bluuebunny/crossref_metadata_2025 huggingface dataset:
Advance Care Planning Shared Decision-Making Tools for Non-Cancer Chronic Serious Illness: A Mixed Method Systematic Review
Authors: Sloan Danetta H. , Hannum Susan M. , DeGroot Lyndsay , Dy Sydney M. , Waldfogel Julie , Chyr Linda C. , Heughan JaAlah-Ai , Zhang Allen , Wilson Renee F. , Yuan Christina T. , Wu David S. , Robinson Karen A. , Cotter Valerie T.
Published: February 2021

Context:

Shared decision-making tools can facilitate advance care planning and goals of care conversations in non-cancer serious illness. More information on integrating these tools in ambulatory care could better support clinicians and patients/caregivers in these conversations.

Objectives:

We evaluated effectiveness and implementation of integrating palliative care shared decision-making tools into ambulatory care for U.S. adults with serious, life-threatening illness and their caregivers.

Data sources:

We searched PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials (2000 - May 2020) for quantitative controlled, qualitative, and mixed-methods studies.

Review methods:

Two reviewers screened articles, abstracted data, and independently assessed risk of bias or study quality. For quantitative trials, we graded strength of evidence for key outcomes: patient/caregiver satisfaction, depression or anxiety, concordance between patient preferences for care and care received, and healthcare utilization, including advance directive documentation.

Results:

We included 6 quantitative effectiveness randomized, controlled trials and 5 qualitative implementation studies across primary care and specialty populations. Shared decision-making tools all addressed goals-of-care communication or advance care planning. Palliative care shared decision-making tools may be effective for improving patient satisfaction with communication and advance directive documentation. We were unable to draw conclusions about concordance between preferences and care received. Patients and caregivers preferred advance care planning discussions grounded in patient and caregiver experiences with individualized timing.

Conclusions:

For non-cancer serious illness, advance care planning shared decision-making tools may improve several outcomes. Future trials should evaluate concordance with care received and other health care utilization.

Key Message:

This mixed-methods review concludes that when integrating palliative care into ambulatory care for serious illness and conditions other than cancer, advance care planning shared decision-making tools may improve patient satisfaction and advance directive documentation.
Paracentral acute middle maculopathy in the setting of central retinal artery occlusion following COVID-19 diagnosis
Authors: Turedi Neslihan , Onal Gunay Betul
Published: February 2021

Background:

Since its emergence in Wuhan, China, COVID-19 has disseminated across many other countries worldwide. In this report, we firstly presented a patient with mild COVID-19 disease who developed paracentral acute middle maculopathy (PAMM) due to CRAO.

Case presentation:

A 54-year-old male patient who reported a contact with a COVID-19 patient applied to the hospital and tested positive for SARS-CoV-2 by polimerase chain reaction testing. He had no significant past medical history. Chest computed tomography was not notable. He had a mild COVID-19 course during hospitalization. Two weeks following COVID-19 diagnosis, he reported profund vision loss (counting fingers) in his right eye where central retinal artery occlusion (CRAO) was detected on fundoscopic examination. Coagulation profile was within normal limits. Hypercoagulable work up was also not notable. Treatment was given for CRAO. Visual acuity was counting fingers at 30 cm. Five days following treatment. Optical coherence tomography analysis showed increased diffuse reflectance and thickening at the level of inner nuclear layer consistent with PAMM. Fluorescein angiography illustrated no perfusion defect.

Conclusion:

This is the first case that reports PAMM in the setting of CRAO following COVID-19 diagnosis. Viral induced microangiopathy may involve in the development of CRAO in our patient without a hypercoagulable state and additional risk factors. Physicians should be vigilant to seek for retinal evaluation in patients with significant visual loss even after a mild COVID-19 history.
Vascular sound visualization system is useful for monitoring and surveillance of vascular access
Authors: Tsuboi Masato , Suzuki Hiroaki , Kawai Hirokazu , Ejima Toru , Mitsuishi Fukumi
Published: February 2021

Backgrounds:

Vascular access (VA) is a lifeline for maintenance hemodialysis patients. Monitoring and surveillance of VA, therefore, play an important role for maintaining VA patency. Surveillance needs special apparatus to estimate the VA function, while, monitoring including physical examination does not usually need such devices but highly skill-dependent and qualitative.

Purpose:

We report the clinical utility in monitoring and surveillance of VA using a newly developed electronic stethoscope and vascular sound visualization application.

Methods:

One hundred eight patients participated in the study. The vascular sounds were collected using the electronic stethoscope, converted into digital data, sent wirelessly to a personal computer, and then calculated. The units for the calculated intensity of the vascular sound were decibel [dB]. The intensity, however, was normalized as INDEX values ranging from 0 to 99 for practical use. Correlation between INDEX and the mean flow volume (mFV) and resistance index (RI) of brachial artery measured by Doppler ultrasound sonography were examined for VA surveillance. INDEX was continually measured at each dialysis session in ten patients who underwent the angioplasty for VA monitoring.

Results:

INDEX significantly correlated with the mFV (coefficient of correlation value = 0.68, p < 0.001) and RI (coefficient of correlation value = −0.51, p < 0.001) of brachial artery. Using the calculated cut-off values, the accuracy of INDEX for the diagnosis of AVF dysfunction ranged from 66% to 82%. INDEX attained the peak just after the angioplasty of culprit lesions and gradually decreased from one patient to another.

