bluuebunny/crossref_metadata_2025 huggingface dataset:
Opportunities and challenges: interleukin-22 comprehensively regulates polycystic ovary syndrome from metabolic and immune aspects
Authors: Geng Yuli , Liu Zhuo , Hu Runan , Ma Wenwen , Wu Xiao , Dong Haoxu , Song Kunkun , Xu Xiaohu , Huang Yanjing , Li Fan , Song Yufan , Zhang Mingmin
Published: July 2023

Polycystic ovary syndrome (PCOS) is known as a prevalent but complicated gynecologic disease throughout the reproductive period. Typically, it is characterized by phenotypic manifestations of hyperandrogenism, polycystic ovary morphology, and persistent anovulation. For now, the therapeutic modality of PCOS is still a formidable challenge. Metabolic aberrations and immune challenge of chronic low-grade inflammatory state are significant in PCOS individuals. Recently, interleukin-22 (IL-22) has been shown to be therapeutically effective in immunological dysfunction and metabolic diseases, which suggests a role in the treatment of PCOS. In this review, we outline the potential mechanisms and limitations of IL-22 therapy in PCOS-related metabolic disorders including its regulation of insulin resistance, gut barrier, systemic inflammation, and hepatic steatosis to generate insights into developing novel strategies in clinical practice.
Prevalent diabetes and long-term cardiovascular outcomes in adult sepsis survivors: a population-based cohort study
Authors: Angriman Federico , Lawler Patrick R. , Shah Baiju R. , Martin Claudio M. , Scales Damon C. ,   the Sepsis Canada Network
Published: July 2023

Background

Sepsis survivors are at elevated risk for cardiovascular disease during long-term follow-up. Whether diabetes influences cardiovascular risk after sepsis survival remains unknown. We sought to describe the association of diabetes with long-term cardiovascular outcomes in adult sepsis survivors.

Methods

Population-based cohort study in the province of Ontario, Canada (2008–2017). Adult survivors of a first sepsis-associated hospitalization, without pre-existing cardiovascular disease, were included. Main exposure was pre-existing diabetes (any type). The primary outcome was the composite of myocardial infarction, stroke, and cardiovascular death. Patients were followed up to 5 years from discharge date until outcome occurrence or end of study period (March 2018). We used propensity score matching (i.e., 1:1 to patients with sepsis but no pre-existing diabetes) to adjust for measured confounding at baseline. Cause-specific Cox proportional hazards models with robust standard errors were used to estimate hazard ratios (HR) alongside 95% confidence intervals (CI). A main secondary analysis evaluated the modification of the association between sepsis and cardiovascular disease by pre-existing diabetes.

Results

78,638 patients with pre-existing diabetes who had a sepsis-associated hospitalization were matched to patients hospitalized for sepsis but without diabetes. Mean age of patients was 71 years, and 55% were female. Median duration from diabetes diagnosis was 9.8 years; mean HbA1c was 7.1%. Adult sepsis survivors with pre-existing diabetes experienced a higher hazard of major cardiovascular disease (HR 1.25; 95% CI 1.22–1.29)—including myocardial infarction (HR 1.40; 95% CI 1.34–1.47) and stroke (HR 1.24; 95% CI 1.18–1.29)—during long-term follow-up compared to sepsis survivors without diabetes. Pre-existing diabetes modified the association between sepsis and cardiovascular disease (risk difference: 2.3%; 95% CI 2.0–2.6 and risk difference: 1.8%; 95% CI 1.6–2.0 for the effect of sepsis—compared to no sepsis—among patients with and without diabetes, respectively).

Conclusions

Sepsis survivors with pre-existing diabetes experience a higher long-term hazard of major cardiovascular events when compared to sepsis survivors without diabetes. Compared to patients without sepsis, the absolute risk increase of cardiovascular events after sepsis is higher in patients with diabetes (i.e., diabetes intensified the higher cardiovascular risk induced by sepsis).
A day-to-day management model improves patient compliance to treatment for Helicobacter pylori infection: a prospective, randomized controlled study
Authors: Yang Zhen , Xiong Wenjie , Yang Ruoyun , Qian Haisheng , He Zhi , Chen Meihong , Yang Jiajia , Sang Huaiming , Yan Jin , Xu Xiaobing , Wang Yun , Zhang Guoxin , Ye Feng
Published: July 2023

Background

The day-to-day (DTD) management model encourages patients to actively participate in their healthcare by setting goals. We determined the effectiveness of the DTD model in the treatment of Helicobacter pylori (H. pylori) infection, as compared with conventional outpatient education (OE).

Methods

We randomized 254 H. pylori-positive patients into a DTD group (127 patients) and an OE group (127 patients) prior to primary treatment with 14-day bismuth-containing quadruple therapy, including esomeprazole, amoxicillin, and clarithromycin. Both groups received consistent medication instructions. Patients in the DTD group recorded daily attendance after completing their daily medication plan from day 1 to day 14. The medication compliance, follow-up compliance, H. pylori eradication rates, and adverse events (AEs) were evaluated.

