bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive Factors of Extubation Failure in COVID-19 Mechanically Ventilated Patients
Authors: Guzatti Natália Godoy , Klein Fernanda , Oliveira Julia Almeida , Rático Gustavo Bruno , Cordeiro Marcos Freitas , Marmitt Luana Patrícia , Carvalho Diego de , Nunes Filho João Rogério , Baptistella Antuani Rafael
Published: April 2022

Purpose: We investigated whether COVID-19 patients on mechanical ventilation (MV) had a different extubation outcome compared to non-COVID-19 patients while identifying predictive factors of extubation failure in the former. Methods: A retrospective, single-center, and observational study was done on 216 COVID-19 patients admitted to an intensive care unit (ICU) between March 2020 and March 2021, aged ≥ 18 years, in use of invasive MV for more than 24 h, which progressed to weaning. The primary outcome that was evaluated was extubation failure during ICU stay. A statistical analysis was performed to evaluate the association of patient characteristics with extubation outcome, and a Poisson regression model determined the predictive value. Results: Seventy-seven patients were extubated; the mean age was 57.2 years, 52.5% were male, and their mean APACHE II score at admission was 17.8. On average, MV duration until extubation was 8.7 ± 3.7 days, with 14.9 ± 10.1 days of ICU stay and 24.6 ± 14.0 days with COVID-19 symptoms. The rate of extubation failure (ie, the patient had to be reintubated during their ICU stay) was 22.1% (n = 17), while extubation was successful in 77.9% (n = 60) of cases. Failure was observed in only 7.8% of cases when evaluated 48 hours after extubation. The mean reintubation time was 4.28 days. After adjusting the analysis for age, sex, during of symptoms, days under MV, dialysis, and PaO2/FiO2 ratio, some parameters independently predicted extubation failure: age ≥ 66 years (APR = 5.12 [1.35-19.46]; p = 0.016), ≥ 31 days of symptoms (APR = 5.45 [0.48-62.19]; p = 0.016), and need for dialysis (APR = 5.10 [2.00-13.00]; p = 0.001), while a PaO2/FiO2 ratio >300 decreased the probability of extubation failure (APR = 0.14 [0.04-0.55]; p = 0.005). The presence of three predictors (ie, age ≥ 66 years, time of symptoms ≥ 31 days, need of dialysis, and PaO2/FiO2 ratio < 200) increased the risk of extubation failure by a factor of 23.0 (95% CI, 3.34-158.5). Conclusion: COVID-19 patients had an extubation failure risk that was almost three times higher than non-COVID-19 patients, with the extubation of the former being delayed compared to the latter. Furthermore, an age ≥ 66 years, time of symptoms ≥ 31 days, need of dialysis, and PaO2/FiO2 ratio > 200 were independent predictors for extubation failure, and the presence of three of these characteristics increased the risk of failure by a factor of 23.0.
Recycled thermoplastic polyurethane as a coupling agent in automotive polypropylene compounds with coconut fibers
Authors: Guillén-Mallette Javier , Valadez-González Alex , Rosado-Sánchez Silvia Isabel
Published: April 2022

This study evaluates the effect of recycled thermoplastic polyurethane (RTPU) on the Izod impact resistance of polypropylene (PP) compounds with 50% coconut fibers arranged randomly. The Izod impact resistance was compared to the performance of a commercial coupling agent (CCA) of maleic anhydride grafted PP copolymer (MAPP). The PP compounds were made with 0, 2.5, and 5% by weight of RTPU or CCA, and with 50% of short or long coconut fibers, in the form of plates molded by thermo-compression, where the plastic components were previously extruded in the form of filaments. The morphology of the resulting materials was studied by scanning electron microscopy (SEM). The functional groups and their possible interactions present were determined by Fourier transform infrared spectroscopy (FTIR). Furthermore, the interfacial shear strength between the polymeric matrix and the coconut fiber was determined. The results showed a higher Izod impact resistance and a higher adhesion between long coconut fiber and PP when they contain 5% RTPU. This is explained by the higher interfacial shear strength between them given by the chemical and/or physical interaction between functional groups such as the lignin of coconut fibers and the isocyanate groups of RTPU, which in turn determined the shortest critical length of coconut fiber. The impact resistance values ranged from 19.8 to 24.4 J/m for mixtures of PP with short coconut fibers and 39.9–71.7 J/m for PP with long coconut fibers.
Timing and Frequency Matter: Same Race/Ethnicity Teacher and Student Achievement by School Level and Classroom Organization
Authors: Hwang NaYoung , Graff Patrick , Berends Mark
Published: April 2022

