bluuebunny/crossref_metadata_2025 huggingface dataset:
Can the Sup-ER Protocol Decrease the Prevalence and Severity of Elbow Flexion Deformity in Brachial Plexus Birth Injuries?
Authors: Yefet Leeor , Bellows Doria , Bucevska Marija , Courtemanche Rebecca , Durlacher Kim , Hynes Sally , Verchere Cynthia
Published: June 2022

Background:

Brachial plexus birth injuries (BPBIs) can often result in functional and cosmetic deficits including, according to a recent scoping review, elbow flexion contractures in up to 48%. A treatment algorithm that includes a custom long-arm orthosis to optimize early glenohumeral joint positioning (Sup-ER protocol) has been shown to improve shoulder range of motion. Although the protocol was not intentionally designed to affect the elbow, this study investigates the prevalence and severity of elbow flexion contractures in children treated with that protocol.

Methods:

This prospective cross-sectional cohort study examined 16 children aged 4 and older with BPBI severe enough to be treated with the Sup-ER protocol. Passive and active elbow flexion and extension range of motion (ROM) were assessed in both arms. Elbow flexion contractures were defined as > 5o from neutral.

Results:

Within the cohort of 16 patients (mean age: 7.0 years, range: 4.5-11.6 years), the mean maximal passive elbow extension was -6.2° in the affected arm and + 5.1° (hyperextension) in the unaffected arm. Zero patients had a severe elbow flexion contracture (>30o) and only 6/16 met the lowest threshold definition of elbow flexion contracture (>5o), with a mean onset at 22 months of age.

Conclusions:

This study suggests an unintended decreased prevalence and severity of elbow flexion contractures in children with more severe BPBI treated with the Sup-ER protocol, relative to published values.
Surgical Outcomes, Trends, and Risk Factors of Distal Triceps Repairs
Authors: Lee Eugenia , Stillson Quinn A. , Seidel Henry D. , Bhattacharjee Sarah , Koh Jason L. , Strelzow Jason A. , Shi Lewis L.
Published: June 2022

Background:

Distal triceps ruptures are rare, and complete ruptures are commonly treated with surgery. Studies of patients in small cohorts with distal triceps tear have reported outcomes and risk factors; however, large-scale data are scant. This study seeks to determine current trends, outcomes, and risk factors of distal triceps tears.

Methods:

Within a large insurance claims database, distal triceps repair patients were identified through Current Procedural Terminology coding with concomitant distal triceps International Classification of Diseases, 9th Revision/10th Revision diagnosis codes and 1-year active status before and after surgery. Demographics, total costs, 90-day complications, and revision rates within 1 year of index surgery were analyzed. Logistic regression was performed for revision and complication rates using sex, age, and comorbidities (anabolic steroid use, diabetes, ischemic heart disease, tobacco use, rheumatoid arthritis, and chronic kidney disease).

Results:

A total of 8143 patients were included in the cohort. Male patients and patients aged 40 to 59 years comprised most of the study population. The postoperative complication rate was 5.8%, and the 1-year revision rate was 2.6%. Male sex, age >60 years, ischemic heart disease, rheumatoid arthritis, and chronic kidney disease were statistically significant risk factors for higher 90-day complication rates. Anabolic steroid use significantly increased the risk of surgical revision.

Conclusions:

Distal triceps repairs in this large cohort study occur most frequently in men aged 40 to 59 years. Complications are generally low, with age >60 years, male sex, ischemic heart disease, rheumatoid arthritis, and chronic kidney disease as risk factors for 90-day complications and prior anabolic steroid use as a risk factor for 1-year revision surgery. This information can help to improve education and expectations of this procedure.
Optimization of the impeller for hydraulic performance improvement of a high-speed magnetic drive pump
Authors: Xu Zhenfa , Kong Fanyu , Zhang Kun , Zhu Han , Wang Jiaqiong , Qiu Ning
Published: June 2022

Magnetic drive centrifugal pumps have compact structure and lower efficiency than ordinary centrifugal pumps. The surrogate-based optimization technique was applied to improve the performance of a high-speed magnetic drive pump with the help of numerical simulations. Eight geometrical parameters of the impeller were considered as the design variable. About 290 samples of impeller were generated by optimal Latin hypercube sampling (OLHS) method, and the corresponding efficiencies of all the impeller samplings were obtained from numerical simulation. The performance test of the prototype pump was carried out, and the experimental results were in good agreement with the numerical simulation results. The hydraulic efficiency at 1.2 Qd of the magnetic drive pump was set as the optimization objective. Using response surface methodology (RSM), surrogate models were established for the objective functions based on the numerical results. The multi-island genetic algorithm (MIGA) was used to optimize the impeller. The hydraulic efficiency of the optimal impeller at rated flow rate was 72.89%, which was 6.23% higher than the prototype impeller.
Theoretical study on the hydraulic sealing integrity of cement sheath in horizontal shale oil wells under fracturing: Crack propagation mode and mechanism
Authors: Su Donghua , Huang Sheng , Li Zaoyuan , Li Jin , Wu Xuning , Tang Shizhong , Li Xiaoxiang
Published: June 2022

