bluuebunny/crossref_metadata_2025 huggingface dataset:
Geospatial indicators of exposure, sensitivity, and adaptive capacity to assess neighbourhood variation in vulnerability to climate change-related health hazards
Authors: Yu Jessica , Castellani Kaitlin , Forysinski Krista , Gustafson Paul , Lu James , Peterson Emily , Tran Martino , Yao Angela , Zhao Jingxuan , Brauer Michael
Published: March 2021

Background

Although the frequency and magnitude of climate change-related health hazards (CCRHHs) are likely to increase, the population vulnerabilities and corresponding health impacts are dependent on a community’s exposures, pre-existing sensitivities, and adaptive capacities in response to a hazard’s impact. To evaluate spatial variability in relative vulnerability, we: 1) identified climate change-related risk factors at the dissemination area level; 2) created actionable health vulnerability index scores to map community risks to extreme heat, flooding, wildfire smoke, and ground-level ozone; and 3) spatially evaluated vulnerability patterns and priority areas of action to address inequity.

Methods

A systematic literature review was conducted to identify the determinants of health hazards among populations impacted by CCRHHs. Identified determinants were then grouped into categories of exposure, sensitivity, and adaptive capacity and aligned with available data. Data were aggregated to 4188 Census dissemination areas within two health authorities in British Columbia, Canada. A two-step principal component analysis (PCA) was then used to select and weight variables for each relative vulnerability score. In addition to an overall vulnerability score, exposure, adaptive capacity, and sensitivity sub-scores were computed for each hazard. Scores were then categorised into quintiles and mapped.

Results

Two hundred eighty-one epidemiological papers met the study criteria and were used to identify 36 determinant indicators that were operationalized across all hazards. For each hazard, 3 to 5 principal components explaining 72 to 94% of the total variance were retained. Sensitivity was weighted much higher for extreme heat, wildfire smoke and ground-level ozone, and adaptive capacity was highly weighted for flooding vulnerability. There was overall varied contribution of adaptive capacity (16–49%) across all hazards. Distinct spatial patterns were observed – for example, although patterns varied by hazard, vulnerability was generally higher in more deprived and more outlying neighbourhoods of the study region.

Conclusions

The creation of hazard and category-specific vulnerability indices (exposure, adaptive capacity and sensitivity sub-scores) supports evidence-based approaches to prioritize public health responses to climate-related hazards and to reduce inequity by assessing relative differences in vulnerability along with absolute impacts. Future studies can build upon this methodology to further understand the spatial variation in vulnerability and to identify and prioritise actionable areas for adaptation.
Risk factors for cholesterol polyp formation in the gallbladder are closely related to lipid metabolism
Authors: Yu Zhihao , Yang Changlin , Bai Xuesong , Yao Guibin , Qian Xia , Gao Wei , Huang Yue , Tian Xiaodong , Cheng Shi , Zheng Yamin
Published: March 2021

Background

The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder.

Methods

This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients who underwent cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with a diagnosis of pathologically confirmed cholesterol polyps larger than 10 mm. Population characteristics and medical data were collected within 24 h of admission before surgery. The non-polyp group included participants from the hospital physical examination center database. They had at least two ultrasound examinations with an interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups.

Results

A total of 4714 participants were recruited, including 376 cholesterol polyp patients and 4338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyps were age, male sex, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), and higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. In multivariate logistic analysis, independent risk factors were age > 50 years (odds ratio [OR] = 3.02, 95% confidence interval [CI] 2.33–3.91, P < 0.001], LDL > 2.89 mmol/L (OR = 1.38, 95% CI 1.08–1.78, P = 0.011), lower HDL (OR = 1.78 95% CI 1.32–2.44, P < 0.001), AST > 40 IU/L (OR = 3.55, 95% CI 2.07–6.07, P < 0.001), and BMI > 25 kg/m 2 (OR = 1.32, 95% CI 1.01–1.72, P = 0.037).

Conclusions

Age, LDL, HDL, AST, and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk for cholesterol polyps.
Prevalence of mental health problems in frontline healthcare workers after the first outbreak of COVID-19 in China: a cross-sectional study
Authors: Guo Wen-Ping , Min Qing , Gu Wei-Wei , Yu Liang , Xiao Xiao , Yi Wei-Bing , Li Hong-Liang , Huang Bei , Li Jun-Li , Dai Ya-Jun , Xia Jian , Liu Jie , Li Bei , Zhou Ben-Hong , Li Minglun , Xu Hong-Xi , Wang Xuan-Bin , Shi Wen-Yuan
Published: March 2021

Background

More than 210,000 medical workers have fought against the outbreak of Coronavirus Disease 2019 (COVID-19) in Hubei in China since December 2019. However, the prevalence of mental health problems in frontline medical staff after fighting COVID-19 is still unknown.

Methods

Medical workers in Wuhan and other cities in Hubei Province were invited to participate a cross-sectional and convenience sampling online survey, which assessed the prevalence of anxiety, insomnia, depression, and post-traumatic stress disorder (PTSD).

