bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term follow-up of patients after acute kidney injury in the neonatal period: abnormal ambulatory blood pressure findings
Authors: Akkoc Gulsen , Duzova Ali , Korkmaz Ayse , Oguz Berna , Yigit Sule , Yurdakok Murat
Published: March 2022

Background

Data on the long-term effects of neonatal acute kidney injury (AKI) are limited.

Methods

We invited 302 children who had neonatal AKI and survived to hospital discharge; out of 95 patients who agreed to participate in the study, 23 cases were excluded due to primary kidney, cardiac, or metabolic diseases. KDIGO definition was used to define AKI. When a newborn had no previous serum creatinine, AKI was defined as serum creatinine above the mean plus two standard deviations (SD) (or above 97.5th percentile) according to gestational age, weight, and postnatal age. Clinical and laboratory features in the neonatal AKI period were recorded for 72 cases; at long-term evaluation (2–12 years), kidney function tests with glomerular filtration rate (eGFR) by the Schwartz formula, microalbuminuria, office and 24-h ambulatory blood pressure monitoring (ABPM), and kidney ultrasonography were performed.

Results

Forty-two patients (58%) had stage I AKI during the neonatal period. Mean age at long-term evaluation was 6.8 ± 2.9 years (range: 2.3–12.0); mean eGFR was 152.3 ± 26.5 ml/min/1.73 m2. Office hypertension (systolic and/or diastolic BP ≥ 95th percentile), microalbuminuria (> 30 mg/g creatinine), and hyperfiltration (> 187 ml/min/1.73 m2) were present in 13.0%, 12.7%, and 9.7% of patients, respectively. ABPM was performed on 27 patients, 18.5% had hypertension, and 40.7% were non-dippers; 48.1% had abnormal findings. Female sex was associated with microalbuminuria; low birth weight (< 1,500 g) and low gestational age (< 32 weeks) were associated with hypertension by ABPM. Twenty-three patients (33.8%) had at least one sign of microalbuminuria, office hypertension, or hyperfiltration. Among 27 patients who had ABPM, 16 (59.3%) had at least one sign of microalbuminuria, abnormal ABPM (hypertension and/or non-dipping), or hyperfiltration.

Conclusion

Even children who experienced stage 1 and 2 neonatal AKI are at risk for subclinical kidney dysfunction. Non-dipping is seen in four out of 10 children. Long-term follow-up of these patients is necessary.
Percent error of ultrasound examination to estimate fetal weight at term in different categories of birth weight with focus on maternal diabetes and obesity
Authors: Dittkrist Luisa , Vetterlein Julia , Henrich Wolfgang , Ramsauer Babett , Schlembach Dietmar , Abou-Dakn Michael , Gembruch Ulrich , Schild Ralf L. , Duewal Antonia , Schaefer-Graf Ute M.
Published: March 2022

Background

Sonography based estimate of fetal weight is a considerable issue for delivery planning. The study evaluated the influence of diabetes, obesity, excess weight gain, fetal and neonatal anthropometrics on accuracy of estimated fetal weight with respect to the extent of the percent error of estimated fetal weight to birth weight for different categories.

Methods

Multicenter retrospective analysis from 11,049 term deliveries and fetal ultrasound biometry performed within 14 days to delivery. Estimated fetal weight was calculated by Hadlock IV. Percent error from birth weight was determined for categories in 250 g increments between 2500 g and 4500 g. Estimated fetal weight accuracy was categorized as accurate ≤ 10% of birth weight, under- and overestimated by >  ± 10% – ± 20% and > 20%.

Results

Diabetes was diagnosed in 12.5%, obesity in 12.6% and weight gain exceeding IOM recommendation in 49.1% of the women. The percentage of accurate estimated fetal weight was not significantly different in the presence of maternal diabetes (70.0% vs. 71.8%, p = 0.17), obesity (69.6% vs. 71.9%, p = 0.08) or excess weight gain (71.2% vs. 72%, p = 0.352) but of preexisting diabetes (61.1% vs. 71.7%; p = 0.007) that was associated with the highest macrosomia rate (26.9%). Mean percent error of estimated fetal weight from birth weight was 2.39% ± 9.13%. The extent of percent error varied with birth weight with the lowest numbers for 3000 g–3249 g and increasing with the extent of birth weight variation: 5% ± 11% overestimation in the lowest and 12% ± 8% underestimation in the highest ranges.

Conclusion

Diabetes, obesity and excess weight gain are not necessarily confounders of estimated fetal weight accuracy. Percent error of estimated fetal weight is closely related to birth weight with clinically relevant over- and underestimation at both extremes. This work provides detailed data regarding the extent of percent error for different birth weight categories and may therefore improve delivery planning.
Circ_0058063 contributes to cisplatin-resistance of bladder cancer cells by upregulating B2M through acting as RNA sponges for miR-335-5p
Authors: Sun Ming , Liu Xuefeng , Zhao Wenyan , Zhang Bin , Deng Peng
Published: March 2022

