bluuebunny/crossref_metadata_2025 huggingface dataset:
Determining the Roles of the Anterior Cruciate Ligament, Posterolateral Corner, and Medial Collateral Ligament in Knee Hyperextension Using the Heel-Height Test
Authors: Perry Allison K. , Knapik Derrick M. , Gursoy Safa , Alter Thomas D. , Clapp Ian M. , Verma Nikhil N. , LaPrade Robert F. , Chahla Jorge
Published: April 2022

Background:

Anterior cruciate ligament (ACL) tears are often associated with other ligamentous injuries. The side-to-side difference in heel height can represent a valuable diagnostic tool in the setting of multiligamentous injuries.

Purpose:

To assess in a cadaveric model how sequential sectioning of the static stabilizing structures of the knee (ACL, fibular collateral ligament [FCL], popliteus tendon [PLT], popliteofibular ligament [PFL], and medial collateral ligament [MCL]) influences heel-height measurements when comparing groups undergoing initial transection of the ACL versus FCL and to assess posterior tibial slope after sequential sectioning.

Study Design:

Controlled laboratory study.

Methods:

A total of 16 fresh cadaveric knees were carefully dissected to expose the ACL, FCL, PLT, PFL, and MCL. Each knee was randomized to either the ACL-first or FCL-first group based on the initial structure sectioned. The sectioning order was as follows: (1) ACL or FCL, (2) FCL or ACL, (3) PLT, (4) PFL, and (5) MCL. Heel height was measured with a standardized superiorly directed 12-N·m force applied to the knee while stabilizing the femur; heel height was also measured with a clinician-applied force. The measurements were compared between and within groups for each sectioned state. The correlation between tibial slope and heel-height measurements was analyzed.

Results:

There were no significant differences in heel-height measurements between the ACL-first and FCL-first groups ( P = .863). Combined ACL-FCL injuries led to a 2.85 ± 0.83–cm increase in heel height compared to the intact state. Significant increases in heel height occurred after all sectioned states, except the PFL sectioned state. Combined ACL–posterolateral corner (PLC) injuries resulted in a 3.72 ± 1.02–cm increase in heel height, and additional sectioning of the MCL resulted in a 4.73 ± 1.35–cm increase compared to the intact state. Tibial slope was not correlated with increases in heel height after each sectioning ( P = .154).

Conclusion:

Combined ACL-FCL, ACL-PLC, and ACL-PLC-MCL injuries resulted in increasing mean heel-height measurements (2.85, 3.72, and 4.73 cm, respectively) compared to the intact state. Tibial slope was not found to influence increases in heel height.

Clinical Relevance:

The side-to-side difference in heel height may be a clinically relevant examination tool for diagnosing multiligament knee injuries.
High-Volume Image-Guided Injections in Achilles and Patellar Tendinopathy in a Young Active Military Population: A Double-Blind Randomized Controlled Trial
Authors: Barker-Davies Robert M. , Baker Polly , Watson James , Goodall Duncan , Wheeler Patrick C. , Nicol Alastair M. , Fong Daniel T.P. , Lewis Mark P. , Bennett Alexander N.
Published: April 2022

Background:

Chronic Achilles and patellar tendinopathy are a significant burden in physically active populations. High-volume image-guided injection (HVIGI) proposes to strip away associated neovascularity, disrupt painful nerve ingrowth, and facilitate rehabilitation.

Purpose:

To investigate the efficacy of HVIGI with and without steroid relative to placebo.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

A total of 62 participants were recruited between May 25, 2016, and March 5, 2020. Participants were men aged 18 to 55 years with Achilles or patellar tendinopathy of at least 6-month chronicity that had not improved with nonoperative management (including physical therapy and shockwave therapy), with ultrasound evidence of neovascularization, tendon thickening, and echogenic changes. They were assigned to the following groups: control (3 mL of subcutaneous 0.5% bupivacaine), HVIGI (10 mL of 0.5% bupivacaine and 30 mL of normal saline, ultrasound-guided between tendon and underlying fat pad), or HVIGI with steroid (HVIGIwSteroid; 0.25 mL of 100 mg/mL hydrocortisone). Clinicians and assessors were blinded. All participants were supervised through a pain-guided progressive loading program for 6 months postinjection. The main outcome measures were the Victoria Institute of Sport Assessments (VISA) for Achilles and patellar tendinopathy and the visual analog scale (VAS) for pain at 6 months postinjection.

Results:

The VISA score improved by a mean of 22.8 points (95% CI, 10.4-35.3 points; effect size [ES], 1.51) in the control group (n = 21), 18.6 points (95% CI, 9.1-28.0 points; ES, 1.31) in the HVIGI group (n = 21), and 18.5 points (95% CI, 3.4-33.6 points; ES, 0.88) in the HVIGIwSteroid group (n = 20). VAS pain improved by a mean of 15 points (interquartile range [IQR], –38.75, 8 points; ES, 0.39) in controls, 13 points (IQR,–34.0, 3.75 points; ES, 0.47) in the HVIGI group, and 27 points (IQR,–38.0, –1.0 points; ES, 0.54) in the HVIGIwSteroid group. The main effects were significant for time ( P < .001) but not group ( P ≥ .48), with no group × time interaction ( P = .71). One participant was lost to follow-up from each group, multiple imputation was used for missing data points. No adverse events occurred.

Conclusion:

Study findings did not demonstrate superiority of HVIGI over control injection.

