bluuebunny/crossref_metadata_2025 huggingface dataset:
Determining a Cutoff Value for Hand Grip Strength to Predict Favorable Outcomes of Adult Spinal Deformity Surgery
Authors: Kwon Ohsang , Ham Dae-Woong , Kim Ho-Joong , Lee Sanghoon , Park Sang-Min , Yeom Jin S.
Published: February 2022

Study Design

Retrospective review.

Objectives

To establish a cutoff value for hand grip strength and predict the favorable outcomes of adult spinal deformity surgery.

Summary of Background Data

Hand grip strength (HGS) has been suggested to predict surgical outcomes in various fields, including adult spinal deformity (ASD). However, to the best of our knowledge, no study has established a cutoff value for HGS in patients with ASD.

Methods

This study included 115 female patients who underwent reconstructive spinal surgery for ASD between September 2016 and September 2020. HGS was measured preoperatively. The Oswestry Disability Index (ODI), EuroQOL-5-dimension (EQ-5D), and visual analog scale (VAS) scores for back pain were all recorded both before and after surgery. Patients were dichotomized either into favorable or unfavorable outcome groups using an ODI cutoff score of 22 at 1 year after surgery. Multivariate logistic regression analysis was done to identify significant factors leading to favorable outcomes. A receiver operating characteristic (ROC) curve was drawn to define the cutoff value of HGS for favorable outcomes.

Results

Multivariate logistic regression analysis showed that HGS is significantly associated with favorable surgical outcomes in ASD ( P = .031). The ROC curve suggested a cutoff value of 14.20 kg for HGS (area under the curve (AUC) = .678, P = .013) to predict favorable surgical outcomes in ASD. The surgical complications were not significantly affected by HGS.

Conclusion

The HGS of patients with ASD can be interpreted with a cutoff value of 14.20 kg. Patients with HGS above this cutoff value showed superior surgical outcomes at 1 year after surgery compared to those below this cutoff value.
A Validated Score for Evaluating Spinal Instability to Assess Surgical Candidacy in Active Spinal Tuberculosis—An Evidence Based Approach and Multinational Expert Consensus Study
Authors: Rajasekaran Shanmuganathan , Soundararajan Dilip Chand Raja , Reddy Gurijala Jyotheswara , Shetty Ajoy P. , Kanna Rishi Mugesh
Published: February 2022

Study design

Modified Delphi Consensus and Observational Study.

Objective

Instability in spinal tuberculosis (STB) leads to disabling spinal deformity and neurodeficit. Identifying and estimating instability remains subjective, mainly based on experience. This study aims to develop an objective scoring system to determine instability in STB.

Materials and Methods

The study included 4 phases. (1) A panel of 10 experienced spine surgeons developed a questionnaire based on literature. (2) 68 spine surgeons from 12 countries opined on the importance of each factor in a survey. Five factors deemed important by >70% of participants were further analyzed (3) 60 representative cases of STB were analyzed for instability. A preliminary scoring system was developed, a threshold score for determining instability was derived, and (4) Results were validated.

Results

All the 5 factors (“Spine at risk” signs, severity of vertebral body loss, Cervicothoracic/Thoracolumbar junction involvement, age ≤15, and kyphotic deformity ≥30°) considered important by >70% of participants were associated with instability and included in scoring: age ≤15 years ( P-value, 0.05), cervicothoracic/thoracolumbar junction involvement ( P-value, 0.028), sagittal deformity angle ratio (DAR) ≥ 15° ( P-value, <.001), vertebral body loss-segmental ratio ≥.5 ( P-value, <.001), and presence of spine at risk signs ( P-value, <.001). A total score of ≥3/09 indicated definite instability with good sensitivity (77%) and excellent specificity (100%). Repeatability assessment showed a good agreement (.9625), and Cohen’s kappa coefficient was strong (.809).

Conclusion

A simple objective scoring system for predicting instability in STB has been developed using 5 main factors; young age, junctional involvement, severity of the deformity, vertebral body loss, and presence of spine at risk signs.
Lumbar Disc Degeneration Affects the Risk of Rod Fracture Following PSO; A Finite Element Study
Authors: Vosoughi Ardalan Seyed , Shekouhi Niloufar , Joukar Amin , Zavatsky Michael , Goel Vijay K. , Zavatsky Joseph M.
Published: February 2022

Study Design

Finite element (FE) study.

Objective

Pedicle subtraction osteotomy (PSO) is a surgical method to correct sagittal plane deformities. In this study, we aimed to investigate the biomechanical effects of lumbar disc degeneration on the instrumentation following PSO and assess the effects of using interbody spacers adjacent to the PSO level in a long instrumented spinal construct.

Methods

A spinopelvic model (T10-pelvis) with PSO at the L3 level was used to generate 3 different simplified grades of degenerated lumbar discs (mild (Pfirrmann grade III), moderate (Pfirrmann grade IV), and severe (Pfirrmann grade V)). Instrumentation included eighteen pedicle screws and bilateral primary rods. To investigate the effect of interbody spacers, the model with normal disc height was modified to accommodate 2 interbody spacers adjacent to the PSO level through a lateral approach. For the models, the rods’ stress distribution, PSO site force values, and the spine range of motion (ROM) were recorded.

