bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived causes and diagnosis of febrile convulsion in selected rural contexts in Cape Coast Metropolis, Ghana
Authors: Owusu Bernard Afriyie
Published: January 2022

Background

Febrile convulsion (FC) is a common seizure disorder among children aged 9 months to 5 years. It is usually benign and self-limiting with favourable prognosis. However, in Ghana, FC is commonly perceived as “not for hospital” and widely diagnosed and managed at home based on several beliefs and practices which are limited in related literature.

Objective

This study explored the perceived causes and diagnosis of FC in selected rural communities in the Cape Coast Metropolis, Ghana.

Methods

A descriptive phenomenological study design underpinned the study at five selected communities located not more than 2 Kilometres from the University of Cape Coast Hospital. Purposive and snowball sampling techniques were used to interview 42 participants made up of 27 parents, two grandmothers, seven registered traditional health practitioners, four herbalists, and two faith healers in the communities. The data was analysed using QSR NVivo 12.

Results

Three perceived causes of FC were identified – biological, social/behavioural, and spiritual. Biological causes include genetic abnormalities and other underlying health conditions. The behavioural factors include poor childcare practices and nutrition. Spiritual causes include harm caused by evil spirits. The diagnosis of FC were observed prior, during and after FC attack, and these includes high body temperature, extreme body jerking, and disability outcomes respectively.

Conclusion

The perceived causes of FC are interplay of complex natural, social and spiritual factors that were deep-rooted in local socio-cultural beliefs and FC experiences. Unlike the attack stage, pre-attack diagnosis were usually missed, or misconstrued to mean other health conditions. These findings indicate the need to intensify maternal and child health (MCH) education programmes on FC in the study area through improved primary healthcare.
Identification of key biomarkers in steroid-induced osteonecrosis of the femoral head and their correlation with immune infiltration by bioinformatics analysis
Authors: Zhao Jun , Zhang Xingshi , Guan Junjie , Su Yu , Jiang Jizhao
Published: January 2022

Objective

This study aimed to identify key diagnostic markers and immune infiltration of (SONFH) by bioinformatics analysis.

Methods

Related SONFH datasets were downloaded from the Gene Expression Omnibus (GEO) database. First, we identified the differentially expressed genes (DEGs) and performed the functional enrichment analysis. Then weighted correlation network analysis (WGCNA) and the MCODE plug-in in Cytoscape were used to identify the diagnostic markers of SONFH. Finally, CIBERSORT was used to analyze the immune infiltration between SONFH and healthy controls, and the correlation between infiltrating immune cells and diagnostic markers was analyzed.

Results

TYROBP, TLR2, P2RY13, TLR8, HCK, MNDA, and NCF2 may be key diagnostic markers of SONFH. Immune cell infiltration analysis revealed that Memory B cells and activated dendritic cells may be related to the SONFH process. Moreover, HCK was negatively correlated with CD8 T cells, and neutrophils were positively correlated with those key diagnostic markers.

Conclusions

TYROBP, TLR2, P2RY13, TLR8, HCK, MNDA, and NCF2 may be used as diagnostic markers of SONFH, and immune-related mechanism of SONFH and the potential immunotherapy are worthy of further study.
Evaluation of early complications, outcome, and mortality in Coronavirus Disease 2019 (COVID-19) infection in patients who underwent orthopedic surgery
Authors: Mohammadpour Mehdi , Yazdi Hamidreza , Bagherifard Abolfazl , Jabalameli Mahmoud , Moghtadaei Mehdi , Torkaman Ali , Yahyazadeh Hooman , Ghaderi Mohammad Taher , Fanaeian Mohammad Mahdi , Langeroudi Moein Khaleghi , Hashemi Peyman , Razi Saeed , Karimpour Amer , Lirgeshasi Sam Bemani , Bahari Milad
Published: January 2022

Background

A higher mortality and morbidity rate has been reported in COVID-19 patients undergoing surgery. To reduce the morbidity and mortality rate in COVID-19 patients undergoing orthopedic procedures, we aimed to increase the threshold for surgical planning.

Methods

In a prospective cohort study, COVID-19 patients who underwent elective or emergent orthopedic surgery in three orthopedic surgery centers from February 2020 to September 2020 were included. In this period, 6751 patients were scheduled for orthopedic surgery. To increase surgical threshold planning, all patients with grade 5 of the American Society of Anesthesiologists (ASA) classification and patients with COVID-19 related moderate to severe pulmonary involvement were identified as high-risk patients and were excluded.

Results

35 deaths occurred during the study. The frequency of deaths was significantly higher in patients with COVID-19, 6 (9.4%) than patients without COVID-19, 29 (0. 43%). The average hospitalization stay was 12.8 ± 12.1 days. The odds ratio (OR) for death was significantly higher in patients with COVID-19 than patients without COVID-19. [OR: 8.13, Confidence interval 95% (CI95%) (5.02–11.25), P: 0.001]. Four (6.3%) COVID-19-associated complications were recorded in this series that all were respiratory failure requiring unexpected postoperative ventilation. Twenty surgical complications (31.3%) were recorded. The odds ratio for ICU admission was significantly higher in patients with COVID-19 than patients without COVID-19. [OR: 5.46, CI 95% (2.68–8.68), P: 0.001].

Conclusions

An increased threshold for orthopedic surgery is suggested for COVID-19 patients with a mortality rate of 9.3%, which is less than the mortality rate in other studies.