Existing research examines whether studying with teachers of the same race/ethnicity affects student achievement, but little is known about whether those effects vary by timing and frequency. We use 7 years of administrative data from third through eighth graders in Indiana to estimate the heterogenous links between same race/ethnicity teachers and achievement by school level (i.e., elementary vs. middle schools) and self-contained classroom (i.e., self-contained vs. departmentalized classrooms). We find that the positive links between same race/ethnicity teachers and improved achievement are stronger for elementary school students and students in self-contained classrooms, particularly for Black students. Our findings highlight the importance of timing and frequent exposure to same race/ethnicity teachers in academic trajectories.
Machinability investigation and sustainability analysis of high-pressure coolant assisted turning of the nickel-based superalloy Inconel 718
Authors: Cica Djordje , Kramar Davorin
Published: April 2022

In recent years, issues related to eco-friendly machining have received more and more attention, leading to the development of new cooling/lubrication techniques. Herein, the paper investigates the effect of high-pressure coolant (HPC) supply on machining performance of Inconel 718 and compare with conventional flood cooling. Significant improvement in tool life, tool wear, tool-chip contact length, material removal volume, and cutting forces have been observed from the outcomes of HPC cooling condition. Moreover, in order to study the environmental impact of machining Inconel 718, a carbon emissions model was established and analyzed for high-pressure and flood cooling conditions, taking into account the carbon emissions from energy, material, cutting tool, and cooling/lubrication fluid. HPC assisted machining was revealed to be better as it makes possible a reduction in overall carbon emissions at higher cutting speeds. In addition, economic analysis for both cutting environments was also carried out. Significant improvement in reduction of the overall machining cost was observed under HPC conditions, especially at higher cutting speeds. In a nutshell, the findings revealed better performance of HPC assisted machining, with regard to machinability, environmental, and economic issues.
Development and evaluation of bioactive 3D zein and zein/nano-hydroxyapatite scaffolds for bone tissue engineering application
Authors: Zaersabet Mona , Salehi Zivar , Hadavi Mahvash , Talesh Sasani Soheila , Rastgoo Noestali Fataneh
Published: April 2022

The aim of this study is to generate and investigate biodegradable and biocompatible zein and zein/nano-hydroxyapatite composite scaffolds for bone defect healing. 3D zein scaffold was successfully fabricated using the salt-leaching method and incorporated with 12.5 wt% nHA for osteogenic differentiation of murine myoblast cell line (C2C12 cells). The scaffolds were subjected to physicochemical and biomechanical characterizations using the scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), biodegradation, porosity, mechanical tests. C2C12 cells were cultured on scaffolds and incubated for 21 days. Cell proliferation was detected by the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Quantitative real-time PCR was used to test the expression of osteoblastic-related genes including Runx2, ALP, and Col1A1. The scaffolds had an adequate mean pore size and a total porosity of 61.1%–70.6%. The addition of 12.5 wt% nHA to the zein scaffold increased the compressive modulus to 79.1 MPa and the ultimate strength to 2.7 MPa. The qRT-PCR analysis confirmed that mRNA transcript levels were significantly higher ( p < 0.05) on the zein/nHA than on the pure zein scaffold. The results suggested that the developed scaffolds could be a potential candidate for bone tissue engineering due to their promising osteoinductivity, surface topography, mechanical behavior, biodegradability.
Financial Crisis at Jet Airways Limited: Turnaround or Bankruptcy
Authors: Soman Siddhesh S. , Punjani Krunal K.
Published: April 2022

In 1992, Naresh Goyal started on a journey to build the best airline in India, Jet Airways. With rising market share and revenues, Jet Airways began climbing up the ladder of success. It gradually became one of the household names in the Indian aviation sector. In 2005, it came up with an initial public offering (IPO) to reach greater heights with large investments from the funding raised. A ‘paradigm shift’ in the Indian airline business came in 2006 with the increased competition and entry of low-cost carriers. The rise in the competition impacted Jet’s turnover, which was ultimately reflected in the diminishing profitability margins. With a series of industry challenges and questionable managerial decisions, Jet became a debt-ridden and loss-making enterprise from being one of the leaders in the aviation sector. Eventually, in April 2019, Jet Airways temporarily ceased its operations because of a lack of funding available to sustain it. The consortium of lenders, led by State Bank of India (SBI), faced a serious dilemma; whether to revive the airline by looking for potential investors or declare Jet bankrupt and begin the bankruptcy proceedings.
The Influence of Green Behaviour Using Theory of Planned Behaviour Approach: Evidence from Malaysia
Authors: Ogiemwonyi Osarodion , Harun Amran , Hossain Mohammad Imtiaz , Karim Asif Mahbub
Published: April 2022