Results

The mildly, moderately, and severely degenerated models indicated approximately 10%, 26%, and 40% decrease in flexion/extension motion, respectively. Supplementing the instrumented spinopelvic PSO model using interbody spacers reduced the ROM by 22%, 21%, 4%, and 11% in flexion, extension, lateral bending, and axial rotation, respectively. The FE results illustrated lower von Mises stress on the rods and higher forces at the PSO site at higher degeneration grades and while using the interbody spacers.

Conclusions

Larger and less degenerated discs adjacent to the PSO site may warrant consideration for interbody cage instrumentation to decrease the risk of rod fracture and PSO site non-union.
Utilizing Multilingual Methods and Rapid Analysis for Global Qualitative Research During a Pandemic
Authors: Graetz Dylan E. , Sniderman Elizabeth , Villegas Cesar , Ragab Iman , Laptsevich Aliaksandra , Maliti Biemba , Naidu Gita , Zhang Hui , Gassant Pascale , Nunes Luciana , Arce Daniela , Vasquez Jacqueline Montoya , Arora Ramandeep S , Alcasabas Ana P , Rusmawatiningtyas Desy , Raza Muhammad Rafie , Hamid Syed A , Velasco Pablo , Kambugu Joyce , Vinitsky Anna , Bolous Nancy S. , Haidar Cyrine E. , Bihannic Laure , Sa da Bandeira Diana , Wang Jade X , Li Dongfang , Graca Flavia , Vasilyeva Aksana , Lesmana Harry , Galindo Carlos R , Agulnik Asya , Moreira Daniel C.
Published: February 2022

Historically, qualitative research has complemented quantitative biologic and epidemiologic studies to provide a more complete understanding of pandemics. The COVID-19 pandemic has generated unique and novel challenges for qualitative researchers, who have embraced creative solutions including virtual focus groups and rapid analyses to continue their work. We present our experience conducting a multilingual global qualitative study of healthcare resilience among teams of pediatric oncology professionals during the COVID-19 pandemic. We provide an in-depth description of our methodology and an analysis of factors we believe contributed to our study’s success including our use of technology, engagement of a large multilingual team, global partnerships, and framework-based rapid analysis. We hope these techniques may be useful to qualitative researchers conducting studies during the current pandemic, as well as for all pediatric oncology studies including multiple languages or geographically disparate subjects.
The Impact of Adverse Childhood Experiences on Health and Development in Young Children
Authors: Webster Erica M.
Published: February 2022

In recent years, there have been advances in research regarding the prevalence of Adverse Childhood Experiences (ACEs) and resulting poor outcomes for children who have experiences ACES. ACE exposure has been connected with poor academic performance, poor health outcomes, and certain diseases. However, there is still relatively little known about the prevalence and impact of ACE exposure in early childhood. Using the 2016 National Survey of Children’s Health, this study assessed the prevalence of adverse childhood experiences for children under the age of six years. This research measured the impact of individual ACEs on health and developmental outcomes and found that financial hardship and parental mental illness both had increased odds of having health and developmental difficulties. Furthermore, this work finds that there is a dose-response relationship between ACE count and increased risk of health and developmental difficulties. Conversely, children who were reported as affectionate with their parent had decreased risk for health and developmental problems. Programs supporting families with young children should focus efforts on enhancing quality of attachment, especially for children experiencing ACEs.
Trends in Women’s and Men’s College Majors across Four Decades in Norway
Authors: Hermansen Are Skeie , Penner Andrew M.
Published: February 2022

Women are now more likely to receive college degrees than men, yet important differences remain in the college majors of women and men. This visualization depicts women’s and men’s college majors across four decades in Norway. The authors document the movement of women into higher paying majors and show that men are increasingly majoring in fields that are gender integrated. However, women remain overrepresented in female-dominated majors, and men remain in overrepresented in majors that have historically been well paid. This visualization thus underscores the progress that has been made in achieving gender parity in education as well as the challenges that remain.
Migration, Insecured Childhood and Social Exclusion: Issues and Challenges in Front of the Dalits in Urban Guwahati, Assam
Authors: Bhattacharjee Somenath
Published: February 2022

Urbanization is a global phenomenon, and rapid urban growth can be noticed in different parts of India. Significantly, in search of better livelihood and income, a large section of people are getting migrated from rural to urban areas. However, is it becoming detrimental to their livelihood and socio-economic condition?

