bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 infection during blinatumomab therapy: Is safety a dilemma?
Authors: Barahona-Correa Julián E , Rueda-Ortiz Camilo , López María-José , Gualtero Sandra , Arevalo-Zambrano Mónica
Published: January 2023

Patients with acute lymphoblastic leukemia may be particularly vulnerable to SARS-CoV-2 infection and severe illness. The mainstay of current treatment is the use of blinatumomab in patients with refractory or relapsed B-cell precursor acute lymphoblastic leukemia. We discuss the case of a patient with relapsed acute lymphoblastic leukemia who became positive for SARS-CoV-2 during blinatumomab therapy. There are no formal recommendations on the decision to continue, withhold, or delay blinatumomab treatment in these patients. More studies exploring this issue are warranted, as SARS-CoV-2 is expected to be here to stay.
Who tweets, and how freely? Evidence from an elite survey among German politicians
Authors: Bauer Paul C. , Ecker Alejandro , Imre Michael , Landesvatter Camille , Malich Sonja
Published: January 2023

Twitter has become one of the primary platforms for politicians to interact with the public. Consequently, research into politicians’ Twitter usage has proliferated with attempts at measuring increasingly complex concepts such as ideology or policy attitudes. So far, many of these studies either implicitly or explicitly assume that politicians’ Twitter accounts are operated by politicians themselves and that politicians are free to present their “true” attitudes and positions. We conducted an elite survey in Germany and present evidence that these assumptions only partially hold true. In our sample, only around a third of Twitter accounts are operated by the corresponding politician alone. In our view, this is a conservative estimate and should further decrease as political elites’ social media strategies professionalize over the coming years. We also find that most politicians state that there are no party guidelines regarding Twitter and that their tweets are not checked by a central authority in the party. We discuss the implications of our findings for research on social media in general.
Primary Care Provider HIV PrEP Knowledge, Attitudes, and Prescribing Habits: A Cross-Sectional Survey of Late Adopters in Rural and Suburban Practice
Authors: Sell Jarrett , Chen Rensa , Huber Christopher , Parascando Jessica , Nunez Jonathan
Published: January 2023

Objective:

Pre-exposure prophylaxis (PrEP) is a recommended strategy for HIV prevention, yet PrEP prescribing rates in primary care remain low. The aim of this study was to further describe the current knowledge, attitudes, and prescribing behaviors of HIV PrEP in primary care providers with a focus on the perceived barriers and facilitators to PrEP prescribing.

Methods:

Cross-sectional survey of primary care providers at rural and suburban practices in a large academic institution.

Results:

Survey response rate was 48.0% (n = 134). Most respondents (96.3%) reported little clinical experience in care of persons living with HIV. Respondents self-reported positive attitudes and high overall knowledge of PrEP with low prescribing rates and less comfort with lab testing. More respondents are asked about PrEP by patients (54%) than start conversations about PrEP with patients (39%). Family Physicians and providers 5 to 10 years from completion of training overall reported higher knowledge, attitudes and prescribing behaviors. Lack of PrEP education was identified as the greatest barrier and an electronic medical record order set as the greatest facilitator to prescribing PrEP.

Conclusions:

With the goal to end the HIV epidemic, PrEP provision in nonurban primary care settings may be an important strategy for increased access to PrEP and reduced HIV transmission. This study, which includes a variety of providers that possess high knowledge, yet low experience prescribing PrEP, likely demonstrates the limitations of interventions which solely focus on provider education. System-based practice solutions, such as order sets, may be needed to target infrequent prescribers of PrEP.
Can Anthropomorphic Slogans Awaken Tourists’ Environmental Responsibility Behavior? Experimental Study Based on Frame Effect Perspective
Authors: Wang Chao , Zheng Qiuqin , Zeng Haimei , Lai Riwen , Xu Anxin
Published: January 2023

The sustainable development of scenic spots have attracted much attention in academic circles, and the influence mechanism of anthropomorphic information framework to guide tourists to enhance environmental responsibility behavior is not clear. Based on the framework theory and prospect theory, the study constructed a theoretical model of anthropomorphic information framework acting on environmental responsibility behavior. The results of three experimental studies showed that: (1) The anthropomorphic information framework could significantly improve tourists’ environmental responsibility behavior, and compared with the positive anthropomorphic information framework, the negative anthropomorphic information framework can significantly improve tourists’ environmental responsibility behavior. (2) Natural empathy played an intermediary role between anthropomorphic information framework and tourists’ environmental responsibility behavior. (3) Self-construal moderated the relationship between anthropomorphic information framework and tourists’ environmental responsibility behavior. Among the interdependent tourists, compared with the positive anthropomorphic information framework, the negative anthropomorphic information framework was more likely to produce stronger environmental responsibility behavior and natural empathy. Among independent tourists, tourists’ environmental responsibility behavior and natural empathy generated by negative anthropomorphic information and positive anthropomorphic information were not significant. Through the above findings, we hope to improve the management level of tourist attractions.
A Multidimensional Comparative Analysis of MENA and International English Research Article Abstracts in Applied Linguistics
Authors: Alamri Basim
Published: January 2023

