bluuebunny/crossref_metadata_2025 huggingface dataset:
A rapidly evolving landscape: immune checkpoint inhibitors in pretreated metastatic endometrial cancer
Authors: Tinker Anna V. , Dhani Neesha C. , Ghatage Prafull , McLeod Deanna , Samouëlian Vanessa , Welch Stephen A. , Altman Alon D.
Published: March 2023

Background and objectives:

Endometrial cancer is a common malignancy and recurrences can be fatal. Although platinum-pretreated endometrial tumors are commonly treated with anthracyclines and taxanes, there is no current standard of care. Both immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) have been extensively assessed in this setting, including tumors selected for DNA mismatch repair (MMR)/microsatellite instability (MSI) and programmed death-ligand 1 expression status. This review will provide evidence-based guidance on use of ICIs alone or in combination with TKIs in patients with pretreated advanced, persistent, or recurrent metastatic endometrial cancer.

Data sources and methods:

Randomized phase II–III trials in unselected populations pretreated, recurrent, or metastatic endometrial cancer and phase I–II trials in biomarker selected populations were identified from PubMed as well as conference proceedings using the key search terms ‘immune checkpoint inhibitors’, ‘endometrial cancer’, and ‘advanced’.

Results:

A total of nine eligible studies were identified assessing ICI monotherapy for biomarker-selected or ICI plus TKI combinations and a dual ICI regimen for biomarker-unselected patients with pretreated recurrent or metastatic endometrial cancer. In MMR/MSI-selected tumors, five phase I/II studies evaluated ICI monotherapy indicating benefit in these patients. Only the phase III KEYNOTE-775 trial reported a statistically significant overall survival improvement for the combination of pembrolizumab plus lenvatinib compared with docetaxel or paclitaxel regardless of MMR/MSI status.

Conclusions:

Pembrolizumab plus lenvatinib is indicated for patients with unselected pretreated metastatic endometrial cancer and pembrolizumab monotherapy is a preferred option for patients with MMRd/MSI-H tumors.
Efficacy of immunotherapy in oncogene-driven non-small-cell lung cancer
Authors: Vokes Natalie I. , Pan Kelsey , Le Xiuning
Published: March 2023

For advanced metastatic non-small-lung cancer, the landscape of actionable driver alterations is rapidly growing, with nine targetable oncogenes and seven approvals within the last 5 years. This accelerated drug development has expanded the reach of targeted therapies, and it may soon be that a majority of patients with lung adenocarcinoma will be eligible for a targeted therapy during their treatment course. With these emerging therapeutic options, it is important to understand the existing data on immune checkpoint inhibitors (ICIs), along with their efficacy and safety for each oncogene-driven lung cancer, to best guide the selection and sequencing of various therapeutic options. This article reviews the clinical data on ICIs for each of the driver oncogene defined lung cancer subtypes, including efficacy, both for ICI as monotherapy or in combination with chemotherapy or radiation; toxicities from ICI/targeted therapy in combination or in sequence; and potential strategies to enhance ICI efficacy in oncogene-driven non-small-cell lung cancers.
Repairing a critical cranial defect using WISP1-pretreated chondrocyte scaffolds
Authors: Carmon Idan , Kalmus Shira , Zobrab Anna , Alterman Michael , Emram Raphaelle , Gussarsky May , Kandel Leonid , Reich Eli , Casap Nardi , Dvir-Ginzberg Mona
Published: March 2023

In cranial flat bone fractures, spontaneous bone repair will occur only when the fracture ends are in close contact. However, in cases wherein bone discontinuity is extensive, surgical interventions are often required. To this end, autologous bone is harvested and surgically integrated into the site of fracture. Here we propose to use cartilage, as an alternative autologous source, to promote cranial fracture repair. The advantage of this approach is the potential reduction in donor site morbidity, likely due to the avascular and aneural nature of cartilage. As a first step we attempted to induce cartilage mineralization in vitro, using micromass primary chondrocyte cultures, incubated with BMP2 and/or WISP1, which were examined histologically following a 3-week culture period. Next, chondrocyte seeded collagen scaffolds were evaluated in vitro for expression profiles and ALP activity. Finally, chondrocyte-seeded collagen scaffolds were implanted in a Lewis rats 8 mm critical calvaria defect model, which was imaged via live CT for 12 weeks until sacrifice. End points were analyzed for microCT, histology, and serum levels of bone related markers. Micromass cultures exhibited an osseous inducing trend following WISP1 administration, which was maintained in chondrocyte seeded scaffolds. Accordingly, in vivo analysis was carried out to assess the impact of WISP1-pretreated chondrocytes (WCS) versus untreated chondrocytes (UCS) in calvaria defect model and compared to untreated control comprised of a defect-associated blood clot (BC) or empty collagen scaffold (CS) implant. Live CT and microCT exhibited higher mineralization volumes in critical defect implanted with UCS, with some structural improvements in WCS. Histological analysis exhibited higher anabolic bone formation in WCS and trabecular bone was detected in WCS and UCS groups. Chondrocytes implanted into critical cranial defect expedite the formation of native-like osseous tissue, especially after WISP1 priming in culture. Ultimately, these data support the use of autologous chondrocytes to repair critical maxillofacial defects.
Experiences of a project-based blended learning approach in a community of inquiry from information and communication technology engineering students at Lapland university of applied sciences in Finland
Authors: Mielikäinen Maisa , Viippola Essi , Tepsa Tauno
Published: March 2023

