bluuebunny/crossref_metadata_2025 huggingface dataset:
Does circumferential casting prevent fracture redisplacement in reduced distal radius fractures? A retrospective multicentre study
Authors: Berger A. C. , Barvelink B. , Reijman M. , Gosens T. , Kraan G. A. , De Vries M. R. , Verhofstad M. H. J. , Lansink K. W. W. , Hannemann P. F. W. , Colaris J. W.
Published: December 2021

Background

This study evaluates whether a circumferential cast compared to a plaster splint leads to less fracture redisplacement in reduced extra-articular distal radius fractures (DRFs).

Methods

This retrospective multicentre study was performed in four hospitals (two teaching hospitals and two academic hospitals). Adult patients with a displaced extra-articular DRF, treated with closed reduction, were included. Patients were included from a 5-year period (January 2012–January 2017). According to the hospital protocol, fractures were immobilized with a below elbow circumferential cast (CC) or a plaster splint (PS). The primary outcome concerned the difference in the occurrence of fracture redisplacement at one-week follow-up.

Results

A total of 500 patients were included in this study (PS n = 184, CC n = 316). At one-week follow-up, fracture redisplacement occurred in 52 patients (17%) treated with a CC compared to 53 patients (29%) treated with a PS. This difference was statistically significant (p = 0.001).

Conclusion

This study suggests that treatment of reduced DRFs with a circumferential cast might cause less fracture redisplacement at 1-week follow-up compared to treatment with a plaster splint.

Level of Evidence Level III, Retrospective study.
Comparison of magnetic resonance imaging and computed tomography for bone assessment of neurogenic heterotopic ossification of the hip: a preliminary study
Authors: Amar Raphaël , Thiry Tristan , Salga Marjorie , Safa Dominique , Chetrit Annaëlle , Gatin Laure , Carlier Robert-Yves
Published: December 2021

Background

Neurogenic heterotopic ossification (NHO) is a frequent complication, often involving the hip. The functional impact may require surgical management and pre-surgical imaging assessment is necessary, usually by computed tomography (CT). We aimed to compare the performances of magnetic resonance imaging (MRI) and CT for bone assessment on pre-surgical imaging of the heterotopic ossifications and their features in NHO of the hip.

Methods

This single-center prospective preliminary study included all patients who underwent surgery for NHO with joint limitation from July 2019 to March 2020. All patients had a CT after biphasic iodinated solution injection and an MRI including T1-weighted, STIR and ZTE sequences. Standardized reports were completed for both exams for each patient, evaluating location, implantation and fragmentation of NHO, relation to the joint capsule and bone mineralization, then were compared.

Results

Seven patients from 32 to 70 years old (mean = 50.2 ± 17.2 years) were evaluated. NHO were bilateral in 2 patients, for a total of nine hips: six right hips and three left hips. Observed concordance rates between MRI and CT were, respectively, 94.4% for location, 100% for circumferential extension, 87.3% for implantation 88.9% for fragmentation, 77.8% for relation to the joint capsule and 66.7% for bone mineralization. It was 100% for femoral neck fracture and osteonecrosis of the femoral head.

Conclusion

This preliminary study suggests that pre-surgical MRI imaging should be considered as effective as CT for bone assessment of NHO and their features.

Trial registration: ClinicalTrials.gov, NCT03832556. Registered February 6, 2019, https://clinicaltrials.gov/ct2/show/NCT03832556.
All-cause mortality risk in aged femoral intertrochanteric fracture patients
Authors: Li Xin-ping , Zhang Ping , Zhu Shi-wen , Yang Ming-hui , Wu Xin-bao , Jiang Xie-yuan
Published: December 2021

Introduction

The 1-year mortality rate after femoral intertrochanteric fracture is higher than that of femoral neck fracture, which also belongs to hip fracture (Cui et al. in Arch Osteoporos 14(1):55, 2019). With the application of the concept of co-management model of orthopedics and geriatrics, the short-term and long-term mortality of all types of hip fractures has decreased (Van Heghe et al. in Calcif Tissue Int, 2021, https://doi.org/10.1007/s00223-021-00913-5). However, the mortality of Chinese femoral intertrochanteric fracture patients under this model has not been reported in the literatures.

Aim

This paper aims to study the risk factors of postoperative all-cause mortality in aged patients with femoral intertrochanteric fracture under the co-management model of orthopedics and geriatrics.

Materials and methods

This is a single-center prospective cohort study based on the real world, under the co-management of orthopedics and geriatrics, 363 patients aged ≥ 65 years with femoral intertrochanteric fracture were enrolled and followed up for 2–3 years; 52 patients were lost to follow up. Age, gender, body mass index (BMI), history of comorbidities, hip Bone Mineral Density (BMD), fracture history, 25(OH)D level, hemoglobin level, anti-osteoporosis treatment were risk factors to be tested. Kaplan–Meier survival curves and multivariate Cox proportional hazards models were constructed to analyze the impact of factors on all-cause mortality.

Results

(1) Most of the dead patients were older (the mean age was 83.4 years, compared with 79.8 years for surviving patients), with more complications and without anti-osteoporosis medication; gender, pre-fracture history, BMI, total hip BMD, hemoglobin, 25(OH)D had no difference between the dead and the living patients. (2) Elderly patients with Intertrochanteric fracture can benefit from the early treatment of Zoledronic Acid (within 3 days after the operation).

