bluuebunny/crossref_metadata_2025 huggingface dataset:
Relations between bullying and distress among youth living in First Nations communities: Assessing direct and moderating effects of culture-related variables
Authors: Paul Jocelyn , McQuaid Robyn J. , Hopkins Carol , Perri Amanda , Stewart Sherry , Matheson Kim , Anisman Hymie , Bombay Amy
Published: July 2022

The well-being of Indigenous peoples continues to be affected by intergenerational effects of numerous harmful government policies, which are considered root causes for bullying and cyberbullying that exist in some communities. Despite ongoing stressors, Indigenous youth demonstrate resilience, which often appears grounded in connecting to their cultural identities and traditional practices. However, few studies have tested the direct and stress-buffering role of various aspects of culture in relation to well-being among First Nations youth. Analyses of the 2015–16 First Nations Regional Health Survey (RHS) revealed that bullying and cyberbullying were associated with increased psychological distress among youth aged 12–17 living in First Nations communities across Canada ( N  = 4,968; weighted = 47,918), and that these links were stronger for females. Feelings of community belonging were directly associated with lower distress and buffered the relationships between bullying/cyberbullying and distress. Among youth who experienced cyberbullying, those who participated in community cultural events at least sometimes reported lower distress compared to those who rarely or never participated. Those who disagreed that traditional cultural events were important reported the highest levels of distress, but perceived importance of such events failed to buffer the associations between bullying/cyberbullying and distress. These national data highlight the importance of certain culture-related variables as key factors associated with the well-being of youth living in First Nations communities across Canada.
Experiment and theoretical analysis of carbon fiber reinforced polymer strengthened square steel tube under eccentric load
Authors: Liu Feiran , Lei Honggang , Wan Haiying
Published: July 2022

Carbon fiber reinforced polymer (CFRP) has many advantages, such as light weight, high strength, and excellent corrosion resistance. In this paper, the experimental research of the square steel tube reinforced by carbon fiber reinforced polymer was performed, and its ultimate bearing capacity formula was derived. The tests were based on the previous results of our research group. Six sets of the test are performed by altering two-layer-CFRP and the eccentricity. The test results demonstrated that CFRP improved the ultimate bearing capacity of square steel tubes. As the number of layers of CFRP increased, the growth rate of bearing capacity gradually declined, and reinforcement of CFRP on specimens of large eccentricity was significantly effective than that of small eccentricity one. After longitudinal CFRP was stuck, a circumferential layer of CFRP in the middle of the square steel tube can improve the reinforcement effect. This paper referred to the existing codes and took the idea of area substitution to derive the ultimate bearing capacity formula of the steel tube reinforced by CFRP. The calculated values of the formula were compared with those of the experiment, and the difference is within the range, which proves the rationality of the derived formula.
Numerical investigation of sloshing pressure distribution in a rectangular tank
Authors: Wang Chenyi , Zou Changfang , Zhu Jiayan , Tang Jingchun , Miao Quanming
Published: July 2022

To clarify distribution characteristics of impact pressure induced by sloshing along the rectangular tank wall and predict the vertical position where the maximum pressure appears, this paper uses VOF method and dynamic mesh technique to simulate the sloshing in the rectangular tank and analyze the sloshing pressure under different conditions. The results show that the vertical position of the maximum sloshing pressure decreases with the increase of the impact strength when liquid does not impact the roof of the tank. The vertical position of the maximum sloshing pressure decreases with the increase of the excitation amplitude. The relationship between the vertical position of the maximum sloshing pressure and the excitation frequency presents parabola-like characteristics and the parabola opens up, which means the vertical position has the minimum value with the change of the excitation frequency, and the minimum of the vertical position occurs when the liquid in the tank near the resonance state. It also shows that the maximum sloshing pressure does not always appear at the static free surface corresponding to different filling levels. Instead, it is distributed regionally as the filling level changes.
Impact of diabetes on long-term all-cause re-hospitalization after revascularization with percutaneous coronary intervention
Authors: Hansen Kirstine N , Noori Manijeh , Christiansen Evald H , Kristiansen Eskild B , Maeng Michael , Zwisler Ann Dorthe O , Borregaard Britt , Søgaard Rikke , Veien Karsten T , Junker Anders , Jensen Lisette Okkels
Published: July 2022

Purpose:

The purpose of the study was to investigate the incidence, cause and probability of re-hospitalization within 30 and 365 days after percutaneous coronary intervention (PCI) in patients with diabetes.

Method:

Between January 2010 and September 2014, 2763 patients with diabetes were treated with PCI at two Hospitals in Western Denmark. Reasons for readmission within 30 and 365 days were identified.

Results:

Readmission risks for patients with diabetes were 58% within 365 days and 18% within 30 days. Reason for readmission was ischemic heart disease (IHD) in 725 patients (27%), and non-IHD-related reasons in 826 patients (31%). IHD-related readmission within 365 days was associated with female gender (OR 1.3, 95% CI: 1.1–1.5), and non-ST-segment elevation myocardial infarction, compared to stable angina at the index hospitalization (OR 1.3, 95% CI: 1.1–1.6). Among patients with diabetes, increased risk of readmission due to other reasons were age (OR 1.3, 95% CI: 1.2–1.5) and higher scores of modified Charlson Comorbidity index (CCI): CCI ≥3 (OR 3.6, 95% CI: 2.8–4.6).

