bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors contributing to postoperative surgical site infections in patients undergoing ankle fracture fixation: A systematic review and meta‐analysis
Authors: Yin Changxin , Sun Lu
Published: December 2023

Surgical site infections (SSIs) following ankle fracture fixation pose significant challenges in patient recovery and healthcare management. Identifying risk factors contributing to SSIs can aid in developing targeted prevention and treatment strategies. This systematic review and meta‐analysis were conducted according to the PRISMA guidelines and the PICO framework. A comprehensive literature search across major databases, including PubMed, Embase, Web of Science and the Cochrane Library, was completed on September 26, 2023. The inclusion criteria encompassed peer‐reviewed studies of various designs that investigated risk factors for SSIs post‐ankle fracture fixation. Quality assessment was performed using the Newcastle‐Ottawa Scale. Statistical analyses assessed heterogeneity and calculated combined effect sizes using fixed‐ or random‐effects models, depending on the heterogeneity observed. The initial search yielded 1250 articles, with seven meeting the inclusion criteria after rigorous screening and full‐text review. The included studies, conducted between 2006 and 2019, predominantly utilized case–control designs. The meta‐analysis identified diabetes, open fractures, smoking, age, alcohol consumption, ASA score ≥3, high BMI, contaminated incisions, fracture dislocation and heart disease as significant risk factors for postoperative SSIs. Publication bias assessment showed no significant bias across studies. The identification of key risk factors such as diabetes, open fractures, smoking, advanced age, alcohol consumption, high ASA score, elevated BMI, contaminated incisions, fracture dislocation and heart disease is essential in managing SSIs post‐ankle fracture fixation. Targeted interventions addressing these risk factors are crucial to reduce the incidence of SSIs and improve overall patient outcomes.
Short‐term recovery of insulin secretion in response to a meal is associated with future glycemic control in type 2 diabetes patients
Authors: Enkaku Asako , Chujo Daisuke , Kamigishi Miki , Inagawa Shinya , Matsukoshi Shinnosuke , Sakai Waka , Takikawa Akiko , Fujisaka Shiho , Tobe Kazuyuki
Published: December 2023

Aims/Introduction

Endogenous insulin secretion could be recovered by improving hyperglycemia in patients with type 2 diabetes. This study aimed to investigate the association between short‐term recovery of insulin secretion during hospitalization and clinical background or future glycemic control in patients with type 2 diabetes.

Materials and Methods

A total of 127 patients with type 2 diabetes were included. The recovery of endogenous insulin secretion was determined using the following indices: index A: fasting C‐peptide index (CPI) at discharge – fasting CPI on admission; index B: postprandial CPI at discharge – postprandial CPI on admission; and index C: Δ C‐peptide immunoreactivity (CPR) (postprandial CPR − fasting CPR) at discharge – ΔCPR on admission. We examined the associations of each index with clinical background and future glycemic control measured by glycosylated hemoglobin and continuous glucose monitoring.

Results

Using index A and B, the age was significantly younger, whereas BMI and visceral fat area were significantly higher in the high‐recovery group than in the low‐recovery group. Changes in glycosylated hemoglobin levels were significantly greater at 6 and 12 months in the high‐recovery group in the analysis of index C. The receiver operating characteristic curve analysis identified the index B and index C as indicators to predict glycosylated hemoglobin <7.0% at 6 months after discharge. Furthermore, index C was positively correlated with the time in the target glucose range, and inversely correlated with the standard deviation of glucose at 3 and 12 months after discharge.

Conclusions

Short‐term recovery of insulin secretion in response to a meal during hospitalization, evaluated with the index‐C, might predict future glycemic control.
Developing ultrasound‐assisted infrared drying technology for bitter melon (Momordica charantia)
Authors: Akhoundzadeh Yamchi Abolfazl , Hosainpour Adel , Hassanpour Ali , Rezvanivand Fanaei Adel
Published: December 2023

The design of specific drying equipment requires correct knowledge of kinetic and thermodynamic characteristics of agricultural products. The purpose of this research is to find a suitable mathematical model to describe the experimental drying process, obtain the activation energy to specify the thermodynamic properties and calculate the specificity energy consumption. Bitter melons were dried in an infrared dryer with different temperatures, ultrasonic pretreatment times, and diverse distances from infrared lamps to reach moisture 0.1 kgw.kgd−1. The Midilli's model, best model to describe the drying process of bitter melon was chosen. The effective diffusion coefficient of bitter melon increased from 1.14 × 10−8to 3.60 × 10−8 m2.s−1with increasing drying temperature and duration of ultrasound treatment and decreasing the distance from infrared lamps. Also, Specific energy consumption decreased from 161.96 to 303.57 kWh.kg−1by increasing the temperature and duration of ultrasound pretreatment and reducing the distance of infrared lamps.