Conclusion:

These results suggest that vascular sound visualization system can be useful in VA monitoring and surveillance for detecting and predicting the access stenosis.
Applying machine learning on home videos for remote autism diagnosis: Further study and analysis
Authors: Nabil Mohamed A. , Akram Ansam , Fathalla Karma M
Published: February 2021

Autism Spectrum Disorder (Autism) is a developmental disorder that impedes the social and communication capabilities of a person through out his life. Early detection of autism is critical in contributing to better prognosis. In this study, the use of home videos to provide accessible diagnosis is investigated. A machine learning approach is adopted to detect autism from home videos. Feature selection and state-of-the-art classification methods are applied to provide a sound diagnosis based on home video ratings obtained from non-clinicians feedback. Our models results indicate that home videos can effectively detect autistic group with True Positive Rate reaching 94.05% using Support Vector Machines and backwards feature selection. In this study, human-interpretable models are presented to elucidate the reasoning behind the classification process and its subsequent decision. In addition, the prime features that need to be monitored for early autism detection are revealed.
Prison official perceptions of technology in prison
Authors: Mufarreh Andrea , Waitkus Jason , Booker Teresa A
Published: February 2021

Several state prisons have provided tablets to imprisoned people which appears to be indicative of a larger trend to increase access to technology for imprisoned people. However, access to and the use of technology in prison has not been evaluated by social scientists. This study surveyed 70 prison officials from six states to report their attitudes toward access to and the use of tablets in prison for imprisoned people and for the prisons themselves. Survey results show that prison officials who work in prisons with more access to technology are more likely to believe technology to be a positive contribution for imprisoned people.
Using the TTX Model to Better Understand the Pathophysiology of a DREADDed Epilepsy—Infantile (Epileptic) Spasms
Authors: Stafstrom Carl E.
Published: February 2021

[Box: see text]
Oncovascular Resection of a Ganglioneuroma Involving the Coeliac Trunk and Hepatic Artery—A Case Report
Authors: Lawrie Kateřina , Whitley Adam , Rokošný Slavomír , Bafrnec Jan , Gürlich Robert , Baláž Peter
Published: February 2021

A large tumorous mass completely surrounding and compressing the coeliac trunk was identified on computed tomography in a young woman with a six-month history of progressive abdominal pain. The tumor was excised along with the coeliac trunk and the proximal parts of its branches. The hepatic artery was reconstructed with an aorto-hepatic autogenous bypass. Postoperatively the patient had neurogenic diarrhea, which subsided on medical treatment. Seven months after surgery the patient is in a good state of health and living a normal life.
Identification method of cashmere and wool based on texture features of GLCM and Gabor
Authors: Zhu Yaolin , Huang Jiayi , Wu Tong , Ren Xueqin
Published: February 2021

The common texture feature extraction method is only in spatial or frequency domain, leading to insufficient texture information and low accuracy. The main aim of this paper is to present a novel texture feature analysis method based on gray level co-occurrence matrix and Gabor wavelet transform to sufficiently extract texture feature of cashmere and wool fibers. Firstly, the gray level co-occurrence matrix is constructed to calculate the four texture feature vectors including of contrast, angular second moment, dissimilarity and energy in spatial domain, and four texture feature vectors, which are contrast, angular second moment, mean and entropy, in frequency domain is obtained through Gabor wavelet transform and Gray-Scale difference statistics method. Then, because the contrast and angle second moment are used as descriptors of fiber image in both spatial and frequency domain, they are fused respectively by introducing a weight to make linear addition, making eight feature values compose a 6-dimensional feature vector. Finally, these feature vectors are fed into the Fisher classifier. The experimental results show that the identification accuracy of the proposed algorithm is improved by 0.682% compared to use 8-dimensional feature vectors describing the sample image. It verifies that the fused method based on texture feature in spatial and frequency domain is an effective approach to identify fibers of cashmere and wool.
Geometric property-based convolutional neural network for indoor object detection
Authors: Ding Xintao , Li Boquan , Wang Jinbao
Published: February 2021

Indoor object detection is a very demanding and important task for robot applications. Object knowledge, such as two-dimensional (2D) shape and depth information, may be helpful for detection. In this article, we focus on region-based convolutional neural network (CNN) detector and propose a geometric property-based Faster R-CNN method (GP-Faster) for indoor object detection. GP-Faster incorporates geometric property in Faster R-CNN to improve the detection performance. In detail, we first use mesh grids that are the intersections of direct and inverse proportion functions to generate appropriate anchors for indoor objects. After the anchors are regressed to the regions of interest produced by a region proposal network (RPN-RoIs), we then use 2D geometric constraints to refine the RPN-RoIs, in which the 2D constraint of every classification is a convex hull region enclosing the width and height coordinates of the ground-truth boxes on the training set. Comparison experiments are implemented on two indoor datasets SUN2012 and NYUv2. Since the depth information is available in NYUv2, we involve depth constraints in GP-Faster and propose 3D geometric property-based Faster R-CNN (DGP-Faster) on NYUv2. The experimental results show that both GP-Faster and DGP-Faster increase the performance of the mean average precision.
Eye-movement patterns to social and non-social cues in early deaf adults
Authors: Bonmassar Claudia , Pavani Francesco , Di Renzo Alessio , Caselli Maria Cristina , van Zoest Wieske
Published: February 2021

