bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations of steps per day and step intensity with the risk of diabetes: the Hispanic Community Health Study / Study of Latinos (HCHS/SOL)
Authors: Cuthbertson Carmen C. , Moore Christopher C. , Sotres-Alvarez Daniela , Heiss Gerardo , Isasi Carmen R. , Mossavar-Rahmani Yasmin , Carlson Jordan A. , Gallo Linda C. , Llabre Maria M. , Garcia-Bedoya Olga L. , Farelo David Goldsztajn , Evenson Kelly R.
Published: April 2022

Background

Higher levels of moderate-to-vigorous physical activity have been associated with a lower risk of diabetes, but less is known about how daily step counts (steps/day) are associated with diabetes risk. Therefore, we examined the association of steps/day and step intensity with incident diabetes.

Methods

We included 6634 adults from the population-based prospective cohort Hispanic Community Health Study/Study of Latinos (HCHS/SOL) (2008–2017). Cox proportional hazard models that accounted for complex survey design and sampling weights were used to estimate the association of baseline accelerometer-assessed steps/day and step intensity with 6-year risk of incident diabetes as hazard ratios (HR) and 95% confidence intervals (CI). We further examined whether the percent of intense steps at a given accumulation of steps/day was associated with diabetes risk, and if associations were modified by specific cohort characteristics.

Results

The average age of cohort members was 39 years and 52% were female. Adults had an average of 8164 steps/day and spent 12 min/day in brisk ambulation (>100 steps/min). Over 6 years of follow-up, there were 1115 cases of diabetes. There was a suggestive lower risk of diabetes with more steps/day– adults had a 2% lower risk per 1000 steps/day (HR = 0.98 (95% CI 0.95, 1.00)). Inverse associations between average steps/day and diabetes incidence were observed across many cohort characteristics, but most importantly among adults at high risk for diabetes – those who were older, or had obesity or prediabetes. Adults who accumulated 17 min/day in brisk ambulation compared to < 2 min/day had a 31% lower risk of diabetes (HR = 0.69 (95% CI 0.53, 0.89)). A greater percent of intense steps for a given accumulation of steps/day was associated with further risk reduction.

Conclusion

Adults who accumulate more daily steps may have a lower risk of diabetes. Accumulating more steps/day and greater step intensity appear to be important targets for preventing diabetes.
MAVE-NN: learning genotype-phenotype maps from multiplex assays of variant effect
Authors: Tareen Ammar , Kooshkbaghi Mahdi , Posfai Anna , Ireland William T. , McCandlish David M. , Kinney Justin B.
Published: April 2022

Multiplex assays of variant effect (MAVEs) are a family of methods that includes deep mutational scanning experiments on proteins and massively parallel reporter assays on gene regulatory sequences. Despite their increasing popularity, a general strategy for inferring quantitative models of genotype-phenotype maps from MAVE data is lacking. Here we introduce MAVE-NN, a neural-network-based Python package that implements a broadly applicable information-theoretic framework for learning genotype-phenotype maps—including biophysically interpretable models—from MAVE datasets. We demonstrate MAVE-NN in multiple biological contexts, and highlight the ability of our approach to deconvolve mutational effects from otherwise confounding experimental nonlinearities and noise.
Comparison of the open kinetic chain and closed kinetic chain strengthening exercises on pain perception and lower limb biomechanics of patients with mild knee osteoarthritis: a randomized controlled trial protocol
Authors: Ng Wei Hui , Jamaludin Nazatul Izzati , Sahabuddin Farhah Nadhirah Aiman , Ab Rahman Shaifuzain , Ahmed Shokri Amran , Shaharudin Shazlin
Published: April 2022

Background

Clinical recommendations suggest exercises as the main treatment modality for patients with knee osteoarthritis (OA). This study aimed to compare the effects of two different exercise interventions, i.e., open kinetic chain (OKC) and closed kinetic chain (CKC) exercises, on the pain and lower limb biomechanics of patients with mild knee OA.

Method

A total of 66 individuals with painful early knee OA, aged 50 years and above, with body mass index (BMI) between 18.9kg/m2 and 29.9 kg/m2 in Kelantan, Malaysia, will be recruited in this study. Participants will be randomly allocated into three different groups, either the OKC, CKC, or control groups. All three groups will attend an individual session with a physiotherapist. The participants in the OKC and CKC groups will perform the exercises three times weekly for 8 weeks at their home. The control group will receive education about clinical manifestations, risk factors, diagnosis, treatment, and nursing care for knee via printed materials. The primary outcomes include self-reported pain scores (visual analog scale), disability scores (Western Ontario and McMaster Universities Arthritis Index), and quality of life scores (Osteoarthritis Knee and Hip Quality of Life). Secondary outcomes include lower limb biomechanics during gait and sit-to-stand as well as isokinetic knee strength. The outcomes will be measured before and after the intervention.

Discussion

The present study will compare the effects of two different home-based exercise intervention programs among patients with mild knee OA. The study findings will provide vital information that can be used to design an effective exercise program that aims at delaying the OA progression.