Bladder cancer (BC) is one of the most common malignant tumors of the urinary system, and cisplatin (CDDP) is a critical chemical drug for the treatment of BC. However, CDDP-resistance seriously limits the therapeutic efficacy of this drug for clinical utilization. Thus, identification of pivotal molecule targets that regulate CDDP-resistance in BC become urgent and necessary. In this study, we firstly identified a novel BC-associated circular RNA circ_0058063 that participates in the regulation of CDDP-resistance in BC. Specifically, circ_0058063 was significantly overexpressed in CDDP-resistant tissue and cells, in contrast with the corresponding CDDP-sensitive counterparts. Further loss-of-function experiments validated that downregulation of circ_0058063 suppressed cell proliferation and tumor growth, whereas induced cell apoptosis in the CDDP-resistant BC cells in vitro and in vivo. In addition, we disclosed that circ_0058063 acts as a sponge for miR-335-5p to positively regulate B2M expression, and further rescuing experiments verified that the enhancing effects of sh-circ_0058063 on CDDP-sensitivity in the CDDP-resistant BC cells were abrogated by silencing miR-335-5p. Taken together, our results demonstrated that circ_0058063 contributed to CDDP resistance of bladder cancer cells via sponging miR-335-5p, and B2M might be the downstream effector gene. This study firstly evidenced that targeting circ_0058063 might be an effective strategy to improve CDDP-sensitivity in BC.
Keeping essential reproductive, maternal and child health services available during COVID-19 in Kenya, Mozambique, Uganda and Zimbabwe: analysis of early-pandemic policy guidelines
Authors: Plotkin Marya K. , Williams Katie M. , Mbinda Absolom , Oficiano Vivaldo Nunes , Nyauchi Benard , Walugembe Patrick , Keyes Emily , Rawlins Barbara , McCarraher Donna , Chabikuli Otto N.
Published: March 2022

Background

The COVID-19 pandemic has disrupted the provision of essential reproductive, maternal, newborn, and child health (RMNCH) services in sub-Saharan Africa to varying degrees. Original models estimated as many as 1,157,000 additional child and 56,700 maternal deaths globally due to health service interruptions. To reduce potential impacts to populations related to RMNCH service delivery, national governments in Kenya, Mozambique, Uganda, and Zimbabwe swiftly issued policy guidelines related to essential RMNCH services during COVID-19. The World Health Organization (WHO) issued recommendations to guide countries in preserving essential health services by June of 2020.

Methods

We reviewed and extracted content related to family planning (FP), antenatal care (ANC), intrapartum and postpartum care and immunization in national policies from Kenya, Uganda, Mozambique, and Zimbabwe from March 2020 to February 2021, related to continuation of essential RMNCH services during the COVID-19 pandemic. Using a standardized tool, two to three analysts independently extracted content, and in-country experts reviewed outputs to verify observations. Findings were entered into NVivo software and categorized using pre-defined themes and codes. The content of each national policy guideline was compared to WHO guidance related to RMNCH essential services during COVID-19.

Results

All four country policy guidelines considered ANC, intrapartum care, FP, and immunization to be essential services and issued policy guidance for continuation of these services. Guidelines were issued in April 2020 by Mozambique, Kenya, and Uganda, and in June 2020 by Zimbabwe. Many elements of WHO’s 2020 recommendations were included in country policies, with some notable exceptions. Each policy guideline was more detailed in some aspects than others — for example, Kenya’s guidelines were particularly detailed regarding FP service provision, while Uganda’s guidelines were explicit about immediate breastfeeding. All policy guidance documents contained a balance of measures to preserve essential RMNCH services while reducing COVID-19 transmission risk within these services.

Conclusions

The national policy guidelines to preserve essential RMNCH services in these four countries reflected WHO recommendations, with some notable exceptions for ANC and birth companionship. Ongoing revision of country policy guidelines to adapt to changing pandemic conditions is recommended, as is further analysis of subnational-level policies.
Health and self-perceived barriers to internet use among older migrants: a population-based study
Authors: Kouvonen Anne , Kemppainen Teemu , Taipale Sakari , Olakivi Antero , Wrede Sirpa , Kemppainen Laura
Published: March 2022

Background

In older adults, including those with a migrant background, ill health is associated with less internet use. However, it is not known what are the specific self-perceived barriers to internet use among older migrants with different health conditions. The aim of this study was to investigate the associations between different health conditions and self-perceived barriers to internet use among older migrants.

Methods

We used the Care, Health and Ageing of Russian-speaking Minority in Finland (CHARM) study, which is a nationally representative survey of community-dwelling Russian-speaking adults aged ≥50 years living in Finland (N=1082, 57% men, mean age 63.2 years, standard deviation 8.4 years, response rate 36%). Postal survey data were collected in 2019. Health indicators were self-rated health (SRH), depressive symptoms, cognitive functioning, and doctor-diagnosed conditions. Linear regression analyses were used to investigate the associations between health indicators and a summary scale consisting of the following barriers of internet use: (1) internet use is too complicated and hard to learn; (2) having concerns about safety issues; (3) internet use is too expensive; (4) physical limitations hinder the internet use; (5) memory problems hinder the internet use. In addition, the two most commonly reported barriers (the first two) were examined separately using logistic regression analyses. The analyses were adjusted for age, sex, education, marital status, local language proficiency, and income support, and the health conditions, and were performed with weights accounting for the survey design and non-response.

Results

After adjustments, spine/back problems (b=0.13; p=0.049), depressive symptoms (b=0.40; p=0.007), and problems in learning new things (b=0.60; p<0.0005) were associated with higher level of overall barriers to internet use. In addition, a number of health conditions were associated with individual barriers, albeit some health conditions appeared protective.