The study focuses on the influence of green behaviour based on the theory of planned behaviour (TPB). A conceptual model has been developed from TPB with additional factors linking green behaviour. A quantitative research method has been adopted. The data is gathered from a survey which has been administered by distributing questionnaires to 280 green consumers in Kuala-Lumpur, Malaysia. The data has been processed vis-à-vis the assessment of measurement and structural model using SmartPLSver3.0. The study contributable examines the role of predictive factors and how it influences green behaviour. Perceived behavioural control (PBC) and attitude dimensions are included as suggested by TPB. The results show that attitude and green culture positively influence green behaviour in TPB; whereas, PBC and awareness show no influence. The study shows the path to translate green culture and attitude to validate the TPB model. While the findings on green culture conform earlier studies, and indicate for a mixed collectivist society like Malaysia; where people showcase their belief while embracing green behaviour. The study further provides an insight to policymakers on how to increase awareness and improve progressive pedagogy on green behaviour.
Factors contributing to neck pain in patients with degenerative cervical myelopathy: A prospective multicenter study
Authors: Inose Hiroyuki , Hirai Takashi , Yoshii Toshitaka , Kimura Atsushi , Takeshita Katsushi , Inoue Hirokazu , Maekawa Asato , Endo Kenji , Miyamoto Takuya , Furuya Takeo , Nakamura Akira , Mori Kanji , Kanbara Shunsuke , Imagama Shiro , Seki Shoji , Matsunaga Shunji , Takahashi Kunihiko , Okawa Atsushi
Published: April 2022

Purpose

Although the understanding of the mechanisms of low back pain due to spinopelvic sagittal imbalance has strengthened, the understanding of the mechanisms of neck pain remains insufficient. Thus, this study aimed to identify the factors associated with preoperative and postoperative neck pain in patients with degenerative cervical myelopathy who underwent laminoplasty.

Methods

In this prospective multicenter study, we prospectively enrolled patients who were scheduled for laminoplasty for degenerative cervical myelopathy. The associations between different variables and the Numerical Pain Rating Scale (NRS) scores for neck pain were investigated using univariate and multiple linear regression models.

Results

In total, 92 patients were included in the current study. The univariate analysis showed that age, sex, cervical lordosis in neutral and extension, and thoracic kyphosis were significantly associated with the preoperative NRS score for neck pain; moreover, preoperative cervical lordosis in extension and range of motion and postoperative cervical lordosis in neutral, flexion, and extension were significantly associated with the postoperative NRS Scale score for neck pain. Stepwise multiple regression analysis showed that the independent factors contributing to preoperative neck pain were preoperative cervical lordosis in extension, sex, and age. The independent preoperative predictor and contributor to postoperative neck pain were preoperative cervical lordosis in extension and postoperative cervical lordosis in extension, respectively.

Conclusions

Cervical lordosis in extension showed significant association with neck pain in patients with degenerative cervical myelopathy. Therefore, when performing laminoplasty for patients with a low cervical lordosis in extension, attention should be paid to residual postoperative neck pain.
Increased signal intensity, not volume variation of infrapatellar fat pad in knee osteoarthritis: A cross-sectional study based on high-resolution magnetic resonance imaging
Authors: He Jinshen , Ba Hongliang , Feng Jing , Peng Cheng , Liao Yunjie , Li Lifeng , Cao Xu , Wang Zili , Shen Minren , Wu Song
Published: April 2022

Background

Infrapatellar fat pad (IPFP) is regarded as an essential knee tissue involved in osteoarthritis (OA) for its potential structural-related or metabolism-related function. This cross-sectional study aims to identify which part is more related to OA.