Registration:

EU Clinical Trials Register (EudraCT: 2015-003587-36).
Understanding Patient Perspectives of the Impact of Anemia in Chronic Kidney Disease: A United States Patient Survey
Authors: Grandy Susan , Palaka Eirini , Guzman Nicolas , Dunn Alicia , Wittbrodt Eric T. , Finkelstein Fredric O.
Published: April 2022

Anemia in chronic kidney disease (CKD) is associated with reduced health-related quality of life and physical functioning. This study investigated knowledge and awareness of anemia in patients with CKD in the United States (US) through an online, quantitative survey administered to patients aged ≥18 years with self-reported CKD, with or without anemia. Of 446 patients included, 255 (57.2%) were diagnosed with anemia and 191 (42.8%) were in the non-anemia cohort. In patients with anemia, 71.0% were aware of the relationship between CKD and anemia versus 52.9% in the non-anemia cohort. In the anemia cohort, 46.3% of patients were aware of their hemoglobin level, versus 27.2% in the non-anemia cohort. Despite 67.4% of patients with anemia believing their condition was well/very well managed, only 50% reported being informed about different treatments without prompting healthcare providers. In the US, patients with anemia and CKD perceived that anemia had a negative impact on physical health and emotional wellbeing. Results emphasize a lack of disease awareness, suggesting patients would benefit from further education on anemia in CKD.
Role of prognostic scores in the evolution of renal involvement in patients with multiple myeloma after bone marrow transplantation
Authors: Murari Patricia , Alves de Brito Germana , Alves Joubert Araujo , Vieira Garles Miller Matias , Baptista Aline Lourenço , Andrade Luis André Silvestre , Imanishe Marina Harume , Pereira Benedito Jorge
Published: April 2022

Introduction:

Treatment of multiple myeloma (MM) with chemotherapy and autologous bone marrow transplantation (BMT) commonly results in renal dysfunction associated with early mortality. Prognostic scores for MM are assessed by either Durie and Salmon (DS) or International Staging System (ISS) methods. Few studies have examined the relationship between these scores and renal damage after BMT.

Aims:

To evaluate DS and ISS prognostic scores as they relate to renal function and mortality in MM patients who have undergone BMT.

Methods:

Retrospective, observational cohort of 95 MM patients who underwent BMT between 2012 and 2014. Renal function was assessed using data on proteinuria, serum creatinine, and estimated glomerular filtration rate from the time of hospital admission to 6 months post-BMT.

Results:

Neither score was significantly associated with death or proteinuria, but patients in DS stage IIIB were 12.8 times more likely to experience renal dysfunction than those in DS stage I–II. Both DS and ISS scores reflected a progressive increase in the chance of renal functional impairment with increased disease staging.

Conclusions:

The prognostic methods studied were useful in the initial recognition of renal dysfunction and after 6 months post BMT, the DS score was still able to predict the reduction of eGFR. Patients in the advanced stages of MM were associated with altered renal function, and these results could help to establish early treatment strategies to reduce the risk of renal damage.
Living apart together: The economic value of ethnic diversity in cities
Authors: Bakens Jessie , Florax Raymond JGM , de Groot Henri LF , Mulder Peter
Published: April 2022

In consumer cities, the presence and location of immigrants impacts house prices through two channels, which both can be valued positively as well as negatively: (i) their presence and contribution to population diversity and (ii) the creation of immigrant-induced consumer amenities like those associated with ethnic restaurants in terms of both their quantity as well as diversity. We hypothesize that these two mechanisms create a trade-off in which city dwellers want to live apart yet consume together. We use unique microdata of house prices and ethnic restaurants in the city of Amsterdam over the 1996–2011 period and a generalized propensity score (GPS) matching technique for multiple continuous treatments to estimate the trade-off between consumers’ love for ethnic goods and their variety on the one hand, and ethnic residential composition on the other hand. We find evidence for the existence of such a trade-off: proximity to ethnically diverse restaurants indeed compensates for a negative correlation between the presence of immigrants and house prices. This trade-off mostly holds for neighborhoods featuring both a diverse population and a high level of amenities in terms of restaurants.
Can Valmiki Become a Poet?
Authors: Deepak Kashyap
Published: April 2022

Dayachand Mayna is one of the most robbed folk poets of Haryana. The article attempts to highlight the ways in which his poetry is stolen by Jaat singers and editors to build the reputation of a Jaat poet, Mehar Singh. The aim of article is to present how Dayachand suffered due to caste barriers, and it is caste that becomes one of the hurdles that blocked his path to success. The hypothesis will present how Dayachand was a victim of caste-based politics that did not allow a talented Valmiki poet to flourish.
Acute Revascularization Induced Reversed Robin Hood Syndrome
Authors: Kumar Mukesh , Khurana Dheeraj , Choudhary Aditya , Ahuja Chirag Kamal
Published: April 2022

Paradoxical intracranial hemodynamic steal (IHS) is a contradictory reduction of cerebral blood flow volume in the territory of the impaired perfusion area occurring spontaneously or in response to vasodilatory stimuli, which can be recorded and evaluated on transcranial doppler (TCD). IHS followed by early neurological worsening (change in National Institute of Health Stroke Scale [NIHSS]> 2) in acute ischemic stroke patients has been described as reversed Robin Hood syndrome (RRHS). We describe two cases of RRHS following carotid artery stenting (CAS) in patients with contralateral carotid occlusion and its further management.

