bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Rhinosinusitis: Other Medical Options
Authors: Incorvaia C. , Leo G.
Published: April 2023

Medical options other than antibiotics or corticosteroids for treating rhinosinusitis include non-specific treatments such as nasal decongestants, naso-sinusal washings, antihistamines, antileukotrienes, mucolytic agents, immunomodulators and immunostimulants, as well as specific agents such as antimycotics in fungal sinusitis or antireflux agents in sinusitis associated to gastroesophageal reflux. In subjects with chronic sinusitis and/or nasal polyposis related to aspirin hypersensitivity protocols of desensitization are available. The available scientific evidence is good for naso-sinus washings with saline solutions, antihistamines in acute allergic rhinosinusitis, antileukotrienes in chronic sinusitis, bacterial lysates for prevention of recurrent sinusitis, and aspirin desensitisation in subjects with aspirin-exacerbated respiratory disease with chronic sinusitis and nasal polyposis. The other treatment options are still in search of scientific demonstration.
Treatment of Rhinosinusitis: The Role of Surgery
Authors: Cazzavillan A. , Gaini R.M. , Pignataro L. , Piacentini E. , Leo G.
Published: April 2023

The treatment of rhinosinusitis in children is mostly medical. Surgery is indicated in few but important exceptions: orbital or intracranial complications of acute rhinosinusitis not responding to medical therapy, chronic rhinosinusitis (CRS) with persisting sinonasal infection and purulent discharge, cystic fibrosis, ciliary discinesia, dacryocistitis due to sinusitis and resistant to medical treatment, fungal rhinosinusitis. According to recent data, 50% of ENT specialist perform an adenoidectomy to manage CRS before endoscopic sinus surgery (ESS). ESS techniques introduced in mid 90s, has significantly modified the treatment of complications of acute rhinosinusitis and of selected cases of chronic recurrent infections. ESS consists of minimally invasive surgical procedure as middle meatal antrostomy and anterior ethmoidectomy. Evidence suggests that adenoidectomy and ESS are the most frequent surgical procedure performed in RS management.
On-campus mental health services for Australian university students: A retrospective analysis of service utilisation
Authors: Francis-Taylor Rohan , Lipscomb Rosie , Sanatkar Samineh , Healy Martin , Kefalas Bill
Published: April 2023

Objective

To investigate on-campus mental health service utilisation by Australian university students.

Method

Retrospective analysis of clinical data from two on-campus health services (general practice and psychology and counselling service). Descriptive statistics include total consults, demographic factors, diagnoses, presenting concerns and rates of suicidal ideation.

Results

Mental health conditions account for the largest proportion of ongoing illness in on-campus health service users, representing 46% of all ongoing health conditions. Depression and anxiety were the most common diagnoses, and stress, anxiety and low mood were the most common presenting concerns. Females utilise mental health services more frequently than males, accounting for 65.3% and 60.1% of patients for the respective services. International students present for specific mental health consults less frequently than domestic students. Rates of suicidal ideation at presentation were high (37%).

Conclusions

This retrospective analysis provides important information regarding the proportion and distribution of mental health conditions and service utilisation amongst Australian university students. There is clear scope for increased access to specialist care, renewed efforts to decrease stigma and increase rates of presentation (particularly amongst international students and males), greater support for general practitioners and more rigorous routine data collection and reporting, both within and across universities nationally.
The Unexpected Benefits of a Decolonized Knowledge Translation Initiative for Indigenous Mother Participants
Authors: Wright Amy , VanEvery Rachel , Burnside Heather , Lopez Kristena B. , Kewageshig-Fyfe Katie , Jacobs Brenda , Floyd Andrea E. M. , Ferron Era M.
Published: April 2023

Western health research’s approach to knowledge translation (KT) has been criticized by Indigenous scholars, leaders, and communities for its misalignment with Indigenous ways of knowing and relational approaches to sharing knowledge. Conversely, Indigenous KT is understood as ‘sharing what we know about living a good life’ (Kaplan-Myrth & Smylie, 2006). Whereas KT in Euro-Western science contexts focuses on closing the know-do gap implying a separation of knowledge and action, knowledge in the Indigenous context is inherently practical and based on centuries old practices including oral traditions, experiential knowledge, and cross-cultural sharing. This article describes the development of a decolonized KT strategy. This community-engaged KT initiative was developed at the suggestion of Indigenous mothers who participated in a research study in Hamilton, Canada, which examined their experiences using health care to meet the health needs of their infants. Indigenous mothers participated in three main roles related to the KT activities: sharing their story in video, participating as team members on an Advisory Board, and directing the creation of a video series and website educational resource (KT strategy). Five Indigenous mothers participated as members of the Advisory Board. The process of participating had positive impacts on the mothers, namely, empowerment, strength, ‘I am not alone’, and healing. These unexpected findings, which go beyond the original project purpose to create an educational resource, show the significant and important benefits for research participants, particularly those from Indigenous communities, to be involved in decolonized KT strategies.
Effect of Early Administration of Vasopressin on New-Onset Arrhythmia Development in Patients With Septic Shock: A Retrospective, Observational Cohort Study
Authors: McCloskey Michele M. , Gibson Gabrielle A. , Pope Hannah E. , Giacomino Bria D. , Hampton Nicholas , Micek Scott T. , Kollef Marin H. , Betthauser Kevin D.
Published: April 2023