Results

In the modified intention-to-treat (MITT) and per-protocol (PP) analyses, the DTD group showed significantly higher medication compliance than the OE group (P = 0.001 and P = 0.031, respectively). Both the MITT and PP analyses showed significant differences in follow-up compliance (P < 0.001 and P = 0.003, respectively) and timing of the review urea breath test (P < 0.001 and P = 0.001, respectively) between the two groups. However, no significant differences were observed in the H. pylori eradication rates (95.8% vs. 93.8%, P = 0.529) in the PP analysis, or AEs incidence (25.4% vs. 28.3%, P = 0.603) between the two groups.

Conclusion

This study demonstrated the novel application of the DTD model in the treatment of H. pylori infection, which enabled patients to develop habitual medication-taking behaviors without physician intervention.
Sociodemographic and clinical characteristics of treated and untreated adults with bulimia nervosa or binge-eating disorder recruited for a large-scale research study
Authors: Carrino Emily A. , Flatt Rachael E. , Pawar Pratiksha S. , Sanzari Christina M. , Tregarthen Jenna P. , Argue Stuart , Thornton Laura M. , Bulik Cynthia M. , Watson Hunna J.
Published: July 2023

Background

Eating disorders affect millions of people worldwide, but most never receive treatment. The majority of clinical research on eating disorders has focused on individuals recruited from treatment settings, which may not represent the broader population of people with eating disorders. This study aimed to identify potential differences in the characteristics of individuals with eating disorders based on whether they self-reported accessing treatment or not, in order to contribute to a better understanding of their diverse needs and experiences.

Methods

The study population included 762 community-recruited individuals (85% female, M ± SD age = 30 ± 7 years) with bulimia nervosa or binge-eating disorder (BN/BED) enrolled in the Binge Eating Genetics Initiative (BEGIN) United States study arm. Participants completed self-report surveys on demographics, treatment history, past and current eating disorder symptoms, weight history, and their current mental health and gastrointestinal symptoms. Untreated participants (n = 291, 38%) were compared with treated participants (n = 471, 62%) who self-reported accessing BN/BED treatment at some point in their lives.

Results

Untreated participants disproportionately self-identified as male and as a racial or ethnic minority compared with treated participants. Treated participants reported a more severe illness history, specifically, an earlier age at onset, more longstanding and frequent eating disorder symptoms over their lifetime, and greater body dissatisfaction and comorbid mental health symptoms (i.e., depression, anxiety, ADHD) at the time of the study. A history of anorexia nervosa was positively associated with treatment engagement. Individuals self-reporting a history of inpatient or residential treatment exhibited the most severe illness history, those with outpatient treatment had a less severe illness history, and untreated individuals had the mildest illness history.

Conclusions

Historically overlooked and marginalized populations self-reported lower treatment access rates, while those who accessed treatment reported more severe eating disorder and comorbid mental health symptoms, which may have motivated them to seek treatment. Clinic-based recruitment samples may not represent individuals with milder symptoms or racial and ethnic diversity, and males. Community-based recruitment is crucial for improving the ability to apply research findings to broader populations and reducing disparities in medical research.

Trial RegistrationClinicalTrials.gov NCT04162574 (https://clinicaltrials.gov/ct2/show/NCT04162574).
Geographical visualization of tweets, misinformation, and extremism during the USA 2020 presidential election using LSTM, NLP, and GIS
Authors: Hashemi Mahdi
Published: July 2023

Disinformation campaigns on online social networks (OSN) in recent years, have underscored democracies’ vulnerability to such operations and the importance of identifying such operations and dissecting their methods, intents, and source. With a focus on the USA 2020 presidential election, a total of 1,349,373 original Tweets have been collected by our server in real-time from the beginning of April 2020 to the end of January 2021, using four keywords: Trump, Biden, Democrats, and Republicans. In this work, deep learning, natural language processing, geographical information systems, and statistical tools are used to geographically visualize and discover if the political misinformation and extremism, political affiliation, and topics of conversations on social media are correlated with the USA 2020 presidential election results. To this end, a deep neural network is trained using 40,000 manually classified Tweets and further used to automatically classify the entire set of Tweets based on their political affiliation, topic, and whether or not they contain misinformation or extremism. It is shown that, there is a correlation between the aforementioned classes of Tweets and the election results. In other words, the political affiliation of topics and the extent of misinformation and extremism on social media are correlated with the election results to some level. The strongest correlation highlighted that the ratio of Rightist versus Leftist misinformation Tweets has a 0.67 correlation coefficient with the ratio of Trump votes versus Biden votes, across different states.
Robots in travel clinics: building on tourism’s use of technology and robots for infection control during a pandemic
Authors: Bauer Irmgard L
Published: July 2023

