bluuebunny/crossref_metadata_2025 huggingface dataset:
‘I’ve left enough data’: Relations between people and data and the production of surveillance
Authors: Lee Hwankyung Janet
Published: May 2023

Exploring emergent relations between data-producing individuals and their data products, this study aims to contribute to the ongoing scholarly discussion on agencies in data practices. It focuses on shifts in surveillance structure in the era of Big Data, in which the individual becomes both a subject and an object in the production of data surveillance. Drawing on the concept of the ‘dividual’, the study analyses data practices for a tracing system invented by the South Korean government during the COVID-19 pandemic, with findings from field research conducted with 11 research participants in various urban sites in Seoul. Highlighting how the tracing system positioned surveillance ‘in the hands of citizens’, the study exposes the complexities of the relations that the participants formed with the data they produced, and how they reflexively reappropriated their practices through alterations and deflections on the basis of their tacit knowledge and imaginaries concerning digital data and their constituent positions in the knowledge production system. The resultant expression of surveillance was directly shaped by the evolving relationship between the producers (participants) and products (digital data). The study proposes that an intersectional focus on surveillance and critical data studies, with close attention to ordinary people's relations with data, has the capacity to inquire into the politics of data more fully.
Disturbing the Balance? How Team Media Position Themselves in the Digital Communication Ecology of Sports
Authors: Nölleke Daniel , Perreault Gregory
Published: May 2023

As journalism has suffered financial and institutional setbacks globally, this has given rise to so-called peripheral actors in numerous subfields of journalism. In sports journalism, this is reflected by team media. Professionals in this arena would seem to be doing very similar work to that of journalists, thereby shifting long-established power structures in the sports/media complex. However, while team media may pose an existential threat to traditional sports reporting there is also reason to believe that they still depend on healthy sports journalism. Through the lens of communication ecology and based on interviews with team media reporters ( n = 28) in Austria and the United States, this study explores how team media actually view their relation to traditional sports journalism. We found that team media reporters rejected the implication that they were somehow to blame for sports journalism’s weakened state in the sports media ecosystem. Instead, they perceived their roles as complementary and were deeply troubled by sports journalism’s weakened standing within the ecology.
An Exploratory Study of the Non-communicable Disease Risk Factors in an Endogamous Caste Population of Reddys from Tirupati, India
Authors: Latheef S. A. A. , Reddy B. Sriteja , Reddy B. Mohan
Published: May 2023

Surveillance of risk factors may help in devising interventions for reducing the burden of non-communicable diseases (NCDs). Most of the studies on NCD risk factors were conducted without taking into consideration the social units of India, like castes and tribes. In this study, an attempt was made to study the NCD risk factors in an endogamous Reddy caste population of Tirupati, India. A sample of 105 adult women and 94 adult men were recruited for this study from the urban areas of Tirupati. Data on demographic, socio-economic, behavioural, anthropometric, blood pressure and biochemical variables were obtained. Significantly higher prevalence of type 2 diabetes ( p = 0.00), waist-hip ratio-based central obesity ( p = 0.00), high total cholesterol/HDL cholesterol ( p = 0.00), high waist-height ratio ( p = 0.00), high per cent body fat ( p = 0.000) and high triglycerides ( p = 0.04) were observed in men, whereas women showed a significantly higher prevalence of low ( p = 0.01) and isolated HDL cholesterol ( p = 0.01). Significantly increased prevalence of WHR-based central obesity ( p = 0.017), prediabetes ( p = 0.037), metabolic syndrome ( p = 0.046) and high total cholesterol ( p = 0.047) and decreased prevalence of isolated low HDL cholesterol ( p = 0.034) in women with age was observed.
Education, Social Exclusion and Inclusive Framework: A Perspective from Dalit Women
Authors: Jyoti  , Bharti Hawaldar
Published: May 2023

The modest attempt of this article is to understand the social exclusion of women in general and Dalit women in particular. This article intends to argue that education is a key instrument for the development of Dalit women to get liberation from the oppressive structures of Hindu caste-patriarchy. Education ultimately ensures the re-establishment of a new social order based on inclusive values. As it is noted that women are one of the largest socially segregated groups in the world. Among them, Dalit women are most segregated and excluded from all the public and private spheres. It is found that Dalit women in India are placed at the bottom of society due to unjust social order. They are segregated and excluded based on their caste, class and gender identity. Every day, approximately four Dalit women and girls are being gang-raped and brutally murdered. It can be argued that Dalit women as an identity but also their issues and concerns are segregated and excluded. This article explores the mechanisms of segregation and exclusion of Dalit women’s identity and their issues. Along with this, the article traces the role of education in the social exclusion and emancipation of Dalit women. Further, this article explores the kind of perspective and framework that Dalit women need to overcome their historical exclusion and marginalization.
Etiopathogenesis of Cardiovocal Syndrome (Ortner’s Syndrome): A Systematic Review of the Literature
Authors: Rajamani Santhosh Kumar , Iyer Radha Srinivasan , Karodpati Nayanna S.
Published: May 2023