Level of evidence III.
Morbimortality assessment in abdominal surgery: are we predicting or overreacting?
Authors: Valenzuela Sebastian , Niño Laura , Conde Danny , Girón Felipe , Rodríguez Lina , Venegas David , Rey Carlos , Nassar Ricardo , Vanegas Marco , Jiménez Daniel
Published: January 2022

Background

High-risk surgical procedures represent a fundamental part of general surgery practice due to its significant rates of morbidity and mortality. Different predictive tools have been created in order to quantify perioperative morbidity and mortality risk. POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and morbidity) is one of the most widely validated predictive scores considering physiological and operative variables to precisely define morbimortality risk. Nevertheless, seeking greater accuracy in predictions P-POSSUM was proposed. We aimed to compare POSSUM and P-POSSUM for patients undergoing abdominal surgery.

Methods

A retrospective observational study with a prospective database was conducted. Patients over 18 years old who complied with inclusion criteria between 2015 and 2016 were included. Variables included in the POSSUM and P-POSSUM Scores were analyzed. Descriptive statistics of all study parameters were provided. The analysis included socio-demographic data, laboratory values ​​, and imaging. Bivariate analysis was performed.

Results

350 Patients were included in the analysis, 55.1% were female. The mean age was 55.9 ± 20.4 years old. POSSUM revealed a moderated index score in 61.7% of the patients, mean score of 12.85 points ± 5.61. 89.1% of patients had no neoplastic diagnosis associated. Overall morbidity and mortality rate was 14.2% and 7.1%. P-POSSUM could predict more precisely mortality (p < 0.00).

Conclusions

The POSSUM score is likely to overestimate the risk of morbidity and mortality in patients with high/moderate risk, while the P-POSSUM score seems to be a more accurate predictor of mortality risk. Further studies are needed to confirm our results.
‘You just really have to assert yourself:’ social work, nursing, and rehabilitation counseling student experiences of providing integrated behavioral health services before and after the immediate start of COVID-19
Authors: Alessi Edward J. , Caldwell Barbara , Zazzarino Anthony S. , Greenfield Brett , Findley Patricia A.
Published: January 2022

Background

Educators who train healthcare students to provide behavioral health services in primary care settings frequently encounter challenges as they work to ensure that students acquire the knowledge and skills to effectively function on interprofessional practice teams. This has become increasingly important during COVID-19, as interprofessional collaborative practice is needed more than ever to address the interrelated health, mental health, and social structural issues linked to the pandemic.

Methods

We used qualitative focus groups to understand the experiences of 6 interprofessional teams (comprised of graduate social work, nursing, and rehabilitation counseling students; n = 19) providing behavioral health services in primary care settings before and after the immediate start of COVID-19. To triangulate data and enrich findings, one focus group with students’ faculty supervisors was also conducted; n = 5). Data were analyzed using thematic analysis.

Results

Four themes highlighted student participants’ need to assert themselves at the beginning of their educational experience, to communicate and learn from one another to develop positive team dynamics, to contend with role confusion and missed opportunities for collaboration, and to manage the emotional impact of COVID-19 on learning.

Conclusion

Findings indicate that educators should work with clinical faculty and agency supervisors to orient students to ensure they have role clarity within the agency. Graduate students providing behavioral health services should also learn to work collaboratively within their scopes of practice to serve patients virtually, especially in preparation for public health emergencies.
Search of antimicrobial lactic acid bacteria from Salmonella-negative dogs
Authors: Jimenez-Trigos Estrella , Toquet Marion , Barba Marta , Gómez-Martín Ángel , Quereda Juan J. , Bataller Esther
Published: January 2022

Background

Salmonellosis is one of the most important food-borne zoonotic disease affecting both animals and humans. The objective of the present study was to identify gastrointestinal (GI) lactic acid bacteria (LAB) of canine-origin from Salmonella-negative dogs’ faeces able to inhibit monophasic Salmonella Typhimurium previously isolated from dogs’ faeces, in order to be used as a potential probiotic in pet nutrition.

Results

Accordingly, 37 LAB were isolated from Salmonella-negative dogs’ faeces and tested against monophasic S. Typhimurium using the spot on lawn method out of which 7 strains showed an inhibition halo higher than 2.5 cm. These 7 strains were also tested with the co-culture method and one showed the greatest inhibition value (p < 0.05). Subsequently, the isolate was identified through 16S rRNA sequencing and sequence homology and designated as Ligilactobacillus salivarius (L. salivarius). LAB from Salmonella-positive dogs were also identified and none was the selected strain. Finally, to identify the mechanism of inhibition of L. salivarius, the supernatant was analyzed, and a dose response effect was observed.

Conclusions

It is concluded that the canine-origin L. salivarius, could possess some in vitro functional attributes of a candidate probiotic and could prevent monophasic S. Typhimurium colonization or inhibit its activity if the infection occurs.
Development of a one-step multiplex qRT–PCR assay for the detection of African swine fever virus, classical swine fever virus and atypical porcine pestivirus
Authors: Liu Huixin , Shi Kaichuang , Zhao Jing , Yin Yanwen , Chen Yating , Si Hongbin , Qu Sujie , Long Feng , Lu Wenjun
Published: January 2022

Background

African swine fever virus (ASFV), classical swine fever virus (CSFV) and atypical porcine pestivirus (APPV) have caused great economic losses to the swine industry in China. Since coinfections of ASFV, CSFV and APPV occur in certain pig herds, it is necessary to accurately and differentially detect these pathogens in field-collected samples. In this study, a one-step multiplex real-time quantitative reverse transcription-polymerase chain reaction (multiplex qRT–PCR) was developed for the simultaneous and differential detection of ASFV, CSFV and APPV.

