bluuebunny/crossref_metadata_2025 huggingface dataset:
Gamblification: A definition
Authors: Macey Joseph , Hamari Juho
Published: March 2022

In recent years, gambling has become increasingly prominent in everyday life; the term ‘gamblification’ first emerged in the late 2000s and was used to describe the colonisation of sports and sporting cultures by the gambling industry. Since that time, gamblification has been used to describe a range of phenomena in increasingly diffuse contexts; it has been variously used as a proxy for the convergence of gaming and gambling, to describe specific monetisation practices, or as a means of motivating consumer behaviours. Conceptual clarity has been further muddied by the positioning of gamblification as a form of gamification. This work provides a definition of gamblification, which draws upon and consolidates existing uses of the term while also providing a lens through which the differing aspects of gamblification can be understood and appraised. By doing so, this work will establish a clear conceptual framework, which can structure in-depth discussions of this multi-dimensional phenomenon.
Characterizing combustion performance and PM emissions of an aviation compression ignition engine by fueling RP-3 kerosene and RP-3/pentanol blends
Authors: Liang Zhirong , Chen Yuejian , Liu Haoye , Wang Chongming , Chen Longfei
Published: March 2022

General aviation (GA) aircraft generally driven by aviation piston engines (APE) are currently experiencing promising growth globally. To relieve the fossil fuel scarce, the application of alternative fuels was extensively encouraged for green GA development. This study aims to investigate the suitability of using aviation kerosene rocket propellant 3 (RP-3) and its pentanol blends (by 30% volume fraction) in an aviation compression ignition (CI) engine, by comparing their combustion performance and emission characteristics differences under various injection timings with baseline diesel. The major combustion parameters including the in-cylinder pressure, heat release rate, ignition delay, combustion duration, indicated thermal efficiency (ITE), and indicated specific fuel consumption (ISFC) were evaluated as the crank angle (CA) 50 swept from 9 to 15° crank angle after top dead center (ATDC). The ITE of RP-3/Pentanol blends presented to be higher than those of diesel by 4.2%−5.0%, and pure RP-3 by 2.6%−3.4%. The improved ITE of the blended fuel is due to the longest ignition delay and the shortest combustion duration under all the CA50. Moreover, the particulate matter (PM) emissions with the number concentration, geometric mean diameter (GMD), size-resolved distribution characteristics were quantitatively analyzed for all the test fuels. RP-3/Pentanol dramatically reduced the number-based PM, by over 50% and two magnitudes of order lower than those of RP-3 and diesel, respectively. Improved PM emissions from the alcohol blends intensively was caused by the better premixing and evaporating states with subsequent homogeneous combustion. Additionally, the PM emissions of the three fuels exhibited different sensitivities to the varied injection timings. With the retardance of injection timings, the PM declined apparently for diesel and RP-3 due to prolonged ignition delay and decreased in-cylinder temperature, but remained nearly unchanged for RP-3/Pentanol because of the growth of nucleation mode PM.
Race and its reformulation in Max Weber: Cultural Germanism as political imperialism
Authors: Barbalet Jack
Published: March 2022

Weber rejected the notion of race founded on innate characteristics, and instead developed one based on cultural and political factors. The importance of Weber’s distinctive characterization of race cannot be appreciated when consideration is given only to his treatment of minorities. Examination, however, of Weber’s account of the German people as a Herrenvolk, master race, consolidated by shared cultural values and realized through the expansive practices of a Machtstaat or power-state, indicates a complex ethnonational conceptualization of race. Weber’s approach to race as an ethnonational manifestation is important for understanding his sociology as well as his commitment to German imperialism.
Ship emissions reduction using weather ship routing optimisation
Authors: Borén Clara , Castells-Sanabra Marcella , Grifoll Manel
Published: March 2022

A significant proportion of global carbon dioxide emissions are attributed to ocean-sailing ships and shipping emissions are predicted to double in less than 30 years. This paper investigates the benefit of using weather ship routing optimisation, assessing the ship emissions for minimum distance routes and optimised routes. The present contribution merges the estimation of shipping pollutants and their mitigation through weather routing optimisation; two lines of research widely analysed separately but seldom discussed together. A previously developed open software of weather ship routing is used to obtain the minimum cost (i.e. optimised route) in terms of sailing time, using high-resolution wave forecasting. The assessment of fuel consumption and ship emissions calculations were inspired by the STEAM2 bottom-up approach, in conjunction with the estimation of the power increase needed to overcome speed decrement due to waves. Several scenarios covering the Western Mediterranean Short Sea Shipping routes (from 24 to 600 nautical miles and using a real Ro-Pax vessel) are compared in terms of emissions between the minimum distance route and the optimum. The ship routing optimisation reveals a reduction up to 30% of ship emissions during severe storms on longer routes. Nevertheless, all the cases studied show emissions mitigation when ship routing optimisation is used. The expected increase of extreme weather events, in terms of frequency, intensity and duration due to climate change, suggests a gradual gain of implementing weather ship routing optimisation in all types of routes, regardless of the distance.
Social capital investment in social justice: How parents shape socioeconomic diversity within early childhood programs
Authors: Demma Rachel
Published: March 2022

