bluuebunny/crossref_metadata_2025 huggingface dataset:
Using social network analysis methods to identify networks of physicians responsible for the care of specific patient populations
Authors: Flemming Ronja , Schüttig Wiebke , Ng Frank , Leve Verena , Sundmacher Leonie
Published: April 2022

Background

Coordinating health care within and among sectors is crucial to improving quality of care and avoiding undesirable negative health outcomes, such as avoidable hospitalizations. Quality circles are one approach to strengthening collaboration among health care providers and improving the continuity of care. However, identifying and including the right health professionals in such meetings is challenging, especially in settings with no predefined patient pathways. Based on the Accountable Care in Germany (ACD) project, our study presents a framework for and investigates the feasibility of applying social network analysis (SNA) to routine data in order to identify networks of ambulatory physicians who can be considered responsible for the care of specific patients.

Methods

The ACD study objectives predefined the characteristics of the networks. SNA provides a methodology to identify physicians who have patients in common and ensure that they are involved in health care provision. An expert panel consisting of physicians, health services researchers, and data specialists examined the concept of network construction through informed decisions. The procedure was structured by five steps and was applied to routine data from three German states.

Results

In total, 510 networks of ambulatory physicians met our predefined inclusion criteria. The networks had between 20 and 120 physicians, and 72% included at least ten different medical specialties. Overall, general practitioners accounted for the largest proportion of physicians in the networks (45%), followed by gynecologists (10%), orthopedists, and ophthalmologists (5%). The specialties were distributed similarly across the majority of networks. The number of patients this study allocated to the networks varied between 95 and 45,268 depending on the number and specialization of physicians per network.

Conclusions

The networks were constructed according to the predefined characteristics following the ACD study objectives, e.g., size of and specialization composition in the networks. This study shows that it is feasible to apply SNA to routine data in order to identify groups of ambulatory physicians who are involved in the treatment of a specific patient population. Whether these doctors are also mainly responsible for care and if their active collaboration can improve the quality of care still needs to be examined.
Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort
Authors: Rocha Aline S. , de Cássia Ribeiro-Silva Rita , Fiaccone Rosemeire L. , Paixao Enny S. , Falcão Ila R. , Alves Flavia Jôse O. , Silva Natanael J. , Ortelan Naiá , Rodrigues Laura C. , Ichihara Maria Yury , de Almeida Marcia F. , Barreto Mauricio L.
Published: April 2022

Background

Preterm birth (PTB) is a syndrome resulting from a complex list of underlying causes and factors, and whether these risk factors differ in the context of prior PTB history is less understood. The aim of this study was to explore whether PTB risk factors in a second pregnancy were different in women with versus without previous PTB.

Methods

We conducted a population-based cohort study using data from the birth cohort of the Center for Data and Knowledge Integration for Health (CIDACS) for the period 2001 to 2015. We used longitudinal transition models with multivariate logistic regression to investigate whether risk factors varied between incident and recurrent PTB.

Results

A total of 3,528,050 live births from 1,764,025 multiparous women were analyzed. We identified different risk factors (Pdifference <0.05) between incident and recurrent PTB. The following were associated with an increased chance for PTB incidence, but not recurrent: household overcrowding (OR 1.09), maternal race/ethnicity [(Black/mixed—OR 1.04) and (indigenous—OR 1.34)], young maternal age (14 to 19 years—OR 1.16), and cesarean delivery (OR 1.09). The following were associated with both incident and recurrent PTB, respectively: single marital status (OR 0.85 vs 0.90), reduced number of prenatal visits [(no visit—OR 2.56 vs OR 2.16) and (1 to 3 visits—OR 2.44 vs OR 2.24)], short interbirth interval [(12 to 23 months—OR 1.04 vs OR 1.22) and (<12 months, OR 1.89, 95 vs OR 2.58)], and advanced maternal age (35–49 years—OR 1.42 vs OR 1.45). For most risk factors, the point estimates were higher for incident PTB than recurrent PTB.

Conclusions

The risk factors for PTB in the second pregnancy differed according to women’s first pregnancy PTB status. The findings give the basis for the development of specific prevention strategies for PTB in a subsequent pregnancy.
Connective tissue growth factor mediates bone morphogenetic protein 2-induced increase in hyaluronan production in luteinized human granulosa cells
Authors: Chang Hsun-Ming , Bai Long , Zhu Yi-Min , Leung Peter C. K.
Published: April 2022

Background

Hyaluronan is the main component of the cumulus-oocyte complex (COC) matrix, and it maintains the basic structure of the COC during ovulation. As a member of the transforming growth factor β (TGF-β) superfamily, bone morphogenetic protein 2 (BMP2) has been identified as a critical regulator of mammalian folliculogenesis and ovulation. However, whether BMP2 can regulate the production of hyaluronan in human granulosa cells has never been elucidated.

Methods

In the present study, we investigated the effect of BMP2 on the production of hyaluronan and the underlying molecular mechanism using both immortalized (SVOG) and primary human granulosa-lutein (hGL) cells. The expression of three hyaluronan synthases (including HAS1, HAS2 and HAS3) were examined following cell incubation with BMP2 at different concentrations. The concentrations of the hyaluronan cell culture medium were determined by enzyme-linked immunosorbent assay (ELISA). The TGF-β type I receptor inhibitors (dorsomorphin and DMH-1) and small interfering RNAs targeting ALK2, ALK3, ALK6 and SMAD4 were used to investigate the involvement of TGF-β type I receptor and SMAD-dependent pathway.