Practical applications

Reducing moisture through mass and heat transfer is necessary to maintain the quality and shelf life and reduce the waste of medicinal plants and food materials. The controlled and scientific drying of bitter melon is of utmost importance due to the sensitivity of its effective constituents to the application of heat during the drying process. The utilization of mathematical modeling to conduct theoretical research offers a robust and expeditious means of evaluating the phenomena of mass and heat transfer in the context of natural drying conditions. In order to ensure quality control, a thorough investigation of the product's drying procedure and reducing energy consumption is imperative. The findings of this investigation are applicable to the enhancement of drying processes within the medicinal plant drying sector.
Genomic footprints of (pre) colonialism: Population declines in urban and forest túngara frogs coincident with historical human activity
Authors: Moran Peter A. , Bosse Mirte , Mariën Janine , Halfwerk Wouter
Published: December 2023

Urbanisation is rapidly altering ecosystems, leading to profound biodiversity loss. To mitigate these effects, we need a better understanding of how urbanisation impacts dispersal and reproduction. Two contrasting population demographic models have been proposed that predict that urbanisation either promotes (facilitation model) or constrains (fragmentation model) gene flow and genetic diversity. Which of these models prevails likely depends on the strength of selection on specific phenotypic traits that influence dispersal, survival, or reproduction. Here, we a priori examined the genomic impact of urbanisation on the Neotropical túngara frog (Engystomops pustulosus), a species known to adapt its reproductive traits to urban selective pressures. Using whole‐genome resequencing for multiple urban and forest populations we examined genomic diversity, population connectivity and demographic history. Contrary to both the fragmentation and facilitation models, urban populations did not exhibit substantial changes in genomic diversity or differentiation compared with forest populations, and genomic variation was best explained by geographic distance rather than environmental factors. Adopting an a posteriori approach, we additionally found both urban and forest populations to have undergone population declines. The timing of these declines appears to coincide with extensive human activity around the Panama Canal during the last few centuries rather than recent urbanisation. Our study highlights the long‐lasting legacy of past anthropogenic disturbances in the genome and the importance of considering the historical context in urban evolution studies as anthropogenic effects may be extensive and impact nonurban areas on both recent and older timescales.
Efficacy and safety of modified Atkins diet therapy for drug‐resistant epilepsy in children and adults: A systematic review and meta‐analysis
Authors: Budiputra Nobel , Budiputri Charista Lydia , Elsa Mary Christina
Published: December 2023

Introduction

Diet‐based treatments have been proposed for drug‐resistant epilepsy (DRE), and the Modified Atkins Diet (MAD) is an alternative. This study aimed to assess the efficacy and safety of MAD as an adjunctive therapy for reducing seizures in patients with drug‐resistant epilepsy.

Methods

A literature search was done on six databases. Randomized controlled trial (RCT) studies were included, comparing DRE patients of all ages on standard antiseizure medications (ASD) who received MAD compared to no‐dietary or other dietary interventions. The outcomes are the seizure frequency reduction and the adverse events. Cochrane risk‐of‐bias tool and GRADE were used to assess study quality and the overall certainty of evidence. The effect size of the efficacy of MAD was computed as risk ratio (95% CI). Subgroup analysis based on each type of comparator was done.

Results

Ten RCT studies (905 participants) were included, comparing MAD to no dietary intervention, ketogenic diet (KD), and low glycemic index treatment (LGIT). Overall, MAD is constantly and significantly more efficacious than no dietary intervention in reducing seizures ≥50% (RR 7.90, 95% CI 4.59–13.62), ≥90% (RR 4.61, 95% CI 2.05–10.36), and inducing complete seizure‐free (RR 7.79, 95% 2.61–23.22) with high certainty. Other dietary therapies and MAD did not differ significantly from one another in terms of efficacy. The risk of adverse events in MAD is insignificantly higher than in others (RR 1.19, 95% 0.92–1.55).

Conclusion

The Modified Atkins Diet has better seizure reduction than no diet intervention but is comparable to other dietary interventions with a negligible increased risk of adverse events.
A rare presentation of unilateral posterior reversible encephalopathy syndrome following a trivial head trauma
Authors: Sen Bonny , Chaudhuri Jasodhara , Nanda Tapasaya , Panda Sourav , Mandal Manamita , Nanda Sourav
Published: December 2023

Posterior reversible encephalopathy syndrome is typically a reversible clinico‐radiological entity associated with some specific features on brain imaging. However, there are several atypical radiological presentations. Unilateral presentation of this condition has rarely been reported in past and may mimic other pathologies. Here, we report a very rare case of atypical, unilateral posterior reversible encephalopathy syndrome in a 25‐year‐old female following a trivial head injury. All other relevant secondary causes had been ruled out.
The effect of salbutamol sulphate inhalation (an anti‐asthmatic medication) on the surfaces of orthodontic Archwires
Authors: Alemran Majd A. , Abbassy Mona A. , Bakry Ahmed S. , Alsaggaf Doaa H. , Abu Haimed Tariq S. , Zawawi Khalid H.
Published: December 2023

Objectives

This study aimed to compare the surface roughness and friction of different orthodontic archwires after exposure to salbutamol sulphate inhalation, an anti‐asthmatic medication.

Methods

Orthodontic archwires (stainless‐steel [StSt], nickel‐titanium [NiTi], beta‐titanium [β‐Ti], and copper‐NiTi [Cu‐NiTi]) were equally divided into two groups. The exposed groups were subjected to 20 mg salbutamol sulphate for 21 days and kept in artificial saliva. The control groups were only kept in artificial saliva. Surface changes were visualized using scanning electron microscopy (SEM). The average surface roughness (Ra) was evaluated using atomic force microscopy (AFM), and friction resistance forces were assessed using a universal testing machine. Statistical analyses were performed using t‐tests and ANOVA followed by post hoc tests.