The cement sheath-formation interface is a weak link in wellbore isolation systems, which is prone to the failure of sealing integrity during fracturing, affecting the fracturing effect, and wellbore safety. In this study, we establish a new model to evaluate the failure mode and crack propagation of cement sheath-formation interface. Using the proposed model, we predicted the propagation direction and length of the interface and zigzag cracks caused by the interface stress, fracturing load, and stress intensity factor (SIF) under temperature and pressure in the shale oil well X in the eastern China oil field. The prediction results were consistent with the distribution law of measured microseismic events. In addition, we analyzed the influence of the internal casing pressure, mechanical properties of cement sheath, and formation on the sealing integrity failure and cracks. At the same time, we discussed the influence of these mechanical properties on the propagation length of interface and zigzag cracks and the propagation direction of the zigzag crack in detail, and proposed the optimal mechanical properties design to avoid the crack propagating to the cement sheath and causing its failure. The results can provide effective guidance for sealing integrity prediction and cement sheath mechanical performance design.
The relationship between perceived discrimination and Chinese migrant children's school adjustment: A moderated mediation model of identity conflict and grit
Authors: Zhang Yan , Jiang Bo , Tan Ding-Liang , Lei, Ting-Ting
Published: June 2022

Research has revealed that perceived discrimination may be a risk factor against school adjustment among Chinese migrant children. However, few studies have examined the underlying mechanisms that may mediate or moderate this association. To fill this gap, this study examined the mediating role of identity conflict and moderating role of grit in the association between perceived discrimination and school adjustment. A sample of 732 Chinese migrant children completed measures of perceived discrimination, school adjustment, identity conflict, and grit. Results showed that identity conflict mediated the relationship between perceived discrimination and school adjustment among Chinese migrant children. Moreover, this mediating effect of identity conflict between perceived discrimination and school adjustment was moderated by grit, with the effect being weaker for Chinese migrant children with higher grit. These findings illuminate the underlying influence of identity conflict and grit in the link between perceived discrimination and school adjustment of Chinese migrant children. Limitations and implications of this study were discussed.
Effects of a Cordyceps militaris With Herba epimedii Complex on Chronic Renal Failure Induced by Adenine in vivo
Authors: Ma Changyang , Wang Xuebiao , Shao Wenjing , Zhao Qingchun , Wei Jinfeng , Liu Zhenhua , Li Changqin
Published: June 2022

In this paper, the relieving effects of Cordyceps militaris and Herba epimedii complex on chronic renal failure (CRF) induced by adenine were investigated. The CRF model with severe damage to kidney tissue and abnormality of physiological and biochemical indices was established by administrating Sprague Dawley male rats daily with adenine (250 mg/kg). After treatments with the complex, the levels of serum creatinine ( P < .001), urea nitrogen ( P < .001), uric acid ( P < .001), and P3+ ( P < .01) were significantly decreased, while the levels of estradiol (E2), luteinizing hormone ( P < .001), nitrite oxide ( P < .001), and Ca2+ ( P < .001) were significantly increased. The damage to kidney tissue of CRF rats was obviously ameliorated. All the treatment groups showed therapeutic effects of CRF induced by adenine. The Cordyceps militaris and Herba epimedii complex showed the best effect at the dose of 10.4 + 10.4 mg/kg/d.
Do Buffer Zone Programs Improve Local Livelihoods and Support Biodiversity Conservation? The Case of Sagarmatha National Park, Nepal
Authors: Silwal Thakur , Devkota Bishnu P. , Poudel Prabin , Morgan Mark
Published: June 2022

Background and Research Aims: Buffer zone programs aim to reduce park-people conflicts by improving local livelihoods through integrated conservation and development activities. A case study was conducted at Sagarmatha National Park, Nepal from 2002–2016 to examine some buffer zone initiatives.

Methods: Focus group discussions ( n = 7), key informant interviews ( n = 14), and field observations were performed in accordance with the IUCN Framework for Assessing Management Effectiveness of Protected Areas 2006 and WWF´s Rapid Assessment and Prioritization of Protected Area Management 2006.

Results: A total of 99 buffer zone activities were identified, including a variety of construction activities such as hydroelectric projects, trails, schools, and monasteries. Park funds were allocated mainly for community development and social welfare (42%), and less on conservation and conflict management (22%). For example, traditional “ Nawa” animal rearing practices, feral dog control, and mitigation of wildlife damages to crops and livestock were overlooked.

Conclusion: Support gained from the buffer zone program to address livelihoods of needy households who suffer from wildlife damages was lacking, despite legal provisions for compensation (e.g. crop damages caused by jharal). This should not occur at the expense of wildlife conservation and if it does, it will diminish the original intent of buffer zones.