Results

Our results showed that BMP2 treatment significantly increased the production of hyaluronan by upregulating the expression of hyaluronan synthase 2 (HAS2). In addition, BMP2 upregulates the expression of connective tissue growth factor (CTGF), which subsequently mediates the BMP2-induced increases in HAS2 expression and hyaluronan production because overexpression of CTGF enhances, whereas knockdown of CTGF reverses, these effects. Notably, using kinase inhibitor- and siRNA-mediated knockdown approaches, we demonstrated that the inductive effect of BMP2 on the upregulation of CTGF is mediated by the ALK2/ALK3-mediated SMAD-dependent signaling pathway.

Conclusions

Our findings provide new insight into the molecular mechanism by which BMP2 promotes the production of hyaluronan in human granulosa cells.
Potential application of hydrogel to the diagnosis and treatment of multiple sclerosis
Authors: Liu Haochuan , Chen Bing , Zhu Qingsan
Published: April 2022

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. This disorder may cause progressive and permanent impairment, placing significant physical and psychological strain on sufferers. Each progress in MS therapy marks a significant advancement in neurological research. Hydrogels can serve as a scaffold with high water content, high expansibility, and biocompatibility to improve MS cell proliferation in vitro and therapeutic drug delivery to cells in vivo. Hydrogels may also be utilized as biosensors to detect MS-related proteins. Recent research has employed hydrogels as an adjuvant imaging agent in immunohistochemistry assays. Following an overview of the development and use of hydrogels in MS diagnostic and therapy, this review discussed hydrogel’s advantages and future opportunities in the diagnosis and treatment of MS.

Graphical abstract
A multicenter non-inferior randomized controlled study comparing the efficacy of laparoscopic versus abdominal radical hysterectomy for cervical cancer (stages IB1, IB2, and IIA1): study protocol of the LAUNCH 2 trial
Authors: Wu Xin , Qiu Ling , Lou Weihua , Wang Xipeng , Zhu Tao , Zhang Yuyang , Hu Weiguo , Xue Xiaohong , Zhu Zhiling , Xiang Libing , Li Jiarui , Fang Xuhong , Gao Shujun , Feng Hua , Diao Wenjing , Zhang Hongwei , Du Ming , Bai Yongrui , Hou Yanli , Yan Weili , Feng Hao , Yu Hailing , Zhu Shurong , Du Yan , Jiang Hua
Published: April 2022

Background

A retrospective study and a randomized controlled trial published in late 2018 have shown that laparoscopic radical hysterectomy (RH) was associated with worse survival than abdominal RH among patients with early-stage cervical cancer. Radical hysterectomy in cervical cancer has been a classic landmark surgery in gynecology; therefore, this conclusion is pivotal. The current trial is designed to reconfirm whether there is a difference between laparoscopic RH and abdominal RH in cervical cancer (stages IB1, IB2, and IIA1) patient survival under stringent operation standards and consistent surgical oncologic principles.

Methods/design

This is an investigator-initiated, Prospective, Randomized, Open, Blinded End-point (PROBE)-controlled non-inferiority trial. A total of 780 patients with stage IB1, IB2, and IIA1 cervical cancer will be enrolled over a period of 3 years. Patients are randomized (1:1) to either the laparoscopic RH or the abdominal RH group. Patients will then be followed up for at least 5 years. The primary endpoint will be 5-year progression-free survival, and secondary endpoints include 5-year overall survival, recurrence, and quality of life measurements.

Discussion

The debate on laparoscopic versus abdominal RH is still ongoing, and high-quality evidences are needed to guide clinical practice. The study results will provide more convincing evidence-based information for early-stage cervical cancer patients and their gynecologic cancer surgeons in their choice of surgical method.

Trial registration

ClinicalTrials.govNCT04929769. Registered on 18 June 2021
Educational intervention for the prevention of occupational neck pain: protocol of randomized trial
Authors: Moradi Zohreh , Tavafian Sedigheh Sadat , Kazemi Seyedeh Somayeh
Published: April 2022

Background

Neck pain is one of the most common work-related musculoskeletal disorders (WMSDs). It has important social and economic consequences such as reduced productivity due to absenteeism, leave, and early retirement and financial losses due to medical expenses for the workforce especially teachers. This study aims to evaluate whether a model-based social media intervention could change the high-risk behaviors that cause work-related neck pain among teachers.

Methods

This is a randomized controlled trial that will be done in three steps. The first stage is a qualitative study to obtain the items and areas of the researcher-made questionnaire based on the health belief model (HBM), the second stage is the psychometric evaluation of the questionnaire, and the third stage is designing and implementation of model-based educational intervention in social media context. The study population is teachers who working in junior high school in the 19th district of education minister in Tehran, Iran, which are randomly divided into two groups of intervention and control. The intervention group receives training packages on social media, and the control group does not receive any training. The educational intervention tries to improve the knowledge, attitude, skills, and self-efficacy in adopting neck pain prevention behaviors among teachers. The study will also assess whether the intervention can promote preventive neck pain behavior among teachers.

Discussion

Work-related neck pain can have a negative impact on teachers’ health. This study is an attempt to investigate the impact of developed interventions in promoting preventive behavior regarding work-related neck pain through social media context.

