bluuebunny/crossref_metadata_2025 huggingface dataset:
Greater Knee Rotatory Instability After Posterior Meniscocapsular Injury Versus Anterolateral Ligament Injury: A Proposed Mechanism of High-Grade Pivot Shift
Authors: Kim Yi-Suk , Koo Seungbum , Kim Jun Ho , Tae Jungyeun , Wang Joon Ho , Ahn Jin Hwan , Jang Ki-Mo , Jeon Jongmin , Lee Do Kyung
Published: September 2023

Background:

For anterolateral rotatory instability as a result of secondary soft tissue injuries in anterior cruciate ligament (ACL)-deficient knees, there is increasing interest in secondary stabilizers to prevent internal rotation (IR) of the tibia.

Purpose:

To determine which secondary stabilizer is more important in anterolateral rotatory instability in ACL-deficient knees.

Study Design:

Controlled laboratory study.

Methods:

The lower extremities of 10 fresh-frozen cadavers (20 extremities) without anterior-posterior or rotational instability were included. Matched-pair randomization was performed, with each side per specimen assigned to 1 of 2 groups. In group 1, the ACL was sectioned, followed by the anterolateral ligament (ALL); in group 2, the ACL was sectioned, followed by sequential sectioning of the posterolateral meniscocapsular complex (PLMCC) and posteromedial meniscocapsular complex (PMMCC). The primary outcome was the change in relative tibial IR during a simulated pivot-shift test with 5 N·m of IR torque and 8.9 N of valgus force. The secondary outcomes were the International Knee Documentation Committee grade in the pivot-shift test and the incidence of the grade 3 pivot shift.

Results:

In group 1, compared with baseline, the change in relative tibial IR at 0° of knee flexion was 1.4° (95% CI, –0.1° to 2.9°; P = .052) after ALL release. In group 2, it was 2.5° (95% CI, 0.4° to 4.8°; P = .007) after PLMCC release and 4.1° (95% CI, 0.5° to 7.8°; P = .017) after combined PLMCC and PMMCC release. Combined PLMCC and PMMCC release resulted in greater change of tibial IR with statistical significance at 0°, 15°, and 30° of knee flexion ( P = .008, .057, and .004, respectively) compared with ALL release. The incidence of grade 3 pivot shifts was 10% in group 1 and 90% in group 2.

Conclusion:

Posterior meniscocapsular laxity caused an increase in relative tibial IR as much as ALL injury in ACL-deficient knees in our simulated laboratory test, and greater anterolateral rotatory instability occurred with posterior meniscocapsular injury compared with ALL injury.

Clinical Relevance:

Repair of the injured posterior meniscocapsular complex may be an important treatment option for reducing anterolateral rotatory instability in the ACL-deficient knee.
Optimization and fuzzy model for evaluation of mechanical and tribological properties of Al-CNT-Si3N4 based nano and hybrid composites
Authors: Ambigai Rajasekaran , Prabhu Sethuramalingam
Published: September 2023

Silicon Nitride (Si3N4) has an extraordinary combination of high hardness, strength, toughness, and advanced properties like excellent wear and corrosion resistant, thermal shock resistance. Also, Carbon Nano Tube (CNT) has grasped interest among the researchers owing to its superior mechanical and thermal properties. Hence, the present study intents to fabricate Al matrix reinforced with Si3N4 nano particulate and Al matrix reinforced with CNT and Si3N4 particulate called hybrid composite via gravity casting route. The fabricated composites were tested for compression test, hardness and tribological test. The L9 orthogonal array was selected to conduct the tribological test in dry sliding conditions. Furthermore, SEM, an optical microscope, and image analysis tools were used to characterize the created composites. To determine the ideal operating conditions of the tribology test, analysis of variance was performed. The correlation between the input parameters and the wear rate, COF, was established using regression models. In order to predict the rate of wear with greater than 95% accuracy, a fuzzy model was developed based on the experimental data.
The Clinical Outcomes of Radiocapitellar Reconstruction With Radiocapitellar Arthroplasty: A Systematic Review and Meta-Analysis
Authors: Sandefur Evan P , Hansen Brian K , Hackley Darren T , Schmitt Mark W , Beck Jadon H , Bravo Cesar J
Published: September 2023

Background

Radiocapitellar arthroplasty fills a treatment void for young patients who experience isolated capitellar fractures or radiocapitellar osteoarthritis who are not candidates for total elbow arthroplasty. The outcomes of this procedure are sparsely reported. We designed a meta-analysis to determine the utility of radiocapitellar arthroplasty with respect to functional and patient reported outcomes.

Methods

The PubMed database was searched for relevant studies. Only studies published in English language that assessed patient reported outcomes following radiocapitellar arthroplasty were included in this study. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses for 2020.

Results

The initial review yielded 562 studies that met the criteria. After excluding duplications and confounding factors, eight case series were identified for review. Of the eight studies, seven were eligible for inclusion in the meta-analysis for Mayo Elbow Performance Score, flexion-extension arc, and pronation–supination arc. The pooled standard mean difference was found to be statistically significant between pre-operative and post-operative outcomes for Mayo Elbow Performance Score (SMD = 3.04, 95% CI [2.40, 3.67]), flexion-extension arc (SMD = 1.28, 95% CI [0.73, 1.83]), and pronation–supination arc (SMD = 0.81, 95% CI [0.43, 1.18]). Cochran's Q-test and I2 statistics indicated statistically significant heterogeneity for Mayo Elbow Performance Score ( p = .04, I2 = 54%) and flexion-extension arc ( p < .01, I2 = 67%).