Results

The one-step multiplex qRT–PCR presented here was able to simultaneously detect ASFV, CSFV and APPV but could not amplify other viruses, including porcine circovirus type 2 (PCV2), pseudorabies virus (PRV), porcine reproductive and respiratory syndrome virus (PRRSV), foot-and-mouth disease virus (FMDV), porcine parvovirus (PPV), porcine epidemic diarrhoea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine rotavirus (PRoV), porcine deltacoronavirus (PDCoV), border disease virus (BDV), bovine viral diarrhoea virus type 1 (BVDV-1), BVDV-2, etc. The limit of detection (LOD) of the assay was 2.52 × 101 copies/μL for ASFV, CSFV and APPV. A repeatability test using standard recombinant plasmids showed that the intra- and interassay coefficients of variation (CVs) were less than 2%. An assay of 509 clinical samples collected in Guangxi Province, southern China, from October 2018 to December 2020 showed that the positive rates of ASFV, CSFV and APPV were 45.58, 12.57 and 3.54%, respectively, while the coinfection rates of ASFV and CSFV, ASFV and APPV, CSFV and APPV were 4.91, 1.38, 0.98%, respectively. Phylogenetic analysis based on the nucleotide sequences of the partial ASFV p72 gene showed that all ASFV strains from Guangxi Province belonged to genotypes I and II.

Conclusion

A one-step multiplex qRT–PCR with high specificity, sensitivity and repeatability was successfully developed for the simultaneous and differential detection of ASFV, CSFV and APPV.
Effects of particulate matter on hospital admissions for respiratory diseases: an ecological study based on 12.5 years of time series data in Shanghai
Authors: Peng Wenjia , Li Hao , Peng Li , Wang Ying , Wang Weibing
Published: January 2022

Background

Previous epidemiological studies on the association between short-term exposure to particulate matter (PM) with hospital admission in major cities in China were limited to shorter study periods or a single hospital. The aim of this ecological study based on a 12.5-year time series was to investigate the association of short-term exposure to PM with aerodynamic diameter ≤ 2.5 μm (PM2.5) and aerodynamic diameter ≤ 10 μm (PM10) with hospital admissions for respiratory diseases.

Methods

Daily hospital admissions data were from the Shanghai Medical Insurance System for the period January 1, 2008 to July 31, 2020. We estimated the percentage change with its 95% confidence interval (CI) for each 10 μg/m3 increase in the level of PM2.5 and PM10 after adjustment for calendar time, day of the week, public holidays, and meteorological factors applying a generalized additive model with a quasi-Poisson distribution.

Results

There were 1,960,361 hospital admissions for respiratory diseases in Shanghai during the study period. A 10 μg/m3 increase in the level of each class of PM was associated with increased total respiratory diseases when the lag time was 0 day (PM2.5: 0.755%; 95% CI: 0.422, 1.089%; PM10: 0.250%; 95% CI: 0.042, 0.459%). The PM2.5 and PM10 levels also had positive associations with admissions for COPD, asthma, and pneumonia. Stratified analyses demonstrated stronger effects in patients more than 45 years old and during the cold season. Total respiratory diseases increased linearly with PM concentration from 0 to 100 μg/m3, and increased more slowly at higher PM concentrations.

Conclusions

This time-series study suggests that short-term exposure to PM increased the risk for hospital admission for respiratory diseases, even at low concentrations. These findings suggest that reducing atmospheric PM concentrations may reduce hospital admissions for respiratory diseases.
Features of chinese patients with sitosterolemia
Authors: Zhou Zhizi , Su Xueying , Cai Yanna , Ting Tzer Hwu , Zhang Wen , Lin Yunting , Xu Aijing , Mao Xiaojian , Zeng Chunhua , Liu Li , Li Xiuzhen
Published: January 2022

Background

Sitosterolemia is a lipid disorder characterized by the accumulation of phytosterols in plasma and organs, caused by mutations in the ABCG5 and/or ABCG8 genes. The disease is frequently misdiagnosed and mistreated as familial hypercholesterolemia (FH). To gain a better understanding of the disease, the current status of diagnosis and treatment of Chinese patients with sitosterolemia was reviewed and summarized.

Method

Literature search was performed. The clinical features and molecular characteristics of Chinese patients with sitosterolemia were analysed. Four children with sitosterolemia and the treatment experience were described.

Results

Fifty-five patients with sitosterolemia have been reported in China. These patients were aged from 3 months to 67 years at diagnosis, and the median was 8 years of age. Several complications, such as xanthomas in 47 patients (85%), thrombocytopenia in 17 patients (31%), anemia in 14 patients (25%), and cardiovascular damage in 12 patients (22%), were observed. Thirty-nine patients (71%) exhibited mutations in the ABCG5 gene, 15 patients (27%) showed mutations in ABCG8, and variations in both genes occurred in one patient (2%). A patient with two clinically rare diseases, namely, sitosterolemia and glycogen storage disease type VI (GSD VI)), is reported here for the first time. The four reported patients were treated with low cholesterol and phytosterol-limited diet alone or combined with cholestyramine. Even though decreases were observed for total plasma cholesterol (TC) and low-density-lipoprotein cholesterol (LDL-C), and these levels were as low as normal in some patients, the levels of plant sterols remained above the normal range. However, TC, LDL-C and plant sterol levels remained at high levels in patients treated with a control diet control only.

