bluuebunny/crossref_metadata_2025 huggingface dataset:
SLAP Repair Versus Subpectoral Biceps Tenodesis for Isolated SLAP Type 2 Lesions in Overhead Athletes Younger Than 35 Years: Comparison of Minimum 2-Year Outcomes
Authors: Lacheta Lucca , Horan Marilee P. , Nolte Philip C. , Goldenberg Brandon T. , Dekker Travis J. , Millett Peter J.
Published: June 2022

Background:

It remains unclear if young overhead athletes with isolated superior labrum anterior-posterior (SLAP) type 2 lesions benefit more from SLAP repair or subpectoral biceps tenodesis.

Purpose:

To evaluate clinical outcomes and return to sport in overhead athletes with symptomatic SLAP type 2 lesions who underwent either biceps tenodesis or SLAP repair.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective analysis of prospectively collected data was performed in patients who underwent subpectoral biceps tenodesis (n = 14) or SLAP repair (n = 24) for the treatment of isolated type 2 SLAP lesions. All patients were aged <35 years at time of surgery, participated in overhead sports, and were at least 2 years out from surgery. Clinical outcomes were assessed with the American Shoulder and Elbow Surgeons (ASES) score; Single Assessment Numerical Evaluation (SANE) score; Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score; and the 12-Item Short Form (SF-12) physical component score. Return to sport and patient satisfaction were documented. Clinical failures requiring revision surgery and complications were reported.

Results:

Preoperative baseline scores in both the tenodesis and SLAP repair groups were similar. There were no significant differences between the groups on any postoperative outcome measure: For biceps tenodesis versus SLAP repair, the ASES score was 92.7 ± 10.4 versus 89.1 ± 16.7, the SANE score was 86.2 ± 13.7 versus 83.0 ± 24.1, the QuickDASH score was 10.0 ± 12.7 versus 9.0 ± 14.3, and SF-12 was 51.2 ± 7.5 versus 52.8 ± 7.7. No group difference in return-to-sports rate (85% vs 79%; P = .640) was noted. More patients in the tenodesis group (80%) reported modifying their sporting/recreational activity postoperatively because of weakness compared with patients in the SLAP repair group (15%; P = .022). One patient in each group progressed to surgery for persistent postoperative stiffness, and 1 patient in the tenodesis group had a postoperative complication related to the index surgery.

Conclusion:

Both subpectoral biceps tenodesis and SLAP repair provided excellent clinical results for the treatment of isolated SLAP type 2 lesions, with a high rate of return to overhead sports and a low failure rate, in a young and high-demanding patient cohort. More patients reported modifying their sporting/recreational activity because of weakness after subpectoral tenodesis.
Sharing Places: Local Socio-Economic Organization and Inequality in Contemporary Short-Term Rental Markets
Authors: Oszkay Yotala
Published: June 2022

Research on markets distinguishes niche markets, characterized by local community engagement and specialization, from mass markets, characterized by arms-length exchange and large-scale production. Yet, this research often overlooks how inequality differentially underpins these forms of exchange. Building on this work, I explore how local socio-economic disparities may structure different segments of short-term rental markets in the platform (i.e., “sharing”) economy. Drawing on cross-sectional analyses of over 300,000 Airbnb listings clustered in 277 U.S. metropolitan areas, I find that microentrepreneurial short-term rental markets—involving small-scale exchanges that typically demand more personal investment and social interaction—are embedded in civically active communities struggling with economic and housing precarity. Large-scale short-term rental markets—typically involving more socially distant exchanges in which operators rent multiple properties—are prevalent in expensive housing markets, where there are real estate investment opportunities to capitalize on housing vacancies. This study thus builds on understandings of market formation and segmentation, incorporating the role of local inequality, while also illuminating the tensions within platform economy markets more broadly.
Trends in Orthopaedic Foot and Ankle Publications
Authors: Sleasman Brian , Chen Caroline , Caughman Alex M. , Hoch Caroline , Scott Daniel , Gross Christopher E.
Published: June 2022

Background:

Scientific publication and original articles remain the primary method of sharing scientific findings and advancing the knowledge base of that subject. Despite the value of these publications, little research has surveyed what topics are being published. This study aims to identify and characterize the most common topics in current foot and ankle literature.

Methods:

We reviewed all 1514 published articles in a 5.5-year period (January 2014–June 2019) in 2 foot and ankle–specific journals: Foot & Ankle International ( FAI) and Foot and Ankle Surgery ( FAS). The articles were sorted into different topic domains to identify the 3 most common categories of publication. The top 3 domains were further characterized by level of evidence (LOE) as well as citations.

Results:

The 3 most published topics in foot and ankle literature were hallux valgus (8.3%), total ankle arthroplasty (TAA) (8.3%), and ankle fracture (6.6%). These 3 subjects accounted for 351 articles (23.2%). Other common topics were patient-reported outcomes (5.0%), osteochondritis dissecans (3.9%), syndesmotic injury (3.8%), ankle instability (3.7%), hallux rigidus (3.0%), and anatomy (2.8%). The average LOE for articles on hallux valgus, TAA, and ankle fracture was 3.27 from FAI, and the average number of annual citations for a given article in both journals was 3.05. Based on our study, there is no correlation between LOE and number of overall citations, but there is a significant, negative linear correlation in ankle fracture data. We also found that articles on TAA had the highest impact factor and that articles from FAI were cited more often than articles from FAS.

Conclusion:

The 3 most published topics in foot and ankle literature comprise only 23.2% of all articles. This finding is indicative of the wide variety of cases performed by orthopaedic foot and ankle surgeons. High-quality data are still needed in all topics.

