bluuebunny/crossref_metadata_2025 huggingface dataset:
Underdiagnosis and underreporting of vertebral fractures on chest radiographs in men aged over 50 years or postmenopausal women with and without type 2 diabetes mellitus: a retrospective cohort study
Authors: Na Ding , Cong Ma , Zhang-Xin Wen , Rong Chen , Qin-Yi Wang , Yang-Na Ou , Zhi-Feng Sheng
Published: May 2022

Background

Osteoporotic vertebral fractures are often clinically silent and unrecognized. The present study aimed to determine whether routine chest radiographs could be a potential screening tool for identifying missed vertebral fractures in men aged over 50 years or postmenopausal women, especially those with type 2 diabetes mellitus (T2DM). In this study, we aimed to determine the prevalence of undetected vertebral fractures in elderly Chinese patients with and without T2DM.

Methods

Clinical data and chest radiographs of 567 individuals with T2DM (T2DM group) and 583 without diabetes (nondiabetic group) at a tertiary hospital in central south China were extracted from the records. Vertebral fractures were specifically looked for on chest radiographs and classified using the Genant semi-quantitative scale. Prevalence was compared between the two groups.

Results

Mean age and sex composition were comparable between the two groups. Mean weight and body mass index were significantly lower in the T2DM group. In both groups, fractures mostly involved the T11–12 and L1 vertebrae. Moderate/severe fractures were identified in 33.3% individuals in the T2DM group (31.4% men and 36.0% women) versus 23.2% individuals (20.9% men and 25.5% women) in the nondiabetic group.

Conclusions

Routine chest radiographs could be a useful screening tool for identifying asymptomatic vertebral fractures.

Trial registration The study was designed as an observational retrospective study, therefore a trial registration was not necessary.
Empagliflozin in kidney transplant recipients with chronic kidney disease G3a-4 and metabolic syndrome: Five Japanese cases
Authors: Miyazaki Ryoichi , Miyagi Kyoko
Published: May 2022

Background

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been shown to exert cardiorenal protective effects in diabetic patients and are widely used clinically. In addition, an increasing number of reports now suggest these drugs may even be beneficial in non-diabetic patients. However, SGLT2 inhibitors are rarely prescribed for kidney transplant recipients due to the risk of renal graft damage and urogenital infections.

Case presentation

We report the cases of 5 renal transplant recipients with chronic kidney disease G3a-4 and metabolic syndrome who were administered the SGLT2 inhibitor empagliflozin, which yielded beneficial results in 4 cases. With the exception of one patient with an initial estimated glomerular filtration rate (eGFR) of less than 30 ml/min/1.73 m2, administration of empagliflozin elicited beneficial metabolic effects. There were no significant reductions in eGFR before or after empagliflozin administration, and no dehydration or urogenital infections were observed during the treatment course.

Conclusion

Empagliflozin showed some positive effects in 4 cases with better renal function than CKD stage 4. Further studies will be required to clarify the efficacy and safety of SGLT2 inhibitors in a larger group of patients with similar medical conditions.
The diagnostic dilemma of idiopathic intracranial hypertension in a child with acute lymphoblastic leukemia: COVID-19 or cytosine arabinoside?
Authors: Rakez Rim , Boufrikha Wiem , Lakhal Sana , Boughammoura Amel , Laatiri Mohamed Adnene
Published: May 2022

Background

Idiopathic intracranial hypertension is a rare neurological condition among children. Its manifestations vary from mild headaches to loss of vision. Although rare, COVID-19 infection and high dose cytosine arabinoside have been reported as risk factors for this neurological disorder. In patients with acute leukemia, idiopathic intracranial hypertension diagnosis is simple, but finding its etiology can be difficult.

Case presentation

We report a case of a 9-year-old boy with an ongoing treatment for T-acute lymphoblastic leukemia presenting with persistent headaches and diplopia. A diagnosis of idiopathic intracranial hypertension was retained based on clinical, imaging and laboratory findings. Due to its rarity, we describe its clinical and therapeutic features and highlight the challenging etiological dilemma between COVID-19 infection and high dose cytosine arabinoside administration.

Conclusion

Persistent headache in a pediatric patient with leukemia can be due to many neurological disorders other than leukemic relapse. Given the improvement of the neurological symptoms after the SARS-CoV-2 PCR negativization and the successful re-introduction of high dose cytosine Arabinoside, the diagnosis of idiopathic intracranial hypertension associated with Covid-19 infection was withheld.
Cardiac disease in pregnancy and the first year postpartum: a story of mental health, identity and connection
Authors: Hutchens Jane , Frawley Jane , Sullivan Elizabeth A.
Published: May 2022

Background

Women with cardiac disease in pregnancy and the first year postpartum often face uncertainty about their condition and the trajectory of their recovery. Cardiac disease is a leading cause of serious maternal morbidity and mortality, and the prevalence is increasing. Affected women are at risk of worsening cardiac disease, chronic illness, mental illness and trauma. This compounded risk may lead to significant and long-term negative outcomes. The aim of this study is to correct the lack of visibility and information on the experiences of women with cardiac disease in pregnancy and the first year postpartum.

Methods

A qualitative study using in-depth semi-structured interviews with twenty-five women who had acquired, congenital or genetic cardiac disease during pregnancy or the first year postpartum. Data were analysed and interpreted using a thematic analysis framework.