Conclusions

Patients undergoing radiocapitellar arthroplasty showed statistically significant improvements in flexion-extension arc, pronation–supination arc, and Mayo Elbow Performance Scores compared to pre-operative measures.
Eliciting and prioritising determinants of improved care in multimorbidity: A modified online Delphi study
Authors: Simpson Glenn , Stuart Beth , Hijryana Marisza , Akyea Ralph Kwame , Stokes Jonathan , Gibson Jon , Jones Karen , Morrison Leanne , Santer Miriam , Boniface Michael , Zlatev Zlatko , Farmer Andrew , Dambha-Miller Hajira
Published: September 2023

Background

Multimorbidity is a major challenge to health and social care systems around the world. There is limited research exploring the wider contextual determinants that are important to improving care for this cohort. In this study, we aimed to elicit and prioritise determinants of improved care in people with multiple conditions.

Methods

A three-round online Delphi study was conducted in England with health and social care professionals, data scientists, researchers, people living with multimorbidity and their carers.

Results

Our findings suggest a care system which is still predominantly single condition focused. ‘Person-centred and holistic care’ and ‘coordinated and joined up care’, were highly rated determinants in relation to improved care for multimorbidity. We further identified a range of non-medical determinants that are important to providing holistic care for this cohort.

Conclusions

Further progress towards a holistic and patient-centred model is needed to ensure that care more effectively addresses the complex range of medical and non-medical needs of people living with multimorbidity. This requires a move from a single condition focused biomedical model to a person-based biopsychosocial approach, which has yet to be achieved.
Quality of testicular spermatozoa improves with changes in composition of culture medium
Authors: Gholizadeh Lida , Khalili Mohammad Ali , Maleki Behnam , Vahidi Serajoddin , Agha-Rahimi Azam
Published: September 2023

Background

Spermatozoa retrieved from the testis and epididymis are deprived of the beneficial effects of seminal fluid. Thus applying an artificial medium with normal seminal fluid characteristics, known as artificial seminal fluid (ASF), may provide an appropriate condition for improving some sperm parameters in azoospermia. The objective was to investigate the impact of in vitro exposure of testicular and epididymal spermatozoa to ASF on sperm quality. The study was conducted on testicular (n = 20) and epididymal (n = 20) sperm specimens obtained from azoospermic men. Each sample was divided into two equal parts: Part I) for processing and incubation with Ham’s F10 medium; Part II) for processing and incubation with ASF.

Results

After 2 h incubation, testicular sperm motility was significantly higher in ASF than in Ham’s F10 medium. In comparison to 0 h, mitochondrial membrane potential levels of testicular spermatozoa were significantly higher after 2 h and 24 h in ASF and after 24 h in Ham’s F10 medium. Furthermore, the data indicated significantly lower rates of epididymal spermatozoa with high MMP in both media after 24 h. There were no significant differences in the DNA fragmentation index of testicular and epididymal spermatozoa between ASF and Ham’s F10 medium at different time points.

Conclusion

The results demonstrated that in vitro incubation of testicular spermatozoa improved their motility more effectively than Ham’s F10 medium in the short term (2 h), but had no effect on epididymal spermatozoa. Since the physiology of testicular spermatozoa is different from that of ejaculated spermatozoa, it seems that a special environment should be designed and used for each of them.
Effectiveness of an exercise intervention based on preactivation of the abdominal transverse muscle in patients with chronic nonspecific low back pain in primary care: a randomized control trial
Authors: Rubí-Carnacea Francesc , Masbernat-Almenara Maria , Climent-Sanz Carolina , Soler-González Jorge , García-Escudero María , Martínez-Navarro Oriol , Valenzuela-Pascual Fran
Published: September 2023

Background

Low back pain is one of the most common disabling pathologies in humanity worldwide. Physical exercises have been used in recent decades to reduce the pain, improve the functionality of the lumbar spine and avoid relapses. The purpose of the study is to analyze the effect of a program based on re-education exercises involving preactivation of the abdominal transverse muscle compared to conventional treatment in adults with chronic nonspecific low back pain.

Methods

A two-arm, single-blind randomized control trial with 35 primary care patients with chronic nonspecific low back pain. Both groups received a 4-week intervention. Data were collected at baseline and at the end of the intervention. Sixteen patients participated in the intervention group, and 19 patients in the control group.

Results

For the experimental group, the outcomes of disability and activation of the abdominal transverse muscle decreased significantly (MD -2.9; CI 95% -5.6 to -0.35; η2 = 0.14; p = 0.028) and (MD 2.3; CI 95% 0.91 to 3.67; η2 = 0.25; p = 0.002) respectively, with a large effect size, compared to the control group. There were no differences between the groups in pain intensity, thickness, and resistance of the transverse abdominal muscle.

Conclusion

A 4-week specific program based on re-education exercises of the preactivation of the abdominal transverse muscle is more effective than conventional treatment for reducing disability and increasing the activation of the abdominal transverse muscle measured by VAS scale and PBU.