In the modern world, the rights of the weaker sections of population in a nation-state, those of minorities, of the poor and the displaced people, are often ignored or encroached upon by the coercive state machinery or by the powerful class. Even sometime a few political circumstances play a major role, whether a community will have accessibility to the land and natural resources or not. Such a situation can be observed among a section of Bangladeshi refugees. Due to partition of India and after that during the formative period of Bangladesh, they were forced to get displaced and they came to India. A section of them and their children are struggling for livelihood in the slum areas of Guwahati, the largest urban centre of entire Northeast India. They are recognized as an undocumented migrant population group. They are deprived in every aspect from the fundamental rights of livelihood, and they have to face all sorts of livelihood obstacles, which are collectively excluding them from the developmental mainstream.
Understanding Identity, Education and Multi-religiosity Among the Nat Tribe of Paschim Champaran in India
Authors: Alam Md Moshabbir , Singh Moksha
Published: February 2022

Invisible social groups are systematically left out of the process of development and have to make choices that are predetermined. Research suggests that the tribal and nomadic communities have been majorly affected by such processes. Nat, a peripatetic nomadic tribe in India has undergone similar exclusionary process. However, they continue to survive as a social group and maintain their distinguishing character. This study, therefore, is an attempt to understand their survival within the mainstream society by systematically analysing the following sociocultural attributes: identity construction, education and mobility, and multi-religious belonging. The Nat of Paschim Champaran, in the state of Bihar in India, were the focus of the study. Data was collected from 30 respondents and analysed by applying narrative inquiry. The findings suggest that their professional identity as acrobats continues to define their distinctiveness even when a few have chosen to shift towards other forms of livelihood. This distinctiveness continues to negatively influence their access to education and as a result no major change is witnessed in terms of social mobility of the group. However, it is observed that they have intelligently assimilated themselves within the popular culture by adopting multiple identities with respect to religion and which are activated for diverse purposes and at different times.
Periconception and Prenatal Exposure to Maternal Perceived Stress and Cord Blood DNA Methylation
Authors: Polinski Kristen J , Putnick Diane L , Robinson Sonia L , Schliep Karen C , Silver Robert M , Guan Weihua , Schisterman Enrique F , Mumford Sunni L , Yeung Edwina H
Published: February 2022

Background:

Maternal prenatal stress is associated with physiologic and adverse mental health outcomes in the offspring, but the underlying biologic mechanisms are unknown. We examined the associations of maternal perceived stress, including preconception exposure, with DNA methylation (DNAm) alterations in the cord blood buffy coats of 358 singleton infants.

Methods:

Maternal perceived stress was measured prior to and throughout pregnancy in a cohort of women enrolled in Effects of Aspirin in Gestation and Reproduction Trial (EAGeR) trial. Perceived stress assessments based on a standardized Likert-scale were obtained in periconception (~2 months preconception and 2-8 weeks of gestation) and pregnancy (8-36 weeks of gestation). Cumulative perceived stress was estimated by calculating the predicted area under the curve of stress reported prior to and during pregnancy. DNAm was measured by the Infinium MethylationEPIC BeadChip. Multivariable robust linear regression was used to assess associations of perceived stress with individual CpG probes.

Results:

Based on a 0 to 3 scale, average reported preconception and early pregnancy stress were 0.76 (0.60) and 0.67 (0.50), respectively. Average mid- to late-pregnancy stress, based on a 0 to 10 scale, was 4.9 (1.6). Neither periconception nor pregnancy perceived stress were associated with individual CpG sites in neonatal cord blood (all false discovery rate [FDR] >5%).

Conclusion:

No effects of maternal perceived stress exposure on array-wide cord blood neonatal methylation differences were found.
Shear-wave velocity map for Pohang Basin, South Korea, based on the P-wave seismogram method
Authors: Lee Junyoung , Kim Kwang-Hee , Kang Su Young , Son Moon , Kim Byungmin
Published: February 2022

The 2017 ML 5.4 Pohang, South Korea earthquake, which caused severe damage, raised attention to the importance of the characterization of the Pohang Basin structure and the identification of active faults. We utilize 366 seismograms recorded at 102 densely deployed seismic stations during 18 microearthquakes with ML ranging from −1.11 to 1.70. We perform the P-wave seismogram method, which has been validated in various regions using seismograms for moderate earthquakes, to estimate the time-averaged shear-wave velocity from the surface to a depth of 30 m ( VS30) in and around the basin. We perform multichannel analyses of surface waves at the 32 sites to obtain shear-wave velocity ( VS) profiles, and additionally acquire the 22 existing VS profiles within the study area. We observe that velocity seismograms predict VS30 more accurately than acceleration and displacement seismograms do. The estimated VS30 values are in good agreement with the measured VS30 values. Approximately 93.3% of the measured and estimated VS30 values are located between the ±100% difference lines. We propose a VS30 map for the vicinity of the Pohang Basin by geospatially interpolating both the measured and estimated VS30 values, which is consistent with the local topography and geology. The proposed map exhibits areas with strong VS30 contrast within the Quaternary and Tertiary sediments, which might be attributed to the existence of faults.
A versatile 5′ RACE-Seq methodology for the accurate identification of the 5′ termini of mRNAs
Authors: Adamopoulos Panagiotis G. , Tsiakanikas Panagiotis , Stolidi Irene , Scorilas Andreas
Published: February 2022

Background

Technological advancements in the era of massive parallel sequencing have enabled the functional dissection of the human transcriptome. However, 5′ ends of mRNAs are significantly underrepresented in these datasets, hindering the efficient analysis of the complex human transcriptome. The implementation of the template-switching mechanism at the reverse transcription stage along with 5′ rapid amplification of cDNA ends (RACE) constitutes the most prominent and efficient strategy to specify the actual 5′ ends of cDNAs. In the current study, we developed a 5′ RACE-seq method by coupling a custom template-switching and 5′ RACE assay with targeted nanopore sequencing, to accurately unveil 5′ termini of mRNA targets.

