bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations of visceral adipose tissue with bone mineral density and fracture: observational and Mendelian randomization studies
Authors: Hu Jianying , Zhao Manying , Lin Chenhao , Sun Zhonghan , Chen Guo-Chong , Mei Zhendong , Zheng Yan
Published: July 2022

Background

The associations between visceral adipose tissue (VAT) and bone mineral density (BMD) or fracture have been controversial and the causality of the associations remains to be assessed. This study aimed to explore the associations of VAT^ (predicted value of VAT mass) with BMD and fracture risk in men and women, and to examine their potential causation by two-sample Mendelian randomization (MR) analyses.

Methods

UK Biobank is a large, population-based prospective cohort study that recruited more than 500,000 participants aged 40–69 in the United Kingdom from 2006 to 2010. In this study, we used a validated and reliable prediction model to estimate the VAT amount of the participants. On this basis, linear and nonlinear multivariable statistical models were used to explore the association of VAT^ with BMD and fracture risk in different groups of sex and BMI. In observational analyses, the multivariable linear regression model and Cox proportional-hazards model were used to assess VAT^ association with BMD and fracture risk, respectively. Inverse variance weighting was used as the main result of MR analysis.

Results

In 190,836 men, an inverted U-shaped association was observed between VAT^ and heel BMD (P for nonlinearity < 0.001), with a turning point of VAT^ = 1.25 kg. Per kg increase in VAT^ was associated with a 0.13 standard deviation (SD) increase in heel BMD (P = 1.5 × 10−16) among men with lower amounts of VAT^, and associated with a 0.05 SD decrease in heel BMD (P = 1.3 × 10−15) among men with higher amounts of VAT^. In 193,592 women, per kg increase in VAT^ was monotonically associated with a 0.16 SD increase in heel BMD (P = 1.2 × 10−136, P for VAT^-sex interaction = 8.4 × 10−51). During a median follow-up of 8.2 years, VAT^ was associated with lower risks of hip fractures in the overall men and women (P for VAT^-sex interaction = 1.9 × 10−4 for total fractures; 1.5 × 10−4 for other fractures). There were significant interactions of VAT^ and BMI on heel BMD and fracture risks in men only (P for VAT^-BMI interaction = 5.9 × 10−31 for heel BMD; 2.7 × 10−4 for total fractures; 5.7 × 10−3 for hip fractures; 6.8 × 10−3 for other fractures). In two-sample MR analyses, evidence of causality was not observed between VAT^ and DXA-derived BMD or fractures.

Conclusions

These novel findings demonstrated gender-dependent associations of VAT^ with BMD and fracture risk, with the association in men being modified by adiposity. Evidence of causality was not observed, suggesting that the observational association of VAT^ with BMD and fracture risk could be the result of confounding.
COVID-19 outbreak in a psychiatric hospital: what makes it worse?
Authors: Zoghbi Marouan , Haddad Chadia , Khansa Wael , Karam Elie , Chamoun Angela , Hachem Dory
Published: July 2022

Background

Psychiatric patients could be at risk of worse outcomes from COVID-19 than the general population. The primary objective of the present study was to describe the symptoms and clinical characteristics of COVID-19 patients living in long-term hospital for mental illness in Lebanon. The secondary objective was to evaluate the factors related to COVID-19 disease severity among these patients.

Methods

A retrospective observational study was conducted from September 2020 to January 2021 at the Psychiatric Hospital of the Cross. The total number of COVID‐19 patients in the infected floors is 410 out of 548. The outcome variable was the severity of COVID-19 illness classified into five categories: asymptomatic, mild, moderate, severe and critically ill.

Results

The rate of infection in the affected floors was 74.81%. Almost half of the patients were asymptomatic (49.3%), 43.4% had hyperthermia and only 28.0% had tachycardia and 25.1% developed hypoxia. The multivariate regression analysis showed that higher temperature (ORa = 6.52), lower saturation (ORa = 0.88), higher BMI (ORa = 1.12), higher CRP (ORa = 1.01), being a female (ORa = 4.59), having diabetes (ORa = 8.11) or COPD (ORa = 10.03) were significantly associated with the increase of the COVID-19 severity.

Conclusions

The current study showed that a high rate of infection from COVID-19 was detected in a psychiatric hospital with the majority having asymptomatic to mild symptoms. Female psychiatric patients, desaturation, increase inflammation and comorbidities such as diabetes and COPD were associated with the severity of COVID‐19 among psychiatric patients. Future studies are needed to better understand the causal relation of the factors with severity and long term effects or sequelae of the disease.
Exposure to polycyclic aromatic hydrocarbons during pregnancy and breast tissue composition in adolescent daughters and their mothers: a prospective cohort study
Authors: Kehm Rebecca D. , Walter E. Jane , Oskar Sabine , White Melissa L. , Tehranifar Parisa , Herbstman Julie B. , Perera Frederica , Lilge Lothar , Miller Rachel L. , Terry Mary Beth
Published: July 2022

Background

Polycyclic aromatic hydrocarbons (PAH), which are found in air pollution, have carcinogenic and endocrine disrupting properties that might increase breast cancer risk. PAH exposure might be particularly detrimental during pregnancy, as this is a time when the breast tissue of both the mother and daughter is undergoing structural and functional changes. In this study, we tested the hypothesis that ambient PAH exposure during pregnancy is associated with breast tissue composition, measured one to two decades later, in adolescent daughters and their mothers.

