bluuebunny/crossref_metadata_2025 huggingface dataset:
Mismatched expectations of internationalisation: Lived experiences of Chinese returnee academics in an international joint university
Authors: Zhang Bowen , Mittelmeier Jenna , Lomer Sylvie , Lim Miguel
Published: November 2022

This study examines the lived experiences of Chinese academic returnee staff working in a joint venture university in China. Through in-depth interviews with 11 Chinese returnees, we explore their expectations and experiences working in an internationalised university environment following an international degree overseas. Using Bourdieu’s concepts of field and habitus as an analytic lens, the findings identify the ways that returnees imagine or expect internationalised habitus and field in the unique design of joint venture universities. Yet, through participant reflection on policies towards 100% English Medium Instruction (EMI) and internationalised curricula, we identified experienced tensions between the institution’s aim to internationalise the campus and its perceived effectiveness in implementation. Many returnees spoke of Sino-foreign institutions as a substitute for the field of Western academia, and reported challenges with implementing EMI policies that caused them to rely more on their Chinese than their international experiences which ran counter to their expectations. This analysis adds nuances to the inter-relationship between field and habitus by analysing the reasons for mismatched expectations and the way individuals engage with their own habitus in response. This article concludes by outlining implications for transnational higher education in China and other host countries.
The Formation Mechanism of Electrospun Beaded Fibers: Experiment and Simulation Study
Authors: Ge Cheng , Zheng Yuansheng , Liu Kai , Xin Binjie , Li Masha , All Amin Newton MD.
Published: November 2022

This research examined the influence of solution concentration on Taylor cone morphology, jet behavior, fiber surface morphology, and the impact of spinning voltage on the microbead shape of the beaded fiber. The straight jet length, envelope cone, whipping frequency of the electrospun jet, and Taylor cone morphology were studied using the images captured by a high-speed photography camera. According to the findings, higher solution concentrations result in longer straight jet lengths, smaller envelope cones, and lower whipping frequencies. Scanning electron microscopy was used to ascertain the diameter and surface morphology of polystyrene fibers, revealing that fibers spun with higher solution concentrations had larger diameters. In contrast, low concentration solutions receive more electric field forces due to higher conductivity. The jet tends to break, and fibers with the beads-on-a-string morphology form. Furthermore, the influence of voltage on microbead shape has been further examined using the simulation software COMSOL. As the spinning voltage increases, the jet’s stretching impact is more prominent, and the bead shape gradually changes from nearly circular to spindle-shaped.
An Investigation into Design of Blood Pressure Cuffs Using the Tekscan Pressure Sensing System
Authors: Naqvi Shenela , Amir Muhammad , Naeem Farhana , Dias Tilak , Lewis Philip S.
Published: November 2022

Cuff design is the most important aspect to work on for the accurate measurement of blood pressure. For the very first time, pressure distribution underneath different parts/components of the fabric cuffs was analysed in detail using an advanced interface pressure sensing system. The pressure distribution at the interface of the selected cuffs and an arm simulator were measured experimentally while simulating blood pressure measurement. Fabrics are the main cuff constructing material and a relationship was found between cuff fabric properties and pressure at the interface of the cuff and the arm simulator. It was also found that the pressure distribution under different parts of the same cuff varied due to the uneven contact of the cuff fabric with the arm simulator. Components attached to cuff fabric which facilitate blood pressure measurement either confine or drive fabric according to their size and placement; they may cause non-uniform interface pressure distribution on the human arm too. It was also examined whether the selected cuffs were applying higher or lower average pressure over the surface of the simulator and the range varied from 8 mmHg to 25 mmHg. This indicates that the subsequent pressure distribution inside the arm tissues and over an artery would also vary further due to the cuffs being of different designs. This study found that cuffs would be unable to transfer the required pressure over the artery to block blood flow as and when needed.
Factors Influencing Postoperative Residual Diastasis after the Operative Treatment of Acute Lisfranc Fracture-Dislocation
Authors: Choi Jun Young , Suh Jin Soo
Published: November 2022

Category:

Trauma; Midfoot/Forefoot

Introduction/Purpose:

Clinically, surgeons may frequently encounter residual diastasis between the medial cuneiform and 2nd metatarsal base after the operative treatment of acute Lisfranc fracture-dislocations. The purpose of this study was to identify factors influencing postoperative residual diastasis. We specifically focused on the preoperative fracture pattern using 3- dimensional computed tomography (3D-CT).

Methods:

Radiographic and clinical findings of 66 patients who underwent operative treatment for acute Lisfranc fracture- dislocation were reviewed. Patients were grouped according to residual diastasis evaluated by weight-bearing anteroposterior radiograph of the foot at the final follow-up. Residual diastasis was defined as distance between the medial cuneiform and 2nd metatarsal base greater than the distance on the contralateral side by 2 mm or more. Demographic parameters and fracture patterns based on preoperative foot 3D-CT were compared. A paired t-test was used to compare continuous numeric parameters, while a chi-square test was used for the proportional parameters. Statistical significance was set at P-value less than 0.05 for all analyses.

Results:

The mean age at operation, sex, body mass index, and the rate of underlying diabetes were not significantly different between the two groups (P>0.05 each). Preoperative foot 3D-CT evaluation showed that the rate of large (>25% of 2nd tarsometatarsal joint involvement), displaced (>2 mm) fracture fragments on the plantar side of the 2nd metatarsal base was more pronounced in the group with residual diastasis (P=0.001), while medial wall avulsion of the 2nd metatarsal base was more frequent in the group without residual diastasis (P=0.001).

