bluuebunny/crossref_metadata_2025 huggingface dataset:
Right-Wing Populism and the European Parliament’s Agonistic Politics
Authors: Guisan Catherine
Published: February 2022

How is it that the European Parliament (EP), the only directly elected institution of the European Union (EU), has both empowered right-wing populist politicians in the UK and France, and helped challenge the right-wing populist governments of Hungary and Poland? Part of the response lies in institutional rules shaping the EP’s elections and its authority, which this article discusses critically. The paradoxical impact of the EP on European right-wing populism leads to another question: Should the EP privilege the rights of right-wing populist and anti-system actors; or, to the contrary, should it “protect democracy against democracy”? This article draws from political theorist Chantal Mouffe’s agonistic politics to assess comparatively the measures the EP majority has taken to limit the influence of right-wing populists within the chamber and beyond in EU member states. It critiques the exclusionary cordon sanitaire within, and conditionality and the “judicialization of conflicts” without, which the EP discusses passionately also.
The Cypriot Peasant Revolt of 1426
Authors: Kyriacou Chrysovalantis
Published: February 2022

The Cypriot Peasant Revolt of 1426 represents a unique expression of peasant resistance during the period of Frankish rule in Cyprus. The island’s Mamluk invasion in 1426 was followed by the defeat and capture of King Janus of Lusignan at the Battle of Khirokitia and the subsequent sack of Nicosia; upon the Muslim withdrawal, the peasants took up arms against the Frankish nobility, establishing their own hierarchy and proclaiming a peasant king: Alexis the serf. Based on the little information we possess on the event, this paper attempts to understand the nature of the revolt by transcending the methodological dichotomy of pure ethnic/national vs. pure class/social conflict.
From the ‘New Party’ to the Party of Nuovismo: The Decline of the Political and Institutional Culture of Italian Communists
Authors: Prospero Michele , Marchianò Francesco
Published: February 2022

This article uses a comparative framework to study the two party models that characterised the early years of the Italian Communist Party and its dissolution: the ‘New Party’ outlined by Palmiro Togliatti and the ‘nuovismo’ introduced in the 1980s by the post-’68 leadership. The analysis focuses on the aspects of political culture, the idea of party organisation, the role of the party within the democratic system, the concept of democracy in the Italian political system, and the role of the party leadership. This analysis brings to light the great foresight of Togliatti, in addition to the constructive role entrusted to the party within the democratic system and the destructive role of later leaders of the party, which resulted in a broader collapse of the Italian political system and the total marginalisation of the heirs of Gramsci.
Gramsci after the ‘Unforgettable ’56’
Authors: Dettori Giulia
Published: February 2022

The aim of this paper is to analyse the rediscovery of two Gramscian themes from 1956: Factory Councils and Americanism and Fordism (1949). It explains their importance, not only in allowing us to better understand the changes taking place at that time, but also in outlining a new conception of Marxism, one that was different from the historicism of Palmiro Togliatti (1893–1964). In particular, the paper focuses on Raniero Panzieri (1921–64) whose theoretical and political research closely resembled that of Antonio Gramsci (1891–1937).
Words for Being and Acting: The pci and Its History
Authors: Tronti Mario
Published: February 2022

Starting from a personal intellectual and political militant position in the Italian Communist Party (pci), this contribution addresses some of the criticisms of the pci on the occasion of the 100th anniversary of its founding. The text offers an insight into the relationship between the party, its political strategy and the action of each communist militant. It stresses the relevance of the language developed within the pci and its importance as a direct expression of a way of being, thinking, communicating and acting as a ‘communist’, as well as the need to return to the revolutionary passion that was masterfully expressed in the young Gramsci’s writing style and form of thought.
The gdpr’s Application and Supervisory Authorities’ Remit on National Parliaments’ Data Processing in Parliamentary Core Activities
Authors: König Sarah
Published: February 2022

Since the entry into force of the gdpr, national Parliaments within the EU have adopted varying legal opinions on its material scope of application and, inter alia, (national) data protection authorities’ supervisory jurisdiction concerning data processing in parliamentary core areas. This article summarizes the findings of a European Centre for Parliamentary Research and Documentation (ecprd) network survey conducted in early 2021 – that is, after the cjeu’s decision Land Hessen of 9 July 2020, C-272/19. It shows that the judgement had an ambiguous effect on parliaments’ legal viewpoints and briefly points out key issues influencing the minority opinion – amongst them the Austrian Parliament’s position – that parliamentary core activities’ data processing is exempted from the gdpr’s scope of application.
Optimizing Automated Kriging to Improve Spatial Interpolation of Monthly Rainfall over Complex Terrain
Authors: Lucas Matthew P. , Longman Ryan J. , Giambelluca Thomas W. , Frazier Abby G. , Mclean Jared , Cleveland Sean B. , Huang Yu-Fen , Lee Jonghyun
Published: February 2022

