bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of different exercise training modes on muscle strength and physical performance in older people with sarcopenia: a systematic review and meta-analysis
Authors: Lu Linqian , Mao Lin , Feng Yuwei , Ainsworth Barbara E. , Liu Yu , Chen Nan
Published: December 2021

Objective

We conducted a systematic review and meta-analysis to clarify the effects of different exercise modes (resistance training [RT], whole body vibration training [WBVT], and mixed training [MT, resistance training combined with other exercises such as balance, endurance and aerobic training]) on muscle strength (knee extension strength [KES]) and physical performance (Timed Up and Go [TUG], gait speed [GS] and the Chair Stand [CS]) in older people with sarcopenia.

Method

All studies published from January 2010 to March 2021 on the effects of exercise training in older people with sarcopenia were retrieved from 6 electronic databases: Pubmed, Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure (CNKI), and Wanfang Database. Two researchers independently extracted and evaluated studies that met inclusion and exclusion criteria. Pooled analyses for pre- and post- outcome measurements were performed using Review Manager 5.4 with standardized mean differences (SMDs) and fixed-effect models.

Result

Twenty-six studies (25 randomized controlled trails [RCTs] and one non-randomized controlled trail) were included in this study with 1191 older people with sarcopenia (mean age 60.6 ± 2.3 to 89.5 ± 4.4). Compared with a control group, RT and MT significantly improved KES (RT, SMD = 1.36, 95% confidence intervals [95% CI]: 0.71 to 2.02, p < 0.0001, I2 = 72%; MT, SMD = 0.62, 95% CI: 0.29 to 0.95, p = 0.0002, I2 = 56%) and GS (RT, SMD = 2.01, 95% CI: 1.04 to 2.97, p < 0.0001, I2 = 84%; MT, SMD = 0.69, 95% CI: 0.29 to 1.09, p = 0.008, I2 = 81%). WBVT showed no changes in KES (SMD = 0.65, 95% CI: − 0.02 to 1.31, p = 0.06, I2 = 80%) or GS (SMD = 0.12, 95% CI: − 0.15 to 0.39, p = 0.38, I2 = 0%). TUG times were significantly improved with all exercise training modes (SMD = -0.66, 95% CI: − 0.94 to − 0.38, p < 0.00001, I2 = 60%). There were no changes in CS times with any of the exercise training modes (SMD = 0.11, 95% CI: − 0.36 to 0.57, p = 0.65, I2 = 87%).

Conclusions

In older people with sarcopenia, KES and GS can be improved by RT and MT, but not by WBVT. All three training modes improved TUG times, but not improved CS times.
The International Classification of Functioning, Disabilities, and Health categories rated as necessary for care planning for older patients with heart failure: a survey of care managers in Japan
Authors: Shiota Shigehito , Kitagawa Toshiro , Hidaka Takayuki , Goto Naoya , Mio Naoki , Kanai Kana , Naka Makiko , Togino Hiroko , Mochizuki Mariko , Ochikubo Hiroyuki , Nakano Yukiko , Kihara Yasuki , Kimura Hiroaki
Published: December 2021

Background

Establishing an information-sharing system between medical professionals and welfare/care professionals may help prevent heart failure (HF) exacerbations in community-dwelling older adults. Therefore, we aimed to identify the ICF categories necessary for care managers to develop care plans for older patients with HF.

Methods

A questionnaire was administered to 695 care managers in Hiroshima, Japan, on ICF items necessary for care planning. We compared the care managers according to their specialties (medical qualifications and welfare or care qualifications). Furthermore, we created a co-occurrence network using text mining, regarding the elements necessary for collaboration between medical and care professionals.

Results

There were 520 valid responses (74.8%). Forty-nine ICF items, including 18 for body functions, one for body structure, 21 for activities and participation, and nine for environmental factors, were classified as “necessary” for making care plans for older people with HF. Medical professionals more frequently answered “necessary” than care professionals regarding the 11 items for body functions and structure and three items for activities and participation (p < 0.05). Medical–welfare/care collaboration requires (1) information sharing with related organisations; (2) emergency response; (3) a system of cooperation between medical care and non-medical care; (4) consultation and support for individuals and families with life concerns, (5) management of nutrition, exercise, blood pressure and other factors, (6) guidelines for consultation and hospitalisation when physical conditions worsen.

Conclusions

Our findings showed that 49 ICF categories were required by care managers for care planning, and there was a significant difference in perception between medical and welfare or care qualifications qualifications.
Increased recurrent falls experience in older adults with coexisting of sarcopenia and knee osteoarthritis: a cross-sectional study
Authors: Iijima Hirotaka , Aoyama Tomoki
Published: December 2021

Background

Sarcopenia and knee osteoarthritis (OA) are two major risk factors for falls in older adults. The coexistence of these two conditions may exacerbate the risk of falls. This cross-sectional study aimed to test the hypothesis that older adults with coexisting sarcopenia and knee OA displayed an increased risk of falls experience.

Methods

Participants recruited from an orthopedic clinic were divided into four groups according to the presence of sarcopenia and radiographic knee OA: isolated sarcopenia, isolated knee OA, sarcopenia + knee OA, and control (i.e., non-sarcopenia with non-OA) groups. We used questionnaires to assess falls experience in the prior 12 months. We performed logistic regression analyses to evaluate the relationship between the four groups and falls experience.

