bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment and associated factors of comprehensive HIV knowledge in an at-risk population: a cross-sectional study from 19,286 young persons in Nigeria
Authors: Kareem Yusuf Olushola , Dorgbetor Cyprian Issahaku , Ameyaw Edward Kwabena , Abubakar Zubaida , Adelekan Babatunde , Goldson Erika , Mueller Ulla , Adegboye Oyelola
Published: April 2023

Background:

The prevalence of HIV among young people aged 15–19 years in Nigeria is estimated as 3.5%, the highest among West and Central African countries. Comprehensive knowledge of HIV is associated with increased awareness of preventive interventions and a reduction in the spread of HIV. Therefore, this article seeks to assess and determine the associated factors of comprehensive HIV knowledge among youths in Nigeria.

Methods:

The study used the 2018 Nigerian Demographic Health Survey, a cross-sectional survey that employed a two-stage cluster sampling method. Comprehensive knowledge of HIV was assessed based on five questions. The data were analysed separately for men and women aged 15–24 years. A multivariable log-binomial regression model was used to determine factors associated with comprehensive HIV knowledge. All analysis was performed using Stata 15.0 and adjusted for weighting, clustering and stratification.

Results:

A total of 15,267 women and 4019 men aged 15–24 years were included in this study. The prevalence of comprehensive knowledge of HIV was higher among women than among men (42.6% versus 33.7%; p < 0.001) and lower among younger ages 15–17 years compared with other ages. The findings revealed that age, ethnicity, wealth, education and exposure to mass media were statistically significant factors associated with comprehensive knowledge of HIV. In addition, religion, place of residence, phone ownership, internet use, currently working and having initiated sex were significant factors among women and modern contraceptive use among men.

Conclusion:

Key findings from this study imply that public health programmes in Nigeria should focus on providing information on HIV/AIDS using different approaches, including comprehensive sex education as well as health promotion and education strategies in the formal and informal sectors. Because media exposure is a common and cost-effective way of public health promotion and education in modern times, emphasis could also be placed on using this channel to reach the target population.
A non-volitional skeletal muscle endurance test measures functional changes associated with impaired blood flow
Authors: Brandenberger Kyle J , Rawdon Chris L , Armstrong Erica , Lonowski Jacob , Cooper Lakee’dra
Published: April 2023

Introduction: An electrically stimulated intermittent fatigue test using mechanomyography was recently proposed as a possible tool for detecting clinically relevant changes in muscle function. This study was designed to determine whether the proposed test can detect additional fatigue when it should be present.

Methods: Subjects ( n = 10) underwent two trials each (occluded and normal blood flow) with a standardized fatigue protocol on the Ankle Dorsiflexors (AD) and Wrist Extensors (WE) using a clinical electrical stimulator.

Results: Mean normalized twitch acceleration was strongly predictive of mean normalized torque ( R2 = 0.828). The WE experienced lower twitch magnitudes throughout the tourniquet trial (10.81 ± 1.25 m/s2) compared to normal blood flow (18.05 ± 1.06 m/s2). The AD twitches were overall reduced in the tourniquet trial (3.87 ± 0.48 m/s2) compared with the control trial (8.57 ± 0.91 m/s2).

Conclusion: Occluding blood flow to a muscle should cause greater muscle fatigue. The ability to detect reduced contraction magnitudes during an electrically stimulated fatigue protocol resulting from low blood flow suggests the proposed test may be capable of detecting clinically relevant muscle deficits.
Use of Virtual Reality and Three-Dimensional Printing in the Surgical Planning of Slide Tracheoplasty
Authors: Romero Lara Diana P , Latorre-Rojas Carlos J , Latorre Quintana Manuel , Velasco Morales Martha L , Pardo Nino Leonardo S , Arango Maria L
Published: April 2023

Purpose: To describe our experience using virtual reality (VR) and three-dimensional (3D) printing as complements for the surgical planning process of slide tracheoplasty (ST) in patients with congenital tracheal stenosis (CTS). Description: VR and 3D printing are used for the surgical planning of ST as a therapeutic option in three female patients under five years of age with CTS. Evaluation: We assessed the planned surgical procedure, procedural time, postoperative complications, and outcomes, as well as the main surgeon's experience with the use of the applied technologies. Conclusions: The interaction within the VR environment allowed for collaboration of the surgical plan between surgical staff and enhancement of the radiologist–surgeon communication, while procedural simulation with 3D printing prototypes allowed for refining technical abilities for the surgical interventions. Based on our experience, the application of these technologies have added value to the surgical planning of ST and its outcomes in the treatment of CTS.
To Trust or Not to Trust: Consumer Perceptions of Corporate Sociopolitical Activism
Authors: Wang Yijing , Bouroncle Linnea
Published: April 2023

When companies take a stance on sociopolitical issues, it is considered corporate social advocacy (CSA). This article examines to what extent perceived corporate motives of engaging in CSA affect consumer skepticism and brand equity. It is one of the few published studies of consumer attitudes toward companies’ CSA involvement. An online survey was conducted ( N = 375). It provides evidence that consumer assessments of the motives that inspire CSA are similar to the better-researched motives that inspire CSR. The findings imply that companies need to develop a good understanding of the consumers’ attributions when engaging in CSA.
Telepresence Robots in Long-Term Care Settings in British Columbia During the COVID-19 Pandemic: Analyzing the Experiences of Residents and Family Members
Authors: Hung Lillian , Hu Grace , Wong Joey , Ren Haopu , Ahmed Nazia , Hussein Ali , Young Erika , Berndt Annette , Mann Jim , Corepal Rekesh , Wong Lily
Published: April 2023

