bluuebunny/crossref_metadata_2025 huggingface dataset:
Thermohydrodynamic behavior of partially coated plain journal bearings with/without considering wall slip
Authors: Cui Shuhui , Gu Le , Fillon Michel , Zhang Chuanwei
Published: December 2021

A thermohydrodynamic model was used to study the influence of partial composite coatings on the behavior of plain journal bearings, considering solid elastic deformations and wall slip occurring at the oil film–polytetrafluoroethylene coating interface, and heat conduction between film, coating, interlayer and basement. The purpose is to design partial polytetrafluoroethylene coating to obtain improved bearing behavior based on analyzing the maximum temperature and minimum film thickness in different coating positions (or slip zones). The influences of coating thickness and coating materials (polytetrafluoroethylene, graphite and diamond-like carbon coatings) at different coating positions are also presented. Results show that polytetrafluoroethylene coatings that are completely located in the film convergent region have a small influence on thermal behavior in both nonslip and slip cases. Without slip, a full polytetrafluoroethylene coating can increase the maximum temperature; however, wall slip occurring on a full polytetrafluoroethylene coating surface is helpful in decreasing the maximum temperature when accompanied by a lower minimum film thickness. A thicker polytetrafluoroethylene coating causes bearing seizures more readily. Unlike polytetrafluoroethylene, graphite and diamond-like carbon coatings improve the thermal behavior.
Teens on screens: Girls’ negotiations of representations of texting in teen film
Authors: Clarke Kyra
Published: December 2021

Teen film is a space where stories about young people’s engagement with technology are told and where relationships and communication are represented. How do girls engage with such stories? This article draws on material from two focus groups held with girls at high schools located in the North Island of Aotearoa New Zealand in November 2019 and places this in the context of other representations of image sharing and texting in teen films over the past 25 years. Participants were shown a scene from Netflix teen film Sierra Burgess Is a Loser (2018), in which Sierra receives a shirtless selfie from Jamey and contemplates how to respond, before finally replying with a picture of a seated elephant. The participants’ discussion illustrates some of the ways girls navigate technology use in their lives and relationships and the complex ways they negotiate popular culture representations of intimacy in teen film.
‘Every day is a challenge’: Expatriate acculturation in the United Arab Emirates
Authors: Thirlwall Alison , Kuzemski Dawn , Baghestani Mahshid , Brunton Margaret , Brownie Sharon
Published: December 2021

The United Arab Emirates (UAE) has a very small population of national citizens, so it relies on foreign workers who bring a range of cultures with them, resulting in a unique multi-cultural context. Unlike Western countries, such as the UK, Canada and Australia, workers are unable to permanently migrate to the UAE, so instead they hold temporary, expatriate status. This exploratory study focuses on the experiences of internationally qualified, expatriate nurses in hospitals in Al Ain, gathered by qualitative interviews. Twenty-one registered nurses participated in this study. The nurses faced challenges associated with language requirements and differing cultural expectations, and displayed limited acculturation, which compromised their ability to provide appropriate care for patients. The temporary nature of the work, cultural expectations, language difficulties and potential improvements are discussed. The findings have important implications for organizations that employ large groups of staff from overseas in all sectors. This article contributes to knowledge of expatriates’ challenges in the UAE and highlights the difficulties of working in a diverse environment, leading to a range of actions being recommended for managers.
Using Focus Groups to Understand Dialysis Staff Perspectives on Delivering Transplant Education
Authors: Kayler Liise K. , Ranahan Molly , Keller Maria , Dolph Beth , H. Feeley Thomas
Published: December 2021

Introduction

Kidney transplant education in dialysis facilities could be optimized with internet resources, like videos, but most qualitative research predates widespread availability of online video education about kidney transplantation. To improve understanding of dialysis staff transplant education practices, as well as the potential value of video, we conducted focus groups of dialysis center staff members in Buffalo, NY.

Methods/Approach

Seventeen focus groups (97 participants: 53 nurses, 10 dialysis technicians, 6 social workers, 6 dieticians, 7 administrative personnel, 2 trainees, and 1 insurance coordinator) from 8 dialysis facilities in Buffalo, NY, were conducted, audio-recorded, transcribed, and analyzed. After thematic data analysis, a diverse patient and caregiver community advisory board was invited to comment, and their voices were integrated. Findings: Five key themes were identified that captured barriers to transplant education delivery and how online video could be a facilitator: (1) delivery of transplant education was reliant on one person, (2) other dialysis staff had time to answer transplant questions but felt uninformed, (3) patient lack of interest in existing supplementary transplant education, (4) patient disinterest in transplantation education was due to education timing, feeling overwhelmed, and transplant fear/ambivalence, and (5) video education could be flexible, low effort, and spark transplant interest. Study limitations are potential selection bias and inclusion of English-speaking participants only.

