bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic accuracy of DNA-based SDC2 methylation test in colorectal cancer screening: a meta-analysis
Authors: Wang Lixing , Liu Yu , Zhang Duohan , Xiong Xiaoliang , Hao Tingting , Zhong Lili , Zhao Yinlong
Published: June 2022

Background

A growing body of research suggests that methylated genes can be used as early diagnostic markers for cancer. Some studies on methylated Syndecan 2 (SDC2) have shown that it has a great diagnostic ability in colorectal cancer. This meta-analysis was aimed to estimate the diagnostic performance of methylated SDC2 as a potential novel biomarker to screen for the colorectal cancer.

Methods

Two independent researchers conducted a comprehensive literature search to identify all relevant studies on SDC2 methylation for the diagnosis of colorectal cancer from inception to March 1, 2021. By using STATA and Revman software, the data were analyzed using a Bivariate mixed model. The quality of each study was also evaluated.

Results

A total of 12 studies comprised of 1574 colorectal cancer patients and 1945 healthy people were included in our meta-analysis. Bivariate analysis showed a pooled sensitivity of 0.81 [95% confidence interval (CI) 0.74–0.86], specificity of 0.95 (95% CI 0.93–0.96), positive likelihood ratio of 15.29 (95% CI 10.83–21.60), and negative likelihood ratio of 0.21 (95% CI 0.15–0.27). The diagnostic odds ratio and the area under the summary ROC curve for diagnosing colorectal cancer were 74.42 (95% CI45.44–121.89) and 0.96 (95% CI 0.94–0.97), respectively. For adenomas, the pooled sensitivity and specificity were 0.47 (95% CI 0.34–0.61) and 0.95 (95% CI 0.92–0.97), respectively.

Conclusions

Our analysis revealed that methylated SDC2 could be considered as a potential novel biomarker to screen for colorectal cancer.
Increasing incidence rates of sexually transmitted infections from 2010 to 2019: an analysis of temporal trends by geographical regions and age groups from the 2019 Global Burden of Disease Study
Authors: Du Min , Yan Wenxin , Jing Wenzhan , Qin Chenyuan , Liu Qiao , Liu Min , Liu Jue
Published: June 2022

Background

World Health Organization announced its goal of ending sexually transmitted infection (STI) epidemics by 2030. To provide a reference for tailored prevention strategies, we analyzed trends and differences in STIs by geographical regions and age groups from 1990 to 2019.

Methods

Annual number of new infections and age-standardized incidence rates (ASRs) of syphilis, chlamydia, gonorrhea, trichomoniasis, and genital herpes were recorded from the 2019 Global Burden of Disease study. We quantified the temporal trends of STIs by calculating changes in new infections and estimated annual percentage changes (EAPCs) of ASR.

Results

The ASRs of syphilis, chlamydia, trichomoniasis, and genital herpes increased by 1.70% (95% confidence interval [CI], 1.62–1.78%), 0.29% (95% CI 0.04–0.54%), 0.27% (95% CI 0.03–0.52%), and 0.40% (95% CI 0.36–0.44%) per year from 2010 to 2019 worldwide, respectively, while that of gonorrhea did not. The American regions had the greatest increase in ASR for syphilis (tropical Latin America: EAPC, 5.72; 95% CI 5.11–6.33), chlamydia (high-income North America: EAPC, 1.23; 95% CI 0.73–1.73), and gonorrhea (high-income North America: EAPC, 0.77; 95% CI 0.12–1.41). Additionally, southern sub-Saharan Africa and East Asia had the greatest increase in ASR for trichomoniasis (EAPC, 0.88; 95% CI 0.57–1.20) and genital herpes (EAPC, 1.44; 95% CI 0.83–2.06), respectively. In the most recent years, the population with the greatest incidence of syphilis tended to be younger globally (25–29 years in 2010 vs. 20–24 years in 2019) but older in North Africa and Middle East (20–24 year vs. 25–29 years); with chlamydia tended to be older in southern sub-Saharan Africa (25–29 years vs. 30–34 years) but younger in Australasia (40–44 years vs. 25–29 years); with genital herpes tended to be older in high-income North America (20–24 years vs. 25–29 years) and South Asia (25–29 years vs. 30–34 years).

Conclusions

Syphilis, chlamydia, trichomoniasis, and genital herpes showed a trend of increasing ASR from 2010 to 2019. The differences in trends by geographical regions and age groups point to the need for more targeted prevention strategies in key regions and populations.
What topics are women interested in during pregnancy: exploring the role of social media as informational and emotional support
Authors: Lee Joo Yun , Lee Eunhee
Published: June 2022

Background

Social media plays an important role as a source for obtaining or sharing health information. It is frequently used as a resource by pregnant women who seek information and emotional support regarding their physical and role changes. To provide high-quality support for pregnant women, it is important to determine what topics they want information on from social media during their pregnancy, and what effects they expect from each topic. This study investigates what topics pregnant women are interested in according to their stage of pregnancy and need for informational or emotional support from each topic of interest.

Methods

An online survey was conducted with 302 pregnant Korean women. The survey questionnaires included information sources and experience of social media. Along with the questionnaires, they were asked to describe three to ten health topics that they were most interested in in the last two weeks.