To better understand how parent choice and program participation fosters socioeconomic diversity within community early learning programs, this in-depth case study examined two high-quality, socioeconomically diverse community early education program sites operating in Baltimore City. Key findings of this study include, (1) Despite their shared belief in its value and benefit, parents across the income continuum did not explicitly seek out enrollment in socioeconomically diverse early care and learning programs; (2) Within the two selected program sites, program recruitment and engagement approaches were neither explicit nor refined enough to appeal universally to parents across varying economic backgrounds; and (3) Parents may struggle against their own class-based social identities and internalized value systems in enacting the choice of program that drive the development of socioeconomically diverse settings.
Comparison of CT-Guided Core Needle Biopsy in Pulmonary Ground-Glass and Solid Nodules Based on Propensity Score Matching Analysis
Authors: An Wenting , Zhang Hanfei , Wang Binchen , Zhong Feiyang , Wang Shan , Liao Meiyan
Published: March 2022

Purpose: To compare the diagnostic accuracy and safety of computed tomography (CT)-guided core needle biopsy (CNB) between pulmonary ground-glass and solid nodules using propensity score matching (PSM) method and determine the relevant risk factors. Methods: This was a single-center retrospective cohort study using data from 665 patients who underwent CT-guided CNB of pulmonary nodules in our hospital between May 2019 and May 2021, including 39 ground-glass nodules (GGNs) and 626 solid nodules. We used a 1:4 PSM analysis to compared the diagnostic yields and complications rates of CT-guided CNB between 2 groups. Results: After PSM, 170 cases involved in the comparison (34 GGNs vs 136 solid nodules) were randomly matched (1:4) by patient demographics, clinical history, lesion characteristics, and procedure-related factors. There was no statistically significant difference in the diagnostic yields and complications rates between 2 groups. Significant pneumothorax incidence increase was noted at small lesion size, deep lesion location, and traversing interlobar fissure ( P < .05). Post-biopsy hemorrhage was a protective factor for pneumothorax ( P < .05). The size/proportion of consolidation of GGN did not influence the diagnostic accuracy and complication incidence ( P > .05). Conclusions: The accuracy and safety of CT-guided CNB were comparable for ground-glass and solid nodules and the size/proportion of consolidation of GGN may be not a relevant risk factor. The biopsy should avoid traversing interlobar fissure as far as possible. Smaller lesion size and deeper lesion location may lead to higher pneumothorax rate and post-biopsy hemorrhage may be a protective factor for pneumothorax.
Hesperetin Inhibits TGF-β1-Induced Migration and Invasion of Triple Negative Breast Cancer MDA-MB-231 Cells via Suppressing Fyn/Paxillin/RhoA Pathway
Authors: Lu Qian , Lai Yongwei , Zhang Hong , Ren Kuang , Liu Wei , An Ying , Yao Jiahong , Fan Hongyan
Published: March 2022

Triple-negative breast cancer is an aggressive subtype of breast cancer with poor clinical outcomes and poor prognosis. Hesperetin is an active component extracted from Citrus fruits and Traditional Chinese Medicine has a wide range of pharmacological effects. Here, we assessed the anti-migration and anti-invasive effects and explored inhibitory mechanisms of hesperetin on metastasis of human triple negative breast cancer MDA-MB-231 cells. Cell viability experiments revealed that 200 μM hesperetin has a clear inhibitory effect on MDA-MB-231 cells. TGF-β1 treatment induces apparent tumor progression in MDA-MB-231 cells including aberrant wound-healing and invasion ability, which is effectively suppressed by hesperetin co-treatment. Additionally, hesperetin inhibited the TGF-β1-mediated actin stress fiber formation. Western blot results showed that hesperetin suppressed the TGF-β1-mediated (i) activation of Fyn, (ii) phosphorylation of paxillin at Y31, Y88, and Y118 sites, (iii) the increased expression of RhoA, and (iv) activation of Rho-kinase. We demonstrated the increased interaction of Fyn with paxillin and RhoA protein in the TGF-β1-induced metastasis of MDA-MB-231 cells. Small interfering RNA Fyn inhibited phosphorylation of paxillin (Y31) and activation of Rho-kinase induced by TGF-β1. In conclusion, hesperetin has a significant inhibitory effect on migration and invasion of MDA-MB-231 cells induced by TGF-β1, which might be attributed to inhibiting the Fyn/paxillin/RhoA pathway.
Comparison of the effectiveness of thoracic epidural and rectus sheath catheter as analgesic modalities following laparotomy: A systematic review and meta-analysis
Authors: Claxton Harry L , Nevins Edward J , McCallum Iain
Published: March 2022

Background:

Rectus sheath catheters are used as an analgesic alternative to thoracic epidural. The aim of this meta-analysis is to compare the analgesic effects and side effects of thoracic epidural and rectus sheath catheter in the setting of emergency or elective laparotomy.

Materials and Methods:

A systematic review of the Cochrane library, Embase, PubMed and Medline was conducted. Papers that directly compared thoracic epidurals and rectus sheath catheters following laparotomy were identified. Literature published between 2001 and 2021 were included. Data were extracted on the following postoperative outcomes: additional analgesic requirements, pain scores, hypotension and ambulation. A random effects meta-analysis model was used to compare additional opioid requirements between thoracic epidural and rectus sheath catheter.

Results:

Eight publications were included from five countries. This comprised 484 patients, with 120 patients being extracted from randomised trials. Thoracic epidural reduced the requirement for additional intravenous analgesia compared with rectus sheath catheters (p = 0.004). Despite this, both analgesic techniques were equivalent with regard to reported pain scores. Furthermore, rectus sheath catheters have a lower rate of postoperative hypotension and allow for earlier ambulation compared with thoracic epidural.