Conclusion:

While treating acute Lisfranc injuries, surgeons should be aware of the presence of a 2nd metatarsal base plantar fracture. A dorsoplantar inter-fragmentary fixation can be considered if the fragment is large and displaced.
Probabilistic approach for seismic microzonation integrating 3D geological and geotechnical uncertainty
Authors: Salsabili Mohammad , Saeidi Ali , Rouleau Alain , Nastev Miroslav
Published: November 2022

A novel probabilistic methodology for regional seismic site characterization is proposed and applied to a region with highly heterogeneous surficial geology and varying soil sediment thickness and stiffness. The method combines various sources of geological and geotechnical uncertainties to develop a three-dimensional (3D) shear-wave velocity ( Vs) model and evaluate the associated uncertainties. A 3D geological model of the unconsolidated deposits was developed using geostatistical interpolation and simulation methods. Sequential indicator simulations produced a quantitative geologic model that explicitly quantified geological uncertainties based on the likelihood of specific soil types occurring. In situ measurements and multivariate statistical analysis allowed the development of empirical correlations between Vs, geotechnical parameters, depth, and soil types. The resulting 3D Vs values were estimated on the basis of Vs-depth correlations and the probability of occurrence of each soil type. In this approach, the propagated uncertainty was also quantified by considering the combined variance. Seismic microzonation mapping was then conducted by transforming the 3D Vs model into two-dimensional (2D) maps that represent the spatial distributions of the time-averaged shear-wave velocity of the top 30 m ( Vs,30) and the fundamental site period ( T0), along with their respective uncertainties using Monte Carlo simulations. The results indicate that microzonation maps and their uncertainties are influenced by the thickness, occurrence probability, and geotechnical properties of soils. The proposed method can be used to assess the probabilistic seismic risk at local and regional scales in areas with geologically and geotechnically complex soil properties.
Premonitory symptoms in migraine: a systematic review and meta-analysis of observational studies reporting prevalence or relative frequency
Authors: Eigenbrodt Anna K. , Christensen Rune Häckert , Ashina Håkan , Iljazi Afrim , Christensen Casper Emil , Steiner Timothy J. , Lipton Richard B. , Ashina Messoud
Published: November 2022

Background

Observational studies on the prevalence of premonitory symptoms in people with migraine, preceding the headache pain (or aura) phase, have shown conflicting results. We conducted a systematic review and meta-analysis to estimate the prevalence, and relative frequency among clinic populations, of premonitory symptoms in people with migraine, overall and of the multifarious individual symptoms, and to review the methodologies used to assess them.

Methods

We searched PubMed and Embase for studies published from database inception until 31st of May 2022. Two investigators independently screened titles, abstracts, and full texts. We retrieved observational studies that reported the prevalence/relative frequency of one or more premonitory symptoms in people with migraine. Two investigators independently extracted data and assessed risk of bias. Results were pooled using random-effects meta-analysis. Our main outcomes were the percentage of people with migraine who experienced at least one premonitory symptom and the percentages who experienced different individual premonitory symptoms. To describe our outcomes, we used the terms prevalence for data from population-based samples and relative frequency for data from clinic-based samples. We also descriptively and critically assessed the methodologies used to assess these symptoms.

Results

The pooled estimated prevalence in population-based studies of at least one premonitory symptom was 29% (95% CI: 8–63; I2 99%) and the corresponding pooled estimated relative frequency in clinic-based studies was 66% (95% CI: 45–82; I2 99%). The data from clinic-based studies only supported meta-analysis of 11 of 96 individual symptoms, with relative frequency estimates ranging from 11 to 49%. Risk of bias was determined as high in 20 studies, moderate in seven, and low in two.

Conclusions

The substantial between-study heterogeneity demands cautious interpretation of our estimates. Studies showed wide methodological variations, and many lacked rigor. Overall, the evidence was insufficient to support reliable prevalence estimation or characterization of premonitory symptoms. More data are needed, of better quality, to confirm the existence of a distinctive premonitory phase of migraine, and its features. Methodological guidelines based on expert consensus are a prerequisite.
Improving safety and communication for healthcare providers caring for SARS-COV-2 patients
Authors: Taher Ahmed , Glazer Peter , Culligan Chris , Crump Stephanie , Guirguis Steven , Jones Jennifer , Dharamsi Alia , Chartier Lucas B.
Published: November 2022

Background

Decreasing healthcare provider (HCP) exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) virus in emergency departments (EDs) is crucial. Approaches include limiting the HCP presence and ensuring sealed isolation rooms, which can result in communication difficulties. This quality improvement (QI) initiative aimed to decrease by 50% duration of isolation room door opening and increasing HCP-perceived communication clarity by one point on a five-point Likert scale.

Methods

This was a prospective, multi-stage project with three Plan-Do-Study-Act (PDSA) cycles between May and July 2020: (1) an educational intervention, (2) the introduction of a novel transceiver communication device, and (3) utilizing a clinical champion. Statistical Process Control XbarR charts were used to assess for special cause variation, and two-tailed Mann-Whitney U tests were used for statistical significance between Likert survey means. Qualitative responses underwent thematic analysis.