Results

Of 291 participants (age: 60–90 years, 78.7% women) included in this study, 25 (8.6%) had sarcopenia + knee OA. Participants with sarcopenia + knee OA had 4.17 times (95% confidence interval: 0.84, 20.6) higher odds of recurrent falls (≥2 falls) than controls after adjustment for age, sex, and body mass index. The increased recurrent falls experience was not clearly confirmed in participants with isolated sarcopenia and isolated knee OA.

Conclusions

People with coexisting of sarcopenia and knee OA displayed increased recurrent falls experience. This study suggests a new concept, “sarcopenic knee OA”, as a subgroup associated with higher risk of falls, which should be validated in future large cohort studies.

Trial registration.

Not applicable.
Health care professionals’ perspectives on self-management for people with Parkinson’s: qualitative findings from a UK study
Authors: Armstrong Megan , Tuijt Remco , Read Joy , Pigott Jennifer , Davies Nathan , Manthorpe Jill , Frost Rachael , Schrag Anette , Walters Kate
Published: December 2021

Background

Parkinson’s disease is a long-term, complex health condition. To improve or maintain quality of life, people with Parkinson’s can have an active involvement in their care through self-management techniques. Given the complexity and individualization of self-management, people with Parkinson’s will need support and encouragement from their healthcare professionals (HCPs). Despite the key role HCPs have in this, research has seldom explored their perspectives and understanding of self-management for people with Parkinson’s.

Methods

Multi-disciplinary teams providing care for people with Parkinson’s across London, Coventry and Hertfordshire were approached and took part in either one of four focus groups or individual interviews. Forty-two HCPs, including a range of specialist doctors, general practitioners, allied health professionals, nurses, and social workers, took part in this study. Interviews were transcribed and analysed using thematic analysis to identify themes.

Results

Four themes were developed from the data: 1) Empowerment of patients through holistic care and being person-centred; 2) Maximising motivation and capability for patients, for example using asset based approaches and increasing opportunities; 3) importance of empowerment of carers to support self-management and 4) contextual barriers to self-management such as the social context.

Conclusions

This study is the first to explore the perspectives of HCPs on self-management in people with Parkinson’s. Our findings have identified important considerations surrounding empowerment, motivation, carers and contextual barriers to better understand how we enable effective self-management techniques in people with Parkinson’s. Research should build on these findings on to develop acceptable and effective self-management tools for use in practice with people affected by Parkinson’s.
Persistent polypharmacy and fall injury risk: the Health, Aging and Body Composition Study
Authors: Xue Lingshu , Boudreau Robert M. , Donohue Julie M. , Zgibor Janice C. , Marcum Zachary A. , Costacou Tina , Newman Anne B. , Waters Teresa M. , Strotmeyer Elsa S.
Published: December 2021

Background

Older adults receive treatment for fall injuries in both inpatient and outpatient settings. The effect of persistent polypharmacy (i.e. using multiple medications over a long period) on fall injuries is understudied, particularly for outpatient injuries. We examined the association between persistent polypharmacy and treated fall injury risk from inpatient and outpatient settings in community-dwelling older adults.

Methods

The Health, Aging and Body Composition Study included 1764 community-dwelling adults (age 73.6 ± 2.9 years; 52% women; 38% black) with Medicare Fee-For-Service (FFS) claims at or within 6 months after 1998/99 clinic visit. Incident fall injuries (N = 545 in 4.6 ± 2.9 years) were defined as the initial claim with an ICD-9 fall E-code and non-fracture injury, or fracture code with/without a fall code from 1998/99 clinic visit to 12/31/08. Those without fall injury (N = 1219) were followed for 8.1 ± 2.6 years. Stepwise Cox models of fall injury risk with a time-varying variable for persistent polypharmacy (defined as ≥6 prescription medications at the two most recent consecutive clinic visits) were adjusted for demographics, lifestyle characteristics, chronic conditions, and functional ability. Sensitivity analyses explored if persistent polypharmacy both with and without fall risk increasing drugs (FRID) use were similarly associated with fall injury risk.

Results

Among 1764 participants, 636 (36%) had persistent polypharmacy over the follow-up period, and 1128 (64%) did not. Fall injury incidence was 38 per 1000 person-years. Persistent polypharmacy increased fall injury risk (hazard ratio [HR]: 1.31 [1.06, 1.63]) after adjusting for covariates. Persistent polypharmacy with FRID use was associated with a 48% increase in fall injury risk (95%CI: 1.10, 2.00) vs. those who had non-persistent polypharmacy without FRID use. Risks for persistent polypharmacy without FRID use (HR: 1.22 [0.93, 1.60]) and non-persistent polypharmacy with FRID use (HR: 1.08 [0.77, 1.51]) did not significantly increase compared to non-persistent polypharmacy without FRID use.

Conclusions

Persistent polypharmacy, particularly combined with FRID use, was associated with increased risk for treated fall injuries from inpatient and outpatient settings. Clinicians may need to consider medication management for FRID and other fall prevention strategies in community-dwelling older adults with persistent polypharmacy to reduce fall injury risk.
Pretarsal orbicularis oculi muscle tightening with skin flap excision in the treatment of lower eyelid involutional entropion
Authors: Cai Jianhao , Zhou Yuansheng , Lv Wenjuan , Chen Wenxia , Cai Weihao , Ng Tsz Kin , Li Zeyi
Published: December 2021

Background

To evaluate a modified technique for involutional entropion correction in a retrospective cohort study.

Methods

The patients with involutional entropion eyelid were corrected by tightening the pretarsal orbicularis oculi muscle and excising the excess skin of the lower eyelid. The patients received correction surgery from April 2013 to March 2019 were followed up for more than 6 months postoperatively. The outcome measures included the complications and the recurrence rates.