Conclusions

The analysis reveals that different from Caucasians carrying mainly variations in ABCG8, most Chinese patients have mutations in the ABCG5 gene, and Arg446Ter, Gln251Ter, anArg389His might be hot-spot mutations in Chinese patients. The current survey provides clinical data to enable the development of a standardized protocol for the diagnosis and treatment of sitosterolemia in China.
Galectin-3 and sST2: associations to the echocardiographic markers of the myocardial mechanics in systemic sclerosis – a pilot study
Authors: Vértes Vivien , Porpáczy Adél , Nógrádi Ágnes , Tőkés-Füzesi Margit , Hajdu Máté , Czirják László , Komócsi András , Faludi Réka
Published: January 2022

Background

Progressive cardiac fibrosis is the central aspect of the myocardial involvement in systemic sclerosis (SSc). We hypothesized that circulating biomarkers of the cardiac fibrosis may be useful in the early diagnosis of the cardiac manifestation in this disease. Thus, we investigated the potential correlations between the levels of galectin-3, soluble suppression of tumorigenicity-2 (sST2) and the echocardiographic markers of the myocardial mechanics in SSc patients.

Methods

Forty patients (57.3 ± 13.7 years, 36 female) were investigated. In addition to the conventional echocardiography, tissue Doppler and speckle tracking-derived strain techniques were used to assess the function of both ventricles and atria. To estimate the correlations between galectin-3 and sST2 levels and the echocardiographic variables, partial correlation method was used with age as correcting factor.

Results

In age adjusted analysis galectin-3 level showed significant correlation with left ventricular global longitudinal strain (r = 0.460,p = 0.005); grade of left ventricular diastolic dysfunction (r = 0.394,p = 0.013); septal e’ (r = − 0.369,p = 0.021); septal E/e’ (r = 0.380,p = 0.017) and with the grade of mitral regurgitation (r = 0.323,p = 0.048). No significant correlation was found between sST2 levels and the echocardiographic variables.

Conclusions

Galectin-3 levels, but not sST2 levels show significant correlation with the parameters of the left ventricular systolic and diastolic function. Galectin-3 may be a useful biomarker for the screening and early diagnosis of SSc patients with cardiac involvement.
Tranexamic acid to prevent operation in chronic subdural haematoma (TORCH): study protocol for a randomised placebo-controlled clinical trial
Authors: Immenga S. , Lodewijkx R. , Roos Y. B. W. E. M. , Middeldorp S. , Majoie C. B. L. M. , Willems H. C. , Vandertop W. P. , Verbaan D.
Published: January 2022

Background

Chronic subdural haematoma (cSDH) occurs mainly in the elderly. Surgical evacuation is effective, but in these old, often frail, patients with multi-comorbidity, surgery carries significant risks for future cognitive functioning and loss of independency. Therefore, a growing interest is noted for a non-surgical treatment with medication such as tranexamic acid (TXA). In five small retrospective series, this antifibrinolytic drug showed a beneficial effect on the spontaneous resolution of the haematoma, and with that, the necessity for surgery.

Methods

For this randomised, placebo-controlled clinical multicentre trial, all cSDH patients, over 50 years old with mild symptoms (Glasgow Coma Score (GCS) ≥ 14, modified National Institutes of Health Stroke Scale (mNIHSS) ≤ 4), a midline shift of ≤ 10 mm and in whom a primary conservative treatment is chosen, are eligible for study participation. After informed consent, 140 patients will be randomised to receive either TXA 500 mg or placebo two times daily for 28 days. The primary outcome is the necessity for surgery within 12 weeks; secondary outcomes are cSDH volume, neurological impairment (mNIHSS), falling incidents, cognitive functioning (Montreal Cognitive Assessment (MOCA)), performance in activities of daily living (Barthel and Lawton score), functional outcome (modified Rankin Scale (mRS)), quality of life (Short Form Health Survey (SF-36) and EuroQol 5-Dimension Health Survey (EQ-5D)), mortality and the use of care and health-related costs (Medical Consumption Questionnaire (iMCQ) and Productivity Cost Questionnaire (iPCQ)) at 12 weeks and 6 months.

Discussion

This phase III trial investigating the efficacy of TXA to prevent surgery for cSDH is the first in including patients using anticoagulants and mentally incompetent patients, since these comprise a significant part of the target population. Also, this study is one of the first to prospectively measure functional outcome and quality of life in cSDH patients. Final results of this study are expected in 2024.

Trial registration

Dutch Trial Registry (Nederlands Trial Register) NL6584. Registered on 11 November 2017

ClinicalTrials.govNCT03582293. Registered on 11 July 2018

EU Clinical Trials Register 2017-004311-40. Registered on 29 March 2018
Characterization and use of the ECV304 autoantigenic citrullinome to understand anti-citrullinated protein/peptide autoantibodies in rheumatoid arthritis
Authors: de França Natalia Regine , Ménard Henri André , Lora Maximilien , Zhou Zhijie , Rauch Joyce , Hitchon Carol , Andrade Luís Eduardo Coelho , Colmegna Inés
Published: January 2022

Background

Anti-citrullinated protein antibodies (ACPAs) are highly specific for rheumatoid arthritis (RA). In vivo, ACPAs target peptidyl-citrulline epitopes (cit-) in a variety of proteins (cit-prot-ACPAs) and derived peptides (cit-pept-ACPAs) generated via the peptidylarginine deiminase (PAD) isoenzymes. We aimed to identify a cell line with self-citrullination capacity, to describe its autoantigenic citrullinome, and to test it as a source of autocitrullinated proteins and peptides.