Conclusions

In general, older migrants with declining health experience more barriers to internet use than their counterparts with better health. To provide better access to healthcare for older adults, including older migrants, rapidly changing devices, software and apps need to be modified and adapted for those with specific health-related needs.
Clinicians’ perceptions of the health status of formerly detained immigrants
Authors: Hampton Kathryn , Mishori Ranit , Griffin Marsha , Hillier Claire , Pirrotta Elizabeth , Wang N. Ewen
Published: March 2022

Background

In the past decade, the U.S. immigration detention system regularly detained more than 30,000 people per day; in 2019 prior to the pandemic, the daily detention population exceeded 52,000 people. Inhumane detention conditions have been documented by internal government watchdogs, and news media and human rights groups who have observed over-crowding, poor hygiene and sanitation and poor and delayed medical care, as well as verbal, physical and sexual abuse.

Methods

This study surveyed health professionals across the United States who had provided care for immigrants who were recently released from immigration detention to assess clinician perceptions about the adverse health impact of immigration detention on migrant populations based on real-life clinical encounters. There were 150 survey responses, of which 85 clinicians observed medical conditions attributed to detention.

Results

These 85 clinicians reported seeing a combined estimate of 1300 patients with a medical issue related to their time in detention, including patients with delayed access to medical care or medicine in detention, patients with new or acute health conditions such as infection and injury attributed to detention, and patients with worsened chronic or special needs conditions. Clinicians also provided details regarding sentinel cases, categorized into the following themes: Pregnant women, Children, Mentally Ill, COVID-19, and Other serious health issue.

Conclusions

This is the first survey, to our knowledge, of health care professionals treating individuals upon release from detention. Due to the lack of transparency by federal entities and limited access to detainees, this survey serves as a source of credible information about conditions experienced within immigration detention facilities and is a means of corroborating immigrant testimonials and media reports. These findings can help inform policy discussions regarding systematic changes to the delivery of healthcare in detention, quality assurance and transparent reporting.
Acromioclavicular joint instability on cross-body adduction view: the biomechanical effect of acromioclavicular and coracoclavicular ligaments sectioning
Authors: Kurata Shimpei , Inoue Kazuya , Shimizu Takamasa , Nagashima Mitsuyuki , Murayama Hirakazu , Kawamura Kenji , Omokawa Shohei , Mahakkanukrauh Pasuk , Tanaka Yasuhito
Published: March 2022

Background

The acromioclavicular (AC) and coracoclavicular (CC) ligaments are important stabilizers of the AC joint. We hypothesized that AC and trapezoid ligament injuries induce AC joint instability and that the clavicle can override the acromion on cross-body adduction view even in the absence of conoid ligament injury. Accordingly, we investigated how sectioning the AC and CC ligaments contribute to AC joint instability in the cross-body adduction position.

Methods

Six fresh-frozen cadaveric shoulders were used in this study, comprising five male and one female specimen, with a mean age of 68.7 (range, 51–87) years. The left side of the trunk and upper limb, and the cervical and thoracic vertebrae and sternum were firmly fixed with an external fixator. The displacement of the distal end of the clavicle relative to the acromion was measured using an electromagnetic tracking device. We simulated AC joint dislocation by the sequential resection of the AC ligament, AC joint capsule, and CC ligaments in the following order of stages. Stage 0: Intact AC and CC ligaments and acromioclavicular joint capsule; stage 1: Completely sectioned AC ligament, capsule and joint disc; stage 2: Sectioned trapezoid ligament; and stage 3: Sectioned conoid ligament. The superior clavicle displacement related to the acromion was measured in the horizontal adduction position, and clavicle overriding on the acromion was assessed radiologically at each stage. Data were analyzed using a one-way analysis of variance and post-hoc tests.

Results

Superior displacement was 0.3 mm at stage 1, 6.5 mm at stage 2, and 10.7 mm at stage 3. On the cross-body adduction view, there was no distal clavicle overriding at stages 0 and 1, and distal clavicle overriding was observed in five cases (5/6: 83%) at stage 2 and in six cases (6/6: 100%) at stage 3.

Conclusion

We found that AC and trapezoid ligament sectioning induced AC joint instability and that the clavicle could override the acromion on cross-body adduction view regardless of conoid ligament sectioning. The traumatic sections of the AC and trapezoid ligament may lead to high grade AC joint instability, and the distal clavicle may subsequently override the acromion.
Oral hygiene practices and their sociodemographic correlates among adults in Burkina Faso: results from the First National Survey
Authors: Diendéré Jeoffray , Ouattara Seydou , Kaboré Jean , Traoré Ibrahim , Zeba Augustin Nawidimbasba , Kouanda Séni
Published: March 2022

Background

Sociodemographic parameters are the driving determinants of oral hygiene practices. This study aims to describe oral hygiene practices and associated sociodemographic factors in the Burkinabè population using the first nationally representative data.

Methods

This descriptive, cross-sectional study included 4677 adults through multistage cluster sampling performed during the first WHO STEPS survey conducted in 2013 in Burkina Faso. The practices we considered were the frequencies of tooth cleaning, fluoridated toothpaste use and dentist visits within the last six months. Sociodemographic variables and oral hygiene practices were described, and the first variables were used as the explanatory variables for the seconds in the multivariable analyses.

