bluuebunny/crossref_metadata_2025 huggingface dataset:
Occipital condyle fracture in the pediatric population: A management algorithm and systematic review
Authors: Morcos Mary M , Liu David S , Farid Alexander R , See Pokmeng , Hogue Grant D
Published: February 2024

Purpose:

This study aims to develop an accessible stepwise management algorithm for pediatric presentations of occipital condyle fractures (OCFs) based on a systematic review of the published literature regarding diagnostic evaluation, treatment, and outcomes.

Methods:

A systematic review of the literature was conducted on PubMed to locate English language studies reporting on the management of pediatric OCFs. Data extraction of clinical presentation, management strategies, imaging, and treatment outcome was performed.

Results:

A total of 15 studies reporting on 38 patients aged 18 years and younger presenting with OCFs were identified. Loss of consciousness (LOC), depressed level of consciousness, neck pain, decreased neck range of motion (ROM), and cranial nerve injury were the most common presenting symptoms. Diagnostic imaging included radiographs, computed tomography (CT) scans, magnetic resonance imaging (MRI), and functional radiographs to assess cervical stability. Treatment options varied and included soft collar, hard collar, and halo vest. All studies resulted in a complete healing of the OCF, with resolution of associated pain.

Conclusion:

The proposed treatment algorithm suggests a framework for the management of pediatric OCFs based on the available evidence (levels of evidence: 3, 4). This review of the literature indicated that a stepwise approach should be utilized in the management of isolated pediatric OCFs.
Preoperative Gallows traction as an adjunct to hip open reduction surgery: Is it safe and is it effective?
Authors: Uren Nicholas C , Judd Julia , Lindisfarne Edward A , Elliott Kirsten G , Aarvold Alexander
Published: February 2024

Background:

Traction is used at our hospital before open reduction in infants with developmental dysplasia of the hip. Theoretically, it reduces soft-tissue tension, allowing an easier surgical reduction and therefore lower surgical complications. Owing to extended hospital stays, potential complications, and lack of evidence, the use of traction has decreased. This study aims to quantify whether traction is safe and whether it has any demonstrable effect.

Methods:

The perioperative course of 80 patients undergoing preoperative traction and hip open reduction were reviewed. The height of hip dislocation was classified using the International Hip Dysplasia Institute classification system on both radiographs taken before and after traction. Any complications related to traction were recorded, along with the requirement for femoral shortening osteotomies, incidence of re-dislocation, and longer-term rate of avascular necrosis.

Results:

Traction lowered the resting position of the majority of hips, with the median International Hip Dysplasia Institute grade before traction improving from 4 to 3, a statistically significant improvement (p < 0.00001). There were no neurovascular complications. Two babies were complicated with broken skin sores; however, surgery still progressed uneventfully. Zero hips in the cohort required femoral shortening osteotomies to achieve a tension-free reduction, and the re-dislocation rate was 0%. However, 96% of hips were Severin 1 or 2 at 6-year follow-up.

Conclusion:

Notably, 1 week of preoperative traction significantly improves the resting position of the hip in high dislocations. It is safe when used in infants weighing <12 kg, and subsequent surgical outcomes are excellent, thus supporting its use ahead of developmental dysplasia of the hip open reduction surgery.

Level of evidence:

Level IV.
Consumer Click Responses to Paid Ad Set Strategies of Search Platforms
Authors: Cheng Ming , Zhu Zhen
Published: February 2024

Search platforms are contemporary digital services that create value on multi-sided markets through providing services to each side of their platforms—indexing contents for all website operators on the internet, placing pages and tracking performance for paid advertisers or sellers, and searching market offerings to match inquiries for web users. Search platforms are interested in developing strategies at the sponsored ad set level to optimize consumer clicks. Drawing literature supports from hospitality, search engine advertising, and product assortment areas, our study examines the relationships between search platforms’ paid ad strategies (in paid ad set size and set attractiveness) and consumer’s single or multiple clicks on the sponsored ad section. We empirically test the relationships in a multinomial logit modeling approach using a large-scale disaggregated, hotel-search dataset collected from a leading Chinese search engine. Our results suggest a positive but diminishing impact of paid ad set size on a consumer’s set selection and multiple click-through behavior. Our study also spotlights the distinct and often divergent moderating effects of two types of ad attractiveness, preference-based and social-based, on the relationship between paid ad set size and consumer responses. We discuss the theoretical and managerial implications of this research to search platforms and advertisers in hospitality alike.
Ewald Hering's (1879) “On Muscle Sounds of the Eye”: A translation and commentary
Authors: Strasburger Hans , Wade Nicholas J.
Published: February 2024

Investigations of eye movements were transformed by Ewald Hering in 1879. He developed a novel method for recording them using the muscular sounds attendant on their rapid movements. Brief “clapping” sounds could be heard with the aid of a device like a stethoscope placed on the eyelid and they occurred when afterimages or “floaters” were seen to move. Hering applied the technique to record eye movements during reading and he called the rapid eye movements Rucke (jerks in English). Hering published a long review of eye movements and spatial vision later in 1879, but without a description of the muscle sounds. Hering's insightful article has been overlooked and a translation of it into English is presented.
Aspergillus granulosus femoral osteomyelitis in a cardiac transplant patient: first reported case and literature review
Authors: Giacinta Alessandro , Blázquez Zorba , García Clemente Paloma , Pedraz Álvaro , Escribano Pilar , Guinea Jesús , Muñoz Patricia , Valerio Maricela
Published: February 2024