Conclusion:

More than half of the patients with diabetes mellitus undergoing PCI were readmitted within 1 year. Comorbidities were the strongest predictor for non-IHD-related readmission, but did not increase the risk for IHD-related readmissions.
Effects of Vigorous Versus Restorative Yoga Practice on Objective Cognition Functions in Sedentary Breast and Ovarian Cancer Survivors: A Randomized Controlled Pilot Trial
Authors: Deng Gary , Bao Ting , Ryan Elizabeth L. , Benusis Lara , Hogan Pasha , Li Qing S. , Dries Annika , Konner Jason , Ahles Tim A. , Mao Jun J.
Published: July 2022

Purpose:

Many cancer survivors experience cancer-related cognitive impairment (CRCI). We conducted a randomized controlled pilot trial of 2 types of yoga practice and evaluated their effects on participants’ objective cognitive function.

Methods:

Sedentary breast or ovarian cancer survivors were randomized to practice either restorative yoga (with more meditative practice and minimal physical exertion) or vigorous yoga (with considerable physical exertion and minimal meditative practice) in 60-minute supervised sessions 3 times a week for 12 weeks, followed by 12 weeks of home practice. We used the NIH Toolbox Cognition Domain to evaluate participants at baseline, week 12, and week 24.

Results:

We enrolled 35 participants. For women in the restorative yoga group, overall cognitive function was statistically significantly improved at weeks 12 and 24 compared to baseline ( P = .03 and 0.004; Cohen’s D = 0.3 and 0.5). Fluid cognitive function also significantly improved at weeks 12 and 24 ( P = .02 and 0.0007; Cohen’s D = 0.3 and 0.6), whereas improvements in crystallized cognition were not significant. For women in the vigorous yoga group, significant improvement was only seen in tasks of crystallized cognition at week 24 ( P = .03; Cohen’s D = 0.5). Between-group comparisons showed that at week 24, women in the restorative yoga group had significantly higher scores on fluid cognition tasks.

Conclusions:

Patients who participated in yoga practice demonstrated improvement in objective cognitive function over time. Restorative yoga may be more effective in improving fluid cognitive function at week 24 when compared to vigorous yoga. These promising findings should be confirmed in definitive studies.

Trial registration:

Clinicaltrials.gov; NCT02305498 (Date Registered: December 2, 2014)
Prison ethnography by correspondence?
Authors: Jardine Cara
Published: July 2022

Prison ethnography offers researchers a unique vantage point from which to explore the relationships, power dynamics, degradations, solidarities and sensory assaults which occur within the prison walls. Yet, despite the valuable insights to be gained from this methodological approach, prison ethnographies can be extremely challenging to conduct. Institutional pressures arising from both the prison and the contemporary University pose considerable obstacles for researchers, and the outbreak of Covid-19 has heightened these barriers further still. This article will argue that the methodology of cultural probes can preserve at least some of the ethos of ethnographic research when conducting research by correspondence. It will reflect on the methodological and ethical challenges of this approach, and critically discuss its potential to offer a more participatory and less extractive means for researching the nuances of prison life while collecting data from a distance.
Anzi Heji Downregulates DNMT1 to Improve Anticardiolipin Antibody (ACA)-Positive Abortion by Regulating JAK/STAT Pathway
Authors: Miao Li , Lu Qibin
Published: July 2022

Anzi Heji (AZHJ) is a traditional Chinese medicine compound prepared for long-term treatment of Anticardiolipin Antibody (ACA)-positive abortion, with small side effects and definite curative effect. Abortion was reported to be related to DNMT1, a methylation transferase regulated by JAK2 pathway, so this study aimed to explore whether AZHJ treated ACA-positive abortion by regulating the DNMT1. Cell proliferation estimation employed Cell counting kit-8 (CCK-8) and flow cytometry. Human β2-glycoprotein I (GPI) was used as an inducer to establish ACA-positive mice model. Western blot was applied to examine the expressions of DNMT1, FOXP3, IL-6, and JAK/STAT3 pathway-related proteins. ACA titers and IL-6 levels in peripheral blood were tested by enzyme-linked immunosorbent assay (ELISA). Placental tissue damage was assessed by hematoxylin and eosin (H&E) staining. Based on the findings from experiments, AZHJ could significantly inhibit apoptosis and regulate the proliferation activity of HTR-8/SVneo cells. AZHJ treatment reduced the expression levels of DNMT1, FOXP3, IL-6, and JAK/STAT3 signaling pathways-related proteins in HTR-8/SVneo cells and maternal–fetal interface (uterine decidua and placenta), and the titer of serum ACA was also significantly decreased. In addition, AZHJ effectively alleviated placental tissue damage caused by ACA-positive abortion compared with model group. To sum up, AZHJ may play a therapeutic role by inhibiting DNMT1 activation through Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway, and then promoting FOXP3 expression in maternal–fetal interface of pregnant mice, thereby improving immune tolerance at the maternal–fetal interface, preventing and treating ACA-positive abortion.
Evidence of nonsurgical treatment for polycystic liver disease
Authors: Yoo Jeong-Ju , Jo Hye In , Jung Eun-Ae , Lee Jae Seung , Kim Sang Gyune , Kim Young Seok , Kim Beom Kyung
Published: July 2022

Background:

Polycystic liver disease (PCLD) is the most common extrarenal manifestation of polycystic kidney disease. There is an urgent need to assess the efficacy and safety of nonsurgical modalities to relieve symptoms and decrease the severity of PCLD. Herein, we aimed to evaluate the efficacy of the nonsurgical treatment of PCLD and the quality of life of affected patients.