Trial registration

Iranian registry of Clinical Trial (IRCT) IRCT20210301050542N1. Registered on 16 March 2021

Ethics code: IR.MODARES.REC.1399.163
Evaluation of right ventricular systolic and diastolic dysfunctions in patients with type 2 diabetes mellitus with poor glycemic control by layer specific global longitudinal strain and strain rate
Authors: Huang Jun , Li Li , Fan Li , Chen Dong-liang
Published: April 2022

Background

In order to evaluate right ventricular (RV) systolic and diastolic dysfunctions in patients with type 2 diabetes mellitus (T2DM) with poor glycemic control by layer specific global longitudinal strain (GLS) and strain rate (GLSr).

Methods

68 T2DM patients and 66 normal controls were enrolled for the present study. RV layer specific GLS (GLSEpi, GLSMid and GLSEndo represent the epimyocardial, middle layer and endomyocardial strains, respectively) and GLSr (GLSr-S, GLSr-E and GLSr-A represent the systole, early-diastole and late-diastole strain rate) were calculated by averaging each of the three regional peak systolic strains and strain rates along the entire RV free-wall (RVFW), entire RV free-wall and septal wall (RVFSW) on RV-focused view.

Results

The absolute values of RV layer specific GLS (GLSEpi, GLSMid and GLSEndo) in RVFW in T2DM patients were significantly lower than normal controls (P < 0.01), while GLSr-A was significantly larger than normal controls (P < 0.001). The absolute values of RV layer specific GLS (GLSEpi and GLSMid) in RVFSW in T2DM patients were significantly lower than normal controls (P < 0.05), while GLSr-A was significantly larger than normal controls (P < 0.001). HbA1c were poor negatived correlated with GLSEpi in RVFW and RVFSW in T2DM patients (P < 0.05). ROC analysis showed that RV layer specific GLS and GLSr-A had a high diagnostic efficacy in T2DM patients, and GLSr-A in RVFSW have the best diagnostic value in RV diastolic function in T2DM patients (AUC: 0.773).

Conclusion

From the research, we found that layer specific GLS and GLSr could detect the RV myocardial dysfunctions and confirmed that the impaired RV systolic and diastole functions in T2DM patients with poor glycemic control. GLSr-A in RVFSW had the best diagnostic value in evaluating RV diastolic function in T2DM patients.
Mesial temporal tau in amyloid-β-negative cognitively normal older persons
Authors: Krishnadas Natasha , Doré Vincent , Groot Colin , Lamb Fiona , Bourgeat Pierrick , Burnham Samantha C. , Huang Kun , Goh Anita M. Y. , Masters Colin L. , Villemagne Victor L. , Rowe Christopher C. ,   for the AIBL research group
Published: April 2022

Background

Tau deposition in the mesial temporal lobe (MTL) in the absence of amyloid-β (Aβ−) occurs with aging. The tau PET tracer 18F-MK6240 has low non-specific background binding so is well suited to exploration of early-stage tau deposition. The aim of this study was to investigate the associations between MTL tau, age, hippocampal volume (HV), cognition, and neocortical tau in Aβ− cognitively unimpaired (CU) individuals.

Methods

One hundred and ninety-nine Aβ− participants (Centiloid < 25) who were CU underwent 18F-MK6240 PET at age 75 ± 5.2 years. Tau standardized uptake value ratio (SUVR) was estimated in mesial temporal (Me), temporoparietal (Te), and rest of the neocortex (R) regions and four Me sub-regions. Tau SUVR were analyzed as continuous variables and compared between high and low MTL SUVR groups.

Results

In this cohort with a stable clinical classification of CU for a mean of 5.3 years prior to and at the time of tau PET, MTL tau was visually observed in 9% of the participants and was limited to Braak stages I–II. MTL tau was correlated with age (r = 0.24, p < 0.001). Age contributed to the variance in cognitive scores but MTL tau did not. MTL tau was not greater with subjective memory complaint, nor was there a correlation between MTL tau and Aβ Centiloid value, but high tau was associated with smaller HV. Participants with MTL tau had higher tau SUVR in the neocortex but this was driven by the cerebellar reference region and was not present when using white matter normalization.

Conclusions

In an Aβ− CU cohort, tau tracer binding in the mesial temporal lobe was age-related and associated with smaller hippocampi, but not with subjective or objective cognitive impairment.
Application of exosomes in the diagnosis and treatment of pancreatic diseases
Authors: Han Li , Zhao Zhirong , Yang Ke , Xin Mei , Zhou Lichen , Chen Siping , Zhou Shibo , Tang Zheng , Ji Hua , Dai Ruiwu
Published: April 2022

Pancreatic diseases, a serious threat to human health, have garnered considerable research interest, as they are associated with a high mortality rate. However, owing to the uncertain etiology and complex pathophysiology, the treatment of pancreatic diseases is a challenge for clinicians and researchers. Exosomes, carriers of intercellular communication signals, play an important role in the diagnosis and treatment of pancreatic diseases. Exosomes are involved in multiple stages of pancreatic disease development, including apoptosis, immune regulation, angiogenesis, cell migration, and cell proliferation. Thus, extensive alterations in the quantity and variety of exosomes may be indicative of abnormal biological behaviors of pancreatic cells. This phenomenon could be exploited for the development of exosomes as a new biomarker or target of new treatment strategies. Several studies have demonstrated the diagnostic and therapeutic effects of exosomes in cancer and inflammatory pancreatic diseases. Herein, we introduce the roles of exosomes in the diagnosis and treatment of pancreatic diseases and discuss directions for future research and perspectives of their applications.
Timing shift-based bi-residual network model for the detection of electricity stealing
Authors: Lu Jie , Li Jingfu , Feng Wenjiang , Zou Yongqi , Zhang Juntao , Li Yuan
Published: April 2022