Trial registration

Clinicaltrials.gov identifier: NCT03097497. Date of registration: 31/03/2017.
Staphylococcus epidermidis induced toxic shock syndrome (TSS) secondary to influenza infection
Authors: Armeftis Charis , Ioannou Andreas , Lazarou Theodorakis , Giannopoulos Achilleas , Dimitriadou Efrosyni , Makrides Kostantinos , Pana Zoi Dorothea
Published: September 2023

Background

To date, few cases of TSS caused by coagulase negative (CoN) staphylococci have been reported in the literature. Recent data show that CoN staphylococci are capable of secreting a number of enterotoxins and cytotoxins, normally produced by S. aureus. Herewith, we describe a case of TSS caused by Staphylococcus epidermidis with a favorable outcome.

Case presentation

We report a case of a 46-year-old man who developed TSS from S. epidermidis. The patient was admitted for a 7-day history of general malaise and headache following a recent influenza infection and a 3-day history of vomiting, diarrhea, diffuse erythroderma, and fever. The main laboratory findings on admission were leukopenia (WBC 800/mm3), thrombocytopenia (Plt count 78.000/mm3), elevated urea, creatine levels and increased inflammatory markers (CRP 368 mg/ml). The patient had clinical and radiological evidence of pneumonia with chest computed tomography (CT) showing diffuse bilateral airspace opacifications with air bronchogram. On the second day, a methicillin resistant S. epidermidis (MRSE) strain was detected in both sets of blood cultures, but the organism was unavailable for toxin testing. All other cultures and diagnostic PCR tests were negative. His clinical signs and symptoms fulfilled at that stage four out of five clinical criteria of TSS with a fever of 39 °C, diffuse erythroderma, multisystem involvement and hypotension. On the same day the patient was admitted to the ICU due to acute respiratory failure. The initial treatment was meropenem, vancomycin, levofloxacin, clindamycin, IVIG and steroids. Finger desquamation appeared on the 9th day of hospitalization, fulfilling all five clinical criteria for TSS.

Conclusions

To our knowledge, this is the first adult case with TSS induced by CoNS (MRSE) secondary to an influenza type B infection, who had favorable progression and outcome. Further research is warranted to determine how TSS is induced by the CoNS infections.
Prevalence and antimicrobial susceptibility pattern of bacterial uropathogens among adult patients in Madinah, Saudi Arabia
Authors: Almutawif Yahya A. , Eid Hamza M. A.
Published: September 2023

Background

Urinary tract infection (UTI) is considered one of the most prevalent infections that may lead to many renal complications. They account for almost 10% of all infections in Saudi Arabia, making them the second most common cause of emergency department admissions. Bacterial pathogens, primarily Escherichia coli, Klebsiella spp., Enterococcus spp., Proteus spp., and Staphylococcus spp. are the most causative agents of UTI. This study aims to evaluate the prevalence and antimicrobial susceptibility patterns of uropathogens in adult patients from Madinah, Saudi Arabia.

Methods

A retrospective cross-sectional study was performed using data collected from patients who visited King Fahad General Hospital in Madinah, Saudi Arabia. Data included 16,803 urine bacterial cultures and their antimicrobial susceptibility profiles collected between January 2019 and October 2021.

Results

Among the 16,803 tested samples, 3937 (23.4%) showed positive results for urine bacterial cultures. UTI prevalence was slightly higher in women (52.1%) than men (47.9%). Escherichia coli (29.8%) was the most prevalent, followed by Klebsiella spp. (23.2%) and Pseudomonas spp. (8.4%). As for Gram-positive bacteria, Enterococcus spp. (10.8%) were most common, followed by Streptococcus spp. (8%) and Staphylococcus spp. (3.3%). Gram-negative bacteria exhibited high resistance rates toward aztreonam (> 83.3%), ampicillin (78.8%), and cephalexin (68.5%). Enterococcus spp. displayed elevated resistance rates (> 62.3%) against ciprofloxacin, gentamicin, and tetracycline. Conversely, Streptococcus spp. showed substantial resistance rates (> 76.6%) toward colistin and trimethoprim/sulfamethoxazole.

Conclusion

To optimize therapy and minimize the risk of multidrug-resistant uropathogenic infections, physicians should consider the local epidemiological trends and antimicrobial resistance patterns of prevalent uropathogens prior to initiating any empirical antibacterial therapy.
Interventions to enhance healthcare utilisation among pregnant women to reduce maternal mortality in low- and middle-income countries: a review of systematic reviews
Authors: Mzembe Themba , Chikwapulo Victor , Kamninga Tony Mwenda , Vellemu Ruth , Mohamed Sahra , Nthakomwa Lomuthando , Chifungo Chimwemwe , Wazny Kerri , Musau Kelvin , Abdullahi Leila , Peterson Maame , Madise Nyovani , Chipeta Michael G.
Published: September 2023

Background

Maternal mortality in low- and middle-income countries (LMIC) has reduced considerably over the past three decades, but it remains high. Effective interventions are available, but their uptake and coverage remain low. We reviewed and synthesised evidence from systematic reviews on interventions to increase healthcare services utilisation to reduce maternal mortality in LMICs.

Methods

We searched Medline PubMed and Cochrane Library databases for systematic reviews published between January 2014 and December 2021, investigating interventions to increase healthcare services uptake among pregnant women in LMICs. We used the AMSTAR tool (A Measurement Tool to Assess Systematic Reviews) to assess the methodological quality of the included reviews. We extracted data on the interventions and their effects and grouped them into broad groups based on the outcomes reported in each systematic review.

Results

We retrieved 4,022 articles. After removing duplicates and screening, we included 14 systematic reviews.