Aspergillus osteomyelitis is a rare complication of extrapulmonary invasive aspergillosis, which usually presents as spondylodiscitis. The clinical picture is usually paucisymptomatic and of long evolution, which leads to diagnostic difficulties, especially in immunosuppressed patients presenting a delayed systemic host response. We report a case of femoral osteomyelitis caused by Aspergillus granulosus in a heart transplant recipient successfully treated with a combined surgical and antifungal approach. A 65-year-old heart transplant male presented with left knee pain lasting 3 months. X-ray and magnetic resonance imaging identified a lesion with aggressive characteristics at the distal third of the left femur, due to which the patient underwent excisional surgery. Aspergillus granulosus was cultured from the removed material and antifungal treatment with oral isavuconazole was started. Chest imaging excluded pulmonary aspergillosis, while the positron emission tomography/computed tomography (PET/CT) identified a remnant of a prosthetic vascular graft sewn to the proximal third of the right axillary artery, through which a catheter-based micro-axial left ventricular assist device was implanted previously as bridge to transplant therapy. The patient presented a rapid clinical improvement with complete functional recovery following the surgical treatment and the antifungal therapy and finally underwent surgical removal of the residual vascular graft. This is the first reported episode of long bone osteomyelitis due to A. granulosus that occurred in a heart transplant recipient without pulmonary infection and was successfully treated with isavuconazole. The PET/CT was useful in supporting the diagnostic process and follow-up. Cryptic fungal species can cause invasive infections, particularly in immunocompromised patients. Molecular methods are crucial in fungal identification.
COVID-19 associated with cryptococcosis: a scoping review
Authors: Quincho-Lopez Alvaro , Poma Nuvith , José Montenegro-Idrogo Juan
Published: February 2024

Background:

There is growing evidence of fungal infections associated with COVID-19. The development of cryptococcosis in these patients has been infrequently reported. However, it can be life-threatening.

Objective:

To identify cases of COVID-19 patients who developed cryptococcosis and to compare baseline characteristics and management between those who survived and those who died.

Methods:

We conducted a scoping review using PubMed, Scopus, Web of Science, and Embase to identify studies that reported patients with COVID-19 and cryptococcosis. No language restriction was applied. Single case reports, case series, and original articles were included. It is important to note that ‘ n’ refers to the total number of individuals with the specified variable.

Results:

A total of 58 studies were included. Among these studies, 51 included individual patient data, detailing information on a total of 65 patients, whereas eight studies reported the proportion of cryptococcosis in COVID-19 patients. One study provided both individual and aggregate case information. From individual patient data, the majority were male (73.9%; n = 48) with a median age of 60 years (range: 53–70). Severe COVID-19 and multiple comorbidities, led by arterial hypertension and diabetes mellitus, were frequently reported, but few had classic immunosuppression factors. On the other hand, HIV status, either negative or positive, was reported in just over half of the patients (61.5%; n = 40). Most were admitted to the intensive care unit (ICU) (58.5%; n = 31), received mechanical ventilation (MV) (50.0%; n = 26), and developed disseminated cryptococcosis (55.4%; n = 36). Secondary infection, mainly bacterial, was reported in 19 patients (29.2%). Mortality was 47.7% ( n = 31). Of the studies that reported the proportion of cryptococcosis in COVID-19 cases, the majority were descriptive studies published as conference abstracts.

Conclusion:

Cryptococcosis in COVID-19 patients has been reported more frequently. However, it is still not as common as other fungal infections associated with COVID-19. Few patients have some classic immunosuppression factors. The factors associated with mortality were male sex, age, ICU admission, MV, secondary infections, and lymphopenia.
Does adult socioeconomic status mediate the relationship between adolescent socioeconomic status and adult quality of life?
Authors: Biderafsh Azam , Rahimi foroushani Abbas , Nedjat Saharnaz
Published: February 2024

Objective:

This study aimed to determine the association between adolescent socioeconomic status (father’s education and adolescent subjective socioeconomic status) and adult quality of life and the mediation roles of adult socioeconomic status, social capital and lifestyle (physical activity and exposure to smoke) among the “Tehran University of Medical Sciences Employees Cohort (TEC) Study” participants.

Method:

Data of 4455 participants were derived from the Tehran University of Medical Sciences Employees Cohort (TEC) Study. In this study, the World Health Organization quality of life-BREF, the World Bank’s Integrated and the International Physical Activity Questionnaire were used. Data were analyzed with structural equation modeling using SPSS Amos 24.0 program.