Two patients with a history of anterior circulation strokes presented with recent complaints of dizziness and a sensation of being pulled back (patient 1), and episodic numbness of upper limbs (patient 2). On CT angiogram, both of the patients had severe extracranial internal carotid artery (ICA) stenosis on the symptomatic side associated with complete occlusion of the ICA on the contralateral side. In addition, both patients had impaired vasomotor reactivity (VMR) on TCD in the bilateral middle cerebral artery (MCA). Therefore, CAS on the symptomatic side was performed in both patients by femoral artery access without any periprocedural and postprocedural complications. However, on day 1 post CAS, complaints of transient upper limb tingling (patient 1) and limb shaking (patient 2) were reported corresponding to the completely occluded ICA, and TCD examinations confirmed RRHS in both patients. Patients were managed by decreasing the dose of antihypertensive medication to augment the blood pressure for 2 weeks. Normalization of the VMR on TCD was seen on follow-up, and both patients remain asymptomatic.
Extracellular vesicle proteomic analysis leads to the discovery of HDGF as a new factor in multiple myeloma biology
Authors: Hoelzinger Dominique B. , Quinton Sophia J. , Walters Denise K. , Vardam-Kaur Trupti , Tschumper Renee C. , Borges da Silva Henrique , Jelinek Diane F.
Published: April 2022

Identifying factors secreted by multiple myeloma (MM) cells that may contribute to MM tumor biology and progression is of the utmost importance. In this study, hepatoma-derived growth factor (HDGF) was identified as a protein present in extracellular vesicles (EVs) released from human MM cell lines (HMCLs). Investigation of the role of HDGF in MM cell biology revealed lower proliferation of HMCLs following HDGF knockdown and AKT phosphorylation following the addition of exogenous HDGF. Metabolic analysis demonstrated that HDGF enhances the already high glycolytic levels of HMCLs and significantly lowers mitochondrial respiration, indicating that HDGF may play a role in myeloma cell survival and/or act in a paracrine manner on cells in the bone marrow (BM) tumor microenvironment (ME). Indeed, HDGF polarizes macrophages to an M1-like phenotype and phenotypically alters naïve CD14+ monocytes to resemble myeloid-derived suppressor cells which are functionally suppressive. In summary, HDGF is a novel factor in MM biology and may function to both maintain MM cell viability as well as modify the tumor ME.
Zinc supplementation modifies brain tissue transcriptome of Apis mellifera honeybees
Authors: Camilli Marcelo Polizel , Kadri Samir Moura , Alvarez Marcus Vinícius Niz , Ribolla Paulo Eduardo Martins , Orsi Ricardo Oliveira
Published: April 2022

Background

Bees are the most important group of pollinators worldwide and their populations are declining. In natural conditions,Apis melliferadepends exclusively on food from the field to meet its physiological demands. In the period of scarcity, available resources are insufficient and artificial supplementation becomes essential for maintaining the levels of vitamins, proteins, carbohydrates, and minerals of colonies. Among these minerals, zinc is essential in all living systems, particularly for the regulation of cell division and protein synthesis, and is a component of more than 200 metalloenzymes.

Results

The total RNA extracted from the brain tissue of nurse bees exposed to different sources and concentrations of zinc was sequenced. A total of 1,172 genes in the treatment that received an inorganic source of zinc and 502 genes that received an organic source of zinc were found to be differentially expressed among the control group. Gene ontology enrichment showed that zinc can modulate important biological processes such as nutrient metabolism and the molting process.

Conclusions

Our results indicate that zinc supplementation modulates the expression of many differentially expressed genes and plays an important role in the development ofApismellifera bees. All the information obtained in this study can contribute to future research in the field of bee nutrigenomics.
The validity, reliability and feasibility of four instruments for assessing the consciousness of stroke patients in a neurological intensive care unit compared
Authors: Yan Xiaoxiang , Xiao Lingjun , Liao Meixin , Huang Jiajian , He Zhijie , Yan Tiebin
Published: April 2022

Background

Early rehabilitation is the foundation for recovery for those admitted to an intensive care unit. Appropriate assessment of consciousness is needed before any rehabilitative intervention begins.

Methods

This prospective study compared the validity, reliability and applicability of the sedation-agitation scale, the Richmond Agitation-Sedation Scale, the motor activity assessment scale and the Glasgow Coma Scale in a working neurological intensive care unit. Eighty-three stroke patients were assessed with the four scales by the same 3 raters acting independently: a senior physician, a senior therapist and a trainee. That generated 996 assessment records for comparison.

Results

Good agreement (r=0.98–0.99) was found among the sedation-agitation scale, the Richmond Agitation-Sedation Scale, the motor activity assessment scale scores, but the Glasgow Coma Scale ratings correlated less well (r=0.72–0.76) with the others. Consistent results were also found among the three raters. After stratification of the ratings by age, gender, level of consciousness and Acute Physiology and Chronic Health Evaluation score, the scales reported significant differences among the levels of consciousness and among those with different Acute Physiology and Chronic Health Evaluation results, but not with different age or gender strata.

Conclusions

The four instruments tested are all reliable enough and feasible for use as a tool for consciousness screening in a neurological intensive care unit.
Association between platelet, white blood cell count, platelet to white blood cell ratio and sarcopenia in community-dwelling older adults: focus on Bushehr Elderly Health (BEH) program
Authors: Gholizade Mohamad , Farhadi Akram , Marzban Maryam , Mahmudpour Mehdi , Nabipour Iraj , Kalantarhormozi Mohammadreza , Shafiee Gita , Ostovar Afshin , Larijani Bagher , Darabi Amir Hossein , Safavi Eisa
Published: April 2022

Background

Sarcopenia is a progressive age-related skeletal muscle disorder associated with harmful impacts on health. The present study aimed to investigate the relation between sarcopenia, platelet (PLT), white blood cell (WBC), and PLT to WBC ratio (PWR) due to the importance of early sarcopenia diagnosis.

