bluuebunny/crossref_metadata_2025 huggingface dataset:
Notions About Men and Masculinities Among Health Care Professionals Working With Men’s Sexual Health: A Focus Group Study
Authors: Persson Tommy , Löve Jesper , Tengelin Ellinor , Hensing Gunnel
Published: June 2022

Health care professionals’ (HCPs) notions about gender may influence the provision and quality of care. If care-seeking men are met by HCPs holding idealized and stereotypical notions of masculinity, this could reinforce barriers to adequate care. This study explored notions about men and masculinities among HCPs working with men’s sexual health in Sweden. Focus group interviews with 35 HCPs from primary health and sexual health clinics were analyzed using qualitative content analysis. The analysis resulted in three descriptive themes: (a) Contradictory masculinity—elusive but clear. Notions of masculinity as a phenomenon or concept were elusive, but masculine and un-masculine traits, behaviors, and qualities were clear. (b) Sexual health care is a social place where men and masculinities can be challenging. Male patients were associated with unwanted sexual tensions. Masculinity could challenge professionality. Seeking sexual health care was perceived as doing un-masculinity. (c) Regarding masculinity as irrelevant—a difficult ambition to achieve. Participants strived for gender-neutrality by regarding patients as humans, individuals, or patients rather than as men and masculine. The analysis also identified a theme of meaning: Notions of masculinity are situated relationally. HCPs situate masculinity in real and hypothetical relationships. Romantic and sexual preferences were used to define preferred masculinity. This study identified themes that showed how HCPs balanced professional and private notions of men and masculinity in their patient encounters. Increased gender awareness and training are needed to professionalize the management of gendered notions in encounters with men who seek care for sexual health problems.
Evaluating the level of patient satisfaction with telehealth antenatal care during the COVID-19 pandemic at King Abdul-Aziz Medical City, Primary Health Care Center, Specialized Polyclinic
Authors: Wali Razaz , Alhakami Amani , Alsafari Nada
Published: June 2022

Aim:

To evaluate the client satisfaction with a phone-based antenatal care consultation and identify the associated factors during the COVID-19 pandemic at King Abdul-Aziz Medical City, Primary Health Care Center Specialized Polyclinic during 2020.

Method:

The study was a cross-sectional, retrospective study conducted with pregnant women attending the maternity clinic at the Specialized Polyclinic, Primary Health Care Center at King Abdul-Aziz Medical City, Jeddah. A self-administered questionnaire was sent via a text message (short message service) to collect the data after signed written consent.

Result:

Of 279 pregnant women, 262 (93.9%) attended phone clinic appointments one to five times. The total satisfaction level score was 73.4 ± 6.5, indicating a high level of satisfaction with the phone clinics, and 252 (90.3%) reported a high level of satisfaction. There was a significant difference in the total score regarding education, occupation, husband’s occupation, smoking, gravidity, parity, menstruation, gestational age, pregnancy complication, number of phone clinics during pregnancy, number of attending clinics during pregnancy, visiting another health facility, and reason of visiting phone clinic ( p < 0.0001, p < 0.0001, p < 0.0001, p = 0.015, p = 0.033, p < 0.0001, p < 0.0001, p = 0.027, p = 0.001, p < 0.0001, and p = 0.002).

Conclusion:

The study indicated a high level of satisfaction with the antenatal telephone clinics during the pandemic, which supports the trend of transition in the direction of the digitalization of antenatal care.
Seating in Doctors’ Waiting Rooms: Has COVID-19 Changed Our Choices?
Authors: Devlin Ann Sloan
Published: June 2022

Objective:

This study investigates preference for five different seating arrangements (e.g., rows, clusters) in a doctor’s office waiting room, whether these reduce stress and improve judgments of medical care, and how such choices may have changed over the pandemic (2013 vs. 2021).

Background:

What is called the doctor’s office layout, with chairs lining the perimeter of the waiting room, is criticized by designers, yet little empirical evidence exists to support that assessment.

Method:

Data collected in 2013 and 2021 used sketches of five different seating arrangements; people saw just one of these. The study examined the effect of time and seating arrangement on anxiety, need for privacy, situational awareness, evaluation of the environment, and perception of the doctor.

Results:

There was no significant impact of the seating arrangement on any of the dependent variables, but ratings were higher for situational awareness, need for privacy, evaluation of the environment, and aspects related to the physician in 2021. In addition, seating preferences favored end, not middle seats, and chair selections with the chair back to a wall.

Conclusion:

In this study, no evidence exists that the doctor’s office layout is less preferred than four other seating arrangements, but seat choice shows people prefer end seats (not middle seats) across arrangements. The doctor’s office layout may offer a supportive familiarity to people; also, given the percentage of people who visit the doctor unaccompanied, layouts designed to encourage social interaction may not always be appropriate.
Can occipital lobe bending, Gibraltar sign of superior sagittal sinus groove and jugular foramen dimensions predict transverse sinus dominance?
Authors: Indiran Venkatraman , Sivakumar Vadivalagianambi , Kumaran R , Jagannathan Kokilavani
Published: June 2022

Background

Asymmetry between the transverse sinuses (TS) is quite common. We sought to test the possible hypothesis that certain anatomical features – namely, occipital lobe bending, Gibraltar sign of superior sagittal sinus groove (SSS) and jugular foramen (JF) dimensions – can predict dominance of the transverse sinuses on routine axial T1- and T2-weighted images.