Background: Adjunctive vasopressin use in septic shock reduces catecholamine requirements and is associated with a lower incidence of new-onset arrhythmias (NOAs). The association of vasopressin timing on NOA development is ill-described. Objective: To determine whether early administration of vasopressin was associated with a lower incidence of NOA in septic shock patients. Methods: A retrospective analysis of intensive care unit (ICU) patients at a large, academic medical center. Septic shock patients who required vasopressin and norepinephrine were eligible for inclusion. Patients were excluded for receipt of other vasoactive agents, history of cardiac arrhythmias, or outside hospital admission. Early vasopressin was defined as receipt within 6 hours of septic shock onset. The primary outcome was incidence of NOA. Results: In total, 436 patients, 220 (50.4%) in the early and 216 (49.6%) in the late vasopressin group, were included. Early vasopressin was not associated with a lower incidence of NOA compared with late vasopressin (9% vs 7%, median absolute difference [95% confidence interval, CI]: −2.1 [−7.2, 3.0], P = 0.41). Early vasopressin patients were observed to have shorter shock duration (2 vs 4 days, median absolute difference [95% CI]: 2 [1, 2], P < 0.001), and ICU length of stay (6 vs 7 days, median absolute difference [95% CI]: 1 [0, 2], P = 0.02). Conclusions and Relevance: Early vasopressin use was not associated with a lower incidence of NOA. Additional studies are needed to elucidate the effect of vasopressin timing on NOA and other clinical outcomes.
Does Early Vasopressin in Septic Shock Improve Outcomes? An Important Piece to This Emerging Puzzle Has Arrived
Authors: White C. Michael
Published: April 2023

In this month’s Annals of Pharmacotherapy, the largest observational study assessing the early versus later use of vasopressin has been published. When this new study is combined with the other available observational studies, there are 2 important outcomes to focus on. When all the observational studies are pooled together, no reduction in new onset arrhythmias is seen (odds ratio [OR] = 0.91, 95% confidence interval [CI] = 0.41-1.95) with early versus late vasopressin use while the reduction in renal replacement therapy just missed statistical significance (OR = 0.56, 95% CI = 0.32-1.00). Early vasopressin likely does not reduce new onset arrhythmias versus later use but might reduce the need for renal replacement therapy.
Developing a Program Model for School-Based Day Treatment for Social, Emotional, and Behavioral Difficulties
Authors: Pierce Kathryn , Yamada Samantha , Major Melissa , Pepler Debra J.
Published: April 2023

School-based day treatment is an intensive mental health service for children with social, emotional, and behavioral difficulties. Research on day treatment is scarce and descriptions of program models are lacking. We used stimulated recall interviews to explore the moment-to-moment processes and strategies of classroom staff in a day treatment program for children in kindergarten and Grade 1 in Canada. Several processes and strategies used by staff emerged from the thematic analysis of the interviews. These included a process of individualized intervention, characterized by a continual and cyclical process of attunement, responsiveness, assessment, and evaluation, using a team-based approach, noticing positives about children, a climate of positive relationships, staff regulating their own emotions, being flexible while also being firm and consistent, and seeing children from a developmental perspective. More specific strategies used by staff (e.g., token economy) also emerged from the interviews. Implications for future research and teacher training are discussed.
Is It Time to Expand Our Definition of “Clinical Utility”?
Authors: Sorscher Steven
Published: April 2023

Currently, genetic tests that predict cancer risk or risk of recurrence in patients who have had their cancer treated with curative intent must have proven “clinical utility” to be recommended by the organizations responsible for publishing the standard-of-care guidelines for cancer care.

Based on the current definition of clinical utility, most patients are denied testing for cancer-predisposing genes or pathogenic germline variants even though germline testing has been proven as highly accurate in identifying pathogenic germline variant carriers, there are measures recommended to prevent and diagnose early cancers associated with particular PGVs, and disparities in patient access to genetic tests are well described.

Similarly, despite dozens of studies demonstrating that detected circulating tumor DNA (ctDNA) after curative intention therapy of different cancer types is a highly accurate biomarker that predicts recurrence, the major organizations that publish guidelines for cancer monitoring after curative intention therapy recommend against using ctDNA assays to detect minimal residual disease and thereby predict recurrence for all solid tumor malignancies.

Here, the primary reasons that these genetic tests are considered to lack proven clinical utility and the primary evidence suggesting that a broader definition of clinical utility should be considered are discussed. By expanding the definition of clinical utility, many patients will benefit from the information gained from having these genetic tests.
Orchestration of materials science workflows for heterogeneous resources at large scale
Authors: Zhou Naweiluo , Scorzelli Giorgio , Luettgau Jakob , Kancharla Rahul R , Kane Joshua J , Wheeler Robert , Croom Brendan P , Newell Pania , Pascucci Valerio , Taufer Michela
Published: April 2023