Results

Salbutamol sulphate did not change the surface roughness of StSt and NiTi archwires (p > .05). However, the change in the surfaces of β‐Ti and Cu‐NiTi archwires was significant (p < .001). The frictional forces of exposed StSt, NiTi, and Cu‐NiTi archwires did not change (p > .05). However, the frictional forces of β‐Ti archwires increased significantly after exposure to salbutamol sulphate (p = .021). Brushing with fluoride after exposure to salbutamol sulphate increased the frictional forces of β‐Ti only (p = .002).

Conclusions

Salbutamol sulphate inhalation significantly affected the surface texture of β‐Ti and Cu‐NiTi orthodontic archwires and increased the friction of β‐Ti archwires. These deteriorating effects were not detected on the surface of StSt and NiTi archwires. Therefore, we suggest that β‐Ti and copper titanium archwires should be used cautiously in individuals under salbutamol sulphate inhalation treatment.
Extensive perineal ecthyma gangrenosum in leukocyte adhesion deficiency type 1 associated with Staphylococcus hominis bacteremia
Authors: Kalyanaprabhakaran Balamurugan , Kumar Venkataraman Ranjith , Ramamoorthy Jaikumar Govindaswamy , Karunakar Pediredla , Gunasekaran Dhandapany , Jindal Bibekanand
Published: December 2023

Leukocyte adhesion deficiency (LAD), a disorder of neutrophil function, is characterized by a defect in leukocyte adhesion to the endothelium. Recurrent infections in the skin, soft tissue, gingiva, and lungs due to Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella sp. are common in these patients. Ecthyma gangrenosum (EG) is an ulcer of skin and subcutaneous tissue with a black eschar and surrounding erythematous halo secondary to a bacterial infection. Here, we report an unusual presentation of LAD type‐1 with extensive EG of perineum secondary to Staphylococcus hominis bacteremia treated successfully with combination of granulocyte transfusion and diversion colostomy.
Analysis of a 5‐year, evidenced‐based, rational blood utilisation project in a South African regional hospital
Authors: Wise Robert , Hood Kirsten , Bishop David , Sharp Gary , Rodseth Reitze ,   Saving Blood Saving Lives Working Group
Published: December 2023

Background

Blood products are a lifesaving but limited resource, particularly in resource‐limited settings. Evidence‐based transfusion criteria tailored to local hospitals have shown great promise in reducing costs, minimising shortages, and ameliorating the morbidity and mortality associated with liberal blood product usage. We implemented the “Saving Blood, Saving Lives” project to: promote responsible blood product use and reduce blood product ordering inefficiencies and expenditure.

Methods

A comprehensive change management programme, preceded by 3 months of clinical department consultation and training, was implemented. A new evidence‐based protocol for blood product utilisation was developed, together with an accountability form. This form was used in monthly audit meetings to refine policies, identify new problems, improve communication, and to drive hospital staff accountability and training. The primary measure of the programme's success was the change in the number of red cell concentrate units ordered.

Results

Project implementation required minimal time and no additional budget or staff. Annual red cell concentrate usage reduced from 7211 units in year one to 4077 units in year 5 (p < 0.001). Similar reductions were seen in freeze‐dried plasma and platelet usage, as well as administrative costs. Total project saving, adjusted to baseline admission numbers, amounted to over R46 million ($2.5 million).

Conclusions

As a change management programme centred the “Saving Blood, Saving Lives” project, was able to significantly reduce blood product‐related administration and expenditure by implementing evidence‐based transfusion criteria. The programme is simple, replicable and cost effective, making it ideally suited for use in resource‐constrained environments.
Risk prediction of iron deficiency for plasmapheresis donors in China: Development and validation of a prediction model
Authors: Xiao Guanglin , Li Changqing , Chen Yongjun , Zhao Peizhe , Li Wan , Xiao Hanzu , Yang Yating , Zhang Yu , Zhou Rong , Liu Aying , Liu Lili , Du Linzhi , Xiang Qian , Yang Jing , Wang Ya
Published: December 2023

Background and Objectives

The present study aims to evaluate the iron stores in plasmapheresis donors and develop and validate an iron deficiency (ID) risk prediction model for plasmapheresis donors with potential or existing ID.

Materials and Methods

We assessed plasmapheresis donors' serum ferritin (SF) and haemoglobin (Hb) levels. The candidate factors showing significant differences in the multivariate logistic regression analysis were used to establish a risk prediction scoring system. The participants were divided into a training cohort and an internal validation cohort in a 7:3 ratio. Additional plasmapheresis donors from a different station were recruited for external validation.

Results

The SF levels in both male and female donors in the high‐frequency group were significantly lower than those of new donors (male: p < 0.001; female: p = 0.008). The prevalence of ID in female regular donors with a high frequency was significantly higher than that in new donors (33.1% vs. 24.6%; odds ratio = 1.209 [95% CI: 1.035–1.412]). Donation frequency, age, Hb, body mass index and being pre‐menopausal were identified as independent risk factors for ID (p < 0.05). The developed model exhibited good discrimination ability (area under the receiver operating characteristic curve >0.7) and calibration (p > 0.05) in development, internal validation cohorts and external validation cohorts.