Implications for Conservation: Although most of the local communities were positive about buffer zone programs and activities, there was a dire need to incorporate “ Nawa” practices, wildlife damage compensation schemes, and feral dog controls. This study suggests to update policies that focus on conflict management.
Medical Device Regulations and custom-made device documentation: Ten frequently asked questions and their answers
Authors: Green James I.J.
Published: June 2022

Dental professionals who practice in the UK must follow the General Dental Council (GDC) Standards, one of which is to “find out about laws and regulations that affect your work and follow them”. Dental professionals manufacture custom-made devices (CMDs) and the legislation that governs these devices has changed. Medical devices manufactured within the European Union (EU) were previously subject to Council Directive 93/42/EEC (Medical Devices Directive [MDD]), which was given effect in UK law by The Medical Devices Regulations 2002 (Statutory Instrument 2002/618 [UK MDR 2002]). Regulation (EU) 2017/745 (Medical Device Regulation [EU MDR]) was scheduled to replace the MDD on 26 May 2020, but this was postponed for one year due to the coronavirus (COVID-19) pandemic. In preparation for the UK’s departure from the EU, the EU MDR was largely transposed into The Medical Devices (Amendment etc.) (EU Exit) Regulations 2019 (Statutory Instrument 2019/791 [UK MDR 2019]), which amended the UK MDR 2002, and was expected to come into effect on 1 January 2021 but a further amendment, The Medical Devices (Amendment etc.) (EU Exit) Regulations 2020 (Statutory Instrument 2020/1478 [UK MDR 2020]), removed these provisions. As of 1 January 2021, medical devices in Great Britain are subject to either the UK MDR 2002 (as amended) or the EU MDR (until 30 June 2023) while those in Northern Ireland must be manufactured in accordance with the EU MDR. This paper provides the answers to some key questions regarding the documentation that must be supplied with CMDs following these changes.
A simulated experiment to explore robotic dialogue strategies for people with dementia
Authors: Yuan Fengpei , Sadovnik Amir , Zhang Ran , Casenhiser Devin , Paek Eun Jin , Zhao Xiaopeng
Published: June 2022

Introduction

Persons with dementia (PwDs) often show symptoms of repetitive questioning, which brings great burdens on caregivers. Conversational robots hold promise of helping cope with PwDs’ repetitive behavior. This paper develops an adaptive conversation strategy to answer PwDs’ repetitive questions, follow up with new questions to distract PwDs from repetitive behavior, and stimulate their conversation and cognition.

Methods

We propose a general reinforcement learning model to interact with PwDs with repetitive questioning. Q-learning is exploited to learn adaptive conversation strategy (from the perspectives of rate and difficulty level of follow-up questions) for four simulated PwDs. A demonstration is presented using a humanoid robot.

Results

The designed Q-learning model performs better than random action selection model. The RL-based conversation strategy is adaptive to PwDs with different cognitive capabilities and engagement levels. In the demonstration, the robot can answer a user’s repetitive questions and further come up with a follow-up question to engage the user in continuous conversations.

Conclusions

The designed Q-learning model demonstrates noteworthy effectiveness in adaptive action selection. This may provide some insights towards developing conversational social robots to cope with repetitive questioning by PwDs and increase their quality of life.
Political Trust and the Ultimate Attribution Error in Explaining Successful and Failed Policy Initiatives
Authors: Priedols Martins , Dimdins Girts , Gaina Viktorija , Leja Veronika , Austers Ivars
Published: June 2022

This study examines how the ultimate attribution error (group attribution bias) plays out in the interaction between trust/distrust in a political actor and the success or failure of the actor’s proposed policy initiative. We conducted an experiment where student participants ( n = 222) from Latvian universities evaluated reasons for the success versus failure of a policy initiative proposed by a trusted versus untrusted political party in terms of the perceived benevolence, competence, and integrity of the political party as dispositional factors contributing to the initiative’s outcome, or external circumstances not under the political party’s control. The results showed evidence of the ultimate attribution error in the participants’ answers. The success of a policy initiative was explained more in terms of positive dispositions of the authoring party when the initiative came from a trusted political party than when it came from a distrusted party, and an initiative’s failure was explained more in terms of a lack of these positive dispositions when the initiative came from a distrusted party. There were no indications of the ultimate attribution error when explaining an initiative’s success or failure by external factors not controlled by the party authoring the initiative. The results provide additional insight into how the mechanisms of intergroup attribution play out in the context of political trust and may influence both overall trust in political actors and the evaluation of specific policy initiatives authored by these actors.
Psychometric Validation of a Teamwork Skills Scale in a Vocational Training Context
Authors: Romero-Díaz de la Guardia José Javier , García-Garnica Marina , Chacón-Cuberos Ramón , Expósito-López Jorge
Published: June 2022

The ability to work in a team is currently one of the most demanded competencies of professionals and, therefore, constitutes one of the key transversal aspects to be targeted by educational systems. This is especially important at stages prior to job insertion. The aim of the present study was to validate a scale measuring perceptions of teamwork skills within a sample of students undertaking vocational training in the south of Spain. For this, both exploratory ( n = 879) and confirmatory ( n = 1,843) factor analyses were performed using the IBM SPSS® 26 and IBM Amos Graphics® 23.0 software packages. This permitted a scale to be developed which was formed of ten indicators of teamwork skills. These indicators were grouped into three dimensions, namely, teamwork behaviors, ratings the importance of teamwork and self-perceptions of teamwork capabilities. Adequate fit indices were obtained (KMO = 0.845; CFI = 0.984; NFI = 0.978; IFI = 0.984; RMSEA = 0.037; and SRMR = 0.044). Thus, a robust and reliable scale is presented that rates student perspectives of essential aspects of Vocational Training, such as teamwork skills.
Endothelialization strategy of implant materials surface: The newest research in recent 5 years
Authors: Bian Qihao , Chen Junying , Weng Yajun , Li Suiyan
Published: June 2022