In the era of big data, materials science workflows need to handle large-scale data distribution, storage, and computation. Any of these areas can become a performance bottleneck. We present a framework for analyzing internal material structures (e.g., cracks) to mitigate these bottlenecks. We demonstrate the effectiveness of our framework for a workflow performing synchrotron X-ray computed tomography reconstruction and segmentation of a silica-based structure. Our framework provides a cloud-based, cutting-edge solution to challenges such as growing intermediate and output data and heavy resource demands during image reconstruction and segmentation. Specifically, our framework efficiently manages data storage, scaling up compute resources on the cloud. The multi-layer software structure of our framework includes three layers. A top layer uses Jupyter notebooks and serves as the user interface. A middle layer uses Ansible for resource deployment and managing the execution environment. A low layer is dedicated to resource management and provides resource management and job scheduling on heterogeneous nodes (i.e., GPU and CPU). At the core of this layer, Kubernetes supports resource management, and Dask enables large-scale job scheduling for heterogeneous resources. The broader impact of our work is four-fold: through our framework, we hide the complexity of the cloud’s software stack to the user who otherwise is required to have expertise in cloud technologies; we manage job scheduling efficiently and in a scalable manner; we enable resource elasticity and workflow orchestration at a large scale; and we facilitate moving the study of nonporous structures, which has wide applications in engineering and scientific fields, to the cloud. While we demonstrate the capability of our framework for a specific materials science application, it can be adapted for other applications and domains because of its modular, multi-layer architecture.
Multidimensional beta-binomial regression model: A joint analysis of patient-reported outcomes
Authors: Najera-Zuloaga Josu , Lee Dae-Jin , Esteban Cristobal , Arostegui Inmaculada
Published: April 2023

Patient-reported outcomes (PROs) are often used as primary outcomes in clinical research studies. PROs are usually measured in ordinal scales and they tend to have excess variability beyond the binomial distribution, a property called overdispersion. Beta-binomial distribution has been previously proposed in this context in order to fit PROs, and beta-binomial regression (BBR) as a good alternative for modelling purposes, including the extension to mixed-effects models in a longitudinal framework. Many PROs have various health dimensions, which are commonly correlated within subjects. However, in clinical analysis, dimensions are separately analysed. In this work, we propose a multidimensional BBR model that incorporates a multidimensional outcome including several PROs in a joint analysis. The proposal has been evaluated and compared to the independent analysis through a simulation study and a real data application with patients with respiratory disease. Results show the advantages that a multidimensional approach offers in terms of parameter significance and interpretation. Additionally, the methods proposed in this work are implemented in the PROreg R-package developed by the authors.
A Systematic Review of Criminal Justice Initiatives to Strengthen the Criminal Investigation and Prosecution of Sexual Violence in East Africa
Authors: Rockowitz Sarah , Wagner Kirstin , Cooper Rachel , Stevens Laura , Davies Kari , Woodhams Jessica , Kanja Wangu , Flowe Heather D.
Published: April 2023

Sexual violence (SV) is a widespread public health and human rights problem, with countries in East Africa having higher rates than the global average. Prosecutions of SV in East Africa are rare, and survivors face many challenges accessing medico-legal justice and services. Developing initiatives that support survivors in navigating the criminal justice system is vital, yet there is limited research on efforts to improve the criminal justice system’s management and treatment of survivors. We conducted a scoping review of research on initiatives to strengthen responses toward investigating and prosecuting cases. We identified 25 academic articles and reports through a search of electronic databases and gray literature that address these initiatives in East Africa. The results reveal that seven types of initiatives have been studied: one-stop centers (OSCs), multisectoral referral networks, gender desks, community interventions, mobile applications, and specialized police and prosecution units. Upon review, we found that barriers to success include a lack of resources and facilities, a lack of trained health care, police, and judicial personnel to perform services, weak medico-legal partnerships, and stigma and impunity restricting the uptake and fair distribution of services. Overall, limited systematic evidence on the effectiveness and adaptability of initiatives exists, showing that SV interventions in East Africa remain an under-researched and under-resourced area, and need greater scientific rigor to inform practice and coordinated advocacy. This review is a call to action for policy makers and service providers working in East Africa—and for international bodies working toward achieving Sustainable Development Goals 5—to improve criminal justice initiatives.
Objective Evaluation of Laparoscopic Experience Based on Muscle Electromyography and Accelerometry Performing Circular Pattern Cutting Tasks: A Pilot Study
Authors: Soto Rodriguez Nestor Adrian , Arroyo Kuribreña Carlos , Porras Hernández Juan Domingo , Gutiérrez-Gnecchi Jose Antonio , Pérez-Escamirosa Fernando , Rigoberto Martinez-Mendez , Minor-martinez Arturo , Lorias-Espinoza Daniel
Published: April 2023