Results

Analysis of the interviews produced three major themes: 1) Ground zero: index events and their emotional and psychological impact, 2) Self-perception, identity and worthiness, and 3) On the road alone; isolation and connection. There was a narrative consistency across the interviews despite the women being diverse in age, cardiac diagnosis and cardiac health status, parity and timing of diagnosis. The thread prevailing over the temporal and clinical differences was one of distress, biographical disruption, identity, isolation, a necessitated re-imagining of their lives, and the process of multi-layered healing.

Conclusion

Acknowledging and understanding the breadth, complexity and depth of women’s experiences is fundamental to improving outcomes. Our findings provide unique insights into women’s experiences and challenges across a spectrum of diseases. Most women did not report an isolated trauma or distressing event, rather there was a layering and persistence of psychological distress necessitating enhanced assessment, management and continuity of care beyond the routine 6-week postpartum check. Further research is required to understand long-term outcomes and to refine the findings for specific disease cohorts to be able to respond effectively.
Androgen Deprivation therapy for Oligo-recurrent Prostate cancer in addition to radioTherapy (ADOPT): study protocol for a randomised phase III trial
Authors: Janssen J. , Staal F. H. E. , Brouwer C. L. , Langendijk J. A. , de Jong I. J. , van Moorselaar R. J. A. , Schuit E. , Verzijlbergen J. F. , Smeenk R. J. , Aluwini S.
Published: May 2022

Background

More than 60% of oligo-recurrent prostate cancer (PCa) patients treated with metastasis-directed radiotherapy (MDRT) develop biochemical recurrence within 2 years. This recurrence rate emphasises the need for improved treatment and patient selection. In line with the treatment of primary PCa, the efficacy of MDRT may be enhanced when combined with androgen-deprivation therapy (ADT). Furthermore, the availability of PSMA PET/CT offers an excellent tool for optimal patient selection for MDRT. This phase III randomised controlled trial will investigate the role of the addition of ADT to MDRT in oligo-recurrent PCa patients selected with PSMA PET/CT to enhance oncological outcome.

Methods

Two hundred and eighty patients will be randomised in a 1:1 ratio to the standard treatment arm (MDRT alone) or the experimental arm (MDRT + 6 months ADT). Patients with biochemical recurrence after primary treatment of PCa presenting with ≤ 4 metastases will be included. The primary endpoint is the 2.5-year metastases progression-free survival (MPFS). Secondary endpoints are acute and late toxicity, quality of life, biochemical progression-free survival, overall survival, and the sensitivity of the PSMA PET/CT for detecting oligometastases at low PSA-levels. So far, between March 2020 and December 2021, one hundred patients have been included.

Discussion

This phase III randomised controlled trial will assess the possible benefit of the addition of 6 months ADT to MDRT on metastases progression-free survival, toxicity, QoL and survival in PCa patients with 1–4 recurrent oligometastatic lesions.

Trial registration

ClinicalTrials.gov, NCT04302454. Registered 10 March 2020.
Clinical impact of primary tumor sidedness and sex on unresectable post-recurrence survival in resected pathological stage II-III colorectal cancers: a nationwide multicenter retrospective study
Authors: Abe Shinya , Kawai Kazushige , Nozawa Hiroaki , Sasaki Kazuhito , Murono Koji , Emoto Shigenobu , Ozawa Tsuyoshi , Yokoyama Yuichiro , Nagai Yuzo , Anzai Hiroyuki , Sonoda Hirofumi , Yamauchi Shinichi , Sugihara Kenichi , Ishihara Soichiro
Published: May 2022

Background

Several studies have demonstrated that right-sided tumors have poorer prognosis than left-sided tumors in patients with unresectable colorectal cancer (CRC). The predictive ability of the tumor sidedness in CRC treated with chemotherapy in each sex is unclear.

Methods

Subjects were 964 unresectable recurrent patients treated with chemotherapy with stage II-III CRC after curative resection between 2004 and 2012. Post-recurrence cancer-specific survival (CSS) for each sex was examined.

Results

Patients were 603 males (222 right-side tumors (cecum to transverse colon) and 381 left-sided tumors (descending colon to rectum)), and 361 females (167 right-side tumors and 194 left-sided tumors). Right-sided tumors developed peritoneal recurrences in males and females. Left-sided tumors were associated with locoregional recurrences in males and with lung recurrences in females. Right-sided tumors were associated with shorter post-recurrence CSS in both sexes. In males, multivariate analyses showed that right-sided tumors were associated with shorter post-recurrence CSS (HR: 1.53, P < 0.0001) together with the presence of regional lymph node metastasis histopathological type of other than differentiated adenocarcinoma, the recurrence of liver only, the recurrence of peritoneal dissemination only, and relapse-free interval less than one-year. In females, multivariate analyses showed that right-sided tumors were associated with shorter post-recurrence CSS (HR: 1.50, P = 0.0019) together with advanced depth of invasion, the presence of regional lymph node metastasis, and recurrence of liver only.

Conclusions

Primary tumor sidedness in both sexes in unresectable recurrent CRC patients treated with chemotherapy may have prognostic implications for post-recurrence CSS.
A rare case of congenital pupillary abnormality: a case report
Authors: Hao Lancao , Ma Zicheng , Song Chenjie , Zhu Siquan
Published: May 2022

Background

Congenital anomalies of the pupil are quite varied, including abnormal size, shape, color, response to stimulus, and function. We are here reporting an unusual case presented with the absence of pupillary opening with folds of iris tissue at the center. Only an extremely small pupil (diameter < 0.5 mm) could be observed during the operation.

