bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prospective Comparison of Groin-Related Complications After Hip Arthroscopy With and Without a Perineal Post
Authors: Kraeutler Matthew J. , Fasulo Sydney M. , Dávila Castrodad Iciar M. , Mei-Dan Omer , Scillia Anthony J.
Published: November 2022

Background:

Previous studies have demonstrated various groin-related nerve and soft tissue complications in patients undergoing hip arthroscopy with a perineal post.

Purpose:

To prospectively compare groin-related nerve and soft tissue complications between patients undergoing hip arthroscopy with and without the use of a perineal post.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A prospective single-surgeon cohort study was performed on all patients undergoing hip arthroscopy by the senior author between January 2020 and March 2022. A post-free hip distraction system was used at 1 center in which the senior author operates, and a system with a large padded perineal post was used at another surgical location. Patients completed a survey at the first postoperative visit (7-10 days) to determine if they had experienced any groin-related complications after surgery (groin numbness, sexual/urinary dysfunction, skin tears). Patients with a positive survey response repeated the survey at each follow-up visit (6 weeks, 3 months, 6 months) until the symptoms resolved. The rate and duration of groin-related complications were then compared between the groups.

Results:

A total of 87 patients were included in the study who underwent hip arthroscopy: 53 with a perineal post and 34 without. No differences were found between the post and postless groups in terms of age at surgery, sex, body mass index, or traction time. We found that 16 patients (30%) in the perineal post group experienced groin numbness versus 0 (0%) in the postless group ( P < .0001). On average, groin numbness lasted 5 ± 3 days (mean ± SD) in the perineal post group. Three patients in the perineal post group experienced sexual dysfunction for a mean 7 days, as compared with none in the postless group. Seventeen patients (32%) in the perineal post group experienced foot numbness versus 4 (12%) in the postless group ( P = .04). One patient in the perineal post group reported a superficial skin tear.

Conclusion:

Postless hip arthroscopy resulted in no risk of groin-related complications as compared with traditional hip arthroscopy with a perineal post.
Elderly Outcomes After Hospitalization: The Hospital Frailty Risk Score Applied on the French Health Data Hub
Authors: Dubnitskiy-Robin Sophie , Laurent Emeline , Herbert Julien , Fougère Bertrand , Guillon-Grammatico Leslie
Published: November 2022

Objectives: To demonstrate the association between the Hospital Frailty Risk Score (HFRS) and 30-day mortality, 30-day hospital readmission and length of stay (LOS) in France. Methods: Logistic regressions were performed using data recorded in the French national health data system ( SNDS) for elderly patients (≥75 years old) hospitalized in France in 2017. Results: Over the 1,111,090 patients included, 30-day mortality was associated with the HFRS: adjusted OR (aOR) for an intermediate HFRS (5–15 points) was 1.91 [95% confidence interval (95% IC); 1.87–1.95] and aOR 2.57 [95% IC; 2.50–2.64] for high HFRS (>15 points), as compared to low HFRS (<5 points). LOS >10 days increased with the HFRS (aOR = 1.36 [95% IC; 1.34–1.38] for an intermediate HFRS and aOR 1.51 [95% IC; 1.48–1.54] for a high HFRS). A high HFRS was associated with 30-day hospital readmission (aOR = 1.06 [95% IC; 1.04–1.08]). Discussion: This real-life analysis of in- and out-patient healthcare pathways confirmed the HFRS’s ability to predict adverse outcomes, after adjustment on social deprivation.
There and Back Again: Neuro-Diverse Employees, Liminality and Negative Capability
Authors: Nash Louise
Published: November 2022

The workplace challenges faced by neuro-diverse employees are currently under-researched. This article considers how such employees experience the world of work, focusing on the demands they face to conform to established expectations around self-presentation and performance and how they utilise spatial resources in order to transcend them. Drawing on data generated from a series of in-depth interviews, it explores both their everyday experiences of frustration alongside how the mobilisation of liminal spaces can assist them in transitioning to and from the demands of the ‘neuro-typical’ workplace. The article seeks to contribute to an understanding of the lived experiences of neuro-diverse employees and how the design and practices of the workplace can contribute to feelings of marginalisation and even exclusion. It highlights the potentially empowering and emancipatory potential of embracing liminality and explores the relationship to ‘negative capability’ as a conceptual and diagnostic lens in studies of workplace diversity.
Between Settlement and Mobilization: Political Logics of Intra-Organizational Union Communication on Social Media
Authors: Hansen Nana Wesley , Hau Mark Friis
Published: November 2022

Since both ‘conflict and co-operation are at the heart of employment relations’, unions need to strike a balance between mobilizing workers against employers and ‘social dialogue’ when communicating with members and the public. Drawing on a case study of unions and grassroots communication on Facebook during sector collective bargaining, this article develops a framework of politico-communicative logics that inform the social media strategies of unions and their grassroots: a logic of mobilization and a logic of settlement. These logics are reflected in how unions and grassroots engage with followers, their choice of words and the topics they address. These theoretical developments on politico-communicative logics on Facebook open up the door for further studies of intra-organizational union communication in an increasingly digitalized world.
All That Glitters is Not Green: Impact of Biophilic Designs on Customer Experiential Values
Authors: Lee Seung Hyun (Jenna) , Tao Chen-Wei (Willie) , Douglas Alecia C. , Oh Haemoon
Published: November 2022

