bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in foot posture evaluated with dynamic pedobarography over the course of childhood in ambulatory youth with cerebral palsy
Authors: Church Chris , Lennon Nancy , Lennon Madison , Henley John D , Shields Thomas , Niiler Tim , Taylor Daveda A , Shrader M Wade , Miller Freeman
Published: January 2024

Purpose:

Foot deformities are prevalent in children with cerebral palsy, but there is limited research on the progression of foot posture during growth. Our study aimed to evaluate the change in dynamic foot posture in children with cerebral palsy.

Methods:

Children with cerebral palsy, aged 17–40 months, were recruited to participate in this Institutional Review Board–approved prospective longitudinal study by having serial foot posture evaluations. The coronal plane index and foot segmental impulses were measured with dynamic pedobarography. Data were compared between children stratified by Gross Motor Function Classification System level and typically developing children using serial Welch’s t-tests across time with Holm correction for multiple comparisons.

Results:

In total, 33 children (54 limbs) were included in the analysis (21 bilateral and 12 unilateral; Gross Motor Function Classification System: I-13, II-14, III-4, IV-2. Children completed 16.9 (± 4.4) evaluations (initial age 2.9 (± 0.7) and final age 18.6 (± 1.7) years)). Early valgus foot posture normalizes in children at Gross Motor Function Classification System levels I/II and persists in children at levels III/IV who do not have foot surgery. For most young children, foot posture development is variable.

Conclusion:

Foot posture in young children with cerebral palsy begins in valgus and tends to normalize in youth who walk without an assistive device. Conservative management of foot deformity is recommended in early childhood.

Level of evidence:

Level II, prognostic study.
These are our stories: Children’s more-than-human encounters with migration in Global South and North contexts
Authors: Kaneva Dimi , Morreira Shannon , Reynolds Rose-Anne
Published: January 2024

This paper explores children’s encounters with migration in global contexts through storytelling. Children from two primary schools in Manchester, UK and Cape Town, South Africa, developed stories of self through object elicitation, poetry and self-made artefacts. The children had either directly or indirectly experienced migration across borders. We combined objects that were brought from home, drawings and annotations in exploring the significance of children’s ordinary everyday encounters. While the children’s story work captures their individual perceptions of self, the collections of objects, drawings and artefacts reflect ideas about what it means to be a child in a world of mobility where human and more-than-human are entangled together. We explore children’s stories in relation to mobility, belonging and more-than-human connections. However, we acknowledge that the interpretation of the ‘final’ stories is incomplete as they continue to change in a process of becoming.
Shadow Politics: Commercial Digital Influencers, “Data,” and Disinformation in India
Authors: Udupa Sahana
Published: January 2024

This article builds on ethnographic research among an emergent group of self-styled political consultants and digital influencers in India to highlight the contours of what is defined here as “shadow politics” and its implications for disinformation research and policy. Shadow politics refers to the dual structure of “official” and “unofficial” streams of campaign organization that can integrate diverse influence actors with the party campaign system. The specificity of this form of political influence management emerges from the growing uptake for digital tools and how commercial consultants anchor “data” to the goal of “narrative building” to favor their political clients, thereby delinking data practices from the moor of political moralities. It sets the stage to draw extreme content as one data type among many to choose from. Through such data practices, a vast substratum of indirectly sanctioned influence operators is linked to the public campaign stream as a “shadow,” with incentive structures to “innovate” upon excitable and inflated content.
Disinformation-for-Hire as Everyday Digital Labor: Introduction to the Special Issue
Authors: Grohmann Rafael , Corpus Ong Jonathan
Published: January 2024

This introduction for the special issue “Disinformation-for-Hire as Everyday Digital Labor” carves out a specific area of inquiry within the ever-growing field of disinformation studies, with its sharp focus on the commercial transactions, organizational logics, and entrepreneurial practices that propel the production of disinformation. Inspired by traditions of political economy, media production studies, and everyday life approaches, this framework draws analytical focus to (1) the slow-burn horror of disinformation as everyday digital labor; (2) the diverse industries and workers engaged in disinformation production; and (3) regulatory areas beyond social media content policy and platform-centric accountability—especially relevant in the Global Majority context. Furthermore, this essay discusses how digital labor studies need to engage more directly with the ways disinformation thrives in the gray in-betweens of formal/informal and licit/illicit digital economies. The essays in our collection mobilize “disinformation-for-hire” as a valuable analytical frame that lays bare disinformation as a product of commercial and political complicities in the late capitalist arrangement of transnational digital industries.
When Decentralization Reduces Regional Disparity: Analyzing Access to College in China
Authors: Liu Qin , Li Tao
Published: January 2024