Results

A total of 1,091 responses (33% male and 67% female) were valid for statistical analysis. The prevalence was anxiety 53%, insomnia 79%, depression 56%, and PTSD 11%. Healthcare workers in Wuhan were more likely to face risks of anxiety (56% vs. 52%, P = 0.03) and PTSD (15% vs. 9%, P = 0.03) than those in other cities of Hubei. In terms of educational attainment, those with doctoral and masters’ (D/M) degrees may experience more anxiety (median of 7.0, [interquartile range (IQR) 2.0–8.5] vs. median 5.0 [IQR 5.0–8.0], P = 0.02) and PTSD (median 26.0 [IQR 19.5–33.0] vs. median 23.0 [IQR 19.0–31.0], P = 0.04) than those with lower educational degrees.

Conclusions

The mental problems were an important issue for the healthcare workers after COVID-19. Thus, an early intervention on such mental problems is necessary for healthcare workers.
Effect and safety of intraoperative intraperitoneal chemotherapy on patients suffering from colorectal cancer
Authors: Shang An , Wang Shuang , Yang Yongping , Li Liping , Zhao Zeyun , Li Donglin , Guo Yu , Wang Min
Published: March 2021

Background

Colorectal cancer (CRC), the third most commonly diagnosed malignant carcinoma and the third most common cause of carcinoma-related mortality, continues to be a major international health problem. And approximately 33% of patients suffer from recurrence after radical surgery. Free malignant cell implanting in the peritoneum is generally accepted as one of the main reasons of such outcome. We did this present clinical study with the aim of evaluating the effects and safety of intraoperative intraperitoneal chemotherapy (IOC) on patients suffering from colorectal cancer, with hoping to find a novel, effective, and available approach to deal with malignant cell implanting during surgeries.

Methods

In total, 391 patients who went through colorectal radical surgery were considered eligible between June 1, 2017, and December 31, 2018. 220 patients were treated with surgery without IOC, while other 171 patients received surgery plus IOC. Clinical characteristics, operative findings, postoperative short-term outcomes, disease-free survival (DFS), and overall survival (OS) were compared between these above 2 groups in the selected population.

Result

The present research included 391 patients (251 men and 140 women) who underwent surgery without IOC (n = 171) or surgery plus IOC (n = 220), with a mean (SD) age of 60.4 (9.7) years in the surgery without IOC group and 60.6 (8.7) in the surgery plus IOC group (P=.85). No significant differences were witnessed between the two groups in surgery-related information and postoperative complications. It is worth noting that IOC independent of other factors was associated with a favor prognosis in CRC patients with stage II/III (HR 0.50, 95%CI 0.30–0.82, P=.006). Moreover, for patients with stage II colorectal carcinoma, DFS did not differ between two groups (P=.553, Kaplan-Meier log-rank), and OS was no exception. In stage III CRC patients, the estimated DFS rate for patients receiving IOC was 82.2% and patients without IOC was 66.4% after 3 years, which demonstrated that IOC was associated with a favorable prognosis in stage III patients (P=.012, Kaplan-Meier log-rank). Furthermore, the differences were still remained between the two groups when considering the influence about postoperative chemotherapy (P=.014, Kaplan-Meier log-rank). IOC can also significantly improve patients’ overall survival whether they get treatment with POC (P=.006, Kaplan-Meier log-rank; P=.025, Kaplan-Meier log-rank).

Conclusions

In the present study, we have found that surgery plus IOC generated a favorable prognosis for stage III CRC patients but not stage II without any side-effects when the dosage of lobaplatin was 0.1g/L. As a new, safe, and simple procedure, IOC therapy is easily performed—and does not require any special devices or techniques. Thus, IOC is a promising and exciting therapeutic strategy for patients with CRC.
Mechanisms of scaling up: combining a realist perspective and systems analysis to understand successfully scaled interventions
Authors: Koorts Harriet , Cassar Samuel , Salmon Jo , Lawrence Mark , Salmon Paul , Dorling Henry
Published: March 2021

Background

Sustainable shifts in population behaviours require system-level implementation and embeddedness of large-scale health interventions. This paper aims to understand how different contexts of scaling up interventions affect mechanisms to produce intended and unintended scale up outcomes.

Methods

A mixed method study combining a realist perspective and systems analysis (causal loop diagrams) of scaled-up physical activity and/or nutrition interventions implemented at a state/national level in Australia (2010–18). The study involved four distinct phases:Phase 1expert consultation, database and grey literature searches to identify scaled-up interventions;Phase 2generating initial Context-Mechanism-Outcome configurations (CMOs) from the WHO ExpandNet framework for scaling up;Phase 3testing and refining CMOs via online surveys and realist interviews with academics, government and non-government organisations (NGOs) involved in scale up of selected interventions (Phase 1); andPhase 4generating cross-case mid-range theories represented in systems models of scaling up; validated by member checking. Descriptive statistics were reported for online survey data and realist analysis for interview data.