Level of Evidence:

Level III, retrospective cohort study.
Arthroscopic Hip Labral Reconstruction: Treatment of Irreparable Labral Tears With Segmental Allograft Reconstruction
Authors: Hevesi Mario , Sivasundaram Lakshmanan , Rice Morgan W. , Paul Katlynn , Nho Shane J.
Published: June 2022

Background:

At the time of hip arthroscopy, some patients are found to have irreparable labral tears that are not amenable to primary repair. For these patients, treatment with segmental reconstruction is a surgical option to restore labral tissue and biomechanics.

Indications:

Patients with segmental irreparable hip labral tears that are technically not amenable for primary labral repair should be considered for labral reconstruction with allograft.

Technique Description:

Standard hip arthroscopic portals are established. An interportal capsulotomy is performed, and acetabular rim trimming is performed to remove the pincer deformity. Visualized segmental labral defects are measured using a piece of suture to allow for measurement of a curved surface and 1.4-mm polyether ether ketone (PEEK) anchors are placed in anticipation of labral fixation. On the back table, the tibialis anterior allograft is prepared for labral reconstruction. We mark a central portion of the graft tissue based on the measured defect size. A 3-0 vicryl suture is used to place a running stitch from one end to the other of the marked portion of the allograft and the marked, prepared graft is sharply divided from the rest of the tissue. Stitches from the anterior and posterior anchors are passed through the graft using a free needle. The graft is then placed through the distal accessory anterolateral portal and positioned into place. The posterolateral and then medial-most anchors are secured and tied using arthroscopic knots, followed by sequential tying of the middle anchors. Any additional arthroscopic procedures, such as cam resection, are performed, and capsular/skin closure is performed using standard methods.

Results:

Published outcomes support reconstruction of the labrum using allograft, with 2 series consisting of a total of 141 segmental/circumferential reconstructions demonstrating similar outcome scores at 2 years of follow-up as compared to matched cases of primary labral repairs.

Discussion/Conclusion:

Hip segmental labral reconstruction with tibialis anterior allograft provides a viable surgical option for patients with labral defects precluding primary labral repair. The presented material demonstrates a readily employable technique as well as clear, step-by-step postoperative rehabilitation protocols, and satisfactory published short- and mid-term outcomes literature.
Sonography of Lateral Plantar Artery Pseudoaneurysm Caused by Knife Cut Injury
Authors: Li Tony Y.
Published: June 2022

Pseudoaneurysms of the lateral plantar artery (LPA) are rare. In this case study, a very rare case of a pseudoaneurysm of the LPA, caused by a knife cut, is reported. A female adult patient presented with a growing lump in the arch of the left foot for 4 weeks. She had an accidental steak knife stab her on the arch of the left foot and had the cut sutured 5 weeks prior. The physical examination revealed a warm, pulsatile, and tender lump without a clear border deep to the scar in the lateral arch. Duplex ultrasonography (DUS) detected a cavity with the wall uneven in thickness and the outer wall undistinguished. Doppler demonstrated a typical Yin-yang sign inside the cavity and a neck-like structure connecting the cavity to an artery along the path of the LPA, suggesting that this was a LPA pseudoaneurysm, caused by penetration trauma. Later, the patient received priority surgery to have the pseudoaneurysm repaired.
Similarity network fusion for aggregating headspace GC–MS and direct analysis in real time–mass spectrometry data from solid samples to enhance species identification efficiency of high–temperature heated wood
Authors: Zhang Maomao , Guo Juan , Lu Yang , Jiao Lichao , He Tuo , Yin Yafang
Published: June 2022

Pterocarpus santalinus and Pterocarpus tinctorius are commonly used species of the genus Pterocarpus in the wood trade. Although both of them have been listed in Appendix II of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) since 2019, it is still critical to identify them in terms of plant taxonomy. Currently, high-temperature heating is an accepted treatment method for high-density wood species such as Pterocarpus to improve dimensional stability and restore previous drying defects partially. It has proved challenging to identify the high-temperature (e.g., 120 °C) heated wood from these two species. Thus, this study approaches species identification of two Pterocarpus of high-temperature (e.g., 120 °C) heated solid wood samples using headspace–gas chromatography–mass spectrometry (HS–GC–MS). Besides, a computational analytical method named similarity network fusion (SNF) was proposed to aggregate data in two different types, respectively, derived from the HS–GC–MS and direct analysis in real time–mass spectrometry (DART–MS) to explore the feasibility of improving the efficiency and accuracy of wood species discrimination. The SNF exhibits more significant differences and higher predictive accuracy (100%) between P. santalinus and P. tinctorius than that based on the HS–GC–MS data (77.78%) or DART–MS (66.67%) alone. These results demonstrated the capability of the HS–GC–MS technique in the analysis of high-temperature heated solid wood and the potential of multidimensional or comprehensive data sets based on the SNF algorithm in the field of wood species identification.
Discovery of a novel mitochondrial DNA molecule associated with tetrad pollen sterility in potato
Authors: Sanetomo Rena , Akai Kotaro , Nashiki Akito
Published: June 2022

Background

Tetrad sterility in potato is caused by a specific cytoplasm, called TSCsto, derived from the Mexican wild tetraploid species Solanum stoloniferum. Different S. stoloniferum accessions crossed as females with S. tuberosum resulted in 12 fertile hybrids and 27 sterile hybrids exhibiting tetrad sterility.