Materials and methods

One hundred consecutively acquired combined MRI-MRV studies of brain were reviewed. On non-contrast axial T1WI, each reviewer assessed the occipital lobe bending, and Gibraltar sign of SSS groove; on axial T2-weighted images, JF dimensions were measured. TS cross-sectional area was measured on non-contrast sagittal 2-dimensional phase contrast MRV images and served as the reference standard.

Results

Of the 51 subjects with right-dominant TS, 37 had occipital bending to the right side and 35 showed sloping of the Gibraltar sign to right side. Of the 18 subjects with left dominant TS, 10 had occipital bending to left side and 13 showed left-sided sloping of the Gibraltar sign. Of the 31 subjects with co-dominant TS, 15 had no occipital bending and 20 showed no sloping of the Gibraltar sign. Mean right and left JF dimensions were higher in the right and left dominant TS respectively with no significant differences in patients with co-dominant sinus ( p < 0.02).

Conclusion

Right occipital bending had a good association with right TS dominance. The other two parameters- Gibraltar sign of superior sagittal sinus groove and jugular foramen dimensions – did not have a very good association with respect to TS dominance.
Planting flags in water
Authors: Koch Natalie
Published: June 2022

In this commentary, I respond to James Riding and Carl Dahlman's article, ‘Montage space: borderlands, micronations, terra nullius, and the imperialism of the geographical imagination’. I build on their arguments about ‘more-than-dry landscapes’ to consider how the relationship between fluid and non-fluid landscapes sheds light on the construction and contestation of political space. To do so, I offer additional examples of how people plant flags in water, shedding light on the political implications of how physical territories are imagined, claimed, and sometimes, simply created at the fluid/non-fluid interface.
Male sex rather than socioeconomic vulnerability as a determinant for COVID-19 death in Sao Paulo: A population-based study
Authors: Hallak Jorge , Teixeira Thiago A , Barrozo Ligia V , Singer Júlio , Kallas Esper G , Saldiva Paulo HN
Published: June 2022

Objectives:

To determine the role of the male sex as a risk factor for coronavirus disease deaths in Sao Paulo and to what extent socioeconomic vulnerability and individual health issues can interfere in such risk.

Methods:

The primary cause of death, age, sex, comorbidities, and code of the Human Development Units of the residence of 37,583 individuals in Sao Paulo, Brazil, were obtained from the records on confirmed coronavirus disease resident hospitalizations of the city of Sao Paulo from the National Influenza Surveillance Information System. A social vulnerability index was assigned to each Human Development Unit. Using “death” as the outcome variable and sex, admission to the intensive care unit, obesity, renal and heart diseases, diabetes, and social vulnerability as confounders, the odds of death for males and females were compared via logistic regression.

Results:

The odds of death for males were 1.242 (confidence interval 95% = 1.237, 1.247) times the corresponding odds for females with the same values for all confounders. We estimated the odds of death for patients living in regions with high social vulnerability as 2.243 (CI 95% = 2.151, 2.339) times the corresponding odds of patients living in regions with very low social vulnerability with the same values of the remaining variables.

Conclusion:

The male:female death ratio by severe acute respiratory syndrome coronavirus 2 infection in Sao Paulo cannot be attributed only to comorbidities or social vulnerabilities. Our results suggest that the male sex is an independent biological risk factor for coronavirus disease death. Besides sex-specific factors, further research should focus on crucial biological factors in male sex coronavirus disease mortality.
From Disembedding to Digital Re-Embedding: Social Media Empowerment and Solidarity Practices of Chinese Truck Drivers
Authors: Liu Nan , Wang Rui
Published: June 2022

In China, truck drivers in the logistics industry have used social media to form various networked organizations for mutual assistance and protection of rights and interests. This study examines the organizational practices of Chinese truck drivers on social media (i.e., WeChat and Douyin). Using online communities, Chinese truck drivers have constructed a new type of solidarity that includes virtual and practical dimensions. Social media empowerment has expanded the social capital of truck drivers, promoting social integration and resource redistribution. This online self-organization provides a reference for collaborative governance among self-employed workers who want to promote professional solidarity. However, our findings also indicate that combating the exploitation of digital labor on capital platforms is fundamentally difficult for organized labor groups.
Verification of a Sense of Community Scale for Hospitals in Japan
Authors: Goto Ryohei , Haruta Junji , Ozone Sachiko
Published: June 2022

Introduction/Objectives:

We aimed to verify whether a sense of community scale developed for hospital wards can be applied to hospitals.

Methods:

A cross-sectional study was conducted using a self-administered questionnaire between July and October 2018 in 3 hospitals in Japan. The subjects were staff members working in these hospitals who provide direct medical or administrative services to patients and their families. The questionnaire inquired about the participants’ basic attributes and workplace satisfaction, and included the sense of community scale and the Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II. We evaluated the scale’s structural validity, internal consistency, and hypothesis testing for construct validity.