Results

Total 152 patients (169 eyes) were included. The mean follow-up period was 29.6 months (range: 6–36 months). Postoperative ectropion (over-correction) was observed in 1 patient with 1 eyelid (0.59%); yet, no further surgery was needed for this patient. Recurrence of entropion was found in 1 patient (0.59%). The patient with recurrent entropion received repeated surgery with the same method and achieved a good eyelid position.

Conclusions

This study demonstrated that tightening the pretarsal orbicularis oculi muscle and excising the excess skin of the lower eyelid could be an effective surgical method to correct lower eyelid involutional entropion. This method is technically easy with a low recurrence rate and not associated with significant complications in Asians.
Association between sedentary time and sleep quality based on the Pittsburgh Sleep Quality Index among South Korean adults
Authors: Jeong Sung Hoon , Jang Bich Na , Kim Seung Hoon , Kim Gyu Ri , Park Eun-Cheol , Jang Sung-In
Published: December 2021

Background

Sleep problems increase the risk of premature illness and death. We evaluated the association between sedentary time and sleep quality among South Korean adults.

Methods

The data of adults (aged ≥ 19 years) from the 2018 Korea Community Health Survey were analyzed. Sedentary time, which included hours spent sitting or lying down daily, was categorized into four standardized groups. Poor sleep quality was defined using the global cutoff point (> 5 points) of the Pittsburg Sleep Quality Index. Multiple logistic regression analyses were performed to identify the association between sedentary time (≤ 3.9, 4.0–5.9, 6.0–7.9, and ≥ 8 hours /day) and sleep quality, by sex.

Results

Of the 224,118 participants, 35,784/100,454 men (35.6%) and 58,271/123,664 women (47.1%) had poor sleep quality. Compared with ≤ 3.9 h/day, sedentary times 4.0–5.9, 6.0–7.9, and ≥ 8 h/day were associated with worse sleep quality among men (odds ratio [OR]: 1.12, 95% confidence interval [CI]: 1.08–1.16; OR: 1.19, 95% CI: 1.14–1.25; OR: 1.30, 95% CI: 1.25–1.34, respectively) and women (OR: 1.06, 95% CI: 1.03–1.10; OR: 1.12, 95% CI: 1.08–1.16; OR: 1.22, 95% CI: 1.18–1.26, respectively). In subgroup analyses of sleep quality, subjective sleep quality, latency, disturbance, use of sleeping medication, and daytime dysfunction showed a strong dose-response relationship with increasing sedentary time in both sexes.

Conclusions

Regardless of sex, the longer the sedentary time, the stronger the association with poor sleep quality. Nationwide efforts are required to recommend standards for sedentary time and develop evidenced-based healthy behavior guidelines.
Women’s outcomes following mixed-sex, women-only, and home-based cardiac rehabilitation participation and comparison by sex
Authors: Heald Fiorella A. , Marzolini Susan , Colella Tracey J. F. , Oh Paul , Nijhawan Rajni , Grace Sherry L.
Published: December 2021

Background

Despite women’s greater need for cardiac rehabilitation (CR), they are less likely to utilize it. Innovative CR models have been developed to better meet women’s needs, yet there is little controlled, comparative data assessing the effects of these models for women. This study compared outcomes in women electing to participate in mixed-sex, women-only, or home-based CR, and a matched sample of men.

Methods

In this retrospective study, electronic records of CR participants in Toronto who were offered the choice of program model between January 2017 and July 2019 were analyzed; clinical outcomes comprised cardiorespiratory fitness, risk factors and psychosocial well-being. These were assessed at intake and post-6-month program and analyzed using general linear mixed models.

Results

There were 1181 patients (727 women [74.7% mixed, 22.0% women-only, 3.3% home-based]; 454 age and diagnosis-matched men) who initiated CR; Cardiorespiratory fitness among women was higher at initiation of mixed-sex than women-only (METs 5.1 ± 1.5 vs 4.6 ± 1.3;P = .007), but no other outcome differences were observed. 428 (58.9%) women completed the programs, with few women retained in the home-based model limiting comparisons. There were significant improvements in high-density lipoprotein cholesterol (P = .001) and quality of life (P = .001), and lower depressive symptoms (P = .030) as well as waist circumference (P = .001) with mixed-sex only. VO2peakwas significantly higher at discharge in mixed-sex than women-only (estimate = 1.67, standard error = 0.63, 95% confidence interval = 0.43–2.91).

Conclusion

Participation in non-gender-tailored women-only CR was not advantageous as expected. More research is needed, particularly including women participating in home-based programs.
Assessment of breast cancer risk among Iraqi women in 2019
Authors: Hashim Hashim Talib , Ramadhan Mustafa Ahmed , Theban Kabas Monther , Bchara John , El-Abed-El-Rassoul Ahed , Shah Jaffer
Published: December 2021

Background

Breast cancer is one of the most common cancers among women worldwide and the leading cause of death among Iraqi women. Breast cancer cases in Iraq were found to have increased from 26.6/100,000 in 2000 to 31.5/100,000 in 2009. The present study aims to assess the established risk factors of breast cancer among Iraqi women and to highlight strategies that can aid in reducing the incidence.

Methods

1093 Iraqi females were enrolled in this cross-sectional study by purposive sampling methods. Data collection occurred from July 2019 to September 2019. 1500 women participated in the study, and 407 women were ultimately excluded. The questionnaire was conducted as a self-administrated form in an online survey. Ethical approval was obtained from the College of Medicine in the University of Baghdad. The Gail Model risk was calculated for each woman by the Breast Cancer Risk Assessment Tool (BCRAT), an interactive model developed by Mitchell Gail that was designed to estimate a woman’s absolute risk of developing breast cancer in the upcoming five years of her life and in her lifetime.

