bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Arthroscopically Confirmed Syndesmotic Widening on Outcome Following Isolated Broström Operation for Chronic Lateral Ankle Instability
Authors: Su Tong , Du Ming-Ze , Parekh Selene G. , Jiang Yan-fang , Jiao Chen , Hu Yue-lin , Guo Qin-wei , Jiang Dong
Published: March 2023

Background:

Tibiofibular syndesmosis (TFS) widening sometimes is not evident on radiography but can be found under arthroscopy in chronic lateral ankle instability (CLAI). This study aimed to evaluate the effect of TFS widening severity on clinical outcomes and return to activities after isolated Broström operation in CLAI patients and to propose an indication for its surgical intervention.

Methods:

A total of 118 CLAI patients undergoing diagnostic ankle arthroscopy and open Broström-Gould operation were included. Based on the middle width of TFS measured under arthroscopy, patients were divided into the TFS-2 group (≤2 mm, n = 44), the TFS-3 group (2-4 mm, n = 42), and the TFS-4 group (≥4 mm, n = 32). The time to return to recreational sport and work, Tegner activity score, and proportion of returning to preinjury sports at the final follow-up were evaluated and compared. Other subjective evaluations included the American Orthopaedic Foot & Ankle Society score, visual analog scale, and Karlsson-Peterson score.

Results:

Among the 3 groups, the TFS-4 group demonstrated the longest mean time to return to work and recreational sports, with the lowest proportion returning to preinjury sports. The TFS-4 group showed a significantly higher rate of sprain recurrence (12.5%) than the other 2 groups ( P =.021). All the other subjective scores significantly improved after the operation without differences among the 3 groups.

Conclusion:

Concomitant severe syndesmotic widening adversely affects the return to activities after Broström operation in CLAI cases. The CLAI patients with a middle TFS width ≥4 mm were associated with delayed return to work and sports, a lower proportion of returning to preinjury sports, and more sprain recurrence, which might require further surgical intervention for syndesmosis in addition to Broström surgery.

Level of Evidence:

Level III, retrospective cohort study.
Perspectives on Self-Sampling for Cancer Screening From Staff at Federally Qualified Health Centers in Rural and Segregated Counties: A Preliminary Qualitative Study
Authors: Wood Jayme , Stoltzfus Kelsey C. , Popalis Madyson , Moss Jennifer L.
Published: March 2023

Background

Self-sampling for colorectal and cervical cancer screening can address the observed geographic disparities in cancer burden by alleviating barriers to screening participation, such as access to primary care. This preliminary study examines qualitative themes regarding cervical and colorectal cancer self-sampling screening tools among federally qualified health center clinical and administrative staff in underserved communities.

Methods

In-depth interviews were conducted with clinical or administrative employees (≥18 years of age) from FQHCs in rural and racially segregated counties in Pennsylvania. Data were managed and analyzed using QSR NVivo 12. Content analysis was used to identify themes about attitudes towards self-sampling for cancer screening.

Results

Eight interviews were conducted. Average participant age was 42 years old and 88% of participants were female. Participants indicated that a shared advantage for both colorectal and cervical cancer self-sampling tests was their potential to increase screening rates by simplifying the screening process and offering an alternative to those who decline traditional screening. A shared disadvantage to self-sampling was the potential for inaccurate sample collection, either through the test itself or the sample collection by the patient.

Conclusions

Self-sampling offers a promising solution to increase cervical and colorectal cancer screening in rural and racially segregated communities. This study’s findings can guide future research and interventions which integrate self-sampling screening into routine primary care practice.
A novel outpatient regimen in management of fluoropyrimidine-induced cardiotoxicity
Authors: Kasi Anup , Gaudel Pramod , Lekkala Manidhar , Al-Rajabi Raed , Saeed Anwaar , Sun Weijing , Porter Charles
Published: March 2023

Introduction

Fluoropyrimidines (FP) are cornerstone drugs in the treatment of gastrointestinal (GI) malignancies. Cardiotoxicity secondary to an FP chemotherapy is a serious complication. There are no standardized guidelines on the treatment of FP induced cardiotoxicity which may result in interruption and even discontinuation of life saving treatment. We present our experience in FP rechallenge using a novel outpatient regimen based on our “up-front” triple agent antianginal protocol.

Methods

We report the retrospective study of the patients with suspected FP induced cardiotoxicity. Patients meeting the criteria were selected by C3OD (curated cancer clinical outcomes database) at Kansas University Medical Center (KUMC). We identified all patients with gastrointestinal malignancies who had suspected FP induced cardiotoxicity from January 2015 to March 2022. We then included the patients who were rechallenged with planned fluoropyrimidine regimen utilizing the three drug KU-protocol. We utilized a novel regimen by repurposing the already FDA-approved anti-anginal drugs in a manner that minimizes the risk of hypotension and bradycardia.

Results

In this retrospective study, 10 patients with suspected fluoropyrimidine induced cardiotoxicity were included from January-2015 to March-2022 at KUMC. Out of 10 patients who were rechallenged utilizing KU-protocol, eight patients (80%) were able to complete the previously planned fluoropyrimidine regimen. None of the patients required ER visits or hospital admission due to cardiac symptoms during the rechallenge utilizing the KU-protocol.