Conclusion

Under the co-management of orthopedics and geriatrics, to Chinese patients with Femoral Intertrochanteric fracture, Doctors should pay more attention to their age and chronic disease, and give anti-osteoporosis treatment if allowed.
Efficacy and safety for combination of t-EMG with O-arm assisted pedicle screw placement in neurofibromatosis type I scoliosis surgery
Authors: Shao Xiexiang , Huang Zifang , Yang Jingfan , Deng Yaolong , Yang Junlin , Sui Wenyuan
Published: December 2021

Background

Due to the characteristics of neurofibromatosis type I (NF-1) scoliosis, the precise placement of pedicle screws still remains to be a challenge. Triggered screw electromyography (t-EMG) has been proved to exhibit high sensitivity to identify mal-positioned pedicle screws, but no previous study assessed the combination of t-EMG with O-arm-assisted pedicle screw placement in NF-1 scoliosis surgery.

Objective

To evaluate efficacy and safety for combination of t-EMG with O-arm-assisted pedicle screw placement in NF-1 scoliosis surgery.

Materials and methods

From March 2018 to April 2020, sixty-five NF-1 scoliosis patients underwent t-EMG and O-arm-assisted pedicle screw fixation were retrospectively reviewed. The channel classification system was applied to classify the pedicle morphology based on pedicle width measurement by preoperative computed tomography scans. The minimal t-EMG threshold for screw path inspection was used as 8 mA, and operative screw redirection was also recorded. All pedicle screws were verified using a second intraoperative O-arm scan. The correlation between demographic and clinical data with amplitude of t-EMG were also analyzed.

Results

A total of 652 pedicle screws (T10-S1) in 65 patients were analyzed. The incidence of an absent pedicle (channel classification type C or D morphology) was 150 (23%). Overall, abnormal t-EMG threshold was identified in 26 patients with 48 screws (7.4%), while 16 out of the 48 screws were classified as G0, 14 out of the 48 screws were classified as G1, and 18 out of the 48 screws were classified as G2. The screw redirection rate was 2.8% (18/652). It showed that t-EMG stimulation detected 3 unacceptable mal-positioned screws in 2 patients (G2) which were missed by O-arm scan. No screw-related neurological or vascular complications were observed.

Conclusions

Combination of t-EMG with O-arm-assisted pedicle screw placement was demonstrated to be a safe and effective method in NF-1 scoliosis surgery. The t-EMG could contribute to detecting the rupture of the medial wall which might be missed by O-arm scan. Combination of t-EMG with O-arm could be recommended for routine use of screw insertion in NF-1 scoliosis surgery.
Association among B lymphocyte subset and rheumatoid arthritis in a Chinese population
Authors: You Haiyan , Cheng Mengwei , Ma Cui , Zheng Wenjuan , Jiang Yu , Chen Di , Tang Yu
Published: December 2021

Background and aim

Autoantibody production are the main risk factors for inflammation of rheumatoid arthritis (RA). This study aimed to investigate differences in B lymphocyte subsets (native B, memory B, and plasmablasts) and several cytokines in RA patients and their correlation with the clinical parameters.

Methods

In total, 81 RA patients (active RA and inactive RA) and 40 healthy subjects were recruited between September 2018 and October 2020. The distribution of B lymphocyte subsets in peripheral blood samples was measured via flow cytometry and the plasma cytokines were detected by enzyme linked immunosorbent assay. The receiver operating characteristic curve (ROC) was used to evaluate the value of each index for RA diagnosis and activity prediction.

Results

The percentages of native B and memory B cells in RA patients did not differ significantly from the percentages of those in healthy controls. However, the percentage of plasmablasts in active RA patients was significantly higher compared with healthy subjects and inactive RA patients. The percentage of plasmablasts was significantly related to C reaction protein. ROC curve analysis showed that when the best cutoff value of plasmablasts/B cell was 1.08%, the area under the curve (AUC) for diagnosing RA was 0.831 (95% CI 0.748 ~ 0.915), the specificity was 91.4%, and the sensitivity was 67.5%. The AUC predicted by the combination of plasmablast and anti-CCP for active RA patients was 0.760, which was higher than that of plasmablast and anti-CCP.

Conclusion

In conclusion, the percentage of plasmablast varies among RA patients in different stages. The percentage of plasmablasts can be used as an early diagnosis marker for RA.
A review of Chinese medicine for the treatment of psoriasis: principles, methods and analysis
Authors: Su Yang , Qin Wen , Wu Lun , Yang Bingyou , Wang Qiuhong , Kuang Haixue , Cheng Genhong
Published: December 2021