Purpose.The aim of this work is to present a new physical laparoscopy simulator with an electromyography (EMG)/accelerometry-based muscle activity recording system, EvalLap EMG-ACC, and perform objective evaluation of laparoscopic skills based on the quantification of muscle activity of participants with different levels of laparoscopic experience. Methods. EMG and ACC signals were obtained from 14 participants (6 experts, 8 medical students) performing circular pattern cutting tasks using a laparoscopic box trainer with the Trigno (Delsys Inc, Natick, MA) portable wireless system of 16 wireless sensors. Sensors were placed on the proximal and distal muscles of the upper extremities. Seven evaluation metrics were proposed and compared between skilled and novice surgeons. Results. The proximal and distal arm muscles (trapezius, deltoids, biceps, and forearms) were most active while executing laparoscopic tasks. Laparoscopic experience was associated with differences in EMG amplitude ([Formula: see text]), muscle activity ([Formula: see text]), hand acceleration ([Formula: see text]), user movement ([Formula: see text]), and muscle fatigue. For the cutting task, the deltoid, bicep, forearm EMG amplitude, and user movement significantly differed between experience groups. Conclusion. This pilot study demonstrates that different muscle groups are preferentially activated during laparoscopic tasks depending on the level of surgical experience. Expert surgeons showed less muscle activity compared with novices. EvalLap EMG-ACC represents a promising means to distinguish surgeons with basic cutting skills from those who have not yet developed these skills.
The Iatrogenic Injury Potential of Self-adherent, Elastic Bandages in Finger Injuries
Authors: Yu Henry H. , Nadeau Jason , Powell Jenna , Fox Charles , Lauder Alexander , Ipaktchi Kyros
Published: April 2023

Background:

The use of a self-adherent, elastic bandage is a practical way to dress finger injuries. Multiple reports describe iatrogenic injuries from elastic bandages, ranging from skin necrosis to finger gangrene, necessitating amputations. This study investigated whether elastic bandages can compromise digital perfusion by occluding arterial blood flow in healthy volunteers and evaluated the utility of pulse oximetry as a monitoring tool for digital perfusion. A technique for safe bandage application is proposed.

Methods:

A commercially available elastic bandage was wrapped around the index finger of 20 healthy volunteers at varying degrees of stretch. Digital perfusion measurements were carried out using photoelectric pulse transduction, laser Doppler flowmetry, and pulse oximetry. Intracompartmental pressure measurements were recorded using a separate in vitro experimental model.

Results:

Elastic bandages applied at maximum stretch did not change digital brachial index or pulse oximetry values, suggesting arterial blood flow was preserved distal to the bandage. Intracompartmental pressure measurements at maximum stretch remained below the systolic digital pressure. In contrast, superficial dermal perfusion fell to 32% of normal as measured by laser Doppler flow, at 100% bandage stretch.

Conclusion:

This study suggests a risk for iatrogenic injury when using elastic bandages for finger dressings. While arterial inflow was never compromised, pressures were high enough to occlude superficial venous outflow, which may begin at 20% bandage stretch. Pulse oximetry failed to detect changes distal to applied dressings, and we do not recommend it to detect digital vascular compromise in this setting.
Nudging to Stimulate Reading in Primary and Secondary Education
Authors: van der Sande Lisa , Wildeman Ilona , Bus Adriana G. , Steensel Roel van
Published: April 2023

Many students infrequently read during leisure time. Due to fast, unconscious decisions, they may overlook the possibility of reading. We tested the impact of nudging on reading frequency, reading attitude, and reading skills. Two studies targeting Grades 4 to 6 ( N = 105) and Grades 7 and 8 ( N = 146) compared: (1) a nudging condition—participants twice a week receiving reminders to read, (2) an information condition—participants once receiving information about the importance of reading, and (3) a control condition—participants receiving neither information nor reminders. In primary education, nudges positively affected parents’ knowledge of children’s books and students’ reading attitudes. In secondary education, nudges positively impacted students’ book knowledge. All effects only occurred for those students and parents most prone to reading. For the majority of the students, nudges did not improve reading outcomes. Therefore, we speculate about more effective ways of nudging reading.
Vasospastic Angina With ST-Segment Elevation Seen During Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring
Authors: Chrisler Oliver , Sawalha Khalid , López-Candales Angel
Published: April 2023

A 54-year-old man presented with significant ST-segment elevations noted on both channels displayed on the mobile cardiac outpatient telemetry (MCOT). Pertinent cardiac history was remarkable for syncope and episodes of atypical chest pain. The latter were described as infrequent and not associated with exercise intolerance. His syncopal episodes were described as occurring mostly in the mornings after the use of the restroom. Episodes happen 1 or 2 times a year since 2015. Patient had undergone thorough investigation with no significant findings. An MCOT was prescribed since frequency of symptoms has recently increased. Significant ST-segment elevations were noted. The patient described atypical chest pain and a sensation of presyncope during these recordings. He was urgently admitted, and a coronary angiogram revealed no epicardial luminal stenosis. However, the presence of sluggish coronary flow was suggestive of possible vasospastic angina. No ST-segment changes were noted during his coronary angiogram. The remarkable element portrayed by this case hinges in showing the unique utility of MCOT, as the most uncharacteristic diagnostic tool, in identifying transient ST-segment elevations that finally led to the diagnosis.
Candidate germline biomarkers of lenalidomide efficacy in mantle cell lymphoma: the Fondazione Italiana Linfomi MCL0208 trial
Authors: Ferrero Simone , Grimaldi Daniele , Arrigoni Elena , Pironti Mariapia , Zaccaria Gian Maria , Alessandria Beatrice , Genuardi Elisa , De Luca Gabriele , Ghislieri Marco , Tavarozzi Rita , Di Rocco Alice , Re Alessandro , Stefoni Vittorio , Cavallo Federica , Boccomini Carola , Balzarotti Monica , Zilioli Vittorio , Moita Filipa , Arcaini Luca , Lucchini Elisa , Ballerini Filippo , Ferreri Andrés J. M. , Puccini Benedetta , Palumbo Giuseppe A. , Galimberti Sara , Cortelazzo Sergio , Di Paolo Antonello , Ladetto Marco
Published: April 2023