Case presentation

A 15-year-old male patient visited our outpatient clinic due to vision difficulty in his right eye for more than ten years. The best-corrected visual acuity was 2.0 logMAR and 0 logMAR for the right and left eye, respectively. There were amblyopia, astigmatism and constant exotropia in his right eye. Ophthalmic examination of the right eye showed flat iris root, minimal iris pigmentation, and the pupil area was entirely covered by iris tissue. Lens status and fundus evaluation could not be commented. The left eye was found to be within normal limit. Based on ophthalmic examination, the admission diagnosis was given as acorea. Pupilloplasty was performed on the right eye due to the situation that the iris tissue blocked the visual axis, which led to visual impairment and stimulus deprivation amblyopia. However, an extremely small pupil at the center of his pupillary area was observed during the operation. The postoperative course was favorable, and a normal pupil was secured. Hospital discharge diagnosis was given as microcoria, and amblyopia treatment was followed.

Conclusions

We report a rare case of congenital pupillary abnormality. The further diagnosis was given as microcoria, which should be differentiated from acorea. For this kind of pupil disorder which blocks the visual axis, early diagnosis and treatment can help prevent the development of stimulus deprivation amblyopia.
Association between dietary fat quality indices with anthropometric measurements in children and adolescents
Authors: Mozafarinia Maedeh , Heidari-Beni Motahar , Abbasi Behnood , Kelishadi Roya
Published: May 2022

Background

The association between anthropometric measures and dietary fat quality indices is unclear in pediatric age groups. The present study aimed to assess the association between dietary lipophilic index (LI) and thrombogenic index (TI) as dietary fat quality indices with anthropometric measurements in children and adolescents.

Method

This nationwide cross-sectional study was conducted on 4323 students aged 6-18 years that were selected by multistage cluster sampling from 31 provinces of Iran. Dietary intake was collected using a validated food frequency questionnaire and dietary LI and TI were calculated by formula. Data on anthropometric measures were collected by standard protocols.

Results

The multivariate regression analysis revealed that TI and LI had inverse association with neck circumference Z-score (β = 0.11, p = 0.013 and β = 0.12 p = 0.006, respectively). There was a positive correlation between LI with height Z-score (β = 0.12, 95% CI: 0.01, p = 0.009). However, there was no significant association between LI and TI with other anthropometric indices (P > 0.05).

Conclusion

The quality of dietary fats was associated with some anthropometric indices. Further large-scale studies are required to highlight the importance of dietary fat quality indices in relation to cardio-metabolic risk factors in pediatric age groups. Reducing intake of saturated fatty acids, increasing consumption of monounsaturated fatty acids and a balanced intake of omega-3 and omega-6 to reduce the risk of cardiovascular diseases risk factors are recommended.
Smartphone addiction and its associated factors among freshmen medical students in China: a cross-sectional study
Authors: Liu Huan , Zhou Zhiqing , Zhu Ergang , Huang Long , Zhang Ming
Published: May 2022

Background

With smartphone use widespread worldwide, smartphone addiction is an emerging epidemic. This study aims to investigate the prevalence of smartphone addiction among freshmen medical students and to explore its association with personal factors, mental health, and professional identity.

Methods

This cross-sectional study was conducted from October 10th to November 10th, 2020 and included 2,182 first-year college students at Wannan Medical College, China. The smartphone addiction test, professional identity, and a 12-item general health questionnaire were used for this cross-sectional survey. Pearson’s correlation coefficient (r) was employed to examine the correlations between smartphone addiction and mental health and professional identity. Binary logistic regression analysis was carried out to assess the factors influencing smartphone addiction. Of the 2,182 students, 866 (39.7%) were identified as having smartphone addiction. The logistic regression analysis shows that four factors (professional identity scale, poor mental health, smartphone use before sleep, and perceived study pressure) were significantly associated with smartphone addiction.

Conclusions

This cross-sectional study suggests that smartphone addiction is common among Chinese freshmen medical students. Smartphone addiction was common among the freshmen medical students surveyed. The findings imply that promotional programs, aimed at enhancing mental health and professional identity among freshmen medical students, help to reduce smartphone addiction in this population.
Community and individual level determinants and spatial distribution of deworming among preschool age children in Ethiopia: spatial and multi-level analysis
Authors: Belay Daniel Gashaneh , Asratie Melaku Hunie , Gashaw Moges , Tsega Nuhamin Tesfa , Endalew Mastewal , Aragaw Fantu Mamo
Published: May 2022

Background

Soil-transmitted helminths caused millions of morbidity of preschool age children in sub-Saharan Africa with low socio-economic status and lack of clean water and sanitation. In Ethiopia, nearly half of children are affected by intestinal parasites. Despite this prevalence, deworming medication utilization among preschool age children is low. Hence, this study aimed to assess the community and individual level determinants and spatial distributions of deworming among preschool age children in Ethiopia.

Methods

Crossectional collected 2016 Ethiopian Demographic and Health Survey datasets with a total weighted 8146 children 12–59 months old were used for this study. The data were cleaned, extracted, and analyzed using STAT Version 16 software and exported to MS excel for spatial analysis. In addition, ArcGIS and SaTScan software were used to detect the geographic distribution of deworming utilization among preschool age children.