Cardiovocal syndrome or Ortner’s syndrome can be caused due to a myriad of etiologies in the neck or mediastinum. The syndrome can also be a consequence of many cardiac or mediastinal pathologies or even complications of surgical treatment. The objective of this research was to systematically review to provide an overview of the etiopathogenesis of Cardiovocal syndrome or Ortner’s syndrome. Cochrane Handbook for Systematic Reviews was used for the methodology of the review and the review adhered to the “Preferred Reporting Items for Systematic Review and Meta-analysis Protocols” PRISMA protocol. The database PubMed and ClinicalKey were searched using prompts “hoarseness” OR “recurrent laryngeal nerve paralysis” AND “Ortne’s syndrome” OR “Cardiovocal syndrome” OR “aneurysm” OR “thoracic aorta” OR “unilateral vocal fold paralysis.” After data extraction synthesis was done based on the 24 most relevant and recent publications reporting and outlining this condition. Newer investigative modalities like Videolaryngostroboscopy and Transcutaneous laryngeal ultrasound (TLUSG) are useful for early recognition of this condition before the development of Aortic dissection or Rupture of Aortic Aneurysm. Cardiac physicians and Otolaryngologists must remain vigilant to the sudden onset of left vocal cord palsy as it can be an early warning sign of an ominous mediastinal pathology.
Examining the dual role among adolescent mothers of pre-tertiary school students in Ghana
Authors: Alhassan Issahaku , Asoma Abiba , Donkoh Hilda Ofori
Published: May 2023

The study set out to give an in-depth analysis of the experiences of adolescent student mothers studying at the pre-tertiary level. Specifically, it examined how they balance caring for the baby while paying attention to their academic work and the implications of their dual role. To achieve the stated goal, a case study design within a qualitative approach was deployed for the study. Findings revealed navigating the dual role at the pre-tertiary level is not easy. Colleagues and family members offer support to achieve a balance. However, this is often limited. Mind and attention split when thinking about the other role. The role conflict put them in a bind. The inability to find a balance leads to the decision to give up one of the roles. This leads to worsening psychological problems, worsening financial burden, poor academic performance, dropping out of school, poor upbringing, and traumatization of adolescent student mothers and their children.
Pre- and Post-Operative Rehabilitation Interventions in Patients at Risk of Poor Outcomes Following Knee or Hip Arthroplasty: Protocol for Two Systematic Reviews
Authors: Karimijashni Motahareh , Yoo Samantha , Barnes Keely , Poitras Stéphane
Published: May 2023

Objective:

Total knee (TKA) and hip arthroplasty (THA) are successful procedures in treating end-stage osteoarthritis when nonoperative treatments fail. However, a growing body of literature has been reporting suboptimal outcomes following TKA and THA. While pre- and post-operative rehabilitation is imperative to recovery, little is known about their effectiveness for patients at risk of poor outcomes. In the 2 systematic reviews with identical methodology, we aim to evaluate the effectiveness of (a) pre-operative and (b) post-operative rehabilitation interventions for patients at risk of poor outcomes following TKA and THA.

Methods:

The 2 systematic reviews will follow the principles and recommendations outlined in the Cochrane Handbook. Only randomized controlled trials (RCTs) and pilot RCTs will be searched in 6 databases: CINAHL, MEDLINE, Embase, Web of Science, Pedro, and OTseeker. Eligible studies including patients at risk of poor outcomes and evaluating rehabilitation interventions following and preceding arthroplasty will be considered for inclusion. Primary outcomes will include performance-based tests and functional patient-reported outcome measures, and secondary outcomes will include health-related quality of life and pain. The quality of eligible RCTs will be evaluated using the Cochrane’s risk of bias tool, and the strength of evidence will be assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE).

Discussion:

These reviews will synthesize the evidence regarding the effectiveness of pre-and post-operative rehabilitation interventions for patients at risk of poor outcomes, which in turn may inform practitioners and patients in planning and implementing the most optimal rehabilitation programs to achieve the best outcomes after arthroplasty.

Systematic Review Registration:

PROSPERO CRD42022355574
The rise of independent artists and the paradox of democratisation in the digital age: Challenges faced by music artists in the new music industry
Authors: Frenneaux Richard
Published: May 2023

This article investigates the evolution of DIY into a component of mainstream cultural output, the divisions of labour in production, and the meaning of DIY to artist and industry. Given the changing nature of the music industry and the musician's place within it, it is important to examine the meaning of DIY. The merging of traditional and new media has resulted for some, in a more democratic and networked paradigm of distribution and consumption. During this evolution, new skills were developed that benefited artists within this digital context. There are, however, new gatekeepers within the platform space which carry forward elements of traditional music industry hegemony. While access to distribution and production tools is advantageous for musicians working in the ‘new’ music industry, it also introduces new hurdles for artists seeking to reach their audience due to market competition, an unpredictable algorithmic environment as well as cultural and financial capital.
Real-world comparative effectiveness of acalabrutinib and ibrutinib in patients with chronic lymphocytic leukemia
Authors: Roeker Lindsey E. , DerSarkissian Maral , Ryan Kellie , Chen Yan , Duh Mei Sheng , Wahlstrom Svea K. , Hakre Shweta , Yu Louise , Guo Helen , Mato Anthony R.
Published: May 2023

