bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantification of ESG Regulations: A Cross-Country Benchmarking Analysis
Authors: Singhania Monica , Saini Neha
Published: November 2021

Environmental, social and governance (ESG) criteria mean investment in economic choices which, without interference with the environment, are intended to promote long-term economic and social well-being. Due to high environmental and social awareness, customers expect companies to devote time and efforts to such sustainable practices. This attitude has led to an overall rise in ESG disclosures and reporting instruments globally with a focus on influence of ESG disclosures on financial performance of companies. Many European countries have already introduced mandatory disclosure of non-financial information. This transition from voluntary to mandatory motivated other countries to adopt mandatory ESG disclosure practices for sustainable development. The practice of reporting non-financial disclosures has been rising due to several reasons, such as increasing visibility, informing customers, avoiding the risk associated with firm performance and achieving sustainability. Countries in the early stages of ESG disclosure need to understand the benchmark practices used by countries with a well-developed ESG system. For preparing the ESG disclosure index and benchmarking based on disclosure score, this study considers a set of developed and developing countries with their ESG disclosures. On the basis of ESG disclosures, the countries have been classified into four different categories. We found Norway, Sweden, Denmark, Finland, United Kingdom, Belgium and France, to have high ESG scores and have been classified as Countries with Well-Developed ESG Framework. Germany, Italy, USA, Australia, Switzerland, Canada, Japan, Brazil and South Africa have medium to high ESG scores and fall under the category Rapidly improving ESG framework. While Singapore, India, China, Philippines, Malaysia and Argentina are categorized as countries with ESG framework at developing stage, Russia, Indonesia, Thailand, Nigeria and Vietnam are classified as Countries with early-stage framework due to low ESG scores.
The effect of chemotherapy type and timing among the other factors on patency of totally implantable vascular access devices in colorectal carcinoma
Authors: Aribas Bilgin Kadri , Yildiz Fatih , Uylar Tugba , Tiken Ramazan , Aydin Hale , Akdulum Ismail , Seber Turgut , Caglar Emrah , Savran Burcu , Aribas Ozge
Published: November 2021

Purpose:

Catheter-related complications are observed in infusion of chemotherapy, and these were encountered with targeted therapies. Our principle is to study non-mechanical effects of type and initiation time of chemotherapy among the other factors on patency of totally implantable vascular access devices (TIVAD) inserted in patients with colorectal carcinoma.

Methods:

This is a one-center retrospective cohort study. We analyzed TIVAD related complications in 624 patients with colorectal carcinoma. The patients were categorized by chemotherapy type (non-target-directed chemotherapy agents (Group A), bevacizumab (Group B), and cetuximab (Group C)). Additionally, we divided the patients into groups by the time interval between TIVAD insertion and chemotherapy initiation. According to our study, a 3-day period was optimal. Therefore, we named the groups as within 3 days and beyond 3 days, and called this process 3 days cut-off. Age, gender, jugular-subclavian access, platelet count, INR, the types of chemotherapy, and the initiation time of chemotherapy were investigated by survival tests. We compared chemotherapy type groups both one-by-one and combined into one group.

Results:

The TIVADs were removed due to the complications in 11 patients of Group A, 6 patients of Group B, and 3 patients of Group C. Only chemotherapy type was significant ( p = 0.011) in Cox regression test. A clear difference ( p = 0.010) was detected between the catheter patency of Group A and combination of Groups B and C, because of skin necrosis and thrombosis. Within 3 days of their first chemotherapy day, an important difference between Group A and Group C ( p = 0.013) was observed in the TIVAD patency. The same observation was made between Group A and Group B ( p = 0.007). Beyond this period, no major difference was detected ( p = 0.341).

Conclusion:

A major effect on catheter patency was detected by using the target-directed chemotherapy agent within 3 days, which should be considered in target-directed chemotherapy.
The Influence of Renal Function Impairment on Kappa Free Light Chains in Cerebrospinal Fluid
Authors: Konen Franz F , Schwenkenbecher Philipp , Wurster Ulrich , Jendretzky Konstantin F , Möhn Nora , Gingele Stefan , Sühs Kurt-Wolfram , Hannich Malte J , Grothe Matthias , Witte Torsten , Stangel Martin , Süße Marie , Skripuletz Thomas
Published: November 2021

Background

The determination of kappa free light chains (KFLC) in cerebrospinal fluid (CSF) is an upcoming biomarker for the detection of an intrathecal immunoglobulin synthesis. Since renal function impairment leads to altered serum KFLC and albumin concentrations, interpretation of KFLC in CSF may be influenced by these parameters.

Methods

In this two-center study, the influence of renal function (according to the CKD-EPI creatinine equation) on KFLC and albumin concentrations was investigated in patients with “physiological” (n = 139), “non-inflammatory” (n = 146), and “inflammatory” (n = 172) CSF profiles in respect to the KFLC index and the evaluation in quotient diagrams in reference to the hyperbolic reference range (KFLC IF).

Results

All sample groups displayed declining KFLC indices and KFLC IF values with decreasing renal function ( P-values between <.0001 and .0209). In “inflammatory” CSF profile samples, 15% of the patients presented a KFLC index <5.9 while 10% showed an intrathecal KFLC fraction below QKappa(lim), suggesting possible false negative KFLC results.

