bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation between body mass index and two-stage revision failure of periprosthetic joint infection following total joint arthroplasty: A systematic review and meta-analysis
Authors: Guo Junbiao , Wu Shuxu , Wang Huimin , Chen Wenzhi , Deng Xiaoqiang
Published: December 2021

Background: Although the correlation between body mass index (BMI) and two-stage revision failure of periprosthetic joint infection (PJI) following total joint arthroplasty (TJA) have been frequently reported, the results remain controversial. Therefore, the correlation between them was systematically evaluated and meta-classified in this study. Methods: Literature on the correlation between BMI and two-stage revision failure of PJI following TJA was retrieved in PubMed, Embase and Cochrane Library due May 2020. Stata 13.0 software and Cochrane Collaboration Review Manager software (RevMan version 5.3) were applied to data synthesis, subgroup analysis, analyses of publication bias, and sensitivity. Results: A total of 15 observational studies included 1267 patients, of which 15 studies were included in systematic review and 11 studies in meta-analysis. Eight studies found a correlation between BMI and two-stage revision failure of PJI following TJA, but seven other studies found no correlation. Meta-analysis found that the risk of two-stage revision failure of PJI following TJA significantly boosted by 3.53 times in patients with BMI ≥ 30 kg/m2 (OR = 3.53; 95% CI = 1.63–7.64 for the BMI ≥ 30 kg/m2 vs. BMI < 30 kg/m2) and the risk of two-stage revision failure of PJI following TJA significantly increased by 2.92 times in patients with BMI ≥ 40 kg/m2 ( OR = 2.92; 95% CI = 1.06–8.03 for the BMI ≥ 40 kg/m2 vs. BMI < 30 kg/m2). The subgroup analysis showed that significant association was observed among the studies performed in TKA ( OR = 3.63; 95% CI = 2.27–5.82), but not among those conducted in THA ( OR = 3.06; 95% CI = 0.42–22.19). A significant association remained consistent, as indicated by sensitivity analyses. Because there are too few studies that can be combined in the included studies, Egger’s and Begg’s tests were not performed. Conclusion: Meta-analysis suggests that the risk of two-stage revision failure of PJI following TJA significantly boosted in obese patients. However, because there may be publication bias of this study, combined overall systematically evaluated and meta-analysis results, we cannot yet conclude that BMI is associated with two-stage revision failure of PJI following TJA.
Overlap of Psoriatic Arthritis and Dermatomyositis
Authors: Schreiber Christopher , Khamlong Melanie , Raza Nadia , Huynh Bao Quynh
Published: December 2021

Psoriatic arthritis is an inflammatory arthritis, most commonly occurring several years after the onset of psoriasis. Psoriatic arthritis is associated with many comorbidities, including diabetes mellitus, nonalcoholic fatty liver disease, fibromyalgia, and cardiovascular disease. Dermatomyositis is an inflammatory myopathy primarily affecting the skin and muscles. As per literature review, cases of psoriasis and dermatomyositis have been reported. In most published cases, the courses of these diseases develop independently. This is the case of a 45-year-old woman initially diagnosed with psoriatic arthritis who developed concurrent dermatomyositis. The methods used were PubMed search and UpToDate search.
Acute Cerebellar Ataxia Associated with COVID-19 Infection in a 5-Year-Old Boy
Authors: O’Neill Kimberly A , Polavarapu Aparna
Published: December 2021

Background:Neurologic manifestations can occur in many adult patients with COVID-19 but are less frequently described in the literature than the respiratory or inflammatory effects of the disease. There are even fewer reports of the neurologic manifestations of the disease in children. Case Report: A 5-year-old boy with type 1 diabetes mellitus had minimal symptoms from COVID-19 infection. Eight days later, he developed acute ataxia, double vision, tremor, and dysmetria. Cerebrospinal fluid (CSF) and imaging were unremarkable. He was treated with supportive care and discharged home after 4 days. Neurologic symptoms gradually improved and resolved at 2 month follow up. Conclusion: Providers should be aware of acute cerebellar ataxia as a possible complication in pediatric patients recovering from COVID-19.
Constructing a Monolith: State Policy, Institutional DEI Plans, and the Flattening of Latinx Identity at Hispanic-Serving Institutions
Authors: Casellas Connors Ishara
Published: December 2021

As racialized institutions, Hispanic-serving institutions educate large portions of racially minoritized students within organizational and policy structures that advance Whiteness. This research considers how the institution-level diversity, equity, and inclusion (DEI) plans, produced in response to state-level DEI policies in Florida, California, and New York, construct narratives of intersectional diversity and a racialized Latinx identity at Hispanic-serving community colleges (HSCCs). Engaging critical discourse analysis, drawing together critical race theory and LatCrit, the analysis expands the consideration of DEI policy implementation at HSCCs. The findings illustrate the interconnectedness of state-level policy, policy implementation guidance, and institution-level discourse related to defining intersectional diversity and demographic data. Furthermore, it captures a lack of attention to racial composition among Latinx students and the limited characterization of HSI status. This study highlights how the implementation of state-level DEI policies can advance or erase the considerations of intersectionality among Latinx students.
Integration Versus Meritocracy? Competing Educational Goals During the COVID-19 Pandemic
Authors: Castillo Elise , Makris Molly Vollman , Debs Mira
Published: December 2021