Novel agents, including Bruton tyrosine kinase inhibitors (BTKis), have become the standard of care for patients with chronic lymphocytic leukemia (CLL). We conducted a real-world retrospective analysis of patients with CLL treated with acalabrutinib vs ibrutinib using the Flatiron Health database. Patients with CLL were included if they initiated acalabrutinib or ibrutinib between 1 January 2018 and 28 February 2021. The primary outcome of interest was time to treatment discontinuation (TTD). Kaplan-Meier analysis was used to estimate unweighted and weighted median TTD. A weighted Cox proportional hazards model was used to compare the TTD between cohorts. Of the 2509 patients included in the analysis, 89.6% received ibrutinib, and 14.1% received acalabrutinib. TTD was not significantly different between cohorts in the unweighted analysis. After weighting, the cohorts were balanced on all baseline characteristics except cardiovascular risk factors and baseline medications use. The median (95% confidence interval [CI]) TTD was not reached (NR; 95% CI, 25.1 to NR) for the acalabrutinib cohort and was 23.4 months (95% CI, 18.1-28.7) for the ibrutinib cohort. The discontinuation rate at 12 months was 22% for the weighted acalabrutinib cohort vs 31% for the weighted ibrutinib cohort (P = .005). After additional adjustment for prior BTKi use, the acalabrutinib cohort had a 41% lower risk of discontinuation vs ibrutinib (hazard ratio, 0.59; 95% CI, 0.43-0.81; P = .001). In the largest available study comparing BTKis, patients with CLL receiving acalabrutinib demonstrated lower rates of discontinuation and a prolonged time to discontinuation vs those receiving ibrutinib.
Deep learning approach for early prediction of COVID-19 mortality using chest X-ray and electronic health records
Authors: Baik Seung Min , Hong Kyung Sook , Park Dong Jin
Published: May 2023

Background

An artificial-intelligence (AI) model for predicting the prognosis or mortality of coronavirus disease 2019 (COVID-19) patients will allow efficient allocation of limited medical resources. We developed an early mortality prediction ensemble model for COVID-19 using AI models with initial chest X-ray and electronic health record (EHR) data.

Results

We used convolutional neural network (CNN) models (Inception-ResNet-V2 and EfficientNet) for chest X-ray analysis and multilayer perceptron (MLP), Extreme Gradient Boosting (XGBoost), and random forest (RF) models for EHR data analysis. The Gradient-weighted Class Activation Mapping and Shapley Additive Explanations (SHAP) methods were used to determine the effects of these features on COVID-19. We developed an ensemble model (Area under the receiver operating characteristic curve of 0.8698) using a soft voting method with weight differences for CNN, XGBoost, MLP, and RF models. To resolve the data imbalance, we conducted F1-score optimization by adjusting the cutoff values to optimize the model performance (F1 score of 0.77).

Conclusions

Our study is meaningful in that we developed an early mortality prediction model using only the initial chest X-ray and EHR data of COVID-19 patients. Early prediction of the clinical courses of patients is helpful for not only treatment but also bed management. Our results confirmed the performance improvement of the ensemble model achieved by combining AI models. Through the SHAP method, laboratory tests that indicate the factors affecting COVID-19 mortality were discovered, highlighting the importance of these tests in managing COVID-19 patients.
Preoperative cerebrospinal fluid biomarkers may be associated with postoperative delirium in patients undergoing knee/hip arthroplasty: the PNDABLE study
Authors: Lin Yanan , Yu Nannan , Lin Xu , Deng Xiyuan , Liu Fanghao , Tao He , Dong Rui , Wang Bin , Bi Yanlin
Published: May 2023

Background

In the global aging population, the incidence of postoperative delirium (POD) is increasing. Therefore, finding its effective predictive tools becomes crucial. We aimed to identify potential Cerebrospinal fluid (CSF)biomarkers for POD.

Methods

A total of 825 patients undergoing knee/hip arthroplasty under combined spinal-epidural anesthesia were selected. The patients were aged 40 to 90 years with American Society of Anesthesiologists physical status I~II. The Mini-Mental State Examination was completed 1 day before the operation. CSF was extracted after successful spinal-epidural combined puncture, and α-synuclein (α-syn), amyloid beta40 (Aβ40), amyloid beta42 (Aβ42), t-Tau, phosphorylated Tau (p-Tau), progranulin (PGRN) and soluble triggering receptor expressed on myeloid cells 2 (sTREM2) in the CSF were measured by enzyme-linked immunosorbent assays (ELISA). The patient’s operation time, anesthesia time, intraoperative blood loss and fluid input were also recorded. After the operation, the occurrence rate and severity of POD were determined by the Confusion Assessment Method and the Memorial Delirium Assessment Scale (MDAS), respectively. Patients were categorized into POD group and non-POD group. Logistic regression analysis was performed on the indicators with statistically significant differences, and the area under the ROC curve (AUC) was used to estimate the predictive accuracy of the biomarkers for POD.

Results

A total of 92 patients developed POD and the incidence of POD was 11.15%. The results of the multivariable logistic regression showed that CSF t-Tau (P = 0.004, OR = 1.006, 95%CI 1.002~1.009) and α-syn (P = 0.004, OR = 1.001, 95%CI 1.000~1.001) were positively associated with the occurrence rate of POD, while Aβ42 (P < 0.001, OR = 0.989, 95%CI 0.986~0.993), CSF PGRN (P = 0.002, OR = 0.999, 95%CI 0.999~1.000), Aβ42/ t-Tau (P < 0.001, OR = 0.181, 95%CI 0.102~0.319) and Aβ42/p-Tau (P < 0.001, OR = 0.617, 95%CI 0.526~0.725) were inversely proportional to the occurrence of POD. ROC curve analysis indicated that Aβ42/t-Tau (AUC = 0.823), CSF Aβ42 (AUC = 0.813), Aβ42/p-Tau (AUC = 0.810), α-syn (AUC = 0.644) and PGRN (AUC = 0.638) could predict the occurrence rate of POD. The combination of all these biomarkers showed a greater AUC(0.896) than using any of them alone.

Conclusions

CSF Aβ42, PGRN, α-syn, Aβ42/t-Tau and Aβ42/p-Tau might be associated with the occurrence rate of POD in patients undergoing knee/hip arthroplasty.