Conclusions

Utilizing our novel outpatient regimen, we have successfully and safely allowed re-challenge of FP chemotherapy with good tolerability and completion of the intended course of chemotherapy without recurrent morbidity.
‘If you press this, I’ll pay’: MrBeast, YouTube, and the mobilisation of the audience commodity in the name of charity
Authors: Miller Vincent , Hogg Eddy
Published: March 2023

This paper examines a new form of philanthropic fundraising as pioneered by the YouTuber MrBeast. We argue that MrBeast, by harnessing the advertising revenue sharing model of YouTube’s Partner Program, has created an innovative model of philanthropic giving funded by mobilising what Marxist communication theorists refer to as the ‘audience’ or ‘prosumer commodity’. Through this method, MrBeast has been able to use the algorithmically managed, revenue sharing model of YouTube, and the spectacle of philanthropy, to draw in ever larger audiences and thus create large amounts of advertising and sponsorship revenue to fund philanthropic activities. This revenue in turn funds even larger philanthropic acts in subsequent videos, drawing more audiences and revenue. Unlike previous media-based fundraising, which would ask audience members to contribute their own money or time to a cause, MrBeast positions his audiences as a knowing audience commodity whose viewership funds direct contributions of other people’s money to good causes, merely by watching and being entertained. We assess the implications of this both for current debates around the ‘work’, labour’, and ‘exploitation’ of audience and prosumer commodities, and their monetisation for philanthropic giving.
Ethnic discrimination and mental health in the Sámi population in Sweden: The SámiHET study
Authors: La Parra-Casado Daniel , San Sebastian Miguel , Stoor Jon Petter A.
Published: March 2023

Aims:

To assess the association between experiences of discrimination and mental health among the Sámi population in Sweden.

Methods:

Cross-sectional study among the self-identified Sámi population living in Sweden in 2021, registered in the electoral roll of the Sámi Parliament, the reindeer mark register and the ‘Labour statistics based on administrative sources’. The analysis was based on a final sample of 3658 respondents aged between 18 and 84 years. Adjusted prevalence ratios aPRs for psychological distress (Kessler scale), self-reported anxiety and depression were estimated for four different forms of discrimination (direct experience of discrimination, offended because of ethnicity, historical trauma, and combined discrimination).

Results:

Higher aPRs of psychological distress, anxiety and depression were observed in women experiencing direct discrimination because of their ethnicity, having been offended because of their ethnicity, and those with a family history of discrimination. Among men, higher aPRs for psychological distress were observed in those experiencing the four different forms of discrimination, but not for anxiety. Depression was only detected in the case of having been offended. Adding experiences of discrimination was associated with a higher prevalence of negative outcomes for all the indicators in women and for psychological distress in men.

Conclusions:

The observed association between experiences of discrimination and mental health problems would support a gender approach when considering ethnic discrimination in public health policies concerning the Sámi in Sweden.
Is being a refugee associated with increased 30-day mortality after visiting the emergency department? A register-based cohort study using Danish data
Authors: Storgaard Signe F. , Wejse Christian , Agergaard Jane , Eiset Andreas H.
Published: March 2023

Aim:

Refugees face many challenges that could lead to disparity in quality of care from the health-care system compared with native Danes. These challenges could be language barriers, cultural differences, mental health co-morbidities and socio-economic status (SES). The aim of this study was to compare the 30-day mortality of refugees and native Danes after visiting the emergency department (ED) at Aarhus University Hospital, Denmark.

Methods:

In this register-based cohort study linking clinical and socio-demographic data, we included all visits to a major Danish ED from 1 January 2016 to 31 December 2018. According to the predefined analysis plan, we present non-parametric Kaplan–Meier plots and propensity score-weighted analysis.

Results:

We included 29,257 eligible unique patients of whom 631 were refugees. In the 30-day time period after discharge from the ED, 11 deaths occurred in the group of refugees, resulting in a Kaplan–Meier estimate of 1.8% (95% confidence interval (CI) 0.7–2.8), and 1638 deaths occurred in the group of Danes, resulting in a Kaplan–Meier estimate of 5.9% (95% CI 5.6–6.1). The adjusted 30-day mortality risk difference was 1.6 percentage points (95% CI −2.0 to −1.2 percentage points) lower for refugees compared to native Danes. The 30-day mortality risk difference decreased from approximately 4 to 1.6 percentage points in the adjusted analysis. Thus, there were 16 fewer deaths among refugees within 30 days per 1000 discharged from the ED compared with native Danes when adjusting for age, sex, SES and co-morbidities.

Conclusions:

This study shows that refugees had a lower 30-day mortality after visiting the ED compared with native Danes.
Commentary on The Right to Higher Education
Authors: Bialystok Lauren
Published: March 2023

Martin’s argument for the right to higher education is an exercise in ideal theory, which specifically distances itself from the familiar failings of compulsory education. I argue that even using sufficientarian criteria for admission to higher education would perpetuate non-ideal patterns of inequality and that reasonable forms of selectivity would still limit access to autonomy-promoting higher education. Martin’s case should prompt us to think about arbitrary divisions between compulsory and post-compulsory education in an autonomy-oriented system.
Transcatheter Edge-to-Edge Repair of Functional Mitral Regurgitation
Authors: Trujillo John F.
Published: March 2023

A 71-year-old man underwent transcatheter edge-to-edge repair for treatment of severe functional mitral regurgitation.
Global political economy, information technologies, and a people’s history of telecommunications: A dialogue with Dan Schiller
Authors: Schiller Dan , Tang Min
Published: March 2023

