bluuebunny/crossref_metadata_2025 huggingface dataset:
Minerals with a palmierite-type structure. Part I. Mazorite Ba3(PO4)2, a new mineral from the Hatrurim Complex in Israel
Authors: Juroszek Rafał , Galuskina Irina , Krüger Biljana , Krüger Hannes , Vapnik Yevgeny , Kahlenberg Volker , Galuskin Evgeny
Published: July 2023

The new mineral mazorite, ideally Ba3(PO4)2, a P-analogue of gurimite Ba3(VO4)2, was discovered in rankinite paralava hosted by the massive gehlenite-bearing pyrometamorphic rocks of the Hatrurim Complex in Israel. It has also recently been discovered in xenolith samples from the Bellerberg volcano in Germany. Holotype mazorite usually forms colourless plate-like crystals up to 70–100 μm in length but also occurs in small aggregates in association with other rare Ba-bearing minerals such as zadovite, celsian, hexacelsian, bennesherite, sanbornite, walstromite, fresnoite, gurimite, alforsite and barioferrite. The mineral is transparent, exhibits vitreous lustre and has a good cleavage on (001). Optically, mazorite is uniaxial (+), with ω = 1.760(3) and ɛ = 1.766(3) (λ = 589 nm). The empirical formula of the holotype mazorite calculated on 8O is (Ba2.69K0.22Na0.04Ca0.02Sr0.01)Σ2.98(P1.16V0.57S0.24Al0.04Si0.03)Σ2.04O8. Mazorite crystallises in space group R$\bar{3}$m, with unit-cell parameters a = 5.6617(5) Å, c = 21.1696(17) Å, V = 587.68(9) Å3 and Z = 3. Its crystal structure consists of BaO12, BaO10, and PO4 polyhedra, ordered along the c-axis in PO4–BaO10–BaO12–BaO10–PO4 columnar arrangement characteristic for palmierite-supergroup minerals. A tetrahedrally coordinated site is generally occupied by P5+ but can be partially substituted by V5+ and S6+. This substitution is shown in the Raman spectrum of mazorite, which reveals bands that can be assigned to the stretching and bending vibrations of (PO4)3–, (VO4)3– and (SO4)2– groups. The Raman spectra of mazorite from two localities (Hatrurim and Bellerberg) and spectra of minerals belonging to the mazorite Ba3(PO4)2 to gurimite Ba3(VO4)2 solid-solution series are presented. The gradual shift of the Raman bands, caused by cation substitutions, is well observed. The high V5+ → P5+ substitution is also observed for gurimite, for which the first X-ray structural data are also presented. Mazorite and other Ba-bearing minerals crystallised from a small portion of residual melt enriched in incompatible elements, such as Ba, V, P, U, S, Ti and Nb, at a temperature of ~1000°C.
ETV6 represses inflammatory response genes and regulates HSPC function during stress hematopoiesis in mice
Authors: Bloom Mackenzie , Oak Ninad , Baskin-Doerfler Rebekah , Feng Ruopeng , Iacobucci Ilaria , Baviskar Pradyumna , Zhao Xujie , Stroh Alexa N. , Li Chunliang , Ozark Patrick , Tillman Heather S. , Li Yichao , Verbist Katherine C. , Albeituni Sabrin , Scott Danny C. , King Moeko T. , McKinney-Freeman Shannon L. , Weiss Mitchell J. , Yang Jun J. , Nichols Kim E.
Published: July 2023

ETS variant 6 (ETV6) encodes a transcriptional repressor expressed in hematopoietic stem and progenitor cells (HSPCs), where it is required for adult hematopoiesis. Heterozygous pathogenic germline ETV6 variants are associated with thrombocytopenia 5 (T5), a poorly understood genetic condition resulting in thrombocytopenia and predisposition to hematologic malignancies. To elucidate how germline ETV6 variants affect HSPCs and contribute to disease, we generated a mouse model harboring an Etv6R355X loss-of-function variant, equivalent to the T5-associated variant ETV6R359X. Under homeostatic conditions, all HSPC subpopulations are present in the bone marrow (BM) of Etv6R355X/+ mice; however, these animals display shifts in the proportions and/or numbers of progenitor subtypes. To examine whether the Etv6R355X/+ mutation affects HSPC function, we performed serial competitive transplantation and observed that Etv6R355X/+ lineage−sca1+cKit+ (LSK) cells exhibit impaired reconstitution, with near complete failure to repopulate irradiated recipients by the tertiary transplant. Mechanistic studies incorporating cleavage under target and release under nuclease assay, assay for transposase accessible chromatin sequencing, and high-throughput chromosome conformation capture identify ETV6 binding at inflammatory gene loci, including multiple genes within the tumor necrosis factor (TNF) signaling pathway in ETV6-sufficient mouse and human HSPCs. Furthermore, single-cell RNA sequencing of BM cells isolated after transplantation reveals upregulation of inflammatory genes in Etv6R355X/+ progenitors when compared to Etv6+/+ counterparts. Corroborating these findings, Etv6R355X/+ HSPCs produce significantly more TNF than Etv6+/+ cells post-transplantation. We conclude that ETV6 is required to repress inflammatory gene expression in HSPCs under conditions of hematopoietic stress, and this mechanism may be critical to sustain HSPC function.
Significance of E-lesions in Hodgkin lymphoma and the creation of a new consensus definition: a report from SEARCH
Authors: Zijtregtop Eline A. M. , Zeal Jamie , Metzger Monika L. , Kelly Kara M. , Mauz-Koerholz Christine , Voss Stephan D. , McCarten Kathleen , Flerlage Jamie E. , Beishuizen Auke
Published: July 2023