Previous research on covert orienting to the periphery suggested that early profound deaf adults were less susceptible to uninformative gaze-cues, though were equally or more affected by non-social arrow-cues. The aim of this work was to investigate whether spontaneous eye movement behaviour helps explain the reduced impact of the social cue in deaf adults. We tracked the gaze of 25 early profound deaf and 25 age-matched hearing observers performing a peripheral discrimination task with uninformative central cues (gaze vs arrow), stimulus-onset asynchrony (250 vs 750 ms), and cue validity (valid vs invalid) as within-subject factors. In both groups, the cue effect on reaction time (RT) was comparable for the two cues, although deaf observers responded significantly slower than hearing controls. While deaf and hearing observers’ eye movement pattern looked similar when the cue was presented in isolation, deaf participants made significantly more eye movements than hearing controls once the discrimination target appeared. Notably, further analysis of eye movements in the deaf group revealed that independent of the cue type, cue validity affected saccade landing position, while latency was not modulated by these factors. Saccade landing position was also strongly related to the magnitude of the validity effect on RT, such that the greater the difference in saccade landing position between invalid and valid trials, the greater the difference in manual RT between invalid and valid trials. This work suggests that the contribution of overt selection in central cueing of attention is more prominent in deaf adults and helps determine the manual performance, irrespective of the cue type.
EU research policy as a transnational memory policy instrument? The framework programmes and the production of competing visions of Europe
Authors: Le Boulay Morgane
Published: February 2021

This article considers the history-based research networks funded by the Framework Programmes for Research and Technological Development (FPs). It sheds light on the interactions between the European Commission and scholars – Commission-appointed experts, funded researchers, but also scholars who disagree with the EU memory policy. Even if the scholars’ influence is significant, the FPs remain an instrument in the hands of the European Commission. The visions of the history of Europe brought forward are in conformance with official narratives highlighted by works on other EU memory policy instruments. This leads to a confrontation between ‘authorised’ and alternative narratives at European level. While the institutionalisation of European research networks as a form of knowledge production which is intended to be specifically European contributes to shaping ‘Europe’, the idea of the emergence of an autonomous ‘European memory space’ nevertheless deserves nuancing because of the FPs’ fragmented nature and of the role that national academic levels continue to play.
Hospital Architecture in Spain and Italy: Gaps Between Education and Practice
Authors: Cambra-Rufino Laura , Brambilla Andrea , Paniagua-Caparrós José León , Capolongo Stefano
Published: February 2021

Aim:

The research sheds light on the challenges and limitations of Spanish and Italian hospital design by looking at the gaps between education and practice.

Background:

Hospital design plays an important role in providing high-quality and cost-effective facilities for any healthcare system. Spain and Italy face contemporary challenges (i.e., elderly population, staff retention, and obsolete healthcare facilities) and have similar issues of life expectancy, health expenditure, hospital beds provision, and decentralized tax-financed healthcare systems.

Method:

A cross-sectional, mixed-method study was used. This involved two different data collection strategies and analysis for each area of investigation: (i) education and (ii) practice. For the former, educational programs were reviewed via a web search; for the latter, an online survey of 53 architectural/engineering offices involved in hospital design was conducted.

Results:

Hospital design education is limited to 0/58 in Spanish and 2/60 courses in Italian universities, although each country offers three postgraduate courses. The practitioners’ survey shows that even though their offices have a long history of healthcare design, only 48% in Spain and 60% in Italy have received specific university training. Office staff lack employees with medical backgrounds, which hinders any partnership between health and design fields either for design practice or the education fields. Laws, national regulations, technical guidelines, and previous experience are the most useful information sources, while international scientific publications appear underused by practitioners.

Conclusions:

Italian and Spanish healthcare architecture could be improved by promoting multidisciplinary teams (in practice and education) and improving the education offer by tailoring it to national needs.
COVID-19 and the ‘ethics of disruption’: Current dilemmas facing longitudinal research in low- and middle-income countries
Authors: Crivello Gina , Favara Marta
Published: February 2021

In this piece, we draw on recent experiences from the Young Lives study to discuss some of the ethical and practical challenges facing longitudinal cohort studies in low- and middle-income countries in the time of coronavirus. We argue that COVID-19 has instigated an ‘ethics of disruption’ for social researchers across the world, and for longitudinal cohort studies like Young Lives, this requires navigating three core considerations: first, managing research relationships and reciprocity within an observational study design; second, maintaining methodological continuity and consistency across time; and third, balancing an immediate short-term response to COVID-19 against the long-term perspective. We refer to the study’s plan to implement a new COVID-19 phone survey to illustrate how the team are navigating this altered ethical terrain.
Incidence, Management, and Outcomes of Adult Spinal Chordoma Patients in the United States
Authors: Patel Saavan , Nunna Ravi S. , Nie James , Ansari Darius , Chaudhry Nauman S. , Mehta Ankit I.
Published: February 2021

Study Design:

Retrospective cohort study.