Results

Observation of 174 patient encounters was completed over 33 days, with 95 meeting the inclusion criteria. Door opening decreased from baseline (n=40; mean 72.97%) to PDSA 3 (n=21; mean 1.58%; p<0.0001). HCP-perceived communication clarity improved from baseline (n=36; mean 3.36) to PDSA-3 (n=49; mean 4.21; p<0.001). Survey themes included positive effects on communication and workflow, with some challenges on the integration of the new device into the clinical workflow. HCP-perceived errors, workarounds, and workflow pauses showed significant improvements.

Conclusion

This QI initiative with a novel transceiver showed significant decreases in isolation room door opening and increases in communication clarity. Future work will expand to operating rooms and intensive care units.
Nanoparticles for MRI-guided radiation therapy: a review
Authors: Smith Leon , Byrne Hilary L. , Waddington David , Kuncic Zdenka
Published: November 2022

The development of nanoparticle agents for MRI-guided radiotherapy is growing at an increasing pace, with clinical trials now underway and many pre-clinical evaluation studies ongoing. Gadolinium and iron-oxide-based nanoparticles remain the most clinically advanced nanoparticles to date, although several promising candidates are currently under varying stages of development. Goals of current and future generation nanoparticle-based contrast agents for MRI-guided radiotherapy include achieving positive signal contrast on T1-weighted MRI scans, local radiation enhancement at clinically relevant concentrations and, where applicable, avoidance of uptake by the reticuloendothelial system. Exploiting the enhanced permeability and retention effect or the use of active targeting ligands on nanoparticle surfaces is utilised to promote tumour uptake. This review outlines the current status of promising nanoparticle agents for MRI-guided radiation therapy, including several platforms currently undergoing clinical evaluation or at various stages of the pre-clinical development process. Challenges facing nanoparticle agents and possible avenues for current and future development are discussed.
New insights into fibrous cap thickness of vulnerable plaques assessed by optical coherence tomography
Authors: Liu Xianglan , He Wujian , Hong Xulin , Li Duanbin , Chen Zhezhe , Wang Yao , Chen Zhaoyang , Luan Yi , Zhang Wenbin
Published: November 2022

Objective

Vulnerable plaques with fibrous cap thickness (FCT) of ≤65 μm are prone to rupture and/or thrombosis. However, plaques with FCT > 65 μm cause acute myocardial infarction and even sudden death. We aimed to investigate the relationship between 65 < FCT ≤ 80 μm and plaque rupture and/or thrombosis using optical coherence tomography (OCT).

Methods

OCT was performed on culprit lesions in 502 consecutively enrolled patients to identify FCT. Patients were classified into three groups according to FCT: Group A (FCT ≤ 65 μm, n = 147), Group B (65 < FCT ≤ 80 μm, n = 84) and Group C (FCT > 80 μm, n = 271). Clinical and laboratory data was collected from the inpatient medical record system.

Results

Plaques with thinner FCT, especially < 65 μm, were more susceptible to rupture and/or thrombosis (P < 0.001). Plaques with FCT between 65 and 80 μm had a higher probability of rupture and/or thrombosis than those with FCT > 80 μm (P < 0.001). In multivariable analysis, FCT ≤ 65 μm and 65 < FCT ≤ 80 μm were independent predictors for plaque rupture ([FCT ≤ 65 μm vs. FCT > 80 μm]: OR = 8.082, 95% CI = 4.861 to 13.435, P < 0.001; [65 < FCT ≤ 80 μm vs. FCT > 80 μm]: OR = 2.463, 95% CI = 1.370 to 4.430, P = 0.003), thrombosis ([FCT ≤ 65 μm vs. FCT > 80 μm]: OR = 25.224, 95% CI = 13.768 to 46.212, P < 0.001; [65 < FCT ≤ 80 μm vs. FCT > 80 μm]: OR = 3.675, 95% CI = 2.065 to 6.542, P < 0.001) and plaque rupture with thrombosis ([FCT ≤ 65 μm vs. FCT > 80 μm]: OR = 22.593, 95% CI = 11.426 to 44.674, P < 0.001; [65 < FCT ≤ 80 μm vs. FCT > 80 μm]: OR = 4.143, 95% CI = 1.869 to 9.184, P < 0.001).

Conclusions

OCT-assessed 65 < FCT ≤ 80 μm was independently associated with increased risk of plaque rupture and/or thrombosis compared with FCT > 80 μm.
Atrial septal defect with a rare occupying lesion in heart
Authors: Chen Jinlan , Gong Xueyang , Xie Li , Wu Qin , Zhao Tianli , Hu Shijun
Published: November 2022

Background

Cardiac epicardium hemangiomas are exceedingly rare; however, they can cause significant hemodynamic impairment and large pericardial effusions. On rare occasion, cardiac tumors coexist with malformations of the heart.

Case presentation

We present the case of a 10-month-old female infant with a rare cardiac surface hemangioma coexisting with malformations of the heart. It revealed an atrial septal defect (ASD) coexisting with an abnormal occupying lesion with high echogenicity. It was 35*12*9 mm in size and was found in the anterior atrioventricular junction to the posterior atrioventricular junction at the bottom of the ventricular septum by transthoracic echocardiography. We performed surgical treatment of the atrial septal defect and performed biopsy with the occupying lesion. The histopathological examination reported a benign tumor as hemangioma. As far as we know, this is the first case in which cardiac surface hemangioma was found to coexist with an atrial septal defect.