Results

Seven interventions were analysed, targeting nutrition (n = 1), physical activity (n = 1), or a combination (n = 5). Twenty-six participants completed surveys; 19 completed interviews. Sixty-three CMO pathways underpinned successful scale up, reflecting 36 scale up contexts, 8 key outcomes; linked via 53 commonly occurring mechanisms. All five WHO framework domains were represented in the systems models. Most CMO pathways included ‘intervention attributes’ and led to outcomes ‘community sustainability/embeddedness’ and ‘stakeholder buy-in/perceived value’. Irrespective of interventions being scaled in similar contexts (e.g., having political favourability); mechanisms still led to both intended and unintended scale up outcomes (e.g., increased or reduced sustainability).

Conclusion

This paper provides the first evidence for mechanisms underpinning outcomes required for successful scale up of state or nationally delivered interventions. Our findings challenge current prerequisites for effective scaling suggesting other conditions may be necessary. Future scale up approaches that plan for complexity and encourage iterative adaptation throughout, may enhance scale up outcomes. Current linear, context-to-outcome depictions of scale up oversimplify what is a clearly a complex interaction between perceptions, worldviews and goals of those involved. Mechanisms identified in this study could potentially be leveraged during future scale up efforts, to positively influence intervention scalability and sustainability.
Parental control and support for physical activity predict adolescents’ moderate to vigorous physical activity over five years
Authors: Doggui Radhouene , Gallant François , Bélanger Mathieu
Published: March 2021

Background

Social factors are important determinants of youth physical activity (PA), but the longitudinal association between parental behaviours and adolescent PA has not been clearly assessed. This prospective study examined average and lagged associations between perceived parental support and control with adolescents’ moderate to vigorous PA (MVPA); and assessed the independent associations between specific parental support and control behaviours and adolescents’ MVPA.

Methods

Data from three cycles of the MATCH study, when 374 participants were 12, 16 and 17 years old, were included in this analysis. At each cycle, participants self-reported questionnaires on perceived tangible parental support, intangible support, and control behaviours as well as number of days per week attaining at least 60 min of MVPA. Mixed effect models were used to assess the longitudinal relationship between parental behaviours and MVPA. Cross-lagged panel design was used to assess the association of parental behaviours during early adolescence with MVPA during late adolescence.

Results

Overall parental support (coef. = 0.46, P < 0.0001), tangible support (coef. = 0.37, P < 0.0001), encouragement (coef. = 0.12, P = 0.025) and transportation (coef. = 0.25, P < 0.0001) were positively associated with MVPA, whereas parental control was a negative predictor of MVPA (coef. = − 0.18, P = 0.003). Perceived parental behaviours appeared to have long term associations (5 y.) with MVPA as parent support (coef. = 0.40, P = 0.006) and co-participation (coef. = 0.33, P = 0.017) reported around age 12 were positively associated with MVPA measured 5 years later.

Conclusions

Parental support for PA, particularly in the form of tangible support, may be a key factor to include in interventions aiming to promote PA during adolescence. In contrast, parents should be encouraged to avoid control behaviours as these appear to lead to lower MVPA among adolescents.
Poor physical activity levels and cardiorespiratory fitness among patients with childhood-onset takayasu arteritis in remission: a cross‐sectional, multicenter study
Authors: Astley Camilla , Gil Saulo , Clemente Gleice , Terreri Maria Teresa , Silva Clovis Artur , Campos Lucia Maria Arruda , Aikawa Nadia Emi , de Sá Pinto Ana Lúcia , Pereira Rosa Maria R. , Roschel Hamilton , Gualano Bruno
Published: March 2021

Background

It is currently unknown whether patients with childhood-onset Takayasu disease (c-TA) are prone to physical inactivity and poor aerobic capacity. In this study, we assessed physical activity levels and cardiorespiratory fitness along with health-related quality of life (HRQL) and various traditional and non-traditional risk factors in patients with c-TA vs. healthy controls.

Methods

c-TA patients with non-active disease (n = 17) and age- and sex-matched healthy controls (n = 17) were enrolled in the study. We assessed physical activity levels, aerobic capacity, body composition, systemic inflammation, cardiometabolic markers, disease-related parameters, and HRQL.

Results

c-TA patients showed greater time spent in sedentary behavior (P = 0.010), and lower moderate-to-vigorous physical activity (P > 0.001) and lower step counts per day (P > 0.001). VO2peak (P < 0.001) and chronotropic response (P = 0.016) were significantly lower in patients with c-TA and they had worse HRQL in physical domain (P < 0.001), lower bone mineral content and density, and higher insulin levels vs. healthy controls (all P ≤ 0.05).

Conclusions

c-TA patients exhibited reduced physical activity levels and aerobic capacity, worse cardiometabolic risk factors and HRQL parameter compared with healthy peers. Physical inactivity and aerobic deconditioning emerge as potentially novel risk factors for c-TA. The role of physical activity interventions in preventing poor outcomes and improving HRQL in c-TA remains to be explored.
Optimizing the design of a contraceptive microarray patch: a discrete choice experiment on women’s preferences in India and Nigeria
Authors: Callahan Rebecca L. , Brunie Aurélie , Lebrun Victoria , Chen Mario , Godwin Christine L. , Lakhwani Kanchan , OlaOlorun Funmilola M.
Published: March 2021

Background

Efforts are underway to develop an easy-to-use contraceptive microarray patch (MAP) that could expand the range of self-administrable methods. This paper presents results from a discrete choice experiment (DCE) designed to support optimal product design.

