bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations of the COVID-19 pandemic with the reported incidence of important endemic infectious disease agents and syndromes in Pakistan
Authors: Missaghi Bayan , Malik Muhammad Wasif , Shaukat Waseem , Ranjha Muazam Abbas , Ikram Aamer , Barkema Herman W.
Published: November 2022

Background

Persons in Pakistan have suffered from various infectious diseases over the years, each impacted by various factors including climate change, seasonality, geopolitics, and resource availability. The COVID-19 pandemic is another complicating factor, with changes in the reported incidence of endemic infectious diseases and related syndromes under surveillance.

Methods

We assessed the monthly incidence of eight important infectious diseases/syndromes: acute upper respiratory infection (AURI), viral hepatitis, malaria, pneumonia, diarrhea, typhoid fever, measles, and neonatal tetanus (NNT), before and after the onset of the COVID-19 pandemic. Administrative health data of monthly reported cases of these diseases/syndromes from all five provinces/regions of Pakistan for a 3-year interval (March 2018–February 2021) were analyzed using an interrupted time series approach. Reported monthly incidence for each infectious disease agent or syndrome and COVID-19 were subjected to time series visualization. Spearman’s rank correlation coefficient between each infectious disease/syndrome and COVID-19 was calculated and median case numbers of each disease before and after the onset of the COVID-19 pandemic were compared using a Wilcoxon signed-rank test. Subsequently, a generalized linear negative binomial regression model was developed to determine the association between reported cases of each disease and COVID-19.

Results

In late February 2020, concurrent with the start of COVID-19, in all provinces, there were decreases in the reported incidence of the following diseases: AURI, pneumonia, hepatitis, diarrhea, typhoid, and measles. In contrast, the incidence of COVID was negatively associated with the reported incidence of NNT only in Punjab and Sindh, but not in Khyber Pakhtunkhwa (KPK), Balochistan, or Azad Jammu & Kashmir (AJK) & Gilgit Baltistan (GB). Similarly, COVID-19 was associated with a lowered incidence of malaria in Punjab, Sindh, and AJK & GB, but not in KPK and Balochistan.

Conclusions

COVID-19 was associated with a decreased reported incidence of most infectious diseases/syndromes studied in most provinces of Pakistan. However, exceptions included NNT in KPK, Balochistan and AJK & GB, and malaria in KPK and Balochistan. This general trend was attributed to a combination of resource diversion, misdiagnosis, misclassification, misinformation, and seasonal patterns of each disease.
Changing patterns of SARS-CoV-2 infection through Delta and Omicron waves by vaccination status, previous infection and neighbourhood deprivation: a cohort analysis of 2.7 M people
Authors: Green Mark A. , Hungerford Daniel J. , Hughes David M. , Garcia-Fiñana Marta , Turtle Lance , Cheyne Christopher , Ashton Matthew , Leeming Gary , Semple Malcolm G. , Singleton Alex , Buchan Iain
Published: November 2022

Background

Our study examines if SARS-CoV-2 infections varied by vaccination status, if an individual had previously tested positive and by neighbourhood socioeconomic deprivation across the Delta and Omicron epidemic waves of SARS-CoV-2.

Methods

Population cohort study using electronic health records for 2.7 M residents in Cheshire and Merseyside, England (3rd June 2021 to 1st March 2022). Our outcome variable was registered positive test for SARS-CoV-2. Explanatory variables were vaccination status, previous registered positive test and neighbourhood socioeconomic deprivation. Cox regression models were used to analyse associations.

Results

Originally higher SARS-CoV-2 rates in the most socioeconomically deprived neighbourhoods changed to being higher in the least deprived neighbourhoods from the 1st September 2021, and were inconsistent during the Omicron wave. Individuals who were fully vaccinated (two doses) were associated with fewer registered positive tests (e.g., individuals engaged in testing between 1st September and 27th November 2021—Hazards Ratio (HR) = 0.48, 95% Confidence Intervals (CIs) = 0.47–0.50. Individuals with a previous registered positive test were also less likely to have a registered positive test (e.g., individuals engaged in testing between 1st September and 27th November 2021—HR = 0.16, 95% CIs = 0.15–0.18. However, the Omicron period saw smaller effect sizes for both vaccination status and previous registered positive test.

Conclusions

Changing patterns of SARS-CoV-2 infections during the Delta and Omicron waves reveals a dynamic pandemic that continues to affect diverse communities in sometimes unexpected ways.
Neonatal eyelid penetration from insertion of a fetal scalp electrode: a case report
Authors: Cheng Brian T. , Laurenti Kelly D. , Kurup Sudhi P.
Published: November 2022

Background

A fetal scalp electrode (FSE), first described by Edward Hon in 1967, is an intrapartum monitoring device embedded directly into the fetal scalp for an accurate measure of fetal heart rate. Though use of an FSE is generally safe, complications can occur from misplacement, including ophthalmic injury.

Case presentation

Patient was a 28-year-old G6P5006 who presented for induction of labor at 39 weeks due to asymptomatic bilateral pulmonary embolism. Concerning findings on external fetal monitoring led to placement of a fetal scalp electrode for close monitoring. Upon delivery, the neonate was noted to have the FSE embedded in the left upper eyelid. Ophthalmology was consulted and could not rule out ocular injury on external examination at the bedside. Examination under anesthesia in the operating room demonstrated no penetration of the ocular globe, and the eyelid laceration was sutured. The laceration was well-healing at one-week follow-up with no further complications.