Gridded monthly rainfall estimates can be used for a number of research applications, including hydrologic modeling and weather forecasting. Automated interpolation algorithms, such as the “autoKrige” function in R, can produce gridded rainfall estimates that validate well but produce unrealistic spatial patterns. In this work, an optimized geostatistical kriging approach is used to interpolate relative rainfall anomalies, which are then combined with long-term means to develop the gridded estimates. The optimization consists of the following: 1) determining the most appropriate offset (constant) to use when log-transforming data; 2) eliminating poor quality data prior to interpolation; 3) detecting erroneous maps using a machine learning algorithm; and 4) selecting the most appropriate parameterization scheme for fitting the model used in the interpolation. Results of this effort include a 30-yr (1990–2019), high-resolution (250-m) gridded monthly rainfall time series for the state of Hawai‘i. Leave-one-out cross validation (LOOCV) is performed using an extensive network of 622 observation stations. LOOCV results are in good agreement with observations (R2 = 0.78; MAE = 55 mm month−1; 1.4%); however, predictions can underestimate high rainfall observations (bias = 34 mm month−1; −1%) due to a well-known smoothing effect that occurs with kriging. This research highlights the fact that validation statistics should not be the sole source of error assessment and that default parameterizations for automated interpolation may need to be modified to produce realistic gridded rainfall surfaces. Data products can be accessed through the Hawai‘i Data Climate Portal (HCDP; http://www.hawaii.edu/climate-data-portal).

Significance Statement

A new method is developed to map rainfall in Hawai‘i using an optimized geostatistical kriging approach. A machine learning technique is used to detect erroneous rainfall maps and several conditions are implemented to select the optimal parameterization scheme for fitting the model used in the kriging interpolation. A key finding is that optimization of the interpolation approach is necessary because maps may validate well but have unrealistic spatial patterns. This approach demonstrates how, with a moderate amount of data, a low-level machine learning algorithm can be trained to evaluate and classify an unrealistic map output.
Association of Arterial Metabolic Content with Cerebral Blood Flow Regulation and Cerebral Energy Metabolism–A Multimodality Analysis in Aneurysmal Subarachnoid Hemorrhage
Authors: Svedung Wettervik Teodor , Hånell Anders , Howells Timothy , Ronne-Engström Elisabeth , Enblad Per , Lewén Anders
Published: February 2022

Background

In this study, the association of the arterial content of oxygen, carbon dioxide, glucose, and lactate with cerebral pressure reactivity, energy metabolism and clinical outcome after aneurysmal subarachnoid hemorrhage (aSAH) was investigated.

Methods

In this retrospective study, 60 patients with aSAH, treated at the neurointensive care (NIC), Uppsala University Hospital, Sweden, between 2016 and 2021 with arterial blood gas (ABG), intracranial pressure, and cerebral microdialysis (MD) monitoring were included. The first 10 days were divided into an early phase (day 1 to 3) and a vasospasm phase (day 4 to 10).

Results

Higher arterial lactate was independently associated with higher/worse pressure reactivity index (PRx) in the early phase (β = 0.32, P = .02), whereas higher pO2 had the opposite association in the vasospasm phase (β = −0.30, P = .04). Arterial glucose and pCO2 were not associated with PRx. Higher arterial lactate (β = 0.29, P = .05) was independently associated with higher MD-glucose in the vasospasm phase, whereas higher pO2 had the opposite association in the vasospasm phase (β = −0.33, P = .03). Arterial glucose and pCO2 were not associated with MD-glucose. Higher pCO2 in the early phase, lower arterial glucose in both phases, and lower arterial lactate in the vasospasm phase were associated ( P < .05) with better clinical outcome.

Conclusions

Arterial variables associated with more vasoconstriction (higher pO2 and lower arterial lactate) were associated with better cerebral pressure reactivity, but worse energy metabolism. In severe aSAH, when cerebral large-vessel vasospasm with exhausted distal vasodilation is common, more vasoconstriction could increase distal vasodilatory reserve and pressure reactivity, but also reduce cerebral blood flow and metabolic supply. The MD may be useful to monitor the net effects on cerebral metabolism in PRx-targeted NIC.
Nanoscale Drug Delivery Systems in Glioblastoma
Authors: Liu Zihao , Ji Xiaoshuai , He Dong , Zhang Rui , Liu Qian , Xin Tao
Published: February 2022

Glioblastoma is the most aggressive cerebral tumor in adults. However, the current pharmaceuticals in GBM treatment are mainly restricted to few chemotherapeutic drugs and have limited efficacy. Therefore, various nanoscale biomaterials that possess distinct structure and unique property were constructed as vehicles to precisely deliver molecules with potential therapeutic effect. In this review, nanoparticle drug delivery systems including CNTs, GBNs, C-dots, MOFs, Liposomes, MSNs, GNPs, PMs, Dendrimers and Nanogel were exemplified. The advantages and disadvantages of these nanoparticles in GBM treatment were illustrated.
For patients with non-obstructive azoospermia, the outcome of testicular sperm extraction correlates with self-esteem, sexual health and the quality of the couple’s relationship
Authors: BENDAYAN Marion , SAIS Emine , ALTER Laura , FATHALLAH Khadija , JAOUL Monique , BOSSET Pierre Olivier , ROBIN Geoffroy , BOITRELLE Florence
Published: February 2022

Background

A very small number of studies have indicated that azoospermia or negative testicular sperm extraction (TESE) outcomes are linked to depression or erectile dysfunction. However, the data are often weak, conflicting and gathered with non-validated questionnaires. Hence, we performed a cross-sectional study of 44 men with non-obstructive azoospermia. Levels of self-esteem and the quality of the couple’s sex life and overall relationship were assessed with validated questionnaires before and after the TESE procedure as a function of the TESE outcome.