Methods

Human cell lines were screened for cit-proteins by Western blot. PAD isoenzymes were identified by RT-PCR. Autocitrullination of ECV304 was optimized, and the ECV304 autocitrullinomes immunoprecipitated by sera from three RA patients were characterized by mass spectrometry. Cit-pept-ACPAs were detected using anti-CCP2 ELISA and cit-prot-ACPAs, by an auto-cit-prot-ECV304 ELISA. Sera from 177 RA patients, 59 non-RA rheumatic disease patients and 25 non-disease controls were tested.

Results

Of the seven cell lines studied, only ECV304 simultaneously overexpressed PAD2 and PAD3 and its extracts reproducibly autocitrullinated self and non-self-proteins. Proteomic analysis of the cit-ECV304 products immunoprecipitated by RA sera, identified novel cit-targets: calreticulin, profilin 1, vinculin, new 14–3-3 protein family members, chaperones, and mitochondrial enzymes. The auto-cit-prot-ECV304 ELISA had a sensitivity of 50% and a specificity of 95% for RA diagnosis.

Conclusions

ECV304 cells overexpress two of the PAD isoenzymes capable of citrullinating self-proteins. These autocitrullinated cells constitute a basic and clinical research tool that enable the detection of cit-prot-ACPAs with high diagnostic specificity and allow the identification of the specific cit-proteins targeted by individual RA sera.
Concomitant uveal melanoma and papillary thyroid carcinoma: a case report
Authors: Kolaii Seiiedeh Samaneh Taghian Jamaleddin , Dehghanian Amir Reza , Jeddi Marjan
Published: January 2022

Background

Melanoma develops in the cells that produce melanin; ocular melanoma accounts for 3–4% of all malignant melanomas. Thyroid tumors are the most common endocrine neoplasms, with more than 95% of cases arising from follicular cell origin. Previous studies have reported associations between malignant melanoma and a wide variety of malignancies.

Case presentation

We report a 54-year-old Iranian woman who was diagnosed with ocular melanoma based on a mushroom-shaped filling defect with homogeneous echo pattern arising from the anterior third of the temporal side of the globe detected on ocular sonography during routine ophthalmological examination. She underwent right globe enucleation and implant replacement. During tumor surveillance, fluorodeoxyglucose positron emission tomography/computed tomography scan showed low-grade metabolically active tumoral involvement in the anterolateral aspect of the right lobe of thyroid. The patient subsequently underwent thyroidectomy and submandibular lymphadenectomy. Pathologic report demonstrated micropapillary carcinoma (9 × 8 mm2), tall cell variant without lymphovascular or perineural invasion in the base of lymphocytic thyroiditis.

Conclusion

This case illustrates the importance of precise active surveillance in case of papillary carcinoma of thyroid or malignant melanoma to avoid missing other associated pathologies and emphasizes the simultaneous treatment of two tumors.
Epidemics, pandemics and income inequality
Authors: Esseau-Thomas Chrys , Galarraga Omar , Khalifa Sherif
Published: January 2022

The novel coronavirus is part of a series of infectious disease outbreaks that include: Ebola, Avian influenza, Middle East respiratory syndrome coronavirus, and Influenza A. This paper addresses the question of how do these epidemics and pandemics affect income inequality in countries around the world during the first two decades of this century. To achieve its objective, the paper develops a model that indicates a positive association between these health crises and income inequality. To empirically test our theoretical predictions, the paper explores the effect on the Gini coefficient of a dummy variable that indicates the occurrence of an epidemic or a pandemic in a country in a given year and the number of deaths per 100,000. To properly address potential endogeneity, we implement a Three-Stage-Least Squares technique. The estimation shows that the number of deaths per 100,000 population variable has a statistically significant positive effect on the Gini coefficient, especially when we incorporate COVID-19 data. This suggests that not only the occurrence, but also the health consequences of COVID-19 have a significant and economically important effect on income inequality.

Background: The purpose of the study is to examine the effect of epidemics and pandemics on income inequality. This has important implications as the outcome of this study can guide policymakers into implementing policies that can mitigate the economic consequences of these health crises.

Methods: The study is a cross country analysis using fixed effects estimation. To address potential endogeneity and determine causality, the paper uses the Three-Stage-Least-Squares estimation.

Results: The paper finds that the number of epidemic deaths per 100,000 population variable has a statistically significant positive effect on the Gini coefficient, especially when we incorporate COVID-19 data.

Conclusions: The paper finds that it is not only the occurrence of an epidemic, captured by the epidemics dummy variable, but also the health consequences, captured by the number of deaths per 100,000 population, that have a significant effect on income inequality. This is especially the case when we incorporate COVID-19 in our analysis.

Trial registration: Not Applicable.
The big five model in bipolar disorder: a latent profile analysis and its impact on longterm illness severity
Authors: Ortelbach Niklas , Rote Jonas , Dingelstadt Alice Mai Ly , Stolzenburg Anna , Koenig Cornelia , O’Malley Grace , Quinlivan Esther , Fiebig Jana , Pfeiffer Steffi , König Barbara , Simhandl Christian , Bauer Michael , Pfennig Andrea , Stamm Thomas J.
Published: January 2022

Background

Using a personality typing approach, we investigated the relationship between personality profiles and the prediction of longterm illness severity in patients with bipolar disorder (BD). While previous research suggests associations between BD and traits from the NEO-FFI profiles, the current study firstly aimed to identify latent classes of NEO-FFI profiles, and, secondly, to examine their impact on the longterm prognosis of BD.