Methods

This cross-sectional study was conducted based on the second stage of the Bushehr Elderly Health (BEH) Program. Sarcopenia was defined based on the revised edition of the European Working Group on Sarcopenia in Older People (EWGSOP2) in accordance with the Iranian cut-off point. Univariate and adjusted multivariate logistic regression and linear regression were used to evaluate the associations.

Results

The prevalence of sarcopenia among participants was 35.73%. PLT count and PWR were statistically higher in severe sarcopenic participants, while no differences were seen in WBC. In crude analysis, sarcopenia was not associated with quartiles of PLT, WBC, and PWR, while after adjusting for age, marital status, and sex, the association was seen in the fourth quartile of PLT and PWR [OR (95%CI) = 1.40 (1.08 to 1.81), p-value = 0.009 for PLT; OR (95%CI) =1.55 (1.20 to 2.00), p-value =0.001 for PWR]. This association remained significant in the fully adjusted model [OR (95%CI) =1.82 (1.20 to 2.78), p-value =0.005 for PLT; OR (95%CI) =1.57 (1.03 to 2.40), p-value =0.035 for PWR]. Among sarcopenia parameters, PLT count was more likely to be associated with handgrip strength and muscle mass. After stratifying the participants by gender, sarcopenia parameters were no longer statistically significant in men.

Conclusion

This study showed that PLT and PWR were associated with sarcopenia after considering confounding factors, while this association was not seen in WBC. Moreover, results showed that gender had an important impact on sarcopenia parameters.
Effect of advance care planning video on do-not-hospitalize orders for nursing home residents with advanced illness
Authors: McCreedy Ellen M. , Yang Xiaofei , Mitchell Susan L. , Gutman Roee , Teno Joan , Loomer Lacey , Moyo Patience , Volandes Angelo , Gozalo Pedro L. , Belanger Emmanuelle , Ogarek Jessica , Mor Vincent
Published: April 2022

Background

The purpose of the study is to evaluate the effect of an Advance Care Planning (ACP) Video Program on documented Do-Not-Hospitalize (DNH) orders among nursing home (NH) residents with advanced illness.

Methods

Secondary analysis on a subset of NHs enrolled in a cluster-randomized controlled trial (41 NHs in treatment arm implemented the ACP Video Program: 69 NHs in control arm employed usual ACP practices). Participants included long (> 100 days) and short (≤ 100 days) stay residents with advanced illness (advanced dementia or cardiopulmonary disease (chronic obstructive pulmonary disease or congestive heart failure)) in NHs from March 1, 2016 to May 31, 2018 without a documented Do-Not-Hospitalize (DNH) order at baseline. Logistic regression with covariate adjustments was used to estimate the impact of the resident being in a treatment versus control NH on: the proportion of residents with new DNH orders during follow-up; and the proportion of residents with any hospitalization during follow-up. Clustering at the facility-level was addressed using hierarchical models.

Results

The cohort included 6,117 residents with advanced illness (mean age (SD) = 82.8 (8.4) years, 65% female). Among long-stay residents (n = 3,902), 9.3% (SE, 2.2; 95% CI 5.0–13.6) and 4.2% (SE, 1.1; 95% CI 2.1–6.3) acquired a new DNH order in the treatment and control arms, respectively (average marginal effect, (AME) 5.0; SE, 2.4; 95% CI, 0.3–9.8). Among short-stay residents with advanced illness (n = 2,215), 8.0% (SE, 1.6; 95% CI 4.6–11.3) and 3.5% (SE 1.0; 95% CI 1.5–5.5) acquired a new DNH order in the treatment and control arms, respectively (AME 4.4; SE, 2.0; 95% CI, 0.5–8.3). Proportion of residents with any hospitalizations did not differ between arms in either cohort.

Conclusions

Compared to usual care, an ACP Video Program intervention increased documented DNH orders among NH residents with advanced disease but did not significantly reduce hospitalizations.

Trial registration.

ClinicalTrials.gov Identifier: NCT02612688.
Prescribing trends of proton pump inhibitors, antipsychotics and benzodiazepines of medicare part d providers
Authors: Toth Jennifer M. , Jadhav Saumil , Holmes Holly M. , Sharma Manvi
Published: April 2022

Background

Proton pump inhibitors, benzodiazepines, and antipsychotics are considered potentially inappropriate medications in older adults according to the American Geriatric Society Beers Criteria, and deprescribing algorithms have been developed to guide use of these drug classes. The objective of this study was to describe the number of beneficiaries prescribed these medications, provider specialty and regional trends in prescribing, and the aggregate costs for these claims in Medicare Part D.

Methods

This was a retrospective cross-sectional study using publicly available Medicare Provider Utilization and Payment Data: Part D Prescriber data for years 2013–2019. Descriptive statistics and the Cochrane-Armitage test were used to summarize the trends.

Results

Overall, 30.1%, 25.6%, 4.6% of Medicare Part D beneficiaries had a proton pump inhibitor, benzodiazepine, and antipsychotic claim in 2013, respectively. These rates decreased to 27.5%, 17.5%, 4.1% in 2019 (p-value < 0.0001). However, the number of standardized 30-day claims increased from 63 million in 2013 to 84 million in 2019 for proton pump inhibitors, remained steady for benzodiazepines and slightly increased (10 million to 13 million) for antipsychotics. Total aggregate costs decreased by almost $1.5 billion for proton pump inhibitor, $100 million for benzodiazepine, and $700 million for antipsychotic from 2013 to 2019 (p-value < 0.0001). Almost 93% of gastroenterologists prescribed a proton pump inhibitor, and 60% of psychiatrists prescribed benzodiazepines and antipsychotics all seven years. The Other region had the highest percentage of providers prescribing all three classes and the highest number of standardized 30-day benzodiazepine claims.