Male-partner interventions were effective in increasing skilled birth attendance (SBA) postnatal visits and maternal antiretroviral (ART) uptake for HIV-positive pregnant women. However, there was no evidence of their effectiveness on increased early ANC initiation or adequate ANC visits.

Mobile health interventions were effective in increasing adequate ANC visits, SBA, facility-based service utilisation, early ANC initiation, and adherence to nutritional supplements.

Incentive-based interventions, particularly financial incentives, were effective in increasing the number of ANC visits but not postnatal visits.

Facility-based interventions were effective in increasing postnatal visits, maternal ART initiation and uptake, immunisation uptake and follow-up ANC visits. None of the reviews assessed their impact on SBA or adequate ANC visits.

Community-based interventions were effective in increasing SBA, ANC service utilisation, ART initiation and uptake, and nutritional supplements and immunisation uptake.

Conclusion

Our findings show that the different interventions effectively improved different outcomes on the maternal healthcare continuum. Implementing these interventions in combination has the potential to enhance healthcare service uptake further.
Guideline adherence and socioeconomic factors in Danish patients referred to secondary care for low back pain: a cross sectional study
Authors: Hestbæk Lise , Schmidt Anne Mette , Hald Majbrit Andsbjerg , Rolving Nanna
Published: September 2023

Background

The pre-referral history of patients with low back pain referred to secondary care is poorly documented, and it is unclear whether it complies with clinical guideline recommendations; specifically, whether they have received appropriate treatment in primary care. This study describes the patient population referred to a spine clinic at a Danish hospital and investigates whether they have received an adequate course of treatment in primary care before referral. Furthermore, a possible association between primary care treatment and socioeconomic factors is estimated.

Methods

We examined self-reported data from 1035 patients with low back pain of at least eight weeks duration referred to secondary care at a medical spine clinic using a cross-sectional design. As an approximation to national clinical guidelines, the definition of an adequate course of treatment in primary care was at least five visits to a physiotherapist or chiropractor prior to referral.

Results

Patients were on average 53 years old, and 56% were women. The average Oswestry Disability Index score was 36, indicating a moderate level of disability. Nearly half of the patients reported pain for over a year, and 75% reported pain below knee level.

Prior to referral, 33% of the patients had not received an adequate course of treatment in primary care. Based on multiple logistic regression with the three socioeconomic variables, age and sex in the model, those who were unemployed had an odds ratio of 2.35 (1.15–4.79) for not receiving appropriate treatment compared to employed patients. Similarly, the odds ratio for patients without vs. with health insurance was 1.71 (1.17–2.50). No significant association was observed with length of education.

Conclusions

Despite national clinical guidelines recommending management for low back pain in primary care, one third of the patients had not received an adequate course of treatment before referral to secondary care. Moreover, the high probability of not having received recommended treatment for patients who were unemployed or lacked health insurance indicates an economic obstacle to adequate care. Therefore, reconsidering the compensation structure for the treatment of back pain patients is imperative to mitigate health inequality within low back pain management.
Head and neck cancer patients show poor oral health as compared to those with other types of cancer
Authors: Nishi Hiromi , Obayashi Taiji , Ueda Tsutomu , Ohta Kouji , Shigeishi Hideo , Munenaga Syuichi , Kono Takashi , Yoshioka Yukio , Konishi Masaru , Taga Ryotaro , Toigawa Yuya , Naruse Takako , Ishida Eri , Tsuboi Eri , Oda Kanae , Dainobu Kana , Tokikazu Tomoko , Tanimoto Kotaro , Kakimoto Naoya , Ohge Hiroki , Kurihara Hidemi , Kawaguchi Hiroyuki
Published: September 2023

Purpose

Several studies have found associations between periodontitis and various types of cancer. Since the site of head and neck cancer (HNC) has contiguity or proximity to the oral cavity, it may be particularly influenced by oral inflammation. This study aimed to determine whether HNC patients have poor oral health as compared to those with other types of cancer.

Methods

This study retrospectively examined oral environmental factors including periodontal inflamed surface area (PISA), a new periodontal inflammatory parameter. A total of 1030 cancer patients were divided into the HNC (n = 142) and other cancer (n = 888) groups. Furthermore, the HNC group was divided into high (n = 71) and low (n = 71) PISA subgroups, and independent risk factors affecting a high PISA value were investigated.

Results

Multivariate logistic regression analysis showed that number of missing teeth (odds ratio 1.72, 95% CI 1.15–2.56, P < 0.01), PISA (odds ratio 1.06, 95% CI 1.03–1.06, P < 0.05), and oral bacterial count (odds ratio 1.02, 95% CI 1.01–1.03, P < 0.01) were independent factors related to HNC. In addition, multivariate logistic regression analysis indicated that current smoker (odds ratio 7.51, 95% CI 1.63–34.71, P < 0.01) and presence of untreated dental caries (odds ratio 3.33, 95% CI 1.23–9.00, P < 0.05) were independent risk factors affecting high PISA values in HNC patients.