In recent years, more and more metal or non-metal materials have been used in the treatment of cardiovascular diseases, but the vascular complications after transplantation are still the main factors restricting the clinical application of most grafts, such as acute thrombosis and graft restenosis. Implant materials have been extensively designed and surface optimized by researchers, but it is still too difficult to avoid complications. Natural vascular endodermis has excellent function, anti-coagulant and anti-intimal hyperplasia, and it is also the key to maintaining the homeostasis of normal vascular microenvironment. Therefore, how to promote the adhesion of endothelial cells (ECs) on the surface of cardiovascular materials to achieve endothelialization of the surface is the key to overcoming the complications after implant materialization. At present, the surface endothelialization design of materials based on materials surface science, bioactive molecules, and biological function intervention and feedback has attracted much attention. In this review, we summarize the related research on the surface modification of materials by endothelialization in recent years, and analyze the advantages and challenges of current endothelialization design ideas, explain the relationship between materials, cells, and vascular remodeling in order to find a more ideal endothelialization surface modification strategy for future researchers to meet the requirements of clinical biocompatibility of cardiovascular materials.
Effect of Sectioning of the Anterior Cruciate Ligament and Posterolateral Structures on Lateral Compartment Gapping: A Randomized Biomechanical Study
Authors: Gursoy Safa , Perry Allison K. , Dandu Navya , Singh Harsh , Vadhera Amar S. , Yanke Adam , LaPrade Robert F. , Chahla Jorge
Published: June 2022

Background:

The contribution of anterior cruciate ligament (ACL) injury to lateral instability under varus stress, particularly compared with posterolateral structures, is not well known.

Purpose:

To investigate the effect of sectioning the ACL and posterolateral knee structures on lateral compartment gapping under varus stress.

Study Design:

Controlled laboratory study.

Methods:

Fourteen nonpaired cadaveric knees were randomized to 1 of 2 groups: sequential sectioning of the ACL, fibular collateral ligament (FCL), popliteus tendon (PLT), and popliteofibular ligament (PFL) (ACL-first group) or sequential sectioning of the FCL, PLT, PFL, and ACL (FCL-first group). Knees were loaded onto a custom jig at a 20° flexion angle. A standardized 12-N·m varus moment was applied to each specimen in the intact state and after each randomized sequential-sectioning state. Lateral compartment opening was measured on radiographs to assess the contribution to the increase in the lateral gap caused by resecting the respective structure. The distance was measured by 3 observers on 15 images (5 testing states each imaged 3 times) per specimen, for a total of 210 radiographs. The articular cartilage surfaces were not included in the measurements.

Results:

The mean increase in lateral opening after sectioning all structures (ACL and posterolateral corner) was 4.6 ± 1.8 mm (range, 1.9-7.7 mm). The ACL and FCL sectioning contributed the most to lateral knee opening (1.3 ± 0.6 and 2.2 ± 1.3 mm, respectively). In both groups, lateral gapping >3 mm was achieved only after both the ACL and FCL were sectioned. All comparisons of increased mean gapping distances demonstrated a significant difference with subsequent sequential sectioning of structures, except comparisons between the FCL and PLT and the PLT and PFL. When considering the effect of the ACL on lateral opening, no significant difference was found between sectioning the ACL first or FCL first ( P = .387).

Conclusion:

ACL deficiency significantly increased lateral opening under varus stress, regardless of the sequence of injury. The effect of injury to the ACL in addition to the lateral structures should be considered when using varus stress radiographs to evaluate knee injuries.

Clinical Relevance:

With the current findings, understanding the effect of ACL and posterolateral corner injuries on lateral gapping under varus stress can aid in correctly diagnosing knee injuries and determining appropriate treatment plans.
The Relationship Between Community Adherence to COVID-19 Containment Measures and the Wellbeing of Older Adults in Rural Kenya
Authors: Thuku Pauline
Published: June 2022

The COVID-19 pandemic has disrupted lives globally but disproportionately affected older adults due to their increased vulnerability to severe illness and higher mortality. To protect older adults from infection, community members in rural Kenya have ensured enhanced adherence to COVID-19 containment measures. However, while restricted social contact is highly recommended in the control of COVID-19 infection, limited research exists on its effect on the psychosocial wellbeing of older adults. This study therefore assessed the relationship between community adherence to COVID-19 containment measures and the overall wellbeing of older adults. Nyeri County in Central Kenya was selected for the study and all adults aged 70 years and above targeted. Snowball sampling was used to collect data from a sample of 360 respondents. Both descriptive and inferential statistics were used in data analysis. The study established a significant inverse relationship between the level of community adherence to COVID-19 protocols and the wellbeing of older adults. Furthermore, the wellbeing of most older adults had deteriorated during the pandemic, with older married women with higher incomes being less affected. The study concluded that although the COVID-19 pandemic had affected everyone, effective containment is a multi-dimensional issue that requires targeted interventions.
Challenging the Romance of the Techno/Metropolis: The Social Critique of the ‘City’ in Zac O’Yeah’s Crime Trilogy
Authors: Bhattacharya Somdatta , T. S. Navami
Published: June 2022