Results:

The mean age of the participants was 42.31 years (SD: 8.37) and most of the subjects were female (60.7%). Correlation analysis results revealed that, quality of life had a significant and positive association with adolescent subjective socioeconomic status ( r = 0.169, p < 0.01) and father’s education ( r = 0.091, p < 0.01). A mediation model testing the direct relationship between adolescent socioeconomic status and adult socioeconomic status and quality of life, showed a positive relationship between adolescent subjective socioeconomic status (β = 0.229, p < 0.001) and father’s education (β = 0.443, p < 0.001) with adult socioeconomic status. Adult socioeconomic status was positively related to quality of life (β = 0.205, p < 0.001). Adult socioeconomic status mediated the relationship between adolescent subjective socioeconomic status (β = 0.047, p < 0.01) and father’s education (β = 0.091, p < 0.01) with quality of life. While adult socioeconomic status fully mediated the relationship between the father’s education and quality of life, it partially mediated the adolescent subjective socioeconomic status-quality of life association. Other variables such as social capital and lifestyle did not have mediator role in a mediation model.

Conclusion:

This study provides the evidence for the role of adult socioeconomic status as a partial mediator between adolescent subjective socioeconomic status and quality of life. Therefore, there are several unknown mediators other than adult socioeconomic status that need to be explored in future studies.
Inattentional Insensitivity As A Predictor of Relevant Situation Awareness Questions And Irrelevant Questions
Authors: Dattel Andrew R. , Wang Hui , Chanoux Sophie , Padilla Cristhian , Jamanzi Haroon , Potdar Rochelle , Maroju Rajan , Zhang Tianxin , Amonkar Pooja
Published: February 2024

This study explored predictors of situation awareness (SA) and predictors of irrelevant information in a complex task. Thirty-one participants were tested on personality, a little-known situation awareness test, working memory, inattentional blindness (IB), and inattentional insensitivity (IIS) as predictors of situation awareness and performance in a driving simulator. The two IIS conditions were visual (IB) and tactile. Participants were paid $25 for about a 1 ½ hour commitment. During the driving simulator scenario, participants answered 10 questions (half related to the driving task and half not critical to safe driving performance). More relevant questions were answered correctly than irrelevant questions. However, few predictors were shown for SA (relevant questions), but IB, and personality variables predicted response time for irrelevant questions. Tactile IIS was found to be better for performance on one of the SA tests and resulted in fewer errors in one of the tactile IIS tasks.
The Importance of Topoi in the Business and Professional Communication Classroom
Authors: McDowell Christina L. , Holba Annette M.
Published: February 2024

This essay discusses the need and the value of explicitly integrating rhetoric within the business classroom setting; introduces basic rhetorical structures that enhance the workplace skill set; identifies the significance of topoi in the business and professional communication classroom pedagogy; and provides an example of the practical application of using topoi as a pedagogical construct in the business and professional communication classroom.
Entrepreneurship Education and its Role in Transitional Entrepreneurship as Veterans Transition From Military to Civilian Life
Authors: Tihic Mirza , Pritchard Adam J. , McKelvie Alexander , Maury Rosalinda Vasquez
Published: February 2024

Programs dedicated to entrepreneurship education of military veterans in the U.S. have expanded remarkably in the last decade. However, much remains to be discovered about the current state of the effectiveness of these programs. This empirical analysis uses the National Survey of Military-Affiliated Entrepreneurs (NSMAE) ( n = 2649) to investigate the effectiveness of entrepreneurship education and training as veterans transition from military to civilian life. This paper provides evidence that entrepreneurship education and training are significant for individuals during their transition. Our results emphasize the need for greater interdisciplinary research focusing on entrepreneurship education and transitional entrepreneurship to inform and expand theorizing and new policy development in supporting of military veterans.
The use of graphic displays and their influence on awareness and understanding of patient safety incidents: An exploratory study
Authors: Schortz Lisen , Mossop Liz , Bergström Annika , Oxtoby Catherine
Published: February 2024

Background

Medical incidents cause harm in both human and veterinary care. Repercussions are similar and reach far beyond the patient, negatively impacting the people close to the patient, healthcare professionals, and the healthcare organization. Whilst good practice is to capture events in incident reporting systems to facilitate learning, critics argue that there is too much focus on this process and too little focus on harnessing the benefits from the data. This exploratory study aimed to investigate how graphic display of data could influence awareness and understanding of patient safety risks.

Methods

A dashboard graphically displaying incident data was created and a mixed methods approach was utilized to investigate how the dashboard influenced participants awareness and understanding of incidents. Quantitative pre-intervention and post-intervention survey data was integrated with semi-structured interview data through a pillar integration process.

Results

The survey response rates were 48% ( n = 77) and 46% ( n = 74), and 12 interviews were conducted. The four pillars: Emerging enlightenment, tools, behaviours and habits, language and education were identified. There was a difference in understanding of incident data between clinically and non-clinically trained participants.