Since COVID-19, people appreciate fully immersing themselves in nature. Bringing elements of nature into service spaces has been an important concern for marketers. Yet, there have been only a few studies addressing the impact of natural and biophilic aspects within servicescapes. This study investigated the effect of biophilic design on experiential values such as esthetics, escapism, economic value, and attitude toward hotels and the role of the hotel segment and its environmental beliefs regarding green behavior on the relationships. The results indicated that in a luxury hotel setting, the biophilic design engendered better esthetic perceptions, escapism, economic value, and attitude toward the hotel. At a midscale hotel, a non-biophilic design induced higher experiential values. In addition, customers’ environmental beliefs had significant effects on experiential values. Results provided practical suggestions for hotel managers, marketers, and interior designers on how biophilic servicescapes can enhance a hotel’s marketing effectiveness.
Femorally inserted central catheter, migration and catheter damage during contrast media injection: A case report
Authors: Stefano Elli , Silvia Cavalli , Scigliano Laura , Gianluca Mastroianni , Egle Rondelli
Published: November 2022

Femorally inserted Central Catheters are increasingly used also for medium and long-term catheterization as an alternative to Centrally and Peripherally inserted Central Catheters. If certified as “power injectable,” they may be used for contrast media injection during radiological examinations. It is important to consider the risk that, as with other types of catheters, the injection of contrast media could cause migration or damage to the device. The case of a Femoral catheter migration in hepatic vein, during CT scan, is described.
‘You Can’t Delete a Memory’: Managing the Data Past on Social Media in Everyday Life
Authors: Jacobsen Benjamin N
Published: November 2022

This article explores how the data past on social media, in the form of packaged ‘memories’, is managed by people in everyday life. Drawing on interview and focus group data, I examine how people make sense of data as ‘memories’ and how these are negotiated and managed when considered painful, awkward, or simply ‘out of place’. As such, the article outlines and discusses three specific ‘tactics’ used to manage the data past in everyday life. First, I explore the use of ‘deletion’ and how it foregrounds ways in which people seek to render certain aspects of their data past invisible, especially memories considered painful or inconsistent with the current view of self. Second, through the tactic of ‘delaying’, the article examines how some participants sought to delay emotional engagements with digital memories rather than to delete them. Finally, the tactic of ‘linking’ highlights the ways in which people sought to make sense of data as memories that were insufficiently contextualised, disjointed, or that felt simply out of place. As such, the article contributes to our understanding of the ways in which people make sense of data as well as some of the complex dynamics inherent in contemporary digital memory work.
Institutional Gap and Mobility–Immobility Transition: International Students’ Study-to-Work Experience in China
Authors: Tu Mengwei
Published: November 2022

Individuals’ transnational mobility trajectories are shaped by personal life stages and intertwined with migration infrastructure. In the case of international student mobility, graduates may seek to ‘stay put’ in the host country for career mobility. However, this mobility–immobility transition is heavily mediated by regulatory institutions, especially in a relatively new migrant-receiving country like China. This article unpacks the process of study-to-work transitions in China. The preliminary findings from policy analysis and two case studies reveal that institutional gaps in China’s migration infrastructure can manifest in multiple forms, including intransparent information accessibility, administrative barriers, and institutional timeframe clashes. These gaps also have a temporal dimension and can shape graduates’ post-study mobility path as their transnational biographies develop. The human cost of individuals in navigating these gaps thus hinders their socio-economic mobility and entails questions regarding the implication of China’s ‘rise’ as an international student/migration destination.
Visually informed accounts: instructed achievements during planetarium visits and sky observations
Authors: Moutinho Ricardo , Carlin Andrew P , Marques Joana BV
Published: November 2022

In this article, the authors explore participants’ accounts of visual scenes produced during the instructed work of observing celestial bodies at planetarium sessions and star-parties. They use as examples some interactions in which participants (i.e. guides and visitors) are giving/following instructions and exchanging descriptions about the observed object based on their (in)direct access to the matter at hand and also on their orientation to the world shared in common. According to the materials analyzed, the authors found that the descriptions of participants’ observations produced and complemented each other’s accounts of the object under scrutiny. This phenomenon helps us understand how instructed observation work is locally and collaboratively managed, which in turn opens the possibility for us to explore how visual accounts are produced through the sequential and categorial aspects of talk. Such enterprise gives guides and trainers a better picture of how visitors make sense of the contents delivered.
Research discourse in the programme for international student assessment: A critical perspective
Authors: Bart Daniel
Published: November 2022

More than 20 years after the first round of the OECD’s Programme for International Student Assessment (PISA), it has become one of the most important large-scale international assessments, at a global level and in particular in Europe. Thus, a growing number of scholars have examined or discussed its research design. Nonetheless, a key feature of PISA seems to have been less examined by critical works: the discourse of the research in the PISA literature. Indeed, the PISA reports appear to be scientific literature, both in textual form and in terms of the intentions expressed. Based on the reports published by the OECD since 1999, this article examines, in line with the French tradition of discourse analysis, the characteristics of research writing in PISA and the explanations of its conceptual approach, test design or result analysis. This analysis shows the differences between the research discourse in PISA and typical scientific rhetoric, particularly in terms of constructing a contradictory theoretical dialogue or a discussion of the limits of its approach. Finally, the article questions how these differences indicate a particular construction of education research within PISA and its possible relationship with the global or European dynamics of this scientific field.
Optimal Sizing of Aortic Stent Graft for Blunt Thoracic Aortic Injury Considering Hypotension-Related Decrease in Aortic Diameter
Authors: Bae Miju , Jeon Chang Ho
Published: November 2022

Purpose:

To evaluate the optimal sizing of an aortic stent graft in patients with blunt thoracic aortic injury (BTAI), considering the decrease in diameter in hypovolemic status.