Following the American discovery of the high concentration of skilled IT professionals in Bengaluru, the Karnataka Government announced its IT policies in the late 1990s which changed the city from a placid ‘pensioners’ paradise’ to the bustling ‘Silicon Valley of India’. With almost an explosion of disruptive changes, the topography and the demography of the city both saw a dramatic transformation. The ‘Mr Majestic Trilogy’ (2012–2017) by Zac O’Yeah is a crime-detection series set in post-millennial Bengaluru. The current paper argues that it is possible to read this crime novel series as a social critique of the changing (social) spaces and interactions in the city, albeit these are represented with humour and light-heartedness in his novels. The paper seeks to read the novels as representing the specificities of the urban experience in this global South Asian city, and as bringing to the fore the dialectics of space and spatiality, especially as it embraces a neoliberal wave of globalisation. It looks at the narratives’ engagement with various aspects of urban experience, including crime and migration, and also investigates the network of relationships that the novels explore in their depiction of the urban/hinterlands duality. For its purposes, the paper borrows insights from theorists of space and urbanity.
Water for whom? Desalination and the cooptation of the environmental justice frame in Southern California
Authors: O’Neill Brian F
Published: June 2022

The environmental justice frame is a key feature of successful grassroots mobilization against the uneven distribution of environmental problems. However, what happens when this discursive framework is questioned, that is, when features of its established definition are made to serve, rather than contest, industry? The article examines this dynamic through an ethnography of a high-volume desalination (potable ocean water) proposal. Findings indicate community groups and non-governmental organizations make normative environmental justice arguments about the high costs of desalination, community disruption, and industrial burden. By contrast, organized labor and public sector actors align with the private sector to promote desalination, using a competing series of arguments about local independence, regional responsibility, and employment. Disentangling these discourses, the author argues that claims in favor of desalination are a part of what this paper calls a cooptation of the environmental justice frame that ultimately facilitates community division in favor of a class bias for a luxury commodity. Interpreting this socio-ecological problem through a political economic lens, this research contributes to discussions about industrial infrastructure conceived within public–private partnership frameworks, calling scholars, activists, and decision-makers to attend to how environmental (in)justice politics can take on surprising meanings amid the expansion of financial capitalism.
Characterization of Crural Repair in Antireflux Surgery: Preliminary Experience with a Standardized Technique
Authors: Fanous Medhat
Published: June 2022

Purpose:

To define and optimize cruroplasty in laparoscopic repair of hiatal hernia (LRHH).

Background:

Crural closure and crural repair in LRHH are used interchangeably. While crural closure entails obliteration of the diaphragmatic defect, cruroplasty involves restoring the anatomy and producing a “functional closure.”

Methods:

This is an IRB-approved retrospective study. Inclusion criteria were sliding hiatal hernia ≤6 cm in axial length, abnormal pH study or erosive esophagitis, use of the endostitch device to standardize surgical bite, and endoscopic fundoplication to standardize the wrap. Exclusion criteria were a history of antireflux surgery, gastroparesis, or preexisting esophageal stricture.

Results:

A total of 68 patients, 21 males, and 47 females met the inclusion criteria. The median age and BMI were 59 and 28, respectively. The average follow-up was 26.3 (12–62) months. There were three anatomical recurrences 3/68 (4.4%) and two of them had symptomatic recurrence. All but eight patients discontinued antisecretory therapy 60/68 (88.2%). Five of these eight patients used these medications at lesser dose or frequency rendering the overall improvement of patients to 65/68 (95.5%). There was no postoperative dysphagia.

Conclusions:

Laparoscopic hiatal hernia repair should focus on crural repair, not merely closure. Optimizing cruroplasty can be achieved by understanding the functional anatomy, recreating the crural sling, and adjusting the crural suture tension. This results in a low recurrence rate of hiatal hernias, a high discontinuation rate of proton pump inhibitors, significant objective clinical improvement of GERD symptoms, and no postoperative dysphagia.
Changes in Nasalance and Velopharyngeal Function Following Conventional Le Fort I and Distraction Osteogenesis Using Perceptual and Instrumental Assessment
Authors: Schleif Eshan Pua , Dillon Katherine , Brady Colin M. , Williams Joseph K. , Riski John E. , Perry Jamie L.
Published: June 2022

Objective:

The objective of this study was to quantify the changes in nasalance and velopharyngeal function in individuals with repaired cleft palate who underwent conventional Le Fort I (LFI) and Distraction Osteogenesis (DO). This study will also examine changes relative to secondary factors of age, cleft type, and previous speech surgery.

Methods:

This retrospective study included 19 patients who underwent LFI and 24 patients who underwent DO at a tertiary level pediatric hospital from 2011 to 2019. All patients had repaired cleft palate and were between 7 and 18 years of age. Pre- and post-operative speech assessment was completed before and after surgery.

Results:

There was a significant increase in nasalance scores for the oral sentences of 12.9% for the LFI group ( P = .006) and 17.9% for the DO group ( P < .001). A significant difference in nasalance scores between patients with and without previous speech surgery in the LFI group.