Conclusion

HNC patients have higher levels of gingival inflammation and poor oral health as compared to patients with other types of cancer, indicating that prompt oral assessment and an effective oral hygiene management plan are needed at the time of HNC diagnosis.
L1077P CFTR pathogenic variant function rescue by Elexacaftor–Tezacaftor–Ivacaftor in cystic fibrosis patient-derived air–liquid interface (ALI) cultures and organoids: in vitro guided personalized therapy of non-F508del patients
Authors: Lo Cicero Stefania , Castelli Germana , Blaconà Giovanna , Bruno Sabina Maria , Sette Giovanni , Pigliucci Riccardo , Villella Valeria Rachela , Esposito Speranza , Zollo Immacolata , Spadaro Francesca , Maria Ruggero De , Biffoni Mauro , Cimino Giuseppe , Amato Felice , Lucarelli Marco , Eramo Adriana
Published: September 2023

Cystic fibrosis (CF) is caused by defects of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. CFTR-modulating drugs may overcome specific defects, such as the case of Trikafta, which is a clinically approved triple combination of Elexacaftor, Tezacaftor and Ivacaftor (ETI) that exhibited a strong ability to rescue the function of the most frequent F508del pathogenic variant even in genotypes with the mutated allele in single copy. Nevertheless, most rare genotypes lacking the F508del allele are still not eligible for targeted therapies. Via the innovative approach of using nasal conditionally reprogrammed cell (CRC) cell-based models that mimic patient disease in vitro, which are obtainable from each patient due to the 100% efficiency of the cell culture establishment, we theratyped orphan CFTR mutation L1077P. Protein studies, Forskolin-induced organoid swelling, and Ussing chamber assays congruently proved the L1077P variant function rescue by ETI. Notably, this rescue takes place even in the context of a single-copy L1077P allele, which appears to enhance its expression. Thus, the possibility of single-allele treatment also arises for rare genotypes, with an allele-specific modulation as part of the mechanism. Of note, besides providing indication of drug efficacy with respect to specific CFTR pathogenic variants or genotypes, this approach allows the evaluation of the response of single-patient cells within their genetic background. In this view, our studies support in vitro guided personalized CF therapies also for rare patients who are nearly excluded from clinical trials.
Macrophage migration inhibitory factor exacerbates asthmatic airway remodeling via dynamin-related protein 1-mediated autophagy activation
Authors: Liu Jin , Chen Yuqian , Chen Huan , Wang Yan , Li Danyang , Zhang Qianqian , Chai Limin , Qiu Yuanjie , Zhang Jia , Shen Nirui , Wang Qingting , Wang Jian , Li Manxiang
Published: September 2023

Background

Macrophage migration inhibitory factor (MIF) and GTPase dynamin-related protein 1 (Drp1)-dependent aberrant mitochondrial fission are closely linked to the pathogenesis of asthma. However, it is unclear whether Drp1-mediated mitochondrial fission and its downstream targets mediate MIF-induced proliferation of airway smooth muscle cells (ASMCs) in vitro and airway remodeling in chronic asthma models. The present study aims to clarify these issues.

Methods

In this study, primary cultured ASMCs and ovalbumin (OVA)-induced asthmatic rats were applied. Cell proliferation was detected by CCK-8 and EdU assays. Western blotting was used to detect extracellular signal-regulated kinase (ERK) 1/2, Drp1, autophagy-related markers and E-cadherin protein phosphorylation and expression. Inflammatory cytokines production, airway reactivity test, histological staining and immunohistochemical staining were conducted to evaluate the development of asthma. Transmission electron microscopy was used to observe the mitochondrial ultrastructure.

Results

In primary cultured ASMCs, MIF increased the phosphorylation level of Drp1 at the Ser616 site through activation of the ERK1/2 signaling pathway, which further activated autophagy and reduced E-cadherin expression, ultimately leading to ASMCs proliferation. In OVA-induced asthmatic rats, MIF inhibitor 4-iodo-6-phenylpyrimidine (4-IPP) treatment, suppression of mitochondrial fission by Mdivi-1 or inhibiting autophagy with chloroquine phosphate (CQ) all attenuated the development of airway remodeling.

Conclusions

The present study provides novel insights that MIF promotes airway remodeling in asthma by activating autophagy and degradation of E-cadherin via ERK/Drp1 signaling pathway, suggesting that targeting MIF/ERK/Drp1 might have potential therapeutic value for the prevention and treatment of asthma.
Socio-demographic factors associated with COVID-19 vaccine uptake and refusal among Ugandan women
Authors: Backhaus Andreas
Published: September 2023

Background

This paper analyzes associations of socio-demographic factors with the uptake of COVID-19 vaccines, the refusal to get vaccinated against COVID-19, and various reasons stated for refusing vaccination against COVID-19 among a representative sample of Ugandan women.

Methods

This paper utilizes a representative cross-sectional survey collected among women aged 15-49 years in Uganda between September and November 2021. Regression analyses are used to study the associations of a broad range of socio-demographic characteristics with COVID-19 vaccine uptake, refusal of vaccination, and reasons for refusal among the respondents.

Results

4211 women were included in the analysis. 11% of them were vaccinated against COVID-19, 76% were willing to get vaccinated, 13% were unwilling to get vaccinated. Fear of side effects was the most commonly stated reason for refusing vaccination (69%). Factors significantly and positively associated with being vaccinated against COVID-19 were age, higher education, urban residency, having savings, partial instead of complete income loss during the pandemic, and usage of modern contraceptives. Factors significantly and positively associated with refusing vaccination against COVID-19 were urban residency and current pregnancy, while age, having savings, and using modern contraceptives were factors associated with a lower likelihood of refusing vaccination, albeit with varying statistical significance. Few factors were strongly related to the stated reasons for refusing the vaccines; the fear of side effects significantly increased with age, while having received negative information on the vaccines was significantly less common among women with higher education.

