bluuebunny/crossref_metadata_2025 huggingface dataset:
Medial epicondylar fissure fracture as a complication of transcondylar screw placement for the treatment of humeral intracondylar fissure
Authors: Jenkins Georgia , Moores Andy P.
Published: April 2022

Objective

To report the incidence of medial epicondylar fissure fracture (MEFF) after medial‐to‐lateral transcondylar screw placement in dogs with humeral intracondylar fissure (HIF) and to identify risk factors for MEFF.

Study design

Retrospective study.

Sample population

Seventy‐four client‐owned dogs (88 elbows).

Methods

Medical records of dogs surgically treated for HIF, and postoperative imaging studies were reviewed for demographics, fracture characteristics, and repair techniques. The width of the transcondylar screw was expressed relative to the height of the condyle. Screw angle and degree of countersinking were recorded. Information from case records and follow‐up radiographs were used to identify complications.

Results

Medial epicondylar fissure fracture was identified in 10 elbows (11.4%) following medial‐to‐lateral transcondylar screw placement: 4 cases were detected intraoperatively, 2 on immediate postoperative radiographs, 1 during routine radiographic follow up, and 3 when radiographs were reviewed for this study. A larger relative screw size was found to increase the risk of MEFF (P = .004, OR = 1.5). Fifteen additional complications were identified in 13/80 elbows at a median of 6 weeks postoperatively (range 1–56 weeks). Screw loosening was the most frequent complication (n = 9) and was the only complication in dogs with MEFF (n = 3); MEFF tended to increase the risk of perioperative screw loosening (P = .06).

Conclusion

Medial epicondylar fissure fracture occurred in 10/88 elbows treated for HIF and was more common in elbows treated with a larger screw size relative to the height of the condyle.

Clinical significance

Placing transcondylar screws with a diameter inferior to 41% of the height of the condyle is recommended to avoid MEFF. Medial epicondylar fissure fracture appears to have a low clinical significance in the perioperative period, although its effect on long‐term outcome remains unknown.
Current use of biologic therapies for musculoskeletal disease: A survey of board‐certified equine specialists
Authors: Knott Lindsay E. , Fonseca‐Martinez B. Alexander , O'Connor Annette M. , Goodrich Laurie R. , McIlwraith C. Wayne , Colbath Aimee C.
Published: April 2022

Objective

To evaluate the use of mesenchymal stem cells (MSCs), autologous conditioned serum (ACS), platelet‐rich plasma (PRP), and autologous protein solution (APS) for the treatment of equine musculoskeletal disease by diplomates of the American College of Veterinary Surgery (ACVS), and American College of Veterinary Sports Medicine and Rehabilitation (ACVSMR).

Study design

Cross‐sectional study.

Sample population

Diplomates (n= 423).

Methods

An email link was sent to ACVS and ACVMR diplomates. A survey contained 59 questions regarding demographics, as well as indications, frequency, adverse effects, and limitations of use. Responses were analyzed using Fisher's exact test.

Results

One hundred and fifty four surveys were analyzed. Years in practice and type of practice were not associated with biologic therapy use. PRP was the most used therapy (120/137; 87.5%). PRP and MSCs were most often administered intralesionally while ACS and APS were most often administered intra‐articularly. ACS (50/104; 48.1%) treatment was repeated commonly within 2 weeks of initial injection. MSCs (39/90; 43.3%) and PRP (38/100; 38%) were commonly repeated 1‐2 months after initial injection and APS was typically repeated >4 months after initial injection (21/53; 39.6%). Local inflammation and expense were the most common adverse effect and limitation of use.

Conclusion

Diplomates most commonly utilized PRP and MSC intralesionally for soft‐tissue injuries, and ACS and ACP intra‐articularly for joint injury. Protocols for repeated administration varied widely. Local inflammation was a clinical concern with the use of biologics.

Clinical significance

Biologic therapies are used commonly by ACVS and ACVSMR diplomates for soft tissue and joint disease.
Cell Behavior in Flow Passing Through Micromachined Gap
Authors: Hashimoto Shigehiro
Published: April 2022

A microgap was created in the flow channel, and the behavior (deformation, rotation) of each cell when passing through the gap was investigated. A gap with a rectangular cross section (7 μm high, 0.4 mm wide, and 0.1 mm long) was manufactured in the middle part of the flow path by photolithography technique. Myoblasts (C2C12: mouse myoblast cell line) sparsely suspended in the medium were used for the test. Deformation of each cell passing through the microgap was observed with an inverted phase contrast microscope. From the contour of the image of each cell passing through the gap, several parameters were analyzed: the two-dimensional projected area, the degree of deformation by ellipse approximation, and the alignment of the major axis of the deformed cell. The experimental results show that the alignment of each cell tends to deviate from the flow direction as the larger projected two-dimensional area pressed in the gap.
Two-Phase Flow Simulations of Liquid/Gas Transport in Radial Centrifugal Pumps With Special Emphasis on the Transition From Bubbles to Adherent Gas Accumulations
Authors: Hundshagen Markus , Rave Kevin , Nguyen Bich-Diep , Popp Sebastian , Hasse Christian , Mansour Michael , Thévenin Dominique , Skoda Romuald
Published: April 2022