Conclusions

Cardiac epicardium hemangiomas is a rare solid tumor of the heart. If the mass is impossible to resect and does not cause hemodynamic impairment, only mass biopsy is possible.
Congenital coronary artery-left ventricular multiple micro-fistulas and hypertrophic cardiomyopathy: a case report and literature review
Authors: Liu Yue , Wang Zhiyuan , Zeng Hong , Yang Sibao , Li Xiangdong
Published: November 2022

Background

Coronary artery-left ventricular multiple micro-fistulas (CA-LVMMFs) is a rare congenital vascular anomaly that may present with no obvious clinical symptoms or a typical angina attack. CA-LVMMFs is usually found unexpectedly during coronary angiography (CAG).

Case presentation

We report a case of a 65-year-old man admitted to the hospital with acute coronary syndrome. CA-LVMMFs was found during coronary angiography. Echocardiography showed apical hypertrophy and blood flow signals were seen in the apical myocardium, connected with the left ventricle. We searched the MEDLINE database and found 39 relevant reports. We made statistics on the clinical characteristics of these patients and found half involved hypertrophy or perfusion defects in the ventricular septum or apex.

Conclusion

As a rare congenital anomaly, the effect of CA-LVMMFs on patients is unclear. By reporting a case and summarizing literature reports, we found that CA-LVMMFs may be associated with myocardial hypertrophy, especially ventricular septal and apical hypertrophy.
Predicting hypoglycemia after treatment of hyperkalemia with insulin and glucose (Glu-K60 score)
Authors: Kijprasert Weerapriya , Tarudeeyathaworn Nilanut , Loketkrawee Chananthita , Pimpaporn Thidarat , Pattarasettaseranee Pornpiyapat , Tangsuwanaruk Theerapon
Published: November 2022

Background

Hyperkalemia can lead to fatal cardiac arrhythmias. Ten units of intravenous (IV) regular insulin with 25 g of glucose is the mainstay for treating hyperkalemia. However, the most important complication of this treatment is hypoglycemia. We aimed to develop a scoring model to predict hypoglycemia after the treatment of hyperkalemia.

Methods

A retrospective study was conducted at a university-based hospital between January 2013 and June 2021. We included the hyperkalemic patients (> 5.3 mmol/L) who were ≥ 18 years old and treated with 10 units of IV regular insulin with 25 g of glucose. Incomplete data on posttreatment blood glucose, pregnancy, and diabetes mellitus were excluded. Endpoint was posttreatment hypoglycemia (≤ 70 mg/dL or ≤ 3.9 mmol/L). Multivariable logistic regression was used to establish a full model and a subsequently reduced model using the backward elimination method. We demonstrated the model performance using the area under the receiver operating characteristic curve (AuROC), calibration plot, and Hosmer–Lemeshow goodness-of-fit test. Internal validation was done with a bootstrap sampling procedure with 1000 replicates. Model optimism was estimated.

Results

Three hundred and eighty-five patients were included, with 97 posttreatment hypoglycemia (25.2%). The predictive model comprised the following three criteria: age > 60 years old, pretreatment blood glucose ≤ 100 mg/dL (≤ 5.6 mmol/L), and pretreatment potassium > 6 mmol/L. The AuROC of this model was 0.671 (95% confidence interval [CI] 0.608 to 0.735). The calibration plot demonstrated consistency with the original data. Hosmer–Lemeshow goodness-of-fit test showed no evidence of lack-of-fit (p 0.792); therefore, the model was also fit to the original data. Internal validation via bootstrap sampling showed a consistent AuROC of 0.670 (95% CI 0.660 to 0.670) with minimal model optimism. A high risk for posttreatment hypoglycemia was indicated if the patient met at least one of those criteria. Sensitivity and specificity were 95.9% and 14.9%, respectively.

Conclusion

High risk was indicated when at least one of the criteria was met: age > 60 years old, pretreatment blood glucose ≤ 100 mg/dL (≤ 5.6 mmol/L), and pretreatment potassium > 6 mmol/L. Blood glucose levels should frequently check in the high-risk group.

Trial registration

TCTR20210225002 (www.thaiclinicaltrials.org).
Characteristics and general practice resource use of people with comorbid cancer and dementia in England: a retrospective cross-sectional study
Authors: Collinson Michelle , Mason Ellen , Kelley Rachael , Griffiths Alys , Ashley Laura , Henry Ann , Inman Hayley , Cowdell Fiona , Hennell June , Jones Liz , Walsh Maria , Ogden Margaret , Farrin Amanda , Surr Claire
Published: November 2022

Background

Cancer and dementia are common in older people and management of the conditions as comorbidities can be challenging, yet little is known about the size or characteristics of this group. We aimed to estimate the prevalence, characteristics and general practice resource usage of people living with both conditions in England.

Methods

Anonymised electronic healthcare records from 391 National Health Service general practices across England using the TPP SystmOne general practice system were obtained from ResearchOne. Data included demographic and clinical characteristics, and general practice healthcare useage (appointments, prescriptions, referrals and secondary care contacts) for people aged 50 and over with a cancer and/or dementia diagnosis consistent with the Quality and Outcomes Framework between 2005 and 2016. Multi-level negative binomial regression was used to analyse the association between having cancer and/or dementia and the number of general practice appointments.