Results

The optimization of the described 5′ RACE-seq method was accomplished using the human BCL2L12 as control gene. We unveiled that the selection of hybrid DNA/RNA template-switching oligonucleotides as well as the complete separation of the cDNA extension incubation from the template-switching process, significantly increase the overall efficiency of the downstream 5′ RACE. Collectively, our results support the existence of two distinct 5′ termini for BCL2L12, being in complete accordance with the results derived from both direct RNA and PCR-cDNA sequencing approaches from Oxford Nanopore Technologies. As proof of concept, we implemented the described 5′ RACE-seq methodology to investigate the 5′ UTRs of several kallikrein-related peptidases (KLKs) gene family members. Our results confirmed the existence of multiple annotated 5′ UTRs of the human KLK gene family members, but also identified novel, previously uncharacterized ones.

Conclusions

In this work we present an in-house developed 5′ RACE-seq method, based on the template-switching mechanism and targeted nanopore sequencing. This approach enables the broad and in-depth study of 5′ UTRs of any mRNA of interest, by offering a tremendous sequencing depth, while significantly reducing the cost-per reaction compared to commercially available kits.
Changes in root microbiome during wheat evolution
Authors: Gholizadeh Somayeh , Mohammadi Seyed Abolghasem , Salekdeh Ghasem Hosseini
Published: February 2022

Background

Although coevolutionary signatures of host-microbe interactions are considered to engineer the healthy microbiome of humans, little is known about the changes in root-microbiome during plant evolution. To understand how the composition of the wheat and its ancestral species microbiome have changed over the evolutionary processes, we performed a 16S rRNA metagenomic analysis on rhizobacterial communities associated with a phylogenetic framework of four Triticum species T. urartu, T. turgidum, T. durum, and T. aestivum along with their ancestral species Aegilops speltoides, and Ae. tauschii during vegetative and reproductive stages.

Results

In this study, we illustrated that the genome contents of wild species Aegilops speltoides and Ae. tauschii can be significant factors determining the composition of root-associated bacterial communities in domesticated bread wheat. Although it was found that domestication and modern breeding practices might have had a significant impact on microbiome-plant interactions especially at the reproductive stage, we observed an extensive and selective control by wheat genotypes on associated rhizobacterial communities at the same time. Our data also showed a strong genotypic variation within species of T. aestivum and Ae. tauschii, suggesting potential breeding targets for plants surveyed.

Conclusions

This study performed with different genotypes of Triticum and Aegilops species is the first study showing that the genome contents of Ae. speltoides and Ae. tauschii along with domestication-related changes can be significant factors determining the composition of root-associated bacterial communities in bread wheat. It is also indirect evidence that shows a very extensive range of host traits and genes are probably involved in host-microbe interactions. Therefore, understanding the wheat root-associated microbiome needs to take into consideration of its polygenetic mosaic nature.
Bacteria associated with acne use glycosaminoglycans as cell adhesion receptors and promote changes in the expression of the genes involved in their biosynthesis
Authors: Martín Carla , Ordiales Helena , Vázquez Francisco , Pevida Marta , Rodríguez David , Merayo Jesús , Vázquez Fernando , García Beatriz , Quirós Luis M.
Published: February 2022

Background

Cell surface glycosaminoglycans (GAGs) participate in many physiological and pathological processes, including infections and inflammatory response. Acne is a common chronic inflammatory skin disorder that affects the pilosebaceous unit and has a multifactorial etiology, including bacterial colonization of the hair follicle. This study aimed to investigate the participation of GAG in the adhesion of Propionibacterium acnes, Staphylococcus aureus and Staphylococcus epidermidis to keratinocytes and fibroblasts of the skin by competition experiments and cell surface removal using specific liases. The alteration in the transcription of the genes responsible for the synthesis of GAG induced by the adhesion of these bacteria was also analyzed by qRT-PCR.

Results

GAGs are involved in bacterial adherence to skin cells, especially fibroblasts, where chondroitin sulfate displayed the higher effect. Bacterial adherence produced different alterations in the transcription of the genes responsible for GAG structures. P. acnes induced mostly changes in keratinocytes, while S. epidermidis was the main cause of alterations in fibroblasts. These variations in gene expression affected all the stages in the biosynthesis of the main species of GAGs, heparan and chondroitin sulphate.