Trial registration

The protocol was registered on 22 December 2020 at ClinicalTrials.gov (registration number: NCT04678609).
Sex difference in frontal plane hip moment in response to lateral trunk obliquity during single-leg landing
Authors: Taniguchi Shohei , Ishida Tomoya , Yamanaka Masanori , Ueno Ryo , Ikuta Ryohei , Chijimatsu Masato , Samukawa Mina , Koshino Yuta , Kasahara Satoshi , Tohyama Harukazu
Published: April 2022

Background

Lateral trunk obliquity during landing is a characteristic of anterior cruciate ligament (ACL) injuries in female athletes and affects their knee and hip kinetics and kinematics. However, it is unclear whether these effects differ between females and males. The purpose of this study was to compare the effects of lateral trunk obliquity on knee and hip kinetics and kinematics in females and males during single-leg landing.

Methods

Eighteen female (aged 22.1 ± 1.5 years) and 18 male participants (aged 21.8 ± 1.1 years) performed single-leg landings under two conditions: (1) without any instructions about trunk position (natural) and (2) with leaning their trunks laterally 15° from the vertical line (trunk obliquity). The kinetics and kinematics of their hip and knee were analyzed using a three-dimensional motion analysis with a force plate. Two-way repeated-measures ANOVA (sex × trunk obliquity) and Bonferroni pairwise comparisons were conducted.

Results

The trunk obliquity angle at initial contact was significantly greater in the trunk-obliquity landing condition than in the natural landing condition (natural 4.0 ± 2.2°, trunk-obliquity 15.1 ± 3.6°, P < 0.001) with no sex difference (95% CI − 1.2 to 2.2°, P = 0.555). The peak knee abduction moment was significantly larger in the trunk-obliquity landing condition than in the natural landing condition (trunk-obliquity, 0.09 ± 0.07 Nm/kg/m; natural, 0.04 ± 0.06 Nm/kg/m; P < 0.001), though there was no sex or interaction effect. A significant interaction between sex and landing condition was found for the peak hip abduction moment (P = 0.021). Males showed a significantly larger peak hip abduction moment in the trunk-obliquity landing condition than in the natural landing condition (95% CI 0.05 to 0.13 Nm/kg/m, P < 0.001), while females showed no difference in the peak hip abduction moment between the two landing conditions (95% CI − 0.02 to 0.06 Nm/kg/m, P = 0.355).

Conclusions

The knee abduction moment increased with a laterally inclined trunk for both female and male participants, while the hip abduction moment increased in males but not in females. It may be beneficial for females to focus on frontal plane hip joint control under lateral trunk-obliquity conditions during single-leg landing.
Quantitative imaging parameters to predict the local staging of prostate cancer in intermediate- to high-risk patients
Authors: Laudicella Riccardo , Skawran Stephan , Ferraro Daniela A. , Mühlematter Urs J. , Maurer Alexander , Grünig Hannes , Rüschoff Hendrik J. , Rupp Niels , Donati Olivio , Eberli Daniel , Burger Irene A.
Published: April 2022

Objectives

PSMA PET/MRI showed the potential to increase the sensitivity for extraprostatic disease (EPD) assessment over mpMRI; however, the interreader variability for EPD is still high. Therefore, we aimed to assess whether quantitative PSMA and mpMRI imaging parameters could yield a more robust EPD prediction.

Methods

We retrospectively evaluated PCa patients who underwent staging mpMRI and [68Ga]PSMA-PET, followed by radical prostatectomy at our institution between 01.02.2016 and 31.07.2019. Fifty-eight cases with PET/MRI and 15 cases with PET/CT were identified. EPD was determined on histopathology and correlated with quantitative PSMA and mpMRI parameters assessed by two readers: ADC (mm2/1000 s), longest capsular contact (LCC, mm), tumor volume (cm3), PSMA-SUVmax and volume-based parameters using a fixed threshold at SUV > 4 to delineate PSMAtotal (g/ml) and PSMAvol (cm3). The t test was used to compare means, Pearson’s test for categorical correlation, and ROC curve to determine the best cutoff. Interclass correlation (ICC) was performed for interreader agreement (95% CI).

Results

Seventy-three patients were included (64.5 ± 6.0 years; PSA 14.4 ± 17.1 ng/ml), and 31 had EPD (42.5%). From mpMRI, only LCC reached significance (p = 0.005), while both volume-based PET parameters PSMAtotal and PSMAvol were significantly associated with EPD (p = 0.008 and p = 0.004, respectively). On ROC analysis, LCC, PSMAtotal, and PSMAvol reached an AUC of 0.712 (p = 0.002), 0.709 (p = 0.002), and 0.718 (p = 0.002), respectively. ICC was moderate–good for LCC 0.727 (0.565–0.828) and excellent for PSMAtotal and PSMAvol with 0.944 (0.990–0.996) and 0.985 (0.976–0.991), respectively.

Conclusions

Quantitative PSMA parameters have a similar potential as mpMRI LCC to predict EPD of PCa, with a significantly higher interreader agreement.
LEO laser microwave hybrid inter-satellite routing strategy based on modified Q-routing algorithm
Authors: Zheng Fei , Wang Chao , Zhou Zou , Pi Zhao , Huang Dongyan
Published: April 2022