Conclusion

Facial or brow presentation during delivery is rare but may increase the risk for misplacement of an FSE. Ultrasound verification of vertex position is warranted immediately prior to placing an FSE for patients at higher risk of facial or brow presentation. Periorbital edema of neonates may protect against damage to deeper structures. However, Ophthalmology should be consulted to rule out ocular injury if the FSE is placed in the periocular region.
The prevalence and associated factors of prenatal depression and anxiety in twin pregnancy: a cross-sectional study in Chongqing, China
Authors: Zhou Ying , Huang Jingui , Baker Philip N. , Liao Bizhen , Yu Xinyang
Published: November 2022

Background

Pregnant women expecting twins are more likely to experience stress, which can lead to anxiety and depression. Our aim was to investigate the prevalence of prenatal anxiety and depressive symptoms in women with twin pregnancies and the associated factors.

Methods

In a cross-sectional survey, 210 women with twin pregnancies who satisfied the inclusion and exclusion criteria in two tertiary centers in Southwestern China were asked to complete a basic information form, the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). To compare statistics with normal distribution in distinct characteristic groups, a paired t-test, and one-way ANOVA were utilized. Binary logistic step regression was used to analyze the associated factors of antenatal anxiety and depressive symptoms.

Results

The 210 women with twin pregnancies (age = 30.8 ± 4.2 years) were between 7 and 37 gestational weeks (29.2 ± 1.2 weeks), were typically well-educated (72.4% had a post-high-school degree), and reasonably affluent (88.1% were above the low-income cutoff). Among them, 34.8% had symptoms associated with clinical levels of anxiety, and 37.1% had symptoms indicating possible depression. The prevalence of co-morbid anxiety and depressive symptoms was 24.3%. Binary stepwise logistic regression analysis showed that previous health status and sleep disturbance during pregnancy were the associated factors of anxiety symptoms in women with twin pregnancies (P < 0.05), whereas age, previous health status, negative life events, and physical activity during pregnancy were the associated factors of depressive symptoms in women with twin pregnancies (P < 0.05).

Conclusion

About one-third of women with twin pregnancies had symptoms of anxiety or depression; these were most strongly predicted by some modifiable factors, suggesting that early preventive mind-body interventions may be a promising strategy to protect against mental health issues for women with twin pregnancies.
The association of serum total bile acid with new-onset hypertension during pregnancy
Authors: Deng Weinan , Zhang Lizi , Du Qiting , Li Yulian , Chen Jingsi , Du Lili , Chen Dunjin
Published: November 2022

Background

There has been considerable interest in the interrelationship between the liver and hypertension. The relationship between serum total bile acid (TBA) and hypertension has been reported. Moreover, intrahepatic cholestasis of pregnancy was correlated to gestation hypertension. However, the association between maternal serum TBA level in the normal range and new-onset hypertension disorders during pregnancy remains unclear. The present study aimed to evaluate the relationship between maternal serum TBA level in the normal range and the risk, disease severity and adverse pregnancy outcomes of new-onset hypertension during pregnancy.

Method

Using the electronic medical records on all pregnant women from the Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, between 2014 and 2020, we conducted a retrospective cohort study of 2581 singleton pregnant women with maternal serum TBA levels in the normal range. Patients were grouped into the non-hypertension during pregnancy (1071), gestational hypertension (480) and preeclampsia (1030) groups.

Result

We found that maternal serum TBA levels were significantly higher in the preeclampsia and gestational hypertension groups than in the non-hypertension group (p < 0.01). Multiple logistic regression analysis showed that TBA level was independently and significantly associated with preeclampsia and gestational hypertension (odds ratio: 1.37, 95% confidence interval [CI]: 1.27–1.48, p = 0.001, odds ratio: 1.34, 95% confidence interval [CI]: 1.24–1.46, p = 0.005, respectively). Moreover, elevated TBA level was positively associated with the risk of severe PE and negatively with mild PE (p < 0.01). In addition, maternal serum TBA levels were negatively related to birth weight (p < 0.001).

Conclusions

These results suggest that maternal serum TBA in the normal range also might be a valuable biomarker for disease severity in preeclampsia and gestational hypertension. Additionally, our results also indicate associations of serum total bile acid levels in the normal range with an increased risk of fetal growth restriction and low birth weight among offspring. These results suggest that TBA could serve as a prognostic biomarker for new-onset hypertension during pregnancy.
Prediction of radiosensitivity and radiocurability using a novel supervised artificial neural network
Authors: Zeng Zihang , Luo Maoling , Li Yangyi , Li Jiali , Huang Zhengrong , Zeng Yuxin , Yuan Yu , Wang Mengqin , Liu Yuying , Gong Yan , Xie Conghua
Published: December 2022

Background

Radiotherapy has been widely used to treat various cancers, but its efficacy depends on the individual involved. Traditional gene-based machine-learning models have been widely used to predict radiosensitivity. However, there is still a lack of emerging powerful models, artificial neural networks (ANN), in the practice of gene-based radiosensitivity prediction. In addition, ANN may overfit and learn biologically irrelevant features.

Methods

We developed a novel ANN with Selective Connection based on Gene Patterns (namely ANN-SCGP) to predict radiosensitivity and radiocurability. We creatively used gene patterns (gene similarity or gene interaction information) to control the "on–off" of the first layer of weights, enabling the low-dimensional features to learn the gene pattern information. ANN-SCGP was trained and tested in 82 cell lines and 1,101 patients from the 11 pan-cancer cohorts.