Methods

Patients with knee OA ( n = 53) and healthy controls ( n = 54) were prospectively recruited. Based on high-resolution magnetic resonance imaging with a slice thickness of only 0.35 mm, IPFP structural-related parameters (volume and maximal area), metabolism-related parameter (signal), degeneration indicators, and patellar maltracking indicators (patellar translation, patellofemoral angle, and Insall-Salvati ratio) were measured. IPFP volume (maximal area, and signal) was compared between healthy controls and OA patients. The level of significance for all comparisons was set as .05.

Results

OA patients had higher IPFP signal (672.9 ± 136.9 vs 567.3 ± 63.6, p = .009), but no significant difference in IPFP volume or maximal area compared with healthy controls. In healthy controls, IPFP signal was positively associated with age ( β = 1.481; 95% CI: 0.286–2.676; p = .018); IPFP maximal area was positively related to Insall-Salvati ratio ( β = 0.001; 95% CI: 0.0003–0.0017; p = .039), but not associated with patellar translation and patellofemoral angle. In OA patients, IPFP signal was positively associated with cartilage loss ( β = 0.005; 95% CI: 0.003–0.007; p = .013); no correlation between knee pain and IPFP volume or maximal area was observed.

Conclusions

The metabolism-related function of IPFP, which can be reflected by the IPFP signal, might play a more critical role in OA progression than its structural function.
Selective layer-by-layer fillering and its effect on the dynamic response of laminated composite plates using higher-order theory
Authors: Parida Sarada Prasad , Jena Pankaj Charan
Published: April 2022

In this work, a fifth-order shear deformation theory is computed using the layer-wise model to determine non-dimensional fundamental frequencies. The theoretical, experimental, and finite element analysis (FEA) results are compared for a standard isotropic material. Hand layup technique is used to prepare glass fiber reinforced polymer composites (GFRPC) with selective layers filled with graphene and flyash. This technique helps to reduce the fabrication cost as the whole structure is not to be strengthened by the fillers. Six classes of the laminated-composite-plate (LCP) such as outer layer graphenated LCP (O-LCP), core layer graphenated LCP(C-LCP), functionally graded LCP (FG-LCP), LCPs only rich in graphene (G-LCP), LCPs only rich in flyash (F-LCP) along with a neat epoxy-glass LCP (N-LCP) are fabricated. A low-cost frequency measurement module is set-up to measure the fundamental frequency (FF) of the fabricated LCPs. FFs, amplitudes, non-dimensional stress parameters, and central deflection of the LCPs under harmonic load, the buckling strength, and displacements of the LCPs are calculated. It is found that harmonically excited C-LCP and O-LCP have better stability accompanied by lower deflections, followed by G-LCP as compared to other kinds of LCPs. Also, the addition of graphene increases the buckling strength of LCPs, which portrays that the local layer filling is a useful technique to enhance the strength of the LCPs.
Comparison of Icare HOME and non-contact tonometer in intraocular pressure measurement in the early stage after ICL V4c implantation
Authors: Ye Yuhao , Yang Fangwen , Ding Lan , Xia Fei , Niu Lingling , Wang Xiaoying , Zhao Jing , Zhou Xingtao
Published: April 2022

Purpose

To investigate the characteristics of intraocular pressure (IOP) measurements using the Icare HOME rebound tonometer (RBT) and non-contact tonometer (NCT) during the early stage after implantable collamer lens (ICL) V4c implantation, and to assess the agreement between the two methods.

Methods

This prospective case series study included 104 eyes of 53 patients (mean age 28.77  ±  5.34 years), who underwent ICL V4c implantation. IOP was measured preoperatively, and at 0.5, 1, 2, 4, and 24 h postoperatively by Icare HOME and NCT, respectively.

Results

All surgeries were uneventful. IOP measurements by Icare and NCT preoperatively were 14.03  ±  2.90 mmHg and 14.09  ±  2.87 mmHg, respectively.The corresponding values were 12.56  ±  8.09 mmHg and 14.12  ±  6.52 mmHg (P > 0.05) at postoperative 0.5 h, 19.21  ±  8.74 mmHg and 19.60  ±  7.66 mmHg at postoperative 1 h (P > 0.05), 21.21  ±  8.10 mmHg and 20.31  ±  6.93 mmHg at postoperative 2 h (P > 0.05), 16.11  ±  5.89 mmHg and 17.04  ±  4.84 mmHg at postoperative 4 h (P > 0.05), and 14.04  ±  3.88 mmHg and 14.78  ±  2.80 mmHg at postoperative 24 h, respectively (P > 0.05). There was good agreement based on intraclass correlation coefficients (ICCs) between NCT and Icare HOME (all ICCs > 0.6 at different time points [range, 0.6986–0.956]). The Bland-Altman plot showed a mean percentage of over 95.81% of the points falling within the limits of agreement. There was a significant difference in the low IOP measurements (<10 mmHg) between Icare HOME and NCT (7.28  ±  2.55 vs. 10.65  ±  2.48, P < 0.001).