Materials and Methods:

From 2014 to 2020, 25 patients who underwent thoracic endovascular aortic repair (TEVAR) for BTAI were included. Hemodynamic parameters in the emergency room (ER) and just before the main procedure (MP) were collected. The aortic sizes were measured during initial computed tomography (CT) on arrival in the ER, aortography (AG) during TEVAR, and final CT in the outpatient clinic. The appropriateness of the inserted stent graft size was investigated.

Results:

The mean values of the final CT/initial CT and final CT/initial AG (proximal descending thoracic aorta [pDTA]) were 113% and 105%, respectively. The final CT/initial CT (pDTA; 122.2% vs 108.8%, p=0.01) and final CT/initial AG (pDTA; 113.4% vs 102.1%, p<0.01) were significantly higher in patients with systolic blood pressure (SBP; MP) ≤90 mm Hg. The final CT/initial CT (pDTA; 120.4% vs 109.0%, p=0.03) and final CT/initial AG (pDTA; 111.4% vs 102.6%, p=0.01) were significantly higher in patients with mean blood pressure (MBP; MP) ≤70 mm Hg. On an average, the inserted stent grafts were oversized by 130% on initial AG. Based on the final CT scan, the inserted stent graft was as large as 122%.

Conclusion:

In the case of hemodynamic instability with SBP (MP) ≤90 mm Hg or MBP (MP) ≤70 mm Hg, despite adequate resuscitation, an oversized TEVAR stent graft of 130% can reduce the occurrence of endoleak and is sufficiently safe.

Clinical Impact

Despite sufficient resuscitation, the aorta size measured during TEVAR in patients with hemodynamic instability with systolic BP <90 mmHg and mean BP <70 mmHg may be reduced by more than 15% compared to that in the normal state. In this study, the mean size of the stent grafts were oversized by 130% on initial aortography, but were oversized by 122% based on final CT. When the stent graft was oversized by 130% in TEVAR for hemodynamic unstable patient with BTAI, the patient reached the proper oversizing subsequent to hemodynamic recovery.
The Deep Learning Method Differentiates Patients with Bipolar Disorder from Controls with High Accuracy Using EEG Data
Authors: Metin Barış , Uyulan Çağlar , Ergüzel Türker Tekin , Farhad Shams , Çifçi Elvan , Türk Ömer , Tarhan Nevzat
Published: November 2022

Background: Bipolar disorder (BD) is a mental disorder characterized by depressive and manic or hypomanic episodes. The complexity in the diagnosis of Bipolar disorder (BD) due to its overlapping symptoms with other mood disorders prompted researchers and clinicians to seek new and advanced techniques for the precise detection of Bipolar disorder (BD). One of these methods is the use of advanced machine learning algorithms such as deep learning (DL). However, no study of BD has previously adopted DL techniques using EEG signals. Method: EEG signals of 169 BD patients and 45 controls were cleaned from the artifacts and processed using two different DL methods: a one-dimensional convolutional neural network (1D-CNN) combined with the long-short term memory (LSTM) and a two-dimensional convolutional neural network (2D-CNN). Additionally, Class Activation Maps (CAMs) acquired from the bipolar and control groups were used to obtain distinctive regions to specify a particular class in an image. Results: Group identifications were confirmed with 95.91% overall accuracy through the 2D-CNN method, demonstrating very high sensitivity and lower specificity. Also, the overall accuracy obtained from the 1D-CNN + LSTM method was 93%. We also found that F4, C3, F7, and F8 electrode activities produce predominant features to detect the bipolar group. Conclusion: To our knowledge, this study used EEG-based DL analysis for the first time in BD. Our results suggest that the raw EEG-based DL algorithm can successfully differentiate individuals with BD from controls. Class Activation Map (CAM) analysis suggests that prefrontal changes are predominant in EEG data of patients with BD.
Impact of Hedonics and Magnitude Upon Validated Psychophysical Olfactory Tests and Olfactory-Specific Quality of Life
Authors: Shih Michael C. , Soler Zachary M. , Germroth Matthew , Snyder Jacob , Nguyen Shaun A. , Schlosser Rodney J.
Published: November 2022

Introduction

Patients often describe the olfactory loss as either the inability to detect unpleasant odors (eg, smoke or spoiled food) or noticeable impairment in enjoying pleasant odors (eg, food and fragrances). This complex relationship between the hedonics of various odors, their perceived magnitude in odor strength, and the impact on patient quality of life is not well understood.

Methods

Sixty-five subjects underwent testing with the Henkin olfaction test which assesses hedonics and magnitude for odors traditionally deemed unpleasant (pyridine/dead fish and thiophene/gasoline) and pleasant (amyl acetate/banana and nitrobenzene/almond). Subjects also completed Smell Identification Test-40 (SIT-40), Sniffin’ Sticks (Sniffin’ Sticks), and Snap & Sniffin’ Sticks (Snap) Olfactory Tests, as well as the 17-item Questionnaire for Olfactory Disorders Negative Statements (QODNS) and olfactory symptom visual analog scale (VAS). Spearman's rank correlations were conducted between various olfactory domains, QODNS and VAS.