Discussion

Dialysis staff barriers of time, insufficient knowledge, and limited resources to provide education to patients and their care partners may be mitigated with online educational videos without increasing staff workload.
Bases of Forensic Pathology Expert Testimony With Emphasis on Iowa v Tyler
Authors: Weedn Victor W.
Published: December 2021

Judicial scrutiny of the forensic sciences is increasing. This scrutiny targets the bases for expert opinions. Forensic pathologists must understand that when they express an opinion it must have an articulable underlying basis. Iowa v Tyler provides a cautionary tale where testimony from a forensic pathologist on the cause and manner of death based exclusively on police reports and audio and video recordings of police interviews of the suspect rather than on medical evidence were held to be inadmissible. Tyler has an odd and distinguishable set of facts, but has been widely cited as an example of problematic forensic pathology testimony.
Can Reducing Implant Costs Increase Revenue for Surgically Treated Ankle Fractures: Time-Driven Activity-Based Costing for 1-Year Episode of Care
Authors: Freking Will , Okelana Bandele , Only Arthur , McMillan Logan , Kibble Kendra , Parikh Harsh , Williams Benjamin , Shearer David , Cunningham Brian
Published: December 2021

Background:

The purpose of this study was to investigate whether decision-making regarding implant selection affects the reimbursement margins for the surgical fixation of ankle fractures.

Methods:

All ankle fractures treated between 2010 and 2017 within a single-insurer database were identified via Current Procedural Terminology codes by review of electronic medical record. Implant cost was determined via the implant record cross-referenced with the single contract institutional charge master database. The Time-Driven Activity-Based Costing (TDABC) technique was used to determine the costs of care during all activities throughout the 1-year episode of care. Statistical analysis consisted of multiple linear regression and goodness-of-fit analyses.

Results:

In all, 249 patients met inclusion criteria. Implant costs ranged from $173 to $3944, averaging $1342 ± $751. The TDABC-estimated cost of care ranged from $1416 to $9185, averaging $3869 ± $1384. Finally, the total reimbursed cost of care ranged between $1335 and $65 645, averaging $13 954 ± $9445. The implant costs occupied an estimated 34.7% of the TDABC-estimated cost of care per surgical encounter. Implant cost, as a percentage of the overall TDABC, was estimated as 36.2% in the inpatient setting and 33% in the outpatient setting, which was the second highest percentage behind surgical costs in both settings. We found a significant increase in net revenue of $1.93 for each dollar saved on implants in the outpatient setting, whereas the increase in net revenue per dollar saved of $1.03 approached significance in the inpatient setting.

Conclusion:

There is a direct relationship between intraoperative decision-making, as evidenced by implant choices, and the revenue generated by surgical fixation of ankle fractures. Intraoperative decision-making that is cognitive of implant cost can facilitate adoption of institutional cost containment measures and prompt increased healthcare value.

Level of Evidence:

Level III: Retrospective cohort study
Northern Michigan University online campus: A case of digital transformation in higher education
Authors: Ngafeeson Madison N
Published: December 2021

The Northern Michigan University (NMU) online campus, fondly known as the “Global Campus,” is now 5 years old. Launched in 2016, this online and distance education initiative had as its mission to create academic programs that meet students’ learning and service needs “at the same high standard we do for on-campus students” (NMU). This was a kind of organic final step in the journey of digital transformation that began sixteen years before. Nonetheless, how does NMU make a pivot from 117 years of traditional face-to-face learning model to create value and compete in the digital education space? Worse still, when the Covid-19 global pandemic hits in March 2020 and the campus is forced to shut down (mandating all face-to-face teaching and learning, and to transition to online delivery within just two business days and a weekend); how does the university handle this new set of challenges as its online model gets tested in real-time? The story of NMU’s evolution to online education is told by intrinsic and extrinsic factors including declining enrollments due to changing local economics and regional demographics, an old business model now compounded by a global pandemic. This mix of factors would seem to present NMU with both an opportunity to refine its online model and some new challenges to overcome. This evolution also speaks to the importance of having an overarching digital strategy that can drive true digital transformation.
Big data: The effect of analytics on marketing and business
Authors: Manko Barbara A.
Published: December 2021

Big data analytics takes raw, real-time data and uses it to predict trends. Successful use of this data can have a powerful impact on a business’s effectiveness and ultimately their bottom line. As the amount of data increases, the need for analytics is growing. This teaching study discusses the role of social media in data analytics, how to approach the subject, and the desired outcomes. Students will explore the expansion of this field of study, familiarize themselves with the concept and where they may have encountered it in their lives so far, and discuss what analytics can contribute to running a successful business.
Multiple Sclerosis International Federation guideline methodology for off-label treatments for multiple sclerosis
Authors: Piggott Thomas , Nonino Francesco , Baldin Elisa , Filippini Graziella , Rijke Nick , Schünemann Holger , Laurson-Doube Joanna
Published: December 2021

Background

A total of 2.8 million people are living with multiple sclerosis and due to disparities in access to medicines, the ability to treat this condition varies widely. Off-label disease-modifying therapies are sometimes more available or affordable in different health systems. Appropriate methodology is integral in creating high-quality and trustworthy guidelines. In this article, we outline Multiple Sclerosis International Federation’s (MSIF) approach to creating guidelines for off-label treatments for multiple sclerosis.