Conclusion

Icare HOME can be used for IOP measurement after ICL V4c implantation and demonstrated good agreement with NCT, except in cases with low intraocular pressure (<10 mmHg).
Why Agricultural Tools Work in Theory But Aren’t Adopted in Practice: A Grounded Theory Approach to ICT in Ghana and Kenya
Authors: Mallory Adrian , Parker Alison , Hutchings Paul , Sakrabani Ruben
Published: April 2022

Organic fertilisers could contribute to addressing the issues of declining soil fertility, food security and waste management by recycling human waste for use in sub-Saharan Africa. The variable nutrient content of such products can make targetted application more difficult than in chemical fertilisers. One solution to this could be the use of in-field soil testing and information, particularly with the expansion of mobile technology. This research investigated the role of information and soil testing in 43 farmers using human waste derived fertilisers in Kenya and Ghana. Interviews were conducted to understand the use and sources of information in farming and the perception of soil testing technologies. It was found that mobile based testing was unlikely to be adopted for reasons of low priority, the type of knowledge being shared and trust after failures of different projects. Farmers did not see soil testing as the major issue that they needed to solve. Mobile technology was mostly used for visual and oral communication whereas soil testing often provided information in an unsuitable way. Farmers also had limited trust in new projects as they had previously had project failures that did not help them. In order to achieve sustainable adoption of technology there needs to be improved methods of disseminating and learning from project failures to prevent repeated attempts at inappropriate technology in the future.
Ventilation time recommendation system incorporating local meteorological data
Authors: Muñuzuri Alberto P , Otero-Cacho Alberto , Mira Jorge
Published: April 2022

Since the airborne transmission of SARS-CoV-2 is the key in the spread of COVID-19, the interest in the quality of the air in enclosed spaces has become utmost importance. Natural ventilation is the first obvious option to improve epidemiological security, and general rules have been widely disseminated. Nevertheless, the changes in weather conditions greatly limit the validity of such rules. Here we present a system that, upon the introduction of basic parameters of a given space, its volume, location, orientation, architectural environment and average occupancy, yields optimized ventilation times on the basis of wind meteorological forecasts. It has been successfully implemented in the educative system of the Autonomous Community of Galicia (northwest Spain) and it is currently operative.
Exploring alcohol cultures and homosocial relationships in women's amateur AFL teams
Authors: Curtis Lily , Roberts Steven
Published: April 2022

Young women's risky drinking cultures are pertinent to the world of amateur Australian Football League, yet they have received limited research attention. Drawing on surveys, focus groups, and semi-structured ‘scroll-back’ interviews, this study provides an in-depth investigation of negotiations of gender and risky drinking in such cultures. A range of intersecting socio-cultural themes were identified, summarised into four overarching elements: drinking as central to initial homosociality; awareness of appropriateness; divergences between women's and men's cultural priorities and alcohol behaviours; and young women's unique cultural prioritisation of collectivity and mutuality. The findings further sociological knowledge on risky drinking and gender.
Consequences of varying compression ratio and ignition timing on engine fueled with E-MEBANOL
Authors: Pandey Jayashish Kumar , MH Dinesh , GN Kumar
Published: April 2022