Telepresence robots are being increasingly used in long-term care (LTC) homes for virtual visits between families and residents. This study investigated the impacts and experiences of residents and their families using a telepresence robot (Double 3) for 4 to 12 months during the COVID-19 pandemic. A total of 51 participants were recruited through purposive sampling, including 9 residents, 15 family members, and 27 staff from 4 LTC homes in British Columbia, Canada. Conversational interviews were conducted with residents and family members. Focus groups and one-to-one interviews were held with frontline staff. Thematic analysis was performed, with five themes identified: (1) Stay connected, (2) Regain autonomy, (3) Relieve caregiver burden, (4) Environmental and technical issues, and (5) Scheduling concerns. In conclusion, telepresence robots helped maintain social connections between residents and families, despite the COVID-19 restrictions.
Effect of Enhanced Recovery After Surgery Protocol on Postoperative Outcomes of Women Undergoing Abdominal Hysterectomy
Authors: Mohamed Ibrahim Shimaa Mosad , Mahmoud El-Sheikh Mona Ahmed , Salama Abdelfattah Amira Mohammed
Published: April 2023

Background

Enhanced recovery after surgery protocol is a standardized, multidisciplinary approach for shorter hospital stay without negatively affecting patient outcomes. The aim of this research was to evaluate the effect of enhanced recovery after surgery protocol on postoperative outcomes of women undergoing abdominal hysterectomy.

Design

A quasi-experimental design was adopted to fulfil the aim of this research.

Setting

The research was conducted at Obstetric and Gynecological Department in Benha University Hospital.

Sample

A purposive sample of 148 women undergoing abdominal hysterectomy divided into two groups.

Data collection

Three tools were used: Tool (I) structured questionnaire sheet. Tool (II) post-operative pain assessment scale (numerical rating scale). Tool (III) post-operative outcomes assessment sheet.

Results

There was a highly statistically significant difference between the studied groups regarding all postoperative outcomes ( p = .000). The women in the study group experienced less mean score of pain compared to those in control group on both 2nd and 3rd day after surgery. Also, there was a statistically significant difference between the studied groups regarding postoperative complication and readmission ( p = .000).

Conclusion

Women undergoing abdominal hysterectomy who received enhanced recovery after surgery protocol had better postoperative outcomes than women who received routine perioperative care.
Analyzing Text and Images in Digital Communication: The Case of Securitization in American White Supremacist Online Discourse
Authors: Karell Daniel , Freedman Michael , Gidron Noam
Published: April 2023

Sociological research on online discourse increasingly uses digital data consisting of messages combining multiple modes of media, with meaning arising from contents’ interaction across modes. Yet, techniques to study this interplay are underdeveloped relative to the toolkit for analyzing solely texts. The authors introduce an automated approach for relationally analyzing texts and images, focusing on how to examine the discursive meaning emerging from concepts’ connections across associated text and image modes. The authors validate this approach using a crowdsourced task and obtain results suggesting that applying social network metrics to semantic space can generate useful insights into how people understand discourse. To illustrate this approach, the authors examine the concept of “securitization” in online white supremacist discourse. The findings indicate that ideas of securitization link notions of personalistic leadership with imagery of space and place. This analysis demonstrates how the authors’ approach helps researchers understand multimodal material and meaning-making in digital discourse.
The contribution of competing mechanisms in stroke despite anticoagulation in patients with atrial fibrillation
Authors: Herlekar Rahul , Sur Roy Akangsha , Hajiev Saur , Induruwa Isuru , Agarwal Smriti , Evans Nicholas R , Khadjooi Kayvan , Markus Hugh , O’Brien Eoin , Warburton Elizabeth , Zachariah George , McCabe John J
Published: April 2023

Background:

For reasons poorly understood, strokes frequently occur in patients with atrial fibrillation (AF) despite oral anticoagulation. Better data are needed to inform randomised trials (RCTs) of new strategies to prevent recurrence in these patients. We investigate the relative contribution of competing stroke mechanisms in patients with AF who have stroke despite anticoagulation (OAC+) compared with those who are anticoagulant naïve (OAC−) at the time of their event.

Patients and methods:

We performed a cross-sectional study leveraging data from a prospective stroke registry (2015–2022). Eligible patients had ischemic stroke and AF. Stroke classification was performed by a single stroke-specialist blinded to OAC status using TOAST criteria. The presence of atherosclerotic plaque was determined using duplex ultrasonography, computerised tomography (CT) or magnetic resonance (MR) angiography. Imaging was reviewed by a single reader. Logistic regression was used to identify independent predictors of stroke despite anticoagulation.

Results:

Of 596 patients included, 198 (33.2%) were in the OAC+ group. A competing cause for stroke was more frequent in patients with OAC+ versus OAC− (69/198 (34.8%)) versus 77/398 (19.3%), p < 0.001). After adjustment, both small vessel occlusion (odds ratio (OR): 2.46, 95% CI: 1.20–5.06) and arterial atheroma (⩾50% stenosis) (OR: 1.78, 95% CI: 1.07–2.94) were independently associated with stroke despite anticoagulation.