Trial registration

Clinical Registration No. ChiCTR2000033439.
Cost-effectiveness analysis of direct admission to acute geriatric unit versus admission after an emergency department visit for elderly patients
Authors: Naouri Diane , Yordanov Youri , Lapidus Nathanael , Pelletier-Fleury Nathalie
Published: May 2023

Background

Elderly individuals represent an increasing proportion of emergency department (ED) users. In the Greater Paris University Hospitals (APHP) direct-admission study, direct admission (DA) to an acute geriatric unit (AGU) was associated with a shorter hospital length of stay (LOS), lower post-acute care transfers, and lower risk of an ED return visit in the month following the AGU hospitalization compared with admission after an ED visit. Until now, no economic evaluation of DA has been available.

Methods

We aimed to evaluate the cost-effectiveness of DA to an AGU versus admission after an ED visit in elderly patients. This was conducted alongside the APHP direct-admission study which used electronic medical records and administrative claims data from the Greater Paris University Hospitals (APHP) Health Data Warehouse and involved 19 different AGUs. We included all patients ≥ 75 years old who were admitted to an AGU for more than 24 h between January 1, 2013 and December 31, 2018. The effectiveness criterion was the occurrence of ED return visit in the month following AGU hospitalization. We compared the costs of an AGU stay in the DA versus the ED visit group. The perspective was that of the payer. To characterise and summarize uncertainty, we used a non-parametric bootstrap resampling and constructed cost-effectiveness accessibility curves.

Results

At baseline, mean costs per patient were €5113 and €5131 in the DA and ED visit groups, respectively. ED return visit rates were 3.3% (n = 81) in the DA group and 3.9% (n = 160) in the ED group (p = 0.21). After bootstrap, the incremental cost-effectiveness ratio was €-4249 (95%CI= -66,001; +45,547) per ED return visit averted. Acceptability curves showed that DA could be considered a cost-effective intervention at a threshold of €-2405 per ED return visit avoided.

Conclusion

The results of this cost-effectiveness analysis of DA to an AGU versus admission after an ED visit for elderly patients argues in favor of DA, which could help provide support for public decision making.
The changing epidemiology of syndactyly in Chinese newborns: a nationwide surveillance-based study
Authors: Chen Zhi-Yu , Li Wen-Yan , Xu Wen-Li , Gao Yu-Yang , Liu Zhen , Li Qi , Yu Bin , Dai Li
Published: May 2023

Background

Little is known about the epidemiologic features of syndactyly (SD) in Chinese newborns.

Methods

Using 2007–2019 data from the Chinese Birth Defects Monitoring Network, we conducted a prevalence analysis on overall, isolated and associated syndactyly according to birth year, maternal age, maternal residence, geographic region and infant sex, with special interests in time trends, perinatal outcomes and clinical phenotypes.

Results

A total of 13,611 SD cases were identified among 24,157,719 births in the study period, yielding the prevalence of 5.63, 4.66 and 0.97 per 10,000 for overall, isolated, and associated SD, respectively. The prevalence of each type of SD exhibited an upward trend over the period. The prevalence of overall SD varied significantly by maternal residence (urban vs. rural, 6.69/10,000 vs. 4.35/10,000), maternal age (< 20 years, 5.43/10,000; 20–24 years, 5.03/10,000; 25–29 year, 5.65/10,000; 30–34 years, 6.07/10,000; ≥ 35 years, 5.76/10,000), geographic region (central, 5.07/10,000; east, 6.75/10,000; west, 5.12/10,000), and infant sex (male vs. female, 6.28/10,000 vs. 4.86/10,000). Newborns with associated SD were more likely to be born prematurely (29.2% vs. 10.6%) or with low birthweight (30.5% vs.9.8%) than those with isolated SD. The bilaterally, and unilaterally affected cases accounted for 18.4% and 76.7%, respectively. The feet were more frequently involved (64.3%) in those bilaterally affected cases, while right side preference (right vs left: 53.8% vs 46.2%) and upper limbs preference (hand vs foot: 50.8% vs 48.0%) were found in unilateral cases.

Conclusions

The prevalence of syndactyly in China is on the rise and notably higher than that in other Asian and European countries, highlighting the importance of investigating the etiology, epidemiology, and clinical implications of this condition in the Chinese population.
Biliary drainage combined with simultaneous 125I seed strand brachytherapy for the treatment of hilar cholangiocarcinoma
Authors: Zhang Chengzhi , Song Mengyao , Sun Zhanguo , Fang Yi , Liu Yiming , Xu Kaihao , Han Xinwei , Jiao Dechao
Published: May 2023

Background

To evaluate the clinical efficacy of percutaneous biliary drainage (PBD) combined with 125I seed strand brachytherapy (ISSB) for the treatment of hilar cholangiocarcinoma (HCCA).

Methods

The clinical data of 64 patients with HCCA (median age 62.5, male 29, female 35) treated in our department from April 2017 to April 2021 were retrospectively analyzed. Thirty-four patients in the experimental group (EG) were treated with PBD combined with ISSB, while 30 patients in the control group (CG) were treated with PBD alone. The primary study endpoints were technical success, clinical success and the 2-month local tumor control (LTC) rate. Secondary endpoints were early/late complications, median progression-free survival (mPFS) and overall survival (mOS).