The relationship between decentralization and inequality remains puzzling. The primary objective of this paper is to study the effects of decentralization on regional education inequality in China where national higher education policies systematically prioritize large cities. We apply the Gini coefficient and the econometric model of regional convergence (i.e., Barro regressions) to study original provincial college admission data in China from 2005 to 2013. We discover that the provincial Gini coefficients have been declining throughout the period. The Barro regression results also suggest that the provincial-level college-going rates have been converging. We further demonstrate that the convergence is driven by provincial rather than national universities. Access to elite national universities remained unequal across provinces and still favored super cities. We conclude that decentralization helps to drive down the regional inequality of access to higher education that is due to national polices. It is not yet clear whether our conclusion is applicable to other policy domains or other countries.
Challenges and Strategies for Knowledge Transfer in Multinational Corporations: The Case of Hotel “Maria the Great”
Authors: Charmchian Langroudi Atefeh , Charmchian Langroudi Maryam , Arasli Furkan , Rahman Imran
Published: January 2024

This case study examines the difficulties multinational corporations (MNCs) encounter when sharing knowledge among their various business units. The study pinpoints four main challenges to knowledge transfer: the hoarding-of-expertise challenge (HEC), the foreigner challenge (FC), the not-invented-here challenge (NIH), and the absorptive capacity challenge (ACC) and presents approaches to tackle these issues. The case study centers around the A&A hotel chain, specifically its subsidiary, “Maria the Great Hotel,” located on Kish Island in Iran. The study identified challenges within the context of this multinational hotel chain. It introduced strategies that can be used to address these challenges, emphasizing the significance of knowledge transfer in attaining organizational success and gaining a competitive edge.
Genetic, Clinical, and Pathologic Backgrounds of Children With X-Linked Alport Syndrome in China: A Monocenter Study
Authors: Juan-Juan Ding , Jia Wang , Li-Li Liu , Si Wang , Xiao-Wen Wang , Jiang-Wei Luan , Li-Qin Ke , Jie Sun , Pei-Wei Zhao
Published: January 2024

Background. Characteristics of X-linked Alport syndrome (XLAS) in a cohort of Chinese children. Methods. This work is a retrospective study covering the clinical information, pathological data, and gene sequencing results of 32 cases with XLAS from 2011 to 2022. Results. Among these 32 patients, the youngest age of onset was 3 months. Renal biopsy was performed on 29 children. The lamellated glomerular basement membrane was observed in 19 children using electron microscopy (65.5%). Of the 26 samples tested, 73.1% were found to be negative for collagen-a5 under immunohistochemical staining, showing clinical significance. Next-generation sequencing (NGS) detected 27 pathogenic gene mutations. A total of 15.4% of patients carried de novo mutations. Conclusions. The boys with XLAS showed more typical pathological performance than the girls. Patients with severe mutation were more likely to have proteinuria and hearing impairment. Renal pathology combined with NSG is an important means of diagnosis of AS.
Mean Ocular Perfusion Pressure Effect During Pars Plana Vitrectomy on the Foveal Avascular Zone: A Pilot Study
Authors: Shaheen Fiza , Khan Hashim Ali , Afzal Farooq , Awan Muhammad Amer
Published: January 2024

Purpose: To evaluate the effect of mean ocular perfusion pressure on the foveal avascular zone (FAZ) area in eyes with successful retinal detachment (RD) surgery. Methods: This prospective pilot fellow eye–controlled study measured the intraoperative mean ocular perfusion pressure in eyes having surgery for rhegmatogenous RD (RRD). Postoperatively, the FAZ area was measured; the change was calculated as the difference in the FAZ area between the operated eye and the contralateral control eye. Results: The study comprised 8 patients with a mean age (±SD) of 53.38 ± 13.92 years. The mean superficial FAZ area was not different between operated eyes and control eyes, while the deep FAZ area was significantly larger in operated eyes. There was a strong negative correlation between the mean ocular perfusion pressure and the change in the deep FAZ area (Spearman ρ, −0.73; P = .04); the correlation between the mean ocular perfusion pressure and the change in the superficial FAZ area was not significant (Spearman ρ, −0.24; P = .57). A significant linear regression was found between the mean ocular perfusion pressure and the change in the deep FAZ area ( R2 = 0.388). The predicted enlargement of the deep FAZ area was 0.03 mm with every 1 mm Hg decrease in the mean ocular perfusion pressure. Conclusions: Lower intraoperative mean ocular perfusion pressure is associated with enlargement of the deep FAZ area in eyes having successful RRD surgery.
Evaluation of a Pharmacist-Managed Diabetes Transitions of Care Medication Management Clinic
Authors: Hall Hayley M. , Ashley Kadin C. , Schadler Aric D. , Naseman Kristina W.
Published: January 2024

Purpose:

The purpose of this study was to determine the impact of a pharmacist-managed transitions of care (TOC) clinic on outcomes in a posthospitalization population with diabetes.

Methods:

A retrospective single center cohort study utilized electronic health records to identify discharged patients followed by the inpatient endocrinology team. The primary outcome was 30-day readmission rates in the target population. Secondary outcomes include 90-day readmission rates, time to first follow-up, emergency department/urgent care encounters, change in A1C, retention with endocrinology, referrals for diabetes education, and types of interventions. The control group included patients prior to the initiation of the TOC clinic compared to patients seen in the TOC clinic, evenly matched by A1C. Readmission rates and other clinical data were queried up to 4 months after discharge.