Conclusion

This novel study suggests that graphic displays of data may bring increased understanding of safety risks, trigger activity, and bridge conversations between clinically and non-clinically trained stakeholders.
Genomic mining of Vibrio parahaemolyticus highlights prevalence of antimicrobial resistance genes and new genetic markers associated with AHPND and tdh + /trh + genotypes
Authors: Vandeputte Marieke , Coppens Sieglinde , Bossier Peter , Vereecke Nick , Vanrompay Daisy
Published: February 2024

Background

Acute Hepatopancreatic Necrosis Disease (AHPND) causes significant mortality in shrimp aquaculture. The infection is primarily instigated by Vibrio parahaemolyticus (Vp) strains carrying a plasmid encoding the binary toxin PirAB. Yet, comprehension of supplementary virulence factors associated with this relatively recent disease remains limited. Furthermore, the same holds for gastroenteritis in humans caused by other Vp genotypes. Additionally, given the prevalent use of antibiotics to combat bacterial infections, it becomes imperative to illuminate the presence of antimicrobial resistance genes within these bacteria.

Results

A subsampled number of 1,036 Vp genomes was screened for the presence of antimicrobial resistance genes, revealing an average prevalence of 5 ± 2 (SD) genes. Additional phenotypic antimicrobial susceptibility testing of three Vp strains (M0904, TW01, and PV1) sequenced in this study demonstrated resistance to ampicillin by all tested strains. Additionally, Vp M0904 showed multidrug resistance (against ampicillin, tetracycline, and trimethoprim-sulfamethoxazole). With a focus on AHPND, a screening of all Vibrio spp. for the presence of pirA and/or pirB indicates an estimated prevalence of 0.6%, including four V. campbellii, four V. owensii, and a Vibrio sp. next to Vp. Their pirAB-encoding plasmids exhibited a highly conserved backbone, with variations primarily in the region of the Tn3 family transposase. Furthermore, an assessment of the subsampled Vp genomes for the presence of known virulence factors showed a correlation between the presence of the Type 3 Secretion System 2 and tdh, while the presence of the Type 6 Secretion System 1 was clade dependent. Furthermore, a genome-wide association study (GWAS) unveiled (new) genes associated with pirA, pirB, tdh, and trh genotypes. Notable associations with the pirAB genotype included outer membrane proteins, immunoglobulin-like domain containing proteins, and toxin-antitoxin systems. For the tdh + /trh + genotypes (containing tdh, trh, or both genes), associations were found with T3SS2 genes, urease-related genes and nickel-transport system genes, and genes involved in a ‘minimal’ type I-F CRISPR mechanism.

Conclusions

This study highlights the prevalence of antimicrobial resistance and virulence genes in Vp, identifying novel genetic markers associated with AHPND and tdh + /trh + genotypes. These findings contribute valuable insights into the genomic basis of these genotypes, with implications for shrimp aquaculture and food safety.
Boosting inpatient exercise after hip fracture using an alternative workforce: a mixed methods implementation evaluation
Authors: March Marie K. , Dennis Sarah M. , Caruana Sarah , Mahony Christopher , Elliott James M. , Polley Stephanie , Thomas Bijoy , Lin Charlie , Harmer Alison R.
Published: February 2024

Background

Hip fracture has a devastating impact on individuals and is an increasing burden for health systems and society. Compared to usual care, increased physiotherapy provision has demonstrated efficacy in improving patient and health service outcomes in this population. However, physiotherapy workforce challenges prevent sustained implementation.

Methods

Our aim was to evaluate the safety, feasibility, acceptability, effectiveness and implementation cost of thrice daily physiotherapy for patients in the acute care setting after hip fracture at two public hospitals. We added twice-daily exercise implemented by an alternative workforce, to usual care consisting of daily mobility practice by a physiotherapist. Sites identified their preferred alternative workforce, with pre-registration physiotherapy students and allied health assistants chosen. We used a mixed methods approach, using the Consolidated Framework for Implementation Research (CFIR) as a determinant framework to guide implementation planning and data collection. We compared hospital length of stay data to a reference cohort.

Results

We recruited 25 patients during the study period. Acute care hospital length of stay decreased from 11 days in the reference cohort to 8 days in the BOOST cohort (mean difference − 3.3 days, 95%CI -5.4 to -1.2 days, p = 0.003). Intervention fidelity was 72% indicating feasibility, no safety concerns were attributed to the intervention, and uptake was 96% of all eligible patients. The intervention was acceptable to patients, carers and healthcare providers. This intervention was cost-effective from the acute orthopaedic service perspective.

Conclusion

Higher daily frequency of physiotherapy can be safely, feasibly and effectively implemented by an alternative workforce for patients in the acute care setting following hip fracture surgery.
Optimal resource allocation model for COVID-19: a systematic review and meta-analysis
Authors: Wang Yu-Yuan , Zhang Wei-Wen , Lu Ze-xi , Sun Jia-lin , Jing Ming-xia
Published: February 2024

Background

A lack of health resources is a common problem after the outbreak of infectious diseases, and resource optimization is an important means to solve the lack of prevention and control capacity caused by resource constraints. This study systematically evaluated the similarities and differences in the application of coronavirus disease (COVID-19) resource allocation models and analyzed the effects of different optimal resource allocations on epidemic control.

Methods

A systematic literature search was conducted of CNKI, WanFang, VIP, CBD, PubMed, Web of Science, Scopus and Embase for articles published from January 1, 2019, through November 23, 2023. Two reviewers independently evaluated the quality of the included studies, extracted and cross-checked the data. Moreover, publication bias and sensitivity analysis were evaluated.