Results

Data from 162,371 people with cancer and/or dementia were analysed; 3616 (2.2%) people were identified as having comorbid cancer and dementia. Of people with cancer, 3.1% also had dementia, rising to 7.5% (1 in 13 people) in those aged 75 and over. Fewer people with both conditions were female (50.7%) compared to those with dementia alone (65.6%) and those with comorbid cancer and dementia were older than those with cancer alone [mean ages 83 (sd = 7), 69 (sd = 12) respectively]. Those with both conditions were less likely to have lung cancer than those with cancer alone (7.5% vs. 10.3%) but more likely to have prostate cancer (20.9% vs. 15.8%). Additional comorbidities were more prevalent for those with both conditions than those with cancer or dementia alone (68.4% vs. 50.2% vs. 54.0%). In the year following the first record of either condition, people with cancer and dementia had 9% more general practice appointments (IRR:1.09, 95% CI:1.01–1.17) than those with cancer alone and 37% more appointments than those with dementia alone (IRR: 1.37, 95% CI: 1.28–1.47).

Conclusions

A significant number of people are living with comorbid cancer and dementia in England. This group have additional comorbidity and higher general practice usage than those with cancer/dementia alone. The needs of this group should be considered in future general practice care planning and research.
Abusive episodes among home-dwelling persons with dementia and their informal caregivers: a cross-sectional Norwegian study
Authors: Steinsheim Gunn , Saga Susan , Olsen Bonnie , Broen Helene Kjeka , Malmedal Wenche
Published: November 2022

Background

Elder abuse is a serious issue with a global prevalence of 15.7% in the community setting. Persons with dementia are at higher risk of elder abuse than the older population in general. With a high and increasing prevalence of dementia this issue cannot be neglected. Hence, the aims of this study were 1) to describe the proportion of abusive episodes among home-dwelling persons with dementia and their informal caregivers, and 2) to explore differences between informal caregivers who have reported committing and not committing abusive acts.

Methods

A cross-sectional survey was conducted among informal caregivers of home-dwelling persons with dementia in Norway from May to December 2021 with a total of 549 participants.

Results

Two-thirds of informal caregivers had committed at least one abusive episode toward the person with dementia in the past year (63.5% psychological abuse, 9.4% physical abuse, 3.9% financial abuse, 2.4% sexual abuse, 6.5% neglect). One-third of informal caregivers had experienced aggression from the person with dementia (33.9% psychological abuse, 7.8% physical abuse, 1.1% financial abuse, 1.4% sexual abuse). Tests for independence showed that the risk of abusive episodes from informal caregivers toward persons with dementia was higher when the informal caregiver was a spouse/partner of the person with dementia and if they experienced aggression from the person with dementia.

Conclusions

The results demonstrate that a majority of informal caregivers commit some form of abusive episodes, and episodes that fall within the scope of psychological abuse are most frequent. This study expands knowledge about elder abuse among home-dwelling persons with dementia. Increased understanding of the dynamics of abuse is essential to be able to reduce risk and prevent abuse.
Quantitative assessment of the effects of massive nucleic acid testing in controlling a COVID-19 outbreak
Authors: Zhu Wenlong , Zhu Yue , Wen Zexuan , Zheng Bo , Xu Ao , Yao Ye , Wang Weibing
Published: November 2022

Background

From 20 July to 26 August 2021, local outbreaks of COVID-19 occurred in Nanjing City and Yangzhou City (Jiangsu Province, China). We analyzed the characteristics of these outbreaks in an effort to develop specific and effective intervention strategies.

Methods

Publicly available data on the characteristics of the COVID-19 outbreaks in Jiangsu Province were collected. Logistic regression was used to assess the association of age and sex with clinical severity. Analysis of onset dates, generation time distributions, and locations were used to estimate the mean transmission distance. A branching process model was used to evaluate different management strategies.

Results

From 20 July to 26 August 2021, 820 patients were diagnosed with COVID-19 in Jiangsu Province, with 235 patients (28.7%) from Nanjing, 570 (69.5%) from Yangzhou, and 15 (1.8%) from other cities. Overall, 57.9% of the patients were female, 13.7% were under 20 years-old, and 58.3% had moderate disease status. The mean transmission distance was 4.12 km, and closed-loop management of the area within 2.23 km of cases seemed sufficient to control an outbreak. The model predicted that the cumulative cases in Yangzhou would increase from 311 to 642 if the interval between rounds of nucleic acid amplification testing (NAAT) increased from 1 to 6 days. It also predicted there would be 44.7% more patients if the NAAT started 10 days (rather than 0 days) after diagnosis of the first case. The proportion of cases detected by NAAT would increase from 11.16 to 44.12% when the rounds of NAAT increased from 1 to 7 within 17 days. When the effective vaccine coverage was 50%, the outbreak would be controlled even when using the most relaxed non-pharmaceutical interventions.

Conclusions

The model predicted that a timely closed-loop management of a 2.23 km area around positive COVID-19 cases was sufficient to control the outbreak. Prompt serial NAAT is likely to contain an outbreak quickly, and our model results indicated that three rounds of NAAT sufficiently controlled local transmission.

