bluuebunny/crossref_metadata_2025 huggingface dataset:
What a Single Electroencephalographic (EEG) Channel Can Tell us About Alzheimer's Disease Patients With Mild Cognitive Impairment
Authors: Del Percio Claudio , Lopez Susanna , Noce Giuseppe , Lizio Roberta , Tucci Federico , Soricelli Andrea , Ferri Raffaele , Nobili Flavio , Arnaldi Dario , Famà Francesco , Buttinelli Carla , Giubilei Franco , Marizzoni Moira , Güntekin Bahar , Yener Görsev , Stocchi Fabrizio , Vacca Laura , Frisoni Giovanni B. , Babiloni Claudio
Published: November 2022

Abnormalities in cortical sources of resting-state eyes closed electroencephalographic (rsEEG) rhythms recorded by hospital settings (10-20 montage) with 19 scalp electrodes characterized Alzheimer's disease (AD) from preclinical to dementia stages. An intriguing rsEEG application is the monitoring and evaluation of AD progression in large populations with few electrodes in low-cost devices. Here we evaluated whether the above-mentioned abnormalities can be observed from fewer scalp electrodes in patients with mild cognitive impairment due to AD (ADMCI). Clinical and rsEEG data acquired in hospital settings (10-20 montage) from 75 ADMCI participants and 70 age-, education-, and sex-matched normal elderly controls (Nold) were available in an Italian-Turkish archive (PDWAVES Consortium; www.pdwaves.eu ). Standard spectral fast fourier transform (FFT) analysis of rsEEG data for individual delta, theta, and alpha frequency bands was computed from 6 monopolar scalp electrodes to derive bipolar C3-P3, C4-P4, P3-O1, and P4-O2 markers. The ADMCI group showed increased delta and decreased alpha power density at the C3-P3, C4-P4, P3-O1, and P4-O2 bipolar channels compared to the Nold group. Increased theta power density for ADMCI patients was observed only at the C3-P3 bipolar channel. Best classification accuracy between the ADMCI and Nold individuals reached 81% (area under the receiver operating characteristic curve) using Alpha2/Theta power density computed at the C3-P3 bipolar channel. Standard rsEEG power density computed from six posterior bipolar channels characterized ADMCI status. These results may pave the way toward diffuse clinical applications in health monitoring of dementia using low-cost EEG systems with a strict number of electrodes in lower- and middle-income countries.
Sexuality Transmitted Infection in the COVID-19 Pandemic and Non-Pandemic Time
Authors: Rezaeian AhmadReza , Ahmadi Pishkuhi Mahin , Oliveira Reis Leonardo , Aghamir Seyed Mohammad Kazem
Published: November 2022

On March 11, 2020, the World Health Organization recognized the SARS-CoV-2 infection as a pandemic. The pandemic itself in addition to its containment measures affects individuals’ lifestyles and welfare including their sexual behaviors. Thus, we hypothesized that sexually transmitted infection (STI) incidence may be changed and so we evaluate urethritis incidence as the most common STI in men and some other related factors. Two cross-sectional surveys during the first 6 months of 2019 and 2020 were undertaken and data were collected from 11 urology offices located in different parts of the capital city. In total, 34,611 male participants were included in our study, and 191 (.55%) patients’ clinical diagnoses were urethritis. The urethritis incidence significantly decreased from 149 of 17,950 (.83%) to 42 of 16,661 (.25%) individuals in the same period of the years 2019 and 2020, respectively ( p-value < .001). There was a higher percentage of single ( p-value = .049) and older ( p-value < .001) urethritis patients in the first 6 months of the year 2020 compared with 2019. Our survey provided urethritis incidence, demographics, symptoms, and treatment characterization. As our results show, the proportion of urethritis patients in all populations admitted to urologist offices had dramatically decreased during the COVID-19 pandemic compared with prior. The indirect effects of the pandemic and its containment measures on people’s sexual health should be noticed and an appropriate reaction and policy-making are recommended to manage issues properly in different aspects of sexual health.
Fabrication, characterization, and utilization of ZnO nanoparticles for stain release, bacterial resistance, and UV protection on cotton fabric
Authors: Tania Imana Shahrin , Ali Mohammad , Akter Mahmuda
Published: November 2022

Textile technology is advancing by incorporating the benefits of nanotechnology into its diverse fields. Nanoparticle inclusion is one of the potential finishing processes in textile treatment to create multifunctional textiles. The goal of this research is to impart antibacterial, stain-release, and UV (ultra-violet) protection properties on cotton fabric by depositing ZnO nanoparticles on the fabric surface. Following the synthesis of the nanoparticles by the use of a sonochemical strategy, the nanoparticles are then fixed onto the fabric through the application of a mechanical thermo-fixation technique. The nanoparticles are applied to the fabric at three different concentrations: 0.5%, 1%, and 2%. The surface characterization shows that nanoparticles are of an average size of 40–100 nm and nearly spherical in shape. The colony count method is used to quantify the antibacterial activity of the nano-treated fabric. The results indicate that the treated fabric is effective against both gram-positive ( S. aureus) and gram-negative ( E. coli) bacteria. The color stain of the direct blue dye of treated fabric has degraded under UV irradiation, indicating the stain release property. The results demonstrate considerable stain release that rises with the amount of ZnO nanoparticles. Excellent UV protection is also found since 2%-ZnO nano-coated fabric shows around 96% blockage of UV rays.
Hepatoprotective Effect of Grape Seed and Skin Extract Against Lithium Exposure Examined by the Window of Proteomics
Authors: Mezni Ali , Khazri Olfa , Jarnier Frédérique , Hardouin Julie , Limam Ferid , Jouenne Thierry , Aouani Ezzeddine , Cosette Pascal
Published: November 2022

Context

The liver is the organ by which the majority of substances are metabolized, including psychotropic drugs. Lithium (Li) used as drug for many neurological disorders such as bipolar disorders.