Results:

Of 826 eligible staff members, 539 were included in the analysis. Mean age was 40.4 years and 77.4% were female. Exploratory factor analysis showed that 24 of the 28 items in the sense of community scale could be categorized under 3 factors. Confirmatory factor analysis demonstrated a goodness of fit index of 0.794, adjusted goodness of fit index of 0.752, comparative fit index of 0.885 and root mean square error of approximation of 0.092. Cronbach’s α for score in the sense of community scale was high (.96). Participants who reported high workplace satisfaction had significantly higher scores in the sense of community scale than those who indicated low workplace satisfaction ( P < .001).

Conclusions:

We verified the reliability and validity of the Japanese version of the sense of community scale, which was originally developed for hospital wards, for the community in hospitals. With further verification, we hope the scale will be useful for evaluating the sense of community in hospitals.
Invasive Lipoma of the Interventricular Septum, a Rare Benign Cardiac Mass With Atypical Presentation and Management
Authors: Nepal Subash , Deshmane Swati-Banait , Donovan Kathleen , May Adriana , Chaudhuri Debanik
Published: June 2022

Lipoma of the interventricular septum involving the tricuspid valve is a rare entity. A 50-year-old woman presented with exertional dyspnea. She was found to have a large right interventricular septal mass in the initial transthoracic echocardiography. This mass was further investigated by transesophageal echocardiography, cardiac gated CT, and cardiac magnetic resonance imaging. It was found to be lipomatous and embedded into the septal leaflet of the tricuspid valve. The diagnosis was confirmed by biopsy. Surgical exploration revealed that the mass was deeply embedded in the interventricular septum and septal leaflet of the tricuspid valve. The mass was resected along with sections of the interventricular septum and tricuspid valve. She underwent bioprosthetic tricuspid valve placement and patch reconstruction of the interventricular septum. We also searched case reports from MEDLINE and studied pathological and epidemiological characteristics of the published cases of cardiac masses in the past year. Cardiac lipoma although a benign tumor can cause serious hemodynamic complications. Initial transthoracic echocardiography followed by multimodality imaging is the cornerstone of the diagnosis.
Shortening the Return-to-Play Times in Elite Athletes With Unstable Isolated Lisfranc Ligament Injuries Using a Knotless Interosseous Suture Button: Case Series and Literature Review
Authors: Sullivan Martin , Peckston Dane , Alpuerto Bernardino
Published: June 2022

Background:

Isolated unstable Lisfranc ligament injuries in elite athletes are associated with a lengthy period of rehabilitation and prolonged absence from competition.

Purpose:

To assess the efficacy of a knotless, interosseous suture button system for repairing isolated unstable ligamentous Lisfranc injuries and its capacity to allow accelerated rehabilitation with earlier weightbearing and return-to-play times in elite athletes.

Study Design:

Case series; Level of evidence, 4.

Methods:

The authors retrospectively reviewed data from a prospectively compiled database for elite athletes treated by a single surgeon. All included patients had clinical and magnetic resonance imaging evidence of an unstable isolated complete ligamentous Lisfranc injury requiring surgical reduction and stabilization. All patients underwent surgery using a knotless interosseous suture button to achieve stabilization, followed by a standardized postoperative regimen involving full weightbearing at 4 weeks, and all had a minimum postoperative follow-up of 2 years.

Results:

Included were 12 patients: 7 National Rugby League (NRL) players, 2 professional dancers, 1 Olympic gymnast, 1 professional wakeboarder, and 1 professional NRL referee. The mean age of the patients was 21.1 years (range, 16-34 years). Ten patients underwent acute surgical stabilization within 3 weeks of the injury, and 2 patients sustained chronic isolated Lisfranc instability that was initially treated nonoperatively. All athletes were able to return to full weightbearing by 4 weeks postoperatively, successfully returned to training by 9 to 12 weeks, and returned to full competition by 12 to 16 weeks. No major complications were reported.

Conclusion:

Knotless interosseous suture button stabilization was a reliable treatment option for both acute and chronic isolated ligamentous Lisfranc injuries in these elite athletes. This technique does not require hardware removal, allows early weightbearing with accelerated rehabilitation, and may shorten the return-to-play interval.
Comparison of the Therapeutic Effects Between Isokinetic and Isotonic Strength Training in Patients After Total Knee Replacement: A Prospective, Randomized Controlled Trial
Authors: Cheng Yuan-Yang , Liu Chuan-Ching , Lin Shih-Yi , Lee Cheng-Hung , Chang Shin-Tsu , Wang Shun-Ping
Published: June 2022

Background:

Rebuilding the strength of the quadriceps as soon as possible after total knee replacement (TKR) is important so as to restore gait stability. To date, there are no standard postoperative strength training programs during the early recovery stage after TKR.

Purpose:

To compare the therapeutic effects between isokinetic and isotonic strengthening in patients after TKR.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

From April 2018 to August 2020, 37 patients met the inclusion criteria and were randomly assigned to perform either 4-week isokinetic or isotonic strength training programs. Other components of the rehabilitation program were kept the same between the 2 groups. All cases were evaluated by the Timed Up and Go (TUG) test, peak torque of knee extension and flexion (60 and 120 deg/s), 36-item Short Form Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis Index (WOMAC).

Results:

After undergoing a 4-week strength training regimen, significant improvements in the TUG test were noted in both groups; however, the time improvement in the isotonic group did not reach the minimal detectable change. All peak torque measurements improved in the isokinetic group but not in the isotonic group for knee flexion at 60 deg/s. The pain subdomain, physical domain, mental domain, total SF-36 score, and WOMAC index all improved significantly in both groups after training. Both training groups improved significantly in peak torque of knee strength, TUG test, and functional scores, but the differences between isokinetic and isotonic training were not statistically significant.