Results

The magnitude of deworming among preschool age children in Ethiopia was 13.32% (95% CI: 12.60, 14.08) and ranges from the lowest 3.34% (95% CI: 1.01, 10.45) Afar region to the highest 28.66% (95% CI:24.95, 32.69) Tigray region. In multilevel multivariable logistics regression analysis; variables such as secondary and above women education [AOR = 1.89; 95%CI; 1.32, 2.73], women who have occupation [AOR = 1.47; 95%CI; 1.23, 1.76], child with 12–23 months old [AOR = 2.00; 95%CI; 1.62, 2.46], having ANC visit [AOR = 1.68; 95%CI; 1.35, 2.08], households that have media exposure [AOR = 1.50; 95%CI; 1.22, 1.85] were significantly associated with deworming among preschool age children. Afar, Eastern Amhara, Dire Dewa, Harari, Somalia, and Eastern SNNPE regions were cold spot regions with Global Moran’s I value 0.268 (p < 0.0001) for deworming of preschool age children.

Conclusions

The prevalence of deworming among preschool age children in Ethiopia is relatively low. Individual-level factors such as; maternal education and occupation, having ANC visit, child age, household media exposure, and community-level variables such as; community media usage had a significant association with deworming among preschool age children in Ethiopia. These findings highlight that, the Ministry of Health (MOH) Ethiopia should prepare a regular campaign for deworming programs for preschool age children. Mass media promotion of deworming should be strengthened. The Ministry of Education should work to strengthen women’s education, household and community media exposure. Prior attention should be given to low deworming regions such as Afar, Somalia, Diredewa, and Harari regions.
Factors associated with sexual and reproductive health service utilisation in high migration communities in six Southern African countries
Authors: Chawhanda Christine , Levin Jonathan , Ibisomi Latifat
Published: May 2022

Background

Migration among women has significant health consequences on their access to and utilisation of health services, particularly sexual and reproductive health services. Despite the large quantity of research on migrant health, there is a paucity of research on the factors associated with utilization of modern methods of contraception, intimate partner violence services and sexual and reproductive health (SRH) referral services among non-migrants, internal and international migrant women. Consequently, understanding the factors associated with utilisation of SRH services among women in Southern Africa motivates this study.

Methods

The study uses secondary data from a cross sectional survey conducted in 2018. Logistic regression models were fitted to investigate the factors associated with utilisation of sexual and reproductive health services among 2070 women aged 15–49 years in high migrant communities in six Southern African countries.

Results

Factors found to be associated with current non-use of modern contraceptive methods were country, employment status, educational level, comprehensive knowledge about SRH, comprehensive knowledge about HIV, desire for another child, partner’s age and partner’s educational level. Regarding utilisation of SRH services, important factors were ever denied access to a public healthcare facility, country, marital status and comprehensive knowledge about HIV. Factors associated with utilising IPV services were migration status, age and attitude towards wife beating.

Conclusion

The findings highlight that migration status is associated with utilisation of IPV services. Comprehensive knowledge about SRH and partner characteristic variables were associated with current non-use of modern contraceptive methods. There is a need for SRH programs that can disseminate accurate information about SRH and encourage male involvement in SRH related issues. In addition, the SRH programs should target all women regardless of their migration status, age, educational level and marital status.
Using traditional healers to treat child malnutrition: a qualitative study of health-seeking behaviour in eastern Ethiopia
Authors: Degefa Ketema , Tadesse Adugna , Ackley Caroline , Madrid Lola , Assefa Nega , Breines Markus , Sivalogan Kasthuri , Maixenchs Maria , Blevins John
Published: May 2022

Background

Malnutrition among children under five years of age is a major public health issue in many low and middle-income constrained countries. According to WHO, 5.3 million under-five children die every year and about 45% of these deaths are linked to malnutrition. While it is clear that poverty and lack of food are important factors in children’s malnutrition, less is known about the ways in which local conceptions of malnutrition affect parents’ treatment choices. In Ethiopia, child malnutrition is a severe public health problem and a common cause of child death, and this paper explores the local views of malnutrition and how these shape people’s health-seeking behaviour.

Methods

The study was conducted in eastern Ethiopia from December 2017 to January 2019, conducting interviews and focus group discussions to explore different views and treatment options malnutrition. The study used grounded theory because it allows new and unexpected themes to arise from the data. Researchers’ assumptions on local terminologies of child malnutrition are also controlled as a principle of ground theory.

Results

Child malnutrition was not only perceived to be related to lack of food but was understood in a wider local conceptualization of health and illness. Parents often relied on healers because they are long-standing members of the community, possess indigenous knowledge, and cost less than other options. Because health professionals and the community perceive and speak of health very differently, people often do not seek support from health services. The misalignments between how health professionals and healers diagnose and treat malnourished children have implications on the possibilities to implement change to reduce malnutrition.

Conclusions

Through an exploration of people’s own terminology and understandings of what a malnourished child is, as well as the underlying reasons for their illness, this paper explores how people understand malnutrition symptoms and why many tend to rely on healers rather than seeking care from health centres.
A novel technique of transpedicular opening-wedge osteotomy for treatment of rigid kyphosis in patients with ankylosing spondylitis
Authors: Zheng Guang Bin , Hong Zhenghua , Wang Zhangfu , Zheng Binbin
Published: May 2022

Background

To investigate the effectiveness and feasibility of a novel vertebral osteotomy technique, transpedicular opening-wedge osteotomy (TOWO) was used to correct rigid thoracolumbar kyphotic deformities in patients with ankylosing spondylitis (AS).