Methods

We conducted a prospective analysis using data from a New York City cohort of non-Hispanic Black and Hispanic mother–daughter dyads (recruited 1998–2006). During the third trimester of pregnancy, women wore backpacks containing a continuously operating air sampling pump for two consecutive days that measured ambient exposure to eight carcinogenic higher molecular weight nonvolatile PAH compounds (Σ8 PAH) and pyrene. When daughters (n = 186) and mothers (n = 175) reached ages 11–20 and 29–55 years, respectively, optical spectroscopy (OS) was used to evaluate measures of breast tissue composition (BTC) that positively (water content, collagen content, optical index) and negatively (lipid content) correlate with mammographic breast density, a recognized risk factor for breast cancer. Multivariable linear regression was used to evaluate associations between ambient PAH exposure and BTC, overall and by exposure to household tobacco smoke during pregnancy (yes/no). Models were adjusted for race/ethnicity, age, and percent body fat at OS.

Results

No overall associations were found between ambient PAH exposure (Σ8 PAH or pyrene) and BTC, but statistically significant additive interactions between Σ8 PAH and household tobacco smoke exposure were identified for water content and optical index in both daughters and mothers (interaction p values < 0.05). Σ8 PAH exposure was associated with higher water content (βdaughters = 0.42, 95% CI = 0.15–0.68; βmothers = 0.32, 95% CI = 0.05–0.61) and higher optical index (βdaughters = 0.38, 95% CI = 0.12–0.64; βmothers = 0.38, 95% CI = 0.12–0.65) in those exposed to household tobacco smoke during pregnancy; no associations were found in non-smoking households (interaction p values < 0.05).

Conclusions

Exposure to ambient Σ8 PAH and tobacco smoke during pregnancy might interact synergistically to impact BTC in mothers and daughters. If replicated in other cohorts, these findings might have important implications for breast cancer risk across generations.
Rapid divergence of a gamete recognition gene promoted macroevolution of Eutheria
Authors: Roberts Emma K. , Tardif Steve , Wright Emily A. , Platt Roy N. , Bradley Robert D. , Hardy Daniel M.
Published: July 2022

Background

Speciation genes contribute disproportionately to species divergence, but few examples exist, especially in vertebrates. Here we test whether Zan, which encodes the sperm acrosomal protein zonadhesin that mediates species-specific adhesion to the egg’s zona pellucida, is a speciation gene in placental mammals.

Results

Genomic ontogeny reveals that Zan arose by repurposing of a stem vertebrate gene that was lost in multiple lineages but retained in Eutheria on acquiring a function in egg recognition. A 112-species Zan sequence phylogeny, representing 17 of 19 placental Orders, resolves all species into monophyletic groups corresponding to recognized Orders and Suborders, with <5% unsupported nodes. Three other rapidly evolving germ cell genes (Adam2, Zp2, and Prm1), a paralogous somatic cell gene (TectA), and a mitochondrial gene commonly used for phylogenetic analyses (Cytb) all yield trees with poorer resolution than the Zan tree and inferior topologies relative to a widely accepted mammalian supertree. Zan divergence by intense positive selection produces dramatic species differences in the protein’s properties, with ordinal divergence rates generally reflecting species richness of placental Orders consistent with expectations for a speciation gene that acts across a wide range of taxa. Furthermore, Zan’s combined phylogenetic utility and divergence exceeds those of all other genes known to have evolved in Eutheria by positive selection, including the only other mammalian speciation gene, Prdm9.

Conclusions

Species-specific egg recognition conferred by Zan’s functional divergence served as a mode of prezygotic reproductive isolation that promoted the extraordinary adaptive radiation and success of Eutheria.
Genetic characterization of Toxoplasma gondii in meat-producing animals in Iran
Authors: Amouei Afsaneh , Sarvi Shahabeddin , Mizani Azadeh , Hashemi-Soteh Mohammad Bagher , Salehi Saeid , Javidnia Javad , Hosseini Seyed Abdollah , Amuei Fateme , Alizadeh Ahad , Shabanzade Shafigheh , Gholami Sara , Daryani Ahmad
Published: July 2022

Background

The consumption of uncooked or undercooked food from infected intermediate hosts can result in Toxoplasma gondii infection in humans. However, few studies have investigated the genetic diversity of this protozoan parasite in Iran. The aim of the present study was to genetically characterize isolates of T. gondii from intermediate host animals in Mazandaran Province, Iran.

Methods

Blood and heart tissue samples were collected from 204 ruminants, and brain tissue was collected from 335 birds. The prevalence of T. gondii infection in these samples was determined serologically using the modified agglutination test and by conventional PCR assays. Those PCR samples positive for T. gondii DNA and 13 DNA samples extracted from aborted fetuses in a previous study were genotyped with 12 genetic markers using the multilocus-nested PCR-restriction fragment length polymorphism (Mn-PCR–RFLP) technique.

Results

Antibodies for parasites were found in 35.7% of the ruminant (39.1% of sheep and 26.4% of goats) samples and in 51.3% of the bird (100% of geese, 52.3% of free-range chickens and 46% of ducks) samples. Molecular detection by PCR of the repetitive 529-bp DNA fragment revealed contamination of 13.2% of ruminant (14.6% of sheep and 9.4% of goats) samples and of 9.6% of bird (11.1% of chickens, 5.7% of ducks and 0% of geese samples). The results from 30 DNA samples revealed five ToxoDB (genome database for the genus Toxoplasma) PCR–RFLP genotypes, including #1 (Type II), #2 (Type III), #10 (Type I), #27 and #48, with genotype #1 the most predominant.