With the increasing number of electricity stealing users, the interests of countries are jeopardized and it brings economic burden to the government. However, due to the small-scale stealing and its random time coherence, it is difficult to find electricity stealing users. To solve this issue, we first generate the hybrid dataset composed of real electricity data and specific electricity stealing data. Then, we put forward the timing shift-based bi-residual network (TS-BiResNet) model. It learns the features of electricity consumption data on two aspects, i.e., shallow features and deep features, and meanwhile takes time factor into consideration. The simulation results show that TS-BiResNet model can detect electricity stealing behaviors that are small scaled and randomly coherent with time. Besides, its detection accuracy is superior to the benchmark schemes, i.e., long short-term memory (LSTM), gated recurrent unit (GRU), combined convolutional neural network and LSTM (CNN-LSTM) and Bi-ResNet.
An adaptive task scheduling algorithm for 3-D target imaging in radar network
Authors: Wang Dan , Zhang Qun , Luo Ying , Liu Xiaowen , Liang Jia
Published: April 2022

An effective task scheduling method is the premise and guarantee for cooperative imaging in radar network. In this article, an adaptive task scheduling algorithm for three-dimensional (3-D) target imaging in radar network is investigated. The aim of our strategy is to achieve the multiple 3-D target imaging tasks with the minimal task time. Firstly, the 3-D target image can be reconstructed by high-resolution inverse imaging aperture radar (ISAR) images from three views, and the sparse imaging algorithm based on compressed sensing (CS) is adopted to acquire the ISAR images of the targets. Then, the adaptive task scheduling optimization model is constructed. Through the steps of target Information perception, radar selection and adjustment of imaging terminal time, the optimal task scheduling strategy is obtained and the resource utilization of radar network is significantly improved. Finally, the experiments highlight the effectiveness of our proposed task scheduling method.
The existence of positive solutions for the Neumann problem of p-Laplacian elliptic systems with Sobolev critical exponent
Authors: Kou Bingyu , An Tianqing
Published: April 2022

The paper aims to consider a class of p-Laplacian elliptic systems with a double Sobolev critical exponent. We obtain the existence result of the above problem under the Neumann boundary for some suitable range of the parameters in the systems.
Optimal feedback control for fractional evolution equations with nonlinear perturbation of the time-fractional derivative term
Authors: Suechoei Apassara , Sa Ngiamsunthorn Parinya
Published: April 2022

We study the optimal feedback control for fractional evolution equations with a nonlinear perturbation of the time-fractional derivative term involving Caputo fractional derivatives with arbitrary kernels. Firstly, we derive a mild solution in terms of the semigroup operator generated by resolvents and a kernel from the general Caputo fractional operators and establish the existence and uniqueness of mild solutions for the feedback control systems. Then, the existence of feasible pairs by applying Filippov’s theorem is obtained. In addition, the existence of optimal control pairs for the Lagrange problem has been investigated.
The association of adolescent e-cigarette harm perception to advertising exposure and marketing type
Authors: Hung Man , Spencer Andrew , Goh Clarissa , Hon Eric S. , Cheever Val Joseph , Licari Frank W. , Moffat Ryan , Raymond Ben , Lipsky Martin S.
Published: April 2022

Background

Despite controversy over their possible health consequences, manufacturers of e-cigarettes employ a variety of marketing media to increase their popularity among adolescents. This study analyzed the relationship between adolescent e-cigarette harm perception and five types of e-cigarette advertising exposures: social media, radio, billboard, newspaper, and television.

Methods

This study used data from Wave 4.5 of the Population Assessment of Tobacco and Health Study (PATH). PATH collects demographic data and interview individuals about issues pertaining to tobacco use, health outcomes, attitudes, and behaviors. This study applied factor analysis to three individual PATH harm perception items to develop a composite harm perception score. Using linear regression, the study explored the relationship of harm perception and participant responses to their recalled viewing of five different types (i.e., newspaper, radio, billboard, television and social media) of advertisements within the past 30 days. A second analysis explored if adjusting for exposure to anti-tobacco messaging and environmental factors such as family approval mitigated the association of harm perception and advertisement types.

Results

The study sample consisted of 12,570 (weighted N = 23,993,149) individuals aged 12 to 17 years old. Unadjusted past 30-day exposure to newspaper, radio, billboard, and social media advertising all correlated with a reduced harm perception, but only the associations for newspaper and social media were statistically significant (p<0.05). After adjusting for environmental support factors, exposure to warning labels, and anti-tobacco advertisements, the analysis yielded statistically significant associations between increased e-cigarette harm perception and exposure to radio, billboard, and television advertisements (p<0.05). Adjusting for covariates also reduced the association of marketing and harm perception for all forms of media.