The increase in remote work in the Information and Communication Technology (ICT) industry has introduced the need for research into team collaboration platforms and education using a project-based blended learning approach. This study investigates the perceptions of ICT engineering students ( N = 56) at Lapland University of Applied Sciences in Finland regarding the social, cognitive, and teaching presences in a blended setting using the Community of Inquiry (CoI) framework. The CoI questionnaire data were analyzed using the Rasch Rating Scale Model, and team collaboration and development platform logs were used to explore platform usage. The results suggest that the students’ overall perception of blended learning was highly positive. Questions associated with discussing through the online medium were relatively harder for the students to agree with, although the online medium was perceived as excellent for social interaction by the students. The results may help institutions develop an understanding of the factors that may improve the quality of blended learning experiences in project-based digital ecosystems.
Automatic entry and coding of social networks and dyadic peer ratings
Authors: Ross Cody T , Redhead Daniel
Published: March 2023

In small-scale communities, social-scientists can use photo-rosters to collect social network and dyadic peer-ratings data. In past work, we introduced an R package to automate photo-standardization, survey construction, and data-entry. This R package, however, lacked two key features required for fully-unsupervised data-entry. First, respondent IDs needed to be manually linked to cellphone photographs of the photo-roster before DieTryin could process the data; second, users needed to identify the locations of the photo-roster in each cellphone photograph using a point-and-click interface. To address the first shortcoming, we introduce a new Android application, DieTryinCam, which facilitates annotation of cell-phone photographs with respondent, question, and panel IDs. To address the second shortcoming, we add new functionality to the DieTryin R package, which allows for the precise location of the photograph roster to be automatically identified. Automated data entry in DieTryin now requires no user input beyond a single function call from R.
Sexually Transmitted Infections and Health Literacy: A Community-Based Preventive Program
Authors: Sul Susana , Ferreira Liliana , Maia Ana Catarina , Coelho Anabela , Costa Andreia
Published: March 2023

Background:

Sexually transmitted infections (STIs) are a public health problem with a high risk of morbidity and community transmissibility. Evidence points to their continuous increase. This study describes the design, development, and implementation of a community-based STI prevention program for community healthcare users.

Methods:

Based on the Health Planning Process design method, a structured, community-based intervention program on STI counseling and detection was conducted in a primary health care unit in Lisbon. Two data collection instruments were applied in the diagnosis of the situation, namely the Health Literacy Survey Portugal (ILS-PT) and the STD Attitude Scale, to 47 patients who attended the health consultation on STI counseling and detection in a primary care unit in Lisbon. Two interventions were implemented, the health education session and the provision of an educational poster. In the evaluation of the project, the acceptance and satisfaction of the patients with the implemented interventions were considered as outcome indicators. A descriptive statistical analysis of the data was performed.

Results:

The participants shows considerably low levels of health literacy and high-risk behaviors for acquiring STIs. After an intervention, a high percentage of the participants point out the project as exciting and valuable and reveal having acquired knowledge that allowed them to improve their health. Furthermore, the patients were very satisfied with the implemented health education session and the educational poster.

Conclusion:

This project revealed the urgent and important need to implement community intervention projects to prevent STIs and promote health literacy among the most vulnerable groups.
Impact of Personality Traits on Knowledge Sharing Behavior of Academicians: A Case of University of Sargodha, Punjab, Pakistan
Authors: Shaukat Rozeen , Ahmad Shakil , Naveed Muhammad Asif , Ur Rehman Shafiq
Published: March 2023

This study examined the impact of personality traits on the knowledge sharing behavior of academicians in the public sector. The data were collected from 237 respondents using a questionnaire. The results showed that the personality trait openness to experience had a significant and positive impact on the knowledge sharing behavior and its sub-dimensions such as written contributions, organizational communication, personal interactions, and communities of practice. Furthermore, the personality traits extraversion and agreeableness positively predicted the knowledge sharing behavior for the dimensions of communities of practice and organizational communication, respectively. The results of this study would be helpful for the administrative staff of universities to develop programs to promote a knowledge sharing culture in universities and improve collaborative learning, research, organizational effectiveness, and performance. It would also be a worthy contribution to the existing literature as only a limited number of studies have addressed the role of personality traits in the knowledge sharing behaviors in the academic environment of a non-western country.
War and Peace, Freeze and Thaw: Regional Narratives of North Korea and the 2018 Winter Olympics
Authors: English Peter , Murray Richard
Published: March 2023

The marching of North and South Korea under one flag at the opening ceremony of the 2018 Winter Olympics opening ceremony was celebrated as a step towards greater harmony in the region. North Korea’s attendance and widespread goodwill during the “Peace Games” even led to talk of a joint Korea bid for the 2032 Summer Olympics. While the 2018 Games were successful in bringing the nations together, the opportunities for long-lasting peace – and a memorable Games legacy – were not achieved. Utilising thematic analysis across 551 articles from four online news publications from North Korea, South Korea, China and Japan, this study examines regional narratives of North Korea’s participation in PyeongChang 2018. The results highlight portrayals in the media towards North Korea and the broader key themes of war, conflict, peace and reconciliation. Overall, it is evident that the hope generated by the nation’s participation in 2018 was a false dawn for long-term aspirations of unification, and reflective of the freeze and thaw approach to engagement by North Korea with its neighbour.
Can a Novel Natural Language Processing Model and Artificial Intelligence Automatically Generate Billing Codes From Spine Surgical Operative Notes?
Authors: Zaidat Bashar , Tang Justin , Arvind Varun , Geng Eric A. , Cho Brian , Duey Akiro H. , Dominy Calista , Riew Kiehyun D. , Cho Samuel K. , Kim Jun S.
Published: March 2023

Study Design

Retrospective cohort.