Conclusions

The influence of renal function should be considered while interpreting KFLC results in patients with neuroinflammatory diseases. The interpretation of KFLC in quotient diagrams is less susceptible to renal function impairment than the KFLC index and should be preferentially used.
Health inequalities between Roma and non-Roma populations in Europe: A study of 118,834 individuals combining the UNDP Roma and the EU-SILC surveys
Authors: La Parra-Casado Daniel , Solheim Erling F. , Estévez Jesús F.
Published: November 2021

Aims:

This study aimed to compare the self-rated health status of the Roma and of the general population by gender and educational level in six Central and Eastern European countries.

Methods:

We analysed the United Nations Development Program Regional Roma Survey and EUROSTAT’s European Union Statistics on Income and Living Conditions surveys from 2011 for Bulgaria, Croatia, Czechia, Hungary, Romania and Slovakia. Using logistic regression, predicted probabilities of good or very good self-rated health were estimated for the Roma ( n=11,401), Roma neighbours ( n=5857) and the general population ( n=101,579) stratified by gender, and adjusted by age, country and educational level.

Results:

There was a distinctive social gradient in self-rated health between the groups among both men and women, and a gap between primary versus secondary or tertiary education among all three groups, but Roma (men) and their neighbours with secondary or higher education had significantly worse predicted self-rated health compared to the general population with similar qualifications.

Conclusions:

These results strongly suggest that ethnicity and gender should be considered as fundamental causes that explain structural health inequalities. Consequently, future research and policy initiatives to reduce health inequities should acknowledge the impact of ethnic minorities and how these fundamental causes extend the general population’s social gradient in health. Study designs enabling direct comparisons between ethnic groups and the general population should be applied. More and better data about ethnic minorities are needed to document and monitor existing health inequalities.
The role of multi-platform news consumption in explaining civic participation during the COVID-19 pandemic: A communication mediation approach
Authors: Waeterloos Cato , Walrave Michel , Ponnet Koen
Published: November 2021

This study employs the orientation–stimulus–reasoning–orientation–response (O-S-R-O-R) framework to examine how multi-platform news consumption is associated with civic participation during the COVID-19 pandemic (offline and via social media) and how this relation is mediated by civic talk and civic attitudes. A survey was administered to 1500 adults in Belgium. Results from structural equation modelling indicate how civic talk with weak ties is not associated with civic attitudes or participation. Analysis of indirect effects reveals that multi-platform news consumption stimulates two different types of participation, through civic talk with strong ties and civic attitudes. The results shed light on previously unexplored pathways towards participation, while providing support for the O-S-R-O-R framework and highlighting the role of social media as an emerging arena for civic participation.
Supporting social work field instructors: Empowerment as a strategy for preventing burnout
Authors: McCarthy Lauren P. , Siegel Jennifer L. , Ware Orrin D.
Published: November 2021

Social work field instructors are integral to social work education and must balance professional responsibilities with supervising students. Empowerment and burnout are concepts that may impact the well-being of social work field instructors. However, few studies have explored empowerment and burnout among this population. This study aimed to a) explore the association between overall empowerment and burnout and b) explore how different elements of empowerment are associated with burnout when controlling for interprofessional work, demographic characteristics, and workplace characteristics. This nonexperimental cross-sectional study utilized primary survey data to examine the association between the Social Worker Empowerment Scale and ProQOL Burnout scores among a sample of social work field instructors (N = 189) of a Mid-Atlantic university.

Findings

Preliminary bivariate analysis found a significant negative association between overall empowerment and burnout. Hierarchical linear regression results displayed a significant negative association between burnout and two elements of empowerment: Collective identity and knowledge. One element of empowerment, propensity to act, was found to have a significant positive association with burnout. Years of social work experience and coping on an interprofessional team were found to have significant negative associations with burnout.

Applications

Agencies and educational institutions can reduce burnout among field instructors by fostering their sense of connection to the social work profession and ensuring they feel knowledgeable and competent in their role. This can be accomplished through fostering strong relationships and providing ongoing, accessible training to field instructors. More detailed recommendations for reducing burnout by increasing empowerment are provided in the manuscript.
Integrating Community Participation With Interpretative Phenomenological Analysis: Reflections on Engaging the Autism Community
Authors: Heselton Gabrielle A. , Rempel Gwen R. , Nicholas David B.
Published: November 2021

Members of the autistic community have long advocated for more input into and participation with autism-related research. Currently, the power to determine the direction of autism-related research and knowledge production related to autism lies with non-autistic researchers, while the wishes and perspectives of the autistic community are largely ignored. There is a growing trend toward ethical autism-related research, however, in which the perspectives of all stakeholders, particularly those of autistic individuals, are sought and their expertise on autism is foregrounded. In a study exploring the experiences of childhood adversity and resilience among autistic adults, we strove to conduct our research in an inclusive and ethical way, by integrating participatory methods, such as community engagement to inform research design, and credibility checking with participants to confirm that the analysis resonated with their experiences. Five stakeholders, representing parents of children on the autism spectrum, professionals, and autistic community members were recruited to provide input into the research design and provide insight into autistic ways of communicating, interacting, and being. The recommendations generated through this community engagement were then integrated into an interpretative phenomenological analysis (IPA) framework and implemented with four adult autistic participants. Through reflection on the process of community engagement, development of research design, implementation of the study, and credibility checking, it is clear that incorporating participatory methods into IPA increases rigor and ensures that autistic perspectives are represented through research.
The ‘recognition of prior learning’ in vocational education and training systems of lower and middle income countries: An analysis of the role of development cooperation in the diffusion of the concept
Authors: Maurer Markus
Published: November 2021

