bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of single-hole and multi-hole orifice energy consumption
Authors: Bikić Siniša , Đurđević Marko , Bukurov Maša , Tašin Slobodan
Published: January 2022

Nowadays, with rising energy prices, energy efficiency is playing an important role in all industries. Differential pressure-based measuring instruments are still widely used instruments with orifice flow meters being the most popular ones. Due to its simplicity, reliability, and ease of maintenance, orifice flow meters are very common measuring instruments in many industries. As these instruments are differential pressure-based instruments, they are increasing energy costs due to increased pressure loss. Conventional single-hole orifice (SHO) flow meters have many advantages but also some disadvantages that are affecting energy efficiency. These disadvantages like higher pressure difference, slower pressure recovery, lower discharge coefficient can be overcome by multi-hole orifice (MHO) flow meters. Computational fluid dynamics (CFD) simulations were used to study energy consumption of both SHO and MHO with four different β parameters. Results showed MHO to be more energy efficient compared to SHO with same β parameter. These results are showing one more advantage MHO have compared to SHO, but further research is needed to make them a drop-in replacement.
A systematic review of the quality of reporting and risk of bias for randomized crossover trials in digestive disease journals
Authors: Zhou Qian , Chen Zhi-hang , Zhang Jin-xin , Peng Sui
Published: January 2022

Background:

The quality of randomized crossover studies on digestive diseases is unclear. We aimed to review crossover trials in digestive disease journals and evaluate their reporting quality and risk of bias.

Methods:

We searched the PubMed, Web of Science, and Scopus databases for all crossover trials in 39 digestive journals between January 2011 and September 2021. Reporting adherence was based on the CONSORT 2010 statement: extension to randomized crossover trials published in July 2019. A newly released Cochrane risk of bias tool 2.0 extension for crossover trials was applied to assess the risk of bias.

Results:

In total, 173 studies were included in the analysis, and 16.2% were published following the CONSORT statement extension. The crossover design was not only widely used in drug efficacy trials (48.6%) but also in endoscopic ultrasound trials (23.7%) and dietary studies (17.9%) in the field of digestive diseases. The overall reporting adherence was 37.6% for full texts and 43.4% for abstracts. The proportions of trials with low, some concerns, and high risk of bias were 13.9%, 15.6%, and 70.5%, respectively. The difference in reporting adherence and high risk of bias between pre- and post-CONSORT was not significant. Having a sample size plan, defining primary end points, and pre-registration showed higher reporting adherence and lower risk of bias than those who did not.

Conclusion:

These findings demonstrated the inadequate quality of randomized crossover trials for digestive diseases. Compliance with the CONSORT extension for crossover trials must be strengthened and improved (PROSPERO CRD: 42021248723).
MOG antibody–associated encephalomyelitis mimicking bacterial meningomyelitis following ChAdOx1 nCoV-19 vaccination: a case report
Authors: Escolà Jordi Kühne , Deuschl Cornelius , Junker Andreas , Dusse Fabian , Pul Refik , Kleinschnitz Christoph , Köhrmann Martin , Frank Benedikt
Published: January 2022

We report a case of anti-myelin oligodendrocyte glycoprotein (MOG) antibody-associated encephalomyelitis following vector-based vaccination against SARS-CoV-2 that mimicked bacterial meningomyelitis upon initial presentation. A 43-year-old woman who had received a first dose of ChAdOx1 nCoV-19 (Vaxzevria; Astra Zeneca, UK Limited) 9 days earlier presented with subacute sensorimotor paraparesis, urinary retention, headache, meningism, and fever. Clinical findings and cerebrospinal fluid (CSF) features were highly suggestive of bacterial infection; however, despite receiving broad anti-infective treatment alongside with high-dose glucocorticoids, symptoms deteriorated. Imaging findings and the detection of immunoglobulin G against MOG substantiated diagnosis of an anti-MOG associated disorder. Treatment with high-dose intravenous (IV) methylprednisolone and plasma exchange resulted in substantial clinical improvement, which sustained under monthly regimen of IV Tocilizumab at 3-month follow-up. Awareness of this post-vaccinal presentation of a rare autoimmune disorder is important to not miss potential treatment options.
Rethinking political PR: A theoretical framework towards supporting social integration in the UK
Authors: Okour Sarah A
Published: January 2022

Political, social and demographic change has resulted in a search for new techniques for building public trust and reconciling relationships between the Muslim community and others in society. In this study, extremism and social cohesion have been chosen as potential new aims for the PR industry. This study assesses whether political PR can be diverted from its role in spin doctoring towards new cultural and social functions. My argument is that political PR can be used as a tool for social integration with particular reference to the Muslim community in the UK. This research distinguishes between two issues. The first connects with political PR within a political communication background, which relates to politicians, election campaigns, news management and their relationship with the media. The second issue is that political PR can be reconsidered from a corporate perspective, one that endorses the use of PR in challenging political environments. My study places emphasis on the second issue. A sample of seven UK PR academics, therefore, evaluated the current communication policies for their effectiveness, explained how political PR could help and gave their recommendations. Seven NGOs in Britain also described their work, the problems they encountered and their concerns. A lack of social integration and the rise of extremism were explained in terms of stereotyping, marginalisation and counterproductive techniques. The results suggest that a change in political PR is possible and should be encouraged to intervene in countering radicalization and enhancing social cohesion. They also show a lack of PR support for NGOs. The findings broadly move the field of inclusivity forward by working on a bottom-up approach instead of a top-down model of communication. The best answer for sustaining long-term community relationships was improved communication and engagement, inclusive messages and campaigns, and the Muslim community remaining open to others in society.
Do submillisievert-chest CT protocols impact diagnostic quality in suspected COVID-19 patients?
Authors: Thieß Hans-Martin , Bressem Keno K , Adams Lisa , Böning Georg , Vahldiek Janis L , Niehues Stefan M
Published: January 2022