Results

Whole-mitochondrial-genome sequencing was performed for two fertile hybrids and three hybrids exhibiting tetrad sterility. Two to seven contigs, with the total assembly lengths ranging from 462,716 to 535,375 bp, were assembled for each hybrid. Unlike for the reference mitochondrial genome (cv. Désirée), two different recombinant-type contigs (RC-I and RC-II) were identified. RC-I featured by the rpl5-ψrps14 gene joined to the nad6 gene, generating a novel intergenic region. Using a PCR marker (P-3), we found that this intergenic region occurred exclusively in interspecific hybrids exhibiting tetrad sterility and in their parental S. stoloniferum accessions. A part of this intergenic sequence was expressed in the pollen. From a large survey in which P-3 was applied to 129 accessions of 27 mostly Mexican wild species, RC-I was found in diploid S. verrucosum and polyploid species. From eight accessions of S. verrucosum used as females, 92 interspecific hybrids were generated, in which only those carrying RC-I exhibited tetrad sterility.

Conclusions

RC-I was clearly associated with tetrad sterility, and the RC-I-specific intergenic region likely contains a causal factor of tetrad sterility.
MedDiet adherence score for the association between inflammatory markers and cognitive performance in the elderly: a study of the NHANES 2011–2014
Authors: Liu Shuting , Chen Xiaorong
Published: June 2022

Background

To explore the optimal Mediterranean diet (MedDiet) adherence score threshold for the association between inflammatory markers and cognitive performance among older adults.

Methods

In this cross-sectional study, we selected data of the elderly (≥ 60 years old) from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 (n = 2830). Participants completed at least one cognitive measurement and two 24-h food recalls. By analyzing the relation between inflammatory markers and cognitive performance using the subdivided MedDiet adherence score, we got the optimal MedDiet adherence score threshold. Then the optimal threshold was used to divide participants into high and low MedDiet adherence groups and multivariate logistic regression models were developed to examine the association between inflammatory markers and cognitive performance in each group. Subgroup analysis was conducted based on gender, race, BMI, physical activity level, and chronic diseases.

Results

We chose 4 as the optimal MedDiet adherence score threshold and included these participants whose MedDiet adherence score was 4 or above into the high MedDiet adherence group, while the MedDiet adherence score of the low adherence group was less than 4. We found that the increased white blood cell (WBC) count (OR = 1.44, 95% CI: 1.09–1.90, P = 0.008), neutrophil count (OR = 1.30, 95% CI: 1.03–1.65, P = 0.023), and neutrophil-albumin ratio (NAR) (OR = 1.34, 95% CI: 1.06–1.70, P = 0.012) were all related to a higher risk of low cognitive performance in the low MedDiet adherence group. A higher PLR was linked to a reduced risk of low cognitive performance (OR = 0.86, 95% CI: 0.74–1.00, P = 0.036) in the high MedDiet adherence group. Significant differences were found in the associations of WBC count, neutrophil count and NAR with low cognitive performance between the low and high MedDiet adherence groups (all P < 0.001). The weakened negative association between inflammatory markers and cognitive performance in the high MedDiet adherence group also existed among male, non-Hispanic white, normal-weight, overweight, moderate work activity, moderate recreational activity, non-depression, hypertension, non-hypertension, non-diabetes, non-stroke, non-heart failure, non-coronary heart disease, or non-heart attack subpopulations of older adults.

Conclusions

The optimal threshold for the MedDiet adherence score was 4, and the negative association between inflammation and cognitive performance could be weakened in older adults whose MedDiet adherence score was ≥ 4.
Advanced lung cancer inflammation index (ALI) predicts prognosis of patients with gastric cancer after surgical resection
Authors: Zhang Xin , Wang Danfang , Sun Tuanhe , Li Wenxing , Dang Chengxue
Published: June 2022

Introduction

Advanced lung cancer inflammation index (ALI) has been implicated in the prognosis of many types of tumors. But few studies elucidate its role in gastric cancer (GC).

Materials and methods

We consecutively recruited 615 GC patients who underwent radical gastrectomy. Patients were grouped according to ALI status. Risk factors for overall survival (OS) and disease-free survival (DFS) in overall and sex-stratified cohorts were determined using multivariate cox regression analysis. We also compared survival differences between the two groups after one-to-one propensity score matching (PSM).

Results

Patients with low ALI showed larger tumor size, more advanced TNM staging, shorter OS (median: 37 vs 42 months) and DFS (median: 37 vs 42 months) (all P < 0.001). Multivariate analysis showed that elevated ALI was independently associated with longer OS and DFS. After stratification by sex, low ALI was an independent risk factor for OS and DFS in male patients but not in female patients. But our further PSM analysis showed prognostic value of ALI in both male and female subgroups.

Conclusion

Preoperative ALI is an independent prognostic factor for GC patients undergoing curative gastrectomy.
Neuroendocrine pathways and breast cancer progression: a pooled analysis of somatic mutations and gene expression from two large breast cancer cohorts
Authors: Hu Kejia , Wang Chengshi , Luo Chuanxu , Zheng Hong , Song Huan , Bergstedt Jacob , Fall Katja , Luo Ting , Czene Kamila , Valdimarsdóttir Unnur A. , Fang Fang , Lu Donghao
Published: June 2022

Background

Experimental studies indicate that neuroendocrine pathways might play a role in progression of breast cancer. We aim to test the hypothesis that somatic mutations in the genes of neuroendocrine pathways influence breast cancer prognosis, through dysregulated gene expression in tumor tissue.