Objective

This study aims to assess lithium toxicity and to evaluate the hepatic-protective properties of a grape skin seed and extract (GSSE).

Materials and methods

Twenty-four male Wistar rats were exposed for 30 days to either various lithium concentrations, GSSE alone, or lithium supplemented with GSSE. The proteomic analysis revealed alterations of liver protein profiles after lithium treatments that were successfully identified by mass spectrometry.

Results

Lithium treatment induced an oxidative damage by the alteration of antioxidant enzymes activities such as superoxide dismutase, CAT, and Gpx. The regulated proteins are mainly involved in the respiratory electron transport chain, detoxification processes, ribosomal stress pathway, glycolysis, and cytoskeleton. Proteins were differentially expressed in a dose-dependent manner. Interestingly, GSSE reversed the situation and restored the level of liver proteins whose abundance was modified after lithium treatment, arguing for its protective activity.

Conclusion

Our data demonstrated the ability of proteomic analysis to underline the toxicity mechanisms of lithium in animal models. Based on these results, GSSE may be envisaged as a nutritional supplement to weaken the liver toxicity of lithium.
Refining the upper limit of normal for the ascending aorta: In search of optimal criteria ‐‐ a large database study of normal individuals
Authors: Yoon Ji Ae , Ahmad Mirza Mujadil , Syed Muhammad Nabeel , Ahmad Mirza Nubair , Hussaini Sharmeen Fatima , Muhammad Mustafa Noor , Pir Syed Haris A , Khandheria Bijoy K , Tajik A. Jamil , Ammar Khawaja Afzal
Published: November 2022

Objectives

The cutoff for dilated mid-ascending aorta (mAA) is controversial and has several definitions. The present study was carried out to determine the prevalence of mAA dilation based on published definitions and to identify the optimal cutoff.

Methods

Echocardiographic studies of patients >15 years of age performed at a large tertiary care center over 4 years, n = 49,330, were retrospectively evaluated. Leading-edge-to-leading-edge technique was used to measure the mAA in diastole. Several cutoff criteria were included. In addition, we defined normals in our database as those who, after 28 causes of dilated aorta were excluded, were normal both clinically and echocardiographically ( n = 2334).

Results

The mean age was 64.2 ± 17.1 years, and 31.5% were men. The prevalence of dilated mAA based on absolute criteria with sex stratification varied between 17% and 23% and based on relative criteria (to age, body surface area, and sex) varied between 6% and 11%. It further decreased to 7.6% on the addition of narrow age stratification (10 year intervals) performed on normals in our database. The multivariate adjusted R2 (for variation in mAA diameter) was 0.25 for age, decreasing to 0.12 for weight and 0.07 for sex and height.

Conclusions

The lowest prevalence of 7.6% probably represents the optimal cutoff for dilated mAA because it includes age, which explains most of the variation in mAA, in narrow (10 year) intervals only performed in our normals, which represents the largest sample size to date.
Clinical course and outcomes of cancer patients admitted in medical ICU with sepsis
Authors: Beniwal Anisha , Singh Omender , Juneja Deven , Beniwal Hemant Kumar , Kataria Sahil , Bhide Madhura , Yadav Devraj
Published: November 2022

Background and aims:

Sepsis is not only a leading cause of intensive care unit (ICU) admission but also one of the variables which affect outcomes of cancer patients. We aimed to assess the clinical characteristics, clinical course, mortality and risk factors associated with 30-day mortality in medical oncology patients admitted in a multi-disciplinary medical ICU.

Methods:

We conducted a retrospective analysis of 435 consecutive cancer patients admitted in medical ICU over a 28 months period. Patients were divided into two groups based on the presence of sepsis at the time of ICU admission. Data regarding baseline patient characteristics, clinical and laboratory data, need for organ support and 30-day mortality were collected. Sepsis patients were further classified as 30-day survivors and non-survivors and risk factors for mortality in these patients were determined.

Results:

Overall 30-day mortality was 57.8%. It was significantly higher in sepsis group patients (73.9%) as compared to non-sepsis patients (46.6%) ( p < 0.001). Most common reason for ICU admission in non-sepsis group was respiratory distress (51.4%) followed by altered sensorium (28.4%). Presence of metastasis [odds ratio, OR: 3.89 (95% confidence interval, CI: 1.536–9.901)], high lactate [OR: 1.374 (95% CI: 1.024–1.843)] and need of invasive mechanical ventilator (IMV) support [OR: 7.634 (95% CI: 2.519–23.256)] or vasopressor support [OR: 3.268 (95% CI: 1.179–9.090)] were directly associated with 30-day mortality.