Alongside the immediate challenges of operating schools during the COVID-19 pandemic, over the past year, parents, students, and policymakers around the country have also debated equity and access to some of the country’s most elite and segregated public schools. This qualitative case study examines how New York City activists conceptualized educational equity during the pandemic. Conceptually framed by Labaree’s (1997) typology of the three competing purposes of education—democratic equality, social efficiency, and social mobility—we document different lessons learned from the pandemic by integration activists, who emphasized school integration for democratic equality; and meritocratic activists, who prioritized retaining the existing stratified system mainly to foster social mobility and social efficiency. Our findings highlight the challenge of sustaining a vision oriented around the public good amid powerful framings emphasizing the individual purposes of education.
Investigating Why Academically Successful Community College Students Leave College Without a Degree
Authors: Ortagus Justin C. , Skinner Benjamin T. , Tanner Melvin J.
Published: December 2021

Even though a postsecondary degree can offer economic, social, and civic benefits, many community college students leave without earning a degree—including some who have performed well academically and made substantial progress toward graduation. To better understand the factors contributing to early exit, we surveyed a number of former students in a large community college system. We improve the generalizability of the survey responses through multilevel regression with poststratification, which we use to reweight the responses to better represent the population in our original survey frame. We find that tuition and fees, living expenses, and no longer being eligible for financial aid are the factors contributing to early exit for the largest share of students. We also find variation in both financial and nonfinancial factors across subgroups, suggesting that targeted supports may be useful in helping students persist or return to college and complete their degree.
Antibiotic consumption at community pharmacies: A multicenter repeated prevalence surveillance using WHO methodology
Authors: Saleem Zikria , Faller Erwin Martinez , Godman Brian , Malik Muhammad Sajeel Ahmed , Iftikhar Aqsa , Iqbal Sonia , Akbar Aroosa , Hashim Mahnoor , Amin Aneeqa , Javeed Sidra , Amir Afreenish , Zafar Alia , Sabih Farah , Hashmi Furqan Khurshid , Hassali Mohamed Azmi
Published: December 2021

Background:

Antibiotics are losing their effectiveness because of the rapid emergence of resistant bacteria. Unnecessary antimicrobial use increases antimicrobial resistance (AMR). There are currently no published data on antibiotic consumption in Pakistan at the community level. This is a concern given high levels of self-purchasing of antibiotics in Pakistan and variable knowledge regarding antibiotics and AMR among physicians and pharmacists.

Objective:

The objective of this repeated prevalence survey was to assess the pattern of antibiotic consumption data among different community pharmacies to provide a baseline for developing future pertinent initiatives.

Methods:

A multicenter repeated prevalence survey conducted among community pharmacies in Lahore, a metropolitan city with a population of approximately 10 million people, from October to December 2017 using the World Health Organization (WHO) methodology for a global program on surveillance of antimicrobial consumption.

Results:

The total number of defined daily doses (DDDs) dispensed per patient ranged from 0.1 to 50.0. In most cases, two DDDs per patient were dispensed from pharmacies. Co-amoxiclav was the most commonly dispensed antibiotic with a total number of DDDs at 1018.15. Co-amoxiclav was followed by ciprofloxacin with a total number of 486.6 DDDs and azithromycin with a total number of 472.66 DDDs. The least consumed antibiotics were cefadroxil, cefotaxime, amikacin, and ofloxacin, with overall consumption highest in December.

Conclusion:

The study indicated high antibiotic usage among community pharmacies in Lahore, Pakistan particularly broad-spectrum antibiotics, which were mostly dispensed inappropriately. The National action plan of Pakistan on AMR should be implemented by policymakers including restrictions on the dispensing of antimicrobials.
Utility of the Modified and High‐Sensitivity Modified Glasgow Prognostic Scores for Hypopharyngeal Squamous Cell Carcinoma
Authors: Iuchi Hiroyuki , Ohori Junichiro , Matsuzaki Hisahiro , Kiyama Satoshi , Yamashita Masaru
Published: December 2021

Objective

To determine whether the modified Glasgow prognostic score (mGPS) and high‐sensitivity mGPS (HS‐mGPS) could predict outcomes among patients with hypopharyngeal squamous cell carcinoma (HSCC).

Study Design

Retrospective cohort study.

Setting

Affiliated university hospital.

Methods

We reviewed the records of 115 patients with histologically confirmed HSCC between March 2007 and December 2019. Univariate and multivariable Cox proportional hazard analyses were performed for overall survival (OS) and disease‐free survival (DFS).

Results

The 5‐year OS rates were 84.0% for the mGPS0 group, 47.8% for the mGPS1 group, and 17.9% for the mGPS2 group (P <. 0001), while the 5‐year OS rates were 86.7% for the HS‐mGPS0 group, 69.0% for the HS‐mGPS1 group, and 22.2% for the HS‐mGPS2 group (P <. 001). The mGPS and HS‐mGPS were both associated with OS in the univariate analyses, although only the HS‐mGPS was independently associated with OS (hazard ratio, 2.68 [95% CI, 1.19‐6.05]; P <. 05). The 5‐year DFS rates were 75.8% for the mGPS0 group, 53.0% for the mGPS1 group, and 13.8% for the mGPS2 group (P <. 001), while the 5‐year DFS rates were 79.8% for the HS‐mGPS0 group, 56.8% for the HS‐mGPS1 group, and 11.6% for the HS‐mGPS2 group (P <. 001). The mGPS and HS‐mGPS were both associated with DFS in the univariate analyses, although only the HS‐mGPS was independently associated with DFS (hazard ratio, 2.35 [95% CI, 1.03‐5.37]; P <. 05).