Results

For survival fraction at 2 Gy, the root mean squared errors (RMSE) of prediction in ANN-SCGP was the smallest among all algorithms (mean RMSE: 0.1587–0.1654). For radiocurability, ANN-SCGP achieved the first and second largest C-index in the 12/20 and 4/20 tests, respectively. The low dimensional output of ANN-SCGP reproduced the patterns of gene similarity. Moreover, the pan-cancer analysis indicated that immune signals and DNA damage responses were associated with radiocurability.

Conclusions

As a model including gene pattern information, ANN-SCGP had superior prediction abilities than traditional models. Our work provided novel insights into radiosensitivity and radiocurability.
Analysing outlier communities to child birth weight outcomes in Malawi: application of multinomial logistic regression model diagnostics
Authors: Sakala Natasha , Kaombe Tsirizani M.
Published: November 2022

Studies have reported significant effect of geographically shared variables on new-born baby weight. Although there is growing use of community-based child health interventions in public health research, such as through provinces, schools, or health facilities, there has been less interest by researchers to study outlying communities to child birth weight outcomes. We apply multinomial logistic regression model diagnostics to identify outlier communities to child birth weight in Malawi. We use a random sample of 850 clusters, each with at least 7 households based on 2015-16 Malawi demographic and health survey data. There were a total of 11,680 children with measured birth weight, that was categorised as either low ($$< 2,500$$<2,500grams), normal ($$2,500 - 4,000$$2,500-4,000grams) or high ($$> 4,000$$>4,000grams). The analyses were done in STATA version 15 and R version 3.6.3. Based on a multinomial logit model with various socio-demographic factors associated with child birth weight, the results showed that two clusters from rural parts of Southern region of Malawi had overly influence on estimated effects of the factors on birth weight. Both clusters had normal to high birth weight babies, with no child having low birth weight. There could be some desired motherhood practices applied by mothers in the two rural clusters worth learning from by policy makers in the child healthcare sector.
Smartphone addiction in children: patterns of use and musculoskeletal discomfort during the COVID-19 pandemic in Iran
Authors: Mokhtarinia Hamid Reza , Torkamani Maryam Heydari , Farmani Ozra , Biglarian Akbar , Gabel Charles Philip
Published: November 2022

Background

Smartphone use has increased significantly, especially during the period of global pandemic caused by the novel SARS-CoV2 coronavirus (COVID-19). Concurrently, smartphone addiction is a growing social problem in children and adolescents with the consequence of adverse health outcomes. This study assessed the prevalence of smartphone addiction, patterns of use, and the experienced body-region discomfort among Iranian school students during the COVID-19 pandemic.

Methods

A cross-sectional study with students from grades 1–9 recruited n = 585 participants (mean age = 14.49 (2.26 years); female = 65.8%). Data were collected from parents and students through the online 'Smartphone addiction scale-short version’ (SAS-SV), self-reported demographic questionnaires, and extracts of the Nordic musculoskeletal questionnaire for the evaluation of musculoskeletal disorders.

Results

The prevalence rate of smartphone addiction (53.3%) was relatively high in the overall sample. Participants spent 6.85 (4.62) hours per day on their smartphones, which had increased 53.86% relative to the pre-pandemic period. The primary smartphone uses were for social networking (77.9%), web-surfing (53.3%), and camera activities (50.9%). There was a positive correlation between smartphone addiction as assessed with the SAS-SV and daily use time (r = 0.34, p < 0.001), and the percentage of change relative to the pre-pandemic period (r = 0.26, p < 0.001). Discomfort related to smartphone use was mostly reported as present in the eyes (39.7%) and neck (39.1%). A positive correlation was found (p < 0.001) between smartphone addiction and discomfort in the eyes, neck, wrists, shoulders, and upper-back.

Conclusion

The more frequent usage of smartphones by students during the Covid-19 pandemic were associated predominantly with discomfort to the eyes and neck. Parents should consider the complications of musculoskeletal and postural changes during the child’s future years and pay particular attention to the individual’s patterns of smartphone use with an emphasis on posture and usage that reduces discomfort to the eyes and the musculoskeletal system, particularly the neck.
Combined negative pressure wound therapy with irrigation and dwell time and artificial dermis prevents infection and promotes granulation formation in a ruptured giant omphalocele: a case report
Authors: Nakagawa Yoichi , Uchida Hiroo , Hinoki Akinari , Shirota Chiyoe , Sumida Wataru , Makita Satoshi , Amano Hizuru , Okamoto Masamune , Takimoto Aitaro , Ogata Seiya , Takada Shunya , Kato Daiki , Gohda Yousuke
Published: November 2022

Background

Omphalocele is a congenital abdominal wall defect of the umbilical cord insertion site. A giant omphalocele, with a fascial defect > 5 cm in diameter and/or containing > 50% of the liver within the hernia sac, can be challenging for pediatric surgeons. Recently, negative pressure wound therapy has been reported as an effective management for giant omphaloceles; however, it is not recommended for an infected wound with necrotic tissue as it may exacerbate infection. We adopted negative pressure wound therapy with irrigation and dwell time (NPWTi-d) for a case of a ruptured giant omphalocele. Artificial membranes, followed by artificial dermis, were used to promote fibrous capsule formation, and then NPWTi-d was used to promote granulation while controlling infection. However, studies have not been conducted regarding NPWTi-d for ruptured giant omphaloceles; hence, we present our treatment experience with NPWTi-d for a giant omphalocele.