Conclusion:

Critically ill cancer patients admitted with sepsis had high mortality. Presence of metastasis, high lactate and need of IMV or vasopressor support was associated with worse prognosis in cancer patients admitted with sepsis in ICU.
Predictors of early response to balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension
Authors: Li Xin , Zhang Yi , Jin Qi , Luo Qin , Zhao Qing , Yang Tao , Zeng Qixian , Yan Lu , Duan Anqi , Huang Zhihua , Hu Meixi , Xiong Changming , Zhao Zhihui , Liu Zhihong
Published: November 2022

Background:

To achieve favorable hemodynamics, the number of balloon pulmonary angioplasty (BPA) sessions varied significantly among patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Increased BPA sessions burdened patients financially and psychologically. We aim to identify baseline characteristics that could predict early BPA response.

Methods:

Consecutive patients who were diagnosed with inoperable CTEPH and received BPA between May 2018 and October 2021 at Fuwai Hospital were retrospectively collected. Patients were categorized into ‘Early BPA responders’ or ‘Non-early BPA responders’ according to the hemodynamic outcome within the first three BPA sessions.

Results:

In total, 101 patients were included into analysis. At baseline, non-early BPA responders had lower female proportion, longer disease duration, and poorer laboratory test results compared with early responders, whereas hemodynamics were comparable. After the first three BPA sessions, hemodynamic improvement was more significant in early responders. Incidence of complication was comparable between the two groups. Multivariable logistic analysis identified that female sex (odds ratio [OR]: 7.155, 95% confidence interval [CI]: 1.323-38.692, p = 0.022), disease duration (OR: 0.851, 95% CI: 0.727-0.995, p = 0.043), baseline total bilirubin (OR: 0.934, 95% CI: 0.875-0.996, p = 0.038), and baseline NT-proBNP (OR: 0.473, 95% CI: 0.255-0.879, p = 0.018) were independently associated with early BPA response. Combination of these four parameters could predict 90% early BPA response.

Conclusions:

Patients with shorter disease duration, female sex, lower baseline NT-proBNP, and lower baseline total bilirubin are more likely to achieve early hemodynamic response to BPA. Moreover, early hemodynamic response was not accompanied with increased incidence of procedure-related complications.
Update on the first-line treatment of Helicobacter pylori infection in areas with high and low clarithromycin resistances
Authors: Shih Chih-An , Shie Chang-Bih , Hsu Ping-I
Published: November 2022

Current international consensuses on Helicobacter pylori eradication therapy recommend that only regimens that reliably produce eradication rates of ⩾90% should be used for empirical treatment. The Real-world Practice & Expectation of Asia-Pacific Physicians and Patients in Helicobacter Pylori Eradication Survey also showed that the accepted minimal eradication rate in H. pylori-infected patients was 91%. According to efficacy prediction model, the per-protocol eradication rates of 7-day and 14-day standard triple therapies fall below 90% when clarithromycin resistance rate ⩾5%. Several strategies including bismuth-containing, non-bismuth-containing quadruple therapies (including sequential, concomitant, hybrid and reverse hybrid therapies), high-dose dual therapy and vonoprazan-based triple therapy have been proposed to increase the eradication rate of H. pylori infection. According to efficacy prediction model, the eradication rate of 14-day concomitant therapy, 14-day hybrid therapy and 7-day vonoprazan-based triple therapy is less than 90% if the frequency of clarithromycin-resistant strains is higher than 90%, 58% and 23%, respectively. To meet the recommendation of the consensus report and patients’ expectation, local surveillance networks for resistance of H. pylori to clarithromycin are required to select appropriate eradication regimens in each geographic region. In areas with low (<5%) clarithromycin resistance (e.g. Sweden, Philippine, Myanmar and Bhutan), 7-day and 14-day standard triple therapies can be adopted for the first-line treatment of H. pylori infection with eradication rates of ⩾90%. In areas with high (⩾5%) clarithromycin resistance (most other countries worldwide) or unknown clarithromycin resistance, 14-day hybrid, 14-day reverse hybrid, 14-day concomitant and 10- to 14-day bismuth quadruple therapy can be used to treat H. pylori infection.
Employees and workplace surveillance: Tensions and ways forward
Authors: Ramasundaram Aiswarya , Gurusamy Ramasundaram , George Amala
Published: November 2022

We are rapidly entering the age of no privacy where everyone is always open to surveillance, where there are no secrets – William O Douglas. This case aims to explore the effects of camera surveillance on individual behaviour at the workplace. We observe that we unconsciously tend to modify our natural behaviour into a designed one as required by the camera, what is called prosocial behaviour. Workplace surveillance has many advantages and applications for theft detection and employee discipline. However, it also impacts employees who may not be enacting deviant behaviour at the workplace. This issue needs to be addressed, as it can affect not only psychological behaviours leading to unseen disorders, but also productivity at the workplace.
AI ethics and data governance in the geospatial domain of Digital Earth
Authors: Micheli Marina , Gevaert Caroline M , Carman Mary , Craglia Max , Daemen Emily , Ibrahim Rania E , Kotsev Alexander , Mohamed-Ghouse Zaffar , Schade Sven , Schneider Ingrid , Shanley Lea A , Tartaro Alessio , Vespe Michele
Published: November 2022

Digital Earth applications provide a common ground for visualizing, simulating, and modeling real-world situations. The potential of Digital Earth applications has increased significantly with the evolution of artificial intelligence systems and the capacity to collect and process complex amounts of geospatial data. Yet, the widespread techno-optimism at the root of Digital Earth must now confront concerns over high-risk artificial intelligence systems and power asymmetries of a datafied society. In this commentary, we claim that not only can current debates about data governance and ethical artificial intelligence inform development in the field of Digital Earth, but that the specificities of geospatial data, together with the expectations surrounding Digital Earth applications, offer a fruitful lens through which to examine current debates on data governance and artificial intelligence ethics. In particular, we argue that for the implementation of ethical artificial intelligence and inclusive approaches to data governance, Digital Earth initiatives need to involve stakeholders and communities at the local level and be sensitive to social, legal, cultural, and institutional contexts, including conflicts that might arise within those contexts.
Academic Visits as Transformative Learning Opportunities: The Case of Chinese Visiting Academics
Authors: Zhao Xiantong , Liu Xu
Published: November 2022