Background

During the ongoing global SARS-CoV-2 pandemic, there is a high demand for quick and reliable methods for early identification of infected patients. Due to its widespread availability, chest-CT is commonly used to detect early pulmonary manifestations and for follow-ups.

Purpose

This study aims to analyze image quality and reproducibility of readings of scans using low-dose chest CT protocols in patients suspected of SARS-CoV-2 infection.

Materials and Methods

Two radiologists retrospectively analyzed 100 low-dose chest CT scans of patients suspected of SARS-CoV-2 infection using two protocols on devices from two vendors regarding image quality based on a Likert scale. After 3 weeks, quality ratings were repeated to allow for analysis of intra-reader in addition to the inter-reader agreement. Furthermore, radiation dose and presence as well as distribution of radiological features were noted.

Results

The exams’ effective radiation doses were in median in the submillisievert range (median of 0.53 mSv, IQR: 0.35 mSv). While most scans were rated as being of optimal quality, 38% of scans were scored as suboptimal, yet only one scan was non-diagnostic. Inter-reader and intra-reader reliability showed almost perfect agreement with Cohen’s kappa of 0.82 and 0.87.

Conclusion

Overall, in this study, we present two protocols for submillisievert low-dose chest CT demonstrating appropriate or better image quality with almost perfect inter-reader and intra-reader agreement in patients suspected of SARS-CoV-2 infection.
Neurally Mediated Syncope Triggered by COVID-19 Nasopharyngeal Swab Specimen Collection: A Case Report
Authors: Bloom William R. , Bloom Thomas D.
Published: January 2022

There are few reports describing adverse events associated with nasopharyngeal swab specimen collection in patients tested for SARS-Cov-2 (COVID-19). Despite the lack of data, providers should be aware of complications associated with swab collection. Instances of nasopharyngeal swab as a syncope trigger are mostly anecdotal and not well described in the medical literature. We present a case of neural reflex mediated syncope associated with the nasopharyngeal swab specimen collection process in a healthy patient undergoing COVID-19 testing prior to elective surgery. This response may be mediated by the trigeminocardiac reflex or via glossopharyngeal nerve stimulation. Less invasive collection practices, such as saliva sampling, may be warranted, particularly in those predisposed to syncopal episodes.
Long-Term Outcomes After Transfemoral-Transcatheter Aortic Valve Implantation in Very Old Patients Using the Balloon-Expandable Bioprosthesis
Authors: Useini Dritan , Schlömicher Markus , Aweimer Assem , Haldenwang Peter , Strauch Justus , Patsalis Polykarpos C.
Published: January 2022

Transcatheter aortic valve implantation (TAVI) can be safely performed in old patients. Increasing longevity raises often the question whether TAVI can be still useful for patients beyond a certain age limit. Data on long-term outcomes of elderly patients after TAVI are sparse. We sought to assess the impact of very advanced age on long-term outcomes after transfemoral (TF)-TAVI. Data of 103 patients undergoing TF-TAVI with the balloon-expandable bioprosthesis between May/2014 and May/2019 were analyzed. We divided the cohort into two age groups: ≥85 years (group1: n = 37; 87.5 ± 2.6 years; STS-Score 3.9 ± 1.4) versus < 85 years (group2: n = 66; 80 ± 3.1 years; STS-Score 3.4 ± 1.8). We conducted up to 6 years clinical follow-up. Overall mortality at 30 days was 3.8% without significant differences between the two age groups. Incidence of major vascular injury (8.6 vs. 6.3%, p = .695) and stroke (2.8 vs. 3%, p = 1) was not significantly different between group 1 and 2, respectively. More than mild paravalvular leakage was found in 1 patient (group 1). The mean long-term survival probability was 51.3 months [95% CI: 42.234–60.430] in group 1 versus 49.5 months [95% CI: 42.155–56.972] in group2 ( p = .921). Long-term outcomes of very old patients after TF-TAVI show a similar treatment benefit compared to the younger patients.
The Prevalence of Accessory Ossicles, Sesamoid Bones, and Biphalangism of the Foot and Ankle: A Radiographic Study
Authors: Candan Busra , Torun Ebru , Dikici Rumeysa
Published: January 2022

Background:

Accessory ossicles, sesamoid bones, and biphalangism of toes are the most common developmental variations of the foot. These bones may be associated with painful syndromes; however, their clinical importance is not well understood because the reported prevalence varies widely. Therefore, we aimed to investigate these variants in Turkish subjects.