Methods

Eighteen AS patients underwent TOWO to correct rigid thoracolumbar kyphosis. Radiographic parameters were compared before surgery, 1 week after surgery and at the last follow-up. The SRS-22 questionnaire was given before surgery and at the last follow-up to evaluate clinical improvement. The operating time, estimated blood loss and complications were analyzed.

Results

The mean operating time and estimated blood loss were 236 min and 595 ml, respectively. The mean preoperative sagittal vertical axis (SVA), thoracic kyphosis (TK), pelvic tilt (PT) and thoracolumbar kyphosis (TLK) were 158.97 mm, 51.24 mm, 43.63 mm and 41.74 mm, respectively, and decreased to 66.72 mm, 35.96 mm, 27.21 mm and 8.67 mm at the last follow-up. The mean preoperative lumbar lordosis (LL) and sacral slope (SS) were 8.30 ± 24.43 mm and 19.67 ± 9.40 mm, respectively, which increased to 38.23 mm and 28.13 mm at the last follow-up. The mean height of the anterior column of osteotomized vertebrae increased significantly from 25.17 mm preoperatively to 37.59 mm at the last follow, but the height of the middle column did not change significantly. SRS-22 scores were improved significantly at the last follow-up compared with preoperatively. Solid bone union was achieved in all patients after 12 months of follow-up, and no screw loosening, screw removal or rod breakage was noticed at the last follow-up.

Conclusions

TOWO could achieve satisfactory kyphosis correction by opening the anterior column instead of vertebral body decancellation and posterior column closing, thus simplifying the osteotomy procedure and improving surgical efficacy.
Associations between the dietary inflammatory index with obesity and body fat in male adolescents
Authors: Gholamalizadeh Maryam , Ahmadzadeh Mina , BourBour Fatemeh , Vahid Farhad , Ajami Marjan , Majidi Nazanin , Hajipour Azadeh , Doaei Saeid , Kalantari Naser , Alizadeh Atiyeh , Jarrahi Alireza Mosavi
Published: May 2022

Background

Obesity and body composition may be affected by the pro-inflammatory and anti-inflammatory components of diets. The aim of this study was to investigate associations between the dietary inflammatory index (DII) and body fat percentage (BF%) in male adolescents.

Methods

This cross-sectional study was carried out on 535 adolescent boys in Tehran, Iran. Bio-impedance analyzer (BIA) scale was used to measure body mass index (BMI) and body composition. A validated semi-quantitative food frequency questionnaire (FFQ) was used to measure DII.

Results

Participants with higher BF% (≥ 19.2%) had higher BMI (P < 0.001), DII, and intake of saturated fatty acids (SFAs), compared with the participants with lower BF%. Participants with a lower DII had significantly higher intakes of fibers (P < 0.001) and lower intakes of fats, SFAs, monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), oleic acid and linoleic acid (P < 0.05) compared with the participants with higher DII (P < 0.01). High BF% was positively associated to DII (OR = 1.6, CI 95%: 1.1–2.3,P = 0.019). Adjustments for age, BMI, physical activity, mothers’ marital status and educational level and the number of siblings did not change the results.

Conclusions

Following a diet with a low inflammatory index score was associated to lower BF% in male adolescents. Thus, a diet rich in anti-inflammatory factors may effectively improve body composition and prevent obesity in adolescents. Further comprehensive studies are necessary to verify these findings and to identify the underlying mechanisms.
Distinguished representation of identical mentions in bio-entity coreference resolution
Authors: Li Yufei , Zhou Xiangyu , Ma Jie , Ma Xiaoyong , Cheng Pengzhen , Gong Tieliang , Li Chen
Published: May 2022

Background

Bio-entity Coreference Resolution (CR) is a vital task in biomedical text mining. An important issue in CR is the differential representation of identical mentions as their similar representations may make the coreference more puzzling. However, when extracting features, existing neural network-based models may bring additional noise to the distinction of identical mentions since they tend to get similar or even identical feature representations.

Methods

We propose a context-aware feature attention model to distinguish similar or identical text units effectively for better resolving coreference. The new model can represent the identical mentions based on different contexts by adaptively exploiting features, which enables the model reduce the text noise and capture the semantic information effectively.

Results

The experimental results show that the proposed model brings significant improvements on most of the baseline for coreference resolution and mention detection on the BioNLP dataset and CRAFT-CR dataset. The empirical studies further demonstrate its superior performance on the differential representation and coreferential link of identical mentions.

Conclusions

Identical mentions impose difficulties on the current methods of Bio-entity coreference resolution. Thus, we propose the context-aware feature attention model to better distinguish identical mentions and achieve superior performance on both coreference resolution and mention detection, which will further improve the performance of the downstream tasks.
A qualitative study exploring the barriers to attending structured education programmes among adults with type 2 diabetes
Authors: Coningsby Imogen , Ainsworth Ben , Dack Charlotte
Published: May 2022

Background

Diabetes self-management education, a universally recommended component of diabetes care, aims to support self-management in people with type 2 diabetes. However, attendance is low (approx. 10%). Previous research investigating the reasons for low attendance have not yet linked findings to theory, making it difficult to translate findings into practice. This study explores why some adults with type 2 diabetes do not attend diabetes self-management education and considers how services can be adapted accordingly, using Andersen’s Behavioural Model of Health Service Utilisation as a framework.