Results

Individuals who cleaned teeth at least once a day represented 82.8% and at least twice a day represented 31.4%; 25.6% used fluoridated toothpaste and 2.1% visited a dentist. With the highest odds ratio, only being educated was a favourable factor for each oral hygiene practice. Living in an urban area or being a younger adult were favourable factors for cleaning teeth at least twice a day or the use of a fluoridated paste. Female gender applied more to regular tooth cleaning, as well as to dentist visits.

Conclusion

Cleaning teeth at least once a day was common among Burkinabè, while cleaning at least twice a day, the use of fluoridated paste or dentist visits were infrequent. Education was the key favourable determinant for healthy oral hygiene practices, and improving oral health literacy interventions through basic health education should be promoted.
Efficacy of air polishing in comparison with hand instruments and/or power-driven instruments in supportive periodontal therapy and implant maintenance: a systematic review and meta-analysis
Authors: Tan Shiuan Lee , Grewal Galvinderjeet Kaur , Mohamed Nazari Nor Shafina , Mohd-Dom Tuti Ningseh , Baharuddin Nor Adinar
Published: March 2022

Background

Supportive periodontal therapy (SPT) is the key for a stable periodontal health following active treatment. Likewise, implant maintenance is crucial following implant placement. This systematic review aimed to assess clinical outcomes, patients’ perception, and cost-effectiveness of repeated periodontal therapy with air polishing devices (APDs) in comparison with hand instruments and/or power-driven instruments (conventional interventions) in SPT and implant maintenance.

Methods

Electronic search for randomised controlled clinical trials with minimum 6 months follow-up for SPT and implant maintenance programme was conducted for data published from 01 January 2000 to 30 April 2020 using multiple databases and hand searching. Risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (RoB 2).

Results

A total of 823 articles were screened. 4 SPT and 2 implant maintenance studies were eligible for inclusion. For SPT, repeated APDs interventions revealed no statistically significant difference when compared to the conventional interventions (weighted mean difference [WMD] 0.11 mm, p = 0.08). Likewise, no statistical difference was noted in terms of percentage of bleeding on probing (BOP) and clinical attachment level (CAL) gain. APDs were associated with lower pain score (based on Visual Analogue Scale) and higher patient acceptance in SPT studies. For implant maintenance, APDs resulted in reduction in PPD and percentage of BOP. However, CAL gain was comparable between the two groups. In terms of patient reported outcomes, no implant maintenance studies recorded any forms of patient reported outcomes. In addition, no studies reported on economic evaluation of APDs in both SPT and implant maintenance.

Conclusion

Within the limitations of this systematic review and meta-analysis, repeated subgingival debridement using APDs in SPT resulted in similar clinical outcomes but better patients’ comfort when compared to the conventional interventions. For implant maintenance, there is limited evidence to show that repeated application of APDs leads to improved clinical outcomes when compared to conventional treatments.
Identification of autophagy-related long non-coding RNAs in endometrial cancer via comprehensive bioinformatics analysis
Authors: Liu Heng , Cheng Yanxiang
Published: March 2022

Background

Endometrial cancer is a common gynaecological malignancy with an increasing incidence. It is of great importance and value to uncover its effective and accurate prognostic indicators of disease outcomes.

Methods

The sequencing data and clinical information of endometrial cancer patients in the TCGA database were downloaded, and autophagy-related genes in the human autophagy database were downloaded. R software was used to perform a Pearson correlation analysis on autophagy-related genes and long non-coding RNAs (lncRNAs) to screen autophagy-related lncRNAs. Next, univariate and multivariate Cox regression analyses were performed to select autophagy-related lncRNAs and construct the prognostic model. Finally, the accuracy of the prognostic prediction of the model was evaluated, the lncRNA–mRNA network was constructed and visualized by Cytoscape, and the gene expression profile of endometrial cancer patients was analysed by GSEA.

Results

A total of 10 autophagy-related lncRNAs were screened to construct the prognostic model. The risk factors were AC084117.1, SOS1-IT1, AC019080.5, FIRRE and MCCC1-AS, and the protective factors were AC034236.2, POC1B-AS1, AC137630.1, AC083799.1 and AL133243.2. This prognostic model could independently predict the prognosis of endometrial cancer patients and had better predictive performance than that of using age and tumour grade. In addition, after classifying patients as high-risk or low-risk based on the prognostic model, we found that the enrichment of the JAK-STAT and MAPK pathways was significantly higher in the high-risk group than that in the low-risk group.

Conclusions

The 10 autophagy-related lncRNAs are potential prognostic biomarkers. Compared with using age and tumour grade, this prognostic model is more predictive for the prognosis of endometrial cancer patients.
Predictive value of matrix metalloprotease 9 on surgical outcomes after pericardiectomy
Authors: Fang Likui , Yu Wenfeng , Yu Guocan , Ye Bo , Chen Gang
Published: March 2022

Background

The effects of matrix metalloproteases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) expressions on the patients with constrictive pericarditis undergoing pericardiectomy remain unclear. This study explored the associations of MMPs and TIMPs expressions with postoperative outcomes in these patients.