Results

Social media (72.85%) and search engines (72.85%) were found to be most frequently used for pregnancy-related health information. The topics of interest slightly differed by stage, but mainly postpartum care, pregnancy symptoms, and daily life issues ranked high. Mood related topics appeared frequently among women in their first trimester or post-partum stage of pregnancy. Informational support was mostly needed for daily life issues, and emotional support needs centered mostly around stories about family and mood during pregnancy.

Conclusions

Pregnant women have different needs for informational or emotional support, depending on their stage of pregnancy and their topics of interest. Therefore, social media support should be delivered with varying content and platforms tailored to women’s needs at each trimester.
Myoinositol supplementation in the treatment of gestational diabetes mellitus: effects on glycaemic control and maternal-foetal outcomes
Authors: Guarnotta Valentina , Cuva Gianluca , Imbergamo Maria Pia , Giordano Carla
Published: June 2022

Background

Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset during pregnancy. It is characterized by high risk of adverse outcomes for the mother and the foetus, if not adequately controlled. The aim of the study was to evaluate the effects of 4000 mg of myoinositol supplementation in women with GDM on maternal-foetal outcomes, compared to controls.

Methods

A cohort of 330 women with GDM, 150 supplemented with myoinositol and 180 controls were enrolled. Clinical and metabolic parameters and the prevalence of maternal and foetal complications were assessed.

Results

The same number of women in the two groups started insulin as additional therapy. Women treated with myoinositol more frequently had a long-acting insulin scheme of treatment than those untreated (p<0.001), while women untreated with myoinositol more frequently had a basal-bolus insulin regimen (p<0.001) compared to women on myoinositol.

Patients treated with myoinositol had significantly lower fasting plasma glucose (p=0.032), post-prandial dinner glucose (p=0.014), insulin requirement both in the 2nd and in the 3rd trimesters (p=0.001 and p<0.001, respectively), than those not treated with myoinositol.

With regard to maternal/foetal outcomes, lower birth weight (p=0.043) and frequency of hypoglycaemic events (p=0.001) were observed in women treated with myoinositol compared to controls.

Conclusions

Women with GDM treated with myoinositol showed an improved glycaemic control in the 3rd trimester of pregnancy and a lower insulin requirement, when insulin was added to the treatment, compared to controls. In addition, they showed lower preterm birth weight and neonatal hypoglycaemia, compared to women not supplemented with myoinositol.
Prognostic implication of bronchoalveolar lavage fluid analysis in patients with Pneumocystis jirovecii pneumonia without human immunodeficiency virus infection
Authors: Chung Chiwook , Lim Chae Man , Oh Yeon-Mok , Hong Sang Bum , Choi Chang-Min , Huh Jin Won , Lee Sei Won , Lee Jae Seung , Jo Kyung-Wook , Ji Wonjun , Park Chan-Jeoung , Kim Mina , Sung Heungsup , Cho Young-Uk , Cho Hyo Sin , Kim Ho Cheol
Published: June 2022

Background

The prognostic value of bronchoalveolar lavage (BAL) fluid analysis in non-human immunodeficiency virus (HIV)-infected patients with Pneumocystis jirovecii pneumonia (PJP) has not been well elucidated. We aimed to investigate the prognostic implication of BAL fluid analysis in non-HIV patients with PJP.

Methods

The data of 178 non-HIV patients diagnosed with PJP based on the results of the polymerase chain reaction assay of BAL fluid specimens between April 2018 and December 2020 were retrospectively reviewed. The clinical characteristics, laboratory findings, and BAL fluid analysis results of patients who died within 90 days after hospital admission were compared.

Results

Twenty patients (11.2%) died within 90 days from admission. The neutrophil count in BAL fluid was significantly higher (median 22.0%, interquartile range [IQR] 2.0–46.0% vs. median 6.0%, IQR 2.0–18.0%, P = 0.044), while the lymphocyte count was significantly lower (median 24.0%, IQR 7.0–37.0% vs. median 41.0%, IQR 22.5–60.5%, P = 0.001) in the non-survivor group compared with that in the survivor group. In the multivariate analysis, the C-reactive protein level (odds ratio [OR] 1.093, 95% confidence interval [CI] 1.020–1.170, P = 0.011) and a BAL fluid lymphocyte count of ≤ 30% (OR 3.353, 95% CI 1.101–10.216, P = 0.033) were independently associated with mortality after adjusting for albumin and lactate dehydrogenase levels.

Conclusion

A low lymphocyte count in BAL fluid may be a predictor of mortality in non-HIV patients with PJP.
Sutureless socket technique after removal of third molars: a multicentric, open, randomized controlled trial
Authors: Takadoum Sarah , Douilly Grégory , de Boutray Marie , Kabani Sarah , Maladière Eric , Demattei Christophe , Lapeyrie Philippe
Published: June 2022

Background

Although wisdom-tooth extraction is a routine intervention, the postoperative period remains marked by local inflammation classically manifesting as pain, edema and trismus. Furthermore, there is no consensus on the best operative techniques, particularly for the mucosal closure stage on impacted mandibular wisdom teeth.