In this academic conversation, Professor Dan Schiller, a critical political economy scholar and historian of information and communications, first shares his up-to-date observation and analysis of developments and changes in contemporary digital capitalism. Professor Schiller then turns to his newly published book Crossed Wires: The Conflicted History of US Telecommunications, From The Post Office To The internet (Oxford University Press, 2023) and details his 40-year journey of research and writing on the history of these vital and recurrently contested infrastructures.
Emerging concepts in male contraception: a narrative review of novel, hormonal and non-hormonal options
Authors: Service C. Austin , Puri Dhruv , Hsieh Tung-Chin , Patel Darshan P.
Published: March 2023

Access to reliable contraception is a pillar of modern society. The burden of unintended pregnancy has fallen disproportionately on the mother throughout human history; however, recent legal developments surrounding abortion have sparked a renewed interest in male factor contraceptives beyond surgical sterilization and condoms. Modern efforts to develop reversible male birth control date back nearly a century and initially focused on altering the hypothalamic-pituitary-testes axis. These hormonal contraceptives faced multiple barriers, including systemic side effects, challenging dosing regimens, unfavorable routes of delivery, and the public stigma surrounding steroid use. Novel hormonal agents are seeking to overcome these barriers by limiting the side effects and simplifying use. Non-hormonal contraceptives are agents that target various stages of spermatogenesis; such as inhibitors of retinoic acid, Sertoli cell–germ cell interactions, sperm ion channels, and other small molecular targets. The identification of reproductive tract–specific genes associated with male infertility has led to more targeted drug development, made possible by advances in CRISPR and proteolysis targeting chimeras (PROTACs). Despite multiple human trials, no male birth control agents have garnered regulatory approval in the United States or abroad. This narrative review examines current and emerging male contraceptives, including hormonal and non-hormonal agents.
A review of recent developments in structural applications of natural fiber-Reinforced composites (NFRCs)
Authors: Abdollahiparsa Hossein , Shahmirzaloo Ali , Teuffel Patrick , Blok Rijk
Published: March 2023

Natural fiber-reinforced composites (NFRCs) are expected to find growing applications in near future, especially in Europe where stringent environmental codes are being legislated and public pressure for their enforcement is increasing. Study has shown that NFRCs are also gaining recognition among civil engineers as a viable alternative to traditional materials for use as concrete reinforcement in load-bearing structural members as in building frames and bridge decks. The present review strives to provide a brief overview of NFRCs, state-of-the-art developments in their manufacture, and examples of their structural applications. Another aspect of the review involves investigation of the challenges facing the use of fiber composite materials in civil engineering. These include the high manufacturing costs, difficulties associated with appraisal of its potential benefits, uncertainties about their properties, lack of understanding among civil engineers of the material and its service life, and the relatively small battery of standards developed for the composite industry. Finally, the study will conclude with the prospects of bio-composite applications and the emerging trends in novel bio-composites for future structural applications.
Severe COVID-19versusmultisystem inflammatory syndrome: comparing two critical outcomes of SARS-CoV-2 infection
Authors: Fraser Rupsha , Orta-Resendiz Aurelio , Dockrell David , Müller-Trutwin Michaela , Mazein Alexander
Published: March 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with diverse host response immunodynamics and variable inflammatory manifestations. Several immune-modulating risk factors can contribute to a more severe coronavirus disease 2019 (COVID-19) course with increased morbidity and mortality. The comparatively rare post-infectious multisystem inflammatory syndrome (MIS) can develop in formerly healthy individuals, with accelerated progression to life-threatening illness. A common trajectory of immune dysregulation forms a continuum of the COVID-19 spectrum and MIS; however, severity of COVID-19 or the development of MIS is dependent on distinct aetiological factors that produce variable host inflammatory responses to infection with different spatiotemporal manifestations, a comprehensive understanding of which is necessary to set better targeted therapeutic and preventative strategies for both.
Strength of association between comorbidities and asthma: a meta-analysis
Authors: Rogliani Paola , Laitano Rossella , Ora Josuel , Beasley Richard , Calzetta Luigino
Published: March 2023

Background

The strength of association between comorbidities and asthma has never been ranked in relation to the prevalence of the comorbidity in the nonasthma population. We investigated the strength of association between comorbidities and asthma.

Methods

A comprehensive literature search was performed for observational studies reporting data on comorbidities in asthma and nonasthma populations. A pairwise meta-analysis was performed and the strength of association calculated by anchoring odds ratios and 95% confidence intervals with the rate of comorbidities in nonasthma populationsviaCohen'sdmethod. Cohen'sd=0.2, 0.5 and 0.8 were cut-off values for small, medium and large effect sizes, respectively; very large effect size resulted for Cohen'sd >0.8. The review was registered in the PROSPERO database; identifier number CRD42022295657.

Results

Data from 5 493 776 subjects were analysed. Allergic rhinitis (OR 4.24, 95% CI 3.82–4.71), allergic conjunctivitis (OR 2.63, 95% CI 2.22–3.11), bronchiectasis (OR 4.89, 95% CI 4.48–5.34), hypertensive cardiomyopathy (OR 4.24, 95% CI 2.06–8.90) and nasal congestion (OR 3.30, 95% CI 2.96–3.67) were strongly associated with asthma (Cohen'sd>0.5 and ≤0.8); COPD (OR 6.23, 95% CI 4.43–8.77) and other chronic respiratory diseases (OR 12.85, 95% CI 10.14–16.29) were very strongly associated with asthma (Cohen'sd>0.8). Stronger associations were detected between comorbidities and severe asthma. No bias resulted according to funnel plots and Egger's test.