The International Staging Evaluation and Response Criteria Harmonization for Childhood, Adolescent, and Young Adult Hodgkin Lymphoma (SEARCH for CAYAHL) seeks to provide an appropriate, universal differentiation between E-lesions and stage IV extranodal disease in Hodgkin lymphoma (HL). A literature search was performed through the PubMed and Google Scholar databases using the terms “Hodgkin disease,” and “extranodal,” “extralymphatic,” “E lesions,” “E stage,” or “E disease.” Publications were reviewed for the number of participants; median age and age range; diagnostic modalities used for staging; and the definition, incidence, and prognostic significance of E-lesions. Thirty-six articles describing 12 640 patients met the inclusion criteria. Most articles reported staging per the Ann Arbor (72%, 26/36) or Cotswolds modification of the Ann Arbor staging criteria (25%, 9/36), and articles rarely defined E-lesions or disambiguated “extranodal disease.” The overall incidence of E-lesions for patients with stage I-III HL was 11.5% (1330/11 602 unique patients). Available stage-specific incidence analysis of 3888 patients showed a similar incidence of E-lesions in stage II (21.2%) and stage III (21.9%), with E-lesions rarely seen with stage I disease (1.1%). E-lesions likely remain predictive, but we cannot unequivocally conclude that identifying E-lesions in HL imparts prognostic value in the modern era of the more selective use of targeted radiation therapy. A harmonized E-lesion definition was reached based on the available evidence and the consensus of the SEARCH working group. We recommend that this definition of E-lesion be applied in future clinical trials with explicit reporting to confirm the prognostic value of E-lesions.
Three-Dimensional Conjugate Tooth Surface Design and Contact Analysis of Harmonic Drive with Double-Circular-Arc Tooth Profile
Authors: Song Chaosheng , Zhu Feihong , Li Xinzi , Du Xuesong
Published: July 2023

A three-dimensional conjugate tooth surface design method for Harmonic Drive with a double-circular-arc tooth profile is proposed. The radial deformation function of the flexspline (FS), obtained through Finite Element (FE) analysis, is incorporated into the kinematics model. By analyzing the FS tooth enveloping process, the optimization of the overlapping conjugate tooth profile is achieved. By utilizing the hobbing process, the three-dimensional machinable tooth surface of FS can be acquired. Utilizing the coning deformation of the FS, simulations are conducted to analyze the multi-section assembly and meshing motion of the machinable tooth surface. The FE method is utilized to analyze and compare the loaded contact characteristics. Results demonstrate that the proposed design method can achieve an internal gear pair consisting of a circular spline with a spur gear tooth surface and the FS with a machinable tooth surface. With the rated torque, approximately 24% of the FS teeth are engaged in meshing, and more than 4/5 of the tooth surface in the axial direction carries the load. The contact patterns, maximum contact pressure, and transmission error of the machinable tooth surface are 227.2%, 40.67%, and 71.24% of those on the spur gear tooth surface, respectively. It clearly demonstrates exceptional transmission performance.
Acute kidney injury secondary to obstructive bladder malakoplakia: a case report
Authors: Jdiaa Sara S. , Degheili Jad A. , Matar Charbel F. , Mocadie Michele F. , Khaled Chirine S. , El Zakhem Aline M.
Published: July 2023

Background

Malakoplakia is a rare granulomatous inflammatory condition that can affect immunosuppressed patients. The genitourinary system is the most involved organ. We present a case of kidney failure caused by obstructing bladder lesions, clinically suspicious for malignancy and pathologically proven to be malakoplakia.

Case presentation

A 70-year-old woman presented with acute kidney injury and Escherichia coli (E.coli) bacteremia. Investigation showed bilateral hydronephrosis with thickening of the renal pelvises suggestive of urothelial malignancy. Cystourethroscopy revealed multiple bladder lesions completely obliterating both ureteral orifices. Pathology of the resected lesions confirmed the diagnosis of malakoplakia. Patient was treated with a prolonged antibiotic course over 6 months with recovery of her kidney function.

Conclusion

Malakoplakia can mimic invasive tumors, and the diagnosis is only attained through histopathology which uniquely demonstrates the pathognomonic Michaelis–Gutmann inclusions inside sheets of histiocytes. Treatment is largely dependent on prolonged antibiotics therapy that must cover the most common isolated pathogen, E.coli.
Investigations on tram-pedestrian impacts by application of virtual testing with human body models
Authors: Lackner Christian , Heinzl Philipp , Leo Christoph , Klug Corina
Published: July 2023

Background

In Austria around 100 trams are involved in accidents with pedestrians every year. Since the service lives of trams are very high, the probabilities are also high that each tram on the network will be involved in an accident of this kind at least once, highlighting the need of protective designs of tram fronts. However, due to lack of studies in this area, this is still a challenging task.

Purpose

The aim of this study is to show the applicability and the usability of virtual testing involving HBMs in tram front design studies to improve passive safety in general.

Methodology

In this study, the impact of pedestrians with a tram was investigated using a generic tram front model in a basic version and a conceptually improved version, respectively, and detailed finite element human body models (HBM). To consider gender-differences and to avoid designs that unintentionally favour only particular groups of the population, the study simulations were carried out with a male and a female 50th percentile finite element human body model (VIVA+). The risk for head, chest, femur and tibia injuries were analysed as the simulation result, since these body areas were identified based on field data to be most relevant in accidents involving pedestrians and trams. Collision scenarios are evaluated for a wide parameter variation in impact location and speed, respectively.