Discussion and conclusion:

Patients with AF-associated stroke despite OAC are much more likely than patients who are OAC-naïve to have competing stroke mechanisms. Rigorous investigation for alternative stroke causes in stroke despite OAC has a high diagnostic yield. These data should be used to guide patient selection for future RCTs in this population.
Consensus on the assessment of systemic sclerosis–associated primary heart involvement: World Scleroderma Foundation/Heart Failure Association guidance on screening, diagnosis, and follow-up assessment
Authors: Bruni Cosimo , Buch Maya H , Djokovic Aleksandra , De Luca Giacomo , Dumitru Raluca B , Giollo Alessandro , Galetti Ilaria , Steelandt Alexia , Bratis Konstantinos , Suliman Yossra Atef , Milinkovic Ivan , Baritussio Anna , Hasan Ghadeer , Xintarakou Anastasia , Isomura Yohei , Markousis-Mavrogenis George , Mavrogeni Sophie , Gargani Luna , Caforio Alida LP , Tschöpe Carsten , Ristic Arsen , Plein Sven , Behr Elijah , Allanore Yannick , Kuwana Masataka , Denton Christopher P , Furst Daniel E , Khanna Dinesh , Krieg Thomas , Marcolongo Renzo , Pepe Alessia , Distler Oliver , Sfikakis Petros , Seferovic Petar , Matucci-Cerinic Marco
Published: April 2023

Introduction:

Heart involvement is a common problem in systemic sclerosis. Recently, a definition of systemic sclerosis primary heart involvement had been proposed. Our aim was to establish consensus guidance on the screening, diagnosis and follow-up of systemic sclerosis primary heart involvement patients.

Methods:

A systematic literature review was performed to investigate the tests used to evaluate heart involvement in systemic sclerosis. The extracted data were categorized into relevant domains (conventional radiology, electrocardiography, echocardiography, cardiac magnetic resonance imaging, laboratory, and others) and presented to experts and one patient research partner, who discussed the data and added their opinion. This led to the formulation of overarching principles and guidance statements, then reviewed and voted on for agreement. Consensus was attained when the mean agreement was ⩾7/10 and of ⩾70% of voters.

Results:

Among 2650 publications, 168 met eligibility criteria; the data extracted were discussed over three meetings. Seven overarching principles and 10 guidance points were created, revised and voted on. The consensus highlighted the importance of patient counseling, differential diagnosis and multidisciplinary team management, as well as defining screening and diagnostic approaches. The initial core evaluation should integrate history, physical examination, rest electrocardiography, trans-thoracic echocardiography and standard serum cardiac biomarkers. Further investigations should be individually tailored and decided through a multidisciplinary management. The overall mean agreement was 9.1/10, with mean 93% of experts voting above 7/10.

Conclusion:

This consensus-based guidance on screening, diagnosis and follow-up of systemic sclerosis primary heart involvement provides a foundation for standard of care and future feasibility studies that are ongoing to support its application in clinical practice.
Barriers and enablers to paramedicine research in Australasia – A cross-sectional survey
Authors: Ross Linda , Reynolds Louise , Reeves Harry , Hutchison Amy , O’Meara Peter , Pap Robin , Barr Nigel , Thomson Michelle , Reardon Matthew , Simpson Paul
Published: April 2023

There has been exponential growth in paramedicine research activity and capacity over the last decade. With a strong academic culture emerging from its tertiary-based paramedicine education pathways, Australasia sits comfortably amongst the leading regions for paramedicine research. In the absence of clear paramedicine research priorities, there is concern that inadequate support infrastructure is in place to guide researchers, academics, paramedics, and policymakers within the profession to produce meaningful research capable of triggering change and advancement. The identification of paramedicine research priorities in Australasia, along with the barriers and enablers to research in this field, will prove invaluable to support the paramedicine profession, and improve healthcare systems, and patient outcomes in Australia and New Zealand. The study used a cross-sectional survey design which aimed to identify perceived barriers and enablers to the conduct of paramedicine research in Australasia and describe the demographic profiles and characteristics of respondents across professional, academic and research themes. Of the 341 respondents, 223 (65.4%) were male, 114 (33.4%) were female, and all geographical areas were represented. Approximately 60% of participants worked for a jurisdictional ambulance service in a clinical role. The median number of years of experience in paramedicine was 13 (IQR: 6, 24), with 52.8% having less than 15 years of experience. The analysis resulted in the identification of three themes for research barriers (system, process and human) and enablers, (work conditions, worker profile, and workplace). This study identifies the disconnect between stakeholders and the provision of resources such as funding, time, training, roles and data as major barriers to conducting paramedicine research. The ability or capacity of paramedics, as health professionals, to lead and undertake their own research was not questioned. The value of evidence-based research and autonomous paramedic-led research was identified as likely to empower future capacity within the profession.
Study on preparation of high-performance binderless board from Broussonetia papyrifera
Authors: Chen Muyang , Zheng Siqi , Wu Jiabiao , Xu Jianying
Published: April 2023