By implementing Biber’s multidimensional analysis (MDA), the present study explored the linguistic co-occurrence patterns of English research article abstracts written by native speakers of Arabic authors residing in the Arab World and international authors from different contexts. The study analyzed three specialized corpora of 300 English abstracts in the field of applied linguistics. Each corpus comprised 100 abstracts named as Middle Eastern Arabs, North African Arabs (MENA), and international authors. Several linguistic features were extracted and tagged using Nini’s Multidimensional Analysis Tagger (MAT). Then, six dimensions representing several communicative functions were identified after conducting factor analysis. Overall, the study showed that the MENA Arabs abstracts tended to be more evaluative and currently information-focused, while the international abstracts showed more informational density features and narrative style. Finally, the study suggests pedagogical implications for raising the international community’s awareness of writing abstracts with linguistic features.
The Impact of Port Infrastructure and Economic Growth in Tanzania: Adopting a Structural Equation Modeling Approach
Authors: Sun Baiqing , Kauzen Ramadhan
Published: January 2023

Tanzania port sector performs an essential function in the development of the economy and transportation of goods and services. The raised question is, what is the impact level of a seaport infrastructure on the Tanzania economy? To respond to this question, we assess the impact of seaport infrastructure on promoting economic growth in low-income country, Tanzania. A Structural Equation Modeling (SEM) approach employed to analyze the rapport of variables, using statistical data from 2005 to 2017. The results demonstrate a direct relationship between seaport infrastructure and economy. In addition, the relationship between seaport infrastructure and international trade were determined. The results also, shows a significant relation between international trade and economic growth. It is recommended in this study that, seaport infrastructure need to be improved alongside with the international trade so as to maximize its potential in promoting the growth of Tanzania’s economy, because transporting of goods through maritime is cheaper compared to other mode of transportation. Likewise the existing transportation and port policies should be maintained and implemented for improving transport infrastructure for promoting the growth of Tanzanian economy.
Linguistic Analysis of Online Domestic Violence Testimonies in the Context of COVID-19
Authors: Buchner Valentin L. , Hamm Sharina , Medenica Barbara , Molendijk Marc L.
Published: January 2023

Worldwide, an increase in cases and severity of domestic violence (DV) has been reported as a result of social distancing measures implemented to decrease the spreading of the Coronavirus Disease (COVID-19). As one’s language can provide insight in one’s mental health, this pre-registered study analyzed word use in a DV online support group, aiming to investigate the impact of the COVID-19 pandemic on DV victims in an ex post facto research design. Words reflecting social support and leisure activities were investigated as protective factors against linguistic indicators of depression in 5,856 posts from the r/domesticviolence subreddit and two neutral comparison subreddits (r/changemyview & r/femalefashionadvice). In the DV support group, the average number of daily posts increased significantly by 22% from pre- to mid-pandemic. Confirmatory analysis was conducted following a registered pre-analysis plan. DV victims used significantly more linguistic indicators of depression than individuals in the comparison groups. This did not change with the onset of COVID-19. The use of negative emotion words was negatively related to the use of social support words (Spearman’s rho correlation coefficient [rho] = −0.110) and words referring to leisure activities (rho = −0.137). Pre-occupation with COVID-19 was associated with the use of negative emotion words (rho = 0.148). We conclude that language of DV victims is characterized by indicators of depression and this characteristic is stable over time. Concerns with COVID-19 could contribute to negative emotions, whereas social support and leisure activities could function to some degree as protective factors. A potential weakness of this study is its cross-sectional design and the lack of experimental control. Future studies could make use of natural language processing and other advanced methods of linguistic analysis to learn about the mental health of DV victims.
A Descriptive Survey of Atmospheric Music Broadcasting in Hot Spring Hotels and Its Further Marketing Strategy
Authors: Chen Yen-Chieh , Li Meng-Chien , Weng Shou-Der , Wang Yi-Chieh
Published: January 2023

The survey purposes are to preliminarily understand the current situation of atmospheric music broadcast in hot spring hotels and why these choices of music were made. We reviewed literatures regarding applied music and music types, and applied questionnaire, participant observation and unstructured interviews with hotel staff who broadcast music in the unique, famous and historic Guanzihling hot spring region of Taiwan. Results show that music is often broadcast in public areas, such as lobby and restaurants. On the contrary, there was no music broadcast in private areas, such as guest rooms and private thermal baths. Light music is the primary music choice. Music types is chosen without rules by staff who have no basic trainings in music. Possible marketing strategies for future studies include the staff trainings and construction of hotel’s own hot spring music database, and better marketing of hotel’s unique multi-sensory brand image through its distinctive and pleasant music.
The effect of peer support psychoeducation based on experiential learning on self-care demands among breast cancer patients with post-chemotherapy
Authors: Dewi Erika Untari , Nursalam  , Mahmudah  , Yunitasari Esti
Published: January 2023

Background:

Breast cancer patients with post-chemotherapy had self-care deficit problems. The patient is unable to perform activities of daily living which can decrease the quality of life. One of the factors that affected self-care deficit among breast cancer patients was inadequate information. This study aimed to determine the effects of peer support psychoeducation based on experiential learning on the self-care demand.