Conclusion

This meta-analysis supports the relevance of individualised strategies for disease management that look beyond asthma. A multidimensional approach should be used to assess whether poor symptom control is related to uncontrolled asthma or to uncontrolled underlying comorbidities.
Paraurethral leiomyoma in a post-menopausal woman: a case report
Authors: Brodie Arjuna , Rai Jaskarn , Alevizopoulos Aristeidis , Ravindra Pravisha
Published: March 2023

Background

Paraurethral leiomyoma are rare, benign, hormone-dependent growths. They originate from smooth muscle cells and occur in the paraurethral space of the urethra. They make up approximately 5% of urethral tumours. They usually appear in the reproductive age group of women with variable clinical presentation depending on the size and location of occurrence. They can either be asymptomatic or can present with local pressure symptoms, dyspareunia, and lower urinary tract symptoms. The usual treatment is surgical excision with confirmation of diagnosis on histology.

Case presentation

We report a case of a 58-year-old lady who initially presented to the gynaecology department with pelvic pain and lower urinary tract symptoms. After initial investigation with an ultrasound scan and MRI, a 5 × 5 × 4 cm mass was detected next to the bladder, with suspicions of it arising from the detrusor muscle. There was also a 3 cm Bartholin’s cyst detected in the left vaginal wall. Her care was referred to the urology team who after further investigation and a transperineal biopsy of the mass diagnosed a paraurethral leiomyoma on histology. Given the patient was symptomatic, she opted for treatment. Embolisation was explored but was deemed not feasible due to a complex blood supply. Therefore, the patient underwent an open excision of leiomyoma as a combined abdominal and vaginal procedure.

Conclusion

Paraurethral leiomyoma are rare benign lesions and therefore pose diagnostic challenges as they must be differentiated from malignant tumours. Radiological imaging aids with diagnosis but diagnosis is confirmed on histology. The mainstay of treatment is surgical excision. This case is unusual given the patient’s age and post-menopausal status as the average age of presentation in the literature is 41 years old. The authors would recommend initial USS imaging for all patients presenting with overactive bladder symptoms and pelvic pain/discomfort.
Blocking Abundant RNA Transcripts by High-Affinity Oligonucleotides during Transcriptome Library Preparation
Authors: Everaert Celine , Verwilt Jasper , Verniers Kimberly , Vandamme Niels , Marcos Rubio Alvaro , Vandesompele Jo , Mestdagh Pieter
Published: March 2023

Background

RNA sequencing has become the gold standard for transcriptome analysis but has an inherent limitation of challenging quantification of low-abundant transcripts. In contrast to microarray technology, RNA sequencing reads are proportionally divided in function of transcript abundance. Therefore, low-abundant RNAs compete against highly abundant - and sometimes non-informative - RNA species.

Results

We developed an easy-to-use strategy based on high-affinity RNA-binding oligonucleotides to block reverse transcription and PCR amplification of specific RNA transcripts, thereby substantially reducing their abundance in the final sequencing library. To demonstrate the broad application potential of our method, we applied it to different transcripts and library preparation strategies, including YRNAs in small RNA sequencing of human blood plasma, mitochondrial rRNAs in both 3′ end sequencing and long-read sequencing, and MALAT1 in single-cell 3′ end sequencing. We demonstrate that the blocking strategy is highly efficient, reproducible, specific, and generally results in better transcriptome coverage and complexity.

Conclusion

Our method does not require modifications of the library preparation procedure apart from simply adding blocking oligonucleotides to the RT reaction and can thus be easily integrated into virtually any RNA sequencing library preparation protocol.
Cardiovascular and psychosocial risks among patients below age 50 with acute myocardial infarction
Authors: Faresjö Åshild , Karlsson Jan-Erik , Segerberg Henrik , Lebena Andrea , Faresjö Tomas
Published: March 2023

Background

Despite improvements in the treatment and prevention of cardiovascular disease since the 1960s, the incidence of cardiovascular diseases among young people has remained the same for many years. This study aimed to compare the clinical and psychosocial attributes of young persons affected by myocardial infarction under the age of 50 years compared to middle-aged myocardial infarction patients 51–65 years old.

Methods

Data from patients with a documented STEMI or NSTEMI elevated acute myocardial infarction in the age groups up to 65 years, were collected from cardiology clinics at three hospitals in southeast Sweden. The Stressheart study comprised a total of 213 acute myocardial infarction patients, of which n = 33 (15.5%) were under 50 years of age and n = 180 (84.5%) were middle-aged, (51–65 years). These acute myocardial infarction patients filled in a questionnaire at discharge from the hospital and further information through documentation of data in their medical records.

Results

Blood pressure was significantly higher in young compared to middle-aged patients. For diastolic blood pressure (p = 0.003), systolic blood pressure (p = 0.028), and mean arterial pressure (p = 0.005). Young AMI patients had a higher (p = 0.030) body mass index (BMI) than the middle-aged. Young AMI patients were reported to be more stressed (p = 0.042), had more frequently experienced a serious life event the previous year (p = 0.029), and felt less energetic (p = 0.044) than middle-aged AMI patients.