Conclusions

This study documents a low COVID-19 vaccination rate and a high willingness to get vaccinated among Ugandan women. Positive age and education gradients in vaccine uptake point to inequity in access to vaccination, potentially resulting from prioritizations of groups at particularly high risk. Refusal to be vaccinated was relatively low and systematic factors behind vaccine refusal were hardly to be found, even less so for particular reasons given for refusal.
From political pledges to quantitative mapping of climate mitigation plans: Comparison of two European cities
Authors: Albarus Ivonne , Fleischmann Giorgia , Aigner Patrick , Ciais Philippe , Denier van der Gon Hugo , Droge Rianne , Lian Jinghui , Narvaez Rincon Miguel Andrey , Utard Hervé , Lauvaux Thomas
Published: September 2023

Background

Urban agglomerates play a crucial role in reaching global climate objectives. Many cities have committed to reducing their greenhouse gas emissions, but current emission trends remain unverifiable. Atmospheric monitoring of greenhouse gases offers an independent and transparent strategy to measure urban emissions. However, careful design of the monitoring network is crucial to be able to monitor the most important sectors as well as adjust to rapidly changing urban landscapes.

Results

Our study of Paris and Munich demonstrates how climate action plans, carbon emission inventories, and urban development plans can help design optimal atmospheric monitoring networks. We show that these two European cities display widely different trajectories in space and time, reflecting different emission reduction strategies and constraints due to administrative boundaries. The projected carbon emissions rely on future actions, hence uncertain, and we demonstrate how emission reductions vary significantly at the sub-city level.

Conclusions

We conclude that quantified individual cities’ climate actions are essential to construct more robust emissions trajectories at the city scale. Also, harmonization and compatibility of plans from various cities are necessary to make inter-comparisons of city climate targets possible. Furthermore, dense atmospheric networks extending beyond the city limits are needed to track emission trends over the coming decades.
Xenograft bone‐patellar tendon‐bone ACL reconstruction: a case series at 20‐year follow‐up as proof of principle
Authors: Stone Kevin R. , Walgenbach Ann W. , Turek Thomas J. , Crues John V. , Galili Uri
Published: September 2023

Purpose

ACL reconstruction has a significant failure rate. To address the need for inexpensive strong tissue, a treatment process to “humanize” porcine tissue was developed and tested in primates and humans. This report describes the long‐term outcomes from the first human clinical trial using a porcine xenograft ACL reconstruction device.

Methods

The study was performed with Z‐Lig™ xenograft ACL device in 2003 as a pilot clinical feasibility study. This device was processed to slow its immune‐mediated destruction by enzymatic elimination of α‐gal epitopes and by partial crosslinking to slow the infiltration of macrophages into the biotransplant.

Results

Ten patients underwent reconstruction with the Z‐Lig™ device. Five of 10 patients failed due to subsequent trauma (n = 3), arthrofibrosis (n = 1), and surgical technical error (n = 1). One patient was lost to follow‐up after the 12‐year evaluation. Each remaining patient reported a stable fully athletic knee. Physical exams are consistent with a score of less than one on the ACL stability tests. MRIs demonstrate mature remodeling of the device. There is no significant degradation in patient‐reported outcome scores, physical exams, or MRI appearance from 12 to 20‐year follow‐ups.

Conclusions

The studies in a small group of patients have demonstrated that implantation of porcine ligament bioprosthesis into patients with torn ACLs can result in the reconstruction of the bioprosthesis into autologous ACL that remains successful over 20 years. The possibility of humanizing porcine tissue opens the door to unlimited clinical material for tissue reconstructions if supported by additional clinical trials.

Level of evidence

IV, case series.
Intra-tidal PaO2 oscillations associated with mechanical ventilation: a pilot study to identify discrete morphologies in a porcine model
Authors: Cronin John N. , Crockett Douglas C. , Perchiazzi Gaetano , Farmery Andrew D. , Camporota Luigi , Formenti Federico
Published: September 2023

Background

Within-breath oscillations in arterial oxygen tension (PaO2) can be detected using fast responding intra-arterial oxygen sensors in animal models. These PaO2 signals, which rise in inspiration and fall in expiration, may represent cyclical recruitment/derecruitment and, therefore, a potential clinical monitor to allow titration of ventilator settings in lung injury. However, in hypovolaemia models, these oscillations have the potential to become inverted, such that they decline, rather than rise, in inspiration. This inversion suggests multiple aetiologies may underlie these oscillations. A correct interpretation of the various PaO2 oscillation morphologies is essential to translate this signal into a monitoring tool for clinical practice. We present a pilot study to demonstrate the feasibility of a new analysis method to identify these morphologies.

Methods

Seven domestic pigs (average weight 31.1 kg) were studied under general anaesthesia with muscle relaxation and mechanical ventilation. Three underwent saline-lavage lung injury and four were uninjured. Variations in PEEP, tidal volume and presence/absence of lung injury were used to induce different morphologies of PaO2 oscillation. Functional principal component analysis and k-means clustering were employed to separate PaO2 oscillations into distinct morphologies, and the cardiorespiratory physiology associated with these PaO2 morphologies was compared.