Alcohols are oxygenated renewable fuels responsible for low carbon emission and high H/C ratio. In the present study, a blend of methanol, ethanol, and n-butanol in equal proportion by volume (E-MEBANOL) is tested as a sustainable fuel for SI engines under variable compression ratio (CR) and ignition timing (SOI). The performance of the engine is found to improve by increasing CR as well as advancing the SOI, as the brake power (BP), brake thermal efficiency (BTE), and volumetric efficiency are found to increase by increasing CR to 15 from 11 at an advanced SOI of 24°CA before top dead center (BTDC) from 16°CA BTDC by 17.54%, 17.47%, and 10.53% respectively. Similarly, combustion is also enhanced with increasing CR and advancing SOI as the peak cylinder pressure (Pmax), and maximum net heat release rate (NHRmax) are found to increase by 60% and 27.64%, respectively, while positions of these peaks are advanced by 17°CA and 18°CA respectively by increasing CR from 11 to 15 and SOI advanced to 24°CA BTDC. The flame development period (CA10) increases with advancing SOI and decreases with increasing CR, while the flame development period (CA10-90) and total combustion duration decrease with both increasing CR and advancing SOI. The CO & HC emissions improve with increasing CR and advancing SOI, while NOx increases drastically, but EGT decreases continuously.
Capacity-related factors associated with computer science access and participation in Georgia public high schools
Authors: Parker Miranda C. , Hendrickson Katie A.
Published: April 2022

States across the United States are enacting policies aimed at increasing computer science (CS) courses and content in K–12 schools. We explore the relationship between such policy with the capacity of high schools to teach CS courses and student access to and participation in CS courses. To do this, we focus on Georgia, a state that has had a robust CS education movement over the past two decades. This paper investigates two research questions: 1) What factors at the school or district level are related to whether a high school teaches CS in Georgia? 2) What factors are related to CS enrollment rates in Georgia high schools? We examine these questions within the context of national and state policy factors that increase capacity of schools to teach CS. We describe the results of correlation and regression analyses of publicly available data for each school and district from 2016 and school CS enrollment from 2012 to 2016 in answering these questions. Results indicate that the odds of a school offering CS in 2016 were greatest for schools that taught CS the prior year, although median income and school size were also significant factors when prior CS was not considered. For CS enrollment, the model that included prior CS enrollment rates explained the most variance, although school size, median income, and the percentage of students who identify as Asian were also significant when prior CS enrollment was not included in the model. CS-specific policy has the potential to mitigate the effects of school size and income by offering capacity supports to schools that do not currently offer CS and can contribute to the sustainability and growth of CS offerings. These results have implications for policy efforts beyond the state of Georgia and provide direction for future research examining the causes of sustained CS offerings and enrollment patterns.
N6-methyladenosine Modification-Related Long Non-Coding RNAs are Potential Biomarkers for Predicting the Prognosis of Patients With Osteosarcoma
Authors: Yang Kun , Wang Fengyan , Li Ke , Peng Guoxuan , Yang Hua , Xu Hong , Xiang Yang , Sun Hong
Published: April 2022

Background: The role of N6-methyladenosine (m6A)-related long non-coding RNAs (lncRNAs) in osteosarcoma (OS) has not been fully studied yet. We aimed to identify m6A-related lncRNAs that could act as prognostic biomarkers for OS. Methods: Pearson correlation was performed to identify m6A-related lncRNAs. Univariate and multivariate Cox regression analyses were performed to construct the risk model and assess whether the risk score was an independent prognostic factor for patients with OS. Gene Set Enrichment Analysis (GSEA) was performed to analyze the functions of genes in high-risk and low-risk groups. StarBase and Cytoscape were used to construct a competing endogenous RNA (ceRNA) network based on m6A-related prognostic lncRNA signature. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to analyze the function of genes involved in the ceRNA network. Results: We extracted 122 common lncRNAs from TCGA and Gene Expression Omnibus (GEO) databases. Pearson correlation results revealed 59 significant m6A-related lncRNAs in The Cancer Genome Atlas (TCGA) database, from which 2 were screened to construct a risk signature in TCGA dataset, which was then validated in the GEO dataset. A corresponding risk score was calculated and shown to be an independent prognostic factor for patients with OS. Enrichment analysis indicated that cell proliferation-related biological processes were more common in the high-risk group, while immune-related biological processes were more common in the low-risk group. Moreover, we established a nomogram that had a good ability to predict the overall survival of patients with OS. Additionally, a ceRNA network based on small nucleolar RNA host gene 7 ( SNHG7) and small nucleolar RNA host gene 12 ( SNHG12) was constructed, with genes that were enriched in hepatocellular carcinoma, gastric cancer, and non-small-cell lung cancer pathways. Conclusion: Our study revealed the prognostic role of m6A-related lncRNAs in OS and identified SNHG7 and SNHG12 as potential biomarkers for predicting the prognosis of patients with OS. These findings have enriched our understanding of the role of m6A modification in the dysregulation of lncRNAs in OS.
School-Based Cognitive-Behavioral Therapy in an Inclusion Model for an Adolescent with Comorbid Major Depressive Disorder, Generalized Anxiety Disorder, and Attention Deficit Hyperactivity Disorder: A Case Study
Authors: Goff Teresa M. , Moody Mary E. , Acosta Liliana L. , Joyce-Beaulieu Diana
Published: April 2022