Conclusions

GAGs species are involved in the adhesion of acne-related bacteria to skin cells in a differential manner depending on each microorganism and cellular type, although other receptors seem to exist. Bacterial adherence led to variations on gene expression in skin cells affecting GAG chains structure what, consequently, should alter their interactions with different ligands, affecting the development of acne disease.
Genomic prediction models for traits differing in heritability for soybean, rice, and maize
Authors: Kaler Avjinder S. , Purcell Larry C. , Beissinger Timothy , Gillman Jason D.
Published: February 2022

Background

Genomic selection is a powerful tool in plant breeding. By building a prediction model using a training set with markers and phenotypes, genomic estimated breeding values (GEBVs) can be used as predictions of breeding values in a target set with only genotype data. There is, however, limited information on how prediction accuracy of genomic prediction can be optimized. The objective of this study was to evaluate the performance of 11 genomic prediction models across species in terms of prediction accuracy for two traits with different heritabilities using several subsets of markers and training population proportions. Species studied were maize (Zea mays, L.), soybean (Glycine max, L.), and rice (Oryza sativa, L.), which vary in linkage disequilibrium (LD) decay rates and have contrasting genetic architectures.

Results

Correlations between observed and predicted GEBVs were determined via cross validation for three training-to-testing proportions (90:10, 70:30, and 50:50). Maize, which has the shortest extent of LD, showed the highest prediction accuracy. Amongst all the models tested, Bayes B performed better than or equal to all other models for each trait in all the three crops. Traits with higher broad-sense and narrow-sense heritabilities were associated with higher prediction accuracy. When subsets of markers were selected based on LD, the accuracy was similar to that observed from the complete set of markers. However, prediction accuracies were significantly improved when using a subset of total markers that were significant at P ≤ 0.05 or P ≤ 0.10. As expected, exclusion of QTL-associated markers in the model reduced prediction accuracy. Prediction accuracy varied among different training population proportions.

Conclusions

We conclude that prediction accuracy for genomic selection can be improved by using the Bayes B model with a subset of significant markers and by selecting the training population based on narrow sense heritability.
Phylogenomic and comparative analyses of Coffeeae alliance (Rubiaceae): deep insights into phylogenetic relationships and plastome evolution
Authors: Amenu Sara Getachew , Wei Neng , Wu Lei , Oyebanji Oyetola , Hu Guangwan , Zhou Yadong , Wang Qingfeng
Published: February 2022

Background

The large and diverse Coffeeae alliance clade of subfamily Ixoroideae (Rubiaceae) consists of 10 tribes, > 90 genera, and > 2000 species. Previous molecular phylogenetics using limited numbers of markers were often unable to fully resolve the phylogenetic relationships at tribal and generic levels. Also, the structural variations of plastomes (PSVs) within the Coffeeae alliance tribes have been poorly investigated in previous studies. To fully understand the phylogenetic relationships and PSVs within the clade, highly reliable and sufficient sampling with superior next-generation analysis techniques is required. In this study, 71 plastomes (40 newly sequenced and assembled and the rest from the GenBank) were comparatively analyzed to decipher the PSVs and resolve the phylogenetic relationships of the Coffeeae alliance using four molecular data matrices.

Results

All plastomes are typically quadripartite with the size ranging from 153,055 to 155,908 bp and contained 111 unique genes. The inverted repeat (IR) regions experienced multiple contraction and expansion; five repeat types were detected but the most abundant was SSR. The size of the Coffeeae alliance clade plastomes and its elements are affected by the IR boundary shifts and the repeat types. However, the emerging PSVs had no taxonomic and phylogenetic implications. Eight highly divergent regions were identified within the plastome regions ndhF, ccsA, ndhD, ndhA, ndhH, ycf1, rps16-trnQ-UUG, and psbM-trnD. These highly variable regions may be potential molecular markers for further species delimitation and population genetic analyses for the clade. Our plastome phylogenomic analyses yielded a well-resolved phylogeny tree with well-support at the tribal and generic levels within the Coffeeae alliance.

Conclusions

Plastome data could be indispensable in resolving the phylogenetic relationships of the Coffeeae alliance tribes. Therefore, this study provides deep insights into the PSVs and phylogenetic relationships of the Coffeeae alliance and the Rubiaceae family as a whole.
Analgesic effects of different concentrations of ropivacaine in transversalis fascia plane block during laparotomy
Authors: Tian Ye , Zhan Yong , Liu Ke , Bu Shaojin , Tian Yalin , Xiong Chunyan , Shen Jintao
Published: February 2022

Objective

To explore the analgesic effects of different concentrations of ropivacaine in transversalis fascia plane (TFP) block during laparotomy.

Methods

Ninety patients who underwent laparotomy admitted to our hospital from March 2019 to March 2020 were selected as the study subjects and were divided equally into a low concentration group, a medium concentration group, and a high concentration group according to the randomized grouping method. The low concentration group adopted 0.4% ropivacaine 40 ml, the medium concentration group was given 0.5% ropivacaine 40 ml, and the high concentration group was given 0.6% ropivacaine 40 ml. The hemodynamic indexes and the incidence of adverse reactions in the two groups were compared. The Numerical Rating Scale (NRS) was used to assess the postoperative pain in the three groups, the Bruggrmann comfort scale (BCS) was used to assess the comfort level in the three groups, and the Mini-mental State Examination (MMSE) was used to evaluate the postoperative cognitive function of the three groups of patients.