Results

The ages of the participants ranged from 35 to 84 years old. The mean 5–year risk of breast cancer was found to be 1.3, with 75.3% of women at low risk and 24.7% of women at high risk. The mean lifetime risk of breast cancer was found to be 13.4, with 64.7% of women at low risk, 30.3% at moderate risk, and 5.0% at high risk. The results show that geographically Baghdad presented the highest 5-year risk, followed by Dhi Qar, Maysan, and Nineveh. However, the highest lifetime risk was found in Najaf, followed by Dhi Qar, Baghdad, and Nineveh, successively.

Conclusion

Breast cancer is a wide-spreading problem in the world and particularly in Iraq, with Gail Model estimations of high risk in several governorates. Prevention programs need to be implemented and awareness campaigns organized in order to highlight the importance of early detection and treatment.
Secondary research use of personal medical data: patient attitudes towards data donation
Authors: Richter Gesine , Borzikowsky Christoph , Hoyer Bimba Franziska , Laudes Matthias , Krawczak Michael
Published: December 2021

Background

The SARS-CoV-2 pandemic has highlighted once more the great need for comprehensive access to, and uncomplicated use of, pre-existing patient data for medical research. Enabling secondary research-use of patient-data is a prerequisite for the efficient and sustainable promotion of translation and personalisation in medicine, and for the advancement of public-health. However, balancing the legitimate interests of scientists in broad and unrestricted data-access and the demand for individual autonomy, privacy and social justice is a great challenge for patient-based medical research.

Methods

We therefore conducted two questionnaire-based surveys among North-German outpatients (n = 650) to determine their attitude towards data-donation for medical research, implemented as an opt-out-process.

Results

We observed a high level of acceptance (75.0%), the most powerful predictor of a positive attitude towards data-donation was the conviction that every citizen has a duty to contribute to the improvement of medical research (> 80% of participants approving data-donation). Interestingly, patients distinguished sharply between research inside and outside the EU, despite a general awareness that universities and public research institutions cooperate with commercial companies, willingness to allow use of donated data by the latter was very low (7.1% to 29.1%, depending upon location of company). The most popular measures among interviewees to counteract reservations against commercial data-use were regulation by law (61.4%), stipulating in the process that data are not sold or resold (84.6%). A majority requested control of both the use (46.8%) and the protection (41.5%) of the data by independent bodies.

Conclusions

In conclusion, data-donation for medical research, implemented as a combination of legal entitlement and easy-to-exercise-right to opt-out, was found to be widely supported by German patients and therefore warrants further consideration for a transposition into national law.
Prediction of total hospital expenses of patients undergoing breast cancer surgery in Shanghai, China by comparing three models
Authors: Chen Minjie , Wu Xiaopin , Zhang Jidong , Dong Enhong
Published: December 2021

Background

Breast cancer imposes a considerable burden on both the health care system and society, and becomes increasingly severe among women in China. To reduce the economic burden of this disease is crucial for patients undergoing the breast cancer surgery, hospital managers, and medical insurance providers. However, few studies have evidenced the prediction of the total hospital expenses (THE) for breast cancer surgery. The aim of the study is to predict THE for breast cancer surgery and identify the main influencing factors.

Methods

Data were retrieved from the first page of medical records of 3699 patients undergoing breast cancer surgery in one tertiary hospital from 2017 to 2018. Multiple liner regression (MLR), artificial neural networks (ANNs), and classification and regression tree (CART) were constructed and compared.

Results

The dataset from 3699 patients were randomly divided into training and test sets at a 70:30 ratio (2599 and 1100 records, respectively). The average total hospital expenses were 12520.54 ± 7844.88 ¥ (US$ 1929.20 ± 1208.11). MLR results revealed six factors to be significantly associated with THE: age, LOS, type of disease, having medical insurance, minimally invasive surgery, and receiving general anesthesia. After comparing three models, ANNs was the best model to predict THEs in patients undergoing breast cancer surgery, and its strong predictive performance was also validated.

Conclusions

To reduce the THEs, more attention should be paid to related factors of LOS, major and minimally invasive surgeries, and general anesthesia for these patient groups undergoing breast cancer surgery. This may reduce the information asymmetry between doctors and patients and provide more reliable cost, practical inpatient medical consumption standards and reimbursement standards reference for patients, hospital managers, and medical insurance providers ,respectively.
Study of geothermal energy potential as a green source of energy with a look at energy consumption in Iran
Authors: Dashti Ali , Gholami Korzani Maziar
Published: December 2021

Regarding disadvantages of fossil fuels, renewables like geothermals can be an eco-friendly source of energy. In Iran, the availability of fossil fuels and poor policies surrounding subsidies (ranked as the first in giving subsidies) caused high energy consumption (1.75 times higher than the global average). Energy is mainly provided by fossil fuels that leads to high CO2 emission. This study evaluates the energy consumption trend and potentials of more sustainable resources like geothermals in Iran. The formation of geothermals is tightly linked with geological prerequisites that are partly present within Iran. Adjacency of the metamorphic with volcanic zones, existence of numerous faults and seismic activity of Iran are notable geological characteristics confirming the geothermal potential. In Iran, 18 regions are being explored as the most promising geothermal prospects. To test the potentials of one of these regions, a geothermal power plant with a capacity of 5 MWe is installed in the Sabalan Field. Northwest (where Sabalan Field is located), central (like Mahalat Region) and southeast of Iran (Makran Zone) can be regarded as promising zones for hosting geothermal prospects.
MMX geodesy investigations: science requirements and observation strategy
Authors: Matsumoto Koji , Hirata Naru , Ikeda Hitoshi , Kouyama Toru , Senshu Hiroki , Yamamoto Keiko , Noda Hirotomo , Miyamoto Hideaki , Araya Akito , Araki Hiroshi , Kamata Shunichi , Baresi Nicola , Namiki Noriyuki
Published: December 2021