Conclusion

A higher donation frequency has been associated with reduced SF levels and an increased risk of ID in women. The developed ID risk prediction model demonstrates moderate discriminative power and good model fitting, suggesting its potential clinical utility.
Effect of Transition Metal/Graphitic Carbon Nitride for Photoreduction of Hexavalent Chromium
Authors: M.S Azami , Fatihh A.R , Nordin A.H , Tan K.H , Jamluddin N , Izzudin N.M , Azmi A.A
Published: December 2023

Recently, the discharge of heavy metals such as hexavalent chromium (Cr(VI)) into water is increasing due to the development of industrials. This poses a huge environmental challenges as toxic waste of heavy metal leads to water pollution which give a negative impact on health and environment. This heavy metal can be treated by reducing the highly poisonous of Cr(VI) to less toxic trivalent chromium Cr(III). Nowadays, the photocatalytic reduction is one of the effective method that can reduce Cr(VI) to harmless toxic into the environment. In this study, the effect of different metal of Ag, Cu and Ni loaded on g-C3N4 were investigated based on the structural, morphological, compositional, and optical properties. The different metal of Ag, Cu and Ni were loaded on g-C3N4 by using impregnation method. The physical and chemical properties of Ag, Cu and Ni loaded on g-C3N4 were analyzed using FTIR and UV-vis/DRS techniques. The performance of photocatalytic activity among Ag, Cu and Ni loaded on g-C3N4 were evaluated for photoreduction of Cr(VI) and the highest performance of photoreduction of Cr(VI) was demonstrated by Ag/C3N4 (87%), followed by Cu/C3N4 (85%), Ni/C3N4 (80%) and pure g-C3N4 (77%) under visible-light. Among of photocatalyst, Ag/C3N4 was revealed as the best performance in photoreduction of Cr(VI) owing to its change in morphology, strong interaction between Ag and C N bonds and low band gap. Besides, the effect of scavengers shows the active species was the photogenerated electron (e-) play an important role on photoreduction of Cr(VI). Overall, the Ag loaded on g-C3N4 was successfully contribute on photoreduction of Cr (VI) under visible light.
GENOME-WIDE ASSOCIATION STUDY FOR GRAIN QUALITY TRAITS IN SPRING BARLEY COLLECTION GROWN IN NORTH KAZAKHSTAN
Authors: Genievskaya Yu. , Almerekova Sh. , Abugalieva S. , Abugalieva A. , Chudinov V. , Turuspekov Ye.
Published: December 2023

Barley is a cereal crop that is grown all over the world. Its grain is used for animal feed, malting, brewing, and food. The quality of barley grain is important, particularly raw starch and protein contents, and it depends on the end-use product. This study looked at a collection of 356 barley accessions from the USA and Kazakhstan grown under conditions of northern Kazakhstan (Karabalyk agricultural experimental station) and genotyped with 1631 polymorphic SNPs markers. The collection was studied for starch (GSC), protein (GPC), cellulose (GCC), and lipids contents (GLC), and for grain test weight (TWL) during two years. Phenotypic analysis demonstrated impact of the year on studied traits and significant associations between grain quality and the yield (P < 0.01). Population structure analysis revealed three subclusters in the studied barley collection with the dominance of the USA’s barley in two of them. As a result of GWAS, 22 significant QTLs (P < 0.001) were identified for the studied grain quality traits including 19 single-trait QTLs, 2 double-trait QTLs, and a one triple-trait QTL. For 16 QTLs, reference quality genes and/or QTLs were found, while the remaining 6 QTLs were presumably novel genetic factors for grain quality traits. As result, these 22 QTLs are expected to be useful for future breeding projects targeting the selection of high grain quality barley cultivars.
INFLUENCE OF LOW POSITIVE TEMPERATURES ON ANATOMICAL CHARACTERISTICS JUGLANS REGIA L. IN VITRO MICROCLONES
Authors: Terletskaya N.V. , Yerbay M. , Shadenova E.A. , Korbozova N.K. , Nazarova I. , Litvinenko Ju.A. , Kudrina N.O.
Published: December 2023

Walnut (Juglans Regia L.) is a promising plant for use in modern medicine. We describe the reactions of Juglans Regia L. microclones exposed to cold stress in vitro at the cell and tissue level. Differences in the water content of plant tissues and the anatomical and morphological structure of the stem and leaf of Juglans Regia L. microclones under control and stress conditions are shown. Significant changes in the anatomical parameters of various stem tissues, both upward and downward, and a tendency for the values of the anatomical parameters of the leaf to decrease under cold stress conditions were revealed. It has been suggested that changes in the anatomical characteristics of organs and tissues of Juglans Regia L. microclones may affect the phytochemical content of biologically active substances in them, valuable for pharmacy.
Motion Compensator for an Untethered Walking Insect Using Adaptive Model Predictive Control
Authors: Rahman Kaushik , Ehme Daniel , Penick Clint , Kim Dal Hyung
Published: December 2023