Methods:

A total of 1651 foot radiographs were retrospectively assessed. Radiographs of feet were examined regarding the prevalence, sex, and bilaterality of accessory ossicles, sesamoid bones, and biphalangism in Turkish subjects.

Results:

Accessory ossicles (26.1%) and sesamoid bones (8%) were detected. The most common accessory ossicles were os trigonum (9.8%), accessory navicular bone (7.9%), and os peroneum (5.8%). Also, we detected os supratalare (0.48%), os calcanei secundarium (0.42%) os subfibulare (0.42%), os supranaviculare (0.36%), os vesalianum (0.30%), os subtibiale (0.24%), os intermetatarseum (0.12%), and os subcalcis (0.12%). We observed bipartite hallux sesamoid in 1.8% and interphalangeal sesamoid bone of the hallux in 0.7% of radiographs. Incidences of metatarsophalangeal sesamoid bones were found as 0.6%, 0.06%, 0.6%, and 5.8% in the second, third, fourth, and fifth digit, respectively. We observed biphalangeal toe in 0.5%, 1.7%, 3.5%, and 37.6% in the second, third, fourth, and fifth toe, respectively.

Conclusion:

This study is the first detailed report on the incidence of the most common variants of the foot and ankle in a wide-ranging patients’ series in Turkish subjects. Our study’s findings will contribute to reducing misdiagnosis.

Clinical Relevance:

The results of this study may provide anatomical data that could help clinicians in the diagnosis and management of disorders that present with pain and discomfort in the feet. Knowledge of these variants is important to prevent misinterpreting them as fractures.
Situating climate change adaptation within plural worlds: The role of Indigenous and local knowledge in Pentecost Island, Vanuatu
Authors: Rarai Allan , Parsons Meg , Nursey-Bray Melissa , Crease Roa
Published: January 2022

Scholars, practitioners, and decision-makers are increasingly recognising that Indigenous knowledge can play a significant role in facilitating adaptation to climate change. Yet, adaptation theorising and practises remain overwhelmingly situated within Euromodern ontologies, and there remains limited space, at present, for plural ontologies or alternative ways of being and knowing. In this paper, and using the Pacific as our case study, we present an argument for the inclusion of multiple ontologies within adaptation policymaking. Pacific adaptation policies and interventions frequently privilege Western scientific knowledge and focus on addressing individual climate risks through technical fixes directed by foreign experts and funding agencies. They are also rooted in a policy architecture that is an artefact of colonisation in the region. Despite these obstacles, Pacific Islander responses to climate change are dynamic, and inclusive of the multiple and competing ontologies they work within, offering insights into how Euromodern and Pacific islander world views could coalesce to builds adaptive capacity and consolidate community resilience into the future. Highlights • Indigenous Knowledge plays a critical role in enabling resilience and facilitating climate change adaptation in some parts of Vanuatu • Ni-Vanuatu people employ dynamic responses to climate risks incorporating multiple knowledge systems and practises • Co-existence of different knowledge systems provide insights into factors that enable adaptive capacity and consolidate community resilience • Diverse worldviews, knowledge systems and practises with Pacific Island cultures highlights the importance of thinking about ontological pluralism within adaptation • Climate adaptation is principally founded on Western ontologies, but there is a need consider non-Western ontologies and epistemologies.
A randomized trial of alendronate as prophylaxis against loss in bone mineral density following lymphoma treatment
Authors: Jensen Paw , Jakobsen Lasse Hjort , Bøgsted Martin , Baech Joachim , Lykkeboe Simon , Severinsen Marianne Tang , Vestergaard Peter , El-Galaly Tarec Christoffer
Published: January 2022

Lymphoma patients often receive high glucocorticoid doses as part of standard therapy. Observational studies have shown a substantial risk of glucocorticoid-induced osteoporosis (GIO) with associated fractures. The aim of the SIESTA trial was to determine if oral alendronate (ALN) is a safe and effective prophylaxis against GIO in lymphoma. SIESTA was a single-center, randomized, double-blinded, phase 2 study of lymphoma patients planned for glucocorticoid-containing chemotherapy. After randomization, patients received weekly ALN 70 mg or placebo for a total of 52 weeks. Bone mineral density (BMD) was assessed at baseline, after completion of chemotherapy (end of treatment [EOT]) (4 to 6 months), and at the end of the study (EOS) (12 months). Vertebral fracture and biomarkers were assessed at baseline and EOS. Patients with baseline BMD assessment and at least 1 follow-up BMD assessment were analyzed for efficacy. The primary endpoint was a change in lumbar spine T-score from baseline to EOS. Of the 59 patients enrolled, 23 of 30 in the ALN arm and 24 of 29 in the placebo arm were analyzed for efficacy. The mean change in T-score from baseline to 12 months at the lumbar spine was +0.15 for ALN and -0.12 for placebo (P = .023). The difference in ΔTEOS between the ALN and placebo groups was larger among females (ALN 0.28; placebo -0.28; P = .01). Biomarker analyses confirmed reduced bone resorption in ALN-treated patients. In conclusion, ALN is a safe and effective primary prophylaxis against loss in BMD following glucocorticoid-containing chemotherapy. Despite reduced BMD loss in the ALN arm, the treatment did not influence fracture risk in this small cohort of patients.
Geometric morphology and population genomics provide insights into the adaptive evolution of Apis cerana in Changbai Mountain
Authors: Nannan Liu , Huamiao Liu , Yan Ju , Xingan Li , Yang Li , Tianjiao Wang , Jinming He , Qingsheng Niu , Xiumei Xing
Published: January 2022