Conclusions

The overall rate of use of proton pump inhibitors, benzodiazepines, and antipsychotics decreased from 2013–2019 among Medicare Part D beneficiaries. Despite the increase in raw number of standardized 30-day claims, the costs decreased which is likely due to generics made available. These prescribing trends may aid in identifying and targeting potential deprescribing interventions.
The impact of having foreign domestic workers on informal caregivers of persons with dementia – findings from a multi-method research in Singapore
Authors: Yuan Qi , Zhang Yunjue , Samari Ellaisha , Jeyagurunathan Anitha , Tan Gregory Tee Hng , Devi Fiona , Wang Peizhi , Magadi Harish , Goveas Richard , Ng Li Ling , Subramaniam Mythily
Published: April 2022

Background

Informal caregivers of persons with dementia (PWDs) sometimes engage foreign domestic workers (FDWs) to support their caregiving journey. However, there has not been much research to establish if this is really beneficial. The current study aims to investigate whether engaging FDWs specifically for caregiving of PWDs truly moderates caregiver stress and to explore caregivers’ experiences of engaging FDWs.

Methods

A multi-method study design with a quantitative and qualitative sub-study was adopted. For the quantitative sub-study, 282 informal caregivers of PWDs were recruited. Propensity score matching analysis was used. For the qualitative sub-study, 15 informal caregivers with FDWs were interviewed. Inductive thematic analysis was conducted.

Results

The quantitative sub-study confirmed that engaging FDWs did moderate the depressive symptoms of informal dementia caregivers (marginal effect = -3.35, p = 0.0497). However, such support did not affect their caregiving burden, self-efficacy, and perceived positive aspects of caregiving. The qualitative sub-study suggested that engaging FDWs is an ambivalent experience, which entails both support and challenges.

Conclusions

The current study confirmed previous research findings, that engaging FDWs moderated depressive symptoms among caregivers of PWDs, and it could be through their physical support such as in daily caregiving activities. Policy-makers may consider providing more subsidies to caregivers caring for PWDs with mobility issues to hire FDWs. They may also consider providing training to FDWs on dementia caregiving skills and improving the intake of such training as this might be helpful for both FDWs and caregivers during this journey.
Resilience and coping strategies of older adults in Hong Kong during COVID-19 pandemic: a mixed methods study
Authors: Chan Siu-Ming , Chung Gary Ka-Ki , Chan Yat-Hang , Chung Roger Yat-Nork , Wong Hung , Yeoh Eng Kiong , Woo Jean
Published: April 2022

Background

Despite the adverse physical health impact of COVID-19 on older adults, whether they are psychosocially vulnerable under the pandemic remains debatable. In this mixed methods study, we examined the psychosocial vulnerability of older adults relative to their younger counterparts and explored how they coped with the pandemic.

Methods

From September to October 2020, 1067 adults in Hong Kong were randomly sampled and completed a telephone survey, whereas 10 older adults were recruited for individual interviews between September 2020 and April 2021. Quantitative measurements included subjective well-being, worries about COVID-19, and changes in social capital and social interaction since the pandemic. The transcribed qualitative data were closely read and summarized using thematic analyses.

Results

Compared with younger adults, older adults tended to be less worried about COVID-19 infection and economic activity/livelihood, despite being slightly more worried about supplies of personal protective equipment. They also had better subjective well-being in terms of happiness and life satisfaction, with their social capital and social interaction less affected. In addition, five themes emerged from the qualitative interviews: (1) life philosophy; (2) economic security; (3) telecommunication; (4) role of community organizations and social workers; and (5) positive coping strategies.

Conclusions

Older adults in this study showed better psychosocial well-being than their younger counterparts under the COVID-19 pandemic, which challenged the deeply rooted societal stereotype about the vulnerability of older adults. The stronger resilience for positive coping, technological assistance, and targeted government and community support may have protected older adults from distress during the pandemic.
The circular RNA circFARSA sponges microRNA-330-5p in tumor cells with bladder cancer phenotype
Authors: Fang Chen , Huang Xin , Dai Jun , He Wei , Xu Le , Sun Fukang
Published: April 2022

Background

Circular RNAs (circRNAs) modulate gene expression in various malignancies. However, their roles in the occurrence of bladder cancer (BC) and their underlying mechanisms of action are currently unclear.

Methods

We measured levels of the circRNA phenylalanyl-tRNA synthetase subunit alpha (circFARSA) and target microRNAs (miRNAs/miRs) in BC tissues and cell lines using quantitative polymerase chain reactions. The functions of circFARSA in tumor formation were examined in mice with BC xenografts in vivo and in BC cells via determination of their proliferation, activity, apoptosis, metastasis, and invasion in vitro using cell counting kit-8 assays, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays, flow cytometry, western blotting, Transwell assays, and cell wound healing assays. Interactions between miR-330 and circFARSA were predicted and confirmed by bioinformatic processing and dual-luciferase reporter gene assays, respectively. Expression profiles of miR-330 targets in BC cells were assessed via western blotting.