Results

The technical and clinical success in the EG and CG showed no significant differences (100 vs. 100%, 94.1 vs. 93.3%, P > 0.05). Both early and late complications showed no significant differences between the two groups (P > 0.05). The 2-month LTC rates were significantly better in the EG versus the CG (94.1% vs. 26.7%, 157.7 ± 115.3 vs. 478.1 ± 235.3 U/ml), respectively (P < 0.05). The mPFS and mOS were 4.3 (95% CI 3.9–4.7) months and 2.8 (95% CI 2.5–3.1) months and 13.5 (95% CI 10.7–16.3) months and 8.8 (95% CI 7.8–9.8) months, respectively, with significant differences (P < 0.05).

Conclusion

PBD combined with ISSB is a safe and effective treatment for HCCA that can inhibit local tumors and prolong PFS and OS.
JMJD2A participates in cytoskeletal remodeling to regulate castration-resistant prostate cancer docetaxel resistance
Authors: Cai Xiang , Duan Xi , Tang Tielong , Cui Shu , Wu Tao
Published: May 2023

Background

To investigate underlying mechanism of JMJD2A in regulating cytoskeleton remodeling in castration-resistant prostate cancer (CRPC) resistant to docetaxel.

Methods

Tissue samples from CRPC patients were collected, and the expression of JMJD2A, miR-34a and cytoskeleton remodeling-related proteins were evaluated by qPCR, western blot and immunohistochemistry, and pathological changes were observed by H&E staining. Further, JMJD2A, STMN1 and TUBB3 were knocked down using shRNA in CRPC cell lines, and cell viability, apoptosis and western blot assays were performed. The interaction between miR-34a/STMN1/β3-Tubulin was analyzed with dual-luciferase reporter and co-immunoprecipitation assays.

Results

In clinical experiment, the CRPC-resistant group showed higher expression of JMJD2A, STMN1, α-Tubulin, β-Tubulin and F-actin, and lower expression of miR-34a and β3-Tubulin compared to the sensitive group. In vitro experiments showed that JMJD2A could regulate cytoskeletal remodeling through the miR-34a/STMN1/β3-Tubulin axis. The expression of miR-34a was elevated after knocking down JMJD2A, and miR-34a targeted STMN1. The overexpression of miR-34a was associated with a decreased expression of STMN1 and elevated expression of β3-Tubulin, which led to the disruption of the microtubule network, decreased cancer cell proliferation, cell cycle arrest in the G0/G1 phase, and increased apoptosis.

Conclusion

JMJD2A promoted docetaxel resistance in prostate cancer cells by regulating cytoskeleton remodeling through the miR-34a/STMN1/β3-Tubulin axis.
Influence of social and meteorological factors on hand, foot, and mouth disease in Sichuan Province
Authors: Jiang Xiaohong , Ma Yue , Lv Qiang , Liu Yaqiong , Zhang Tao , Yin Fei , Shui Tiejun
Published: May 2023

Background

Hand, foot and mouth disease (HFMD) caused by a variety of enteroviruses remains a major public health problem in China. Previous studies have found that social factors may contribute to the inconsistency of the relationship patterns between meteorological factors and HFMD, but the conclusions are inconsistent. The influence of social factors on the association between meteorology and HFMD is still less well understood. We aimed to analyze whether social factors affected the effect of meteorological factors on HFMD in Sichuan Province.

Method

We collected daily data on HFMD, meteorological factors and social factors in Sichuan Province from 2011 to 2017. First, we used a Bayesian spatiotemporal model combined with a distributed lag nonlinear model to evaluate the exposure-lag-response association between meteorological factors and HFMD. Second, by constructing the interaction of meteorological factors and social factors in the above model, the changes in the relative risk (RR) under different levels of social factors were evaluated.

Results

The cumulative exposure curves for average temperature, relative humidity, and HFMD were shaped like an inverted “V” and a “U” shape. As the average temperature increased, the RR increased and peaked at 19 °C (RR 1.020 [95% confidence interval CI 1.004–1.050]). The urbanization rate, per capita gross domestic product (GDP), population density, birth rate, number of beds in health care centers and number of kindergartens interacted with relative humidity. With the increase in social factors, the correlation curve between relative humidity and HFMD changed from an “S” shape to a “U” shape.

Conclusions

Relative humidity and average temperature increased the risk of HFMD within a certain range, and social factors enhanced the impact of high relative humidity. These results could provide insights into the combined role of environmental factors in HFMD and useful information for regional interventions.
Association between iron-folic acid supplementation and pregnancy-induced hypertension among pregnant women in public hospitals, Wolaita Sodo, Ethiopia 2021: a case- control study
Authors: Asres Abiyot Wolie , Samuel Serawit , Daga Wakgari Binu , Tena Atsede , Alemu Afework , Workie Shimelash Bitew , Alemayehu Mihiretu , Messel Habtamu
Published: May 2023

Background

Pregnancy-induced hypertension is the new onset of high blood pressure after 20 weeks of gestation in women with previously normal blood pressure. To the best of our knowledge, no study has been conducted in our country to investigate the association between this pregnancy problem and iron-folic acid supplementation. The aim of this study was to determine the association between iron-folic acid supplementation and pregnancy-induced hypertension (PIH) in pregnant women at public hospitals in the Wolaita Sodo zone.

Methods

An institution-based case–control study was conducted among pregnant women who visited public hospitals in the Wolaita Sodo zone from March 3, 2022, to August 30, 2022. A consecutive sampling method was used to select the study participants. The total sample size was 492, of which 164 were cases and 328 were controls. The data were collected by conducting face-to-face interviews and measurements. The data were entered into EpiData version 4.6 and exported to STATA 14 for analysis. Those variables with ap-value less than 0.05 were considered statistically significant. Descriptive statistics and odds ratios were presented using texts, tables, and figures.