Conclusion:

The study findings showed that a 4-week strengthening exercise program in the early postoperative stage, involving either isokinetic or isotonic training, resulted in significant improvements in patients undergoing TKR.

Registration:

NCT02938416 ( ClinicalTrials.gov identifier).
Be in the Digital Room Where it Happens, Part I: Tweeting & Technology for Career Development
Authors: Martindale Jaclyn M. , Goldstein Jessica , Xixis Kathryn , Lakhotia Arpita , Rodman Adam , Strauss Lauren D. , Strowd Roy E. , Bass Nancy
Published: June 2022

Social media has become a part of everyday life. It has changed the way we obtain and distribute information, connect, and interact with others. As the number of platforms and users grow, medical professionals have learned the value social media can have in education, research, advocacy, and clinical care initiatives. Platforms provide opportunities to network, build collaborations, and develop a reputation. This is part one of a two-part series. This article provides an overview on how social media can benefit professional career development for clinicians and researchers, as well as for advocacy to raise awareness against biases, disparities, and for patient benefit. We review challenges, limitations, and best practices for social media use by medical professionals with neurology-specific examples.
Variations in the Clinical Anatomy of the Femoral and Popliteal Vessels
Authors: Kalinin Roman E. , Suchkov Igor A. , Shanaev Ivan N. , Mzhavanadze Nina D. , Klimentova Emma A.
Published: June 2022

Objective:

The aim of this study was to assess the topography of the femoral and popliteal vessels focusing mainly on the venous variants, in patients with chronic venous disease (CVD).

Materials and Methods:

Duplex ultrasonography (DUS) was performed on 200 patients with varicose veins (VVs) and 253 patients with postthrombotic syndrome (PTS). In addition, an anatomical dissection was performed on 30 amputated lower extremities, without signs of CVD.

Results:

Duplication of the femoral vein (FV) was found in 14% of patients with VVs. Multiple FV trunks were identified in 42% of patients with PTS. One patient had a developmental anomaly with a hypoplastic FV and dilated deep FV. Two trunks of the popliteal vein (PV) below the knee level were detected in 83.3% of cases during anatomical dissection, in 87.5% of cases in patients with VVs, and in 90.1% of cases in PTS subjects during DUS. In 98.2% of cases, popliteal artery (PA) had a typical bifurcation. One patient was presented with a duplication of PA above the level of the knee. In 1.8% of cases, the PA was divided into an anterior tibial and peroneal artery.

Conclusion:

This study found variant anatomy in the FV and PV, which is frequent, with major changes occurring in patients with PTS. Variant anatomy of the PA was also found and is considered uncommon, occurring in less than 2% of cases.
The Relationship Between Cognitive Variables for Academic and Clinical Success After the Completion of One Year of Courses for Diagnostic Medical Sonography and Radiography Students
Authors: Miller Elena
Published: June 2022

Objective:

Most health care programs have competitive entry and selective admission procedures. The purpose of this study was to investigate the relationship between cognitive variables such as the Test of Essential Academic Skills (TEAS) composite scores, the preprogram academic grade point average (GPA), as well as clinical GPA for diagnostic medical sonography (DMS) or radiography (RT) students.

Materials and Methods:

The participants of this study were 26 imaging students. The convenient sample included 10 DMS and 16 RT students, enrolled in an Associate Degree in Applied Sciences program, within a community college. The student’s program success was examined over a period of one academic year.

Results:

The analysis of the findings determined that a significant relationship existed between some of the cognitive variables such as the TEAS composite scores, academics, as well as the clinical success for the DMS students. However, these RT students did not show the same outcome. In addition, there was no significant relationship between preprogram GPA and academic as well as clinical success, for either educational program.

Conclusion:

The results of this study provide empirical evidence that a strong relationship may exist between the TEAS composite scores, academics, as well as clinical success for the DMS students. This is an important finding that may support the use of the TEAS test, as part of the admission process, for other DMS programs.
Lung function in young adulthood: differences between males and females with asthma
Authors: Mogensen Ida , Hallberg Jenny , Palmberg Lena , Ekström Sandra , Georgelis Antonios , Melén Erik , Bergström Anna , Kull Inger
Published: June 2022

Background

There are phenotypic differences in asthma in males and females. Differences in lung function between the sexes at the peak lung function level in young adulthood are so far not directly addressed. The aim of the present study was to assess lung function in early adulthood in males and females depending on asthma onset and remission.

Methods

Participants were included from the population-based birth cohort BAMSE and classified as having: never asthma, childhood asthma in remission, adolescent onset asthma or persistent asthma. Pre- and post-bronchodilator lung function (in Z-score) and lung clearance index (LCI) were measured at age 24 years. Lung function was compared stratified for sex between the never asthma and asthma groups univariately and in multiple linear regression analyses adjusted for maternal and paternal asthma, maternal smoking during pregnancy, secondary smoking, daily smoking, early respiratory syncytial virus infection, traffic pollution, childhood allergic sensitisation, and body mass index at age 24 years.