Results

A total of 22 articles were included for systematic review; in the application of optimal allocation models, 59.09% of the studies used propagation dynamics models to simulate the allocation of various resources, and some scholars also used mathematical optimization functions (36.36%) and machine learning algorithms (31.82%) to solve the problem of resource allocation; the results of the systematic review show that differential equation modeling was more considered when testing resources optimization, the optimization function or machine learning algorithm were mostly used to optimize the bed resources; the meta-analysis results showed that the epidemic trend was obviously effectively controlled through the optimal allocation of resources, and the average control efficiency was 0.38(95%CI 0.25–0.51); Subgroup analysis revealed that the average control efficiency from high to low was health specialists 0.48(95%CI 0.37–0.59), vaccines 0.47(95%CI 0.11–0.82), testing 0.38(95%CI 0.19–0.57), personal protective equipment (PPE) 0.38(95%CI 0.06–0.70), beds 0.34(95%CI 0.14–0.53), medicines and equipment for treatment 0.32(95%CI 0.12–0.51); Funnel plots and Egger’s test showed no publication bias, and sensitivity analysis suggested robust results.

Conclusion

When the data are insufficient and the simulation time is short, the researchers mostly use the constructor for research; When the data are relatively sufficient and the simulation time is long, researchers choose differential equations or machine learning algorithms for research. In addition, our study showed that control efficiency is an important indicator to evaluate the effectiveness of epidemic prevention and control. Through the optimization of medical staff and vaccine allocation, greater prevention and control effects can be achieved.
Early blood pressure lowering therapy is associated with good functional outcome in patients with intracerebral hemorrhage
Authors: Lv Xinni , Liu Xueyun , Hu Zicheng , Deng Lan , Li Zuoqiao , Cheng Jing , Pu Mingjun , Li Qi
Published: February 2024

Background

The implementation of a care bundle might improve functional outcome for patients with intracerebral hemorrhage (ICH). However, the impact of anti-hypertensive treatment on ICH outcomes remains uncertain. Our objective is to examine whether early blood pressure (BP) lowering therapy within first 12 h is associated with good outcome in ICH patients.

Methods

We included acute ICH patients who had baseline computed tomography (CT) scans within 6 h after onset of symptoms between October 2013 and December 2021. Early BP reduction was defined as use of anti-hypertensive agents within 12 h after onset of symptom. The clinical characteristics were compared between patients who received early BP lowering therapy and those without. The associations between early BP lowering and good outcome and functional independence at 3 months were assessed by using multivariable logistic regression analyses.

Results

A total of 377 patients were finally included in this study for outcome analysis. Of those, 212 patients received early BP reduction within 12 h after ICH. A total of 251 (66.6%) patients had good outcome. After adjustment for age, admission systolic BP, admission GCS score, baseline hematoma volume, hematoma expansion, and presence of intraventricular hemorrhage, early BP lowering therapy was associated with functional independence (adjusted odd ratio:1.72, 95% confidence interval:1.03–2.87; P = 0.039) and good outcome (adjusted odd ratio: 2.02, 95% confidence interval:1.08–3.76; P = 0.027).

Conclusions

In ICH patients presenting within 6 h after symptom onset, early BP reduction within first 12 h is associated with good outcome and functional independence when compared to those who do not undergo such early intervention. Implementation of quality measures to ensure early BP reduction is crucial for management of ICH.
Glycosylation-related genes mediated prognostic signature contribute to prognostic prediction and treatment options in ovarian cancer: based on bulk and single‑cell RNA sequencing data
Authors: You Yue , Yang Qing
Published: February 2024

Background

Ovarian cancer (OC) is a complex disease with significant tumor heterogeneity with the worst prognosis and highest mortality among all gynecological cancers. Glycosylation is a specific post-translational modification that plays an important role in tumor progression, immune escape and metastatic spread. The aim of this work was to identify the major glycosylation-related genes (GRGs) in OC and construct an effective GRGs signature to predict prognosis and immunotherapy.

Methods

AUCell algorithm was used to identify glycosylation-related genes (GRGs) based on the scRNA-seq and bulk RNA-seq data. An effective GRGs signature was conducted using COX and LASSO regression algorithm. The texting dataset and clinical sample data were used to assessed the accuracy of GRGs signature. We evaluated the differences in immune cell infiltration, enrichment of immune checkpoints, immunotherapy response, and gene mutation status among different risk groups. Finally, RT-qPCR, Wound-healing assay, Transwell assay were performed to verify the effect of the CYBRD1 on OC.

Results

A total of 1187 GRGs were obtained and a GRGs signature including 16 genes was established. The OC patients were divided into high- and low- risk group based on the median riskscore and the patients in high-risk group have poor outcome. We also found that the patients in low-risk group have higher immune cell infiltration, enrichment of immune checkpoints and immunotherapy response. The results of laboratory test showed that CYBRD1 can promote the invasion, and migration of OC and is closely related to the poor prognosis of OC patients.