Design and methods:

This study used a quasi-experimental design with pretest and posttest. The independent variable of the study was the application of peer support psychoeducation based on experiential learning and the dependent variable was the self-care demand. The inclusion criteria in this study were breast cancer patients with post-chemotherapy. The exclusion criteria in this study were patients who were unconscious. We selected the experimental and control group randomly. The total sample in this study was 60 people, 30 respondents for the experiment group and 30 respondents for the control group. Peer support psychoeducation based on experiential learning was developed from Wauchope’s psychoeducational theory, Orem’s self-care, and David Kolb’s experiential learning. We used a self-report questionnaire to measure self-care demand. Data were analyzed using Wilcoxon signed rank and Mann–Whitney U tests.

Results:

Peer support psychoeducation based on experiential learning has a significant effect on self-care demand, namely ADL ( p = 0.002), pain management ( p = 0.002), nutritional management ( p = 0.000), and rest and sleep ( p = 0.000).

Conclusion:

Psychoeducation based on experiential learning was recommended for nursing care or physician to increase self-care demand.
The Daily Grind of Living With Chronic Pain: An Applied Hermeneutic Exploration
Authors: Hovey Richard B.
Published: January 2023

The purpose of this research is to explore the philosophy regarding understanding the complex experience of living with chronic pain. As well, this article addresses a person’s suffering as an evolving process of learning to not only manage pain but to learn how to live well through exploring their suffering narrative. A hermeneutical interpretive approach was used to engage participants in this research and to offer a philosophical reinterpretation of living with chronic pain from a humanistic and tacit perspective. This work is offered to invite and extend our discussions about the complexity of living with chronic pain. It can also be understood as a process of rewriting oneself from a lived chaotic state of pain into a new affective historical consciousness. This transition from acute to chronic pain explored through a philosophical context can provide insight into the ways in which patients learn to live well with their condition.
Discussing Cost and Value in Patient Decision Aids and Shared Decision Making: A Call to Action
Authors: Politi Mary C. , Housten Ashley J. , Forcino Rachel C. , Jansen Jesse , Elwyn Glyn
Published: January 2023

Direct and indirect costs of care influence patients’ health choices and the ability to implement those choices. Despite the significant impact of care costs on patients’ health and daily lives, patient decision aid (PtDA) and shared decision-making (SDM) guidelines almost never mention a discussion of costs of treatment options as part of minimum standards or quality criteria. Given the growing study of the impact of costs in health decisions and the rising costs of care more broadly, in fall 2021 we organized a symposium at the Society for Medical Decision Making’s annual meeting. The focus was on the role of cost information in PtDAs and SDM. Panelists gave an overview of work in this space at this virtual meeting, and attendees engaged in rich discussion with the panelists about the state of the problem as well as ideas and challenges in incorporating cost-related issues into routine care. This article summarizes and extends our discussion based on the literature in this area and calls for action. We recommend that PtDA and SDM guidelines routinely include a discussion of direct and indirect care costs and that researchers measure the frequency, quality, and response to this information.
Pectoralis Major Tendon Repair: Transosseous Suture Technique
Authors: Belk John W. , Bravman Jonathan T. , Frank Rachel M. , Seidl Adam J. , McCarty Eric C.
Published: January 2023

Background:

Pectoralis major ruptures are rare injuries that occur in young men between 20 and 40 years of age, typically during resistance training in the eccentric phase of muscle contraction. As the incidence of these ruptures increases with increasing activity levels and use of anabolic steroids, it is important to understand effective repair techniques.

Indications:

Repair of the ruptured pectoralis major tendon is indicated for young, active patients seeking to regain full functionality of the affected upper extremity.

Technique Description:

In short, after the pectoralis major is identified, the insertion site is revealed just lateral to the biceps tendon. The site for the bone trough is then exposed through cauterization of superficial tissue, and a cortical bone trough is drilled vertically using a small round burr. The location of 3 pilot holes is identified just lateral to the cortical bone trough, and then the holes are drilled to allow for placement of the anchors later in the procedure. The tendon itself is then identified, and sutures are placed in the bulk of the muscle tendon in a Krackow fashion. After the tendon is properly sutured, it is placed under tension to test the structural integrity of the suture pattern and ensure proper load capacity. The sutures are then passed through the pilot holes, the tendon is pulled down into the trough, and the sutures are tied down to the bone.

Results:

After an appropriate rehabilitation protocol is followed for up to 6 months postoperatively, the transosseous suture technique in the context of pectoralis major tendon repairs allows for adequate tissue to bone healing and near-complete restoration of patient functionality and strength.

Conclusion:

Acute repair of pectoralis major tendon tears using a transosseous suture technique is effective in restoring upper extremity strength and functionality and is associated with high patient satisfaction. The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
A DesignSafe earthquake ground motion database for California and surrounding regions
Authors: Ji Chunyang , Cabas Ashly , Kottke Albert , Pilz Marco , Macedo Jorge , Liu Chenying
Published: January 2023