Results

PaO2 oscillations from 73 ventilatory conditions were included. Five functional principal components were sufficient to explain ≥ 95% of the variance of the recorded PaO2 signals. From these, five unique morphologies of PaO2 oscillation were identified, ranging from those which increased in inspiration and decreased in expiration, through to those which decreased in inspiration and increased in expiration. This progression was associated with the estimates of the first functional principal component (P < 0.001, R2 = 0.88). Intermediate morphologies demonstrated waveforms with two peaks and troughs per breath. The progression towards inverted oscillations was associated with increased pulse pressure variation (P = 0.03).

Conclusions

Functional principal component analysis and k-means clustering are appropriate to identify unique morphologies of PaO2 waveform associated with distinct cardiorespiratory physiology. We demonstrated novel intermediate morphologies of PaO2 waveform, which may represent a development of zone 2 physiologies within the lung. Future studies of PaO2 oscillations and modelling should aim to understand the aetiologies of these morphologies.
European health literacy survey questionnaire short form (HLS-Q12): adaptation and evidence of validity for the Brazilian context
Authors: Zanini Daniela Sacramento , Peixoto Evandro Morais , de Andrade Josemberg Moura , Fernandes Iorhana Almeida , da Silva Maynara Priscila Pereira
Published: September 2023

Health literacy (HL) refers to knowledge, motivation and skills to understand, evaluate and apply health information, enabling appropriate decision making in daily life on health care and health promotion. Studies show that HL is associated with several social determinants, health outcomes, and health promotion. In Brazil, studies on the thematic are still scarce. Thus, the present study aimed to adapt, seek evidence of validity, reliability and estimate the parameters of the items of the European Health Literacy Survey Questionnaire Short Form (HLS-Q12) for the Brazilian context. 770 individuals participated, recruited through advertisements in the media and social networks, 82.1% female, aged between 18 and 83 (M = 35.5, SD = 13.52), from 21 Federative Units of Brazil and the Federal District. The subjects answered the HLS-Q12 and a sociodemographic questionnaire. Exploratory factor analysis indicated a unifactorial structure with good psychometric characteristics (GFI = 0.98; CFI = 0.98; RMSEA = 0.08; RMSR = 0.07). Cronbach's alpha, Guttman's lambda 2 and McDonald’s omega reliability indicators were equal to 0.87. We conclude that the HLS-Q12 is an adequate instrument to assess the level of HL in the Brazilian population.
Cardiovascular disease prevention should start in early life
Authors: Noubiap Jean Jacques , Nyaga Ulrich Flore
Published: September 2023

Adolescence and young adulthood are critical periods for building the foundation of cardiovascular health. Unfortunately, the incidence of cardiovascular disease has substantially increased in adolescents and young adults in the last three decades. Multilevel interventions are needed to preserve ideal cardiovascular health in this population.
Assessing aetiological overlap between child and adult attention-deficit hyperactivity disorder symptoms in an extended family design
Authors: Wechsler Daniel L. , Rijsdijk Fruhling V. , Adamo Nicoletta , Eilertsen Espen M. , Ahmadzadeh Yasmin I. , Badini Isabella , Hannigan Laurie J. , Ystrom Eivind , McAdams Tom A.
Published: September 2023

Background

Several longitudinal studies have cast doubt on the aetiological overlap between child and adult attention-deficit hyperactivity disorder (ADHD). However, a lack of genetically sensitive data following children across adulthood precludes direct evaluation of aetiological overlap between child and adult ADHD.

Aims

We circumvent the existing gap in longitudinal data by exploring genetic overlap between maternal (adult) and offspring (child) ADHD and comorbid symptoms in an extended family cohort.

Method

Data were drawn from the Norwegian Mother, Father and Child Cohort Study, a Norwegian birth registry cohort of 114 500 children and their parents. Medical Birth Registry of Norway data were used to link extended families. Mothers self-reported their own ADHD symptoms when children were aged 3 years; reported children's ADHD symptoms at age 5 years; and children's ADHD, oppositional defiant disorder (ODD), conduct disorder, anxiety and depression symptoms at age 8 years. Genetic correlations were derived from Multiple-Children-of-Twins-and-Siblings and extended bivariate twin models.

Results

Phenotypic correlations between adult ADHD symptoms and child ADHD, ODD, conduct disorder, anxiety and depression symptoms at age 8 years were underpinned by medium-to-large genetic correlations (child ADHD: rG = 0.55, 95% CI 0.43−0.93; ODD: rG = 0.80, 95% CI 0.46−1; conduct disorder: rG = 0.44, 95% CI 0.28−1; anxiety: rG = 0.72, 95% CI 0.48−1; depression: rG = 1, 95% CI 0.66−1). These cross-generational adult–child genetic correlations were of a comparable magnitude to equivalent child–child genetic correlations with ADHD symptoms at age 5 years.

Conclusions

Our findings provide genetically sensitive evidence that ADHD symptoms in adulthood share a common genetic architecture with symptoms of ADHD and four comorbid disorders at age 8 years. These findings suggest that in the majority of cases, ADHD symptoms in adulthood are not aetiologically distinct from in childhood.
Virtual Reality Distraction for Reducing Acute Postoperative Pain After Hip Arthroplasty: A Randomized Trial
Authors: Araujo-Duran Jorge , Kopac Orkun , Montalvo Campana Mateo , Bakal Omer , Sessler Daniel I. , Hofstra Richard L. , Shah Karan , Turan Alparslan , Ayad Sabry
Published: September 2023

BACKGROUND:

Relaxation and distraction provided by virtual reality presentations might be analgesic and reduce the need for opioid analgesia. We tested the hypothesis that a virtual reality program (AppliedVR) decreases acute postoperative pain and opioid requirements in patients recovering from hip arthroplasty. We also evaluated whether virtual reality distraction improves patient mobility and reduces the need for antiemetics.