The arrival of COVID-19 impacted every aspect of life around the world. The virus, whose spread was facilitated overwhelmingly by people’s close contact at home and by travelling, devastated the tourism, hospitality, and transportation industry. Economic survival depended largely on demonstrating to authorities and potential travellers the strict adherence to infection control measures. Fortunately, long before the pandemic, the industry had already employed digital technology, artificial intelligence, and service robots, not to keep the world safe, but to either bridge staff shortages or save costs, reduce waiting times, streamline administration, complete unattractive, tedious, or physical tasks, or use technology as marketing gimmicks. With COVID-19, offering social distancing and touchless service was an easy step by extending quickly what was already there. The question arose: could travellers’ acceptance of technology and robots for infection control be useful in travel medicine? COVID-19 fostered the rapid and increased acceptance of touchless technology relating to all things travel. The public’s expectations regarding hygiene, health and safety, and risk of infection have changed and may stay with us long after the pandemic is ‘the new normal’, or a new one approaches. This insight, combined with the current experience with robots in health and medicine, is useful in exploring how robots could assist travel medicine practice. However, several aspects need to be considered in terms of type of robot, tasks required, and the public’s positive or negative attitudes towards robots to avoid known pitfalls. To meet the crucial infection control measures of social distancing and touch avoidance, the use of robots in travel medicine may not only be readily accepted but expected, and implications for management, practice, and research need to be considered.
Reporting involvement activities with children and young people in paediatric research: a framework analysis
Authors: Preston Jennifer , Biglino Giovanni , Harbottle Victoria , Dalrymple Emma , Stalford Helen , Beresford Michael W.
Published: July 2023

Background

The active involvement of patients and the public in the design and delivery of health research has been increasingly encouraged, if not enforced. Knowledge of how this is realised in practice, especially where children and young people (CYP) are concerned, is limited, partly due to the low level of reporting of patient and public involvement (PPI) in general. The aim of this work was to assess how researchers funded by the National Institute for Health and Care Research (NIHR) report the involvement of CYP in the design and conduct of child health research to better understand the opportunities offered to CYP, and the realities of involvement in practice.

Methods

A participation matrix, analysis framework and accompanying tools were adapted from existing frameworks, including a child-rights informed framework, the Guidance for Reporting Involvement of Patients and the Public Checklist Short Form (GRIPP2SF), and NIHR reporting expectations. Child-focused research reports were identified from the NIHR Journals Library, including any interventional or observational study involving CYP aged 0–< 24 years. In two co-design workshops with healthcare professionals and CYP, we tested and refined the participation matrix, analysis framework and accompanying tools.

Results

Only thirty-two NIHR reports out of 169 (19%) were identified as relevant and included reporting of PPI with CYP. We identified significant variability in the way PPI with CYP was reported. Only 4/32 (12%) reports fully met NIHR (and GRIPP2SF) reporting criteria. Only 3/32 (9%) reports formally evaluated or self-reflected on PPI activities with CYP, whilst 15/32 (47%) provided minimal information about CYP involvement. The most common approach to involving CYP (23/32, 72%) was through the medium of existing groups or networks.

Conclusion

Despite the NIHR’s commitment to increase the quality, transparency, and consistency of reporting PPI, the reporting of involvement with CYP remains sub-optimal. Neglecting to report key details of involvement methods and impacts deprives the research community of knowledge to advance the field of delivering ‘meaningful’ PPI with CYP. Practical guidance on how researchers can report the processes and outputs of CYP involvement more rigorously may help child health researchers to involve them more meaningfully. This research offers practical tools informed by CYP to aid the reporting process.
Game-based inoculation versus graphic-based inoculation to combat misinformation: a randomized controlled trial
Authors: Hu Bo , Ju Xing-Da , Liu Huan-Huan , Wu Han-Qian , Bi Chao , Lu Chang
Published: July 2023

Misinformation affects various aspects of people’s lives, such as politics, entertainment, and social interactions. However, effective intervention measures to combat misinformation are lacking. The inoculation theory has become a prevalent measure of misinformation. This study employed inoculation theory and developed an interactive game to help the public counter misinformation. In this game, players take on the role of the misinformation spreader, intending to add more followers to their virtual accounts using different strategies. A total of 180 Chinese participants were randomly assigned to game-based inoculation, graphic-based inoculation, and control groups. The results indicated that both types of inoculation interventions significantly decreased the perceived credibility and sharing intention of misinformation. Game-based inoculation was more effective than graphic-based inoculation in terms of misinformation perceived credibility, and the intervention effects were stable after 2 weeks. The graphic-based inoculation contained the sleeper effect, which interventions required a period of time to take effect. Neither inoculation produced countereffects on perceived credibility and nor sharing intention of accurate information.
Acceptability of the routine use and collection of a generic patient reported outcome measure from the perspective of healthcare staff: a qualitative study
Authors: Snowdon David A , Srikanth Velandai , Beare Richard , Noeske Kate E , Le Elizabeth , O’Bree Bridget , Andrew Nadine E
Published: July 2023

Background

Patient-reported outcome measures (PROMs) provide a measure of self-perceived health status or health-related quality of life. They have been used to support provider-patient decisions, healthcare delivery, and value-based healthcare models. A barrier to routine collection of PROMs is the perception that PROMs lack clinical utility. As such, it is important to establish clinicians’ acceptability of the PROM prior to large-scale implementation. This study explored the acceptability of the routine use and collection of a generic PROM in healthcare services from the perspective of healthcare staff.

Methods

Individual semi-structured interviews were completed from September 2020 to March 2021 with 26 staff from two multi-disciplinary community healthcare services in Melbourne, Australia. Interviews explored their experiences of using the EQ-5D-5L in their routine care. Interviews were recorded and transcribed verbatim. Data were analysed according to a framework approach, using inductive and deductive techniques.