Binderless particleboards were prepared without any resin adhesives fromBroussonetia papyriferatrunk by hot pressing. The effects of particle size, pressing time, pressing temperature and board density on the physical and mechanical properties of binderless boards were investigated. The effects of chemical changes inBroussonetia papyriferabinderless particleboards on the board properties were investigated by chemical, spectroscopic and cellulose crystallinity analyses. The bonding performance of the latex ofBroussonetia papyriferawas discussed. The results showed: (1) the smaller size of the particle, the higher internal bonding (IB) strength and lower thickness swelling (TS) of the binderless board had. The modulus of rupture (MOR), the modulus of elasticity (MOE) and the IB values of the boards increased with the increase of board density. Within a certain range, the binderless boards manufactured at higher temperature and longer pressing time had better properties. Under the optimum board manufacturing condition of 220 ℃/30 min/1.0 g/cm3, theBroussonetia papyriferabinderless board recorded a MOR 28 MPa, MOE 5.3 GPa, IB 2.74 MPa and 24 h TS of 7.4%, which met the performance requirements of Chinese national standard for heavy-duty particleboard. (2) The degradation of cellulose and hemicellulose during hot pressing resulted in decrease of cellulose and hemicellulose content and increase of extractives. Some of the degradation products form new bonding to increase the bonding strength and dimensional stability of the binderless boards. (3) The formation of pseudo-lignin and increased C–O–C and cellulose crystallinity of the boards during hot pressing contributed to high quality of the binderless boards. (4) The poplar veneers bonded with the latex ofBroussonetia papyriferahad a certain bonding strength (0.6 MPa), indicating the latex played a positive role in self-bonding of theBroussonetia papyriferaparticleboard.
A two-stage hybrid biomarker selection method based on ensemble filter and binary differential evolution incorporating binary African vultures optimization
Authors: Li Wei , Chi Yuhuan , Yu Kun , Xie Weidong
Published: April 2023

Background

In the field of genomics and personalized medicine, it is a key issue to find biomarkers directly related to the diagnosis of specific diseases from high-throughput gene microarray data. Feature selection technology can discover biomarkers with disease classification information.

Results

We use support vector machines as classifiers and use the five-fold cross-validation average classification accuracy, recall, precision and F1 score as evaluation metrics to evaluate the identified biomarkers. Experimental results show classification accuracy above 0.93, recall above 0.92, precision above 0.91, and F1 score above 0.94 on eight microarray datasets.

Method

This paper proposes a two-stage hybrid biomarker selection method based on ensemble filter and binary differential evolution incorporating binary African vultures optimization (EF-BDBA), which can effectively reduce the dimension of microarray data and obtain optimal biomarkers. In the first stage, we propose an ensemble filter feature selection method. The method combines an improved fast correlation-based filter algorithm with Fisher score. obviously redundant and irrelevant features can be filtered out to initially reduce the dimensionality of the microarray data. In the second stage, the optimal feature subset is selected using an improved binary differential evolution incorporating an improved binary African vultures optimization algorithm. The African vultures optimization algorithm has excellent global optimization ability. It has not been systematically applied to feature selection problems, especially for gene microarray data. We combine it with a differential evolution algorithm to improve population diversity.

Conclusion

Compared with traditional feature selection methods and advanced hybrid methods, the proposed method achieves higher classification accuracy and identifies excellent biomarkers while retaining fewer features. The experimental results demonstrate the effectiveness and advancement of our proposed algorithmic model.
Kernelized multiview signed graph learning for single-cell RNA sequencing data
Authors: Karaaslanli Abdullah , Saha Satabdi , Maiti Tapabrata , Aviyente Selin
Published: April 2023

Background

Characterizing the topology of gene regulatory networks (GRNs) is a fundamental problem in systems biology. The advent of single cell technologies has made it possible to construct GRNs at finer resolutions than bulk and microarray datasets. However, cellular heterogeneity and sparsity of the single cell datasets render void the application of regular Gaussian assumptions for constructing GRNs. Additionally, most GRN reconstruction approaches estimate a single network for the entire data. This could cause potential loss of information when single cell datasets are generated from multiple treatment conditions/disease states.

Results

To better characterize single cell GRNs under different but related conditions, we propose the joint estimation of multiple networks using multiple signed graph learning (scMSGL). The proposed method is based on recently developed graph signal processing (GSP) based graph learning, where GRNs and gene expressions are modeled as signed graphs and graph signals, respectively. scMSGL learns multiple GRNs by optimizing the total variation of gene expressions with respect to GRNs while ensuring that the learned GRNs are similar to each other through regularization with respect to a learned signed consensus graph. We further kernelize scMSGL with the kernel selected to suit the structure of single cell data.