Case presentation

The patient was a boy born at 38 weeks and 3 days of gestation, weighing 1896 g. He was diagnosed with a ruptured giant omphalocele with a total liver and intestine defect hole of 10 cm × 10 cm. The patient underwent silo placement using an artificial mesh, followed by plicating the artificial mesh at 4 days of age. The herniated viscera were gradually reduced into the abdominal cavity; however, the defect size was still large. Hence, a collagen-based artificial dermis was patched on the defect hole. After creating a fresh and smooth granulated tissue, NPWTi-d was applied at 33 days of age to promote granulation and control infection. We used the 3 M™ V.A.C.® Ulta Therapy Unit with 3 M™ VeraFlo™ therapy. NPWTi-d was stopped at 60 days of age when the granulation tissue was well formed including at the artificial dermis site. The wound was managed with prostandin ointment and appropriate debridement, resulting in complete epithelialization at 5 months of age.

Conclusions

Artificial membranes followed by artificial dermis were used to promote a fibrous capsule and artificial dermis granulation, which protects against organ damage. NPWTi-d achieved better control of infection and promoted wound healing. NPWTi-d combined with artificial dermis can effectively treat ruptured giant omphaloceles.
Real-world effectiveness of omalizumab for severe allergic asthma treatment in Colombia
Authors: Torres-Duque Carlos A. , Ocampo-Gómez Jaime , Castillo Mauricio Morales , Cano-Rosales Diana , Giraldo-Montoya Ángela , Rodríguez Freddy , Palacios-Ortega Isabel , Durán-Silva Mauricio , Reynales Humberto , García Elizabeth ,   REXACOL Consortium, Proaños-Jurado Juliana , Carreño Alejandro , Celis Ana M. , Chapman Edgardo , García Maria B. , González-García Mauricio , Jiménez-Maldonado Libardo , Londoño Julian , Morales Edison , Morales-Castillo Mauricio , Valencia Viviana , Vanegas Ingrid , Vargas-Ramírez Leslie
Published: November 2022

Background

The allergic phenotype is responsible for more than 50% of severe asthma cases. In a stepwise approach, add-on treatments such as anti-IgE are used for severe allergic asthma (SAA). This study was aimed to describe the real-world effectiveness of omalizumab in adult and pediatric patients with SAA in Colombia.

Methods

This was an observational, non-interventional, retrospective study. Data from patients with SAA that received at least one month of treatment with omalizumab was obtained from medical records at eight sites in Colombia. Time-zero (t − 0) was defined as the date of initiation of omalizumab, and data was gathered for a 12-month period before t − 0 and a 12-month period after t − 0. Clinical outcomes, including exacerbations, were assessed at 6 and 12 months. Effectiveness of omalizumab was evaluated in terms of the reduction of the risk of exacerbations (annualized rate).

Results

We included 143 patients with SAA. There was a decrease of 72.4% of the annualized rate of clinically significant asthma exacerbations during the year after omalizumab (from 1.74 before to 0.48 after) with a substantial reduction of the risk of exacerbations by 56.7% (RR [95% CI] 0.43 [0.30–0.63]p < 0,001).

Conclusion

The use of omalizumab in Colombia as a treatment for SAA notably reduced the risk of clinically significant exacerbations. This study is the first to evaluate omalizumab real-life effectiveness in pediatric and adult patients in the country.
Effects of mitochondrial dysfunction on bone metabolism and related diseases: a scientometric study from 2003 to 2022
Authors: Zhang Wei , Xia Chang-Liang , Ma Jun-Nan , Li Jia-Xuan , Chen Qi , Ou Shuan-Ji , Yang Yang , Qi Yong , Xu Chang-Peng
Published: November 2022

Background

In recent years, mitochondrial dysfunction has been extensively studied and published, but research on the effects of mitochondrial dysfunction on bone metabolism and related diseases is only just beginning. Furthermore, no studies have been carried out to systematically illustrate this area from a scientometric point of view. The goal of this research is to review existing knowledge and identify new trends and possible hotspots in this area.

Methods

All publications related to the relationship between mitochondrial dysfunction and bone metabolism and related diseases from 2003 to 2022 were searched at the Web of Science Core Collection (WoSCC) on May 7, 2022. Four different analytical tools: VOSviewer 1.6.18, CiteSpace V 6.1, HistorCite (12.03.07), and Excel 2021 were used for the scientometric research.

Results

The final analysis included 555 valid records in total. Journal of Biological Chemistry (Co-citations = 916) is the most famous journal in this field. China (Percentage = 37%), the United States (Percentage = 24%), and Korea (Percentage = 12%) are the most productive countries. Blanco FJ and Choi EM are the main researchers with significant academic influence. Current research hotspots are basic research on mitochondrial dysfunction and the prevention or treatment of bone metabolism-related diseases.