Cross-border academic visits by university faculty members are becoming prevalent globally. Unlike previous research, which has focused on the cross-cultural adaptation arising from the cross-border movement of people, we view scholars’ visiting experiences as a learning opportunity in light of Mezirow’s transformative learning theory (TLT). We employ Addleman et al.’s three-stage proposal to better understand the transformative learning process of Chinese visiting scholars. Drawing on Hoggan’s typology, we identify changes in scholars’ worldviews, selves, and behavior as outcomes of transformative learning. We conclude that international experience is beneficial for scholars and call for more study abroad opportunities for Chinese university faculty.
Motivational Strategies Adopted in Postgraduate English Academic Writing Courses: Perspectives of Doctoral Students
Authors: Lee Tim S. O. , Lin Linda H. F.
Published: November 2022

Despite postgraduates’ struggles to master English academic writing, the fulfilment of postgraduates’ motivational needs in classes of English academic writing has been scarcely researched. This study examines the motivational practices of teachers of postgraduate English academic writing, the perceived effectiveness of the adopted strategies, and possible ways to further enhance their effectiveness. Reflective writing was collected from 59 doctoral students who spoke English as a foreign language (EFL) and were enrolled in a thesis writing course. The major findings are: (1) The reported motivational strategies correspond fairly closely to those endorsed in Dörnyei’s influential framework, yet some appear to be common teaching techniques; (2) the majority of the reported positive effects pertain to enhanced knowledge, performance, and confidence; and (3) the participants called for increased use of motivational strategies, more student engagement, and diverse facilitative input from the English teacher. The findings confirm the need to extend studies on the use and perceptions of motivational strategies to postgraduate language teaching contexts.
Anatomic Structures at Risk When Utilizing Percutaneous Intramedullary Fibular Screw Fixation for Lateral Malleolus Fractures: A Cadaveric Study
Authors: Shah Ashish , Littlefield Zachary , Boyd Brandon , Patch David A. , Jacob Roshan , Prahad Srihari R. , Reed Logan , Elphingstone Joseph , Young Sean M. , Sanchez Thomas , Sankey Turner
Published: November 2022

Category:

Ankle

Introduction/Purpose:

Isolated lateral malleolus fractures are a common ankle fracture that a foot and ankle surgeon will encounter. Retrograde intramedullary fixation for unstable lateral malleolus fractures has become a viable option for patients at higher risk for potentially devastating wound complications. The aim of this cadaveric study was to assess the relative risk of injuring adjacent anatomic structures with percutaneous implantation of an intramedullary fibular screw for lateral malleolus fractures to minimize iatrogenic injury.

Methods:

Seven fresh-frozen below-the-knee cadaver specimens were used for this study. Prior to investigations, specimens were inspected with fluoroscopic radiographs for preexisting pathology or prior surgical intervention. Lateral dissection of the lateral malleolus was performed after screw placement to determine the proximity of the peroneus longus (PL), peroneus brevis (PB), and sural nerve (SN) to the inserted hardware. The mean, standard deviation, and range for distances were calculated for all structures. Analysis of variance (ANOVA) was used to determine statistical significance.

Results:

Percutaneous intramedullary fibular screw placement was performed in seven specimens, six females and one male, with an average age of 79.3 +- 8.1 years. Amongst the seven specimens, only one resulted in an injury to a structure of interest (sural nerve). The peroneus longus and peroneus brevis were not injured in any of the specimens. Table 1 shows the average distance between the guidewire and each structure of interest.

Conclusion:

This study shows the potential risks to lateral structures when placing an intramedullary fibular screw for unstable lateral malleolus fractures. We suggest that orthopedic surgeons exercise caution when performing critical steps of the procedure to minimize avoidable injury to structures of importance that may increase the morbidity of the patient.
Medial Structures at Risk During Sinus Tarsi Approach for Fixation of Sustentaculum Tali Fractures: A Cadaveric Study
Authors: Shah Ashish , Kothari Ezan A. , Young Sean M. , Sanchez Thomas , Sankey Turner , Murali Sudarsan , Littlefield Zachary , Luque-Sanchez Kevin S. , Prahad Srihari R. , Young Matthew
Published: November 2022

Category:

Hindfoot; Trauma; Other

Introduction/Purpose:

Calcaneal fractures are a common injury with potential for concomitant involvement of the sustentaculum tali. Common surgical repair involves a sinus tarsi approach with placement of a lag screw from lateral to medial. There is no current study that focuses on the potential damage to the medial structures after screw placement. The goal of this paper was to describe the incidence in which medial structures were damaged using a sinus tarsi approach for lateral to medial screw fixation of the sustentaculum tali.