Conclusions

As evidenced by the results of this study, ruminants and birds are infected with T. gondii in the region, suggesting that they are likely to be involved in the transmission of T. gondii to humans through meat consumption. The identification of different genotypes may suggest a higher genetic diversity of this parasite in Mazandaran, reflecting local environmental contamination. These results have important public health implications for the prevention and control strategies of infection.

Graphical Abstract
Neonatal hemolytic disease due to anti-Diegoa antibody: a case report
Authors: Fu Yangxi , Liu Ying , Yang Zhenzhen , An Yinghua , Su Jun , Hu Shuli , Luo Lingying
Published: July 2022

Background

The Diegoa antigen commonly occurs in certain Asian and South American Indian populations. In general, hemolysis caused by anti-Diegoa antigen is not severe, and exchange transfusion is rarely needed. Here, we report a neonate with moderate hemolytic disease caused by anti-Diegoa antigen in the Baoji area of China.

Case presentation

A 39-week gestation male newborn of Han nationality was delivered by second cesarean section because of scarred uterus. The newborn’s birth weight was 3700 g with an Apgar score of 9. Four hours after delivery, transcutaneous bilirubin test revealed a level of 17 mg/dl. After 23 hours, the neonate developed anemia and hyperbilirubinemia. Bacterium, virus and other pathogens, as well as tests for arcuate and glucose-6-phosphate dehydrogenase, were all negative. Direct antiglobulin test of the neonate was positive. Diegoa antigens of the baby and his father were positive, while his mother was negative. The newborn was successfully cured with phototherapy and one-dose intravenous injection of human albumin.

Conclusions

It is important to consider and test for the anti-Diegoa antibody in cases of hemolytic disease of the newborn of the Han ethnicities of China.
Trajectories of prices in generic drug markets: what can we infer from looking at trajectories rather than average prices?
Authors: Trujillo Antonio J. , Gutierrez Jose C. , Garcia Morales Emmanuel E. , Socal Mariana , Ballreich Jeromie , Anderson Gerard
Published: July 2022

Background

Well-functioning competitive markets are key to controlling generic drug prices. This is important since over 90% of all drugs sold in the US are generics. Recently, there have been examples of large price increases in the generic market.

Methods

This paper examines price trajectories for generic drugs using a group-based trajectory modelling approach (GBTM). We fit the model using quarterly price information in the IBM MarketScan claims database for the past decade.

Results

We identify three dominant price trajectories for this period: rapid increase trajectories, slow decline and rapid decline. Most generic drugs show a slow or a rapid decline in price trajectories. However, around 17% of all generic drugs show rapid price increase trajectories.

Conclusions

As Congress is exploring an excise tax on drugs whose list price increases faster than the rate of inflation, we discuss what drugs would be most likely to be affected by this law.
Target-driven obstacle avoidance algorithm based on DDPG for connected autonomous vehicles
Authors: Chen Yu , Han Wei , Zhu Qinghua , Liu Yong , Zhao Jingya
Published: July 2022

In the field of autonomous driving, obstacle avoidance is of great significance for safe driving. At present, in addition to traditional obstacle avoidance algorithms including VFH algorithm, artificial potential field method, a large number of related researches are focused on algorithms based on vision and neural networks. Researches on these algorithms have achieved some results, and some of which have completed real road tests. However, most of algorithms consider only local environmental information which may cause local optimum in complex driving environments. Therefore, it is necessary to consider the environmental information beyond the sensor's perceptual ability for autonomous driving in complex environment. In the network-assisted automated driving system, networked vehicles can obtain road obstacles’ and condition information through roadside sensors and mobile network, so as to gain extra sensing ability. Therefore, network-assisted automated driving is of great significance in obstacle avoidance. Under this background, this paper presents an automatic driving obstacle avoidance strategy combining path planning and reinforcement learning. At first, a global optimal path is planned through global information, then merge the global optimal path and vehicle information into a vector. Use this vector as input of reinforcement learning neural network and output vehicle control signals to follow optimal path while avoiding obstacles.
Pathologic examination of the placenta and its benefits in treatment plan or follow-up of patients: a cross-sectional study
Authors: Akhavan Setareh , Borna Sedigheh , Abdollahi Alireza , Shariat Mamak , Zamani Narges
Published: July 2022

Background

The placental examination provides important information about the effect of maternal abnormalities on the placenta or the cause of preterm delivery, fetal growth restriction, or fetal neurodevelopmental damage. In this study, the frequency of placental pathologies of patients in a tertiary hospital was investigated.

Methods

In this longitudinal and cross-sectional study, all removed placentas after any type of pregnancy termination referred to a pathological examination, within 1 year (2019–2020). All placentas were examined macroscopically and microscopically by two pathologists.

Results

Unfortunately, because of the COVID-19 pandemic, the number of pregnant women in our hospital declined. A total of 258 placentas were examined. The type of delivery in 193 cases (79.4%) was cesarean section and 50 cases (20.6%) had a vaginal delivery. In the pathological assessment of placentas, 238 (92.2%) cases were normal and 20 cases (7.8%) were abnormal. Infarct and chorioamnionitis were the pathologies with higher frequencies (4.3% and 2.7%, respectively). Intra-uterine fetal death (p = 0.701), preeclampsia (p = 0.51) had no significant difference was seen in normal and abnormal placentas. Maternal age (p = 0.83), gestational age based on the last menstrual period (p = 0.38), and gestational age based on the first ultrasound (p = 0.78) did not show a significant relationship with any of the pathological complications categories.