Methods

This parallel, randomized, non-blinded study compared pain following removal of impacted third molars, with and without sutures. Patients were electronically allocated 1:1 to extraction with versus without sutures. Patients ≥ 14 years’ old scheduled for extraction of four impacted wisdom teeth under general anesthesia at three French hospitals were eligible for inclusion. Exclusion criteria included taking antiplatelet agents or anticoagulants, coagulation disorders or immunosuppression, and planned orofacial surgical procedures or emergency pain/infection. The primary objective was pain evaluated by Visual Analogue Scale on Day 3. Secondary outcomes were edema, trismus, healing, complications, painkiller consumption and quality of life on Day 3 and 31.

Results

Between June 2016 and November 2018, 100 patients were randomized. Finally, 44 patients in the Suture group and 50 patients in the Without Suture group were analyzed. Mean age was 16.5 years and 66.6% of patients were female. After adjustment on center, age and smoking, no statistical difference was seen between groups for pain on Day 3 (p = 0.904). No differences were seen for swelling, trismus, consumption of painkillers, healing, complications or quality of life. Smokers had a 3.65 times higher complications rate (p = 0.0244).

Conclusions

Sutureless removal of third molars is thus a reliable technique without negative consequence on outcomes, and allows shorter operating time. Smoking is a risk factor for postoperative complications.

Trial registration www.clinicaltrials.gov (NCT02583997), registered 22/10/2015
Surface roughness and oxygen inhibited layer control in bulk-fill and conventional nanohybrid resin composites with and without polishing: in vitro study
Authors: Gaviria-Martinez Andrea , Castro-Ramirez Leonor , Ladera-Castañeda Marysela , Cervantes-Ganoza Luis , Cachay-Criado Hernán , Alvino-Vales María , Garcia-Luna Goretty , López-Gurreonero Carlos , Cornejo-Pinto Alberto , Cayo-Rojas César F.
Published: June 2022

Background

It has been demonstrated that dental restorations with rough surfaces can have several disadvantages such as pigment retention or plaque accumulation, which can facilitate caries formation, color variation, loss of brightness, degradation of restoration, among others. The present study aimed to assess surface roughness in bulk fill and conventional nanohybrid resins with and without polishing, controlling the oxygen inhibited layer.

Methods

This in vitro and longitudinal experimental study consisted of 120 resin blocks of 6 mm diameter and 4 mm depth, divided into two groups: Bulk Fill (Tetric® N-Ceram Bulk-fill, Opus Bulk Fill APS, Filtek™ Bulk Fill) and conventional nanohybrid (Tetric® N-Ceram, Opallis EA2, Filtek™ Z250 XT). Each resin group was divided into two equal parts, placing glycerin only on one of them, in order to control the oxygen inhibited layer. Subsequently, the surface roughness was measured before and after the polishing procedure with Sof-Lex discs. The data were analyzed with the T-test for related measures, and for comparison between groups before and after polishing, the non-parametric Kruskal Wallis test with the Bonferroni post hoc was used, considering a significance level of p < 0.05.

Results

Before polishing, the resin composites with the lowest surface roughness were Opus Bulk Fill APS (0.383 ± 0.186 µm) and Opallis EA2 (0.430 ± 0. 177 µm) with and without oxygen inhibited layer control, respectively; while after polishing, those with the lowest surface roughness were Opus Bulk Fill APS (0.213 ± 0.214 µm) and Tetric N-Ceram (0.097 ± 0.099 µm), with and without oxygen inhibited layer control, respectively. Furthermore, before and after polishing, all resins significantly decreased their surface roughness (p < 0.05) except Opus Bulk Fill APS resin with oxygen inhibited layer control (p = 0.125). However, when comparing this decrease among all groups, no significant differences were observed (p < 0.05).

Conclusion

The Opus Bulk Fill APS resin with oxygen inhibited layer control presented lower surface roughness both before and after polishing, being these values similar at both times. However, after polishing the other bulk fill and conventional nanohybrid resins with and without oxygen inhibited layer control, the surface roughness decreased significantly in all groups, being this decrease similar in all of them.
Evaluation of the effectiveness of the standard traditional Korean medicine-based health promotion program for disadvantaged children in South Korea
Authors: Hyun Eunhye , Ryu Jiseon , Kim Kibong , Lee Sangjae , Kim Seungtae , Lim Byungmook
Published: June 2022

Background

Traditional Korean Medicine (TKM) is highly integrated with the modern health care system of South Korea and is actively used in the public health field. Since 2014, the Ministry of Health and Welfare of South Korea has supported the development of standard models for TKM-based health promotion programs. This study aimed to develop and evaluate a standard TKM-based health promotion program for disadvantaged children.

Methods

Using convenience sampling, we recruited 16 Community Children’s Centers (CCCs) located in Busan and Yangsan, South Korea, which are welfare daytime facilities for children from socially disadvantaged families. The CCCs were divided into two groups of eight CCCs—intervention CCCs and control CCCs—through random allocation, and children in each group were selected as subjects for the study. For 12 weeks, the TKM-based health promotion program developed in this study along with the basic services of CCCs were applied to children in the intervention group, and only the basic services of CCCs were provided to children in the control group. Data were obtained through pre- and post-surveys with the legal representatives of the children prior to implementing the program and after the 12-week program, respectively. The outcome variables—the number of outpatient visits, absences, lateness/early leaves, infectious symptoms, and EuroQol-5D and EQ-visual analog scale scores–were measured and statistically compared between the groups by descriptive analysis, chi-square test, t-test, and difference-in-differences model with regression analysis.