This article presents a ground motion database for California and its close surroundings (i.e. areas near the border in Nevada, Oregon, and Arizona) from earthquakes between 1999 and 2021. This data set includes events with magnitudes larger than 3.2 and focal depths less than 40 km, and it is available on DesignSafe. Ground motion records and events included in this data set are collected from 65 different seismic networks and processed with an automated software tool called gmprocess, which was developed by the United States Geological Survey (USGS). Path measures such as rupture distance and epicentral distance are computed, 5%-damped spectral accelerations, duration metrics, and other ground motion intensity measures (IMs) are provided for records that pass the quality assurance check performed by the gmprocess toolkit. The quality of processed ground motions is also screened by using outlier detection algorithms and a multiple wave-train arrivals identification algorithm. In addition, site metadata are provided, including wave velocity information (from proxy-based time-averaged shear-wave velocity for the top 30 m, Vs30, and from P- and S-wave measured velocity profiles when available), predominant frequency measured from microtremor-based horizontal-to-vertical ratios (mHVSR), and site-specific (high-frequency spectral decay) [Formula: see text] values computed from multiple ground motions recorded at sites when available. The final database contains 287,804 three-component ground motions recorded at 3709 stations from 2641 earthquakes with magnitudes and distances ranging from 3.2 to 7.2 and 0.15 to 335 km, respectively. This ground motion database contributes to advancing both engineering seismology studies and earthquake engineering applications in shallow crustal tectonic settings.
Diagnosis and management of pulmonary hypertension related to chronic respiratory disease
Authors: Krompa Anastasia , Marino Philip
Published: January 2023

Pulmonary hypertension (PH) is a recognised and significant complication of chronic lung disease (CLD) and hypoxia (referred to as group 3 PH) that is associated with increased morbidity, decreased quality of life and worse survival. The prevalence and severity of group 3 PH varies within the current literature, with the majority of CLD-PH patients tending to have non-severe disease. The aetiology of this condition is multifactorial and complex, while the prevailing pathogenetic mechanisms include hypoxic vasoconstriction, parenchymal lung (and vascular bed) destruction, vascular remodelling and inflammation. Comorbidities such as left heart dysfunction and thromboembolic disease can further confound the clinical picture. Noninvasive assessment is initially undertaken in suspected cases (e.g.cardiac biomarkers, lung function, echocardiogram), while haemodynamic evaluation with right heart catheterisation remains the diagnostic gold standard. For patients with suspected severe PH, those with a pulmonary vascular phenotype or when there is uncertainty regarding further management, referral to specialist PH centres for further investigation and definitive management is mandated. No disease-specific therapy is currently available for group 3 PH and the focus of management remains optimisation of the underlying lung therapy, along with treating hypoventilation syndromes as indicated.
Assembly and annotation of the Gossypium barbadense L. ‘Pima-S6’ genome raise questions about the chromosome structure and gene content of Gossypium barbadense genomes
Authors: Chávez Montes Ricardo A. , Ulloa Mauricio , Biniashvili Tammy , Zackay Arik , Kfir Nir , Lopez-Arredondo Damar , Herrera-Estrella Luis
Published: January 2023

Background

Gossypium barbadense L. Pima cotton is known for its resistance to Fusarium wilt and for producing fibers of superior quality highly prized in the textile market. We report a high-quality genome assembly and annotation of Pima-S6 cotton and its comparison at the chromosome and protein level to other ten Gossypium published genome assemblies.

Results

Synteny and orthogroup analyses revealed important differences on chromosome structure and annotated proteins content between our Pima-S6 and other publicly available G. barbadense assemblies, and across Gossypium assemblies in general. Detailed synteny analyses revealed chromosomal rearrangements between Pima-S6 and other Pima genomes on several chromosomes, with three major inversions in chromosomes A09, A13 and D05, raising questions about the true chromosome structure of Gossypium barbadense genomes.

Conclusion

Analyses of the re-assembled and re-annotated genome of the close relative G. barbadense Pima 3–79 using our Pima-S6 assembly suggest that contig placement of some recent G. barbadense assemblies might have been unduly influenced by the use of the G. hirsutum TM-1 genome as the anchoring reference. The Pima-S6 reference genome provides a valuable genomic resource and offers new insights on genomic structure, and can serve as G. barbadense genome reference for future assemblies and further support FOV4-related studies and breeding efforts.
Effect of volatile compounds produced by the cotton endophytic bacterial strain Bacillus sp. T6 against Verticillium wilt
Authors: Zhang Lin , Wang Yu , Lei Shengwei , Zhang Hongxin , Liu Ziyang , Yang Jianwei , Niu Qiuhong
Published: January 2023

Background

Verticillium wilt, caused by the fungus Verticillium dahliae, leads to significant losses in cotton yield worldwide. Biocontrol management is a promising means of suppressing verticillium wilt. The purpose of the study was to obtain and analyze endophytic bacteria with Verticillium wilt-resistant activities from the roots of Gossypium barbadense ‘Xinhai15’ and to explore the interactions between the soil and plants.

Results

An endophytic bacterium Bacillus sp. T6 was obtained from the Verticillium wilt-resistant cotton G. barbadense ‘Xinhai15’, which showed significant antagonistic abilities against cotton Verticillium wilt. The bioassay results indicated that the strain possessed strong antagonistic abilities that inhibited V. dahliae spore germination and mycelial growth without contact, and thus it was speculated that the active factor of the bacteria might be volatile compounds. A total of 46 volatile substances were detected via headspace solid-phase microextraction and gas chromatography–mass spectrometry analysis. The pure product verification experiment confirmed that the styrene produced by the T6 strain was the main virulence factor. Transcriptome analysis showed that following styrene induction, 247 genes in V. dahliae, including four hydrolase genes, eight dehydrogenase genes, 11 reductase genes, 17 genes related to transport and transfer were upregulated. Additionally, 72 genes, including two chitinase genes, two protease genes, five transport-related genes, and 33 hypothetical protein genes, were downregulated. The quantitative real-time PCR results confirmed that the expression of the four genes VDAG_02838, VDAG_09554, VDAG_045572, and VDAG_08251 was increased by 3.18, 78.83, 2.71, and 2.92 times, respectively, compared with the uninduced control group.