Conclusion

The study of the consequences of mitochondrial dysfunction on bone metabolism and associated diseases is advancing rapidly. Several prominent researchers have published extensive literature and are widely cited. Future research in this area will focus on oxidative stress, aging, gene expression, and the pathogenesis of bone metabolism-related diseases.
MiR-145 inhibits the differentiation and proliferation of bone marrow stromal mesenchymal stem cells by GABARAPL1 in steroid-induced femoral head necrosis
Authors: Xu Pengfei , Chang Jun , Ma Guangwen , Liao Faxue , Xu Tangbing , Wu Yunfeng , Yin Zongsheng
Published: November 2022

Steroid-induced osteonecrosis of femoral head (SANFH) involves impaired differentiation of bone marrow mesenchymal stem cells (BMSC), the mechanism of which is regulated by multiple microRNAs. Studies have shown that miR-145 is a key regulatory molecule of BMSC cells, but its mechanism in steroid-induced femur head necrosis remains unclear. The present study mainly explored the specific mechanism of miR-145 involved in SANFH. In this study dexamethasone, a typical glucocorticoid, was used to induce osteogenic differentiation of BMSC cells. Western blot, qPCR, CCK8 and flow cytometry were used to investigate the effects of miR-145 on the proliferation and differentiation of BMSC. The relationship between miR-145 and GABA Type A Receptor Associated Protein Like 1(GABARAPL1) was identified using dual luciferase reports and the effects of the two molecules on BMSC were investigated in vitro. The results showed that miR-145 was up-regulated in SANFH patients, while GABARAPL1 was down-regulated. Inhibition of miR-145 can improve apoptosis and promote proliferation and activation of BMSC. GABARAPL1 is a downstream target gene of miR-145 and is negatively regulated by miR-145. In conclusion, miR-145 regulates the proliferation and differentiation of glucocorticoid-induced BMSC cells through GABARAPL1 and pharmacologically inhibit targeting miR-145 may provide new aspect for the treatment of SANFH.
Prevalence of musculoskeletal disorders among taxi drivers in Yaoundé, Cameroon: preventive effect of physical activity
Authors: Ngatcha Tchounga Chrystelle Cassandre , Azabji Kenfack Marcel , Guessogo Wiliam Richard , Mekoulou Ndongo Jerson , Bika Léle Elysée Claude , Ayina Ayina Clarisse Noël , Temfemo Abdou , Bongue Bienvenu , Mandengue Samuel Honoré , Etoundi Ngoa Laurent Serge , Assomo Ndemba Peguy Brice
Published: November 2022

Background

Musculoskeletal Disorders (MSDs) are very common conditions in the workplace. Among professional drivers, there would be an increased risk of developing these disorders. Identifying the associated factors would allow us to better devise effective prevention strategies. Our objective was to determine the prevalence of MSDs among taxi drivers in the city of Yaoundé and to search for associated factors, mainly the level of physical activity.

Methods

We conducted an analytical cross-sectional study of 151 adult male professional taxi drivers. We used a non-probabilistic consecutive and non-exhaustive sampling method. Sociodemographic, anthropometric and occupational data were collected. MSDs over the past 12 months were assessed using the Nordic Questionnaire and physical activity level was determined by the World Health Organization (WHO) Global Physical Activity Questionnaire (GPAQ). Univariate logistic regression models, followed by a multivariate logistic regression, were used to determine factors associated with the presence of MSDs.

Results

The overall prevalence of MSDs was 86.8% (95% CI 80.8 – 91.4); the most affected areas were mainly the lower back (72.8%) the neck (42.4%), and the knees (29.1%). Job dissatisfaction was associated with MSDs (OR = 2.1 95%CI = 1.1–3.9). Most taxi drivers (62.9%) had a low physical activity level and no association was found between the physical activity level and MSDs.

Conclusions

MSDs are common ailments among taxi drivers in Yaoundé (Cameroon). There is a need to think about how to address job dissatisfaction and better identify other associated factors in order to define good prevention strategies.
Clinical efficacy and feasibility of laser correction technology with an ordinary laser pen and surgical instrument box in open-wedge high tibial osteotomy
Authors: Xu Zhe , Tian Guang , Zhang Ruguo , Wu Zhanyu , Liu Chen , Ye Chuan
Published: November 2022

Background

The clinical outcomes of open-wedge high tibial osteotomy (OWHTO) for medial knee osteoarthritis primarily depend on the corrective precision. The present study aimed to determine the efficacy and feasibility of laser correction technology with an ordinary laser pen and surgical instrument box.

Methods

This prospective and randomized trial included 71 patients randomly divided into laser (n = 36) and traditional groups (n = 35). In the laser group, the hip centre, knee (Fujisawa point), and ankle centre were located preoperatively using the surgical instrument box lid. The leg was aligned with an ordinary laser pen. In the traditional group, the lower limb alignment was corrected by a metal cable. Radiation exposure, operative time, and rate of outliers (lower limb force line does not pass through 62–66% of the lateral tibial plateau) were evaluated. The visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were recorded. After 24 months, the femoral tibial angle (FTA), medial proximal tibial angle (MPTA), and posterior slope angle (PSA), were recorded. The Kaplan-Meier method was used to evaluate the survival time of affected knees, and postoperative complications were recorded.

Results

The radiation exposure, operative time and rate of outliers were lower in the laser correction group (P < 0.05). Six months postoperatively, the VAS and WOMAC scores were significantly improved in both groups (P < 0.001). At 24 months, the FTA, MPTA, and PSA were corrected in both groups (P < 0.001). There were no differences in the postoperative knee survival time from OWHTO to knee arthroplasty between the groups or postoperative complications (P = 0.53; P = 0.61).