Results

Participants discussed the acceptability of the EQ-5D-5L with reference to four themes: practicalities of use; holistic nature; influence on client care; and influence on health service. Participants found the EQ-5D-5L quick and easy to administer, and appreciated that it measured multiple domains of health that were relevant to their clients’ care. They believed the EQ-5D-5L helped to identify client problems, and inform service delivery. They also reported features that were less acceptable, including a lack of item specificity to some healthcare disciplines. Participants reported the challenge of managing conflict between their assessment of the client’s health and the client’s perspective of their own health, leading some to question whether the client could provide an accurate reflection of their own health.

Conclusions

The EQ-5D-5L has several features that healthcare staff viewed as acceptable for routine collection and use in healthcare. Training on the validity of the patient reported perspective and broadening the scope of PROMs collection beyond the EQ-5D-5L should be considered to facilitate large-scale implementation.
Metal artifact reduction on musculoskeletal CT: a phantom and clinical study
Authors: Midthun Petter , Kirkhus Eva , Østerås Bjørn Helge , Høiness Per Reidar , England Andrew , Johansen Safora
Published: July 2023

Background

Artifacts caused by metal implants are challenging when undertaking computed tomography (CT). Dedicated algorithms have shown promising results although with limitations. Tin filtration (Sn) in combination with high tube voltage also shows promise but with limitations. There is a need to examine these limitations in more detail. The purpose of this study was to investigate the impact of different metal artefact reduction (MAR) algorithms, tin filtration, and ultra-high-resolution (UHR) scanning, alone or in different combinations in both phantom and clinical settings.

Methods

An ethically approved clinical and phantom study was conducted. A modified Catphan® phantom with titanium and stainless-steel inserts was scanned with six different MAR protocols with tube voltage ranging from 80 to 150 kVp. Other scan parameters were kept identical. The differences (∆) in mean HU and standard deviation (SD) in images, with and without metal, were measured and compared. In the clinical study, three independent readers performed visual image quality assessments on eight different protocols using retrospectively acquired images.

Results

Iterative MAR had the lowest ∆HU and ∆SD in the phantom study. For images of the forearm, the soft tissue noise for Sn-based 150-kVp UHR protocol with was significantly higher (p = 0.037) than for single-energy MAR protocols. All Sn-based 150-kVp protocols were rated significantly higher (p < 0.046 than the single-energy MAR protocols in the visual assessment.

Conclusions

All Sn-based 150-kVp UHR protocols showed similar objective MAR in the phantom study, and higher objective MAR and significantly improved visual image quality than single-energy MAR.

Relevance statement

Images with less metal artifacts and higher visual image quality may be more clinically optimal in CT examination of musculoskeletal patients with metal implants.

Key points

• Metal artifact reduction algorithms and Sn filter combined with high kVp reduce artifacts.

• Metal artifact reduction algorithms introduce new artifacts in certain metals.

• Sn-based protocols alone may be considered as low metal artifact protocols.

Graphical Abstract
Evaluation of the role of transcutaneous electrical nerve stimulation for postoperative pain relief in laparoscopic cholecystectomy: a prospective comparative study
Authors: Tara Siddharth , Sharma Shruti , Chandra Alka , Ram Dharamveer
Published: July 2023

Background

Postoperative pain after laparoscopic cholecystectomy still remains a fairly common challenge for the anesthesiologist. Commonly used drugs such as NSAIDs and opioids have their own side effects requiring a need to substantially evaluate the use of non-pharmacological methods like TENS as adjuvants to conventional methods of pain control. We studied the effect of transcutaneous electrical nerve stimulation (TENS) on postoperative pain in laparoscopic cholecystectomy. The primary objective was to compare postoperative analgesia between TENS and placebo groups using visual analog scale (VAS). The secondary objectives were to compare the requirement and dosage of rescue analgesia, hemodynamic parameters (blood pressure and heart rate), and incidence of nausea and emesis between placebo and TENS groups. A total of 64 patients of age group 18 years to 60 years of either gender posted for elective laparoscopic cholecystectomy were randomly allocated into two groups using a computer-generated sequence of random numbers: Group P (n= 32): placebo TENS and Group A (n= 32): active TENS. Statistical analysis was performed by the SPSS program for Windows, version 17.0 (SPSS, Chicago, Illinois). Unpaired t test, Mann-Whitney U test, chi-square test, and Fisher’s exact test were used for statistical analysis.

Results

The two groups were statistically similar in terms of age, gender, and weight. The VAS scores were significantly lower in patients in the active TENS group for up to 2 h after surgery, and the total weighted dose of diclofenac consumed over 8 h in the active TENS group was significantly lower as compared to the placebo TENS group. Patients who received TENS showed significantly less rise in blood pressure and heart rate and remained hemodynamically stable. Total episodes of nausea and emesis though less in the active TENS group were statistically insignificant.

Conclusion

We conclude that TENS is an effective adjuvant non-pharmacologic modality for postoperative pain relief after laparoscopic cholecystectomy.
A case series measuring campus and clinic level factors during implementation of a sexual violence prevention intervention in campus health and counseling centers: does environment matter?
Authors: Anderson Jocelyn C. , Peruggia Gabrielle , Miller-Walfish Summer , Talis Janine , Burrell Carmen , Hayes Micaela , Miller Elizabeth
Published: July 2023

Objective

This study examined campus and clinic factors that may influence likelihood of implementing sexual violence (SV) prevention for college students seeking care in campus health and counseling centers.