Methods:

Seven fresh-frozen below-the-knee cadaver specimens were used for the present anatomic dissection study. Prior to investigations, specimens were inspected with fluoroscopic radiographs for any pathology or prior operational intervention Each specimen underwent screw placement using the sinus tarsi approach. Medial dissection of the calcaneus was performed after screw placement to determine the proximity of the anatomical structures of interest to the inserted hardware. The four anatomical structures of interest were the tibialis posterior tendon, flexor hallucis longus, flexor digitorum longus, and posterior neurovascular bundle. Distance from the 4.0 mm screw to the previously mentioned anatomic structures was measured with a scientific ruler and recorded to the nearest millimeter. The mean, standard deviation, and range for distances were calculated for all structures. Analysis of variance (ANOVA) was used to determine statistical significance.

Results:

The average patient age, height, and weight were 79.3 years, 5 feet 4 inches, and 127 lbs respectively. The primary outcome of interest was the longitudinal distance between the medial aspect of the screw to the anatomical structures of interest. On average, the posterior neurovascular bundle had the closest proximity to the medial aspect of the screw for all seven specimens with a mean distance of 6.4 mm. The second closest structure was the FHL with a mean distance of 7 mm, followed by the FDL and tibialis posterior tendon, with mean distances of 9.9 mm and 13.9 mm respectively. The posterior neurovascular bundle was hit by the screw on one occasion, whereas the hardware contacted the FDL on two separate occasions. The screw was placed through the FDL in one of the two occasions; however, the FDL was not transected or ruptured.

Conclusion:

This study sheds more light on the potential risks to medial structures when placing the sustentacular screw during open reduction and internal fixation of displaced intraarticular calcaneal fractures. We urge the orthopedic surgeon to exercise extreme caution when performing this critical step of the procedure to minimize avoidable injury to structures of importance that may increase the morbidity of the patient.
Biomechanical Study of Syndesmotic Stability in AITFL and PITFL Injury Models
Authors: Takahashi Katsunori , Teramoto Atsushi , Murahashi Yasutaka , Shiwaku Kosuke , Nabeki Shogo , Kamiya Tomoaki , Watanabe Kota , Yamashita Toshihiko
Published: November 2022

Category:

Basic Sciences/Biologics; Trauma

Introduction/Purpose:

Severe ankle syndesmotic injuries can cause not only anterior inferior tibiofibular ligament (AITFL) injury but also posterior inferior tibiofibular ligament (PITFL) injury. However, the biomechanical stability and the best surgical treatment method for PITFL injuries are unknown. This study aimed to evaluate the stability of AITFL and PITFL injury models and the treatment models with suture-button (SB) fixation, AITFL augmentation with suture-tape (aST), and PITFL augmentation with suture-tape (pST). We hypothesized that PITFL injury causes posterior instability of syndesmosis and that this can be stabilized with pST fixation

Methods:

This study was approved by our institution's ethics review board. Ten normal fresh-frozen cadaver legs (4 males and 6 females) that were donated to our university's department of anatomy were used. The specimens were tested with the application of traction and rotational forces for dorsiflexion and external and internal rotation of the ankle joint. The fibular rotational angle related to the tibia (FRA), anterior tibiofibular diastasis (aTFD), and posterior tibiofibular diastasis (pTFD) were measured using the magnetic tracking system. Intact, injured (AITFL, PITFL and IOM resection), SB fixation, SB + aST fixation, and SB + aST + pST fixation models were made and loaded with forces. One-way ANOVA was used to evaluate the relationship between the models. Post-hoc analysis of the differences between the models was performed using Dunnett's test. A p value of 0.05 was chosen as the level of significance.

Results:

In the injured model, both FRA and TFD were significantly increased compared with those of the intact model in all directions. In the SB fixation model, only FRA with an external rotation force was significantly increased compared with that of the intact model. In the SB+aST model, both FRA and aTFD were not significantly different from those in the intact model.

Conclusion:

The results of this study showed that there was external and internal rotational instability in the AITFL and PITFL injury models, while there was stability in the SB + aST model. SB fixation alone did not reduce FRA with an external rotation force and there was no significantly different FRA with an internal rotation force. With SB fixation alone, anterior instability was found to be greater than posterior stability, while aST fixation was associated with anterior stability. In this study, the change in syndesmosis stability after pST fixation was found to be restrictive.
Hounsfield Unit Assessed Bone Density Amongst Non-Traumatic and Post-Traumatic Arthritic Total Ankle Arthroplasty Patients
Authors: Thompson John M. , Hyer Christopher F. , Berlet Gregory C. , Houng Brian E. , Perkins Jacob M.
Published: November 2022

Category:

Ankle Arthritis; Ankle; Hindfoot; Trauma

Introduction/Purpose:

The etiology of ankle arthritis is multifactorial and secondary osseous changes to the tibiotalar joint can be variable. The relationship of bone density within the tibia and talus with respect to type of ankle arthritis is not well understood. Improved insight of osseous characteristics amongst ankle arthritis patients is helpful in determining optimal implant selection for total ankle arthroplasty. The purpose of this study is to retrospectively analyze pre-operative total ankle arthroplasty patients' films for osseous characteristics associated traumatic ankle arthritis compared to other forms of arthritis using computed tomography (CT) generated Hounsfield units (HU) to analyze bone mineral density and rate of cyst formation.

Methods:

A retrospective analysis was performed of 440 patients, under a single orthopedic practice, who underwent primary TAA between 2013-2019. Pre-operative HU of tibia and talus were analyzed amongst two groups (Non-traumatic OA, Post- traumatic OA) within one year prior to TAA.