Background

Exploration of adaptive evolution of organisms in response to environmental change can help to understand the evolutionary history of species and the underlying mechanisms of adaptation to local environments, thus guiding future conservation programmes. Before the introduction of Apis mellifera in China, eastern honey bees (Apis cerana) were the only species used for beekeeping in this region. In the mountains of Changbai, populations of A. cerana are considered a distinct ecotype of the species which formed through the distinct selective pressures in this area over time.

Result

We performed a measure of 300 wing specimens of eastern honey bees and obtained the geometric morphological variation in the wing of A. cerana in Changbai Mountain. A total of 3,859,573 high-quality SNP loci were yielded via the whole-genome resequencing of 130 individuals in 5 geographic regions.

Conclusion

Corresponding geometric morphology and population genomics confirmed the particularity of the A. cerana in Changbai Mountain. Genetic differentiation at the subspecies level exists between populations in Changbai Mountain and remaining geographic regions, and a significant reduction in the effective population size and an excessive degree of inbreeding may be responsible for a substantial loss of population genetic diversity. Candidate genes potentially associated with cold environmental adaptations in populations under natural selection were identified, which may represent local adaptations in populations. Our study provided insights into the evolutionary history and adaptation of A. cerana in Changbai Mountain, as well as its conservation.
A qualitative study of challenges and enablers faced by private general practitioners providing primary care to patients with complex needs in Singapore
Authors: Wong Peng Yong, Andrew , Chan Foong Yee, Sara , Ong Laysee , Lee Kheng Hock
Published: January 2022

Background

Singapore faces an ageing population with increasingly complex healthcare needs, a problem which could be addressed by high quality primary care. Many patients with complex needs are not managed by private general practitioners (GPs) who form the majority of the primary care workforce. Currently, there is paucity of literature describing the needs of these private GPs in providing such care.

Aim

Understand the challenges, enablers and possible solutions from the perspective of private GPs in providing primary care of patients with complex needs.

Method

We conducted a qualitative study using an inductive approach. Private GPs were interviewed using a semi-structured question guide with convenience sampling until thematic saturation was reached. These 12 interviewees were part of a network of clinics that provide primary care for complex patients who were recently discharged from a community hospital providing post-acute care. Data was transcribed prior to a process of familiarisation, coded and analysed using thematic analysis by three independent investigators.

Results

Three themes emerged in the analysis. From a micro-organizational standpoint, private GPs and patients with complex needs must be willing to accept each other to have a therapeutic encounter (e.g., patients’ multidimensional needs, GP clinic set-up is simple yet busy). Next, from a meso-organizational view, trust and good communication channels between the referring doctors and private GPs must exist for effective collaboration in managing complex care. Lastly, macro-organizationally, external stakeholders (e.g., policy-makers) should fund care models, which are financially viable to both patients, and private GPs (e.g., via adequate subsidies and renumeration respectively) as such complex care require many resources.

Conclusion

Multiple factors exist which influence the ability of private GPs in Singapore to care for patients with complex needs. Addressing these factors may reduce the over dependence on high-cost hospitals for care delivery in similar healthcare systems.
PADI4 promotes epithelial-mesenchymal transition(EMT) in gastric cancer via the upregulation of interleukin 8
Authors: Chang Xiao-tian , Wu Hui , Li Hui-lin , Li Hong-lei , Zheng Ya-bing
Published: January 2022

Background

Gastric cancer (GC) is one of the deadliest tumours due to its ability to metastasize. The Epithelial–to-mesenchymal transition plays a crucial role in promoting the GC metastasis, which increases the migration and metastasis of tumour cells. Peptidyl arginine deiminase IV (PADI4) is a susceptibility gene for gastric carcinoma. The aim of this study was to evaluate the functional roles of PADI4 in gastric cancer.

Methods

The expression of PADI4 was examined by qRT-PCR, western blot and immunohistochemistry. In addition, the functional roles of PADI4 were explored by over-expression PADI4 plasmids in gastric cancer cells.

Results

We found that the expression of PADI4 was up-regulated in GC. PADI4 overexpression in GC cells increased the proliferation, migration, metastasis, clone forming ability, and tumorigenic ability, but reduced the apoptosis ability. The Multi-Analyte ELISArray Kit results showed that interleukin 8 (IL-8) is upregulated in PADI4-overexpressing gastric cells. Using short interfering RNA (siRNA) to silence the expression of IL-8, we demonstrated that IL-8 silencing significantly inhibited the increased migratory capacity in PADI4-overexpressing GC cells.