A locomotion compensator is normally utilized to observe the behavior of walking insects. These compensators cancel out the movement of freely walking insects to facilitate long-term imaging for studying behavior. However, controlling the locomotion compensator with a small error (≤ 1 mm) has been challenging due to the random motion of walking insects. This study introduces an adaptive model predictive control (MPC) approach combined with trajectory prediction to effectively control the transparent omnidirectional locomotion compensator (TOLC) for a randomly walking fire ant. The proposed MPC with prediction (MPCwP) utilizes the average velocity from the previous gaiting cycle to estimate its future trajectory. Experimental results demonstrate that MPCwP significantly outperforms MPC without prediction (MPCwoP), which relies solely on the current position and orientation. The distance error of the MPCwP method remains below 0.6 mm for 90.3% and 1.0 mm for 99.2% of the time, whereas MPCwoP achieves this only 32.6% and 69.1% of the time, respectively. Furthermore, the proposed method enhances the tracking performance of the heading angle, with the heading angle error staying below 8 deg for 92.6% of the time (wθ=1.0). The enhanced performance of the proposed MPC has the potential to improve the observation images and enable the integration of additional equipment such as an optical microscope for brain or organ imaging.
Assessing Support for Policy Actions With Co-Benefits for Climate Change and Physical Activity in Canada
Authors: Fagan Matthew J. , Vanderloo Leigh M. , Banerjee Ananya , Ferguson Leah J. , Lee Eun-Young , O’Reilly Norman , Rhodes Ryan E. , Spence John C. , Tremblay Mark S. , Faulkner Guy
Published: December 2023

Background: Calls to action addressing the interconnections between physical (in)activity and the climate crisis are increasing. The current study aimed to investigate public support for policy actions that potentially have co-benefits for physical activity promotion and climate change mitigation. Methods: In 2023, a survey through the Angus Reid Forum was completed by 2507 adults living in Canada. Binary logistic regressions were conducted. Separate models were created to reflect support or opposition to the 8 included policy items. Several covariates were included in the models including age, gender, political orientation, physical activity levels, income, urbanicity climate anxiety, and attitudes surrounding physical activity and climate change. The data were weighted to reflect the gender, age, and regional composition of the country. Results: Most individuals living in Canada strongly or moderately supported all actions (ranging from 71% to 85%). Meeting the physical activity guidelines, higher self-reported income, and scoring high on personal experience of climate change were associated with higher odds of supporting the policy actions related to climate actions. Conclusions: Most adults living in Canada support policies that align with the recommended policy actions related to physical activity and climate change. National campaigns enhancing awareness and understanding of the bidirectional relationship between physical activity and climate change are warranted, and these should consider the consistent demographic differences (eg, gender, age, and political orientation) seen in public support for physical activity-related policies.
Effect of Neuromuscular Electrostimulation With Blood Flow Restriction on Acute Muscle Swelling of the Abductor Hallucis
Authors: Okamura Kazunori , Hamaguchi Manami , Ueno Yuna , Kida Taira
Published: December 2023

Context: Plantar intrinsic foot muscle strength training is difficult to master to a degree sufficient to elicit muscle hypertrophy in most individuals. It is possible that combining neuromuscular electrostimulation (NMES) and blood flow restriction (BFR) can elicit plantar intrinsic foot muscle hypertrophy regardless of the individual’s technique. This study aimed to determine the effects of NMES training with BFR on acute muscle swelling in the abductor hallucis. Design: Randomized, controlled, single-blind trial design. Methods: Forty-eight participants were randomly allocated to the NMES + BFR, NMES, or Sham NMES + BFR groups. All participants received abductor hallucis NMES for 15 minutes. Participants in the NMES + BFR and Sham NMES + BFR groups received NMES with BFR. The intensity of NMES was the sensory threshold in the Sham NMES + BFR group. The cross-sectional area of the abductor hallucis was measured pretraining and posttraining using ultrasonography by a single investigator blinded to the participants’ allocations. Results: After 15 minutes of training, the cross-sectional area of the abductor hallucis was significantly increased in the NMES + BFR (P < .001) and the Sham NMES + BFR (P = .004) groups. Moreover, the rate of increase was significantly higher in the NMES + BFR group than in the NMES or the Sham NMES + BFR groups (P < .001 and P = .001, respectively). Conclusions: Since it is possible that the amount of muscle swelling immediately after training correlates with muscle hypertrophy when training is continued, the results of this study suggest that NMES training with BFR is a training method that can be expected to produce plantar intrinsic foot muscle hypertrophy. Further studies are needed to confirm the long-term effects of NMES training with BFR.
An Atypical relapsing follicular lymphoma to composite Hodgkin’s lymphoma
Authors: Abadir Sandra , Iska Sindu , Bunting Silvia Tse , Fu Chieh-Lin
Published: December 2023

Composite lymphoma is defined as two or more lymphomas with distinct morphological and immunophenotypical characteristics synchronously diagnosed at the same anatomical site. Composite lymphoma is rare, and the most common combination is follicular lymphoma (FL) associated with diffuse large B cell lymphoma, followed by FL associated with classic Hodgkin’s lymphoma (HL). Histologically, composite lymphomas display a mixed pattern or distinct zonal distribution of each lymphoma component. Composite lymphoma poses a diagnostic challenge, especially when two lymphoma components are mixed in the same lymph node. Here, we report a case of composite HL and FL 11 years after initial and repeat biopsies consistent with FL in a man in his 70s emphasising the importance of repeat biopsy in lymphoma diagnosis.
New era of robotic surgery: first case in Spain of right hemicolectomy on Hugo RAS surgical platform
Authors: Caruso Riccardo , Vicente Emilio , Quijano Yolanda , Ferri Valentina
Published: December 2023