In recent optical flow experiments on a transparent volute-type radial centrifugal pump, an accumulation of air bubbles to adherent gas pockets within the impeller blade channels was observed. A transition of unsteady bubbly flow toward an attached gas pocket at the blade suction side was found for increasing air loading of the liquid water phase. This steadily attached pocket shows a distinctive unsteady wake. A reproduction of the transition from bubbly to pocket flow in a three-dimensional (3D) flow simulation demands the treatment of dispersed bubbly flow, on the one hand, and of coherent air regions, on the other hand. Therefore, a hybrid flow solver is adopted based on an Euler–Euler two-fluid (EE2F) method for dispersed flows and features volume-of-fluid (VOF) properties when air accumulations form. A scale-adaptive simulation (SAS) turbulence model is utilized to account for highly unsteady flow regions. For the time being, a monodisperse bubble size distribution is assumed for the dispersed part of the flow. For an operation range close to the design point and rising air loading, the flow transition from bubbly to pocket flow is well captured by the hybrid simulation method. Even an alternating pocket flow in between bubbly and pocket flow regime is predicted. The simulation method is still limited by an appropriate choice of a monodisperse bubble diameter. Therefore, the disperse model part of the hybrid flow solver will be coupled with population balance and bubble interaction models in future studies.
Heave Motion Induced Vortex-Induced Vibrations of a Full-Scale Steel Lazy Wave Riser
Authors: Yin Decao
Published: April 2022

Deepwater steel lazy wave risers (SLWR) subject to vessel motion will be exposed to time-varying oscillatory flow, vortices could be generated and the cyclic vortex-shedding force causes the structure vibrate, such fluid–structure interaction is called vortex-induced vibrations (VIV). To investigate VIV on a riser with nonlinear structures under vessel motion and oscillatory flows, time-domain approaches are needed. In this study, a time-domain approach is used to simulate a full-scale SLWR. Two cases with simplified riser top motions are simulated numerically. By using default input parameters to the time-domain approach, the key oscillatory flow induced VIV response characteristics such as response frequency, curvature, and displacements are examined and discussed. More accurate VIV prediction could be achieved by using realistic hydrodynamic inputs into the time domain model.
Active Absorption of Random Waves in Wave Flume Using Artificial Neural Networks
Authors: Ramos Áureo I. W. , Fernandes Antonio C. , Thomaz Vanessa M.
Published: April 2022

A wave flume is primarily intended to reproduce actual sea conditions in order to provide a reliable means of testing for small-scale models. The realization of scaled tests is extremely important for the validation of a project on real scale, since, through the laws of similitude, such tests make it possible to predict the behavior of structures in the ocean as well as their performance during operation. This research aims to develop, test, and validate an active control algorithm for wave absorption in a two-dimensional wave channel—that is, when the waves propagate in only one direction—based on artificial neural networks (ANN). The ANN control algorithm relies on the linear wave theory and the principle of time-reversal of wave propagation; i.e., the phenomenon of wave absorption corresponds to the wave generation when observed in the reverse direction of time. Through this principle, data from wave generation experiments, after proper manipulation, are used to train an ANN capable of generating the control signal used to move the wave-generator device, this time as a wave absorber
Non-monochromatic He I and He II UPS spectra of polycrystalline silver
Authors: Salim Muhammad G. , Casamento Joseph
Published: April 2022

The surface composition of clean polycrystalline Silver (Ag) was analyzed by ultraviolet photoelectron spectroscopy (UPS) at optimal instrument operation parameters for both nonmonochromatic He I and He II emission. UPS valence band spectra were obtained using a differentially pumped He gas-discharge lamp (He I: 21.2 eV; He II: 40.8 eV). Fermi levels (Ef) in UPS spectra arising from each source line are observed—where the energy difference between Ef arising from He I or He II is equivalent to the difference in source energy of He I and He II primary lines (19.6 eV), useful for calibration of UPS systems or spectra analysis.
SARS-CoV-2 BA.1 variant is neutralized by vaccine booster–elicited serum but evades most convalescent serum and therapeutic antibodies
Authors: Lusvarghi Sabrina , Pollett Simon D. , Neerukonda Sabari Nath , Wang Wei , Wang Richard , Vassell Russell , Epsi Nusrat J. , Fries Anthony C. , Agan Brian K. , Lindholm David A. , Colombo Christopher J. , Mody Rupal , Ewers Evan C. , Lalani Tahaniyat , Ganesan Anuradha , Goguet Emilie , Hollis-Perry Monique , Coggins Si’Ana A. , Simons Mark P. , Katzelnick Leah C. , Wang Gregory , Tribble David R. , Bentley Lisa , Eakin Ann E. , Broder Christopher C. , Erlandson Karl J. , Laing Eric D. , Burgess Timothy H. , Mitre Edward , Weiss Carol D.
Published: April 2022

The rapid spread of the highly contagious Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) along with its high number of mutations in the spike gene has raised alarms about the effectiveness of current medical countermeasures. To address this concern, we measured the neutralization of the Omicron BA.1 variant pseudovirus by postvaccination serum samples after two and three immunizations with the Pfizer/BioNTech162b2 SARS-CoV-2 mRNA (Pfizer/BNT162b2) vaccine, convalescent serum samples from unvaccinated individuals infected by different variants, and clinical-stage therapeutic antibodies. We found that titers against the Omicron variant were low or undetectable after two immunizations and in many convalescent serum samples, regardless of the infecting variant. A booster vaccination increased titers more than 30-fold against Omicron to values comparable to those seen against the D614G variant after two immunizations. Neither age nor sex was associated with the differences in postvaccination antibody responses. We also evaluated 18 clinical-stage therapeutic antibody products and an antibody mimetic protein product obtained directly from the manufacturers. Five monoclonal antibodies, the antibody mimetic protein, three antibody cocktails, and two polyclonal antibody preparations retained measurable neutralization activity against Omicron with a varying degree of potency. Of these, only three retained potencies comparable to the D614G variant. Two therapeutic antibody cocktails in the tested panel that are authorized for emergency use in the United States did not neutralize Omicron. These findings underscore the potential benefit of mRNA vaccine boosters for protection against Omicron and the need for rapid development of antibody therapeutics that maintain potency against emerging variants.
Sexually transmitted infections in suspected child sexual abuse
Authors: Driscoll Sarah Jane , Fidler Katy J , Shears Annalie , Whetham Jennifer , White Ann
Published: April 2022