Methods

We conducted an extreme case–control study including 208 breast cancer patients with poor invasive disease-free survival (iDFS) and 208 patients with favorable iDFS who were individually matched on molecular subtype from the Breast Cancer Cohort at West China Hospital (WCH; N = 192) and The Cancer Genome Atlas (TCGA; N = 224). Whole exome sequencing and RNA sequencing of tumor and paired normal breast tissues were performed. Adrenergic, glucocorticoid, dopaminergic, serotonergic, and cholinergic pathways were assessed for differences in mutation burden and gene expression in relation to breast cancer iDFS using the logistic regression and global test, respectively.

Results

In the pooled analysis, presence of any somatic mutation (odds ratio = 1.66, 95% CI: 1.07–2.58) of the glucocorticoid pathway was associated with poor iDFS and a two-fold increase of tumor mutation burden was associated with 17% elevated odds (95% CI: 2–35%), after adjustment for cohort membership, age, menopausal status, molecular subtype, and tumor stage. Differential expression of genes in the glucocorticoid pathway in tumor tissue (P = 0.028), but not normal tissue (P = 0.701), was associated with poor iDFS. Somatic mutation of the adrenergic and cholinergic pathways was significantly associated with iDFS in WCH, but not in TCGA.

Conclusion

Glucocorticoid pathway may play a role in breast cancer prognosis through differential mutations and expression. Further characterization of its functional role may open new avenues for the development of novel therapeutic targets for breast cancer.
Incidental irradiation of the regional lymph nodes during deep inspiration breath-hold radiation therapy in left-sided breast cancer patients: a dosimetric analysis
Authors: Wolf Jule , Kurz Steffen , Rothe Thomas , Serpa Marco , Scholber Jutta , Erbes Thalia , Gkika Eleni , Baltas Dimos , Verma Vivek , Krug David , Juhasz-Böss Ingolf , Grosu Anca-Ligia , Nicolay Nils H. , Sprave Tanja
Published: June 2022

Background

Radiotherapy using the deep inspiration breath-hold (DIBH) technique compared with free breathing (FB) can achieve substantial reduction of heart and lung doses in left-sided breast cancer cases. The anatomical organ movement in deep inspiration also cause unintended exposure of locoregional lymph nodes to the irradiation field.

Methods

From 2017–2020, 148 patients with left-sided breast cancer underwent breast conserving surgery (BCS) or mastectomy (ME) with axillary lymph node staging, followed by adjuvant irradiation in DIBH technique. Neoadjuvant or adjuvant systemic therapy was administered depending on hormone receptor and HER2-status.

CT scans in FB and DIBH position with individual coaching and determination of the breathing amplitude during the radiation planning CT were performed for all patients. Intrafractional 3D position monitoring of the patient surface in deep inspiration and gating was performed using Sentinel and Catalyst HD 3D surface scanning systems (C-RAD, Catalyst, C-RAD AB, Uppsala, Sweden). Three-dimensional treatment planning was performed using standard tangential treatment portals (6 or 18 MV). The delineation of ipsilateral locoregional lymph nodes was done on the FB and the DIBH CT-scan according to the RTOG recommendations.

Results

The mean doses (Dmean) in axillary lymph node (AL) level I, II and III in DIBH were 32.28 Gy (range 2.87–51.7), 20.1 Gy (range 0.44–53.84) and 3.84 Gy (range 0.25–39.23) vs. 34.93 Gy (range 10.52–50.40), 16.40 Gy (range 0.38–52.40) and 3.06 Gy (range 0.21–40.48) in FB (p < 0.0001). Accordingly, in DIBH the Dmean for AL level I were reduced by 7.59%, whereas for AL level II and III increased by 22.56% and 25.49%, respectively.

The Dmean for the supraclavicular lymph nodes (SC) in DIBH was 0.82 Gy (range 0.23–4.11), as compared to 0.84 Gy (range 0.22–10.80) with FB (p = 0.002). This results in a mean dose reduction of 2.38% in DIBH.

The Dmean for internal mammary lymph nodes (IM) was 12.77 Gy (range 1.45–39.09) in DIBH vs. 11.17 Gy (range 1.34–44.24) in FB (p = 0.005). This yields a mean dose increase of 14.32% in DIBH.

Conclusions

The DIBH technique may result in changes in the incidental dose exposure of regional lymph node areas.
Estrogen replacement therapy: effects of starting age on final height of girls with chronic kidney disease and short stature
Authors: Amirkashani Davoud , Rohani Farzaneh , Khodadost Mahmoud , Hoseini Rozita , Alidoost Hamidreza , Madani Sedigheh
Published: June 2022

Introduction

We investigated the age of starting Estrogen replacement therapy as a key parameter for reaching near normal Final Height (FH) in Chronic Kidney Disease (CKD) girls with growth retardation.

Method

This open label, quasi-experimental designed and matched controlled clinical trial was performed on CKD girls with short stature and later onset of puberty or delayed puberty according to clinical and laboratory investigations. Participants of group 1 and 2 had been treated with Growth Hormone (GH), and Ethinyl Estradiol (EE). EE was administered from 11 and 13 yrs. old in groups 1 and 2 respectively. Group 3 was selected from patients that did not accept to start GH or EE till 15 years old. The effect of the age of starting EE on FH, GH therapy outcomes, bone density, and calcium profile were evaluated.

Result

Overall, 16, 22, and 21 patients were analyzed in groups 1, 2, and 3 respectively. Mean Mid-Parental Height (MPH) had no significant difference between the 3 groups. GH therapy significantly enhanced mean FH in groups 1 and 2 in comparison with group 3 (β = − 4.29, p < 0.001). Also, multivariable backward linear regression illustrated significant negative association between FH and age of starting EE (β = 0.26, p < 0.001). Mean Para Thyroid Hormone (PTH), mean femoral and lumbar bone density were significantly enhanced after GH and EE therapy (p value: < 0.001).