Methods

We conducted a DCE survey of users and non-users of contraception in New Delhi, India (496 women) and Ibadan, Nigeria (two versions with 530 and 416 women, respectively) to assess stated preferences for up to six potential product attributes: effect on menstruation, duration of effectiveness, application pain, location, rash after application, and patch size. We estimated Hierarchical Bayes coefficients (utilities) for each attribute level and ran simulations comparing women’s preferences for hypothetical MAPs with varying attribute combinations.

Results

The most important attributes of the MAP were potential for menstrual side effects (55% of preferences in India and 42% in Nigeria) and duration (13% of preferences in India and 24% in Nigeria). Women preferred a regular period over an irregular or no period, and a six-month duration to three or one month. Simulations show that the most ideal design would be a small patch, providing 6 months of protection, that would involve no pain on administration, result in a one-day rash, and be applied to the foot.

Conclusions

To the extent possible, MAP developers should consider method designs and formulations that limit menstrual side effects and provide more than one month of protection.
Virtual reality‐based assessment of cognitive‐locomotor interference in healthy young adults
Authors: Deblock-Bellamy Anne , Lamontagne Anouk , McFadyen Bradford J. , Ouellet Marie-Christine , Blanchette Andreanne K.
Published: March 2021

Background

A recent literature review emphasized the importance of assessing dual-task (DT) abilities with tasks that are representative of community ambulation. Assessing DT ability in real-life activities using standardized protocols remains difficult. Virtual reality (VR) may represent an interesting alternative enabling the exposure to different scenarios simulating community walking. To better understand dual-task abilities in everyday life activities, the aims of this study were (1) to assess locomotor and cognitive dual-task cost (DTC) during representative daily living activities, using VR, in healthy adults; and 2) to explore the influence of the nature and complexity of locomotor and cognitive tasks on DTC.

Methods

Fifteen healthy young adults (24.9 ± 2.7 years old, 8 women) were recruited to walk in a virtual 100 m shopping mall corridor, while remembering a 5-item list (DT condition), using an omnidirectional platform and a VR headset. Two levels of difficulty were proposed for the locomotor task (with vs. without virtual agent avoidance) and for the cognitive task (with vs. without items modification). These tasks were also performed in single task (ST) condition. Locomotor and cognitive DTC were measured by comparing performances in ST and DT conditions. Locomotor performance was characterized using walking speed, walking fluidity, and minimal distance between the participant and the virtual agent during avoidance. Cognitive performance was assessed with the number of items correctly recalled. Presence of DTC were determined with one-sample Wilcoxon signed-rank tests. To explore the influence of the tasks’ complexity and nature on DTC, a nonparametric two-way repeated measure ANOVA was performed.

Results

No locomotor interference was measured for any of the outcomes. A cognitive DTC of 6.67% was measured (p = .017) while participants performed simultaneously both complex locomotor and cognitive tasks. A significant interaction between locomotor task complexity and cognitive task nature (p = .002) was identified on cognitive DTC.

Conclusions

In challenging locomotor and cognitive conditions, healthy young adults present DTC in cognitive accuracy, which was influenced by the locomotor task complexity task and the cognitive task nature. A similar VR-based protocol might be used to investigate DT abilities in older adults and individuals with a stroke.
Towards the validation of high-throughput sequencing (HTS) for routine plant virus diagnostics: measurement of variation linked to HTS detection of citrus viruses and viroids
Authors: Bester Rachelle , Cook Glynnis , Breytenbach Johannes H. J. , Steyn Chanel , De Bruyn Rochelle , Maree Hans J.
Published: March 2021

Background

High-throughput sequencing (HTS) has been applied successfully for virus and viroid discovery in many agricultural crops leading to the current drive to apply this technology in routine pathogen detection. The validation of HTS-based pathogen detection is therefore paramount.

Methods

Plant infections were established by graft inoculating a suite of viruses and viroids from established sources for further study. Four plants (one healthy plant and three infected) were sampled in triplicate and total RNA was extracted using two different methods (CTAB extraction protocol and the Zymo Research Quick-RNA Plant Miniprep Kit) and sent for Illumina HTS. One replicate sample of each plant for each RNA extraction method was also sent for HTS on an Ion Torrent platform. The data were evaluated for biological and technical variation focussing on RNA extraction method, platform used and bioinformatic analysis.

Results

The study evaluated the influence of different HTS protocols on the sensitivity, specificity and repeatability of HTS as a detection tool. Both extraction methods and sequencing platforms resulted in significant differences between the data sets. Using a de novo assembly approach, complemented with read mapping, the Illumina data allowed a greater proportion of the expected pathogen scaffolds to be inferred, and an accurate virome profile was constructed. The complete virome profile was also constructed using the Ion Torrent data but analyses showed that more sequencing depth is required to be comparative to the Illumina protocol and produce consistent results. The CTAB extraction protocol lowered the proportion of viroid sequences recovered with HTS, and the Zymo Research kit resulted in more variation in the read counts obtained per pathogen sequence. The expression profiles of reference genes were also investigated to assess the suitability of these genes as internal controls to allow for the comparison between samples across different protocols.