Conclusions

scMSGL is shown to have superior performance over existing state of the art methods in GRN recovery on simulated datasets. Furthermore, scMSGL successfully identifies well-established regulators in a mouse embryonic stem cell differentiation study and a cancer clinical study of medulloblastoma.
Assessment of plasmids for relating the 2020 Salmonella enterica serovar Newport onion outbreak to farms implicated by the outbreak investigation
Authors: Commichaux Seth , Rand Hugh , Javkar Kiran , Molloy Erin K. , Pettengill James B. , Pightling Arthur , Hoffmann Maria , Pop Mihai , Jayeola Victor , Foley Steven , Luo Yan
Published: April 2023

Background

The Salmonella enterica serovar Newport red onion outbreak of 2020 was the largest foodborne outbreak of Salmonella in over a decade. The epidemiological investigation suggested two farms as the likely source of contamination. However, single nucleotide polymorphism (SNP) analysis of the whole genome sequencing data showed that none of the Salmonella isolates collected from the farm regions were linked to the clinical isolates—preventing the use of phylogenetics in source identification. Here, we explored an alternative method for analyzing the whole genome sequencing data driven by the hypothesis that if the outbreak strain had come from the farm regions, then the clinical isolates would disproportionately contain plasmids found in isolates from the farm regions due to horizontal transfer.

Results

SNP analysis confirmed that the clinical isolates formed a single, nearly-clonal clade with evidence for ancestry in California going back a decade. The clinical clade had a large core genome (4,399 genes) and a large and sparsely distributed accessory genome (2,577 genes, at least 64% on plasmids). At least 20 plasmid types occurred in the clinical clade, more than were found in the literature for Salmonella Newport. A small number of plasmids, 14 from 13 clinical isolates and 17 from 8 farm isolates, were found to be highly similar (> 95% identical)—indicating they might be related by horizontal transfer. Phylogenetic analysis was unable to determine the geographic origin, isolation source, or time of transfer of the plasmids, likely due to their promiscuous and transient nature. However, our resampling analysis suggested that observing a similar number and combination of highly similar plasmids in random samples of environmental Salmonella enterica within the NCBI Pathogen Detection database was unlikely, supporting a connection between the outbreak strain and the farms implicated by the epidemiological investigation.

Conclusion

Horizontally transferred plasmids provided evidence for a connection between clinical isolates and the farms implicated as the source of the outbreak. Our case study suggests that such analyses might add a new dimension to source tracking investigations, but highlights the need for detailed and accurate metadata, more extensive environmental sampling, and a better understanding of plasmid molecular evolution.
Titration-based normalization of antibody amount improves consistency of ChIP-seq experiments
Authors: Caride Ariel , Jang Jin Sung , Shi Geng-Xian , Lenz Sam , Zhong Jian , Kim Kwan Hyun , Allen Mariet , Robertson Keith D. , Farrugia Gianrico , Ordog Tamas , Ertekin-Taner Nilüfer , Lee Jeong-Heon
Published: April 2023

Chromatin immunoprecipitation (ChIP) is an antibody-based approach that is frequently utilized in chromatin biology and epigenetics. The challenge in experimental variability by unpredictable nature of usable input amounts from samples and undefined antibody titer in ChIP reaction still remains to be addressed. Here, we introduce a simple and quick method to quantify chromatin inputs and demonstrate its utility for normalizing antibody amounts to the optimal titer in individual ChIP reactions. For a proof of concept, we utilized ChIP-seq validated antibodies against the key enhancer mark, acetylation of histone H3 on lysine 27 (H3K27ac), in the experiments. The results indicate that the titration-based normalization of antibody amounts improves assay outcomes including the consistency among samples both within and across experiments for a broad range of input amounts.
Crystalline sirolimus-coated balloon (cSCB) angioplasty in an all-comers, patient population with stable and unstable coronary artery disease including chronic total occlusions: rationale, methodology and design of the SCORE trial
Authors: Otto Sylvia , Díaz Victor Alfonso Jiménez , Weilenmann Daniel , Cuculi Florim , Nuruddin Amin Ariff , Leibundgut Gregor , Alfonso Fernando , Wan Ahmad Wan Azman , Pyxaras Stylianos , Rittger Harald , Steen Philip , Gaede Luise , Schulze Christian , Wöhrle Jochen , Rosenberg Mark , Waliszewski Matthias W.
Published: April 2023

Background

A decade ago, the iopromide-paclitaxel coated balloon (iPCB) was added to the cardiologist‘s toolbox to initially treat in-stent restenosis followed by the treatment of de novo coronary lesions. In the meantime, DES technologies have been substantially improved to address in-stent restenosis and thrombosis, and shortened anti-platelet therapy. Recently, sirolimus-coated balloon catheters (SCB) have emerged to provide an alternative drug to combat restenosis.

Methods

The objective of this study is to determine the safety and efficacy of a novel crystalline sirolimus-coated balloon (cSCB) technology in an unselective, international, large-scale patient population. Percutaneous coronary interventions of native stenosis, in-stent stenosis, and chronic total occlusions with the SCB in patients with stable coronary artery disease or acute coronary syndrome were included. The primary outcome variable is the target lesion failure (TLF) rate at 12 months, defined as the composite rate of target vessel myocardial infarction (TV-MI), cardiac death or ischemia-driven target lesion revascularization (TLR). The secondary outcome variables include TLF at 24 months, ischemia driven TLR at 12 and 24 months and all-cause death, cardiac death at 12 and 24 months.

Discussion

Since there is a wealth of patient-based all-comers data for iPCB available for this study, a propensity-score matched analysis is planned to compare cSCB and iPCB for the treatment of de novo and different types of ISR. In addition, pre-specified analyses in challenging lesion subsets such as chronic total occlusions will provide evidence whether the two balloon coating technologies differ in their clinical benefit for the patient.