Results

All asthma phenotypes were associated with a lower forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) post-bronchodilation at 24 years. This was most pronounced in males with persistent asthma compared to males with never asthma (regression coefficient: −0.503; 95% CI: −0.708– −0.298). Childhood asthma (in remission or persistent) was associated with a lower FEV1. After adjustment, the associations remained significant for males. For females, the significant associations with lower FEV1and FEV1/FVC remained only for subjects with asthma in remission. Persistent asthma was associated with higher LCI in females.

Conclusions

In females, in contrast to males, the association between asthma and lower lung function was attenuated after adjustment for known risk factors.
Acute effects of fine particulate matter (PM2.5) on hospital admissions for cardiovascular diseases in Lanzhou, China: a time-series study
Authors: Wu Tingting , Yang Xinyi , Chu Aiai , Xie Xinling , Bai Ming , Peng Yu , Zhang Zheng
Published: June 2022

Background

Up until now, evidence pertaining to the short-term effects of fine particulate matter (PM2.5) in cardiovascular diseases (CVD) is scarce in China. In this study, we aim to estimate the association between short-term exposure to PM2.5 and hospitalizations for total and cause-specific CVD in Lanzhou of China.

Methods

Daily counts of cardiovascular admissions were obtained from three large general hospitals in Lanzhou, China between 2014 and 2019. Air quality and meteorological data were obtained from the monitoring stations nearest to the admitting hospitals. We utilized Quasi-Poisson time-series regressions with distributed lag nonlinear models (DLNM) to assess the association between PM2.5 and CVD admitted in the three general hospitals. A stratified analysis was also conducted for age, sex, and disease subcategories.

Results

PM2.5 was positively correlated with daily admissions for total or other cause-specific CVD under different lag patterns. For every 10 μg/m3 increase in the PM2.5 concentration, the relative risk of daily admissions for total CVD, ischemic heart disease (IHD), heart rhythm disturbances (HRD), heart failure (HF), and cerebrovascular disease (CD) was: 1.011 [95% confidence interval (CI), 1.001–1.020] in lag01; 1.020 (95% CI 1.004–1.036) in lag07; 1.013 (95% CI 1.001–1.026) in lag7; 1.018 (95% CI 1.005–1.038) in lag1; and 1.007 (95% CI 1.001–1.018) in lag1. Both low and high temperatures increased the risk of cardiovascular hospitalization. No differences were found after stratification by gender and age. We found an almost linear relationship between the exposure to PM2.5 and cause-specific CVD admissions with no threshold effect. Males as well as the elderly, aged ≥ 65 years, were more vulnerable to PM 2.5 exposure.

Conclusions

Our results have demonstrated that PM2.5 has adverse impacts on cardiovascular hospitalizations in Lanzhou, especially on IHD.
The time cost of saving money: detouring and connecting time losses in the virtually interlined European airport network
Authors: Meire Sarah , Derudder Ben
Published: June 2022

Virtual interlining, the use of actively marketed self-connecting flight itineraries, is often assumed to be a money-saving air travel strategy. Earlier research on this topic broadly confirmed the money-saving character of virtual interlining, but to date non-monetary costs associated with this price advantage have not yet been systematically examined. In this paper, we address this lacuna by juxtaposing the price advantage of virtual interlining with the potential time costs for the case of indirect flight itineraries in the European airport network. Focusing on those markets where the cheapest virtually interlined itinerary renders a price advantage over its indirect traditional counterpart, we analyse the time cost from two complementary perspectives: (1) connecting time and (2) detour factor. To this end, we query Kiwi.com’s Tequila platform to obtain data on all available flight itineraries in the first week of August, October and December 2019. Based on a series of sign tests, we reveal the time costs of saving money: while virtually interlined itineraries render a price advantage compared to their indirect traditional counterparts, they come with a significantly larger connecting time and detour factor. We reflect on possible explanations, and highlight a number of avenues for future research.
Super-taxon in human microbiome are identified to be associated with colorectal cancer
Authors: Dai Wei , Li Cai , Li Ting , Hu Jianchang , Zhang Heping
Published: June 2022

Background

Microbial communities in the human body, also known as human microbiota, impact human health, such as colorectal cancer (CRC). However, the different roles that microbial communities play in healthy and disease hosts remain largely unknown. The microbial communities are typically recorded through the taxa counts of operational taxonomic units (OTUs). The sparsity and high correlations among OTUs pose major challenges for understanding the microbiota-disease relation. Furthermore, the taxa data are structured in the sense that OTUs are related evolutionarily by a hierarchical structure.

Results

In this study, we borrow the idea of super-variant from statistical genetics, and propose a new concept called super-taxon to exploit hierarchical structure of taxa for microbiome studies, which is essentially a combination of taxonomic units. Specifically, we model a genus which consists of a set of OTUs at low hierarchy and is designed to reflect both marginal and joint effects of OTUs associated with the risk of CRC to address these issues. We first demonstrate the power of super-taxon in detecting highly correlated OTUs. Then, we identify CRC-associated OTUs in two publicly available datasets via a discovery-validation procedure. Specifically, four species of two genera are found to be associated with CRC: Parvimonas micra, Parvimonas sp., Peptostreptococcus stomatis, and Peptostreptococcus anaerobius. More importantly, for the first time, we report the joint effect of Parvimonas micra and Parvimonas sp. (p = 0.0084) as well as that of Peptostrepto-coccus stomatis and Peptostreptococcus anaerobius (p = 8.21e-06) on CRC. The proposed approach provides a novel and useful tool for identifying disease-related microbes by taking the hierarchical structure of taxa into account and further sheds new lights on their potential joint effects as a community in disease development.