Conclusion

Our study suggests that the HS‐mGPS is useful as prognostic factor in HSCC.
Dealing with sentient surplus: A moral economy of greyhound rehoming
Authors: Stevens Emily Grace , Baker Tom , Lewis Nicolas
Published: December 2021

This paper explores greyhound rehoming as a practice through which the sentient surplus of New Zealand's racing industry is dealt with. We bring nature-society geography and moral economy scholarship into productive alignment to ask how and to what effect new forms of value are (re)generated from greyhound bodies and lives that have been cast outside the pale of value as surplus. Accounts offered by both literatures tend not to venture beyond the commodity and are yet to fully engage with the entangled nature of morality and the economy. We seek to address these gaps by mapping the workings of a project that attempts to deal with the moral-economic excess of a capitalist nature(culture). By drawing on interviews with five key rehoming actors and an analysis of industry-affiliated documentary material, we trace the material and discursive practices that are aligned around surplus greyhounds in the interest of making value realisable again. Out of our analysis emerge three configurations through which the bodies and labours of these creatures are brought back into the pale of value: as companions-in-waiting, as undead things, and as transformational figures. While these orientations are contested and the value generated from them unevenly distributed, they see value in this capitalist natureculture be reworked so that accumulation can continue. We argue that sentient surplus is a productive paradox that allows the moral and the political to be brought into a fraught but ultimately productive alignment that obscures the contingencies, asymmetries and grim realities of value creation and distribution in greyhound worlds.
The impact of implementation climate on community mental health clinicians’ attitudes toward exposure: An evaluation of the effects of training and consultation
Authors: Woodard Grace S. , Triplett Noah S. , Frank Hannah E. , Harrison Julie P. , Robinson Sophia , Dorsey Shannon
Published: December 2021

Background

Most evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD) and anxiety disorders include exposure; however, in community settings, the implementation of exposure lags behind other EBT components. Clinician-level determinants have been consistently implicated as barriers to exposure implementation, but few organizational determinants have been studied. The current study examines an organization-level determinant, implementation climate, and clinician-level determinants, clinician demographic and background factors, as predictors of attitudes toward exposure and changes in attitudes following training.

Method

Clinicians ( n = 197) completed a 3-day training with 6 months of twice-monthly consultation. Clinicians were trained in cognitive behavioral therapy (CBT) for anxiety, depression, behavior problems, and trauma-focused CBT (TF-CBT). Demographic and background information, implementation climate, and attitudes toward exposure were assessed in a pre-training survey; attitudes were reassessed at post-consultation. Implementation climate was measured at the aggregated/group-level and clinician-level.

Results

Attitudes toward exposure significantly improved from pre-training to post-consultation ( t(193) = 9.9, p < .001; d = 0.71). Clinician-level implementation climate scores did not predict more positive attitudes at pre-training ( p > .05) but did predict more positive attitudes at post-consultation (ß = −2.46; p < .05) and greater changes in those attitudes (ß = 2.28; p < .05). Group-level implementation climate scores did not predict attitudes at pre-training, post-consultation, or changes in attitudes (all ps > .05). Higher frequency of self-reported CBT use was associated with more positive attitudes at pre-training (ß = −0.81; p < .05), but no other clinician demographic or background determinants were associated with attitudes at post-consultation (all p > .05) or with changes in attitudes (all p > .05).

Conclusions

Clinician perceptions of implementation climate predicted greater improvement of attitudes toward exposure following EBT training and consultation. Findings suggest that organizational determinants outside of training impact changes in clinicians’ attitudes. Training in four EBTs, only two of which include exposure as a component, resulted in positive changes in clinicians’ attitudes toward exposure, which suggests non-specialty trainings can be effective at changing attitudes, which may enable scale-up.
Examination and Redesign of Inclusive Special Education Service Delivery in a Rural School
Authors: Haines Shana J. , Giangreco Michael F. , Shepherd Katharine G. , Suter Jesse C. , Moore Mika
Published: December 2021

In this article, we describe the self-directed change made by a rural elementary school in response to a data-based examination of its service-delivery model that revealed its lowest performing students were spending most of their time with the school’s least qualified staff. This mixed-method case study describes (a) why and how the school shifted personnel deployment and utilization, (b) factors that facilitated the shifts in service delivery, and (c) perceived effects of the changes. Findings demonstrate how implementing data-based decision-making through strong collaborative leadership led to recognizing, exploring, and modifying the school’s overreliance on paraprofessionals by increasing the availability of more highly skilled personnel to facilitate more inclusive instruction and collaboration. Participants also described challenges and perceived negative aspects related to change. We conclude with implications for practice, including how this study could inform similar change efforts in small rural schools, and suggestions for future research.
Nasopharyngeal metatranscriptome profiles of infants with bronchiolitis and risk of childhood asthma: a multicentre prospective study
Authors: Raita Yoshihiko , Pérez-Losada Marcos , Freishtat Robert J. , Hahn Andrea , Castro-Nallar Eduardo , Ramos-Tapia Ignacio , Stearrett Nathaniel , Bochkov Yury A. , Gern James E. , Mansbach Jonathan M. , Zhu Zhaozhong , Camargo Carlos A. , Hasegawa Kohei
Published: December 2021

Background

Bronchiolitis is not only the leading cause of hospitalisation in US infants but also a major risk factor for asthma development. Growing evidence supports clinical heterogeneity within bronchiolitis. Our objectives were to identify metatranscriptome profiles of infant bronchiolitis, and to examine their relationship with the host transcriptome and subsequent asthma development.