In order to investigate the origin of Phobos and Deimos, the Japanese Martian Moons eXploration (MMX) mission is scheduled for launch in 2024. MMX will make comprehensive remote-sensing measurements of both moons and return regolith samples from Phobos to Earth. Geodetic measurements of gravity, shape, and rotation parameter of a body provides constraints on its internal structure reflecting its origin and evolution. Moments of inertia are important parameters to constrain the internal mass distribution, but they have not been well determined for the Martian moons yet. We discuss the mission requirements related to the moments of inertia to detect a potential heterogeneity of the mass distribution inside Phobos. We introduce mission instruments and operational strategies to meet the mission requirements. We present a preliminary imaging strategy from a quasi-satellite orbit for a base shape model that is expected to be created at the early stage of the mission. Geodetic products including ephemeris, gravity field, rotation parameter of Phobos, and spacecraft orbit are of importance not only for the geodetic study, but also for interpreting data from various mission instruments and selecting possible landing sites.

Graphical Abstract
Comparison of volcanic explosions in Japan using impulsive ionospheric disturbances
Authors: Cahyadi Mokhamad Nur , Handoko Eko Yuli , Rahayu Ririn Wuri , Heki Kosuke
Published: December 2021

Using the ionospheric total electron content (TEC) data from ground-based Global Navigation Satellite System (GNSS) receivers in Japan, we compared ionospheric responses to five explosive volcanic eruptions 2004–2015 of the Asama, Shin-Moe, Sakurajima, and Kuchinoerabu-jima volcanoes. The TEC records show N-shaped disturbances with a period ~ 80 s propagating outward with the acoustic wave speed in the F region of the ionosphere. The amplitudes of these TEC disturbances are a few percent of the background absolute vertical TEC. We propose to use such relative amplitudes as a new index for the intensity of volcanic explosions.

Graphical Abstract
Effect of omega-3 supplementation on cardiometabolic indices in diabetic patients with non-alcoholic fatty liver disease: a randomized controlled trial
Authors: Sangouni Abbas Ali , Orang Zahra , Mozaffari-Khosravi Hassan
Published: December 2021

Background

Patients with non-alcoholic fatty liver disease (NAFLD) as well as type 2 diabetes mellitus (T2DM) are at increased risk for cardiovascular diseases (CVD). Omega-3 supplementation has been proposed as a possible strategy for management of cardiometabolic risk. Cardiometabolic indices can predict and evaluate the cardiometabolic risk.

Aims

We investigated the effect of omega-3 supplementation on accurate and available cardiometabolic indices including atherogenic index of plasma (AIP), Castelli risk index I, Castelli risk index II and atherogenic coefficient (AC) in diabetic patients with NAFLD.

Methods

We conducted a double-blind, randomized controlled trial (RCT) for 12 weeks. From August 2016 to March 2017, the subjects referred to Faghihi hospital in Shiraz, Iran, were recruited. Sixty diabetic patients with NAFLD were randomly assigned into the omega-3 (2000 mg/d omega-3 capsule contained 360 mg/d eicosapentaenoic acid and 240 mg/d docosahexaenoic acid) and the placebo (liquid paraffin) groups using computer-generated random number table.

Results

Omega-3 supplementation compared to the placebo had no significant effect on AIP (− 0.11 ± 0.20 vs. -0.03 ± 0.16; P = 0.11), Castelli risk index I (− 0.25 ± 0.6 vs. -0.07 ± 0.7; P = 0.42), Castelli risk index II (− 0.24 ± 0.5 vs. -0.14 ± 0.5; P = 0.63) and AC (− 0.25 ± 0.6 vs. -0.07 ± 0.7; P = 0.42). After adjusting for confounding factors, the findings remained without change.

Conclusion

Omega-3 supplementation (2000 mg/d) for 12 weeks has no effect on cardiometabolic risk. It seems, higher doses of omega-3 can improve cordiometabolic risk. The trial was registered at Iranian Registry of Clinical Trials IRCT2016102530489N1.
Combined and hybrid marker models for radiostereometry assessment of polyethylene liner motion in dual mobility hip prosthesis: a proof-of-concept study
Authors: Jørgensen Peter Bo , Kaptein Bart L. , Søballe Kjeld , Jakobsen Stig S. , Stilling Maiken
Published: December 2021

Background

Investigation of polyethylene liner movement in total hip arthroplasty requires bead-marking for radiographic visibility of the liner. However, occlusion of markers poses a challenge for marker registration in radiographs.

Methods

The polyethylene of a dual mobility acetabular system was marked with twelve 1-mm tantalum markers (four groups of three markers) using a custom-made drill guide. Liner motion in a phantom and a patient was investigated with dynamic radiostereometry analysis (dRSA) at 1-year follow-up and static radiostereometry analysis (sRSA) postoperatively and at 1- and 2-year follow-up. A combined marker configuration (CMC) model was calculated from the registered positions of the liner markers and the femoral head in several images. Furthermore, the CMC model and the theoretic marker positions from computer-assisted models of the drill guide were combined in a hybrid model.