‘Recognition of prior learning’ (RPL) has developed into an important instrument to support the permeability of education and training systems. Based on an extensive review of documents, this article analyses the global diffusion of RPL in vocational education and training systems (VET), with a specific focus on its diffusion through development cooperation between multi- and bilateral donors and lower and middle income countries (LMIC). This article argues that RPL became a core component of development cooperation when VET came to be seen as a means to foster equitable access to employment and income for the poorest. At the same time, it shows that the model of RPL transferred to LMICs is derived from the specific relations between labour markets and education and training systems in donor countries, where VET qualifications are often critical to accessing positions in the labour market, which is often not the case in LMICs.
Comparative outcomes of total wrist arthrodesis for salvage of failed total wrist arthroplasty and primary wrist arthrodesis
Authors: Zijlker Hero J. A. , Fakkert Ruben K. , Beumer Annechien , IJsselstein Cees B. , Wessels Mascha , Ritt Marco J. P. F.
Published: November 2021

A retrospective study compared outcomes of total wrist arthrodesis as a salvage for total wrist arthroplasty versus primary total wrist arthrodesis. Seventy-one wrists were reviewed after a minimum follow-up of 12 months. Thirty-two wrists with failed total wrist arthroplasty were converted to a wrist arthrodesis and 39 wrists received a primary wrist arthrodesis. Seven converted wrist arthrodeses and five primary arthrodeses failed to fuse. Mean patient-rated wrist and hand evaluation scores and work-related questionnaire for upper extremity disorders scores were 43 and 39 for converted total wrist arthrodesis and 38 and 33 for the primary total wrist arthrodesis. Overall, there were 25 complications in 15 patients in the converted wrist arthrodesis group and 21 complications in 16 patients after a primary wrist arthrodesis. The results between the two groups were slightly in favour of patients with a primary wrist arthrodesis. Therefore, we conclude that the timing, primary or conversion, of total wrist arthrodesis could influence patient outcomes.

Level of evidence: III
2020 Association for Applied and Clinical Sociology Membership Survey
Authors: Carr Joel L.
Published: November 2021

The Association for Applied and Clinical Sociology (AACS) was formed in 2005 by the merger of the Society for Applied Sociology and the Sociological Practice Association giving name recognition to both applied and clinical sociology, and a professional home for all sociological practitioners. In an effort to provide greater benefit and value to members, and to better meet the needs of its members, the AACS conducted a membership survey. On October 9, 2020, a membership survey was sent to AACS members to gather data. While the current survey results could have benefited from a greater response rate, the data gathered provides some degree of insight to members’ characteristics and attitudes toward the AACS. It is recommended that the AACS consider conducting future membership studies periodically to determine how to better meet member needs, and to estimate the value of AACS to its members.
Comparison of Electrocoagulation Tuboplasty and Continued Medical Therapy for Treating Persistent Eustachian Tube Dysfunction With Hypertrophic Mucosa Disease
Authors: Tang Yongmei , Lou Zhengcai , Jin Kangfeng , Sun Junzhi , Deng Yue
Published: November 2021

Objectives

The objective of this trial was to compare outcomes of electrocoagulation tuboplasty and continued medical therapy for treating persistent Eustachian tube dysfunction (ETD) with hypertrophic mucosa disease in the Eustachian tube (ET) orifice.

Study Design

Prospective, case-control trial.

Material and Methods

Patients with persistent ETD were recruited and allocated to electrocoagulation tuboplasty and continued medical therapy groups. The ETD questionnaire-7 (ETDQ-7) score and objective parameters were compared between the groups at 6 and 12 months.

Results

The proportion of patients with a decrease in ETDQ-7 scores was greater in the electrocoagulation group than in the medical therapy group at the 6-month follow-up (53.49% and 34.38%, respectively; p = .158), but the difference was not statistically significant. However, at the 12-month follow-up, there was a significantly higher proportion of patients with a decrease in ETDQ-7 scores in the electrocoagulation group (88.37% and 40.63%, respectively; p = .001). Additionally, a significant difference was observed between the groups in terms of the proportion of patients who improved 12 months after the treatment (tympanometry: 72.09% and 9.38%, respectively; p = .001; air-bone gap: 79.07% and 25.00%, respectively; p = .001; tympanic membrane status: 62.79% and 0.00%, respectively). In addition, the proportion of patients with improvements in the ET inflammation score was significantly different between the groups at 6-month (67.44% and 34.38%, respectively; p = .009) and 12-month (93.02% and 34.38%; p = .001) follow-ups. No device- or procedure-related serious adverse events were reported in any patients.

