bluuebunny/crossref_metadata_2025 huggingface dataset:
Deciphering the role of microRNAs in mustard gas–induced toxicity
Authors: Mishra Neha , Raina Komal , Agarwal Rajesh
Published: December 2020

Mustard gas (sulfur mustard, SM), a highly vesicating chemical warfare agent, was first deployed in warfare in 1917 and recently during the Iraq–Iran war (1980s) and Syrian conflicts (2000s); however, the threat of exposure from stockpiles and old artillery shells still looms large. Whereas research has been long ongoing on SM‐induced toxicity, delineating the precise molecular pathways is still an ongoing area of investigation; thus, it is important to attempt novel approaches to decipher these mechanisms and develop a detailed network of pathways associated with SM‐induced toxicity. One such avenue is exploring the role of microRNAs (miRNAs) in SM‐induced toxicity. Recent research on the regulatory role of miRNAs provides important results to fill in the gaps in SM toxicity–associated mechanisms. In addition, differentially expressed miRNAs can also be used as diagnostic markers to determine the extent of toxicity in exposed individuals. Thus, in our review, we have summarized the studies conducted so far in cellular and animal models, including human subjects, on the expression profiles and roles of miRNAs in SM‐ and/or SM analog–induced toxicity. Further detailed research in this area will guide us in devising preventive strategies, diagnostic tools, and therapeutic interventions against SM‐induced toxicity.
Homogenous and Heterogenous Prognostic Factors for Patients with Bone Sarcoma
Authors: Xu Guijun , Wu Haixiao , Xu Yao , Zhang Yanting , Lin Feng , Baklaushev Vladimir P , Chekhonin Vladimir P , Peltzer Karl , Wang Xin , Mao Min , Wang Guowen , Cui Ping , Zhang Chao
Published: December 2020

Objective

The aim of this study was to examine the survival rate of patients with different bone sarcomas and to investigate homogenous and heterogenous prognostic factors for different types of bone sarcomas.

Methods

This is a retrospective analysis of records from the Surveillance, Epidemiology, and End Result (SEER) database. Clear information on the distant metastasis of cancer is provided in the SEER database for patients diagnosed between January 2010 and December 2016. Data for the four types of malignant bone sarcomas were extracted, including osteosarcoma, chondrosarcoma, Ewing sarcoma, and chordoma. Patients with bone sarcomas originated from other sites, diagnosed at autopsy, or indicated in death certification were excluded. The overall survival was calculated for the entire cohort and across different bone sarcomas using the Kaplan–Meier method. A subgroup analysis of the different survival rates of four types of bone sarcomas in various levels of each variable was conducted and the differences were tested with the log‐rank test. Cox proportional hazard regression analysis was performed to determine the prognostic factors. Variables with P < 0.05 in the univariate Cox regression analysis were further analyzed using a multivariate Cox regression analysis. The prognostic factors in four groups of bone sarcomas were compared to determine the homogenous and heterogenous factors.

Results

A total of 4732 patients were included with a follow up of 25 (0–83) months. The mean age of patients was 39.7 ± 24.1 years. The 1‐year, 3‐year, and 5‐year overall survival rate for the entire cohort was 86.2% (95% confidence interval [CI]: 85.2%–87.2%), 70.5% (95% CI: 68.9%–72.1%), and 63.0% (95% CI: 61.2%–64.8%), respectively. Factors including age older than 40 years, higher grade, regional and distant stage, tumor in the extremities, T2 stage, bone and lung metastases, and non‐surgery were significantly associated with the poor survival of the entire cohort. The mean overall survival duration of patients with chordoma, chondrosarcoma, Ewing sarcoma, and osteosarcoma was 66.86 (95% CI: 64.06–69.66), 63.53 (95% CI: 61.81–65.25), 58.06 (95% CI: 55.49–60.62) and 54.91 (95% CI: 53.14–56.69) months, respectively. Compared with chordoma, the hazard ratio (HR) and 95% CI for patients with chondrosarcoma, Ewing sarcoma, and osteosarcoma were 1.30 (95% CI: 1.04–1.62; P = 0.023), 1.69 (95% CI: 1.33–2.14; P < 0.001), and 2.00 (95% CI: 1.61–2.48; P <0.001), respectively. Different bone sarcomas showed homogenous and heterogenous prognostic factors.

Conclusion

Different clinicopathological characteristics and prognoses were revealed in patients with osteosarcoma, chondrosarcoma, Ewing sarcoma, and chordoma. The risk factors can potentially guide prognostic prediction and sarcoma‐specific treatment.
Usefulness of a Simple Preoperative Planning Technique using Plain X‐rays for Direct Anterior Approach for Total Hip Arthroplasty
Authors: Peng Hui‐ming , Feng Bin , Chen Xi , Wang Yi‐ou , Bian Yan‐yan , Wang Wei , Weng Xi‐sheng , Qian Wen‐wei
Published: December 2020

Objective

To examine the accuracy, reliability, and reproducibility of a simple preoperative planning technique using plain X‐rays.