Low earth orbit (LEO) satellite communication networks require huge load capacity and information processing speed to carry global communication traffic. Inter-satellite links and the on-board processing are the key technologies to achieve this goal, but the new network architecture leads to great challenges on satellite routing. This paper designs a hybrid inter-satellite link with the same-orbit laser and the different-orbit microwave to increase the link capacity and adopts a CPU centralized scheduling to improve the utilization of computing resources. Then, this paper establishes minimum delay function by considering the inter-satellite transmission delay and the on-board processing delay. The transmission delay model bases on the orbital period, and the processing delay adopts the multi-services model, the limited-capacity single-service model, and the unlimited-capacity single-service model in the queuing theory to model the on-board CPU centralized scheduling, photoelectric converters, and electro-optical converters, respectively. Based on this model, this paper proposes an inter-satellite routing strategy with modified Q-routing algorithm. The modified algorithm uses Dijkstra algorithm to accelerate the convergence of Q-routing algorithm and retains the strong real-time performance of Q-routing algorithm. Simulations show that the delay of the modified algorithm is 83.3$$\%$$
%
lower than that of the Dijkstra algorithm, and the larger the network and the traffic, the more obvious the advantage.
Effectiveness of multicomponent treatment in patients with fibromyalgia: protocol for a systematic review and meta-analysis
Authors: Araya-Quintanilla Felipe , Gutiérrez-Espinoza Héctor , Fuentes Jorge , Prieto-Lafrentz Fernanda , Pavez Leonardo , Cristi-Montero Carlos , Cavero-Redondo Iván , Álvarez-Bueno Celia
Published: April 2022

Background

The purpose of this protocol is to provide a new systematic review with meta-analysis using the current methodology to compare the effectiveness of multicomponent treatment versus other interventions for patients with fibromyalgia.

Methods

This protocol conforms to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and the recommendations of the Cochrane Collaboration Handbook. An electronic search will be conducted in MEDLINE, EMBASE, Web of Science, Cochrane CENTRAL, LILACS, CINAHL, and PEDro, from inception until April 2022. There will be no language restrictions. The Cochrane Collaboration tool for assessing the risk of bias (RoB2) will be used. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) scale will be used to evaluate the strength of the evidence. The Hartung-Knapp-Sidik-Jonkman random effects or Mantel-Haenszel fixed effects methods will be used, depending on the heterogeneity, to compute a pooled estimate of the mean difference (MD) or standardized mean difference (SMD) and respective 95% confidence intervals for clinical outcomes.

Discussion

This systematic review will synthesize evidence on the effectiveness of multicomponent treatment in patients with fibromyalgia and could add important evidence in the treatment of FM to improve clinical practice and decision-making/actions in this field. This new systematic review will try to show the effects of multicomponent treatment by type (endurance, resistance, stretching, or mind-body exercises [pilates or taichi]) and intensity (light, moderate, moderate-to-vigorous, vigorous) of exercise in patients with FM. The results will be disseminated by publication in a peer-reviewed journal. Ethics approval will not be needed because the data used for this systematic review will be obtained from individual trials and there will be no concerns about privacy. However, if we identify ethical issues during the development of the systematic review, these findings will be reported in the discussion of the study.

Systematic review registration

PROSPERO CRD42020142082.
Family history of psychiatric disorders as a risk factor for maternal postpartum depression: a systematic review protocol
Authors: Kjeldsen Mette-Marie Zacher , Bricca Alessio , Liu Xiaoqin , Frokjaer Vibe G. , Madsen Kathrine Bang , Munk-Olsen Trine
Published: April 2022

Background

Postpartum depression (PPD) is the most common postpartum psychiatric disorder, affecting 11–15% of new mothers, and initiatives towards early identification and treatment are essential due to detrimental consequences. Family history of psychiatric disorders is a risk factor for developing psychiatric episodes outside the postpartum period, but evidence of the association between familial risk and PPD is not clear. Hence, the objective of this systematic review is to summarize the current literature on the association between family history of psychiatric disorders and PPD.

Methods

This protocol has been developed and reported according to the PRISMA-P guidelines for systematic reviews. A comprehensive literature search will be conducted in PubMed, Embase, and PsycINFO from inception of the databases, supplemented with citation tracking and reference screening of the included studies. Two independent authors will examine all retrieved articles for inclusion in two steps: title/abstract screening and full-text screening. Eligible studies are case-control and cohort studies reporting a risk estimate for the association between family history of psychiatric disorders and PPD. Studies will be assessed for risk of bias using the Newcastle-Ottawa Scale. The association between family psychiatry and PPD will be combined in a meta-analysis using a restricted maximum likelihood method (REML). Heterogeneity will be quantified using I2 and investigated through meta-regression, subgroup and sensitivity analyses, and publication bias will be evaluated via visual inspection of a funnel plot. The overall strength and quality of the findings will be evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. If meta-analysis is not possible, data will be synthesized narratively in text and tables.

Discussion

This systematic review will be the first to summarize current knowledge and present an overall estimate for the association between family history of psychiatric disorders and PPD. Evaluation of psychiatric family history as a PPD risk factor is essential to assist early identification of women at high risk of PPD in routine perinatal care.

Systematic review registration

PROSPERO ID: 277998 (registered 10th of September 2021).
Medical students’ knowledge about COVID-19 and evaluation of the effectiveness of the applied preventive strategies
Authors: Sarzyńska Kathie , Czwojdziński Eddie , Kuźniarski Amadeusz , Rayad Sadri , Piwowar Agnieszka , Jankowska-Polańska Beata
Published: April 2022

Background

SARS-CoV-2 is a novel coronavirus which has caused a global pandemic. Due to the lack of available treatment for COVID-19 infections, prevention plays the most important role in combating the virus. Educational programs among students of medical faculties is necessary, because in the future they will act as health educators in the healthcare system. The aim of the study is to assess the students’ knowledge as an initial stage to the implementation of further preventive strategies against the spread of SARS-CoV-2 virus infections and to the evaluation of the effectiveness of the implemented preventive measures by continuous monitoring of the number of implemented administrative procedures.