Methods

A cross-sectional semi-structured qualitative interview study was carried out. Semi-structured interviews were conducted by telephone with 14 adults with type 2 diabetes who had verbally declined their invitation to attend diabetes self-management education in Bath and North East Somerset, UK, within the last 2 years. Data were analysed using inductive thematic analysis before mapping the themes onto the factors of Andersen’s Behavioural Model.

Results

Two main themes were identified: ‘perceived need’ and ‘practical barriers’. The former theme explored participants’ tendency to decline diabetes education when they perceived they did not need the programme. This perception tended to arise from participants’ high self-efficacy to manage their type 2 diabetes, the low priority they attributed to their condition and limited knowledge about the programme. The latter theme, ‘practical barriers’, explored the notion that some participants wanted to attend but were unable to due to other commitments and/or transportation issues in getting to the venue.

Conclusions

All sub-themes resonated with one or more factors of Andersen’s Behavioural Model indicating that the model may help to elucidate attendance barriers and ways to improve services. To fully understand low attendance to diabetes education, the complex and individualised reasons for non-attendance must be recognised and a person-centred approach should be taken to understand people’s experience, needs and capabilities.
Imagery ability assessments: a cross-disciplinary systematic review and quality evaluation of psychometric properties
Authors: Suica Zorica , Behrendt Frank , Gäumann Szabina , Gerth Ulrich , Schmidt-Trucksäss Arno , Ettlin Thierry , Schuster-Amft Corina
Published: May 2022

Background

Over the last two centuries, researchers developed several assessments to evaluate the multidimensional construct of imagery. However, no comprehensive systematic review (SR) exists for imagery ability evaluation methods and an in-depth quality evaluation of their psychometric properties.

Methods

We performed a comprehensive systematic search in six databases in the disciplines of sport, psychology, medicine, education: SPORTDiscus, PsycINFO, Cochrane Library, Scopus, Web of Science, and ERIC. Two reviewers independently identified and screened articles for selection. COSMIN checklist was used to evaluate the methodological quality of the studies. All included assessments were evaluated for quality using criteria for good measurement properties. The evidence synthesis was summarised by using the GRADE approach.

Results

In total, 121 articles reporting 155 studies and describing 65 assessments were included. We categorised assessments based on their construct on: (1) motor imagery (n = 15), (2) mental imagery (n = 48) and (3) mental chronometry (n = 2). Methodological quality of studies was mainly doubtful or inadequate. The psychometric properties of most assessments were insufficient or indeterminate. The best rated assessments with sufficient psychometric properties were MIQ, MIQ-R, MIQ-3, and VMIQ-2 for evaluation of motor imagery ability. Regarding mental imagery evaluation, only SIAQ and VVIQ showed sufficient psychometric properties.

Conclusion

Various assessments exist to evaluate an individual’s imagery ability within different dimensions or modalities of imagery in different disciplines. However, the psychometric properties of most assessments are insufficient or indeterminate. Several assessments should be revised and further validated. Moreover, most studies were only evaluated with students. Further cross-disciplinary validation studies are needed including older populations with a larger age range. Our findings allow clinicians, coaches, teachers, and researchers to select a suitable imagery ability assessment for their setting and goals based on information about the focus and quality of the assessments.

Systematic reviews register

PROSPERO CRD42017077004.
Management of pulmonary arteriovenous malformations involves additional factors aside from the diameter of feeding arteries: a 3-year case-case retrospective analysis
Authors: Ma Xu , Li Ling-Ling , Yu Dong , Jie Bing , Jiang Sen
Published: May 2022

Background

Pulmonary arteriovenous malformations (PAVMs) are rare but cause various manifestations. Although the diameter of feeding arteries has been linked to treatment decisions, relationships among the characteristics of PAVMs, clinical symptoms, and treatment effect remain unclear. The present study was performed to investigate how collective characteristics of PAVMs relate to clinical symptoms and to provide proper treatment recommendations for patients with PAVMs.

Methods

We retrospectively analysed 838,447 patients’ radiographic data and medical records from January 2018 to December 2020. Patients were included if a PAVM was radiographically detected for the first time in our hospital. Ordered multivariable logistic regression and hierarchical multiple regression were performed to analyse the relationships between characteristics of PAVMs and various clinical symptoms. We investigated the management of PAVMs in four tertiary university hospitals.

Results

Detection rate of PAVMs was 0.025% (207/838,447), and 37.6% of patients (78/207) also had hereditary haemorrhagic telangiectasia. Eight patients were diagnosed with bilateral diffuse PAVMs. Two hundred thirty-six lesions were detected in 199 patients, and the mean diameter of the feeding artery was 4.13 ± 1.92 mm. Most PAVMs were the simple type and located in the peripheral pulmonary area. In total, 34.3% of patients (71/207) were symptom-free; remaining patients showed various manifestations, and respiratory symptoms were most common (dyspnoea on exertion, 47.8%). The diameter of the feeding artery and the type and the number of PAVMs were correlated with hypoxaemia (P < 0.001, P < 0.001, and P = 0.037, respectively). The collective characteristics of PAVMs were not related to the severity of central nervous system symptoms (largest diameter of feeding artery, P = 0.8; largest diameter of sac, P = 0.42; number of PAVMs, P = 0.35; type of PAVMs, P = 0.99). Various symptoms were greatly relieved after treatment. The hospital investigation showed that management of PAVMs was not generally appreciated in clinical practice.