Findings

The results show a reduction in head injury risk for both the female and the male HBM at different speeds and impact locations for impact with the enhanced version of the tram front. Depending on the gender of the HBM, the considered improvement shows different effects for each body region, with a greater reduction in the likelihood of head injury for the female model, and a greater reduction in the likelihood of thoracic injury for the male model. These differences are due to the considered anthropomorphic variations. A reduction for the risk of femur injuries can be achieved in all cases using the modified tram front. The study showcases the application of detailed human body models for tram pedestrian impact analyses in the context of pedestrian safety and in particular for tram front improvements. It was shown that even a minor modification of the tram front with softer front skirt attachments leads to remarkable benefits with respect to injury criteria in all investigated crash scenarios. The presented research goes beyond current technical recommendations and shows the benefit of virtual testing including HBMs and considering a wide variety of impact speeds, anthropometries and injury assessments, respectively.
Employment trajectories of workers in low-skilled jobs in Western Germany
Authors: Kaboth Arthur , Hünefeld Lena , Himmelreicher Ralf
Published: July 2023

According to the segmentation theory, low-skilled jobs belong to the secondary sector of the labour market. Low-skilled jobs do not require vocational training and workers are interchangeable. Therefore, workers in this sector have poor working conditions and are regularly affected by employment interruptions. The current state of research, however, does not provide any longitudinal information about individual employment stability of workers performing low-skilled jobs. Furthermore, most of these workers are employed full-time and have completed professional training. Against this background, this paper deals with employment trajectories of workers in low-skilled jobs and their changes over time with regard to standard employment relationship. The aim of the explorative study is to analyse the assignment of workers in low-skilled jobs within the segmentation theory and to determine how segments have changed over time.

We use data from the German Socio-Economic Panel (GSOEP) to analyse the employment trajectories of two cohorts aged 35 to 44 years in Western Germany over a period of ten years. The employment trajectories are compared by means of sequence analysis with optimal matching algorithm as well as cluster analysis applying the “Partitioning Around Medoids” method (PAM) in combination with results from hierarchical ward clusters. The employment trajectories indicate that low-skilled jobs can be assigned to both the secondary and the primary sectors. The cohort comparison of employment trajectories shows change and continuity in the context of segments.
Fever and health-seeking behaviour among migrants living along the Thai-Myanmar border: a mixed-methods study
Authors: Khirikoekkong Napat , Asarath Supa-at , Munruchaitrakun Mayreerat , Blay Naw , Waithira Naomi , Cheah Phaik Yeong , Nosten François , Lubell Yoel , Landier Jordi , Althaus Thomas
Published: July 2023

Background

Fever is a common reason to seek healthcare in Southeast Asia, and the decline of malaria has complexified how is perceived, and what actions are taken towards it. We investigated the concept of fever and the determinants influencing health-seeking behaviours among migrants on the Thai-Myanmar border, where rapid economic development collides with precarious political and socio-economic conditions.

Methods

We implemented a mixed-methods study between August to December 2019. Phase I used a qualitative approach, with in-depth interviews and focus group discussions. Phase II used a quantitative approach with a close-ended questionnaire based on Phase I findings. A conditional inference tree (CIT) model first identified geographic and socio-demographic determinants, which were then tested using a logistic regression model.

Results

Fever corresponded to a high diversity of conceptions, symptoms and believed causes. Self-medication was the commonest behaviour at fever onset. If fever persisted, migrants primarily sought care in humanitarian cost-free clinics (45.5%, 92/202), followed by private clinics (43.1%, 87/202), health posts (36.1%, 73/202), public hospitals (33.7%, 68/202) and primary care units (30, 14.9%). The qualitative analysis identified distance and legal status as key barriers for accessing health care. The quantitative analysis further investigated determinants influencing health-seeking behaviour: living near a town where a cost-free clinic operated was inversely associated with seeking care at health posts (adjusted odds ratio [aOR], 0.40, 95% confidence interval [95% CI] [0.19–0.86]), and public hospital attendance (aOR 0.31, 95% CI [0.14–0.67]). Living further away from the nearest town was associated with health posts attendance (aOR 1.05, 95% CI [1.00–1.10] per 1 km). Having legal status was inversely associated with cost-free clinics attendance (aOR 0.27, 95% CI [0.10–0.71]), and positively associated with private clinic and public hospital attendance (aOR 2.56, 95% CI [1.00–6.54] and 5.15, 95% CI [1.80–14.71], respectively).

Conclusions

Fever conception and believed causes are context-specific and should be investigated prior to any intervention. Distance to care and legal status were key determinants influencing health-seeking behaviour. Current economic upheavals are accelerating the unregulated flow of undocumented migrants from Myanmar to Thailand, warranting further inclusiveness and investments in the public health system.
Orthostatic proteinuria due to inferior vena cava interruption without nutcracker phenomenon in an old obese female: a case report and literature review
Authors: Lin Liling , Zhang Kai , Yang Xiao , Lin Lu , Li Xuemei , Qiu Ling
Published: July 2023

Background

Nutcracker syndrome (NCS) caused by left renal vein (LRV) entrapment, is one of the most common causes of orthostatic proteinuria. In stereotype, orthostatic proteinuria is often accompanied by left renal vein obstruction and is found in young and underweight individuals. Here, we report a rare case with orthostatic proteinuria in an old obese female caused by a rare type of congenital inferior vena cava (IVC) interruption.