Results

Mean age was 52.1 years (range: 28-86), with 63.1% females. Magnitude estimation was greatest for pyridine. Most people rated thiophene (75.4%) and pyridine (92.3%) as “unpleasant.” Although most people rated amyl acetate (47.7%) and nitrobenzene (56.9%) as “pleasant,” many rated amyl acetate (52.3%) and nitrobenzene (43.1%) as “neutral” or “unpleasant” scents. Hedonics for unpleasant odors correlated with each other ( rs = 0.60), but not with hedonics for pleasant odors. Hedonics for unpleasant odors also correlated with magnitude estimation and other psychophysical tests. These findings were not seen for hedonics of pleasant odors.

Conclusions

The use of unpleasant odors in Henkin testing showed unique relationship patterns with patient-reported outcome measures and validated olfactory tests, which may provide utility in characterizing olfactory dysfunction. The incorporation of more unpleasant odors in current psychophysical olfactory testing may provide enhanced information regarding the patient impact of olfactory dysfunction.
Spontaneous remission of idiopathic minimal change disease in a cat
Authors: Broadbridge Catherine , Hall Harriet , McCallum Katie E
Published: November 2022

Case summary

A 5-year-old female neutered domestic mediumhair cat presented with acute onset hyporexia, lethargy, ascites, hypoalbuminaemia and ventral subcutaneous oedema. Further investigations revealed a bicavitary effusion, myocardial injury, hypercholesterolaemia and concurrent marked proteinuria. A panel of infectious disease tests yielded negative results. Nephrotic syndrome was suspected and renal biopsies were performed. Histopathology and electron microscopy confirmed a diagnosis of minimal change disease (MCD). The patient was successfully managed with benazepril, clopidogrel and a veterinary prescription renal diet. Follow-up two weeks later documented almost complete resolution of the cardiac abnormalities, absence of clinical signs and marked improvement in clinicopathological findings. The hypoalbuminaemia and proteinuria had resolved two months after presentation. At the time of writing, 13 months post-admission, the cat remained asymptomatic with no evidence of disease relapse.

Relevance and novel information

MCD is rarely described in the veterinary literature, with only four cases reported to date. To our knowledge, this report describes the first case of successfully treated MCD-associated nephrotic syndrome in a cat without the use of glucocorticoid treatment.
Candidate entry in a non-partisan context: Evidence from Indonesia
Authors: Allen Nathan W
Published: November 2022

Why do candidates enter an electoral contest? The Rational Model of Candidate Entry offers a parsimonious explanation focusing on the probability of victory, the benefit of holding office, as well as campaign costs. Quality challengers enter when there is a high probability of victory, while long-shot races attract amateurs. In most contexts, the presence of parties makes it difficult to disentangle candidate decisions from organizational recruitment strategies. To test the basic assumptions of the Rational Model of Candidate Entry, this Research Note examines candidate entry decisions in Indonesia's Regional Representative Council ( Dewan Perwakilan Daerah, DPD), the world's largest elected non-partisan assembly. An analysis of constituency-level candidate lists in all four DPD elections indicates that entry decisions are affected by the perceived probability of victory, with fewer candidates entering in constituencies with a more concentrated vote in the previous election. Potentially winnable DPD races attract a greater number of experienced challengers, partisan amateurs, and non-partisan amateurs. Only the number of non-partisan amateur candidates consistently correlates with socio-demographic variables, further underlining the importance of electoral context for ambitious, politically savvy elites. The findings affirm the broad applicability of the Rational Model and spotlight Indonesia's often-overlooked DPD as a venue of strategic behaviour.
The influence of multiple impedance contrasts on mHVSR site period estimates in the Canterbury Plains of New Zealand and implications for site classification
Authors: Stolte Andrew , Wotherspoon Liam , Cox Brady , Wood Clinton , Jeong Seokho , Munro James
Published: November 2022

An experimental study of the fundamental period of vibration of geologic strata above multiple impedance contrasts is presented for the Canterbury Plains, a deep, complex sedimentary basin on the South Island of New Zealand. Microtremor Horizontal-to-Vertical Spectral Ratio (mHVSR) analysis was used at 152 locations to investigate the fundamental period of the strata above three significant impedance contrasts in the region: the Riccarton Gravel, the Banks Peninsula volcanic (BPV) rock, and the deep graywacke basement bedrock. Up to three mHVSR peaks were observed in many of the mHVSR curves, with the long-period (2–7 s) peaks controlled by the BPV and/or the underlying bedrock. As the thickness of the BPV increases, the response of the geologic strata above the basement bedrock was masked by the shallower BPV, effectively changing the definition of what constitutes the reference condition (i.e. engineering bedrock) for site response analyses. The mHVSR peaks matched the long-period amplification peaks observed in the response spectra calculated from ground motions recorded during the Canterbury Earthquake Sequence events, underscoring the importance of the identification and consideration of deep impedance contrasts in site classification.
Cost-effectiveness of chimeric antigen receptor T-cell therapy in adults with relapsed or refractory follicular lymphoma
Authors: Potnis Kunal C. , Di Mengyang , Isufi Iris , Gowda Lohith , Seropian Stuart E. , Foss Francine M. , Forman Howard P. , Huntington Scott F.
Published: November 2022