Conclusions:

The literature suggests that rectus sheath catheters provide similar analgesic effect to thoracic epidurals, but rectus sheath catheters have a favourable side effect profile.
Combination therapy using scoring and sirolimus drug-coated balloons during lower limb endovascular revascularization for chronic limb threatening ischaemia: A case series
Authors: Bong Tiffany SH , Yap Charyl JQ , Soon Shereen XY , Tang Tjun Y
Published: March 2022

The aim of this case series was to document our early experience using combination therapy with UltraScore™ Focused Force percutaneous transluminal angioplasty balloon (BD Interventional, New Jersey, US) and Selution Sustained Limus Release (SLR)™ (M.A. MedAlliance SA, Nyon, Switzerland) sirolimus-coated balloon catheter for anti-restenotic drug elution, in the setting of multifocal high-grade stenosis for chronic limb threatening ischaemia. Our anecdotal experience was that preparing the lesion with scoring balloon and then using sirolimus drug-eluting balloon may have synergistic effect when used in tandem, especially in the setting of calcified arterial lesions, where the scoring wires may achieve deeper clefts within the atheromatous plaque to allow better drug absorption into the arterial wall. We report two cases with high-grade multifocal stenosis affecting the superficial femoral and anterior tibial arteries, respectively. Combination therapy using the scoring balloon to first prepare the lesion followed by sirolimus elution achieved technical and procedural success in both cases and a 100% 30-day primary patency. There were no complications related to flow-limiting dissections, vessel perforation or acute recoil. However, whether this combination therapy leads to better primary vessel patency with longer freedom from target lesion revascularization in the medium term remains to be determined.
Cultural Transformation in Healthcare: How Well Does the Veterans Health Administration Vision for Whole Person Care Fit the Needs of Patients at an Academic Rehabilitation Center?
Authors: Barnhill Jessica L , Roth Isabel J , Faurot Keturah R , Honvoh Gilson D , Lynch Chanee E , Thompson Karla L , Gaylord Susan A
Published: March 2022

Background

The Veterans Health Administration is undergoing a cultural transformation toward person-driven care referred to as the Whole Health System of Care.

Objective

This pilot study evaluated whether the Whole Health model resonates with patients of a large public university rehabilitation clinic.

Methods

Thirty participants completed the Veterans Health Administration’s Personal Health Inventory (PHI), and six attended the course “Taking Charge of My Life and Health.” Researchers analyzed PHI responses and post-course focus group transcripts. A short post-PHI survey and post-course evaluation were collected.

Results

Participants agreed the PHI is a simple, useful tool. The course, while well attended, did not meet participants’ expectations. Participants wanted access to integrative therapies and opportunities to contribute to healthcare transformation.

Conclusion

Rehabilitation patients resonated with the Whole Health vision. They expressed enthusiasm for the cultural transformation represented by the model along with frustration that standard healthcare experiences fall short of this vision.
Institutions for Women’s Education in Delhi (1900–1920): Philanthropists, Missionaries and the Government
Authors: Kumari Sangeeta
Published: March 2022

Delhi has been the seat of power for long. The British made their centre of power in Calcutta for sometimes for strategic reasons perhaps but soon they realised the importance of Delhi as the centre of power and thus, shifted the British capital from Calcutta to Delhi in 1911. This change brought with it many changes in all aspects of lives for the people of Delhi. This also meant changes in administration and education system of Delhi. Like all other parts of India Delhi too had its own system of education but the new scenario necessitated further expansion and development of education. The philanthropists, individuals, the Christian missionaries and the Colonial government responded to this new situation with various frames of interests and motivation. In Delhi Arya Samajists and Sanatanis played an important role in the development of education for all in general and for girls’ in particular. The British government set up the education board to meet the rising needs of education not only of native population but also for the children of the government employees.
The Impact of Country of Origin, Trust, and Satisfaction on Online Purchase Intention in Emerging Markets: An Indian Perspective
Authors: Bhattacharya Saptarshi , Sharma Rajendra Prasad
Published: March 2022

This study investigates consumer online purchase intentions in emerging markets by focusing on the impact of country of origin (COO), trust, and satisfaction. The findings emanate from an analysis of the online survey completed by 987 Indian online shoppers. The partial least squares structural equation modeling (PLS-SEM) on SmartPLS was used for analyzing the data. The results indicate that COO plays a vital role in influencing online purchase intentions with the mediating effect of trust and satisfaction. The study finds that COO cues enhance consumer trust and satisfaction, thereby leading to purchase intention. The results indicate that online retailers operating in India, originating either from India or developed countries like the USA should use their country brand to build popularity. Furthermore, this study helps to understand the influence of COO on online purchase intentions in an emerging market like India more comprehensively.
Deep Infrapatellar Bursitis in Preadolescent Baseball Players: A Cross-Sectional Study
Authors: Omae Hiroaki , Ohsawa Takashi , Omodaka Takuya , Hashimoto Shogo , Oshima Atsufumi , Takase Ryota , Kobayashi Hiroki , Takamine Shuhei , Tajika Tsuyoshi , Chikuda Hirotaka
Published: March 2022

Background:

Deep infrapatellar bursitis (DIB) has been detected in cases of Osgood-Schlatter disease (OSD). However, the clinical implications of DIB in the apophyseal stage, during the period when OSD has not yet developed, remain unclear.