Results

At baseline, there were 156 children in the intervention group and 153 children in the control group, among which 155 and 147 children, respectively, were included in the analysis. Results indicated that the number of outpatient visits was significantly lower (by 65%) in the intervention group than in the control group (p = 0.03), and this was similar in the sensitivity analysis. Regarding other outcome variables, the effects were not consistently significant.

Conclusions

A standard TKM-based health promotion program has the potential to improve the health of disadvantaged children. In the future, studies with long-term interventions and a larger sample are needed to enhance the applicability of these programs in communities.
A telemonitoring system to support CPAP therapy in patients with obstructive sleep apnea: a participatory approach in analysis, design, and evaluation
Authors: Aalaei Shokoufeh , Amini Mahnaz , Mazaheri Habibi Mohammad Reza , Shahraki Hadi , Eslami Saeid
Published: June 2022

Background

Continues positive airway pressure (CPAP) therapy is a gold standard treatment for moderate to severe cases of OSA (obstructive sleep apnea). The present research aimed to describe the analysis, design, and evaluation of a telemonitoring system to improve CPAP adherence in patients afflicted with OSA.

Methods

The telemonitoring system was developed in five phases. In the exploratory phase, the body of related literature was reviewed. Then a need analysis was conducted through a focus group discussion with sleep medicine specialists and sales company representatives and an interview with patients. The third phase involved data integration. Then the content and system development were done based on the previous phases. Finally, usability and functionality tests were used to evaluate the system.

Results

The exploratory phase and the needs analysis were conducted by four sleep medicine specialists, two medical informatics specialists, six key figures of the sales companies, two system developers, and 46 patients in different phases. Based on the results obtained from the data integration phase, the telemonitoring system involved three main parts: a patient’s application, a doctor’s portal, a selling companies’ portal (operator’s portal) along with facilitating software for patients to send the CPAP data. Usability and functionality tests were given to 7 and 10 patients, respectively. The total number of usability issues reported by users in the evaluation process was 18, with an average of 2.5 issues per user. The installation problems, disrupted links and improper playing of videos were the main functionalities problems that were solved.

Conclusion

The telemonitoring system, as a means of communication between patients, doctors, and selling companies, can be used to support patients clinically and technically. It has the potential to improve CPAP adherence in patients with OSA.
Use of high flow nasal cannula in patients with acute respiratory failure in general wards under intensivists supervision: a single center observational study
Authors: Colombo Sebastiano Maria , Scaravilli Vittorio , Cortegiani Andrea , Corcione Nadia , Guzzardella Amedeo , Baldini Luca , Cassinotti Elisa , Canetta Ciro , Carugo Stefano , Hu Cinzia , Fracanzani Anna Ludovica , Furlan Ludovico , Paleari Maria Chiara , Galazzi Alessandro , Tagliabue Paola , Peyvandi Flora , Blasi Francesco , Grasselli Giacomo
Published: June 2022

Background

Few data exist on high flow nasal cannula (HFNC) use in patients with acute respiratory failure (ARF) admitted to general wards.

Rationale and objectives

To retrospectively evaluate feasibility and safety of HFNC in general wards under the intensivist-supervision and after specific training.

Methods

Patients with ARF (dyspnea, respiratory rate-RR > 25/min, 150 < PaO2/FiO2 < 300 mmHg during oxygen therapy) admitted to nine wards of an academic hospital were included. Gas-exchange, RR, and comfort were assessed before HFNC and after 2 and 24 h of application.

Results

150 patients (81 male, age 74 [60–80] years, SOFA 4 [2–4]), 123 with de-novo ARF underwent HFNC with flow 60 L/min [50–60], FiO2 50% [36–50] and temperature 34 °C [31–37]. HFNC was applied a total of 1399 days, with a median duration of 7 [3–11] days. No major adverse events or deaths were reported. HFNC did not affect gas exchange but reduced RR (25–22/min at 2–24 h, p < 0.001), and improved Dyspnea Borg Scale (3–1, p < 0.001) and comfort (3–4, p < 0.001) after 24 h. HFNC failed in 20 patients (19.2%): 3 (2.9%) for intolerance, 14 (13.4%) escalated to NIV/CPAP in the ward, 3 (2.9%) transferred to ICU. Among these, one continued HFNC, while the other 2 were intubated and they both died. Predictors of HFNC failure were higher Charlson’s Comorbidity Index (OR 1.29 [1.07–1.55]; p = 0.004), higher APACHE II Score (OR 1.59 [1.09–4.17]; p = 0.003), and cardiac failure as cause of ARF (OR 5.26 [1.36–20.46]; p = 0.02).

Conclusion

In patients with mild-moderate ARF admitted to general wards, the use of HFNC after an initial training and daily supervision by intensivists was feasible and seemed safe. HFNC was effective in improving comfort, dyspnea, and respiratory rate without effects on gas exchanges.