The goal of the current case study was to illustrate evidence-based cognitive-behavioral treatment (CBT) for an adolescent female with comorbid major depressive disorder, generalized anxiety disorder, attention deficit hyperactivity disorder, suicidal ideations, and a history of multiple involuntary hospitalizations. Multimodal assessment of the child’s symptoms was conducted, including parent, teacher, and child self-report, academic data, and hospital records to inform case conceptualization. Treatment included a combination of psychoeducation, cognitive restructuring, positive self-talk, relaxation skills, and the support of a school-based personal aide. Significant improvements with inattentive, anxiety, and depressive symptoms were reported, with gains being maintained at 1 year follow-up. In addition to a reduction of reported psychosocial problems, treatment benefits also included a decrease in classroom disruptions, improvement in academic performance, and withdrawal of paraprofessional support at school. This study illustrates the use of school-based CBT strategies coupled with additional focused Tier 4 behavior supports as an efficacious treatment for youth with significant comorbidity.
PRP Versus Standard of Care for Venous leg Ulcers: A Systematic Review and Meta-Analysis of Prospective Comparative Studies
Authors: Yammine Kaissar , Ghanimeh Joe , Jil Agopian Sira , Assi Chahine , Hayek Fady
Published: April 2022

Venous leg ulcers (VLUs) are chronic and recalcitrant lower limb wounds that affect millions of patients annually, severely reducing their quality of life, and causing a significant burden on the health care system. Recently, Platelet rich plasma (PRP) has been used to improve healing of VLUs. This systematic review aimed at evaluating the effectiveness of PRP versus the standard of care commonly used to treat VLUs. Ten prospective studies (8 randomized) met the inclusion criteria comprising 451 patients with 527 VLUs. Results were as follows: a) the weighted Odds Ratio (OR) of the mean healing rate was 2.84 (95% CI = 1.160 to 5.056, I2 = 41.4%, p = 0.0004), b) the mean healed ulcer areas were 79.2 ± 19% for the PRP group and 51.7 ± 36% for the control group (p = 0.007) in favor of the PRP group, and c) the weighted infection OR showed no significant difference between both groups. Additionally, negative correlations were found between healing rate and duration of VLUs and initial size of the ulcers. This meta-analysis demonstrated significant beneficial effects of PRP versus standard of care on healing rate, reduction in surface, and reduction in healing time of VLUs. Infection and other complications were similar to standard of care. Therefore, our analytical data would support the use of PRP as a safe and effective treatment for VLUs.
Early, Intensive, Lower Extremity Rehabilitation Shows Preliminary Efficacy After Perinatal Stroke: Results of a Pilot Randomized Controlled Trial
Authors: Hurd Caitlin , Livingstone Donna , Brunton Kelly , Smith Allison , Gorassini Monica , Watt Man-Joe , Andersen John , Kirton Adam , Yang Jaynie F.
Published: April 2022

Background

Perinatal stroke injures motor regions of the brain, compromising movement for life. Early, intensive, active interventions for the upper extremity are efficacious, but interventions for the lower extremity remain understudied.

Objective

To determine the feasibility and potential efficacy of ELEVATE—Engaging the Lower Extremity Via Active Therapy Early—on gross motor function.

Methods

We conducted a single-blind, two-arm, randomized controlled trial (RCT), with the Immediate Group receiving the intervention while the Delay Group served as a 3-month waitlist control. A separate cohort living beyond commuting distance was trained by their parents with guidance from physical therapists. Participants were 8 months to 3 years old, with MRI-confirmed perinatal ischemic stroke and early signs of hemiparesis. The intervention was play-based, focused on weight-bearing, balance and walking for 1 hour/day, 4 days/week for 12 weeks. The primary outcome was the Gross Motor Function Measure-66 (GMFM-66). Secondary outcomes included steps and gait analyses. Final follow-up occurred at age 4.