Conclusions

This study revealed that persons under the age of 50 affected by acute myocardial infarction exhibit traditional cardiovascular risk factors like high blood pressure, and higher BMI, and were more exposed to some psychosocial risk factors. The risk profile of young persons under age 50 affected by AMI was in these respects more exaugurated than for middle-aged persons with AMI. This study underlines the importance of the early discovery of those at increased risk and encourages preventative actions to focus on both clinical and psychosocial risk factors.
Cost-effectiveness analysis of typhoid conjugate vaccines in an outbreak setting: a modeling study
Authors: Phillips Maile T. , Antillon Marina , Bilcke Joke , Bar-Zeev Naor , Limani Fumbani , Debellut Frédéric , Pecenka Clint , Neuzil Kathleen M. , Gordon Melita A. , Thindwa Deus , Paltiel A. David , Yaesoubi Reza , Pitzer Virginia E.
Published: March 2023

Background

Several prolonged typhoid fever epidemics have been reported since 2010 throughout eastern and southern Africa, including Malawi, caused by multidrug-resistant Salmonella Typhi. The World Health Organization recommends the use of typhoid conjugate vaccines (TCVs) in outbreak settings; however, current data are limited on how and when TCVs might be introduced in response to outbreaks.

Methodology

We developed a stochastic model of typhoid transmission fitted to data from Queen Elizabeth Central Hospital in Blantyre, Malawi from January 1996 to February 2015. We used the model to evaluate the cost-effectiveness of vaccination strategies over a 10-year time horizon in three scenarios: (1) when an outbreak is likely to occur; (2) when an outbreak is unlikely to occur within the next ten years; and (3) when an outbreak has already occurred and is unlikely to occur again. We considered three vaccination strategies compared to the status quo of no vaccination: (a) preventative routine vaccination at 9 months of age; (b) preventative routine vaccination plus a catch-up campaign to 15 years of age; and (c) reactive vaccination with a catch-up campaign to age 15 (for Scenario 1). We also explored variations in outbreak definitions, delays in implementation of reactive vaccination, and the timing of preventive vaccination relative to the outbreak.

Results

Assuming an outbreak occurs within 10 years, we estimated that the various vaccination strategies would prevent a median of 15–60% of disability-adjusted life-years (DALYs). Reactive vaccination was the preferred strategy for WTP values of $0–300 per DALY averted. For WTP values > $300, introduction of preventative routine TCV immunization with a catch-up campaign was the preferred strategy. Routine vaccination with a catch-up campaign was cost-effective for WTP values above $890 per DALY averted if no outbreak occurs and > $140 per DALY averted if implemented after the outbreak has already occurred.

Conclusions

Countries for which the spread of antimicrobial resistance is likely to lead to outbreaks of typhoid fever should consider TCV introduction. Reactive vaccination can be a cost-effective strategy, but only if delays in vaccine deployment are minimal; otherwise, introduction of preventive routine immunization with a catch-up campaign is the preferred strategy.
Epidemiological and clinical characteristics predictive of ICU mortality of patients with traumatic brain injury treated at a trauma referral hospital – a cohort study
Authors: Réa-Neto Álvaro , da Silva Júnior Elizeu Daniel , Hassler Gabriela , dos Santos Valkiria Backes , Bernardelli Rafaella Stradiotto , Kozesinski-Nakatani Amanda Christina , Martins-Junior Marcelo José , Reese Fernanda Baeumle , Cosentino Mariana Bruinje , Oliveira Mirella Cristine , Teive Hélio Afonso Ghizoni
Published: March 2023

Background

Traumatic brain injury (TBI) has substantial physical, psychological, social and economic impacts, with high rates of morbidity and mortality. Considering its high incidence, the aim of this study was to identify epidemiological and clinical characteristics that predict mortality in patients hospitalized for TBI in intensive care units (ICUs).

Methods

A retrospective cohort study was carried out with patients over 18 years old with TBI admitted to an ICU of a Brazilian trauma referral hospital between January 2012 and August 2019. TBI was compared with other traumas in terms of clinical characteristics of ICU admission and outcome. Univariate and multivariate analyses were used to estimate the odds ratio for mortality.

Results

Of the 4816 patients included, 1114 had TBI, with a predominance of males (85.1%). Compared with patients with other traumas, patients with TBI had a lower mean age (45.3 ± 19.1 versus 57.1 ± 24.1 years, p < 0.001), higher median APACHE II (19 versus 15, p < 0.001) and SOFA (6 versus 3, p < 0.001) scores, lower median Glasgow Coma Scale (GCS) score (10 versus 15, p < 0.001), higher median length of stay (7 days versus 4 days, p < 0.001) and higher mortality (27.6% versus 13.3%, p < 0.001). In the multivariate analysis, the predictors of mortality were older age (OR: 1.008 [1.002–1.015], p = 0.016), higher APACHE II score (OR: 1.180 [1.155–1.204], p < 0.001), lower GCS score for the first 24 h (OR: 0.730 [0.700–0.760], p < 0.001), greater number of brain injuries and presence of associated chest trauma (OR: 1.727 [1.192–2.501], p < 0.001).

Conclusion

Patients admitted to the ICU for TBI were younger and had worse prognostic scores, longer hospital stays and higher mortality than those admitted to the ICU for other traumas. The independent predictors of mortality were older age, high APACHE II score, low GCS score, number of brain injuries and association with chest trauma.
Diagnostic value of a nanopore sequencing assay of bronchoalveolar lavage fluid in pulmonary tuberculosis
Authors: Liu Zhifeng , Yang Yang , Wang Qingfeng , Wang Lei , Nie Wenjuan , Chu Naihui
Published: March 2023

Background

To determine the diagnostic accuracy of a nanopore sequencing assay of PCR products from a M. tuberculosis complex-specific region for testing of bronchoalveolar lavage fluid (BALF) samples or sputum samples from suspected pulmonary tuberculosis (PTB) patients and compare the results to results obtained for MGIT and Xpert assays.