Conclusions

Our study established a GRGs signature consisting of 16 genes based on the scRNA-seq and bulk RNA-seq data, which provides a new perspective on the prognosis prediction and treatment strategy for OC.
Knowledge about glaucoma among adults in Africa: a systematic review
Authors: Yimam Wondwossen , Anbesaw Tamrat , Seid Muhammed , Kumar Prem , Wolie Hawa
Published: February 2024

Background

Africa is one of the continents with a substantial burden of glaucoma, where it is approximately twice as common as it is worldwide. If left untreated, glaucoma can cause blindness and permanent vision loss if it is not addressed promptly. Good knowledge is essential for preventing glaucoma’s irreversible blindness and ocular damage. However, no systematic review has been done to report the pooled percentage of adults in Africa who have good knowledge about glaucoma. This study aimed to estimate the level of knowledge about glaucoma in Africa and its determinants.

Methods

The study followed the PRISMA guidelines for systematic review. Seven electronic databases which include PubMed/MEDLINE, Web of Science, PROQUEST (PQDT), CINAHL (EBSCO), Google Scholar, African Journal Online, and WHO HINARI databases were searched from January 1, 2013, to July 31, 2023for studies conducted with a focus on the knowledge about glaucoma among adults in Africa. The quality of the final articles was assessed using the Joanna Briggs Institute quality assessment tool for cross-sectional studies.

Results

In the present systematic review, 2781 articles were initially identified and evaluated. Of these, eight studies that met the inclusion criteria were included in the final analysis. In this review, the proportion of knowledge about glaucoma among adults in Africa was low. Educational status, family history of glaucoma, occupation, being a male, and having a history of eye examination were the main determinants of good knowledge about glaucoma among adults in Africa.

Conclusion

The systematic review found that only a few had good knowledge about glaucoma. Education campaigns and eye exam promotions are recommended to enhance awareness.

Trail registration

This systematic review was registered on 30/07/2023 with PROSPERO ID: CRD42023430723.
Development and validation of a prospective study to predict the risk of readmission within 365 days of respiratory failure: based on a random survival forest algorithm combined with COX regression modeling
Authors: Liu Zhongxiang , Sun Zhixiao , Hu Hang , Yin Yuan , Zuo Bingqing
Published: February 2024

Background

There is a need to develop and validate a widely applicable nomogram for predicting readmission of respiratory failure patients within 365 days.

Methods

We recruited patients with respiratory failure at the First People’s Hospital of Yancheng and the People’s Hospital of Jiangsu. We used the least absolute shrinkage and selection operator regression to select significant features for multivariate Cox proportional hazard analysis. The Random Survival Forest algorithm was employed to construct a model for the variables that obtained a coefficient of 0 following LASSO regression, and subsequently determine the prediction score. Independent risk factors and the score were used to develop a multivariate COX regression for creating the line graph. We used the Harrell concordance index to quantify the predictive accuracy and the receiver operating characteristic curve to evaluate model performance. Additionally, we used decision curve analysiso assess clinical usefulness.

Results

The LASSO regression and multivariate Cox regression were used to screen hemoglobin, diabetes and pneumonia as risk variables combined with Score to develop a column chart model. The C index is 0.927 in the development queue, 0.924 in the internal validation queue, and 0.922 in the external validation queue. At the same time, the predictive model also showed excellent calibration and higher clinical value.

Conclusions

A nomogram predicting readmission of patients with respiratory failure within 365 days based on three independent risk factors and a jointly developed random survival forest algorithm has been developed and validated. This improves the accuracy of predicting patient readmission and provides practical information for individualized treatment decisions.
Efficacy of radiotherapy in combined treatment of hepatocellular carcinoma patients with portal vein tumor thrombus: a real-world study
Authors: Xiao Ying , Li Keren , Zhao Ying , Yang Shizhong , Yan Jun , Xiang Canhong , Zeng Jianping , Lu Qian , Zhang Chen , Li Gong , Li Guangxin , Dong Jiahong
Published: February 2024

Background and aims

Hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) has an extremely poor prognosis. A previous study proved that low-dose radiotherapy (RT) could prolong the prognosis of HCC patients with PVTT. This study aims to explore the sensitivity of PVTT to RT treatment.

Methods

Patients were selected based on imaging diagnosis of HCC accompanied by PVTT and received combined treatment of radiotherapy, antiangiogenic drugs and immune checkpoint inhibitors, followed by hepatectomy or liver transplantation from January 2019 to August 2022. The efficacy was evaluated by Response Evaluation Criteria in Solid Tumors (RECIST) guidelines and pathological assessment. The sensitivity of tumor cells to the treatment was compared between the primary tumor (PT)and PVTT by analyzing their residual tumor and pathologic complete remission (PCR) incidence.

Results

Data from 14 patients were collected in the study. After combined treatment, the size of PVTT decreased more significantly than that of the primary tumor in the imaging study (p < 0.05). The residual cancer was significantly more restrictive than that of primary tumor in paired patients based on pathological measurement (p = 0.008). The PCR incidence of the primary tumor (21.42%) was significantly lower (p = 0.008) than that of PVTT in the pathologic study (78.57%).