Methods

Pericardial specimens were obtained during pericardiectomy from the patients with constrictive pericarditis. The levels of MMP1, MMP2, MMP9 and TIMP1 in pericardium were analyzed by quantitative real-time polymerase chain reaction. The enrolled patients were divided into two groups according to the optimal cutoff value of gene expression predicting postoperative complications. Postoperative outcomes were compared between the two groups. Binary logistic regression analysis was performed to determine the degree of contribution of gene expression on postoperative outcomes.

Results

A total of 22 patients and their pericardial specimens were included. The level of MMP9 was significantly associated with postoperative complications and the optimal cutoff value predicting postoperative complications was 3.67. The patients with low level of MMP9 (< 3.67) had lower incidence of postoperative complications (P = 0.002), shorter postoperative intensive care unit (P = 0.040) and hospital stay (P = 0.043) in comparison to those with high level of MMP9 (≥ 3.67). Binary logistic regression analysis showed that high level of MMP9 increased the risk of postoperative complications (OR 27.096, 95% CI 1.166–629.886, P = 0.040).

Conclusions

High level of MMP9 in the pericardium was associated with poor postoperative outcomes and was the independent risk factor of postoperative complications. The level of MMP9 could be used as a potential marker for prediction of surgical outcomes.
Metallosis following hip arthroplasty: two case reports
Authors: Mastel M. , Boisvert A. , Moore R. , Sutherland F. , Powell J.
Published: March 2022

Background

There has been increasing recognition of local and systemic adverse events associated with the release of metal ions and nanoparticles from hip arthroplasty components. Adverse local tissue reactions to metal ion debris can include periprosthetic solid and cystic masses known as pseudotumors. These masses can result in pain, swelling, extensive destruction to surrounding hip soft-tissues, and compression syndromes on neurovascular, gastrointestinal, and genitourinary structures. As reports of pseudotumors requiring multidisciplinary excision are limited, we present two pseudotumor cases that were excised through a combined approach.

Case presentations

The first case involves a 60-year-old Caucasian female with a large pseudotumor with intrapelvic and vascular involvement associated with a metal-on-polyethylene total hip arthroplasty, excised with contributions from general surgery, vascular surgery, and orthopedic surgery. Pseudotumor excision was followed by a revision total hip reconstruction in addition to an abductor mechanism reconstruction with tendo-Achilles allograft. The second case is that of a 64-year-old Caucasian female with a pseudotumor in close relationship to the femoral vessels following a metal-on-metal hip resurfacing, excised with a combination of vascular surgery and orthopedic surgery, with subsequent revision total hip reconstruction.

Conclusions

There remains a lack of literature to support the extensiveness of pseudotumor excision required in complex cases with significant intrapelvic or vascular involvement. Given the potential for significant adverse effects of large masses, the authors’ preference is to involve a multidisciplinary team to achieve a more comprehensive excision while minimizing the risk of potential complications.
Neonatal interstitial lung disease in a girl with Jacobsen syndrome: a case report
Authors: Dalen Marit Lunde , Vigerust Natalya Filipchuk , Hammarström Clara , Holmstrøm Henrik , Andresen Jannicke Hanne
Published: March 2022

Background

We report a case of the neonatal interstitial lung disease pulmonary interstitial glycogenosis in a girl with Jacobsen syndrome. While Jacobsen syndrome is caused by a deletion on the long arm of chromosome 11 and is genetically confirmed, pulmonary interstitial glycogenosis is of unknown etiology and is diagnosed by lung biopsy. Pulmonary interstitial glycogenosis has not previously been described in association with Jacobsen syndrome.

Case presentation

A term newborn small for gestational age Caucasian girl presented with respiratory distress, pulmonary hypertension, congenital heart defects, immunodeficiency, and thrombocytopenia. She was diagnosed with Jacobsen syndrome, but also had pulmonary interstitial glycogenosis, which contributed to significant morbidity. There was striking clinical improvement after steroid treatment of the pulmonary interstitial glycogenosis.

Conclusions

Interstitial lung disease should be considered as a differential diagnosis when respiratory distress and hypoxemia in the perinatal period worsens or persists despite standard treatment. Importantly, pulmonary interstitial glycogenosis may be treatable with corticosteroids. Whether there is a genetic link between pulmonary interstitial glycogenosis and Jacobsen syndrome is still unknown.
Authors’ rebuttal to Integrated Risk Information System (IRIS) response to “Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools”
Authors: Eick Stephanie M. , Goin Dana E. , Lam Juleen , Woodruff Tracey J. , Chartres Nicholas
Published: March 2022

This letter responds to the US Environmental Protection Agency’s Integrated Risk Information System (IRIS) program letter by Radke et al. (2021) that was published in response to the application of the IRIS risk of bias tool in our recent study “Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools.” Their letter stated that we misrepresented the IRIS approach. Here, we respond to their three points raised and how we did not misrepresent their tool and also identified areas for improvement: (1) why it should be expected that different reviewers could reach different conclusions with the IRIS tool, as ratings are subject to reviewer judgment; (2) why our interpretation that “low” or “uninformative” studies could be excluded from a body of evidence was reasonable; and (3) why we believe the use of a rating system that generates an overall rating based on an individual domain or a combination of identified deficiencies essentially acts as a score and assumes that we know empirically how much each risk of bias domain should contribute to the overall rating for that study. We have elaborated on these points in our letter.
Survival time to Implanon discontinuation and its predictors among a cohort of Implanon users who enrolled in public hospitals of southern Ethiopia, 2021: a retrospective cohort study
Authors: Habte Aklilu , Wondimu Merertu , Abdulkadir Hanan
Published: March 2022