Results

A total of 471 women participated in this study, yielding a response rate of 96%. The cases had a mean age of 25 ± 4.43, while the controls had a mean age of 25 ± 3.99. The mean age at first pregnancy among cases was 20 ± 2.82 and among controls was 20 ± 2.97. The average number of deliveries for cases and controls was 1.97 ± 1.41 and 1.95 ± 1.38, respectively. There is no significant association between iron-folic acid supplementation and PIH. Pregnant women with high hemoglobin levels had higher odds of PIH as compared to those without it (AOR = 3.65; 95% CI: 1.0–12.9). Eating kocho (AOR = 14.4; 95% CI: 1.2–16.7) was positively associated with PIH.

Conclusions

There is no association between iron-folic acid supplementation during pregnancy and pregnancy-induced hypertension. Pregnant women with high hemoglobin levels had higher odds of PIH as compared to those without it. There is an association between kocho consumption and PIH. More research should be done using stronger designs.
The combination therapy of isomucronulatol 7-O-beta-glucoside (IMG) and CEP-9722 targeting ferroptosis-related biomarkers in non-small cell lung cancer (NSCLC)
Authors: Cui Xiaofei , Liu Chang , Dong Penghua , Liu Chao , Bai Yu
Published: May 2023

Background

NSCLC is a malignant tumor with a high incidence. Ferroptosis presents an essential function in regulating carcinogenesis and tumor progression. However, the ferroptosis-associated prognostic model based on single-cell sequencing of NSCLC remains unexplored. Our study aims to establish a potential predictive model for NSCLC patients and provide available targeted drugs for clinical treatment.

Methods

The data on NSCLC patients were collected from TCGA and GEO databases to analyze their gene expression profiles. ConsensusCluster was adopted to divide the patients into different groups based on ferroptosis-related genes. Then, the univariable Cox and LASSO analyses were applied to data analysis and model establishment. Single-cell analysis was used to explore the risk score genes in different cell populations and states. The protein levels of these genes were also investigated through the HPA database. Drug sensitivity was evaluated in CellMiner database. CCK8 and colony formation assays were performed to validate potential drugs’ effects on lung cancer cell lines.

Results

A ferroptosis-related prognostic model involving 14 genes in NSCLC patients was established. The risk score model was developed in training set GSE31210 and validated in the test set TCGA. The low-risk score group showed a better prognosis than the high-risk score group. The single-cell analysis revealed that the risk score genes were mainly derived from lung tumor cells. Most risk score genes were more highly expressed in tumor tissue than in normal tissue, according to the HPA database. Besides, these genes were associated with 106 drugs in CellMiner database. Finally, the drug effects on NSCLC cell growth were evaluated by cck8 and colony formation.

Conclusions

We identified an effective ferroptosis-related prognostic model based on single-cell sequencing. The potential prediction model is devoted to exploring clinical therapeutic targets for NSCLC.
Physical activity after revision knee arthroplasty including return to sport and work: a systematic review and meta-analysis including GRADE
Authors: van der Wilk Sten , Hoorntje Alexander , Blankevoort Leendert , van Geenen Rutger , Kerkhoffs Gino M. M. J. , Kuijer P. Paul F. M.
Published: May 2023

Background

The number of primary knee arthroplasties (KAs) performed annually is rising, especially among active, working age patients. Consequently, revision KA is also increasingly performed. Our aim was to systematically review the extent to which patients were physically active following revision KA, and the rate and timing of return to sport and work.

Methods

A search was conducted in the databases Medline and Embase until February 24th, 2023. Studies describing patients with revision total knee arthroplasty (rTKA) or revision unicondylar knee arthroplasty (rUKA), with outcomes regarding physical activity or return to sport (RTS) or work (RTW) were included. Quality of studies was assessed using the Newcastle–Ottawa scale, meta-analyses were performed using RevMan 5.4 and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).

Results

Of the 4,314 articles screened, 22 studies were included describing 2,462 rTKA patients (no rUKA), 42% were male with a mean age of 67 years (range 24 – 95). No studies reported objective physical activity measurements. Twenty-two studies reported patient reported outcome measures (PROMs). The PROMs that were pooled on a scale from zero to ten were the UCLA Activity Score, the Tegner Activity Level Scale, the Lower-Extremity Activity Scale, Devane Activity Score, and physical activity related subscales of the Knee injury and Osteoarthritis Outcome Score. The retrospective studies of moderate quality showed a statistically significant postoperative improvement of 1.7 points (MD = 1.71, 95% CI 1.48 – 1.94 (p < 0.0001); 14 studies,n = 1,211). For the prospective moderate-quality studies, a statistically significant postoperative increase of 0.9 points was found (MD = 0.89, 95% CI 0.48 – 1.30 (p < 0.0001); 6 studies,n = 1,027). Regarding RTS, 12% of patients participated in so-called ‘non-recommended’ activities (i.e., hockey, soccer, football, gymnastics, jogging, singles tennis, and basketball) after rTKA (1 study,n = 206). The pooled RTW was 86% (2 studies, range 18–95%,n = 234).

Conclusions

The majority of patients self-reported an improved postoperative activity level after rTKA. Patients could maintain an active lifestyle in daily life, including sports and work. For reliable physical activity, RTS and RTW estimations, more studies are required. In terms of GRADE, the quality of evidence for the five prospective studies was rated as low.