Results:

Patients in the TOC cohort had similar 30-day readmission rates compared to the non-TOC cohort and were found to have lower A1C values within 120 days of discharge. Overall, patients in the TOC cohort were more likely to have a follow-up appointment and had closer follow-up after discharge.

Conclusion:

This study highlights that although there was no difference in readmission rates, a pharmacist-managed diabetes TOC clinic may decrease time to follow-up and improve long-term diabetes outcomes.
Assessment of Population-Based Approach to Direct Oral Anticoagulant Management
Authors: Ha Nghi , Mouland Erin , Renner Elizabeth , Sutter-Long Denise , Bici Anisa , Lanham Michael , Barnes Geoffrey D.
Published: January 2024

Background: As preferences for oral anticoagulation shift from warfarin to direct oral anticoagulants (DOACs), a new care management model is needed. A population approach leveraging a DOAC Dashboard was implemented to track all patients on a DOAC followed by a physician at an academic medical center. The DOAC Dashboard is a real-time report within the electronic health record (EHR) that identifies patients who require evaluation for DOAC dose/therapy adjustment due to changing renal function, age, weight, indication, and/or significant drug-drug interaction (DDI). Objective: This study aims to describe the initial phase of DOAC Dashboard implementation, to evaluate the effectiveness of interventions, and to assess a multidisciplinary approach to management. Method: Retrospective descriptive study of the DOAC Dashboard from August 22, 2019, to January 20, 2022. Primary outcomes include total number of alerts addressed and interventions needed. Secondary outcome is the proportion of interventions implemented by the prescribing clinician. Result: A total of 10 912 patients were identified by the DOAC Dashboard at baseline. A total of 5038 alerts were identified, with 668 critical alerts, 3337 possible critical alerts, and 1033 other alerts. Pharmacists addressed 1796 alerts during the study period (762 critical alerts and 1034 possible critical). Critical alerts included 62 significant DDI, 379 inappropriate dosing, and 321 others. Of the critical alerts, intervention was needed in 291 cases (38%), with 255 (88%) of proposed interventions implemented. Critical alerts and possible critical alerts not requiring intervention were resolved by data entry. Conclusion: The DOAC Dashboard provides an efficient method of identifying patients on DOACs that require dose adjustments or therapeutic modifications.
A novel experimental database on the cyclic response of mine tailings
Authors: Arnold Cody , Macedo Jorge
Published: January 2024

Understanding the cyclic response of mine tailings is key for areas with moderate to high seismicity and an active mining industry (e.g. the United States, Peru, and Chile). However, assessing the cyclic response of mine tailings still relies on procedures and correlations developed for natural soils (i.e. sands and clays). This is due to information on the cyclic response of mine tailings being rather scarce compared to natural soils. Hence, it remains unclear if more efficient approaches can be implemented. This study presents an experimental database focused on the cyclic response of mine tailings compiled from various sources. The database is organized considering three classes, where all three contain cyclic simple shear (CSS) information. Class A also includes triaxial (Tx) and cone penetration testing (CPTu) information, Class B has Tx or CPTu information, and Class C contains no additional information beyond CSS. Most materials belong to Class A. It is worth noting that Class C (only cyclic information) is comparable with most databases for natural soils, hence highlighting the uniqueness of our database. In total, the database contains 129 CSS tests on 20 materials that represent a broad range of mine tailings. Thirteen materials belong to Class A, 5 to Class B, and 2 to Class C. In discussing the database, key information (e.g. the range of liquefaction resistance curves) is shared. In addition, potential assessments that can be conducted with the database are illustrated. The study closes by presenting the database organization and discussing potential uses. The database is available under the following DOI: https://doi.org/10.17603/ds2-1k0a-dt17
Modeling the limits of detection for antimicrobial resistance genes in agri-food samples: a comparative analysis of bioinformatics tools
Authors: Cooper Ashley L. , Low Andrew , Wong Alex , Tamber Sandeep , Blais Burton W. , Carrillo Catherine D.
Published: January 2024

Background

Although the spread of antimicrobial resistance (AMR) through food and its production poses a significant concern, there is limited research on the prevalence of AMR bacteria in various agri-food products. Sequencing technologies are increasingly being used to track the spread of AMR genes (ARGs) in bacteria, and metagenomics has the potential to bypass some of the limitations of single isolate characterization by allowing simultaneous analysis of the agri-food product microbiome and associated resistome. However, metagenomics may still be hindered by methodological biases, presence of eukaryotic DNA, and difficulties in detecting low abundance targets within an attainable sequence coverage. The goal of this study was to assess whether limits of detection of ARGs in agri-food metagenomes were influenced by sample type and bioinformatic approaches.