Conclusions

Pathological examination of the placenta from all live-birth deliveries is not worthwhile, and it’s recommended to modify the guidelines as to when the placenta is submitted for pathological evaluation.
Eating behaviors, eating styles and body mass index during COVID-19 confinement in a college sample: a predictive model
Authors: Escrivá-Martínez Tamara , Miragall Marta , Herrero Rocío , Rodríguez-Arias Marta , Baños Rosa M.
Published: July 2022

Background

COVID-19 confinement affected lifestyles. There is inconclusive evidence about changes in eating patterns, and there are few studies on the impact on body mass index (BMI), the occurrence of dysfunctional behaviors (binge eating, fat intake), and the predictive role of maladaptive eating styles (emotional, external, and restrained eating).

Objectives

(1) To analyze the differences in binge eating, fat intake, BMI, and maladaptive eating styles before and during COVID-19 confinement, and (2) to analyze whether maladaptive eating styles (before confinement) predicted binge eating, fat intake, and BMI during confinement.

Methods

The sample consisted of 146 Spanish college students, divided into 104 females (71.2%; age: M = 22.20, SD = 2.97) and 42 males (28.8%; age: M = 24.74; SD = 3.53). All completed several dietary measures and BMI twice: before COVID-19 confinement (T1, November 2019) and during COVID-19 confinement (T2, April 2020).

Results

BMI and maladaptive eating styles did not change in T2 (vs. T1). However, binge eating and fat intake decreased in T2. Emotional eating at T1 positively predicted BMI and binge eating at T2. External eating at T1 positively (and marginally) predicted fat intake at T2. Restrained eating at T1 positively predicted binge eating at T2, and negatively (and marginally) predicted BMI and fat intake at T2. The model explained 80.5% of the variance in BMI, 41.5% of the variance in binge eating, and 25.8% of the variance in fat intake during COVID-19 confinement.

Conclusions

The COVID-19 confinement had a positive impact on some eating behaviors. Future policies should focus part of their prevention on maladaptive eating styles to curb dysfunctional eating behaviors and BMI problems in times of stress.
Blumea chishangensis sp. nov. (Asteraceae: Inuleae) from Taiwan and new insights into the phylogeny of Blumea
Authors: Chung Shih-Wen , Huang Wei-Jie , Chen Zhi-Hao , Liu Shih-Hui
Published: July 2022

Background

Blumea plants are widely distributed in the tropical areas of Asia, Africa, and Australia, especially tropical Asia. Limited studies left the taxonomy and infrageneric phylogeny of Blumea insubstantial. Here, a new species, Blumea chishangensis S. W. Chung, Z. H. Chen, S. H. Liu & W. J. Huang, from Taiwan is described, and an extended phylogeny is reconstructed to provide new perceptions of Blumea evolution.

Results

The new species is distinguished from B. hieraciifolia by the following features: leaf blade sparsely pilose or glabrescent (vs. silky villous), the leaves margins regularly remote mucronulate (vs. double serrate or dentate), capitula pedicelled (vs. capitula sessile or subsessile), and leaves basal rosette or sub-basal rosette and a few cauline (vs. mostly cauline). Phylogenetic analysis based on the ITS, trnL-trnF, and trnH-psbA regions places the new species in the subclade II in B. lacera clade and shows a close relationship with B. axillaris and B. oxyodonta. A key to Blumea species in Taiwan and the studied species in the subclade II is provided. Moreover, the evolutionary inferences of B. conspicua, B. linearis, and B. sinuata are first reported here. The paraphyly of B. formosana and B. sinuata are also revealed for the first time.

Conclusions

Both morphological and molecular data support that B. chishangensis is a new species. Our phylogeny highlights the need for further taxonomic and evolutionary studies on Blumea.
Chlorhexidine gluconate lavage during total joint arthroplasty may improve wound healing compared to dilute betadine
Authors: Lung Brandon E. , Le Ryan , Callan Kylie , McLellan Maddison , Issagholian Leo , Yi Justin , McMaster William C. , Yang Steven , So David H.
Published: July 2022

Purpose

Intraoperative wound irrigation prior to closure during total joint arthroplasty (TJA) is an essential component of preventing infections and limiting health care system costs. While studies have shown the efficacy of dilute betadine in reducing infection risk, there remains concerns over its safety profile and theoretical inactivation by blood and serum. This study aims to compare infection and wound complications between chlorhexidine gluconate (CHG) and betadine lavage during TJA.

Methods

All primary TJA between 2019–2021 were analyzed at a single institution, and periprosthetic joint infection (PJI), wound drainage, 30 and 90-day emergency room (ER) readmission due to wound complications, aseptic loosening, and revision surgery rate were compared between patients undergoing intraoperative CHG versus betadine lavage prior to closure. Baseline demographics were controlled, and multivariate logistic regression was performed to compare complication rates.