Objective

Billing and coding-related administrative tasks are a major source of healthcare expenditure in the United States. We aim to show that a second-iteration Natural Language Processing (NLP) machine learning algorithm, XLNet, can automate the generation of CPT codes from operative notes in ACDF, PCDF, and CDA procedures.

Methods

We collected 922 operative notes from patients who underwent ACDF, PCDF, or CDA from 2015 to 2020 and included CPT codes generated by the billing code department. We trained XLNet, a generalized autoregressive pretraining method, on this dataset and tested its performance by calculating AUROC and AUPRC.

Results

The performance of the model approached human accuracy. Trial 1 (ACDF) achieved an AUROC of .82 (range: .48-.93), an AUPRC of .81 (range: .45-.97), and class-by-class accuracy of 77% (range: 34%-91%); trial 2 (PCDF) achieved an AUROC of .83 (.44-.94), an AUPRC of .70 (.45-.96), and class-by-class accuracy of 71% (42%-93%); trial 3 (ACDF and CDA) achieved an AUROC of .95 (.68-.99), an AUPRC of .91 (.56-.98), and class-by-class accuracy of 87% (63%-99%); trial 4 (ACDF, PCDF, CDA) achieved an AUROC of .95 (.76-.99), an AUPRC of .84 (.49-.99), and class-by-class accuracy of 88% (70%-99%).

Conclusions

We show that the XLNet model can be successfully applied to orthopedic surgeon’s operative notes to generate CPT billing codes. As NLP models as a whole continue to improve, billing can be greatly augmented with artificial intelligence assisted generation of CPT billing codes which will help minimize error and promote standardization in the process.
Correlation of C-Peptide With Complications Observed in Children and Adolescents With Type 1 Diabetes in Tanzania: A Cross-Sectional Survey
Authors: Majaliwa Edna Siima , Muze Kandi Catherine , Ndayongeje Joel , Mfinanga Sayoki Geofrey , Mmbaga Blandina Theophil , Ramaiya Kaushik
Published: March 2023

Type 1 diabetes mellitus (T1DM) complications corelate with C-peptide levels. However, the C-Peptide role has not been explored in resource limited countries. This study explored the relationship between C-peptide and complications. A cross-sectional study involving participants aged 0 to 25 years with T1DM in Dar es salaam Tanzania, between 2021 and 2022 was done. Diabetes nephropathy and retinopathy were assessed. About 281 (92.4%) participants were screened, 144 (51.2%) were females. Mean age was 19 ± 6 years. Majority 175 (62.3%) had poor glycemic control (HbA1c) > 10%, and low C-Peptide level 201 (71.5%). Retinopathy was 11.7% and risk for nephropathy was 41.3%. About 13.4% and 41.8% with low C peptide had Retinopathy and high-risk nephropathy respectively. Age at diagnosis, poor glycemic control, low c peptide and duration of diabetes were associated with complications. Further prospective studies are needed to capture when complications set in, so to have better strategies to prevent complications.
Turnout in Serbian parliamentary elections during the two decades after the end of Milošević’s rule
Authors: Lazić Uroš A
Published: March 2023

Methodological uniformity and the relatively small number of studies concerning election turnout in Serbia strikingly detract from the social importance of the topic. The goal was to reduce this disparity by studying turnout in the 21st century under a statistically atypical approach that uses objective, publicly available data at the municipalities/cities level. Beginning in 2012, the trend of a worrying, almost linear decrease in turnout was found. Canonical correlation analysis showed that socio-demographic-economic variables are highly predictive of voter turnout. Six pairs of statistically significant canonical factors were isolated from the space of socio-demographic-economic characteristics and corresponding variables of electoral participation. It was indirectly established that the analytically extracted types of environments whose inhabitants exhibit specific electoral-participative behavior also show specific constellations of electoral preferences. The findings were then discussed in light of the regression to Vučić’s hybrid regime.
Genetic liability to migraine and functional outcome after ischemic stroke
Authors: Wang Mengmeng , Daghlas Iyas , Zhang Zhizhong , Ye Dan , Li Shun , Liu Dandan
Published: March 2023

Background and purpose:

To evaluate the association of genetic liability to migraine with functional outcome after ischemic stroke using Mendelian randomization.

Methods:

Genetic proxies for migraine were obtained from the largest genome-wide association study meta-analysis of 102,084 migraine cases and 771,257 controls. Genetic associations with functional outcome after ischemic stroke were obtained from the Genetics of Ischemic Stroke Functional Outcome network study ( N = 6021). Poor functional outcome after ischemic stroke was defined as a score of 3–6 on the modified Rankin scale at 3 months ( N = 2280). The inverse-variance weighted method was used to estimate the association of genetic liability to migraine with functional outcome, and we performed sensitivity analyses to assess the robustness of results.