Methods:

PubMed, Ovid, MEDLINE, EMBASE, and the Cochrane Library were searched for studies on the nonsurgical modalities, either medications or radiological intervention to manage PCLD. Treatment efficacy, adverse events (AEs), and patient quality of life were evaluated.

Results:

In total, 27 studies involving 1037 patients were selected. After nonsurgical treatment, liver volume decreased by 259 ml/m [mean change (Δ) of 6.22%] and the effect was higher in the radiological intervention group [−1617 ml/m (−15.49%)] than in the medication group [−151 ml/m (−3.78%)]. The AEs and serious AEs rates after overall nonsurgical treatment were 0.50 [95% confidence interval (CI): 0.33–0.67] and 0.04 (95% CI: 0.01–0.07), respectively. The results of the SF-36 questionnaire showed that PCLD treatment improved physical function [physical component summary score of 4.18 (95% CI: 1.54–6.83)] but did not significantly improve mental function [mental component summary score of 0.91 (95% CI: −1.20 to 3.03)].

Conclusion:

Nonsurgical treatment was effective and safe for PCLD, but did not improve the quality of life in terms of mental health. Radiological intervention directly reduces hepatic cysts, and thus they should be considered for immediate symptom relief in patients with severe symptoms, whereas medication might be considered for maintenance treatment.

Registration number:

PROSPERO (International Prospective Register of Systematic Reviews) CRD42021279597
Dyslipidemia and associated cardiovascular risk factors in HIV-positive and HIV-negative patients visiting ambulatory clinics: A hospital-based study
Authors: Woldu Minyahil A. , Minzi Omary , Engidawork Ephrem
Published: July 2022

Background

Dyslipidemia is a well-known risk factor for cardiovascular disease (CVD), accounting for more than half of all instances of coronary artery disease globally (CAD).

Purpose

The purpose of this study was to determine lipid-related cardiovascular risks in HIV-positive and HIV-negative individuals by evaluating lipid profiles, ratios, and other related parameters.

Methods

A hospital-based study was carried out from January 2019 to February 2021 in both HIV + and HIV- ambulatory patients.

Results

High TG (p = .003), high TC (p = .025), and low HDL (p < .001) were all associated with a two-fold increased risk of CVD in people aged 45 and up. Due to higher TG (p < .001) and lower HDL (p < .001), males were found to have a higher risk of atherogenic dyslipidemia. A twofold increase in the likelihood of higher TG levels has been associated with smoking (p = .032) and alcohol intake (p = .022). A twofold increase in a high TC/HDL ratio and an elevated TG/HDL ratio was observed with an increase in waist-to-height ratio (p = .030) and a high level of FBS (126 mg/dl) and/or validated diabetes (p = .017), respectively. In HIV + participants, central obesity (p < .001), diabetes (p < .001), and high blood pressure (p < .001) were all less common than in HIV- participants.

Conclusions

Dyslipidemia is linked to advanced age, male gender, diabetes, smoking, alcohol consumption, and increased waist circumference, all of which could lead to an increased risk of CVD, according to the study. The study also revealed that the risks are less common in HIV + people than in HIV-negative ambulatory patients.
Neonatal near miss and associated factors among neonates admitted to neonatal intensive care unit of hospitals in East Wollega, Western Ethiopia, 2019
Authors: Gutema Edosa Amente , Getachew Erena Motuma , Kasaye Habtamu Kebebe
Published: July 2022

Background:

Neonatal near miss is an infant who nearly died but survived from birth to 28 days. Neonatal period is the most vulnerable time for child’s healthiness and continued existence. Globally, about 2.5 million children died in their first month of life and 7000 die/day.

Objective:

To assess neonatal near miss and associated factors among neonates admitted to intensive care unit at hospitals in East Wollega, West Ethiopia, 2019.

Methods:

Quantitative, facility-based cross-sectional study was conducted from 15 July to 30 August 2019 on 403 neonates admitted to neonatal intensive care unit of hospitals. After ethical clearance, five recruited and trained nurses collected the data with pretested structured questionnaire. Neonates sampled were selected using systematic random sampling. Data entered into Epi-info version 7.1 and exported to SPSS Version 24. Binary logistic regression was performed, and adjusted odds ratio with P-value ⩽ 0.05 at 95% confidence interval was used as statistically significant.

Results:

All, 403, study participants were included in this study, yielding 100% response rate. From these, 196 (48.60%) neonates were near miss. In multivariable logistic regression, mother who lived in rural area (adjusted odds ratio = 3.84, 95% confidence interval = (1.78, 8.31)), cesarean section (adjusted odds ratio = 10.68, 95% confidence interval = (2.95, 38.71)), and neonates referred to hospitals (adjusted odds ratio = 3.32, 95% confidence interval = (3.27, 12.01)). Also, female neonates (adjusted odds ratio = 2.99, 95% confidence interval = (1.45, 6.14)) and multiple birth (adjusted odds ratio = 3.07, 95% confidence interval = (1.32, 7.16)) were significantly associated with neonatal near miss.