Methods

As part of a multicentre prospective cohort study of infants (age <1 year) hospitalised for bronchiolitis, we integrated virus and nasopharyngeal metatranscriptome (species-level taxonomy and function) data measured at hospitalisation. We applied network-based clustering approaches to identify metatranscriptome profiles. We then examined their association with the host transcriptome at hospitalisation and risk for developing asthma.

Results

We identified five metatranscriptome profiles of bronchiolitis (n=244): profile A: virusRSVmicrobiomecommensals; profile B: virusRSV/RV-AmicrobiomeH.influenzae; profile C: virusRSVmicrobiomeS.pneumoniae; profile D: virusRSVmicrobiomeM.nonliquefaciens; and profile E: virusRSV/RV-CmicrobiomeM.catarrhalis. Compared with profile A, profile B infants were characterised by a high proportion of eczema,Haemophilus influenzaeabundance and enriched virulence related to antibiotic resistance. These profile B infants also had upregulated T-helper 17 and downregulated type I interferon pathways (false discovery rate (FDR) <0.005), and significantly higher risk for developing asthma (17.9%versus38.9%; adjusted OR 2.81, 95% CI 1.11–7.26). Likewise, profile C infants were characterised by a high proportion of parental asthma,Streptococcus pneumoniaedominance, and enriched glycerolipid and glycerophospholipid metabolism of the microbiome. These profile C infants had an upregulated RAGE signalling pathway (FDR <0.005) and higher risk of asthma (17.9%versus35.6%; adjusted OR 2.49, 95% CI 1.10–5.87).

Conclusions

Metatranscriptome and clustering analysis identified biologically distinct metatranscriptome profiles that have differential risks of asthma.
Association between depression and sleep apnoea: a Mendelian randomisation study
Authors: Chen Gui , Xie Junyang , Liu Weixing , Liang Tianhao , Liao Xiao , Liao Wenjing , Song Lijuan , Zhang Xiaowen
Published: December 2021

Background

Studies have reported a close relationship between depression and sleep apnoea, yet it is unknown whether these are causally related. Thus, we aimed to determine whether depression is associated with the aetiology of sleep apnoea.

Methods

We used publicly available genetic summary data from two large consortia: the Psychiatric Genomics Consortium, with data from 36 single-nucleotide polymorphisms (SNPs) closely associated with major depressive disorder (MDD), and the UK Biobank, including 456 736 patients with sleep apnoea and 766 964 controls. For Mendelian randomisation (MR) analysis, we used the inverse-variance weighted method, weighted median method, MR-Egger regression, MR pleiotropy residual sum and outlier test to retrieve summary data. Analyses were performed using the “TwoSampleMR” package in R.

Results

Out of the 36 SNPs associated with MDD, we found statistically significant evidence of a potential causal effect of MDD on the risk of sleep apnoea (OR 1.004, 95% CI 1.001–1.006; p=0.001). Similar results were obtained using the MR-Egger and weighted median methods. Additionally, we found no heterogeneity or pleiotropy.

Conclusions

Our findings suggest that depression slightly increases the risk of sleep apnoea. Further investigation of the potential biological mechanisms is necessary.
Respiratory symptoms and radiological findings in post-acute COVID-19 syndrome
Authors: Jutant Etienne-Marie , Meyrignac Olivier , Beurnier Antoine , Jaïs Xavier , Pham Tai , Morin Luc , Boucly Athénaïs , Bulifon Sophie , Figueiredo Samy , Harrois Anatole , Jevnikar Mitja , Noël Nicolas , Pichon Jérémie , Roche Anne , Seferian Andrei , Soliman Samer , Duranteau Jacques , Becquemont Laurent , Monnet Xavier , Sitbon Olivier , Bellin Marie-France , Humbert Marc , Savale Laurent , Montani David
Published: December 2021

Rationale

The characteristics of patients with respiratory complaints and/or lung radiologic abnormalities after hospitalisation for coronavirus disease 2019 (COVID-19) are unknown. The objectives were to determine their characteristics and the relationships between dyspnoea, radiologic abnormalities and functional impairment.

Methods

In the COMEBAC (Consultation Multi-Expertise de Bicêtre Après COVID-19) cohort study, 478 hospital survivors were evaluated by telephone 4 months after hospital discharge, and 177 who had been hospitalised in an intensive care unit (ICU) or presented relevant symptoms underwent an ambulatory evaluation. New-onset dyspnoea and cough were evaluated, and the results of pulmonary function tests and high-resolution computed tomography of the chest were collected.