Purpose:

To investigate the factors related to DIB in the apophyseal stage in preadolescent baseball players.

Study Design:

Cross-sectional study, Level of evidence, 3.

Methods:

The study participants were junior baseball players who participated in a medical checkup in 2020. We included knees in the apophyseal stage evaluated using ultrasonography, and classified them into the bursitis and no-bursitis groups using color-enhanced Doppler ultrasonography. We also investigated bone lesions of the tibial tuberosity, determined by fragmentation of the bone and irregularity of the ossification center. Demographic data, practice duration, pressure pain on tuberosity, pain while playing baseball (visual analog scale), heel-buttock distance (HBD), straight-leg raise angle, and range of hip internal and external rotation were evaluated. Group comparisons were performed using the Mann-Whitney U test and Fisher exact test, and a logistic regression analysis was performed.

Results:

A total of 261 knees (139 male players; age 10.5 ± 1.1 years) were included, 30 in the bursitis group and 231 in the no-bursitis group. Bone lesions were present in 4 knees in the bursitis group and in 32 knees in the no-bursitis group; there was no significant relationship between the presence of bone lesions and bursitis. Compared with the no-bursitis group, the bursitis group had a significantly longer practice duration (12.9 ± 3.3 vs 15.2 ± 3.8 hours/week, respectively; P = .003) and larger HBD (0.5 ± 1.3 vs 1.4 ± 2.4 cm, respectively; P = .003). The logistic regression analysis showed that practice duration ( P = .001) and HBD ( P = .004) were significantly related to the presence of bursitis.

Conclusion:

DIB in the apophyseal stage was related to practice duration and thigh muscle tightness. These findings may help predict overload and thigh muscle tightness at a very early stage.
Determinants of Financial Inclusion Among Dalit Women in Kancheepuram District, Tamil Nadu
Authors: Aparna Vemulapalli , Anthuvan Victor Louis
Published: March 2022

Over the years many efforts were made to improve the status of financial inclusion of people. Financial inclusion measures access and usage of financial products such as deposits, loans, insurance products and quality of financial services. Financial inclusion is the process of providing financial services to the people who are outside the formal financial system. High levels of financial inclusion improve economic development and equitable distribution of wealth. This study focuses on status of financial inclusion among Dalit women in Kancheepuram district of Tamil Nadu. It was found that education level of the people; government initiatives such as general credit card, Pradhan Mantri Jan Dhan Yojana; satisfaction of the self-help group model; financial practices and financial literacy were positively and significantly associated with financial inclusion. Usage of non-bank agencies and cultural barriers were negative and insignificant.
Epidemiological cut-off values for a 96-well broth microdilution plate for high-throughput research antibiotic susceptibility testing ofM. tuberculosis
Authors:   The CRyPTIC Consortium
Published: March 2022

Drug susceptibility testing ofM. tuberculosisis rooted in a binary susceptible/resistant paradigm. While there are considerable advantages in measuring the minimum inhibitory concentrations (MICs) of a panel of drugs for an isolate, it is necessary to measure the epidemiological cut-off values (ECOFF/ECVs) to permit comparison with qualitative data. Here we present ECOFF/ECVs for 13 anti-tuberculosis compounds, including bedaquiline and delamanid, derived from 20 637 clinical isolates collected by 14 laboratories based in 11 countries on five continents. Each isolate was incubated for 14 days on a dry 96-well broth microdilution plate and then read. Resistance to most of the drugs due to prior exposure is expected and the MIC distributions for many of the compounds are complex, and therefore aphenotypicallywild-type population could not be defined. Since a majority of samples also underwent genetic sequencing, we defined agenotypicallywild-type population and measured the MIC of the 99th percentile by direct measurement andviafitting a Gaussian using interval regression. The proposed ECOFF/ECVs were then validated by comparing with the MIC distributions of high-confidence genetic variants that confer resistance and with qualitative drug susceptibility tests obtainedviathe Mycobacterial Growth Indicator Tube (MGIT) system or Microscopic-Observation Drug Susceptibility (MODS) assay. These ECOFF/ECVs will inform and encourage the more widespread adoption of broth microdilution: this is a cheap culture-based method that tests the susceptibility of 12–14 antibiotics on a single 96-well plate and so could help personalise the treatment of tuberculosis.
Lung function from school age to adulthood in primary ciliary dyskinesia
Authors: Halbeisen Florian S. , Pedersen Eva S.L. , Goutaki Myrofora , Spycher Ben D. , Amirav Israel , Boon Mieke , Cohen-Cymberknoh Malena , Crowley Suzanne , Emiralioglu Nagehan , Haarman Eric G. , Karadag Bulent , Koerner-Rettberg Cordula , Latzin Philipp , Loebinger Michael R. , Lucas Jane S. , Mazurek Henryk , Morgan Lucy , Marthin June , Pohunek Petr , Santamaria Francesca , Schwerk Nicolaus , Thouvenin Guillaume , Yiallouros Panayiotis , Nielsen Kim G. , Kuehni Claudia E.
Published: March 2022