Conclusion

We recommend starting EE from 11 yrs. old in CKD short stature girls who have no clinical and laboratory sign of sexual maturity at 11 yrs. to enhance the cost effectiveness of GH therapy.
A Wearable Diagnostic Assessment System vs. SNAP-IV for the auxiliary diagnosis of ADHD: a diagnostic test
Authors: Luo Jie , Huang Huanhuan , Wang Shuang , Yin Shengjian , Chen Sijian , Guan Lin , Jiang Xinlong , He Fan , Zheng Yi
Published: June 2022

Objective

We design a diagnostic test to evaluate the effectiveness and accuracy of A non-intrusive Wearable Diagnostic Assessment System versus SNAP-IV for auxiliary diagnosis of children with ADHD.

Methods

This study included 55 children aged 6–16 years who were clinically diagnosed with ADHD by DSM-5, and 55 healthy children (typically developing). Each subject completes 10 tasks on the WeDA system (Wearable Diagnostic Assessment System) and Parents of each subject complete the SNAP-IV scale. We will calculate the validity indexes, including sensitivity, specificity, Youden's index, likelihood ratio, and other indexes including predictive value, diagnostic odds ratio, diagnostic accuracy and area under the curve [AUC] to assess the effectiveness of the WeDA system as well as the SNAP-IV.

Results

The sensitivity (94.55% vs. 76.36%) and the specificity (98.18% vs. 80.36%) of the WeDA system were significantly higher than the SNAP-IV. The AUC of the WeDA system (0.964) was higher than the SNAP-IV (0.907). There is non-statistically significant difference between groups (p = 0.068), and both of them have high diagnostic accuracy. In addition, the diagnostic efficacy of the WeDA system was higher than that of SNAP-IV in terms of the Youden index, diagnostic accuracy, likelihood ratio, diagnostic odds ratio and predictive value.

Conclusion

The advantages of the WeDA system in terms of diagnostic objectivity, scientific design and ease of operation make it a promising system for widespread use in clinical practice.
The future costs of cancer attributable to excess body weight in Brazil, 2030-2040
Authors: Rezende Leandro F. M. , Malhão Thainá Alves , da Silva Barbosa Rafael , Schilithz Arthur Orlando Correa , da Silva Ronaldo Corrêa Ferreira , Moreira Luciana Grucci Maya , Machado Paula Aballo Nunes , Arguelhes Bruna Pitasi , Melo Maria Eduarda Leão Diogenes
Published: June 2022

Background

Excess body weight (EBW), herein defined as body mass index (BMI) ≥25 kg/m2, is a well-known modifiable risk factor for cancer and a pivotal vector for growing healthcare costs. We estimated the future (2030) federal direct healthcare costs of cancer in the Brazilian Unified Health System (SUS) attributable to EBW. We also projected direct healthcare costs of cancer that could be potentially saved in 2040, considering counterfactual (alternative) scenarios of population-wide reductions in the BMI to be achievedin 2030.

Methods

We developed a macrosimulation model by sex using self-reported BMI data in adults ≥ 20 years who relied exclusively on the public health system from the Brazilian National Health Survey (PNS) 2019; relative risks for 12 types of cancer from the World Cancer Research Fund/American Institute Cancer Research (WCRF/AICR) meta-analysis; and nationwide registries of federal direct healthcare costs of inpatient and outpatient procedures in adults ≥30 years with cancer from 2008-2019. We calculated the attributable costs of cancer via comparative risk assessment, assuming a 10-year lag between exposure and outcome. We used the potential impact fraction (PIF) equation and the Monte Carlo simulation method to estimate the attributable costs and 95% uncertainty intervals, considering the theoretical-minimum-risk exposure and other counterfactual (alternative) scenarios of the EBW prevalence. We assessed the cancer costs attributable to EBW, multiplying PIF by the direct healthcare costs of cancer.

Results

In 2030, 2.4% or US$ 62.8 million in direct healthcare costs of cancer may be attributable to EBW. We projected potential savings of approximately US$ 10.3 to 26.6 million in 2040 by reducing the prevalence of EBW in 2030.

Conclusions

We estimated high future costs of cancer attributable to EBW in Brazil. Our findings may support interventions and policies focused on the primary prevention of EBW and cancer.
Beneficial short-term effect of autogenic drainage on peripheral resistance in childhood cystic fibrosis disease
Authors: Bokov Plamen , Gerardin Michèle , Brialix Géraldine , Da Costa Noble Emmanuelle , Juif Romain , Foucher Antonia Vital , Le Clainche Laurence , Houdouin Véronique , Mauroy Benjamin , Delclaux Christophe
Published: June 2022

Background

Airway clearance techniques are supposed to be a necessary adjunct for the enhancement of impaired peripheral clearance in cystic fibrosis (CF). The objective was to assess the effect of one physiotherapy session (autogenic drainage: AD) on mucus clearance (sputum wet weight) and impulse oscillometry system (IOS) indices, including those obtained from extended Resistance-Inertance-Compliance (eRIC) modelling, considering the degree of bronchial congestion.

Methods

Thirty children with CF (median age: 12.7 years) in a stable condition prospectively underwent IOS measurements at baseline and after AD. They were divided in two groups: with (visual analog scale of bronchial congestion by the physiotherapist ≥ 5/10) and without (scale < 5/10) bronchial congestion. Paired-comparison of the effects of AD on airway resistance measurements was done with Wilcoxon test.