Methods

The study involved 482 students of medical faculties. Participants completed a questionnaire based on knowledge about the SARS-CoV-2 virus. Additionally, a number of preventive measures were introduced, including vaccination against COVID-19. During the entire period of the study, the number of administrative procedures (isolation and quarantine) were monitored.

Results

The results of the knowledge test about COVID-19 were generally low and amounted to 11.0 (SD = 2.2). Significant differences in knowledge about COVID-19 between students of particular medical faculties were found. The most appropriate answers to questions about the incubation time of the SARS-CoV-2 virus were given by students of medicine (55%), followed by nursing (42.14%) and pharmacy (26%) students. Nursing students were the most correct in identifying the 3 main symptoms of COVID-19 (91.07%), followed by students of medicine (85.83%), and finally dentistry (77.27%) and pharmacy (76.67%) students. The Median (IQR) of students quarantined or isolating during steps 1, 2, 3, and 4 was 117,5 (142); 40 (43); 38, (20); and 9,5 (15), respectively.

Conclusion

Students of certain faculties showed a low level of knowledge about transmission routes and procedures for dealing with a person suspected of being infected with SARS-CoV-2 or who has tested positive for COVID-19. Additional educational programs were conducted among medical students, along with other prevention strategies, which contributed to a decrease in the number of applied administrative procedures (isolation or quarantine).
Feasibility and acceptability of Narrative Exposure Therapy to treat individuals with PTSD who are homeless or vulnerably housed: a pilot randomized controlled trial
Authors: Edgar Nicole E. , Bennett Alexandria , Dunn Nicole Santos , MacLean Sarah E. , Hatcher Simon
Published: April 2022

Background

Diagnosed PTSD rates in people who are homeless are more than double that of the general population, ranging between 21 and 53%. Complex PTSD (cPTSD) also appears to be more common than PTSD. One treatment option is Narrative Exposure Therapy (NET), a brief trauma-focused psychotherapy which attempts to place trauma within a narrative of the person’s life. Our primary aim was to assess the feasibility and acceptability of recruiting people to a randomized controlled trial (RCT) of NET alone compared to NET augmented by a genealogical assessment. We hypothesized that incorporating a genealogical assessment may be more effective than NET alone in a population with predominately complex PTSD.

Methods

This pilot RCT enrolled participants who were 18 years of age or older, currently homeless or vulnerably housed, and with active symptoms of PTSD. Participants were randomized to NET alone or NET plus a genealogical assessment. Rates of referral, consent, and retention were examined as part of feasibility. Demographic and clinical data were collected at baseline. Symptoms of PTSD, drug use, and housing status were re-assessed at follow-up visits. We conducted a thematic analysis of qualitative interviews of service providers involved in the study which explored barriers and facilitators of study participation.

Results

Twenty-two potential participants were referred to the study, with 15 consenting to participate. Of these, one was a screen failure and 14 were randomized equally to the treatment arms. One randomized participant was withdrawn for safety. Attrition occurred primarily prior to starting therapy. Once therapy began, retention was high with 80% of participants completing all six sessions. Seven participants completed all follow-up sessions. Service providers identified a clear need for the treatment and emphasized the importance of trauma-informed care, a desire to know more about NET, and more communication about the process of referral.

Conclusion

Recruiting participants who were vulnerably housed to an RCT of a trauma-based therapy was possible. Once therapy had started, participants were likely to stay engaged. We will incorporate the results of this trial into a conceptual model which we will test in a factorial study as part of the optimization phase of MOST.

Trial registration

ClinicalTrials.govNCT03781297. Registered: December 19, 2018
Association of adherence measured by self-reported pill count with achieved blood pressure level in hypertension patients: a cross-sectional study
Authors: Ernawati Iin , Lubada Eziah Ika , Lusiyani Ria , Prasetya Rahmad Aji
Published: April 2022

Background

Medication adherence plays an essential role in controlling blood pressure to reduce morbidity and mortality of hypertension disease. Thus, this study aimed to determine the association of medication adherence measured by self-reported pill count with blood pressure levels among patients at several community health centers in Surabaya.

Methods

Adherence was assessed using the pill count method by comparing the total number of antihypertension drugs taken with the prescribed drugs. The inclusion criteria involved hypertensive patients who received antihypertension drugs, specifically adults and elderly, except the pregnant woman. The patient blood pressure was measured by healthcare workers in the targeted community health centers. Descriptive and multivariable logistic regression analyses were performed to assess factors associated with medication adherence with blood pressure levels.

Results

A total of 264 hypertensive outpatients participating in this study, 77.65% of participants were adherent to antihypertensive drugs based on the pill count method, and 40.91% of participants had controlled blood pressure. Patients with uncontrolled blood pressure were about six times (adjusted odds ratio [AOR]: 6.15; 95% confidence interval [CI]: 2.694–14.039; P = 0.000) more likely to have non-adherent medication than patients with controlled blood pressure. Reciprocally, non-adherent participants (pill count < 80%) were about six times (AOR: 6.081; 95% CI: 2.672–13.838; P = 0.000) more likely to have uncontrolled blood pressure compared to adherent patients (pill count ≥ 80%). Age less than 40 years old (AOR: 5.814; 95% CI: 1.519–22.252; P = 0.01) and having middle school educational level (AOR: 0.387; 95% CI: 0.153–0.974; P = 0.045) were found to be independent factors associated with uncontrolled blood pressure.