Conclusions

This study highlights the need to measure the level of variation that can arise from the different variables of an HTS protocol, from sample preparation to data analysis. HTS is more comprehensive than any assay previously used, but with the necessary validations and standard operating procedures, the implementation of HTS as part of routine pathogen screening practices is possible.
A longitudinal study of mental health before and during COVID-19 lockdown in the French population
Authors: Ramiz Leila , Contrand Benjamin , Rojas Castro Madelyn Yiseth , Dupuy Marion , Lu Li , Sztal-Kutas Catherine , Lagarde Emmanuel
Published: March 2021

Background

The impact of general population lockdown implemented in the face of the COVID-19 epidemic needs to be evaluated. We describe here a longitudinal study on the mental health of adults in France.

Methods

We did a secondary analysis of a web-based cohort, initially set up to study home and leisure injuries, in order to measure the consequences of the national lockdown implemented in France from 17 March 2020 to 11 May 2020, and to assess potential vulnerability and resilience factors. Eligible participants were invited to answer an online questionnaire designed to assess their living conditions and health during lockdown. Comparisons were done with answers provided 4.8 years earlier on average.

Results

On 15th April 2020, we sent email invitations to 9598 participants recruited between November 2014 and December 2019 and 1237 volunteers took part in the study by completing the online questionnaire. The proportion of those with anxiety symptoms markedly increased from 17.3 to 20.1%. The average self-rated level of mental health decreased from 7.77 to 7.58. Women, the elderly and the youngest appeared to be more vulnerable. A small living space (less than 30 m2) was associated with an increase in depression symptoms (PHQ-9 score), and poorer self-rated physical health at recruitment was associated with an increase in anxiety symptoms (GAD-7 score). On the contrary, the average self-rated level of physical health markedly increased from 7.44 to 7.94 between recruitment and lockdown, and the proportion of those who reported a level of 9 or 10 jumped from 25.7% at recruitment to 43.1% during lockdown.

Conclusions

Mental health deteriorated during lockdown in France during the 2020 COVID-19 crisis. Overall, self-rated physical health improved but those who experienced a worse physical health were more likely to report anxiety symptoms.
The management of surgical patients in the emergency setting during COVID-19 pandemic: the WSES position paper
Authors: De Simone Belinda , Chouillard Elie , Sartelli Massimo , Biffl Walter L. , Di Saverio Salomone , Moore Ernest E. , Kluger Yoram , Abu-Zidan Fikri M. , Ansaloni Luca , Coccolini Federico , Leppänemi Ari , Peitzmann Andrew B. , Pagani Leonardo , Fraga Gustavo P. , Paolillo Ciro , Picetti Edoardo , Valentino Massimo , Pikoulis Emmanouil , Baiocchi Gian Luca , Catena Fausto
Published: March 2021

Background

Since the COVID-19 pandemic has occurred, nations showed their unpreparedness to deal with a mass casualty incident of this proportion and severity, which resulted in a tremendous number of deaths even among healthcare workers. The World Society of Emergency Surgery conceived this position paper with the purpose of providing evidence-based recommendations for the management of emergency surgical patients under COVID-19 pandemic for the safety of the patient and healthcare workers.

Method

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) through the MEDLINE (PubMed), Embase and SCOPUS databases. Synthesis of evidence, statements and recommendations were developed in accordance with the GRADE methodology.

Results

Given the limitation of the evidence, the current document represents an effort to join selected high-quality articles and experts’ opinion.

Conclusions

The aim of this position paper is to provide an exhaustive guidelines to perform emergency surgery in a safe and protected environment for surgical patients and for healthcare workers under COVID-19 and to offer the best management of COVID-19 patients needing for an emergency surgical treatment.

We recommend screening for COVID-19 infection at the emergency department all acute surgical patients who are waiting for hospital admission and urgent surgery. The screening work-up provides a RT-PCR nasopharyngeal swab test and a baseline (non-contrast) chest CT or a chest X-ray or a lungs US, depending on skills and availability. If the COVID-19 screening is not completed we recommend keeping the patient in isolation until RT-PCR swab test result is not available, and to manage him/she such as an overt COVID patient.

The management of COVID-19 surgical patients is multidisciplinary.

If an immediate surgical procedure is mandatory, whether laparoscopic or via open approach, we recommend doing every effort to protect the operating room staff for the safety of the patient.
Morquio A syndrome and effect of enzyme replacement therapy in different age groups of Turkish patients: a case series
Authors: Kılavuz Sebile , Basaran Sibel , Kor Deniz , Bulut Fatma Derya , Erdem Sevcan , Ballı Hüseyin Tuğsan , Dağkıran Muhammed , Bisgin Atil , Mungan Halise Neslihan Önenli
Published: March 2021

Background

This case series includes longitudinal clinical data of ten patients with Morquio A syndrome from south and southeastern parts of Turkey, which were retrospectively collected from medical records. All patients received enzyme replacement therapy (ERT). Clinical data collected included physical appearance, anthropometric data, neurological and psychological examinations, cardiovascular evaluation, pulmonary function tests, eye and ear-nose-throat examinations, endurance in the 6-min walk test and/or 3-min stair climb test, joint range of motion, and skeletal investigations (X-rays, bone mineral density).