Methods

A retrospective analysis of 96 consecutive cases of primary direct anterior approach (DAA)‐total hip arthroplasty (THA) from July 2015 to December 2018 was performed. The 96 patients included 24 males and 72 females, with an average age of 70 years. The standard AP pelvis radiographs with the patients' hips extended and internally rotated were obtained pre‐ and postoperatively. The preoperative planning was also completed on the standardized AP pelvic radiographs. The prearranged cup positioning was radiologically measured intraoperatively using fluoroscopy. The correct leg length was assessed intraoperatively, which was compared with the preoperative planning. The component positioning was measured by three independent researchers. Two of the researchers completed the measurements three times, and intra‐observer and inter‐observer reliability were calculated. All patients received at least 6 months follow‐up (6 months–4 years).

Results

In all cases, the median leg length discrepancy (LLD) was 4.4 mm (range 1.6–15.9 mm), and 84 patients had an LLD smaller than 10 mm, of which 58 patients had an LLD of less than 5 mm. None of the patients had a critical LLD of 2 cm or larger. The multivariable logistic regression for LLD (safe range: yes/no) with the co‐variables including gender, ASA classification, type of cup, the surgeon's experience level, and the presence of a total hip arthroplasty (THA) on the contralateral side did not present statistical significance. The median angle of the inclination of the acetabular component (IA) was 42.3° (range: 28.7°–52.2°). Ninety‐one patients were within the defined safe range. The hit ratio for the cup to be within the safe zone was significantly higher for the Pinnacle cups than that for the Continuum cups (P < 0.05). However, there was no significant difference in gender, ASA classification, the surgeon's experience level, and the presence of a total hip arthroplasty (THA) on the contralateral side. The median of its anteversion (AA) was 20.6° (range: 10.6°–40.1°). Only 41 patients were within the defined safe range. None of the co‐variables presented a statistical significance affecting the AA of the cup positioning. Meanwhile, the average fluoroscopy time for the cup positioning (n = 86, missing data in 10 cases) was 4 seconds (range: 1–74), with most of the patients (97.9%) having a fluoroscopy time of fewer than 20 seconds.

Conclusions

The combination of correct preoperative planning and standardized intraoperative measurements can reestablish right leg length and assure the correct cup positioning.
Why the Wrongness of Killing Innocents is Not a Universal Moral Certainty
Authors: Ariso José María
Published: December 2020

In this paper, I argue that the certainty about the wrongness of killing must not be considered as a universal, but as a local one. Initially, I show that there exist communities in which the wrongness of killing innocents is not a moral certainty and that this kind of case cannot be justified by arguing that such people are psychopaths. Lastly, I argue that universal certainties do not admit of exceptions: thus, the fact that some exceptional cases affect the certainty that killing innocents is wrong, leads me to conclude that it is a local certainty.
Clinical features of genetic cutaneous porphyrias in Israel: A nationwide survey
Authors: Snast Igor , Kaftory Ran , Lapidoth Moshe , Mamet Rivka , Hodak Emmilia , Edel Yonatan , Levi Assi
Published: December 2020

Background

There are three major types of genetic cutaneous porphyrias (GCP): erythropoietic protoporphyria (EPP), variegate porphyria (VP), and hereditary coproporphyria (HCP). Scarce data are available regarding their impact on patients' quality of life in the Mediterranean region.

Purpose

To describe the cutaneous features of GCP in Israel.

Methods

An established nationwide cohort of patients with GCP diagnosed during 1988‐2019 was surveyed by telephone for cutaneous features of GCP. Impact on quality of life was assessed using the Dermatology Life Quality Index.

Results

Of the 95 patients with GCP, 71 (75%) completed the survey (21 HCP; 40 VP; 10 EPP). All EPP patients reported cutaneous symptoms compared with 58% of VP and 5% of HCP (P < .001). Mean age at symptom onset was 7 ± 6 years in EPP and 25 ± 15 years in VP (P < .001). Photosensitivity was the most common symptom in EPP (90%). In VP photosensitivity (52%), blistering (52%) and scarring (74%) were all common symptoms. In both VP and EPP, the dorsal hands/forearms were the most affected regions (≥96%), and in ≥ 78%, symptoms occurred on an almost daily basis. All EPP patients changed their lifestyle due to cutaneous symptoms vs 57% in VP. Major effect on quality of life was observed among EPP patients compared with a moderate effect in VP. No treatment was effective in EPP, while phototherapy and moisturizers were effective in 5 of 7 (71%) VP patients.

Conclusion

This study sheds light on the cutaneous features of the GCP, which have a substantial effect on patients' quality of life.
Evaluation of sperm morphometry of rabbits (Oryctolagus cuniculus f. domesticus)
Authors: Szeleszczuk Olga , Andraszek Katarzyna , Banaszewska Dorota , Niedbała Piotr , Kuchta‐Gładysz Marta , Grzesiakowska Anna
Published: December 2020

Contents

Sperm morphology and morphometry are considered parameters in fertility diagnosis. They are especially important in the case of species for which there is no standard with respect to morphometric sperm parameters. It is then crucial to apply the staining technique that has the least influence on the sperm structure and provides the most detailed image, so as to enable measurements. The aim of the research was to assess the morphometric parameters of rabbit sperm using silver nitrate staining. The staining process revealed a detailed image of the spermatozoon head and tail, thus enabling precise measurements. From these basic morphometric parameters, four additional shape indices characterizing the sperm head were calculated: ellipticity, elongation, roughness and regularity. These parameters more precisely characterize the shape of the sperm head. Silver nitrate staining can be used as an independent technique in assessment of sperm structure or to supplement routine diagnostics.
Household chaos, parental responses to emotion, and child emotion regulation in middle childhood
Authors: Hong Yelim , McCormick Sarah A. , Deater‐Deckard Kirby , Calkins Susan D. , Bell Martha Ann
Published: December 2020