Trial registration number

ClinicalTrials.gov Identifier: NCT04470934.
Patients’ perspectives on, experience with and concerns about crohn's disease: insights from Chinese social media
Authors: Sun Shaopeng , Hu Yunhong , Li Heng , Chen Jiajia , Lou Yijie , Weng Chunyan , Chen Lixia , Lv Bin
Published: April 2023

Aim

The aim of this study was to explore the experience and perceptions of patients with Crohn’s disease in China.

Methods

Data mining was used to investigate posts in Crohn’s disease online medical communities. The data were collected through the crawler code, and latent Dirichlet allocation (LDA) and grounded theory were used to mine the theme features after data cleaning.

Results

In analyzing the topic characteristics of online posts, LDA divided 6757 posts into 15 topics on four aspects: seeking disease information, making decisions on medication use, psychological burden, and communicating about diet and nutrition.

Conclusion

Overall, social media is patient-centric and helps us better understand the experiences and perceptions of patients. This study can help medical staff predict the thoughts and concerns of Crohn's disease patients during the treatment process, facilitate doctor-patient communication, and assist in the formulation of medical policies.
Assessment of drug-related problems at the emergency department in older patients living with frailty: pharmacist-led medication reviews within a geriatric care team
Authors: van Nuland Merel , Butterhoff Madelon , Verwijmeren Karin , Berger Florine , Hogervorst Vera M. , de Jonghe Annemarieke , van der Linden Paul D
Published: April 2023

Background

Older patients are vulnerable to experiencing drug related problems (DRPs), which may result in emergency department (ED) visits. However, it is not standard practice to conduct medications reviews during ED visit. The aim of this study was to assess the number of DRPs in older patients living with frailty at the ED, identified through pharmacist-led medication reviews within a geriatric care team, and to determine the acceptance rate of pharmacists’ recommendations among hospital physicians and general practitioners or elderly care specialists.

Methods

A retrospective observational study was performed in patients ≥ 70 years living with frailty at the ED at Tergooi Medical Center. Pharmacist-led medication reviews were conducted to identify and classify DRPs as part of a larger geriatric assessment. The acceptance rate of given recommendations was determined during follow-up.

Results

A total of 356 ED visits were included. The mean (standard deviation, SD) age of patients was 83 (6.8) years. About 76% of patients had at least one DRP. In total, 548 DRPs were identified with a mean of 1.5 DRP (SD 1.3) per patient. The acceptance rate of medication recommendations in admitted patients was 55%, and 32% among general practitioners/elderly care specialists in discharged patients.

Conclusions

Pharmacist-led medication reviews as part of a geriatric care team identified DRPs in 76% of older patients living with frailty at the ED. The acceptance rate was substantially higher in admitted patients compared to discharged patients.
Association between any underlying health condition and COVID-19-associated hospitalization by age group, Washington State, 2020–2021: a retrospective cohort study
Authors: McConnell Kate H. , Hajat Anjum , Sack Coralynn , Mooney Stephen J. , Khosropour Christine M.
Published: April 2023

Background

Presence of at least one underlying health condition (UHC) is positively associated with severe COVID-19, but there is limited research examining this association by age group, particularly among young adults.

Methods

We examined age-stratified associations between any UHC and COVID-19-associated hospitalization using a retrospective cohort study of electronic health record data from the University of Washington Medicine healthcare system for adult patients with a positive SARS-CoV-2 test from February 29, 2020, to March 13, 2021. Any UHC was defined as documented diagnosis of at least one UHC identified by the CDC as a potential risk factor for severe COVID-19. Adjusting for sex, age, race and ethnicity, and health insurance, we estimated risk ratios (aRRs) and risk differences (aRDs), overall and by age group (18–39, 40–64, and 65 + years).

Results

Among patients aged 18–39 (N = 3,249), 40–64 (N = 2,840), 65 + years (N = 1,363), and overall (N = 7,452), 57.5%, 79.4%, 89.4%, and 71.7% had at least one UHC, respectively. Overall, 4.4% of patients experienced COVID-19-associated hospitalization. For all age groups, the risk of COVID-19-associated hospitalization was greater for patients with any UHC vs. those without (18–39: 2.2% vs. 0.4%; 40–64: 5.6% vs. 0.3%; 65 + : 12.2% vs. 2.8%; overall: 5.9% vs. 0.6%). The aRR comparing patients with vs. those without UHCs was notably higher for patients aged 40–64 years (aRR [95% CI] for 18–39: 4.3 [1.8, 10.0]; 40–64: 12.9 [3.2, 52.5]; 65 + : 3.1 [1.2, 8.2]; overall: 5.3 [3.0, 9.6]). The aRDs increased across age groups (aRD [95% CI] per 1,000 SARS-CoV-2-positive persons for 18–39: 10 [2, 18]; 40–64: 43 [33, 54]; 65 + : 84 [51, 116]; overall: 28 [21, 35]).