Results:

Genetic liability to migraine was associated with poor functional outcome after ischemic stroke (odds ratio of poor functional outcome per doubling in migraine odds 1.22, 95% confidence interval 1.02–1.45, p = 0.031). This association remained directionally consistent across sensitivity analyses.

Conclusions:

This study provides genetic support that migraine is associated with poor functional outcome after ischemic stroke. These findings warrant further follow-up and, if replicated, may have clinical implications for post-stroke recovery.
Conjuring a cooler world? Imaginaries of Improvement in Blockchain Climate Finance Experiments
Authors: Campbell-Verduyn Malcolm
Published: March 2023

Meeting on the second anniversary of the Paris Agreement signing, the United Nations Climate Change Secretariat founded the Climate Chain Coalition (CCC) in 2017. Backed by a number of multi-stakeholder groups like the Blockchain for Climate Foundation, the Ottawa-based CCC promotes the use of this emergent technology as a pathway to achieving the goals of the Paris Agreement. What kind of ‘cooler’ world are blockchain-based climate projects conjuring? This article scrutinizes the shared visions materializing in particular across climate finance experiments, locating them as extensions of existing imaginaries of how financial markets can address planetary concerns. The imaginaries identified underpin these ‘cool’ technological feats yet provide only incremental improvements to existing modes of market-led climate governance that are far from the scale required to actually conjure a cooler planet.
Uses of epistemic uncertainties in the USGS National Seismic Hazard Models
Authors: Kwong N. Simon , Jaiswal Kishor S.
Published: March 2023

The need for US Geological Survey (USGS) National Seismic Hazard Models (NSHMs) to report estimates of epistemic uncertainties in the hazard (e.g. fractile hazard curves) in all forthcoming releases is increasing. With fractile hazard curves as potential new outputs from the USGS 2023 NSHM, a simultaneous need is to help end-users better understand these epistemic uncertainties and clarify their potential uses. In this article, we address the latter need by (1) characterizing epistemic uncertainties in two updates of the USGS NSHM (2014 for California and 2021 for Hawaii), (2) illustrating a variety of downstream applications of fractile hazard curves in both hazard and risk contexts, and (3) discussing implications from the various types of uncertainties. We found that the epistemic uncertainty in hazard is generally larger for Hawaii than for California, the epistemic uncertainty in hazard can be reasonably approximated with a lognormal distribution for most of the cases considered, and the correlation between epistemic uncertainty in hazard at two different intensity measure levels generally varies with both location and type of intensity measure. Furthermore, we developed models for readily generating approximate fractile hazard curves in California and Hawaii. Finally, given the complexities involved in the hazard modeling process, we developed an open-source interactive tool to enable a broad range of users to independently examine and potentially start using such epistemic uncertainties for their respective applications.
Role of the human solute carrier family 14 member 1 gene in hypoxia-induced renal cell carcinoma occurrence and its enlightenment to cancer nursing
Authors: Shi Jing , Sha Ruili , Yang Xilan
Published: March 2023

Background

Hypoxia is considered a critical contributor to renal cell carcinoma progression, including invasion and metastasis. However, the potential mechanisms by which it promotes invasion and metastasis have not yet been clarified. The purpose of this study was to investigate the role and mechanism of hypoxia-induced renal cell carcinoma and provide evidence-based medical proof for improvements to postoperative nursing of renal cell carcinoma patients. A total of 64 patients with renal cell carcinoma were divided into the observation group (nursing based on oxygen administration) and the control group (conventional nursing). Renal function indexes, serum inflammatory factors, and tumor markers were evaluated. The human renal cell carcinoma cell line A498 under hypoxia/normoxia was used as an experimental model in vitro and the biological characteristics and mitochondrial function of the cells were assessed.

Results

Nursing based on oxygen administration decreased the value of renal function indexes, serum inflammatory factors, and tumor markers in renal cell carcinoma patients. Hypoxia was found to induce A498 cell invasion, migration, and the release of inflammatory cytokines, while repressing human solute carrier family 14 member 1 gene expression. Elevated levels of solute carrier family 14 member 1 expression induced mitochondrial reactive oxygen species accumulation, diminished the intracellular adenosine triphosphate level, and destroyed both mitochondrial membrane potential integrity and mitochondrial morphology. Overexpression of the solute carrier family 14 member 1 gene could abolish hypoxia-induced invasion, reduce the migration of A498 cells, inhibit the hypoxia-induced release of inflammatory cytokines, and arrest the cell cycle at the G1/S checkpoint.

Conclusions

These data reveal that nursing based on oxygen administration can improve the clinical efficacy of renal cell carcinoma therapies, being safe and effective. The results elucidate a mechanism wherein the solute carrier family 14 member 1 gene participates in the occurrence and development of hypoxia-induced renal cell carcinoma in a mitochondria-dependent manner.
A novel clinical prediction model of severity based on red cell distribution width, neutrophil-lymphocyte ratio and intra-abdominal pressure in acute pancreatitis in pregnancy
Authors: Liao Wenyan , Tao Guangwei , Chen Guodong , He Jun , Yang Chunfen , Lei Xiaohua , Qi Shuo , Hou Jiafeng , Xie Yi , Feng Can , Jiang Xinmiao , Deng Xin , Ding Chengming
Published: March 2023

Background

Acute pancreatitis in pregnancy (APIP) with a high risk of death is extremely harmful to mother and fetus. There are few models specifically designed to assess the severity of APIP. Our study aimed to establish a clinical model for early prediction of severity of APIP.