Case presentation

A 65-year-old obese woman, who suffered from fluctuated proteinuria, had been misdiagnosed as chronic glomerulitis for 30 years. Instead of having any sign of NCS, she had a unique type of IVC interruption. Most venous blood from infrarenal IVC and right kidney drained into her LRV, and then through the expanded communicating vessel, drained into the left ascending lumbar vein which extended as hemiazygos vein. To the best of our knowledge, this is one of the first cases reported of orthostatic proteinuria attributed to the subsequent hemodynamic irregularity caused by IVC interruption without nutcracker phenomenon.

Conclusion

Adult-onset orthostatic proteinuria is relatively rare, hard to be recognized and could be misdiagnosed as chronic glomerulonephritis. The case provided a novel differential diagnostic condition for those who suffered from fluctuated proteinuria of unknown causes.
Four-year visual outcomes and optical quality of SMILE and implantable collamer lens V4c (EVO-ICL) implantation for high myopia: a retrospective study
Authors: Luo Wuqiang , Aruma Aruma , Li Meiyan , Wang Jing , Xie Jing , Xiao Xin , Shen Yang , Niu Lingling , Wang Xiaoying , Zhou Xingtao
Published: July 2023

Background

To compare the 4-year visual outcomes of implantable collamer lens V4c (EVO-ICL) implantation and small incision lenticule extraction (SMILE) for high myopia and astigmatism.

Methods

This retrospective case study included 64 eyes of 40 patients. These patients with preoperative manifest refraction spherical equivalent (SE) between − 6.00 and − 10.00 diopters (D) were screened from the database of SMILE and EVO-ICL implantation procedures in 2015. The ICL group [32 eyes of 19 patients (mean age, 29.6 ± 6.3 years); mean SE, -8.71 ± 1.06 D] and SMILE group [32 eyes of 21 patients (mean age, 27.7 ± 5.6 years); mean SE, -8.35 ± 0.65D] were compared. All patients were then prospectively examined at a four-year follow-up for routine postoperative examinations, higher-order ocular aberrations, retinal image quality and a questionnaire.

Results

The safety indexes were 1.15 ± 0.14 and 1.22 ± 0.21 (P = 0.36) for the SMILE and ICL groups, respectively. No eyes lost two or more lines of CDVA in either group. The efficacy indexes were 0.97 ± 0.16 and 0.96 ± 0.19 (P = 0.87), respectively. Twenty-three eyes (72%) in ICL and 26 eyes (81%) in SMILE groups were within ± 0.5 D of the attempted SE (P < 0.01). ICL-treated eyes had significantly less spherical aberration and coma (P < 0.01 and < 0.05, respectively) postoperatively. Halos were the prevalent visual disturbance in both groups.

Conclusion

SMILE and EVO-ICL implantation provided safe and effective correction of high myopia. SMILE showed slightly better long-term predictability. Mild postoperative visual disturbances were observed after ICL and SMILE at 4-year follow-up.
Clinical observation of phacoemulsification under the low perfusion pattern and low negative pressure in patients with low corneal endothelial cell density
Authors: Lin Yan , Zhou Biting , Yao Yihua , Ye Qin , Zhu Yihua , Wang Xiaohui
Published: July 2023

Background

To observe the safety and effect of phacoemulsification combined with intraocular lens (IOL) implantation in patients with low corneal endothelial cell density (CD) under the low perfusion pattern with low negative pressure.

Methods

In this retrospective case series study, a total of 16 patients (17 eyes) were studied. They had all been diagnosed with low corneal endothelial (CD) and cataracts in the First Affiliated Hospital of Fujian Medical University from December 2019 to October 2021. They underwent phacoemulsification combined with IOL implantation under the low perfusion pattern with low negative pressure. The variations of corneal endothelial( CD), coefficient of variation (CV) of the cell area, central corneal thickness (CCT), visual acuity, and intraocular pressure before and after the operation were observed and assessed. Then a paired t-test, repeated measures analysis of variance, and Pearson correlation analysis were adopted for data analysis.

Results

The mean intraocular pressure of the 17 eyes was 16.88 ± 6.47 mmHg before the operation and 14.41 ± 3.10 mmHg after the operation, showing a statistically significant difference of t = 2.222, and p = 0.041. Before the operation, the mean visual acuity was 0.16 ± 0.09, and after the operation, it was 0.45 ± 0.16, displaying a statistically significant difference of t = -9.917, p < 0.001. Before and after the operation, four of the 17 eyes had no detectable CD. The mean CD of the other 13 eyes at one month after the operation (644.308 ± 106.24 cells/mm2) was lower than that before the operation (709.62 ± 119.19 cells/mm2), and the differences were statistically significant (F = 20.044, p < 0.001). However, no statistically significant differences were found in the mean CV before the operation (31.23 ± 4.21), and at one month after the operation (32.62 ± 3.80; F = 2.130, p = 0.157). Moreover, the mean CCT of 14 eyes at one month after the operation (562.72 ± 27.82 μm) was larger than that before the operation (534.79 ± 24.69 μm).