Conclusion:

Neonatal near miss found to be high compared to previously existing research in Brazil. Health institutions, health professionals, and concerned bodies on plan and implementation of neonatal care need to consider these factors during pregnancy, delivery, and for neonates immediate after birth and in neonatal intensive care unit.
Chronic abdominal aortic rupture mimicking femoral neuropathy
Authors: Modugno Pietro , Salman Fadia , Picone Veronica , Maiorano Maurizio , Centritto Enrico Maria , Massetti Massimo
Published: July 2022

Chronic-contained rupture of an aortic aneurysm is a rare subset of ruptured aneurysms. The presentation is unusual, and the diagnosis is frequently delayed. Here, we describe a case of contained rupture of abdominal aortic aneurysm that presented with signs and symptoms of femoral neuropathy. Clinical and radiological findings were initially misinterpreted. The correct diagnosis was formulated belatedly, causing a progressively increased risk of fatal events. Surgical aortic repair was performed and the postoperative course was uneventful. In conclusion, in the presence of a retroperitoneal mass, a diagnosis of chronic-contained rupture of an abdominal aortic aneurysm should be considered.
Effects of body fat components on early renal functions of individuals following kidney donation
Authors: Yığman Metin , Tangal Semih
Published: July 2022

Objective:

Obesity stands as a risk factor for the chronic kidney disease. The objective of this study was to investigate the relationship between early renal function following kidney donation and the measurements of body fat components.

Methods:

In total, 86 donors followed up for at least 6 months postoperatively were included. Height and weight measurements and results of laboratory analysis of all donors were recorded retrospectively. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), hepatic fat (HF), pancreatic fat (PF) and splenic fat (SF) measurements were performed, and pancreatic splenic fat fraction difference (P−S) and pancreatic splenic fat fraction ratio (P/S) were calculated by a radiologist using the records of preoperative computed tomography scans of donors.

Results:

The estimated glomerular filtration rate (eGFR), serum creatinine and spot urinary microalbumin/creatinine ratio values of the donors at the sixth month postoperatively were statistically different from those of the preoperative values ( p < 0.001). In addition, the individuals were divided into two categories based on the postoperative eGFR: ⩾ 60 mL/min/1.73 m2 and < 60 mL/min/1.73 m2. Age, low-density lipoprotein (LDL) level and VAT/SAT ratio were lower in group eGFR: ⩾ 60 ( p < 0.001, p = 0.03, p = 0.007, respectively). Age and VAT/SAT ratio were the parameters found to be affecting the eGFR significantly, and VAT/SAT ratio (0.729, 95% CI: 0.602–0.856, p = 0.007) had higher predictive value in receiver operating characteristic curve (ROC).

Conclusion:

Preoperative measurements of body fat components may provide significant information to predict postoperative renal functions of kidney donor candidates.

Level of evidence:

Not applicable.
Nodular Lymphocyte-Predominant Hodgkin Lymphoma: Review of Current Literature and Case Discussion
Authors: Sidda Adarsh , Naleid Nikolas Kristopher , Manu Gurusidda , Graffeo Vincent , Jamil Muhammad Omer
Published: July 2022

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare subset of Hodgkin lymphoma (HL). It has a distinct clinical and pathological presentation. Unlike classic HL, where the predominant malignant cells are Reed Sternberg cells, the malignant cells in NLPHL are known as lymphocyte predominant (LP) cells, with their own unique immunohistochemistry antigen expression and staining pattern. Based on risk stratification and staging of the disease, treatment can range from active surveillance in asymptomatic patients with no organ compromise or bulky disease, to aggressive chemotherapeutic agents in advanced disease. Guidelines on which of these chemotherapy regimens would offer the most benefit to our patients are limited due to lack of randomized-controlled studies. Majority of the current prospective data on treatment were inclusive of both HL and NLPHL. Thus, the regimens employed in treatment of NLPHL are similar to the ones used in HL, though NLPHL is often viewed as its own distinct entity. This article aims to review the current literature and future advances on treatment of this rare disease.
Use of Opioids in the Early Postoperative Period After Arthroscopic Rotator Cuff Repair: A Systematic Review
Authors: Davis William H. , Sandler Alexis B. , Scanaliato John P. , Dunn John C. , Parnes Nata
Published: July 2022

Background:

Postoperative treatment plans after orthopaedic procedures frequently include opioids for pain relief.

Purpose:

To evaluate opioid use in the early postoperative phase after arthroscopic rotator cuff repair (ARCR) to develop a procedure-specific understanding of the current role of opioids in pain management for this procedure.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A PubMed search was used to identify eligible studies. Data on patient demographics, visual analog scale pain scores, and opioid use patterns (in morphine milligram equivalents [MMEs]) were collected and assessed. Cumulative MMEs were reported on postoperative day (POD) zero, and mean MMEs were reported on subsequent PODs (days 1, 2, 3, 5, 7, and 14). Metaregression, I 2 indices, and Cochran Q tests were used to evaluate study variation, heterogeneity, and variance.