Conclusions

Electrocoagulation Eustachian tuboplasty appears to be a safe and feasible procedure for adult persistent ETD with hypertrophic mucosa disease in the ET orifice, and is superior to continued medical management alone. The improvements in ETDQ-7 and objective parameters persisted for 12 months.
Dance the Night Away: How Automatic TikTok Use Creates Pre-Sleep Cognitive Arousal and Daytime Fatigue
Authors: Wang Kexin , Scherr Sebastian
Published: November 2021

TikTok is one of the most popular apps. TikTok's endless stream of content, the lack time stamps or notifications of ever being “all caught up,” and concealing the phone's clock make it easy to lose track of time on TikTok. However, there is a lack of knowledge about how TikTok use may therefore interfere with our circadian rhythms, particularly our sleep hygiene. By focusing on pre-sleep cognitive arousal, this study aimed to close this knowledge gap by investigating the association between automatic TikTok use and daytime fatigue. We also investigated how individual preferences for sensation seeking and delayed gratification moderated this relationship. Within a sample of 1,050 TikTok/Douyin users in China, automatic TikTok use was associated with increased daytime fatigue that was mediated by higher levels of cognitive arousal before sleep. This relationship was aggravated by a preference for sensation seeking, and attenuated by a preference for delayed gratification. Above and beyond these early empirical insights, we also provide an early explanatory framework that is meant to systematize both existing and future knowledge about the use of TikTok.
Imaging and Electrophysiology for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 9]
Authors: Martin Allan R. , Tetreault Lindsay , Nouri Aria , Curt Armin , Freund Patrick , Rahimi-Movaghar Vafa , Wilson Jefferson R. , Fehlings Michael G. , Kwon Brian K. , Harrop James S. , Davies Benjamin M. , Kotter Mark R. N. , Guest James D. , Aarabi Bizhan , Kurpad Shekar N
Published: November 2021

Study Design

Narrative review.

Objective

The current review aimed to describe the role of existing techniques and emerging methods of imaging and electrophysiology for the management of degenerative cervical myelopathy (DCM), a common and often progressive condition that causes spinal cord dysfunction and significant morbidity globally.

Methods

A narrative review was conducted to summarize the existing literature and highlight future directions.

Results

Anatomical magnetic resonance imaging (MRI) is well established in the literature as the key imaging tool to identify spinal cord compression, disc herniation/bulging, and inbuckling of the ligamentum flavum, thus facilitating surgical planning, while radiographs and computed tomography (CT) provide complimentary information. Electrophysiology techniques are primarily used to rule out competing diagnoses. However, signal change and measures of cord compression on conventional MRI have limited utility to characterize the degree of tissue injury, which may be helpful for diagnosis, prognostication, and repeated assessments to identify deterioration. Early translational studies of quantitative imaging and electrophysiology techniques show potential of these methods to more accurately reflect changes in spinal cord microstructure and function.

Conclusion

Currently, clinical management of DCM relies heavily on anatomical MRI, with additional contributions from radiographs, CT, and electrophysiology. Novel quantitative assessments of microstructure, perfusion, and function have the potential to transform clinical practice, but require robust validation, automation, and standardization prior to uptake.
Low Risk of Fracture With End-Range Movements of the Hip in People With Low Bone Mineral Density: A Narrative Review
Authors: Ziebart Christina , PT Caitlin McArthur, , PT Judi Laprade,
Published: November 2021

Background: The risks of end-range movements for people with osteoporosis, specifically at the hips and shoulder, are not well understood. Objectives: To synthesize literature on the safety of stretching for people with osteoporosis by searching: 1) biomechanical literature to determine how much force results from an end-range maneuverer and is required to fracture joint components (focusing on the hip joint) and 2) clinical literature to describe techniques used, populations studied, effects, and reported adverse events. Methods: We conducted two separate search strategies in PubMed, EMBASE, and Scopus (1955–2020). Results: 16 articles described either biomechanical or clinical effects of passive and active end ranges of the hip joint. The largest load in the hip, described in the literature was in a crescent lunge during yoga. The moment produced in a crescent lunge is much smaller than that of the tensile strength of osteoporotic bone, suggesting the crescent lunge movement could be considered safe. Clinically, no adverse events were reported in exercise, stretching or yoga interventions. Conclusion: This review found no evidence that end range movements of the hip are unsafe, but there is little evidence. No studies were identified that explored the risk of humeral fracture during end range stretches.
Automated annotation of rare-cell types from single-cell RNA-sequencing data through synthetic oversampling
Authors: Bej Saptarshi , Galow Anne-Marie , David Robert , Wolfien Markus , Wolkenhauer Olaf
Published: November 2021

Background

The research landscape of single-cell and single-nuclei RNA-sequencing is evolving rapidly. In particular, the area for the detection of rare cells was highly facilitated by this technology. However, an automated, unbiased, and accurate annotation of rare subpopulations is challenging. Once rare cells are identified in one dataset, it is usually necessary to generate further specific datasets to enrich the analysis (e.g., with samples from other tissues). From a machine learning perspective, the challenge arises from the fact that rare-cell subpopulations constitute an imbalanced classification problem. We here introduce a Machine Learning (ML)-based oversampling method that uses gene expression counts of already identified rare cells as an input to generate synthetic cells to then identify similar (rare) cells in other publicly available experiments. We utilize single-cell synthetic oversampling (sc-SynO), which is based on the Localized Random Affine Shadowsampling (LoRAS) algorithm. The algorithm corrects for the overall imbalance ratio of the minority and majority class.