Conclusions

The low perfusion pattern with low negative pressure is safe and effective for corneal endothelial dysfunction patients complicated with cataracts.
A rapid landscape review of postpartum anaemia measurement: challenges and opportunities
Authors: Yourkavitch Jennifer , Obara Hiromi , Usmanova Gulnoza , Semrau Katherine E. A. , Moller Ann-Beth , Garcia-Casal Maria Nieves , Daru Jahnavi
Published: July 2023

Background

Anaemia is a reduction in haemoglobin concentration below a threshold, resulting from various factors including severe blood loss during and after childbirth. Symptoms of anaemia include fatigue and weakness, among others, affecting health and quality of life. Anaemic pregnant women have an increased risk of premature delivery, a low-birthweight infant, and postpartum depression. They are also more likely to have anaemia in the postpartum period which can lead to an ongoing condition and affect subsequent pregnancies. In 2019 nearly 37% of pregnant women globally had anaemia, and estimates suggest that 50–80% of postpartum women in low- and middle-income countries have anaemia, but currently there is no standard measurement or classification for postpartum anaemia.

Methods

A rapid landscape review was conducted to identify and characterize postpartum anaemia measurement searching references within three published systematic reviews of anaemia, including studies published between 2012 and 2021. We then conducted a new search for relevant literature from February 2021 to April 2022 in EMBASE and MEDLINE using a similar search strategy as used in the published reviews.

Results

In total, we identified 53 relevant studies. The timing of haemoglobin measurement ranged from within the immediate postpartum period to over 6 weeks. The thresholds used to diagnose anaemia in postpartum women varied considerably, with < 120, < 110, < 100 and < 80 g/L the most frequently reported. Other laboratory results frequently reported included ferritin and transferrin receptor. Clinical outcomes reported in 32 out of 53 studies included postpartum depression, quality of life, and fatigue. Haemoglobin measurements were performed in a laboratory, although it is unclear from the studies if venous samples and automatic analysers were used in all cases.

Conclusions

This review demonstrates the need for improving postpartum anaemia measurement given the variability observed in published measures. With the high prevalence of anaemia, the relatively simple treatment for non-severe cases of iron deficiency anaemia, and its importance to public health with multi-generational effects, it is crucial to develop common measures for women in the postpartum period and promote rapid uptake and reporting.
Structure and dynamics of the course of chronic non-infectious somatic diseases in patients during war events on the territory of Ukraine
Authors: Kiro Liudmyla , Zak Maksym , Chernyshov Oleh
Published: July 2023

Background

The work studied and compared the dynamics of changes in the course of hypertension, type 2 diabetes, and somatized disorders in Ukrainian population, in the 1st period before war (October 2021 – February 2022) and 2nd period during the war (March -July 2022). The choice of the study of the above-mentioned nosology is due, first of all, to the increase in cases of referrals to outpatient doctors regarding hypertensive crises, the increase in the frequency of patients’ complaints about the lability of glycemic indicators during routine monitoring of glucose levels with ambulatory glucometers, the appearance of chronic pain syndrome of unspecified pathology with the beginning of war events.

Methods

272 people were examined in Mykolaiv Region (Ukraine). The patients were divided into three clinical groups: 1st group − 90 people patients with arterial hypertension; 2nd group – 92 people with type 2 diabetes; the 3rd group – 90 people with somatiform disorders.

Results

In the patients of the 1st group during the 2nd period, amount of people with hypertension of the 1st stage increased in 1.8 times (p = 0.0412), with 2nd stage hypertension increased in 2 times (p = 0.0491) and 3rd stage hypertension increased in 2.5 times (p = 0.0391); somatized disorders in 3rd group also increased in 4.1 times (p = 0.001 < 0.05); in 2nd group recorded an increase in HbA1c by 0.99 ± 0.57 mmol/l (p = 1.795e-07 < 0.05), in comparison with the indicators for the 1st observation period.

Conclusions

The war events in Ukraine not only changed the life of every Ukrainian, but also had a significant impact on the dynamics and structure of chronic somatic diseases, in particular due to an increase in patient referrals for hypertensive crises, exacerbations of type 2 diabetes, somatized disorders, and chronic pain syndrome of unknown etiology. Considering these results, it is important to increase the equipment of regional primary care centers with antihypertensive, hypoglycemic and sedative drugs.
Successful repair of transplant renal artery aneurysm (TRAA)
Authors: Ho Collin Elijah Rui Hung , So Wei Zheng , Wong Julian , Tiong Ho Yee
Published: July 2023

Background

Transplant renal artery aneurysm (TRAA) is rare. TRAA that develops post transplantation consists of 0.10% of the vascular complications post renal transplant (Transplant Proc 41:1609-1614, 2009; Indian J Urol 29:42-47, 2013).

Case presentation

We report a case of TRAA in an asymptomatic young female. CT angiogram with detailed 3D reconstruction showed a 2.6 × 2.2 cm wide neck saccular TRAA arising from the anterior segmental branch of the graft renal artery (Figs. 2 and 3). A multidisciplinary team of interventional radiologists, vascular and urologist was involved for preoperative surgical planning and unique repair methods. Endovascular and percutaneous approaches were deemed not feasible, and an open in vivo approach with a saphenous vein graft was taken.

Conclusion

TRAA, albeit rare, is a complication that can occur post renal transplant. In-vivo surgical repair of TRAA is feasible with a multidisciplinary approach and careful preoperative planning. Saphenous vein graft is still a versatile graft and can be used as a conduit successfully.
An analysis of changes in the prevalence and patterns of intimate partner violence against women in seven Asian countries
Authors: Vyas Seema , Jansen Henrica A.F.M , Gardner Jessica , Tuladhar Sujata , Hammond Kate , Diemer Kristin
Published: July 2023

Background

Assessments of changes in prevalence and patterns of violence against women are critical to inform prevention and response approaches and to monitor progress towards elimination. Most countries in the Asia Region have data on violence and several have completed second and third waves of surveys. This study sought to assess and compare the prevalence and patterns of physical and/or sexual partner violence in seven Asian countries with at least two rounds of comparable national-level data.