In the Fondazione Italiana Linfomi MCL0208 phase 3 trial, lenalidomide maintenance (LEN) after autologous stem cell transplantation (ASCT) in mantle cell lymphoma (MCL) improved progression-free survival (PFS) vs observation (OBS). The host pharmacogenetic background was analyzed to decipher whether single-nucleotide polymorphisms (SNPs) of genes encoding transmembrane transporters, metabolic enzymes, or cell-surface receptors might predict drug efficacy. Genotypes were obtained via real-time polymerase chain reaction of the peripheral blood germ line DNA. Polymorphisms of ABCB1 and VEGF were found in 69% and 79% of 278 patients, respectively, and predicted favorable PFS vs homozygous wild-type (WT) in the LEN arm was 3-year PFS of 85% vs 70% (P < .05) and 85% vs 60% (P < .01), respectively. Patients carrying both ABCB1 and VEGF WT had the poorest 3-year PFS (46%) and overall survival (76%); in fact, in these patients, LEN did not improve PFS vs OBS (3-year PFS, 44% vs 60%; P = .62). Moreover, the CRBN polymorphism (n = 28) was associated with lenalidomide dose reduction or discontinuation. Finally, ABCB1, NCF4, and GSTP1 polymorphisms predicted lower hematological toxicity during induction, whereas ABCB1 and CRBN polymorphisms predicted lower risk of grade ≥3 infections. This study demonstrates that specific SNPs represent candidate predictive biomarkers of immunochemotherapy toxicity and LEN efficacy after ASCT in MCL.
Preliminary construct validity of patient-reported outcomes to assess chronic pain in adults with sickle cell disease
Authors: Mucalo Lana , Field Joshua J. , Highland Janelle , Khan Hamda , Hankins Jane S. , Singh Ashima , Brandow Amanda M.
Published: April 2023

Chronic pain affects 30% to 40% of individuals with sickle cell disease (SCD) and impairs patient functioning. Clinically meaningful, practical, and valid assessment tools for investigation, evaluation, and management of chronic pain are limited, representing a barrier for advancing SCD care. We sought to determine whether patient-reported outcomes (PROs) show preliminary construct validity in identifying individuals with SCD who were a priori defined as suggestive of having chronic pain based on previously published criteria. All individuals completed the Patient-Reported Outcomes Measurement Information System (PROMIS) domains: pain interference, pain behavior, pain quality (nociceptive, neuropathic), fatigue, sleep disturbance, depression, and anxiety; the Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me) domains: pain impact and emotional impact; and the painDETECT questionnaire. Thirty-three adults living with SCD were enrolled, and 42.4% had chronic pain. Pain-related PROs scores distinctly differentiated individuals with chronic pain from those without. Individuals with chronic pain had significantly worse pain-related PROs scores: PROMIS pain interference (64.2 vs 54.3), PROMIS pain behavior (63.2 vs 50), and ASCQ-Me pain impact (42.9 vs 53.2). According to published PROMIS clinical cut scores for the pain-related domains, individuals with chronic pain were categorized as having moderate impairment, whereas those without chronic pain had mild or no impairment. Individuals with chronic pain had PRO pain features consistent with neuropathic pain and worse scores in fatigue, depression, sleep disturbance, and emotional impact. Pain-related PROs show preliminary construct validity in differentiating individuals with and without chronic SCD pain and could be used as valuable tools for research and clinical monitoring of chronic pain.
Repeatability of radiomics studies in colorectal cancer: a systematic review
Authors: Liu Ying , Wei Xiaoqin , Feng Xu , Liu Yan , Feng Guiling , Du Yong
Published: April 2023

Background

Recently, radiomics has been widely used in colorectal cancer, but many variable factors affect the repeatability of radiomics research. This review aims to analyze the repeatability of radiomics studies in colorectal cancer and to evaluate the current status of radiomics in the field of colorectal cancer.

Methods

The included studies in this review by searching from the PubMed and Embase databases. Then each study in our review was evaluated using the Radiomics Quality Score (RQS). We analyzed the factors that may affect the repeatability in the radiomics workflow and discussed the repeatability of the included studies.

Results

A total of 188 studies was included in this review, of which only two (2/188, 1.06%) studies controlled the influence of individual factors. In addition, the median score of RQS was 11 (out of 36), range-1 to 27.

Conclusions

The RQS score was moderately low, and most studies did not consider the repeatability of radiomics features, especially in terms of Intra-individual, scanners, and scanning parameters. To improve the generalization of the radiomics model, it is necessary to further control the variable factors of repeatability.
Chylothorax due to hepatic alveolar echinococcosis with infiltration of diaphragm and left pleura: a case report
Authors: Schneider Anne , Klengel Steffen , Lübbert Christoph , Trawinski Henning
Published: April 2023

Background

Alveolar echinococcosis (AE) is an endemic parasitic zoonosis in Germany. In most cases, the liver is the primary organ affected.