Results

At the time of ERT initiation, two patients were infants (1.8 and 2.1 years), five were children (3.4–7.1 years), and three were adults (16.5–39.5 years). Patients had up to 4 years follow-up. Most patients had classical Morquio A, based on genotypic and phenotypic data. Endurance was considerably reduced in all patients, but remained relatively stable or increased over time in most cases after treatment initiation. Length/height fell below normal growth curves, except in the two infants who started ERT at ≤ 2.1 years of age. All patients had skeletal and/or joint abnormalities when ERT was started. Follow-up data did not suggest improvements in skeletal abnormalities, except in one of the younger infants. Nine patients had corneal clouding, which resolved after treatment initiation in the two infants, but not in the other patients. Hepatomegaly was reported in seven patients and resolved with treatment in five of them. Other frequent findings at treatment initiation were coarse facial features (N = 9), hearing loss (N = 6), and cardiac abnormalities (N = 6). Cardiac disease deteriorated over time in three patients, but did not progress in the others.

Conclusions

Overall, this case series with Morquio A patients confirms clinical trial data showing long-term stabilization of endurance after treatment initiation across ages and suggest that very early initiation of ERT optimizes growth outcomes.
Patient safety from the perspective of quality management frameworks: a review
Authors: Shenoy Amrita
Published: March 2021

Patient safety is one of the overarching goals of patient care and quality management. Of the many quality management frameworks, Beauchamp and Childress’s four principles of biomedical ethics presents aspects of patient centeredness in clinical care. The Institute of Medicine’s six aims for improvement encapsulates elements of high-quality patient care. The Institute of Healthcare Improvement’s Triple Aim focuses on three aspects of care, cost, and health. Given the above frameworks, the present review was designed to emphasize the initiatives the system has taken to address various efforts of improving quality and patient safety. We, hereby, present a contemplative review of the concepts of informed consent, informed refusal, healthcare laws, policy programs, and regulations. The present review, furthermore, outlines measures and policies that management and administration implement and enforce, respectively, to ensure patient centered care. We, conclusively, explore prototype policies such as the Delivery System Reform Incentive Payment Program that imbues the elements of quality management frameworks, Hospital-Acquired Conditions Reduction Program that supports patient safety, and Hospital Readmissions Reduction Program that focuses on curbing readmissions.
Correction to: Cancer-associated fibroblasts promote the survival of irradiated nasopharyngeal carcinoma cells via the NF-κB pathway
Authors: Huang Weiqiang , Zhang Longshan , Yang Mi , Wu Xixi , Wang Xiaoqing , Huang Wenqi , Yuan Lu , Pan Hua , Wang Yin , Wang Zici , Wu Yuting , Huang Jihong , Liang Huazhen , Li Shaoqun , Liao Liwei , Liu Laiyu , Guan Jian
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Correction to: Risks of ventilator-associated pneumonia and invasive pulmonary aspergillosis in patients with viral acute respiratory distress syndrome related or not to Coronavirus 19 disease
Authors: Razazi Keyvan , Arrestier Romain , Haudebourg Anne Fleur , Benelli Brice , Carteaux Guillaume , Decousser Jean‑Winoc , Fourati Slim , Woerther Paul Louis , Schlemmer Frederic , Charles-Nelson Anais , Botterel Francoise , de Prost Nicolas , Mekontso Dessap Armand
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Prophylactic Antibiotic Regimens In Tumor Surgery (PARITY): a multi-center randomized controlled study comparing alternative antibiotic regimens in patients undergoing tumor resections with endoprosthetic replacements—a statistical analysis plan
Authors:   on behalf of the PARITY Investigators, Schneider Patricia , Heels-Ansdell Diane , Thabane Lehana , Ghert Michelle
Published: March 2021

Background

Limb salvage with endoprosthetic reconstruction is the current standard practice for the surgical management of lower extremity bone tumors in skeletally mature patients and typically includes tumor resection followed by the functional limb reconstruction with modular metallic and polyethylene endoprosthetic implants. However, owing to the complexity and length of these procedures, as well as the immunocompromised nature of patients treated with chemotherapy, the risk of surgical site infection (SSI) is high. The primary research objective of the Prophylactic Antibiotic Regimens In Tumor Surgery (PARITY) trial is to assess whether a 5-day regimen of post-operative antibiotics decreases the risk of SSI at 1 year post-operatively compared to a 1-day regimen. This article describes the statistical analysis plan for the PARITY trial.

Methods/design

The PARITY trial is an ongoing multi-center, blinded parallel two-arm randomized controlled trial (RCT) of 600 participants who have been diagnosed with a primary bone tumor, a soft tissue sarcoma that has invaded the bone or oligometastatic bone disease of the femur or tibia that requires surgical resection and endoprosthetic reconstruction. This article describes the overall analysis principles, including how participants will be included in each analysis, the presentation of results, adjustments for covariates, the primary and secondary outcomes, and their respective analyses. Additionally, we will present the planned sensitivity and sub-group analyses.