Results

A positive TESE outcome (n = 24) was associated with a statistically significant increase in self-esteem (particularly with regard to family aspects), sexual health and couples’ adjustment quality. In contrast, a negative TESE outcome (n = 20) was associated with statistically significant decreases in self-esteem, erectile function, intercourse satisfaction, orgasmic function, couples’ adjustment quality and all aspects of the couple’s relationship (consensus, cohesion, satisfaction and affection).

Conclusion

For men with non-obstructive azoospermia (NOA), negative TESE outcomes may have a negative impact on self-esteem and the quality of the couple’s sex life and overall relationship. This should be borne in mind when counselling men with NOA and their partners to (ideally) help them to cope with and decrease the harmful impacts of azoospermia and negative TESE.
Comparison of propofol-nalbuphine and propofol-fentanyl sedation for patients undergoing endoscopic retrograde cholangiopancreatography: a double-blind, randomized controlled trial
Authors: Wang Peiqi , Chen Yan , Guo Ying , Cao Jiangbei , Wang Hong , Mi Weidong , Xu Longhe
Published: February 2022

Background

Endoscopic retrograde cholangiopancreatography (ERCP) has been increasingly used to treat patients with biliary/pancreatic duct obstruction or stricture outside the operating room. Effective and safe sedation techniques are needed because of painful stimuli and the long duration of the ERCP procedure.Nalbuphine has been shown to cause less respiratory depression during sedation than similar cases without nalbuphine. This study compared the effects of propofol-nalbuphine (PN) and propofol-fentanyl (PF) sedation in patients undergoing ERCP.

Methods

Four hundred patients scheduled for ERCP procedures were divided into two groups: the PF group (receiving PF sedation,n = 199) and the PN group (receiving PN sedation,n = 201). Vital signs, adverse events during surgery, patient movement scores, pain scores, and adverse events one day post-ERCP were recorded.

Results

Stable haemodynamics were observed in both groups.Compared to the PF group, the PN group showed significantly decreased respiratory depression (P < 0.0001) and surgical interruptions (P = 0.048).Nalbuphine decreased patient movement by reducing pain from ERCP.

Conclusion

Nalbuphine, instead of fentanyl, precipitated less respiratory depression while permitting adequate/equivalent sedation for ERCP and therefore provides more efficient and safer sedation.

Trial registration

ChiCTR, ChiCTR1800016018, Registered 7 May 2018, http://www.chictr.org.cn/showproj.aspx?proj=27085
Echocardiographic left ventricular hypertrophy and geometry in Chinese chronic hemodialysis patients: the prevalence and determinants
Authors: Zhao Xinju , Zhu Li , Jin Wenying , Yang Bing , Wang Yan , Ni Mengfan , Zhao Yuchao , Gan Liangying , Zuo Li
Published: February 2022

Background

To investigate the prevalence of left ventricular hypertrophy (LVH) and explore left ventricular geometry in maintenance hemodialysis (MHD) patients, and to explore the risk factors of LVH which is an important predictor of cardiovascular events.

Methods

The subjects were patients who are on MHD for more than 3 months in Peking University People's Hospital from March 2015 to February 2017. Demographic and clinical data were retrospectively collected. Left ventricular mass was measured by echocardiography. LVH is defined by Left ventricular mass index (LVMI) > 115 g/m2 for men and > 95 g/m2 in women. LVMI and relative wall thickness were used to determine left ventricular geometry. Logistic regression was used to analyze the risk factors of LVH.

Results

Altogether, 131 patients including 77 males were enrolled. The median age was 60 (47, 69) years, with a median dialysis vintage of 48 (18, 104) months. There were 80 patients with LVH, the prevalence rate was 61.1%, and 66.3% of them were moderate to severe LVH. We found that (1) most of the patients were concentric hypertrophy; (2) one-third of the patients were concentric remodeling; (3) only 4 cases with normal geometry. The pre-dialysis serum sodium level and time average pre-dialysis systolic blood pressure (SBP) were independent risk factors of LVH.

Conclusion

LVH is prevalent in MHD patients. Concentric hypertrophy and concentric remodeling are the most common geometric patterns. Attention should be paid to long-term pre-dialysis SBP management and pre-dialysis sodium control as they might be potentially modifiable risk factors for LVH.
Sex inequality in under-five deaths and associated factors in low and middle-income countries: a Fairlie decomposition analysis
Authors: Fagbamigbe Adeniyi Francis , Morakinyo Oyewale Mayowa , Balogun Folusho Mubowale
Published: February 2022

Background

There exist sex disparities in the burden of Under-five deaths (U5D) with a higher prevalence among male children. Factors explaining this inequality remain unexplored in Low-and Medium-Income Countries (LMIC). This study quantified the contributions of the individual- and neighborhood-level factors to sex inequalities in U5D in LMIC.

Methods

Demographic and Health Survey datasets (2010-2018) of 856,987 under-five children nested in 66,495 neighborhoods across 59 LMIC were analyzed. The outcome variable was U5D. The main group variable was the sex of the child while individual-level and neighborhood-level factors were the explanatory variables. Fairlie decomposition analysis was used to quantify the contributions of explanatory factors to the male-female inequalities in U5D at p<0.05.