Results:

Forty-nine qualified patients (23 NTA, 26 PTA) with mean follow-up in months of 19.98 (SD 15.22) were analyzed. Cystic changes at level of TAA cuts or retained bone: 5 tibia (10.2%), 7 talus (14.29%), 16 combined (32.65%). Overall tibial HU mean 270.23 (SD 91.28) and talus 463.26 (103.65). HU of the tibia amongst post-traumatic and non-traumatic patients was 257.21 (SD 93.9) and 284.94 (SD 87.9) (p=0.29137) and talus 434.53 (104.7) and 495.75 (94.33) (p=0.0365).

Conclusion:

Our results suggest with tibiotalar arthritis HU is a useful tool to predict bone quality. Clinical results amongst the NTA and PTA groups was comparable. Significantly lower HU values were recorded for the PTA groups. Rate of cystic formation within bone of distal tibia does not necessarily correlate with overall HU measured bone mineral density.
Calcaneal Osteotomies in Prevention of Deformity-Driven Subtalar Joint Arthritis
Authors: Vacketta Vincent G. , Togher Cody J. , Prissel Mark A. , Thompson John M.
Published: November 2022

Category:

Hindfoot

Introduction/Purpose:

Calcaneal osteotomies (CO) have been described thoroughly in reduction of hindfoot and global deformities of the foot and ankle. Their ability to alter the ground reactive forces and abnormal joint motion in various deformities, realigning the mechanical axes to a more normal alignment has been well-described in the literature. Despite the high volume of studies involving calcaneal osteotomies in the correction of hindfoot deformities, few have investigated the protective nature of them in the prevention of end-stage osteoarthritis of the subtalar joint. The purpose of the present study was to identify the preventative nature of calcaneal osteotomies in the prevention of deformity-driven subtalar joint arthritis.

Methods:

255 patients who underwent various calcaneal osteotomies (medial calcaneal displacement, lateral column lengthening, Dwyer) in a 2-year span were reviewed. Minimum of 3 years of follow up was required for the present study, and patient charts were reviewed to see if any went on to subtalar joint fusion secondary to deformity-driven osteoarthritis. Charts were also evaluated for hardware removal and nonunion rates, while lateral radiographs were evaluated for preoperative and long-term postoperative arthritis based on the Kellgren-Lawrence scale.

Results:

After inclusion criteria was applied, 44 patients were ultimately included in the study with an average follow up time of 51.8 months. In the end, 2.3% of patients underwent subtalar joint arthrodesis for treatment of deformity-driven osteoarthritis (1/44). Hardware removal and nonunion rates were 25% (11/44) and 2.3% (1/44), respectively. Kellgren-Lawrence evaluation showed there was some protective nature of CO's in prevention of subtalar joint arthritis, but the inter-observer coefficient was fair between two observers. ICC was fair for preoperative Kelgren Lawrence scores between the two presenters (ICC = 0.664), and poor for postoperative Kelgren Lawrence scores (ICC = 0.459).

Conclusion:

This is one of the only studies to evaluate the protective nature of calcaneal osteotomies in the prevention of deformity-driven subtalar joint arthritis. Clinical evaluation of this group suggested there is some protective nature in calcaneal osteotomies in the prevention of subtalar joint arthritis requiring arthrodesis, supporting the use of these osteotomies in the correction of hindfoot deformities. While the identified KG scores were not consistent between the two presenters, this is consistent with previous studies who investigated KG in the subtalar joint.
Kinematic, Electromyographic Activity and Muscular Architecture Description in Patients Operated with Pars-Dresden Technique
Authors: Valencia Oscar , Silva Diego , Rossi Rafael , Guzman-Venegas Rodrigo , Pellegrini Manuel J. , Ortiz Cristian A. , Chaparro Felipe R. , Carcuro Giovanni M. , Espinoza Carolina Avilés
Published: November 2022

Category:

Sports; Ankle; Basic Sciences/Biologics

Introduction/Purpose:

Kinematic, muscular architecture and myoelectric activity are altered during the healing process after Achilles tendon surgery. Currently, there are minimally invasive surgical techniques (PARS-Dresden) which have accelerated rehabilitation processes. However, evidence that compares kinematic, architecture and myoelectric activity between operated vs. non-operated leg is limited. The aim of this study is to describe the kinematic changes, muscular architecture and electromyographic (EMG) activity of the lower limb between operated vs. non-operated legs after Achilles tendon surgery.

Methods:

After obtaining IRB approval, patients undergoing the PARS-Dresden technique for acute Achilles tendon ruptures were invited to participate. We excluded patients with previous injuries or surgery in lower limbs that affect gait, muscular activity, or architecture. Eleven patients met the inclusion/exclusion criteria. Patients were evaluated at three time-frames: 8, 12, and 24 weeks. Evaluations were performed walking on a treadmill at self-selected speed, while kinematic and surface EMG activity was measured in stance and swing phases of the gait. Kinematic variables were captured using a 3D motion analysis system with eight infrared cameras and twenty reflective markers over the lower limbs. Muscle architecture was evaluated using ultrasonography. A descriptive analysis was performed comparing operated versus non-operated legs.