We describe the first robot-assisted right hemicolectomy performed in Spain using the new Hugo RAS (robotic-assisted surgery) (Medtronic, Minneapolis, Minnesota, USA). No conversion was registered, and no intraoperative complications or technical failures of the system were recorded. The operative time was 200 min, the docking time was 5 min and the length of the hospital stay was 8 days. We conclude that a right hemicolectomy using the Hugo RAS system is safe and feasible. Our earlier experience provides important skills for those who are starting to use this new robotic system.
Anaesthetic management of an infant with cleft palate lateral synechiae syndrome
Authors: Gayathri Balasubramaniam , Venkatraman Rajagopalan , Murugan Pasupathy , Ramamurthy Balaji
Published: December 2023

An infant with restricted mouth opening from birth had presented for cleft lip repair. He had an interalveolar gap of 6 mm and was diagnosed as a case of cleft palate lateral synechiae syndrome. Fibreoptic bronchoscope of appropriate size was not available at the time of the procedure, and we had to device an alternative plan. The case describes the common challenges that can arise while anaesthetising infants with this syndrome in a resource-limited setting and highlights the importance of adapting the protocol to the demands.
Acute labyrinthitis: a manifestation of COVID-19 in a teenager
Authors: Saniasiaya Jeyasakthy , Kulasegarah Jeyanthi
Published: December 2023

Audiovestibular symptoms following COVID-19 have been long acknowledged, especially in adults. However, acute labyrinthitis presenting as an early manifestation of COVID-19 has not been reported in children. We report COVID-19-induced acute labyrinthitis in a teenager. We report on a boy in his early adolescence with a sudden onset of spinning sensation, imbalance and unilateral hearing loss with a positive SARS-CoV-2 test. Vestibular investigations point towards right labyrinthine hypofunction, and an audiometry test revealed right-sided severe hearing loss. Symptoms improved gradually with steroids and vestibular rehabilitation therapy. However, the long-term repercussions of post-COVID-19 acute labyrinthitis are unknown and must be followed up closely. To our knowledge, this is the first reported case of acute labyrinthitis secondary to COVID-19 in paediatrics. Additionally, we conducted a literature search to elucidate the outcome of COVID-19-induced acute vestibular syndrome in children.
The role of social media in public health crises caused by infectious disease: a scoping review
Authors: Terry Kirsty , Yang Fei , Yao Qiang , Liu Chaojie
Published: December 2023

Importance

The onset of the COVID-19 global pandemic highlighted the increasing role played by social media in the generation, dissemination and consumption of outbreak-related information.

Objective

The objective of the current review is to identify and summarise the role of social media in public health crises caused by infectious disease, using a five-step scoping review protocol.

Evidence review

Keyword lists for two categories were generated: social media and public health crisis. By combining these keywords, an advanced search of various relevant databases was performed to identify all articles of interest from 2000 to 2021, with an initial retrieval date of 13 December 2021. A total of six medical and health science, psychology, social science and communication databases were searched: PubMed, Web of Science, Scopus, Embase, PsycINFO and CNKI. A three-stage screening process against inclusion and exclusion criteria was conducted.

Findings

A total of 338 studies were identified for data extraction, with the earliest study published in 2010. Thematic analysis of the role of social media revealed three broad themes: surveillance monitoring, risk communication and disease control. Within these themes, 12 subthemes were also identified. Within surveillance monitoring, the subthemes were disease detection and prediction, public attitude and attention, public sentiment and mental health. Within risk communication, the subthemes were health advice, information-seeking behaviour, infodemics/misinformation circulation, seeking help online, online distance education and telehealth. Finally, within disease control, the subthemes were government response, public behaviour change and health education information quality. It was clear that the pace of research in this area has gradually increased over time as social media has evolved, with an explosion in attention following the outbreak of COVID-19.

Conclusions and relevance

Social media has become a hugely powerful force in public health and cannot be ignored or viewed as a minor consideration when developing public health policy. Limitations of the study are discussed, along with implications for government, health authorities and individual users. The pressing need for government and health authorities to formalise evidence-based strategies for communicating via social media is highlighted, as well as issues for individual users in assessing the quality and reliability of information consumed on social media platforms.
Intended changes in smoking behaviour of Dutch young adults after an increase in excise tax: a cross-sectional survey
Authors: Visscher Kirsten , Everaars Babette , Suijkerbuijk Anita WM , Lambooij Mattijs , de Wit G Ardine
Published: December 2023

Objectives

Increasing the price of tobacco is one of the most effective measures to reduce the prevalence of smoking. In the Netherlands, the excise tax on tobacco increased by €1.14 in 2020, raising the price of a standard package of cigarettes to €8.00. This study investigates how young adults intend to change their smoking behaviour in the case of hypothetical price increases of a pack of cigarettes, and which background characteristics are associated with intended behaviour change.

Design

A cross-sectional online survey was carried out between September and November 2020. Smokers indicated how they would react to several hypothetical increases in price. Four behavioural options were investigated: smoking less, quitting smoking, switching to another/cheaper product and buying cheaper cigarettes cross-border.