Trial registration We did not involve clinical trial.
Seroprevalence of SARS-CoV-2 antibodies among children and adolescents recruited in a malariometric survey in north-eastern Tanzania July 2021
Authors: Lyimo Eric , Fougeroux Cyrielle , Malabeja Anangisye , Mbwana Joyce , Hayuma Paul M. , Liheluka Edwin , Turner Louise , Gesase Samwel , Lavstsen Thomas , Lusingu John P. A. , Minja Daniel T. R. , Wang Christian W.
Published: November 2022

Background

African countries stand out globally as the region seemingly least affected by the COVID-19 pandemic, caused by the virus SARS-CoV-2. Besides a younger population and potential pre-existing immunity to a SARS-CoV-2-like virus, it has been hypothesized that co-infection or recent history of Plasmodium falciparum malaria may be protective of COVID-19 severity and mortality. The number of COVID-19 cases and deaths, however, may be vastly undercounted. Very little is known about the extent to which the Tanzanian population has been exposed to SARS-CoV-2. Here, we investigated the seroprevalence of IgG to SARS-CoV-2 spike protein in two Tanzanian rural communities 1½ years into the pandemic and the association of coinciding malaria infection and exposure.

Methods

During a malariometric survey in July 2021 in two villages in north-eastern Tanzania, blood samples were taken from 501 participants (0–19 years old). Malaria was detected by mRDT and microscopy. Levels of IgG against the spike protein of SARS-CoV-2 were measured by ELISA as well as IgG against five different antigens of P. falciparum; CIDRα1.1, CIDRα1.4 and CIDRα1.5 of PfEMP1 and GLURP and MSP3.

Results

The seroprevalence of SARS-CoV-2 IgG was 39.7% (106/267) in Kwamasimba and 32.5% (76/234) in Mkokola. In both villages the odds of being seropositive increased significantly with age (AOR = 1.12, 95% CI 1.07–1.17, p < 0.001). P. falciparum malaria prevalence by blood smear microscopy was 7.9% in Kwamasimba and 2.1% in Mkokola. 81.3% and 70.5% in Kwamasimba and Mkokola, respectively, showed recognition of minimum one malaria antigen. Residing in Kwamasimba was associated with a broader recognition (AOR = 1.91, 95% CI 1.34–2.71, p < 0.001). The recognition of malaria antigens increased significantly with age in both villages (AOR = 1.12; 95% CI 1.08–1.16, p < 0.001). Being SARS-CoV-2 seropositive did not associate with the breadth of malaria antigen recognition when adjusting for age (AOR = 0.99; 95% CI 0.83–1.18; p = 0.91).

Conclusion

More than a third of the children and adolescents in two rural communities in Tanzania had antibodies to SARS-CoV-2. In particular, the adolescents were seropositive but being seropositive did not associate with the status of coinciding malaria infections or previous exposure. In Tanzania, natural immunity may have developed fast, potentially protecting a substantial part of the population from later variants.
Epidemiologic features, clinical characteristics, and predictors of mortality in patients with candidemia in Alameda County, California; a 2017–2020 retrospective analysis
Authors: Meyahnwi Didien , Siraw Bekure B. , Reingold Arthur
Published: November 2022

Background

Bloodstream infections caused by Candida species are responsible for significant morbidity and mortality worldwide, with an ever-changing epidemiology. We conducted this study to assess trends in the epidemiologic features, risk factors and Candida species distribution in candidemia patients in Alameda County, California.

Methods

We analyzed data collected from patients in Alameda County, California between 2017 and 2020 as part of the California Emerging Infections Program (CEIP). This is a laboratory-based, active surveillance program for candidemia. In our study, we included incident cases only.

Results

During the 4-year period from January 1st, 2017, to December 31st, 2020, 392 incident cases of candidemia were identified. The mean crude annual cumulative incidence was 5.9 cases per 100,000 inhabitants (range 5.0–6.5 cases per 100,000 population). Candida glabrata was the most common Candida species and was present as the only Candida species in 149 cases (38.0%), followed by Candida albicans, 130 (33.2%). Mixed Candida species were present in 13 patients (3.3%). Most of the cases of candidemia occurred in individuals with one or more underlying conditions. Multivariate regression models showed that age ≥ 65 years (RR 1.66, CI 1.28–2.14), prior administration of systemic antibiotic therapy, (RR 1.84, CI 1.06–3.17), cirrhosis of the liver, (RR 2.01, CI 1.51–2.68), and prior admission to the ICU (RR1.82, CI 1.36–2.43) were significant predictors of mortality.

Conclusions

Non-albicans Candida species currently account for the majority of candidemia cases in Alameda County.
MSmonitor-plus program and video calling care (MPVC) for multidisciplinary care and self-management in multiple sclerosis: study protocol of a single-center randomized, parallel-group, open label, non-inferiority trial
Authors: Hoving M. , Jongen P. J. , Evers S. M. A. A. , Edens M. A. , Zeinstra E. M. P. E.
Published: November 2022

Background

We designed a new multi-modal version of the MSmonitor, called the MSmonitor-Plus and Video calling Care (MPVC), a self-management and education program with e-health interventions that combines frequent use of specific questionnaires with video calling in treating multiple sclerosis (MS) patients.

Objective

To assess the effectiveness, cost-effectiveness and feasibility of MPVC compared to care as usual (CAU), with the goal of achieving equal or better quality of life for MS patients and their partners/informal caregivers.

Our hypothesis is that by using MPVC, monitoring will become more efficient, that patients’ self-efficacy, quality of life, and adherence to treatment will improve, and that they will be able to live their lives more autonomously.