Results

The CMC model included eleven markers in the phantom and nine markers in the patient, which was sufficient for dRSA. Liner movement in the phantom followed liner contact with the femoral neck, while liner movement in the patient was independent. The hybrid model was necessary to determine liner orientation in sRSA recordings, which clearly changed from postoperative to 1- and 2-year follow-up even though the patient was positioned similarly.

Conclusion

Polyethylene liner motion in dual mobility hip prosthesis can be assessed with CMC models in dRSA recordings. In sRSA, the liner position between follow-ups is unpredictable and analysis requires inclusion of all markers in the model, accomplished with a hybrid marker model.

Trial registration

ClinicalTrials.gov [NCT02301182], 25 October 2015.
Effect of eggshell powder application on the shear bond strength of bulk-fill resin composite to bleached enamel
Authors: Moharam Lamiaa M. , Hassan Shahinaz N.
Published: December 2021

Objective

To investigate experimental eggshell powder (ESP) solution application effect on shear bond strength (SBS) test timing of bulk-fill resin composite to bleached enamel.

Methods

Eighty bovine-extracted anterior teeth were alienated to eight groups (n = 10), representing shear bond strength test timing periods (immediate or delayed) and the remineralizing agents investigated (MI paste Plus and ESP solution). Enamel surfaces were bleached using in-office chemical bleaching agent and the two remineralizing agents were applied then self-etch adhesive and bulk-fill resin composite were performed at 24 h and 14 d before SBS test was done. One-way ANOVA followed by Tukey post hoc test was performed for statistical analysis.

Results

The control groups showed the highest mean values, while the bleached enamel groups recorded the least mean values. ESP bleached enamel group recorded a significantly higher mean SBS values than MI paste Plus bleached group. Delayed SBS groups showed higher mean values than immediate SBS groups except for control group.

Conclusions

ESP had a positive and significant effect on SBS of bulk-fill resin composite to bleached enamel surface. Delaying the bonding procedure and restoration of the bleached teeth using resin composite restorations results in a better bond durability.
Value of ultrasound in grading the severity of sarcopenia in patients with hepatic cirrhosis
Authors: Mahmoud Heba , Kamal Heba , El-Liethy Nevien , Hassan Mohamed , Said Elham
Published: December 2021

Background

Ultrasound is emerging as an efficient significant method for measuring muscle mass in patients with liver cirrhosis. It has been applied in numerous studies as an accurate measuring tool for the muscles of the limbs. This study was conducted to assess the severity of sarcopenia in liver cirrhosis patients, through utilizing ultrasound in measuring the cross-sectional area and consequently estimating the muscle mass of both the upper and lower limb muscles, than correlating the results with hand grip strength as representative of functional status. Also, the severity of sarcopenia was correlated with conventional prognostic scores for liver cirrhosis, like Child or MELD scores and detecting its effect on the duration of hospital stay and mortality.

Results

This study was conducted on 101 liver cirrhosis patients who were admitted to the internal medicine hospital, 30 healthy participants were added as a control group. Using the FNIH (Foundation for the national Institutes of health) cuff off of hand grip (< 26 kg in male and < 16 kg in female, Quadriceps muscle index cutoff was estimated to be(1.67 cm/m2 for male and 1.58 cm/m2 for female).

Ultrasound (mid upper arm, mid-thigh and Quadriceps muscle index) showed significant indirect correlation with (Child even in Child A and MELD) scores, as well as with the duration of hospital stay. Also, they showed a direct correlation with HGS.

Conclusion

Sarcopenia in cirrhotic patients assessed by ultrasonography of (mid upper arm, mid-thigh muscle thickness) and HGS are independent predictors of disease severity and poor outcome, which is assessed by high Child and MELD scores. Also, ultrasound and HGS are straightforward bedside techniques used for assessment of sarcopenia.
International Socioeconomic Predictors of Colon and Rectal Cancer Mortality: Is Colorectal Cancer a First World Problem?
Authors: Cui Christina L. , Dornisch Anna M. , Umlauf Anya E. , Cuomo Raphael E. , Murphy James D. , Lopez Nicole E.
Published: December 2021

PURPOSE

Colorectal cancer (CRC) is a leading cause of international morbidity and is the second highest cause of cancer-related mortality in the world. The purpose of this study was to investigate the relationship between international health care spending on CRC mortality over time.

METHODS

This is a retrospective study using a publicly available data from the WHO Global Health Observatory database. General estimating equations were used to analyze the relationship between total health care expenditure per capita (THEpc) and CRC mortality at the country level. The primary predictors of interest were quartiles of THEpc. Other exposure variables included gross domestic product per capita (GDPpc), smoking (% of adult population smoking), physician density (per 10,000), and time.

RESULTS

Mortality decreased significantly from 2000 to 2016 (coefficient [95% CI], −2.2 [−3.3 to −1.1]; P < .001). THEpc, GDPpc, time, and percentage of adult population smoking were significant predictors of CRC mortality. Patients in the top two quartiles of THEpc had 3% higher rates of CRC mortality compared with countries in Q1 THEpc (Q3: 3.4 [1.9-4.8], P < .001; Q4: 3.2 [1.4-5.0], P = .001). Similar trends were seen in GDPpc (Q4: 3.2 [1.4-5.0], P = .001; Q3: 3.4 [1.9-4.8], P < .001; Q2: 1.7 [0.7-2.6], P < .001; Q1: reference).