Level of evidence

Level 3.
Associations between empirically derived dietary patterns and oxidative stress and inflammation in adults with primary hypothyroidism: a case-control study
Authors: Taherinia Sorour , Heidari Zahra , Salehidoost Rezvan , Karimifar Mozhgan , Arab Arman , Alshahrani Shadia Hamoud , Askari Gholamreza
Published: May 2023

Background

Primary hypothyroidism is a common endocrine disorder caused by impaired production of thyroid hormones. Recent studies have shown that dietary habits, oxidative stress, and inflammation may play roles in thyroid hypofunction. Thus, the present article aimed to determine the relationship between major dietary patterns and oxidative stress and inflammation in primary hypothyroid patients and healthy people in Iranian adults.

Methods

This matched case-control study was conducted on 200 participants (100 cases and 100 controls). The presence of primary hypothyroidism was determined by endocrinologists based on American Thyroid Association (ATA) criteria. Dietary intake was assessed using a validated 168-item, semi-quantitative food frequency questionnaire (FFQ). The principal component analysis (PCA) method was used to derive major dietary patterns. Statistical analysis was performed using logistic regression analysis, and the findings were reported using odds ratios (ORs) with 95% CIs.

Results

We identified 2 major dietary patterns (i.e., healthy and Western dietary patterns). After adjusting for confounding variables, participants in the highest tertile of the healthy eating pattern had lower odds of primary hypothyroidism. Also, there was a significant relationship between total antioxidant capacity (TAC) levels and thyroid hypofunction; however, no significant correlation was seen between the Western dietary pattern and malondialdehyde (MDA) and C-reactive protein (CRP) with hypothyroidism.

Conclusions

There were statistically direct associations between healthy dietary patterns (loaded with vegetables, nuts and seeds, fruits, dried fruits, olives, garlic, black pepper, starchy vegetables, low-fat dairy, and legumes) and increased TAC levels with a decreased risk of thyroid hypofunction. However, Western dietary patterns and MDA and CRP levels did not associate with an underactive thyroid.
Endocervical curettage for diagnosing high-grade squamous intraepithelial lesions or worse in women with type 3 transformation zone lesions: a retrospective, observational study
Authors: Wei Bingrui , Li Qing , Seery Samuel , Qiao Youlin , Jiang Yu
Published: May 2023

Background

This study aimed to assess the value of endocervical curettage (ECC) in detecting high-grade squamous intraepithelial lesion or worse (HSIL+) in women with type 3 transformation zone (TZ3) lesions, and to identify the clinical characteristics of patients with TZ3 lesions who benefit most from ECC.

Methods

This retrospective, multicenter study included 1,905 women with TZ3 lesions who attended cervical screening in one of seven tertiary hospitals in China between January 2020 and November 2021. All participants had received abnormal results and had been referred to colposcopy. Risk factors were identified through univariate and multifactorial logistic analyses.

Results

In total, 20.5% (n = 391) of HSIL+ cases with TZ3 lesions had been diagnosed with biopsy and ECC. ECC detected 0.8% (n = 15) HSIL+ cases otherwise missed by biopsy alone. Multivariate analysis identified four factors which influenced detection performance. The probability of detecting HSIL+ with ECC is 2.653 (95% confidence interval [CI] 1.009–6.977) times greater in women aged 40–49 years and 2.545 (95% CI 0.965–6.716) times greater for those aged 50 years and older compared to those younger than 30 years. The probability of ASC-H (atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion) and HSIL cytologies were respectively 2.415 (95% CI 1.213–4.808) and 2.933 (95% CI 1.648–5.220) times higher than for NILM (negative for intraepithelial lesion or malignancy). Women with human papillomavirus 16/18 infections were 2.299 (95% CI 0.942–5.613) times more likely to be HSIL+. Precancerous lesions were 35.884 (95% CI 12.214–105.426) times more likely in women who had high-grade colposcopic impressions compared to those with normal impressions.

Conclusions

ECC should be performed for patients with ASC-H or HSIL cytologies, human papillomavirus 16/18 infections, and for those with high-grade colposcopic impressions. This will increase the number of HSIL+ cases identified using biopsy by reducing the number of false negatives.
Bactericidal and anti-inflammatory effects of Moquilea tomentosa Benth. flavonoid-rich leaf extract
Authors: Campos Mariana Freire , Baratto Leopoldo Clemente , Vidal Vinícius Mendes , Nascimento Ivana Ventura , Gomes Brendo Araujo , de Lima Martins Neto Genes , Olsen Priscilla Christina , Leo Rodrigo Ribeiro Tarjano , Moreira Lilian Oliveira
Published: May 2023

Background

Natural products are an important source of bioproducts with pharmacological properties. Here we investigate the components of leaves from M. tomentosa Benth. (Fritsch) (Chrysobalanaceae) and its effects on bacterial cell growth, biofilm production and macrophage activity.

Methods

The effect of the different leaf extracts against bacterial cell growth was performed using the microdilution method. The most active extract was analyzed by mass spectrometry, and its effect on bacterial biofilm production was evaluated on polystyrene plates. The extract effect on macrophage activity was tested in the RAW264.7 cell line, which was stimulated with different concentrations of the extract in the presence or absence of LPS.

Results

We show that the ethyl acetate (EtOAc) extract was the most effective against bacterial cell growth. EtOAc extract DI-ESI (-)MSn analysis showed the presence of a glycosylated flavonoid tentatively assigned as myricetin 3-O-xylosyl-rhamnoside (MW 596). Also, the EtOAc extract increased biofilm formation by S. aureus and inhibited cytokine and NO production induced by LPS in RAW macrophages.