Methods

Cases with suspected PTB (n = 55) were diagnosed from January 2019 to December 2021 based on results of nanopore sequencing, MGIT culture, and Xpert MTB/RIF testing of BALF and sputum samples collected during hospitalization. Diagnostic accuracies of assays were compared.

Results

Ultimately, data from 29 PTB patients and 26 non-PTB cases were analyzed. PTB diagnostic sensitivities of MGIT, Xpert MTB/RIF, and nanopore sequencing assays were 48.28%, 41.38%, and 75.86%, respectively, thus demonstrating that nanopore sequencing provided greater sensitivity than was provided by MGIT culture and Xpert assays (P < 0.05). PTB diagnostic specificities of the respective assays were 65.38%, 100%, and 80.77%, which corresponded with kappa coefficient (κ) values of 0.14, 0.40, and 0.56, respectively. These results indicate that nanopore sequencing provided superior overall performance as compared to Xpert and MGIT culture assays and provided significantly greater PTB diagnostic accuracy than Xpert and sensitivity comparable to that of the MGIT culture assay.

Conclusion

Our findings suggest that improved detection of PTB in suspected cases was achieved using nanopore sequencing-based testing of BALF or sputum samples than was achieved using Xpert and MGIT culture-based assays, and nanopore sequencing results alone cannot be used to rule out PTB.
Outcomes and complications of cerebral aneurysms operated on by eyebrow incision according to aneurysm type and location
Authors: Eun Jin , Park Ik Seong
Published: March 2023

Objective

Trans-eyebrow supraorbital aneurysmal neck clipping, also known as keyhole surgery, have many advantages of minimal invasive surgery. However, there are few studies on whether there is a difference in keyhole surgery according to the location of the aneurysm, and how the complications after keyhole approach differ from the conventional approach. The authors investigated the surgical outcome of keyhole aneurysmal surgery for clarify the characteristics of keyhole surgery.

Methods

A retrospective study was performed with review of medical records and images of patients with anterior circulation aneurysm undergoing aneurysmal clipping with keyhole surgery. The patient's clinical condition, imaging, surgical condition, and outcome were investigated.

Results

As a result of analysis about the location of the aneurysm, middle cerebral artery (MCA) aneurysm group had a longer operation time than internal carotid artery and anterior cerebral artery aneurysm groups, but there was no significant difference in complication rate. The olfactory dysfunction occurred more than that of conventional surgery and occurred less in MCA aneurysm group than others. Scalp sensory change in the surgical site was more common in patients with unruptured aneurysms.

Conclusion

By accurately investigating the frequency and severity of complications associated with trans-eyebrow aneurysmal neck clipping surgery, it can help to select a surgical approach considering risk versus benefit. In addition, patient’s satisfaction can be increased by providing information to patients and caregivers in advance about the outcome of this approach and the anticipated complications.
Early detection of myocardial ischemia in resting ECG: analysis by HHT
Authors: Wang Chun-Lin , Wei Chiu-Chi , Tsai Cheng-Ting , Lee Ying-Hsiang , Liu Lawrence Yu-Min , Chen Kang-Ying , Lin Yu-Jen , Lin Po-Lin
Published: March 2023

Background

Exercise electrocardiography (ECG) is a noninvasive test aiming at producing ischemic changes. However, resting ECG cannot be adopted in diagnosing myocardial ischemia till ST-segment depressions. Therefore, this study aimed to detect myocardial energy defects in resting ECG using the Hilbert–Huang transformation (HHT) in patients with angina pectoris.

Methods

Electrocardiographic recordings of positive exercise ECG by performing coronary imaging test (n = 26) and negative exercise ECG (n = 47) were collected. Based on the coronary stenoses severity, patients were divided into three categories: normal, < 50%, and ≥ 50%. During the resting phase of the exercise ECG, all 10-s ECG signals are decomposed by HHT. The RT intensity index, composed of the power spectral density of the P, QRS, and T components, is used to estimate the myocardial energy defect.

Results

After analyzing the resting ECG using HHT, the RT intensity index was significantly higher in patients with positive exercise ECG (27.96%) than in those with negative exercise ECG (22.30%) (p < 0.001). In patients with positive exercise ECG, the RT intensity index was gradually increasing with the severity of coronary stenoses: 25.25% (normal, n = 4), 27.14% (stenoses < 50%, n = 14), and 30.75% (stenoses ≥ 50%, n = 8). The RT intensity index of different coronary stenoses was significantly higher in patients with negative exercise ECG, except for the normal coronary imaging test.

Conclusions

Patients with coronary stenoses had a higher RT index at the resting stage of exercise ECG. Resting ECG analyzed using HHT could be a method for the early detection of myocardial ischemia.
TaME-seq2: tagmentation-assisted multiplex PCR enrichment sequencing for viral genomic profiling
Authors: Hesselberg Løvestad Alexander , Stosic Milan S. , Costanzi Jean-Marc , Christiansen Irene Kraus , Aamot Hege Vangstein , Ambur Ole Herman , Rounge Trine B.
Published: March 2023

Background

Previously developed TaME-seq method for deep sequencing of HPV, allowed simultaneous identification of the human papillomavirus (HPV) DNA consensus sequence, low-frequency variable sites, and chromosomal integration events. The method has been successfully validated and applied to the study of five carcinogenic high-risk (HR) HPV types (HPV16, 18, 31, 33, and 45). Here, we present TaME-seq2 with an updated laboratory workflow and bioinformatics pipeline. The HR-HPV type repertoire was expanded with HPV51, 52, and 59. As a proof-of-concept, TaME-seq2 was applied on SARS-CoV-2 positive samples showing the method’s flexibility to a broader range of viruses, both DNA and RNA.