Results:

Median age 36 years, 3 females. Kinematic evaluation shows sagittal plane asymmetry between operated versus non- operated legs at 8 and 12w. However, the 24w evaluation shows symmetry between both lower limbs. The EMG shows lower activity in the stance phase for the medial gastrocnemius, lateral gastrocnemius, and soleus for operated legs at 8w and 12w, but at the 24w evaluation the activity was symmetric for these muscles evaluated in both legs. The muscular architecture shows less thickness in gastrocnemius muscles in the operated leg at 8w (median 11.2% operated vs 35.4% no-operated), reaching a symmetric thickness at 24w (median 34.2% operated vs 35.7% no-operated). Achilles tendon present asymmetric transversal area between both legs at three time-frames (median 1.88 cm2 versus 0.59 cm2). The pennation angles showed no difference between both legs in the three evaluation periods (median 22.0° versus 24.3° for MG, and 15.0° versus 13.5° for LG).

Conclusion:

We described kinematic, electromyographic and architectonic asymmetries between operated versus non-operated legs at 8 and 12 weeks postoperative of patients who underwent PARS-Dresden surgery for acute Achilles tendon ruptures. All patients achieved symmetric results at 24 weeks evaluation.
Equity in access to safely managed sanitation and prevalence of diarrheal diseases in Bangladesh: a national and sub-national analysis
Authors: Akter Jahanara , Islam Md. Rashedul , Akter Shamima , Rahman Md. Mizanur , Hossain Fahima , Anam Md Rifat , Alam Md. Ashraful , Sultana Papia , Rashid Shahedur
Published: November 2022

Background

In Bangladesh, safely managed sanitation (SMS) coverage is low, and diarrheal disease is a significant health problem. This study estimated the inequality in access to SMS facilities at the national and sub-national levels and assessed the prevalence of diarrheal diseases in connection with these improved facilities.

Methods

Data were extracted from the Bangladesh Demographic and Health Survey, conducted during 2017–2018. SMS was defined as using an improved sanitation facility, which designed to hygienically separate excreta from human contact and include the use of a flush toilet connected to piped sewer system, septic tank, ventilated improved pit latrine, pit latrine with a slab, and composting toilet. The slope index of inequality (SII) and multi-level regression models were used for inequality and risk factors of SMS respectively.

Results

The national coverage of SMS was 44.0% (45.3% and 43.5% in urban and rural areas, respectively). At the sub-national level, the lowest and highest coverage of SMS was observed in Mymensingh (32.9%) and Chittagong (54.1%) divisions, respectively. The national level SII indicated that wealthy households had access to higher SMS by 60.8 percentage points than poor households. Additionally, greater inequality was observed in rural areas, which was 71.9 percentage points higher in the richest households than in the poorest households. The coverage gap between the rich and poor was highest in the Sylhet division (85.3 percentage points higher in rich than in poor) and lowest in Dhaka (34.9 percentage points). Old and highly educated household heads and richest households had better access to higher levels of adequate sanitation. After adjusting for confounding variables, the prevalence of diarrheal disease was 14.0% lower in the SMS user group than in their counterparts.

Conclusion

Substantial inequalities in access to SMS exist at both national and sub-national levels of Bangladesh, with the prevalence of diarrhea being lower among SMS users. These findings may help to prioritize resources for reducing inequality and expanding the coverage of improved sanitation in Bangladesh.
Associations of extended work, higher workloads and emotional work demands with sleep disturbance among night-shift workers
Authors: Jeon Bo Min , Kim Su Hyun
Published: November 2022

Background

In-depth investigation of the factors that exacerbate sleep disturbance among night-shift workers is essential to develop a successful implementation strategy to improve sleep. Although some characteristics of work associated with sleep disturbances have been investigated, there are inconsistencies in the findings. This study aimed to assess the influence of working time and work characteristics on sleep disturbance among night-shift workers.

Methods

This study was a secondary data analysis of a nationally representative sample of data from the fifth Korean Working Condition Survey in 2017. A total of 1,790 wage workers aged between 19 and 64 years with night shift schedules were selected and analyzed. A multiple logistic regression analysis was conducted to analyze the influences of working time characteristics, including shift type, frequency of night shift, and extended work; as well as work characteristics, including physical work demands, workload, emotional work demands, social support, and communication, on sleep disturbance among night-shift workers.

Results

Of those analyzed, 8.4% of night-shift workers experienced sleep disturbances. Night-shift workers with extended work, higher workloads, and emotional work demands were more likely to experience sleep disturbances (OR = 1.53, 95% CI = 1.05 to 2.23; OR = 1.01, 95% CI = 1.01 to 1.03; OR = 1.03, 95% CI = 1.02 to 1.05; respectively).

Conclusion

Extended work, higher workload, and emotional work demands were significant factors for sleep disturbance among night-shift workers. These findings highlight the importance of adjusting work demands and mitigating extended work to reduce sleep disturbance in night-shift workers.
Relationship between estrus endometrial edema and progesterone production in pregnant mares two weeks after ovulation
Authors: Grabowska Anna , Kozdrowski Roland
Published: November 2022

Background

Progesterone plays a crucial role in the maintenance of pregnancy from conception to about 100–120 days of gestation when placenta becomes the main source of gestagens. The aim of the study was to test progesterone concentration 14 days after ovulation in pregnant mares and relate it to peak estral endometrial edema and the presence of intrauterine fluid (IUF) after artificial insemination (AI), the number of treatments against IUF, and the time from AI to the day when the uterus was found free of fluid.