Results

circFARSA expression was markedly upregulated in BC tissues and cell lines compared with that in normal bladder samples. Silencing circFARSA expression decreased BC cell proliferation, invasion, and migration but induced their apoptosis in vitro. Downregulating circFARSA expression slowed tumor growth in vivo and directly sponged miR-330 and inhibited its function in BC cells in vitro. Inhibiting miR-330 expression abolished the regulatory effects of circFARSA silencing on the tumor phenotypes of BC cells.

Conclusions

circFARSA expression is upregulated and exerts oncogenic functions in BC by sponging miR-330.
The prognostic potential of alkaline phosphatase and lactic acid dehydrogenase in bmCRPC patients without significant PSA response under enzalutamide
Authors: Poteska Renata , Rahbar Kambiz , Semjonow Axel , Schrader Andres Jan , Boegemann Martin , Schlack Katrin
Published: April 2022

Background

In patients with bone metastatic castration-resistant prostate cancer (bmCRPC) on systemic treatment, it is difficult to differentiate between continuous rise of prostate specific antigen (PSA) representing progression, and PSA-surge, which is followed by clinical response or stable disease. The purpose of this study was to evaluate the prognostic value of dynamic changes of alkaline phosphatase (ALP) and lactic acid dehydrogenase (LDH) levels as a predictor of clinical efficacy or therapeutic resistance of patients who do not show a sufficient initial PSA decline of ≥50% from baseline during early therapy with Enzalutamide.

Methods

Forty-eight men with bmCRPC on Enzalutamide 07/2010-09/2019 with initially rising PSA were analyzed. We monitored PSA, LDH and ALP at week 0, 2, 4, and every 4 weeks thereafter and analyzed the correlation between ALP rising at 12 weeks with or without LDH-normalization and the association with survival. For this we used Kaplan Meier analysis and uni- and multivariate cox-regression models.

Results

In Kaplan-Meier analysis, ALP rising at 12 weeks with or without LDH-normalization was associated with significantly worse median progression-free survival (PFS) of 3 months vs. 5 months (Log rank P = 0.02) and 3 months vs. 5 months (P = 0.01), respectively and overall survival (OS) with 8 months vs. 15 months (P = 0.02) and 8 months vs. 17 months (P < 0.01). In univariate analysis of PFS, ALP rising at 12 weeks alone, ALP rising at 12 weeks without LDH-normalization and application of Enzalutamide after chemotherapy showed a statistically significant association towards shorter PFS (hazard ratio (HR): 0.51, P = 0.04; HR: 0.48, P = 0.03; HR: 0.48, P = 0.03). Worse OS was significantly associated with ALP rising at 12 weeks alone, ALP rising at 12 weeks without LDH-normalization, and application of Enzalutamide after chemotherapy (HR: 0.47, P = 0.02; HR: 0.36, P < 0.01; HR: 0.31, P < 0.01). In multivariate analysis only the application of Enzalutamide after chemotherapy remained an independent prognostic factor for worse OS (HR: 0.36, P = 0.01).

Conclusions

Dynamic changes of ALP (non-rise) and LDH (normalization) under therapy with Enzalutamide may be associated with clinical benefit, better PFS, and OS in patients with bmCRPC who do not show a PSA decline.
Are habitually barefoot children compelled to wear ill-fitting school shoes? A cross-sectional study
Authors: Breet Marise Carina , Venter Ranel
Published: April 2022

Background

Research shows that ill-fitting shoes can negatively impact the development of the pediatric foot, in a very direct manner. The primary aim of the study was to determine if the dimensions of available prescribed school shoes fit the foot dimensions of habitually barefoot South African children and adolescents.

Methods

A cross-sectional observational study was conducted where static standing foot measurements of children and adolescents from urban and rural schools were obtained with a mobile caliper. The maximum heel-toe-length and foot width with an added 10 mm toe- and width fit allowance to each participant, were compared to the corresponding school shoe length and shoe width available in retail. A mixed model ANOVA was used to compare foot dimensions between gender, age and side.

Results

Six hundred and ninety-eight school children (N = 698) (431 girls; 267 boys; average age 10.86 years, SD = 2.55) were participants. A total of seventy-seven (N = 77) black coloured prescribed school shoes currently available in retail ranging from different styles and brands were measured. Results show that, comparing the shoe length and maximum heel-toe-length of participants, as well as taking 10 mm toe allowance into account, fifty-nine percent (59%) of children wore shoes that were not the correct length. With regards to the shoe width and the added 10 mm of width fit allowance, ninety-eight percent (98%) of the shoes worn by participants were too narrow for their feet.

Conclusions

Results confirmed that school shoes currently available in retail, are not suited for the habitually barefoot population studied. It is recommended that the shoe manufacturing industry should consider the shoe width of school shoes for children and adolescents in habitually barefoot populations to avoid the long-term negative effect of ill-fitting shoes on the pediatric foot.
Does an active play standard change childcare physical activity and healthy eating policies? A natural policy experiment
Authors: Tugault-Lafleur Claire N. , Naylor Patti-Jean , Carson Valerie , Faulkner Guy , Lau Erica Y. , Wolfenden Luke , Mâsse Louise C.
Published: April 2022

Background

In 2017, the provincial government of British Columbia (BC) implemented a mandatory policy outlining Active Play Standards (AP Standards) to increase physical activity (PA) levels, sedentary and motor skills among children attending licensed childcare centers. Concurrently, a capacity-building initiative was launched to help implement policies and practices supporting both PA and healthy eating (HE) in the early years. This study evaluated differences in center-level PA and HE policies and practices before and after the enforcement of the new provincial AP Standards.