CONCLUSION

Overall, mortality decreased significantly over the study period. Countries with higher health expenditures and higher gross domestic products experienced higher rates of CRC mortality. Further research will be necessary to determine the cause for this, but we postulate that it may be a result of more robust diagnostic and follow-up methods in countries with more resources.
Optimal Donor Nerve to Restore Elbow Flexion After Traumatic Brachial Plexus Injury: A Systematic Review and Meta-Analysis
Authors: Kim Robert B. , Bounajem Michael , Hamrick Forrest , Mahan Mark A.
Published: December 2021

BACKGROUND:

Traumatic brachial plexus injuries (BPIs) often lead to devastating upper extremity deficits. Treatment frequently prioritizes restoring elbow flexion through transfer of various donor nerves; however, no consensus identifies optimal donor nerve sources.

OBJECTIVE:

To complete a meta-analysis to assess donor nerves for restoring elbow flexion after partial and total BPI (TBPI).

METHODS:

Original English language articles on nerve transfers to restore elbow flexion after BPI were included. Using a random-effects model, we calculated pooled, weighted effect size of the patients achieving a composite motor score of ≥M3, with subgroup analyses for patients achieving M4 strength and with TBPI. Meta-regression was performed to assess comparative efficacy of each donor nerve for these outcomes.

RESULTS:

Comparison of the overall effect size of the 61 included articles demonstrated that intercostal nerves and phrenic nerves were statistically superior to contralateral C7 (cC7; P = .025, <.001, respectively) in achieving ≥M3 strength. After stratification by TBPI, the phrenic nerve was still superior to cC7 in achieving ≥M3 strength (P = .009). There were no statistical differences among ulnar, double fascicle, or medial pectoral nerves in achieving ≥M3 strength. Regarding M4 strength, the phrenic nerve was superior to cC7 (P = .01) in patients with TBPI and the ulnar nerve was superior to the medial pectoral nerve (P = .036) for partial BPI.

CONCLUSION:

Neurotization of partial BPI or TBPI through the intercostal nerve or phrenic nerve may result in functional advantage over cC7. In patients with upper trunk injuries, neurotization using ulnar, median, or double fascicle nerve transfers has similarly excellent functional recovery.
Household overcrowding and risk of SARS-CoV-2: analysis of the Virus Watch prospective community cohort study in England and Wales
Authors: Aldridge Robert W , Pineo Helen , Fragaszy Ellen , Eyre Max T , Kovar Jana , Nguyen Vincent , Beale Sarah , Byrne Thomas , Aryee Anna , Smith Colette , Devakumar Delan , Taylor Jonathon , Katikireddi Srinivasa Vittal , Fong Wing Lam Erica , Geismar Cyril , Patel Parth , Shrotri Madhumita , Braithwaite Isobel , Patni Nicholas , Navaratnam Annalan M.D. , Johnson Anne M. , Hayward Andrew
Published: December 2021

Background: Household overcrowding is associated with increased risk of infectious diseases across contexts and countries. Limited data exist linking household overcrowding and risk of COVID-19. We used data collected from the Virus Watch cohort to examine the association between overcrowded households and SARS-CoV-2.

Methods: The Virus Watch study is a household community cohort of acute respiratory infections in England and Wales. We calculated overcrowding using the measure of persons per room for each household. We considered two primary outcomes: PCR-confirmed positive SARS-CoV-2 antigen tests and laboratory-confirmed SARS-CoV-2 antibodies. We used mixed-effects logistic regression models that accounted for household structure to estimate the association between household overcrowding and SARS-CoV-2 infection.

Results: 26,367 participants were included in our analyses. The proportion of participants with a positive SARS-CoV-2 PCR result was highest in the overcrowded group (9.0%; 99/1,100) and lowest in the under-occupied group (4.2%; 980/23,196). In a mixed-effects logistic regression model, we found strong evidence of an increased odds of a positive PCR SARS-CoV-2 antigen result (odds ratio 2.45; 95% CI:1.43–4.19; p-value=0.001) and increased odds of a positive SARS-CoV-2 antibody result in individuals living in overcrowded houses (3.32; 95% CI:1.54–7.15; p-value<0.001) compared with people living in under-occupied houses.

Conclusion: Public health interventions to prevent and stop the spread of SARS-CoV-2 should consider the risk of infection for people living in overcrowded households and pay greater attention to reducing household transmission.
Effect of early tranexamic acid treatment on fatigue in patients with mild traumatic brain injury: data from the CRASH-3 clinical trial
Authors: Mansukhani Raoul , Belli Antonio , Brenner Amy , Chaudhri Rizwana , Frimley Lauren , Faizah Jamaluddin Sabariah , Jooma Rashid , Shakur-Still Haleema , Shokunbi Temitayo , Roberts Ian
Published: December 2021

Background: Each year world-wide about 65 million people sustain a mild traumatic brain injury (mTBI). Fatigue is a common and distressing symptom after mTBI. We examine the effect of tranexamic acid (TXA) on fatigue in patients with mTBI using data from the CRASH-3 trial.

Methods: The CRASH-3 trial randomised 9,202 patients with traumatic brain injury and no significant extracranial bleeding to receive TXA or placebo within 3 hours of injury. The primary outcome was death from head injury within 28 days of injury. The methods and results are presented elsewhere. Fatigue was recorded as “None”, “Moderate” or “Extreme.” This study examines the effect of TXA on extreme fatigue in the 2,632 patients with mTBI (Glasgow Coma Scale [GCS] score≥13). Our analyses were not prespecified.