Results

Mares were divided into two groups: group A (n = 13; age 10.8 ± 4.5 years) in which a normal embryonic vesicle with a diameter ≥ 14 mm and a corpus luteum with a diameter ≥ 15 mm were found 14 days after ovulation, and group B (n = 22; age 9.4 ± 4 .0 years) in which 14 days after ovulation, a small (< 15 mm) corpus luteum and/or a small embryonic vesicle was observed (diameter < 14 mm). Mares from group A had a significantly higher progesterone concentrations at 14 days after ovulation compared with group B mares. The presence of IUF, the number of treatments against IUF, and the time from AI to the day when uterus was found free of fluid did not affect progesterone concentration measured 14 days after ovulation. In group B, a significant correlation was found between progesterone concentration measured 14 days after ovulation and endometrial edema evaluated during estrus.

Conclusions

In some cases poor development of endometrial edema during estrus can be associated with lower progesterone production 14 days after ovulation. Nevertheless, scientific explanation for this finding cannot be given based on our study.
Management of type 1 immediate hypersensitivity reactions to antituberculosis drug: succesful desensitization
Authors: Katran Zeynep Yegin , Bulut İsmet , Babalik Aylin , Keren Metin
Published: November 2022

Objective

In this study, it was aimed to investigate the prevalence of type 1 hypersensitivity reaction under tuberculosis treatment and the management of hypersensitivity.

Methods

The study is a case series. All of the patients who were hospitalized between 01.02.2015–01.05.2021 were examined. All patients who developed a drug-induced type 1 immediate hypersensitivity reaction were included. Antituberculosis drugs were given with the protocol made by Buhari et al. However, unlike what is stated in the protocol, pyrazinamide was given last during the administration of the drugs.

Results

2677 patients received inpatient tuberculosis treatment; type 1 immediate hypersensitivity reactions were seen in 94 (3.5%) patients. Due to missing data in the file, 81 patients were included in the study. 44 (54.3%) of the cases were women; mean age (mean ± SD) 50.7 ± 17.69 years; 76 (93.8%) of them are citizens of the Republic of Turkey; 58 (71.6%) of them were diagnosed bacteriologically; 65 (80.2%) of them were pulmonary tuberculosis. The most common skin finding was urticaria in 49 (60.5%). The drug responsible for the most common reaction was pyrazinamide. In 49 (60.5%) cases, drugs were given by desensitization and it was successful. The duration of treatment was 7.91 ± 2.5 months (6–18 months). When evaluated in terms of treatment results, 68 (84%) patients successfully completed the treatment.

Conclusion

Our study is the largest series of patients who developed type 1 immediate hypersensitivity reaction while receiving antituberculosis treatment. A practical, easy desensitization scheme has been shared.
Evaluation of the national sobriety checkpoints program in Mexico: a difference-in-difference approach with variation in timing of program adoption
Authors: Mullachery Pricila H. , Quistberg D. Alex , Lazo Mariana , Indvik Katherine , Perez-Ferrer Carolina , López-Olmedo Nancy , Colchero M. Arantxa , Bilal Usama
Published: November 2022

Background

Up to a third of global road traffic deaths, and one in five in Mexico, are attributable to alcohol. In 2013, Mexico launched a national sobriety checkpoints program designed to reduce drink-driving in municipalities with high rates of alcohol-related collisions. Our study measured the association between the sobriety checkpoints program and road traffic mortality rates in 106 urban municipalities.

Methods

We leveraged data from the Salud Urbana en America Latina (SALURBAL), which compiles health and environmental data from cities with over 100,000 residents. Death data from 2005 to 2019 (i.e., outcome) were from official vital statistics. Among 106 Mexican municipalities defined as priority areas for intervention, 54 adopted the program (i.e., treatment) in 2013, 16 municipalities did so in 2014, 16 in 2015, 10 in 2016, 7 in 2017, and 2 in 2019. We used a difference-in-difference approach with inverse probability weighting adapted to a context where program adoption is staggered over time.

Results

There was a 12.3% reduction in road traffic fatalities per 10,000 passenger vehicles in the post-treatment period compared to the pre-treatment period (95% Confidence Interval, − 17.8; − 6,5). There was a clear trend of decline in mortality in municipalities that adopted the program (vs. comparison) particularly after year 2 of the program.

Conclusions

In this study of 106 municipalities in Mexico, we found a 12.3% reduction in traffic fatalities associated with the adoption of sobriety checkpoints. There was a clear trend indicating that this association increased over time, which is consistent with sustained changes in drink-driving behavior. These findings provide support and insight for efforts to implement and evaluate the impact of sobriety checkpoint policies across Latin America.
Migration complications of lumboperitoneal shunts
Authors: Elshirbiny Mohammad Fekry , Badr Hatem , ahmed Assem , serag Samer , Khalil Amr farid
Published: November 2022

Background

Lumboperitoneal (LP) shunts have been described as a safe and effective option for idiopathic intracranial hypertension (IIH). However, it had many complications, including migration. Herein, we report our experience regarding the incidence, different sites, presentation, and management of LP shunt migration in patients with IIH.

Patients and methods

This retrospective series reviewed the data of IIH patients who had migration after LP shunt during the period between January 2018 and June 2021.

Results

From 67 patients who had LP shunt, 12 patients developed shunt migration. Two cases had intrathecal migration, while three cases had intraperitoneal migration. In four cases, the distal tube migrated to the subcutaneous location at the abdomen, whereas the other two cases had the proximal tube migrated outside the thecal sac to the subcutaneous location in the back. In one case, the distal tube migrated from the abdomen to the back subcutaneously.

Conclusion

The insertion of LP shunts appears to be a relatively safe technique. Shunt migration, on the other hand, is a common side effect. While various theories have been proposed to explain shunt migration, good shunt fixation remains the most critical component in preventing shunt migration.