Conclusions

Our work shows that proposed approaches are effective to study the microbiota-disease relation taking into account for the sparsity, hierarchical and correlated structure among microbes.
Predicting miRNA-disease associations based on graph attention network with multi-source information
Authors: Li Guanghui , Fang Tao , Zhang Yuejin , Liang Cheng , Xiao Qiu , Luo Jiawei
Published: June 2022

Background

There is a growing body of evidence from biological experiments suggesting that microRNAs (miRNAs) play a significant regulatory role in both diverse cellular activities and pathological processes. Exploring miRNA-disease associations not only can decipher pathogenic mechanisms but also provide treatment solutions for diseases. As it is inefficient to identify undiscovered relationships between diseases and miRNAs using biotechnology, an explosion of computational methods have been advanced. However, the prediction accuracy of existing models is hampered by the sparsity of known association network and single-category feature, which is hard to model the complicated relationships between diseases and miRNAs.

Results

In this study, we advance a new computational framework (GATMDA) to discover unknown miRNA-disease associations based on graph attention network with multi-source information, which effectively fuses linear and non-linear features. In our method, the linear features of diseases and miRNAs are constructed by disease-lncRNA correlation profiles and miRNA-lncRNA correlation profiles, respectively. Then, the graph attention network is employed to extract the non-linear features of diseases and miRNAs by aggregating information of each neighbor with different weights. Finally, the random forest algorithm is applied to infer the disease-miRNA correlation pairs through fusing linear and non-linear features of diseases and miRNAs. As a result, GATMDA achieves impressive performance: an average AUC of 0.9566 with five-fold cross validation, which is superior to other previous models. In addition, case studies conducted on breast cancer, colon cancer and lymphoma indicate that 50, 50 and 48 out of the top fifty prioritized candidates are verified by biological experiments.

Conclusions

The extensive experimental results justify the accuracy and utility of GATMDA and we could anticipate that it may regard as a utility tool for identifying unobserved disease-miRNA relationships.
Ultrasound-guided peripheral nerve blocks for preoperative pain management in hip fractures: a systematic review
Authors: Exsteen Oskar Wilborg , Svendsen Christine Nygaard , Rothe Christian , Lange Kai Henrik Wiborg , Lundstrøm Lars Hyldborg
Published: June 2022

Systematic reviews associate peripheral nerve blocks based on anatomic landmarks or nerve stimulation with reduced pain and need for systemic analgesia in hip fracture patients. We aimed to investigate the effect of ultrasound-guided nerve blocks compared to conventional analgesia for preoperative pain management in hip fractures. Five databases were searched until June 2021 to identify randomised controlled trials. Two independent authors extracted data and assessed risk of bias. Data was pooled for meta-analysis and quality of evidence was evaluated using Grades of Recommendation Assessment, Development and Evaluation (GRADE). We included 12 trials (976 participants) comparing ultrasound-guided nerve blocks to conventional systemic analgesia. In favour of ultrasound, pain measured closest to two hours after block placement decreased with a mean difference of -2.26 (VAS 0 to 10); (p < 0.001) 95% CI [–2.97 to –1.55]. In favour of ultrasound, preoperative analgesic usage of iv. morphine equivalents in milligram decreased with a mean difference of –5.34 (p=0.003) 95% CI [–8.11 to –2.58]. Time from admission until surgery ranged from six hours to more than three days. Further, ultrasound-guided nerve blocks may be associated with a lower frequency of delirium: risk ratio 0.6 (p = 0.03) 95% CI [0.38 to 0.94], fewer serious adverse events: risk ratio 0.33 (p = 0.006) 95% CI [0.15 to 0.73] and higher patient satisfaction: mean difference 25.9 (VAS 0 to 100) (p < 0.001) 95% CI [19.74 to 32.07]. However, the quality of evidence was judged low or very low. In conclusion, despite low quality of evidence, ultrasound-guided blocks were associated with benefits compared to conventional systemic analgesia.
Validation of the new ABC score for predicting 30-day mortality in gastrointestinal bleeding
Authors: Saade Marie Christelle , Kerbage Anthony , Jabak Suha , Makki Maha , Barada Kassem , Shaib Yasser
Published: June 2022

Background/Aim

The ABC score is a new pre-endoscopic scoring system that was recently developed to accurately predict one-month mortality in upper and lower gastrointestinal bleeding (GIB). We aim to validate this new score on a cohort of Lebanese patients treated in a tertiary care center and to compare it to currently existing scores.

Methods

Adult patients admitted to the American University of Beirut Medical Center (AUBMC) with overt GIB between January 2013 and August 2020 were included. The area under receiver operating characteristic (AUROC) curves of the ABC score in predicting 30-day mortality was calculated using the SPSS software. Other optimal existing scores for predicting mortality (the Oakland score for lower GIB, the AIMS-65 and the Rockall scores for upper GIB)s were also assessed and compared to the ABC score.