Primary ciliary dyskinesia (PCD) presents with symptoms early in life and the disease course may be progressive, but longitudinal data on lung function are scarce. This multinational cohort study describes lung function trajectories in children, adolescents and young adults with PCD. We analysed data from 486 patients with repeated lung function measurements obtained between the age of 6 and 24 years from the International PCD Cohort and calculated z-scores for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio using the Global Lung Function Initiative 2012 references. We described baseline lung function and change of lung function over time and described their associations with possible determinants in mixed-effects linear regression models. Overall, FEV1, FVC and FEV1/FVC z-scores declined over time (average crude annual FEV1decline was −0.07 z-scores), but not at the same rate for all patients. FEV1z-scores improved over time in 21% of patients, remained stable in 40% and declined in 39%. Low body mass index was associated with poor baseline lung function and with further decline. Results differed by country and ultrastructural defect, but we found no evidence of differences by sex, calendar year of diagnosis, age at diagnosis, diagnostic certainty or laterality defect. Our study shows that on average lung function in PCD declines throughout the entire period of lung growth, from childhood to young adult age, even among patients treated in specialised centres. It is essential to develop strategies to reverse this tendency and improve prognosis.
Clinical, radiological and pathological findings in patients with persistent lung disease following SARS-CoV-2 infection
Authors: Ravaglia Claudia , Doglioni Claudio , Chilosi Marco , Piciucchi Sara , Dubini Alessandra , Rossi Giulio , Pedica Federica , Puglisi Silvia , Donati Luca , Tomassetti Sara , Poletti Venerino
Published: March 2022

Some patients experience pulmonary sequelae after SARS-CoV-2 infection, ranging from self-limited abnormalities to major lung diseases. Morphological analysis of lung tissue may help our understanding of pathogenic mechanisms and help to provide consistent personalised management. The aim of this study was to ascertain morphological and immunomolecular features of lung tissue. Transbronchial lung cryobiopsy was carried out in patients with persistent symptoms and computed tomography suggestive of residual lung disease after recovery from SARS-CoV-2 infection. 164 patients were referred for suspected pulmonary sequelae after COVID-19; 10 patients with >5% parenchymal lung disease underwent lung biopsy. The histological pattern of lung disease was not homogeneous and three different case clusters could be identified, which was mirrored by their clinical and radiological features. Cluster 1 (“chronic fibrosing”) was characterised by post-infection progression of pre-existing interstitial pneumonias. Cluster 2 (“acute/subacute injury”) was characterised by different types and grades of lung injury, ranging from organising pneumonia and fibrosing nonspecific interstitial pneumonia to diffuse alveolar damage. Cluster 3 (“vascular changes”) was characterised by diffuse vascular increase, dilatation and distortion (capillaries and venules) within otherwise normal parenchyma. Clusters 2 and 3 had immunophenotypical changes similar to those observed in early/mild COVID-19 pneumonias (abnormal expression of STAT3 in hyperplastic pneumocytes and PD-L1, IDO and STAT3 in endothelial cells). This is the first study correlating histological/immunohistochemical patterns with clinical and radiological pictures of patients with post-COVID lung disease. Different phenotypes with potentially different underlying pathogenic mechanisms have been identified.
Predictors of outcome of chest tube drainage of nonpurulent exudative pleural effusions
Authors: Nwagboso Chimaobi Ikechukwu , Echieh Chidiebere Peter , Eze John Nkemakolam , Ogbudu Stephen Omirigbe , Njoku Chibueze Haggai , Etiuma Anietimfon Umoh , Bassey Okokon Odonkwo
Published: March 2022

Background

Although chest tube drainage is the primary management method for many pleural effusions, it has a failure rate of 9.4–48%. In this study, we examined the factors that predict the outcome of management of nonpurulent exudative effusions. The aim of this study was to determine the predictors of outcomes of chest tube drainage of pleural effusions.

Methodology

Consecutive patients who had a chest tube drainage of nonpurulent exudative pleural effusions were followed up in a prospective observational cohort study until extubation and discharge. Data on the management of the patients were recorded, analysed and compared between groups of patients with good and poor outcomes.

Results

Of the 52 patients studied, 38 had good outcomes, while 14 had poor outcomes. The mean±sdage was 39.7±15.9 years. Multivariate analysis demonstrated that empyema thoracis complicating drainage was an independent predictor of a poor outcome, while the duration of drainage ≤14 days and duration of illness before presentation <30 days were predictive of a good outcome.

Conclusion

Our results show that the development of empyema thoracis during drainage, a long duration of drainage and a prolonged period of illness before presentation are predictive of the outcome of chest tube drainage.
Plethysmography-derived gas trapping lacks utility in predicting response to bronchial thermoplasty
Authors: Rajan Ashwin , Bennetts Kim , Langton David
Published: March 2022

There is a paucity of literature on measurable baseline parameters predicting response and guiding selection for bronchial thermoplasty. This study examines whether baseline gas trapping, as assessed by plethysmography, is associated with a response to bronchial thermoplasty at 12 months.

43 consecutive patients with severe asthma (mean±sdage 57.6±13.3 years) were evaluated at baseline and 12 months post bronchial thermoplasty. Data collected at both time points included spirometry, body plethysmography and four clinical outcome measures, namely Asthma Control Questionnaire (ACQ) score, annual exacerbation frequency, maintenance oral corticosteroid requirement and short-acting β-agonist use.