Methods

Using a repeat cross-sectional design, surveys were distributed to managers and staff of licensed childcare facilities serving children aged 2–5 years before (2016–2017 or ‘time 1’) and after (2018–2019 or ‘time 2’) implementation of the AP Standards across BC. The total sample included 1,459 respondents (910 and 549 respondents at time 1 and time 2, respectively). Hierarchical mixed effects models were used to examine differences in 9 and 7 PA/sedentary policies and practices, respectively, as well as 11 HE policies between time 1 and time 2. Models controlled for childcare size and area-level population size, education, and income.

Results

Compared to centers surveyed at time 1, centers at time 2 were more likely to report written policies related to: fundamental movement skills, total amount of Active Play (AP) time, staff-led AP, unfacilitated play/free play, total amount of outdoor AP time, limiting screen time, breaking up prolonged sitting, staff role modeling of PA, and training staff about PA (P < 0.01 for all 9 policies examined). Compared to time 1, centers at time 2 reported more frequent practices related to ensuring children engaged in at least 120 min of AP, 60 min of outdoor AP daily, and limiting screen time (P < 0.01 for 3 out of 7 practices examined). Despite no additional policy intervention related to HE, centers were more likely to report having written policies related to: HE education for children, encouraging new foods, having family-style meals, offering only milk or water, limiting the amount of juice served, staff role modeling of HE, limiting the types of foods at parties/celebrations and foods brought from home (P < 0.05 for 9 out of 11 HE policies).

Conclusion

Approximately a year after the implementation of a governmental policy targeting PA supported by a capacity-building initiative, childcare centers reported positive changes in all 9 PA/sedentary policies examined, all 3 out of 7 PA/sedentary practices and 9 out of 11 HE policies evaluated at the center-level.
Awareness of Palestinians about lung cancer symptoms: a national cross-sectional study
Authors: Elshami Mohamedraed , Abukmail Hanan , Aqel Wafa , Alser Mohammed , Al-Slaibi Ibrahim , Shurrab Hanan , Qassem Shahd , Usrof Faten Darwish , Alruzayqat Malik , Nairoukh Roba , Mansour Ahmad , Kittaneh Rahaf , Sawafta Nawras , Habes Yousef M. N. , Ghanim Obaida , Aabed Wesam Almajd , Omar Ola , Daraghmeh Motaz , Aljbour Jomana , Elian Razan , Zuhour Areen , Habes Haneen , Al-Dadah Mohammed , Abu-El-Noor Nasser , Bottcher Bettina
Published: April 2022

Background

The majority of lung cancer (LC) cases are diagnosed at an advanced stage. Poor awareness of LC symptoms is a contributor to late diagnosis. This study aimed to assess the awareness of LC symptoms among Palestinians, and to examine the factors associated with displaying good awareness.

Methods

Participants were recruited from hospitals, primary healthcare centers and public spaces using convenience sampling. A translated-into-Arabic version of the validated LC awareness measure was used to assess recognition of 14 LC symptoms. One point was given for each recognized symptom. The total score was calculated and categorized based on the number of symptoms recognized: poor (0–4), fair (5–9), and good (10–14). Multivariable logistic regression was used to examine the association between participant characteristics and having good awareness. The multivariable analysis adjusted for age-group, gender, education, monthly income, occupation, residence, marital status, any chronic disease, knowing someone with cancer, smoking history, and site of data collection.

Results

Of 5174 potential participants approached, 4817 completed the questionnaire (response rate = 93.1%) and 4762 were included in the final analysis. Of these, 2742 (56.9%) were from the West Bank and Jerusalem (WBJ) and 2020 (43.1%) were from the Gaza Strip. Participants from the WBJ were older, had higher monthly income but lower education, and suffered from more chronic diseases. The most recognized respiratory LC symptom was ‘worsening in an existing cough’(n = 3884, 81.6%) while the least recognized was ‘a cough that does not go away for two or three weeks’(n = 2951, 62.0%). The most recognized non-respiratory LC symptom was ‘persistent tiredness or lack of energy’(n = 3205, 67.3%) while the least recognized was ‘persistent shoulder pain’(n = 1170, 24.6%).

A total of 2466 participants (51.8%) displayed good awareness of LC symptoms. Participants from both the Gaza Strip and the WBJ had similar likelihoods to have good awareness levels. Factors associated with a higher likelihood to display good awareness included female gender, having post-secondary education, being employed, knowing someone with cancer, and visiting hospitals and primary healthcare centers.

Conclusion

About half of the study participants displayed a good level of awareness of LC symptoms. Further improvement in public awareness of LC symptoms by educational interventions might reduce LC mortality by promoting early diagnosis.
Retrospective clinical outcomes in the definitive treatment of high-energy tibial diaphyseal fractures using hexapod external fixator versus monolateral external fixator
Authors: Liu Yanshi , Liu Kai , Cai Feiyu , Zhang Xingpeng , Li Hong , Zhang Tao , Ma Chuang , Yusufu Aihemaitijiang
Published: April 2022

Background

External fixation, which can preserve the biomechanical microenvironment of fracture healing, plays an important role in managing the high-energy fractures with poor surrounding soft tissues. The purpose of this study was to determine the differences of clinical outcomes, if any, between hexapod external fixator and monolateral external fixator in the definitive treatment of high-energy tibial diaphyseal fractures.