Background

Pieces of evidence strongly indicate that providing high-quality family planning services is accompanied by an increase in contraceptive uptake and a decrease in contraception discontinuation. Contraceptive, especially Implanon discontinuation is a global issue that could be linked to a summary outcome indicator of poor family planning service quality. Although Implanon is becoming more popular among Ethiopian contraceptive users, little is known regarding the survival and predictors of discontinuation. The study aimed at exploring the survival and predictors of Implanon discontinuation among women enrolled in family planning units of Public hospitals in southern Ethiopia, 2021.

Methods

A hospital-based retrospective cohort study was conducted among Implanon users who enrolled in family planning units of Public Hospitals. Five years of medical records, from January 1, 2016, to December 30, 2020, were reviewed. A total of 502 women were selected by using a random sampling technique. A standardized abstraction tool was used to collect data from medical records and registration books. The data were entered into Epidata Version 3.1 and then exported to STATA 14 for analysis. The median was calculated in the case of survival time. Across covariates, the Kaplan Meier survival curve was used to estimate time to Implanon discontinuation. To identify statistically significant predictors of Implanon discontinuation, a multivariable Cox proportional hazard model was fitted.

Results

The incidence rate of Implanon discontinuation was 1.87(95% CI = 1.63, 2.15) per 100 person-months of observation. The overall estimated survival probability at the end of 24 and 36 months was 67.4% (95%CI, 62.5, 71.8) and 25.9% (95%CI, 18.4, 34.1) months respectively. Residence [AHR = 1.50; 95%CI: 1.09, 2.08], parity [AHR = 2.02; 95%CI: 1.65, 3.67], pre-insertion counselling [AHR = 2.41; 95%CI: 1.72, 3.70], experiencing heavy vaginal bleeding [AHR = 3.91; 95%CI: 2.67, 5.32], post-insertion follow up [AHR = 3.15; 95%CI:2.11, 4.75] were identified as a significant predictors of Implanon discontinuation.

Conclusion

The risk Implanon of discontinuation was high, especially at 24 and 36 months. In family planning service delivery points, health care providers should pay special attention to clients who live in rural areas and do not have children. In addition, health care providers should provide pre-insertion counseling and post-insertion follow-up that focus on potential side effects. Finally, family planning units need to engage in early side effect management and reassurance to mitigate discontinuation.
Metagenomics reveals global-scale contrasts in nitrogen cycling and cyanobacterial light-harvesting mechanisms in glacier cryoconite
Authors: Murakami Takumi , Takeuchi Nozomu , Mori Hiroshi , Hirose Yuu , Edwards Arwyn , Irvine-Fynn Tristram , Li Zhongqin , Ishii Satoshi , Segawa Takahiro
Published: March 2022

Background

Cryoconite granules are mineral–microbial aggregates found on glacier surfaces worldwide and are hotspots of biogeochemical reactions in glacier ecosystems. However, despite their importance within glacier ecosystems, the geographical diversity of taxonomic assemblages and metabolic potential of cryoconite communities around the globe remain unclear. In particular, the genomic content of cryoconite communities on Asia’s high mountain glaciers, which represent a substantial portion of Earth’s ice masses, has rarely been reported. Therefore, in this study, to elucidate the taxonomic and ecological diversities of cryoconite bacterial consortia on a global scale, we conducted shotgun metagenomic sequencing of cryoconite acquired from a range of geographical areas comprising Polar (Arctic and Antarctic) and Asian alpine regions.

Results

Our metagenomic data indicate that compositions of both bacterial taxa and functional genes are particularly distinctive for Asian cryoconite. Read abundance of the genes responsible for denitrification was significantly more abundant in Asian cryoconite than the Polar cryoconite, implying that denitrification is more enhanced in Asian glaciers. The taxonomic composition ofCyanobacteria, the key primary producers in cryoconite communities, also differs between the Polar and Asian samples. Analyses on the metagenome-assembled genomes and fluorescence emission spectra reveal that Asian cryoconite is dominated by multiple cyanobacterial lineages possessing phycoerythrin, a green light-harvesting component for photosynthesis. In contrast, Polar cryoconite is dominated by a single cyanobacterial speciesPhormidesmis priestleyithat does not possess phycoerythrin. These findings suggest that the assemblage of cryoconite bacterial communities respond to regional- or glacier-specific physicochemical conditions, such as the availability of nutrients (e.g., nitrate and dissolved organic carbon) and light (i.e., incident shortwave radiation).