At baseline, participants had severe airflow obstruction (forced expiratory volume in 1 s 49.1±15.8%) with marked gas trapping (residual volume (RV) 150.3±40.8%, RV/total lung capacity (TLC) 51.3±10.5%), poor symptom control (ACQ 3.3±1.0) and frequent exacerbations (median 4, interquartile range 8). 12 months after bronchial thermoplasty, significant improvements were observed in all four clinical outcome measures. However, baseline RV and RV/TLC were not significantly associated with changes in ACQ nor any other clinical outcome measure, and changes in RV and RV/TLC did not significantly correlate with a change in any clinical outcome measure.

Plethysmography-derived gas trapping does not demonstrate utility in predicting response and guiding selection for bronchial thermoplasty. An improvement in gas trapping was not associated with positive clinical outcomes, suggesting that this may not be the dominant mode of action of bronchial thermoplasty in generating clinical improvement.
Discriminative Features of Abnormities in a Spiral Groove Gas Face Seal Based on Dynamic Model Considering Contact
Authors: Yin Yuan , Huang Weifeng , Li Decai , Hu Songtao , Liu Xiangfeng , Liu Ying
Published: March 2022

It is a difficult task to root the cause of the failure of a gas face seal because different causes may result in similar observations. In the work being presented, the discrimination of multiple types of abnormities in a spiral groove gas face seal is studied. A dynamic model is employed to analyze groups of cases in order to uncover the dynamic behaviors when the face contact is induced by different mixtures of abnormities, whose discriminative features when motion and contact are monitored are studied and uncovered. A circumferential-pattern-related oscillation phenomenon is discovered, which is extracted from contact information and implies the relative magnitude of the moment on stator and the rotor tilt. The experimental observation shows consistent results. It means that the grooves (or other circumferential patterns) generate useful informative features for monitoring. These results provide guidance for designing a monitored gas face seal system.
Sarcomatoid carcinoma of the prostate presenting as bilateral cervical lymphadenopathy: a rare case report
Authors: Jayasinghe K. I. , Abeysinghe A. H. M. G. B.
Published: March 2022

Background

Sarcomatoid carcinoma (also called carcinosarcoma in the latest WHO classification 2016) of the prostate gland is a biphasic malignant neoplasm which exhibits epithelial and mesenchymal differentiation [1]. Sarcomatoid carcinoma is a rare tumour, considered as a variant of acinar adenocarcinoma in the WHO classification, with less than 200 reported cases in the literature to date [2]. Sarcomatoid carcinoma of prostate presenting with bilateral cervical lymph node deposits as the first clinical manifestation, is even rarer, and reported cases were not found in the literature; hence, this is the first case report of such, to the best of our knowledge.

Case presentation

We report a case of sarcomatoid carcinoma of the prostate in a 72-year-old Sri Lankan man who presented with bilateral cervical lymphadenopathy. He had hard nodular prostate on digital rectal examination (DRE). Ultrasound scan of abdomen (USS) revealed the presence of paraaortic lymphadenopathy, in addition. The excision biopsy of the right cervical lymph node revealed deposit of a carcinoma of epithelioid histomorphology, which showed patchy strong positivity for immunohistochemical marker (IHCm), PSA. His serum PSA value was 48 ng/ml (reference < 5.40 ng/ml). Contrast-enhanced computed tomography (CECT) showed mildly enlarged prostate gland with irregular outline, sclerotic lesions in cervico-thoracic and lumbosacral vertebrae and generalized lymphadenopathy. Transrectal ultrasound guided biopsy of the prostate revealed sarcomatoid carcinoma. Disseminated sarcomatoid carcinoma of prostate was diagnosed. The patient has undergone bilateral orchidectomy, marking a serum PSA value of 5.4 ng/ml two months thereafter. He is surviving for six months after diagnosis and is currently under chemotherapy with docetaxel for the disseminated disease.

Conclusion

Sarcomatoid carcinoma can present with cervical lymphadenopathy with absent lower urinary tract symptoms. In elderly patients with cervical lymphadenopathy, serum PSA, DRE and trans-rectal ultrasound scan are advocated to rule out prostate cancer. Immunohistochemical markers are required for the diagnosis of primary tumour and secondary deposit of sarcomatoid carcinoma of prostate.
Measuring distance from the incisors to the esophageal cancer by FDG PET/CT: endoscopy as the reference
Authors: Hsu Szu-Wei , Chang Jeffrey S. , Chang Wei-Lun , Lin Forn-Chia , Chiu Nan-Tsing
Published: March 2022

Background

Using endoscopy as the reference, this study evaluated the accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in measuring distance from the incisors to the PET detectable esophageal cancer. If there is high concordance between endoscopic and PET measurements, our results may provide a basis to use FDG PET/CT in cooperation with endoscopic measurement to localize those PET/CT and CT undetectable esophageal tumors for radiotherapy planning.

Materials

Esophageal cancer patients with pretreatment endoscopy and FDG PET/CT detectable esophageal tumors were recruited retrospectively. The distances from the incisors to the proximal esophageal tumor margins were determined by endoscopy and by the sagittal images of FDG PET/CT. The endoscopic measurement was used as the comparative reference. A nuclear medicine doctor and a radiation oncologist each performed the FDG PET/CT measurement twice for every patient. We analyzed the differences in these measurements, and assessed agreement and reproducibility of the results by the intraclass correlation coefficient (ICC).