Results

A total of 310 patients were included in our study. For upper GIB, the ABC score showed good performance in predicting 30-day mortality (AUROC: 0.79), outperforming both the AIMS-65 score (AUROC 0.67, p < 0.001) and the Rockall score (AUROC: 0.62, p < 0.001). For lower GIB, the ABC score also had good performance which was comparable to the Oakland score (AUROC: 0.70 vs 0.56, p = 0.26).

Conclusion

In our cohort of patients, the ABC score demonstrated good performance in predicting 30-day mortality for patients with upper and lower GIB compared to other established risk scores, which may help guide management decisions. This simple and novel score provides valuable prognostic information for patients presenting with GIB and appears to be reproducible in different patient populations.
Pancreatic involvement in Erdheim-Chester disease: a case report and review of the literature
Authors: Dai Jia-wen , He Tian-hua , Duan Ming-hui , Li Yue , Cao Xin-xin
Published: June 2022

Background

Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis characterized by infiltration of lipid-laden foamy macrophages within different tissues. Clinical manifestations of ECD are highly heterogeneous. Bone lesions are found in 80%-95% of patients, while extraosseous lesions usually involve the cardiovascular system, retroperitoneum, central nervous system (CNS), and skin. Pancreatic involvement in ECD has barely been reported.

Case presentation

A 29-year-old female initially presented with menoxenia, diabetes insipidus and diabetes mellitus. 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG-PET/CT) revealed hypermetabolic foci in the bilateral frontal lobe, saddle area, and pancreas. A 99mTc-MDP bone scrintigraphy scan revealed symmetrical increased uptake in distal femoral and proximal tibial metaphysis, which was confirmed to be osteosclerosis by high-resolution peripheral quantitative computed tomography. The patient underwent incomplete resection of the sellar mass. Histological examination of biopsies showed histiocytic aggregates, which were positive for S100 and negative for CD1a and CD207 on immunohistochemistry. Enhanced abdominal CT scan showed hypointense nodules within the body and tail of the pancreas. Endoscopic ultrasonography guided fine-needle aspiration (EUS-FNA) found no evidence of malignancy. She was diagnosed with ECD and treated with high-dose IFN-α. Repeated examinations at three-and eight-months post treatment revealed markedly reduction of both intracranial and pancreatic lesions.

Conclusions

ECD is a rare histiocytic neoplasm that can involve almost every organ, whereas pancreatic involvement has barely been reported to date. Here, we present the rare case of pancreatic lesions in ECD that responded well to interferon-α. We further reviewed reports of pancreatic involvement in histiocytic disorders and concluded the characteristics of such lesions to help diagnosis and treatment, in which these lesions mimicked pancreatic adenocarcinoma and caused unnecessary invasive surgeries.
Sibling cases of gross hematuria and newly diagnosed IgA nephropathy following SARS-CoV-2 vaccination
Authors: Uchiyama Yuri , Fukasawa Hirotaka , Ishino Yuri , Nakagami Daisuke , Kaneko Mai , Yasuda Hideo , Furuya Ryuichi
Published: June 2022

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has become a major part of the strategy to reduce Coronavirus disease 2019 (COVID-19) numbers worldwide. To date, vaccinations based on several mechanisms have been used clinically, although relapse of existent glomerulonephritis presenting as gross hematuria, and occurrence of de novo glomerulonephritis have been reported.

Case presentation

We report the first sibling cases newly diagnosed as immunoglobulin A (IgA) nephropathy after the second dose of SARS-CoV-2 vaccination. 15- and 18-year-old men presented with gross hematuria following the second dose of SARS-CoV-2 vaccine (Pfizer, BNT162b2) received on the same day. Pathological findings of each kidney biopsy specimen were consistent with IgA nephropathy. Gross hematuria in both cases spontaneously recovered within several days.

Conclusions

These cases indicate that SARS-CoV-2 vaccination might trigger de novo IgA nephropathy or stimulate its relapse, and also highlight the necessity of understanding the immunological responses to the novel mRNA vaccines in patients with kidney diseases.
The rate, cost and outcomes of parathyroidectomy in the united states dialysis population from 2016–2018
Authors: Danese Mark D , Fox Kathleen M , Duryea Jennifer L. , Desai Pooja , Rubin Robert J
Published: June 2022

Background

In end-stage kidney disease, patients may undergo parathyroidectomy if secondary hyperparathyroidism cannot be managed medically. This study was designed to estimate the parathyroidectomy rate in the United States (US) and to quantify changes in costs and other outcomes after parathyroidectomy.

Methods

This was a retrospective observational cohort study using US Renal Data System data for 2015–2018. Parathyroidectomy rates were estimated for adult hemodialysis and peritoneal dialysis patients alive at the beginning of 2016, 2017, and 2018 who were followed for a year or until parathyroidectomy, death, or transplant. Incremental differences in economic and clinical outcomes were compared before and after parathyroidectomy in adult hemodialysis and peritoneal dialysis patients who received a parathyroidectomy in 2016 and 2017.