Making associations between sexually transmitted infections (STIs) and child sexual abuse can be controversial. To contribute to the paucity of research in this field, this service evaluation aims to (1) define the prevalence of STIs in children aged 0–13 years seen at a regional Children’s Sexual Assault Referral Centre, (2) determine whether sexual transmission is the most likely mode of transmission for diagnosed STIs, (3) identify factors affecting application of STI screening and (4) assess follow-up. Methods consisted of retrospective analysis of an anonymous database for all patients seen between 1 July 2016 and 1 July 2019. Of 241 children seen, 114/241 (47.3%) received STI screening and 10/114 (8.8%) tested positive (4.1% of children seen overall). No asymptomatic child was diagnosed with an STI. Sexual transmission was the most likely mode of transmission based on child disclosure and physical examination findings for 6/10 children diagnosed with an STI.
Vulnerabilities in clinician–parent exchanges and the cascade of communication traps: a review
Authors: Ferretti Emanuela , Schoenherr Jordan Richard , Mattiola Alessandra , Daboval Thierry
Published: April 2022

This review considers parent–clinician interactions that are associated with vulnerabilities in communication and what we refer to as ‘communication traps’. Communication traps are defined by high-stress situations with affect-laden subject matter that can lead to progressively dysfunctional communications/exchanges that are avoidable. While this framework was developed in neonatology, it can be applied to other clinical practices.

Communication competencies in paediatrics require the rapid development of a therapeutic alliance between parents and clinicians to ensure the provision of best care to their infants. In order to facilitate parent–clinician communication, our framework focuses clinicians’ attention on the affective, behavioural and cognitive (ABC) cues that are indicative of real, apparent or potential communication traps. Strategies are provided to slow down clinicians’ responses to more effectively consider ABC cues that suggest if patients/parents have failed to engage or disengage from a situation. This framework is illustrated by presenting a narrative synthesised from a number of experiences that clinicians have encountered. This review identifies key decision points in the communication process that, if left unaddressed, can cascade into communication traps which may be difficult to escape.

Using results from communication studies and psychological research, our framework was developed to identify key decision points for ABC cues that can be used to prevent falling into communication traps.
Vesical clear cell adenocarcinoma of Müllerian origin treated conservatively with partial cystectomy
Authors: Harold Justin A , Casilla-Lennon Marianne , Kenney Patrick A , Ratner Elena S
Published: April 2022

A 71-year-old woman presented with an intravesical bladder mass found to be a clear cell adenocarcinoma of Müllerian origin with positive PAX-8 staining after transurethral resection. Partial cystectomy along with total hysterectomy were performed, and final pathology revealed no residual tumour and extensive endometriosis. She declined adjuvant therapy and was dispositioned to surveillance.
Platypnoea-orthodeoxia syndrome and hemidiaphragm paralysis
Authors: Walker-Jacobs Abigail , Mota Bruno , Hajjar Karine , Abdul-Samad Omar , Sankaran Prasanna
Published: April 2022

A woman in her 70s was admitted to hospital with worsening shortness of breath and no prior respiratory history of note. This patient’s shortness of breath was posture-dependent; symptoms were markedly worse and oxygen saturations were lower on sitting upright than in recumbency. Her shortness of breath had started several weeks prior to admission and had slowly worsened. Chest X-ray revealed a raised right hemidiaphragm. Further investigation revealed a patent foramen ovale, which was managed with percutaneous closure. This is one of several cases that demonstrate right-to-left shunting through a septal defect secondary to right hemidiaphragmatic paralysis. However, previous reports have not provided a clear guide for management of these cases. We suggest where patients are admitted with new onset breathlessness and platypnoea-orthodeoxia, a septal defect should be suspected. In this report, we have suggested a flowchart for the investigation and management of platypnoea-orthodeoxia syndrome.
Real-world use of once-weekly semaglutide in patients with type 2 diabetes: pooled analysis of data from four SURE studies by baseline characteristic subgroups
Authors: Yale Jean-François , Bodholdt Ulrik , Catarig Andrei-Mircea , Catrina Sergiu , Clark Alice , Ekberg Neda Rajamand , Erhan Umut , Holmes Patrick , Knudsen Søren Tang , Liutkus Joanne , Sathyapalan Thozhukat , Schultes Bernd , Rudofsky Gottfried
Published: April 2022

Introduction

This post hoc pooled analysis of four real-world studies (SURE Canada, Denmark/Sweden, Switzerland and UK) aimed to characterize the use of once-weekly (OW) semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), in patients with type 2 diabetes (T2D).