Results

Among the 478 patients, 78 (16.3%) reported new-onset dyspnoea, and 23 (4.8%) new-onset cough. The patients with new-onset dyspnoea were younger (56.1±12.3versus61.9±16.6 years), had more severe COVID-19 (ICU admission 56.4%versus24.5%) and more frequent pulmonary embolism (18.0%versus6.8%) (all p≤0.001) than patients without dyspnoea. Among the patients reassessed at the ambulatory care visit, the prevalence of fibrotic lung lesions was 19.3%, with extent <25% in 97% of the patients. The patients with fibrotic lesions were older (61±11versus56±14 years, p=0.03), more frequently managed in an ICU (87.9versus47.4%, p<0.001), had lower total lung capacity (74.1±13.7versus84.9±14.8% pred, p<0.001) and diffusing capacity of the lung for carbon monoxide (DLCO) (73.3±17.9versus89.7±22.8% pred, p<0.001). The combination of new-onset dyspnoea, fibrotic lesions andDLCO<70% pred was observed in eight out of 478 patients.

Conclusions

New-onset dyspnoea and mild fibrotic lesions were frequent at 4 months, but the association of new-onset dyspnoea, fibrotic lesions and lowDLCOwas rare.
GENPPI: standalone software for creating protein interaction networks from genomes
Authors: Anjos William F. , Lanes Gabriel C. , Azevedo Vasco A. , Santos Anderson R.
Published: December 2021

BackGround

Bacterial genomes are being deposited into online databases at an increasing rate. Genome annotation represents one of the first efforts to understand organisms and their diseases. Some evolutionary relationships capable of being annotated only from genomes are conserved gene neighbourhoods (CNs), phylogenetic profiles (PPs), and gene fusions. At present, there is no standalone software that enables networks of interactions among proteins to be created using these three evolutionary characteristics with efficient and effective results.

Results

We developed GENPPI software for the ab initio prediction of interaction networks using predicted proteins from a genome. In our case study, we employed 50 genomes of the genus Corynebacterium. Based on the PP relationship, GENPPI differentiated genomes between the ovis and equi biovars of the species Corynebacterium pseudotuberculosis and created groups among the other species analysed. If we inspected only the CN relationship, we could not entirely separate biovars, only species. Our software GENPPI was determined to be efficient because, for example, it creates interaction networks from the central genomes of 50 species/lineages with an average size of 2200 genes in less than 40 min on a conventional computer. Moreover, the interaction networks that our software creates reflect correct evolutionary relationships between species, which we confirmed with average nucleotide identity analyses. Additionally, this software enables the user to define how he or she intends to explore the PP and CN characteristics through various parameters, enabling the creation of customized interaction networks. For instance, users can set parameters regarding the genus, metagenome, or pangenome. In addition to the parameterization of GENPPI, it is also the user’s choice regarding which set of genomes they are going to study.

Conclusions

GENPPI can help fill the gap concerning the considerable number of novel genomes assembled monthly and our ability to process interaction networks considering the noncore genes for all completed genome versions. With GENPPI, a user dictates how many and how evolutionarily correlated the genomes answer a scientific query.
Asymptomatic Bacteriuria, antimicrobial susceptibility pattern and associated risk factors among pregnant women attending antenatal care in Assosa General Hospital, Western Ethiopia
Authors: Abu Duresa , Abula Teferra , Zewdu Tesfu , Berhanu Muluken , Sahilu Tamiru
Published: December 2021

Background

Asymptomatic bacteriuria is a common problem in pregnant women and about 40% of women with untreated asymptomatic bacteriuria during pregnancy develop pyelonephritis, which might lead to low birth weight, premature rupture of membranes, and preterm labour. Therefore, this study aimed to assess the prevalence of asymptomatic bacteriuria, antimicrobial susceptibility pattern of the isolates among pregnant women attending the antenatal care of Assosa general hospital, western Ethiopia.

Methods

A facility-based cross-sectional study was conducted from January to February 2019. Two hundred and eighty-three pregnant women with no symptoms of urinary tract infections participated in the study. Bacterial isolates were identified as per the standard bacteriological procedure using colony characteristics, Gram-staining, and series of biochemical tests. Antimicrobial susceptibility test was carried out by Kirby- Bauer disk diffusion technique on Muller-Hinton agar medium and the diameter of zone of inhibition was interpreted according to Clinical Laboratory Standard Institute guidelines.

Results

The overall prevalence of asymptomatic bacteriuria among pregnant women in this study was 13.78% (i.e. 39 out of 283 urine samples were positive for bacterial isolates). E. coli was the most predominant isolate (53.8%) followed by K. pneumoniae (17.95%), S. aureus (15.4%), and coagulase-negative staphylococci (12.8%). Gram-negative bacteria were highly resistant to tetracycline (96.4%), and ampicillin (90.5%).

Conclusion

Significant bacteriuria was observed in asymptomatic pregnant women. A large number of the bacterial isolates were resistant to the commonly used antimicrobial drugs.
Sex differences in treatment strategy and adverse outcomes among patients 75 and older with atrial fibrillation in the MarketScan database
Authors: Subramanya Vinita , Claxton J’Neka S. , Lutsey Pamela L. , MacLehose Richard F. , Chen Lin Y. , Chamberlain Alanna M. , Norby Faye L. , Alonso Alvaro
Published: December 2021

Background

Women with atrial fibrillation (AF) experience greater symptomatology, worse quality of life, and have a higher risk of stroke as compared to men, but are less likely to receive rhythm control treatment. Whether these differences exist in elderly patients with AF, and whether sex modifies the effectiveness of rhythm versus rate control therapy has not been assessed.