Methods

We use the Guidelines International Network (GIN)-McMaster Guideline Development Checklist and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) Evidence-to-Decision (EtD) framework. We developed detailed health descriptors for health outcomes and the panel drafted PICO (Population, Intervention, Comparator, Outcome) questions and prioritised outcomes. We collaborate with independent organisations, which systematically review and collate the information. We are actively engaging stakeholders and consulting with relevant organisations, boards, working groups and individuals.

Results

The draft guideline recommendations will be published for open comment and stakeholders will be encouraged to endorse and disseminate the guidelines. Our methodology ensures integrity and transparency in the criteria, evidence and judgement used to make recommendations.

Conclusions

This approach will facilitate transparent creation of high-quality and trustworthy guidelines, and allow the global guidelines to be adopted or adapted into national settings.
Virtual Hand Illusion in younger and older adults
Authors: Campos Jennifer L. , El-Khechen Richandi Graziella , Coahran Marge , Fraser Lindsey E. , Taati Babak , Keshavarz Behrang
Published: December 2021

Introduction

Embodiment involves experiencing ownership over our body and localizing it in space and is informed by multiple senses (visual, proprioceptive and tactile). Evidence suggests that embodiment and multisensory integration may change with older age. The Virtual Hand Illusion (VHI) has been used to investigate multisensory contributions to embodiment, but has never been evaluated in older adults. Spatio-temporal factors unique to virtual environments may differentially affect the embodied perceptions of older and younger adults.

Methods

Twenty-one younger (18–35 years) and 19 older (65+ years) adults completed the VHI paradigm. Body localization was measured at baseline and again, with subjective ownership ratings, following synchronous and asynchronous visual-tactile interactions.

Results

Higher ownership ratings were observed in the synchronous relative to the asynchronous condition, but no effects on localization/drift were found. No age differences were observed. Localization accuracy was biased in both age groups when the virtual hand was aligned with the real hand, indicating a visual mislocalization of the virtual hand.

Conclusions

No age-related differences in the VHI were observed. Mislocalization of the hand in VR occurred for both groups, even when congruent and aligned; however, tactile feedback reduced localization biases. Our results expand the current understanding of age-related changes in multisensory embodiment within virtual environments.
Clinical Outcomes of Robotic Versus Freehand Pedicle Screw Placement After One-to Three-Level Lumbar Fusion
Authors: Karamian Brian A. , DiMaria Stephen L. , Sawires Andrew N. , Canseco Jose A. , Basques Bryce A. , Toci Gregory R. , Radcliff Kris E. , Rihn Jeffrey A. , Kaye I. David , Hilibrand Alan S. , Lee Joseph K. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D.
Published: December 2021

Study Design

Retrospective cohort study

Objectives

The purpose of this study is to compare patient-reported outcome measures (PROMs) for patients undergoing one-to three-level lumbar fusion using robotically assisted vs freehand pedicle screw placement.

Methods

Patients who underwent either robotically assisted or freehand pedicle screw placement for one-to three-level lumbar fusion surgery from January 1, 2014 to August 31, 2020 at a single academic institution were identified. Propensity score matching was performed based on demographic variables. Clinical and surgical outcomes were compared between groups. Recovery Ratios (RR) and the proportion of patients achieving the minimally clinically important difference (%MCID) were calculated for Oswestry Disability Index, PCS-12, MCS-12, VAS Back, and VAS Leg at 1 year. Surgical outcomes included complication and revision rates.

Results

A total of 262 patients were included in the study (85 robotic and 177 freehand). No significant differences were found in ΔPROM scores, RR, or MCID between patients who underwent robotically assisted vs freehand screw placement. The rates of revision (1.70% freehand vs 1.18% robotic, P = 1.000) and complications (.57% freehand vs 1.18% robotic, P = .546) were not found to be statically different between the 2 groups. Controlling for demographic factors, procedure type (robotic vs freehand) did not emerge as a significant predictor of ΔPROM scores on multivariate linear regression analysis.

Conclusions

Robotically assisted pedicle screw placement did not result in significantly improved clinical or surgical outcomes compared to conventional freehand screw placement for patients undergoing one-to three-level lumbar fusion.
COVID-19 Lockdown Restrictions and Small Business Survival Strategy: Government Supporting Schemes
Authors: Assefa Minyahil
Published: December 2021

From antiquity to the present day, the contribution of small businesses to the economic development of a country is overwhelming. Nowadays, COVID-19 lockdown restrictions have exerted an outrageous impact on small businesses survival. In developing countries where government-supporting capacity is low, the severity is substantial. The present study predicts the impact of COVID-19 lockdown restriction and government supporting schemes on small business survival. To meet this purpose, the study primarily used PLS-SEM and binary logit models. The results confirmed that over 44% of small businesses would fail in the first month of lockdown restriction. Moreover, only 6% have cash reserve to survive twelve months. In this regard, the present study suggested that the government should have to abstain from total lockdown measures, without government-supporting schemes. As such, the study has examined the relative importance of COVID-19 based special loan, suspension of payments, withdrawal of restricted funds, and exemption of tax and penalty payments. Among these supporting schemes, COVID-19 based special loan is the most important government-supporting scheme followed by the suspension of interest and principal payments. However, the exemption of tax payments and withdrawal of restricted funds were not significant.
Mindfulness Access Points in General Music: Singing, Breathing, and Self-Awareness
Authors: Varner Edward
Published: December 2021