Conclusions

Laser correction technology can effectively reduce radiation exposure, the operative time, and the rate of outliers (trial identification number (retrospectively registered): ChiCTR2200060480; date of register: 03/06/2022).
Efficacy of transforaminal lumbar interbody fusion in the treatment of double-level lumbar spondylolisthesis with sagittal imbalance
Authors: Luan Haopeng , Wang Yao , Liu Kai , Sheng Weibin , Deng Qiang
Published: December 2022

Objective

To analyze the clinical efficacy of transforaminal lumbar interbody fusion (TLIF) in the treatment of continuous double-level lumbar spondylolisthesis with sagittal imbalance.

Methods

The clinical data of 36 patients with double-level spondylolisthesis treated with TLIF were included and divided into L3/L4 double spondylolisthesis group and L4/L5 double spondylolisthesis group according to the site of spondylolisthesis. The sagittal parameters of the patients were measured by standing anteroposterior and lateral X-rays of the whole spine, and the visual analogue scale (VAS) for lumbar and lower limb pain, Japanese Orthopaedic Association (JOA), and Oswestry Disability Index (ODI) were recorded. The imaging parameters and clinical parameters of the patients before surgery, after surgery, and at the last follow-up were compared and statistically analyzed.

Results

A total of 36 patients were included in the study and all had sagittal imbalance. Among them, there were 21 cases of L3 and L4 spondylolisthesis, 6 males and 15 females, with an average age of 64.7 ± 9.4 years; there were 15 cases of L4 and L5 spondylolisthesis, 4 males and 11 females, with an average age of 66.5 ± 8.0 years. 36 patients completed the operation, the operation time was 190.28 ± 6.12 min, and intraoperative blood loss was 345 ± 11 ml. Compared with preoperative, there were significant differences in SVA, TPA, T1-SPi, LL, PT, SS, PI-LL, SD, SA, and SP between patients after surgery and at the last follow-up (P < 0.05). Compared with preoperative, VAS score, JOA score, and ODI index of waist and lower limbs were significantly improved after the operation and at the last follow-up, and there was a significant difference (P < 0.05).

Conclusion

TLIF can effectively relieve the symptoms of patients with continuous double-level lumbar spondylolisthesis, restore lumbar lordosis and sagittal spinal sequence, and improve the quality of life of patients.
Associations between 44 nonmetric permanent dental traits or anomalies with skeletal sagittal malocclusions and sex, besides correlations across the variations or abnormalities
Authors: Ashoori Negin , Ghorbanyjavadpour Fataneh , Rakhshan Vahid
Published: November 2022

Introduction

Nonmetric dental traits and the shape, size, or number of dental anomalies are essential to various dental fields such as orthodontics, dental anatomy, anthropology, pathology, and forensic dentistry. Nonetheless, many are not well assessed worldwide. Moreover, most studies are limited to a few nonmetric traits. Therefore, we aimed to examine several nonmetric dental traits/anomalies.

Methods

In this cross-sectional epidemiological study, ~ 9000 permanent teeth of 331 non-syndromic orthodontic patients (radiographs and dental casts) with fully erupted permanent dentitions (except the third molars and some cases of a few teeth missing or excluded) were evaluated by two observers, each twice, in search for 62 nonmetric traits/shape-number-size anomalies. The traits/anomalies of interest were supernumerary, microdontia, peg-shaped lateral, shovelings, talon cusps, Carabelli cusps, fifth/sixth/seventh cusps on the molars, hypocone/hypoconulid absence, protostylid, deflecting wrinkle‏s, canine mesial ridge, distal trigonid crest, canine distal accessory ridge, accessory cusps in the mesial/distal marginal ridges, mesial/distal accessory ridges, and accessory cusps in the lingual of the mandibular premolars and second molars). Data, at both patient/quarter levels, were analyzed regarding the associated factors (skeletal Angle classes, crowding, sex, and sides) as well as the correlations among traits, using the chi-square test and Spearman correlation coefficient (α = 0.05).

Results

Prevalence rates of 44 traits/anomalies were reported (18 out of the 62 searched traits/anomalies were not found [prevalence = 0%]). Microdontia and accessory cusps on the marginal ridge of the second mandibular molars were significantly more common in women (P < 0.05). Canine talon cusp and distal trigonid crest of the second mandibular molars were more prevalent in men (P < 0.05). Shoveling, canine talon cusp, canine distal accessory ridge, and accessory cusp in the first premolar might be more prevalent in skeletal Angle class II; whereas, accessory cusp in the mesial marginal ridge of the second premolar might be rather more prevalent in skeletal Angle class I (P < 0.05). Few dental traits were positively and moderately or strongly correlated with each other (Spearman Rho ≥ 0.4, P < 0.0005).

Conclusions

Sex dimorphism was uncommon in nonmetric dental traits/anomalies. Skeletal malocclusions may be associated with a few dental abnormalities or variations.
Promising minimally invasive treatment modalities for symptomatic temporomandibular joint disc displacement with reduction: a randomized controlled clinical trial
Authors: Rady Nermeen A. , Bahgat Mariam M. , Abdel-Hamid Ahmed M.
Published: December 2022

Background

Pain and clicking are the primary complaints in patients suffering from temporomandibular joint disc displacement with reduction (DDwR), negatively affecting the patients' quality of life, making the treatment essential. This prospective randomized controlled trial (RCT) was conducted to evaluate the effectiveness of botulinum toxin type-A (BTX-A) and low level laser therapy (LLLT) in comparison to anterior repositioning appliance (ARA) for the treatment of DDwR.