Chinese medicine (CM) has a long history in the treatment of psoriasis, and its different understanding angle and treatment mode from modern medicine have unique wisdom. In this article, we consulted a large number of literatures and collected data in order to systematically clarify how CM understands psoriasis, including the classification and judgment of syndrome types, the diagnosis and thinking of etiology and pathogenesis, the application of treatment ideas, principles, methods and various prescriptions, and suggestions on patient care, so as to provide a clear CM treatment process and experience for the world clinic. In addition, we analyzed the efficacy and safety through clinical data, and summarize the methods and prescriptions worthy of promotion, so as to provide reference for doctors to prescribe prescriptions and medication. Finally, we found that compared with modern medicine, CM has unique advantages in the treatment of psoriasis, including the uniqueness of syndrome classification, the abundantly and flexibility of treatment ideas. Not only many famous doctors have studied the ideas in ancient books, but also made great efforts to innovate, which has left a lot of valuable experiences for clinical practice. Moreover, a large number of treatment methods, prescriptions and medicines have achieved high effectiveness and safety in clinical practices for many years, which has been proved to be worthy of clinical reference and in-depth research. In addition, we also think about the deficiencies of CM in the treatment of psoriasis and the direction of breakthrough combined with modern medicine. The treatment of psoriasis with CM is worth popularizing, and we hope it can benefit more patients.
P2Y12 receptor as a new target for electroacupuncture relieving comorbidity of visceral pain and depression of inflammatory bowel disease
Authors: Li Yanzhen , Zhang Hong , Yang Jingwen , Zhan Muouyang , Hu Xuefei , Liu Yongmin , Yu Lingling , Yan Xiaochen , Liang Shangdong , Zhang Ruyue , Lu Ying , Li Beining , Liu Cunzhi , Li Man
Published: December 2021

Background

The P2Y12 receptor is a kind of purinoceptor that is engaged in platelet aggregation, and P2Y12 inhibitors have been used in clinical antithrombotic therapy. The P2Y12 receptor in microglia induces interleukin-1β (IL-1β) expression, which is a key mediator of depression in the brain. Although peripheral P2Y12 is involved in neuropathic pain, whether P2Y12 expression in the medial prefrontal cortex (mPFC) is associated with comorbidities of visceral pain and depression remains unclear. Accumulating evidence suggests that electroacupuncture (EA) is effective in treating inflammatory bowel disease (IBD), but its mechanism is unknown. This study aimed to determine whether P2Y12 expression in the mPFC is associated with comorbidities of visceral pain and depression in IBD and whether EA treats IBD by targeting the P2Y12 receptor.

Methods

We used 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced IBD mice. P2Y12 short hairpin RNA (shRNA) was stereotaxically injected into the bilateral mPFC. EA was performed on bilateral “Dachangshu” (BL25) acupoints once a day for 7 days. Von Frey filaments and colorectal distension were used to detect the mechanical pain threshold and visceral pain sensitivity. The sucrose preference test, tail suspension test and forced swimming test were used to evaluate depression in mice. Western blotting was used to test the expression of P2Y12 and IL-1β. Immunofluorescence staining was used to assess microglial activity.

Results

We found that IBD mice presented visceral pain and depression associated with increased P2Y12 expression in the mPFC. P2Y12 shRNA significantly attenuated visceral pain and depression in IBD mice. P2Y12 shRNA significantly downregulated IL-1β expression and inhibited the activation of microglia in the mPFC of IBD mice. Meanwhile, EA played a similar role of P2Y12 shRNA. EA significantly downregulated P2Y12 expression, weakened the activation of microglia, and then inhibited IL-1β expression in the mPFC, thus relieving visceral pain and depression in IBD mice.

Conclusion

The present study provided new ideas that the P2Y12 receptor in the mPFC could be a new target for the treatment of comorbid visceral pain and depression by EA. This may not only deepen our understanding of the analgesic and antidepressant mechanisms of EA but also promote the application of EA to treat IBD.
Gaucher disease: clinical phenotypes and refining GBA mutational spectrum in Thai patients
Authors: Phetthong Tim , Tim-Aroon Thipwimol , Khongkraparn Arthaporn , Noojarern Saisuda , Kuptanon Chulaluck , Wichajarn Khunton , Sathienkijkanchai Achara , Suphapeetiporn Kanya , Charoenkwan Pimlak , Tantiworawit Adisak , Noentong Naruwan , Wattanasirichaigoon Duangrurdee
Published: December 2021

Background

Gaucher disease (GD) is a rare lysosomal storage disorder, characterized by hepatosplenomegaly and pancytopenia, with or without neurologic involvement. The disorder is categorized into three phenotypes: GD type 1 or nonneuronopathic GD; GD type 2 or acute neuronopathic GD; and GD type 3 or chronic neuronopathic GD. The purposes of this study were to describe clinical characteristics of Thai GD in patients diagnosed and/or followed up during 2010–2018 and to perform re-genotyping including analysis of GBA recombinant alleles which had not been investigated in Thai patients before.