The purpose of this column is to promote the use of focused breathing and singing as access points to improved student self-awareness in the general music classroom. Singing is a holistic activity with the healing potential to improve and transform many traumatic life experiences endured by our students. Similarly, mindfulness breathwork is a holistic approach used to enhance self-awareness in the moment and can reduce anxiety. Both pursuits have the potential to help students overcome difficulties of fear, stress, and anxiety. Both practices expose participants to new ways of understanding themselves and the world around them while creating important access points to mindfulness and self-awareness.
Music for a Boss Fight: Creating for the Context of Video Game Worlds
Authors: Hatch Emily
Published: December 2021

Creating music increases student engagement, and drawing on students’ background knowledge is a respectful way to value students’ lived experiences. By challenging students to create music for the context of a video game world, teachers can build on students’ previous knowledge and bridge that knowledge to the elements of music and creating music for specific contexts and purposes. This column outlines a project for fourth graders to create video game music for specific contexts within the game.
Considerations With Virtual Secondary Music Students
Authors: Bucura Elizabeth
Published: December 2021

The global COVID-19 pandemic disrupted learning environments, adding significantly to an already-challenging time for adolescents. In many cases, students and teachers have abruptly shifted to online learning platforms that may occur entirely in a home environment. Music often plays a significant role in adolescents’ processes of identity-building and social connection. Music classes might play an important role in coping during these times, even when learning is virtual. Music teachers may question students’ well-being and their own mentorship roles. This article includes concerns about teaching music with adolescents, specifically when adapted to virtual technologies. Considerations are detailed for pedagogical care and possible benefits of at-home learning that might enhance students’ music learning experiences.
Diminished ovarian reserve in young women with sickle cell anemia
Authors: Pecker Lydia H. , Hussain Sarah , Mahesh Jaanvi , Varadhan Ravi , Christianson Mindy S. , Lanzkron Sophie
Published: December 2021

Women with sickle cell anemia (SCA) have higher rates of diminished ovarian reserve (DOR) than age-matched controls. Pecker et al report a small study of patients with SCA that compares ovarian reserve in patients after stem cell transplant, on therapy with hydroxyurea (HU), and on supportive care. As expected, patients who received transplants have severe DOR. About one-third of patients on HU have DOR, while DOR was absent in patients on supportive care. Whether this reflects an impact of HU or is a biomarker of severe disease remains to be established in a larger study.
Precision medicine in bronchiectasis
Authors: Pembridge Thomas , Chalmers James D.
Published: December 2021

Bronchiectasis, due to its highly heterogenous nature, requires an individualised approach to therapy. Patients experience symptoms and exacerbations driven by a combination of impaired mucociliary clearance, airway inflammation and airway infection. Treatment of bronchiectasis aims to enhance airway clearance and to address the underlying causes of inflammation and infection susceptibility. Bronchiectasis has multiple causes and so the pathophysiology leading to individual symptoms and exacerbations are different between individuals. Standardised investigations are recommended by international guidelines to identify the underlying causes of bronchiectasis. The process of identifying the underlying biology within an individual is called “endotyping” and is an emerging concept across chronic diseases. Endotypes that have a specific treatment are referred to as “treatable traits” and a treatable traits approach to managing patients with bronchiectasis in a holistic and evidence-based manner is the key to improved outcomes. Bronchiectasis is an area of intense research. Endotyping allows identification of subsets of patients to allow medicines to be tested differently in the future where trials, rather than trying to achieve a “one size fits all” solution, can test efficacy in subsets of patients where the treatment is most likely to be efficacious.
Identification of QTL Combinations that Cause Spikelet Sterility in Rice Derived from Interspecific Crosses
Authors: Lee Chang-Min , Suh Jung-Pil , Park Hyun-Su , Baek Man-Kee , Jeong O-Young , Yun Song-Joong , Cho Young-Chan , Kim Suk-Man
Published: December 2021

Background

The exploitation of useful genes through interspecific and intersubspecific crosses has been an important strategy for the genetic improvement of rice. Postzygotic reproductive isolation routinely occurs to hinder the growth of pollen or embryo sacs during the reproductive development of the wide crosses.

Result

In this study, we investigated the genetic relationship between the hybrid breakdown of the population and transferred resistance genes derived from wide crosses using a near-isogenic population composed of 225 lines. Five loci (qSS12, qSS8, qSS11, ePS6-1, and ePS6-2) associated with spikelet fertility (SF) were identified by QTL and epistatic analysis, and two out of five epistasis interactions were found between the three QTLs (qSS12, qSS8 and qSS11) and background marker loci (ePS6-1 and ePS6-2) on chromosome 6. The results of the QTL combinations suggested a genetic model that explains most of the interactions between spikelet fertility and the detected loci with positive or negative effects. Moreover, the major-effect QTLs, qSS12 and qSS8, which exhibited additive gene effects, were narrowed down to 82- and 200-kb regions on chromosomes 12 and 8, respectively. Of the 13 ORFs present in the target regions, Os12g0589400 and Os12g0589898 for qSS12 and OS8g0298700 for qSS8 induced significantly different expression levels of the candidate genes in rice at the young panicle stage.