Conclusion

E-cigarette advertising influences adolescent perceptions of harm in e-cigarette use, particularly for social media and newspaper advertisements. This association weakens when adjusted for covariates such as environmental support and exposure to anti-tobacco marketing. These findings provide evidence for policy makers to continue anti-tobacco marketing and incorporate environmentally supportive strategies such as holistic, family-centered educational approaches to reduce e-cigarette use among adolescents.
Divergent responses of plant biomass and diversity to short-term nitrogen and phosphorus addition in three types of steppe in Inner Mongolia, China
Authors: Guo Ning , Xie Mingyang , Fang Zhao , Jiao Feng , Han Xiaoyu
Published: April 2022

Background

Understanding the response of the plant community to increasing nitrogen (N) and phosphorus (P) inputs is helpful for managing and protecting grassland ecosystems in semiarid areas. However, information about different types of steppe responses to N and P availability in semiarid grasslands is limited. In 2017–2018, two field experiments were conducted with six levels of N (from 5 to 30 g N m−2 yr−1) and P (from 2.5 g to 15 g P m−2 yr−1) additions in three different temperate steppes, including meadow steppe (MS), typical steppe (TS), and desert steppe (DS), in northern China to study the effects of these addition rates on community biomass and diversity.

Results

Our results showed that plant biomass and diversity in the three steppe types in Inner Mongolia responded differently to elevated N and P inputs. Increasing P promoted aboveground and belowground biomass more than increasing N in the three temperate steppes. Short-term N and P additions reduced plant diversity to some extent, with the most pronounced decreases in MS and DS. It is noteworthy that there were response thresholds for plant diversity and biomass in response to N and P inputs in different steppe types (e.g., 10 g P m−2 yr−1). Furthermore, redundancy analysis and stepwise regression analysis revealed that changes in soil properties induced by nutrient addition and climate conditions jointly regulated changes in vegetation biomass and diversity.

Conclusions

The plant biomass and diversity of three steppe types in Inner Mongolia respond divergently to elevated N and P inputs. Our results indicate that regional differences in climate and soil substrate conditions may jointly contribute to the divergent responses of plant biomass and diversity to short-term N and P addition. Our analyses provide new insights into managing and protecting grassland ecosystems. Considering that the effects of nutrient addition on plant diversity and productivity may have increasing effects over time, studies on long-term in situ nutrient addition are necessary.
Anxiety and depression in patients with intracranial meningioma: a mixed methods analysis
Authors: Kasper Graham , Hart Shannon , Samuel Nardin , Fox Colleen , Das Sunit
Published: April 2022

Background

While diagnosis with a high-grade intracranial tumor is known to be associated with increased psychosocial burden, the burdens associated with meningioma are less well described. This study aimed to investigate the mental health burden in patients with meningiomas who have undergone surgical resection or serial observation, so as to identify and enhance awareness of gaps in care.

Methods

The Hospital Anxiety and Depression Scale (HADS) was administered to participants. Fisher’s Exact tests were performed to evaluate frequency distributions and t-tests were applied to compare postoperative and non-surgical patients’ HADS scores. Semi-structured interviews were completed on a subset of participants. Thematic analysis of interviews identified emerging themes.

Results

Thirty patients with intracranial meningiomas met inclusion criteria. The cohort’s mean age was 56.01 years and 66.67% were women (n = 20). Fourteen underwent surgery; sixteen were treated conservatively with observation. The average time since diagnosis of the sample was 37.6 months. Prevalence of mild to severe symptoms of anxiety was 28.6% amongst surgical management patients and 50% for active surveillance patients (p = 0.325). The prevalence of mild to severe symptoms of depression was 7.14% amongst surgical management patients and 6.25% for active surveillance patients (p = 0.533). Emerging themes from eight interviews reveal the influence of resilience, uncertainty and time, social support, interactions with medical experts, and difficulties during recovery on mental health.

Conclusion

The findings from the present study reveal that patients with meningiomas experience a significant mental health burden, illustrating the need for enhanced patient-centred care focusing on mental health.
Pediatric suicide by violent means: a cry for help and a call for action
Authors: Theodorou Christina M. , Yamashiro Kaeli J. , Stokes Sarah C. , Salcedo Edgardo S. , Hirose Shinjiro , Beres Alana L.
Published: April 2022

Background

Suicide is the second most common cause of death among adolescents and young adults. In the pediatric population, gunshot wounds (GSWs) and hangings are common mechanisms of pediatric suicide. Comorbid psychiatric illness is prevalent in this population, but psychiatric resource utilization after self-inflicted traumatic injury is not well characterized.

Methods

We analyzed patients < 18 years old presenting to a level 1 pediatric trauma center after suicide attempt by GSW, hanging, or jumping from a height from 2009 to 2019. The primary outcome was psychiatric resource utilization. Secondary outcomes included prior emergency department (ED) visits to identify prior opportunities for intervention.

Results

Of 6538 pediatric trauma patients, there were 219 GSWs, 7 hangings, and 7 jumps from height, for a total of 233 patients. Of these, 14 presented following a suicide attempt (four GSWs, six hangings, and four jumps, total 6.0%). Half of these patients died due to their injuries. Self-inflicted GSWs had the highest mortality (75%). Most surviving patients were placed on involuntary psychiatric holds (n = 5/7, 71.4%), and three patients were discharged to an inpatient psychiatric hospital (n = 3/7, 42.9%). Five of the 14 patients had prior ED visits (35.7%), and of these, 60% were for suicidal ideation or suicide attempts.