Discussion

Our prior work has demonstrated (1) high rates of SSI after the treatment of lower extremity tumors by surgical excision and endoprosthetic reconstruction, (2) highly varied opinion and practice among orthopedic oncologists with respect to prophylactic antibiotic regimens, (3) an absence of applicable RCT evidence, (4) extensive support from international investigators to participate in a RCT, and (5) the feasibility of conducting a definitive RCT to evaluate a 5-day regimen of post-operative antibiotics in comparison with a 1-day regimen.

Trial registration

ClinicalTrials.govNCT01479283. Registered on 24 November 2011
Mucosa‐associated cultivable aerobic gut bacterial microbiota among colorectal cancer patients attending at the referral hospitals of Amhara Regional State, Ethiopia
Authors: Siraj Yesuf Adem , Biadgelign Melesse Gebeyehu , Yassin Mensur Osman , Chekol Yohannes Zenebe
Published: March 2021

Background

Colorectal cancer (CRC) is one of the top ten causes of cancer deaths in the world. Despite an increased prevalence of colorectal cancer has been documented from developing countries, there is no any report regarding gut microbiota among colorectal cancer patients in Ethiopia. Therefore, the current study evaluated cultivable aerobic gut bacterial distributions among malignant and its adjacent normal biopsies of CRC patients.

Methods

CRC patients who were under colorectal cancer resection surgery during April 2017 to February 2018 at Felege Hiwot Referral and University of Gondar Teaching Hospitals enrolled in the study. Biopsy specimens were taken from malignant and its adjacent normal-appearing tissues. Bacterial cultivation, quantification and characterization of saline washed biopsies were performed under aerobic and candle jar conditions. Differences in bacterial microbiota compositions between malignant and normal tissue biopsies were evaluated and analyzed using Microsoft excel 2010 and GraphPad Prism5 statistical software.

Results

Fifteen CRC patients were participated with a mean age of 53.8 ± 10.8 years old and majorities (73.3 %) of patients were in between the age groups of 40 and 60 years old. The mean ± SD bacterial microbiota of malignant biopsies (3.2 × 105 ± 1.6 × 105 CFU/ml) was significantly fewer than that of adjacent normal tissue biopsies (4.0 × 105 ± 2.2 × 105 CFU/ml). This dysbacteriosis is positively correlated with the occurrence of CRC (p = 0.019). Proteobacteria (55.6 %), Firmicutes (33.3 %) and Fusobacteria (11.1 %) were the most frequently isolated phyla from non-malignant biopsies while only Proteobacteria (58.8 %) and Firmicutes (41.2 %) were from malignant ones. Family level differences were observed among phyla (Firmicutes and Proteobacteria) isolated from the study participants. For instance, the relative abundance of family Bacillaceae from malignant (26 %) was lower than the normal biopsies (39 %). On other hand, family Enterobacteriaceae was twice more abundant in malignant tissues (45 %) than in its matched normal tissues (23 %). Furthermore, the family Enterococcaceae (14 %) of phylum Firmicutes was solely isolated from malignant tissue biopsies.

Conclusions

The overall microbial composition of normal and malignant tissues was considerably different among the study participants. Further culture independent analysis of mucosal microbiota will provide detail pictures of microbial composition differences and pathogenesis of CRC in Ethiopian settings.
New Ther1-derived SINE Squam3 in scaled reptiles
Authors: Vassetzky Nikita S. , Kosushkin Sergei A. , Korchagin Vitaly I. , Ryskov Alexey P.
Published: March 2021

Background

SINEs comprise a significant part of animal genomes and are used to study the evolution of diverse taxa. Despite significant advances in SINE studies in vertebrates and higher eukaryotes in general, their own evolution is poorly understood.

Results

We have discovered and described in detail a new Squam3 SINE specific for scaled reptiles (Squamata). The subfamilies of this SINE demonstrate different distribution in the genomes of squamates, which together with the data on similar SINEs in the tuatara allowed us to propose a scenario of their evolution in the context of reptilian evolution.

Conclusions

Ancestral SINEs preserved in small numbers in most genomes can give rise to taxa-specific SINE families. Analysis of this aspect of SINEs can shed light on the history and mechanisms of SINE variation in reptilian genomes.
A competing risk joint model for dealing with different types of missing data in an intervention trial in prodromal Alzheimer’s disease
Authors: van Oudenhoven Floor M. , Swinkels Sophie H. N. , Soininen Hilkka , Kivipelto Miia , Hartmann Tobias , Rizopoulos Dimitris ,   on behalf of the LipiDiDiet clinical study group, Hartmann Tobias , Soininen Hilkka , Kivipelto Miia , Solomon Alina , Visser Pieter Jelle
Published: March 2021

Background

Missing data can complicate the interpretability of a clinical trial, especially if the proportion is substantial and if there are different, potentially outcome-dependent causes.

Methods

We aimed to obtain unbiased estimates, in the presence of a high level of missing data, for the intervention effects in a prodromal Alzheimer’s disease trial: the LipiDiDiet study. We used a competing risk joint model that can simultaneously model each patient’s longitudinal outcome trajectory in combination with the timing and type of missingness.