Conclusions

Individuals with UHCs are at significantly increased risk of COVID-19-associated hospitalization regardless of age. Our findings support the prevention of severe COVID-19 in adults with UHCs in all age groups and in older adults aged 65 + years as ongoing local public health priorities.
A potential link between fibroblast growth factor-23 and the progression of AKI to CKD
Authors: Lu Yinghui , Xu Shutian , Tang Rong , Han Cui , Zheng Chunxia
Published: April 2023

Background

Patients who recover from acute kidney injury (AKI) have a 25% increase in the risk of chronic kidney disease (CKD) and a 50% increase in mortality after a follow-up of approximately 10 years. Circulating FGF-23 increases significantly early in the development of AKI, is significantly elevated in patients with CKD and has become a major biomarker of poor clinical prognosis in CKD. However, the potential link between fibroblast growth factor-23 levels and the progression of AKI to CKD remains unclear.

Method

Serum FGF-23 levels in AKI patients and ischaemia‒reperfusion injury (IRI) mice were detected with ELISA. Cultured HK2 cells were incubated with FGF-23 and PD173074, a blocker of FGFR, and then TGFβ/Smad and Wnt/β-catenin were examined with immunofluorescence and immunoblotting. Quantitative real-time polymerase chain reaction was used to detect the expression of COL1A1 and COL4A1. Histologic staining confirmed renal fibrosis.

Results

The level of serum FGF-23 was significantly different between AKI patients and healthy controls (P < 0.01). Moreover, serum FGF-23 levels in the CKD progression group were significantly higher than those in the non-CKD progression group of AKI patients (P < 0.01). In the AKI-CKD mouse model, serum FGF-23 levels were increased, and renal fibrosis occurred; moreover, the protein expression of β-catenin and p-Smad3 was upregulated. PD173074 downregulated the expression of β-catenin and p-Smad3 and reduced fibrosis in both mice and HK2 cells.

Conclusion

The increase in FGF-23 may be associated with the progression of AKI to CKD and may mediate renal fibrosis via TGF-β and Wnt/β-catenin activation.
The relationship between psychological conditions and recurrence of benign paroxysmal positional vertigo: a retrospective cohort study
Authors: Shu Yuexin , Liao Nannan , Fang Fang , Shi Qiuling , Yan Ning , Hu Yaoyue
Published: April 2023

Background

Psychological conditions have been found to be associated with an increased risk of incident benign paroxysmal positional vertigo (BPPV). However, much less is known on whether and how psychological conditions such as anxiety, insomnia and obsessive–compulsive disorder (OCD) affect the recurrence of BPPV.

Methods

A retrospective cohort study of 2,612 outpatients and inpatients diagnosed with BPPV between September 2012 and August 2020. BPPV recurrence was followed up until February 2021. The Cox proportional hazard regression was used to analyze the association between psychological conditions and the risk of the first recurrence. Poisson regression was applied to analyze the association between psychological conditions and the number of recurrences in patients with at least one relapse.

Results

During the follow-up, 391 patients had at least one BPPV recurrence. Female BPPV patients were more likely than male patients to experience relapses than male patients, but the characteristics of BPPV recurrence (number of recurrences and duration between recurrences) did not differ between men and women. After adjustment for sex, age and comorbidities, a heightened risk of first BPPV recurrence was found to be associated with anxiety (hazard ratio [HR]: 1.30, 95% confidence interval [CI]: 1.01, 1.68) and OCD (HR: 2.15, 95% CI: 1.31, 3.52). An increased risk of first BPPV recurrence associated with insomnia was only observed in male patients (HR: 2.22, 95% CI: 1.24, 3.98) but not in female patients (HR: 0.91, 95% CI: 0.63, 1.31). None of these psychological conditions were associated with the number of recurrences in patients who experienced recurrence.

Conclusions

The presence of anxiety and OCD increased the risk of first BPPV recurrence, as well as insomnia for male patients. These psychological conditions were not associated with the number of BPPV recurrences. Diagnosis and treatment of these psychological conditions could be a useful strategy to prevent the recurrence of BPPV.
A prospective, double-blinded cohort study using quantitative fetal fibronectin testing in symptomatic women for the prediction of spontaneous preterm delivery
Authors: Ng Vivian Wai Yan , Seto Mimi Tin Yan , Lewis Holly , Cheung Ka Wang
Published: April 2023

Background

Spontaneous preterm birth (PTB) affects 6.5% of deliveries in Hong Kong. Quantitative fetal fibronectin (fFN) is under-utilised as a test for PTB prediction in Hong Kong. Our objective was to evaluate the effectiveness of quantitative fFN in predicting spontaneous PTB in women with symptoms of threatened preterm labour (TPTL) in our population.

Methods

A prospective, double-blinded cohort study of women with a singleton gestation and TPTL symptoms presenting to a tertiary hospital in Hong Kong between 24 + 0 to 33 + 6 weeks was performed from 1st October 2020 and 31st October 2021. Women with vaginal bleeding, ruptured membranes, and cervical dilation > 3 cm were excluded. The primary outcome was to test the characteristics of quantitative fFN in predicting spontaneous PTB < 37 weeks. Secondary outcome was to investigate the relationship between fFN value and time to PTB. Test characteristics of quantitative fFN at different thresholds were evaluated.

Results

48 women with TPTL were recruited. All had fFN testing at admission with the results being concealed from the obstetrician managing the patient. 10 mothers had PTB (< 37 weeks’ gestation). 7/48 (15%) had a subsequent PTB within 14 days from testing and 5 (10%) delivered within 48 h. The negative predictive value (NPV) of predicting delivery within 14 days was 97.3% and 100% when using a cut-off of < 50ng/ml and < 10ng/ml respectively. Using > 200 ng/ml as cut-off can also reliably predict delivery within 48 h – 7 days with positive predictive value PPV of 100%; as well as PTB before 37 weeks.