Results: Our study primary outcome, extreme fatigue, was reported for 10 (0.8%) of 1,328 patients receiving TXA and 19 (1.5%) of 1,288 patients receiving placebo (risk ratio [RR]=0.51, 95% confidence interval [CI] 0.24-1.09). Death within 28 days of injury was reported for 34 (2.6%) of 1,328 patients receiving TXA versus 47 (3.6%) of 1,288 patients receiving placebo (RR=0.70, 95% CI 0.45-1.08). Among patients allocated to TXA, 44 (3.3%) patients either died or reported extreme fatigue versus 66 (5.1%) patients among those allocated to placebo (RR=0.65, 95% CI 0.44-0.94).

Conclusions: Early tranexamic acid treatment may reduce fatigue in mTBI patients, but these results need to be confirmed in a larger trial.

Registration: ISRCTN (ISRCTN15088122, 19/07/2011), ClinicalTrials.gov (NCT01402882, 26/07/2011), EudraCT (2011-003669-14, 25/07/2011), Pan African Clinical Trial Registry (PACTR20121000441277, 30/10/2012).
Reflections on Industrial Heritage Transformation in Slovakia (based on a Case Study)
Authors: Krešáková Viera
Published: December 2021

In the paper, we have a look at one of the most popular and most used forms of protection of industrial heritage today: transformation. Central Slovakia is the region with the most industrial monuments and sites in Slovakia and many of them are more or less aesthetic elements of the local landscape since the Middle Ages. However, except of some popular destinations, Central Slovakia does not belong among the regions with high attendance of domestic and foreign tourists. Several industrial monuments are in poor condition and located in remote places where tourists rarely venture. In this article, we would like to point out transformation and adaptive reuse as an appropriate form of protection for industrial monuments and have a closer look at the potential of rural regions and small towns. As a positive example of a conversion, we analyze the Čiernohronská Forest Railway in Čierny Balog in more detail. We focus not only on its positive economic and aesthetic impact on the surrounding landscape and people’s lives, but also on building prestige and an important position of the rural and unattractive touristically region in comparison with popular and prestigious tourist destinations.
Filling a Theater During the COVID-19 Pandemic
Authors: Blom Danny , Pendavingh Rudi , Spieksma Frits
Published: December 2021

In the summer of 2020, Music Building Eindhoven (MBE) had to deal with the economic consequences of the COVID-19 pandemic for theater halls because governmental regulations were having a severe impact on the occupancy. In particular, MBE faced the challenge of determining how to maximize the number of guests in a theater hall while respecting social distancing rules. We have developed and implemented an optimization model based on trapezoid packings to address this challenge. The model showed that up to 40% of the normal capacity can be realized for a single show setting and up to 70% in cases where artists opt for two consecutive performances per evening without reusing seats. The solution was adopted by MBE with significant monetary and managerial benefits.

History: This paper was refereed. This article has been selected for inclusion in the Special Issue on Analytics Remedies to COVID-19.

Funding: The research of F. Spieksma is supported by Dutch Research Council (NWO) Gravitation Project NETWORKS [Grant 024.002.003].
Performance of Accountable Care Organizations: Health Information Technology and Quality–Efficiency Trade-Offs
Authors: Bao Chenzhang , Bardhan Indranil R.
Published: December 2021

Under a traditional fee-for-service payment model, healthcare providers typically compromise the quality of care in order to reduce costs. Drawing on data from a national sample of accountable care organizations (ACOs), we study whether financial incentives offered under the Affordable Care Act led to fundamental changes in care delivery. Our research suggests that effective use of health information technology (IT) by ACO providers is critical in balancing competing goals of quality and efficiency. Unlike hospitals that did not participate in value-based care initiatives, ACOs were able to generate better quality outcomes while also improving overall efficiency. Furthermore, ACO providers that used health IT effectively demonstrated better patient health outcomes due to greater information integration with other providers. In other words, ACOs created value by not only reducing the cost of care but also improving patient outcomes simultaneously. Our research provides a roadmap for practitioners to succeed in a value-based healthcare environment and for policy makers to design better incentives to promote interorganizational information sharing across providers. Our findings suggest that healthcare policy needs to incorporate appropriate incentives to foster effective IT use for care coordination between healthcare providers.
Customer Review Provision Policies with Heterogeneous Cluster Preferences
Authors: Xiao Shihong , Chen Ying-Ju , Tang Christopher S.
Published: December 2021

Companies often post user-generated reviews online so that potential buyers in different clusters (age, geographic region, occupation, etc.) can learn from existing customers about the quality of an experience good and cluster preferences before purchasing. In this paper, we evaluate two common user-generated review provision policies for selling experience goods to customers in different clusters with heterogeneous preferences. The first policy is called the association-based policy (AP) under which a customer in a cluster can only observe the aggregate review (i.e., average rating) generated by users within the same cluster. The second policy is called the global-based policy (GP) under which each customer is presented with the aggregate review generated by all users across clusters. We find that, in general, the firm benefits from a policy that provides a larger number of “relevant reviews” to customers. When customers are more certain about the product quality and when clusters are more diverse, AP is more profitable than GP because it provides cluster-specific reviews to customers. Otherwise, GP is more profitable as it provides a larger number of less relevant reviews. Moreover, we propose a third provision policy that imparts the union of the information by AP and GP and show that it is more profitable for the firm. Although the third policy always renders a higher consumer welfare than GP, it may generate a lower consumer welfare than AP.

This paper was accepted by Martínez-de-Albéniz Victor, operations management.