Results:

A total of 1487 patients in 22 studies were included in the analysis. An estimated 51% (95% CI, 31%-70%) of patients with nerve blocks (NBs) were opioid-free through POD-0 versus 40% (95% CI, 1.2%-97%) of patients without NBs, which increased to 65% (95% CI, 55%-74%) versus 25% (95% CI, 1.7%-86%) by POD-1. Opioid requirements were highest in the first 72 hours after ARCR. NB use reduced opioid requirement on POD-0 compared with no NB use (15.8 vs 45.0 MMEs, respectively; P < .001) but did not reduce requirements after that. In addition, NB use led to a statistically significant increase in opioid requirements on POD-7 (28.6 vs 9.5 MMEs, respectively; P < .001). Using a model that assumes stable opioid requirements between our time points, weighted mean cumulative opioid consumption was 163 MMEs in the first week and 273 MMEs in the first 2 weeks (150 and 287 MMEs in patients with NB; 180 and 261 MMEs in patients without NB, respectively).

Conclusion:

Opioid use is relatively common in the early postoperative period after ARCR. Pain scores and opioid requirements may spike on POD-1; however, patients should be educated and reassured that they will gradually decrease usage over the initial 2-week postoperative period.
The Effects of Hearing-Aid Amplification and Noise on Conversational Dynamics Between Normal-Hearing and Hearing-Impaired Talkers
Authors: Petersen Eline Borch , MacDonald Ewen N. , Josefine Munch Sørensen A.
Published: July 2022

There is a long-standing tradition to assess hearing-aid benefits using lab-based speech intelligibility tests. Towards a more everyday-like scenario, the current study investigated the effects of hearing-aid amplification and noise on face-to-face communication between two conversational partners. Eleven pairs, consisting of a younger normal-hearing (NH) and an older hearing-impaired (HI) participant, solved spot-the-difference tasks while their conversations were recorded. In a two-block randomized design, the tasks were solved in quiet or noise, both with and without the HI participant receiving hearing-aid amplification with active occlusion cancellation. In the presence of 70 dB SPL babble noise, participants had fewer, slower, and less well-timed turn-starts, while speaking louder with longer inter-pausal units (IPUs, stretches of continuous speech surrounded by silence) and reducing their articulation rates. All these changes are indicative of increased communication effort. The timing of turn-starts by the HI participants exhibited more variability than that of their NH conversational partners. In the presence of background noise, the timing of turn-starts by the HI participants became even more variable, and their NH partners spoke louder. When the HI participants were provided with hearing-aid amplification, their timing of turn-starts became faster, they increased their articulation rate, and they produced shorter IPUs, all indicating reduced communication effort. In conclusion, measures of the conversational dynamics showed that background noise increased the communication effort, especially for the HI participants, and that providing hearing-aid amplification caused the HI participant to behave more like their NH conversational partner, especially in quiet situations.
Putting implementation into context: Exploring the influence of physical, social, and task contexts on the implementation of health promotion programs
Authors: Roehl Maximilian Tim
Published: July 2022

The aim of this paper is to empirically examine the influence of organizational context on the implementation effectiveness of human resource management (HRM) practices with the aim of maintaining the health and well-being of employees, known as health promotion programs (HPPs). HPPs are a strategic function in HRM and play a crucial role in creating and maintaining human capital. Effective implementation is typically viewed as a critical prerequisite for the success of HPPs. By exploring the influence of organizational context on the implementation of HPPs, this paper offers a fresh approach to understanding HRM implementation in a relatively neglected area of research. To uncover contextual influences a multiple-case study in four German organizations operating in the chemical industry was conducted. Data was collected using a multi-method design consisting of an analysis of documents and 28 semi-structured interviews. The study is among the first to apply the categorical model of context by Johns to the investigation of the implementation of health promotion programs. The results contribute to a more nuanced view of HRM implementation by highlighting the interrelationships between contextual factors stemming from the physical, social, and task context and implementation fidelity. By providing initial empirical evidence of the mechanisms underlying this relationship, this study sheds light on the complexity and breadth of contextual influences during the implementation of HPPs and offers several theoretical and practical implications.
Translation of 3D Anatomy to 2D Radiographic Angle Measurements in the Ankle Joint: Validity and Reliability
Authors: Vuurberg Gwendolyn , Tümer Nazli , Sierevelt Inger , Dobbe Johannes G. G. , Hemke Robert , Wiegerinck Jan Joost , Maas Mario , Kerkhoffs Gino M. M. J. , Tuijthof Gabriëlle J. M.
Published: July 2022

Background:

The objective consisted of 2 elements, primarily to define 2 bone geometry variations of the ankle that may be of prognostic value on ankle instability and secondly to translate these bone variations from a 3D model to a simple 2D radiographic measurement for clinical use.

Methods:

The 3D tibial and talar shape differences derived from earlier studies were translated to two 2D radiographic parameters: the medial malleolar height angle (MMHA) and talar convexity angle (TCA) respectively to ensure clinical use. To assess validity, the MMHA and TCA were measured on 3D polygons derived from lower leg computed tomographic (CT) scans and 2D digitally reconstructed radiographs (DRRs) of these polygons. To assess reliability, the MMHA and TCA were measured on standard radiographs by 2 observers calculating the intraclass correlation coefficient (ICC).

Results:

The 3D angle measurements on the polygons showed substantial to excellent agreement with the 2D measurements on DRR for both the MMHA (ICC 0.84-0.93) and TCA (ICC 0.88-0.96). The interobserver reliability was moderate with an ICC of 0.58 and an ICC of 0.64 for both the MMHA and TCA, respectively. The intraobserver reliability was excellent with an ICC of 0.96 and 0.97 for the MMHA and the TCA, respectively.