Methods

A total of 27 patients were randomly allocated to 3 groups; ARA (control group), BTX-A, and LLLT; with 9 patients each. All patients were evaluated before and 3 months after the treatment using a visual analogue scale (VAS) and magnetic resonance imaging (MRI).

Results

At 3 months follow-up, all groups showed a significant reduction in pain assessed by VAS (P = 0.007). Measured on MRI, there was a significant improvement in disc position and joint space index (JSI) in BTX-A group (P < 0.001, P = 0.011) and LLLT group (P = 0.002, P = 0.017) in comparison to the control group (P = 0.087, P = 0.066) respectively. As for time of recovery, a statistically significant difference was observed in BTX-A group (P < 0.001) and LLLT (P < 0.001) group in comparison to ARA group, which showed the most prolonged duration for reduction of DDwR symptoms.

Conclusion

We concluded that BTX-A and LLLT could be considered effective alternative treatment modalities to ARA regarding reducing joint pain, clicking, and improving disc position in patients with symptomatic DDwR.

Trial registration

This prospective double-blinded RCT has been registered at ClinicalTrials.gov with identification number: NCT05194488, 18/1/2022.
Attitudes and barriers to pelvic floor muscle exercises of women with stress urinary incontinence
Authors: Sawettikamporn Wilai , Sarit-apirak Sirirat , Manonai Jittima
Published: November 2022

Background

Pelvic floor muscle exercise (PFME) is a first-line treatment for stress urinary incontinence (SUI), but adherence to PFME is often problematic. The aim of this study was to better understand the attitudes and barriers to practicing pelvic floor muscle exercise among women with SUI.

Methods

We conducted a qualitative study using semi-structured interviews. Purposive sampling was used to approach eligible participants. The interview included questions focused on women’s perceptions regarding SUI and PFME, sources of information, support, and barriers and motivators of PFME. In-depth interviews were conducted until data saturation occurred. After several readings of written interview transcripts, codes were retrieved, and thematic analysis was conducted.

Results

Seven women participated in the study (average age 53.2 years), and most (4/7) were retired. Three salient themes emerged from the data: (1) perception of SUI, (2) barriers to PFME, and (3) motivators to exercise. Participants highlighted various barriers to PFME: (1) lack of self-discipline owing to both intrinsic and extrinsic factors, (2) lack of confidence in how to perform the exercises properly, and (3) skepticism regarding the efficacy of treatment according to women’s direct and indirect experiences. Achievement of desired outcomes, symptom severity, women’s expectations, and fear of surgery were motivators to regularly perform PFME.

Conclusions

The main barriers to regular PFME were inadequate self-discipline, knowledge, and confidence in performing the exercises, and a poor perception about the effectiveness of PFME.
Clinical presentation of perineal endometriosis and prognostic nomogram after surgical resection
Authors: Zhu Shiyang , Gu Zhiyue , Li Xiaoyan , Dai Yi , Shi Jinghua , Leng Jinhua
Published: November 2022

Background

This retrospective study evaluated the clinical features of perineal endometriosis (PEM) and established a prognostic nomogram for recurrence probability in patients treated with surgical resection.

Methods

This study enrolled 130 PEM patients who had received surgical treatment in Peking Union Medical College Hospital (PUMCH) between January 1992 and September 2020. We collected their clinical features and conducted outpatient or telephone follow-up. The predictive nomogram was constructed based on 104 patients who had completed follow-up by July 2021. The Cox proportional hazards regression model was used to evaluate the prognostic effects of multiple clinical parameters on recurrence. The Index of concordance (C-index) and calibration curves were used to access the discrimination ability and predictive accuracy of the nomogram respectively, and the results were further validated via bootstrap resampling. Calculating the area under the curve (AUC) via risk scores of patients aimed to further access the predictive power of the model. In addition, the survival curve was depicted using Kaplan–Meier plot and compared by log-rank method.

Results

Most PEM patients had been symptomatic for 24–48 months before the lesion resection. With a median 99.00 (interquartile range: 47.25–137.50) months of postoperative observation, there were 16 (15.1%) out of 104 cases who finished follow-up reported symptomatic recurrence. On multivariate analysis of derivation cohort, multiple lesions, microscopically positive margin (mPM) and anal sphincter involvement (ASI) were selected into the nomogram. The C-index of the nomogram for predicting recurrence was 0.84 (95% CI 0.77–0.91). The calibration curve for probability of recurrence for 36, 60 and 120 months showed great agreement between prediction by nomogram and actual observation. Furthermore, the AUCs of risk score for 36, 60 and 120 months were 0.89, 0.87 and 0.82 respectively.

Conclusions

PEM is a rare kind of endometriosis and surgery is the primary treatment. Multiple lesions and ASI are independent risk factors for postoperative recurrence, and wide resection with more peripheral tissue could be preferred. The proposed nomogram resulted in effective prognostic prediction for PEM patients receiving surgical excision. In addition, this predictive nomogram needs external data sets to further validate its prognostic accuracy in the future.
Computation and molecular pharmacology to trace the anti-rheumatoid activity of Angelicae Pubescentis Radix
Authors: Zhang Junhao , Wang Rui , Liang Xiao , Bai Hao Tian , Li Ya Lan , Sun Shuhui , Zhang Qianqian , Yang Jing
Published: November 2022

Background

The mechanism of action of Angelicae Pubescentis Radix in rheumatoid arthritis treatment is complex; the pathways and protein targets involved remain unclear. This study predicted the targets and signaling pathways of Angelicae Pubescentis Radix for rheumatoid arthritis treatment using network pharmacology and molecular docking technology and clarified its mechanism of action using in vitro cellular experiments.