Results

We simulated metagenomes containing different proportions of AMR pathogens and analysed them for taxonomic composition and ARGs using several common bioinformatic tools. Kraken2/Bracken estimates of species abundance were closest to expected values. However, analysis by both Kraken2/Bracken indicated presence of organisms not included in the synthetic metagenomes. Metaphlan3/Metaphlan4 analysis of community composition was more specific but with lower sensitivity than the Kraken2/Bracken analysis. Accurate detection of ARGs dropped drastically below 5X isolate genome coverage. However, it was sometimes possible to detect ARGs and closely related alleles at lower coverage levels if using a lower ARG-target coverage cutoff (< 80%). While KMA and CARD-RGI only predicted presence of expected ARG-targets or closely related gene-alleles, SRST2 (which allows read to map to multiple targets) falsely reported presence of distantly related ARGs at all isolate genome coverage levels. The presence of background microbiota in metagenomes influenced the accuracy of ARG detection by KMA, resulting in mcr-1 detection at 0.1X isolate coverage in the lettuce but not in the beef metagenome.

Conclusions

This study demonstrates accurate detection of ARGs in synthetic metagenomes using various bioinformatic methods, provided that reads from the ARG-encoding organism exceed approximately 5X isolate coverage (i.e. 0.4% of a 40 million read metagenome). While lowering thresholds for target gene detection improved sensitivity, this led to the identification of alternative ARG-alleles, potentially confounding the identification of critical ARGs in the resistome. Further advancements in sequencing technologies providing increased coverage depth or extended read lengths may improve ARG detection in agri-food metagenomic samples, enabling use of this approach for tracking clinically important ARGs in agri-food samples.
Insights into the early transcriptomic response against watermelon mosaic virus in melon
Authors: López-Martín María , Montero-Pau Javier , Ylla Guillem , Gómez-Guillamón María Luisa , Picó Belén , Pérez-de-Castro Ana
Published: January 2024

Background

Watermelon mosaic virus (WMV) is one of the most prevalent viruses affecting melon worldwide. Recessive resistance to WMV in melon has previously been reported in the African accession TGR-1551. Moreover, the genomic regions associated to the resistance have also been described. Nevertheless, the transcriptomic response that might infer the resistance to this potyvirus has not been explored.

Results

We have performed a comparative transcriptomic analysis using mock and WMV-inoculated plants of the susceptible cultivar “Bola de oro” (BO) and a resistant RIL (Recombinant inbred line) derived from the initial cross between “TGR-1551” and BO. In total, 616 genes were identified as differentially expressed and the weighted gene co-expression network analysis (WGCNA) detected 19 gene clusters (GCs), of which 7 were differentially expressed for the genotype x treatment interaction term. SNPs with a predicted high impact on the protein function were detected within the coding regions of most of the detected DEGs. Moreover, 3 and 16 DEGs were detected within the QTL regions previously described in chromosomes 11 and 5, respectively. In addition to these two specific genomic regions, we also observde large transcriptomic changes from genes spread across the genome in the resistant plants in response to the virus infection. This early response against WMV implied genes involved in plant-pathogen interaction, plant hormone signal transduction, the MAPK signaling pathway or ubiquitin mediated proteolysis, in detriment to the photosynthetic and basal metabolites pathways. Moreover, the gene MELO3C021395, which coded a mediator of RNA polymerase II transcription subunit 33A (MED33A), has been proposed as the candidate gene located on chromosome 11 conferring resistance to WMV.

Conclusions

The comparative transcriptomic analysis presented here showed that, even though the resistance to WMV in TGR-1551 has a recessive nature, it triggers an active defense response at a transcriptomic level, which involves broad-spectrum resistance mechanisms. Thus, this study represents a step forward on our understanding of the mechanisms underlaying WMV resistance in melon. In addition, it sheds light into a broader topic on the mechanisms of recessive resistances.
Sex differences in the association between socioeconomic status and untreated hypertension among residents with hypertension in rural Khánh Hòa, Vietnam: a post-hoc analysis
Authors: Yokobori Yuta , Fukunaga Ami , Okawa Sumiyo , Hachiya Masahiko , Nguyen Chau Que , Pham Thuy Phuong Thi , Hoang Dong Van , Phan Danh Cong , Huynh Dong Van , Le Huy Xuan , Do Hung Thai , Mizoue Tetsuya , Inoue Yosuke
Published: January 2024

Background

Several studies have examined the association between socioeconomic status (SES) and the proportion of untreated hypertension, but have produced conflicting findings. In addition, no study has been conducted to determine sex differences in the association between SES and untreated hypertension. Thus, the aim of this study was to examine whether the associations between SES and the proportion of untreated hypertension differed by sex in Vietnam.

Methods

This study was conducted using the data of 1189 individuals (558 males and 631 females) who were judged to have hypertension during the baseline survey of a prospective cohort study of 3000 residents aged 40–60 years in the Khánh Hòa Province. A multilevel Poisson regression model with a robust variance estimator was used to examine whether sex and SES indicators (household income and educational attainment) interacted in relation to untreated hypertension.

Results

The proportion of untreated hypertension among individuals identified as hypertensive was 69.1%. We found significant interaction between sex and SES indicators in relation to untreated hypertension (education: p < 0.001; household income: p < 0.001). Specifically, the association between SES and untreated hypertension was inverse among males while it was rather positive among females.