Results

There were 27 patients from seven medical centers, enrolled in the study. All the cases had pediatric onset. GD3 (44.5%) was the most common phenotype, followed by GD2 (40.7%) and GD1 (14.8%), with one case of neonatal GD. The median age of onset for GD1, GD2, and GD3 was 72, 4 and 12 months, respectively, suggesting relatively earlier onset of GD1 and GD3 in Thai patients. All patients with GD1 and most patients with GD3 received ERT. Four patients with GD3 had ERT followed by HSCT. Patients with GD3 who received no or late ERT showed unfavorable outcomes. We identified 14 variants including two novel (p.S384F and p.W533*) and 12 reported pathogenic variants: p.L483P, p.N409S, p.R159W, p.P305A, p.A175G, p.D448H, p.V414L, IVS2+1G>A, IVS6-1G>C, IVS7+1G>C, IVS9-3C>G, and Rec1a. The p.L483P was the most prevalent allele found in this study, at 66% (33/50 alleles), followed by IVS2+1G>A, Rec1a, and IVS6-1G>C. Twenty-four percent of patients were reassigned with validated genotypes, most of whom (4 of 6) were patients with GD2. The [p.S384F + p.W533*] being compounded with p.L483P, was found in the patient with neonatal GD, suggesting that the p.S384F could potentiate the deleterious effect of the p.W533*, and/or vice versa.

Conclusions

Neuronopathic GD was strikingly prevalent among Thai affected population. Homozygous p.L483P was the most common genotype identified in Thai patients. Recombinant allele Rec1a and splicing mutations were associated with GD2 and severe cases of GD3. Mutation spectrum could be useful for designing stepwise molecular analysis, genetic screenings in population, and new therapeutic research for neuronopathic GD.
“A mismatch between what is happening on the inside and going on, on the outside”: a qualitative study of therapists’ perspectives on student mental health
Authors: Marszalek Maja Anna , Faksvåg Helene , Frøystadvåg Thea Hannestad , Ness Ottar , Veseth Marius
Published: December 2021

Background

Although a growing number of studies indicates a high prevalence of reported mental health problems in students and that the problems are growing in number and severity, less is known about the experiences of students facing mental health problems and personnel who interact with students that seek help for these problems. The aim of this study is to examine the perspectives of therapists working with students seeking therapy for mental health problems.

Methods

A qualitative study of 15 therapists’ perspectives. Data are collected with in-depth, semistructured and open-ended interviews, and analyzed using a reflexive thematic analysis.

Results

We developed four themes that summarize how the therapists viewed and understood the students’ experiences of mental health problems: (1) an agonizing mismatch between the inside and the outside, (2) conflicting needs for closeness and distance, (3) no room for pain, and (4) a major potential for ripple effects.

Conclusions

We relate our findings to the existing theory and research, and we discuss the implications for clinical practice and the limitations of the study. We argue that our findings demonstrate the need to provide students room to explore and make meaning of their difficulties and pain related to mental health problems, in addition to offer some symptom-reducing tools and techniques that can enhance performance and academic achievements. More research is needed to understand what student mental health problems might be related to and what students need.
Fetal ischemia monitoring with in vivo implanted electrochemical multiparametric microsensors
Authors: Dulay Samuel , Rivas Lourdes , Pla Laura , Berdún Sergio , Eixarch Elisenda , Gratacós Eduard , Illa Miriam , Mir Mònica , Samitier Josep
Published: December 2021

Under intrauterine growth restriction (IUGR), abnormal attainment of the nutrients and oxygen by the fetus restricts the normal evolution of the prenatal causing in many cases high morbidity being one of the top-ten causes of neonatal death. The current gold standards in hospitals to detect this relevant problem is the clinical observation by echography, cardiotocography and Doppler. These qualitative techniques are not conclusive and requires risky invasive fetal scalp blood testing and/or amniocentesis. We developed micro-implantable multiparametric electrochemical sensors for measuring ischemia in real time in fetal tissue and vascular. This implantable technology is designed to continuous monitoring for an early detection of ischemia to avoid potential fetal injury. Two miniaturized electrochemical sensors were developed based on oxygen and pH detection. The sensors were optimized in vitro under controlled concentration, to assess the selectivity and sensitivity required. The sensors were then validated in vivo in the ewe fetus model, by means of their insertion in the muscle leg and inside the iliac artery of the fetus. Ischemia was achieved by gradually obstructing the umbilical cord to regulate the amount of blood reaching the fetus. An important challenge in fetal monitoring is the detection of low levels of oxygen and pH changes under ischemic conditions, requiring high sensitivity sensors. Significant differences were observed in both; pH and pO2 sensors under changes from normoxia to hypoxia states in the fetus tissue and vascular with both sensors. Herein, we demonstrate the feasibility of the developed sensors for future fetal monitoring in medical applications.
Hidden biases in germline structural variant detection
Authors: Khayat Michael M. , Sahraeian Sayed Mohammad Ebrahim , Zarate Samantha , Carroll Andrew , Hong Huixiao , Pan Bohu , Shi Leming , Gibbs Richard A. , Mohiyuddin Marghoob , Zheng Yuanting , Sedlazeck Fritz J.
Published: December 2021

Background

Genomic structural variations (SV) are important determinants of genotypic and phenotypic changes in many organisms. However, the detection of SV from next-generation sequencing data remains challenging.

Results

In this study, DNA from a Chinese family quartet is sequenced at three different sequencing centers in triplicate. A total of 288 derivative data sets are generated utilizing different analysis pipelines and compared to identify sources of analytical variability. Mapping methods provide the major contribution to variability, followed by sequencing centers and replicates. Interestingly, SV supported by only one center or replicate often represent true positives with 47.02% and 45.44% overlapping the long-read SV call set, respectively. This is consistent with an overall higher false negative rate for SV calling in centers and replicates compared to mappers (15.72%). Finally, we observe that the SV calling variability also persists in a genotyping approach, indicating the impact of the underlying sequencing and preparation approaches.