Methods

A retrospective study in a total of 188 patients with APIP was enrolled. The hematological indicators, IAP (intra-abdominal pressure) and clinical data were obtained for statistical analysis and prediction model construction.

Results

According to univariate and multivariate logistic regression analysis, we found that red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR) and Intra-abdominal pressure (IAP) are prediction indexes of the severity in APIP (p-value < 0.05). Our novel clinical prediction model was created by based on the above three risk factors and showed superior predictive power in primary cohort (AUC = 0.895) and validation cohort (AUC = 0.863). A nomogram for severe acute pancreatitis in pregnancy (SAPIP) was created based on the three indicators. The nomogram was well-calibrated.

Conclusion

RDW, NLR and IAP were the independent risk factors of APIP. Our clinical prediction model of severity in APIP based on RDW, NLR and IAP with predictive evaluation is accurate and effective.
Effects of maternal pre-pregnancy body mass index and gestational weight gain on antenatal mental disorders in China: a prospective study
Authors: Zhou Xuan , Rao Lin , Yang Dongjian , Wang Tong , Li Hong , Liu Zhiwei
Published: March 2023

Background

Maternal obesity is the most common medical condition among women of reproductive age worldwide. The pre-pregnancy body mass index and gestational weight gain have been suggested to be associated with maternal mental disorders. This study aimed to investigate the effects of the pre-pregnancy body mass index and gestational weight gain on antenatal depression, stress, and anxiety.

Methods

In total, 4,890 pregnant women were enrolled in the present study, which is based on an ongoing prospective cohort study. We used self-reported pre-pregnancy weights and the last weights measured prior to delivery (using professional instruments) to calculate the pre-pregnancy body mass index and gestational weight gain. The questionnaires used included the Center for Epidemiologic Studies Depression Scale (CES-D), Self-Rating Anxiety Scale (SAS), and 10-item version of the Perceived Stress Scale (PSS-10). We used Pearson product-moment correlation and multivariable logistic regression models to examine the impact of the pre-pregnancy body mass index and gestational weight gain on different maternal mental disorders.

Results

After adjusting for conception, annual household income, occupation, education, smoking status, and drinking status, excessive gestational weight gain during pregnancy was associated with a greater chance of anxiety symptoms in the entire sample (adjusted model: odds ratio = 1.479, 95% confidence interval = 1.128, 1.938) and especially in women with a normal body mass index (adjusted model: odds ratio = 1.668, 95% confidence interval = 1.209, 2.302). However, the relationship between the maternal pre-pregnancy body mass index and mental health was not significant.

Conclusion

Pregnant women with a normal pre-pregnancy body mass index had a greater chance of experiencing anxiety symptoms before delivery if gestational weight gain was excessive; however, its effects on depression or stress symptoms were not observed. The maternal pre-pregnancy body mass index may not be independently associated with maternal mental disorders.
Analysis of the clinical outcomes of microbial contamination caused by environmental contamination of the embryology laboratory during IVF-ET treatment cycles
Authors: Zheng Tingting , Li Qinhua , Chen Ningjing , Du Peiyao , Ye Hong
Published: March 2023

Background

Bacterial contamination may cause loss of or damage to cultured oocytes or embryos, resulting in the lack of transplantable embryos during IVF embryo culture. However, there are few reports about IVF embryo contamination caused by embryology laboratories. In this work, we evaluated clinical pregnancy outcomes and the risk of maternal and infant complications after embryo contamination caused by environmental pollution during IVF.

Methods

The authors retrospectively analyzed 2490 IVF-ET ovulation induction therapy cycles in the Reproductive Center of Yichang Central People's Hospital from January 2015 to May 2022. According to the presence or absence of embryo culture medium contamination, the two groups were divided into an embryo contamination cycle and a nonembryo contamination cycle. The primary outcome parameters were the characteristics and progress of embryo culture medium contamination. Embryo laboratory outcomes, pregnancy outcomes, and maternal and infant complications were secondary outcome parameters.

Results

One case of embryo contamination originated from semen contamination. The remaining 15 cases involved environmental contamination outbreaks in embryo culture chambers, caused by Staphylococcus pasteuri. Compared with conventional uncontaminated IVF cycles, the 15 cases of contaminated embryo cycles showed no significant difference in embryo laboratory outcomes, pregnancy outcomes, or maternal and infant complications except for a slightly higher rate of fetal growth retardation. Ultimately, 11 live-born infants were successfully delivered, of which 2 were premature. The remaining 4 patients did not become pregnant after 1–2 transfers due to a lack of transferable embryos.

Conclusion

When the embryo culture medium is contaminated due to the environmental contamination of the IVF culture room, it is feasible to perform daily rapid rinsing of the culture medium and avoid blastocyst culture as remedial treatment. However, the long-term impact on offspring needs further prospective research.
DNMT3A low-expression is correlated to poor prognosis in childhood B-ALL and confers resistance to daunorubicin on leukemic cells
Authors: Li Weijing , Liu Shuguang , Wang Chanjuan , Cui Lei , Zhao Xiaoxi , Liu Wei , Zhang Ruidong , Li Zhigang
Published: March 2023

Background

Little is known about DNMT3A expression and its prognostic significance in childhood B cell acute lymphoblastic leukemia (B-ALL).