Trial registration This is a single-centre, noninterventional, retrospective analysis of clinical data.
Population genetic structure and evolutionary genetics of Anopheles sinensis based on knockdown resistance (kdr) mutations and mtDNA-COII gene in China–Laos, Thailand–Laos, and Cambodia–Laos borders
Authors: Zhang Yilong , Zhang Canglin , Wu Linbo , Luo Chunhai , Guo Xiaofang , Yang Rui , Zhang Yilong
Published: June 2022

Background

Vector control is still a pivotal method for preventing malaria, and its potency is weakened by the increasing resistance of vectors to chemical insecticides. As the most abundant and vital malaria vector in Southeast Asia, the chemical insecticide resistance status in Anopheles sinensis remains elusive in Laos, which makes it imperative to evaluate the true nature of chemical insecticide resistance-associated genetic mutations in An. sinensis in Laos.

Methods

Adult An. sinensis were collected from three border regions in Laos. DNA was extracted from individual mosquitoes. PCR amplification and DNA sequencing of a fragment containing codon 1014 of the voltage-gated sodium channel (vgsc) gene were completed to study the kdr allele frequency distribution, kdr intron polymorphism, population genetic diversity, and the evolutionary status of the kdr codon. The mitochondrial cytochrome c oxidase subunit II gene (COII) was amplified and sequenced to examine population variations, genetic differentiation, spatial population structure, population expansion, and gene flow patterns.

Results

Nine wild kdr haplotypes of the vgsc gene were detected in this study, and eight of them, namely 1014L1, 1014L2, 1014L4, 1014L7, 1014L9, 1014L10, 1014L11, and 1014L21, were discovered in the China–Laos border (northern Laos), while 1014L3 was only detected in the Thailand–Laos border (northwestern Laos) and Cambodia–Laos border (southern Laos). The newly identified haplotype, 1014L21, was uniquely distributed in the China–Laos border and was not identified in other countries. Based on sequence analysis of the mitochondrial COII genes, significant genetic differentiation and limited gene flow were detected between the China–Laos and Cambodia–Laos An. sinensis populations, which suggested that those two regions were genetically isolated. The distinct distribution of the kdr haplotype frequencies is probably the result of geographical isolation in mosquito populations.

Conclusions

Lack of kdr mutations in the vgsc gene was probably due to genetic isolation and the absence of intense selection pressure in the three border regions of Laos. This study reveals that pyrethroid-based chemical insecticides are still appropriate for battling An. sinensis in parts of Laos, and routine monitoring of chemical insecticide resistance should be continuously implemented and focused on more restricted areas as part of chemical insecticide resistance management.

Graphical Abstract
Prevalence, incidence, and risk factors associated with cytomegalovirus infection in healthcare and childcare worker: a systematic review and meta-analysis
Authors: Balegamire Safari Joseph , McClymont Elisabeth , Croteau Agathe , Dodin Philippe , Gantt Soren , Besharati Amir Abbas , Renaud Christian , Mâsse Benoît , Boucoiran Isabelle
Published: June 2022

Background

Cytomegalovirus (CMV) is transmitted by direct contact with body fluids from infected individuals. Transmission of CMV in households, particularly those with young children, contributes significantly to CMV infection in the general population. However, little is known about the contribution of occupational healthcare or childcare exposure to risk of CMV infection.

Objectives

To determine CMV seroprevalence, incidence of primary infection, and associated risk factors in healthcare and childcare workers.

Methods

Six electronic databases were searched systematically for publications on CMV infection in healthcare and childcare workers until March 7, 2022. Two authors independently evaluated the literature for quality and inclusion in our analyses. The pooled results for seroprevalence, incidence, and relative risk (RR) were determined using a random effects model. Heterogeneity among studies was quantified and further investigated in subgroup analysis and meta-regression. Publication bias was assessed using funnel plot. Statistical analyses were preformed using R version 4.05.

Results

Forty-eight articles were included in this meta-analysis (quality assessment: 18 good, 14 fair, and 16 poor). Pooled CMV seroprevalence was 59.3% (95% CI: 49.8–68.6) among childcare workers and 49.5% (95% CI: 40.3–58.7) among healthcare workers, and pooled incidences of primary CMV infection per 100 person-years were respectively 7.4 (95% CI: 3.9–11.8) and 3.1 (95% CI: 1.3–5.6). RR for primary infection compared to controls were 3.4 (95% CI: 1.3–8.8) and 1.3 (95% CI: 0.6–2.7) for healthcare and childcare workers, respectively. The odds of CMV seropositivity were 1.6 (95% CI: 1.2–2.3) times higher for childcare workers compared to controls, but not significantly different between healthcare workers and controls (0.9; 95% CI: 0.6–1.2). CMV seropositivity in both groups was significantly associated with having one or more children residing at home, marital status, ethnicity, and age.

Conclusions

Childcare workers, but not healthcare workers, have an increased risk of prevalent and incident CMV infection, a risk that is further increased with the presence of at least one child living at home. These findings suggest that enforcing simple, conventional hygienic measures in childcare settings could help reduce transmission of CMV, and that special precautionary measures for preventing CMV infection may not be required for pregnant healthcare workers.