Conclusions

Our genome-resolved metagenomics provides the first characterization of the taxonomic and metabolic diversities of cryoconite from contrasting geographical areas, highlighted by the distinct light-harvesting approaches ofCyanobacteriaand nitrogen utilization between Polar and Asian cryoconite, and implies the existence of environmental controls on the assemblage of cryoconite communities. These findings deepen our understanding of the biodiversity and biogeochemical cycles of glacier ecosystems, which are susceptible to ongoing climate change and glacier decline, on a global scale.
Is high sensitive-troponin I a reliable biomarker for cardiac injury in methadone toxicity? A prospective cross-sectional study
Authors: Shemirani Hasan , Sadeghi Masoumeh , Dehkordi Azadeh Davoudian , Gheshlaghi Farzad
Published: March 2022

Background

Methadone is a synthetic opioid mostly used for detoxification therapy, as its use increases; the possibility for methadone-induced cardiotoxicity may rise. The aim of this study was to determine the association of high-sensitivity troponin I levels as a predictor of cardiac injury in methadone toxicity.

Methods

Sixty methadone toxicity patients included in this prospective cross-sectional study from October 2018–November 2020. High-sensitivity troponin I level and electrocardiogram were assessed in patients at admission. All patients underwent echocardiography at admission and 30 days later and compared this finding between two groups based on high-sensitivity troponin I results.

Results

Mean age of the patients was 34.5 ± 11.1 years (males: 67%). Twenty (20%) patients had positive high sensitive-troponin results. Long QT interval and inverted T in precordial leads were mostly observed in individuals with positive high-sensitivity troponin I (75% vs. 35%, P = 0.013 and 83% vs. 16%, P < 0.001, respectively). Patients with elevated troponin had reduced left ventricular ejection fraction in comparison to normal group during admission (43.1 ± 15.4% vs. 55%, P < 0.001) and this left ventricular ejection fraction remained abnormal after 30 days (43.7 ± 21.6%). Patients in positive high-sensitivity troponin I group had higher regional wall motion abnormality frequency both at admission and 30 days later compared to the other group (0 day: 42% vs. 0, P < 0.001, 30th days: 25% vs. 4%, P = 0.020).

Conclusion

Patients with simultaneous methadone toxicity and positive high-sensitivity troponin I had worse cardiac outcomes and this biomarker could be probably used for better implementation of therapeutic interventions and prognosis.
Self-harm in people experiencing homelessness: investigation of incidence, characteristics and outcomes using data from the Multicentre Study of Self-Harm in England
Authors: Clements Caroline , Farooq Bushra , Hawton Keith , Geulayov Galit , Casey Deborah , Waters Keith , Ness Jennifer , Patel Anita , Townsend Ellen , Appleby Louis , Kapur Navneet
Published: March 2022

Background

People who experience homelessness are thought to be at high risk of suicide, but little is known about self-harm in this population.

Aims

To examine characteristics and outcomes in people experiencing homelessness who presented to hospital following self-harm.

Method

Data were collected via specialist assessments and/or hospital patient records from emergency departments in Manchester, Oxford and Derby, UK. Data were collected from 1 January 2000 to 31 December 2016, with mortality follow-up via data linkage with NHS Digital to 31 December 2019. Trend tests estimated change in self-harm over time; descriptive statistics described characteristics associated with self-harm. Twelve-month repetition and long-term mortality were analysed using Cox proportional hazards models and controlled for age and gender.

Results

There were 4841 self-harm presentations by 3270 people identified as homeless during the study period. Presentations increased after 2010 (IRR = 1.09, 95% CI 1.04–1.14, P < 0.001). People who experienced homelessness were more often men, White, aged under 54 years, with a history of previous self-harm and contact with psychiatric services. Risk of repetition was higher than in domiciled people (HR = 2.05, 95% CI 1.94–2.17, P < 0.001), as were all-cause mortality (HR = 1.45, 95% CI 1.32–1.59. P < 0.001) and mortality due to accidental causes (HR = 2.93, 95% CI 2.41–3.57, P < 0.001).

Conclusions

People who self-harm and experience homelessness have more complex needs and worse outcomes than those who are domiciled. Emergency department contact presents an opportunity to engage people experiencing homelessness with mental health, drug and alcohol, medical and housing services, as well as other sources of support.
Lessons from the pandemic: why having a good understanding of occupational psychiatry is more important now than ever before
Authors: Greenberg Neil , Tarn Mark , Tracy Derek
Published: March 2022

The COVID-19 pandemic has once again highlighted the need for all psychiatrists to have a good understanding of the bi-directional relationship between mental health and a person's ability to function well at work. Ensuring patients are able to work should be a key treatment outcome for all psychiatrists.
Future of Perioperative Precision Medicine: Integration of Molecular Science, Dynamic Health Care Informatics, and Implementation of Predictive Pathways in Real Time
Authors: Nirvik Pal , Kertai Miklos D.
Published: March 2022