Research design and methods

The Semaglutide Real-world Evidence (SURE) studies had a duration of ~30 weeks. Changes in glycated hemoglobin (HbA1c) and body weight (BW) were analyzed for the overall population and the following baseline subgroups: GLP-1RA-naïve/GLP-1RA switchers; body mass index <25/≥25–<30/≥30–<35/≥35 kg/m2; age <65/≥65 years; HbA1c<7%/≥7–≤8%/>8–≤9%/>9%; T2D duration <5/≥5–<10/≥10 years. Data for patients achieving treatment targets were analyzed in the overall population and the baseline HbA1c≥7% subgroup.

Results

Of 1212 patients, 960 were GLP-1RA-naïve and 252 had switched to semaglutide from another GLP-1RA. In the overall population, HbA1cwas reduced from baseline to end of study (EOS) by –1.1% point and BW by –4.7 kg; changes were significant for all subgroups. There were significantly larger reductions of HbA1cand BW in GLP-1RA-naïve versus GLP-1RA switchers and larger reductions in HbA1cfor patients with higher versus lower baseline HbA1c. At EOS, 52.6% of patients in the overall population achieved HbA1c<7%. No new safety concerns were identified in any of the completed SURE studies.

Conclusions

In this pooled analysis, patients with T2D initiating OW semaglutide showed significant improvements from baseline to EOS in HbA1cand BW across various baseline subgroups, including patients previously treated with a GLP-1RA other than semaglutide, supporting OW semaglutide use in clinical practice.

Trail registration numbers

NCT03457012;NCT03631186;NCT03648281;NCT03876015.
Plasma C1q/tumor necrosis factor-related protein-3 concentrations are associated with diabetic peripheral neuropathy
Authors: Lin Ke , Yang Liu , Xiong Yuyuan , Feng Keduo , Zeng Wang , Deng Bo
Published: April 2022

Introduction

To analyze the associations of circulating C1q/tumor necrosis factor-related protein-3 (CTRP3) concentrations with several metabolic parameters and to investigate the possible role of CTRP3 in subjects with diabetic peripheral neuropathy (DPN).

Research design and methods

A total of 347 participants were recruited in this study, and plasma CTRP3 concentrations were analyzed in subjects with DPN (n=172) and without DPN (non-DPN, n=175). The nerve conduction test and oral glucose tolerance test were performed, and Neuropathy Symptom Score (NSS)/Neuropathy Disability Score (NDS) and biochemical parameters were measured in all participants.

Results

Plasma CTRP3 concentrations were significantly lower in patients with DPN compared with those in patients with diabetes without DPN (p<0.01), despite the comparable glucose and lipid metabolism levels in both groups. Groups with a higher plasma CTRP3 level had a faster nerve conduction velocity. In addition, plasma CTRP3 concentrations were negatively correlated with hemoglobin A1c (HbA1c), urea acid (UA), triglyceride, NSS and NDS (p<0.05) after being adjusted for age and sex. Multivariate logistic regression analysis revealed that plasma CTRP3 concentrations were significantly correlated with DPN after being controlled for age, sex, body mass index, HbA1c, blood pressure, lipid profiles, and renal function.

Conclusions

Plasma CTRP3 concentrations were significantly lower in patients with DPM and positively correlated with nerve conduction velocity. The relationship between CTRP3 levels and DPN is independent of the glucose and lipid status. Therefore, circulating CTRP3 might serve as a predictor of impairment of nerve conduction in patients with DPN.
Effect of social distancing on injury incidence during the COVID-19 pandemic: an interrupted time-series analysis
Authors: Cho Yong Soo , Ro Young Sun , Park Jeong Ho , Moon Sungwoo
Published: April 2022

Objectives

To evaluate the effects of social distancing on the incidence and characteristics of injuries during the COVID-19 pandemic.

Design and setting

This cross-sectional study used the National Emergency Department Information System (NEDIS) database.

Participants

Injured patients who visited all 402 emergency departments (EDs) between 29 February and 29 May 2020 (after-distancing), and in the corresponding period in 2019 (before distancing) to control for seasonal influences.

Outcome measures

The study outcome was the incidence of injury. Using the interrupted time-series analysis models, we analysed weekly trends of study outcomes in both periods (before and after distancing), the step change (the effect of intervention), and the slope change over two periods (the change in the effect over time).

Results

The incidence rates of injury per 100 000 person-days were 11.2 and 8.6 in the before-distancing and after-distancing periods, respectively. In the after-distancing period, the incidence rate of injury decreased (step change −3.23 (95% CI −4.34 to −2.12) per 100 000 person-days) compared with the before-distancing period, while the slope change was 0.10 (95% CI 0.04 to 0.24). The incidence rate ratios of all injuries and intentional injuries for the after-distancing period were 0.67 (95% CI 0.60 to 0.75) and 1.28 (95% CI 1.18 to 1.40), respectively, compared with the before-distancing period.

Conclusions

Fewer injuries occurred after the implementation of social distancing programme compared with the same period in the previous year. However, this effect gradually decreased postimplementation.
Impact of family presence during cardiopulmonary resuscitation on team performance and perceived task load: a prospective randomised simulator-based trial
Authors: Willmes Mareike , Sellmann Timur , Semmer Norbert , Tschan Franziska , Wetzchewald Dietmar , Schwager Heidrun , Russo S G , Marsch Stephan
Published: April 2022

Objectives

Guidelines recommend family presence to be offered during cardiopulmonary resuscitation (CPR). Data on the effects of family presence on the quality of CPR and rescuers’ workload and stress levels are sparse and conflicting. This randomised trial investigated the effects of family presence on quality of CPR, and rescuers’ perceived stress.

Design

Prospective randomised single-blind trial.