Results

We demonstrate the effectiveness of our method for three independent use cases, each consisting of already published datasets. The first use case identifies cardiac glial cells in snRNA-Seq data (17 nuclei out of 8635). This use case was designed to take a larger imbalance ratio (~1 to 500) into account and only uses single-nuclei data. The second use case was designed to jointly use snRNA-Seq data and scRNA-Seq on a lower imbalance ratio (~1 to 26) for the training step to likewise investigate the potential of the algorithm to consider both single-cell capture procedures and the impact of “less” rare-cell types. The third dataset refers to the murine data of the Allen Brain Atlas, including more than 1 million cells. For validation purposes only, all datasets have also been analyzed traditionally using common data analysis approaches, such as the Seurat workflow.

Conclusions

In comparison to baseline testing without oversampling, our approach identifies rare-cells with a robust precision-recall balance, including a high accuracy and low false positive detection rate. A practical benefit of our algorithm is that it can be readily implemented in other and existing workflows. The code basis in R and Python is publicly available at FairdomHub, as well as GitHub, and can easily be transferred to identify other rare-cell types.
Systematic analysis of the lysine malonylome in Sanghuangporus sanghuang
Authors: Wang Tong , Wang Guangyuan , Zhang Guoli , Hou Ranran , Zhou Liwei , Tian Xuemei
Published: November 2021

Background

Sanghuangporus sanghuang is a well-known traditional medicinal mushroom associated with mulberry. Despite the properties of this mushroom being known for many years, the regulatory mechanisms of bioactive compound biosynthesis in this medicinal mushroom are still unclear. Lysine malonylation is a posttranslational modification that has many critical functions in various aspects of cell metabolism. However, at present we do not know its role in S. sanghuang. In this study, a global investigation of the lysine malonylome in S. sanghuang was therefore carried out.

Results

In total, 714 malonyl modification sites were matched to 255 different proteins. The analysis indicated that malonyl modifications were involved in a wide range of cellular functions and displayed a distinct subcellular localization. Bioinformatics analysis indicated that malonylated proteins were engaged in different metabolic pathways, including glyoxylate and dicarboxylate metabolism, glycolysis/gluconeogenesis, and the tricarboxylic acid (TCA) cycle. Notably, a total of 26 enzymes related to triterpene and polysaccharide biosynthesis were found to be malonylated, indicating an indispensable role of lysine malonylation in bioactive compound biosynthesis in S. sanghuang.

Conclusions

These findings suggest that malonylation is associated with many metabolic pathways, particularly the metabolism of the bioactive compounds triterpene and polysaccharide. This paper represents the first comprehensive survey of malonylation in S. sanghuang and provides important data for further study on the physiological function of lysine malonylation in S. sanghuang and other medicinal mushrooms.
Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization
Authors: Lang Jiaxin , Liu Yuchao , Zhang Yuelun , Huang Yuguang , Yi Jie
Published: November 2021

Background

This study sought to evaluate the diagnostic accuracy of peri-operative diaphragm ultrasound in assessing post-operative residual curarization (PORC).

Methods

Patients undergoing non-thoracic and non-abdominal surgery under general anaesthesia were enrolled from July 2019 to October 2019 at Peking Union Medical College Hospital. A train-of-four ratio (TOFr) lower than 0.9 was considered as the gold standard for PORC. Diaphragm ultrasound parameters included diaphragmatic excursion (DE) and diaphragm thickening fraction (DTF) during quiet breathing (QB) and deep breathing (DB). The diaphragm excursion fraction (DEF) was calculated as the DE-QB divided by the DE-DB. The diaphragm excursion difference (DED) was defined as DE-DB minus DE-QB. Receiver operating characteristic curve analysis was used to determine the cut-off values of ultrasound parameters for the prediction of PORC.

Results

In total, 75 patients were included, with a PORC incidence of 54.6%. The DE-DB and DED were positively correlated with the TOFr, while the DEF was negatively correlated with the TOFr. The DE-DB cut-off value for predicting PORC was 3.88 cm, with a sensitivity of 85.4% (95% confidence interval [CI]: 70.1–93.9%), specificity of 64.7% (95% CI: 46.4–79.7%), positive likelihood ratio of 2.42 (95% CI 1.5–3.9), and negative likelihood ratio of 0.23 (95% CI: 0.1–0.5). The DED cut-off value was 1.5 cm, with a specificity of 94.2% (95% CI: 80.3–99.3%), sensitivity of 63.4% (95% CI: 46.9–77.9%), positive likelihood ratio of 10.78 (95% CI: 2.8–42.2), and negative likelihood ratio of 0.39 (95% CI: 0.3–0.6).

Conclusions

Peri-operative diaphragm ultrasound may be an additional method aiding the recognition of PORC, with DED having high specificity.
Educational attainment in patients with congenital heart disease: a comprehensive systematic review and meta-analysis
Authors: Cocomello Lucia , Dimagli Arnaldo , Biglino Giovanni , Cornish Rosie , Caputo Massimo , Lawlor Deborah A.
Published: November 2021

Background

Our aim was to comprehensively review published evidence on the association between having a congenital heart disease (CHD) compared with not, on educational attainment (i.e. not obtaining a university degree, completing secondary education, or completing any vocational training vs. obtaining/completing) in adults.

Method

Studies were eligible if they reported the rate, odds, or proportion of level of educational attainment in adults by whether or not they had a CHD.