Conclusions

This study provides the first detailed insights into the sources of variability in SV identification from next-generation sequencing and highlights remaining challenges in SV calling for large cohorts. We further give recommendations on how to reduce SV calling variability and the choice of alignment methodology.
MultiMAP: dimensionality reduction and integration of multimodal data
Authors: Jain Mika Sarkin , Polanski Krzysztof , Conde Cecilia Dominguez , Chen Xi , Park Jongeun , Mamanova Lira , Knights Andrew , Botting Rachel A. , Stephenson Emily , Haniffa Muzlifah , Lamacraft Austen , Efremova Mirjana , Teichmann Sarah A.
Published: December 2021

Multimodal data is rapidly growing in many fields of science and engineering, including single-cell biology. We introduce MultiMAP, a novel algorithm for dimensionality reduction and integration. MultiMAP can integrate any number of datasets, leverages features not present in all datasets, is not restricted to a linear mapping, allows the user to specify the influence of each dataset, and is extremely scalable to large datasets. We apply MultiMAP to single-cell transcriptomics, chromatin accessibility, methylation, and spatial data and show that it outperforms current approaches. On a new thymus dataset, we use MultiMAP to integrate cells along a temporal trajectory. This enables quantitative comparison of transcription factor expression and binding site accessibility over the course of T cell differentiation, revealing patterns of expression versus binding site opening kinetics.
Comparison of intradialytic neuromuscular electrical stimulation and oral nutritional supplements in hemodialysis patients: study protocol for a multicenter, parallel-group, randomized controlled trial in Korea
Authors: Yu Mi-yeon , Park Jae Hyeon , Kim Yong Chul , Park Jae Yoon , Cha Ran-hui
Published: December 2021

Background

The prevalence of sarcopenia increases as renal function decreases, and a considerable number of hemodialysis (HD) patients have sarcopenia. Exercise and nutritional support are established interventions to prevent and treat sarcopenia. Recently, many studies evaluating intradialytic neuromuscular electrical stimulation (NMES) showed improvement of muscular strength and mass, functional capacity, and quality of life (QOL). However, there has been no research about the effect of simultaneous nutritional support and NMES in HD patients.

Methods

This is a 12-week, randomized controlled, parallel-group, multicenter trial of intradialytic NMES and protein supplementation for HD patients. Seventy-two patients receiving HD will be randomly assigned in a 1:1:1:1 ratio to control, intradialytic NMES only, protein supplementation only, and intradialytic NMES combined with protein supplementation groups. NMES will be delivered to a total of four areas of the bilateral vastus medialis and vastus lateralis using a 4-channel NMES instrument. A total of 25 g of protein supplements will be provided at the beginning of every dialysis session or after the NMES. The primary endpoint is the difference of hand grip and leg muscle strength at 12 weeks among 4 treatment groups. Secondary endpoints include muscle mass, physical performances, and questionnaires about QOL and physical activity.

Discussion

In this study, we will evaluate the differential effectiveness of nutritional support and NMES during HD on muscle strength, muscle mass, physical function, and QOL. We expect that this study can provide guidelines for a new therapeutic option for HD patients who are unable or hesitant to exercise. Furthermore, this option can offer an opportunity to improve the physical function, QOL, and prognosis of HD patients.

Trial registration

Clinical Research Information Service (CRIS), Korea,KCT0005573. Retrospectively registered on 03 November 2020
A cross-sectional survey of potential factors, motivations, and barriers influencing research participation and retention among people who use drugs in the rural USA
Authors: Hetrick Angela T. , Young April M. , Elman Miriam R. , Bielavitz Sarann , Alexander Rhonda L. , Brown Morgan , Waddell Elizabeth Needham , Korthuis P. Todd , Lancaster Kathryn E.
Published: December 2021

Background

Despite high morbidity and mortality among people who use drugs (PWUD) in rural America, most research is conducted within urban areas. Our objective was to describe influencing factors, motivations, and barriers to research participation and retention among rural PWUD.

Methods

We recruited 255 eligible participants from community outreach and community-based, epidemiologic research cohorts from April to July 2019 to participate in a cross-sectional survey. Eligible participants reported opioid or injection drug use to get high within 30 days and resided in high-needs rural counties in Oregon, Kentucky, and Ohio. We aggregated response rankings to identify salient influences, motivations, and barriers. We estimated prevalence ratios to assess for gender, preferred drug use, and geographic differences using log-binomial models.

Results

Most participants were male (55%) and preferred methamphetamine (36%) over heroin (35%). Participants reported confidentiality, amount of financial compensation, and time required as primary influential factors for research participation. Primary motivations for participation include financial compensation, free HIV/HCV testing, and contribution to research. Changed or false participant contact information and transportation are principal barriers to retention. Respondents who prefer methamphetamines over heroin reported being influenced by the purpose and use of their information (PR = 1.12; 95% CI: 1.00, 1.26). Females and Oregonians (versus Appalachians) reported knowing and wanting to help the research team as participation motivation (PR = 1.57; 95% CI: 1.09, 2.26 and PR = 2.12; 95% CI: 1.51, 2.99).