Conclusions

Our data suggest that PADI4 accelerate metastasis by promoting IL-8 expression in gastric cancer cells, indicating that it is a new PADI4/IL-8 signalling pathway in metastatic GC.
Vessel segmentation for X-ray coronary angiography using ensemble methods with deep learning and filter-based features
Authors: Gao Zijun , Wang Lu , Soroushmehr Reza , Wood Alexander , Gryak Jonathan , Nallamothu Brahmajee , Najarian Kayvan
Published: January 2022

Background

Automated segmentation of coronary arteries is a crucial step for computer-aided coronary artery disease (CAD) diagnosis and treatment planning. Correct delineation of the coronary artery is challenging in X-ray coronary angiography (XCA) due to the low signal-to-noise ratio and confounding background structures.

Methods

A novel ensemble framework for coronary artery segmentation in XCA images is proposed, which utilizes deep learning and filter-based features to construct models using the gradient boosting decision tree (GBDT) and deep forest classifiers. The proposed method was trained and tested on 130 XCA images. For each pixel of interest in the XCA images, a 37-dimensional feature vector was constructed based on (1) the statistics of multi-scale filtering responses in the morphological, spatial, and frequency domains; and (2) the feature maps obtained from trained deep neural networks. The performance of these models was compared with those of common deep neural networks on metrics including precision, sensitivity, specificity, F1 score, AUROC (the area under the receiver operating characteristic curve), and IoU (intersection over union).

Results

With hybrid under-sampling methods, the best performing GBDT model achieved a mean F1 score of 0.874, AUROC of 0.947, sensitivity of 0.902, and specificity of 0.992; while the best performing deep forest model obtained a mean F1 score of 0.867, AUROC of 0.95, sensitivity of 0.867, and specificity of 0.993. Compared with the evaluated deep neural networks, both models had better or comparable performance for all evaluated metrics with lower standard deviations over the test images.

Conclusions

The proposed feature-based ensemble method outperformed common deep convolutional neural networks in most performance metrics while yielding more consistent results. Such a method can be used to facilitate the assessment of stenosis and improve the quality of care in patients with CAD.
Alpha-1 antitrypsin deficiency and risk of lung cancer in never-smokers: a multicentre case–control study
Authors: Tubío-Pérez Ramón Antonio , Torres-Durán María , García-Rodríguez María Esmeralda , Candal-Pedreira Cristina , Rey-Brandariz Julia , Pérez-Ríos Mónica , Barros-Dios Juan , Fernández-Villar Alberto , Ruano-Raviña Alberto
Published: January 2022

Background

Lung cancer (LC) is the most commonly diagnosed cancer and the leading cause of cancer-related death in both sexes worldwide. Although the principal risk factor in the western world is tobacco smoking, genetic factors, including alpha-1 antitrypsin deficiency (AATD), have been associated with increased risk. This study is the continuation of an earlier one published by the same group in 2015, aimed at analysing risk of LC in never-smokers, associated with carriers of the AATD genotype.

Methods

A multicentre case–control study was conducted in Spain across the period January 2011 to August 2019. Cases were non-smokers diagnosed with LC, and controls were composed of never-smoking individuals undergoing major non-cancer-related surgery. Data were collected on epidemiological characteristics, exposure to environmental tobacco smoke (ETS), residential radon levels, and alpha-1 antitrypsin (AAT) genotype.

Results

The study included 457 cases (42%) and 631 controls (58%), with a predominance of women (72,8%). The most frequent histological type was adenocarcinoma (77.5%), followed by squamous cell carcinoma (7.7%). No association of risk of LC was found with the status of AATD genotype carrier, both overall and broken down by age, sex, or exposure to ETS.

Conclusions

No risk association was found between being a carrier of an AAT deficiency genotype and LC among never-smokers. In order to establish the existence of an association, we consider it important to expand the studies in never smokers in different geographical areas as well as to include patients with previous chronic lung diseases to assess if it influences the risk.
Correction to: Fluid handling and blood flow patterns in neonatal respiratory distress syndrome versus transient tachypnea: a pilot study
Authors: Ismail Rana , Murthy Prashanth , Abou Mehrem Ayman , Liang Zhiying , Stritzke Amelie
Published: January 2022

An amendment to this paper has been published and can be accessed via the original article.
Analysis of regional differences in the amount of hypnotic and anxiolytic prescriptions in Japan using nationwide claims data
Authors: Okui Tasuku , Park Jinsang
Published: January 2022

Background

In Japan, there has been no investigation of regional differences in the number or amount of prescriptions of anxiolytics or hypnotics. Attributes related to the high amount of prescriptions for these drugs are unknown. We investigated recent trends and regional differences in the amount of prescriptions of hypnotics and anxiolytics in Japan and identified factors associated with these regional differences.

Methods

The National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open data from 2015 to 2018 were used. We calculated diazepam-equivalent doses (mg) for each drug and the total amount of prescriptions per capita for hypnotics and anxiolytics by sex and age. In addition, we calculated the standardized claim ratio (SCR) of the amount of prescriptions by prefecture. We investigated factors associated with regional differences in the SCRs of hypnotics and anxiolytics using the prefectures’ medical, socioeconomic, and physical characteristics by an ecological study using a linear mixed-effects model.