Results

Thirty-four patients, with 35 esophageal tumors, were included. By endoscopy and FDG PET/CT, the mean distances from the incisors to the proximal esophageal tumor margin were 27.3 ± 6.4 cm (range 17.1–40.0 cm) and 26.8 ± 6.3 cm (range 15.7–41.3 cm), respectively. The mean absolute differences between the endoscopic and four FDG PET/CT measurements ranged from 1.129 to 1.289 cm (SD: 0.98–1.19). The measurement agreement between FDG PET/CT and endoscopy by ICC was between 0.962 and 0.971. The intra- and interobserver reproducibilities of the two readers were excellent (intraobserver ICC: 0.985, 0.996; interobserver ICC: 0.976–0.984).

Conclusions

FDG PET/CT was in high agreement with endoscopy in measuring the distance from the incisors to the proximal esophageal tumor margin. For FDG PET/CT and CT undetectable esophageal cancer, incorporation of the endoscopic measurement with PET/CT might be a way for making radiotherapy plan.
Creating opportunities to improve detection of older adult abuse: a national interRAI study
Authors: Hall Yvette , Smith Jim , Turner Robin M. , Greco Philippa , Hau Kenny , Barak Yoram
Published: March 2022

Despite being recognized as a major global health issue, older adult abuse (OAA) remains largely undetected and under-reported. Most OAA assessment tools fail to capture true prevalence. Follow up of patients where abuse exposure is not easily determined is a necessity. The interRAI-HC (International Resident Assessment Instrument—Home Care) currently underestimates the extent of abuse. We investigated how to improve detection of OAA using the interRAI-HC. Analysis of 7 years of interRAI-HC data from an Aotearoa New Zealand cohort was completed. We identified that through altering the criteria for suspicion of OAA, capture rates of at-risk individuals could be nearly doubled from 2.6% to 4.8%. We propose that via adapting the interRAI-HC criteria to include the "unable to determine" whether abuse occurred (UDA) category, identification of OAA sufferers could be substantially improved. Improved identification will facilitate enhanced protection of this vulnerable population.
The impact of regional socioeconomic deprivation on the timing of HIV diagnosis: a cross-sectional study in Germany
Authors: Pantke Annemarie , Hoebel Jens , an der Heiden Matthias , Michalski Niels , Gunsenheimer-Bartmeyer Barbara , Hanke Kirsten , Bannert Norbert , Bremer Viviane , Koppe Uwe
Published: March 2022

Background

HIV infections which are diagnosed at advanced stages are associated with significantly poorer health outcomes. In Germany, the proportion of persons living with HIV who are diagnosed at later stages has remained continuously high. This study examined the impact of regional socioeconomic deprivation on the timing of HIV diagnosis.

Methods

We used data from the national statutory notification of newly diagnosed HIV infections between 2011 and 2018 with further information on the timing of diagnosis determined by the BED-Capture-ELISA test (BED-CEIA) and diagnosing physicians. Data on regional socioeconomic deprivation were derived from the German Index of Socioeconomic Deprivation (GISD). Outcome measures were a non-recent infection based on the BED-CEIA result or an infection at the stage of AIDS. The effect of socioeconomic deprivation on the timing of diagnosis was analysed using multivariable Poisson regression models with cluster-robust error variance.

Results

Overall, 67.5% (n = 10,810) of the persons were diagnosed with a non-recent infection and 15.2% (n = 2746) with AIDS. The proportions were higher among persons with heterosexual contact compared to men who have sex with men (MSM) (76.8% non-recent and 14.9% AIDS vs. 61.7% non-recent and 11.4% AIDS). MSM living in highly deprived regions in the countryside (< 100 k residents) were more likely to have a non-recent infection (aPR: 1.16, 95% CI: 1.05–1.28) as well as AIDS (aPR: 1.41, 95% CI: 1.08–1.85) at the time of diagnosis compared to MSM in less deprived regions in the countryside. No differences were observed among MSM from towns (100 k ≤ 1 million residents) or major cities (≥ 1 million residents), and no differences overall in the heterosexual transmission group.

Conclusions

An effect of socioeconomic deprivation on the timing of HIV diagnosis was found only in MSM from countryside regions. We suggest that efforts in promoting HIV awareness and regular HIV testing are increased for heterosexual persons irrespective of socioeconomic background, and for MSM with a focus on those living in deprived regions in the countryside.
Incidence of impaired kidney function among people with HIV: a systematic review and meta-analysis
Authors: Shi Ruizi , Chen Xiaoxiao , Lin Haijiang , Ding Yingying , He Na
Published: March 2022

Background

In the era of combination antiretroviral therapy (ART), the incidence, manifestations and severity of kidney diseases have dramatically changed in people living with HIV (PLWH). Little is known about the incidence of impaired kidney function (IKF) measured by serum creatine-based estimated glomerular filtration rate (eGFR) in PLWH.

Methods

In this systematic review and meta-analysis, we searched PubMed, Ovid, Medline, Embase and Web of Science for studies published before May 7th, 2021, with estimates of incidence of IKF among PLWH. We independently reviewed each study for quality by using the Newcastle-Ottawa scale. The incidence and 95% confidence intervals (CIs) were calculated using random-effects model.