Methods

We determined DNMT3A mRNA expression in 102 children with B-ALL. Correlations with relapse-free survival (RFS) and common clinical characteristics were analyzed. DNMT3A was stably knocked out by CRISPR/Cas9 gene editing technology in Reh and 697 B-ALL cell lines. Cell proliferation activity after treated with daunorubicin (DNR) was determined by CCK8 assay in DNMT3A KO Reh and 697 cell lines.

Results

DNMT3A expression in B-ALL patients who were in continuous complete remission (CCR) was higher than in those who got relapse (P = 0.0111). Receiver operating characteristic curve showed prognostic significance of DNMT3A expression (P = 0.003). Low expression of DNMT3A (≤ 0.197) was significantly correlated with poor RFS (P < 0.001) in children with B-ALL. Knock-out of DNMT3A in Reh and 697 cell lines significantly increased IC50 of DNR (P = 0.0201 and 0.0022 respectively), indicating elevated resistance to DNR.

Conclusion

Low expression of DNMT3A associates with poor prognosis in children with B-ALL. Knock-out of DNMT3A confers resistance to DNR on leukemic cells.
Association between neonatal near miss and infant development: the Ribeirão Preto and São Luís birth cohorts (BRISA)
Authors: Aristizábal Liliana Yanet Gómez , Rocha Paulo Ricardo Higassiaraguti , Confortin Susana Cararo , Simões Vanda Maria Ferreira , Bettiol Heloisa , Barbieri Marco Antonio , da Silva Antônio Augusto Moura
Published: March 2023

Aim

To analyze the association between neonatal near miss and infant development at two years.

Methods

Data from two birth cohorts, one conducted in Ribeirão Preto (RP)/São Paulo and the other in São Luís (SL)/Maranhão, were used. The cognitive, motor and communication development of children was evaluated using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). The following criteria were used for the definition of NNM: birth weight < 1,500 g, 5-min Apgar score < 7, gestational age < 32 weeks, and report of congenital malformations. The relationship between neonatal near miss and development was assessed using the weighted propensity score from the Inverse Probability of Treatment Weighting (IPTW). A directed acyclic graph was built to select the adjustment variables.

Results

A total of 1,050 mother-newborn dyads were evaluated in SL and 1,840 in RP. Regarding outcomes in SL and RP, respectively, 2.4% and 17.3% of the children were not competent in the cognitive domain, 12.1% and 13.3% in the receptive communication domain, 39.2% and 47.1% in the expressive communication domain, 20.7% and 12.6% in the fine motor domain, and 14.3% and 13.8% in the gross motor domain. The prevalence of neonatal near miss was 5.4% in SL and 4.3% in RP. Unadjusted analysis showed an association of neonatal near miss with fine motor development in SL and RP and with the cognitive, receptive communication, expressive communication, and gross motor domains only in RP. These associations remained after adjusted analysis.

Conclusion

Neonatal near miss is a risk factor for developmental delays.
Premature infants receiving delayed cord clamping with and without cord milking: a randomized control trial
Authors: Prachukthum Sariya , Tanprasertkul Chamnan , Somprasit Charintip
Published: March 2023

Background

Preterm infants often have long hospital stays and frequent blood tests; they often develop anemia requiring multiple blood transfusions. Placental transfusion via delayed cord clamping (DCC) or umbilical cord milking (UCM) helps increase blood volume. We hypothesized umbilical cord milking (UCM), together with DCC, would be superior in reducing blood transfusions.

Objectives

To compare the effects of DCC and DCC combined with UCM on hematologic outcomes among preterm infants.

Methods

One hundred twenty singleton preterm infants born at 280/7- 336/7 weeks of gestation at Thammasat University Hospital were enrolled in an open-label, randomized, controlled trial. They were placed into three groups (1:1:1) by a block-of-three randomization: DCC for 45 s, DCC with UCM performed before clamping (DCM-B), and DCC with UCM performed after clamping (DCM-A). The primary outcomes were hematocrit levels and number of infants receiving blood transfusions during the first 28 days of life. Intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC) were secondary outcomes. Analyses were performed with an intent-to-treat approach.

Results

One hundred twenty preterm infants were randomized. There was no statistically significant difference in neonatal outcomes; hematocrit on admission 54.0 ± 5.5, 53.3 ± 6.0, and 54.3 ± 5.8 (p = 0.88), receiving blood transfusions 25%, 20%, and 12.5% (p = 0.24), incidence of NEC 7.5, 0 and 10% (p = 0.78) in the DCC, DCM-B and DCM-A groups, respectively. There were no preterm infants with severe IVH, polycythemia, maternal or neonatal death.

Conclusion

The placental transfusion techniques utilized, DCC and DCC combined with UCM, provided the same benefits for preterm infants born at GA 28 and 33 weeks in terms of reducing the need for RBC transfusions, severities of IVH and incidence of NEC without increasing comorbidity.