Conclusion

PVTT is more sensitive to radiotherapy treatment than the primary tumor in patients with HCC. This combination therapy might be an effective option as a downstaging therapy for patients with HCC with PVTT.
Dietary amino acid patterns and cardiometabolic risk factors among subjects with obesity; a cross-sectional study
Authors: Abdi Fatemeh , Mohammadzadeh Milad , Abbasalizad-Farhangi Mahdieh
Published: February 2024

Background

The prevalence of obesity is a growing global public health concern. Certain dietary amino acids have been shown to have a potential therapeutic role in improving metabolic syndrome parameters and body composition in individuals with obesity. However, some amino acids have been linked to an increased risk of cardiometabolic disorders. This cross-sectional study aims to investigate the association between dietary amino acid patterns and cardiometabolic risk factors in individuals with obesity.

Methods

This cross-sectional study included 335 participants with obesity (57.9% males and 41.5% females) from Tabriz and Tehran, Iran. The participants were between the ages of 20–50, with a body mass index (BMI) of 30 kg/m2 or higher, and free from certain medical conditions. The study examined participants’ general characteristics, conducted anthropometric assessments, dietary assessments, and biochemical assessments. The study also used principal component analysis to identify amino acid intake patterns and determined the association between these patterns and cardiometabolic risk factors in individuals with obesity.

Results

Upon adjusting for potential confounders, the study found that individuals in the third tertiles of pattern 1 and 2 were more likely to have lower LDL levels (OR = 0.99 and 95% CI (0.98–0.99)) for both. Additionally, a significant decrease in total cholesterol was observed in the third tertiles of pattern 2 in model II (OR = 0.99, 95% CI (0.98–0.99)). These findings suggest a potential cardioprotective effect of these amino acid patterns in managing cardiometabolic risk factors in individuals with obesity.

Conclusions

This study found that two identified amino acid patterns were associated with lower serum LDL and total cholesterol levels, while a third pattern was associated with higher serum triglycerides. The specific amino acids contributing to these patterns highlight the importance of targeted dietary interventions in managing cardiometabolic risk factors in individuals with obesity.
Examining birth preparedness and complication readiness: a systematic review and meta-analysis of pregnant and recently delivered women in India
Authors: Singh Tanya , Tripathy Brajaraj , Pandey Anuj Kumar , Gautam Diksha , Mishra Sidharth Sekhar
Published: February 2024

Background

Birth preparedness and complication readiness (BPCR) is an essential component of safe motherhood programs. This study aims to systematically identify and synthesize available evidence on birth preparedness and complication readiness among pregnant and recently delivered women in India.

Methods

The study followed PRISMA guidelines and used databases such as PubMed, Cochrane Library, and ProQuest. Joanna Briggs Institute [JBI] Tool was used for critical appraisal of studies. The meta-analysis was conducted using Comprehensive Meta-Analysis [CMA] tool and R studio software. Statistical heterogeneity was evaluated using visual inspection of the forest plot, Cochran’s Q test, and the I2 statistic results. Funnel plot and Egger’s tests were applied to explore the possibility of the publication bias in the studies [PROSPERO: CRD42023396109].

Result

Thirty-five cross-sectional studies reported knowledge on one or more components of birth preparedness [BP], whilst knowledge on complication readiness [CR] or danger signs was reported in 34 included studies. Utilizing the random effect model, the pooled result showed that only about half of the women [49%; 95% CI: 44%, 53%] were aware on BPCR components. This result ranged between 15% [95% CI: 12%, 19%] to 79% [95% CI: 72%, 84%] in Maharashtra and Karnataka respectively [I2 = 94%, p = < 0.01]. High heterogeneity [> 90%] is observed across all components [p < 0.01]. The result of subgroup analysis indicated no significant difference in the proportion on BPCR among pregnant women [50%; 95% CI: 45%, 55%] and recently delivered women [54%; 95% CI: 46%, 62%]. However, the southern region of India indicates relatively better [56%; 95% CI: 45%, 67%] prevalence.

Conclusion

Our study highlights the low prevalence of BPCR in India and the factors associated with it. Scaling up cost-effective interventions like BPCR that have a positive overall effect is necessary. Authors strongly suggests that birth preparedness and complication readiness should be given utmost importance to reduce maternal morbidity and mortality to achieve the Sustainable Development Goals. Consideration should be given to fortifying existing resources, such as frontline workers and primary healthcare, as a strategic approach to augmenting the effectiveness of awareness initiatives.
Characterizing the limitations of using diagnosis codes in the context of machine learning for healthcare
Authors: Guo Lin Lawrence , Morse Keith E. , Aftandilian Catherine , Steinberg Ethan , Fries Jason , Posada Jose , Fleming Scott Lanyon , Lemmon Joshua , Jessa Karim , Shah Nigam , Sung Lillian
Published: February 2024

Background

Diagnostic codes are commonly used as inputs for clinical prediction models, to create labels for prediction tasks, and to identify cohorts for multicenter network studies. However, the coverage rates of diagnostic codes and their variability across institutions are underexplored. The primary objective was to describe lab- and diagnosis-based labels for 7 selected outcomes at three institutions. Secondary objectives were to describe agreement, sensitivity, and specificity of diagnosis-based labels against lab-based labels.