Result

Out of 1537 articles screened, we identified 11 (N = 104,585 participants, 10,487 with CHD), 10 (N = 167,470 participants, 11,820 with CHD), and 8 (N = 150,813 participants, 9817 with CHD) studies reporting information on university education, secondary education, and vocational training, respectively in both CHD and non-CHD participants. Compared to their non-CHD peers, CHD patients were more likely not to obtain a university degree (OR = 1.38, 95% CI [1.16, 1.65]), complete secondary education (OR = 1.33, 95% CI [1.09, 1.61]) or vocational training (OR = 1.11, 95% CI [0.98, 1.26]). For all three outcomes there was evidence of between study heterogeneity, with geographical area contributing to this heterogeneity.

Conclusion

This systematic review identified all available published data on educational attainment in CHD patients. Despite broad inclusion criteria we identified relatively few studies that included a comparison group from the same population, and amongst those that did, few adjusted for key confounders. Pooled analyses suggest evidence of lower levels of educational attainment in patients with CHD when compared to non-CHD peers. The extent to which this may be explained by confounding factors, such as parental education, or mediated by treatments is not possible to discern from the current research literature.
Usefulness of cardiac magnetic resonance images for prediction of sudden cardiac arrest in patients with mitral valve prolapse: a multicenter retrospective cohort study
Authors: Lee Jae-Hyuk , Uhm Jae-Sun , Suh Young Joo , Kim Min , Kim In-Soo , Jin Moo-Nyun , Cho Min Soo , Yu Hee Tae , Kim Tae-Hoon , Hong Yoo Jin , Lee Hye-Jeong , Shim Chi Young , Kim Young Jin , Kim Jun , Kim Jong-Youn , Joung Boyoung , Hong Geu-Ru , Pak Hui-Nam , Nam Gi-Byoung , Choi Kee-Joon , Kim You-Ho , Lee Moon-Hyoung
Published: November 2021

Background

An association has been identified between mitral valve prolapse (MVP) and sudden cardiac arrest (SCA), and ventricular arrhythmias (VA). This study aimed to elucidate predictive factors for SCA or VA in MVP patients.

Methods

MVP patients who underwent cardiac magnetic resonance (CMR) were retrospectively included. Patients with other structural heart disease or causes of aborted SCA were excluded. Clinical characteristics (sex, age, body mass index, histories of diabetes, hypertension, and dyslipidemia) and electrocardiographic (PR interval, QRS duration, corrected QT interval, inverted T wave in the inferior leads, bundle branch block, and atrial fibrillation), echocardiographic [mitral regurgitation grade, prolapsing mitral leaflet, and right ventricular systolic pressure (RVSP)], and CMR [left atrial volume index, both ventricular ejection fractions, both ventricular end-diastolic and systolic volume indexes, prolapse distance, mitral annular disjunction, systolic curling motion, presence of late gadolinium enhancement (LGE), LGE volume and proportion] parameters were analyzed.

Results

Of the 85 patients [age, 54.0 (41.0–65.0) years; 46 men], seven experienced SCA or VA. Younger age and wide QRS complex were observed more often in the SCA/VA group than in the no-SCA/VA group. The SCA/VA group exhibited lower RVSP, more systolic curling motion and LGE, greater LGE volume, and higher LGE proportion. The presence of LGE [hazard ratio (HR), 19.8; 95% confidence interval (CI) 2.65–148.15; P = 0.004], LGE volume (HR 1.08; 95% CI 1.02–1.14; P = 0.006) and LGE proportion (HR 1.32; 95% CI 1.08–1.60; P = 0.006) were independently associated with higher risk of SCA or VA in MVP patients together with systolic curling motion in each model.

Conclusions

The presence of systolic curling motion, high LGE volume and proportion, and the presence of LGE on CMR were independent predictive factors for SCA or VA in MVP patients.
30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population
Authors: Khalil Mohamed Hassene , Sekma Adel , Yaakoubi Hajer , Bel Haj Ali Khaoula , Msolli Mohamed Amine , Beltaief Kaouthar , Grissa Mohamed Habib , Boubaker Hamdi , Sassi Mohamed , Chouchene Hamadi , Hassen Youssef , Ben Soltane Houda , Mezgar Zied , Boukef Riadh , Bouida Wahid , Nouira Semir
Published: November 2021

Background

Chest pain remains one of the most challenging serious complaints in the emergency department (ED). A prompt and accurate risk stratification tool for chest pain patients is paramount to help physcian effectively progrnosticate outcomes. HEART score is considered one of the best scores for chest pain risk stratification. However, most validation studies of HEART score were not performed in populations different from those included in the original one.

Objective

To validate HEART score as a prognostication tool, among Tunisian ED patients with undifferentiated chest pain.

Methods

Our prospective, multicenter study enrolled adult patients presenting with chest pain at chest pain units. Patients over 30 years of age with a primary complaint of chest pain were enrolled. HEART score was calculated for every patient. The primary outcome was major cardiovascular events (MACE) occurrence, including all-cause mortality, non-fatal myocardial infarction (MI), and coronary revascularisation over 30 days following the ED visit. The discriminative power of HEART score was evaluated by the area under the ROC curve. A calibration analysis of the HEART score in this population was performed using Hosmer–Lemeshow goodness of test.

Results

We enrolled 3880 patients (age 56.3; 59.5% males). The application of HEART score showed that most patients were in intermediate risk category (55.3%). Within 30 days of ED visit, MACE were reported in 628 (16.2%) patients, with an incidence of 1.2% in the low risk group, 10.8% in the intermediate risk group and 62.4% in the high risk group. The area under receiver operating characteristic curve was 0.87 (95% CI 0.85–0.88). HEART score was not well calibrated (χ2 statistic = 12.34; p = 0.03).