Setting

Voluntary workshops of educational courses.

Participants

1085 physicians (565 men) randomised to 325 teams entered the trial. 318 teams completed the trial without protocol violation.

Interventions

Teams were randomised to a family presence group (n=160) or a control group (n=158) and to three versions of leadership: (a) designated at random, (b) designated by the team or (c) left open. Thereafter, teams were confronted with a simulated cardiac arrest which was video-recorded. Trained actors played a family member according a scripted role.

Main outcome measures

The primary endpoint was hands-on time. Secondary outcomes included interaction time, rescuers’ perceived task load and adherence to CPR algorithms.

Results

Teams interacted with the family member during 24 (17–36) % of the time spent for resuscitation. Family presence had no effect on hands-on time (88% (84%–91%) vs 89% (85%–91%); p=0.18). Family presence increased frustration (60 (30–75) vs 45 (30–70); p<0.001) and perceived temporal (75 (55–85) vs 70 (50–80); p=0.001) and mental demands (75 (60–85) vs 70 (55–80); p=0.009), but had no relevant effect on CPR performance markers. Leadership condition had no effects.

Conclusions

Interacting with a family member occupied about a quarter of the time spent for CPR. While this additional task was associated with an increase in frustration and perceived temporal and mental demands, family presence had no relevant negative effect on the quality of CPR.

Trial registration number

DRKS00024759.
Use of technology to prevent, detect, manage and control hypertension in sub-Saharan Africa: a systematic review
Authors: Stokes Katy , Oronti Busola , Cappuccio Francesco P , Pecchia Leandro
Published: April 2022

Objective

To identify and assess the use of technologies, including mobile health technology, internet of things (IoT) devices and artificial intelligence (AI) in hypertension healthcare in sub-Saharan Africa (SSA).

Design

Systematic review.

Data sources

Medline, Embase, Scopus and Web of Science.

Eligibility criteria

Studies addressing outcomes related to the use of technologies for hypertension healthcare (all points in the healthcare cascade) in SSA.

Methods

Databases were searched from inception to 2 August 2021. Screening, data extraction and risk of bias assessment were done in duplicate. Data were extracted on study design, setting, technology(s) employed and outcomes. Blood pressure (BP) reduction due to intervention was extracted from a subset of randomised controlled trials. Methodological quality was assessed using the Mixed Methods Appraisal Tool.

Results

1717 hits were retrieved, 1206 deduplicated studies were screened and 67 full texts were assessed for eligibility. 22 studies were included, all reported on clinical investigations. Two studies were observational, and 20 evaluated technology-based interventions. Outcomes included BP reduction/control, treatment adherence, retention in care, awareness/knowledge of hypertension and completeness of medical records. All studies used mobile technology, three linked with IoT devices. Short Message Service (SMS) was the most popular method of targeting patients (n=6). Moderate BP reduction was achieved in three randomised controlled trials. Patients and healthcare providers reported positive perceptions towards the technologies. No studies using AI were identified.

Conclusions

There are a range of successful applications of key enabling technologies in SSA, including BP reduction, increased health knowledge and treatment adherence following targeted mobile technology interventions. There is evidence to support use of mobile technology for hypertension management in SSA. However, current application of technologies is highly heterogeneous and key barriers exist, limiting efficacy and uptake in SSA. More research is needed, addressing objective measures such as BP reduction in robust randomised studies.

PROSPERO registration number

CRD42020223043.
Using human-centred design to tackle COVID-19 vaccine hesitancy for children and youth: a protocol for a mixed-methods study in Montreal, Canada
Authors: McKinnon Britt , Abalovi Krystelle , Vandermorris Ashley , Dubé Ève , Tuong Nguyen Cat , Billou Niels , Fortin Geneviève , Parvez Maryam , Senga Joyeuse , Abou-malhab Joe , Antoine Bellamy Medjine , Quach Caroline , Zinszer Kate
Published: April 2022

Introduction

To successfully combat COVID-19 vaccine hesitancy and increase uptake, research has demonstrated that interventions are most effective when tailored to meet local needs through active engagement and co-development with communities. This mixed-methods project uses a human-centred design (HCD) approach to understand local perspectives of COVID-19 vaccine hesitancy and develop strategies to enhance vaccine confidence for children and adolescents.

Methods and analysis

Project ECHO (Étude Communautaire sur l’Hésitation vaccinale contre la COVID-19) combines population-based surveys of parents and adolescents with community-based participatory action research to design and pilot strategies to enhance COVID-19 vaccine confidence in two underserved and ethnoculturally diverse neighbourhoods of Montreal, Canada. Two surveys conducted 6 months apart through primary and secondary schools are used to monitor vaccine acceptance and its social determinants among children and youth. Analyses of survey data include descriptive and inferential statistical approaches. Community-led design teams of parents and youth from the two participating neighbourhoods, supported by academic researchers, design thinking experts and community partners, use an HCD approach to: (1) gather data to understand COVID-19 vaccine decision-making among parents and youth in their community and frame a design challenge (inspiration phase); (2) develop an intervention to address the design challenge (ideation phase) and (3) pilot the intervention (implementation phase). Strategies to evaluate the community-led interventions will be co-developed during the implementation phase.