Case presentation

A 59-year old female patient presented with increasing exertional dyspnea and unintentional weight loss. A computed tomography (CT) scan showed a left-sided chylous pleural effusion and multiple intrahepatic masses with infiltration of the diaphragm and the pleura. The findings were initially misinterpreted as hepatocellular carcinoma (HCC) with infiltrating growth. Liver biopsy of one of the masses showed no evidence of malignancy, but an amorphous necrosis of unclear origin. HCC was further ruled out by magnetic resonance imaging (MRI). However, MRI findings were highly suspicious for hepatothoracic dissemination and complications due to AE. Typical histologic findings in a repeated and more specific examination of the liver tissue and a positive serology for echinococcosis confirmed the diagnosis of AE. As the hepatic and pulmonary manifestations were considered inoperable in a curative matter, an anti-parasitic treatment with albendazole was initiated. A video-assisted thoracoscopic surgery (VATS) with removal of the chylous effusion as well as a talc pleurodesis was performed to relieve the patient from dyspnea. Two months later, the patient was asymptomatic and a positron emission tomography (PET)-CT-scan with [18 F] fluoro-2-deoxy-d-glucose (FDG) showed a remarkable diminution of the hepatic manifestation.

Conclusions

This case demonstrates a rare presentation of alveolar echinococcosis with a focus on pulmonary symptoms, emphasizing the importance of evaluation for pulmonary involvement in patients with AE and respiratory symptoms.
Lipids and transaminase elevations in ARV-experienced PLWH switching to a doravirine-based regimen from rilpivirine or other regimens
Authors: Maggi Paolo , Ricci Elena Delfina , Cicalini Stefania , Pellicanò Giovanni Francesco , Celesia Benedetto Maurizio , Vichi Francesca , Cascio Antonio , Sarchi Eleonora , Orofino Giancarlo , Squillace Nicola , Madeddu Giordano , De Socio Giuseppe Vittorio , Bargiacchi Olivia , Molteni Chiara , Masiello Addolorata , Saracino Annalisa , Menzaghi Barbara , Falasca Katia , Taramasso Lucia , Di Biagio Antonio , Bonfanti Paolo
Published: April 2023

Background

Doravirine (DOR) is a newly approved antiretroviral belonging to the class of non-nucleoside reverse transcriptase inhibitors (NNRTI), well tolerated and leading to an improved lipid profile in antiretroviral experienced people living with HIV (PLWH). We aimed at evaluating if the lipid-lowering effect is linked to the drug class, using real-life data from the SCOLTA cohort.

Methods

We compared the lipid profile modifications in experienced PLWH switching to a DOR-based regimen from rilpivirine or another NNRTI-based regimen or from an integrase strand transferase (INSTI)-based regimen. T0 and T1 were defined as the baseline and 6-month follow-up respectively. Data were collected at baseline and prospectively every six months and changes from baseline were compared using a multivariable linear model.

Results

In 107 PLWH, enrolled in the SCOLTA DOR cohort, with undetectable HIV-RNA at baseline, 32.7% switched from RPV-based regimens (DOR1), 29.9% from other NNRTI-including regimens (DOR2) and 37.4% switched from INSTI-including regimens (DOR3). At T1, TC significantly decreased in DOR2 (-15 mg/dL) and DOR3 (-23 mg/dL), and significantly more in DOR3 than in DOR1 (-6 mg/dL) (p = 0.016). HDL-C declined in DOR2 (-2 mg/dL) whereas it increased in DOR1 (+ 3 mg/dL) (p = 0.042) and remained stable in DOR3. LDL-C significantly decreased from baseline in DOR2 (-12 mg/dL) and DOR3 (-22 mg/dL) and was different between DOR1 (-8 mg/dL) and DOR3 (p = 0.022). TC/HDL ratio showed a significant decline in the DOR3 group (-0.45), although similar to DOR1 (-0.23, p = 0.315) and DOR2 (-0.19, p = 0.254). Triglycerides did not noticeably change. ALT significantly decreased in PLWH with a baseline level > 40 UI/mL.

Conclusions

PLWH on doravirine treatment showed different trends in blood lipids according to their previous regimen. In PLWH switching from RPV, minimal modifications were seen, whereas in those switching from other NNRTIs and from INSTI-including regimens, we observed an overall improvement in lipid profile, seemingly independent of the “statin effect” of TDF.
Association of body mass index and waist-to-height ratio with outcomes in ischemic stroke: results from the Third China National Stroke Registry
Authors: Li Xiaolin , Xu Qin , Wang Anxin , Zheng Pei , Zhu Huimin , Guo Ai , Meng Xia , Jiang Yong
Published: April 2023

Background and purpose

Conflicting reports of obesity paradox have led to confusion about weight management strategies for post-stroke patients. The main purpose of this study is to determine whether the obesity paradox measured by body mass index (BMI) or by waist-to-height ratio (WHtR) is real.

Methods

We evaluated the association of general obesity measured by BMI, and abdominal obesity measured by WHtR with 1-year all-cause mortality, recurrence of stroke and combined vascular events of acute ischemic stroke (AIS) patients in a cohort —— the Third China National Stroke Registry (CNSR-III). Cox proportional hazards models and restricted cubic splines were performed to investigate the association between obesity and clinical outcomes.