Parents' responses to children's negative emotional states play a key role in the socialization of emotion regulation skills in childhood. Much of the prior research on child ER has focused on early development using cross‐sectional designs. The current study addresses these gaps by using a longitudinal design to examine individual differences of ER at two times points in middle childhood. We examined the development of children's ER by testing hypotheses about the interplay of parent response to emotions and household chaos in the prediction of individual differences in children's ER. Participants were the mothers of children at 6 and 9 years of age among 224 families in a socioeconomically diverse sample that was part of an ongoing longitudinal study. Mothers completed questionnaires regarding themselves, their children, and their home environment. Mothers' reports of better child ER at both time points were positively associated with mothers' more supportive responses and negatively associated with mothers' less non‐supportive responses, as well as lower household chaos. Chaos statistically moderated the link between non‐supportive parental responses to emotion and child ER, but only at 6 years of age. The strength of the link between child ER and non‐supportive parental responses to emotions was strong only at lower levels of household chaos. At the beginning of middle childhood, family processes linking parent responses to child emotions and children's developing ER may not function at higher levels of household chaos.
Characterization of the novel HLA‐C*14:114 allele by next‐generation sequencing
Authors: Genebrier Steve , Elsermans Vincent , Nivet Carl , Chérel Mathilde , Renac Virginie
Published: December 2020

HLA‐C*14:114 differs from C*14:02:01:01 by one nucleotide substitution at position 1077 in exon 7.
Improvements and limitations in developing multivariate models of hemorrhage and transfusion risk for the obstetric population
Authors: Pressly Michelle A. , Parker Robert S. , Waters Jonathan H. , Beck Stacy L. , Jeyabalan Arundhathi , Clermont Gilles
Published: December 2020

Background

Maternal hemorrhage protocols involve risk screening. These protocols prepare clinicians for potential hemorrhage and transfusion in individual patients. Patient‐specific estimation and stratification of risk may improve maternal outcomes.

Study Design and Methods

Prediction models for hemorrhage and transfusion were trained and tested in a data set of 74 variables from 63 973 deliveries (97.6% of the source population of 65 560 deliveries included in a perinatal database from an academic urban delivery center) with sufficient data at pertinent time points: antepartum, peripartum, and postpartum. Hemorrhage and transfusion were present in 6% and 1.6% of deliveries, respectively. Model performance was evaluated with the receiver operating characteristic (ROC), precision‐recall curves, and the Hosmer‐Lemeshow calibration statistic.

Results

For hemorrhage risk prediction, logistic regression model discrimination showed ROCs of 0.633, 0.643, and 0.661 for the antepartum, peripartum, and postpartum models, respectively. These improve upon the California Maternal Quality Care Collaborative (CMQCC) accuracy of 0.613 for hemorrhage. Predictions of transfusion resulted in ROCs of 0.806, 0.822, and 0.854 for the antepartum, peripartum, and postpartum models, respectively. Previously described and new risk factors were identified. Models were not well calibrated with Hosmer‐Lemeshow statistic P values between .001 and .6.

Conclusions

Our models improve on existing risk assessment; however, further enhancement might require the inclusion of more granular, dynamic data. With the goal of increasing translatability, this work was distilled to an online open‐source repository, including a form allowing risk factor inputs and outputs of CMQCC risk, alongside our numerical risk estimation and stratification of hemorrhage and transfusion.
The effects of additive solutions on the development of storage lesions in stored canine platelet concentrates
Authors: Haines Jillian M. , Hwang Julianne K. , Wardrop Katherine Jane
Published: December 2020

Objective

To determine if platelet additive solutions (PAS) decrease the occurrence and degree of platelet storage lesions, maintain platelet function, and extend storage time in vitro beyond 5 days at 22°C when compared to platelets stored in plasma only.

Design

Prospective, ex vivo experimental controlled study.

Setting

Research laboratory in a school of veterinary medicine.

Animals

Twelve units of canine platelet concentrate prepared from fresh whole blood donations.

Interventions

Platelet concentrates were aliquoted into 4 units and stored at room temperature (22°C) under constant agitation in either 100% plasma (control) or 35% plasma and 65% of 1 of 3 different PAS (Plasma‐Lyte A, Isoplate, and InterSol) for 7 days. At days 0, 3, 5, and 7, samples were analyzed for presence of swirling, degree of aggregate formation, platelet count, platelet indices, glucose, lactate, lactate dehydrogenase, Pvo2, and Pvco2 concentrations, aggregation via light aggregometry, and activation percentage based on flow cytometric measurement of surface P‐selectin. Bacterial cultures were performed on days 0, 5, and 7.

Measurements and main results

Isoplate had a higher incidence of aggregate formation on day 0 (n = 2), and Plasma‐Lyte A had a higher incidence of loss of swirl on day 7 (n = 5). Plasma‐stored samples had significantly higher platelet counts (P < 0.001), pH (P < 0.05), Pvco2 (P < 0.001), and lactate (P < 0.001), and significantly lower lactate dehydrogenase (P < 0.05) as compared to all PAS. The mean pH remained above 7.2 in PAS and plasma. There was no difference in platelet activation between plasma and PAS. Changes in platelet indices, glucose consumption, and maximum aggregation varied by storage solution. There was no bacterial growth seen in any samples.