Conclusions

Among pediatric trauma patients, suicide attempts are rare, but are highly lethal, with the highest mortality rate seen in self-inflicted GSWs. Psychiatric resource utilization is high both during and after the hospitalization. Prior ED visits may represent opportunities for depression and suicidality screening in this at-risk population.
In vitro anthelmintic activity of Physalis minima ethanolic leaves and stem extracts against Paramphistomum cervi from cattle
Authors: Ahmed Fazle Rabbi Shakil , Sultana Afroza , Sultana Mst. Jesmin , Saha Antara
Published: April 2022

Background

Crude ethanolic extracts of leaves and stem of Physalis minima (Solanaceae) were evaluated for in vitro anthelmintic activity on the Bangladeshi mature parasitic flatworm Paramphistomum cervi (Trematoda) in cattle. To compare the test results, Albendazole was used as a standard drug.

Methods

A leaves and stem extract of the P. minima was prepared in a Soxhlet apparatus using ethanol as a solvent. After concentrating in a vacuum rotary evaporator, the extract was analyzed for phytochemical activities. In vitro anthelmintic activity was tested against the flat worm P. cervi.

Results

The results of anthelmintic activity of P. minima were evaluated by paralysis instead of taking as of the paralysis time and death time of the flatworm. The study concluded that the ethanolic leaves and stem extracts of P. minima had anthelmintic activity in a dose-dependent inhibition of spontaneous motility of flatworm. From the screening experiment, the crude extracts showed the best anthelmintic activity. Furthermore, our phytochemical studies point out that ethanolic extract of the leaves and stem of P. minima contains flavonoids, phenols alkaloids, terpenoids, tannins, steroids, proteins and cardiac glycosides.

Conclusions

The studies of total phenolic and flavonoids content were quantified for all parts of the plant. The results of the present study suggest that P. minima extracts are a promising alternative to the commercially available anthelmintics for the treatment of gastrointestinal nematodes of cattle. Further research is required to confirm the possibility of the antimicrobial and antiproliferative applications.
Longitudinal dynamics of the bovine udder microbiota
Authors: Winther Anja Ruud , Narvhus Judith A. , Smistad Marit , da Silva Duarte Vinicius , Bombelli Alberto , Porcellato Davide
Published: April 2022

Background

In recent years, the number of studies concerning microbiota of the intramammary environment has increased rapidly due to the development of high-throughput sequencing technologies that allow mapping of microbiota without culturing. This has revealed that an environment previously thought to be sterile in fact harbours a microbial community. Since this discovery, many studies have investigated the microbiota of different parts of the udder in various conditions. However, few studies have followed the changes that occur in the udder microbiota over time. In this study, the temporal dynamics of the udder microbiota of 10 cows, five with a low somatic cell count (SCC, SCC < 100,000 cells/mL) and five with a high SCC (SCC > 100,000 cells/mL), were followed over 5 months to gather insights into this knowledge gap.

Results

Analysis of the temporal changes in the microbial composition of milk from udders with a low SCC revealed a dynamic and diverse microbiota. When an imbalance due to one dominating genus was recorded, the dominant genus quickly vanished, and the high diversity was restored. The genera dominating in the samples with a high SCC remained the dominant genera throughout the whole sampling period. These cows generally displayed a heightened SCC or an intramammary infection in at least one quarter though-out the sampling period.

Conclusion

Our results show that the bovine udder has a diverse microbiota, and that the composition and diversity of this community affects udder health with regards to SCC. Understanding what influences the composition and stability of this community has important implications for the understanding, control, and treatment of mastitis.
How much preoperative flexion contracture is a predictor for residual flexion contracture after total knee arthroplasty in hemophilic arthropathy and rheumatoid arthritis?
Authors: Lee Hyun Woo , Park Cheol Hee , Bae Dae Kyung , Song Sang Jun
Published: April 2022

Background

Although total knee arthroplasty (TKA) in hemophilic arthropathy (HA) or rheumatoid arthritis (RA) can improve functional ability, the postoperative range of motion (ROM) and prosthesis durability are reduced compared with those in osteoarthritic patients.

Aim

We aimed to compare (1) the pre- and postoperative flexion contracture after TKA in HA and RA, (2) the threshold of preoperative flexion contracture as a predictor of residual contracture > 15° after TKA, and (3) the survival rate.

Methods

Data from a consecutive cohort comprising 48 TKAs in HA and 92 TKAs in RA were retrospectively reviewed. The degree of flexion contracture was analyzed. Through receiver operating characteristics analysis, we aimed to determine the cutoff value of preoperative flexion contracture that increases the risk of residual contracture > 15° after TKA and compare the cutoff value in HA and RA. The survival rate was evaluated based on life table analysis and the Kaplan–Meier method.

Results

The degree of preoperative flexion contracture was not significantly different. The degree of postoperative residual flexion contracture was 5.6° in the HA group and 1.4° in the RA group, respectively (p < 0.001). The cutoff value of preoperative flexion contracture for residual contracture of > 15° at last-follow up was 25.0° in the HA group and 32.5° in the RA group. The 5- and 12-year survival rates were 96% and 87% in the HA and 99% and 95% in the RA group, respectively (n.s.).