Results

The congestion scale correlated with the wet weight of sputum production during the session (Pearson test: p < 0.0001, R = 0.66). Ten children had bronchial congestion and 20 were without congestion. In the whole group, R5–20 Hz significantly decreased after AD (P = 0.049), which was related to a decrease in the children with congestion (P = 0.025), whereas it was not significantly modified in the children without congestion (P = 0.327). The eRIC model allowed the calculation of the peripheral resistance of the respiratory system, which also decreased in the children with congestion (P = 0.037), however, not modified in the children without congestion (P = 0.390).

Conclusion

One session of autogenic drainage has the ability to decrease peripheral resistance obtained from IOS measurements, more specifically in children with CF with moderate to severe bronchial congestion.

Trial registration

ClinicalTrials.gov Identifier: NCT04094441.
Identifying the content, functionalities, and features of a mobile application for contact lens wearers
Authors: Falahati-Marvast Fatemeh , Pucker Andrew D. , Alipour Fateme , Farokhzadian Jamileh , Ahmadian Leila
Published: June 2022

Background

Lack of attention to end-users' requirements and preferences may lead to the failure of health information technology (IT) interventions. Identifying users’ needs for designing a mobile application can lead to the development of an acceptable intervention. This study aimed to determine the requirements for designing a mobile application to educate and provide needed information to contact lens (CL) wearers.

Methods

A qualitative study was conducted on 24 CL wearers and nine eye care practitioners from the three CL clinics in Iran. Data were collected through semi-structured interviews and analyzed using the conventional content analysis proposed by Lundman and Graneheim. Lincoln and Guba's criteria were used to ensure the trustworthiness of the data.

Results

The three main categories that emerged from the interviews were mobile application content, mobile application functionalities, and mobile application features. Ten subcategories and 57 sub-subcategories were also identified. It was determined that mobile content should focus on advice and information for optimizing the CL wearing experience and training regarding the use of CLs. Entering information required for self-care, computational capability, interactivity, updates, and reminders were determined as needed functionalities. The participants recommended features for the structure and user interface of the mobile application and information presentation methods.

Conclusion

This study identified the information needed to develop a mobile application for CL wearers. This also provides insights regarding required functionalities when applying IT interventions. These findings can be used by CL clinics, developers of health information systems, policymakers, and health planners to design better CL-related care and compliance interventions.
Validation of the ELAN-HF Score and self-care behaviour on the nurse-led heart failure clinic after admission for heart failure
Authors: Vinck T. A. M. , Deneer R. , Verstappen CCAG , Kok WE , Salah K. , Scharnhorst V. , Otterspoor LC ,   The Severity of bioMArkers and Self-care in Heart failure
Published: June 2022

Aim

To validate the predictive value of the European coLlaboration on Acute decompeNsated Heart Failure (ELAN-HF) score, and to assess the effect of self-care behaviour on readmission and mortality in patients after admission with acute decompensated heart failure (ADHF).

Design

Quantitative, prospective, single centre, cohort study.

Methods

N-Terminal pro–B-type natriuretic peptide (NT-proBNP) levels were measured on admission and discharge, and were used together with clinical and laboratory parameters to calculate the ELAN-HF score. Patients were stratified into four risk groups (low, intermediate, high, very high) according to their ELAN-HF score. The performance of the ELAN-HF score was evaluated and compared to the original study. Self-care behaviour was assessed by the European Heart Failure Self-care Behaviour Scale (EHFScBS-9). Survival analysis was used to estimate the association between both scores and re-admission for HF and/or all-cause mortality within 180 days.

Results

88 patients were included. The median age of the study population was 75 years (IQR 69–83), 43% was female. NYHA III/IV functional class was present at discharge in 68 patients (85%) and 27 patients (34%) had a left ventricular ejection fraction < 40%. Complete data and 180 day follow up was available for 80 patients. 55% reached the endpoint of readmission and/or all-cause mortality. There was a significant association between the ELAN-HF score and re-admission and/or mortality < 180 days (HR = 1.25, 95% CI 1.08—1.45, p = 0.003). The median EHFScBS-9 score was 68.1 (IQR 58.3 – 77.8). There was no significant association between the EHFScBS-9 score and readmission and/or mortality < 180 days (HR = 1.01, 95% CI 0.99—1.03, p = 0.174).

Conclusion

This study confirms the validity and therefore the potential of the ELAN-HF score to triage patients with ADHF before discharge. Using this score may optimize the follow-up treatment on the nurse-led heart failure clinic in order to decrease readmission and mortality. Self-care behaviour was non-significantly associated with readmission and/or mortality in our study population.

Trial Registration

This study has been registered with the ethics committee MEC-U (Nieuwegein, The Netherlands), registration nr: V.160999/W18.208/HG/mk.
Gaps in knowledge and practices of malaria prevention in Francophone African immigrants in Metropolitan Edmonton
Authors: Hanna Taylor A. , Ahmed Ali , Vincent Rémi , Coulibaly Kongnon Sangué , Ahmed Youssef , Petrick Ryland , Vincent Etienne , Hafid Mélanie El , Hawkes Michel T. , Ravi Srilata , Gnidehou Sedami
Published: June 2022

Background

Important knowledge gaps exist in the understanding of the management of the risks of imported malaria in Canada among Francophone immigrants from sub-Saharan Africa (FISSA). The aim of this cross-sectional study was to investigate the malaria related-knowledge, attitude and practices (KAP) of FISSA in Edmonton, where these immigrants are in an official minority language situation and the impact of language barriers on these factors.

Methods

A structured survey was used to examine the KAP of 382 FISSA in the Edmonton area from 2018 to 2019. Fisher’s Exact Test was applied to determine if there were associations between knowledge of malaria and different risk factors.