Methods

Campus-, clinic-, and student-level data were collected from both intervention and control campuses as part of a 28-campus cluster randomized controlled trial. A case series exploratory data analysis assessed differences in the implementation of an SV prevention intervention by campus characteristics.

Results

All large schools were in the top quartile for reporting positive prevention policies regarding SV. At the clinic level, the presence of SV protocols and procedures varied widely with no clear correlation with school size. Students at intervention schools where providers received instruction and tools to facilitate these discussions reported more discussions with providers about SV. Only school size appeared to be associated with positive SV policies on campus and student-reported receipt of SV prevention intervention. Large schools performed well on campus-level policies, yet students reported some of the lowest levels of intervention receipt in the clinics at these larger schools.

Implications

Consistency between campus and clinic environments and implementation of the intervention was not observed. Our findings suggest that high performance regarding SV policy and prevention on a campus do not necessarily translate to implementation of appropriate SV prevention and care for students seeking care on campus, including assessments, resources, referrals, and services.

Trial registration

NCT registration: NCT02355470
Medicament testing on acupuncture points as a non-invasive diagnostic tool for determining the daily doses of sofosbuvir in patients with chronic hepatitis C virus infection
Authors: Djumaeva Naylya , Akhundjanova Gulnara , Djumaeva Leyla , Urunova Dilbar
Published: July 2023

Background

Acupuncture points are known for their unique bioelectric properties. Medication testing at acupuncture points has not previously been used to determine the daily doses of sofosbuvir in patients with chronic hepatitis C virus infection.

Results

This pilot study included 61 patients with a confirmed diagnosis of chronic hepatitis C virus infection. Medicament testing of acupuncture points of the liver meridian (“Xing-jian”) and Voll’s circulation meridian (“Cells and lobules of the liver”) was performed to determine the daily doses of sofosbuvir. A correlation analysis was carried out between the tested doses of the drug and the viral load in the blood of patients to confirm the results of testing the daily doses of sofosbuvir. Patients with chronic hepatitis C virus infection showed a significant positive correlation between tested daily doses of sofosbuvir and viral load in their blood. The mean values of the tested doses of sofosbuvir did not vary at different acupuncture points and significantly differed depending on viral load.

Conclusions

This study showed that acupuncture points can serve as a diagnostic tool in the process of medicament testing and allow the determination of daily doses of sofosbuvir in patients with chronic hepatitis C virus infection. To further assess the clinical applications and physiological basis of medicament testing methods, additional clinical and instrumental studies are needed with a large sample of patients.
Nanovaccines to combat drug resistance: the next-generation immunisation
Authors: Manju K. , Raj S. Niranjan , Ranjini H. K. , Nayaka S. Chandra , Ashwini P. , Satish S. , Prasad M. N. Nagendra , Chouhan Raghuraj Singh , Baker Syed
Published: July 2023

Background

The present review envisages the role of nanovaccines to combat the global challenges of antimicrobial resistance. Nanovaccines are a novel formulation comprised of nanomaterials coupled with an immunogenic component to elicit the immune response and provide protection against the desired infectious disease. The nanovaccines with unique physicochemical properties can be more efficient against targeting the desired tissues in the body, aids in prolong circulation to promote antigen-presenting cells to act upon the target antigens.

Main content

The present review envisages the development of nanovaccines against antimicrobial-resistant pathogens. The use of nanovaccines can exhibit potent antigenicity with prolonged retention and controlled release to induce both cell- and antibody-mediated responses. Nanovaccines usage is still in the early stages and can be next-generation immunisation for prophylactic and therapeutic efficiency. The future development of nanovaccines against multi-drug-resistant pathogens can explore new avenues. Based on these facts, the present review is designed from the previously reported scientific studies and compiled with the fact that nanovaccines can revolutionise vaccine strategies. The articles were extracted from reputed databases like PubMed, Scopus, and ESCI. The size and conjugating chemistry of nanomaterials can be beneficial in developing novel multi-nanovaccine formulations that can target pools of antimicrobial resistance mechanisms.

Conclusion

Overall, the nanovaccines can form one of the best effective modes of targeting multi-drug-resistant pathogens. The nanovaccines can stimulate the innate immune response and generate effective immune-therapeutic novel formulation against infectious pathogens. Based on these facts and considerations, the present article makes an alarming call to develop nanovaccines to counter multi-drug resistance.
Paediatric gastrointestinal trichobezoar—an uncommon entity: a case series with recent literature review
Authors: Jalil Shazia , Azhar Mohammed , ElKadi Tarek Talaat Harb , AlFaifi Khalid , Hamidi Saad Al , Saiady Moath Al , Ali Abdelbasit E. , Wahid Fazal N.
Published: July 2023

Background

Gastrointestinal (GI) tract bezoars are aggregates or concretions of inedible and undigested material mostly found in the stomach but can also be found elsewhere in the gastrointestinal tract. Trichobezoar, an infrequent form of bezoar seen mostly in young females, consists of a compact mass of swallowed hair. It is primarily located in the stomach but may extend through the pylorus into the duodenum and small bowel, a condition labelled as Rapunzel syndrome.