Conclusion:

Two newly defined radiographic parameters (MMHA and TCA) are valid and can be assessed with excellent intraobserver reliability on standard radiographs. The interobserver reliability was moderate and indicates training is required to ensure uniformity in measurement technique. The current method may be used to translate more variations in bone shape prior to implementation in clinical practice.

Level of Evidence:

Level III, cohort study.
Testing machine learning models for seismic damage prediction at a regional scale using building-damage dataset compiled after the 2015 Gorkha Nepal earthquake
Authors: Ghimire Subash , Guéguen Philippe , Giffard-Roisin Sophie , Schorlemmer Danijel
Published: July 2022

Assessing post-seismic damage on an urban/regional scale remains relatively difficult owing to the significant amount of time and resources required to acquire information and conduct a building-by-building seismic damage assessment. However, the application of new methods based on artificial intelligence, combined with the increasingly systematic availability of field surveys of post-seismic damage, has provided new perspectives for urban/regional seismic damage assessment. This study analyzes the effectiveness and relevance of a number of machine learning techniques for analyzing spatially distributed seismic damage after an earthquake at the regional scale. The basic structural parameters of a portfolio of buildings and the post-earthquake damage surveyed after the Nepal 2015 earthquake are analyzed and combined with macro-seismic intensity values provided by the United States Geological Survey ShakeMap tool. Among the methods considered, the random forest regression model provides the best damage predictions for specified ground motion intensity values and structural parameters. For traffic-light-based damage classification (three classes: green-, amber-, and red-tagged buildings based on post-earthquake damage grade), a mean accuracy of 0.68 is obtained. This study shows that restricting learning to basic features of buildings (i.e. number of stories, height, plinth area, and age), which could be readily available from authoritative databases (e.g. national census) or field-surveyed databases, yields a reliable prediction of building damage (4 features/3 damage grade accuracy: 0.64).
De novo headache in ischemic stroke patients treated with thrombectomy: a prospective study
Authors: Gallo Daniel , Manrique Leire , Polanco Marcos , González-Mandly Andrés , Torres Eduardo , Palacio Enrique , Vázquez José Luis , Pérez-Pereda Sara , González-Quintanilla Vicente , Madera Jorge , Pascual Julio
Published: July 2022

Background and aim

Headache attributed to intracranial endovascular procedures is described in the ICHD-3. Our aim was to study the frequency and characteristics of headache specifically related to thrombectomy in patients with ischemic stroke.

Methods

Prospective evaluation of clinical features of headache after thrombectomy using an ad hoc questionnaire.

Results

One hundred seventeen patients were included (52.1% females). Most had an anterior circulation artery occlusion (91.5%). 93 (79.5%) received general anaesthesia. 111 (94.9%) required stent retriever, 21 (24.4%) angioplasty and 19 (16.2%) aspiration thrombectomy. 31 (26.5%; 95% CI 18.8–35.5%) had headache related to thrombectomy, and it was associated with a history of primary headache (p = 0.004). No differences about sex, initial NIHSS score, or the type or complexity of the procedure were observed. Headache was usually moderate and oppressive, ipsilateral to the artery occlusion and usually lasted less than 48 hours.

Conclusions

Almost one-third of patients with ischemic stroke who undergo endovascular thrombectomy experience headache in the first 24 hours, occurring more frequently in patients who had a previous history of headaches regardless of the procedure complexity.
Establishment of a qualified integrated care system after total knee arthroplasty as a role of regional rheumatoid and degenerative arthritis centers
Authors: Han Eun Young , Kim Sang Rim , Cho Kye Hee , Im Sang Hee
Published: July 2022

Background

The geriatric population and advanced knee osteoarthritis are rapidly increasing in Korea, and the socioeconomic burden of total knee arthroplasty (TKA) is increasing. This study aimed to analyze the demographic, clinical and socioeconomic characteristics of patients who underwent TKA and to differentiate the factors affecting participation in inpatient-intensive rehabilitation programs after TKA in the Jeju regional rheumatoid and degenerative arthritis center established by the government.

Methods

This retrospective cohort study included 845 patients (735 females; 72.0 ± 5.8 years) diagnosed with primary osteoarthritis (OA) of the knee who underwent elective unilateral primary TKA between January 2013 and June 2016. Demographic, clinical, and socioeconomic characteristics, including age, body mass index, obesity, length of stay, OA severity, underlying disease, education level, occupation, and location of residence were reviewed. Patients were allocated to the TKA-only group (home discharge) and to the TKA + rehab group (participation in post-TKA rehabilitation). The variables were analyzed and compared before and after the establishment of the center and according to participation in intensive rehabilitation.

Results

Patients who underwent TKA were mostly female, in the 60 s, and had a high prevalence of comorbidities and obesity. After the rehabilitation center's establishment, the intensive post-TKA participation increased profoundly from 3% to 59.2%. Participants after the center establishment had lower mean BMI and a higher proportion of K-L grade 4 compared to those before the center establishment. The location of residence was the only factor differentiating the participation in the intensive rehabilitation.