Conclusion

The results will be useful for obtaining a further understanding of the mechanism causing the hybrid breakdown of a wide cross and will provide new information for developing rice cultivars with wide compatibility.
Hypospadias treatment by tubulated pedicled preputial island flap according to the DUCKETT technique: single-center experience in sub-Saharan Africa
Authors: Ndiaye Modou , Sow Yaya , Sarr Alioune , Thiam Amath , Faye Samba Thiapato , Ndour Ndiaga Seck , Sine Babacar , Zé-Ondo Cyrille , Sow Ousmane , Ndiath Abdoulaye , Traore Aboubacar , Bagayogo Ndeye Aissatou , Fall Boubacar , Diao Babacar , Fall Papa Ahmed , Ndoye Alain Khassim
Published: December 2021

Background

Hypospadias is the second most frequent congenital condition in boys after cryptorchidism, with an incidence of 0.3–0.7% compared to 2–4% for cryptorchidism. Since the 1980s, single-stage operations, such as the one described by Duckett, have been adopted by some authors. To assess the results of hypospadias surgery by tubed pedicled preputial island flap (DUCKETT’s procedure) in a West African reference hospital.

Methods

This is a retrospective and descriptive study that includes 41 patients with hypospadias who underwent DUCKETT procedure by a tubed pedicled preputial island flap during a period of 12 years. After penile degloving, the curvature has been corrected by skin bridging with or without Nesbit’s plication. The urethroplasty was done according to the DUCKETT procedure.

Results

The patients mean age was 11 ± 8.5 years. All of them had posterior foreskin and a ventral curvature of the penis. The urethral meatus was posterior in 37%. Six of them had a previous hypospadias repair. The complication rate was 58.5%. Wound infection and meatal stenosis occurred in 14.6% and 19.6% of cases, respectively. After a mean follow-up of 20 ± 9 months, total success, relative success and failure rates were 63%, 27% and 10%, respectively.

Conclusion

The DUCKETT procedure is associated with a high complication rate in our daily practice.
An efficient scRNA-seq dropout imputation method using graph attention network
Authors: Xu Chenyang , Cai Lei , Gao Jingyang
Published: December 2021

Background

Single-cell sequencing technology can address the amount of single-cell library data at the same time and display the heterogeneity of different cells. However, analyzing single-cell data is a computationally challenging problem. Because there are low counts in the gene expression region, it has a high chance of recognizing the non-zero entity as zero, which are called dropout events. At present, the mainstream dropout imputation methods cannot effectively recover the true expression of cells from dropout noise such as DCA, MAGIC, scVI, scImpute and SAVER.

Results

In this paper, we propose an autoencoder structure network, named GNNImpute. GNNImpute uses graph attention convolution to aggregate multi-level similar cell information and implements convolution operations on non-Euclidean space on scRNA-seq data. Distinct from current imputation tools, GNNImpute can accurately and effectively impute the dropout and reduce dropout noise. We use mean square error (MSE), mean absolute error (MAE), Pearson correlation coefficient (PCC) and Cosine similarity (CS) to measure the performance of different methods with GNNImpute. We analyze four real datasets, and our results show that the GNNImpute achieves 3.0130 MSE, 0.6781 MAE, 0.9073 PCC and 0.9134 CS. Furthermore, we use Adjusted rand index (ARI) and Normalized mutual information (NMI) to measure the clustering effect. The GNNImpute achieves 0.8199 (ARI) and 0.8368 (NMI), respectively.

Conclusions

In this investigation, we propose a single-cell dropout imputation method (GNNImpute), which effectively utilizes shared information for imputing the dropout of scRNA-seq data. We test it with different real datasets and evaluate its effectiveness in MSE, MAE, PCC and CS. The results show that graph attention convolution and autoencoder structure have great potential in single-cell dropout imputation.
Intra-wound vancomycin powder for the eradication of periprosthetic joint infection after debridement and implant exchange: experimental study in a rat model
Authors: Wei Jian , Tong Kai , Zhou Siqi , Wang Hui , Wen Yinxian , Chen Liaobin
Published: December 2021

Background

Intra-wound vancomycin powder (VP) has been used in clinical practice to prevent periprosthetic joint infection (PJI) after primary knee/hip arthroplasty. The role of intra-wound VP in the setting of debridement and implant exchange after PJI remains undefined. This study aimed to explore the efficacy and safety of intra-wound VP in the control of methicillin-resistant S. aureus (MRSA) infection after debridement and implant exchange.

Methods

PJI modeling by knee prosthesis implantation and MRSA inoculation, debridement and implant exchange were performed in Wistar rats successively to mimic the one-stage exchange arthroplasty of PJI patients. Two weeks of systemic vancomycin (SV) or/and intraoperative intra-wound VP of single dosage were applied after revision surgery.

Results

No post-surgery deaths, incision complications and signs of drug toxicity were observed. The microbial counts of SV or intra-wound VP group were significantly reduced compared with the control group, while bacteria were still detected on the bone, soft-tissue and prosthesis. The elimination of bacterial counts, along with improvement of tissue inflammation and serum inflammatory markers, were observed in the rats with SV plus intra-wound VP. Serum levels of vancomycin in all groups were lower than that of causing nephrotoxicity, while no statistic difference was observed in the serum biochemical marker among the groups.