Follicular lymphoma (FL) is traditionally considered treatable but incurable. In March 2021, the US Food and Drug Administration approved the use of chimeric antigen receptor (CAR) T-cell therapy in patients with relapsed or refractory (R/R) FL after ≥2 lines of therapy. Priced at $373 000, CAR T-cell therapy is potentially curative, and its cost-effectiveness compared with other modern R/R FL treatment strategies is unknown. We developed a Markov model to assess the cost-effectiveness of third-line CAR T-cell vs standard of care (SOC) therapies in adults with R/R FL. We estimated progression rates for patients receiving CAR T-cell and SOC therapies from the ZUMA-5 trial and the LEO CReWE study, respectively. We calculated costs, discounted life years, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) of CAR T-cell vs SOC therapies with a willingness-to-pay threshold of $150 000 per QALY. Our analysis was conducted from a US payer’s perspective over a lifetime horizon. In our base-case model, the cost of the CAR T-cell strategy was $731 682 compared with $458 490 for SOC therapies. However, CAR T-cell therapy was associated with incremental clinical benefit of 1.50 QALYs, resulting in an ICER of $182 127 per QALY. Our model was most sensitive to the utilities associated with CAR T-cell therapy remission and third-line SOC therapies and to the total upfront CAR T-cell therapy cost. Under current pricing, CAR T-cell therapy is unlikely to be cost-effective in unselected patients with FL in the third-line setting. Both randomized clinical trials and longer term clinical follow-up can help clarify the benefits of CAR T-cell therapy and optimal sequencing in patients with FL.
RNA-Sequencing of Heterorhabditis nematodes to identify factors involved in symbiosis with Photorhabdus bacteria
Authors: Bhat Chaitra G. , Budhwar Roli , Godwin Jeffrey , Dillman Adler R. , Rao Uma , Somvanshi Vishal S.
Published: November 2022

Background

Nematodes are a major group of soil inhabiting organisms.Heterorhabditisnematodes are insect-pathogenic nematodes and live in a close symbiotic association withPhotorhabdusbacteria.Heterorhabditis-Photorhabduspair offers a powerful and genetically tractable model to study animal-microbe symbiosis. It is possible to generate symbiont bacteria free (axenic) stages inHeterorhabditis. Here, we compared the transcriptome of symbiotic early-adult stageHeterorhabditisnematodes with axenic early-adult nematodes to determine the nematode genes and pathways involved in symbiosis withPhotorhabdusbacteria.

Results

A de-novo reference transcriptome assembly of 95.7 Mb was created forH. bacteriophoraby using all the reads. The assembly contained 46,599 transcripts with N50 value of 2,681 bp and the average transcript length was 2,054 bp. The differentially expressed transcripts were identified by mapping reads from symbiotic and axenic nematodes to the reference assembly. A total of 754 differentially expressed transcripts were identified in symbiotic nematodes as compared to the axenic nematodes. The ribosomal pathway was identified as the most affected among the differentially expressed transcripts. Additionally, 12,151 transcripts were unique to symbiotic nematodes. Endocytosis, cAMP signalling and focal adhesion were the top three enriched pathways in symbiotic nematodes, while a large number of transcripts coding for various responses against bacteria, such as bacterial recognition, canonical immune signalling pathways, and antimicrobial effectors could also be identified.

Conclusions

The symbioticHeterorhabditisnematodes respond to the presence of symbiotic bacteria by expressing various transcripts involved in a multi-layered immune response which might represent non-systemic and evolved localized responses to maintain mutualistic bacteria at non-threatening levels. Subject to further functional validation of the identified transcripts, our findings suggest thatHeterorhabditisnematode immune system plays a critical role in maintenance of symbiosis withPhotorhabdusbacteria.
Comparison of onset time, duration of action, and intubating conditions after cisatracurium 0.15 mg/kg in young and elderly patients
Authors: Vested Matias , Kristensen Camilla Meno , Pape Pernille , Vang Malene , Hartoft Mian , Hjelmdal Caroline , Rasmussen Lars Simon
Published: November 2022

Introduction

Tracheal intubation during anesthesia can be facilitated by the neuromuscular blocking agent cisatracurium. However, limited data exists about onset time, duration of action and effect on intubating conditions in elderly patients above 80 years of age. We hypothesized that elderly patients would present a longer onset time and duration of action compared to younger adults.

Methods

This prospective observational study included 31 young (18–40 years) and 29 elderly (≥ 80 years) patients. Patients were given fentanyl 2 μg/kg and propofol 1.5–2.5 mg/kg for induction of anesthesia and maintained with remifentanil and propofol. Monitoring of neuromuscular function was performed with acceleromyography. Primary outcome was onset time defined as time from injection of cisatracurium 0.15 mg/kg (based on ideal body weight) to a train-of-four (TOF) count of 0. Other outcomes included duration of action (time to TOF ratio ≥ 0.9), intubation conditions using the Fuchs-Buder scale and the Intubating Difficulty Scale (IDS), and occurrence of hoarseness and sore throat postoperatively.

Results

Elderly patients had significantly longer onset time compared with younger patients; 297 seconds (SD 120) vs. 199 seconds (SD 59) (difference: 98 seconds (95% CI: 49–147), P < 0.001)). Duration of action was also significantly longer in elderly patients compared with younger patients; 89 minutes (SD 17) vs. 77 minutes (SD 14) (difference: 12 minutes (95% CI: 2.5–20.5) P = 0.01)). No difference was found in the proportion of excellent intubating conditions (Fuchs-Buder); 19/29 (66%) vs 21/31 (68%) (P = 0.86) or IDS score (P = 0.74). A larger proportion of elderly patients reported hoarseness 24 hours postoperatively; 62% vs 34% P = 0.04.