Results

Overall weighted prevalence of U5D was 51/1000 children, 55 among males and 48 among females (p<0.001). Higher prevalence of U5D was recorded among male children in all countries except Liberia, Kyrgyz Republic, Bangladesh, Nepal, Armenia, Turkey and Papua New Guinea. Pro-female inequality was however not significant in any country. Of the 59 countries, 25 had statistically significant pro-male inequality. Different factors contributed to the sex inequality in U5D in different countries including birth order, birth weight, birth interval and multiple births.

Conclusions

There were sex inequalities in the U5D in LMIC with prominent pro-male-inequality in many countries. Interventions targeted towards the improvement of the health system that will, in turn, prevent preterm delivery and improve management of prematurity and early childhood infection (which are selective threats to the male child survival) are urgently required to address this inequality.
Efficacy and safety evaluation of black ginseng (Panax ginseng C.A. Mey.) extract (CJ EnerG): broad spectrum cytotoxic activity in human cancer cell lines and 28-day repeated oral toxicity study in Sprague-Dawley rats
Authors: Park Jin-Sung , Kim Seung-Hyun , Han Kang-Min , Kim Yun-Soon , Kwon Euna , Paek Se-Hee , Seo Yong-Ki , Yun Jun-Won , Kang Byeong-Cheol
Published: February 2022

Background

Ginseng (Panax ginseng C.A. Mey.) has been used as a valuable ingredient in traditional medicine for thousands of years mostly in Asian countries due to its therapeutic effects in various diseases. Among the processed ginseng products, black ginseng is produced by a repeated steaming and drying process of ginseng roots and has been known for its superior efficacy based on high accumulation of minor ginsenosides as recently discovered. Despite its popularity and increasing use, the toxicity information on black ginseng still remained largely lacking, raising safety concerns. This study was therefore carried out to determine the repeated oral toxicity of black ginseng extract (BGE; CJ EnerG) with evaluation of cytotoxic activity as validation of its pharmacological activity for toxicity testing.

Methods

Prior to the toxicity test, we examined the cytotoxicity of BGE in six cancer cell lines derived from distinct human tissues in comparison with red ginseng extract (RGE), ginsenosides Rg5 and 20(S)-Rg3, and then assessed 28-day repeated oral toxicity in Sprague-Dawley (SD) rats using daily administration of up to 2000 mg/kg BGE.

Results

BGE showed higher cytotoxicity than RGE in all the cell lines used in this study. Interestingly, the efficacy of BGE closely resembled the cytotoxic pattern of Rg5, suggesting Rg5 as the main effector in the cytotoxic activity of BGE. During the toxicity study, BGE-treated groups showed no noticeable abnormality in clinical signs, body weight gain, food and water consumption and urinalysis. Furthermore, hematological, serum biochemical and histopathological analyses did not find any BGE-related toxicity.

Conclusion

Our findings demonstrated that BGE has broad-spectrum in vitro cytotoxic activity, and that NOAEL of BGE in SD rats is > 2000 mg/kg, providing the essential safety information for human consumption.
Tollip interaction with STAT3: a novel mechanism to regulate human airway epithelial responses to type 2 cytokines
Authors: Schaunaman Niccolette , Dimasuay Kris Genelyn , Kraft Monica , Chu Hong Wei
Published: February 2022

Background

Toll-interacting protein (Tollip) is one of the key negative regulators in host innate immunity. Genetic variation of Tollip has been associated with less Tollip expression and poor lung function in asthmatic patients, but little is known about the role of Tollip in human airway type 2 inflammatory response, a prominent feature in allergic asthma.

Objective

Our goal was to determine the role and underlying mechanisms of Tollip in human airway epithelial responses such as eotaxin to type 2 cytokine IL-13.

Methods

Tollip deficient primary human airway epithelial cells from 4 healthy donors were generated by the gene knockdown approach and stimulated with IL-13 to measure activation of transcription factor STAT3, and eotaxin-3, an eosinophilic chemokine.

Results

Following IL-13 treatment, Tollip deficient cells had significantly higher levels of STAT3 activation and eotaxin-3 than the scrambled control counterpart, which was reduced by a STAT3 inhibitor. Interaction between Tollip and STAT3 proteins was identified by co-immunoprecipitation.

Conclusion

Our results, for the first time, suggest that Tollip inhibits excessive eotaxin-3 induction by IL-13, in part through the interaction and inhibition of STAT3. These findings lend evidence to the potential of a STAT3 inhibitor as a therapeutic target, especially for type 2 inflammation-high asthmatics with Tollip deficiency.
Robotic total gastrectomy with thrombectomy and portal vein reconstruction for gastric cancer and portal vein tumor thrombus
Authors: Yamamoto Masaaki , Omori Takeshi , Shinno Naoki , Hara Hisashi , Mukai Yosuke , Sugase Takahito , Takeoka Tomohira , Asukai Kei , Kanemura Takashi , Nakai Nozomu , Hasegawa Shinichiro , Sugimura Keijiro , Akita Hirofumi , Haraguchi Naotsugu , Nishimura Junichi , Wada Hiroshi , Takahashi Hidenori , Matsuda Chu , Yasui Masayoshi , Miyata Hiroshi , Ohue Masayuki
Published: February 2022

Background

Gastric cancer with portal vein tumor thrombus (PVTT) is poor prognosis, and the treatment remains challenging. Regarding surgery, there are only reports of highly invasive laparotomy. We report some techniques of the completely robotic total gastrectomy with thrombectomy and portal vein reconstruction for the patient with gastric cancer and PVTT for the first time.