Results

The mean artery pressure (MAP) and heart rate (HR) levels at T1 and T2 were significantly lower in the medium concentration group than in the other two groups (P < 0.05). The low concentration group had a significantly higher NRS score at T2 than the medium concentration group and the high concentration group (P < 0.05). A significantly higher BCS score was observed in the high concentration group than the other two groups (P < 0.05). There were significantly higher Ramsay scores and MMSE scores in the medium concentration group than in the low concentration and high concentration groups (P < 0.05). The overall incidence of adverse reactions of the high concentration group was significantly higher than that of the low concentration group (P < 0.05), but showed similar results with the medium concentration group.

Conclusion

The medium concentration group exhibits a better analgesic effect than the low concentration group and higher safety than the high concentration group. Therefore, the use of medium concentration ropivacaine in TFP block may provide a referential basis for clinical treatment.
Regional variation in coronary angiography rates: the association with supply factors and the role of indication: a spatial analysis
Authors: Frank-Tewaag Julia , Bleek Julian , Günster Christian , Schneider Udo , Horenkamp-Sonntag Dirk , Marschall Ursula , Franke Sebastian , Schlößler Kathrin , Donner-Banzhoff Norbert , Sundmacher Leonie
Published: February 2022

Background

Coronary angiographies (CAs) are among the most common diagnostic procedures carried out in German hospitals, and substantial regional differences in their frequency of use have been documented. Given the heterogeneity with regard to the expected benefits and the varying scope for discretion depending on the indication for the procedure, we hypothesized that the observed variation and the association of need and supply factors differs by indication for CA.

Methods

We investigated the correlation between supply factors and the regional rates of CAs in Germany while controlling for need using spatial‐autoregressive error models (SARE) and spatial cross-regressive models with autoregressive errors (SCRARE). The overall rates of CAs and the rates in specific patient subgroups, namely, patients with and without myocardial infarction (MI), were calculated based on a comprehensive set of nationwide routine data from three statutory health insurances at the district level.

Results

Although little variation was found in cases with MI, considerable variation was seen in the overall cases and cases without MI. The SARE models revealed a positive association between the number of hospitals with a cardiac catheterization laboratory per 10,000 population and the rates of overall cases and cases without MI, whereas no such relationship existed in cases with MI. Additionally, an association between regional deprivation and the rates of CAs was found in cases with MI, but no such association was seen in cases without MI.

Conclusions

The results supported the hypothesis that the relative association of need and supply factors differed by the indication for CA. Although the regional differences in the frequency of use of CAs can only be explained in part by the factors examined in our study, it offers insight into patient access to and the provision of CA services and can provide a platform for further local research.
Prevalence and impact of migraine among university students in Bangladesh: findings from a cross-sectional survey
Authors: Rafi Abdur , Islam Saiful , Hasan M. Tasdik , Hossain Golam
Published: February 2022

Background

Migraine is one of the main causes of long-term morbidity, and it is one of the major contributors of all types of headaches in worldwide. Despite its disruptive effect, it is frequently underdiagnosed and undertreated in Bangladesh. The aim of the present study was to determine the prevalence of migraines and its impact on daily life of university students in Bangladesh.

Methods

This cross-sectional study was conducted among 2,352 students of Rajshahi University and Jahangirnagar University during March 2020 through a self-administered online survey. ID Migraine™ scale and HIT-6 scale were used to screen migraine and its impact respectively. Frequency distribution, Chi-square test and t-test along with multiple logistic regressions model were used to determine the prevalence and associated factors of migraine respectively.

Results

The overall prevalence of migraine among the participants was 21.4%. The prevalence was higher among females (29%) than males (12%). A multivariable logistic regression model provided the following eight risk factors of migraine: (i) gender (p < 0.01), (ii) family income (p < 0.01), (iii) marital status (p < 0.01), (iv) infrequent exercise (p < 0.01), (v) family history of headache (p < 0.01), (vi) high screen time (p < 0.05), (vii) depressive symptoms (p < 0.05) and (viii) anxiety disorder (p < 0.01). More than two-thirds of the people with migraines reported more than five attacks during the past month with moderate to severe intense headache. Stress was the most reported trigger of migraine among university students (71%) followed by irregular sleep (47%), academic pressure (33%), and external noise (28%). Almost 37% of the participants who had migraines reported that headache caused severe impact in their day to day life.

Conclusions

The prevalence of migraine among university students of Bangladesh is alarmingly high. Frequent migraine attacks and severe intensity of headache cause a substantial level of impact among the sufferers. Cautious avoidance of the triggering factors through appropriate interventions and prophylactic medication can mitigate the negative impact of migraine as well as improve the quality of life.
Norepinephrine promotes glioma cell migration through up-regulating the expression of Twist1
Authors: Wang Xue , Wang Ying , Xie Fang , Song Zi-Tian , Zhang Zi-Qian , Zhao Yun , Wang Shi-Da , Hu Hui , Zhang Yan-Shu , Qian Ling-Jia
Published: February 2022

Background

Glioma cells are characterized by high migration ability, resulting in aggressive growth of the tumors and poor prognosis of patients. It has been reported that the stress-induced hormone norepinephrine (NE) contributes to tumor progression through mediating a number of important biological processes in various cancers. However, the role of NE in the regulation of glioma migration is still unclear. Epithelial-to-mesenchymal transition (EMT) is one of the most important steps for tumor migration and metastasis. Twist1, as a key regulator of EMT, has been found to be elevated during glioma migration. But it is still unknown whether Twist1 is involved in the effect of NE on the migration of glioma cells.