Conclusions

The research provides a new reference for the development and application of the volatile compounds of endophytic bacteria as new biocontrol agents for the control of Verticillium wilt and as biological preservatives for agricultural products.
An alkaline protease from Bacillus cereus NJSZ-13 can act as a pathogenicity factor in infection of pinewood nematode
Authors: Li Liangliang , Sun Yufeng , Chen Fengmao , Hao Dejun , Tan Jiajin
Published: January 2023

Endophytic bacteria are an important biological control for nematodes. We isolated the nematicidal Bacillus cereus NJSZ-13 from healthy Pinus elliottii trunks. Bioassay experiments showed killing of all tested nematodes by proteins from the NJSZ-13 culture filtrate within 72 h. Degradation of the nematode cuticles was observed, suggesting the action of extracellular bacterial enzymes. The responsible protease was purified by ammonium sulfate precipitation, hydrophobic interaction chromatography, ion-exchange chromatography, and SDS-PAGE. The protease had a molecular weight of 28 kDa and optimal activity at 55 °C and pH 9, indicating an alkaline protease. The study suggests the potential for using this B. cereus NJSZ-13 strain protease to prevent pinewood nematode infection.
Comparison of hemodynamics during induction of general anesthesia with remimazolam and target-controlled propofol in middle-aged and elderly patients: a single-center, randomized, controlled trial
Authors: Sekiguchi Ryo , Kinoshita Michiko , Kawanishi Ryosuke , Kakuta Nami , Sakai Yoko , Tanaka Katsuya
Published: January 2023

Background

Remimazolam confers a lower risk of hypotension than propofol. However, no studies have compared the efficacy of remimazolam and propofol administered using target-controlled infusion (TCI). This study aimed to investigate hemodynamic effects of remimazolam and target-controlled propofol in middle-aged and elderly patients during the induction of anesthesia.

Methods

Forty adults aged 45–80 years with the American Society of Anesthesiologists Physical Status 1–2 were randomly assigned to remimazolam or propofol group (n = 20 each). Patients received either remimazolam (12 mg/kg/h) or propofol (3 μg/mL, TCI), along with remifentanil for inducing anesthesia. We recorded the blood pressure, heart rate (HR), and estimated continuous cardiac output (esCCO) using the pulse wave transit time. The primary outcome was the maximum change in mean arterial pressure (MAP) after induction. Secondary outcomes included changes in HR, cardiac output (CO), and stroke volume (SV).

Results

MAP decreased after induction of anesthesia in both groups, without significant differences between the groups (− 41.1 [16.4] mmHg and − 42.8 [10.8] mmHg in remimazolam and propofol groups, respectively; mean difference: 1.7 [95% confidence interval: − 8.2 to 4.9]; p = 0.613). Furthermore, HR, CO, and SV decreased after induction in both groups, without significant differences between the groups. Remimazolam group had significantly shorter time until loss of consciousness than propofol group (1.7 [0.7] min and 3.5 [1.7] min, respectively; p < 0.001). However, MAP, HR, CO, and SV were not significantly different between the groups despite adjusting time until loss of consciousness as a covariate. Seven (35%) and 11 (55%) patients in the remimazolam and propofol groups, respectively, experienced hypotension (MAP < 65 mmHg over 2.5 min), without significant differences between the groups (p = 0.341).

Conclusions

Hemodynamics were not significantly different between remimazolam and target-controlled propofol groups during induction of anesthesia. Thus, not only the choice but also the dose and usage of anesthetics are important for hemodynamic stability while inducing anesthesia. Clinicians should monitor hypotension while inducing anesthesia with remimazolam as well as propofol.

Trial registration

UMIN-CTR (UMIN000045612).
Team-based primary care reforms and older adults: a descriptive assessment of sociodemographic trends and prescribing endpoints in two Canadian provinces
Authors: Austin Nichole , Rudoler David , Allin Sara , Dolovich Lisa , Glazier Richard H. , Grudniewicz Agnes , Martin Elisabeth , Sirois Caroline , Strumpf Erin
Published: January 2023

Background

Team-based primary care reforms aim to improve care coordination by involving multiple interdisciplinary health professionals in patient care. Team-based primary care may support improved medication management for older adults with polypharmacy and multiple points of contact with the healthcare system. However, little is known about this association. This study compares sociodemographic and prescribing trends among older adults in team-based vs. traditional primary care models in Ontario and Quebec.

Methods

We constructed two provincial cohorts using population-level health administrative data from 2006–2018. Our primary exposure was enrollment in a team-based model of care. Key endpoints included adverse drug events (ADEs), potentially inappropriate prescriptions (PIPs), and polypharmacy. We plotted prescribing trends across the observation period (stratified by model of care) in each province. We used standardized mean differences to compare characteristics of older adults and providers, as well as prescribing endpoints.

Results

Formal patient/physician enrollment increased in both provinces since the time of policy implementation; team-based enrollment among older adults was higher in Quebec (47%) than Ontario (33%) by the end of our observation period. The distribution of sociodemographic characteristics was reasonably comparable between team-based and non-team-based patients in both provinces, aside from a persistently higher share of rural patients in team-based care. Most PIPs assessed either declined or remained relatively steady over time, regardless of model of care and province. Several PIPs were more common among team-based patients than non-team-based patients, particularly in Quebec. We did not detect notable trends in ADEs or polypharmacy in either province.