Methods

We studied 135,850 men and 139,767 women aged ≥ 75 years diagnosed with AF in the MarketScan Medicare database between 2007 and 2015. Anticoagulant use was defined as use of warfarin or a direct oral anticoagulant. Rate control was defined as use of rate control medication or atrioventricular node ablation. Rhythm control was defined by use of anti-arrhythmic medication, catheter ablation or cardioversion. We used multivariable Poisson and Cox regression models to estimate the association of sex with treatment strategy and to determine whether the association of treatment strategy with adverse outcomes (bleeding, heart failure and stroke) differed by sex.

Results

At the time of AF, women were on average (SD) 83.8 (5.6) years old and men 82.5 (5.2) years, respectively. Compared to men, women were less likely to receive an anticoagulant or rhythm control treatment. Rhythm control (vs. rate) was associated with a greater risk for heart failure with a significantly stronger association in women (HR women = 1.41, 95% CI 1.34–1.49; HR men = 1.21, 95% CI 1.15–1.28, p < 0.0001 for interaction). No sex differences were observed for the association of treatment strategy with the risk of bleeding or stroke.

Conclusion

Sex differences exist in the treatment of AF among patients aged 75 years and older. Women are less likely to receive an anticoagulant and rhythm control treatment. Women were also at a greater risk of experiencing heart failure as compared to men, when treated with rhythm control strategies for AF. Efforts are needed to enhance use AF therapies among women. Future studies will need to delve into the mechanisms underlying these differences.
Sweet’s syndrome and mucosal prolapse polyps in a male patient with ulcerative colitis
Authors: Zhao Xixian , Jiang Si , Chen Yanan , Liu Jialong , Liu Jing , Shi Xianyan
Published: December 2021

Background

Sweet’s syndrome (SS), also known as acute febrile neutrophilic dermatosis, is a rare neutrophilic dermatitis characterized by pyrexia, neutrophilia and painful papulonodular lesions with a neutrophilic dermal infiltrate.

Case presentation

We presented a case report of classical SS associated with ulcerative colitis (UC) and mucosal prolapse polyps (MPPs) in a male patient.

Conclusions

The particularity of this case is the occurrence of MPPs in a male patient with UC and classical SS. We also discussed whether this patient with concurrent Epstein–Barr virus infection could be treated with corticosteroids.
The microbiological diagnostic performance of metagenomic next-generation sequencing in patients with sepsis
Authors: Ren Di , Ren Chao , Yao Renqi , Zhang Lin , Liang Xiaomin , Li Guiyun , Wang Jiaze , Meng Xinke , Liu Jia , Ye Yu , Li Haoli , Wen Sha , Chen Yanhong , Zhou Dan , He Xisi , Li Xiaohong , Lai Kai , Li Ying , Gui Shuiqing
Published: December 2021

Background

In this study, we aimed to perform a comprehensive analysis on the metagenomic next-generation sequencing for the etiological diagnosis of septic patients, and further to establish optimal read values for detecting common pathogens.

Methods

In this single-center retrospective study, septic patients who underwent pathogen detection by both microbial culture and metagenomic next-generation sequencing in the intensive care unit of the Second People’s Hospital of Shenzhen from June 24, 2015, to October 20, 2019, were included.

Results

A total of 193 patients with 305 detected specimens were included in the final analysis. The results of metagenomic next-generation sequencing showed significantly higher positive rates in samples from disparate loci, including blood, bronchoalveolar lavage fluid, and cerebrospinal fluid, as well as in the determination of various pathogens. The optimal diagnostic reads were 2893, 1825.5, and 892.5 for Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae, respectively.

Conclusions

The metagenomic next-generation sequencing is capable of identifying multiple pathogens in specimens from septic patients, and shows significantly higher positive rates than culture-based diagnostics. The optimal diagnostic reads for frequently detected microbes might be useful for the clinical application of metagenomic next-generation sequencing in terms of timely and accurately determining etiological pathogens for suspected and confirmed cases of sepsis due to well-performed data interpretation.
Blood pressure and risk of cancer: a Mendelian randomization study
Authors: Chan Io Ieong , Kwok Man Ki , Schooling C. Mary
Published: December 2021

Background

Previous large observational cohort studies showed higher blood pressure (BP) positively associated with cancer. We used Mendelian randomization (MR) to obtain less confounded estimates of BP on total and site-specific cancers.

Methods

We applied replicated genetic instruments for systolic and diastolic BP to summary genetic associations with total cancer (37387 cases, 367856 non-cases) from the UK Biobank, and 17 site-specific cancers (663–17881 cases) from a meta-analysis of the UK Biobank and the Kaiser Permanente Genetic Epidemiology Research on Adult Health and Aging. We used inverse-variance weighting with multiplicative random effects as the main analysis, and sensitivity analyses including the weighted median, MR-Egger and multivariable MR adjusted for body mass index and for smoking. For validation, we included breast (Breast Cancer Association Consortium: 133384 cases, 113789 non-cases), prostate (Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome Consortium: 79194 cases, 61112 non-cases) and lung (International Lung and Cancer Consortium: 10246 cases, 38295 non-cases) cancer from large consortia. We used asthma as a negative control outcome.

Results

Systolic and diastolic BP were unrelated to total cancer (OR 0.98 per standard deviation higher [95% confidence interval (CI) 0.89, 1.07] and OR 1.00 [95% CI 0.92, 1.08]) and to site-specific cancers after accounting for multiple testing, with consistent findings from consortia. BP was nominally associated with melanoma and possibly kidney cancer, and as expected, not associated with asthma. Sensitivity analyses using other MR methods gave similar results.