Objective:

Spinal chordomas are rare primary malignant neoplasms of the primitive notochord. They are slow growing but locally aggressive lesions that have high rates of recurrence and metastasis after treatment. Gold standard treatment remains en-bloc surgical resection with questionable efficacy of adjuvant therapies such as radiation and chemotherapy. Here we provide a comprehensive analysis of prognostic factors, treatment modalities, and survival outcomes in patients with spinal chordoma.

Methods:

Patients with diagnosis codes specific for chordoma of spine, sacrum, and coccyx were queried from the National Cancer Database (NCDB) during the years 2004-2016. Outcomes were investigated using Cox univariate and multivariate regression analyses, and survival curves were generated for comparative visualization.

Results:

1,548 individuals were identified with a diagnosis of chordoma, 60.9% of which were at the sacrum or coccyx and 39.1% at the spine. The mean overall survival of patients in our cohort was 8.2 years. Increased age, larger tumor size, and presence of metastases were associated with worsened overall survival. 71.2% of patients received surgical intervention and both partial and radical resection were associated with significantly improved overall survival ( P < 0.001). Neither radiotherapy nor chemotherapy administration improved overall survival; however, amongst patients who received radiation, those who received proton-based radiation had significantly improved overall survival compared to traditional radiation.

Conclusion:

Surgical resection significantly improves overall survival in patients with spinal chordoma. In those patients receiving radiation, those who receive proton-based modalities have improved overall survival. Further studies into proton radiotherapy doses are required.
Prevalence of Anxiety and Depression Among Medical Students During the Covid-19 Pandemic: A Cross-Sectional Study
Authors: Halperin Scott J , Henderson Matthew N , Prenner Sofia , Grauer Jonathan N
Published: February 2021

Purpose:

The Covid-19 pandemic is a public health emergency with both physical and mental health risks. Medical students have baseline elevated rates of anxiety, depression and burnout. As such, they may be especially susceptible to the psychological stresses of Covid-19. The current study aimed to evaluate the prevalence of anxiety and depression among United States medical students during the Covid-19 pandemic.

Methods:

A cross-sectional, survey-based study collected demographic data as well as the 7-item Generalized Anxiety Disorder (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9) to assess anxiety and depression symptoms, respectively. The survey was administered from April 13, 2020 to April 28, 2020 amidst the height of the Covid-19 pandemic.

Results:

A total of 1,428 students from 40 US medical schools completed the survey. From those surveyed, 30.6% and 24.3% of respondents screened positive for anxiety and depression, respectively. Median GAD-7 scores were higher among females (7.0 vs 5.0, P < .00001), pre-clinical students (7.0 vs 6.0, P < .00004), and those with a friend or relative diagnosed with Covid-19 (7.0 vs 6.0, P=.001). Median PHQ-9 scores were higher among females (6.0 vs 4.0, P < .00001) and pre-clinical students (6.0 vs 4.0, P < .00001).

Conclusion:

When compared to previous medical student studies, these results are 61% higher for anxiety and 70% higher for depression during the Covid-19 era. The current study suggests that there should be a heightened awareness of and sensitivity to student’s mental health during the Covid-19 pandemic with certain cohorts at greater potential risk.
Book review: Anand Pandian, A Possible Anthropology: Methods for Uneasy Times
Authors: Kawlra Aarti
Published: February 2021

Anand Pandian, A Possible Anthropology: Methods for Uneasy Times. Duke University Press, 2019, 168pp., ₹2,115, ISBN: 978-1-4780-0375-5 (paperback). ISBN:978-1-4780-0311-3 (cloth).
The Clinical Significance of Promoter Methylation of Fluoropyrimidine Metabolizing and Cyclooxygenase Genes in Colorectal Cancer
Authors: Fouad Mariam Ahmed , Salem Salem Eid , Hussien Marwa M. , Badr Doaa Mohamed , Zekri Abdelrahman N. , Hafez Hafez Farouk , Shouman Samia A.
Published: February 2021

Aims:

This study investigated the impact of promoter methylation of flouropyrimidine (FP) metabolizing and cyclooxygenase 2 (COX2) genes on their mRNA expression and on the clinical outcome of colorectal cancer (CRC) patients.

Methods:

Methylation specific-PCR and real time-PCR of thymidylate synthase (TS), thymidine phosphorylase (TP), dihydropyrimidine dehydrogenase (DPD) and COX2 were performed at baseline and after 3 and 6 months of FP therapy. Pairwise comparisons were conducted between the subgroups of CRC patients. The event free survival (EFS) and the hazard of progression were estimated by univariate and multivariate analyses.

Results:

At baseline CRC patients, both TS and TP were overexpressed, in spite of the unmethylation of TS and the full methylation of TP genes. Significant downexpression of DPD and COX2 were associated their promoter’s methylation. At the end of FP therapy, TS, DPD and COX2 were overexpressed by 7.52, 2.88 and 3.45 folds, respectively, while TP was downexpressed by 0.54 fold. However, no change was observed in the methylation status of genes with FP therapy. Pairwise comparisons revealed significant difference in the expression and the methylation status of genes according to the clinicopathological characters of CRC patients either at baseline or after FP therapy. The overexpression of DPD and COX2 genes were indicators for a poor EFS of CRC patients. Also, the high level of COX2 expression was found to be significantly correlated with the hazard of progression (HR = 1.73, 95% CI = 1.02-3.03).