Conclusions

The postoperative residual flexion contracture was greater and the cutoff value of preoperative flexion contracture for residual contracture was smaller in the HA group than the RA group. Appropriate intra- and postoperative care to avoid postoperative residual contracture is required in HA patients.

Level of evidence

III.
Nanostructured lipid carriers: a promising drug carrier for targeting brain tumours
Authors: Garg Jivesh , Pathania Khushboo , Sah Sangeeta Pilkhwal , Pawar Sandip V.
Published: April 2022

Background

In recent years, the field of nanotechnology and nanomedicine has transformed the pharmaceutical industry with the development of novel drug delivery systems that overcome the shortcomings of traditional drug delivery systems. Nanostructured lipid carriers (NLCs), also known as the second-generation lipid nanocarriers, are one such efficient and targeted drug delivery system that has gained immense attention all across due to their myriad advantages and applications. Scientific advancements have revolutionized our health system, but still, brain diseases like brain tumour have remained formidable owing to poor prognosis and the challenging drug delivery to the brain tissue. In this review, we highlighted the application and potential of NLCs in brain-specific delivery of chemotherapeutic agents.

Main body

NLCs are lipid-based formulations with a solid matrix at room temperature and offer advantages like enhanced stability, low toxicity, increased shelf life, improved drug loading capacity, and biocompatibility over other conventional lipid-based nanocarriers such as nanoemulsions and solid lipid nanoparticles. This review meticulously articulates the structure, classification, components, and various methods of preparation exemplified with various research studies along with their advantages and disadvantages. The concept of drug loading and release has been discussed followed by a brief about stability and strategies to improve stability of NLCs. The review also summarizes variousin vitroand in vivo research studies on NLCs encapsulated with cytotoxic drugs and their potential application in brain-specific drug delivery.

Conclusion

NLCs are employed as an important carrier for the delivery of food, cosmetics, and medicines and recently have been used in brain targeting, cancer, and gene therapy. However, in this review, the applications and importance of NLCs in targeting brain tumour have been discussed in detail stating examples of various research studies conducted in recent years. In addition, to shed light on the promising role of NLCs, the current clinical status of NLCs has also been summarized.

Graphical Abstract
Effect of initial C/N ratio and turning frequency on quality of final compost of turkey manure and olive pomace
Authors: El-mrini Soufiane , Aboutayeb Rachid , Zouhri Abdeljalil
Published: April 2022

In Morocco, the potential of agricultural waste is estimated at 34.7 MT/year. Composting is an effective way for waste management. If badly monitored, it can affect the environment. Initial C/N ratio (C/Ni) and aeration appear to be major factors impacting the composting process. This work studied the effect of C/Ni and turning frequency (TF) on the olive pomace and turkey manure co-composting process and on the final compost quality. The study concerned the Moroccan agricultural region Chaouia-Ouardigha where these two by-products are abundant and not valued. Six heaps (H1 to H6), at three levels of C/Ni (20, 22, 28) and two levels of TF (once and twice a week), were studied. Statistical tests showed that the studied factors had no significant effects on pH, total nitrogen, electrical conductivity, and cation exchange capacity (CEC). However, C/Ni had a significant increase of 60% in nitrates. Varying from 20 to 22 or from 22 to 28, C/Ni reversed its significant effect on final C/N and CEC/organic carbon. TF reduced significantly OM and final C/N by about 22% and 9% respectively. The dendrogram showed that the six heaps could form at the end two groups: group 1 (four heaps) and group 2 (two heaps) with a similarity of about 75 and 90 respectively. C/Ni of 22 and TF of twice a week seem to be an optimum to produce a final compost of better quality. This work shows that (1) C/Ni and TF significantly impact several final quality parameters of composts from olive pomace and turkey manure, and (2) composting has a strong effect of reducing the variability between heaps initially different to produce very similar final composts.
Exercise Across the Cancer Care Continuum: Why It Matters, How to Implement It, and Motivating Patients to Move
Authors: Coletta Adriana M. , Basen-Engquist Karen M. , Schmitz Kathryn H.
Published: April 2022

Annually, nearly 2 million people are diagnosed with cancer. Cancer is the second leading cause of death in the United States. Strong evidence supports exercise in the prevention of seven different types of cancers. Among cancer survivors, exercise across the cancer care continuum is effective at reducing various treatment-related adverse effects, such as fatigue, anxiety, and depression, and improves quality of life, physical function, sleep, and bone health. Considering the benefits of exercise for people living with and beyond cancer, there are several models to facilitate the implementation of exercise as part of the cancer care plan. These models span clinically supervised settings to supervised and nonsupervised community-based settings. Barriers such as payment and workforce development prevent the implementation of these programs nationwide. Oncology providers and cancer care team members also play an important role in promoting exercise to cancer survivors. In fact, a salient theme for motivating survivors to engage in exercise is support from their medical oncologist. Resources and tools are available to help the cancer care team motivate survivors to engage in exercise, such as enhancing enjoyment of the activity, goal-setting, self-monitoring, and social support. Together, exercise is beneficial across the cancer care continuum, and action can be taken right now to facilitate patient and survivor engagement in exercise.
Internal Mammary Node Irradiation in Patients With Node-Positive Early Breast Cancer: Fifteen-Year Results From the Danish Breast Cancer Group Internal Mammary Node Study
Authors: Thorsen Lise B.J. , Overgaard Jens , Matthiessen Louise W. , Berg Martin , Stenbygaard Lars , Pedersen Anders N. , Nielsen Mette H. , Overgaard Marie , Offersen Birgitte Vrou ,   on behalf of the DBCG Radiotherapy Committee
Published: April 2022

PURPOSE

The Danish Breast Cancer Group Internal Mammary Node study demonstrated improved 8-year overall survival (OS) with internal mammary node irradiation (IMNI) in patients with node-positive early breast cancer. Here, we present long-term results from the Danish Breast Cancer Group Internal Mammary Node study cohort.