Conclusions

The 3 PAS performed similarly and could all be considered as potential replacements for plasma during the room temperature storage of canine platelet concentrate for up to 7 days.
Hermite collocation method for fractional order differential equations
Authors: Akgonullu Pirim Nilay , Ayaz Fatma
Published: December 2020

This paper focuses on the approximate solutions of the higher order fractional differential equations with multi terms by the help of Hermite Collocation method (HCM). This new method is an adaptation of Taylor's collocation method in terms of truncated Hermite Series. With this method, the differential equation is transformed into an algebraic equation and the unknowns of the equation are the coefficients of the Hermite series solution of the problem. This method appears as a useful tool for solving fractional differential equations with variable coefficients. To show the pertinent feature of the proposed method, we test the accuracy of the method with some illustrative examples and check the error bounds for numerical calculations.
Enhancing the perceptual segregation and localization of sound sources with a triple beamformer
Authors: Kidd Gerald , Jennings Todd R. , Byrne Andrew J.
Published: December 2020

A triple beamformer was developed to exploit the capabilities of the binaural auditory system. The goal was to enhance the perceptual segregation of spatially separated sound sources while preserving source localization. The triple beamformer comprised a variant of a standard single-channel beamformer that routes the primary beam output focused on the target source location to both ears. The triple beam algorithm adds two supplementary beams with the left-focused beam routed only to the left ear and the right-focused beam routed only to the right ear. The rationale for the approach is that the triple beam processing exploits sound source segregation in high informational masking (IM) conditions. Furthermore, the exaggerated interaural level differences produced by the triple beam are well-suited for categories of listeners (e.g., bilateral cochlear implant users) who receive limited benefit from interaural time differences. The performance with the triple beamformer was compared to normal binaural hearing (simulated using a Knowles Electronic Manikin for Auditory Research, G.R.A.S. Sound and Vibration, Holte, DK) and to that obtained from a single-channel beamformer. Source localization in azimuth and masked speech identification for multiple masker locations were measured for all three algorithms. Taking both localization and speech intelligibility into account, the triple beam algorithm was considered to be advantageous under high IM listening conditions.
Cross-linguistic filled pause realization: The acoustics of uh and um in native Dutch and non-native English
Authors: de Boer Meike M. , Heeren Willemijn F. L.
Published: December 2020

It has been claimed that filled pauses are transferred from the first (L1) into the second language (L2), suggesting that they are not directly learned by L2 speakers. This would make them usable for cross-linguistic forensic speaker comparisons. However, under the alternative hypothesis that vowels in the L2 are learnable, L2 speakers adapt their pronunciation. This study investigated whether individuals remain consistent in their filled pause realization across languages, by comparing filled pauses (uh, um) in L1 Dutch and L2 English by 58 females. Next to the effect of language, effects of the filled pauses' position in the utterance were considered, as these are expected to affect acoustics and also relate to fluency. Mixed-effects models showed that, whereas duration and fundamental frequency remained similar across languages, vowel realization was language-dependent. Speakers used um relatively more often in English than Dutch, whereas previous research described speakers to be consistent in their um:uh ratio across languages. Results furthermore showed that filled-pause acoustics in the L1 and L2 depend on the position in the utterance. Because filled pause realization is partially adapted to the L2, their use as a feature for cross-linguistic forensic speaker comparisons may be restricted.
A mathematical model of ctDNA shedding predicts tumor detection size
Authors: Avanzini Stefano , Kurtz David M. , Chabon Jacob J. , Moding Everett J. , Hori Sharon Seiko , Gambhir Sanjiv Sam , Alizadeh Ash A. , Diehn Maximilian , Reiter Johannes G.
Published: December 2020

A mathematical model of tumor evolution and ctDNA shedding informs new cancer early detection approaches.
Inability to control gestational weight gain: an interpretive content analysis of pregnant Chinese women
Authors: Mo Xiuting , Cao Jiangxia , Tang Hong , Miyazaki Kikuko , Takahashi Yoshimitsu , Nakayama Takeo
Published: December 2020

Objective

This study aims to explore barriers to controlling gestational weight gain in pregnant Chinese women.

Design

Data were collected through semistructured interviews with pregnant women experiencing excessive gestational weight gain who struggled with weight management, and the data were examined using an interpretive content analysis.

Settings and participants

Fifty participants (≥18 years, with excessive gestational weight gain) were recruited when they visited the hospital for antenatal health checkups in Wuhan city (n=36) and Jinan city (n=14) between September and October 2018.

Results

Interpretive content analysis identified 75 barriers after examining diet, physical activity levels and general issues stemming from knowledge and beliefs, and physical, social, logistical, emotional and structural characteristics. Compared with reported deductive codes, this study inductively extracted 15 new codes. The most frequent codes showed that expectant grandparents greatly influenced pregnant women’s lifestyles, through overprotection, traditional and conservative ideas and practices, and a lack of reliable knowledge or acceptable guidance on gestational weight control.