Conclusion:

The promoter methylation of FP metabolizing and COX2 genes has significant impact on the expression and the treatment outcome of CRC patients.
Instalment of the margarosanite group, and data on walstromite–margarosanite solid solutions from the Jakobsberg Mn–Fe deposit, Värmland, Sweden
Authors: Holtstam Dan , Cámara Fernando , Karlsson Andreas
Published: February 2021

The margarosanite group (now officially confirmed by IMA-CNMNC) consists of triclinic Ca-(Ba, Pb) cyclosilicates with three-membered [Si3O9]6–rings (3R), with the general formulaAB2Si3O9, whereA= Pb, Ba and Ca andB= Ca. A closest-packed arrangement of O atoms parallel to (101) hosts Si andBcations in interstitial sites in alternating layers. The 3R layer has three independent Si sites in each ring. Divalent cations occupy three independent sites: Ca inBoccupies two nonequivalent sites,Ca1 (8-fold coordinated), andCa2 (6-fold coordinated).A(=Ca3) is occupied by Pb2+(or Ba2+) in 6+4 coordination, or 6+1 when occupied by Ca; this third site occurs within the 3R-layer in a peripheral position. Three minerals belong to this group: margarosanite (ideally PbCa2Si3O9), walstromite (BaCa2Si3O9) and breyite (CaCa2Si3O9). So far, no solid solutions involving theCa1 andCa2 sites have been described. Therefore, root names depend on the composition of theCa3 site only. Isomorphic replacement at theCa3 sites has been noted. We here report data on a skarn sample from the Jakobsberg Mn–Fe oxide deposit, in Värmland, Sweden, representing intermediate compositions on the walstromite–margarosanite binary, in the rangeca.50–70% mol.% BaCa2Si3O9. The Pb-rich walstromite is associated closely with celsian, phlogopite, andradite, vesuvianite, diopside and nasonite. A crystal-structure refinement (R1= 4.8%) confirmed the structure type, and showed that theCa3 (Ba, Pb) site is split into two positions separated by 0.39 Å, with the Ba atoms found slightly more peripheral to the 3R-layers.
Recovery trajectories over six weeks in patients selected for a high-intensity physiotherapy program after Total knee Arthroplasty: a latent class analysis
Authors: Harmelink K. E. M. , Dandis R. , der Van der Wees PJ P. J. , Zeegers A. V. C. M. , der Sanden M. W. Nijhuis-van , Staal J. B.
Published: February 2021

Background

Recovery trajectories differ between individual patients and it is hypothesizes that they can be used to predict if an individual patient is likely to recover earlier or later. Primary aim of this study was to determine if it is possible to identify recovery trajectories for physical functioning and pain during the first six weeks in patients after TKA. Secondary aim was to explore the association of these trajectories with one-year outcomes.

Methods

Prospective cohort study of 218 patients with the following measurement time points: preoperative, and at three days, two weeks, six weeks, and one year post-surgery (no missings). Outcome measures were performance-based physical functioning (Timed Up and Go [TUG]), self-reported physical functioning (Knee injury and Osteoarthritis Outcome Score-Activities of Daily Living [KOOS-ADL]), and pain (Visual Analogue Scale [VAS]). Latent Class Analysis was used to distinguish classes based on recovery trajectories over the first six weeks postoperatively. Multivariable regression analyses were used to identify associations between classes and one year outcomes.

Results

TUG showed three classes: “gain group” (n = 203), “moderate gain group” (n = 8) and “slow gain group” (n = 7), KOOS showed two classes: “gain group” (n = 86) and “moderate gain group” (n = 132), and VAS-pain three classes: “no/very little pain” (n = 151), “normal decrease of pain” (n = 48) and “sustained pain” (n = 19). The” low gain group” scored 3.31 [95% CI 1.52, 5.09] seconds less on the TUG than the “moderate gain group” and the KOOS “gain group” scored 11.97 [95% CI 8.62, 15.33] points better than the “moderate gain group” after one year.

Patients who had an early trajectory of “sustained pain” had less chance to become free of pain at one year than those who reported “no or little pain” (odds ratio 0.11 [95% CI 0.03,0.42].

Conclusion

The findings of this study indicate that different recovery trajectories can be detected. These recovery trajectories can distinguish outcome after one year.
Lipoprotein-associated phospholipase A2 levels, endothelial dysfunction and arterial stiffness in patients with stable coronary artery disease
Authors: Mourouzis Konstantinos , Siasos Gerasimos , Oikonomou Evangelos , Zaromitidou Marina , Tsigkou Vicky , Antonopoulos Alexis , Bletsa Evanthia , Stampouloglou Panagiota , Vlasis Konstantinos , Vavuranakis Manolis , Tousoulis Dimitris
Published: February 2021

Background

Lipoprotein-associated Phospholipase A2 (Lp-PLA2), can exert proinflammatory as well as proatherogenic properties on the vascular wall. The current study sought to evaluate the influence of high Lp-PLA2 levels on indices of arterial wall properties in patients with stable coronary artery disease (CAD).