Systematic review registration

PROSPERO CRD42020139756
On a class of generalized saddle-point problems arising from contact mechanics
Authors: Matei Andaluzia
Published: June 2022

In the present paper we consider a class of generalized saddle-point problems described by means of the following variational system: $$\begin{aligned} &a(u,v-u)+b(v-u,\lambda )+j(v)-j(u)+J(u,v)-J(u,u)\geq (f,v-u)_{X}, \\ &b(u,\mu -\lambda )-\psi (\mu )+\psi (\lambda )\leq 0, \end{aligned}$$

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Post-fire Bond Behaviors Between Grout and Steel Rebar
Authors: Liu Liang-Lin , Luo Chun-Yong , Ouyang Lu-Xia , Xia Zhen-Hua , Li Wei-Hua
Published: June 2022

Firstly, according to the theoretical analysis, the force mechanism and failure modes were assured for the bond behavior between grout and steel rebar. Then, a pull-out experiment was exerted to probe the bond behavior developments of specimens after exposed to 500 °C. It is found that the mixed measures of pre-drying and slow elevating rate, i.e., 5 °C/min, inhibits the explosive spalling in grout with compressive strength of 76.7 MPa. In addition, there are two failure modes including the steel rebar fracture and the bond slip failure in the test. Based on the elevated temperature, compressive strength of post-fire grout, diameter of steel rebar and its embedment length, a new expression has been built to calculate the bond strength between grout and steel rebar of post-fire specimens. Furthermore, the finite element simulation is employed to investigate the bond behaviors of pull-out specimens after exposed to elevated temperatures up to 500 °C. The steel rebar fracture is captured firstly in the pull-out test simulation. Moreover, it is found that the peak slips increase and peak loads decrease along with the temperature elevating. Finally, it is proposed that the crucial elevated temperatures of the failure mode change should be 300, 300 and 400 °C for the specimens with embedment lengths of 6, 7 and 8 times diameter of steel rebar with diameter of 16 mm, respectively, which is beneficial for evaluating the fire safety of the existing structure elements.
A systematic review of interventions aiming to improve newly-qualified doctors’ wellbeing in the United Kingdom
Authors: Krishnan Aditya , Odejimi Opeyemi , Bertram Ian , Chukowry Priyamvada Sneha , Tadros George
Published: June 2022

Background

Newly-qualified doctors in the United Kingdom experience a great deal of stress and have poor wellbeing when compared to more senior counterparts. A number of interventions have been put in place to boost healthcare professionals’ wellbeing, but little is known about interventions aimed to improve the wellbeing of newly-qualified doctors in the United Kingdom. This study aims to systematically review current evidence of interventions which improved the wellbeing of newly-qualified junior doctors in the United Kingdom.

Methods

Five key electronic databases were searched. Subsequently, reference scanning and citation search was performed. Studies were included if they were conducted from the commencement of the Foundation Programme in 2004, until 2019. In addition, studies had to be performed on junior doctors: working in the United Kingdom and within their first five years post-qualification and have a quantitative outcome. Studies which did not meet these criteria were excluded. Quality was assessed using the modified Newcastle-Ottawa scale. Bias was not formally assessed using a standardised tool.

Results

Seven papers met the inclusion criteria and identified three main types of interventions: mentorship, mindfulness and clinical preparation interventions. The majority of included studies reported a positive result from the performed intervention, suggesting these to be beneficial in improving junior doctor wellbeing, and thereby reducing anxiety and stress levels. However, most of the studies used small sample sizes.

Conclusions

This review reveals that there is dearth of evidence on the effectiveness of intervention to improve the wellbeing of newly-qualified doctors in the United Kingdom. Most of the identified interventions focused on relieving stress and anxiety inherent within newly-qualified doctors’ training programmes. However, wellbeing interventions need to take into cognisance all the factors which impact on wellbeing, particularly job-related factors. We recommend that future researchers implement large-scale holistic interventions using appropriate research methods.

Systematic review registration: PROSPERO CRD42019127341.
Application of a Convolutional Neural Network for Multitask Learning to Simultaneously Predict Microvascular Invasion and Vessels that Encapsulate Tumor Clusters in Hepatocellular Carcinoma
Authors: Chu Tongjia , Zhao Chen , Zhang Jian , Duan Kehang , Li Mingyang , Zhang Tianqi , Lv Shengnan , Liu Huan , Wei Feng
Published: June 2022

Background

Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer death worldwide, and the prognosis remains dismal. In this study, two pivotal factors, microvascular invasion (MVI) and vessels encapsulating tumor clusters (VETC) were preoperatively predicted simultaneously to assess prognosis.

Methods

A total of 133 HCC patients who underwent surgical resection and preoperative gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) were included. The statuses of MVI and VETC were obtained from the pathological report and CD34 immunohistochemistry, respectively. A three-dimensional convolutional neural network (3D CNN) for single-task learning aimed at MVI prediction and for multitask learning aimed at simultaneous prediction of MVI and VETC was established by using multiphase Gd-EOB-DTPA-enhanced MRI.

Results

The 3D CNN for single-task learning achieved an area under receiver operating characteristics curve (AUC) of 0.896 (95% CI: 0.797–0.994). Multitask learning with simultaneous extraction of MVI and VETC features improved the performance of MVI prediction, with an AUC value of 0.917 (95% CI: 0.825–1.000), and achieved an AUC value of 0.860 (95% CI: 0.728–0.993) for the VETC prediction. The multitask learning framework could stratify high- and low-risk groups regarding overall survival (p< 0.0001) and recurrence-free survival (p< 0.0001), revealing that patients with MVI+/VETC+ were associated with poor prognosis.