PATIENTS AND METHODS

This nationwide, prospective cohort study allocated patients with node-positive early breast cancer to adjuvant radiotherapy with or without IMNI depending on cancer laterality. Patients with right-sided cancer received IMNI. Patients with left-sided cancer were treated without IMNI because of risk of radiation-induced heart disease. Other treatment was independent of laterality. The primary study end point was OS. Secondary end points were distant recurrence and breast cancer mortality. Analyses were by intention to treat.

RESULTS

During 2003-2007, 3,089 women were allocated to IMNI (right-sided, n = 1,491) or no IMNI (left-sided, n = 1,598). With a median follow-up of 14.8 years, 589 patients with and 701 patients without IMNI had died. The corresponding 15-year OS rates were 60.1% and 55.4%. The adjusted hazard ratio (HR) for death was 0.86 (95% CI, 0.77 to 0.96; P = .007) in favor of IMNI. The 15-year risk of developing distant recurrence was 35.6% (523 recurrences) and 38.6% (602 recurrences) with vs. without IMNI (adjusted HR, 0.88 [95% CI, 0.79 to 0.99; P = .04]). The 15-year breast cancer mortality with IMNI was 31.7% (467 deaths) compared with 33.9% (537 deaths) without IMNI (adjusted HR, 0.88 [95% CI, 0.78 to 1.00; P = .05]). The distribution of other deaths was similar across groups.

CONCLUSION

In patients with node-positive early breast cancer treated with IMNI or without IMNI depending on breast cancer laterality, IMNI reduced the risk of distant recurrence and death from breast cancer, thereby improving long-term survival.
Simultaneous photonic and phononic topological pseudospin-dependent edge states in phoxonic crystals
Authors: Hu Zhong , Lei LinLin , He Lingjuan , Liu Wenxing , Yu Tianbao , Wang Tongbiao , Liao Qinghua
Published: April 2022

The topological pseudospin-dependent edge states for sound and light are achieved simultaneously in phoxonic crystals (PxCs). By studying the topological phase transition mechanisms, we find that photonic bands can be inverted by changing the distance from the center of rods to the center of the unit cell, and phononic bands can be inverted by modifying the rotation angle of rods. Based on different adjustment schemes for light and sound, band inversions of both photonic and phononic modes are realized by simultaneously deforming the lattice and rotating the rods. Dual topological pseudospin-dependent edge states thus can be observed at the domain wall interfaces between two PxCs with distinct topological phases. The pseudospin-dependent one-way propagations and the topologically robust propagations against three types of defects for both light and sound are further numerically demonstrated. The proposed PxCs provide a platform for designing topologically integrated management of photons and phonons.
Evaluation of First Seizure and Newly Diagnosed Epilepsy
Authors: Wirrell Elaine
Published: April 2022

PURPOSE OF REVIEW

This article focuses on the evaluation of children and adults who present with new-onset seizures, with an emphasis on differential diagnosis, classification, evaluation, and management.

RECENT FINDINGS

New-onset seizures are a common presentation in neurologic practice, affecting approximately 8% to 10% of the population. Accurate diagnosis relies on a careful history to exclude nonepileptic paroxysmal events. A new classification system was accepted in 2017 by the International League Against Epilepsy, which evaluates seizure type(s), epilepsy type, epilepsy syndrome, etiology, and comorbidities. Accurate classification informs the choice of investigations, treatment, and prognosis. Guidelines for neuroimaging and laboratory and genetic testing are summarized.

Accurate diagnosis and classification of first seizures and new-onset epilepsy are key to choosing optimal therapy to maximize seizure control and minimize comorbidities.
Seizures and Epilepsy in Childhood
Authors: Gogou Maria , Cross Judith Helen
Published: April 2022

PURPOSE OF REVIEW

This article highlights basic concepts of seizures and epilepsy in pediatric patients, as well as basic treatment principles for this age group.

RECENT FINDINGS

Epilepsy is the most common neurologic disorder in childhood. Accurate diagnosis is key; in older children, epileptic seizures need to be differentiated from various paroxysmal nonepileptic events, whereas in neonates, the majority of seizures are subclinical (electroencephalographic). Antiseizure medications remain the first-line treatment, but ketogenic diet and epilepsy surgery have also shown positive outcomes and can decrease drug burden. Genetic causes account for approximately 30% of cases, and the recognition of electroclinical syndromes is being replaced by the concept of genetic spectrums. Precision medicine therapies are promising, but wide application in daily practice still has a long way to go. Early access to specialist centers and optimal treatments positively affects prognosis and future neurodevelopment.

Although novel findings from all fields of research are being incorporated into everyday clinical practice, a better quality of life for children with seizures and epilepsy and their families is the ultimate priority.