Methods

Wound healing assay and transwell assay were conducted to evaluate the migration of glioma cells upon different treatments. The mesenchymal-like phenotype and the expression of Twist1 after NE treatment were assessed by cell diameters, real-time PCR, western blot and immunofluorescence staining. The gain-and loss-of-function experiments were carried out to investigate the biological function of Twist1 in the migration induced by NE. Finally, the clinical significance of Twist1 was explored among three public glioma datasets.

Results

In this study, our finding revealed a facilitative effect of NE on glioma cell migration in a β-adrenergic receptor (ADRB)-dependent way. Mechanistically, NE induced mesenchymal-like phenotype and the expression of Twist1. Twist1 overexpression promoted glioma cells migration, while knockdown of Twist1 abolished the discrepancy in the migration ability between NE treated glioma cells and control cells. In addition, the clinical analysis demonstrated that Twist1 was up-regulated in malignant gliomas and recurrent gliomas, and predicted a poor prognosis of glioma patients.

Conclusions

NE enhanced the migration ability of glioma cells through elevating the expression of Twist1. Our finding may provide potential therapeutic target for protecting patients with glioma from the detrimental effects of stress biology on the tumor progression.
What is the effect of independent medical evaluation on days on sickness benefits for long-term sick listed employees in Norway? A pragmatic randomised controlled trial, the NIME-trial
Authors: Mæland Silje , Holmås Tor Helge , Øyeflaten Irene , Husabø Elisabeth , Werner Erik L. , Monstad Karin
Published: February 2022

Background

Independent medical evaluations are used to evaluate degree and reason for work disability, uncertainty around the functional status, and/or the employee’s rehabilitation potential in several jurisdictions, but not in Norway. The main aim of this trial was to test the return to work effect of independent medical evaluation (IME) (summoning and consultation) compared to treatment as usual (TAU) in Norway, for workers who have been on continuous sick leave for 6 months.

Methods

This was a pragmatic randomised controlled trial including all employees aged 18–65 years, sick-listed by their general practitioner and on full or partial sick leave for the past 26 weeks in Hordaland County, Norway in 2015/16. Trial candidates were drawn from a central register at the Norwegian Labour and Welfare Administration at 22 weeks of sick leave. Pregnant women, individuals with cancer or dementia diagnoses, those with secret address, employed by NAV or sick listed by the specialist health services were excluded. Separate regression analyses were conducted to investigate the “intention-to-treat” and “treatment on the treated” effects, using the ordinary least squares and instrumental variable methods, respectively.

Results

After exemption based on predefined exclusion criteria, 5888 individuals were randomised to either IME (n = 2616) or TAU (n = 2599). The final intervention group constitutes 1698 individuals, of which 937 attended the IME consultation. No baseline differences were found between the IME and TAU group regarding gender, age, and previous sick leave. Individuals attending the IME were older than those who cancelled the appointment ((47/45),p = 0.006) and those who did not show up without cancelling ((47/42),p < 0.001). Mainly the IME physician agreed with the regular GP upon level of sick leave. In cases with different assessments, the difference tended to be towards a lower sick leave level. There were no intention to treat or treatment on the treated effect on days of sick leave after randomisation during follow up.

Conclusions

Overall, the analyses showed no effect of IME on changes in sick leave for sick listed employees. This result was consistent for those who were offered an IME consultation (intention to treat) and those who undertook an IME consultation (treatment on the treated).

Trial registration

ClinicalTirals.gov trial numberNCT02524392first registration 14.08.2015.
In situ reconstruction of ruptured mycotic iliac artery aneurysm with autologous fascial-peritoneal tissue: a case report and literature review
Authors: Sang GuiFeng , Guo XiaoYan , Liu GuoLong , Che HaiJie
Published: February 2022

Background

Infectious aneurysms are rare in clinic with poor therapeutic outcomes. When artery rupture occurs, the disease tends to progress resulting in a high mortality, and there remains no ideal treatment.

Case presentation

We report a case of rupture of infectious iliac artery pseudoaneurysm, who was assigned to receive artery reconstruction with autologous fascial-peritoneal tissue and obtained satisfied short-term outcome. The follow-up of 6 months after operation was good and long-term follow-up is continuing.

Conclusion

The posterior rectus fascia-peritoneal layer seems to be a feasible autologous biomaterial for vascular substitution in urgent setting when no other autologous material was available.
Laparoscopic-assisted Soave procedure for Hirschsprung disease: 10-year experience with 106 cases
Authors: Wang Yun-jin , He Yuan-bin , Chen Liu , Lin Yu , Liu Ming-kun , Zhou Chao-ming
Published: February 2022

Background

The purpose of this study was to summarize the clinical experience and 10 year follow-up results of laparoscopic assisted Soave procedure for the treatment of long-segment Hirschsprung disease (HD).