Methods

A randomized, parallel-group, open label, non-inferiority trial will be conducted to compare MPVC with CAU in MS patients and their partners/informal caregivers. A total of 208 patients will be included with follow-up measurements for 2 years (at baseline and every 3 months). One hundred four patients will be randomized to MPVC and 104 patients to CAU. Partners/informal caregivers of both groups will be asked to participate.

The study will consist of three parts: 1) a clinical effectiveness study, 2) an economic evaluation, and 3) a process evaluation. The primary outcome relates to equal or improved disease-specific physical and mental quality of life of the MS patients. Secondary outcomes relate to self-efficacy, efficiency, cost-effectiveness, autonomy, satisfaction with the care provided, and quality of life of partners/informal caregivers.

Discussion

The idea behind using MPVC is that MS patients will gain more insight into the individual course of the disease and get a better grip on their symptoms. This knowledge should increase their autonomy, give patients more control of their condition and enable them to better and proactively interact with health care professionals.

As the consulting process becomes more efficient with the use of MPVC, MS-related problems could be detected earlier, enabling earlier multidisciplinary care, treatment or modification of the treatment. This could have a positive effect on the quality of life for both the MS patient and his/her partner/informal caregiver, reducing health and social costs.

Trial registration

NCT05242731 Clinical Trials.gov. Date of registration: 16 February 2022 retrospectively registered.
Effect of internet-based cognitive behaviour therapy among women with negative birth experiences on mental health and quality of life - a randomized controlled trial
Authors: Sjömark Josefin , Svanberg Agneta Skoog , Larsson Margareta , Viirman Frida , Poromaa Inger Sundström , Skalkidou Alkistis , Jonsson Maria , Parling Thomas
Published: November 2022

Background

Giving birth is often a positive experience, but 7–44% have negative experiences and about 4% develop posttraumatic stress disorder following childbirth (PTSD FC). This randomized controlled trial (RCT) investigated the effect of internet-based cognitive behaviour therapy (iCBT) for women with negative birth experiences and/or at risk for PTSD FC.

Methods

This was a superiority nonblinded multicentre RCT comparing iCBT combined with treatment as usual (TAU) with TAU only. Data were collected through questionnaires at baseline, at 6 weeks, 14 weeks and 1 year after randomization. The RCT was conducted at four delivery clinics in Sweden and participants were recruited from September 2013 until March 2018. Women who rated their childbirth experience as negative on a Likert scale, and/or had an immediate caesarean section or a haemorrhage of > 2000 ml were eligible. Primary outcomes were symptoms of posttraumatic stress (Traumatic Event Scale, TES) and symptoms of depression (Edinburgh Postnatal Depression Scale, EPDS). Secondary outcomes were satisfaction with life (Satisfaction With Life Scale, SWLS) and coping (Ways of Coping Questionnaire, WCQ).

Results

Out of 1810 eligible women, 266 women were randomised to iCBT+TAU (n = 132) or to TAU (n = 134). In the iCBT+TAU group 59 (45%) completed the treatment. ICBT+TAU did not reduce PTSD FC at 6 weeks, at 14 weeks, or at 1 year follow-up compared with TAU, according to the TES. Both the ITT and completer analyses showed significant time and quadratic time effects due to reduction of symptoms in both groups on the TES (re-experience subscale) and on the EPDS, and significant time effect on the self-controlling subscale of the WCQ (which increased over time). There was also a significant main effect of group on the SWLS where the TAU group showed higher initial satisfaction with life. Exploratory subgroup analyses (negative birth experience, immediate caesarean section, or severe haemorrhage) showed significant time effects among participants with negative birth experience on re-experience, arousal symptoms and depressive symptoms.

Conclusions

The ICBT intervention did not show superiority as both groups showed similar beneficial trajectories on several outcomes up to 1 year follow-up. This intervention for women with negative birth experiences and/or at risk for PTSD FC was feasible; however, the study suffered from significant drop out rate. Future studies with more narrow inclusion criteria and possibly a modified intervention are warranted.

Trial registration

ISRCTN39318241. Date for registration 12/01/2017.
Integrated analysis identified prognostic microRNAs in breast cancer
Authors: Shang Cong , Chen Qingyan , Zu Fuqiang , Ren Weidong
Published: November 2022

Background

MicroRNAs (miRNAs) play pivotal roles in the development and progression of breast cancer (BC). In this study, we attempted to identify miRNAs associated with BC prognosis and progression via integrated analysis.

Methods

We first screened 83 differentially expressed miRNAs (DEMs) in 1249 BC samples and 151 normal samples. We then validated their roles in expression and prognosis of BC, identified two survival-related DEMs, and established a risk model. The prediction efficiency was assessed in both the training and validation groups. Tissue and cell experiments were conducted to verify the regulatory effects of miR-127 in BC.

Results

The ROC curve indicated good prediction ability with 1-, 3-, and 5-year survival rates of 0.73, 0.72, and 0.72, respectively. Moreover, hsa-miR-127 was found to be an independent prognostic factor of BC. Functional analyses revealed that it is involved in various cancer pathways such as the PI3K-Akt and p53 pathways. miR-127 expression was down-regulated in both BC tissues and cell lines. The knockdown of miR-127 substantially increased, whereas overexpression decreased BC cell proliferation, invasion, and migration. This effect of miR-127 was consistent with its tumorigenic ability and tumor volume in nude mice.