Cases presentation

In this series, we report four consecutive cases of trichobezoars in the paediatric age group, all managed at a single institution King Saud Medical City Hospital Riyadh between 2019 and 2022. All the cases were girls between the ages of ten to fourteen with psychosocial problems. All the patients had a definite mass in the epigastrium and a history of not gaining weight. One presented with intestinal obstruction. X-ray abdomen and computed tomography (CT) scan abdomen were the imaging modalities that led to the diagnosis. All patients underwent surgery with successful removal of the trichobezoar and were referred to a psychiatrist for evaluation and treatment of a psychological disorder.

Conclusion

Trichobezoar is a rare entity that should be considered as a differential diagnosis in young female patients with vague, non-specific clinical symptoms and a palpable, upper-abdominal mass. In our experience and in line with the published literature, conventional laparotomy is still the gold standard in cases of GI trichobezoars.

Along with the removal of the trichobezoar, treatment of the existing psycho-social ailment is of utmost importance and needs long-term counselling with periodic psychological evaluation in follow-up clinics to avoid recurrence.
Improved tests of genuine entanglement for multiqudits
Authors: Zhang Xia , Jing Naihuan , Zhao Hui , Liu Ming , Ma Haitao
Published: July 2023

We give an improved criterion of genuine multipartite entanglement for an important class of multipartite quantum states using generalized Bloch representations of the density matrices. The practical criterion is designed based on the Weyl operators and can be used for detecting genuine multipartite entanglement in higher-dimensional systems. The test is shown to be significantly stronger than some of the most recent criteria.
Vaccine Nationalism: How China's State Media Misinform about Western Vaccines and Highlight the Successes of Chinese Vaccines to Different Audiences
Authors: Chester Patrick J. , Shih Victor
Published: July 2023

What motivates state-sponsored vaccine misinformation campaigns, given clear scientific evidence of vaccines' efficacy? The authors explored this issue through the lens of state-owned presses in mainland China and in Hong Kong. They first collected an original database of media reports on both Western and Chinese vaccines from 16 Chinese-language media publications based in mainland China, Hong Kong, and Taiwan. They found the quantity of coverage of Western vaccines by mainland state-owned media outlets to be much less than their coverage of Chinese vaccines, reflecting the unavailability of Western vaccines in mainland China. However, applying a dictionary-based sentiment analysis, the authors found that state-owned presses in mainland China still portrayed Western vaccines negatively. In Hong Kong, where there is direct competition between Chinese and Western vaccines, they found that state-owned presses gave high coverage of both Western and Chinese vaccines but greater negative coverage of Western vaccines. These findings are consistent with a Chinese producer–oriented “vaccine nationalism” policy designed to nurture the domestic biotechnology sector.
Emergency Regulatory Procedures, Pharmaceutical Regulatory Politics, and the Political Economy of Vaccine Regulation in the COVID-19 Pandemic
Authors: Nachlis Herschel , Thomson Kyle
Published: July 2023

Context: Regulatory approaches to COVID-19 vaccine authorizations varied substantially across countries. Facing a common public health threat, what accounts for regulatory variation? This study focuses on emergency pharmaceutical and vaccine regulatory procedures and whether and how regulators' emergency pharmaceutical regulatory procedures going into the pandemic shaped regulatory processes and decisions during the pandemic.

Methods: The authors conducted an analysis of seven high-impact national and international pharmaceutical regulators with case studies from Brazil, China, India, Russia, the United Kingdom, the United States, and the European Medicines Agency. The authors analyzed evidence from primary source executive and legislative branch regulations and statutes as well as national and international scientific and general press reporting; they also drew on the secondary analysis of scholars, practitioners, and international organizations.

Findings: Inherited emergency pharmaceutical and vaccine regulatory procedures substantially shaped COVID-19 vaccine regulation during the pandemic. Variation in the presence and content of emergency regulatory procedures affected the quality of pandemic regulatory processes, outcomes, and procedural updates and differentially empowered policy-making experts and elected politicians.

Conclusions: Emergency regulatory procedures affect key features of regulatory political economy and public health practices during crises. To improve future public health crisis responses, the authors provide policy recommendations for (1) establishing clear emergency pharmaceutical regulatory procedures, and (2) international collaboration.
A Review of Preoperative Embolization Effectiveness in Patients With Arteriovenous Malformations
Authors: Catapano Joshua S. , Koester Stefan W. , Rumalla Kavelin , Rangel India C. , Stonnington Henry O. , Singh Rohin , Memon Ali , Kimata Anna R. , Winkler Ethan A. , Baranoski Jacob F. , Cole Tyler S. , Graffeo Christopher S. , Srinivasan Visish M. , Jadhav Ashutosh P. , Ducruet Andrew F. , Albuquerque Felipe C. , Lawton Michael T.
Published: July 2023

BACKGROUND AND OBJECTIVES:

Preoperative embolization of arteriovenous malformations (AVMs) remains controversial. This study sought to analyze the cost-effectiveness of preoperative embolization of AVMs.

METHODS:

Patients who underwent AVM resection at a single institute (January 1, 2015—December 31, 2020) were analyzed. Patients with preoperative embolization (embolization cohort) were compared with those without preoperative embolization (nonembolization cohort). Cost-effectiveness score (CE) was the primary outcome of interest and was determined by dividing the total 1-year cost by effectiveness, which was derived from a validated preoperative to last follow-up change in the modified Rankin Scale utility score. A lower CE signifies a more cost-effective treatment strategy.