Results

The amount of prescriptions of hypnotics and anxiolytics, specifically, the amount of prescriptions of benzodiazepine receptor agonists (BZRAs), decreased in many of the adult age groups from 2015 to 2018. The regression analysis revealed that the number of medical clinics per capita, the number of public assistance recipients per capita, the proportion of persons whose HbA1c ≥ 6.5%, and the proportion of persons whose BMI ≥25 kg/m2were positively and significantly associated with the SCR of hypnosis. In contrast, the number of public assistance recipients per capita and the proportion of persons whose BMI ≥25 kg/m2were positively and significantly associated with the SCR of anxiolytics.

Conclusions

Factors associated with prescription amount of hypnotics and anxiolytics were revealed in this study, and a further study is needed for investigating causal relationships between the prescriptions amount and the associated factors using individual data.
Schistosomiasis, soil transmitted helminthiasis, and malaria co-infections among women of reproductive age in rural communities of Kwale County, coastal Kenya
Authors: Jeza Victor Tunje , Mutuku Francis , Kaduka Lydia , Mwandawiro Charles , Masaku Janet , Okoyo Collins , Kanyi Henry , Kamau Joyce , Ng’ang’a Zipporah , Kihara Jimmy Hussein
Published: January 2022

Background

Schistosoma haematobium, soil transmitted helminthes (STH), and malaria lead to a double burden in pregnancy that eventually leads to poor immunity, increased susceptibility to other infections, and poor pregnancy outcomes. Many studies have been carried out on pre-school and school aged children but very little has been done among the at risk adult population including women of reproductive age (WRA). Our current study sought to establish the risk factors and burden of co-infection with S. haematobium, STH, and Plasmodium sp. among WRA in Kwale County, Coastal Kenya.

Methods

A total of 534 WRA between the ages of 15–50 were enrolled in this cross-sectional study from four villages; Bilashaka and Mwaluphamba in Matuga sub-County, and Mwachinga and Dumbule in Kinango sub-County. Socio-demographic information was collected using a pre-tested standardized questionnaire. Parasitological examination was done using urine filtration method for Schistosoma haematobium, Kato Katz for STH (Ascaris lumbricoides, Hookworm, Trichuris trichiura), and standard slide microscopy for Plasmodium sp. Statistical analyses were carried out using STATA version 15.1.

Results

The overall prevalence of S. haematobium was 3.8% (95% CI: 2.6–5.4) while that for malaria was 4.9% (95% CI: 2.0–11.7). The prevalence of STH was 5.6% (95% CI: 2.8–11.3) with overall prevalence of 5.3% (95% CI: 2.5–10.9) for hookworm and 0.6% (95% CI: 0.2–1.9) for T. trichiura. The occurrence of co-infection was low and was recorded between S. haematobium and P. falciparum (0.6%), followed by S. haematobium and STH (0.4%).

Among pregnant women, 2.6% had co-infection with S. haematobium and P. falciparum. Only 1.3% had co-infection with S. haematobium and hookworm or T. trichiura. Among non-pregnant women, co-infection with S. haematobium and P. falciparum was 0.2%. Similarly, co-infection with S. haematobium and hookworm or T. trichiura was 0.2%.

Bed net ownership and usage among pregnant women was 87.8 and 96.6%, respectively. 66.3% of the women reported using improved water sources for drinking while 78.1% reported using improved sanitation facilities.

Conclusion

The use of improved WASH activities might have contributed to the low prevalence of STHs and S. haematobium infections. Further, bed net ownership and usage might have resulted in the low prevalence of Plasmodium sp. infections observed.
Research on grandchild care and depression of chinese older adults based on CHARLS2018: the mediating role of intergenerational support from children
Authors: Tang Shaoliang , Yang Tongling , Ye Chaoyu , Liu Meixian , Gong Ying , Yao Ling , Xu Yun , Bai Yamei
Published: January 2022

Background

There may be differences in gender and marital status in the impact of grandchild care on the depression of the Chinese older adults. This research explores the effect of grandchild care on the depression of Chinese older adults of different genders and marital status, and explores the mediating role of intergenerational support from children between grandchild care and depression.

Methods

This research uses the data of 3540 Chinese older adults from the China Health and Retirement Longitudinal Study (CHARLS) in 2018. The OLS model is used to analyze the effect of grandchild care on the depression of the older adults. and the older adults are classified according to gender and marital status, and the differences in the effect of grandchild care on the depression of the elderly of different genders and marital status is explored. Finally, the bootstrap method is used to test the mediating effect of intergenerational support from children.

Results

The research finds that grandchild care has a significant impact on the depression of the older adults in China, and providing grandchild care can significantly reduce the depression of the older adults. The effect of grandchild care on the depression of the older adults is different between different genders and marital status. After categorizing the older adults by gender, the grandchild care only has a significant impact on the depression of female older adults; after classified by marital status, grandchild care only has a significant impact on the depression of the older adults who don’t have a spouse. The mediating effect analysis shows that both children’s emotional support and children’s economic support have a mediating effect between grandchild care and depression of the older adults.