Methods

We conducted primary descriptive analyses using Demographic and Health data from India, Nepal, and Pakistan (South Asia), and from Cambodia, the Philippines, Timor-Leste, and extracted data from reports from Vietnam (Southeast Asia). We examined differences in partner violence by type of violence, reference periods, severity of violence, and age group. Pearson chi-square tests and Mantel-Haenszel test for trend were used to assess whether differences between time points were significant (p < 0.05).

Results

Prevalence and patterns of violence vary across countries and sub-regions. In Southeast Asia, women in Cambodia and Vietnam experienced increasing and relatively high levels of sexual violence alongside declining physical violence. Reported levels of violence were lowest in the Philippines and prevalence showed consistent declines. Timor-Leste stands out as having the highest prevalence of physical partner violence, and there were consistently significant increases in estimates. Women in South Asia experienced predominantly physical violence and there were consistent declines in all three countries, though physical violence increased among older women in India.

Conclusions

Data from Asian countries where more than one prevalence survey had been done provided a unique opportunity to analyse differences in estimates of violence against women at two time points. Deeper analyses into types and severity of violence revealed that overall prevalence estimates hid more complex patterns. There are clear limitations in using survey data to understand the nuances which highlighted the need for depth analysis identifying contextual factors of violence to inform situation specific policies and interventions for the greatest impact. It is also clear that more than two data points are necessary to identify change over time, and interventions driving or preventing that change.
Effectiveness of visceral fascial therapy targeting visceral dysfunctions outcome: systematic review of randomized controlled trials
Authors: da Silva Fabiana C. , Vieira Leonardo S. , Santos Lucas V. , Gaudreault Nathaly , Cruvinel-Júnior Ronaldo H. , Santos Gilmar M.
Published: July 2023

Background

Fascial Therapy is an ancient and widespread practice throughout the world. These approaches are very common in osteopathic practice and taught in workshops for professionals from different areas of health care, including Physiotherapy. This type of treatment is quite specialized and centered on the therapist. However, there is a lack of high-quality and low-risk bias studies that justify the use of this practice. Despite this, there is little scientific evidence about the effectiveness of Fascial Therapy to treat some visceral disorders. The purpose of this study was to critically appraise the scientific literature concerning the clinical efficacy of techniques used in Fascial Therapy targeting the visceral system.

Methods

This systematic review included randomized controlled trials in any language or date of publication. All primary outcomes reported were included. The methodological quality and statistical reporting of each eligible trial were evaluated using the version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). This systematic review provided a synthesis of current evidence on the effects of Fascial Therapy in patients with visceral disorders and/or pain. A total of 11 studies were included, with five of them covering gastrointestinal dysfunction, two covering cardiorespiratory dysfunction, two covering musculoskeletal dysfunction, and two covering urogenital dysfunction.

Results

Fascial Therapy targeting the visceral system has been shown to be effective in reducing pain over the long term in people with low back pain when combined with standard physical therapy and effective in reducing gastroesophageal reflux symptoms over the short term. Considering the overall bias, six studies were at high risk of bias, two studies had some concerns and only three studies were at low risk of bias. Of the three studies with a low risk of bias, only two showed positive results and were effective in improving the studied outcome.

Conclusion

This systematic review shows that currently, there is poor evidence for the efficacy of the techniques used in Fascial Therapy targeting the visceral system, and this information can help healthcare professionals in decision-making related to the use of Fascial Therapy targeting the visceral system in patients with visceral disorders and/or pain.
Undergraduate nursing students’ experiences of palliative care in the intensive care unit
Authors: Sukcharoen Pilaiporn , Polruk Jidapa , Lukthitikul Sununta , Eamchunprathip Sadakan , Petchsuk Raphatphorn
Published: July 2023

Background

The terminal ill patients in the Intensive Care Unit had physical, mental, social, and spiritual suffering. Nursing students must be aware of own feelings to be able to deliver humanistic care and enable patients to live the rest of lives with dignity. The aim of the study was to investigate experiences of providing palliative care in the Intensive Care Unit (ICU).

Method

This study is a qualitative case study research. In-depth interviews were conducted with the key informants. The key informants were nine Thai third-year nursing students were purposively selected.

Results

The experiences of providing palliative care involved two Themes: (1) self-perception while providing care for terminal ill patients and (2) providing care for terminal ill patients with respect in the patients’ dignity.

Conclusion

These results can be applied to create learning activities to promote nursing students’ self-awareness and enable them to provide humanized care for terminal ill patients.
Acceptability of telemedicine for follow up after contraceptive implant initiation at an obstetrics and gynecologic training center
Authors: Vatrasresth Jarika , Prapaisilp Peerapong , Sukrong Monchada , Sinthuchai Natchanika , Karroon Parichart , Maitreechit Duangporn , Ittipuripat Sirarat , Kuptarak Arissara , Sathitloetsakun Sarochinee , Santibenchakul Somsook , Jaisamrarn Unnop
Published: July 2023

Background

During the COVID-19 pandemic, telemedicine has become a popular adjunct to in-person visits, including for family planning services. This study determined the proportion of clients participated in telemedicine services and the association between sociodemographic factors and telemedicine participation during the COVID-19 pandemic. The adverse effects within the first seven days post-insertion were also reported.