Methods

Three hundred seventy-four consecutive patients with stable CAD (mean age 61 ± 11 years, 89% males) were enrolled in this single-center cross-sectional study. Flow-mediated dilation (FMD) was used to assess endothelial function and augmentation index (AIx) of the central aortic pressure was used to assess reflected waves. ELISA was used to determine Lp-PLA2 serum levels.

Results

After dividing the participants in 3 equal groups based on the tertiles of circulating Lp-PLA2 values, no significant differences were demonstrated between those in the 3rd tertile with Lp-PLA2 values > 138 μg/L, in the 2nd tertile with Lp-PLA2 values between 101 and 138 μg/L and in the 1st tertile (Lp-PLA2 values < 101 μg/L) regarding age, male gender, smoking habits, family history of CAD or history of a previous myocardial infarction, diabetes mellitus, arterial hypertension, hyperlipidemia, duration of CAD and treatment with relevant medication. Importantly, subjects with Lp-PLA2 values in the highest tertile, had significantly reduced FMD values compared to the middle and lower tertile (4.43 ± 2.37% vs. 4.61 ± 1.97% vs. 5.20 ± 2.52% respectively, P = 0.03). Patients in the highest tertile of Lp-PLA2 values had significantly higher AIx values (24.65 ± 8.69% vs. 23.33 ± 9.65%, P = 0.03), in comparison to the lowest tertile, with Lp-PLA2 values < 101 μg/L. A linear regression analysis showed that Lp-PLA2 values > 138 μg/L negatively correlated to FMD [b = − 0.45 (95% CI: − 0.79 – -0.11), P = 0.01] and AIx values [b = 1.81 (95% CI: 0.57–3.05), P < 0.001] independently of cofounders like gender, age, diabetes mellitus, arterial hypertension, dyslipidemia, smoking habits, family history of CAD, history of previous myocardial infarction, serum glucose, circulating lipid levels, duration of CAD, antihypertensive medication, antidiabetic drugs, statin therapy and treatment with β-blockers.

Conclusions

Elevated Lp-PLA2 levels relate to endothelial dysfunction and arterial stiffness in patients with stable CAD independently from classical risk factors for CAD, statin use, antihypertensive treatment, and duration of the disease.
Pre- and postoperative left atrial and ventricular volumetric and deformation analyses in severe aortic regurgitation
Authors: Jenner Jonas , Ilami Ali , Petrini Johan , Eriksson Per , Franco-Cereceda Anders , Eriksson Maria J. , Caidahl Kenneth
Published: February 2021

Background

The impact of volume overload due to aortic regurgitation (AR) on systolic and diastolic left ventricular (LV) indices and left atrial remodeling is unclear. We assessed the structural and functional effects of severe AR on LV and left atrium before and after aortic valve replacement.

Methods

Patients with severe AR scheduled for aortic valve replacement (n = 65) underwent two- and three-dimensional echocardiography, including left atrial strain imaging, before and 1 year after surgery. A control group was selected, and comprised patients undergoing surgery for thoracic aortic aneurysm without aortic valve replacement (n = 20). Logistic regression analysis was used to assess predictors of impaired left ventricular functional and structural recovery, defined as a composite variable of diastolic dysfunction grade ≥ 2, EF < 50%, or left ventricular end-diastolic volume index above the gender-specific normal range.

Results

Diastolic dysfunction was present in 32% of patients with AR at baseline. Diastolic LV function indices and left atrial strain improved, and both left atrial and LV volumes decreased in the AR group following aortic valve replacement. Preoperative left atrial strain during the conduit phase added to left ventricular end-systolic volume index for the prediction of impaired LV functional and structural recovery after aortic valve replacement (modelp < 0.001, accuracy 70%; addition of left atrial strain during the conduit phase to end-systolic volume indexp = 0.006).

Conclusions

One-third of patients with severe AR had signs of diastolic dysfunction. Aortic valve surgery reduced LV and left atrial volumes and improved diastolic indices. Left atrial strain during the conduit phase added to the well-established left ventricular end-diastolic dimension for the prediction of impaired left ventricular functional and structural recovery at follow-up. However, long-term follow-up studies with hard endpoints are needed to assess the value of left atrial strain as predictor of myocardial recovery in aortic regurgitation.
Surgical drainage after limb salvage surgery and endoprosthetic reconstruction: is 30 mL/day critical?
Authors: Liu Jiayong , Fan Zhengfu , El Beaino Marc , Lewis Valerae O. , Moon Bryan S. , Satcher Robert L. , Bird Justin E. , Frink Spencer J. , Lin Patrick P.
Published: February 2021

Background

Periprosthetic infection is a major cause of failure after segmental endoprosthetic reconstruction. The purpose of this study is to determine whether certain aspects of drain output affect infection risk, particularly the 30 mL/day criterion for removal.

Methods

Two hundred and ninety-five patients underwent segmental bone resection and lower limb endoprosthetic reconstruction at one institution. Data on surgical drain management and occurrence of infection were obtained from a retrospective review of patients’ charts and radiographs. Univariate and multivariate Cox regression analyses were performed to identify factors associated with infection.