Results

Sixty out of 3797 identifiable studies were eligible for the meta-analysis. A total of 19 definitions of IKF were described and categorized into three types: the threshold of eGFR, an absolute or percent decrease in eGFR, and certain eGFR threshold combined with decrement in eGFR. The eGFR< 60 ml/min/1.73m2 was the most widely used definition or criterion for IKF, by which the pooled incidence rate of IKF was 12.50 (95%CI: 9.00–17.36) per 1000 person years (PYs). The second most-studied outcome was a > 25% decrease in eGFR, followed by eGFR< 90 ml/min/1.73m2, eGFR< 30 ml/min/1.73m2 and a combination of eGFR threshold plus decreased eGFR. The reported incidence rates of IKF differ widely by different definitions of IKF. The highest pooled incidence was observed for those with > 25% decrease in eGFR, while the lowest was observed in those with eGFR < 30 ml/min/1.73m2. Substantial heterogeneity was identified across most estimates.

Conclusion

Our study provides a comprehensive summary of eGFR-based definitions and incidence rates of IKF in PLWH, not only promoting our understanding of IKF, but also underscoring needs for a concerted action to unify definitions and outcomes of IKF and their applications in AIDS care.
Consistency of the estimated target weights and ECW/TBW using BIA after hemodialysis in patients between standing and lying-down positions
Authors: Choi Gwangho , Yoon Ho Joong , Song Young Jin , Jeong Hae Min , Gu Jae Eon , Han Miyeun , Kim Seok Hyung , Yoon Jong-Woo , Kim Hyunsuk
Published: March 2022

Background

As hemodialysis is administered with the patient lying down, the distribution of body fluid is stable in the lying position, which is why this position is recommended for bioimpedance analysis (BIA). Although the InBody S10 is widely used for hemodialysis patients in the lying position, clinicians must make the measurements in person. In contrast, patients can use the InBody 770 to obtain measurements by themselves in the standing position, which may be more convenient. Therefore, this study compared the measurements of hemodialysis patients’ estimated target weight and ECW/TBW obtained lying down using the S10 to those obtained in the standing position using the 770.

Methods

This study was conducted among maintenance hemodialysis patients at Chuncheon Sacred Heart Hospital in October 2020. Measurements from 56 patients before and after hemodialysis were obtained using the 2 machines. Each (S10 or 770) estimated target weight, both pre- and post-hemodialysis, was considered ideal when the ECW/TBW ratio was 0.380. R2 was calculated and the Bland-Altman test was performed.

Results

The patients’ median age was 64 years old, and 51% were men. The actual ultrafiltration was 2 kg, and the mean TBW change measured using the InBody devices was 1.5 L (R2 = 0.718) for the S10 and 1.7 L (R2 = 0.616) for the 770. The estimated target weight at pre- and post-hemodialysis showed a remarkably high correlation with the patients’ actual pre- and post-hemodialysis weight (R2 > 0.095). The correlation between these measurements (lying vs. standing) before and after hemodialysis was also very close (R2 = 1.0000). In addition, ECW/TBW had a good correlation (R2 ≥ 0.970) The Bland-Altman test of dry weight and ECW/TBW yielded similar results.

Conclusions

This study showed that patients’ estimated target weights in the lying position using the InBody S10 device and in the standing position using the InBody 770 device were consistent in both pre- and post-hemodialysis states.
A patient-initiated treatment model for blepharospasm and hemifacial spasm: a randomized controlled trial
Authors: Lawes-Wickwar Sadie , McBain Hayley , Brini Stefano , Hirani Shashivadan P. , Hurt Catherine S. , Flood Chris , Dunlop Nicola , Solly Dianne , Crampton Bridget , Newman Stanton P. , Ezra Daniel G.
Published: March 2022

Background

To test, in a two-arm, single center, superiority, randomized controlled trial, the effectiveness of and costs associated with a patient-initiated treatment model for people with hemifacial spasm (HFS) and blepharospasm (BEB) in comparison to usual care.

Methods

One hundred and thirty patients with HFS or BEB, aged 18 years or over, were recruited from a nurse-led botulinum toxin type A clinic at an eye hospital in the United Kingdom (UK), completed baseline measures and were randomized (1:1). The intervention group determined their own botulinum toxin type A (BoNT/A) treatment schedule during the trial period (9 months) and received an information leaflet with a “hotline” number to book an appointment. Usual care appointments were scheduled by treating clinicians. Data analysts were blind to study group. The primary outcomes were disease severity and functional disability, as measured by the Jankovic Rating Scale and Blepharospasm Disability Index, respectively. Secondary outcomes included quality of life, anxiety and depression, satisfaction with care, confidence in the service, economic costs and employment days lost.

Results

Sixty-five patients were randomized to each group. The intervention demonstrated no statistically significant difference to usual care for any of primary outcomes. On secondary outcomes the levels of anxiety differed significantly (F2, 142.39 = 1.65,p = 0.02), with the intervention arm exhibiting a decrease and the control arm an increase (Hedges’ g = − 0.26 [99% CI -0.83, 0.32]). No other statistically significant differences were found for secondary outcomes. Overall healthcare costs and costs to the patient were on average £198.95 less (95% CI -£256.76, £654.67;p = 0.10) per participant for those in the intervention compared to usual care, although this finding was not significant.

Conclusions

We did not observe differences between the patient-initiated treatment model and usual care for people with BEB or HFS, on any primary outcome measure, quality of life, or depression. The patient-initiated treatment model may, however, have the potential to save healthcare costs and reduce anxiety. Patients using this new model were also equally as satisfied in the service and confident in their care as those receiving treatment as usual.

Trial registration

Clinicaltrials.gov IDNCT02577224, 16th October 2015.