Trial registration

TCTR20190131002. Registered 31 January 2019—Retrospectively registered.
Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy
Authors: Tanır Basaranoğlu Sevgen , Karaaslan Ayşe , Salı Enes , Çiftçi Ergin , Gayretli Aydın Zeynep Gökçe , Aldemir Kocabaş Bilge , Kaya Cemil , Şen Bayturan Semra , Kara Soner Sertan , Yılmaz Çiftdoğan Dilek , Çay Ümmühan , Gundogdu Aktürk Hacer , Çelik Melda , Ozdemir Halil , Somer Ayper , Diri Tijen , Yazar Ahmet Sami , Sütçü Murat , Tezer Hasan , Karadag Oncel Eda , Kara Manolya , Çelebi Solmaz , Özkaya Parlakay Aslınur , Karakaşlılar Sabahat , Arısoy Emin Sami , Tanır Gönül , Tural Kara Tuğçe , Devrim İlker , Erat Tuğba , Aykaç Kübra , Kaba Özge , Güven Şirin , Yeşil Edanur , Tekin Yılmaz Ayşe , Yaşar Durmuş Sevgi , Çağlar İlknur , Günay Fatih , Özen Metehan , Dinleyici Ener Çağrı , Kara Ateş
Published: March 2023

Background

Antibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region.

Methods

The prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre.

Results

A result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarrhea. In the analysis of antibiotic-associated diarrhea occurrence according to different geographical regions of Turkey, antibiotic-associated diarrhea episodes differed significantly (p = 0.014), particularly higher in The Eastern Anatolia and Southeastern Anatolia. Though most commonly encountered with cephalosporin use, antibiotic-associated diarrhea is not a frequent side effect.

Conclusion

This study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region.
Discrepancies between workers with disabilities and their supervisors in reported work accommodations and associations with return to work
Authors: Jansen Joke , Snippen Nicole , Koning Pierre , Boot Cécile , van Ooijen Raun , Brouwer Sandra
Published: March 2023

Background

The aims of this study were: (1) to explore the frequency of discrepancies in work accommodations reported by workers and their supervisors, and (2) to investigate whether these discrepancies are associated with full return to work (RTW).

Methods

We used data from a longitudinal survey study of long-term sick-listed workers and their supervisors (n = 406). Discrepancies in reports on implementing eight types of work accommodations were explored. Logistic regression analyses were conducted to test associations between discrepancies in reported work accommodations and odds of full RTW 27 months after the sick-leave onset.

Results

Discrepancies were the lowest for the work accommodation therapeutic RTW (53%) and the highest (85%) for job training or education and reimbursement of therapy or treatment. Four out of eight types of work accommodations were more often reported by workers than by their supervisors. Only a discrepancy on a job reassignment within the organization was associated with lower odds of full RTW (OR 0.56, 95%-CI 0.36–0.88).

Conclusion

We found substantial discrepancies in the reported implementation of work accommodations between workers and their supervisors. Future research should focus on disentangling mechanisms that lead to discrepancies to avoid inefficiencies in the RTW process.
Associations of parents’ and adolescents’ active travel behavior across various destinations – a sex/gender analysis
Authors: Beck Franziska , Marzi Isabel , Renninger Denise , Demetriou Yolanda , Engels Eliane Stephanie , Niermann Christina , Reimers Anne Kerstin
Published: March 2023

Background

Active travel behavior such as walking and cycling is associated with several health benefits. Especially the family environment seems to be important for active travel in children and adolescents. Currently, little is known regarding travel behavior in leisure time and associations of travel behavior within parent-adolescent dyads.

Methods

The present analysis is based on the German ARRIVE study (Active tRavel behavioR in the famIly enVironmEnt), which incorporated a large scale, representative cross-sectional online survey including 517 parent–child dyads consisting of adolescents (N = 517; boys = 263, girls = 254) aged 11–15 years and one of their parents (N = 517; fathers = 259, mothers = 258). Based on that survey which took place in June 2021 (during the COVID-19 pandemic), we calculated the prevalence of active travel to four commonly visited destinations (school/work, friends/relatives, shopping stores and recreational activities) using an adapted version of the travel to school questionnaire by Segura-Diaz JM, Rojas-Jimenez A, Barranco-Ruiz Y, Murillo-Pardo B, Saucedo-Araujo RG, Aranda-Balboa MJ, et al. (Int J Environ Res Public Health 17(14), 2020). In addition, we investigated the associations between parents’ and adolescents’ travel behavior using scores for school/work, leisure time (friends/relatives, shopping stores and recreational activities) and overall (school/work and leisure time).

Results

Across all destinations, prevalence of active travel in adolescents (63.08%) was higher than in parents (29.21%). Active travel to school (47.33%) as well as to work (20.43%) indicated the lowest prevalence. Linear regression models revealed significant associations in overall active travel between mothers and adolescents (girls: β = 0.308, p < 0.001; boys: β = 0.302, p = 0.001) and in leisure time active travel behavior between mothers and daughters (β = 0.316, p < 0.001). Related to school/work active travel there were no associations between parents and adolescents.