Conclusion

In elderly patients cisatracurium 0.15 mg/kg had significantly longer onset time and duration of action compared with younger patients. No difference was found in intubating conditions at a TOF count of 0.

Trial registration

Clinicaltrials.gov (NCT04921735, date of registration 10 June 2021).
Prevalences of cardiometabolic risk and lifestyle factors in young parents: evidence from a German birth cohort study
Authors: Brunner Jana , Fill Malfertheiner Sara , Brandstetter Susanne , Seelbach-Göbel Birgit , Apfelbacher Christian , Melter Michael , Kabesch Michael , Baessler Andrea ,   KUNO-Kids Study Group, Arndt Petra , Berneburg Mark , Böse-O’Reilly Stephan , Brunner Romuald , Buchalla Wolfgang , Franke André , Häusler Sebastian , Heid Iris , Herr Caroline , Högler Wolfgang , Kerzel Sebastian , Koller Michael , Leitzmann Michael , Rothfuß David , Rösch Wolfgang , Schaub Bianca , Weber Bernhard H. F. , Weidinger Stephan , Wellmann Sven
Published: November 2022

Background

Studies show that parents significantly impact their children’s health through their cardiometabolic risk profile and health behavior. There is only little information about the prevalence of cardiometabolic risk factors and lifestyle factors among new parents yet. The aims of this study are therefore to evaluate the prevalences of cardiometabolic risk factors in parents of infants in Germany and to examine their lifestyle and health behavior.

Methods

In the KUNO-Kids health study, an ongoing birth cohort, parents (n = 930 mothers and 769 fathers) were asked about cardiometabolic risk factors (obesity/hypertension/type 2 diabetes mellitus) and lifestyle factors (dietary/sports/smoking habits/alcohol consumption) during the first year after the birth of their children via questionnaires. Chi-square as well as fisher exact tests were conducted to analyse associations between lifestyle factors and cardiometabolic risk factors.

Results

34.2% of mothers and 58.5% of fathers were overweight or obese. In 11.8% of the families, at least one parent suffered from hypertension, in 2.4% from type 2 diabetes mellitus. One year after delivery, 8.5% of mothers were smoking, 6.9% showed a risky alcohol consumption (> 10 g/d). 16.0% of fathers were smoking 4 weeks after childbirth, 10.7% showed risky alcohol consumption (> 20 g/d). 21.6% of mothers carried out sports activity for more than 2 h a week then. Parental hypertension was linked to a higher prevalence of risky alcohol consumption, obesity to a lower prevalence of daily fruits consumption.

Conclusions

Cardiometabolic risk factors were widespread among new parents with obesity and overweight having the highest prevalences. A considerable number of parents also practiced an unhealthy lifestyle showing that there is potential for improvement to promote the healthy development of their children.
Association of intergenerational relationships with cognitive impairment among Chinese adults 80 years of age or older: prospective cohort study
Authors: Yang Qingqing , Jia Jinzhu
Published: November 2022

Background

The oldest-old (aged 80 or older) are the most rapidly growing age group, and they are more likely to suffer from cognitive impairment, leading to severe medical and economic burdens. The influence of intergenerational relationships on cognition among Chinese oldest-old adults is not clear. We aim to examine the association of intergenerational relationships with cognitive impairment among Chinese adults aged 80 or older.

Methods

This was a prospective cohort study, and data were obtained from the Chinese Longitudinal Healthy Longevity Survey, 14,180 participants aged 80 or older with at least one follow-up survey from 1998 to 2018. Cognitive impairment was assessed by the Chinese version of Mini Mental State Examination, and intergenerational relationships were assessed by getting main financial support from children, living with children or often being visited by children, and doing housework or childcare. We used time-varying Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of associations between intergenerational relationships and cognitive impairment.

Results

We identified 5443 incident cognitive impairments in the 24-cut-off MMSE cohort and 4778 in the 18-cut-off MMSE cohort between 1998 and 2018. After adjusting for a wide range of confounders, the HR was 2.50 (95% CI: 2.31, 2.72) in the old who received main financial support from children, compared with those who did not. The HR was 0.89 (95% CI: 0.83, 0.95) in the oldest-old who did housework or childcare, compared with those who did not. However, there were no significant associations between older adults’ cognitive impairments and whether they were living with or often visited by their children. Our findings were consistent in two different MMSE cut-off values (24 vs. 18) for cognitive impairment.

Conclusions

Sharing housework or childcare for children showed a protective effect on older adults’ cognitive function, whereas having children provide primary financial support could increase the risk for cognitive impairments. Our findings suggest that governments and children should pay more attention to older adults whose main financial sources from their children. Children can arrange some easy tasks for adults 80 years of age or older to prevent cognitive impairments.
High-risk HPV infection-associated hypermethylated genes in oropharyngeal squamous cell carcinomas
Authors: Inokawa Yoshikuni , Hayashi Masamichi , Begum Shahnaz , Noordhuis Maartje G. , Sidransky Daivd , Califano Joseph , Koch Wayne , Brait Mariana , Westra William H. , Hoque Mohammad O.
Published: November 2022

Background

HPV-positive oropharyngeal squamous cell carcinomas (OPSCCs) are sensitive to chemo-radiation therapy and have favorable survival outcomes compared with HPV-negative cancers. These tumors are usually not related to tobacco and alcohol exposure. Therefore, diagnosing HPV-positive OPSCCs for the appropriate disease management is crucial, and no suitable markers are available for detecting early malignancies in HPV-infected tissues. In this study, we attempt to find HPV-specific epigenetic biomarkers for OPSCCs.