Conclusions

A deep learning framework based on 3D CNN for multitask learning to predict MVI and VETC simultaneously could improve the performance of MVI prediction while assessing the VETC status. This combined prediction can stratify prognosis and enable individualized prognostication in HCC patients before curative resection.
Comparison of Redo percutaneous mitral valvuloplasty for mitral restenosis with first procedure for de novo mitral stenosis
Authors: Ramzan Muhammad , Kashif Javed Muhammad , Rizwan Hafiz Muhammad , ` Jahanzeb
Published: June 2022

Objectives: To evaluate and compare the effects of redo percutaneous mitral valvuloplasty with initial percutaneous mitral valvuloplasty (PMV) in mitral restenosis (MR) and de novo mitral stenosis (MS) patients, respectively.

Methods: A retrospective study was conducted at the cardiology department of Ch. Pervaiz Elahi Institute of Cardiology Multan for the period of one year from 6th July 2020 to 6th July 2021. A total of 50 patients were recruited in the study. Out of them, 20 de novo MS patients were placed in one group, while 30 patients with mitral restenosis, after successful initial percutaneous mitral valvuloplasty, were placed in another group. Ante grade trans-septal approach was adopted to perform percutaneous mitral valvuloplasty. The procedure was considered successful in achieving a 50% increase in the area of the mitral valve, without any major complication.

Results: Procedural success in first PMV patients was more (18 patients; 90.0%) than in redo PMV patients (26 patients; 86.6%) (Non-significant). The patients in both groups didn’t differ significantly in terms of MVA after the procedure, the increase of MVA, the average difference in blood pressure across the mitral valve, and the complications experienced after the complete procedure. However, the final mitral valve area was negatively correlated with the initial area in both groups.

Conclusion: Redo PMV for MR when performed after successful initial PMV is effective, has considerable rate of procedural success, which is achieved with a complication rate less as compared to initial PMV for de novo mitral stenosis.

doi: https://doi.org/10.12669/pjms.38.6.5447

How to cite this:Ramzan M, Javed MK, Rizwan HM, Jahanzeb. Comparison of Redo percutaneous mitral valvuloplasty for mitral restenosis with first procedure for de novo mitral stenosis. Pak J Med Sci. 2022;38(6):---------.  doi: https://doi.org/10.12669/pjms.38.6.5447

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinicopathological features and prognostic factors for uterine myoma
Authors: Wu Xiaoli , Zheng Yanqing
Published: June 2022

Objectives: To investigate the clinicopathological features of patients with uterine myoma and to analyze and summarize factors affecting patient prognosis.

Methods: This study retrospectively investigated records of uterine myoma patients treated at Huzhou Central Hospital between June 2018 and May 2020. A total of 149 patients were included in this study, including 121 patients with good prognosis and 28 patients with poor prognosis. Clinical and pathological characteristics, including age, average body mass index (BMI), menopausal status, average lesion diameter, presence of hypertension or diabetes mellitus, operation method, myoma type, location, and quantity, number of fibroids, and presence of pelvic adhesion were analyzed via multivariate analysis.

Results: Among the 149 patients with uterine uterine myoma, 92 had anterior wall uterine myoma, 36 had posterior wall uterine myoma, and 21 had uterine fundus uterine myoma. In terms of location, 94 cases were intramural and 55 cases were subserosal. Quantity-wise, 107 had 1-3 myomas while 42 had four or more. Moderate or more severe pelvic adhesions were present in 33 cases. Univariate analysis showed significant differences in age, operation method, myoma type, myoma location, myoma number, and pelvic adhesion severity between patients with good and poor prognosis. Multivariate analysis showed that age, surgical method, uterine myoma type, uterine myoma location, uterine myoma quantity, and pelvic adhesion severity were risk factors affecting the prognosis.

Conclusion: Many prognostic factors, including age, operation method, myoma type, myoma location, myoma number, and pelvic adhesion severity are linked to uterine myoma patient prognosis.

doi: https://doi.org/10.12669/pjms.38.6.5455

How to cite this:Wu X, Zheng Y. Clinicopathological features and prognostic factors for uterine myoma. Pak J Med Sci. 2022;38(6):---------.  doi: https://doi.org/10.12669/pjms.38.6.5455

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Analysis of the improvement of serological indexes in patients with diabetic nephropathy and hypertension using Valsartan combined with Nifedipine controlled-release regimen
Authors: Cai Lili , Zhu Hailli
Published: June 2022

Objective: To investigate the effect of valsartan combined with nifedipine controlled-release Tablets on diabetic nephropathy (DN) patients with hypertension.

Methods: The clinical records of 80 DN patients with hypertension registered in our hospital from April 2020 to April 2021 were collected. The records showed that 38 patients were treated with oral nifedipine controlled-release tablets (control group) and 42 - with oral valsartan combined with nifedipine controlled-release tablets (observation group). The improvement of serological indexes after treatment was compared and analyzed between the two groups.