Conclusions

Our finding suggests that the role of SES in the proportion of untreated hypertension might differ by sex.
Does health literacy influence health-related lifestyle behaviors among specialists of health management? A cross-sectional study
Authors: Kinoshita Shunsuke , Hirooka Nobutaka , Kusano Takeru , Saito Kohei , Aoyagi Ryutaro
Published: January 2024

Background

Noncommunicable diseases (NCDs), such as health-related lifestyle diseases, are the leading cause of mortality and societal and economic burdens. Poor lifestyle behaviors, which are modifiable to improve health, can cause diseases, including NCDs. Health literacy has been recognized as an important determinant of health, and studies have shown that higher health literacy is associated with better health outcomes and positive health-related behaviors. However, few studies have investigated the association between health literacy and health-related lifestyle behaviors to understand the mechanistic link between them. Thus, this study investigated the extent to which health literacy at different levels influences health-related lifestyle behaviors.

Methods

A cross-sectional study was conducted among Japanese health management specialists (N = 1,920). Functional, critical, and communicative health literacy were measured. Lifestyle behaviors (exercise, diet and nutrition, sleep, rest, smoking, and alcohol intake), in line with the Japanese National Health Promotion Program, were assessed and calculated into a total cumulative score of health-related lifestyle behaviors. Moreover, we analyzed the associations between the three levels of health literacy and lifestyle behaviors using regression analyses by adjusting for socio-psycho-demographic factors.

Results

Multiple linear regression analyses showed a significant association between the Japanese version of the European Health Literacy Survey Questionnaire and total health-related lifestyle scores (standardized β = 0.160, p < 0.001, R2 = 0.136) after adjusting for sociodemographic factors. Similarly, the association between communicative and critical health literacy and the total health-related lifestyle scores was significant (standardized β = 0.122, p < 0.001, R2 = 0.125). The analysis indicated that individuals who had higher level of health literacy (critical and communicative) than functional health literacy (Japanese version of the Newest Vital Sign score) had higher health-related lifestyle behaviors.

Conclusions

A higher level of health literacy is associated with health-related lifestyle behaviors. Health literacy can be a target for interventions to achieve the national goal of lifestyle-related disease prevention and control.
Barriers and facilitators to depression care among Latino men in a primary care setting: a qualitative study
Authors: Swetlitz Nathan , Hinton Ladson , Rivera Morgan , Liu Mishen , Fernandez Anna Claire , Garcia Maria E
Published: January 2024

Background

In the United States, Latinos face a wide array of cultural and structural barriers to accessing and utilizing mental health care. Latino men specifically are at high risk of receiving inadequate mental health care, possibly due to additional obstacles they experience that are related to masculinity. Among men more generally, greater adherence to emotional control and self-reliance is associated with higher depression severity and less depression help-seeking. Men experience more stigma toward depression and help-seeking and are less likely to be diagnosed with depression than women. However, Latino men’s barriers and facilitators to depression care remain largely unexplored. The objective of this study was to examine barriers and facilitators to depression care that are related to masculinity among English- and Spanish-speaking Latino men in a primary care setting.

Methods

We used convenience and purposive sampling to recruit primary care patients who self-identified as Latino men, spoke English or Spanish, and screened positive for depressive symptoms on the Patient Health Questionnaire-2 or had a history of depression. Semi-structured interviews were conducted between December 2020 and August 2021. The interview guide examined views and experiences of depression, masculinity, and barriers and facilitators to engaging in depression care. Utilizing consensual qualitative research and thematic analysis informed by modified grounded theory, barriers and facilitators to depression care were identified.

Results

We interviewed thirteen participants who varied in English proficiency, education, income, and country of origin. Barriers and facilitators were placed into three domains—Self-Recognition of Depression, Seeking Help for Depression, and Depression Diagnosis and Treatment. Participants described aspects of masculinity as barriers (emotional control and pressure to provide), facilitators (honesty, courage, collaboration, practicality, and responsibility), or both (self-reliance and autonomy).

Conclusions

Masculinity influences barriers and facilitators for depression care among Latino men at the levels of self-recognition, seeking help, and diagnosis and treatment. Clinicians may promote Latino men’s engagement in depression care by understanding patients’ values and framing depression care as affirming masculinity. Providing education to primary care physicians and other healthcare professionals on gender and depression and addressing structural barriers are essential to providing access to all who need depression care.
Predictive factors for esophageal stenosis in patients receiving prophylactic steroid therapy after endoscopic submucosal dissection for esophageal squamous cell carcinoma
Authors: Mizuno Junichi , Urabe Yuji , Oka Shiro , Konishi Hirona , Ishibashi Kazuki , Fukuhara Motomitsu , Tanaka Hidenori , Tsuboi Akiyoshi , Yamashita Ken , Hiyama Yuichi , Kotachi Takahiro , Takigawa Hidehiko , Yuge Ryo , Hiyama Toru , Tanaka Shinji
Published: January 2024

Background

Methods to prevent esophageal stenosis (ES) after endoscopic submucosal dissection (ESD) for superficial esophageal squamous cell carcinoma (ESCC) have received increasing attention. Although steroid administration is a prophylactic treatment, the risk factors for ES during prophylactic steroid therapy remain unknown. Therefore, this study aimed to retrospectively evaluate the risk factors for refractory ES in patients administered prophylactic steroids after ESD for ESCC.