Methods

This study included three cohorts: SickKids from The Hospital for Sick Children, and StanfordPeds and StanfordAdults from Stanford Medicine. We included seven clinical outcomes with lab-based definitions: acute kidney injury, hyperkalemia, hypoglycemia, hyponatremia, anemia, neutropenia and thrombocytopenia. For each outcome, we created four lab-based labels (abnormal, mild, moderate and severe) based on test result and one diagnosis-based label. Proportion of admissions with a positive label were presented for each outcome stratified by cohort. Using lab-based labels as the gold standard, agreement using Cohen’s Kappa, sensitivity and specificity were calculated for each lab-based severity level.

Results

The number of admissions included were: SickKids (n = 59,298), StanfordPeds (n = 24,639) and StanfordAdults (n = 159,985). The proportion of admissions with a positive diagnosis-based label was significantly higher for StanfordPeds compared to SickKids across all outcomes, with odds ratio (99.9% confidence interval) for abnormal diagnosis-based label ranging from 2.2 (1.7–2.7) for neutropenia to 18.4 (10.1–33.4) for hyperkalemia. Lab-based labels were more similar by institution. When using lab-based labels as the gold standard, Cohen’s Kappa and sensitivity were lower at SickKids for all severity levels compared to StanfordPeds.

Conclusions

Across multiple outcomes, diagnosis codes were consistently different between the two pediatric institutions. This difference was not explained by differences in test results. These results may have implications for machine learning model development and deployment.
A human stomach cell type transcriptome atlas
Authors: Öling S. , Struck E. , Noreen-Thorsen M. , Zwahlen M. , von Feilitzen K. , Odeberg J. , Pontén F. , Lindskog C. , Uhlén M. , Dusart P. , Butler L. M.
Published: February 2024

Background

The identification of cell type-specific genes and their modification under different conditions is central to our understanding of human health and disease. The stomach, a hollow organ in the upper gastrointestinal tract, provides an acidic environment that contributes to microbial defence and facilitates the activity of secreted digestive enzymes to process food and nutrients into chyme. In contrast to other sections of the gastrointestinal tract, detailed descriptions of cell type gene enrichment profiles in the stomach are absent from the major single-cell sequencing-based atlases.

Results

Here, we use an integrative correlation analysis method to predict human stomach cell type transcriptome signatures using unfractionated stomach RNAseq data from 359 individuals. We profile parietal, chief, gastric mucous, gastric enteroendocrine, mitotic, endothelial, fibroblast, macrophage, neutrophil, T-cell, and plasma cells, identifying over 1600 cell type-enriched genes.

Conclusions

We uncover the cell type expression profile of several non-coding genes strongly associated with the progression of gastric cancer and, using a sex-based subset analysis, uncover a panel of male-only chief cell-enriched genes. This study provides a roadmap to further understand human stomach biology.
#Fail: the quality and accuracy of nutrition-related information by influential Australian Instagram accounts
Authors: Denniss Emily , Lindberg Rebecca , Marchese Laura E. , McNaughton Sarah A.
Published: February 2024

Background

Social media is a popular source of information about food and nutrition. There is a high degree of inaccurate and poor-quality nutrition-related information present online. The aim of this study was to evaluate the quality and accuracy of nutrition-related information posted by popular Australian Instagram accounts and examine trends in quality and accuracy based on author, topic, post engagement, account verification and number of followers.

Methods

A sample of posts by Australian Instagram accounts with ≥ 100,000 followers who primarily posted about nutrition was collected between September 2020 and September 2021. Posts containing nutrition-related information were evaluated to determine the quality and accuracy of the information. Quality was assessed using the Principles for Health-Related Information on Social Media tool and accuracy was assessed against information contained in the Australian Dietary Guidelines, Practice-based Evidence in Nutrition database, Nutrient Reference Values and Metafact.

Results

A total of 676 posts were evaluated for quality and 510 posts for accuracy, originating from 47 Instagram accounts. Overall, 34.8% of posts were classified as being of poor quality, 59.2% mediocre, 6.1% good and no posts were of excellent quality. A total of 44.7% of posts contained inaccuracies. Posts authored by nutritionists or dietitians were associated with higher quality scores (β, 17.8, CI 13.94–21.65; P < 0.001) and higher accuracy scores (OR 4.69, CI 1.81–12.14, P = 0.001) compared to brands and other accounts. Information about supplements was of lower accuracy (OR 0.23, CI 0.10–0.51, P < 0.001) compared to information about weight loss and other nutrition topics. Engagement tended to be higher for posts of lower quality (β -0.59, P = 0.012), as did engagement rate (β -0.57, P = 0.016). There was no relationship between followers or account verification and information quality or accuracy and no relationship between engagement and accuracy.

Conclusions

Nutrition-related information published by influential Australian Instagram accounts is often inaccurate and of suboptimal quality. Information about supplements and posts by brand accounts is of the lowest quality and accuracy and information posted by nutritionists and dietitians is of a higher standard. Instagram users are at risk of being misinformed when engaging with Australian Instagram content for information about nutrition.