Participants

Data were obtained from 776 Dutch smokers between 15 and 25 years.

Results

At a hypothetical price of €10 per package, most respondents reported an intention to smoke less (67%), followed by switching to another/cheaper product (61%), quitting smoking (49%) and shopping for cigarettes cross-border (47%). Prior quit attempts, agreeing with the increase in excise tax and the intention to quit smoking in the future increased the odds of changing behaviour. Higher self-efficacy decreased the odds of behavioural change.

Conclusion

Many young adults intend to change their smoking behaviour in the event of increased prices. Although intended behaviour can deviate significantly from actual behaviour, an increase in excise tax may result in a significant amount of quit attempts and reduced smoking among young adults.
Efficacy of cell-based immunotherapies on patients with glioma: an umbrella review of systematic reviews and meta-analysis protocol
Authors: Nikoobakht Mehdi , Shamshiripour Parisa , Mostafavi Zadeh Seyed Mostafa , Rahnama Mehrana , Hajiahmadi Fahime , Ramezani Aghdas , Farzam Rad Vahideh , Nazari Elaheh , Moradi Ali-Reza , Akbarpour Mahzad , Ahmadvand Davoud
Published: December 2023

Introduction

Glial brain tumours are highly mortal and are noted as major neurosurgical challenges due to frequent recurrence or progression. Despite standard-of-care treatment for gliomas, the prognosis of patients with higher-grade glial tumours is still poor, and hence empowering antitumour immunity against glioma is a potential future oncological prospect. This review is designed to improve our understanding of the efficacy of cell-based immunotherapies for glioma.

Methods and analysis

This systematic review will be performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of main electronic databases: PubMed/MEDLINE, Scopus, ISI Web of Science EMBASE and ProQuest will be done on original articles, followed by a manual review of review articles. Only records in English and only clinical trials will be encountered for full-text review. All the appropriate studies that encountered the inclusion criteria will be screened, selected and then will undergo data extraction step by two independent authors. For meta-analyses, data heterogeneity for each parameter will be first evaluated by Cochran’s Q and I2 statistics. In case of possible heterogeneity, a random-effects meta-analysis will be performed and for homogenous data, fixed-effects models will be selected for reporting the results of the proportional meta-analysis. Bias risk will be assessed through Begg’s and Egger’s tests and will also be visualised by Funnel plots.

Ethics and dissemination

As this study will be a systematic review without human participants’ involvement, no ethical registration is required and meta-analysis will be presented at a peer-reviewed journal.

PROSPERO registration number

CRD42022373297
Co-designing a nature-based intervention to promote postnatal mental health for mothers and their infants: a complex intervention development study in England
Authors: Hall Katherine , Evans Jonathan , Roberts Rosa , Brown Richard , Duggan Lucy , Williamson Melanie , Moran Paul , Turner Katrina M , Barnes Christopher
Published: December 2023

Objectives

There is burgeoning evidence for the potential of nature-based interventions to improve wellbeing. However, the role of nature in enhancing maternal mental health, child development and early relationships remains relatively unexplored. This study aimed to develop a co-designed nature-based intervention to improve postnatal mothers’ and infants’ wellbeing.

Design, setting and participants

Person-based and co-design approaches informed the planning and design of the postnatal nature-based intervention. In stage 1, a multidisciplinary team was formed to agree research questions and appropriate methodology, and a scoping review was conducted. Six qualitative focus groups were then held with 30 mothers and 15 professional stakeholders. In stage 2, intervention guiding principles and a logic model were developed, and a stakeholder consensus meeting was convened to finalise the prototype intervention. The research was conducted in Bristol, UK, across voluntary, educational and community-based healthcare settings.

Results

Stakeholder consultation indicated significant enthusiasm for a postnatal nature-based intervention. A scoping review identified little existing research in this area. Focus group data are reported according to four broad themes: (1) perceived benefits of a group postnatal nature-based intervention, (2) potential drawbacks and barriers to access, (3) supporting attendance and implementation, and (4) ideas for intervention content. The developed intervention was tailored for mothers experiencing, or at risk of, postnatal mental health difficulties. It was identified that the intervention should facilitate engagement with the natural world through the senses, while taking into account a broad range of postnatal-specific practical and psychological needs.

Conclusions

To our knowledge, this is the first reported use of person-based and co-design approaches to develop a postnatal nature-based intervention. The resulting intervention was perceived by target users to address their needs and preferences. Further research is needed to determine the feasibility, clinical and cost-effectiveness of this approach.
Characterisation of internal tremors and vibration symptoms
Authors: Massey Dorothy , Sawano Mitsuaki , Baker Anna D , Güthe Diana Berrent , Güthe Nick , Shidlovsky Suzanne Pincus , Fisher Liza , Grady Connor B , Caraballo Cesar , Zhou Tianna , Sharma Richa , Krumholz Harlan M
Published: December 2023

Objectives

To describe the experiences of patients who have postacute sequelae SARS-CoV-2 infection with internal vibrations and tremors as a prominent component, we leveraged the efforts by Survivor Corps, a grassroots COVID-19 patient advocacy group, to gather information from individuals belonging to its Facebook group with a history of COVID-19 suffering from vibrations and tremors.