Results

Thirty-one of 295 patients (10.5%) developed infection at a median time of 13 months (range 1–108 months).Staphylococcus aureuswas the most common organism and was responsible for the majority of cases developing within 1 year of surgery. Mean output at the time of drain removal was 72 mL/day. Ten of 88 patients (11.3%) with ≤ 30 mL/day drainage and 21 of 207 patients (10.1%) with > 30 mL/day drainage developed infection (p= 0.84). In multivariate analysis, independent predictive factors for infection included sarcoma diagnosis (HR 4.13, 95% CI 1.4–12.2,p= 0.01) and preoperative chemotherapy (HR 3.29, 95% CI 1.1–9.6,p= 0.03).

Conclusion

Waiting until drain output is < 30 mL/day before drain removal is not associated with decreased risk of infection for segmental endoprostheses of the lower limb after tumor resection. Sarcoma diagnosis and preoperative chemotherapy were independent predictors of infection.
Review of the impact of heat stress on reproductive performance of sheep
Authors: van Wettere William H. E. J. , Kind Karen L. , Gatford Kathryn L. , Swinbourne Alyce M. , Leu Stephan T. , Hayman Peter T. , Kelly Jennifer M. , Weaver Alice C. , Kleemann David O. , Walker Simon K.
Published: February 2021

Heat stress significantly impairs reproduction of sheep, and under current climatic conditions is a significant risk to the efficiency of the meat and wool production, with the impact increasing as global temperatures rise. Evidence from field studies and studies conducted using environmental chambers demonstrate the effects of hot temperatures (≥ 32 °C) on components of ewe fertility (oestrus, fertilisation, embryo survival and lambing) are most destructive when experienced from 5 d before until 5 d after oestrus. Temperature controlled studies also demonstrate that ram fertility, as measured by rates of fertilisation and embryo survival, is reduced when mating occurs during the period 14 to 50 d post-heating. However, the contribution of the ram to heat induced reductions in flock fertility is difficult to determine accurately. Based primarily on temperature controlled studies, it is clear that sustained exposure to high temperatures (≥ 32 °C) during pregnancy reduces lamb birthweight and will, therefore, decrease lamb survival under field conditions. It is concluded that both ewe and ram reproduction is affected by relatively modest levels of heat stress (≥ 32 °C) and this is a concern given that a significant proportion of the global sheep population experiences heat stress of this magnitude around mating and during pregnancy. Despite this, strategies to limit the impacts of the climate on the homeothermy, behaviour, resource use and reproduction of extensively grazed sheep are limited, and there is an urgency to improve knowledge and to develop husbandry practices to limit these impacts.
Bilateral scrotoshisis a rare entity: case report
Authors: Perveen Shazia , Shaikh Mishraz , Ali Sajid
Published: February 2021

Background

Scrotoschisis is a rare anomaly in which the testis is lying outside scrotum congenitally. Only few cases have been reported in literature under different names most of which are unilateral. We have found only one case of bilateral scrotoschisis in literature.

Case presentation

Newborn presented to us after normal term twin delivery as a case of bilateral scrotoschisis in which both testes were lying outside the scrotum congenitally. Baby underwent uneventful bilateral orchiopexy and was discharged home the next day.

Conclusion

Scrotoschisis is a very rare genital anomaly with only a few cases reported in literature. This report would add to the literature which would help in studying the exact mechanism and embryopathogenesis of this anomaly which is not known yet.
Study of wavelet entropy for airport pavement inspection using a multistatic ground-penetrating radar system
Authors: Zou Lilong , Kikuta Kazutaka , Alani Amir M. , Sato Motoyuki
Published: February 2021

The multilayer nature of airport pavement structures is susceptible to the generation of voids at the bonding parts of the structure, which is also called interlayer debonding. Observations have shown that the thickness of the resulting voids is usually at the scale of millimeters, which makes it difficult to inspect. The efficient and accurate characteristics of ground penetrating radar (GPR) make it suitable for large area inspections of airport pavement. In this study, a multistatic GPR system was used to inspect the interlayer debonding of a large area of an airport pavement. A special antenna arrangement can obtain common-midpoint (CMP) gathers during a common-offset survey. The presence of interlayer debonding affects the phase of the reflection signals, and the phase disturbance can be quantified by the wavelet transform. Therefore, we have developed an advanced approach that uses the average entropy of the wavelet transform parameters in CMP gathers to detect the interlayer debonding of airport pavement. The results demonstrate that the regions with high entropy correspond to regions where tiny voids exist. The new approach introduced in this study was then evaluated by a field-base experiment at an airport taxiway model. The results show that our approach can detect interlayer debonding of the pavement model accurately and efficiently. On-site coring results confirm the performance of our approach.
Improving attitudes toward electroconvulsive therapy
Authors: Cheung Oakley , Baker Marc , Tabraham Paul
Published: February 2021

Aims and method

Electroconvulsive therapy (ECT) often causes fear in the general public because of media representation and negative reported side-effects. This study evaluates a new video focusing on experiences of ECT and how this can aid communicating medical information to the public. Knowledge and attitudes toward ECT after watching the video were compared with a group that received no information and a group that read the current NHS leaflet on ECT. The role of empathy was also considered as a covariate.

Results

The video was the only condition found to positively affect knowledge and attitudes toward ECT. The video was especially beneficial to those that possessed low perspective-taking trait empathy.