Conclusions

Our findings offer encouraging evidence that many PIPs are declining over time in this population, regardless of patients’ enrollment in team-based care. Rates of decline appear similar across models of care, suggesting these models may not meaningfully influence prescribing endpoints. Additional efforts are needed to understand the impact of team-based care among older adults and improve primary care prescribing practices.
Predictors of subclinical atherosclerosis in HIV
Authors: Fernández Soto Julia , Romero-Jiménez Manuel J. , Alarcón García José Carlos , Bonet Estruch Elena , Sánchez Ramos José Luís , Castaño López Miguel Ángel
Published: January 2023

Background

Cardiovascular disease is a major cause of morbidity and mortality in people with HIV. The detection of subclinical atherosclerosis through vascular ultrasound allows us to identify patients at an increased risk of cardiovascular disease as a primary prevention strategy; this test is not routine. Our objective is to identify predictors of subclinical atherosclerosis in a population with HIV.

Methods

People with HIV infection were selected for primary prevention and underwent carotid and femoral ultrasound to detect atheromatous plaques. Logistic regression analysis including vascular risk factors was performed to predict the presence of atherosclerosis.

Results

One hundred eighty-three patients were included, 54% of whom were smokers; the mean duration of HIV infection was 9.52 years, and all patients were undergoing antiretroviral treatment. Subclinical atherosclerosis was present in 62.29% of the patients; 83.32% had plaque in the carotid territory, 57.93% in the femoral territory and 25.6% in both vascular territories. Compared to those without atherosclerosis, patients with atherosclerosis were on average 5.35 years older (53.86 vs. 48.51, p < 0.001) and had a higher prevalence of smoking (63.23% vs. 39.12%, p = 0.020) and a CD4/CD8 ratio below 0.7 (44.23% vs. 29.02%, p = 0.043). A CD4/CD8 ratio lower than 0.3 was always associated with subclinical atherosclerosis (95% confidence interval (CI): 83.9–100%). The inclusion of smoking, the CD4/CD8 ratio and age in the logistic regression analysis led to a diagnostic yield of 72% measured by the area under the receiving operator characteristic (ROC) curve (95% CI: 64–80%).

Conclusions

Tobacco use, age and a CD4/CD8 ratio below 0.7 allow prediction of the presence of subclinical atherosclerosis in primary prevention. A CD4/CD8 ratio below 0.3 was a diagnostic indicator of atherosclerosis in HIV patients undergoing primary prevention in our sample.
18F-FDG gallbladder uptake: observation from a total-body PET/CT scanner
Authors: Calabro’ Anna , Abdelhafez Yasser G. , Triumbari Elizabeth K. A. , Spencer Benjamin A. , Chen Moon S. , Albano Domenico , Cassim Christopher R. , Bertagna Francesco , Dondi Francesco , Cherry Simon R. , Badawi Ramsey D. , Sen Fatma , Nardo Lorenzo
Published: January 2023

Background

Total-body positron emission tomography/computed tomography (PET/CT) scanners are characterized by higher signal collection efficiency and greater spatial resolution compared to conventional scanners, allowing for delayed imaging and improved image quality. These advantages may also lead to better detection of physiological processes that diagnostic imaging professionals should be aware of. The gallbladder (GB) is not usually visualized as an 18F-2-fluorodeoxyglucose (18F-FDG)-avid structure in routine clinical PET/CT studies; however, with the total-body PET/CT, we have been increasingly visualizing GB activity without it being involved in an inflammatory or neoplastic process. The aim of this study was to report visualization rates and characteristics of GB 18F-FDG uptake observed in both healthy and oncological subjects scanned on a total-body PET/CT system.

Materials and methods

Scans from 73 participants (48 healthy and 25 with newly diagnosed lymphoma) who underwent 18F-FDG total-body PET/CT were retrospectively reviewed. Subjects were scanned at multiple timepoints up to 3 h post-injection. Gallbladder 18F-FDG activity was graded using liver uptake as a reference, and the pattern was qualified as present in the wall, lumen, or both. Participants’ characteristics, such as age, sex, body-mass index, blood glucose, and other clinical parameters, were collected to assess for any significant correlation with GB 18F-FDG uptake.

Results

All 73 subjects showed GB uptake at one or more imaging timepoints. An increase in uptake intensity overtime was observed up until the 180-min scan, and the visualization rate of GB 18F-FDG uptake was 100% in the 120- and 180-min post-injection scans. GB wall uptake was detected in a significant number of patients (44/73, 60%), especially at early timepoint scans, whereas luminal activity was detected in 71/73 (97%) subjects, especially at later timepoint scans. No significant correlation was found between GB uptake intensity/pattern and subjects’ characteristics.