Conclusions

The result showed that non-adherence to antihypertension drugs is associated with uncontrolled blood pressure. Then, age could be associated with uncontrolled blood pressure. Thus, pharmacists and other healthcare providers should pay attention to improving medication adherence and maintaining the controlled blood pressure.
Dilutional acidosis during whole lung lavage under general anesthesia due to excessive absorption of normal saline
Authors: Inada Mikako , Kawagoe Izumi , Kudoh Osamu , Satoh Daizoh , Mitaka Chieko , Hayashida Masakazu
Published: April 2022

Background

Whole lung lavage (WLL) is an effective therapy for pulmonary alveolar proteinosis. We report a rare dilutional acidosis following WLL in a female patient.

Case presentation

Under general anesthesia, a left-sided double-lumen tube was inserted with its bronchial lumen connected to the saline delivery system. Preoperatively, arterial blood gases were within normal limits. During 14 l of fluid was instilled into the lung for 2.5 hours, a decrease in pH, K+, and base excess, alongside an increase in Na+ and Cl−, indicated a strong ion difference; the diagnosis was dilutional hyperchloremic metabolic acidosis. Although she remained hemodynamically stable and had no indicators of massive absorption, she stayed in the ICU for mechanical ventilation for one night out of concern of pulmonary edema.

Conclusions

Inappropriate irrigating fluid pressure might lead to absorption of normal saline. Continuous monitoring and careful observation during WLL can help prevent intraoperative dilutional acidosis.
Ketogenic dietary therapy in adult status epilepticus: current progress and clinical application
Authors: Cai Mengting , Xu Wanyin , Zheng Yang , Ding Meiping
Published: April 2022

Status epilepticus (SE) is a common fatal neurological disease with high morbidity and mortality. Even if a large proportion of patients might be relieved from anti-seizure medications, sedatives and anesthetics, some still remain out of control. The ketogenic dietary (KD) has been proven useful in patients refractory to medications and/or who have failed to respond to surgical intervention. Recently, KD has shown beneficial therapeutic effects in children with SE, but studies in adults have rarely been reported. In this paper, we review the efficacy and utility of KD in adult SE patients and highlight its application for clinical reference and management.
Deep learning approaches in flow visualization
Authors: Liu Can , Jiang Ruike , Wei Datong , Yang Changhe , Li Yanda , Wang Fang , Yuan Xiaoru
Published: April 2022

With the development of deep learning (DL) techniques, many tasks in flow visualization that used to rely on complex analysis algorithms now can be replaced by DL methods. We reviewed the approaches to deep learning technology in flow visualization and discussed the technical benefits of these approaches. We also analyzed the prospects of the development of flow visualization with the help of deep learning.
The role of extracellular matrix on unfavorable maternal–fetal interface: focusing on the function of collagen in human fertility
Authors: Liu Rang , Dai Mengyuan , Gong Guidong , Chen Mei , Cao Canhui , Wang Tianren , Hou Zhenhui , Shi Yu , Guo Junling , Zhang Yaoyao , Xia Xi
Published: April 2022

Extracellular matrix (ECM) is characterized as widespread, abundant, and pluripotent. Among ECM members, collagen is widely accepted as one of the most prominent components for its essential structural property that can provide a scaffold for other components of ECM and the rich biological functions, which has been extensively used in tissue engineering. Emerging evidence has shown that the balance of ECM degradation and remodeling is vital to regulations of maternal–fetal interface including menstrual cycling, decidualization, embryo implantation and pregnancy maintenance. Moreover, disorders in these events may eventually lead to failure of pregnancy. Although the improvement of assisted conception and embryo culture technologies bring hope to many infertile couples, some unfavorable outcomes, such as recurrent implantation failure (RIF), recurrent pregnancy loss (RPL) or recurrent miscarriage (RM), keep troubling the clinicians and patients. Recently, in vitro three-dimensional (3D) model mimicking the microenvironment of the maternal–fetal interface is developed to investigate the physiological and pathological conditions of conception and pregnancy. The progress of this technology is based on clarifying the role of ECM in the endometrium and the interaction between endometrium and conceptus. Focusing on collagen, the present review summarized the degradation and regulation of ECM and its role in normal menstruation, endometrium receptivity and unsatisfying events occurring in infertility treatments, as well as the application in therapeutic approaches to improve pregnancy outcomes. More investigations about ECM focusing on the maternal–fetal interface interaction with mesenchymal stem cells or local immunoregulation may inspire new thoughts and advancements in the clinical application of infertility treatments.

Graphical abstract
Validated establishment of anthropometric measurements of mid-face zone in Egyptian healthy preschool-age children: a cross-sectional study
Authors: El Ella Soheir S. Abou , Tawfik Maha A. , El Shaheed Mona Yakout Abd , Barseem Naglaa Fathy
Published: April 2022

Objectives

To provide normal reference data and identify growth patterns for craniofacial dimensions of a mid-face zone in healthy preschool Egyptian children.