Results

Almost all FISSA (97%) had an accurate knowledge of fever as the key symptom of malaria. Interestingly, 60% of participants identified bed nets as a preventive method and only 19% of participants had accurate knowledge of malaria transmission. An accurate knowledge of symptoms was significantly associated with a high perceived risk of contracting malaria [odds ratio (OR) 4.33, 95% confidence interval (CI) 1.07–20.62]. Furthermore, even though 70% of FISSA had a high perceived risk of contracting malaria in endemic regions, only 52% of travellers had a pre-travel medical encounter. Importantly, language was not the predominant reason for not seeking pre-travel medical advice, although 84% of respondents chose French as their official language of preference when seeking medical advice. Having a French-speaking physician was correlated with satisfactory prevention knowledge (OR 1.96, 95% CI 1.16–3.35). With respect to health-seeking behaviour, 88% of respondents with a child < 5 years of age would seek medical care for fever in the child after travel to sub-Saharan Africa (SSA).

Conclusion

This study highlights that factors other than knowledge, risk assessment, and language might determine the lack of compliance with pre-travel medical encounters. It underscores the need for effective strategies to improve this adherence in minority settings.
A cluster randomized trial of delivery of intermittent preventive treatment of malaria in pregnancy at the community level in Malawi
Authors: Rubenstein Beth L. , Chinkhumba Jobiba , Chilima Ethel , Kwizombe Collins , Malpass Ashley , Cash Shelby , Wright Katherine , Troell Peter , Nsona Humphrey , Kachale Fannie , Ali Doreen , Kaunda Evans , Lankhulani Sosten , Kayange Michael , Mathanga Don P. , Munthali John , Gutman Julie R.
Published: June 2022

Background

Malaria in pregnancy doubles the risk of low birthweight; up to 11% of all neonatal deaths in sub-Saharan Africa are associated with malaria in pregnancy. To prevent these and other adverse health consequences, the World Health Organization recommends administering intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine–pyrimethamine for all pregnant women at each antenatal care (ANC) visit, starting as early as possible in the second trimester. The target is for countries to administer a minimum of three doses (IPTp3+) to at least 85% of pregnant women.

Methods

A cluster randomized, controlled trial was conducted to assess the effect of delivery of IPTp by community health workers on the coverage of IPTp3 + and ANC visits in Malawi. Community delivery of IPTp was implemented within two districts in Malawi over a 21-month period, from November 2018 to July 2020. In control sites, IPTp was delivered at health facilities. Representative samples of women who delivered in the prior 12 months were surveyed at baseline (n = 370, December 2017) and endline (n = 687, August 2020). A difference in differences analysis was conducted to assess the change in coverage of IPTp and ANC over time, accounting for clustering at the health facility level.

Results

Overall IPTp coverage increased over the study period. At baseline, women received a mean of 2.3 IPTp doses (range 0–5 doses) across both arms, and at endline, women received a mean of 2.8 doses (range 0–9 doses). Despite overall increases, the change in IPTp3 + coverage was not significantly different between intervention and control groups (6.9%, 95% CI: -5.9%, 19.6%). ANC4 + coverage increased significantly in the intervention group compared with the control group, with a difference-in-differences of 25.3% points (95% CI: 1.3%, 49.3%).

Conclusions

In order to reduce the burden of malaria in pregnancy, new strategies are needed to improve uptake of effective interventions such as IPTp. While community health workers’ delivery of IPTp did not increase uptake in this study, they may be effective in other settings or circumstances. Further research can help identify the health systems characteristics that are conducive to community delivery of IPTp and the operational requirements for effective implementation.

Trial registration: ClinicalTrials.gov Identifier: NCT03376217. Registered December 6, 2017, https://clinicaltrials.gov/ct2/show/NCT03376217.
Hyperandrogenism induces proportional changes in the expression of Kiss-1, Tac2, and DynA in hypothalamic KNDy neurons
Authors: Okada Hiroe , Kanasaki Haruhiko , Tumurbaatar Tuvshintugs , Tumurgan Zolzaya , Oride Aki , Kyo Satoru
Published: June 2022

Background

Kisspeptin released from Kiss-1 neurons in the hypothalamus plays an essential role in the control of the hypothalamic–pituitary–gonadal axis by regulating the release of gonadotropin-releasing hormone (GnRH). In this study, we examined how androgen supplementation affects the characteristics of Kiss-1 neurons.

Methods

We used a Kiss-1-expressing mHypoA-55 cell model that originated from the arcuate nucleus (ARC) of the mouse hypothalamus. These cells are KNDy neurons that co-express neurokinin B (NKB) and dynorphin A (DynA). We stimulated these cells with androgens and examined them. We also examined the ARC region of the hypothalamus in ovary-intact female rats after supplementation with androgens.

Results

Stimulation of mHypoA-55 cells with 100 nM testosterone significantly increased Kiss-1 gene expression by 3.20 ± 0.44-fold; testosterone also increased kisspeptin protein expression. The expression of Tac3, the gene encoding NKB, was also increased by 2.69 ± 0.64-fold following stimulation of mHypoA-55 cells with 100 nM testosterone. DynA gene expression in these cells was unchanged by testosterone stimulation, but it was significantly reduced at the protein level. Dihydrotestosterone (DHT) had a similar effect to testosterone in mHypoA-55 cells; kisspeptin and NKB protein expression was significantly increased by DHT, whereas it significantly reduced DynA expression. In ovary-intact female rats, DTH administration significantly increased the gene expression of Kiss-1 and Tac3, but not DynA, in the arcuate nucleus. Exogenous NKB and DynA stimulation failed to modulate Kiss-1 gene expression in mHypoA-55 cells. Unlike androgen stimulation, prolactin stimulation did not modulate kisspeptin, NKB, or DynA protein expression in these cells.