Setting and design

A narrative analysis was performed on 140 emails and 450 social media comments from 140 individuals collected as a response to a call to >180 000 individuals participating in Survivor Corps between 15 July and 27 July 2021. We used common coding techniques and the constant comparative method for qualitative data synthesis and categorising emails. Coded data were entered into NVivo V.12 to identify recurrent themes, theme connections and supporting quotations. Comments were analysed using Word Clouds, generated with R V.4.0.3 usingquanteda,wordcloudandtmpackages.

Main outcome measures

Patient-reported long COVID symptom themes and domains related to internal tremors and vibration.

Results

The respondents’ emails represented 22 themes and 7 domains pertaining to their experience with internal tremor and vibrations. These domains were as follows: (1) symptom experience, description and anatomic location; (2) initial symptom onset; (3) symptom timing; (4) symptom triggers or alleviators; (5) change from baseline health status; (6) experience with medical establishment and (7) impact on individuals’ lives and livelihood. There were 22 themes in total, each corresponding to one of the broader domains. Among the responses, many described symptoms that varied in location, timing and triggers, occurred soon after their COVID-19 infection, and were markedly debilitating. There were often frustrating experiences with the healthcare system.

Conclusions

This study describes key themes and experiences among a group of people reporting long COVID and having a prolonged and debilitating symptom complex that prominently features internal tremors and vibrations.
Safety and efficacy of remimazolam tosilate combined with low-dose fentanyl for procedural sedation in obese patients undergoing gastroscopy: study protocol for a single-centre, double-blind, randomised controlled trial
Authors: Yan Lijuan , Wang Xiao , Chen Zhenyi , Wu Ningning , Li Hao , Yang Bin
Published: December 2023

Introduction

Obese patients are susceptible to hypoxaemia during procedural sedation. Propofol combined with low-dose opioids is commonly used as a sedation strategy, but it can exacerbate hypoxaemia by causing cardiopulmonary depression and airway obstruction, especially in obese patients. Remimazolam, a novel ultra-short-acting benzodiazepine, has minimal accumulative effects and less cardiorespiratory depression. This study aims to evaluate the safety and efficacy of combining remimazolam tosilate with low-dose fentanyl as an alternative option for procedural sedation in obese patients undergoing gastroscopy.

Methods and analysis

This randomised controlled trial (RCT) will be conducted in the Endoscopy Centre of the First Affiliated Hospital of Xiamen University, recruiting 174 participants scheduled for painless gastroscopy with a body mass index of 30–39.9 kg×m–2. All patients will be randomly divided into two groups in a 1:1 ratio. The sedation strategy of the intervention group is remimazolam tosilate combined with fentanyl, while the control group is propofol combined with fentanyl. The primary outcome is the incidence of hypoxaemia and the secondary outcomes include the time to ambulation, need for airway manoeuvres and rescue sedation, sleep quality, the incidence of sedation failure, adverse events and the cost of sedatives. All statistical tests will be performed using IBM SPSS V.20.0 statistical software. A p value<0.05 is considered statistically significant.

Ethics and dissemination

This RCT was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Xiamen University (Scientific Research Ethics Review 2022, No.093). The results will be published in peer-reviewed journals.

Trial registration number

ChiCTR2200067076.
Utilising patient-reported outcomes for goal-directed therapy of hip fracture patients: a sequential controlled trial
Authors: Schroeder Hanna , Israeli Avi , Liebergall Meir , Or Omer , Abu Ahmad Wiessam , Paltiel Ora , Justo Dan , Zimlichman Eyal
Published: December 2023

Background

Hip fracture patients (HFPs) frequently have multiple underlying conditions, necessitating that agreed-upon goals take these complications into consideration. Communication regarding goals between medical-personnel and patients is not always effective. Patient-reported outcomes (PROs) can outline personal goals and help promote quality health care in HFPs. Few studies have been published on this topic. The study’s aim was to outline the process of using PROs for goal-directed therapy among HFPs.

Methods

This sequential controlled trial was conducted among HFPs from two medical centres. The control and the intervention group received integrative rehabilitation. PROs were measured in both groups using the SF36 questionnaire three times postsurgery: 24–48 hours, 2 weeks and 3 months. During the first round of questioning, only the intervention group was asked ‘what matters most to you?’ during the rehabilitative process. Accordingly, agreed-upon goals that were determined by the SF36’s eight topics and were incorporated into the HFP’s rehabilitative process. A Likert scale of 1–5, ‘1’ indicating no-achievement and ‘5’ full-achievement, was used to assess the goal achievement 4–6 months post-fracture.

Results

84 HFPs participated in the study: 40 and 44 in the intervention and control group, respectively. In both groups, PROs declined after the HF, then improved somewhat 3 months later, but did not return to prefracture scores. Among the intervention group, 39% reached their specific goals (Likert level 5). Patients who achieved their goals had better PROs in comparison to others. The intervention group indicated PROs helped them articulate their desires and introduced them to new areas of care.

Conclusions

Shifting from asking ‘what’s the matter?’ to ‘what matters most to you?’ can improve the understanding of HFPs’ own priorities, promote quality outcomes and enhance patient-centred care. Using PROs as a guide for goal-directed therapy can create a more inclusive process that includes the patients’ most important health determinants and needs.