Conclusion

The consistent observation of GB 18F-FDG uptake recorded in this study in healthy participants and subjects with a new oncological diagnosis indicates that this is a normal physiologic finding rather than representing an exception.
Computed tomography findings of thyroid hemiagenesis: differentiation from hemithyroidectomy
Authors: Yoon Dae Young , Kim Eun Soo , Lee Chae Woon , Seo Young Lan , Lee Yul , Kwon Mi Jung , Lee Sang Min
Published: January 2023

Objectives

Thyroid hemiagenesis is a rare congenital anomaly characterized by the lack of development of one thyroid lobe. The purpose of this study was to evaluate computed tomography (CT) findings of thyroid hemiagenesis and to establish useful CT criteria for differentiating thyroid hemiagenesis from the hemithyroidectomy state.

Methods

The CT images of 11 patients with thyroid hemiagenesis were retrospectively reviewed and compared with those of 100 (49 left and 51 right) patients in a hemithyroidectomy state. Image analysis was performed according to the following CT parameters: (a) side of thyroid hemiagenesis, (b) edge of the medial end of the remnant thyroid gland, (c) location of the medial end of the remnant thyroid gland, expressed as the angle of the medial end and (d) any other thyroid abnormality observed during the initial examination.

Results

The missing lobe occurred more often in the left than in the right lobe (72.7% vs. 27.3%) as well as concomitant isthmus agenesis (100% vs. 37.5%). The sharp edge of the medial end of the remnant thyroid gland was more common in thyroid hemiagenesis (64%) than in hemithyroidectomy (26%) (P = 0.0153). In left thyroid hemiagenesis, the angle of the medial end (63%) was more frequently >  + 30° than in hemithyroidectomy (0%) (P < 0.0001). Two patients presented with hypothyroidism; the remaining nine showed a normal thyroid function. The associated thyroid diseases were autoimmune thyroiditis (n = 1) and papillary thyroid carcinoma (n = 1).

Conclusions

The sharp edge of the medial end of the remnant thyroid gland and an angle of >  + 30° for the medial end in cases wherein the left lobe is absent are useful CT features for distinguishing thyroid hemiagenesis from hemithyroidectomy.
Surgical treatment of neuromuscular Early Onset Scoliosis with a bilateral posterior one-way rod compared to the Spring Distraction System: study protocol for a limited-efficacy Randomized Controlled Trial (BiPOWR)
Authors: Lemans Justin V.C. , Tabeling Casper S. , Scholten E. Pauline , Stempels Hilde W. , Miladi Lotfi , Castelein René M. , Kruyt Moyo C.
Published: January 2023

Background

Early Onset Scoliosis (EOS) is a progressive spinal deformity in children, and a potentially life-threatening disease. “Growth-friendly” surgical techniques aim to control the deformity, while allowing the spine and trunk to maintain growth. Current “growth-friendly” systems such as the traditional growing rod (TGR) and magnetically controlled growing rod (MCGR) have limitations that reduce their efficacy and cost-effectiveness. Recently, two “growth-friendly” systems have been developed that mitigate many of these limitations, the Spring Distraction System (SDS) and the One Way Self-Expanding Rod (OWSER). The purpose of the multicenter BiPOWR trial is to investigate, describe and compare the 1-year limited-efficacy and -safety of both strategies in the treatment of neuromuscular EOS.

Methods

After informed consent, 28 neuromuscular EOS patients will be randomized to receive either the SDS or the OWSER. Patients and caregivers will be blinded to allocation until after surgery. Primary outcomes will be maintenance of coronal curve correction and the occurrence of serious adverse events. In addition, spinal growth, implant lengthening, and perioperative findings are recorded systematically. At each follow-up moment, the Early Onset Scoliosis Questionnaire (EOSQ-24) will be used to assess health-related quality of life. All outcomes will be compared between groups.

Discussion

The BiPOWR trial is the first randomized controlled trial that compares two specific “growth-friendly” implants in a specified EOS population. It will determine the 1-year limited-efficacy and safety of the SDS and OWSER implants.

Trial registration

Clinicaltrials.gov: NCT04021784 (13–06-2019). CCMO registry: NL64018.041.17 (06–05-2019).
Low-level laser therapy prevents medication-related osteonecrosis of the jaw-like lesions via IL-1RA-mediated primary gingival wound healing
Authors: Zheng Yi , Dong Xian , Chen Shuo , He Yang , An Jingang , Liu Meng , He Linhai , Zhang Yi
Published: January 2023

Background

Medication-related osteonecrosis of the jaw (MRONJ) is a serious debilitating disease caused by anti-resorption and anti-angiogenesis drugs, significantly affecting patients' quality of life. Recent studies suggested that primary gingival wound healing may effectively prevent the development of MRONJ. This study aimed to evaluate the effects of low-level light therapy (LLLT) on promoting gingival wound healing in extraction sockets of MRONJ-like mice and preventing the occurrence of MRONJ. Furthermore, we explored underlying mechanisms.

Methods

Mice were randomly divided into the Ctrl, Zol, and Zol + LLLT groups. Administration of zoledronate and tooth extraction of bilateral maxillary second molars were used to build the MRONJ model, and LLLT was locally administered into the tooth sockets to examine the effect of LLLT. Next, to explore the function of IL-1RA, we performed LLLT with interleukin-1 receptor antagonist (IL-1RA) neutralizing antibody (named Zol + LLLT + IL-1RA NAb group) or negative control antibodies for tooth extraction in subsequent rescue animal experiments. Stereoscope observations, micro-computed tomography, and histological examination were conducted to evaluate gingival wound healing and bone regeneration in tooth sockets. The effects of LLLT on the migration capacities of zoledronate-treated epithelial cells were assessed in vitro.