Methods

Angelicae Pubescentis Radix active components and related targets were retrieved from the traditional Chinese medicine systems pharmacology database. All human proteins were mined from the global protein database, and the network of active components and targets of Angelicae Pubescentis Radix was drawn using Cytoscape 3.7.1. GeneCard, Online Mendelian Inheritance in Man, and DrugBank databases were used to mine rheumatoid arthritis-related genes. Metascape was used for Gene Ontology function analysis and Kyoto Encyclopedia of Genes and Genomes enrichment pathways. β-sitosterol’s molecular docking was determined using AutoDock Tools; pathway verification was performed in the Kyoto Encyclopedia of Genes and Genomes database, and the verified genes were input into the Human Protein Atlas database to observe the expression levels in various human body tissues.

Results

Eight main active components were screened out of Angelicae Pubescentis Radix from the traditional Chinese medicine systems pharmacology database, and 60 targets related to major active ingredients were obtained. Forty-two core pathogenic rheumatoid arthritis-related genes were screened from GeneCard and other related databases. The enrichment of the Kyoto Encyclopedia of Genes and Genomes pathway included the vascular endothelial growth factor signaling pathway that proved to be the decisive pathway for rheumatoid arthritis treatment by a high degree value. In vitro experiments confirmed that Angelicae Pubescentis Radix mainly regulated cell proliferation and survival through the vascular endothelial growth factor signaling pathway and showed significant therapeutic effects on rheumatoid arthritis. The prostaglandin endoperoxide synthase 2 gene was associated with rheumatoid arthritis via pathway verification and monitoring of human gene expression levels.

Conclusions

The mechanism of the multi-component, multi-target, and multi-channel treatment of rheumatoid arthritis via Angelicae Pubescentis Radix was explored using network pharmacology and molecular docking technology, providing new thinking and research directions for future rheumatoid arthritis treatment using Angelicae Pubescentis Radix.
Content and strength of conflict of interest policies at Scandinavian medical schools: a cross sectional study
Authors: Fabbri Alice , Mulinari Shai , Johansson Martin , Ghaur Weda , Khalil Abdullah Muhammad , Lundh Andreas
Published: November 2022

Background

Concerns around staffs’ and students’ interactions with commercial entities, for example drug companies, have led several North American medical schools to implement conflict of interest (COI) policies. However, little is known about COI policies at European medical schools. We analysed the content and strength of COI policies at Scandinavian medical schools.

Methods

We searched the websites of medical schools in Denmark, Norway, and Sweden and emailed the Deans for additional information. Using comparable methodology to previous studies, the strength of the COI policies was rated on a scale from 0 to 2 across 11 items (higher score more restrictive); we also assessed the presence of oversight mechanisms and sanctions.

Results

We identified 77 unique policies for 15 medical schools (range 2–8 per school). Most of the policies (n = 72; 94%) were University wide and only five (6%) were specific for the medical schools. For six of eleven items one or more schools had a restrictive policy (score of two). None of the schools had a restrictive policy for the five additional items (speaking relationships, sales representatives, on-site education activities, medical school curriculum, and drug samples). Honoraria was the item with the highest score, with eight of the 15 schools having a score of two. Thirteen of the 15 schools had policies that identified a party responsible for policy oversight and mentioned sanctions for non-compliance.

Conclusion

Our study provides the first evaluation of all Scandinavian medical schools’ COI policies. We found that the content of COI policies varies widely and still has shortcomings. We encourage Scandinavian medical schools to develop more stringent COI policies to regulate industry interactions with both faculty and students.
Gastrointestinal stromal tumor (GIST) presenting as a multilocular cystic intra-abdominal mass in a dog
Authors: Blaxill John Edward , Bender Hannah , Hoon Qicai Jason , Sow Jia Wen , Cheng Katrina Y. , Bennett Peter Francis
Published: November 2022

Background

Gastrointestinal stromal tumor (GIST) is a malignant mesenchymal neoplasm described in humans, dogs, and cats. A hallmark of diagnosis for GISTs is positive immunohistochemical labelling with c-Kit (CD117). The differentiation of GIST from other mesenchymal neoplasms of the gastrointestinal tract is pivotal to allow for initiation of appropriate treatment. In humans, cystic GIST has been described, though this has not been reported in dogs. In humans, the cystic form of GIST has been associated with a favorable prognosis. In the present paper, we report a case of multilocular cystic GIST in a dog, which has not previously been described in this species.

Case presentation

A ten-year-old, male-entire Maltese terrier mix breed dog presented with a large cystic mural mass of the duoedenum and orad jejunum. Histopathology and positive immunohistochemical staining with CD117 confirmed a diagnosis of GIST. No evidence of metastasis was detected on routine staging with abdominal sonography and thoracic radiography at the time of diagnosis. Surgical resection was performed and toceranib therapy was initiated post-operatively. Metastasis was documented 251 days after surgery on computed tomography. Due to clinical deterioration, the patient was humanely euthanised 370 days after surgical excision.

Conclusions

There are few differential diagnoses for large multilocular cystic intra-abdominal masses in dogs. This case presents a previously undescribed presentation of gastrointestinal stromal tumor in the dog as a predominantly multilocular cystic mass. It remains unclear if the cystic form of GIST may represent a favorable prognosis in dogs.