Ethics and dissemination

This study has been approved by the research ethics boards of the Sainte-Justine University Hospital Centre and the University of Montreal. Community design teams will be involved in the dissemination of findings and the design of knowledge translation initiatives that foster dialogue related to COVID-19 vaccination for children and adolescents among community, school and public health stakeholders. Findings will be disseminated through peer-reviewed publications, conference presentations, community forums, policy briefs, and social media content.
Vision tests on spectacle lenses and contact lenses for optical myopia correction: a pilot study
Authors: Kaymak Hakan , Neller Kai , Schütz Saskia , Graff Birte , Sickenberger Wolfgang , Langenbucher Achim , Seitz Berthold , Schwahn Hartmut
Published: April 2022

Objective

Visual performance and short-term tolerability of different designs of myopia correcting options, including therapeutically relevant bifocal contact lenses (CL) and spectacle lenses with ‘defocus incorporated multiple segments (DIMS)’ technology were compared.

Methods and analysis

In myopic volunteering subjects (n=8; spherical equivalent range: −1 to −7 D) visual acuity (VA) using Landolt C and contrast sensitivity (CS) using contrast C were assessed at three different gaze positions (−22° nasal, +22° temporal and 0° central), corresponding to a gaze through the DIMS area or the clear area of the DIMS lens design, respectively, after short-term wear of each of single vision spectacle lenses (SV), DIMS spectacle lenses (DIMS), monofocal soft CL and centre-near multifocal soft CL (MCL). Also, CS was assessed under photopic and mesopic light conditions with and without glare using sinusoidal gratings at 1.5, 3, 6, 12 and 18 cpd.

Results

Mean VA (Landolt C) was −0.12 to –0.10, −0.05 and 0.10 logMAR (SV, DIMS, CL, MCL) at central gaze (0°). At nasal gaze (−22°), VA differed by 0.12, 0.33, 0.05 and 0.01, and at temporal gaze (+22°) by 0.05, 0.26, 0 and −0.08 compared with central gaze values. Mean CS (Contrast C) was 1.74, 1.73, 1.69 and 1.61 logCS (SV, DIMS, CL, MCL) at central gaze at nasal gaze, CS differed by −0.02 to –0.13, −0.01 and −0.01, and at temporal gaze by −0.02 to –0.16, −0.01 and +0.06 compared with central gaze values.

Conclusion

When compared with SV, MCL leads to a general decrease in VA and CS, while DIMS did not differ from SV at straight gaze (0° gaze). With DIMS, VA and CS are decreased to a similar level as with the MCL, but only at nasal and temporal gaze.
BTS clinical statement for the diagnosis and management of ocular tuberculosis
Authors: Kon Onn Min , Beare Nicholas , Connell David , Damato Erika , Gorsuch Thomas , Hagan Guy , Perrin Felicity , Petrushkin Harry , Potter Jessica , Sethi Charanjit , Stanford Miles
Published: April 2022

The BTS clinical statement for the diagnosis and management of ocular tuberculosis (TB) draws on the expertise of both TB and and ophthalmic specialists to outline the current understanding of disease pathogenesis, diagnosis and management in adults. Published literature lacks high-quality evidence to inform clinical practice and there is also a paucity of data from animal models to elucidate mechanisms of disease. However, in order to improve and standardise patient care, this statement provides consensus points with the currently available data and agreed best practice.
Selective estrogen receptor modulators contribute to prostate cancer treatment by regulating the tumor immune microenvironment
Authors: Tong Dali
Published: April 2022

Prostate cancer (PC) has previously been established as a cold tumor and develops in an inert immunosuppressive environment. Current research focuses on altering the immune microenvironment of PC from cold to hot; thus, in the present review, the diverse roles of estrogen and estrogen receptor (ER) signaling was examined in the tumor cell and tumor immune microenvironment (TIM). We hypothesized that ERα promotes PC progression and ERβ impedes epithelial-mesenchymal transition in PC cells, while in the TIM, ERβ mediates the immunosuppressive environment, and low levels of ERα is associated with disease development. Selective estrogen receptor modulators (SERMs) or selective ER degraders play diverse roles in the regulation of ER isoforms. Patients with PC may benefit from the use of SERMs, including raloxifene, in combination with anti-PD1/PD-L1 checkpoint immunotherapy, or TGF-β or Wnt antagonists. The present review demonstrated that immunotherapy-based strategies combined with SERMs may be an option for the future of PC-targeting therapy.
Reversal of immune-checkpoint inhibitor fulminant myocarditis using personalized-dose-adjusted abatacept and ruxolitinib: proof of concept
Authors: Nguyen Lee S , Bretagne Marie , Arrondeau Jennifer , Zahr Noel , Ederhy Stephane , Abbar Baptiste , Pinna Bruno , Allenbach Yves , Mira Jean-Paul , Moslehi Javid , Rosenzwajg Michelle , Salem Joe-Elie
Published: April 2022

Immune-checkpoint inhibitors (ICI) have revolutionized cancer therapy but are associated with infrequent but lethal myocarditis, for which management remains uncertain. Abatacept, a CTLA-4 fusion protein targeting CD86 on antigen presenting cells and leading to global T-cell anergy, has been described as a potential treatment in individual reports. Yet, abatacept treatment dosage, schedule and optimal combination with other immunosuppressive therapies are unclear. We describe a 25-year-old man who developed pembrolizumab (anti-PD1)-induced myocarditis 14 days after first injection for thymoma treatment, which deteriorated into cardiogenic shock, with sustained ventricular arrhythmia, requiring urgent extracorporeal life support implantation, despite prompt initiation of corticosteroids and mycophenolate-mofetil. Using a strategy of serial measurement ensuring with a target of >80% CD86 receptor occupancy on circulating monocytes, abatacept dose was adjusted and combined with ruxolitinib and methylprednisolone. This strategy resulted in high-dose of abatacept: 60 mg/kg in three doses (20 mg/kg each) within the first 10 days, followed by two doses. Clinical improvement occurred within 7 days, with resolution of systolic cardiac dysfunction, and ventricular arrhythmias resulting in successful discharge from hospital. We reversed a case of nearly lethal ICI-myocarditis, using specific patient-dose adjusted abatacept, which may serve as basis for personalized treatment of patients with severe ICI-adverse events. Trial registration number:NCT04294771.
Volume-based tomography for the diagnosis of incipient silicosis in former gold miners
Authors: Carneiro Ana Paula Scalia , da Silva Leandro Liberino , Silva Francisco das Chagas Lima , Hering Kurt Georg , Algranti Eduardo
Published: April 2022