Conclusions

Beyond financial compensation, researchers should emphasize confidentiality, offer testing and linkage with care, use several contact methods, aid transportation, and accommodate demographic differences to improve research participation and retention among rural PWUD.
Effect of oral intake of royal jelly on endothelium function in hemodialysis patients: study protocol for multicenter, double-blind, randomized control trial
Authors: Ohba Kojiro , Miyata Yasuyoshi , Shinzato Takeaki , Funakoshi Satoshi , Maeda Kanenori , Matsuo Tomohiro , Mitsunari Kensuke , Mochizuki Yasushi , Nishino Tomoya , Sakai Hideki
Published: December 2021

Background

Hemodialysis (HD) is a common renal replacement therapy for patients with renal failure. Cardiovascular and cerebrovascular diseases are known to shorten survival periods and worsen the quality of life of HD patients. Atherosclerosis is a major cause of vascular diseases, and various factors such as abnormality of lipid metabolism and increased macrophage activity, oxidative stress, and endothelial dysfunction are associated with its pathogenesis and progression. Further, endothelial stem cells (ESCs) have been reported to play important roles in endothelial functions. Royal jelly (RJ) affects atherosclerosis- and endothelial function-related factors. The main aim of this trial is to investigate whether oral intake of RJ can maintain endothelial function in HD patients. In addition, the effects of RJ intake on atherosclerosis, ESC count, inflammation, and oxidative stress will be analyzed.

Methods

This will be a multicenter, prospective, double-blind, randomized controlled trial. We will enroll 270 participants at Nagasaki Jin Hospital, Shinzato Clinic Urakami, and Maeda Clinic, Japan. The participants will be randomized into RJ and placebo groups. The trial will be conducted according to the principles of the Declaration of Helsinki, and all participants will be required to provide written informed consent. The RJ group will be treated with 3600 mg/day of RJ for 24 months, and the placebo group will be treated with starch for 24 months. The primary endpoint will be the change in flow-mediated dilation (FMD), a parameter of endothelium function, from the time before treatment initiation to 24 months after treatment initiation. The secondary and other endpoints will be changes in FMD; ESC count; serum levels of vascular endothelial cell growth factor, macrophage colony-stimulating factor, 8-hydroxydeoxyguanosine, and malondialdehyde; the incidence of cardiovascular diseases, cerebrovascular diseases, and stenosis of blood access; and safety.

Discussion

This trial will clarify whether oral intake of RJ can maintain endothelial function and suppress the progression of atherosclerosis in HD patients. In addition, it will clarify the effects of RJ on ESCs, oxidative stress, and angiogenic activity in blood samples.

Trial registration

The Japan Registry of Clinical Trials jRCTs071200031.  Registered on 7 December 2020.
Assessing the impact of storage time on the stability of stool microbiota richness, diversity, and composition
Authors: Holzhausen Elizabeth A. , Nikodemova Maria , Deblois Courtney L. , Barnet Jodi H. , Peppard Paul E. , Suen Garret , Malecki Kristen M.
Published: December 2021

Background

New technologies like next-generation sequencing have led to a proliferation of studies investigating the role of the gut microbiome in human health, particularly population-based studies that rely upon participant self-collection of samples. However, the impact of methodological differences in sample shipping, storage, and processing are not well-characterized for these types of studies, especially when transit times may exceed 24 h. The aim of this study was to experimentally assess microbiota stability in stool samples stored at 4 °C for durations of 6, 24, 48, 72, and 96 h with no additives to better understand effects of variable shipping times in population-based studies. These data were compared to a baseline sample that was immediately stored at − 80 °C after stool production.

Results

Compared to the baseline sample, we found that the alpha-diversity metrics Shannon’s and Inverse Simpson’s had excellent intra-class correlations (ICC) for all storage durations. Chao1 richness had good to excellent ICC. We found that the relative abundances of bacteria in the phyla Verrucomicrobia, Actinobacteria, and Proteobacteria had excellent ICC with baseline for all storage durations, while Firmicutes and Bacteroidetes ranged from moderate to good. We interpreted the ICCs as follows: poor: ICC < 0.50, moderate: 0.50 < ICC < 0.75, good: 0.75 < ICC < 0.90, and excellent: ICC > 0.90. Using the Bray–Curtis dissimilarity index, we found that the greatest change in community composition occurred between 0 and 24 h of storage, while community composition remained relatively stable for subsequent storage durations. Samples showed strong clustering by individual, indicating that inter-individual variability was greater than the variability associated with storage time.

Conclusions

The results of this analysis suggest that several measures of alpha diversity, relative abundance, and overall community composition are robust to storage at 4 °C for up to 96 h. We found that the overall community richness was influenced by storage duration in addition to the relative abundances of sequences within the Firmicutes and Bacteroidetes phyla. Finally, we demonstrate that inter-individual variability in microbiota composition was greater than the variability due to changing storage durations.
Cerebral lesions in hematological malignancies: a case report
Authors: D’Ettore Nicoletta , Scheggi Valentina , Alterini Brunetto , Marchionni Niccolò
Published: December 2021

Background

Progressive multifocal leukoencephalopathy is a rare central nervous system disease, resulting from reactivation of latent John Cunningham virus. Monoclonal antibodies have recently become a relevant risk factor for developing progressive multifocal leukoencephalopathy.