Case presentation

A 79-year-old man was diagnosed with a 5-cm gastric cancer on the side of the lesser curvature from the middle of the gastric body to the cardia. Computed tomography revealed a massive PVTT extending from the left gastric vein to the portal trunk (28 x 16 mm). There were no other distant metastases. After 3 cycles of the chemotherapy, the PVTT shrank to 19 x 12 mm. After obtaining informed consent from the patient, robotic total gastrectomy with regional lymphadenectomy and thrombectomy were performed. We used the da Vinci Xi Surgical System. A 3-cm incision was made at the umbilicus, and a wound retractor was placed. Five additional ports were placed. The right side suprapancreatic lymph nodes were performed at the time of the thrombectomy. It was important to identify the precise extent of the PVTT with intraoperative ultrasonography before the thrombectomy. After PVTT identification, the portal trunk was clamped above and below the tumor thrombus with vascular clips. The membrane on the anterior wall of the portal trunk around the PVTT was carefully incised with da Vinci Scissors. The tumor thrombus was completely enucleated without separation. The incised part of the portal trunk was reconstructed with continuous 5-0 synthetic monofilament nonabsorbable polypropylene sutures. After removing the vascular clamps, we made sure there was no leakage from the portal vein and no tumor thrombus remnants with intraoperative ultrasonography. Robotic total gastrectomy with lymphadenectomy and Roux-en-Y reconstruction were performed. The patient was discharged without complications. The patient has remained alive for 30 months after surgery.

Conclusions

Robotic total gastrectomy with thrombectomy and portal vein reconstruction is a safe, minimally invasive, and precise surgery. It may contribute to improved prognosis of gastric cancer with PVTT when combined with chemotherapy.
Magnitude and determinants of male partner involvement in PMTCT service utilization of pregnant women attending public health facilities of Ethiopia, 2021: a systematic review and meta-analysis
Authors: Melis Tamirat , Fikadu Yohannes
Published: February 2022

Background

Infant antiretroviral prophylaxis has an important role in reduction of Human immune virus transmission from mother to child during the postpartum period. Male partner involvement was considered as a priority aforementioned area needs to be enhanced in Prevention of Mother-To Child Transmission (PMTCT). PMTCT service utilization can minimize the risk of the transmission of HIV from mother to child and related mortalities. Adequate utilization and adherence to this service has been challenging for some of the women if their partners are not aware or do partners do not support the women. The aim of this study is to assess the magnitude and determinants of male involvement in PMTCT service in Ethiopia.

Methods and materials

We had conducted an extensive search of literature as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). We had used PubMed, Google Scholar, and cross reference for searching articles. We had used the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument for critical appraisal of studies. Met-analysis and meta-regression were computed to present the pooled prevalence and determinants of male partner involvement with a 95% confidence interval using Revman.

Results

Among a total of 338 studies, 11 studies were included in this analysis. The estimated pooled magnitude of male partner involvement was 40% (95% CI: 29.11–50.69). Knowledge of husband on PMTCT (2.30, 95% CI 1.75, 3.02), perceived responsibility for the women (4.22, 95% CI 2.31, 7.71), being government employee (2.89, 95% CI 2.02, 4.12), cultural barriers (3.44, 95% CI 2.54, 4.65) and educational status of husband (2.4, 95% CI 1.79, 3.50) were the determinants of pooled estimates of male partner involvement in PMTCT activities.

Conclusion

The pooled prevalence of male partner involvement was lower than the study conducted in sub Saharan Africa. Knowledge of husband on PMTCT, perceived responsibility for women, occupational status, cultural barriers and educational status of husband were determinants of male partner involvement. Therefore, the existing strategies to improve male involvement should be strengthened.
The accuracy of D-dimer in the diagnosis of periprosthetic infections: a systematic review and meta-analysis
Authors: Wang Renwei , Zhang Hui , Ding Peng , Jiao Qiang
Published: February 2022

Background

Periprosthetic joint infection (PJI) is a devastating complication after total hip arthroplasty (THA) or total knee arthroplasty (TKA). It is scarce and contradicting evidence supporting the use of serum D-dimer to diagnose PJI in revision THA and TKA. This systematic review and meta-analysis aimed to investigate the accuracy of D-dimer in the diagnosis of periprosthetic infections.

Methods

The PubMed, Embase, Web of Science were systematically searched from the inception dates to August 15, 2020. We included all diagnostic studies of D-dimer in the diagnosis of periprosthetic infections. The literature's quality was evaluated by the QUADAS-2 tool, and Stata16 and Revman5.3 software carried out the meta-analysis.