Conclusion

M. tomentosa flavonoid-enriched EtOAc extract presented a bactericidal and anti-inflammatory pharmacological potential.
Logical definition-based identification of potential missing concepts in SNOMED CT
Authors: Hao Xubing , Abeysinghe Rashmie , Roberts Kirk , Cui Licong
Published: May 2023

Background

Biomedical ontologies are representations of biomedical knowledge that provide terms with precisely defined meanings. They play a vital role in facilitating biomedical research in a cross-disciplinary manner. Quality issues of biomedical ontologies will hinder their effective usage. One such quality issue is missing concepts. In this study, we introduce a logical definition-based approach to identify potential missing concepts in SNOMED CT. A unique contribution of our approach is that it is capable of obtaining both logical definitions and fully specified names for potential missing concepts.

Method

The logical definitions of unrelated pairs of fully defined concepts in non-lattice subgraphs that indicate quality issues are intersected to generate the logical definitions of potential missing concepts. A text summarization model (called PEGASUS) is fine-tuned to predict the fully specified names of the potential missing concepts from their generated logical definitions. Furthermore, the identified potential missing concepts are validated using external resources including the Unified Medical Language System (UMLS), biomedical literature in PubMed, and a newer version of SNOMED CT.

Results

From the March 2021 US Edition of SNOMED CT, we obtained a total of 30,313 unique logical definitions for potential missing concepts through the intersecting process. We fine-tuned a PEGASUS summarization model with 289,169 training instances and tested it on 36,146 instances. The model achieved 72.83 of ROUGE-1, 51.06 of ROUGE-2, and 71.76 of ROUGE-L on the test dataset. The model correctly predicted 11,549 out of 36,146 fully specified names in the test dataset. Applying the fine-tuned model on the 30,313 unique logical definitions, 23,031 total potential missing concepts were identified. Out of these, a total of 2,312 (10.04%) were automatically validated by either of the three resources.

Conclusions

The results showed that our logical definition-based approach for identification of potential missing concepts in SNOMED CT is encouraging. Nevertheless, there is still room for improving the performance of naming concepts based on logical definitions.
Neutrophil extracellular traps in acute coronary syndrome
Authors: Wu Yawen , Wei Shilin , Wu Xiangyang , Li Yongnan , Han Xue
Published: May 2023

Acute coronary syndrome (ACS) is a group of clinical syndromes caused by acute myocardial ischemia, which can cause heart failure, arrhythmia and even sudden death. It is the major cause of disability and death worldwide. Neutrophil extracellular traps (NETs) are reticular structures released by neutrophils activation and have various biological functions. NETs are closely related to the occurrence and development of ACS and also the subsequent damage after myocardial infarction. The mechanisms are complex and interdependent on various pathways, which require further exploration. This article reviewed the role and mechanism of NETs in ACS, thereby providing a valuable reference for the diagnosis and clinical treatment of ACS.
The effectiveness of atorvastatin for the prevention of deep vein thrombosis in cancer patients undergoing chemotherapy
Authors: Setiawan Budi , Budianto Widi , Sukarnowati Tri Wahyu , Rizky Daniel , Pangarsa Eko Adhi , Santosa Damai , Sudoyo Aru Wisaksono , Winarni Tri Indah , Riwanto Ignatius , Setiabudy Rahajuningsih Dharma , Suharti Catharina
Published: May 2023

Background

Deep vein thrombosis (DVT) is a common complication in cancer. Although thromboprophylaxis in cancer patients is recommended by the guidelines, clinicians’ use of thromboprophylaxis remains limited due to cost, bleeding complications, and reluctance to give injectable anticoagulants. Inflammation plays essential roles in the pathogenesis of cancer-associated thrombosis. Owing to its ability to decrease proinflammatory cytokines, statins have anti-inflammatory properties. Thus, statins can be possibly utilized as thromboprophylaxis therapy in cancer patients undergoing chemotherapy.

Objective

To compare the effectiveness of atorvastatin and rivaroxaban for DVT prevention in high-risk thrombosis patients with cancer undergoing chemotherapy.

Methods

Double-blind, randomized controlled trial involving cancer patients with high-risk of thrombosis undergoing chemotherapy. We randomly assigned patients without deep-vein thrombosis at screening to receive atorvastatin 20 mg or rivaroxaban 10 mg daily for up to 90 days. Doppler ultrasonography was performed 90 days following chemotherapy to diagnose DVT. Average cost-effectiveness analysis was performed to analyze the cost of atorvastatin compared to rivaroxaban.

Results

Of the eighty six patients who underwent randomization, primary efficacy end point was observed in 1 of 42 patients (2.3%) in the atorvastatin group and in 1 of 44 (2.2%) in the rivaroxaban group (Odds Ratio [OR], 0.953; 95% confidence interval [CI], 0.240 to 3.971; p = 1.000). There was a significant difference in the incidence of major bleeding, 2 of 42 patients (4.8%) in the atorvastatin group and 12 of 44 (27.3%) in the rivaroxaban group (OR, 0.257; 95% CI, 0.07 to 0.94; p = 0.007). The average cost-effectiveness ratio of using atorvastatin was lower than that of rivaroxaban.

Conclusion

Atorvastatin did not differ significantly from rivaroxaban in reducing the incidence of DVT, lower bleeding risk, and cost-effectiveness for thromboprophylaxis in high-risk thrombosis patients with cancer undergoing chemotherapy. The presence of limited statistical power and wide confidence intervals in this study needs further study to strengthen the efficacy of atorvastatin as DVT prophylaxis in cancer patients.

Trial registration

ISRCTN71891829, Registration Date: 17/12/2020.