Conclusion

The regional rheumatoid and degenerative arthritis center was appropriate to satisfy the high unmet need for participating in the intensive rehabilitation after TKA and to execute the qualified integrated post-TKA care system. Policy support should ensure the early rehabilitation and a qualified integrated care system and prepare for the increased burden of revision. Future longitudinal studies should be conducted to assess the long-term effect of the integrated post-TKA rehabilitation program on functional outcomes and patient survivorship free from revision.
Impact of the Canadian CT head rule supplemented by the original published minimum inclusion criteria to assist emergency department clinicians’ assessment of patients presenting post fall from residential aged care: a retrospective audit
Authors: Lee Charlene , Beavers Jonathan , Pham Jonathan , Hackett Liam , Miller Joseph , Buntine Paul
Published: July 2022

Background

A large number of CT brain (CTB) scans are ordered in the ED for older patients with a confirmed or possible head strike but no ongoing symptoms of a head injury. This study aimed to evaluate the effect of the Canadian CT head rule supplemented by the original published minimum inclusion criteria to assist clinician assessment of the need for CTB following minimal trauma fall in patients presenting from residential aged care facilities to a major metropolitan emergency department (ED).

Methods

This study was conducted as a pre- and post-intervention retrospective audit. The intervention involved implementation of a decision support tool to help clinicians assess patients presenting to the ED following a fall. The tool integrated the Canadian CT Head Rule (CCHR) in conjunction with a simplified set of inclusion criteria to help clinicians define a minimum threshold for a “minor head injury”. Outcome data pertaining to CT brain ordering practices and results were compared over symmetrical 3-month time periods pre- and post-intervention in 2 consecutive years.

Results

The study included 233 patients in the pre-intervention arm and 241 in the post-intervention arm. Baseline demographics and clinical characteristics were similar in both groups. There was a 20% reduction in the total number of CTB scans ordered following tool implementation, with 134 (57.0%) scans in the pre-intervention group and 90 (37.3%) in the post-intervention group (p <  0.01). The diagnostic yield in the pre- and post-intervention groups was 3.7 and 5.6% respectively (p = 0.52). No variation was observed in medical management between groups, and no patients in either group underwent neurosurgical intervention.

Conclusions

Use of the CCHR supplemented by the original published minimum inclusion criteria appeared to safely reduce the number of CTB scans performed in residential aged care facility residents presenting to an ED after a fall, with no associated adverse outcomes. A larger study across multiple centres is required to determine widespread efficacy and safety of this tool.
Association of frailty and functional recovery in an Acute Care for Elders unit: a prospective observational study
Authors: Chang Hsiao-Chen , Lu Yi-Yen , Kao Sheng-Lun
Published: July 2022

Background

Evidence on the effects of Acute Care for Elders (ACE) units in frail older adults remains limited. Therefore, we aimed to evaluate the effects of the ACE unit on functional outcomes in frail older adults.

Methods

In this prospective observational study, we enrolled 114 consecutive patients aged 65 years and older admitted to the ACE unit for acute medical conditions between October 2019 and September 2020. The FRAIL scale (5-question assessment of fatigue, resistance, aerobic capacity, illnesses, and loss of weight) was used to classify the patients into three groups: robust (score = 0, n = 28), prefrail (score = 1–2, n = 57), and frail (score = 3–5, n = 29). The primary outcome was the activities of daily living (ADL) measured by the Barthel Index at admission and before discharge. Paired sample t-test was employed to determine the difference in ADL. Multiple linear regression analysis, with adjustment for covariates, was conducted to examine the association between frailty status and change in ADL.

Results

Among 114 patients enrolled (mean age, 79.8 ± 8.1 years; mean length of stay, 6.4 ± 5.6 days), 77 (67.5%) were female. ADL at admission (60.3 ± 31.9) and before discharge (83.7 ± 21.6) were significantly different (P < 0.001). After covariates adjustment, a significant association between frailty status and change in ADL was found (prefrail vs. robust: β = 9.0, 95% confidence interval [CI] 0.3–17.6, P = 0.04; frail vs. robust: β = 13.4, 95% CI 2.7–24.0, P = 0.01).

Conclusions

Older adults with frailty experienced functional improvement after admission to the ACE unit. Prefrail and frail groups were associated with a more significant change in ADL between admission and discharge compared to the robust group.
Practices and perspectives of patients and healthcare professionals on shared decision-making in nephrology
Authors: van Dulmen Sandra , Roodbeen Ruud , Schulze Lotte , Prantl Karen , Rookmaaker Maarten , van Jaarsveld Brigit , Noordman Janneke , Abrahams Alferso
Published: July 2022

Background

Given the complexity and variety in treatment options for advanced chronic kidney disease (CKD), shared decision-making (SDM) can be a challenge. SDM is needed for making decisions that best suit patients’ needs and their medical and living situations. SDM might be experienced differently by different stakeholders. This study aimed to explore clinical practice and perspectives on SDM in nephrology from three angles: observers, patients and healthcare professionals (HCPs).

Methods

An explanatory sequential mixed methods design was used. First, in the quantitative part of the study, outpatient consultations with patients with advanced chronic kidney disease (eGFR < 20 ml/min) were video recorded and SDM was assessed using the OPTION5 instrument. Subsequently, in the qualitative part, patients and HCPs reflected on their own SDM behaviour during individual stimulated recall interviews which were analysed using deductive thematic content analysis.

Results

Twenty nine consultations were recorded and observed in seven hospitals. The mean SDM score was 51 (range 25–80), indicating that SDM was applied to a moderate extent. The stimulated recall interviews with patients showed that they rely on the information provision and opinion of HCPs, expect consistency and support, and desire a proactive role. They also expect to be questioned by the HCP about their SDM preferences. HCPs said they were willing to incorporate patients’ preferences in SDM, as long as there are no medical contraindications. They also prefer patients to take a prominent role in SDM. HCPs ascribe various roles to themselves in supporting patients’ decision-making.