Conclusions

In contrast to previous observational evidence, BP does not appear to be a risk factor for cancer, although an effect on melanoma and kidney cancer cannot be excluded. Other targets for cancer prevention might be more relevant.
Incidental neuroendocrine tumor of a complete subserosal appendix: an unusual presentation of a rare anatomical variation. A case report and review of literature
Authors: Cañizares Quisiguiña Stalin Isaías , Guamán Maldonado Lucía Vanessa , Hidalgo Jaramillo Iván Marcelo , Borja Herrera Tatiana Paola , Carrión Guzmán Cecilia de los Ángeles
Published: December 2021

Background

Appendix’ anatomical variations are a rare occurrence which can mislead diagnosis and delay appropriate treatment.

Case presentation

We present a 9-year-old female patient that came with a clinical picture compatible with acute appendicitis. However, a cecal mass was identified instead of an inflamed appendix during surgery. Therapeutic decisions were extremely challenging due to clinical deterioration and an uncertain etiology. Only the histopathology report revealed the presence of a complete subserosal appendix which was responsible for the entire symptomatology. Here, we review all case reports regarding intramural, intracecal or subserosal appendixes. A discussion of the general approach to this specific case and the importance of consensual diagnostic criteria for these specimens are also presented. At last, an incidental finding is exposed and final treatment options are discussed given the overall presentation.

Conclusions

Considering these variants would guide physicians towards a more accurate approach to similar clinical pictures and hence an improved long-term prognosis.
Comparison of stresses in monoblock tilted implants and conventional angled multiunit abutment-implant connection systems in the all-on-four procedure
Authors: Zincir Özge Özdal , Parlar Ateş
Published: December 2021

Background

The All-on-four dental implant method is an implantology method designed to provide a comfortable prosthetic treatment option by avoiding advanced surgical procedures. This research aims to compare and evaluate the stress and tension values in conventional angled multiunit abutment-implant connection systems and monoblock dental implants used in the all-on-four procedure with finite element analysis.

Methods

Two master models were created by placing four implants connected to multiunit abutments (group A) in the interforaminal region of a completely edentulous mandible and four monoblock implants (group B) in the same region of another completely edentulous mandible. Group A implants were classified according to their diameter as follows: 3.5 mm (M1A), 4.0 mm (M2A), and 4.5 mm (M3A). Similarly, group B implants were classified as M1B, M2B, and M3B. In the six models rehabilitated with acrylic fixed prostheses, a 100 N force was applied to the anterior implant region, and a 250 N force was applied to the posterior cantilever in both axial and 30° oblique directions. Von Mises stresses were analyzed in the bone and implant regions of all models.

Results

M1A and M1B, M2A and M2B, and M3A and M3B were compared with each other under axial and oblique forces. The maximum Von Mises stresses in the bone around implants and the prosthesis screws, and the maximum and minimum principal stresses in the cortical and trabecular bone in group A models were significantly higher than those in group B models.

Conclusions

In monoblock implant systems under axial and oblique forces, higher stress is accumulated in the bone, prosthesis screw and implant compared to multiunit abutment-implant connection systems.
Feasibility of promoting physical activity using mHEALTH technology in rural women: the step-2-it study
Authors: Khare Manorama M. , Zimmermann Kristine , Lyons Rebecca , Locklin Cara , Gerber Ben S.
Published: December 2021

Background

Rural women are more likely to be obese and have a higher risk for chronic disease than their non-rural counterparts. Inadequate physical activity (PA) at least in part contributes to this increased risk. Rural women face personal, social and environmental barriers to PA engagement. Interventions promoting walking among rural women have demonstrated success; however, few of these studies use text messaging to promote PA.

Methods

Step-2-It was a pilot study to assess the feasibility, acceptability, and effectiveness of text-messaging combined with a pedometer to promote PA, specifically walking among English-speaking women, aged 40 and older, living in a rural, northwest Illinois county. Enrolled participants completed baseline assessments, received pedometers and two types of automated text messages: motivational messages to encourage walking, and accountability messages to report pedometer steps. Participants engaged in 3, 6, 9, and 12-week follow-ups to download pedometer data, and completed post-intervention assessments at 12 weeks.

Results

Of the 44 enrolled participants, 35 participants (79.5%) completed the intervention. Among completers, the proportion meeting PA guidelines increased from 31.4% (11/35) at baseline to 48.6% (17/35) at post-intervention, those with no PA decreased from 20% (7/35) to 17.1% (6/35). During weeks 1-12, when participants received motivational text messages, average participant daily step count was 5926 ± 3590, and remained stable during the intervention. Pedometer readings were highly correlated with self-reported steps (r = 0.9703; p < 0.001).

Conclusion

Step-2-It was a feasible and acceptable walking intervention for older rural women. Technology, including text messaging, should be investigated further as an enhancement to interventions for rural women.