Methods

A total of 127 surgical samples were analyzed for HPV positivity and promoter methylation of a panel of genes. HPV detection was performed by PCR detection of HPV E6 and E7 viral oncoproteins. In addition, promoter methylation of a total of 8 genes (DAPK, FHIT, RASSF1A, TIMP3, AGTR1, CSGALNACT2, GULP1 and VGF) was analyzed by quantitative-methylation specific PCR (QMSP), and their associations with HPV positivity or RB/p16 expressions were evaluated.

Results

AGTR1 and FHIT were frequently methylated in HPV-positive OPSCC samples with a good area under the curve (AUC over 0.70). In addition, these genes' promoter methylation was significantly associated with p16 positive and RB negative cases, which were the characteristics of OPSCC cases with favorable survival outcomes. Either AGTR1 or FHIT methylated cases were significantly associated with HPV-positive cancers with 92.0% sensitivity (P < 0.001). Also, they had significantly better overall survival (P = 0.047) than both unmethylated cases.

Conclusions

A combination of AGTR1 and FHIT methylation demonstrated a suitable detection marker of OPSCCs derived from the HPV-infected field, familiar with p16-positive and RB-negative phenotypes.
Comparison of widefield swept-source optical coherence tomography angiography with ultra-widefield fluorescein angiography for the evaluation of lesions in retinal vein occlusion
Authors: Siying Li , Qiaozhu Zeng , Xinyao Han , Linqi Zhang , Mingwei Zhao , Jinfeng Qu
Published: November 2022

Background

To compare widefield swept-source optical coherence tomography angiography (SS-OCTA) with ultra-widefield fundus fluorescein angiography (UWF-FA) for detecting retinal vein occlusion (RVO) lesions.

Methods

Thirty-four eyes of 32 patients with treatment-naïve RVO were enrolled at Peking University People’s Hospital from September 2021 to March 2022. Patients were imaged with a UWF-FA (200°) and a widefield SS-OCTA using 24 × 20 mm scan single capture. Quantitative assessments of RVO lesions such as foveal avascular zone (FAZ) area and perimeter, non-perfusion areas (NPA), number of microaneurysms (MAs), capillary changes and collateral vessels were performed.

Results

The measurement of FAZ area and perimeter were comparable between SS-OCTA and UWF-FA (0.373 (range, 0.277–0.48) mm2vs. 0.370 (range, 0.277–0.48) mm2,P = 0.818 and 2.480 (range, 2.011–2.998) vs. 2.330 (range, 2.027–2.807) mm,P = 0.536, respectively). Intraclass correlation coefficients (ICCs) of FAZ area and perimeter between SS-OCTA and UWF-FA was high (0.999, [0.997–0.999] and 0.996 [0.991–0.996], respectively), suggesting good agreement. The mean NPA area was larger on SS-OCTA than that on UWF-FA (89.977 ± 78.805 mm2vs. 87.944 ± 77.444 mm2,P = 0.037). The ICC of NPA area was also high (0.999, [0.999–1.000]). The median of total MA count was less on SS-OCTA than on UWF-FA (7 (range, 0–19) vs.12 (range, 0–23),P < 0.001). Agreement in detecting MAs between SS-OCTA and UWF-FA was found to be good (ICC = 0.920, [0.555–0.974]).The total capillary changes and collateral vessels count were less on UWF-FA than SS-OCTA (11 ± 9 vs 6 ± 7,P < 0.001 and 4 (range, 0–6) vs 0 (range, 0–0),P < 0.001, respectively). Agreement in detecting capillary changes and collateral vessels between OCTA and UWF-FA was found to be fair (ICC = 0.733, [0.081–0.905] and 0.564, [0.039–0.805], respectively).

Conclusion

Compared with UWF-FA, widefield SS-OCTA was found comparable or even superior in detecting FAZ, NPA, capillary changes and collateral vessels except MAs in RVO. Widefield SS-OCTA may offer a more efficient alternative to FA for diagnosis and monitoring RVO.
COVID-19 vaccine hesitancy and short-term and long-term intentions among unvaccinated young adults: a mixed-method approach
Authors: Kim Soojung , Willis Erin , Wehlage Shane , Scheffer-Wentz Hannah , Dulitz Michael
Published: November 2022

Background

Only 63.8% of Americans who are 18-to-24-years-old have been fully vaccinated for COVID-19 as of June 1, 2022. The Grand Forks County, North Dakota is facing a similar challenge. As of June 2022, 47% of individuals in the 19-to-29-year-old age group are vaccinated. Focusing on unvaccinated individuals in their 20s, Study 1 aims to understand the ways in which receiving COVID-19 vaccines is construed using qualitative interviews; and Study 2 compares the predictors of short-term vaccination intention (i.e., next month) with those of long-term vaccination intention (i.e., three to 5 years) using an online survey.