Results

Compared to TaME-seq version 1, the bioinformatics pipeline of TaME-seq2 is approximately 40× faster. In total, 23 HPV-positive samples and seven SARS-CoV-2 clinical samples passed the threshold of 300× mean depth and were submitted to further analysis. The mean number of variable sites per 1 kb was ~ 1.5× higher in SARS-CoV-2 than in HPV-positive samples. Reproducibility and repeatability of the method were tested on a subset of samples. A viral integration breakpoint followed by a partial genomic deletion was found in within-run replicates of HPV59-positive sample. Identified viral consensus sequence in two separate runs was > 99.9% identical between replicates, differing by a couple of nucleotides identified in only one of the replicates. Conversely, the number of identical minor nucleotide variants (MNVs) differed greatly between replicates, probably caused by PCR-introduced bias. The total number of detected MNVs, calculated gene variability and mutational signature analysis, were unaffected by the sequencing run.

Conclusion

TaME-seq2 proved well suited for consensus sequence identification, and the detection of low-frequency viral genome variation and viral-chromosomal integrations. The repertoire of TaME-seq2 now encompasses seven HR-HPV types. Our goal is to further include all HR-HPV types in the TaME-seq2 repertoire. Moreover, with a minor modification of previously developed primers, the same method was successfully applied for the analysis of SARS-CoV-2 positive samples, implying the ease of adapting TaME-seq2 to other viruses.
Effects of eating together online on autonomic nervous system functions: a randomized, open-label, controlled preliminary study among healthy volunteers
Authors: Hasuo Hideaki , Kusaka Nahoko , Sano Mutsuo , Kanbara Kenji , Kitawaki Tomoki , Sakuma Hiroko , Sakazaki Tomoya , Yoshida Kohei , Shizuma Hisaharu , Araki Hideo , Suzuki Motoyuki , Nishiguchi Satoshi , Shuzo Masaki , Masuda Gaku , Shimonishi Kei , Kondo Kazuaki , Ueda Hirotada , Nakamura Yuichi
Published: March 2023

Background

Eating alone has been significantly associated with psychological distress. However, there is no research that evaluates the effects or relation of eating together online to autonomic nervous system functions.

Methods

This is a randomized, open-label, controlled, pilot study conducted among healthy volunteers. Participants were randomized into either an eating together online group or an eating-alone group. The effect of eating together on autonomic nervous functions was evaluated and compared with that of the control (eating alone). The primary endpoint was the change in the standard deviation of the normal-to-normal interval (SDNN) scores among heart rate variabilities (HRV) before and after eating. Physiological synchrony was investigated based on changes in the SDNN scores.

Results

A total of 31 women and 25 men (mean age, 36.6 [SD = 9.9] years) were included in the study. In the comparison between the aforementioned groups, two-way analysis of variance revealed interactions between time and group on SDNN scores. SDNN scores in the eating together online group increased in the first and second halves of eating time (F[1,216], P < 0.001 and F[1,216], P = 0.022). Moreover, high correlations were observed in the changes in each pair before and during the first half of eating time as well as before and during the second half of eating time (r = 0.642, P = 0.013 and r = 0.579, P = 0.030). These were statistically significantly higher than those in the eating-alone group (P = 0.005 and P = 0.040).

Conclusions

The experience of eating together online increased HRV during eating. Variations in pairs were correlated and may have induced physiological synchrony.

Trial registration

The University Hospital Medical Information Network Clinical Trials Registry, UMIN000045161. Registered September 1, 2021. https://center6.umin.ac.jp/cgi-open-bin/icdr/ctr_view.cgi?recptno=R000051592.
Efficacy of silymarin in patients with non-alcoholic fatty liver disease — the Siliver trial: a study protocol for a randomized controlled clinical trial
Authors: de Avelar Camila Ribeiro , Nunes Beatriz Vieira Coelho , da Silva Sassaki Betina , dos Santos Vasconcelos Mariana , de Oliveira Lucivalda Pereira Magalhães , Lyra André Castro , Bueno Allain Amador , de Jesus Rosângela Passos
Published: March 2023

Background

Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent liver diseases globally. Pharmacological treatments for NAFLD are still limited. Silymarin, a compound extracted from Silybum marianum, is an herbal supplement traditionally used in folk medicine for liver disorders. It has been proposed that silymarin may possess hepatoprotective and anti-inflammatory properties. The present trial aims to assess the efficacy of silymarin supplementation in the adjuvant treatment of NAFLD in adult patients.

Method

This is a randomized double-blind placebo-controlled clinical trial recruiting adult NAFLD patients in therapy on an outpatient basis. Participants are randomized to an intervention (I) or control (C) group. Both groups receive identical capsules and are followed for 12 weeks. I receives 700mg of silymarin + 8mg vitamin E + 50mg phosphatidylcholine daily, while C receives 700mg maltodextrin + 8mg vitamin E + 50mg phosphatidylcholine daily. Patients undergo a computerized tomography (CT) scan and blood tests at the beginning and end of the study. Monthly face-to-face consultations and weekly telephone contact are carried out for all participants. The primary outcome assessed will be change in NAFLD stage, if any, assessed by the difference in attenuation coefficient between liver and spleen, obtained by upper abdomen CT.