Conclusion

The depression of the Chinese older adults is affected by grandchild care, and this effect is more prominent in female older adults and the older adults who don’t have a spouse. The society should support and encourage capable older adults to participate in grandchild care, and children should also provide more intergenerational support to the older adults who provide grandchild care, so as to further play the role of grandchild care in relieving depression of the older adults.
Patient safety when receiving telephone advice in primary care – a Swedish qualitative interview study
Authors: Berntsson Karin , Eliasson Maria , Beckman Linda
Published: January 2022

Background

A lack of patient safety is a significant global public health challenge and is one of the leading causes of death and disability, entailing significant financial and economic costs. However, patient safety can be improved and patients can avoid being harmed if more knowledge could be gained about what it is that impacts patient safety. Patient safety when receiving telephone advice is an important issue given the increase in digitalization in healthcare services.

Aim

The aim of this study was to explore district nurses’ (“telenurses”) experiences and perceptions of patient safety when providing health advice over the phone.

Methods

Data collection was performed using semi-structured interviews and analyzed using qualitative content analysis. The participants (n = 12) were telnurses in primary care.

Results

The theme “Being able to make the right decision” was formed based on two categories: “Communication” and “Assessment”. Through effective communication with the right conditions to make an assessment, the correct decision can be made when a patient calls, and the district nurse feels that their telephone advice is safe for the patient.

Conclusions

Patient safety can be challenged when receiving telephone advice, particularly when they feel stressed due to organizational factors. There is a need to shift from the individual to the organization. Further, while computerized knowledge support generally results in safe decisions, there may also be problems. Hence, it is imperative to develop computerized knowledge support as a part of improved patient safety in telephone advice.
Exploring nurse perceptions and experiences of resilience: a meta-synthesis study
Authors: KIM Eun Young , CHANG Sung Ok
Published: January 2022

Aim

To understand nurse resilience by integrating the qualitative research results on nurses’ resilience-related experiences.

Methods

We applied the seven steps of the meta-ethnographic process by Noblit and Hare (1988). Five databases (PubMed, EMBASE, Web of Science, CINAHL and PsycINFO) were used to search for relevant studies published from January 2011 to September 2021.

Results

Sixteen qualitative studies were included. The four themes of “self-development based on one’s inner self”, “fostering a positive attitude towards life”, “developing personal strategies for overcoming adversity” and “building professionalism to become a better nurse” illustrate that they want to improve their inner strength and develop themselves through self-examination.

Conclusion

In this study, we examined nurse resilience, and the results can provide fundamental conclusions useful for the development of an intervention study to improve nurse resilience.
Hospital market concentration and the use of mechanical circulatory support devices in acute myocardial infarction complicated by cardiogenic shock
Authors: Vohra Adam S. , Jang Sun-Joo , Feldman Dmitriy N. , Goyal Parag , Krishnan Udhay , Sciria Christopher , Cheung Jim W. , Kim Luke K.
Published: January 2022

Background

As health care markets in the United States have become increasingly consolidated, the role of market concentration on physician treatment behavior remains unclear. In cardiology, specifically, there has been evolving treatment of acute myocardial infarction complicated by cardiogenic shock (AMI-CS) with increasing use of mechanical circulatory support (MCS). However, there remains wide variation in it use. The role of market concentration in the utilization of MCS in AMI-CS is unknown. We examined the use of MCS in AMI-CS and its effect on outcomes between competitive and concentrated markets.

Methods and results

We used the National Inpatient Sample to query patients admitted with AMI-CS between 2003 and 2009. The primary study outcome was the use of mechanical circulatory support. The primary study exposure was market concentration, measured using the Herfindahl-Hirschman Index, which was used to classify markets as unconcentrated (competitive), moderately concentrated, and highly concentrated. Baseline characteristics, procedures, and outcomes were compared for patients in differently concentrated markets. Multivariable logistic regression was used to examine the association between HHI and use of MCS.

Results

There were 32,406 hospitalizations for patients admitted with AMI-CS. Patients in unconcentrated markets were more likely to receive MCS than in highly concentrated markets (unconcentrated 46.8% [5087/10,873], moderately concentrated 44.9% [2933/6526], and high concentrated 44.5% [6676/15,007], p < 0.01). Multivariable regression showed that patients in more concentrated markets had decreased use of MCS in patients in later years of the study period (2009, OR 0.64, 95% CI 0.44–0.94, p = 0.02), with no effect in earlier years. There was no significant difference in in-hospital mortality.

Conclusion

Multivariable analysis did not show an association with market concentration and use of MCS in AMI-CS. However, subgroup analysis did show that competitive hospital markets were associated with more frequent use of MCS in AMI-CS as frequency of utilization increased over time. Further studies are needed to evaluate the effect of hospital market consolidation on the use of MCS and outcomes in AMI-CS.
Characterizing memory T helper cells in patients with psoriasis, subclinical, or early psoriatic arthritis using a machine learning algorithm
Authors: den Braanker Hannah , Razawy Wida , Wervers Kim , Mus Anne-Marie C. , Davelaar Nadine , Kok Marc R. , Lubberts Erik
Published: January 2022

Background

Psoriasis patients developing psoriatic arthritis (PsA) are thought to go through different phases. Understanding the underlying events in these phases is crucial to diagnose PsA early. Here, we have characterized the circulating memory T helper (Th) cells in psoriasis patients with or without arthralgia, psoriasis patients who developed PsA during follow-up (subclinical PsA), early PsA patients and healthy controls to elucidate their role in PsA development.

