income inequality on inadequate sleep in the United States.