Methods

This retrospective cohort study considered data from all women initiating contraceptive implantation between June 2020 and August 2021 at King Chulalongkorn Memorial Hospital. Clients were offered the following two options for follow-up visits: in-person or communication via an online LINE® Official Account (LINE® OA), a free chat application widely used among the Thais. Logistic regression analyses were used to assess the association between socio-demographic factors and telehealth usage.

Results

In total, 574 of 947 (60.6%) clients participated in telemedicine follow-up services during the period considered. A significant association between telemedicine usage and the following were observed: the peak of second wave COVID-19 outbreak in Thailand, using the period preceding the second wave as a reference [adjusted odds ratio (aOR) = 1.47 (95% confidence interval [CI]: 1.12–1.96)]; participants receiving governmental benefits for contraceptive implant payment (aOR: 3.23, 95% CI: 1.86–5.60), and timing of contraceptive implant(s) initiation, using interval insertion as a reference for which aORs of postpartum and immediate postpartum insertions were 0.62 (95% CI: 0.43–0.90) and 0.35 (95% CI: 0.24–0.52), respectively. Significant ecchymosis at the insertion site was observed in 13.1% of participants.

Conclusion

This study emphasizes the significance of telemedicine during the COVID-19 epidemic, particularly in facilitating contraceptive implant initiation. Our data show a significant increase in the uptake and utilization of telemedicine during the pandemic’s peak. The data also shows that during the period of Thailand’s second COVID-19 epidemic, government benefits for contraceptive implant payment, and the timing of contraceptive implant initiation, are significantly associated with telemedicine use. This finding supports the continued use of telemedicine in healthcare, particularly for services like family planning, where remote follow-ups can provide safe, efficient, and timely care.
Gait asymmetry in children with Duchenne muscular dystrophy: evaluated through kinematic synergies and muscle synergies of lower limbs
Authors: Xiong Qiliang , Liu Yuan , Mo Jieyi , Chen Yuxia , Zhang Lianghong , Xia Zhongyan , Yi Chen , Jiang Shaofeng , Xiao Nong
Published: July 2023

Background

Gait is a complex, whole-body movement that requires the coordinated action of multiple joints and muscles of our musculoskeletal system. In the context of Duchenne muscular dystrophy (DMD), a disease characterized by progressive muscle weakness and joint contractures, previous studies have generally assumed symmetrical behavior of the lower limbs during gait. However, such a symmetric gait pattern of DMD was controversial. One aspect of this is criticized, because most of these studies have primarily focused on univariate variables, rather than on the coordination of multiple body segments and even less investigate gait symmetry under a motor synergy of view.

Methods

We investigated the gait pattern of 20 patients with DMD, compared to 18 typical developing children (TD) through 3D Gait Analysis. Kinematic and muscle synergies were extracted with principal component analysis (PCA) and non-negative matrix factorization (NNMF), respectively. The synergies extracted from the left and right sides were compared with each other to obtain a symmetry value. In addition, bilateral spatiotemporal variables of gait, such as stride length, percentage of stance and swing phase, step length, and percentage of double support phase, were used for calculating the symmetry index (SI) to evaluate gait symmetry as well.

Results

Compared with the TD group, the DMD group walked with decreased gait velocity (both p < 0.01), stride length (both p < 0.01), and step length (both p < 0.001). No significant difference was found between groups in SI of all spatiotemporal parameters extracted between the left and right lower limbs. In addition, the DMD group exhibited lower kinematic synergy symmetry values compared to the TD group (p < 0.001), while no such significant group difference was observed in symmetry values of muscle synergy.

Conclusions

The findings of this study suggest that DMD influences, to some extent, the symmetry of synergistic movement of multiple segments of lower limbs, and thus kinematic synergy appears capable of discriminating gait asymmetry in children with DMD when conventional spatiotemporal parameters are unchanged.
High triglyceride levels increase the risk of diabetic microvascular complications: a cross-sectional study
Authors: Li Jiahang , Shi Lei , Zhao Guohong , Sun Fei , Nie Zhenxing , Ge Zhongli , Gao Bin , Yang Yan
Published: July 2023

Background

The prevalence of microvascular complications in type 2 diabetes mellitus (T2DM) is increasing. The effect of lipid profiles on diabetic microvascular complications remains debated. This research aimed to study the correlation between lipid profiles and microvascular complications.

Methods

This retrospective cross-sectional study included 1096 T2DM patients. The patients were divided into the control, diabetic retinopathy (DR), nephropathy (DKD), and peripheral neuropathy (DPN) groups based on the existence of corresponding complications. The lipid profiles were analyzed, and the effect on complications was assessed by logistic regression.

Results

Compared with the control group, the diabetic microvascular complications group had a higher dyslipidemia rate. The rate of high TGs increased significantly with an increasing number of complications. High TG levels contributed to the risk of DKD, DR, and DPN [odds ratios (ORs): 2.447, 2.267, 2.252; 95% confidence interval: 1.648–3.633, 1.406–3.655, 1.472–3.445]. In the age (years) > 55, T2DM duration (years) > 10, and HbA1c (%) ≥ 7 groups, the risk of high TGs was higher for DKD (ORs: 2.193, 2.419, 2.082), DR (ORs: 2.069, 2.317, 1.993), and DPN (ORs: 1.811, 1.405, 1.427).