Conclusions

This study provides a better understanding of the most important obstacles faced during decision making about gestational weight control in Chinese settings, especially the influence of traditional ideas/practices and expectant grandparents. Identifying the specific barriers to weight control should facilitate potential tailored supportive interventions. More efforts on health education for the whole family and a better use of maternal handbooks would be particularly beneficial.
Interpersonal factors contributing to tension in the Chinese doctor–patient–family relationship: a qualitative study in Hunan Province
Authors: Xiao Siyu , Wang Lixuan , Edelman E Jennifer , Khoshnood Kaveh
Published: December 2020

Objective

To identify actionable barriers to communication that contribute to tension in the Chinese doctor–patient–family relationship (DPFR) among surgeons, surgical patients and their family members.

Design

We employed qualitative research methods using in-depth, semistructured interviews in Mandarin and English and conducted preoperatively and postoperatively. Interviews were audio recorded, transcribed and translated into English. Data were analysed using thematic analysis.

Setting

An urban, tertiary-level teaching hospital in Hunan Province, China.

Participants

We recruited a purposive sample of 11 inpatients undergoing the same minor surgery, 9 of their family members and 9 surgeons between June and August 2015.

Results

We identified three emergent themes. First, trust degradation occurred before and during the healthcare experience. Second, the healthcare-seeking experience for patients and family members was marked by unmet expectations for achieving a basic understanding of the illness as well as powerlessness over their situation. Third, societal pressures on doctors contributed to a state of learned helplessness.

Conclusions

Our findings suggest that tension in the DPFR is associated with interpersonal and structural challenges, with communication playing an important role. Reforms at all levels are needed to promote a more patient-centred experience while ensuring the well-being and security of providers.
Adapting the UCLA 3-item loneliness scale for community-based depressive symptoms screening interview among older Chinese: a cross-sectional study
Authors: Liu Tianyin , Lu Shiyu , Leung Dara K Y , Sze Lesley C Y , Kwok Wai Wai , Tang Jennifer Y M , Luo Hao , Lum Terry Y S , Wong Gloria H Y
Published: December 2020

Objective

Loneliness is a significant and independent risk factor for depression in later life. Particularly in Asian culture, older people may find it less stigmatising to express loneliness than depression. This study aimed to adapt a simple loneliness screen for use in older Chinese, and to ascertain its relevance in detecting depressive symptoms as a community screening tool.

Design, setting and participants

This cross-sectional study was conducted among 1653 older adults aged 60 years or above living in the community in Hong Kong. This was a convenient sample recruited from four local non-governmental organisations providing community eldercare or mental healthcare services. All data was collected by trained social workers through face-to-face interviews.

Measures

Loneliness was measured using an adapted Chinese version of UCLA 3-item Loneliness Scale, depression symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and social support with emotional and instrumental support proxies (number of people who can offer help). Basic demographics including age, gender, education and living arrangement were also recorded.

Results

The average loneliness score was 3.9±3.0, and it had a moderate correlation with depressive symptoms (r=0.41, p<0.01). A loneliness score of 3 can distinguish those without depression from those with mild or more significant depressive symptoms, defined as a PHQ-9 score of ≥5 (sensitivity 76%, specificity 62%, area under the curve=0.73±0.01). Loneliness explained 18% unique variance of depressive symptoms, adding to age, living arrangement and emotional support as significant predictors.

Conclusion

A 3-item loneliness scale can reasonably identify older Chinese who are experiencing depressive symptoms as a quick community screening tool. Its wider use may facilitate early detection of depression, especially in cultures with strong mental health stigma.

Trial registration number

ClinicalTrials.gov NCT03593889
Periprosthetic fractures: the next fragility fracture epidemic? A national observational study
Authors: Bottle Alex , Griffiths Richard , White Stuart , Wynn-Jones Henry , Aylin Paul , Moppett Iain , Chowdhury Emyr , Wilson Helen , Davies Benjamin M
Published: December 2020

Objectives

Periprosthetic fractures have considerable clinical implications for patients and financial implications for healthcare systems. This study aims to determine the burden of periprosthetic fractures of the lower and upper limbs in England and identify any factors associated with differences in treatment and outcome.

Design

A national, observational study.

Setting

England.

Participants

All individuals admitted to hospital with periprosthetic fractures between 1 April 2015 and 31 December 2018.

Primary and secondary outcome measures

Mortality, length of stay, change in rate of admissions.

Methods

We analysed Hospital Episode Statistics data using the International Classification of Diseases 10th Revision code M96.6 (Fracture of bone following insertion of orthopaedic implant, joint prosthesis, or bone plate) to identify periprosthetic fractures recorded between April 2013 and December 2018. We determined the demographics, procedures performed, mortality rates and discharge destinations. Patient characteristics associated with having a procedure during the index admission were estimated using logistic regression. The annual rate of increase in admissions was estimated using Poisson regression.

Results

Between 1 April 2015 and 31 December 2018, there were 13 565 patients who had 18 888 admissions (89.5% emergency) with M96.6 in the primary diagnosis field. There was a 13% year-on-year increase in admissions for periprosthetic fracture in England during that period. Older people, people living in deprived areas and those with heart failure or neurological disorders were less likely to receive an operation. 14.4% of patients did not return home after hospital discharge. The overall inpatient mortality was 4.3% and total 30-day mortality was 3.3%.