Conclusions

Although SDM was applied by HCPs to a moderate extent, improvement is needed, especially in helping patients get the information they need and in making sure that every patient is involved in SDM. This is even more important given the complex nature of the disease and the relatively high prevalence of limited health literacy among patients with chronic kidney disease.
An anatomical feasibility study using CTA reconstruction for modified percutaneous lumbar vertebroplasty
Authors: Xu Jianbiao , Fan Shali , Ni Yu , Ngwayi James Reeves Mbori , Porter Daniel Edward , Guo Jun
Published: July 2022

Background

Lumbar vertebroplasty via several different types of extrapedicular approach has been reported with acceptable clinical results yet the anatomical basis for its safety is not fully explored. Injury to the lumbar arteries (LAs) is one of the most important potential complications. However, anatomical research on the course and variability of this structure is lacking. To investigate the anatomical feasibility of percutaneous vertebroplasty for lumbar osteoporotic vertebral compression fractures via a unilateral Extrapedicular approach.

Methods

A total of 300 LAs of 30 patients with non-spinal disorders were retrospectively analyzed by computed tomographic angiography (CTA). The lateral aspect of the vertebral body was divided into 9 zones of approximately equal area. The anatomy and orientation of LAs were analyzed in detail.

Results

LAs were most commonly found in the middle third of the body (zones 4, 5, and 6); the upper 1/3 of the vertebral body had LAs distributed only anteriorly and laterally (zones 1 and 2). No arteries were observed in the postero-superior segment (zone 3). From L1 to L3 an arched pattern predominated. At L4 an inferior oblique pattern (antero-superior to postero-inferior) predominated. Limited CTA visualization at L4 and particularly L5 as well as greater anatomical variation means that there is more uncertainty at these levels.

Conclusion

From L1 to L3, the posterior superior segment (zone 1) of the vertebral body appears to be a safe area with low risk of arterial injury. This has relevance for design of a safe lumbar vertebral extrapedicular approach.
A modified kidney-sparing portal vein arterialization model of heterotopic auxiliary liver transplantation increases liver IL-6, TNF-α, and HGF levels and enhances liver regeneration: an animal model
Authors: Li Jun , Ren Jianjun , Zhang JunJing , Meng Xingkai
Published: July 2022

Background and Aim

The success of partial donor liver transplantation is affected by the implantation site of the donor liver and the vascular reconstruction approach. We investigated the effects of different donor liver implantation sites and vascular reconstruction approaches on liver regeneration using a rat kidney-sparing heterotopic auxiliary liver transplantation model, with portal vein arterialization (PVA).

Methods

Sixty male Sprague–Dawley rats underwent end-to-end anastomosis of the donor liver portal vein and the right renal artery stent (control group), or end-to-side anastomosis of the donor liver portal vein and the left common iliac artery (experimental group).

Results

The experimental group had significantly lower plasma levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, and cholinesterase than the control group (all, P < 0.05). The levels of tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), and hepatocyte growth factor (HGF) in the liver were significantly higher in the experimental group than that in the control group (all, P < 0.05). Hematoxylin and eosin (HE) staining of the liver tissue specimens indicated that the experimental group had greater hepatocyte regeneration compared to the control group.

Conclusions

The modified kidney-sparing PVA model of heterotopic auxiliary liver transplantation is more conducive to liver regeneration with quicker return of liver function.
Circulating amino acids and acylcarnitines correlated with different CAC score ranges in diabetic postmenopausal women using LC–MS/MS based metabolomics approach
Authors: Hosseinkhani Shaghayegh , Salari Pooneh , Bandarian Fatemeh , Asadi Mojgan , Shirani Shapour , Najjar Niloufar , Dehghanbanadaki Hojat , Pasalar Parvin , Razi Farideh
Published: July 2022

Background

Diabetes mellitus (DM) and its cardiovascular disease (CVD) complication are among the most frequent causes of death worldwide. However, the metabolites linking up diabetes and CVD are less understood. In this study, we aimed to evaluate serum acylcarnitines and amino acids in postmenopausal women suffering from diabetes with different severity of CVD and compared them with healthy controls.

Methods

Through a cross-sectional study, samples were collected from postmenopausal women without diabetes and CVD as controls (n = 20), patients with diabetes and without CVD (n = 16), diabetes with low risk of CVD (n = 11), and diabetes with a high risk of CVD (n = 21) referred for CT angiography for any reason. Metabolites were detected by a targeted approach using LC–MS/MS and metabolic -alterations were assessed by applying multivariate statistical analysis. The diagnostic ability of discovered metabolites based on multivariate statistical analysis was evaluated by ROC curve analysis.

Results

The study included women aged from 50–80 years with 5–30 years of menopause. The relative concentration of C14:1, C14:2, C16:1, C18:1, and C18:2OH acylcarnitines decreased and C18 acylcarnitine and serine increased in diabetic patients compared to control. Besides, C16:1 and C18:2OH acylcarnitines increased in high-risk CVD diabetic patients compared to no CVD risk diabetic patients.

Conclusion

Dysregulation of serum acylcarnitines and amino acids profile correlated with different CAC score ranges in diabetic postmenopausal women. (Ethic approval No: IR.TUMS.EMRI.REC.1399.062).