METHODS:

We evaluated 106 adults who were recovering from elective primary total hip arthroplasty. Participating patients were randomized to 2- to 8-minute-long 3-dimensional immersive virtual reality relaxation and distraction video presentations (eg, guided breathing exercises, games, mindfulness) or to 2-dimensional presentations of nature short films (eg, forest wildlife) with neutral music that was chosen to be neither overly relaxing nor distracting, presented through identical headsets. Our primary outcome was pain after virtual reality or sham video presentations, adjusted for pretreatment scores. Secondary outcomes included total opioid consumption, pain scores obtained per routine by nurse staff, perception of video system usability, and pain 1 week after hospital discharge.

RESULTS:

Fifty-two patients were randomized to virtual reality distraction and relaxation, and 54 were assigned to 2-dimensional sham presentations. Virtual reality presentations were not found to affect pain scores before and after presentations, with an estimated difference in means (virtual reality minus sham video) of −0.1 points (95% confidence interval [CI], −0.5 to 0.2; P = .391) on a 0 to 10 scale, with 10 being the worst. The mean (standard error [SE]) after-intervention pain score was estimated to be 3.4 (0.3) in the virtual reality group and 3.5 (0.2) in the reference group. Virtual reality treatment was not found to affect postoperative opioid consumption in morphine milligram equivalents, with an estimated ratio of geometric means (virtual reality/sham video) of 1.2 (95% CI, 0.6–2.1; P = .608). Virtual reality presentations were not found to reduce pain scores collected every 4 hours by nursing staff, with an estimated difference in means of 0.1 points (95% CI, −0.9 to 0.7; P = .768).

CONCLUSIONS:

We did not observe statistically significant or clinically meaningful reductions in average pain scores or opioid consumption. As used in our trial, virtual reality did not reduce acute postoperative pain.
Intermittent hypoxia differentially affects metabolic and oxidative stress responses in two species of cyprinid fish
Authors: Falfushynska Halina , Sokolova Inna M.
Published: September 2023

Oxygen fluctuations are common in freshwater habitats and aquaculture and can impact ecologically and economically important species of fish like cyprinids. To gain insight into the physiological responses to oxygen fluctuations in two common cyprinid species, we evaluated the impact of short-term intermittent hypoxia on oxidative stress and metabolic parameters (including levels of prooxidants and oxidative lesions, antioxidants, mitochondrial enzyme activities, mitochondrial swelling, markers of apoptosis, autophagy and cytotoxicity) in silver carp Hypophthalmichthys molitrix and gibel carp Carassius gibelio. During hypoxia, gibel carp showed higher baseline levels of antioxidants and less pronounced changes in oxidative and metabolic biomarkers in the tissues than silver carp. Reoxygenation led to a strong shift in metabolic and redox-related parameters and tissue damage, indicating high cost of post-hypoxic recovery in both species. Species-specific differences were more strongly associated with oxidative stress status, whereas metabolic indices and nitrosative stress parameters were more relevant to the response to hypoxia-reoxygenation. Overall, regulation of energy metabolism appears more critical than the regulation of antioxidants in the response to oxygen deprivation in the studied species. Further research is needed to establish whether prioritizing metabolic over redox regulation during hypoxia-reoxygenation stress is common in freshwater cyprinids.
Antibiotic versus surgery in the treatment of acute appendicitis in the pregnant population: A systematic review and meta-analysis
Authors: Candrawinata Valeska , Hanafi Ricarhdo , Baskoro Bernard Agung , Irawan Andry , Ekapatria Christofani , Christina Natalia Maria , Koerniawan Heru Sutanto , Halim Freda
Published: September 2023

Introduction: Acute appendicitis is the most common surgical emergency in pregnant women. There has been a wide variance in clinical practice worldwide, with some favoring an antibiotic-only approach while others prefer surgery as the first-line management. Therefore, we designed the current analysis to synthesize the available evidence on the efficacy and safety of antibiotics versus surgery management.

Methods: We searched PubMed, Scopus, EuropePMC, and Cochrane Central from March 4, 1904 until November 25, 2022, to look for studies comparing antibiotics and surgery in pregnant patients with acute appendicitis. We only included studies that provided a comparison between the two treatments. Measured outcomes included preterm delivery, fetal loss, maternal death, and complications, defined as those arising from the pathological processes or treatment, including, but not limited to, sepsis or septic shock, pneumonia, venous thromboembolism (VTE), and surgical site infection. The results were compared using an odds ratio and 95% confidence interval. We also performed a sensitivity analysis by excluding studies with a serious risk of bias.

Results: We included five non-randomized studies for the analysis. We found that patients in the antibiotic group had a lower risk of preterm labor (OR 0.63 [95% CI 0.43–0.92]; p 0.02) but a higher risk of complications (OR 1.79 [95% CI 1.19–2.69]; p 0.005). We did not find any difference in the other outcomes.

Conclusion: The increased risk of complications should caution clinicians about using antibiotics as the first-line management. More studies are required to identify patients who would benefit the most before antibiotics could be adopted as a treatment for acute appendicitis in pregnant patients.