Results: After treatment, the levels of fasting blood glucose (FBG), systolic and diastolic blood pressure, bone oligomeric matrix protein (COMP), thrombin regulatory protein (TM) and Microalbumin (mALB) in the observation group were lower than those in the control group (P<0.05), while the level of angiopoietin-1 (Ang-1) was higher than those in the control group (P<0.05). After the treatment, the levels of homocysteine (Hcy), Cystatin C (CysC) and transforming growth factor β1(TGF-β1) in the observation group were lower than those in the control group (P<0.05). The levels of adiponectin (APN), aldosterone (ALD) and gastric growth promoting factor (ghrelin) in the observation group after the treatment were lower than those in the control group (P<0.05).

Conclusions: A combination of valsartan and nifedipine controlled-release tablets in DN patients with hypertension can effectively control blood glucose and blood pressure, improve the serological indexes such as COMP, TM, mAlb, Ang-1, Hcy, CysC, TGF-β1, APN, ALD and ghrelin, and potentially reduce and delay renal function damage.

doi: https://doi.org/10.12669/pjms.38.6.5871

How to cite this:Cai L, Zhu H. Analysis of the improvement of serological indexes in patients with diabetic nephropathy and hypertension using Valsartan combined with Nifedipine controlled-release regimen. Pak J Med Sci. 2022;38(6):---------.  doi: https://doi.org/10.12669/pjms.38.6.5871

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Linear Programming with Relative Bounded Variables
Authors: Duguay Claude , Todd Michael , Wagner Harvey M.
Published: June 2022

Linear programming problems with simple upper and lower bounds on the variables have been well explored. Here we investigate the problems containing a system of relative lower bounds and/or relative upper bounds. We suggest computational procedures that exploit the special triangular structure of these constraints.
Minimax Policies for Selling a Nondivisible Asset
Authors: Bawa Vijay S.
Published: June 2022

In this paper we have obtained a simple expression for the minimax regret policy for selling an asset. The policy is very simple to implement. As opposed to most optimal stopping rules, it does not involve any iterative computation of the stopping boundary. Also in using this result, only the maximum possible increase and decrease in prices in each period have to be known, as opposed to the entire distribution function of price changes in each period.
Information Sharing on Retail Platforms
Authors: Liu Zekun , Zhang Dennis J. , Zhang Fuqiang
Published: June 2022

Problem definition : This paper studies the information-sharing strategy for a retail platform on which multiple competing sellers distribute their products. Academic/practical relevance : Because of the rapid growth of retail platforms in recent years, information sharing has become an increasingly important issue because retail platforms can gather an enormous amount of consumer information that may not be visible to the sellers. Understanding how to share such information with those sellers will provide useful implications from both the theoretical and practical perspectives. Methodology : We develop a game-theoretic model where multiple sellers engage in Cournot competition on a retail platform by selling substitutable products, and the platform charges a commission fee for each transaction. The platform owns superior demand information and can control the accuracy level when sharing the information with the sellers. Results : We find that the platform has incentives to share the information, and such sharing is beneficial both to the platform and to all sellers. Under the asymmetric information-sharing format, the optimal strategy for the platform is to select a subgroup of sellers and truthfully share information with them. Under the symmetric sharing format, the platform must use the same accuracy level and the same set of information for all sellers, and thus has incentives to reduce the accuracy of the shared information. Moreover, we identify a simple pricing mechanism that can achieve the optimal information-sharing outcome. Managerial implications : This research highlights the importance of considering the impact of information sharing for a retail platform with competing sellers. It also proposes a simple, single-price mechanism to implement the optimal sharing strategy. These results could provide useful guidelines for platform managers to better design their information-sharing services.
The Latest News for May 2022 All You Need to Know on Monkeypox
Authors: Makkar Dheeraj
Published: June 2022

Monkeypox virus was named so because of its detection in monkeys in 1958. It belongs to the same family as smallpox and chickenpox viruses. There had been numerous outbreaks of this malady initially in the African continent and other parts of the world. The simultaneous spread in nineteen countries in 2022 has raised some serious concerns.

Monkeypox is no more a rare disease and has the potential for bioweapon use. We discuss the various ways to prevent its spread, treatment options available, diagnosis, and differentiation from other closely related diseases. We also discuss if the present outbreak could be a bioattack or if this disease is here to stay.

The literature suggests that we can effectively manage Monkeypox because of the availability of drugs and vaccination against smallpox. There is also a need for active surveillance against the new resistant recombinant viral strains. The possibility of this outbreak being a bioattack seems remote, although there are questions about the transmission which still need to be answered.
Why franchising is a smart business model: a comprehensive review
Authors: E. Soliman Mohamed
Published: June 2022

Entrepreneurship is the act of starting and running your own business or the creative desire to work on your own projects. The notion of entrepreneurship has evolved significantly over the last few decades, and it cannot be disregarded today. Many businesses have emerged, and the most successful are those that rely on a sound business model. The franchising business model is one solid business model that has proven its effectiveness in recent years. Franchising is a type of marketing and distribution in which the owner of a business system (the franchisor) provides the right to run a business by selling a product or delivering a service using the franchisor's brand and business system to an individual or group of people (the franchisee). This concept is well-known in the fast-food business (which has several famous franchisors such as McDonald's and KFC). This paper provides an overview of franchising: what it is, how it evolved, and what the pros and cons of franchising are for both the franchisor and the franchisee.