Trial Registration on Clinicaltrials.gov: NCT04812756, registered on March 22, 2021
JNK signaling provides a novel therapeutic target for Rett syndrome
Authors: Musi Clara Alice , Castaldo Anna Maria , Valsecchi Anna Elisa , Cimini Sara , Morello Noemi , Pizzo Riccardo , Renieri Alessandra , Meloni Ilaria , Bonati Maurizio , Giustetto Maurizio , Borsello Tiziana
Published: December 2021

Background

Rett syndrome (RTT) is a monogenic X-linked neurodevelopmental disorder characterized by loss-of-function mutations in the MECP2 gene, which lead to structural and functional changes in synapse communication, and impairments of neural activity at the basis of cognitive deficits that progress from an early age. While the restoration of MECP2 in animal models has been shown to rescue some RTT symptoms, gene therapy intervention presents potential side effects, and with gene- and RNA-editing approaches still far from clinical application, strategies focusing on signaling pathways downstream of MeCP2 may provide alternatives for the development of more effective therapies in vivo. Here, we investigate the role of the c-Jun N-terminal kinase (JNK) stress pathway in the pathogenesis of RTT using different animal and cell models and evaluate JNK inhibition as a potential therapeutic approach.

Results

We discovered that the c-Jun N-terminal kinase (JNK) stress pathway is activated in Mecp2-knockout, Mecp2-heterozygous mice, and in human MECP2-mutated iPSC neurons. The specific JNK inhibitor, D-JNKI1, promotes recovery of body weight and locomotor impairments in two mouse models of RTT and rescues their dendritic spine alterations. Mecp2-knockout presents intermittent crises of apnea/hypopnea, one of the most invalidating RTT pathological symptoms, and D-JNKI1 powerfully reduces this breathing dysfunction. Importantly, we discovered that also neurons derived from hiPSC-MECP2 mut show JNK activation, high-phosphorylated c-Jun levels, and cell death, which is not observed in the isogenic control wt allele hiPSCs. Treatment with D-JNKI1 inhibits neuronal death induced by MECP2 mutation in hiPSCs mut neurons.

Conclusions

As a summary, we found altered JNK signaling in models of RTT and suggest that D-JNKI1 treatment prevents clinical symptoms, with coherent results at the cellular, molecular, and functional levels. This is the first proof of concept that JNK plays a key role in RTT and its specific inhibition offers a new and potential therapeutic tool to tackle RTT.
Influence of contextual factors on physical demands and technical-tactical actions regarding playing position in professional soccer players
Authors: Díez Adrián , Lozano Demetrio , Arjol-Serrano Jose Luis , Mainer-Pardos Elena , Castillo Daniel , Torrontegui-Duarte Marcelino , Nobari Hadi , Jaén-Carrillo Diego , Lampre Miguel
Published: December 2021

Background

The aim of this study was to analyse the physical demands and technical-tactical actions for each playing position according to game location and final outcome in professional soccer players.

Methods

A convenience sample was obtained from twenty-one professional male soccer players, belonged to same soccer team of the Spanish Second Division. Players’ physical demands were monitored during each match using a portable 18 Hz GPS unit and 600 Hz triaxial accelerometer. These analysed demands were total distance, moderate speed running distance (>14.4 km·h-1), high-speed running distance (>19.8. km·h-1), sprint distance (>25.0 km·h-1), number of accelerations between 2 and 4 m·s-2 and above 4 m·s-2, and number of decelerations between 2 and 4 m·s-2 and above 4 m·s-2. The data related to technical-tactical actions were obtained from WyScout®, a computerized multiple-camera tracking system based on the OPTA® track analysis tool. The obtained indicators were general, defensive and offensive.

Results

For all players, higher total distance (p = 0.045; effect size [ES] = 0.24, small effect) was covered and greater deceleration 2-4 m·ss-2 (p = 0.001; ES = 0.68, medium effect) was performed when the team plays at home and lose and for all players, playing at home and winning demanded higher defensive volume (p =0.014; ES = − 1.49, large effect) and nº interceptions (p =0.031; ES = − 1.40, large effect) in comparison to playing at home and losing.

Conclusions

The physical demands and technical-tactical actions vary when contextual game factors (i.e., match location and final outcome) are considered. We can confirm that, although the training of physical demands does not influence the final result of the match, the training of technical tactical actions could help to achieve an optimal performance of the team to win matches.
Climate change and agriculture management: Western Balkan region analysis
Authors: Županić Franc Željko , Radić Danka , Podbregar Iztok
Published: December 2021

Background

This paper aims to analyze the possibilities of the agricultural sector of the Western Balkan to assess compliance with the European Green Deal, which provides for the implementation of activities, which should enable the transition to sustainable agriculture and climate change mitigation. This paper is among the first to present the causality of agriculture and climate change (status, mitigation, and perspectives) in general and in light of the European Green Deal for the Western Balkan territory.

Main text

Agricultural production is a leading industry in the Western Balkan. Climate change and predictions that temperatures will increase by 4 °C in the coming decades pose a risk not only to agricultural production but also to the safety of the population, because agriculture is the main source of income for a significant part of it. Uncontrolled floods and droughts caused by climate change are a particular danger for agriculture and human existence. This paper demonstrates that agriculture in the WB can be considered critically affected by climate change.

Conclusions

Unless appropriate measures are taken and risk management for water resources and agriculture is improved, there will be a further decrease in precipitation and an increase in dry days by 20%. Such a scenario endangers not only the already vulnerable climate sustainability and biodiversity of the region but also the existence of a population employed in agriculture and the contribution of the agricultural sector to the gross domestic product. However, future planning based on the Common Agriculture Policy (CAP) and European Green Deal, the adoption of a related regulatory framework, the establishment and regular monitoring of supporting financing mechanisms, regional cooperation, and improving risk management (with emphasis on the local level) can mitigate the present impact and decrease the expected negative impact of climate change on agriculture and biodiversity in the WB region.