Methods

We used peripheral blood mononuclear cells of sex and age-matched psoriasis patients included in Rotterdam Joint Skin study (n=22), early PsA patients included in Dutch South West Early Psoriatic Arthritis Cohort (DEPAR) (n=23) and healthy controls (HC; n=17). We profiled memory Th cell subsets with flow cytometry and used the machine learning algorithm FlowSOM to interpret the data.

Results

Three of the 22 psoriasis patients developed PsA during 2-year follow-up. FlowSOM identified 12 clusters of memory Th cells, including Th1, Th2, Th17/22, and Th17.1 cells. All psoriasis and PsA patients had higher numbers of Th17/22 than healthy controls. Psoriasis patients without arthralgia had lower numbers of CCR6-CCR4+CXCR3+ memory Th cells and higher numbers of CCR6+CCR4-CXCR3-memory Th cells compared to HC. PsA patients had higher numbers of Th2 cells and CCR6+CCR4+CXCR3- cells, but lower numbers of CCR6+CCR4+CXCR3+ memory Th cells compared to HC. The number of CCR6+ Th17.1 cells negatively correlated with tender joint counts and the number of CCR6+ Th17 cells positively correlated with skin disease severity.

Conclusions

Unsupervised clustering analysis revealed differences in circulating memory Th cells between psoriasis and PsA patients compared to HC; however, no specific subset was identified characterizing subclinical PsA patients.
Bacteremia caused by Enterobacter asburiae misidentified biochemically as Cronobacter sakazakii and accurately identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry: a case report
Authors: Horinouchi Noboru , Shiota Seiji , Takakura Takeshi , Yoshida Atsushi , Kikuchi Ken , Nishizono Akira , Miyazaki Eishi
Published: January 2022

Background

Biochemical analyses of causative bacteria do not always result in clear identification, and new technologies aimed at improving diagnostic accuracy continue to be developed. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry is a rapid and accurate technique for bacterial identification. Misidentification of Cronobacter sakazakii is related to clinical and industrial problems. Here, we encountered a case of rare bacteremia in which the causative organism Enterobacter asburiae was biochemically misidentified as C. sakazakii before being correctly identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

Case presentation

An 87-year-old Asian man with no diabetes or active disease developed bacteremia and was admitted to our hospital. While the route of infection could not be determined despite various examinations, the clinical course was good following antibiotic therapy. Biochemical analyses identified the causative organism as C. sakazakii, but colonies on the blood agar medium showed a grayish coloration, differing from the yellowish coloration of typical Cronobacter colonies. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was therefore performed, identifying the bacterium as E. asburiae on three independent analyses. This result was confirmed by multilocus sequence analysis using five housekeeping genes.

Conclusions

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry may reduce misidentification of bacteria as C. sakazakii and improve the reporting rate of E. asburiae. This technique should be considered when biochemical bacterial misidentification is suspected.
An annotated dataset for extracting gene-melanoma relations from scientific literature
Authors: Zanoli Roberto , Lavelli Alberto , Löffler Theresa , Perez Gonzalez Nicolas Andres , Rinaldi Fabio
Published: January 2022

Background

Melanoma is one of the least common but the deadliest of skin cancers. This cancer begins when the genes of a cell suffer damage or fail, and identifying the genes involved in melanoma is crucial for understanding the melanoma tumorigenesis. Thousands of publications about human melanoma appear every year. However, while biological curation of data is costly and time-consuming, to date the application of machine learning for gene-melanoma relation extraction from text has been severely limited by the lack of annotated resources.

Results

To overcome this lack of resources for melanoma, we have exploited the information of the Melanoma Gene Database (MGDB, a manually curated database of genes involved in human melanoma) to automatically build an annotated dataset of binary relations between gene and melanoma entities occurring in PubMed abstracts. The entities were automatically annotated by state-of-the-art text-mining tools. Their annotation includes both the mention text spans and normalized concept identifiers. The relations among the entities were annotated at concept- and mention-level. The concept-level annotation was produced using the information of the genes in MGDB to decide if a relation holds between a gene and melanoma concept in the whole abstract. The exploitability of this dataset was tested with both traditional machine learning, and neural network-based models like BERT. The models were then used to automatically extract gene-melanoma relations from the biomedical literature. Most of the current models use context-aware representations of the target entities to establish relations between them. To facilitate researchers in their experiments we generated a mention-level annotation in support to the concept-level annotation. The mention-level annotation was generated by automatically linking gene and melanoma mentions co-occurring within the sentences that in MGDB establish the association of the gene with melanoma.

Conclusions

This paper presents a corpus containing gene-melanoma annotated relations. Additionally, it discusses experiments which show the usefulness of such a corpus for training a system capable of mining gene-melanoma relationships from the literature. Researchers can use the corpus to develop and compare their own models, and produce results which might be integrated with existing structured knowledge databases, which in turn might facilitate medical research.