Discussion

The results of this study may provide a valuable opinion on whether silymarin can be used as adjuvant therapy for the management or treatment of NAFLD. The data presented on the efficacy and safety of silymarin may provide more foundation for further trials and for a possible use in clinical practice.

Trial registration

This study has been approved by the Research Ethics Committee of the Professor Edgard Santos University Hospital Complex, Salvador BA, Brazil, under protocol 2.635.954. The study is carried out according to guidelines and regulatory standards for research involving humans, as set out in Brazilian legislation. Trial registration - ClinicalTrials.gov : NCT03749070. November 21, 2018
Geo-epidemiology of autoantibodies in rheumatoid arthritis: comparison between four ethnically diverse populations
Authors: de Moel Emma C. , Trouw Leendert A. , Terao Chikashi , Govind Nimmisha , Tikly Mohammed , El-Gabalawy Hani , Smolik Irene , Bang Holger , Huizinga Tom W. J. , Toes René E. M. , van der Woude Diane
Published: March 2023

Background

Rheumatoid arthritis (RA) occurs across the globe in different ethnic populations. Most RA patients harbor anti-modified protein antibodies (AMPA); however, it is unclear whether differences exist in autoantibody responses at different geographic locations and between different ethnic groups, which could provide new clues regarding factors underlying autoantibody development. We therefore investigated AMPA prevalence and association with HLA DRB1 alleles and smoking in four ethnically diverse populations on four different continents.

Methods

Anti-carbamylated (anti-CarP), anti-malondialdehyde acetaldehyde (anti-MAA), and anti-acetylated protein antibodies (anti-AcVim) IgG were determined in anti-citrullinated protein antibody-positive Dutch (NL, n = 103), Japanese (JP, n = 174), First Nations Peoples in Canada (FN, n = 100), and black South African (SA, n = 67) RA patients. Ethnicity-matched local healthy controls were used to calculate cut-offs. Risk factors associated with AMPA seropositivity in each cohort were identified using logistic regression.

Results

Median AMPA levels were higher in First Nations Peoples in Canada and especially South African patients, as reflected by percentage seropositivity: NL, JP, FN, and SA: anti-CarP: 47%, 43%, 58%, and 76% (p < 0.001); anti-MAA: 29%, 22%, 29%, and 53% (p < 0.001); and anti-AcVim: 20%, 17%, 38%, and 28% (p < 0.001). Total IgG levels also differed markedly, and when autoantibody levels were normalized to total IgG, differences between cohorts became less pronounced. Although there were some associations with AMPA and HLA risk alleles and smoking, none was consistent across all four cohorts.

Conclusions

AMPA against various post-translational modifications could consistently be detected on different continents across ethnically diverse RA populations. Differences in AMPA levels corresponded to differences in total serum IgG levels. This suggests that, despite differences in risk factors, a common pathway may be involved in AMPA development across geographic locations and ethnicities.
Long non-coding RNA H19 regulates matrisome signature and impacts cell behavior on MSC-engineered extracellular matrices
Authors: Moura Sara Reis , Freitas Jaime , Ribeiro-Machado Cláudia , Lopes Jorge , Neves Nuno , Canhão Helena , Rodrigues Ana Maria , Barbosa Mário Adolfo , Almeida Maria Inês
Published: March 2023

Background

The vast and promising class of long non-coding RNAs (lncRNAs) has been under investigation for distinct therapeutic applications. Nevertheless, their role as molecular drivers of bone regeneration remains poorly studied. The lncRNAH19mediates osteogenic differentiation of Mesenchymal Stem/Stromal Cells (MSCs) through the control of intracellular pathways. However, the effect ofH19on the extracellular matrix (ECM) components is still largely unknown. This research study was designed to decode theH19-mediated ECM regulatory network, and to reveal how the decellularized siH19-engineered matrices influence MSC proliferation and fate. This is particularly relevant for diseases in which the ECM regulation and remodeling processes are disrupted, such as osteoporosis.

Methods

Mass spectrometry-based quantitative proteomics analysis was used to identify ECM components, after oligonucleotides delivery to osteoporosis-derived hMSCs. Moreover, qRT-PCR, immunofluorescence and proliferation, differentiation and apoptosis assays were performed. Engineered matrices were decellularized, characterized by atomic force microscopy and repopulated with hMSC and pre-adipocytes. Clinical bone samples were characterized by histomorphometry analysis.

Results

Our study provides an in-depth proteome-wide and matrisome-specific analysis of the ECM proteins controlled by the lncRNAH19. Using bone marrow-isolated MSC from patients with osteoporosis, we identified fibrillin-1 (FBN1), vitronectin (VTN) and collagen triple helix repeat containing 1 (CTHRC1), among others, as having different pattern levels followingH19silencing. Decellularized siH19-engineered matrices are less dense and have a decreased collagen content compared with control matrices. Repopulation with naïve MSCs promotes a shift towards the adipogenic lineage in detriment of the osteogenic lineage and inhibits proliferation. In pre-adipocytes, these siH19-matrices enhance lipid droplets formation. Mechanistically,H19is targeted by miR-29c, whose expression is decreased in osteoporotic bone clinical samples. Accordingly, miR-29c impacts MSC proliferation and collagen production, but does not influence ALP staining or mineralization, revealing thatH19silencing and miR-29c mimics have complementary but not overlapping functions.

Conclusion

Our data suggestH19as a therapeutic target to engineer the bone ECM and to control cell behavior.