Background

Anthropometry is the biological science that provides objective data to the craniofacial morphology evaluation, through a series of head and face measurements by using simple, noninvasive, low-risk, and inexpensive techniques.

Methods

The study was conducted on 3080 randomly selected healthy preschool boys and girls enrolled with criteria favoring good general health state and absence of any systemic disorders or long-term therapies. All children were subjected to detailed medical history, anthropometric measurements, head measurement (head circumference, head length, and width), and midface zone including eye measurements (inner canthal, outer canthal, inter-pupillary distance, and palpebral fissure length), nasal measurements (length, width, protrusion, columella length, and width), and ear measurements (length, width, projection, ear position, and rotation), with emphasis on the head should be erect (in the resting position) and both eyes facing forward.

Results

Upon plotting general measurements, head measurements, and specific measures of eye, nose, and ear on Z-score charts, it was shown that no significant difference was detected for the studied mid-face dimensions in both sexes with 0.6–1% low set ear setting which may be of a familial pattern. Egyptian facial morphology shows no similarities to Afro-Americans, but resembles those of Iranians with observed disagreeable ear features in comparison to Turkish children.

Conclusion

This study presents first referenced national Z-score curves that were accomplished to describe the growth pattern of mid-face proportions for Egyptian preschool healthy children.
Effect of pressures and type of ventilation on aerosol delivery to chronic obstructive pulmonary disease patients
Authors: Boules Marina E. , Laz Nabila Ibrahim , Elberry Ahmed A. , Hussein Raghda R. S. , Abdelrahim Mohamed E. A.
Published: April 2022

Background

Continuous Positive Airway Pressure (CPAP), BiPhasic Positive Airway Pressure (BiPAP), and high flow nasal cannula (HFNC) show some evidence to have efficacy in COVID-19 patients. Delivery during noninvasive mechanical ventilation (NIV) or HFNC gives faster and more enhanced clinical effects than when aerosols are given without assisted breath. The present work aimed to compare the effect of BiPhasic Positive Airway Pressure (BiPAP) mode at two different pressures; low BiPAP (Inspiratory Positive Airway Pressure (IPAP)/Expiratory Positive Airway Pressure (EPAP) of 10/5 cm water) and high BiPAP (IPAP/EPAP of 20/5 cm water), with HFNC system on pulmonary and systemic drug delivery of salbutamol. On the first day of the experiment, all patients received 2500 μg salbutamol using Aerogen Solo vibrating mesh nebulizer. Urine samples 30 min post-dose and cumulative urinary salbutamol during the next 24 h were collected on the next day. On the third day, the ex-vivo filter was inserted before the patient to collect the delivered dose to the patient of the 2500 μg salbutamol. Salbutamol was quantified using high-performance liquid chromatography (HPLC).

Results

Low-pressure BiPAP showed the highest amount delivered to the lung after 30 min followed by HFNC then high-pressure BiPAP. But the significant difference was only observed between low and high-pressure BiPAP modes (p = 0.012). Low-pressure BiPAP showed the highest delivered systemic delivery amount followed by HFNC then high-pressure BiPAP. Low-pressure BiPAP was significantly higher than HFNC (p = 0.017) and high-pressure BiPAP (p = 0.008). No significant difference was reported between HFNC and high-pressure BiPAP. The ex-vivo filter was the greatest in the case of low-pressure BiPAP followed by HFNC then high-pressure BiPAP. Low-pressure BiPAP was significantly higher than HFNC (p = 0.033) and high-pressure BiPAP (p = 0.008). Also, no significant difference was found between HFNC and high-pressure BiPAP.

Conclusions

Our results of pulmonary, systemic, and ex-vivo drug delivery were found to be consistent. The low BiPAP delivered the highest amount followed by the HFNC then the high BiPAP with the least amount. However, no significant difference was found between HFNC and high BiPAP.
Cytotoxic effects of chitosan nanoparticles containing Zataria multiflora essential oil against human breast and melanoma cells
Authors: Alipanah Hiva , Yarian Fatemeh , Rasti Fatemeh , Safari Mojdeh , Hatami Shekoufeh , Osanloo Mahmoud
Published: April 2022

Background

Breast cancer is the most common cancer among women, and melanoma incidence increases worldwide. The emergence of drug resistance and side effects of chemotherapy drugs has led to a great deal of attention being paid to the development of natural medicines, especially using essential oil. The preparation of essential oil-based nanoformulation has thus recently received more attention.

Results

In this study, chitosan nanoparticles (ChiNPs) containing Zataria multiflora essential oil with a particle size of 177 ± 10 nm, a narrow particle size distribution (SPAN 0.96), and a cubic-like shape were first prepared. IC50 values of the prepared nanoformulation against human melanoma (A-375) and breast cancer cell lines (MCF-7 and MDA-MB-468) were obtained as 32 (12–84), 46 (32–67), and 105 (85–131) µg/mL. Besides, an electrospun polycaprolactone–polyethylene oxide scaffold was prepared as a dressing after treatment with the nanoformulation. Fourier transform infrared analysis confirmed the scaffold's preparation as well as successful loading of the essential oil in chitosan nanoparticles. Furthermore, the scaffold did not show a cytotoxic effect on A-375, MCF-7, and MDA-MB-468, and its surface was hydrophobic as the water contact angle with the surface was 136.5°.

Conclusions

The prepared prototype with natural ingredients and high efficacy could be considered for further consideration in vivo study or complementary medicine.