Clinical implications

These findings demonstrate the video improved knowledge and attitudes toward ECT compared with current material or no information. We suggest that the addition of personal experiences to public information adds perspective, improving overall attitudes toward health treatments.
Setting priorities for people with intellectual disability/intellectual developmental disorders across the lifespan: a call to action by the World Psychiatric Association
Authors: Roy Ashok , Courtenay Ken , Odiyoor Mahesh , Walsh Patricia , Keane Sarah , Biswas Asit , Marston Geoff , Thirulokachandran Suchithra , Munir Kerim
Published: February 2021

People with DSM-5 intellectual disability/intellectual developmental disorder (ID/IDD) or ICD-11 disorders of intellectual development (DID) have multiple healthcare needs, but in many countries these needs are neither recognised nor managed effectively. This paper discusses the negative impact that stigma, discrimination and social exclusion have on the identification and care of persons with ID/IDD in low- and middle-income countries (LMICs). It also reviews different models of care for children, adolescents and adults. In discussing some initiatives in LMICs the emphasis is on early diagnosis, with success in providing locally sourced care for affected people and their families. This is where the medical, social and rights-based models of care intersect and is a premise of the person-centred biopsychosocial framework of the World Psychiatric Association's Presidential Action Plan 2020–2023. The plan invites psychiatrists to take a lead in changing the culture of care, as well as medical education, clinical training and research, with a renewed emphasis on workforce integration and service development in terms of community-based rehabilitation strategies.
Contribution of birth weight to mental health, cognitive and socioeconomic outcomes: two-sample Mendelian randomisation
Authors: Orri Massimiliano , Pingault Jean-Baptiste , Turecki Gustavo , Nuyt Anne-Monique , Tremblay Richard E. , Côté Sylvana M. , Geoffroy Marie-Claude
Published: February 2021

Background

Low birth weight is associated with adult mental health, cognitive and socioeconomic problems. However, the causal nature of these associations remains difficult to establish owing to confounding.

Aims

To estimate the contribution of birth weight to adult mental health, cognitive and socioeconomic outcomes using two-sample Mendelian randomisation, an instrumental variable approach strengthening causal inference.

Method

We used 48 independent single-nucleotide polymorphisms as genetic instruments for birth weight (genome-wide association studies’ total sample: n = 264 498) and considered mental health (attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder, bipolar disorder, major depressive disorder, obsessive–compulsive disorder, post-traumatic stress disorder (PTSD), schizophrenia, suicide attempt), cognitive (intelligence) and socioeconomic (educational attainment, income, social deprivation) outcomes.

Results

We found evidence for a contribution of birth weight to ADHD (OR for 1 s.d. unit decrease (~464 g) in birth weight, 1.29; 95% CI 1.03–1.62), PTSD (OR = 1.69; 95% CI 1.06–2.71) and suicide attempt (OR = 1.39; 95% CI 1.05–1.84), as well as for intelligence (β = −0.07; 95% CI −0.13 to −0.02) and socioeconomic outcomes, i.e. educational attainment (β = −0.05; 95% CI −0.09 to −0.01), income (β = −0.08; 95% CI −0.15 to −0.02) and social deprivation (β = 0.08; 95% CI 0.03–0.13). However, no evidence was found for a contribution of birth weight to the other examined mental health outcomes. Results were consistent across a wide range of sensitivity analyses.

Conclusions

These findings support the hypothesis that birth weight could be an important element on the causal pathway to mental health, cognitive and socioeconomic outcomes.
Proteomic Profile of Urinary Extracellular Vesicles Identifies AGP1 as a Potential Biomarker of Primary Aldosteronism
Authors: Barros Eric R , Rigalli Juan Pablo , Tapia-Castillo Alejandra , Vecchiola Andrea , Young Morag J , Hoenderop Joost G J , Bindels René J M , Fardella Carlos E , Carvajal Cristian A
Published: February 2021

Context

Primary aldosteronism (PA) represents 6% to 10% of all essential hypertension patients and is diagnosed using the aldosterone-to-renin ratio (ARR) and confirmatory studies. The complexity of PA diagnosis encourages the identification of novel PA biomarkers. Urinary extracellular vesicles (uEVs) are a potential source of biomarkers, considering that their cargo reflects the content of the parent cell.

Objective

We aimed to evaluate the proteome of uEVs from PA patients and identify potential biomarker candidates for PA.

Methods

Second morning spot urine was collected from healthy controls (n = 8) and PA patients (n = 7). The uEVs were isolated by ultracentrifugation and characterized. Proteomic analysis on uEVs was performed using LC-MS Orbitrap.

Results

Isolated uEVs carried extracellular vesicle markers, showed a round shape and sizes between 50 and 150 nm. The concentration of uEVs showed a direct correlation with urinary creatinine (r = 0.6357; P = 0.0128). The uEV size mean (167 ± 6 vs 183 ± 4nm) and mode (137 ± 7 vs 171 ± 11nm) was significantly smaller in PA patients than in control subjects, but similar in concentration. Proteomic analysis of uEVs from PA patients identified an upregulation of alpha-1-acid glycoprotein 1 (AGP1) in PA uEVs, which was confirmed using immunoblot. A receiver operating characteristic curve analysis showed an area under the curve of 0.92 (0.82 to 1; P = 0.0055).

Conclusion

Proteomic and further immunoblot analyses of uEVs highlights AGP1 as potential biomarker for PA.