Conclusions

Intra-wound VP is effective after debridement and implant exchange in our current rat PJI model. Neither SV nor intra-wound VP alone could eradicate the bacteria within a two-weeks treatment course, while SV plus intra-wound VP could eliminate the MRSA infection, without notable hepatic or renal toxicity and any incision complications.
Factors affecting sufentanil consumption for intravenous controlled analgesia after hepatectomy: retrospective analysis
Authors: Wu Yue , Tian Lina , Li Chunye , Liu Minjun , Qiao Shina , Zhang Weibo , Tian Suming , Chen Gang
Published: December 2021

Background

Pain control after hepatectomy is usually achieved by opioids. There are significant individual differences in the amount of opioids used after hepatectomy, and the metabolism of opioids is liver-dependent. The purpose of our study was to explore the possible risk factors for opioid consumption during the first 48 h after surgery.

Methods

In a retrospective study design involving 562 patients undergoing open or laparoscopic hepatectomy, all patients were treated with intravenous patient-controlled analgesia (IV-PCA) along with continuous and bolus doses of sufentanil for a duration of 48 h after surgery during the time period of August 2015 and February 2019. The primary endpoint was high sufentanil consumption 48 h after hepatectomy, and patients were divided into two groups: those with or without a high PCA sufentanil dosage depending on the third quartile (Q3). The secondary endpoint was the effect of a high PCA sufentanil dosage on various possible clinical risk factors. The relevant parameters were collected, and correlation and multivariate regression analyses were performed.

Results

The median operation time was 185 min (range, 115–250 min), and the median consumption of sufentanil 48 h after the operation was 91 μg (IQR, 64.00, 133.00). Factors related to the consumption of sufentanil at 48 h after hepatectomy included age, operation time, blood loss, intraoperative infusion (red blood cells and fresh-frozen plasma), pain during movement after surgery (day 1 and day 2), preoperative albumin, and postoperative blood urea nitrogen. Age (≤ 60 and > 60 years), extent of resection (minor hepatic resection and major hepatic resection), surgical approach (laparoscope and open) and operation time (min) were independent risk factors for sufentanil consumption at 48 h postoperatively.

Conclusion

Age younger than 60 years, major hepatic resection, an open approach and a longer operation are factors more likely to cause patients to require higher doses of sufentanil after hepatectomy, and the early identification of such patients can increase the efficacy of perioperative pain management.
Effects of colchicine on major adverse cardiac events in next 6-month period after acute coronary syndrome occurrence; a randomized placebo-control trial
Authors: Akrami Mehdi , Izadpanah Peyman , Bazrafshan Mehdi , Hatamipour Unes , Nouraein Navid , Drissi Hamed Bazrafshan , Manafi Alireza
Published: December 2021

Background

Cardiovascular disease in particular acute coronary syndrome (ACS) is remained one of the most cause of morbidity and mortality, annually. Considering inflammatory pathway of atherosclerosis, colchicine as an anti-inflammatory drug is introduced to be effective in pathogenesis, prognosis and mortality rate of these patients. So in order to find out the effects of this drug we conducted this trial to know whether it reduces major adverse cardiac events (MACE) in ACS patients or not.

Methods

In a prospective randomized double-blinded placebo-controlled trial, we enrolled ACS patients (40–70 years) with recent ST-segment elevation myocardial infarction (STEMI) or NSTE-ACS diagnosed by coronary angiography and managed with either medical therapy or percutaneous coronary intervention. Patients were assigned to two groups either receiving colchicine 0.5 mg daily or placebo for 6 months. Both groups simultaneously received standard medical therapy as accessible guidelines. MACE occurrence consists of decompensated heart failure, ACS, stroke and survival rate compared between two groups.

Results

A total of 249 patients were recruited between October 2019-March 2020 with mean age of 56.89 ± 7.54, 69.5% males; 120 assigned to the colchicine group and 129 assigned to the placebo group. Over the 6 months’ period, 36 MACE occurred that were 8 events in the colchicine group compared with 28 events in the placebo group experiencing the event (P = 0.001). All of four deaths in the colchicine group and two in the placebo group were due to cardiovascular events. Evaluating adverse effects, gastrointestinal symptom was the most with the rate of 15 (12.5%) in the colchicine group and 3 (2.5%) in the controls. (P = 0.002).

Conclusion

The addition of colchicine to standard medical therapy in ACS patients significantly reduces MACE occurrence and improves survival rate over the time.
The application of the theory of planned behavior to nutritional behaviors related to cardiovascular disease among the women
Authors: Khani Jeihooni Ali , Jormand Hanieh , Saadat Negin , Hatami Mahmood , Abdul Manaf Rosliza , Afzali Harsini Pooyan
Published: December 2021

Background

Nutritional factors have been identified as preventable risk factors for cardiovascular disease; this study aimed to investigate the application of the Theory of Planned Behavior (TPB) in nutritional behaviors related to cardiovascular diseases among the women in Fasa city, Fars province, Iran.