Conclusion

HEART score showed a good discrimination performance in predicting MACE occurrence at 30 days for Tunisian patients with undifferentiated acute chest pain. Heart score was not well calibrated in our population.
Fecal microbiota profiling in irritable bowel syndrome and inflammatory bowel disease patients with irritable bowel syndrome-type symptoms
Authors: Cui Xiufang , Wang Haiyang , Ye Ziping , Li Yi , Qiu Xinyun , Zhang Hongjie
Published: November 2021

Background

The intestinal microbiota is thought to be involved in the occurrence of inflammatory bowel disease in remission with irritable bowel syndrome (IBS)-type symptoms, but the specific distinct profile of these bacteria remains unclear. This cross-sectional study aims to investigate the fecal microbiota profiling in patients with these diseases.

Methods

Fecal samples from 97 subjects, including Crohn’s disease patients in remission with IBS-type symptoms (CDR-IBS+) or without IBS-type symptoms (CDR-IBS−), ulcerative colitis patients in remission with IBS-type symptoms (UCR-IBS+) or without IBS-type symptoms (UCR-IBS−), IBS patients and healthy controls, were collected and applied 16S ribosomal DNA (rDNA) gene sequencing. The V4 hypervariable regions of 16S rDNA gene were amplified and sequenced by the Illumina MiSeq platform. The differences in the sample diversity index in groups were analyzed with R software.

Results

The richness of the intestinal microbiota in the CDR-IBS group was markedly lower than those in the control and IBS groups based on the analysis of observed species and the Chao index (P < 0.05). The observed species index in the CDR-IBS+ group was higher than that in the CDR-IBS− group (median index: 254.8 vs 203, P = 0.036). No difference was found in alpha diversity between UCR patients with IBS-type symptoms and those without related symptoms. At the genus level, the number of Faecalibacterium in CDR patients with IBS-type symptoms increased significantly, while Fusobacterium decreased versus those without such symptoms (mean relative abundance of Faecalibacterium: 20.35% vs 5.18%, P < 0.05; Fusobacterium: 1.51% vs 5.2%, P < 0.05). However, compared with the UCR-IBS− group, the number of Faecalibacterium in the UCR-IBS+ group decreased, while the number of Streptococcus increased, but there was no significant difference in the genus structure. The abundance and composition of the microbiota of IBS patients were not distinct from those of healthy controls.

Conclusions

The IBS-type symptoms in CD patients in remission may be related to an increase in Faecalibacterium and a decrease in Fusobacterium. The IBS-type symptoms in UC patients in remission cannot be explained by changes in the abundance and structure of the intestinal microbiota.
Institutionalized elderly are able to detect small viscosity variations in thickened water with gum-based thickeners: should texture classifications be reviewed?
Authors: Calmarza-Chueca Fernando , Cristina-Sánchez-Gimeno Ana , Perez-Nogueras Javier , Caverni-Muñoz Alberto , Sanz-Arque Alejandro , Arbones-Mainar José Miguel , Sanz-Paris Alejandro
Published: November 2021

Background

The prevalence of dysphagia is very high in institutionalized elderly. Knowledge of the rheological and sensory characteristics of the various thickeners in elderly is limited, although it has been seen that there are differences between the rheological behaviors of gum-based thickeners with different composition. Moreover, we have not found sensory studies of viscosity in institutionalized elderly. Our hypothesis was that viscosity ranges established by the scientific societies, such as the National Dysphagia Diet Task Force (NDD), seem to be very wide and individuals might be able to detect small differences within the same texture range. The objectives of our study were 1) comparing the rheological characteristics of two commercial gum-based thickeners with different composition, dissolved in water under standard conditions, and 2) perform a sensory analysis (with both adults and institutionalized elderly) to detect different viscosities within the same texture (nectar and honey).

Methods

Two commercial thickeners based on gums (NC and RC) were studied analyzing their viscosity in water with different concentrations (shear rate: 50 s− 1; temperature: 22–25 °C). A sensory analysis involving 26 elderly and 29 adult controls was carried out to evaluate whether differences within nectar and honey textures among gum-based thickeners could be distinguished.

Results

As the shear rate increases, viscosity decreases (non-Newtonian and pseudoplastic behavior). At the same concentration, each thickener produces a different viscosity (p < 0.05). Institutionalized elderly detected viscosity differences in nectar range of 49.9 (2.5) mPa·s (p < 0.05) and 102.2 (4.7) mPa·s (p < 0.0001). They also detected viscosity differences in honey texture range of 134.6 (9.7) mPa·s (p < 0.05) y 199.3 (9.2) mPa·s (p < 0.0001). Their caregivers also detected viscosity differences in both viscosity ranges (p < 0.0001) and with greater intensity than the elderly in honey texture (p: 0.016).