Conclusions:

Findings may aid surgeons and speech pathologists in informing patients about the potential increase in nasalance following LFI or DO. Findings may indicate that timing of speech surgery is more favorable before LFI, but not influential for individuals undergoing DO.
Single-Pulse Transcranial Magnetic Stimulation for the preventive treatment of difficult-to-treat migraine: a 12-month prospective analysis
Authors: Lloyd J.O. , Hill B. , Murphy M. , Al-Kaisy A. , Andreou A. P. , Lambru G.
Published: June 2022

Background

Initial evidence have shown the short-term efficacy of sTMS in the acute and preventive treatment of migraine. It is unknown whether this treatment approach in the long-term is effective and well tolerated in difficult-to-treat migraine.

Methods

This is a prospective, single centre, open-label, real-world analysis conducted in difficult-to-treat patients with high-frequency episodic migraine (HFEM) and chronic migraine (CM) with and without medication overuse headache (MOH), who were exposed to sTMS therapy. Patients responding to a three-month sTMS treatment, continued the treatment and were assessed again at month 12. The cut-off outcome for treatment continuation was reduction in the monthly moderate to severe headache days (MHD) of at least 30% (headache frequency responders) and/or a ≥ 4-point reduction in headache disability using the Headache Impact test-6 (HIT-6) (headache disability responders).

Results

One hundred fifty-three patients were included in the analysis (F:M = 126:27, median age 43, IQR 32.3–56.8). At month 3, 93 out of 153 patients (60%) were responders to treatment. Compared to baseline, the median reduction in monthly headache days (MHD) for all patients at month 3 was 5.0 days, from 18.0 (IQR: 12.0–26.0) to 13.0 days (IQR: 5.75–24.0) (P = 0.002,r = − 0.29) and the median reduction in monthly migraine days (MMD) was 4.0 days, from 13.0 (IQR: 8.75–22.0) to 9.0 (IQR: 4.0–15.25) (P = 0.002,r = − 0.29). Sixty-nine out of 153 patients (45%) reported a sustained response to sTMS treatment at month 12. The percentage of patients with MOH was reduced from 52% (N = 79/153) at baseline to 19% (N = 29/153) at month 3, to 8% (N = 7/87) at month 12. There was an overall median 4-point reduction in HIT-6 score, from 66 (IQR: 64–69) at baseline to 62 at month 3 (IQR: 56–65) (P < 0.001,r = − 0.51). A total of 35 mild/moderate adverse events were reported by 23 patients (15%). One patient stopped sTMS treatment due to scalp sensitivity.

Conclusions

This open label analysis suggests that sTMS may be an effective, well-tolerated treatment option for the long-term prevention of difficult-to-treat CM and HFEM.
A novel non-invasive method allowing for discovery of pathologically relevant proteins from small airways
Authors: Östling Jörgen , Van Geest Marleen , Olsson Henric K. , Dahlen Sven-Erik , Viklund Emilia , Gustafsson Per M. , Mirgorodskaya Ekaterina , Olin Anna-Carin
Published: June 2022

Background

There is a lack of early and precise biomarkers for personalized respiratory medicine. Breath contains an aerosol of droplet particles, which are formed from the epithelial lining fluid when the small airways close and re-open during inhalation succeeding a full expiration. These particles can be collected by impaction using the PExA method (Particles in Exhaled Air), and are derived from an area of high clinical interest previously difficult to access, making them a potential source of biomarkers reflecting pathological processes in the small airways.

Research question

Our aim was to investigate if PExA method is useful for discovery of biomarkers that reflect pathology of small airways.

Methods and analysis

Ten healthy controls and 20 subjects with asthma, of whom 10 with small airway involvement as indicated by a high lung clearance index (LCI ≥ 2.9 z-score), were examined in a cross-sectional design, using the PExA instrument. The samples were analysed with the SOMAscan proteomics platform (SomaLogic Inc.).

Results

Two hundred-seven proteins were detected in up to 80% of the samples. Nine proteins showed differential abundance in subjects with asthma and high LCI as compared to healthy controls. Two of these were less abundant (ALDOA4, C4), and seven more abundant (FIGF, SERPINA1, CD93, CCL18, F10, IgM, IL1RAP). sRAGE levels were lower in ex-smokers (n = 14) than in never smokers (n = 16). Gene Ontology (GO) annotation database analyses revealed that the PEx proteome is enriched in extracellular proteins associated with extracellular exosome-vesicles and innate immunity.

Conclusion

The applied analytical method was reproducible and allowed identification of pathologically interesting proteins in PEx samples from asthmatic subjects with high LCI. The results suggest that PEx based proteomics is a novel and promising approach to study respiratory diseases with small airway involvement.
Lack of autoantibodies against collagen and related proteins in collagenous colitis
Authors: JK Larsson , B Roth , B Ohlsson , K Sjöberg
Published: June 2022

Introduction

Collagenous colitis (CC) is a common cause of chronic diarrhea and is characterized by a subepithelial thickened collagen layer in the colonic mucosa.

It shares many of the characteristics found in autoimmune diseases, but no autoantibodies have been identified. In CC, an imbalance in collagen turnover is evident. The purpose of the present study was to investigate whether any collagen-associated autoantibodies or other antibodies such as TPO and ASCA were present, and if levels of total IgE were increased.