Results

A total of 410 TJA, including 160 hip and 250 knee arthroplasties were included. Compared to the dilute betadine cohort, all TJA patients undergoing CHG lavage had a statistically significant lower 30 and 90-day emergency room readmission rate due to wound complications. Both hip and knee arthroplasty patients with CHG had a statistically significant lower rate of postoperative superficial drainage and dressing saturation at clinic follow-up, but only knee arthroplasty patients had significant decreased readmission rate for incisional wound vacuum placement and close inpatient monitoring of wound healing. Among all TJA, there was no significant association in the rate of PJI requiring return to the OR between groups.

Conclusions

Although betadine is cost-effective and has been shown to reduce PJI rates, there remains concerns in the literature over soft tissue toxicity and wound healing. This study suggests CHG may be as efficacious as dilute betadine in preventing PJI while also decreasing the risk of superficial drainage and wound complications needing unplanned ER visits during the acute postoperative period.
Transnational voting rights and policies in violent democracies: a global comparison
Authors: Nyblade Benjamin , Wellman Elizabeth Iams , Allen Nathan
Published: July 2022

In recent decades more than one hundred countries have enfranchised their diasporas, allowing emigrants to vote from abroad. However, this widespread formal recognition of extraterritorial voting rights does not always lead to increased participation of emigrants in home country politics. Migrant-sending countries have complex relationships with their diasporas, and this relationship is particularly fraught for countries with endemic violence. This article leverages a new dataset documenting the adoption and implementation of extraterritorial voting rights and restrictions for 195 countries from 1950 to 2020 to demonstrate how transnational voting rights and policies in violent democracies differ from other regimes. While violent democracies extend transnational voting rights to their emigrants at rates comparable to other regime types, they are less likely to implement those rights, and when they do implement them, they are more likely to restrict them to insulate domestic politics from external influence.
Auditory perceptual discomfort and low-hearing tolerance in the first episode psychosis
Authors: de Bustamante Simas Maria Lúcia , dos Santos Naianna Ribeiro Mocelin , Lacerda Aline Mendes
Published: July 2022

Awareness of perceptual and sensory changes that might occur in visual, auditory, proprioception, and other senses, in the early stages towards the First Episode Psychosis (FEP), and their subsequent sensorial evolution as the disturb progresses deeper into an acute episode, might be a key element for interrupting the process. In the present study, we investigated hearing discomfort/tolerance to 16 given sound streams. Sixteen people diagnosed with FEP, participated in the experiment. Sixteen frequency sweeps varying in modulation envelopes (sawtooth, sine), order (ascending, descending), duration (4s, 8s), and range (50–8000 Hz, 2–8 kHz) were presented randomly, but always in the same sequence, to FEP and healthy controls (HC). The level of discomfort was estimated by the participant by making a mark across a continuous line whose extremes read “nothing bad” (left) and “too bad” (right). Results showed that ascending sine pure frequency sweeps (p < 0.01) and descending sine pure frequencies sweeps (p < 0.01) caused the maximum discomfort in FEP. Other variables also showed differences between FEP and HC, and FEP were always more intolerant to such pure frequency sweeps than HC. We conclude that this might be useful for very early assessment of people at risk, people with FEP, and people with schizophrenia.
Enhancing hospital quality management and patient safety in Vietnam: a technical assistance project utilizing online solutions during COVID-19 pandemic
Authors: Moriyama Jun , Ito Tomoo , Doi Masahiko , Seino Kaori , Luong Duong Huy , Iwamoto Azusa , Murakami Hitoshi
Published: July 2022

Since 2015, the National Center for Global Health and Medicine in Japan has been conducting a technical assistance project for improving patient safety in Vietnamese hospitals. During the COVID-19 pandemic, the project conducted a patient safety training program utilizing online solutions for participants from Vietnam. This resulted in an increase in the number of participants, and ensured access from remote locations. The convenience of easy access from smartphones encouraged further participation. In addition to online training, the utilization of platforms such as Facebook, a common social networking service in Vietnam, contributed to the dissemination of good practices.
Who engaged in the team-based assessment? Leveraging EdTech for a self and intra-team peer-assessment solution to free-riding
Authors: Gunning Tiffany K. , Conlan Xavier A. , Collins Paul K. , Bellgrove Alecia , Antlej Kaja , Cardilini Adam P. A. , Fraser Catherine L.
Published: July 2022

A STEM-based faculty in an Australian university leveraged online educational technology to help address student and academic concerns associated with team-based assessment. When engagement and contribution of all team members cannot be assured, team-based assessment can become an unfair and inaccurate measure of student competency. This case study explores the design and capacity of an online self and intra-team peer-assessment of teamwork strategy to measure student engagement and enable peers to hold each other accountable during team-based assessments. Analysis of student interactions across 39 subjects that implemented the strategy in 2020, revealed that an average of 94.4% of students completed the self and intra-team peer-assessment task when designed as part of a summative team-based assessment. The analysis also revealed that an average of 10.3% of students were held accountable by their peers, receiving feedback indicating their teamwork skills and behaviours were below the required minimum standard. Furthermore, the strategy was successfully implemented in cohorts ranging from seven to over 700 students, demonstrating scalability. Thus, this online self and intra-team peer-assessment strategy provided teaching teams with evidence of student engagement in a team-based assessment while also enabling students to hold each other accountable for contributing to the team task. Lastly, as the online strategy pairs with any discipline-specific team-based assessment, it provided the faculty with a method that could be used consistently across its schools to support management and engagement in team-based assessments.
Online information on medical cannabis is not always aligned with scientific evidence and may raise unrealistic expectations
Authors: Macedo Arthur Cassa , de Faria André Oliveira Vilela , Bizzi Isabella , Moreira Fabrício A. , Colasanti Alessandro , Ghezzi Pietro
Published: July 2022

Background

There is a growing literature on the potential medical uses of Cannabis sativa and cannabinoid compounds. Although these have only been approved by regulatory agencies for a few indications, there is a hype about their possible benefits in a variety of conditions and a large market in the wellness industry. As in many cases patients search for information on cannabis products online, we have analyzed the information on medical cannabis available on the Internet. Therefore, this study aims at assessing the quality of the information available online on medical cannabis.