Methods

Based on the NEO-FFI profiles of 134 euthymic patients diagnosed with BD (64.2% female, mean age = 44.3 years), successive latent profile analyses were conducted. Subsequently, a subsample (n = 80) was examined prospectively by performing multiple regression analysis of the latent classes to evaluate the longitudinal course of the disease (mean: 54.7 weeks) measured using a modified Morbidity Index.

Results

The latent profile analyses suggested a 3-class model typifying in a resilient (n = 68, 51%), vulnerable (n = 55, 41%) and highly vulnerable (n = 11, 8%) class. In the regression analysis, higher vulnerability predicted a higher longterm Morbidity Index (R2 = 0.28).

Conclusions

Subgroups of patients with BD share a number of discrete personality features and their illness is characterized by a similar clinical course. This knowledge is valuable in a variety of clinical contexts including early detection, intervention planning and treatment process.
The pattern of medication use, and determinants of the prevalence of polypharmacy among patients with a recent history of depressive disorder: results from the pars cohort study
Authors: Ghaed-Sharaf Mehrnoosh , Hariri Sanam , Poustchi Hossein , Nourollahi Maryam , Khani Sara , Taherifard Erfan , Mohammadi Zahra , Hadipour Maryam , Sabaei Rasoul , Gandomkar Abdullah , Malekzadeh Fatemeh , Vardanjani Hossein Molavi
Published: January 2022

Background

Inappropriate medication use among individuals with depressive disorders (DD) is a rising public health challenge. We aimed to investigate the polypharmacy and its determinants among individuals with DD in a less developed region, and evaluate the pattern of medication use in this population.

Methods

Data was extracted from Pars Cohort Study (PCS) between 2016 and 2019. Participants were asked to bring all the medication they were using regularly, and history of DD during the last 12 months prior to study was obtained. The Anatomical Therapeutic Chemical classification was applied and polypharmacy was defined as concurrent use of five or more medications. Logistic regression models were developed to estimate the associations between polypharmacy and DD, adjusted for relevant covariates. The prevalence of consumption of each drug class was estimated among males, females, and elders. Logistic regression was applied and the adjusted odds ratio (OR) and its 95% confidence interval (CI) were estimated.

Results

A total of 9264 participants with a mean age of 52.6 (SD: 9.7) were enrolled. The prevalence of polypharmacy was 22.6% [95% CI (20.7–24.6)]. The most common drug classes were genitourinary system (55.4%) and nervous system (29.1%) medication, respectively. Recent history of DD was reported among 19.4% (n = 1795) participants, the majority of whom were females. Factors associated with polypharmacy include female gender (OR: 1.51), Fars ethnicity (OR: 1.52), lower physical activity (OR: 1.74), and higher socioeconomic status (OR: 1.40). The prevalence of antidepressant use among males was higher than females (P < 0.001).

Conclusion

The prevalence of polypharmacy is high among patients with a recent history of depressive disorder. Females, individuals with higher socioeconomic status and lower physical activity, and those who use tobacco are more likely to be polymedicated. Surveillance measures need to be established to monitor the patterns of medication use among individuals with depressive disorders.
Analysis of food sources and nutrient intakes of selected breastfeeding mothers in Metro Manila, Philippines
Authors: Angeles-Agdeppa Imelda , Custodio Ma. Rosel S. , Tanda Keith V.
Published: January 2022

Background

This study evaluated the food and nutrient intakes of selected breastfeeding mothers and identified the top food sources of nutrient intakes.

Methods

This is a cross-sectional, non-interventional study conducted in one of the private medical centers in Metro Manila, Philippines. Participants: The sample size included 70 mothers of healthy, term, exclusively breastfed infants aged 21–26 days at enrollment. Mothers were scheduled to visit the clinic at days 1, 22, 57, and day 90.Similarly, food diaries were obtained during these periods with a 3-day food record per clinic visit totaling to 12 records per mother at the end of 90 days. At every clinic visit, the records were validated face – to – face by the registered nutritionist – dietitians. An extension of the mother’s participation until day 155 was implemented for the collection of clinical outcomes used by Pediatricians. Mean food intakes were calculated. A PC-Software for Intake Distribution Estimation (PC-SIDE) program was used in the estimation of inadequate intakes. Socio-economic status was collected using standard questionnaires. Weight and height were measured using standard techniques to compute for BMI.

Results

Anthropometric results for the breastfeeding mothers reported a mean weight of 56.9 kg (SE = 1.3) and a mean height of 152.4 cm (SE = 0.6). In terms of body mass index (BMI), 8.6% were chronic energy deficient, and 34.3% were overweight while 12.9% were obese. Mean energy intake of breastfeeding mothers was 2516.7 kcal/day, which was 28.6% higher than the EER of 1957 kcal/day. Mean protein intake was 78.4 g/day, which was 37% inadequate while fat intake as percentage of total energy was excessive by 4%. Nutrient inadequacy is high for almost all nutrients: iron (99%), folate (96%), riboflavin (39%), vitamin B6 (63%), vitamin B12 (46%) and thiamine (22%). The top 5-food sources with highest percent contribution to energy are rice (43.1%), bread (8.1%), pork (7.7%), powdered milk (5.9%), and sweet bakery products (5%).