Methods

Among 795 patients with ESCC (854 lesions), 180 patients (211 lesions) administered local triamcinolone acetonide (TrA) and/or oral prednisolone were recruited for this study. We compared the total number of endoscopic balloon dilatation (EBD) procedures performed for post-ESD ES and clinical findings (tumor size, ESD history or chemoradiation therapy [CRT], entire circumferential resection, muscle layer damage, supplemental oral prednisolone administration, EBD with TrA injection, and additional CRT) between patients with refractory and non-refractory ES. EBD was continued until dysphagia resolved. We categorized cases requiring ≥ 8 EBD procedures as refractory postoperative stenosis and divided the lesions into two groups.

Results

Multivariate logistic regression analysis revealed that factors such as ESD history, CRT history, tumor size, and entire circumferential resection were independently associated with the development of refractory ES. The withdrawal rates of EBD at 3 years were 96.1% (52/53) and 58.5% (39/59) in the non-refractory and refractory groups, respectively.

Conclusions

Our data suggest that entire circumferential resection and CRT history are risk factors for refractory post-ESD ES in ESCC, even with prophylactic steroid administration.
Langerhans cell histiocytosis of the thyroid mimicking thyroiditis in a boy: a case report and literature review
Authors: Cheng Yu Fan , Wang Ching Che , Tsai Pei Shan , Lin Dao Chen , Huang Wen Hui
Published: January 2024

Background

Langerhans cell histiocytosis affecting the thyroid commonly presents with nonspecific clinical and radiological manifestations. Thyroid Langerhans cell histiocytosis is typically characterized by non-enhancing hypodense lesions with an enlarged thyroid on computed tomography medical images. Thyroid involvement in LCH is uncommon and typically encountered in adults, as is salivary gland involvement. Therefore, we present a unique pediatric case featuring simultaneous salivary and thyroid involvement in LCH.

Case presentation

A 3-year-old boy with complaints of an anterior neck mass persisting for 1 to 2 months, accompanied by mild pain, dysphagia, and hoarseness. A physical examination revealed a 2.5 cm firm and tender mass in the left anterior neck. Laboratory examinations revealed normal thyroid function test levels. Ultrasonography revealed multiple heterogeneous hypoechoic nodules with unclear and irregular margins in both lobes of the thyroid. Contrast-enhanced neck computed tomography revealed an enlarged thyroid gland and bilateral submandibular glands with non-enhancing hypointense nodular lesions, and multiple confluent thin-walled small (< 1.5 cm) cysts scattered bilaterally in the lungs. Subsequently, a left thyroid excisional biopsy was performed, leading to a histopathological diagnosis of LCH. Immunohistochemical analysis of the specimen demonstrated diffuse positivity for S-100, CD1a, and Langerin and focal positivity for CD68. The patient received standard therapy with vinblastine and steroid, and showed disease regression during regular follow-up of neck ultrasonography.

Conclusions

Involvement of the thyroid and submandibular gland as initial diagnosis of Langerhans cell histiocytosis is extremely rare. It is important to investigate the involvement of affected systems. A comprehensive survey and biopsy are required to establish a definitive diagnosis.
Current agreement between ActiGraph and CUPAR in measuring moderate to vigorous intensity physical activity for adolescents
Authors: Lu Yijuan , Hu Liang , Yu Kehong
Published: January 2024

The study aims to develop and validate the Curriculum-related Physical Activity Recall questionnaire (CUPAR) as a measure of physical activity in adolescents. 83 middle-school students (13.23 ± 0.74 yrs) completed the CUPAR and whore ActiGraph accelerometers for seven consecutive days. Correlations and Bland–Altman plots were to examine the agreement between these two measures. Significant correlations were observed between the CUPAR and ActiGraph accelerometer for 5-day MPA (r = 0.29, p < 0.01), and for both 5-day and 7-day VPA (r = 0.47 and 0.79, ps < 0.01), and MVPA (r = 0.79 and 0.42, ps < 0.01). Plots showed reasonable agreement between the CUPAR and ActiGraph estimates of VPA and MVPA. The agreement between CUPAR and ActiGraph was higher for in-school VPA (r = 0.58, p < 0.01) and MVPA (r = 0.44, p < 0.01) as compared to the out-school VPA (r = 0.22, p < 0.05) and MVPA (r = 0.26, p < 0.05). The CUPAR can reduce respondents’ burden, representing a reliable and efficient measure of physical activity among adolescents, especially for PA occurred during in-school sessions and at vigorous intensity.
Predictors of time to full enteral feeding in low birth weight neonates admitted to neonatal intensive care unit: a prospective follow up study
Authors: Terefe Abraraw , Demtse Asrat , Abebe Fikertemariam , Mislu Esuyawkal , Tachbele Erdaw
Published: January 2024

Background

Survival of LBW infants has increased in recent years because of novel perinatal interventions, but the introduction and advancement of enteral feeds for low birth weight infants is challenging. In Ethiopia the proportion of low birth weight infants is thought to be 17.3%. The purpose of this study was to determine the time to full enteral feeding (FEF) and its predictors in LBW neonates admitted to neonatal intensive care unit in selected hospitals of Addis Ababa, Ethiopia.