Objective

To evaluate silicosis diagnosed through CT, with integration of clinical-occupational data, in silica-exposed workers presenting chest X-rays within International Labor Organization (ILO) category 0.

Methods

Cross-sectional study with 339 former gold miners, with comparable exposures and X-rays classified as ILO subcategory 0/0 (n=285) and 0/1 (n=54) were submitted to volume-based CT. The findings were classified according to the International Classification of HRCT CT for Occupational and Environmental Respiratory Diseases.

Results

A profusion degree of round opacities (RO)>1 was found in 22.4% (76/339) of the CT exams. After integrating the CT findings with clinical and occupational data, silicosis was diagnosed as follows: 43/285 (15.1%) and 14/54 (25.9%) in workers whose X-rays had been classified as 0/0 and 0/1, respectively. There was an upward trend towards longer exposures, reaching 38.9% when working more than 10 years underground and classified as 0/1 (p=0019). Those with presence of RO whose final diagnosis was not silicosis were mainly cases of tuberculosis or ‘indeterminate nodules’. Emphysema was found in 65/339 (19.1%), only 5 being detected in the X-ray.

Conclusion

Volume-based CT proved to be useful in the investigation of silicosis among individuals with a relevant exposure to silica, capturing diagnoses that had not been identified on X-rays. A response gradient of silicosis was showed by CT even in this population with ILO category 0 radiographs. It can be indicated based on quantitative and/or qualitative criteria of occupational exposure, especially considering the possibilities of low CT dosage.
Clinical, functional and prognostic implications of severe atrial dilation in secondary mitral regurgitation
Authors: Layoun Habib , Mentias Amgad , Akintoye Emmanuel , Matta Milad , Kanaan Chris , Daou Remy , Ramchand Jay , Burns Daniel , Gillinov A Marc , Bhattacharya Sanjeeb , Puri Rishi , Collier Patrick , Griffin Brian , Kapadia Samir , Harb Serge C
Published: April 2022

Objective

Atrial dilation is known to be a poor prognostic indicator. However, its clinical, functional and prognostic implications have not been thoroughly explored in secondary mitral regurgitation (SMR). We sought to describe the implications of severe atrial dilation (SAD) in SMR.

Methods

We included all adult patients with severe SMR due to left ventricle dysfunction (with no organic mitral valve disease) who underwent transthoracic echocardiography between January 2012 and March 2021 at our institution. The concomitant presence of severe left atrial (LA) dilation (>48 mL/m2) defined SADMR (SAD in SMR), and these patients were compared with those without SAD.

Results

A total of 2011 patients were included (mean age 70% and 41% females), with 71% having SADMR. MR severity and ejection fraction were similar between both groups. Patients with SADMR were older, less females and had more diabetes, but similar rates of atrial fibrillation. Mechanistically, they had lower A wave velocity (0.61 vs 0.72 cm/sec, p<0.001) and more impaired LA reservoir strain (9.7% vs 15.5%, p<0.001). Geometrically, SADMR had shallower leaflets’ angulations, lower tenting height, larger annuli and smaller leaflet length/annular diameter ratios (all p<0.001). They underwent fewer MV interventions, although these were associated with better outcomes (log-rank p<0.001). Over the study period, SAD was an independent predictor of mortality (HR 1.26, p=0.04).

Conclusion

SADMR is associated with specific mechanistic and functional alterations and confers a worse prognosis.
Antibody development and disease severity of COVID-19 in non-immunised patients with rheumatic immune-mediated inflammatory diseases: data from a prospective cohort study
Authors: Boekel Laura , Hooijberg Femke , Vogelzang Erik H , Besten Yaëlle R , Leeuw Maureen , Atiqi Sadaf , van Vollenhoven Ronald F , Wijbrandts Carla A , Gerritsen Martijn , Krieckaert C , Dijkshoorn Bas , Bakhlakh Siham , Crooijmans Juliette J , Voskuyl Alexandre , van der Horst-Bruinsma Irene E , Lems Willem , Kuijpers Taco W , van Ham S Marieke , Wieske Luuk , Eftimov Filip , Kummer Laura Y , van Dam PJ Koos , Stalman Eileen W , Steenhuis Maurice , Keijzer Sofie , Cristianawati Olvi , Keijser Jim , Loeff Floris C , Tas Sander W , Nurmohamed Michael T , Boers Maarten , Rispens Theo , Wolbink Gertjan
Published: April 2022

Background

Research on the disease severity of COVID-19 in patients with rheumatic immune-mediated inflammatory diseases (IMIDs) has been inconclusive, and long-term prospective data on the development of SARS-CoV-2 antibodies in these patients are lacking.