Methods

We searched “medical cannabis” on June 2019 using google.com and downloaded the first 243 websites. After excluding dead links or websites with no information about cannabis, 176 websites were included. They were then classified for their typology (e.g., commercial, government, news outlets). As an indicator of trustworthiness, we used the Journal of American Medical Association (JAMA) score, which assesses the indication of date, author, ownership of the website, and the presence of references. We also considered if a website is certified by Health-On-the-Net (HON), an independent organization, by displaying a HONCode symbol. Subsequently, we performed a content analysis to assess both the medical cannabis indications mentioned by webpages and the completeness of the information provided (whether they mentioned potential side effects and legal/regulatory issues or not).

Results

Analyzing 176 webpages returned by a search engine, we found that 52% of them were news websites. Pain, epilepsy, and multiple sclerosis were the most frequently mentioned therapeutic areas (cited in 92, 84 and 80 webpages, respectively), which did not always match those for which there is regulatory approval. Information was also incomplete, with only 22% of the webpages mentioning potential side effects. Health portal websites provided the most complete information, with all of them (n = 7) reporting side effects. On average, 80% of webpages had a neutral stance on the potential benefits of medical cannabis, with commercial websites having more frequently a positive stance (67%).

Conclusions

We conclude that the information that can be found online is not always aligned in terms of the therapeutic areas for which science-based evidence is often still weak.
Revisiting some overlooked registered Thai traditional medicine preparations: an alert to a regulatory affair
Authors: Vimolmangkang Sornkanok , Rani Dolly , Prestwong Naruemon , Sutcharitchan Chayanis , Pakdeesattayapong Duangkamol
Published: July 2022

Objective

This study evaluated the heavy metal identity and content of registered Thai Traditional medicine (TTM) preparations in Thailand to ensure consumer safety.

Methods

Both qualitative and quantitative information about the elemental composition of the heavy metal content in each TTM crude drug and the heavy metal content in some registered TTM preparations in Thailand was performed. Seven kinds of mineral-based TTM crude drugs, namely realgar, orpiment, Chinese powder, Sen, vermilion, natural vermilion, and cinnabar, were analyzed with X-ray diffraction and scanning electron microscopy and energy-dispersive spectroscopy techniques to determine the type of metal and elemental composition to confirm their chemical formulas. Furthermore, the number of heavy metals, such as arsenic (As), lead (Pb), and mercury (Hg), was in three samples of realgar-containing preparations; one sample of Sen-containing preparation, and eight samples of cinnabar-containing preparations. Heavy metals were determined with inductively coupled plasma-optical emission spectrometry.

Results

It was observed that realgar and orpiment consisted of arsenic sulfide (AsS) and arsenic trisulfide (As2S3), respectively. Both crude drugs contained approximately 50% of As. Vermilion, natural vermilion, and cinnabar consisted of mercuric sulfide (HgS), with Hg accounting for approximately 66%. Sen consisted of Pb (II, IV) oxide (Pb3O4) with an approximate Pb percentage of 80%. However, Pb was absent in Chinese powder and consisted mainly of calcium carbonate (CaCO3). A traditional detoxification procedure can reduce the amount of As and Hg in processed crude drugs by at least 20%.

Conclusions

Pb was higher in some TTM preparations, and no CaCO3 was detected in Chinese powder. Our results raise concerns on both safety and efficacy to consumers and alert public health policymakers that they should implement regulations so that the quality (authenticity) and quantity of elemental medicine used in traditional medicine are correctly labeled and within permissible limits to prevent threats to consumers.
“Hiding beaver tail liver”: a rare case report of a beaver tail liver lookalike variant located medially to the spleen, mimicking a perisplenic hematoma
Authors: Arkoudis Nikolaos-Achilleas , Stamelos Konstantinos , Tsochatzis Athanasios , Moschovaki-Zeiger Ornella , Spiliopoulos Stavros
Published: July 2022

Background

Liver lobe anatomic variations are uncommon and may often cause clinical difficulties. We present a trauma patient with a previously unreported (to our knowledge) hepatic morphology, which was initially misdiagnosed as a possible perisplenic hematoma, leading to unnecessary further investigations.

Case presentation

A 32-year-old male patient was brought to our hospital’s emergency department following a low-energy motor vehicle accident. The patient was ambulatory, had a GCS of 15/15, and appeared hemodynamically stable with normal hematocrit (Hct)/hemoglobin (Hb) blood counts. No clinical signs/symptoms of bleeding were noted, and no significant complaints were documented, besides minor left flank tenderness with overlying abrasions. The patient's past medical history was insignificant. FAST (Focused Assessment with Sonography for Trauma) scan performed gave the impression of a crescent-shaped hypoechoic lesion/collection medially to the spleen, raising suspicion of a perisplenic hematoma. Subsequent computed tomography (CT) scan displayed no trauma-related findings, while the suspected hematoma was seen to correspond to variant left hepatic lobe morphology.