RESULTS:

Of 188 patients, 88 (47%) underwent preoperative embolization. The mean (SD) total cost was higher in the embolization group than in the nonembolization group ($117 594 [$102 295] vs $84 348 [$82 326]; P < .001). The mean (SD) CE was higher in the embolization cohort ($336 476 [$1 303 842]) than in the nonembolization cohort ($100 237 [$246 255]; P < .001). Among patients with Spetzler-Martin (SM) grade I and II AVMs, the mean (SD) CE was higher in the embolization (n = 40) than in the nonembolization (n = 72) cohort ($164 950 [$348 286] vs $69 021 [$114 938]; P = .004). Among patients with SM grade III AVMs, the mean (SD) CE was lower in the embolization (n = 33) than in the nonembolization (n = 25) cohort ($151 577 [$219 130] vs $189 195 [$446 335]; P = .006). The mean (SD) CE was not significantly different between cohorts among patients with higher-grade AVMs (embolization cohort [n = 3] vs nonembolization cohort [n = 15]: $503 639 [$776 492] vs $2 048 419 [$4 794 758]; P = .49). The mean CE for embolized SM grade III aneurysms was nonsignificant in the ruptured group; however, for the unruptured group, CE was significantly higher in the embolization cohort (n = 26; $160 871 [$240 535]) relative to the nonembolization cohort (n = 15; $108 152 [$166 446]) (P = .006).

CONCLUSION:

Preoperative embolization was cost-effective for patients with SM grade III AVMs but not for patients with lower-grade AVMs.
Further Observations on Flagellated Organisms in the Blood of Animals
Authors: Lewis Timothy Richards
Published: July 2023

In a memoir on “The Microscopic Organisms found in the Blood of Man and Animals,” published in the ‘Fourteenth Annual Report-of the Sanitary Commissioner with the Government of India,’ and which was, in great part, reproduced in the first three numbers of the f Quarterly Journal of Microscopical Science ‘for 1879, a chapter was devoted to a description of certain flagellated organisms which I had found in the blood of rats. This chapter will be found in the January number at p. 109, so that it will not be necessary on the present occasion to do more than very briefly recapitulate what was given therein.
On the Occurrence of Chitin as a Constituent of the Cartilages of Limulus and Sepia.
Authors: Halliburton W. D.
Published: July 2023

The question of the chemical composition of the cartilage that occurs in various invertebrate animals does not seem to have been the object of previous research.1 In an article by Professor Lankester on “The Skeleto-trophic tissues of Limulus,” which appeared recently in this Journal2 he states that Professor Schafer having, at his request, chemically examined the ento-sternite of that animal, had found, that chitin was probably present in that organ. Professor Lankester subsequently placed a larger supply of this tissue in my hands for the purpose of determining the presence of chitin; in addition I have, at Professor Lankester’s suggestion, submitted to a similar examination the cartilage found in the head of the cuttle-fish (Sepia).
Axis-to-Center Chirality Transfer Reactions of Phosphates with a Binaphthyl Group and Their Congeners: New Synthetic Routes to P-Chirogenic Organophosphorus Compounds
Authors: Murai Toshiaki
Published: July 2023

Novel synthetic methods for P-chirogenic four-coordinate pentadentate organophosphorus compounds are described. The synthetic pathways commenced with the use of phosphates bearing a binaphthyl group and their congeners. These compounds underwent reactions with fluoride ion, metal hydroxides, metal alkoxides, and Grignard reagents, resulting in the transfer of axial chirality from the binaphthyl group to the central chirality of the phosphorus atom. As a result, P-chirogenic products incorporating a binaphthyl group were obtained. The substitution reactions of these newly formed products with metal alkoxides and Grignard reagents led to the formation of P-chirogenic phosphates, phosphonates, phosphinates, and some sulfur isologues.
College Enrollment and Mandatory FAFSA Applications: Evidence from Louisiana
Authors: Deneault Christa
Published: July 2023

I estimate the impact of a Louisiana state policy that mandated Free Application for Federal Student Aid (FAFSA) applications as a high school graduation requirement. I find significant increases in FAFSA completion rates (19 percentage points), and my estimates imply an increase of 1–2 percentage points in college enrollment. There is suggestive evidence that these effects were more concentrated among lower-income students/schools, and merit-based state financial aid applications also increased. The design of this mandate implies that pushing students into action may be more effective than informational nudges and that localized support systems such as counselors are important for the success of a top-down policy. (JEL D91, H75, I21, I22, I23, I28)
Computation of periodic orbits using classical and heuristic methods and applications in gravitational fields of asteroids
Authors: Καρύδης Διονύσιος
Published: July 2023