Methods

Sera from women with active CC were analysed with ELISA for detection of autoantibodies against collagen type III and IV (Col III and IV), matrix metalloproteinase-9 (MMP-9), tissue inhibitors of metalloproteinase-1 (TIMP-1) and tenascin-C (TNC). Sera were also analysed for TPO, ASCA and total IgE. Healthy female blood donors served as controls. The cut-off value in the control group was defined as relative units > 97.5th percentile.

Results

Sixty-six women were included (mean age 60 years; range 31–74, mean disease duration 6 years; range 1–22). No autoantibody was significantly overexpressed in the CC population compared to controls. The mean disease duration was lower (p = 0.03) in the subjects who expressed collagen-associated autoantibodies (3.7 years; range 1–14), compared to those who did not (6.4 years; range 1–22). Treatment with budesonide was not associated with any of these autoantibodies.

Conclusion

No increased presence of the investigated antibodies could be found in the present study of CC. Neither could antibodies against ASCA or TPO, or elevated levels of IgE, be found. Consequently, no association was found between CC and these proteins, even though this may not be generalizable to other compounds in the collagen layer.
Associations of walking impairment with visual impairment, depression, and cognitive function in U.S. older adults: NHANES 2013–2014
Authors: Gao Wei , Dai Pengfei , Wang Yuqian , Zhang Yurong
Published: June 2022

Background

Walking impairment, a common health problem among older adults, has been linked to poor vision and mental health. This study aimed to investigate the associations of walking impairment with visual impairment, depression, and cognitive function in older adults.

Methods

A total of 1,489 adults aged 60 years and older who had participated in the National Health and Examination Survey (NHANES) 2013–2014 in the United States were included. Multivariate logistic regression models were used to examine the associations of walking impairment with visual impairment, depression, and four subdomains of cognitive function. Sample weights were used to ensure the generalizability of the results.

Results

Among all the participants (median age = 68 years; 53.7% women), 17.5% reported walking impairment. Walking impairment was significantly associated with visual impairment (adjusted odds ratio [aOR] = 2.76; 95% CI: 1.47–5.20) and depression (aOR = 4.66; 95% CI: 3.11–6.99). Walking impairment was only associated with the Digit Symbol Substitution (DSST) subdomain of cognitive function in total participants (aOR = 0.97; 95% CI: 0.95–0.99) and in non-Hispanic white adults (aOR = 0.96; 95% CI: 0.94–0.98). Participants with two or three impairment indicators had a higher OR of walking impairment (aOR = 3.64, 95% CI = 2.46–5.38) than those with 0–1 (reference group) impairment indicator.

Conclusions

Walking impairment was associated with visual impairment, depression, and cognitive impairment in American older adults and also positively associated with the number of impairment indicators. The association between walking impairment and cognitive impairment varied according to race. Evaluations of vision, cognition, and depression should be conducted among older adults with walking impairment, and the needs of older adults should be provided in the evaluations alongside information on the biological aspects of their particular race.
Triclosan activates c-Jun/miR-218-1-3p/SLC35C1 signaling to regulate cell viability, migration, invasion and inflammatory response of trophoblast cells in vitro
Authors: Huo Weiwei , Wang Ying , Chen Ting , Cao Tianyue , Zhang Yue , Shi Zhouhong , Hou Shunyu
Published: June 2022

Background

Spontaneous abortion is considered as the commonest complication of pregnancy. Triclosan (TCS) is an antimicrobial agent, which participates in the process of multiple human diseases, including spontaneous abortion. Our study aimed to evaluate the effect of TCS on spontaneous abortion and disclose the possible regulatory mechanism in vitro.

Results

RT-qPCR analyzed that miR-218-1-3p derived from abortion-associated factor slit guidance ligand 2 (SLIT2) was up-regulated in trophoblast cells under TCS treatment. Supported by western blot analysis, functional experiments demonstrated that miR-218-1-3p overexpression impeded the proliferation, migration and invasion while exacerbating the inflammatory response of trophoblast cells. Moreover, mechanism assays revealed that TCS modulated c-Jun production to promote MIR218–1 transcription and enhance miR-218-1-3p expression. Moreover, solute carrier family 35 member C1 (SLC35C1) was validated as a target gene of miR-218-1-3p, and miR-218-1-3p was sustained to negatively modulate SLC35C1 expression in trophoblast cells. Rescue assays validated the role of TCS/miR-218-1-3p/SLC35C1 axis in regulating the viability, migration, invasion and inflammatory response of trophoblast cells.

Conclusions

TCS regulated miR-218-1-3p/SLC35C1 axis to modulate the proliferation, migration, invasion and inflammatory response of trophoblast cells in vitro, which might provide novel insights for spontaneous abortion prevention.

Graphical Abstract
Comparing the efficacy and safety of cisplatin and other platinum-based chemotherapies in locally advanced nasopharyngeal carcinoma: a systematic review and meta-analysis
Authors: Li Zhiru , Li Chao , Yang Dong , Song Junmei , Liu Ting , Zhou Ziyan , Zhou Lifang , Kang Min
Published: June 2022

Background

Cisplatin-based concurrent chemoradiotherapy has been identified as the primary and standard treatment for locally advanced nasopharyngeal carcinoma (NPC). However, the side effects of cisplatin affect the compliance to therapy. Thus, the search for a platinum-based substitute for NPC has always been a research focus. However, there is a variability in the efficacy of different platinum-based chemotherapies in the treatment of NPC. We performed a meta-analysis to compare the efficacy and safety of cisplatin-based regimens and other platinum-based derivatives (carboplatin, nedaplatin, and lobaplatin) for locally advanced NPC.