Conclusions

The clinical and operational burden of periprosthetic fractures is considerable and increasing rapidly. We suggest that the management of people with periprosthetic fractures should be undertaken and funded in a similar manner to that successfully employed for people sustaining hip fractures, using national standards and data collection to monitor and improve performance.
Prevalence and health correlates of reduced kidney function among community-dwelling Chinese older adults: the China Health and Retirement Longitudinal Study
Authors: Jin Haiyu , Zhou Jingyi , Wu Chenkai
Published: December 2020

Objectives

We aimed to understand the prevalence of reduced kidney function in China by sociodemographics and geographical region, and to examine health correlates of reduced kidney function.

Design

Cross-sectional study.

Setting and participants

Participants were 6706 adults ≥60 years from the 2015–2016 wave of the China Health and Retirement Longitudinal Study.

Outcome measures

Reduced kidney function was defined as an estimated glomerular filtration rate of less than 60 mL/min per 1.73 m². The estimated glomerular filtration rate was calculated with the creatinine–cystatin C equation developed by the Chronic Kidney Disease Epidemiology Collaboration in 2012. The associations between reduced kidney function and potential risk factors were analysed using multivariable regression models.

Results

The prevalence of reduced kidney function was 10.3% (95% CI: 9.3% to 11.2%), corresponding to approximately 20 million older adults. Multivariable analysis showed that older adults with hypertension (β=−3.61, 95% CI: −4.42 to 2.79), cardiac disease (β=−1.90, 95% CI: −2.93 to 0.86), who had a stroke (β=−3.75, 95% CI: −6.35 to 1.15), kidney disease (β=−3.88, 95% CI: −5.62 to 2.13), slow gait speed (β=−2.23, 95% CI: −3.27 to 1.20), and living in the South (β=−4.38, 95% CI: −5.95 to 2.80) and South Central (β=−1.85, 95% CI: −3.15 to 0.56) were more significantly likely to have reduced kidney function.

Conclusions

Kidney function screening should be performed, especially in patients with hypertension, cardiac disease and who had a stroke. More efforts should be paid to improve the kidney function of older adults living in the South and South Central parts of China.
Birth experience during COVID-19 confinement (CONFINE): protocol for a multicentre prospective study
Authors: Bertholdt Charline , Epstein Jonathan , Banasiak Claire , Ligier Fabienne , Dahlhoff Sandra , Olieric Marie France , Mottet Nicolas , Beaumont Marine , Morel Olivier
Published: December 2020

Introduction

The absence of companionship during childbirth is known to be responsible for negative emotional birth experience, which can increase the risk of postpartum depression and post-traumatic stress disorder. The context of COVID-19 epidemic and the related confinement could increase the rate of negative experience and mental disorders. The main objective is to compare, in immediate post partum, the maternal sense of control during childbirth between a group of women who gave birth during confinement (‘confinement’ group) versus a group of women who gave birth after confinement but in the context of epidemic (‘epidemic’ group) versus a group of control women (‘control’ group; excluding confinement and epidemic context).

Methods and analysis

This is a national multicentre prospective cohort study conducted in four French maternity units. We expect to include 927 women in a period of 16 months. Women will be recruited immediately in post partum during three different periods constituting the three groups: ‘confinement’; ‘epidemic’ and ‘control’ group. The maternal sense of control will be evaluated by the Labour Agentry Scale questionnaire completed immediately in post partum. Postnatal depression (Edinburgh Postnatal Depression Scale), post-traumatic stress disorder (Impact of Event Scale—Revised) and breast feeding (evaluative statement) will be evaluated at 2 months post partum.

Ethics and dissemination

The study was approved by the French Ethics Committee, the CPP (Comité de Protection des Personnes) SUD OUEST ET OUTRE-MER IV on 16th of April 2020 with reference number CPP2020-04-040. The results of this study will be published in a peer-reviewed journal and will be presented at relevant conferences.

Trial registration number

NCT04348929.
Factors associated with the mental health status of medical students during the COVID-19 pandemic: a cross-sectional study in Japan
Authors: Arima Makiko , Takamiya Yusuke , Furuta Atsuko , Siriratsivawong Kris , Tsuchiya Shizuma , Izumi Miki
Published: December 2020

Objective

The COVID-19 pandemic had a substantial impact on university students, including those in medical schools, with disruption in routine education causing significant psychological distress. The objective of this study was to evaluate the factors associated with psychological distress among medical students during the period of enforced home quarantine from March through May 2020.

Design

A cross-sectional study.

Setting

One Japanese medical school.

Participants

571 medical students.

Primary and secondary outcome measures

Self-administered electronic questionnaires including the K-6 scale for psychological distress, the Rosenberg Self-Esteem Scale (RSES) for self-esteem and the General Self-Efficacy Scale (GSES) for self-efficacy were distributed. To assess the determinant factor for psychological distress, variables such as sex, grade in school, living conditions, and RSES and GSES scores were evaluated in regression analysis.

Results

163 respondents (28.5%) scored ≥5 on the K-6 scale, indicating a significant degree of psychological distress. Logistic regression revealed that a higher score on RSES (p<0.001) and GSES (p<0.01) was an independent factor associated with lower levels of psychological distress. Multiple regression analysis focusing on students with a K-6 score ≥5 revealed that higher scores on RSES correlated with lower levels of psychological distress. By contrast, those with higher GSES scores also scored higher for indicators of psychological distress.