Results

Of 115 citations identified by the search strategy, 10 studies (comprising 1756 participants) met the inclusion criteria.The literature quality assessment results show that most of the literature is low-risk bias literature. The combined sensitivity of D-dimer in diagnosing periprosthetic infections was 0.81 (95% confidence interval [CI] 0.71–0.88), combined specificity was 0.74 (95% CI 0.61–0.84), combined positive likelihood ratio was 3.1 (95% CI 2.0–5.0), combined negative likelihood ratio 0.26 (95% CI 0.16–0.41), combined diagnosis odds ratio 12 (95% CI 5–27), area under the Summary Receiver Operator Characteristic Curve (SROC) is 0.85 (95% CI 0.81–0.88). The data are statistically significant.

Conclusion

D-dimer has a high diagnostic value in diagnosing PJI and has clinical significance in diagnosing periprosthetic infection. In addition, there are relatively few studies on the threshold of D-dimer, different sampling types, different laboratory detection methods, and different races, so more prospective trials with large samples, multi-centers, and scientific design should be carried out in the future.
Deciphering mechanisms of immune escape to inform immunotherapeutic strategies in multiple myeloma
Authors: Swamydas Muthulekha , Murphy Elena V. , Ignatz-Hoover James J. , Malek Ehsan , Driscoll James J.
Published: February 2022

Multiple myeloma is an incurable cancer characterized by the uncontrolled growth of malignant plasma cells nurtured within a permissive bone marrow microenvironment. While patients mount numerous adaptive immune responses directed against their disease, emerging data demonstrate that tumor intrinsic and extrinsic mechanisms allow myeloma cells to subvert host immunosurveillance and resist current therapeutic strategies. Myeloma downregulates antigens recognized by cellular immunity and modulates the bone marrow microenvironment to promote uncontrolled tumor proliferation, apoptotic resistance, and further hamper anti-tumor immunity. Additional resistance often develops after an initial clinical response to small molecules, immune-targeting antibodies, immune checkpoint blockade or cellular immunotherapy. Profound quantitative and qualitative dysfunction of numerous immune effector cell types that confer anti-myeloma immunity further supports myelomagenesis, disease progression and the emergence of drug resistance. Identification of tumor intrinsic and extrinsic resistance mechanisms may direct the design of rationally-designed drug combinations that prevent or overcome drug resistance to improve patient survival. Here, we summarize various mechanisms of immune escape as a means to inform novel strategies that may restore and improve host anti-myeloma immunity.
Responding to foot health needs of people experiencing homelessness: the role of a publicly funded community‐based podiatry service
Authors: Mullins Robyn M. , Mannix Rebecca E. , Marshall Nicole J. , Lewis Virginia J.
Published: February 2022

Background

People experiencing homelessness are known to suffer from poor health and can be reluctant to seek healthcare except in crisis. Foot and ankle problems are a concern; as well as causing discomfort and pain, they may escalate from a minor problem to a very serious one without timely and appropriate treatment. Little is known about the foot and ankle problems of people experiencing homelessness.

This paper describes a podiatric service specifically for people experiencing homelessness, which includes a fixed site as well as outreach services. The service operates as part of the Homelessness Team program at Cohealth, a large community health service in Melbourne.

Methods

The study used routinely collected data. Every person who was seen by the podiatrist in the Cohealth Homelessness Team in 2019, whether on site or on outreach, was included in the study (n = 295). Of these, 156 were attending for the first time and 139 were returning clients. People who used the service were predominantly rough sleeping (45.2%), with 32.2% in unstable or insecure housing and 22.6% recently housed.

Results

Skin and nail pathologies (68.1%), inadequate footwear (51.9%) and biomechanical issues (44.1%) were the most common presentations. People sleeping rough were particularly likely to present with biomechanical issues (50.8%), acute wound care needs (17.4%) or traumatic injury (10.6%). Most people presented with more than one issue (mean = 2.4), and new clients (mean = 2.53) and those rough sleeping (mean = 2.69) had more issues than others.

Outreach was the most effective way to reach clients in the most difficult circumstances (48.9% of those in unstable housing, 34.8% of rough sleepers). Most of the clients (81.4%) had connections with other services offered by Cohealth, such as social work or physiotherapy.

Conclusions

This study demonstrated that reaching and intervening on foot and ankle problems of people experiencing homelessness who may not seek care on their own could be achieved through a publicly funded health service, using simplified pathways to care including outreach. In addition to the long‐ and short‐ term benefits of the immediate podiatric treatment, building trust and connections through footcare may provide an entry point into accepting other health and welfare services.
Comparative evaluation of the efficacy of customized maxillary oral appliance with mandibular advancement appliance as a treatment modality for moderate obstructive sleep apnea patients—protocol for a randomized controlled trial
Authors: Belkhode Vikram , Godbole Surekha , Nimonkar Sharayu , Nimonkar Pranali , Pisulkar Sweta
Published: February 2022

Background

Obstructive sleep apnea (OSA) is due to the obstruction of the upper airway during sleep. This condition is often associated with multiple symptoms and co-morbidities. There are many treatment options mentioned in the literature to manage OSA, among which interventional option of continuous positive airflow (CPAP) and non-interventional option, i.e., mandibular advancement device (MAD), which is an oral appliance (OA), are the most preferred ones. This study aims to evaluate the efficacy of customized maxillary oral appliances with mandibular advancement devices in moderate OSA patients.