Methods

PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov were systematically searched for all potentially eligible clinical trials as of February 15, 2022. The pooled hazard ratios, risk ratio, and 95% confidence interval were calculated using Review Manager Software version 5.4.

Results

A total of 1,907 patients with locally advanced NPC were eligible from the 1,265 retrieved records. This systematic review included eight articles, six of which were randomized controlled clinical trials. There was no significant difference in the 3- and 5-year overall survival, progression-free survival, distant metastasis-free survival, and locoregional relapse-free survival between cisplatin-based chemotherapy and other platinum-based chemotherapy. Severe acute hematological side effects (≥ grade 3) during treatment, such as neutropenia, leukopenia, and thrombocytopenia, were equivalent in both groups. However, the incidence of anemia was higher in patients receiving other platinum-based chemotherapies. The risk of nausea, vomiting and weight loss was higher in the cisplatin group; however, there was no significant difference in the other non-hematological and late side effects between the two groups.

Conclusions

Other types of platinum-based chemotherapies are as effective as cisplatin-based chemotherapy in the treatment of locally advanced NPC, thus acting as potential alternatives to cisplatin. Further studies providing high-level evidence are needed.
The relationship between depression and risk of violence in portuguese community-dwelling older people
Authors: Mendes Felismina , Pereira Joana , Zangão Otília , Pereira Catarina , Bravo Jorge
Published: June 2022

Background

Mental disorders are highly prevalent in older people, being depression a predominant disorder. Evidence points to a possible relationship between depression and violence against older people. Nonetheless, the role of the depressive symptomology severity in the risk of violence against older people remains unclear. Thus, this study’s main objective was to analyze the relationship between geriatric depressive symptomatology and the risk of violence against older people.

Methods

This exploratory study involved 502 community-dwelling older persons aged 65 to 96 years (73.3 ± 6.5). Measures were performed using the Geriatric Depression Scale and the Risk Assessment of Violence against the Non-Institutionalized Elderly scale.

Results

One hundred nineteen older people (23.7%) had mild/moderate depressive symptomology, and twenty-six (5.2%) had severe depressive symptomology. There were significant relationships between the severity of depressive symptomatology and the risk of violence (p < 0.05). The presence of depressive symptomatology increased the likelihood of being victims of violence, particularly among women (odds ratio: 2–8, p < 0.05).

Conclusions

The severity of depressive symptomatology plays an essential role in the risk of violence against community-dwelling older people. Moreover, it was found that older persons with depression symptomatology were at higher risk of being victims of violence. Our study findings support the need for protective measures within mental health national or regional policies to prevent depression and violence against community-dwelling older people.
A gender-specific assessment of tobacco use risk factors: evidence from the latest Pakistan demographic and health survey
Authors: Zubair Faiqa , Husnain Muhammad Iftikhar ul , Zhao Ting , Ahmad Hasnat , Khanam Rasheda
Published: June 2022

Background

The high prevalence of tobacco use in Pakistan poses a substantial health and economic burden to Pakistani individuals, families, and society. However, a comprehensive assessment of the key risk factors of tobacco use in Pakistan is very limited in the literature. A better understanding of the key risk factors of tobacco use is needed to identify and implement effective tobacco control measures.

Objectives

To investigate the key socioeconomic, demographic, and psychosocial determinants of tobacco smoking in a recent large nationally representative sample of Pakistani adults.

Methods

N = 18,737 participants (15,057 females and 3680 males) from the 2017–18 Pakistan Demographic Health Survey, aged 15–49 years, with data on smoking use and related factors were included. Characteristics of male and female participants were compared using T-tests (for continuous variables) and χ2-tests (for categorical variables). Multivariable logistic regression models were used to identify gender-specific risk factors of tobacco use. The Receiver Operating Characteristic Curve test was used to evaluate the predictive power of models.

Results

We found that the probability of smoking for both males and females is significantly associated with factors such as their age, province/region of usual residence, education level, wealth, and marital status. For instance, the odds of smoking increased with age (from 1.00 [for ages 15–19 years] to 3.01 and 5.78 respectively for females and males aged 45–49 years) and decreased with increasing education (from 1.00 [for no education] to 0.47 and 0.50 for females and males with higher education) and wealth (from 1.00 [poorest] to 0.43 and 0.47 for richest females and males). Whilst the odd ratio of smoking for rural males (0.67) was significantly lower than that of urban males (1.00), the odds did not differ significantly between rural and urban females. Finally, factors such as occupation type, media influence, and domestic violence were associated with the probability of smoking for Pakistani females only.

Conclusions

This study identified gender-specific factors contributing to the risk of tobacco usage in Pakistani adults, suggesting that policy interventions to curb tobacco consumption in Pakistan should be tailored to specific population sub-groups based on their sociodemographic and psychosocial features.