Conceptually, precision medicine is a deep dive to discover disease origin at the molecular or genetic level, thus providing insights that allow clinicians to design corresponding individualized patient therapies. We know that a disease state is created by not only certain molecular derangements but also a biologic milieu promoting the expression of such derangements. These factors together lead to manifested symptoms. At the level of molecular definition, every average, “similar” individual stands to be “dissimilar.” Hence, there is the need for customized therapy, moving away from therapy based on aggregate statistics. The perioperative state is a mix of several, simultaneously active molecular mechanisms, surgical insult, drugs, severe inflammatory response, and the body’s continuous adaptation to maintain a state of homeostasis. Postoperative outcomes are a net result of several of those rapid genetic and molecular transformations that do or do not ensue. With the advent and advances of artificial intelligence, the translation from identifying these intricate mechanisms to implementing them in clinical practice has made a huge leap. Precision medicine is gaining ground with the help of personalized health recorders and personal devices that identify disease mechanics, patient-reported outcomes, adverse drug reactions, and drug-drug interaction at the individual level in a closed-loop feedback system. This phenomenon is especially true given increasing surgeries in older adults, many of whom are on multiple medications and varyingly frail. In this era of precision medicine, to provide a comprehensive remedy, the perioperative surgical home must expand, incorporating not only clinicians but also basic science experts and data scientists.
Deep Neural Networks Can Accurately Detect Blood Loss and Hemorrhage Control Task Success From Video
Authors: Kugener Guillaume , Zhu Yichao , Pangal Dhiraj J. , Sinha Aditya , Markarian Nicholas , Roshannai Arman , Chan Justin , Anandkumar Animashree , Hung Andrew J. , Wrobel Bozena B. , Zada Gabriel , Donoho Daniel A.
Published: March 2022

BACKGROUND:

Deep neural networks (DNNs) have not been proven to detect blood loss (BL) or predict surgeon performance from video.

OBJECTIVE:

To train a DNN using video from cadaveric training exercises of surgeons controlling simulated internal carotid hemorrhage to predict clinically relevant outcomes.

METHODS:

Video was input as a series of images; deep learning networks were developed, which predicted BL and task success from images alone (automated model) and images plus human-labeled instrument annotations (semiautomated model). These models were compared against 2 reference models, which used average BL across all trials as its prediction (control 1) and a linear regression with time to hemostasis (a metric with known association with BL) as input (control 2). The root-mean-square error (RMSE) and correlation coefficients were used to compare the models; lower RMSE indicates superior performance.

RESULTS:

One hundred forty-three trials were used (123 for training and 20 for testing). Deep learning models outperformed controls (control 1: RMSE 489 mL, control 2: RMSE 431 mL, R2 = 0.35) at BL prediction. The automated model predicted BL with an RMSE of 358 mL (R2 = 0.4) and correctly classified outcome in 85% of trials. The RMSE and classification performance of the semiautomated model improved to 260 mL and 90%, respectively.

CONCLUSION:

BL and task outcome classification are important components of an automated assessment of surgical performance. DNNs can predict BL and outcome of hemorrhage control from video alone; their performance is improved with surgical instrument presence data. The generalizability of DNNs trained on hemorrhage control tasks should be investigated.
Diverse Crystal Structures of Ion Pairs Consisting of Oxaporphyrinium Cations and Pentacyanocyclopentadienide
Authors: Takiguchi Asahi , Tanaka Hiroki , Maeda Hiromitsu , Shinokubo Hiroshi
Published: March 2022

Intermolecular interaction is the key to controlling the crystal packing structure of π-conjugated systems. Here we synthesized ion pairs consisting of various oxaporphyrinium cations and pentacyanocyclopentadienide. Their crystal packing structures differed depending on the central metals of the oxaporphyrinium cation. Energy decomposition analysis clarified that dispersion and electrostatic forces played a critical role in determining the packing structures.
Power Loading–Induced Fatigue Is Influenced by Menstrual Cycle Phase
Authors: PELTONEN HEIKKI , MIKKONEN-TAIPALE RITVA , UIMONEN TEEMU , WALKER SIMON , HACKNEY ANTHONY C. , VALTONEN MAARIT , KYRÖLÄINEN HEIKKI , IHALAINEN JOHANNA K.
Published: March 2022

Purpose

This study aimed to examine the effects of fatiguing power loading on neuromuscular properties, force production, and metabolic capacities during four phases of the menstrual cycle (MC): menstruation (M), midfollicular (mid FOL), ovulation (OV), and midluteal (mid LUT).

Methods

Sixteen eumenorrheic women performed sessions of maximal explosive leg press (2 × 10 at 60% one-repetition maximum load with 2-min recovery between sets). Serum hormones and neuromuscular responses were measured.

Results

The loading protocol significantly decreased power (between −14.2% and −12.5%; P < 0.001) and maximal force production (between maximum voluntary force (MVC); −15.0% and −7.8%; P < 0.001–0.05), while decreasing activation level (between AL; −6.9% and −2.2%; P < 0.001–0.05) in all MC phases. The decreases in AL were greater during mid LUT (P < 0.01) compared with OV. Changes in MVC and AL were associated (r
2 = 0.53; P < 0.01) at all MC phases. The decrease in EMG during MVC did not differ between the MC phases; however, mean power frequency was higher during M (+7.7%; P < 0.05) and mid LUT (+3.1%; P < 0.05) compared with OV (−7.5%). Resting twitch force decreased during mid FOL (−6.9%; P < 0.05) and mid LUT (−16.2%; P < 0.001), and these values were significantly decreased (P < 0.05) compared with OV. In addition, resting twitch force at mid LUT was lower (P < 0.01) compared with M. Blood lactate levels increased more (P < 0.05) during M compared with mid LUT. Some serum hormone concentrations were associated with fatigue-induced changes in neuromuscular properties and force production, but these correlations behaved differently between the MC phases.

Conclusions

OV may offer a more favorable hormonal milieu for acute neural responses, whereas mid FOL and mid LUT seem to be superior for acute muscular responses.