Στη διατριβή αυτή αναζητούμε περιοδικές τροχιές και οικογένειες αυτών, σε ισχυρά διαταραγμένα βαρυτικά συστήματα όπως αυτό των τριών σωμάτων, σε σώματα τυχαίας κατανομής μάζας, με περιστροφή γύρω από τους άξονές τους, με επίδραση από την πίεση της ηλιακής ακτινοβολίας και άλλες παρόμοιες διαταραχές. Η διδακτορική αυτή εργασία έχει ως βασικό σκοπό τη μελέτη σύνθετων δυναμικών συστημάτων όπως αυτό ενός αληθινού αστεροειδούς. Η εύρεση των περιοδικών τροχιών γίνεται όχι μόνο με κλασικές μεθόδους, όπως αυτή των διαφορικών προσεγγίσεων αλλά και με τη βοήθεια γενετικών-εξελικτικών αλγορίθμων ή μεθόδων ελαχιστοποίησης που προσομοιώνουν φυσικές διεργασίες. Συγκεκριμένα αναλύονται οι περιοδικές τροχιές γύρω από τον αστεροειδή 433-Έρωτα και το διπλό σύστημα του 65803-Δίδυμου-Δίμορφου. Αναπτύσσεται μια μέθοδος συνέχισης σχήματος από ένα απλό, αναλυτικό γεωμετρικό στερεό, όπως το τριαξονικό ελλειψοειδές, σε αυτό του ανομοιόμορφου αστεροειδούς αποτελούμενου από πλήθος σημειακών μαζών.
The short-term cost-effectiveness of once-weekly semaglutide versus once-weekly dulaglutide for the treatment of type 2 diabetes mellitus in Colombian adults
Authors: Liebisch-Rey Hans , Suarez-Chacon Andrea-Marcela , Fuentes Yuli-V. , Blanco Jhosep , Kock Joshua , Lechtig-Wassermann Sharon , Bustos Rosa Helena
Published: July 2023

Background: Type 2 Diabetes Mellitus (T2DM) is a highly prevalent disease worldwide and in Colombia, representing one of the main causes of death and placing a considerable burden on healthcare systems. 13 classes of drugs are approved for the treatment of T2DM, with Glucagon-like Peptide-1 (GLP-1) receptor agonists being a first-line treatment option for patients with or at high risk of certain cardiovascular diseases and chronic kidney disease. The objective of this study is to conduct a short-term cost-effectiveness analysis of once-weekly semaglutide versus once-weekly dulaglutide in Colombian adults with T2DM, from a third-party payer perspective. Methods: Numbers needed to treat were calculated for different single and composite endpoints of the SUSTAIN 7 trial, annual costs for once weekly semaglutide 1.0 mg and dulaglutide 1.5 mg were extracted from the public SISMED database. With these inputs a cost of control model was developed, to obtain the annual cost of bringing one T2DM patient to relevant clinical outcomes by using semaglutide or dulaglutide. Results: Semaglutide was considered cost-effective compared to dulaglutide across all pre-specified endpoints, even in the different scenarios evaluated in the sensitivity analyses, and in a particularly pronounced manner for weight loss outcomes. Semaglutide at a dose of 1.0 mg once-weekly was cost-effective compared to dulaglutide 1.5 mg across all outcomes in the short-term, making it an appropriate first-line choice in the treatment of T2DM when deciding between these two GLP-1 receptor agonists. Conclusions: This is the first short-term cost-effectiveness study of semaglutide and dulaglutide in T2DM Colombian patients. Our modeled results suggest that once-weekly semaglutide represents a cost-effective option for treating individuals with T2DM in Colombia who are not achieving glycaemia control with metformin, and it would be expected to improve HbA1C, promote greater weight loss and reduce costs from a third-payer perspective compared with treatment with dulaglutide.
Youth experience matters: participation in physical activity by young people with physical disability. A protocol for a national participation snapshot and Delphi consensus study
Authors: Brady Karen , Kiernan Damien , McConkey Elaine , O'Gorman Eva , Kerr Claire , McDonough Suzanne , Ryan Jennifer , Malone Ailish
Published: July 2023

Young people with physical disability experience challenges to being physically active. To attain the health benefits of physical activity (PA) and sustain engagement, it is essential that participation is meaningful and enjoyable. This study aims to understand “what really matters” for participating in PA, from the perspectives of adolescents with physical disability. A parallel convergent mixed methods study will be undertaken, comprising a national cross-sectional quantitative assessment of PA participation (“Participation Snapshot”) and Delphi consensus study (“Delphi”). Young people (n=100) aged 13-17 years with a primary physical disability diagnosis will be invited to take part. The Participation Snapshot primary outcome is the Children’s Assessment of Participation and Enjoyment (CAPE). Contextual factors including disability diagnosis, demographics, mobility (Functional Mobility Scale), hand function (Manual Ability Classification System) and health related quality of life (Child Health Utility 9D) will also be collected. The Delphi will comprise two to four survey rounds, until consensus is reached. Round 1 (“Your Experience”) consists of a bespoke survey, designed and piloted with a public and patient involvement (PPI) panel, with open-ended questions and Likert scales inviting contributions from young people on their prior experience, barriers and facilitators, and ideas on participation in PA.  Responses will be analysed using reflexive thematic analysis to construct the key themes, conceptualized under the “F-words” framework of the International Classification of Functioning, Disability and Health (ICF). These themes will be presented back to participants in subsequent rounds for selection and ranking, until consensus is achieved on the “top 10 priorities”. The project team and PPI panel will then co-design dissemination material and identify targets for dissemination to relevant stakeholder or policy groups. The findings will provide a basis for developing interventions aiming to empower, encourage and sustain future physical activity participation in a meaningful way by young people with physical disability.