Graphical abstract
Epidemiological, clinical and aetiological aspects of otalgia at the Renaissance University Hospital
Authors: Taoussi Aboubakar Assidick , Houzibé Thierry , Assi Constant
Published: April 2022

Background

Otalgia is a frequent reason for medical consultation. In Africa, few studies have been devoted to the epidemiology and aetiology of otalgia. To our knowledge, no study has been carried out in Chad.

Aims

The objective of this study is to describe the epidemiological, clinical and aetiological aspects of otalgia in Chadian hospitals.

Methods

This was a prospective, descriptive and analytical study conducted at the Renaissance University Hospital from January to August 2020. All the patients that were consulting in the ENT department for otalgia were included. Data was analysed using SPSS version 26. The chi-square test was used to compare the results.

Results

88 (22.3%) of the 395 patients suffered from otalgia. Their sex ratio was 1:1 (M:F). Their average age was 30.4 ± 19.5 years. The median age was 31.5 years with extremes from 1 to 70 years. Children (1–18 years) represented 30.7% of the cases. The average time of consultation was 27.8 ± 35.0 days. Otalgia was associated with deafness in 33% of the cases and 29.5% of the patients have used cotton swabs. Otogenic otalgia in 73.9% of the cases was significantly more frequent in children (92.6% versus 65.6%, P =0.008). Otogenic otalgia was related to otitis externa, chronic otitis media and Eustachian tube dysfunction in 44.6%, 21.5%, and 13.9% of cases respectively. The aetiologies of the referred otalgias were angina and rhinopharyngitis (30.4%), trigeminal neuralgia (21.7%) and oral cavity, pharyngeal and laryngeal cancer (21.7%).

Conclusion

Otalgia is a frequent reason for medical consultation at any age regardless of sex. However, ear infections are more frequent in children. Referred otalgias predominate in adults, dominated by pharyngeal infections, trigeminal neuralgia and oral cavity, pharyngeal and laryngeal cancers.
Exploration of cooperative management system of transregional cultural landscape heritage: a case study of Loire Valley between Sully-sur-Loire and Chalonnes
Authors: Peng Liang , Marinos Alain
Published: April 2022

There seems to be a general consensus that management and policy play a very significant role in landscape evolution, and the protection and development of cultural landscapes are considered important components of sustainable development. This study introduces an overall landscape protection framework and explores the cooperative management system of the Loire Valley cultural landscapes as a World Heritage Site. By analysing the transregional management system and the relevant policies for protecting the Loire Valley cultural landscapes, this article tries to determine how this coordinating mechanism is constituted and operated and how local authorities and stakeholders can be coordinated to implement protection and development projects that visibly influence the evolution of cultural landscapes in the area. This transregional cooperative management system actively promotes the rehabilitation and revitalisation of the cities and territories of the Loire Valley. Thus, the article summarises key actors and ways to establish an effective cooperation management system that can provide a reference for other transregional heritage sites.
Undergraduate R Programming Anxiety in Ecology: Persistent Gender Gaps and Coping Strategies
Authors: Forrester Chiara , Schwikert Shane , Foster James , Corwin Lisa
Published: April 2022

Women students in ecology reported higher R programming anxiety than their classmates who are men, a gap that narrowed but persisted over the course of a semester in a class that used R. However, specific coping skills were associated with decreases in R anxiety that may be targets for educational interventions.
Feasibility and Prediction of Adverse Events in a Postoperative Monitoring Program of Patient-Reported Outcomes and a Wearable Device Among Gynecologic Oncology Patients
Authors: Barber Emma L. , Garg Ravi , Strohl Anna , Roque Dario , Tanner Edward
Published: April 2022

PURPOSE

The objective of this study was to test the feasibility of implementing a postoperative monitoring program for women with gynecologic cancers composed of patient-reported outcomes (PROs) and a wearable activity monitor.

METHODS

We prospectively enrolled patients undergoing gynecologic cancer surgery to this single-arm study. Enrolled patients completed PROs (Patient-Reported Outcomes Measurement Information System physical function, sleep disturbance, anxiety, fatigue, and pain intensity) at baseline and one-week intervals for 4 weeks. They also wore a wearable accelerometer device that measured steps, heart rate, and intensity of physical activity. The primary outcome was feasibility. The secondary outcome was prediction of unscheduled contacts with the health care system on a given postoperative day.

RESULTS

We enrolled 34 women. Three patients were unevaluable. The mean age was 58 years. The mean body mass index was 31 kg/m2; 17 patients were White (54.8%), 12 patients were Black (38.7%), and two patients (6.5%) were Asian. The overall wear time was 83.8%, and patients responded to 80.4% of the PRO instruments. Twenty-two patients (71%) had an unscheduled contact with the health care system postoperatively (median 1.5, 0.0-8.0). The day of an unscheduled health care utilization event was predicted with acceptable discrimination (area under the receiver operating characteristic curve 0.75; 95% CI, 0.67 to 0.81). PROs of fatigue and physical function were most predictive followed by wearable device outputs of lightly active minutes and average daily heart rate.