Method

An institutional based prospective follow up study was conducted from March 15 to June 15, 2022 among 282 LBW neonates admitted to six randomly selected hospitals. Both primary and secondary data was used by interviewing mothers and prospective medical chart review of neonates. The Cox regression model was used and variables having a p-value less than 0.05 with 95% CIs in a multivariable analysis were declared as statistically significant association with time to full enteral feeding.

Result

Out of 282 neonates involved in this study, 211 (74.8%) of them reached at FEF. The overall median time to full enteral feeding was 5 days. Predictors significantly associated with time to full enteral feeding were educational level, birth weight, cesarean delivery, hospital acquired infection, being on antibiotics, age at initiation of trophic feeding, routine gastric residual evaluation and NICU location (hospital).

Conclusions

This study demonstrated the difficulty of understanding which low birth weight neonate will attain FEF in a timely manner and factors that affect time to FEF. There is a delay in full enteral feeding achievement among low birth weight neonates and there is a great deal of heterogeneity of practice among health care providers regarding feeding of infants as it was evidenced by a variation in feeding practice among hospitals. Nutrition should be considered as part of the management in neonatal intensive care units since low birth weight neonates are developing edematous malnutrition while they are in the NICU. There should be standard feeding protocol to avoid heterogeneity of practice and additional study should be conducted for each categories of GA and BW with long follow up time.
Hemolytic anemia associated with intravenous immunoglobulin in Kawasaki disease
Authors: Cheon Eun Jung , Oh Jun Suk
Published: January 2024

Background

The administration of high-dose intravenous immunoglobulin (IVIG) is a standard treatment for the management of Kawasaki disease (KD). IVIG is known to be a highly effective and safe treatment.

Case presentation

We report the development of hemolytic anemia in seven children receiving repeated doses of IVIG. The children were aged 3–44 months and included 4 girls and 3 boys. All children received 10% IVIG and a second course of immunoglobulin because they did not respond to the first course of immunoglobulin. Two received high-dose aspirin (50 mg/kg), and five received low-dose aspirin (5 mg/kg). Two patients required additional methylprednisolone pulse therapy (30 mg/kg) after the second dose of immunoglobulin, and three patients received oral prednisolone therapy for defervescence. Three patients showed coronary artery dilation during hospitalization and normalized within two months. Pretreatment hemoglobin averaged 11.3–14.2 g/dL, and post-hemolytic anemia hemoglobin ranged from 7.4 to 9.6 g/dL, with a difference of 1.7–6.8 g/dL. Reticulocytes were increased to 3.3–13.2%. Peripheral blood smears showed normochromic normocytic anemia, and anisopoikilocytosis. All children were positive for warm-type antibodies with IgG+, C3d- in direct antiglobulin test, and the blood group was A + in five and B + in two. None of the patients received immunomodulatory therapy or red blood cell transfusions. They were followed for a year and all recovered.

Conclusion

Especially, in non-O blood group KD patients who are refractory to initial IVIG and require a second dose of IVIG or 10% formulation the possibility of immune hemolytic anemia should be carefully considered, and close follow-up should be maintained after therapy.
A novel missense mutation in the MECOM gene in a Chinese boy with radioulnar synostosis with amegakaryocytic thrombocytopenia
Authors: Huang Duowen , Jiang Mingyan , Zhu Yiping , Li Dongjun , Lu Xiaoxi , Gao Ju
Published: January 2024

Radioulnar synostosis with amegakaryocytic thrombocytopenia (RUSAT) type 2, caused by MDS1 and EVI1 complex locus (MECOM) gene mutations, is a rare inherited bone marrow failure syndrome (IBMFS) with skeletal anomalies, characterized by varying presentation of congenital thrombocytopenia (progressing to pancytopenia), bilateral proximal radioulnar synostosis, and other skeletal abnormalities. Due to limited knowledge and heterogenous manifestations, clinical diagnosis of the disease is challenging. Here we reported a novel MECOM mutation in a Chinese boy with typical clinical features for RUSAT-2. Trio-based whole exome sequencing of buccal swab revealed a novel heterozygous missense mutation in exon 11 of the MECOM gene (chr3:168818673; NM_001105078.3:c.2285G > A). The results strongly suggest that the variant was a germline mutation and disease-causing mutation. The patient received matched unrelated donor hematopoetic stem cell transplantation (HSCT). This finding was not only expanded the pathogenic mutation spectrum of MECOM gene, but also provided key information for clinical diagnosis and treatment of RUSAT-2.
Systematic review of cash plus or bundled interventions targeting adolescents in Africa to reduce HIV risk
Authors: Rogers Kate , Le Kirkegaard Rikke , Wamoyi Joyce , Grooms Kaley , Essajee Shaffiq , Palermo Tia
Published: January 2024

Background

HIV remains a leading cause of death for adolescents and young people aged 10–24 years. HIV prevention requires multisectoral approaches that target adolescents and young people, addressing HIV risk pathways (e.g., transactional sex, gender-based violence, and school attendance) through bundled interventions that combine economic strengthening, health capabilities, and gender equality education. However, best practices are unknown because evidence on multisectoral programming targeted to adolescents and combining these components has not been systematically reviewed.