Results

A total of 14,146 patients with ischemic stroke were included. When BMI was used as a measure of obesity, compared to the normal weight patients, mortality decreased in overweight patients (hazard ratio [HR] 0.74 [95% confidence interval (CI) 0.61–0.91], P = 0.0035) and obese patients (HR 0.54 [0.40–0.73], P < 0.0001); and increased in underweight patients (HR 2.55 [1.75–3.73], P < 0.0001). After adjustment for confounding factors, the protective effect of obesity and overweight disappeared. BMI had no association with recurrence of stroke or combined vascular events. When WHtR was used as a measure of obesity, obese patients had lower 1-year all-cause mortality (HR 0.64 [0.43–0.97], P = 0.0357). After adjustment for confounding factors, this difference disappeared; overweight patients still had lower all-cause mortality (adjusted hazard ratio [aHR] 0.42 [0.26–0.67], P = 0.0003), recurrence of stroke (aHR 0.77 [0.60–0.99], P = 0.0440) and combined vascular events (aHR 0.75 [0.58–0.95], P = 0.0198).

Conclusions

Among Chinese patients with AIS, our study does not support the BMI paradox; overweight patients measured by WHtR had a more favorable prognosis. TOAST subtypes did not modify the association.
ART outcomes of patients in women with Isolated Hypogonadotropic Hypogonadism: a retrospective study in China
Authors: Xu Wanxue , li Rong , Qiao Jie
Published: April 2023

Background

Isolated Hypogonadotropic Hypogonadism (IHH) is a rare reproductive disorder caused by the dysfunction of the gonadotropin-releasing hormone axis. Patients with IHH typically fail to enter or develop through puberty and retain infertile without an exogenous hormone supplement. This study aimed to investigate the population characteristics and reproductive outcomes in IHH patients undergoing assisted reproductive technology (ART) treatment, and evaluate the best-performed predictor for ovarian response and clinical pregnancy in patients with IHH.

Methods

This retrospective cohort study included 83 women with IHH who underwent fresh ART cycles and non-diagnosed controls (n = 676). The receiver operating characteristic curves were generated to assess the predictor for the ovarian response. Logistic regression analyses were performed to investigate the independent factors for clinical pregnancy in IHH.

Results

The basal hormone levels were significantly lower in the IHH group compared to the control group. The fertilization rate and 2PN rate were significantly higher in IHH groups, as was the number of transferable embryos. The study identified that AMH was the best predictor of high ovarian response in IHH, with an AUC of 0.767 (0.573, 0.961). Conversely, the follicle-to-oocyte index (FOI) exhibited the highest AUC of 0.814 (0.642, 0.985) for predicting low ovarian response. Based on FOI values, the IHH patients were divided into two groups, and the study found a significant increase in clinical pregnancy rate (43.8%, 58%; P < 0.001) and live birth rate (37.5%, 58%; P < 0.001) from the low FOI to the normal FOI groups. Moreover, the number of oocytes retrieved, fertilized embryos/rate, 2PN embryos/rate, and number of excellent quality embryos were significantly higher in the normal FOI group (P < 0.001 or P = 0.005) than in the low FOI group. Logistic regression analyses revealed FOI to be the independent factor affecting clinical pregnancy in IHH patients.

Conclusions

The study findings suggest that patients with IHH were good responders to IVF treatment. Although AMH was the best-performed predictor for the high ovarian response, FOI had the best capability in predicting the low ovarian response. FOI was an independent factor affecting clinical pregnancy in IHH undergoing IVF/ICSI.
HPV vaccine narratives on Twitter during the COVID-19 pandemic: a social network, thematic, and sentiment analysis
Authors: Boucher Jean-Christophe , Kim So Youn , Jessiman-Perreault Geneviève , Edwards Jack , Smith Henry , Frenette Nicole , Badami Abbas , Scott Lisa Allen
Published: April 2023

Introduction

The COVID-19 pandemic has increased online interactions and the spread of misinformation. Some researchers anticipate benefits stemming from improved public awareness of the value of vaccines while others worry concerns around vaccine development and public health mandates may have damaged public trust. There is a need to understand whether the COVID-19 pandemic, vaccine development, and vaccine mandates have influenced HPV vaccine attitudes and sentiments to inform health communication strategies.

Methods

We collected 596,987 global English-language tweets from January 2019-May 2021 using Twitter’s Academic Research Product track. We determined vaccine confident and hesitant networks discussing HPV immunization using social network analysis. Then, we used a neural network approach to natural language processing to measure narratives and sentiment pertaining to HPV immunization.

Results

Most of the tweets in the vaccine hesitant network were negative in tone (54.9%) and focused on safety concerns surrounding the HPV vaccine while most of the tweets in the vaccine confident network were neutral (51.6%) and emphasized the health benefits of vaccination. Growth in negative sentiment among the vaccine hesitant network corresponded with legislative efforts in the State of New York to mandate HPV vaccination for public school students in 2019 and the WHO declaration of COVID-19 as a Global Health Emergency in 2020. In the vaccine confident network, the number of tweets concerning the HPV vaccine decreased during the COVID-19 pandemic but in both vaccine hesitant and confident networks, the sentiments, and themes of tweets about HPV vaccine were unchanged.