Conclusions

There is a high prevalence of protein and micronutrient inadequacies in the diet of breastfeeding mothers. The prevalence of overweight and obesity is high among breastfeeding mothers. These findings might be explained by the low variety and nutrient-poor foods consumed by the breastfeeding mothers. Understanding the major food sources of nutrient intake of breastfeeding mothers could be used to intensify if not craft interventions to address the nutrient gaps. Improving the maternal nutrition may contribute to having quality breastmilk to infants.
Massive hemoptysis treated with embolization of an ectopic bronchial artery arising from the right thyrocervical trunk: a case report
Authors: Cho Songhyon , Kubota Kenji , Hirose Yoshikazu , Yoshimura Norihiko , Murai Yui , Hirose Yasuo
Published: January 2022

Background

Ectopic bronchial artery and non-bronchial systemic arteries may be the culprit vessels of hemoptysis. The main cause of clinical failure of bronchial artery embolization is incomplete embolization caused by the misidentification of the culprit arteries by conventional angiography. Multidetector computed tomography angiography is useful for visualizing the culprit arteries.

Case presentation

An 82-year-old man was admitted with hemoptysis. Preprocedural multidetector computed tomography angiography revealed an ectopic bronchial artery branching from the right thyrocervical trunk. Superselective embolization of the ectopic bronchial artery was performed using gelatin sponge particles and metallic coils. Hemoptysis was controlled by this procedure without any associated complications.

Conclusions

Ectopic bronchial arteries originating from the thyrocervical trunk are rare. Preprocedural multidetector computed tomography angiography is useful for visualizing the culprit arteries of hemoptysis, especially if a patient has an ectopic bronchial artery or an ectopic non-bronchial systemic artery.
Anti-phospholipid antibodies in the setting of thromboembolic events associated with severe COVID-19 pneumonia
Authors: Badr Omaima Ibrahim , Elrefaey Wael Aly , Abu-Zaid Mohammed Hassan , Elmedany Samah Hamdy
Published: January 2022

Background

Thrombotic consequences have been reported in COVID-19-infected patients, especially those who are critically ill. Multiple studies have tested antiphospholipid antibodies (aPLs) among COVID-19 patients, but to date, the actual frequency of aPLs is still uncharted.

In this cohort study, we analyzed the outcomes of 173 consecutive patients with confirmed COVID-19 infection. Anti-phospholipid antibodies, which include anti-cardiolipin antibodies [aCL (IgM), aCL (IgG)], and B2-glycoprotein I antibodies [aβ2GPI (IgM), aβ2GPI (IgG)] were detected by using immunoassays. In contrast, lupus anti-coagulant (LAC) antibodies are identified through a coagulation-based assay.

Results

The study demonstrated a high incidence of thrombotic consequences in severe COVID pneumonia cases and supported an increased risk of developing aPLs following COVID-19 infection. Pulmonary embolism had the most common prevalence of all thrombotic events. Among the various aPLs tested in thrombotic patients, lupus anti-coagulant (LAC) had the highest positivity (46.2%). Most patients with arterial thromboembolism (stroke, myocardial infarction, limb ischemia, bowel ischemia, and renal artery thrombosis) had triple positivity of anti-phospholipid antibodies. Testing aPLs antibodies after 12 weeks of recovery for survived patients only 2 out of 23 patients had aPLs positivity compared to 35 out of 65 tested during hospital admission. Furthermore, we found no significant changes in aPLs positivity between survived and non-survived patients with thrombotic event.

Conclusions

aPLs increased transiently as an inflammatory-mediated condition. Individuals with aPLs triple positivity (positive LAC, aCL, and aB2GPI) had a considerable risk of arterial thromboembolism (ATE).
A review of dust accumulation on PV panels in the MENA and the Far East regions
Authors: Shenouda R. , Abd-Elhady M. S. , Kandil H. A.
Published: January 2022

This paper presents a comprehensive review regarding the published work related to the effect of dust on the performance of photovoltaic panels in the Middle East and North Africa region as well as the Far East region. The review thoroughly discusses the problem of dust accumulation on the surface of photovoltaic panels and the severity of the problem. Moreover, a survey of the most advanced cleaning techniques is presented, and their applicability is evaluated. There are plenty of techniques that have been used to remove the dust accumulated on the surface of PV panels, and these include manual and self-cleaning methods. However, it is concluded from the presented review that there is a strong need for developing new cleaning methods especially for the Middle East and North Africa region, which do not consume water and have low capital and operational costs with less human intervention, especially for hot, arid, and dusty regions.
Phase II Trial of Imatinib Plus Binimetinib in Patients With Treatment-Naive Advanced Gastrointestinal Stromal Tumor
Authors: Chi Ping , Qin Li-Xuan , Nguyen Bastien , Kelly Ciara M. , D'Angelo Sandra P. , Dickson Mark A. , Gounder Mrinal M. , Keohan Mary L. , Movva Sujana , Nacev Benjamin A. , Rosenbaum Evan , Thornton Katherine A. , Crago Aimee M. , Yoon Sam , Ulaner Gary , Yeh Randy , Martindale Moriah , Phelan Haley T. , Biniakewitz Matthew D. , Warda Sarah , Lee Cindy J. , Berger Michael F. , Schultz Nikolaus D. , Singer Samuel , Hwang Sinchun , Chen Yu , Antonescu Cristina R. , Tap William D.
Published: January 2022

PURPOSE

Dual targeting of the gastrointestinal stromal tumor (GIST) lineage-specific master regulators, ETV1 and KIT, by MEK and KIT inhibitors were synergistic preclinically and may enhance clinical efficacy. This trial was designed to test the efficacy and safety of imatinib plus binimetinib in first-line treatment of GIST.