Results

LLLT promoted primary gingival wound healing without exposed necrotic bone. Micro-computed tomography results showed higher bone volume and mineral density of the tooth sockets after LLLT. Histology analysis showed complete gingival coverage, obvious bone regeneration, and reduced soft tissue inflammation, with down-regulated pro-inflammation cytokines, like interleukin-1 beta (IL-1β) and tumor necrosis factor-α (TNF-α), and up-regulated IL-1RA expression in the gingival tissue in the LLLT group. The rescue assay further showed that the effects of LLLT promoting gingival wound healing and preventing MRONJ might be partially abolished by IL-1RA neutralizing antibodies. In vitro studies demonstrated that LLLT accelerated zoledronate-treated epithelial cell migration.

Conclusions

LLLT might promote primary gingival wound healing and contribute to subsequent bone regeneration of the tooth extractions in MRONJ-like lesions via IL-1RA-mediated pro-inflammation signaling suppression.
Cone beam computed tomography in the assessment of TMJ deformity in children with JIA: repeatability of a novel scoring system
Authors: Augdal Thomas A. , Angenete Oskar W. , Shi Xie-Qi , Säll Mats , Fischer Johannes M. , Nordal Ellen , Rosendahl Karen
Published: January 2023

Background

The temporomandibular joint (TMJ) is frequently involved in juvenile idiopathic arthritis (JIA). Diagnostic imaging is necessary to correctly diagnose and evaluate TMJ involvement, however, hitherto little has been published on the accuracy of the applied scoring systems and measurements. The present study aims to investigate the precision of 20 imaging features and five measurements based on cone beam computed tomography (CBCT).

Methods

Imaging and clinical data from 84 participants in the Norwegian study on juvenile idiopathic arthritis, the NorJIA study, were collected. Altogether 20 imaging features and five measurements were evaluated independently by three experienced radiologists for intra- and interobserver agreement. Agreement of categorical variables was assessed by Fleiss’, Cohen’s simple or weighted Kappa as appropriate. Agreement of continuous variables was assessed with 95% limits of agreement as advised by Bland and Altman.

Results

“Overall impression of TMJ deformity” showed almost perfect intraobserver agreement with a kappa coefficient of 0.81 (95% CI 0.69–0.92), and substantial interobserver agreement (Fleiss’ kappa 0.70 (0.61–0.78)). Moreover, both “flattening” and “irregularities” of the eminence/fossa and condyle performed well, with intra- and interobserver agreements of 0.66–0.82 and 0.55–0.76, respectively. “Reduced condylar volume” and “continuity” of the fossa/eminence had moderate intra- and interobserver Kappa values, whereas continuity of the condyle had Kappa values above 0.55. Measurements of distances and angles had limits of agreement of more than 15% of the sample mean.

Conclusions

We propose a CBCT-based scoring system of nine precise imaging features suggestive of TMJ deformity in JIA. Their clinical validity must be tested.
Systemic inhibition of 5-lipoxygenase by MK-886 exacerbates apical periodontitis bone loss in a mouse model
Authors: Petean Igor Bassi Ferreira , Silva-Sousa Alice Corrêa , da Silva Raquel Assed Bezerra , Lucisano Marília Pacífico , da Silva Léa Assed Bezerra , de Castro Guilherme Piedade Assed , Sousa-Neto Manoel Damião , Faccioli Lúcia Helena , Paula-Silva Francisco Wanderley Garcia
Published: January 2023

Background

To investigate if 5-LO selective inhibitor (MK-886) could be used for systemic treatment of experimentally induced apical periodontitis in a mouse model.

Methods

Twenty-four C57BL/6 mice were used. After coronal opening, a solution containing Escherichiacoli LPS (1.0 µg/µL) was inoculated into the root canals of the lower and upper right first molars (n = 72 teeth). After 30 days apical periodontitis was established, and the animals were treated with MK-886 (5 mg/kg), a 5-LO inhibitor, for 7 and 14 days. The tissues were removed for histopathological and histometric analyses, evaluation of osteoclast number and gene expression for receptor activator of nuclear factor kappa-B (Tnfrsf11a), receptor activator of nuclear factor kappa-B ligand (Tnfsf11), osteoprotegerin (Tnfrsf11b), tartrate-resistant acid phosphatase (Acp5), matrix metalloproteinase-9 (Mmp9), cathepsin K (Ctsk) and calcitonin receptor (Calcr). Statistical data analysis was performed using Kruskal Wallis followed by Dunn’s tests (α = 0.05).

Results

Administration of MK-886 for 7 days exerted no effect on apical periodontitis progression compared to LPS inoculation without treatment (p = 0.3549), while treatment for 14 days exacerbated bone loss (p < 0.0001). Administration of MK-886 enhanced osteoclastogenesis signaling and osteoclast formation within 7 days (p = 0.0005), but exerted no effect at 14 days (p > 0.9999). After 7 days of treatment, MK-886 induced mRNA expression for Acp5 (p = 0.0001), Calcr (p = 0.0003), Mmp9 (p = 0.0005) and Ctsk (p = 0.0008), however no effect in those gene expression was observed after 14 days (p > 0.05).

Conclusion

Systemic treatment with MK-886 exacerbated LPS-induced apical periodontitis in a mouse model.