Methods

We conducted a systematic review to summarize the evidence on bundled interventions combining health and economic strengthening components for adolescents and young people and their effects on HIV/STI incidence and risk factors. We included studies from Africa published between 2005 and 2023, combining at least one economic strengthening and one health component, directed toward adolescents and young people aged 10–24 years. Included studies measured programmatic impacts on primary outcomes: HIV and STI incidence/prevalence; and mediators as secondary outcomes: sexual behaviours, sexual and reproductive health, school attendance, health-seeking behaviours, and violence. We conducted key word searches in PubMed, EMBASE, and Web of Science, imported titles/abstracts from the initial search, and reviewed them using the inclusion criteria. Full texts of selected articles were reviewed and information was extracted for analysis. Findings from the full texts identified were summarized.

Results

We reviewed 58 studies, including 43 quantitative studies and 15 qualitative studies, evaluating 26 unique interventions. A majority of studies reviewed were conducted in Eastern and Southern Africa. Interventions reviewed showed a greater number of significant results in improving economic outcomes; mental health and psychosocial outcomes; sexual and reproductive health knowledge and services utilization; and HIV prevention knowledge and testing. They showed fewer significant results in improving outcomes related to HIV incidence/prevalence; sexual risk behaviours; gender-based violence; gender attitudes; education; STI incidence, prevalence and testing; and sexual debut.

Conclusions

Our review demonstrated the potential for bundled, multisectoral interventions for preventing HIV and facilitating safe transitions to adulthood. Findings have implications for designing HIV sensitive programmes on a larger scale, including how interventions may need to address multiple strata of the social ecological model to achieve success in the prevention of HIV and related pathways.
Effect of twice daily inhaled albuterol on cardiopulmonary exercise outcomes, dynamic hyperinflation, and symptoms in secondhand tobacco-exposed persons with preserved spirometry and air trapping: a randomized controlled trial
Authors: Zeng Siyang , Nishihama Melissa , Weldemichael Lemlem , Lozier Helen , Gold Warren M. , Arjomandi Mehrdad
Published: January 2024

Background

In tobacco-exposed persons with preserved spirometry (active smoking or secondhand smoke [SHS] exposure), air trapping can identify a subset with worse symptoms and exercise capacity. The physiologic nature of air trapping in the absence of spirometric airflow obstruction remains unclear. The aim of this study was to examine the underlying pathophysiology of air trapping in the context of preserved spirometry and to determine the utility of bronchodilators in SHS tobacco-exposed persons with preserved spirometry and air trapping.

Methods

We performed a double-blinded placebo-controlled crossover randomized clinical trial in nonsmoking individuals at risk for COPD due to exposure to occupational SHS who had preserved spirometry and air trapping defined as either a residual volume-to-total lung capacity ratio (RV/TLC) > 0.35 or presence of expiratory flow limitation (EFL, overlap of tidal breathing on maximum expiratory flow-volume loop) on spirometry at rest or during cardiopulmonary exercise testing (CPET). Those with asthma or obesity were excluded. Participants underwent CPET at baseline and after 4-week trials of twice daily inhalation of 180 mcg of albuterol or placebo separated by a 2-week washout period. The primary outcome was peak oxygen consumption (VO2) on CPET. Data was analyzed by both intention-to-treat and per-protocol based on adherence to treatment prescribed.

Results

Overall, 42 participants completed the entire study (66 ± 8 years old, 91% female; forced expiratory volume in 1 s [FEV1] = 103 ± 16% predicted; FEV1 to forced vital capacity [FVC] ratio = 0.75 ± 0.05; RV/TLC = 0.39 ± 0.07; 85.7% with EFL). Adherence was high with 87% and 93% of prescribed doses taken in the treatment and placebo arms of the study, respectively (P = 0.349 for comparison between the two arms). There was no significant improvement in the primary or secondary outcomes by intention-to-treat or per-protocol analysis. In per-protocol subgroup analysis of those with RV/TLC > 0.35 and ≥ 90% adherence (n = 27), albuterol caused an improvement in peak VO2 (parameter estimate [95% confidence interval] = 0.108 [0.014, 0.202]; P = 0.037), tidal volume, minute ventilation, dynamic hyperinflation, and oxygen-pulse (all P < 0.05), but no change in symptoms or physical activity.

Conclusions

Albuterol may improve exercise capacity in the subgroup of SHS tobacco-exposed persons with preserved spirometry and substantial air trapping. These findings suggest that air trapping in pre-COPD may be related to small airway disease that is not considered significant by spirometric indices of airflow obstruction.