Case summary

We report the case of a 62-year-old Caucasian man who was admitted to our department in June 2020 because of right homonymous hemianopia. Magnetic resonance imaging findings were first interpreted as an intracranial relapsed lymphoma, so brain biopsy was performed, but no neoplastic cell was found. Histological sample only showed a large number of macrophages. The patient came back to our attention because of the worsening of neurological symptoms. A second magnetic resonance imaging showed widespread lesions suggestive of a demyelinating process. John Cunningham virus DNA was detected by polymerase chain reaction assay of the cerebrospinal fluid (over 9 million units/μL). The patient was treated supportively, but the outcome was poor.

Discussion

A multidisciplinary assessment should be performed for differential diagnosis of cerebral lesions in hematologic malignancies. Progressive multifocal leukoencephalopathy should be suspected in cases of subacute neurological symptoms and imaging findings consistent with it, especially if the patient received immunosuppressive or immunomodulatory drugs.
A throughput analysis of an energy-efficient spectrum sensing scheme for the cognitive radio-based Internet of things
Authors: Miah Md Sipon , Schukat Michael , Barrett Enda
Published: December 2021

Spectrum sensing in a cognitive radio network involves detecting when a primary user vacates their licensed spectrum, to enable secondary users to broadcast on the same band. Accurately sensing the absence of the primary user ensures maximum utilization of the licensed spectrum and is fundamental to building effective cognitive radio networks. In this paper, we address the issues of enhancing sensing gain, average throughput, energy consumption, and network lifetime in a cognitive radio-based Internet of things (CR-IoT) network using the non-sequential approach. As a solution, we propose a Dempster–Shafer theory-based throughput analysis of an energy-efficient spectrum sensing scheme for a heterogeneous CR-IoT network using the sequential approach, which utilizes firstly the signal-to-noise ratio (SNR) to evaluate the degree of reliability and secondly the time slot of reporting to merge as a flexible time slot of sensing to more efficiently assess spectrum sensing. Before a global decision is made on the basis of both the soft decision fusion rule like the Dempster–Shafer theory and hard decision fusion rule like the “n-out-of-k” rule at the fusion center, a flexible time slot of sensing is added to adjust its measuring result. Using the proposed Dempster–Shafer theory, evidence is aggregated during the time slot of reporting and then a global decision is made at the fusion center. In addition, the throughput of the proposed scheme using the sequential approach is analyzed based on both the soft decision fusion rule and hard decision fusion rule. Simulation results indicate that the new approach improves primary user sensing accuracy by$$13\%$$13%over previous approaches, while concurrently increasing detection probability and decreasing false alarm probability. It also improves overall throughput, reduces energy consumption, prolongs expected lifetime, and reduces global error probability compared to the previous approaches under any condition [part of this paper was presented at the EuCAP2018 conference (Md. Sipon Miah et al. 2018)].
Using machine learning to find the hidden relationship between RTT and TCP throughput in WiFi
Authors: Chaudhry Aizaz U.
Published: December 2021

Is it possible to find hidden relationships among variables in WiFi network usingmachine learning(ML)? Can we use ML to find a variable that significantly affects the TCP throughput in WiFi? In this work, we employ a publicly available WiFi dataset to investigate these questions. We use ML techniques, includingprincipal component analysis (PCA),linear regression(LR), andrandom forest(RF), to study the effect of link speed, received signal strength,round-trip time(RTT), and number of available access points on TCP throughput in WiFi. More specifically, we are interested in employing ML to find the variable that most accurately predicts and thereby most significantly affects the throughput. Simple correlation analysis indicates that a combination of multiple variables is more likely to act as a reasonable predictor of the throughput, whereas a single variable, such as RTT, alone is not likely to predict the throughput with reasonable accuracy. From PCA, thefirst principal component(PC1) is seen as highly correlated to RTT. During predictive analysis, it is observed that the LR model is unable to find any hidden relationship between throughput and other variables. However, the RF model discovers that RTT explains the variation in throughput more closely and as such it predicts the throughput more accurately compared to other variables. PC1 captures nearly all of the variation in throughput with the RF model and predicts throughput with very high accuracy, which indirectly confirms RTT as the variable that most significantly affects the TCP throughput in WiFi. Consequently, we discover a very close relationship between RTT and TCP throughput using appropriate ML techniques, and these results can be helpful in developing a better understanding of the relationship between latency and throughput for designing future low-latency networks.
A secure approach to monitoring emergency health resources
Authors: Rivero-García Alexandra , Santos-González Iván , Hernández-Goya Candelaria , Caballero-Gil Pino
Published: December 2021