Conclusions

Our study revealed a low detection rate of PAVMs and a low degree of association with hereditary haemorrhagic telangiectasia in the general population. Considering the connection between collective characteristics of PAVMs and various clinical symptoms, clinicians should consider the type and number of PAVMs, the largest diameter of the feeding artery, and clinical symptoms when managing patients with PAVMs.
Involvement of IL-26 in bronchiolitis obliterans syndrome but not in acute rejection after lung transplantation
Authors: Magnusson Jesper M. , Ericson Petrea , Tengvall Sara , Stockfelt Marit , Brundin Bettina , Lindén Anders , Riise Gerdt C.
Published: May 2022

Background

 The main long-term complication after lung transplantation is bronchiolitis obliterans syndrome (BOS), a deadly condition in which neutrophils may play a critical pathophysiological role. Recent studies show that the cytokine interleukin IL-26 can facilitate neutrophil recruitment in response to pro-inflammatory stimuli in the airways. In this pilot study, we characterized the local involvement of IL-26 during BOS and acute rejection (AR) in human patients.

Method

 From a biobank containing bronchoalveolar lavage (BAL) samples from 148 lung transplant recipients (LTR), clinically-matched patient pairs were identified to minimize the influence of clinical confounders. We identified ten pairs (BOS/non-BOS) with BAL samples harvested on three occasions for our longitudinal investigation and 12 pairs of patients with and without AR. The pairs were matched for age, gender, preoperative diagnosis, type of and time after surgery. Extracellular IL-26 protein was quantified in cell-free BAL samples using an enzyme-linked immunosorbent assay. Intracellular IL-26 protein in BAL cells was determined using immunocytochemistry (ICC) and flow cytometry.

Results

 The median extracellular concentration of IL-26 protein was markedly increased in BAL samples from patients with BOS (p < 0.0001) but not in samples from patients with AR. Intracellular IL-26 protein was confirmed in alveolar macrophages and lymphocytes (through ICC and flow cytometry) among BAL cells obtained from BOS patients.

Conclusions

 Local IL-26 seems to be involved in BOS but not AR, and macrophages as well as lymphocytes constitute cellular sources in this clinical setting. The enhancement of extracellular IL-26 protein in LTRs with BOS warrants further investigation of its potential as a target for diagnosing, monitoring, and treating BOS.
Increased expression of prokineticin 2 and its receptor in endometrium of recurrent implantation failure patients decreased the expression of MMP9 important for decidualization
Authors: Zhai Jun , Ma Linna , Chang Ziyin , Yu Ting
Published: May 2022

Background

Studies have shown that abnormalities in the decidualization process were closely related to recurrent implantation failure (RIF). Prokineticin 2 (PK2) is a secreted protein with angiogenic and tissue remodeling functions but its role in the endometrium is unknown.

Methods

PK2 levels and its receptor PKR1 mRNA and protein levels in mid-secretory endometrium from normal and RIF women were examined by real-time PCR and western blotting, respectively. The effects of PK2 were evaluated by overexpressed PK2 in immortalized endometrial T-HESC cells using lentivirus vector and found different expression of Matrix metalloproteinase 9(MMP9) and lncRNA LUCAT1 by RNA-sequencing. The ability of PK2 to regulate LUCAT1 and MMP9 was verified in endometrial cells by real-time PCR and western blotting.

Results

Using endometrial biopsies from normal and RIF patients, we found increased expression of PK2, together with its receptor PKR1 in RIF patients. We then overexpressed PK2 in immortalized endometrial T-HESC cells using lentivirus vector and found decreased expression of Matrix metalloproteinase 9(MMP9), and increased expression of lncRNA LUCAT1. We verified the ability of PK2 to stimulate LUCAT1 and decrease MMP9 in endometrial cells. We further demonstrated that increased expression of a long noncoding RNA LUCAT1 and decreased expression of MMP9 in endometrial biopsies of patients with RIF. Thus, we highlighted the important role of PK2 and its receptor PKR1 in decidualization and RIF.

Conclusion

Prokineticin 2 and its receptor are important in endometrium decidualization. PK2 may affect endometrial decidualization through the LUCAT1- MMP9 pathway, thereby affecting embryo implantation.
Musculoskeletal involvement in childhood leukemia: Characteristics and survival outcomes
Authors: Kittivisuit Sirinthip , Sripornsawan Pornpun , Songthawee Natsaruth , Chavananon Shevachut , McNeil Edward B. , Chotsampancharoen Thirachit
Published: May 2022

Background 

Childhood leukemia with musculoskeletal (MSK) involvement mimics various conditions, which consequently leads to diagnostic delays. The clinical implication of MSK involvement in this disease on survival outcomes is inconclusive. This study aimed to compare characteristics and survival outcomes between MSK and non-MSK involvement in childhood leukemia.

Methods

The medical records of children newly diagnosed with acute leukemia of an age under 15 years were retrospectively reviewed. Two-to-one nearest-neighbor propensity score-matching was performed to obtain matched groups with and without MSK involvement. The Kaplan–Meier method and log-rank test were then used to assess the effect of MSK involvement on survival outcomes.