Conclusion

The “hiding beaver tail liver” (HBTL) is a hepatic morphology variant encountered when the lateral part of the left liver lobe (beaver’s tail) extends across the midline and lies medially to the visceral surface of the spleen, following an acute angulation (in hiding). As it can mimic true pathology, familiarity with this morphology is crucial to avoid false diagnosis and unnecessary investigations.
Use of Herbal Medicine Is Associated With Late-Stage Presentation in Tanzanian Patients With Cancer: A Survey to Assess the Utilization of and Reasons for the Use of Herbal Medicine
Authors: Henke Oliver , Bruchhausen Walter , Massawe Anna
Published: July 2022

PURPOSE

In Tanzania, patients with cancer present late with advanced stages. Among other reasons, the use of herbal medicine (HM) might contribute to delay in diagnosis and treatment. This study aims to understand the utilization of HM and the reasons for its' use.

METHODS

A semistructured 30-item questionnaire with closed- and open-ended questions was applied to a cohort of patients with cancer at Kilimanjaro Christian Medical Centre. Content analysis was performed for answers to open-ended questions.

RESULTS

Three hundred two patients were interviewed, 50.9% males and 49.1% females. The mean age was 64 years. 71.6% were in stages III/IV. 70.5% patients used HM and 67.1% started conventional medicine after stopping HM, 7.5% started HM after conventional medicine, and 24.9% combined both. Stage IV patients used HM as first line significantly more often in comparison: stage I 55.6%; II 58.1%; III 57.2%; and IV 70.6%. 77.5% did not tell their doctors about the use of HM. Commonest reasons to use HM were belief in cure, hope of symptom relief, lack of cancer services, and tradition.

CONCLUSION

The majority of patients used HM before consulting a doctor, which contributes to stage IV presentation. Use of HM alongside with chemotherapy is mostly not known to the treating physician and may lead to interactions. These findings must alert health care workers and health policymakers to further foster health education about cancer and its treatment. Further research is needed to understand the wide use of HM among Tanzanian patients with cancer and the role that traditional and spiritual healers play in the field of cancer care.
Long-Term Benefits of Tagraxofusp for Patients With Blastic Plasmacytoid Dendritic Cell Neoplasm
Authors: Pemmaraju Naveen , Sweet Kendra L. , Stein Anthony S. , Wang Eunice S. , Rizzieri David A. , Vasu Sumithira , Rosenblat Todd L. , Brooks Christopher L. , Habboubi Nassir , Mughal Tariq I. , Kantarjian Hagop , Konopleva Marina , Lane Andrew A.
Published: July 2022

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an aggressive myeloid malignancy. We report long-term results, including data from the continued access phase, of the largest prospective BPDCN trial evaluating the CD123-targeted therapy tagraxofusp (TAG) in adults with treatment-naive and relapsed/refractory BPDCN. The primary outcome was complete response (CR) + clinical CR (CRc: CR with residual skin abnormality not indicative of active disease). Eighty-four (65 treatment-naive and 19 relapsed/refractory) of 89 patients received TAG 12 μg/kg once daily; the median follow-up was 34.0 months. For treatment-naive patients, the overall response rate was 75%; 57% achieved CR + CRc. The median time to remission was 39 (range, 14-131) days, and the median CR + CRc duration was 24.9 (95% CI, 3.8 to not reached) months. Nineteen patients (51%) with CR + CRc were bridged to stem-cell transplant, with a median CR + CRc duration of 22.2 (range, 1.5-57.4) months. Most common adverse events were increased alanine (64%) or aspartate (60%) aminotransferase and hypoalbuminemia (51%); most occurred in cycle 1 and were transient. Capillary leak syndrome occurred in 21% of patients (grade ≥ 3: 7%). In first-line patients with BPDCN, TAG monotherapy resulted in high and durable responses, allowing many to bridge to stem-cell transplant. TAG was generally well-tolerated with a predictable and manageable safety profile.
Diffraction-induced entanglement loss of high-dimensional orbital angular-momentum states
Authors: Zhu Kuntuo , Ye Zhangdong
Published: July 2022

The entanglement loss of high-dimensional entangled orbital angular-momentum states in far-field diffraction by a circular aperture was studied theoretically. A general expression for high-dimensional entanglement decay is provided. The results show that the loss depends on both the parity and the magnitude of the orbital angular-momentum index, and it is not affected by a small misalignment error of the aperture.
Facial Nerve Massage for the Treatment of Hemifacial Spasm Refractory to Microvascular Decompression: Outcomes and Complications
Authors: Patel Kevin P. , Eubanks Komal , Wecht Daniel A. , Sekula Raymond F.
Published: July 2022

BACKGROUND:

After microvascular decompression (MVD) for hemifacial spasm (HFS), a minority of patients realize little to no relief of spasms. In some patients, the absence of relief of spasms results from incomplete or inadequate decompression of vascular compression of the facial nerve, and these patients represent excellent candidates for repeat MVD. However, in other patients, repeat MVD is not appropriate because adequate decompression and resolution of neurovascular compression, as determined by postoperative high-resolution MRI, was achieved with the initial operation.