Results

The rate of parathyroidectomy per 1,000
person-years decreased from 6.5 (95% CI 6.2-6.8) in 2016 to 5.3 (95% CI
5.0-5.6) in 2018. The incremental
increase in 12-month cost after versus before parathyroidectomy was $25,314
(95% CI $23,777-$27,078). By the second
month after parathyroidectomy, 58% of patients had a corrected calcium level
< 8.5 mg/dL. In the year after
parathyroidectomy (versus before), hospitalizations increased by 1.4 per
person-year (95% CI 1.3-1.5), hospital days increased by 12.1 per person-year
(95% CI 11.2-13.0), dialysis visits decreased by 5.2 per person-year (95% CI
4.4-5.9), and office visits declined by 1.3 per person-year (95% CI
1.0-1.5). The incremental rate per 1,000
person years for hematoma/bleed was 224.4 (95% CI 152.5-303.1), for vocal cord
paralysis was 124.6 (95% CI 59.1-232.1), and for seroma was 27.4 (95% CI
0.4-59.0).

Conclusions

Parathyroidectomy was a relatively uncommon event in the hemodialysis and peritoneal dialysis populations. The incremental cost of parathyroidectomy was mostly attributable to the cost of the parathyroidectomy hospitalization. Hypocalcemia occurred in over half of patients, and calcium and phosphate levels were reduced. Clinicians, payers, and patients should understand the potential clinical and economic outcomes when considering parathyroidectomy.
Recognition of freezing of gait in Parkinson’s disease based on combined wearable sensors
Authors: Ren Kang , Chen Zhonglue , Ling Yun , Zhao Jin
Published: June 2022

Freezing of gait is a common gait disorder among patients with advanced Parkinson’s disease and is associated with falls. This paper designed the relevant experimental procedures to obtain FoG signals from PD patients. Accelerometers, gyroscopes, and force sensing resistor sensors were placed on the lower body of patients. On this basis, the research on the optimal feature extraction method, sensor configuration, and feature quantity selection in the FoG detection process is carried out. Thirteen typical features consisting of time domain, frequency domain and statistical features were extracted from the sensor signals. Firstly, we used the analysis of variance (ANOVA) to select features through comparing the effectiveness of two feature selection methods. Secondly, we evaluated the detection effects with different combinations of sensors to get the best sensors configuration. Finally, we selected the optimal features to construct FoG recognition model based on random forest. After comprehensive consideration of factors such as detection performance, cost, and actual deployment requirements, the 35 features obtained from the left shank gyro and accelerometer, and 78.39% sensitivity, 91.66% specificity, 88.09% accuracy, 77.58% precision and 77.98% f-score were achieved. This objective FoG recognition method has high recognition accuracy, which will be helpful for early FoG symptoms screening and treatment.
Anti-lipolysis-stimulated lipoprotein receptor monoclonal antibody as a novel therapeutic agent for endometrial cancer
Authors: Nagase Yoshikazu , Hiramatsu Kosuke , Funauchi Masashi , Shiomi Mayu , Masuda Tatsuo , Kakuda Mamoru , Nakagawa Satoshi , Miyoshi Ai , Matsuzaki Shinya , Kobayashi Eiji , Kimura Toshihiro , Serada Satoshi , Ueda Yutaka , Naka Tetsuji , Kimura Tadashi
Published: June 2022

Background

Endometrial cancer (EC) is a common gynecologic malignancy and patients with advanced and recurrent EC have a poor prognosis. Although chemotherapy is administered for those patients, the efficacy of current chemotherapy is limited. Therefore, it is necessary to develop novel therapeutic agents for EC. In this study, we focused on lipolysis-stimulated lipoprotein receptor (LSR), a membrane protein highly expressed in EC cells, and developed a chimeric chicken–mouse anti-LSR monoclonal antibody (mAb). This study investigated the antitumor effect of an anti-LSR mAb and the function of LSR in EC.

Methods

We examined the expression of LSR in 228 patients with EC using immunohistochemistry and divided them into two groups: high-LSR (n = 153) and low-LSR groups (n = 75). We developed a novel anti-LSR mAb and assessed its antitumor activity in an EC cell xenograft mouse model. Pathway enrichment analysis was performed using protein expression data of EC samples. LSR-knockdown EC cell lines (HEC1 and HEC116) were generated by transfected with small interfering RNA and used for assays in vitro.

Results

High expression of LSR was associated with poor overall survival (hazard ratio: 3.53, 95% confidence interval: 1.35–9.24, p = 0.01), advanced stage disease (p = 0.045), deep myometrial invasion (p = 0.045), and distant metastasis (p < 0.01). In EC with deep myometrial invasion, matrix metalloproteinase (MMP) 2 was highly expressed along with LSR. Anti-LSR mAb significantly inhibited the tumor growth in EC cell xenograft mouse model (tumor volume, 407.1 mm3versus 726.3 mm3, p = 0.019). Pathway enrichment analysis identified the mitogen-activated protein kinase (MAPK) pathway as a signaling pathway associated with LSR expression. Anti-LSR mAb suppressed the activity of MAPK in vivo. In vitro assays using EC cell lines demonstrated that LSR regulated cell proliferation, invasion, and migration through MAPK signaling, particularly MEK/ERK signaling and membrane-type 1 MMP (MT1-MMP) and MMP2. Moreover, ERK1/2-knockdown suppressed cell proliferation, invasion, migration, and the expression of MT1-MMP and MMP2.

Conclusions

Our results suggest that LSR contributes to tumor growth, invasion, metastasis, and poor prognosis of EC through MAPK signaling. Anti-LSR mAb is a potential therapeutic agent for EC.