Results

Of 1042 childhood leukemia cases, 81 (7.8%) children had MSK involvement at initial presentation. MSK involvement was more likely in children with acute lymphoblastic leukemia than acute myeloid leukemia (p < 0.05). Hematologic abnormalities were less frequent in the MSK involvement group (p < 0.05). The absence of peripheral blast cells was significantly higher in the MSK involvement group (17.3% vs 9.6%, p = 0.04). Normal complete blood counts with absence of peripheral blast cells were found 2.5% of the children with MSK involvement. By propensity score-matching for comparable risk groups of children with and without MSK involvement, the 5-year overall survival was not significantly different (48.2% vs 57.4%, respectively, p = 0.22), nor was event-free survival (43.3% vs 51.8%, respectively, p = 0.31).

Conclusion

Childhood leukemia with MSK involvement had the characteristics of minimal or absent hematologic abnormalities and peripheral blast counts.
Perspectives on high-quality interpersonal care among people obtaining abortions in Argentina
Authors: Bercu Chiara , Filippa Sofía , Ramirez Ana Maria , Katz Anna , Grosso Belén , Zurbriggen Ruth , Vázquez Sandra , Baum Sarah E.
Published: May 2022

Introduction

Little is known about how people who have abortions describe high-quality interpersonal care in Argentina. This qualitative study aimed to understand preferences and priorities in their interactions with providers.

Study design

We conducted 24 in-depth interviews with people who obtained abortions at a comprehensive reproductive health clinic or with support from a feminist accompaniment group in Buenos Aires and Neuquén, Argentina. We iteratively coded transcripts using a thematic analysis approach based on interpersonal domains present in current quality of care frameworks.

Results

Participants described high-quality abortion care as feeling acompañamiento and contención from their providers – terms that imply receiving kind, caring, compassionate and emotionally supportive care throughout their abortion. They described four key elements of interpersonal interactions: attentive communication from providers and accompaniers, clear and understandable information provision, non-judgmental support, and individualized options for pain management.

Conclusions

People obtaining abortions in Argentina consistently identified receiving compassionate and supportive care throughout an abortion as a key aspect of care. The findings have implications for incorporating people’s perspectives in the development of care guidelines, training of providers, and monitoring and improving of services. This is particularly important as the government of Argentina prepares to expand legal access to abortion.
Enhancer transcription detected in the nascent transcriptomic landscape of bread wheat
Authors: Xie Yilin , Chen Yan , Li Zijuan , Zhu Jiafu , Liu Min , Zhang Yijing , Dong Zhicheng
Published: May 2022

The precise spatiotemporal gene expression is orchestrated by enhancers that lack general sequence features and thus are difficult to be computationally identified. By nascent RNA sequencing combined with epigenome profiling, we detect active transcription of enhancers from the complex bread wheat genome. We find that genes associated with transcriptional enhancers are expressed at significantly higher levels, and enhancer RNA is more precise and robust in predicting enhancer activity compared to chromatin features. We demonstrate that sub-genome-biased enhancer transcription could drive sub-genome-biased gene expression. This study highlights enhancer transcription as a hallmark in regulating gene expression in wheat.
A high-throughput visual screening method for p-hydroxybenzoate hydroxylase to increase phenolic compounds biosynthesis
Authors: Chen Zhenya , Chen Tongtong , Yu Shengzhu , Huo Yi-Xin
Published: May 2022

Background

Gallic acid (GA) and pyrogallol are phenolic hydroxyl compounds and have diverse biological activities. Microbial-based biosynthesis, as an ecofriendly method, has been used for GA and pyrogallol production. In GA and pyrogallol biosynthetic pathways, the low hydroxylation activity of p-hydroxybenzoate hydroxylase (PobA) towards 3,4-dihydroxybenzoic acid (3,4-DHBA) limited the high-level biosynthesis of GA and pyrogallol.

Results

This work reported a high activity PobA mutant (Y385F/T294A/V349A PobA) towards 3,4-DHBA. This mutant was screened out from a PobA random mutagenesis library through a novel naked eye visual screening method. In vitro enzyme assay showed this mutant has a kcat/Km of 0.059 μM−1 s−1 towards 3,4-DHBA, which was 4.92-fold higher than the reported mutant (Y385F/T294A PobA). Molecular docking simulation provided the possible catalytic mechanism explanation of the high activity mutant. Expression of this mutant in E. coli BW25113 (Fʹ) can generate 840 ± 23 mg/L GA from 1000 mg/L 3,4-DHBA. After that, this mutant was assembled into a de novo GA biosynthetic pathway. Subsequently, this pathway was introduced into a 3,4-DHBA-producing strain (E. coli BW25113 (Fʹ)ΔaroE) to achieve 301 ± 15 mg/L GA production from simple carbon sources. Similarly, assembling this mutant into a de novo pyrogallol biosynthetic pathway enabled 129 ± 15 mg/L pyrogallol production.

Conclusions

This work established an efficient screening method and generated a high activity PobA mutant. Assembling this mutant into de novo GA and pyrogallol biosynthetic pathways achieved the production of these two compounds from glucose. Besides, this mutant has great potential for the production of GA or pyrogallol derivatives. The screening method could be used for other GA biosynthesis-related enzymes.