Conclusions

Our observations imply that hyperandrogenemia affects KNDy neurons and changes their neuronal characteristics by increasing kisspeptin and NKB levels and decreasing DynA levels. These changes might cause dysfunction of the hypothalamic–pituitary–gonadal axis.
NLRP3 inflammasome-mediated choroid plexus hypersecretion contributes to hydrocephalus after intraventricular hemorrhage via phosphorylated NKCC1 channels
Authors: Zhang Zhaoqi , Tan Qiang , Guo Peiwen , Huang Suna , Jia Zhengcai , Liu Xin , Feng Hua , Chen Yujie
Published: June 2022

Background

Hydrocephalus is a severe complication of intracerebral hemorrhage with ventricular extension (ICH-IVH) and causes cerebrospinal fluid (CSF) accumulation. The choroid plexus epithelium plays an important role in CSF secretion and constitutes the blood–CSF barrier within the brain–immune system interface. Although the NLRP3 inflammasome, as a key component of the innate immune system, promotes neuroinflammation, its role in the pathogenesis of hydrocephalus after hemorrhage has not been investigated. Therefore, this study aimed to investigate the potential mechanism of NLRP3 in hydrocephalus to discover a potential marker for targeted therapy.

Methods

A rat model of hydrocephalus after ICH-IVH was developed through autologous blood infusion in wild-type and Nlrp3−/−rats. By studying the features and processes of the model, we investigated the relationship between the NLRP3 inflammasome and CSF hypersecretion in the choroid plexus.

Results

The ICH-IVH model rats showed ventricular dilation accompanied by CSF hypersecretion for 3 days. Based on the choroid plexus RNA-seq and proteomics results, we found that an inflammatory response was activated. The NLRP3 inflammasome was investigated, and the expression levels of NLRP3 inflammasome components reached a peak at 3 days after ICH-IVH. Inhibition of NLRP3 by an MCC950 inflammasome inhibitor or Nlrp3 knockout decreased CSF secretion and ventricular dilation and attenuated neurological deficits after ICH-IVH. The mechanism underlying the neuroprotective effects of NLRP3 inhibition involved decreased phosphorylation of NKCC1, which is a major protein that regulates CSF secretion by altering Na+- and K+-coupled water transport, via MCC950 or Nlrp3 knockout. In combination with the in vitro experiments, this experiment confirmed the involvement of the NLRP3/p-NKCC1 pathway and Na+and K+flux.

Conclusions

This study demonstrates that NKCC1 phosphorylation in the choroid plexus epithelium promotes NLRP3 inflammasome-mediated CSF hypersecretion and that NLRP3 plays an important role in the pathogenesis of hydrocephalus after hemorrhage. These findings provide a new therapeutic strategy for treating hydrocephalus.
Factors associated with testing for HIV and other sexually transmitted infections in men who have sex with men and transgender women in Bangkok, Thailand
Authors: Crowell Trevor A. , Nitayaphan Sorachai , Sirisopana Narongrid , Wansom Tanyaporn , Kitsiripornchai Suchai , Francisco Leilani , Li Qun , Dear Nicole , O’Connell Robert J. , Pitisuttithum Punnee , Vasan Sandhya ,   for the RV348B Study Group
Published: June 2022

Background

Routine screening for HIV and other sexually transmitted infections (STIs) facilitates early diagnosis and treatment, thereby preventing morbidity and onward transmission. We estimated the prevalence of prior HIV/STI testing among men who have sex with men (MSM) and transgender women (TGW) in Bangkok, Thailand, and identified factors associated with prior testing.

Methods

Cross-sectional analyses were performed using data collected at enrollment into an HIV incidence cohort. From April to October 2017, MSM and TGW were enrolled if they were aged 18–35 years, reported anal intercourse with a male or TGW partner, and reported behavioral vulnerability to HIV. Participants answered questions about demographics, sexual behaviors, and lifetime HIV/STI testing history. Multivariable robust Poisson regression was used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for factors potentially associated with prior testing.

Results

Among 1,014 participants, 348 (34.3%) were TGW and the median age was 21.6 (interquartile range 20.0-24.8) years. Prior testing for HIV was reported by 421 (41.5%) and for other STIs by 268 (26.4%). HIV testing was more common among participants aged ≥ 22 years (RR 1.37 [95% CI 1.13–1.67]), with college education as compared to secondary or less (RR 1.37 [95% CI 1.08–1.72]), and who met male sexual partners online (RR 1.52 [95% CI 1.24–1.85]), but lower among participants attracted to both men and women as compared to men only (RR 0.64 [95% CI 0.51–0.81]) and who met male sexual partners in bars (RR 0.83 [95% CI 0.72–0.97]). Similar associations were observed with prior testing for other STIs, including increased testing among participants with college education (RR 1.52 [95% CI 1.11–2.09]) and who met male sexual partners online (RR 1.73 [95% CI 1.30–2.31]), but lower among participants attracted to both men and women (RR 0.70 [95% CI 0.51–0.96]) and who met male sexual partners in bars (RR 0.67 [95% CI 0.54–0.83]).

Conclusions

Despite behavioral vulnerability, prior testing for HIV and other STIs was uncommon. Online engagement strategies may be effectively reaching Thai MSM and TGW who meet sexual partners online, but new interventions are needed to encourage testing among younger, less educated, and bisexual MSM and TGW.