Conclusions

Although we did not observe a difference in narratives or sentiments surrounding the HPV vaccine during the COVID-19 pandemic, we observed a decreased focus on the HPV vaccine among vaccine confident groups. As routine vaccine catch-up programs restart, there is a need to invest in health communication online to raise awareness about the benefits and safety of the HPV vaccine.
Epidemiology of type 2 diabetes mellitus and treatment utilization patterns among the elderly from the first wave of Longitudinal Aging study in India (2017-18)using a Heckman selection model
Authors: Barman Papai , Das Milan , Verma Madhur
Published: April 2023

Introduction

Unmanaged Type 2 diabetes mellitus (T2DM) substantially contributes to the multi-morbidity of the elderly. Fewer research has concentrated on understanding the determinants of treatment utilization among older people, with even lesser concerns about missing data in outcome variables leading to biased estimates. The present study intends to evaluate the epidemiology of T2DM in the elderly in India and explore the socioeconomic and behavioral risk factors determining the treatment utilization among the elderly > 60 years in India by addressing the missing data to generate robust estimates.

Methods

The secondary analysis used data from the Longitudinal Ageing Study in India. The key dependent variables were the presence or absence of T2DM and treatment utilization. Descriptive statistics were used to understand the differences in the prevalence of diabetes and the utilization of treatment across various socio-demographic characteristics. Heckman’s statistical technique evaluated the predictors of T2DM and treatment utilization. Analysis was done using STATA software version 14.0.

Results

Almost 14% elderly reported to be living with T2DM. The odds of living with T2DM increased with non-working status, a sedentary lifestyle, and a higher BMI. A higher proportion of the elderly was on oral drugs than insulin and had been practicing lifestyle modifications to control their disease. The probability of developing T2DM was lower among females than males, but females had better odds for treatment utilization of health medication than males. Lastly, treatment utilization was significantly affected by socio-demographic characteristics like education and monthly per capita expenditure.

Conclusions

Treatment utilization by the elderly living with T2DM is significantly affected by socio-demographic characteristics. Keeping in mind the increasing proportion of the geriatric population in our country, it is pertinent to tailor-made counseling sessions for the elderly to improve medication utilization and adherence and realize our goals concerning non-communicable diseases.
No association between in utero exposure to emissions from a coalmine fire and post-natal lung function
Authors: Hemstock Emily J. , Foong Rachel E. , Hall Graham L. , Wheeler Amanda J. , Dharmage Shyamali C. , Dalton Marita , Williamson Grant J. , Gao Caroline , Abramson Michael J. , Johnston Fay H. , Zosky Graeme R.
Published: April 2023

Background and objective

Studies linking early life exposure to air pollution and subsequent impaired lung health have focused on chronic, low-level exposures in urban settings. We aimed to determine whether in utero exposure to an acute, high-intensity air pollution episode impaired lung function 7-years later.

Method

We conducted a prospective cohort study of children who lived in the vicinity of a coalmine fire. Respiratory function was measured using the forced oscillation technique (FOT). Z-scores for resistance at 5 Hz (R5), reactance at 5 Hz (X5) and area under the reactance curve (AX) were calculated. Two sets of analyses were conducted to address two separate questions: (1) whether mine fire exposure (a binary indicator; conceived after the mine fire vs in utero exposed) was associated with the respiratory Z-scores; (2) whether there was any dose–response relationship between fire-related PM2.5 exposure and respiratory outcomes among those exposed.

Results

Acceptable lung function measurements were obtained from 79 children; 25 unexposed and 54 exposed in utero. Median (interquartile range) for daily average and peak PM2.5 for the exposed children were 4.2 (2.6 – 14.2) and 88 (52—225) µg/m3 respectively. There were no detectable differences in Z-scores between unexposed and exposed children. There were no associations between respiratory Z-scores and in utero exposure to PM2.5 (daily average or peak).

Conclusion

There was no detectable effect of in utero exposure to PM2.5 from a local coalmine fire on post-natal lung function 7-years later. However, statistical power was limited.
Machine learning algorithm for early-stage prediction of severe morbidity in COVID-19 pneumonia patients based on bio-signals
Authors: Baik Seung Min , Kim Kyung Tae , Lee Haneol , Lee Jung Hwa
Published: April 2023

Background

Paralysis of medical systems has emerged as a major problem not only in Korea but also globally because of the COVID-19 pandemic. Therefore, early identification and treatment of COVID-19 are crucial. This study aims to develop a machine-learning algorithm based on bio-signals that predicts the infection three days in advance before it progresses from mild to severe, which may necessitate high-flow oxygen therapy or mechanical ventilation.

Methods

The study included 2758 hospitalized patients with mild severity COVID-19 between July 2020 and October 2021. Bio-signals, clinical information, and laboratory findings were retrospectively collected from the electronic medical records of patients. Machine learning methods included random forest, random forest ranger, gradient boosting machine, and support vector machine (SVM).

Results

SVM showed the best performance in terms of accuracy, kappa, sensitivity, detection rate, balanced accuracy, and run-time; the area under the receiver operating characteristic curve was also quite high at 0.96. Body temperature and SpO2 three and four days before discharge or exacerbation were ranked high among SVM features.

Conclusions

The proposed algorithm can predict the exacerbation of severity three days in advance in patients with mild COVID-19. This prediction can help effectively manage the reallocation of appropriate medical resources in clinical settings. Therefore, this algorithm can facilitate adequate oxygen therapy and mechanical ventilator preparation, thereby improving patient prognosis, increasing the efficiency of medical systems, and mitigating the damage caused by a global pandemic.