Methods

The study was conducted in two stages. First, the factors affecting nutritional behaviors associated with cardiovascular disease on 350 women who were referred to Fasa urban health centers were determined based on the TPB. In the second stage, based on the results of a cross-sectional study, quasi-expeimental study was performed on 200 women covered by Fasa health centers. The questionnaire used for the study was a questionnaire based on TPB. The questionnaire was completed by the experimental and control groups before and three months after the intervention. Data were analyzed by SPSS software using logistic regression, paired t-test, independent sample t-test, and chi-square test. The level of significance is considered 0.05.

Result

The constructs of attitude, subjective norms, and perceived behavioral control (PBC) were predictors of nutritional behaviors associated with cardiovascular disease in women. The constructs predicted 41.6% of the behavior. The results showed that mean scores of attitude, subjective norms, PBC, intention, nutritional performance related to the cardiovascular disease before intervention were, respectively, 24.32, 14.20, 18.10, 13.37 and 16.28, and after the intervention, were, respectively, 42.32, 25.40, 33.72, 30.13 and 41.38. All the constructs except the attitude in the intervention group were significantly higher (p < 0.001) than the control group.

Conclusion

The results of the present study showed that the educational intervention based on the TPB would be consider an effective educational and promotinal strategy for the nutritional behaviors to prevent cardiovascular disease in women. Considering the role of mothers in providing family food baskets and the effect of their nutritional behaviors on family members, the education of this group can promote healthy eating behaviors in the community and family.
Muscle strength, an independent determinant of glycemic control in older adults with long-standing type 2 diabetes: a prospective cohort study
Authors: Koo Bo Kyung , Moon Seoil , Moon Min Kyong
Published: December 2021

Background

Although the proportion of older patients with type 2 diabetes mellitus (T2DM) has increased, few studies have reported the factors affecting glucose levels in older patients with long-standing T2DM. This study assessed the determinants of glycemic control in older adults with T2DM of a duration of ≥10 years, including muscle mass, muscle quality, and β-cell function.

Methods

This was a prospective study of older patients aged ≥60 years with a T2DM duration of ≥10 years. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index, handgrip strength (HGS), and body composition through bioelectrical impedance analysis were assessed. The primary outcome was a composite of: (i) increment of glycated hemoglobin (HbA1c) from the baseline ≥0.6% and (ii) HbA1c ≥ 9% at any time point during the follow-up period. To find the predicting determinants of the outcome, we performed the Cox proportional hazard analysis.

Results

Among 100 patients (mean age, 64.0 ± 8.6 years; median duration of diabetes, 20 [interquartile range (IQR), 17–23] years; median HbA1c at baseline, 7.1 [IQR, 6.7–7.4] %), the primary outcome was observed in 40 (40.0%) patients during 4.0 (IQR 2.3–5.0) years of follow-up. A Cox proportional hazards model adjusted for age, sex, baseline HbA1c, obesity, duration of DM and anti-diabetic medication at baseline showed that low HGS and insulin resistance at the baseline were independent determinants of the primary outcome (hazard ratio [HR] = 2.23 [95% confidence interval (CI), 1.06–4.72] and 2.39 [95% CI, 1.18–4.83], respectively). Sex stratification confirmed that HGS and muscle mass were independent determinants of the primary outcome only in women (HR per quartile, 0.58 [95% CI, 0.37–0.93] and 0.46 [95% CI, 0.25–0.85], respectively). `.

Conclusions

Low HGS and insulin resistance were independent risk factors for aggravated glycemic control among older patients with long standing T2DM.
The risk of fall-related hospitalisations at entry into permanent residential aged care
Authors: Inacio Maria C. , Moldovan Max , Whitehead Craig , Sluggett Janet K. , Crotty Maria , Corlis Megan , Visvanathan Renuka , Wesselingh Steve , Caughey Gillian E.
Published: December 2021

Background

Entering permanent residential aged care (PRAC) is a vulnerable time for individuals. While falls risk assessment tools exist, these have not leveraged routinely collected and integrated information from the Australian aged and health care sectors. Our study examined individual, system, medication, and health care related factors at PRAC entry that are predictors of fall-related hospitalisations and developed a risk assessment tool using integrated aged and health care data.

Methods

A retrospective cohort study was conducted on N = 32,316 individuals ≥65 years old who entered a PRAC facility (01/01/2009-31/12/2016). Fall-related hospitalisations within 90 or 365 days were the outcomes of interest. Individual, system, medication, and health care-related factors were examined as predictors. Risk prediction models were developed using elastic nets penalised regression and Fine and Gray models. Area under the receiver operating characteristics curve (AUC) assessed model discrimination.

Results

64.2% (N = 20,757) of the cohort were women and the median age was 85 years old (interquartile range 80-89). After PRAC entry, 3.7% (N = 1209) had a fall-related hospitalisation within 90 days and 9.8% (N = 3156) within 365 days. Twenty variables contributed to fall-related hospitalisation prediction within 90 days and the strongest predictors included fracture history (sub-distribution hazard ratio (sHR) = 1.87, 95% confidence interval (CI) 1.63-2.15), falls history (sHR = 1.41, 95%CI 1.21-2.15), and dementia (sHR = 1.39, 95%CI 1.22-1.57). Twenty-seven predictors of fall-related hospitalisation within 365 days were identified, the strongest predictors included dementia (sHR = 1.36, 95%CI 1.24-1.50), history of falls (sHR = 1.30, 95%CI 1.20-1.42) and fractures (sHR = 1.28, 95%CI 1.15-1.41). The risk prediction models had an AUC of 0.71 (95%CI 0.68-0.74) for fall-related hospitalisations within 90 days and 0.64 (95%CI 0.62-0.67) for within 365 days.