Conclusion

High TG levels increase the risk of diabetic microvascular complications, and patients with older age, longer T2DM duration, and higher HbA1c levels are recommended to keep lipid levels more strictly.
Low-density lipoprotein cholesterol and risk of hepatocellular carcinoma: a Mendelian randomization and mediation analysis
Authors: Cao Jiali , Wang Ziwen , Zhu Mengpei , Huang Yumei , Jin Ze , Xiong Zhifan
Published: July 2023

Background

A previous study demonstrated that low-density lipoprotein cholesterol (LDL-C) is associated with hepatocellular carcinoma (HCC); however, the causality between them has not been proven due to conflicting research results and the interference of confounders. This study utilized Mendelian randomization (MR) to investigate the causal relationship between LDL-C and HCC and identify the mediating factors.

Methods

LDL-C, HCC, and coronary artery disease (CAD) genome-wide association study (GWAS) data were obtained from a public database. To investigate causality, inverse variance weighting (IVW) was the main analysis approach. MR‒Egger, simple mode, weighted median (WM), and weighted mode were employed as supplementary analytic methods. In addition, horizontal pleiotropy and heterogeneity were tested. To evaluate the stability of the MR results, a "leave-one-out" approach was used. Multivariate MR (MVMR) was utilized to correct the confounders that might affect causality, and mediation analysis was used to investigate the potential mediating effects. Finally, we used HCC risk to infer the reverse causality with LDL-C level.

Results

Random effects IVW results were (LDL-C-HCC: odds ratio (OR) = 0.703, 95% confidence interval (CI) = [0.508, 0.973], P = 0.034; CAD–HCC: OR = 0.722, 95% CI = [0.645, 0.808], P = 1.50 × 10–8; LDL-C–CAD: OR = 2.103, 95% CI = [1.862, 2.376], P = 5.65 × 10–33), demonstrating a causal link between LDL-C levels and a lower risk of HCC. Through MVMR, after mutual correction, the causal effect of LDL-C and CAD on HCC remained significant (P < 0.05). Through mediation analysis, it was proven that CAD mediated the causative connection between LDL-C and HCC, and the proportion of mediating effect on HCC was 58.52%. Reverse MR showed that HCC could affect LDL-C levels with a negative correlation (ORIVW = 0.979, 95% CI = [0.961, 0.997], P = 0.025).

Conclusion

This MR study confirmed the causal effect between LDL-C levels and HCC risk, with CAD playing a mediating role. It may provide a new view on HCC occurrence and development mechanisms, as well as new metabolic intervention targets for treatment.
Impact of COVID-19 pandemic on health care workers (HCWs) in Sindh Province of Pakistan
Authors: Saifullah  , Ma Zhiqiang , Li Mingxing , Maqbool Muhammad Qasim
Published: July 2023

Background

In Pakistan, the COVID-19 outbreak posed a significant challenge for healthcare workers in the country’s public hospitals. The HCWs faced several problems in terms of the COVID-19 pandemic. Therefore this study investigated how the COVID-19 pandemic has affected the medical staff at the public hospital in Sindh Province, Pakistan.

Methods

In this study, a qualitative exploratory design was used. Semi-Structure interviews (SSI) were conducted by using an open-indeed questionnaire (OIQ) for data collection. An inductive approach was used for theoretical data analysis. A total of 320 HCWs participated to complete the criteria of the study from 10 different public hospitals.

Results

The study result showed the Sindh public hospital’s insufficient infrastructure, lack of health protective equipment, shortages of isolation rooms and beds, and emergencies during the COVID-19 pandemic caused HCWs to experience physical and psychological weariness, sleep disturbance, mental stress, and fear of infection.

Conclusion

The study concluded that public hospitals’ insufficient infrastructure, furniture, emergency wards, and safety equipment during the COVID-19 pandemic significantly damaged HCWs’ physical and psychological health, generating fear of infection and sleep disturbance. Additionally, Sindh healthcare workers’ fear of illness and isolation may impair family connections.
Fingertip coverage with uni-pedicled volar rotational advancement flap with large Z-plasty: a report on 112 cases
Authors: Park Seong Oh , Kim Dae Kwan , Ahn Hee Chang , Kim Youn Hwan
Published: July 2023

Background

Simple and safe fingertip reconstruction methods involve the use of local neurovascular islands flaps that can preserve functional length and sensitivity, and reconstruction with skin of the same texture. However, techniques involving flaps have numerous drawbacks and do not satisfy all the requirements for fingertip reconstruction. A particular problem is the persistence of contracture deformity due to lack of full flap advancement. We present a new technique using uni-pedicled volar rotational advancement flap with large Z-plasty, and describe the results of long-term follow-up.

Methods

From October 1993 to December 2009, 112 fingers of 98 patients were covered with uni-pedicled volar rotational advancement flap with large Z-plasty after sustaining various types of injuries or finger pulp avulsion. A longitudinal incision was made along the lateral border of the digit and a large neurovascular volar flap was elevated just above the pulleys and flexor tendon sheath. To release tension, a large Z-plasty was applied at the metacarpophalangeal joint or interphalangeal joint crease. The final patient outcomes were reviewed retrospectively.

Results

All fingertip injuries were treated without flap necrosis. Partial wound dehiscence was observed in two patients and average static two-point discrimination was 5.2 mm. There were no postoperative contracture deformities, joint stiffness, paresthesia, or hypersensitivity. Most patients were left with acceptable scarring and were free of postoperative pain and cold intolerance during the long-term follow-up.

Conclusions

Our novel technique provides durable, completely sensate, and well-vascularized coverage of the fingertip with minimal discomfort to patients.