Methods

A total of 53 patients with high-energy tibial diaphyseal fractures and definitively treated by the hexapod external fixator (HEF) or monolateral external fixator (MEF) were retrospectively collected and analyzed, from March 2015 to June 2019. There were 31 patients in the HEF treatment, and the other 22 patients were managed by the MEF. The demographic data, surgical duration, external fixation time, final radiological results, complications, and clinical outcomes were documented and analyzed. Difficulties that occurred during the treatment were classified according to Paley. The clinical outcomes were evaluated by the Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at the last clinical visit.

Results

The mean surgical duration in the HEF group (62.4 ± 8.3 min) was shorter than that in the MEF group (91.4 ± 6.9 min) (P < 0.05). All patients acquired complete bone union finally. Patients in the HEF group (24.2 ± 3.1 weeks) underwent a shorter average external fixation time than that in the MEF group (26.3 ± 3.8 weeks) (P < 0.05). Satisfactory alignment was achieved in all patients without the need for remanipulation. The residual sagittal plane deformities in the HEF group were all less than that in the MEF group (P < 0.05). The complication rate was 35.5% in the HEF group, while 45.5% in the MEF group. There was no statistically significant difference between the two groups in ASAMI scores (P > 0.05).

Conclusion

There is no statistically significant difference in finally clinical outcomes between hexapod external fixator and monolateral external fixator in the definitive treatment of high-energy tibial diaphyseal fractures. The hexapod external fixation treatment is a superior effective method, including advantages of stable fixation, less surgical duration, postoperatively satisfactory fracture reduction, and fewer complications.
Characteristics of the patellofemoral joint of patients with DDH and the effects of Bernese periacetabular osteotomy on the patellofemoral joint
Authors: Peng Jianping , Xiao Fei , Zhu Junfeng , Shen Chao , Li Yang , Han Xiuguo , Cui Yimin , Chen Xiaodong
Published: April 2022

Background

Some patients with developmental dysplasia of the hip (DDH) complained of anterior knee pain (AKP) before and after Bernese periacetabular osteotomy (PAO) surgery. The purpose of this study was to (1) identify the characteristics of patellofemoral joint (PFJ) deformities in patients with DDH and (2) to determine the effects of PAO on the PFJ.

Methods

Seventy patients (86 hips) were included in the DDH group. Thirty-three patients (33 knees) without AKP and hip pain were included in the control group. All patients underwent simultaneous CT scans of the hip and knee joints before PAO and after hardware removal surgery. The distance from the anterior inferior iliac spine to the ilioischial line (DAI), was measured in DDH patients. Imaging parameters of knees, including the sulcus angle (SA), femoral trochlear depth (FTD), patellar width (PW), tibial tuberosity-trochlear groove (TT-TG), patellar tilt angle (PTA) and lateral shift of the patella (LSP) were measured in patients in both the DDH and control group. TT-TG, PTA, and LSP of DDH patients were measured before PAO and after hardware removal. The DAI, PTA, LSP and TT-TG of all DDH patients before and after Bernese PAO were compared using paired t-tests. The FTD, PW, and SA of the DDH patients and the control group were analyzed using independent t-tests. PTA, TT-TG, and LSP between the control group and preoperative DDH patients, between the control group and post PAO patients were compared using independent t-tests.

Results

The DAI changed from 4.04 ± 0.61 mm before PAO surgery to 5.44 ± 0.63 mm after PAO surgery. The SA of the DDH group (140.69 ± 11.30 degree) was greater than that of the control group (130.82 ± 6.43 degree). The FTD and the PW of the DDH group (5.45 ± 1.59 mm, 4.16 ± 0.36 mm) were smaller than that of the control group (7.39 ± 1.20 mm, 4.24 ± 0.38 mm). The changes in LSP, PTA, and TT-TG before and after surgery were not statistically significant. Both before and after PAO, there was no statistically significant difference in the parameters of LSP, PTA, and TT-TG compared with the control group.

Conclusion

The knee joints of DDH patients presented a certain degree of femur trochlear groove dysplasia and patellofemoral instability. PAO surgery did not change PFJ stability, although the origination point of the rectus femoris muscle moved laterally during PAO surgery.
Evaluation and comparison of errors on nursing notes created by online and offline speech recognition technology and handwritten: an interventional study
Authors: Peivandi Sahar , Ahmadian Leila , Farokhzadian Jamileh , Jahani Yunes
Published: April 2022

Background

Despite the rapid expansion of electronic health records, the use of computer mouse and keyboard, challenges the data entry into these systems. Speech recognition software is one of the substitutes for the mouse and keyboard. The objective of this study was to evaluate the use of online and offline speech recognition software on spelling errors in nursing reports and to compare them with errors in handwritten reports.

Methods

For this study, online and offline speech recognition software were selected and customized based on unrecognized terms by these softwares. Two groups of 35 nurses provided the admission notes of hospitalized patients upon their arrival using three data entry methods (using the handwritten method or two types of speech recognition software). After at least a month, they created the same reports using the other methods. The number of spelling errors in each method was determined. These errors were compared between the paper method and the two electronic methods before and after the correction of errors.

Results

The lowest accuracy was related to online software with 96.4% and accuracy. On the average per report, the online method 6.76, and the offline method 4.56 generated more errors than the paper method. After correcting the errors by the participants, the number of errors in the online reports decreased by 94.75% and the number of errors in the offline reports decreased by 97.20%. The highest number of reports with errors was related to reports created by online software.

Conclusion

Although two software had relatively high accuracy, they created more errors than the paper method that can be lowered by optimizing and upgrading these softwares. The results showed that error correction by users significantly reduced the documentation errors caused by the software.