METHODS

In this trial ( NCT01991379 ), treatment-naive adult patients with confirmed advanced GISTs received imatinib (400 mg once daily) plus binimetinib (30 mg twice daily), 28-day cycles. The primary end point was RECIST1.1 best objective response rate (ORR; complete response plus partial response [PR]). The study was designed to detect a 20% improvement in the ORR over imatinib alone (unacceptable rate of 45%; acceptable rate of 65%), using an exact binomial test, one-sided type I error of 0.08 and type II error of 0.1, and a planned sample size of 44 patients. Confirmed PR or complete response in > 24 patients are considered positive. Secondary end points included Choi and European Organisation for Research and Treatment of Cancer Response Rate, progression-free survival (PFS), overall survival (OS), pathologic responses, and toxicity.

RESULTS

Between September 15, 2014, and November 15, 2020, 29 of 42 evaluable patients with advanced GIST had confirmed RECIST1.1 PR. The best ORR was 69.0% (two-sided 95% CI, 52.9 to 82.4). Thirty-nine of 41 (95.1%) had Choi PR approximately 8 weeks. Median PFS was 29.9 months (95% CI, 24.2 to not estimable); median OS was not reached (95% CI, 50.4 to not estimable). Five of eight patients with locally advanced disease underwent surgery after treatment and achieved significant pathologic response (≥ 90% treatment effect). There were no unexpected toxicities. Grade 3 and 4 toxicity included asymptomatic creatinine phosphokinase elevation (79.1%), hypophosphatemia (14.0%), neutrophil decrease (9.3%), maculopapular rash (7.0%), and anemia (7.0%).

CONCLUSION

The study met the primary end point. The combination of imatinib and binimetinib is effective with manageable toxicity and warrants further evaluation in direct comparison with imatinib in frontline treatment of GIST.
The Contribution of Deleterious Rare Alleles in ENPP1 and Osteomalacia Causative Genes to Atypical Femoral Fracture
Authors: Furukawa Hiroshi , Oka Shomi , Kondo Naoki , Nakagawa Yasuaki , Shiota Naofumi , Kumagai Kenji , Ando Keiji , Takeshita Tsutao , Oda Takenori , Takahashi Yoshinori , Izawa Kazutaka , Iwasaki Yoichi , Hasegawa Kazuhiro , Arino Hiroshi , Minamizaki Takeshi , Yoshikawa Norie , Takata Shinjiro , Yoshihara Yasuo , Tohma Shigeto
Published: January 2022

Context

Atypical femoral fractures (AFFs) are very rare atraumatic or mild trauma fractures in the subtrochanteric region or femoral shaft. Some unique genetic variants in Asian populations might confer susceptibility to AFF, since the incidence of AFFs is higher in Asian populations.

Objective

Because rare variants have been found to be causative in some diseases and the roles of osteomalacia causative genes have not been reported, we investigated rare variants in genes causing abnormal mineralization.

Methods

Exome sequencing was performed to detect variants in gene coding and boundary regions, and the frequencies of deleterious rare alleles were compared between Japanese patients with AFF (n = 42) and controls of the 4.7KJPN panel of Tohoku Medical Megabank by whole genome sequencing (n = 4773).

Results

The frequency of the deleterious rare allele of ENPP1 was significantly increased in AFF (P = .0012, corrected P [Pc] = .0155, OR 4.73, 95% CI 2.15-10.40). In multigene panel analysis, the frequencies of deleterious rare alleles of candidate genes were increased in AFF (P = .0025, OR 2.72, 95% CI 1.49-4.93). Principal component analysis of bone metabolism markers identified a subgroup of patients with AFF with higher frequencies of deleterious rare alleles in ENPP1 (P = 4.69 × 10–5, Pc = .0006, OR 8.47, 95% CI 3.76-19.09) and the candidate genes (P = 1.08 × 10–5, OR 5.21, 95% CI 2.76-9.86).

Conclusion

AFF is associated with genes including ENPP1 that cause abnormal mineralization, suggesting that osteomalacia is an underlying condition predisposing to AFF and that higher incident rates of AFFs in Asian populations might be explained by the genetic risk factors including ENPP1.
Relation of Testosterone, Dihydrotestosterone, and Estradiol With Changes in Outcomes Measures in the Testosterone Trials
Authors: Stephens-Shields Alisa J , Snyder Peter J , Ellenberg Susan S , Taylor Lynne , Bhasin Shalender
Published: January 2022

Context

Many effects of testosterone are mediated through dihydrotestosterone (DHT) and estradiol.

Objective

To determine the relative contributions of each hormone to the observed effects of testosterone treatment in older men with hypogonadism.

Methods

Using data from the Testosterone Trials, we assessed the association of changes in total testosterone, estradiol, and DHT levels over 12 months of testosterone treatment with hemoglobin, high-density lipoprotein (HDL) cholesterol, volumetric bone mineral density (vBMD) of lumbar spine, sexual desire, and prostate-specific antigen (PSA). We used random forests to model the associations of predicted mean changes in outcomes with change in each hormone at low, mean, or high change in the other 2 hormones. Stepwise regression models were run to confirm the findings of random forests.

Result

Predicted increases in hemoglobin and sexual desire were greater with larger increases in estradiol and were larger with high change in DHT compared with low change in DHT. Greater increases in estradiol were associated with larger decreases in HDL cholesterol; this association did not vary according to changes in DHT or testosterone. Change in vBMD was most robustly associated with change in estradiol and was greater with high change in testosterone and DHT. There was no consistent relation between change in PSA and change in any hormone.

Conclusion

Change in estradiol level was the best predictor not only of the change in vBMD and sexual desire but also of the changes in hemoglobin and HDL cholesterol. Consideration of testosterone, estradiol, and DHT together offers a superior prediction of treatment response in older hypogonadal men than testosterone alone.