Conclusions

This study identified that self-efficacy and self-esteem were both influential factors for predicting psychological distress during the current COVID-19 pandemic. Medical schools should provide support for mental health and educational initiatives directed at enhancing self-esteem and self-efficacy, with a focus on improving personal resilience. In emergency situations, such as that faced in response to the COVID-19 pandemic, initial programmes might target students with higher levels of self-efficacy. By contrast, under routine situations, these efforts should be directed towards students with lower self-esteem as primary means to prevent depression.
Discontinuation of oral anticoagulation in atrial fibrillation and risk of ischaemic stroke
Authors: García Rodríguez Luis Alberto , Cea Soriano Lucía , Munk Hald Stine , Hallas Jesper , Balabanova Yanina , Brobert Gunnar , Vora Pareen , Sharma Mike , Gaist David
Published: December 2020

Objective

To evaluate associations between oral anticoagulant (OAC) discontinuation and risk of ischaemic stroke (IS) among patients with atrial fibrillation (AF).

Methods

We undertook a population-based cohort study with nested case–control analysis using UK primary care electronic health records (IQVIA Medical Research Data-UK) and linked registries from the Region of Southern Denmark (RSD). Patients with AF (76 882 UK, 41 526 RSD) were followed to identify incident IS cases during 2016–2018. Incident IS cases were matched by age and sex to controls. Adjusted ORs for OAC discontinuation (vs current OAC use) were calculated using logistic regression.

Results

We identified 616 incident IS cases in the UK and 643 in the RSD. ORs for IS with any OAC discontinuation were 2.99 (95% CI 2.31 to 3.86, UK) and 2.30 (95% CI 1.79 to 2.95, RSD), for vitamin K antagonist discontinuation they were 2.38 (95% CI 1.72 to 3.30, UK) and 1.83 (95% CI 1.34 to 2.49, RSD), and for non-vitamin K antagonist oral anticoagulant discontinuation they were 4.59 (95% CI 2.97 to 7.08, UK) and 3.37 (95% CI 2.35 to 4.85, RSD). ORs were unaffected by time since discontinuation and duration of use. Annually, up to 987 IS cases in the UK and 132 in Denmark could be preventable if OAC therapy is not discontinued.

Conclusions

Our results suggest that patients with AF who discontinue OAC therapy have a significant twofold to threefold higher risk of IS compared with those who continue therapy. Addressing OAC discontinuation could potentially result in a significant reduction in AF-attributed IS.
Impact of off-shell dynamics on the transport properties and the dynamical evolution of charm quarks at RHIC and LHC temperatures
Authors: Sambataro Maria Lucia , Plumari Salvatore , Greco Vincenzo
Published: December 2020

We evaluate drag and diffusion transport coefficients comparing a quasi-particle approximation with on-shell constituents of the QGP medium and a dynamical quasi-particles model with off-shell bulk medium at finite temperature T. We study the effects of the width $$\gamma $$
γ
of the particles of the bulk medium on the charm quark transport properties exploring the range where $$\gamma < M_{q,g}$$

γ
<

M

q
,
g

. We find that off-shell effects are in general quite moderate and can induce a reduction of the drag coefficient at low momenta that disappear already at moderate momenta, $$p \gtrsim $$

p
≳

2–3 GeV. We also observe a moderate reduction of the breaking of the fluctuation–dissipation theorem (FDT) at finite momenta. Moreover, we have performed a first study of the dynamical evolution of HQ elastic energy loss in a bulk medium at fixed temperature extending the Boltzmann (BM) collision integral to include off-shell dynamics. A comparison among the Langevin dynamics, the BM collisional integral with on-shell and the BM extension to off-shell dynamics shows that the evolution of charm energy when off-shell effects are included remain quite similar to the case of the on-shell BM collision integral.
An answer to a question about maximal non-integrally closed subrings
Authors: Jarboui Noômen
Published: December 2020

The main purpose of this paper is to answer a question which was left open in N. Jarboui and S. Aljubran [Maximal non-integrally closed subrings of an integral domain, Ric. Mat. (2020), doi.org/10.1007/s11587-020-00500-0] asking for a characterization of maximal non-integrally closed subrings of arbitrary rings.
Synthesis of Heterostructure g-C3N4/h-MoO3 with Enhanced Photoactivity: Influencing Factors and Mechanism Insight
Authors: Wu Kun , Li Fengrui , Guo Jia , Zou Jian , Li Hao , Li Jianding , Wu Huadong , Zhang Linfeng
Published: December 2020

Photocatalytic degradation is an attractive technology for treating the growing environmental problems. In this work, the g-C3N4/h-MoO3 composite photocatalyst was fabricated through a simple mixed evaporation and subsequent annealing process. The prepared g-C3N4/h-MoO3 composites show enhanced photocatalytic performance compared with pristine h-MoO3 and g-C3N4 as well as their physical mixture. The apparent rate constants for tetracycline (TC) degradation of the C-M3 composite are estimated to be 0.01273 min[Formula: see text], which is 8.43 and 3.13 times as high as that of MoO3 and g-C3N4, respectively. The improved photodegradation activity is due to the broadened light absorption and more efficient charge separation. Therefore, a faster generation rate of superoxide radical ([Formula: see text]O[Formula: see text] and hydroxyl radical (•OH) is observed in the composites. According to the trapping experiments, the •O[Formula: see text] and photogenerated holes (h[Formula: see text] are the predominant active species in the photocatalytic degradation process, while the [Formula: see text]OH plays a negligible role. Notably, due to the matched band structure, a direct Z-scheme g-C3N4/h-MoO3 heterojunction is formed, which is verified by radical trapping experiments and density functional theory simulation. It is expected that the prepared heterostructure composties coud be employed as a promising photocatalyst for wastewater remediation.
Reduced pericyte and tight junction coverage in old diabetic rats are associated with hyperglycemia-induced cerebrovascular pericyte dysfunction
Authors: Liu Yedan , Zhang Huawei , Wang Shaoxun , Guo Ya , Fang Xing , Zheng Baoying , Gao Wenjun , Yu Hongwei , Chen Zongbo , Roman Richard J. , Fan Fan
Published: December 2020