This proposal presents an optimized, efficient and secure system designed to improve healthcare staff management in emergency situations through a complete tool to classify victims in a emergency situation according the severity of their condition, providing at the same time their location and the best route to reach them. The developed tool consists on a mobile application (assigned to medical and healthcare staff), a web service and Near Field Communication tags (assigned to victims). The mobile application supports secure communication among health staff and implements triage algorithms which result is stored in NFC tags. Apart from this, it helps to indicate which should be the next victim to be treated. The developed web service provides a global view of the emergency status and the current position of victims and staff. Data security is a key objective, overall in health applications; for this reason, tokens are used to protect the triage results before being stored in NFC tags, and the use of IDentity-Based Signcryption provides confidentiality and authentication to communications. Two different signcryption methods are used depending on the communication mode (peer-to-peer or broadcast mode).
Preparing for future waves and pandemics: a global hospital survey on infection control measures and infection rates in COVID-19
Authors: Matoori Simon , Kuritzkes Daniel R. , Goh Yonggeng , Quek Swee Tian , Wang Liang , Sun Ziyan , di Marco Fabiano , Borleri Daniela , Buoro Sabrina , Fagiuoli Stefano , Ferrari Tatiana , Rizzi Marco , Raimondi Federico , Cesa Simonetta , Koh Dow-Mu , Froehlich Johannes M. , Janssen Sonja , Lange Bettina , Egle Alexander , Erb Stefan , Mossdorf Erik , Gutzeit Andreas
Published: December 2021

A survey of hospitals on three continents was performed to assess their infection control preparedness and measures,
and their infection rate in hospital health care workers during the COVID-19 pandemic. All surveyed hospitals used similar PPE but differences in preparedness, PPE shortages, and infection rates were reported.
Disseminated Kaposi sarcoma following COVID-19 in a 61-year-old Albanian immunocompetent man: a case report and review of the literature
Authors: Gardini Giulia , Odolini Silvia , Moioli Giovanni , Papalia Dorothea Angela , Ferrari Vittorio , Matteelli Alberto , Caligaris Silvio
Published: December 2021

Background

COVID-19 and its related anti-inflammatory treatment (steroids, immunomodulators) may induce the reactivation of latent bacterial, parasitic, and viral infections. According to our knowledge, no case of disseminated HHV-8-related Kaposi sarcoma (KS) after COVID-19 and its treatment has been described so far. Only one case of cutaneous KS concurrently with COVID-19 has been previously reported.

Case presentation

We describe a case of disseminated KS in a 61-year-old immunocompetent Albanian man after hospitalization for COVID-19.

Methods for literature research

We used PubMed as biomedical database for the literature research. We selected keyword combinations including “Kaposi sarcoma,” “HHV-8,” “immunocompetent,” “COVID-19,” “SARS-CoV-2,” and “steroids.” No time or language limitation was set. Titles and abstracts of selected articles were systematically screened. Articles were included in the examination if they were published under free access through the digital library of the University of Brescia (Italy), and provided full text. Articles were excluded if the topic was beyond the aim of our study. Finally, we selected 15 articles.

Results

We describe a case of KS in COVID-19 patient and postulate that Interleukin-6 (IL-6) activity and steroid-induced immunodeficiency may play a major role in KS emergence. No published case of disseminated KS following COVID-19 in otherwise healthy individuals was found through the systematic literature review, despite the high incidence of COVID-19 in areas with medium–high prevalence of HHV-8 infection. This observation might be explained by the role of individual genetic susceptibility factors.

Conclusions

SARS-CoV-2 infection and its treatment may lead to reactivation of several latent infections, including HHV-8 and its related clinical syndrome, Kaposi sarcoma.
Agro-morphological traits-based genetic diversity assessment in Ethiopian barley (Hordeum vulgare L.) landrace collections from Bale highlands, Southeast Ethiopia
Authors: Gadissa Fekadu , Abebe Meskerem , Bekele Tesfaye
Published: December 2021

Background

Cultivated barley (Hordeum vulgareL.) is one of the world’s important cereal crops. Ethiopia is claimed to be the centre of origin due to its high phenotypic diversity and flavonoid patterns. It is widely cultivated on subsistence bases and important in supporting the livelihood of local poor. However, the local landraces are currently under threat of severing genetic erosion. Hence, assessing the extents of its genetic diversity is timely in improvement and conservation.

Methodology

120 representative cultivated barley landraces have been collected from Bale highlands, Ethiopia, and tested at two locations using alpha lattice design. Data were collected on 21 agro-morphometric traits and analysed using MINITAB 19, SAS 9.4 and FigTree v1.4.3.

Results

Most morphotypes in each of the qualitative traits considered and mean performance values in most of the quantitative traits revealed wide range of variations suggesting existence of phenotypic diversity among the landraces. Analysis of variance also showed significant variations among the landraces. All the traits, except days to maturity and plant height showed a significant variation for location and treatment-location interactions revealing the high impact of environmental conditions on the variations. Estimates of the variance components also revealed a wider range of variations in most of the traits considered with eventual medium to low genotypic (GCV), phenotypic (PCV) and genotype–environment coefficients of variation (GECV). Estimates of heritability in broad sense (H2) is low (< 40%) in all the traits except in days to maturity. Grouping of the landraces showed poor geographic areas of collection-based pattern suggesting extensive gene flow among the areas.

Conclusion

The landraces evaluated in the present study showed high morphological diversity. However, the effect of environment factor is pronounced and thus, multiple locations and years with large number of samples must be considered to exploit the available genetic-based variations for breeding and conservation of the crop.