Methods

A prospective interventional study with a randomized controlled trial will be carried out involving 40 participants (sample size), with an apnea-hypopnea index (AHI) > 15–30, recorded on polysomnography (PSG). Study participants will be randomly divided into the following treatment groups: control group or group subjected to mandibular advancement device (MAD,n=20) and second group subjected to customized maxillary oral appliance (CMOA,n=20). Baseline assessment of apnea/hypopnea index (AHI), oxygen saturation in blood, percentage of rapid eye movement, electroencephalogram, electrocardiogram, oro-nasal airflow via a pressure transducer, and Epworth Sleepiness Scale will be done. Then both study group participants will receive their respective appliances. And after one month and three months of delivery of the appliance, all the parameters, i.e., AHI, oxygen saturation in blood, percentage of rapid eye movement, electroencephalogram, electrocardiogram, oro-nasal airflow via a pressure transducer, and Epworth Sleepiness Scale will be re-evaluated and compared with the baseline measurements. Descriptive and analytical statistics will be done. SPSS (Statistical Package for Social Sciences) Version 20.1 will be used as statistical software. The statistical significance between the two groups after one month and three months will be evaluated atp< 0.05.

Discussion

We expect, customized maxillary oral appliance to be more efficient in managing moderate OSA, in comparison with MAD. If the hypothesis of the present study is confirmed, then this customized maxillary appliance will be quoted as a “gold standard” for managing moderate OSA.

Trial registration

CTRI/2020/07/026936Registered 31 July 2020.
Association between matrix metalloproteinase-3 gene polymorphisms and tendon-ligament injuries: evidence from a meta-analysis
Authors: Guo Rui , Aizezi Aihaiti , Fan Yong , Ji Zhe , Li Wenzong , Li Yongxian , Wang Zhigang , Ning Kai
Published: February 2022

Background

Tendon-ligament injuries (TLIs), including Achilles tendinopathy, cruciate ligament injury, tennis elbow, rotator cuff injury, patellar tendinopathy, and tibial tendinopathy, are common musculoskeletal soft injuries during physical activity. Matrix metalloproteinase-3 (MMP-3) gene polymorphisms have been implicated in the etiology of TLIs in several genetic association studies with inconsistent results. The purpose of this study was to collect and synthesize the current evidences on the association of MMP-3 polymorphisms and TLIs.

Methods

The search was conducted using PubMed, Web of Science, EMBASE, Cochrane Library, CNKI and Wanfang databases, prior to July, 2021. Newcastle Ottawa Scale was used to appraise the study quality. Strengths of association were represented by odds ratios (ORs) and 95% confidence intervals (95% CIs).

Results

Thirteen studies with 2871 cases and 4497 controls met the eligibility criteria, and each study was in high quality. The overall analyzes suggested rs3025058 was associated with an increased TLIs risk (5A vs. 6A, OR = 1.20, 95% CI 1.03–1.40, P = 0.020). However, the association was not found for rs679620, rs591058, and rs650108 polymorphisms. Subgroup analysis by injury type suggested that rs679620 polymorphism was associated with a reduced risk to Achilles tendon rupture (AA + AG vs. GG, OR = 0.46, 95% CI 0.25–0.87, P = 0.020), and rs3025058 was associated with an elevated risk to anterior cruciate ligament injury (5A5A + 5A6A vs. 6A6A, OR = 1.46, 95% CI 1.03–2.06, P = 0.030). When stratified by ethnicity, the findings indicated that rs3025058 polymorphism was associated with an increased TLIs risk among Caucasians (5A6A vs. 6A6A, OR = 1.55, 95% CI 1.09–2.42, P = 0.020) and Brazilians (5A5A vs. 5A6A + 6A6A, OR = 2.80, 95% CI 1.44–5.45, P = 0.002).

Conclusion

Findings of this study suggest that rs679620 polymorphism is associated with a reduced Achilles tendon rupture risk, and rs3025058 polymorphism contributes to an increased TLIs risk in Caucasians and Brazilians. However, rs591058 and rs650108 polymorphisms do not show any association with TLIs.
Setting up minimal invasive surgery services in gynecology in a resource-limited setting: an experience from Bhutan
Authors: Tshering Sangay , Dorji Thinley , Dorji Namkha , Monger Renuka , Choden Kesang , Lhamo Kezang
Published: February 2022

Objective

To describe the clinical profile of minimal invasive procedures performed in gynecology at the national referral hospital in Bhutan. A review of such procedures performed in gynecology was needed to assess the baseline information and generate our own experience. We conducted a descriptive study with a review of hospital records of minimal invasive procedures performed from 1st January to 31st December 2020 at the Department of Gynecology. Data were extracted into a structured pro forma. Descriptive statistics were used to express the results.