Conclusion

Routinely collected aged and health care data, when integrated at a clear point of action such as entry into PRAC, can identify residents at risk of fall-related hospitalisations, providing an opportunity for better targeting risk mitigation strategies.
Emergence of SARS-CoV-2 resistance mutations in a patient who received anti-SARS-COV2 spike protein monoclonal antibodies: a case report
Authors: Fenaux Honorine , Gueneau Romain , Chaghouri Amal , Henry Benoît , Mouna Lina , Roque-Afonso Anne-Marie , Vauloup-Fellous Christelle
Published: December 2021

Background

To manage severe or potentially severe cases of CoronaVirus Disease 2019 (COVID-19), therapeutic monoclonal antibodies targeting Spike protein of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) have been designed. It has been noted in vitro that upon exposure to these treatments, mutations could be selected.

Case presentation

We here report the case of an immunosuppressed patient infected with a B.1.1.7 variant, who received a combination of monoclonal antibodies, and subsequently selected mutations K417N, E484K and Q493R on Spike protein of SARS-CoV-2.

Conclusions

Our case raises the importance of monitoring SARS-CoV-2 mutations in patients receiving monoclonal antibodies and having persistent excretion of the virus, in order to offer optimal management of their infection, and strengthen prevention measures to avoid subsequent transmission of these selected variants.
Complicated Trichosporon asahii mastoiditis in immunocompetent child
Authors: Al Momani Miral , Yusef Dawood H. , Hamasha Du’a , Hamad Moh’d Rawhi Abu , Farran Sara
Published: December 2021

Background

Trichosporon asahii is an opportunistic fungus that causes infections in immunosuppressed patients. It is rarely seen in children and immunocompetent hosts. The mortality rates are still high despite early treatment with proper antifungal drugs. Trichosporon asahii mastoiditis in an immunocompetent child makes this case challenging.

Case presentation

This report presents a case of Trichosporon asahii mastoiditis which was complicated by transverse sinus thrombosis, in an otherwise healthy 21-month-old girl, and successfully treated with voriconazole. Trichosporon asahii was isolated, in three different occasions, from ear discharge of an immunocompetent healthy child, who presented with prolonged history of fever and received appropriate dosages of multiple types of antimicrobials as an outpatient but without improvement. After 48 h of starting the Voriconzole; post auricular swelling and ear discharge improved significantly.

Conclusion

A high index of clinical and microbiological suspicion is needed for optimal diagnosis of Trichosporon infection. Trichosporon asahii can also cause infection in immunocompetent individual even without previous history of hospitalization or intervention. We emphasize the importance of early pediatric infectious evaluation and intervention.
A novel pyroptosis-related gene signature predicts the prognosis of glioma through immune infiltration
Authors: Zhang Moxuan , Cheng Yanhao , Xue Zhengchun , Sun Qiang , Zhang Jian
Published: December 2021

Background

Glioma is the most common primary intracranial tumour and has a very poor prognosis. Pyroptosis, also known as inflammatory necrosis, is a type of programmed cell death that was discovered in recent years. The expression and role of pyroptosis-related genes in gliomas are still unclear.

Methods

In this study, we analysed the RNA-seq and clinical information of glioma patients from The Cancer Genome Atlas (TCGA) database and Chinese Glioma Genome Atlas (CGGA) database. To investigate the prognosis and immune microenvironment of pyroptosis-related genes in gliomas, we constructed a risk model based on the TCGA cohort. The patients in the CGGA cohort were used as the validation cohort.

Results

In this study, we identified 34 pyroptosis-related differentially expressed genes (DEGs) in glioma. By clustering these DEGs, all glioma cases can be divided into two clusters. Survival analysis showed that the overall survival time of Cluster 1 was significantly higher than that of Cluster 2. Using the TCGA cohort as the training set, a 10-gene risk model was constructed through univariate Cox regression analysis and LASSO Cox regression analysis. According to the risk score, gliomas were divided into high-risk and low-risk groups. Survival analysis showed that the low-risk group had a longer survival time than the high-risk group. The above results were verified in the CGGA validation cohort. To verify that the risk model was independent of other clinical features, the distribution and the Kaplan-Meier survival curves associated with risk scores were performed. Combined with the characteristics of the clinical cases, the risk score was found to be an independent factor predicting the overall survival of patients with glioma. The analysis of single sample Gene Set Enrichment Analysis (ssGSEA) showed that compared with the low-risk group, the high-risk group had immune cell and immune pathway activities that were significantly upregulated.

Conclusion

We established 10 pyroptosis-related gene markers that can be used as independent clinical predictors and provide a potential mechanism for the treatment of glioma.