Conclusions

Our results suggest that the accepted viscosity ranges by NDD for the different textures might be too wide because institutionalized elderly and their caregivers are able to discern small differences in viscosity in nectar and honey textures. Gum-based thickeners with different composition showed differences in viscosity capacity, so they are not interchangeable.
Outcomes between prediabetes and type 2 diabetes mellitus in older adults with acute myocardial infarction in the era of newer-generation drug-eluting stents: a retrospective observational study
Authors: Kim Yong Hoon , Her Ae-Young , Jeong Myung Ho , Kim Byeong-Keuk , Hong Sung-Jin , Park Sang-Ho , Kim Byung Gyu , Kim Seunghwan , Ahn Chul-Min , Kim Jung-Sun , Ko Young-Guk , Choi Donghoon , Hong Myeong-Ki , Jang Yangsoo
Published: November 2021

Background

The comparative clinical outcomes between prediabetes and type 2 diabetes mellitus (T2DM) in older adults with AMI in the era of newer-generation drug-eluting stents (DES) are limited. We investigated the 2-year clinical outcomes of these patients.

Methods

A total of 5492 AMI patients aged ≥65 years were classified into three groups according to their glycemic status: normoglycemia (group A: 1193), prediabetes (group B: 1696), and T2DM (group C: 2603). The primary outcome was the occurrence of major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization. The secondary outcome was stent thrombosis (ST).

Results

The primary and secondary outcomes cumulative incidences were similar between the prediabetes and T2DM groups. In both the prediabetes and T2DM groups, the cumulative incidences of MACE (adjusted hazard ratio [aHR]: 1.373; p = 0.020 and aHR: 1.479; p = 0.002, respectively) and all-cause death or MI (aHR: 1.436; p = 0.022 and aHR: 1.647; p = 0.001, respectively) were significantly higher than those in the normoglycemia group. Additionally, the cumulative incidence of all-cause death in the T2DM group was significantly higher than that in the normoglycemia group (aHR, 1.666; p = 0.003).

Conclusions

In this retrospective study, despite the 2-year clinical outcomes of the patients with prediabetes and T2DM in the older adults were worse than those in the normoglycemia group; they were similar between the prediabetes and T2DM groups. Hence, comparable treatment strategies should be strengthened between prediabetes and T2DM in older adults with AMI.

Trial registration

Retrospectively registered.
Persistence of SARS-CoV-2 infection on personal protective equipment (PPE)
Authors: Córdoba-Lanús Elizabeth , García-Pérez Omar , Cazorla-Rivero Sara , Rodríguez-Esparragón Francisco , Piñero José-Enrique , Clavo Bernardino , Lorenzo-Morales Jacob
Published: November 2021

Background

SARS-CoV-2 stability and infection persistence has been studied on different surfaces, but scarce data exist related to personal protective equipment (PPE), moreover using realist viral loads for infection. Due to the importance for adequate PPE management to avoid risk of virus infection, RNA stability was evaluated on PPE.

Methods

Persistence of SARS-CoV-2 infection and detection of genomic RNA in PPE (gowns and face masks) were determined by in-vitro assays and RT-qPCR, respectively. Samples were infected with a clinical sample positive for SARS-CoV-2 (Clin-Inf), and with a heat-inactivated SARS-CoV-2 strain sample (Str-Inf) as a control.

Results

PPE samples infected with Clin-Inf were positive for the 3 viral genes on gowns up to 5 days post-infection, whereas these overall genes were detected up to 30 days in the case of face masks. However, gowns and FFP2 masks samples contaminated with Clin-Inf showed a cytopathic effect over VERO cells up to 5–7 days post-infection.

Conclusions

SARS-CoV-2 RNA was detected on different PPE materials for 5 to 30 days, but PPE contaminated with the virus was infectious up to 5–7 days. These findings demonstrate the need to improve PPE management and to formulate strategies to introduce viricidal compounds in PPE fabrics.
Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study
Authors: Fruscalzo A. , Reinecke K. , Londero A. P. , Gantert M.
Published: November 2021

Objective

To evaluate the impact on cesarean section (CS) rate with of a program of multiple non-clinical interventions targeted at health-care professional within a hospital maternity ward.

Materials and methods

Retrospective quasi-experimental pre-post intervention study with an historical control group conducted in a second-level teaching hospital. All women who gave birth in the period 2014 to 2018 were included. A series of multiple non-clinical interventions including a dedicated team of obstetricians for delivery room and antenatal counseling, monthly internal audits and physician education by local opinion leader were prospectively introduced from September 2016. The primary outcome of the study was the CS rate. The incidences of operative vaginal delivery, 3rd−/4th-degree perineal tears and further maternal and neonatal complications were considered as secondary outcomes.

Results

The CS rate dropped from 33.05 to 26.06% after starting the interventions (p < 0.01); in particular, the cumulative rate of CS performed during labor decreased significantly from 19.46 to 14.11% (p < 0.01). CS reduction was still statistically significant after multivariate correction (OR = 0.66, CI.95 = 0.57–0.76, p < 0.01). Results further showed an increased prevalence of 3rd-degree perineal tears (0.97% versus 2.24%, p < 0.01), present also after correcting for possible confounding factors (OR = 2.36, CI.95 = 1.48–3.76, p < 0.01). No differences were found in the rate of vaginal-operative births and further maternal complications, while the composite neonatal outcome was found to be improved (OR = 0.73, CI.95 = 0.57–0.93, p = 0.010).

Conclusions

The introduction of multiple non-clinical interventions can significantly reduce the CS rate. However, beside an improvement in neonatal composite outcome, a potential increase in high-degree perineal tears should be taken in account.