Conclusions

These findings indicate that low expression of miR-127 contributes to BC migration, invasion, and tumorigenesis and that it can be a therapeutic target and prognostic biomarker for BC.
Programmed death ligand 1 and tumor-infiltrating CD8+ T lymphocytes are associated with the clinical features in meningioma
Authors: Zhang Yaochuan , Wang Xiaoliang , Shi Mengwu , Song Yifu , Yu Juanhan , Han Sheng
Published: November 2022

Objective

To investigate the expression of programmed death ligand-1 (PD-L1) and the levels of CD8+ tumor-infiltrating lymphocytes (TILs) in meningioma as well as determine the association between their levels and the clinical outcomes.

Methods

We performed a retrospective case-control study on 93 patients with meningioma. The patients showed tumor recurrence and were matched with the control patients without recurrence in their age, gender, admission time, tumor sites, tumor volume, peritumoral brain edema (PTBE), Simpson grade resection, WHO grade, postoperative radiotherapy, and the follow-up duration. We reviewed the clinical data of patients and performed immunohistochemistry analysis to investigate the PD-L1 expression and the levels of CD8+ TILs. Multivariate logistic regression was performed to analyze the association between clinical features and immune markers. The conditional logistic regression models were used to calculate the odds ratios (ORs) with 95% confidence intervals (CIs), and Kaplan–Meier analysis was performed to analyze tumor recurrence.

Results

Tumor volume was correlated with the PD-L1 expression (P = 0.003, HR = 5.288, 95%CI, 1.786–15.651). PTBE served as an independent predictor of CD8+ TIL levels (P = 0.001, HR = 0.176, 95%CI 0.065–0.477). The levels of CD8+ TILs were associated with tumor recurrence (P = 0.020, OR = 0.325, 95%CI, 0.125–0.840).

Conclusion

Tumor volume was associated with PD-L1 expression, and PTBE was an independent predictor of CD8+ TIL levels in meningioma. CD8+ TIL levels correlated with tumor recurrence in meningioma.
A high serum dehydroepiandrosterone concentration is a predictor of candidates for active surveillance in men with serum prostate-specific antigen < 10 ng/mL
Authors: Miyoshi Yasuhide , Kawahara Takashi , Uemura Hiroji
Published: November 2022

Background

There is no consensus on the role of serum dehydroepiandrosterone (DHEA) concentrations in the detection of prostate cancer. This study examined the effectiveness of serum DHEA in predicting candidate patients for active surveillance (AS) prior to prostate biopsy.

Methods

A systematic prostate needle biopsy was performed in 203 men with serum PSA levels of < 10 ng/mL to detect prostate cancer. Serum DHEA concentrations were measured with liquid chromatography-tandem mass spectrometry (LC–MS/MS) just before biopsy. Patient’s age, serum prostate-specific antigen (PSA) levels, prostate volume, and serum DHEA concentrations were compared with pathological findings in multivariate analyses.

Results

The median patient’s age, PSA, serum DHEA concentration and prostate volume were 68 years, 5.5 ng/mL, 1654.7 pg/mL, and 31.2 mL, respectively. In a multivariate analysis, low PSA values, high serum DHEA concentrations, and large prostate volume were significant predictors of the patients with benign prostatic hyperplasia (BPH) or prostate cancer with a Gleason score of ≤ 3 + 4 who are candidate for AS. The DHEA cut-off point for predicting BPH or prostate cancer with a Gleason score of ≤ 3 + 4 was 2188 pg/mL, with a sensitivity, specificity, positive predictive value, and negative predictive value of 33.7%, 96.0%, 98.4%, and 16.9%, respectively.

Conclusion

The study indicated that higher serum DHEA concentrations prior to prostate biopsy might predict the patients with BPH or prostate cancer with a Gleason score ≤ 3 + 4 who are candidate for AS, in men with PSA of < 10 ng/mL.
Bioinformatics analysis of potential key genes and pathways in neonatal necrotizing enterocolitis
Authors: Liu Xuexiu , Zhang Xianhong , Li Luquan , Wang Jianhui , Chen Yanhan , Wu Liping
Published: November 2022

Objective

To detect differentially expressed genes in patients with neonatal necrotizing enterocolitis (NEC) by bioinformatics methods and to provide new ideas and research directions for the prevention, early diagnosis and treatment of NEC.

Methods

Gene chip data were downloaded from the Gene Expression Omnibus database. The genes that were differentially expressed in NEC compared with normal intestinal tissues were screened with GEO2R. The functions, pathway enrichment and protein interactions of these genes were analyzed with DAVID and STRING. Then, the core network genes and significant protein interaction modules were detected using Cytoscape software.

Results

Overall, a total of 236 differentially expressed genes were detected, including 225 upregulated genes and 11 downregulated genes, and GO and KEGG enrichment analyses were performed. The results indicated that the upregulated differentially expressed genes were related to the dimerization activity of proteins, while the downregulated differentially expressed genes were related to the activity of cholesterol transporters. KEGG enrichment analysis revealed that the differentially expressed genes were significantly concentrated in metabolism, fat digestion and absorption pathways. Through STRING analysis, 9 key genes in the protein network interaction map were identified: EPCAM, CDH1, CFTR, IL-6, APOB, APOC3, APOA4, SLC2A and NR1H4.

Conclusion

Metabolic pathways and biological processes may play important roles in the development of NEC. The screening of possible core targets by bioinformatics is helpful in clarifying the pathogenesis of NEC at the gene level and in providing references for further research.