Methods

From January 2010 to February 2020, 106 children with long-segment HD participated in this study. The laparoscopic-assisted Soave procedure was performed for the treatment of long-segment HD. The follow-up time was two weeks, one month, and three months after the operation, and then every six months to one year.

Results

The operation was successful for all 106 children. All patients were discharged 5–7 days after the operation. The median time in surgery was 150 (100–190) minutes, and the median volume of bleeding was 6 (3–10) ml. The short-term postoperative daily defecation frequency was 4–11 times, 3–7 times within 6 months, and 2–3 times after 6–12 months. Postoperative complications included anastomotic leakage in two cases, perianal dermatitis in 13 cases, anastomotic stenosis in four cases, adhesive bowel obstruction in two cases, enterocolitis in 16 cases, soiling in 11 cases, and constipation recurrence in three cases.

Conclusions

The laparoscopic-assisted Soave procedure is a safe and effective surgical method for treating long-segment HD, and it causes little trauma or bleeding and has a fast postoperative recovery. Yet some complications may occur. Preoperative diagnosis, intraoperative and postoperative standardized processing can reduce the postoperative complications.
Multi-country clinical practice patterns, including use of biomarkers, among physicians’ treatment of BCG-unresponsive non-muscle invasive bladder cancer (NMIBC)
Authors: Broughton Edward I. , Gooden Kyna M. , Mycock Katie L. , Rajkovic Ivana , Taylor-Stokes Gavin
Published: February 2022

Background

Intravesical bacillus Calmette-Guérin (BCG) fails in a considerable proportion of non-muscle invasive bladder cancer (NMIBC) patients despite treatment per recommended protocol. This real-world study aimed to understand the current patterns of treatment and disease management for the broad BCG-unresponsive NMIBC patient population, alongside collecting sufficient data on patients who do not undergo cystectomy.

Methods

This was a multicenter, retrospective survey of physicians treating BCG-unresponsive NMIBC patients. Data were collected in eight countries – France, Germany, Spain, Italy, United Kingdom, United States, China, and Japan – between January and May 2019. The study consisted of a short online physician survey and a retrospective chart review of eligible BCG-unresponsive NMIBC patients. Physicians abstracted chart data for the last 10 (five patients in Japan) eligible BCG-unresponsive NMIBC patients meeting the inclusion criteria, and the data were analysed for all countries combined using descriptive statistics. Country-specific analyses were also carried out, as appropriate.

Results

Overall, 508 physicians participated in the study. Almost one-quarter (22.9%) of physicians’ current NMIBC patient caseload was BCG-unresponsive, whereby BCG therapy was no longer considered an option. Half of physicians (49.4%) did not regularly use biomarker tests in their practice, with particularly few physicians undertaking biomarker testing in Spain and Japan. Biomarker testing varied considerably, with the proportions of physicians selecting ‘none’ ranging from 11.4% in China to 70.3% in Japan. Physicians reported transurethral resection of the bladder tumor (TURBT) and BCG as the most common current treatments received by their patients. Chemotherapy and anti-PD-L1 treatment options were considered impactful new therapies by 94.7% and 90.0% of physicians surveyed in this study, respectively.

Conclusions

The most common treatments received by patients in this study were TURBT and BCG. Emerging new treatments are driven by exploring biomarkers, but in real-world clinical practice only half of physicians or fewer regularly tested their NMIBC patients for biomarkers; PD-1/PD-L1 was the most common biomarker test used. Most physicians reported that, in addition to chemotherapy, anti-PD-L1 was an impactful new therapy.
Women's experiences in the transition to menopause: a qualitative research
Authors: Refaei Mansoureh , Mardanpour Soraya , Masoumi Seyedeh Zahra , Parsa Parisa
Published: February 2022

Background

Around the time of transition to menopausal period, women experience mental, and psychological disorders that require adequate attention to these symptoms. This study aimed to explore the experiences of women in the face of premenopausal symptoms.

Methods

This qualitative study was conducted using a content analysis method in Javanrood, Iran, in 2020. The data were collected through in-depth semi-structured face to face interviews with 16 premenopausal using interview guide in a private room in comprehensive health centers. The women inclusion criteria were approaching menopause, having irregular menstruation, and having no disease or medication that affects menstruation. Furthermore, the exclusion criteria were the absence of menstruation for more than 12 months, and the women's refusal to continue the interview. The participants were selected using purposive sampling and sampling continued until data saturation. The collected data were analyzed with MAXQDA10 software following the multi-step method proposed by Graneheim and Lundman.

Results

The participants' mean age was 47 ± 2.98 years. The data analysis revealed 5 categories including: "menopause and aging", "life transformation", confrontation of fear and hope", "life adjustment", and "need to facilitate the transition time".

Conclusion

This study suggested the women's experience of the transition to menopause was characterized by the fear of the future and its consequences and the need for reassurance about it. Besides, the women sought solutions to their problems in health care providers, peers, and the family.