OBJECTIVE:

To present a cohort of patients with a history of HFS refractory to MVD, with no evidence of neurovascular compression on postoperative MRI, who underwent facial nerve massage (FNM) in the posterior fossa in an attempt to relieve spasms.

METHODS:

Thirteen patients with a history of incomplete relief of spasms after technically adequate MVD surgery for hemifacial spasm underwent FNM. Immediate and long-term degree of spasm relief and complications after FNM were documented through in-person or telemedicine interview.

RESULTS:

At follow-up after FNM, 7 of 12 patients (58.3%) reported complete spasm relief (grade I), 2 of 12 patients (16.7%) reported >75% spasm relief (grade II), 0 patient (0%) reported >50% spasm relief (grade III), 3 of 12 (25.0%) patients reported <50% spasm relief (grade IV), and 1 patient was lost to follow-up. One patient experienced a delayed facial paresis, and another patient experienced high-frequency hearing loss.

CONCLUSION:

After FNM, durable and, at least, partial relief of spasms with a relatively low complication rate was observed in most patients with HFS with incomplete relief of spasms after technically adequate prior MVD.
Pharmacological intervention of the FGF–PTH axis as a potential therapeutic for craniofacial ciliopathies
Authors: Bonatto Paese Christian Louis , Chang Ching-Fang , Kristeková Daniela , Brugmann Samantha A.
Published: July 2022

Ciliopathies represent a disease class characterized by a broad range of phenotypes including polycystic kidneys and skeletal anomalies. Ciliopathic skeletal phenotypes are among the most common and most difficult to treat due to a poor understanding of the pathological mechanisms leading to disease. Using an avian model (talpid2) for a human ciliopathy with both kidney and skeletal anomalies (orofaciodigital syndrome 14), we identified disruptions in the FGF23–PTH axis that resulted in reduced calcium uptake in the developing mandible and subsequent micrognathia. Although pharmacological intervention with the U.S. Food and Drug Administration (FDA)-approved pan-FGFR inhibitor AZD4547 alone rescued expression of the FGF target SPRY2, it did not significantly rescue micrognathia. In contrast, treatment with a cocktail of AZD4547 and teriparatide acetate, a PTH agonist and FDA-approved treatment for osteoporosis, resulted in molecular, cellular and phenotypic rescue of ciliopathic micrognathia in talpid2 mutants. Together, these data provide novel insight into pathological molecular mechanisms associated with ciliopathic skeletal phenotypes and a potential therapeutic strategy for a pleiotropic disease class with limited to no treatment options.
Empirical estimation of skin resistance to water loss in amphibians: agar evaluation as a non-resistance model to evaporation
Authors: Senzano Luis M. , Bovo Rafael P. , Andrade Denis V.
Published: July 2022

Total resistance (rt) to evaporative water loss (EWL) in amphibians is given by the sum of the boundary layer (rb) and the skin resistance (rs). Thus, rs can be determined if the rb component is defined (rs=rt−rb). The use of agar models has become the standard technique to estimate rb under the assumption that the agar surface imposes no barrier to evaporation (rs=0). We evaluated this assumption by determining EWL rates and rb values from exposed surfaces of free water, a physiological solution mimicking the osmotic properties of a generalized amphibian, and agar gels prepared at various concentrations using either water or physiological solution as diluent. Water evaporation was affected by both the presence of solutes and agar concentration. Models prepared with agar at 5% concentration in water provided the most practical and appropriate proxy for the estimation of rb.
Differentiation of multiple myelomas from osteolytic bone metastases: Diagnostic value of tumor homogeneity on Contrast-Enhanced CT
Authors: Huh Yeon Jong , Lee So-Yeon , Kim Sanghee , Lee Seung Eun , Jung Joon-Yong
Published: July 2022

Objectives:

To investigate the diagnostic value of tumor homogeneity on contrast-enhanced (CE) computed tomography (CT) to differentiate multiple myeloma (MM) from osteolytic bone metastases (Mets).

Methods:

This retrospective study included patients who were diagnosed with MM or Mets and had multiple (≥2) osteolytic bone tumors on pre-treatment CE-CT. Intratumoral homogeneity was assessed by coefficient of variation (CV, ratio of standard deviation to mean) of the density of a single lesion (CV-lesion). Intertumoral homogeneity was assessed as the CV of the densities of multiple lesions in one patient (CV-patient). A classification model was built from CT parameters using classification and regression tree (CART) analysis. Diagnostic performance of the model was evaluated using C-statistics.

Results:

A total of 272 lesions (81 MM and 191 Mets) of 105 patients were analyzed. The mean CV-lesion and CV-patient of MM were significantly lower than those of Mets: 0.17 vs 0.26 for CV-lesion (p = 0.005) and 0.16 vs 0.23 for CV-patient (p = 0.013). Thickened struts were more common in MM than in Mets (49.1% vs 12.8%, p ≤ 0.001). In CART analysis, CV-lesion was the first partitioning predictor, followed by thickened struts and by CV patient. The CART model could distinguish MM from Mets in both the model development cohort (C-statistic: 0.843) and the temporal validation cohort (0.721, 0.686, and 0.686 for three reviewers, respectively).

Conclusions:

MM showed intratumoral and intertumoral homogeneity compared with Mets on CE-CT. The combination of CV-lesion and CV-patient can be helpful to radiologists in differentiation of MM from Mets.

Advances in knowledge:

Our study showed that MM had intratumoral and intertumoral homogeneity compared with Mets on contrast-enhanced CT.