Methods

For Study 1, we conducted five focus groups and four in-depth interviews via Zoom with a total of 26 unvaccinated individuals in their 20s living in the Grand Forks County. Constant comparison process was used to categorize data into themes and to recognize characteristics of the identified themes. The aim was to develop themes and associated characteristics. For Study 2, we conducted an online survey with a convenience sample of 526 unvaccinated individuals. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between attitudes, perceptions, and beliefs in misinformation and short-term and long-term vaccination intentions, accounting for demographics and socioeconomic status.

Results

In Study 1, two themes were identified: feelings of uncertainty sparked by profits and monetization and navigating the fear of the unknown. In Study 2, an increase in the confidence of COVID-19 vaccines showed significantly higher odds of short-term intention (OR = 2.658, 95%CI 1.770, 3.990) and long-term intention (OR = 1.568, 95% CI 1.105, 2.226). Believing in misinformation had significantly lower odds of short-term intention (OR = 0.712, 95%CI 0.513, 0.990), while more positive attitudes (OR = 1.439, 95% CI 1.024, 2.024), stronger preference in calculating the benefits of COVID-19 vaccines (OR = 2.108, 95% CI 1.541, 2.882), and greater perceived susceptibility (OR = 1.471, 95% CI 1.045, 2.070) to and severity of contracting COVID-19 (OR = 1.362, 95% CI 1.020, 1.820) were significantly associated with higher odds of long-term intention.

Conclusions

Short-term and long-term intentions were predicted differently. Instilling strong confidence in COVID-19 vaccines should increase both short-term and long-term intentions.
Analgesic effects and arthritic changes following intra-articular injection of diclofenac etalhyaluronate in a rat knee osteoarthritis model
Authors: Arai Takahito , Suzuki-Narita Miyako , Takeuchi Jun , Tajiri Ikuko , Inage Kazuhide , Kawarai Yuya , Eguchi Yawara , Shiga Yasuhiro , Hozumi Takashi , Kim Geundong , Tsuchiya Ryuto , Otagiri Takuma , Mukaihata Tomohito , Hishiya Takahisa , Toshi Noriyasu , Okuyama Kohei , Tokeshi Soichiro , Furuya Takeo , Maki Satoshi , Matsuura Yusuke , Suzuki Takane , Nakamura Junichi , Hagiwara Shigeo , Ohtori Seiji , Orita Sumihisa
Published: November 2022

Background

Diclofenac etalhyaluronate (DF-HA) is a recently developed analgesic conjugate of diclofenac and hyaluronic acid that has analgesic and anti-inflammatory effects on acute arthritis. In this study, we investigated its analgesic effect on osteoarthritis, using a rat model of monoiodoacetate (MIA).

Methods

We injected MIA into the right knees of eight 6-weeks-old male Sprague–Dawley rats. Four weeks later, rats were randomly injected with DF-HA or vehicle into the right knee. Seven weeks after the MIA injection, fluorogold (FG) and sterile saline were injected into the right knees of all the rats. We assessed hyperalgesia with weekly von Frey tests for 8 weeks after MIA administration. We took the right knee computed tomography (CT) as radiographical evaluation every 2 weeks. All rats were sacrificed 8 weeks after administration of MIA for histological evaluation of the right knee and immunohistochemical evaluation of the DRG and spinal cord. We also evaluated the number of FG-labeled calcitonin gene-related peptide (CGRP)-immunoreactive(ir) neurons in the dorsal root ganglion (DRG) and ionized calcium-binding adapter molecule 1 (Iba1)-ir microglia in the spinal cord.

Results

Administration of DF-HA significantly improved pain sensitivity and reduced CGRP and Iba1 expression in the DRG and spinal cord, respectively. However, computed tomography and histological evaluation of the right knee showed similar levels of joint deformity, despite DF-HA administration.

Conclusion

DF-HA exerted analgesic effects on osteoarthritic pain, but did not affect joint deformity.
Gastric duplication cyst with ectopic pancreas in a teenager successfully resected by endoscopic submucosal dissection
Authors: Ye Xiaodan , Wang Muqing , Wang Yuanyuan , Lin Daiying , Wang Xiaozhong
Published: November 2022

Background

Gastric duplication cyst associated with ectopic pancreas is rare and we aimed to alert clinician to this congenital anomaly.

Case presentation

A 15-year-old girl presented with intermittent vomiting. Gastroscopy showed a submucosal tumor with an approximate diameter of 40 mm in the anterior wall of the gastric antrum. The lesion had a central umbilication and was diagnosed preliminarily as gastric ectopic pancreas with pseudocyst formation on the basis of its appearance. However, computed tomographic scan showed a thick-walled cystic lesion with an enhanced outline of the cystic wall in the antrum of stomach, suggestive of duplication cyst. Serum amylase was normal. Endoscopic ultrasonography revealed a solid-cystic lesion; the solid portion were inhomogeneously mixed with echoes, and had indistinct border to muscularis propria; the cystic portion had echogenic internal mucosal layer and distinct border to muscularis propria. Endoscopic submucosal dissection (ESD) was suggested for the patient to relieve symptoms and diagnose the lesion definitely. The operation procedure was uneventful and the solid-cystic lesion was resected completely. Histopathologic examination revealed that the solid portion was ectopic pancreas, and the cystic portion was gastric duplication cyst. After resection, the patient discharged successfully and neither symptoms nor tumors recurred during the 9 months follow-up period.

Conclusions

This is the first case of a solid-cystic lesion with central umbilication in the stomach diagnosed as gastric duplication cyst associated with ectopic pancreas. ESD could be an optional treatment to provide a definitive diagnosis.