Results

Using the competing risk joint model, we were able to provide unbiased estimates of the intervention effects in the presence of the different types of missingness. For the LipiDiDiet study, the intervention effects remained statistically significant after this correction for the timing and type of missingness.

Conclusion

Missing data is a common problem in (Alzheimer) clinical trials. It is important to realize that statistical techniques make specific assumptions about the missing data mechanisms. When there are different missing data sources, a competing risk joint model is a powerful method because it can explicitly model the association between the longitudinal data and each type of missingness.

Trial registration

Dutch Trial Register, NTR1705. Registered on 9 March 2009
Improvement of ECM-based bioroot regeneration via N-acetylcysteine-induced antioxidative effects
Authors: Zhang Jiayu , Lan Tingting , Han Xue , Xu Yuchan , Liao Li , Xie Li , Yang Bo , Tian Weidong , Guo Weihua
Published: March 2021

Background

The low survival rate or dysfunction of extracellular matrix (ECM)-based engineered organs caused by the adverse effects of unfavourable local microenvironments on seed cell viability and stemness, especially the effects of excessive reactive oxygen species (ROS), prompted us to examine the importance of controlling oxidative damage for tissue transplantation and regeneration. We sought to improve the tolerance of seed cells to the transplant microenvironment via antioxidant pathways, thus promoting transplant efficiency and achieving better tissue regeneration.

Methods

We improved the antioxidative properties of ECM-based bioroots with higher glutathione contents in dental follicle stem cells (DFCs) by pretreating cells or loading scaffolds with the antioxidant NAC. Additionally, we developed an in situ rat alveolar fossa implantation model to evaluate the long-term therapeutic effects of NAC in bioroot transplantation.

Results

The results showed that NAC decreased H2O2-induced cellular damage and maintained the differentiation potential of DFCs. The transplantation experiments further verified that NAC protected the biological properties of DFCs by repressing replacement resorption or ankylosis, thus facilitating bioroot regeneration.

Conclusions

The following findings suggest that NAC could significantly protect stem cell viability and stemness during oxidative stress and exert better and prolonged effects in bioroot intragrafts.
Empirical likelihood inference for threshold autoregressive conditional heteroscedasticity model
Authors: Peng Cuixin , Zhao Zhiwen
Published: March 2021

This paper considers the parameter estimation problem of a first-order threshold autoregressive conditional heteroscedasticity model by using the empirical likelihood method. We obtain the empirical likelihood ratio statistic based on the estimating equation of the least squares estimation and construct the confidence region for the model parameters. Simulation studies indicate that the empirical likelihood method outperforms the normal approximation-based method in terms of coverage probability.
A divided differences based medium to analyze smoothness of the binary bivariate refinement schemes
Authors: Hameed Rabia , Mustafa Ghulam , Baleanu Dumitru , Chu Yu-Ming
Published: March 2021

In this article, we present the continuity analysis of the 3D models produced by the tensor product scheme of $(m+1)$
(
m
+
1
)
-point binary refinement scheme. We use differences and divided differences of the bivariate refinement scheme to analyze its smoothness. The $C^{0}$

C
0

, $C^{1}$

C
1

and $C^{2}$

C
2

continuity of the general bivariate scheme is analyzed in our approach. This gives us some simple conditions in the form of arithmetic expressions and inequalities. These conditions require the mask and the complexity of the given refinement scheme to analyze its smoothness. Moreover, we perform several experiments by using these conditions on established schemes to verify the correctness of our approach. These experiments show that our results are easy to implement and are applicable for both interpolatory and approximating types of the schemes.
Bed management in psychiatry: ensuring that the patient perspective is not forgotten
Authors: Kotwal Tejas , Fluck Thomas , Valsraj Koravangattu
Published: March 2021

Bed management and the transfer of patients is an area of clinical care that is frequently overlooked. Often, the lack of discussion leads to the patient perspective being ignored and to transfers to new hospitals without appropriate handovers, both to the detriment of patient outcomes. This article reflects on the real-world consequences of the bed management systems used within the UK's National Health Service (NHS), using the example of a patient in psychiatric services.
Multithermally invisible cloaks and sensors with complex shapes
Authors: Wang C. Q. , Xu L. J. , Jiang T. , Zhang L. , Huang J. P.
Published: March 2021

Multithermal metamaterials are more practical to control thermal energy because there are three basic modes of thermal transport in nature. However, existing theories for multithermotics, such as the transformation theory and effective medium theory, are limited to complicated parameters or regular shapes. To solve the problem, we apply the thermal uniqueness theorem together with the heat flux conservation to design multithermal metamaterials including invisible cloaks and sensors. Multithermotics refers to the combination of conduction and radiation, which are described by the Fourier law and the Rosseland diffusion approximation, respectively. The present scheme can simplify parameters despite complex shapes, which only requires simple layered structures. We further perform finite-element simulations with different shapes to confirm the desired effects. These results provide guidance for multithermal management such as considering the combination of other basic modes of thermal transport.