CONCLUSION

Implementation of a postoperative monitoring program of patient-reported outcomes and a wearable device was feasible. The specific day of an unscheduled contact with the health care system was predicted with acceptable discrimination.
Addressing the Needs of Older Adults With Cancer in Low- and Middle-Income Settings
Authors: Webb Tracy , Verduzco-Aguirre Haydee Cristina , Rao Abhijith Rajaram , Ramaswamy Anant , Noronha Vanita
Published: April 2022

The number of older adults in the world is projected to increase steeply over the next 30 years; most older adults will live in low- and middle-income countries. This will have a direct impact on the global cancer burden, as cancer is largely a disease of aging. A revolution in the way we care for older adults in low- and middle-income settings is needed to meet rapidly rising demands. Regardless of a nation’s relative wealth or resources, implementing the geriatric assessment in cancer care has presented a challenge because of omission of the principles of geriatric oncology from formal training and continuing education, lack of time, and a shortage of qualified personnel. To meet the challenge of caring for older adults globally, we must: (1) re-imagine aging-focused training for providers and nurses, (2) create and strengthen collaborations/partnerships between geriatric oncology teams and aging-service organizations, and (3) increase advocacy for age-friendly health care policy. By harnessing technology, the reach of specialized oncology education and care can be extended even–or especially–to low- and middle-income settings.
Natural History of Obesity Due to POMC, PCSK1, and LEPR Deficiency and the Impact of Setmelanotide
Authors: Wabitsch Martin , Farooqi Sadaf , Flück Christa E , Bratina Natasa , Mallya Usha G , Stewart Murray , Garrison Jill , van den Akker Erica , Kühnen Peter
Published: April 2022

Context

Rare homozygous or biallelic variants in POMC, PCSK1, and LEPR can disrupt signaling through the melanocortin-4 receptor (MC4R) pathway, resulting in hyperphagia and severe early-onset obesity. In pivotal Phase 3 clinical trials, treatment with the MC4R agonist setmelanotide reduced hunger and weight in patients with obesity due to proopiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency.

Objective

To characterize the historical weight trajectory in these patients.

Methods

This analysis included data from 2 pivotal single-arm, open-label, Phase 3 trials (NCT02896192, NCT03287960). These were multicenter trials. Patients had obesity due to POMC/PCSK1 or LEPR deficiency. During the trial, patients were treated with setmelanotide. Historical data on measured weight and height were obtained during screening.

Results

A total of 17 patients (POMC, n = 8; PCSK1, n = 1; LEPR, n = 8) with historical weight and height data were included in this analysis. Before setmelanotide treatment, patients with obesity due to POMC/PCSK1 or LEPR deficiency were above the 95th percentile for weight throughout childhood, demonstrated continuous weight gain, and did not show long-term weight loss upon interventions (eg, diet, surgery, exercise). Setmelanotide treatment attenuated weight and body mass index trajectories over the observation period of 1 year.

Conclusion

In patients with POMC, PCSK1, or LEPR deficiency, traditional interventions for weight loss had limited impact on the trajectory of severe early-onset obesity. However, setmelanotide treatment attenuated weight and body mass index trajectories and led to weight loss associated with health benefits in most individuals.
Pro-Con Debate: Are Patients With a Cardiovascular Implantable Electronic Device Suitable to Receive Care in a Free-Standing Ambulatory Surgery Center?
Authors: Rosero Eric B. , Rajan Niraja , Joshi Girish P.
Published: April 2022

Migration of surgical and other procedures that require anesthesia care from a hospital to a free-standing ambulatory surgery center (ASC) continues to grow. Patients with cardiac implantable electronic devices (CIED) might benefit from receiving their care in a free-standing ASC setting. However, these patients have cardiovascular comorbidities that can elevate the risk of major adverse cardiovascular events. CIEDs are also complex devices and perioperative management varies between devices marketed by various manufacturers and require consultation and ancillary services, which may not be available in a free-standing ASC. Thus, perioperative care of these patients can be challenging. Therefore, the suitability of this patient population in a free-standing ASC remains highly controversial. Although applicable advisories exist, considerable discussion continues with surgeons and other proceduralists about the concerns of anesthesiologists. In this Pro-Con commentary article, we discuss the arguments for and against scheduling a patient with a CIED in a free-standing ASC.
Association Between Preoperative Fibrinogen-to-Albumin Ratio and All-Cause Mortality After Off-Pump Coronary Artery Bypass Grafting: A Retrospective Observational Study
Authors: Park Seoyeong , Nam Karam , Kim Tae Kyong
Published: April 2022

BACKGROUND:

The fibrinogen-to-albumin ratio (FAR) is a recently introduced prognostic marker for patients with coronary artery disease. The present study investigated whether the FAR is associated with clinical outcome after off-pump coronary artery bypass grafting (OPCAB).

METHODS:

We retrospectively reviewed 1759 patients who underwent OPCAB (median duration of follow-up, 46 months). To evaluate the association between FAR and mortality in OPCAB patients, time-dependent coefficient Cox regression analyses were used to assess the association between FAR and all-cause mortality.

RESULTS:

In multivariable time-dependent coefficient Cox regression analyses, preoperative FAR was an independent risk factor for all-cause mortality after OPCAB (adjusted hazard ratio, 1.051; 95% confidence interval, 1.021–1.082). In the restricted cubic spline function curve of the multivariable-adjusted relationship between the preoperative FARs, a linear increase in the relative hazard for all-cause mortality was observed as the FAR increased (P = .001).

CONCLUSIONS:

A higher FAR is associated with increased all-cause mortality after OPCAB. The preoperative FAR could be a prognostic factor for predicting higher mortality after OPCAB.