This study demonstrates that the loss of contractile capability in pericytes in diabetes is associated with enhanced ROS and reduced ATP production. Enhanced advanced glycation end products (AGEs) in diabetes accompany with reduced pericyte and endothelial tight junction coverage in the cortical capillaries of old diabetic rats. These results suggest our previous findings that the impaired cerebral hemodynamics, BBB leakage, and cognitive impairments in old DM model are associated with hyperglycemia-induced cerebrovascular pericyte dysfunction.
Stress and Quality of Life of Patients with Cancer: The Mediating Role of Mindfulness
Authors: Dehghan Mahlagha , Jazinizade Moazame , Malakoutikhah Alireza , Madadimahani Ali , Iranmanesh Mohammad Hossein , Oghabian Shahriar , Mohammadshahi Fatemeh , Janfaza Fatemehzahra , Zakeri Mohammad Ali
Published: December 2020

Background. Cancer is one of the major health problems worldwide, which in addition to physical disorders, causes stress and anxiety in patients and affects the quality of life of cancer patients. Mindfulness can affect stress and improve the quality of life. This research explained the correlation between stress, quality of life, and mindfulness. Materials and Methods. Two hundred five cancer patients participated in this cross-sectional study. Patients completed the EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Mindfulness Attention and Awareness Scale (MAAS), and Perceived Stress Scale (PSS). Results. Perceived stress and mindfulness predict nearly 39% of the changes of QOL in cancer patients. In addition, perceived stress was negatively associated with mindfulness and quality of life

P
<
0.05

. Mindfulness was positively correlated with quality of life

P
<
0.05

. Mindfulness played a mediating role in the relationship between perceived stress and quality of life (standardized β = −0.13; SE = 0.07, 95% confidence interval = −0.28 to −0.01;

P

value = 0.04). Conclusion. In the present study, the variables of mindfulness and perceived stress affected the quality of life of cancer patients. Mindfulness can affect the quality of life of cancer patients directly and indirectly. These results emphasize the importance of mindfulness in the lives of cancer patients.
Protective Effects of Cinnamaldehyde against Mesenteric Ischemia-Reperfusion-Induced Lung and Liver Injuries in Rats
Authors: Almoiliqy Marwan , Wen Jin , Qaed Eskandar , Sun Yuchao , Lian Mengqiao , Mousa Haithm , Al-Azab Mahmoud , Zaky Mohamed Y. , Chen Dapeng , Wang Li , AL-Sharabi Abdulkarem , Liu Zhihao , Sun Pengyuan , Lin Yuan
Published: December 2020

The aim of this study was to characterize and reveal the protective effects of cinnamaldehyde (CA) against mesenteric ischemia-reperfusion- (I/R-) induced lung and liver injuries and the related mechanisms. Sprague-Dawley (SPD) rats were pretreated for three days with 10 or 40 mg/kg/d, ig of CA, and then induced with mesenteric ischemia for 1 h and reperfusion for 2 h. The results indicated that pretreatment with 10 or 40 mg/kg of CA attenuated morphological damage in both lung and liver tissues of mesenteric I/R-injured rats. CA pretreatment significantly restored the levels of aspartate transaminase (AST) and alanine transaminase (ALT) in mesenteric I/R-injured liver tissues, indicating the improvement of hepatic function. CA also significantly attenuated the inflammation via reducing myeloperoxidase (MOP) activity and downregulating the expression of inflammation-related proteins, including interleukin-6 (IL-6), interleukin-1β (IL-1β), cyclooxygenase-2 (Cox-2), and tumor necrosis factor receptor type-2 (TNFR-2) in both lung and liver tissues of mesenteric I/R-injured rats. Pretreatment with CA significantly downregulated nuclear factor kappa B- (NF-κB-) related protein expressions (NF-κB p65, NF-κB p50, I kappa B alpha (IK-α), and inhibitor of nuclear factor kappa-B kinase subunit beta (IKKβ)) in both lung and liver tissues of mesenteric I/R-injured rats. CA also significantly downregulated the protein expression of p53 family members, including caspase-3, caspase-9, Bax, and p53, and restored Bcl-2 in both lung and liver tissues of mesenteric I/R-injured rats. CA pretreatment significantly reduced TUNEL-apoptotic cells and significantly inhibited p53 and NF-κB p65 nuclear translocation in both lung and liver tissues of mesenteric I/R-injured rats. CA neither induced pulmonary and hepatic histological alterations nor affected the parameters of inflammation and apoptosis in sham rats. We conclude that CA alleviated mesenteric I/R-induced pulmonary and hepatic injuries via attenuating apoptosis and inflammation through inhibition of NF-κB and p53 pathways in rats, suggesting the potential role of CA in remote organ ischemic injury protection.