Methods

Adult patients with rheumatic IMIDs from the Amsterdam Rheumatology and Immunology Center, Amsterdam were invited to participate. All patients were asked to recruit their own sex-matched and age-matched control subject. Clinical data were collected via online questionnaires (at baseline, and after 1–4 and 5–9 months of follow-up). Serum samples were collected twice and analysed for the presence of SARS-CoV-2-specific antibodies. Subsequently, IgG titres were quantified in samples with a positive test result.

Findings

In total, 3080 consecutive patients and 1102 controls with comparable age and sex distribution were included for analyses. Patients were more frequently hospitalised compared with controls when infected with SARS-CoV-2; 7% vs 0.7% (adjusted OR: 7.33, 95% CI: 0.96 to 55.77). Only treatment with B-cell targeting therapy was independently associated with an increased risk of COVID-19-related hospitalisation (adjusted OR: 14.62, 95% CI: 2.31 to 92.39). IgG antibody titres were higher in hospitalised compared with non-hospitalised patients, and slowly declined with time in similar patterns for patients in all treatment subgroups and controls.

Interpretation

We observed that patients with rheumatic IMIDs, especially those treated with B-cell targeting therapy, were more likely to be hospitalised when infected with SARS-CoV-2. Treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) and biological DMARDs other than B-cell targeting agents is unlikely to have negative effects on the development of long-lasting humoral immunity against SARS-CoV-2.
First report of Heterodera glycines infecting commercial dry beans (Phaseolus vulgaris) in Canada
Authors: Trueman Cheryl , Blauel Tyler , Abaya Abdurraouf , Zhang Kaiqi , Gillard Chris
Published: April 2022

Edible bean is an important human protein source, and Canada is the fifth largest exporter worldwide. Soybean cyst nematode (SCN; Heterodera glycines Ichinohe) is a key soybean ( Glycine max L.) pest, though it also infects dry beans ( Phaseolus spp.). Cysts were observed on black bean roots in a commercial field in Bruce County, Ontario, in August 2018. Based on morphological characteristics, molecular evidence and pathogenicity experiments, SCN was confirmed. This is the first report of naturally occurring SCN infection associated with visible plant damage in a commercial dry bean field in Canada, which is a potential threat to this important niche industry.
A Clinical Study on the Relationship Among Insomnia, Tongue Diagnosis, and Oral Microbiome
Authors: Park Seo-Hyun , Shin Na Rae , Yang Meng , Bose Shambhunath , Kwon Ojin , Nam Dong-Hyun , Lee Jun-Hwan , Song Eun-Ji , Nam Young-Do , Kim Hojun
Published: April 2022

Currently, there is a lack of adequate methods to assess insomnia objectively. This study addresses the usefulness of tongue features and oral microbial profile as a potential diagnostic biomarker of insomnia. One hundred insomniac patients and 20 healthy control subjects were selected. Their demographic and clinical characteristics, as well as the tongue diagnostic indices and oral microbial profile, were examined. Compared to the control group, insomniac patients showed a higher abnormal low-frequency/high-frequency (LF/HF) ratio. In tongue diagnosis, the indices related to lightness of tongue body and tongue coating were higher in the insomniac group vs. the control group. Furthermore, linear discriminant analysis (LDA) of oral microbial population revealed that the relative abundances of Clostridia, Veillonella, Bacillus and Lachnospiraceae were significantly higher in the insomniac patients than the control group. Additionally, the tongue features of the insomniac group exhibited that the non-coating group had a poor sleep condition compared to the thick-coating group, although the difference was insignificant. On the other hand, the oral microbial communities of the insomniac patients revealed greater alpha and beta diversities in the non-coating group vs. the thick-coating group. The alpha and beta diversities were higher in orotype1 than orotype2. Collectively, this study highlighted that the lightness of tongue body and tongue coating as well as oral microbial profiles of SR1, Actinobacteria, Clostridia and Lachnospiraceae_unclassified could be considered potential biomarkers of insomnia.
VIDEO-BASED TABLE TENNIS TRACKING AND TRAJECTORY PREDICTION USING CONVOLUTIONAL NEURAL NETWORKS
Authors: LI HAOXUAN , ALI SABA GHAZANFAR , ZHANG JUNHAO , SHENG BIN , LI PING , JUNG YOUNHYUN , WANG JIHONG , YANG PO , LU PING , MUHAMMAD KHAN , MAO LIJIUAN
Published: April 2022

One of the fascinating aspects of sports rivalry is that anything can happen. The significant difficulty is that computer-aided systems must address how to record and analyze many game events, and fractal AI plays an essential role in dealing with complex structures, allowing effective solutions. In table tennis, we primarily concentrate on two issues: ball tracking and trajectory prediction. Based on these two components, we can get ball parameters such as velocity and spin, perform data analysis, and even create a ping-pong robot application based on fractals. However, most existing systems rely on a traditional method based on physical analysis and a non-machine learning tracking algorithm, which can be complex and inflexible. As mentioned earlier, to overcome the problem, we proposed an automatic table tennis-aided system based on fractal AI that allows solving complex issues and high structural complexity of object tracking and trajectory prediction. For object tracking, our proposed algorithm is based on structured output Convolutional Neural Network (CNN) based on deep learning approaches and a trajectory prediction model based on Long Short-Term Memory (LSTM) and Mixture Density Networks (MDN). These models are intuitive and straightforward and can be optimized by training iteratively on a large amount of data. Moreover, we construct a table tennis auxiliary system based on these models currently in practice.