Conclusion

The associations between adolescents’ and parents’ travel behavior differ depending on gender: they are solely seen in mother-adolescents dyads. Furthermore, our findings conclude that travel is a routine and independent of the destination.
Digital self-management of hip and knee osteoarthritis and trajectories of work and activity impairments
Authors: Kiadaliri Ali , Lohmander L. Stefan , Ignjatovic Majda Misini , Nero Håkan , Dahlberg Leif E.
Published: March 2023

Objective

To investigate the trajectories of work and activity impairments among people participating in a digital self-management program for osteoarthritis (OA).

Methods

We conducted an observational longitudinal study using data for baseline, 3, 6, 9 and 12 months follow ups from people participating in a digital OA treatment between June 2018 and September 2021. The Work Productivity and Activity Impairment–Osteoarthritis (WPAI–OA) questionnaire was used to measure work and activity impairments. We applied linear mixed models and group-based trajectory modelling (GBTM) to assess the trajectories of work and activity impairments and their variability. Dominance analysis was performed to explore the relative importance of baseline characteristics in predicting the trajectory subgroup membership.

Results

A total of 14,676 participants with mean (± standard deviation) age 64.0 (± 9.1) years and 75.5% females were included. The adjusted mean improvements in work impairment from baseline were 5.8% (95% CI 5.3, 6.4) to 6.1% (95% CI 5.5, 6.8). The corresponding figures for activity impairment were 9.4% (95% CI 9.0, 9.7) to 11.3% (95% CI 10.8, 11.8). GBTM identified five (low baseline–declining, moderate baseline–declining, high baseline–declining, very high baseline–substantially declining, and very high baseline–persistent) and three (low baseline–declining, mild baseline–declining, high baseline–declining) subgroups with distinct trajectories of activity and work impairments. Dominance analysis showed that baseline pain was the most important predictor of membership in trajectory subgroups.

Conclusion

While participation in a digital self-management program for OA was, on average, associated with improvements in work and activity impairments, there were substantial variations among the participants. Baseline pain may provide useful insights to predict trajectories of work and activity impairments.
Tracheostomy-related indications, early complications and their predictors among patients in low resource settings: a prospective cohort study in the pre-COVID-19 era
Authors: Nyanzi Daniel J. , Atwine Daniel , Kamoga Ronald , Birungi Caroline , Nansubuga Caroline A. , Nyaiteera Victoria , Nakku Doreen
Published: March 2023

Background

Tracheostomy is a life-saving procedure whose outcomes may vary between hospitals based on disparities in their existing expertise. We aimed at establishing the indications, early tracheostomy-related complications and their associated factors in Uganda.

Methods

In a prospective cohort study, we consecutively enrolled one-hundred patients, both adults and children 2 h post-tracheostomy procedure. At baseline, information on patients’ socio-demographics, tracheostomy indications, pre- and post-procedural characteristics was collected through researcher administered questionnaires and from medical records. Clinical examination was performed at baseline but also at either day 7 or whenever a tracheostomy-related complication was suspected during the 7 days follow-up. Comparison of patients’ baseline characteristics, tracheostomy indications and complications across two hospitals was done using Pearson’s chi-square. For predictors of early tracheostomy complications, bivariate and multivariate analysis models were fitted using binomial regression in STATA 13.0 software.

Results

All patients underwent surgical tracheostomy. Majority were adults (84%) and males (70%). The commonest tracheostomy indications were; pulmonary toilet (58%) and anticipated prolonged intubation (42%). Overall, 53% (95% CI: 43.0 – 62.7) had early complications with the commonest being tube obstruction (52.6%). Independent predictors of early tracheostomy-related complications were; anticipated prolonged intubation as an indication (RR = 1.8, 95%CI: 1.19 – 2.76), Bjork flap tracheal incision (RR = 1.6, 95%CI: 1.09 – 2.43), vertical tracheal incision (RR = 1.53, 95%CI: 1.02 – 2.27), and age below 18 years (RR = 1.22, 95%CI: 1.00 – 1.47).

Conclusion

Pulmonary toilet is the commonest tracheostomy indication at major hospitals in Uganda. The incidence of early tracheostomy complications is high and majorly related to post-procedure tracheostomy tube management. Having anticipated prolonged intubation as an indication for tracheostomy, a Bjork flap or vertical tracheal incisions and being a child were associated with increased risk of complications. Emphasis on multidisciplinary team care, standardization of tracheostomy care protocols, and continuous collection of patient data as well as paying attention to patient quality of life factors such as early return to oral feeding, ambulation and normal speech may have great potential for improved quality of tracheostomy care in low resource settings.
Hair embedding after transperineal prostate biopsy: two case reports
Authors: Ni Jiaxuan , Ni Ying , Zhang Tielong , Wang Gang , Ding Xuefei , Zhou Guangchen
Published: March 2023

Background

Transperineal prostate biopsy is gradually becoming the standard methodology for diagnosing prostate cancer because of its high accuracy and low risk of infection, but careful preparation is not always highlighted before a transperineal biopsy.

Case summary

we reported two cases of hair embedding during transurethral resection of the prostate following transperineal puncture biopsy with a Bard MC1820 disposable biopsy needle. Histological examination did not find the hair follicle structure required for hair growth. The hair source was suspected to be percutaneously brought in by needle during the biopsya simulated experiment was used to analyze and reconstruct the process of hair embedding in prostate tissue.

Conclusion

Hair embedding caused by perineal prostate biopsy is a consumable-related adverse event, and skin preparation before a transperineal prostate biopsy is recommended.