Conclusions

Quantitative fFN has predictive value for spontaneous PTB prediction in symptomatic women in a Hong Kong population. fFN concentration could help clinicians rule out PTB and avoid unnecessary interventions and hospitalisation.
Lovastatin inhibits erythroleukemia progression through KLF2-mediated suppression of MAPK/ERK signaling
Authors: Gao Jian , Hu Jifen , Yu Fang , Wang Chunlin , Sheng Danmei , Liu Wuling , Hu Anling , Yu Kunling , Xiao Xiao , Kuang Yi , Zacksenhaus Eldad , Gajendran Babu , Ben-David Yaacov
Published: April 2023

Background

Lovastatin, an HMG-CoA inhibitor and an effective cholesterol lowering drug, exhibits anti-neoplastic activity towards several types of cancer, although the underlying mechanism is still not fully understood. Herein, we investigated mechanism of growth inhibition of leukemic cells by lovastatin.

Methods

RNAseq analysis was used to explore the effect of lovastatin on gene expression in leukemic cells. An animal model of leukemia was used to test the effect of this statin in vivo. FAM83A and DDIT4 expression was knocked-downed in leukemia cells via lentivirus-shRNA. Western blotting, RT-qPCR, cell cycle analysis and apoptosis assays were used to determine the effect of lovastatin-induced growth suppression in leukemic cells in vitro.

Results

Lovastatin treatment strongly inhibited cancer progression in a mouse model of erythroleukemia induced by Friend virus. In tissue culture, lovastatin inhibited cell proliferation through induction of G1 phase cell cycle arrest and apoptosis. Interestingly, lovastatin induced most known genes associated with cholesterol biosynthesis in leukemic cells. Moreover, it suppressed ERK1/2 phosphorylation by downregulating FAM83A and DDIT4, two mediators of MAP-Kinase signaling. RNAseq analysis of lovastatin treated leukemic cells revealed a strong induction of the tumor suppressor gene KLF2. Accordingly, lentivirus-mediated knockdown of KLF2 antagonized leukemia cell suppression induced by lovastatin, associated with higher ERK1/2 phosphorylation compared to control. We further show that KLF2 induction by lovastatin is responsible for lower expression of the FAM83A and DDIT4 oncogenes, involved in the activation of ERK1/2. KLF2 activation by lovastatin also activated a subset of cholesterol biosynthesis genes that may further contribute to leukemia suppression.

Conclusions

These results implicate KLF2-mediated FAM83A/DDIT4/MAPK suppression and activation of cholesterol biosynthesis as the mechanism of leukemia cell growth inhibition by lovastatin.
Known risk factors of the developmental dysplasia of the hip predicting more severe clinical presentation and failure of Pavlik harness treatment
Authors: Lankinen Vilma , Helminen Mika , Bakti Karim , Välipakka Jarmo , Laivuori Hannele , Hyvärinen Anna
Published: April 2023

Purpose

Developmental dysplasia of the hip (DDH) varies from mild instability of the hip to subluxation or total dislocation of the joint. Well-known risk factors of DDH include pre-natal breech position, female sex, positive family history, hip side, primiparity and the mode of delivery. Aim of the present study was to further evaluate known risk-factors of DDH, find associations with more severe dysplasia (characterized with Ortolani positivity) and find risk factors of failure of the Pavlik harness treatment.

Material and methods

All children with the diagnosis of DDH treated in Tampere University hospital in the years 1998–2018 were retrospectively identified for the study and the data was collected from the medical records. Teratological dislocations (n = 3) were excluded from the analysis. Total of 945 patients were included.

Results

Breech presentation was strongly associated with Ortolani positivity (p < 0.001). Breech presentation was not associated with ending up for spica casting and/or operative treatment (p = 0.291) despite the association with Ortolani positivity. Ortolani positivity (p = 0.002), positive family history (p = 0.013) and girl sex (p = 0.029) were associated with ending up for spica casting and/or operative treatment.

Conclusion

Breech presentation seems to increase the risk of Ortolani positive DDH. However, these infants are likely to recover with initially started Pavlik harness treatment, as it was not associated with elevated risk for undergoing more robust treatments. Positive family history and girl sex are associated with the most severe cases of developmental dysplasia of the hip, and it may predispose to the failure of the Pavlik harness treatment.
Complicated urachal cyst in two pediatric patients: a case report
Authors: Kamel Karol , Nasr Hadeer , Tawfik Sherifa , Azzam Ahmed , Elsaid Mohamed , Qinawy Mohamed , Kamal Ahmed , Taher Heba
Published: April 2023

Background

A urachal cyst has a rare incidence that has been reported as 1/5,000 live birth.

Case presentation

We report two patients with a complicated urachal cyst, a 5-year-old female who presented to the emergency department with severe abdominal pain and a 3-year-old female presenting with abdominal pain and constipation. Upon laparoscopic exploration both patients had complicated urachal cysts which were adherent to the urinary bladder.

Conclusion

Complicated urachal cysts can present with acute abdominal pain.