Results

The mean age of the patients was 33.9 ± 8.6 years of which the maximum was in the age group 25–34 years. 28 (17.5%) and 132 (82.5%) patients underwent emergency and elective procedures respectively. 142 (88.8%) and 18 (11.2%) patients underwent laparoscopic and hysteroscopic procedures respectively. Ovarian cystectomy was the most commonly performed procedure. The median operating time was 100 min (IQR 62.5–157.5). The overall complication rate was 2.5%. The median postoperative length of hospital stay was 24 h (IQR 3–24). Using our data and experience, we recommend a new health policy to recognize MIS in gynecology as a subspecialty and strengthen the existing service in gynecological MIS.
Quality control of compaction with lightweight deflectometer (LWD) device: a state-of-art
Authors: Duddu Sidhu Ramulu , Chennarapu Hariprasad
Published: February 2022

The infrastructure plays a vital role in stimulating economic growth. Any infra project requires proper planning, design, construction, quality control (QC), and quality assessment (QA). It is important to comply with QC and QA to avoid failure and enhance the long-term pavement performance in order to provide a safe and solid system of transportation. Researchers were replacing laborious and time-consuming density-based methods (sand cone and/or core cutter) with advanced stiffness or modulus-based NDT devices for the QC of compacted geomaterials. The lightweight deflectometer (LWD) is such a highly advanced and sophisticated device that was developed to evaluate the deformation modulus (ELWD) of compacted geomaterials as an alternative of density test. This device is portable, light-weight, user-friendly, and it is ideally suitable for all constructional  geomaterials. This study is intended to provide a state-of-the-art on the LWD device as well as presented the ranges of deformation modulus for various geomaterials from several studies. For instance, in the case of soils, aggregates, and asphalt materials deformation modulus values were found to be in the range of 35–60 MPa, 80–120 MPa, and 120–170 MPa respectively. In addition, several studies have been compiled to completely comprehend the relationship between LWD and various devices.
Myositis with prominent B-cell aggregates causing shrinking lung syndrome in systemic lupus erythematosus: a case report
Authors: Roy Flavie , Korathanakhun Pat , Karamchandani Jason , Dubé Bruno-Pierre , Landon-Cardinal Océane , Routhier Nathalie , Peyronnard Caroline , Massie Rami , Leclair Valérie , Meyer Alain , Bourré-Tessier Josiane , Satoh Minoru , Fritzler Marvin J. , Senécal Jean-Luc , Hudson Marie , O’Ferrall Erin K. , Troyanov Yves , Ellezam Benjamin , Makhzoum Jean-Paul
Published: February 2022

Background

Shrinking lung syndrome (SLS) is a rare manifestation of systemic lupus erythematosus (SLE) characterized by decreased lung volumes and diaphragmatic weakness in a dyspneic patient. Chest wall dysfunction secondary to pleuritis is the most commonly proposed cause. In this case report, we highlight a new potential mechanism of SLS in SLE, namely diaphragmatic weakness associated with myositis with CD20 positive B-cell aggregates.

Case presentation

A 51-year-old Caucasian woman was diagnosed with SLE and secondary Sjögren’s syndrome based on a history of pleuritis, constrictive pericarditis, polyarthritis, photosensitivity, alopecia, oral ulcers, xerophthalmia and xerostomia. Serologies were significant for positive antinuclear antibodies, anti-SSA, lupus anticoagulant and anti-cardiolopin. Blood work revealed a low C3 and C4, lymphopenia and thrombocytopenia. She was treated with with low-dose prednisone and remained in remission with oral hydroxychloroquine. Seven years later, she developed mild proximal muscle weakness and exertional dyspnea. Pulmonary function testing revealed a restrictive pattern with small lung volumes. Pulmonary imaging showed elevation of the right hemidiaphragm without evidence of interstitial lung disease. Diaphragmatic ultrasound was suggestive of profound diaphragmatic weakness and dysfunction. Based on these findings, a diagnosis of SLS was made. Her proximal muscle weakness was investigated, and creatine kinase (CK) levels were normal. Electromyography revealed fibrillation potentials in the biceps, iliopsoas, cervical and thoracic paraspinal muscles, and complex repetitive discharges in cervical paraspinal muscles. Biceps muscle biopsy revealed dense endomysial lymphocytic aggregates rich in CD20 positive B cells, perimysial fragmentation with plasma cell-rich perivascular infiltrates, diffuse sarcolemmal upregulation of class I MHC, perifascicular upregulation of class II MHC, and focal sarcolemmal deposition of C5b-9. Treatment with prednisone 15 mg/day and oral mycophenolate mofetil 2 g/day was initiated. Shortness of breath and proximal muscle weakness improved significantly.

Conclusion

Diaphragmatic weakness was the inaugural manifestation of myositis in this patient with SLE. The spectrum of myologic manifestations of myositis with prominent CD20 positive B-cell aggregates in SLE now includes normal CK levels and diaphragmatic involvement, in association with SLS.
A six-chambered heart: cor triatriatum sinister with double-chambered right ventricle in association with ventricular septal defect
Authors: Jaswal Vivek , Rana Pratyaksha , Bansal Vidur , Gourav Krishna Prasad , Sharma Arun , Thingnam Shyam Kumar Singh
Published: February 2022

Background

Cor triatriatum has been described as a heart with three atria in which the left atrium (cor triatriatum sinistrum) or right atrium (cor triatriatum dextrum) is divided into two compartments by a fold of tissue, a membrane, or a fibromuscular band. Double-chambered right ventricle, on the other hand, is identified by the presence of an anomalous muscle bundle dividing the right ventricle into two chambers.

Case presentation

Here, we describe the case of a child who had a combination of both of these rare entities, effectively creating a heart with six chambers. The child underwent a successful intracardiac repair.

Conclusions

The association of CTS with DCRV forming a “6-chambered heart” is extremely rare. Awareness of its existence and accurate preoperative diagnosis has important implications in its surgical repair with all the components of this disease spectrum, further increasing the complexity of a successful surgical repair.