Results

Thirty-four children participated (25 RCT, 9 Parent-trained). The improvement in GMFM-66 over 12 weeks was greater for the Immediate than the Delay Group in the RCT (average change 3.4 units higher) and greater in younger children. Average step counts reached 1370-3750 steps/session in the last week of training for all children. Parent-trained children also improved but with greater variability.

Conclusions

Early, activity-intensive lower extremity therapy for young children with perinatal stroke is feasible and improves gross motor function in the short term. Longer term improvement may require additional bouts of intervention.

Clinical trial registration

This study was registered at ClinicalTrials.gov (NCT01773369).
International research priority setting exercises in stroke: A systematic review
Authors: Leitch Stephanie , Logan Monica , Beishon Lucy , Quinn Terence J
Published: April 2022

Background:

Agreeing on priority topics for stroke research can help make best use of limited funding, people, and time. Formal priority-setting exercises collate stakeholders’ opinions to reach consensus on the most important research questions. Several stroke research priority setting exercises have been published. Exploring commonalities and differences between these exercises could bring a better understanding of priority research topics.

Aim:

We collated and compared published stroke research priority setting exercises across international healthcare systems.

Summary of review:

Multidisciplinary, electronic literature databases were searched from 2000 to 2021, using a validated search syntax. Inclusion criteria were: full article; stroke focus (any subtype); prioritization method described; and lists priorities for research. Priorities were extracted, coded, and assigned to categories using thematic analysis. The Nine Common Themes of Good Practice and the Reporting guideline for priority setting of health research checklists were used to assess methodological and reporting quality respectively. From 623 titles assessed, 14 studies were eligible for inclusion, including 2410 participants and describing 165 priorities. The majority of priority setting exercises were conducted in high-income countries (86%, n = 12 articles), published between 2011 and 2021 (64%, n = 9), and included views of healthcare professionals (57%, n = 8), and stroke survivors (50%, n = 7). Caregivers (n = 3, 21%) were under-represented. The James Lind Alliance priority setting method was most commonly used (50%, n = 7). Priorities were grouped into 10 thematic categories. Rehabilitation and follow-up was the most common priority theme (15%, n = 25 priorities), followed by psychological recovery (14%, n = 23), pathology (14%, n = 23), and caregivers and support (14%, n = 23). Priorities differed by year and case-mix (stakeholder group and demographics) of respondents. No article was judged high quality for all aspects of method or reporting. Common limitations were around inclusiveness and evaluation of the exercise.

Conclusion:

Stroke research priorities are dynamic and context-specific. However, there was a common theme of prioritizing research that considered life after stroke. Future priority settings should consider the inclusion of nonindustrialized countries and stroke survivors with a range of impairments.
Pharmacovigilance pregnancy data in a large population of patients with chronic inflammatory disease exposed to certolizumab pegol
Authors: Clowse Megan , Fischer-Betz Rebecca , Nelson-Piercy Catherine , Scheuerle Angela E. , Stephan Brigitte , Dubinsky Marla , Kumke Thomas , Kasliwal Rachna , Lauwerys Bernard , Förger Frauke
Published: April 2022

Introduction:

Chronic inflammatory diseases (CIDs), including rheumatic diseases and other inflammatory conditions, often affect women of reproductive age. Tumor necrosis factor inhibitors (TNFi) are widely used to treat CID, but there is limited information on outcomes of TNFi-exposed pregnancies. We evaluated pregnancy outcomes from 1392 prospectively reported pregnancies exposed to certolizumab pegol (CZP), a PEGylated, Fc-free TNFi with no to minimal placental transfer.

Methods:

CZP-exposed pregnancies in patients with CID from the UCB Pharmacovigilance global safety database were reviewed from the start of CZP clinical development (July 2001) to 1 November 2020. To limit bias, the analysis focused on prospectively reported cases with known pregnancy outcomes.

Results:

In total, 1392 prospective pregnancies with maternal CZP exposure and known pregnancy outcomes ( n = 1425) were reported; 1021 had at least first-trimester CZP exposure. Live birth was reported in 1259/1425 (88.4%) of all prospective outcomes. There were 150/1425 (10.5%) pregnancy losses before 20 weeks (miscarriage/induced abortion), 11/1425 (0.8%) stillbirths, and 5/1392 (0.4%) ectopic pregnancies. Congenital malformations were present in 30/1259 (2.4%) live-born infants, of which 26 (2.1%) were considered major according to the Metropolitan Atlanta Congenital Defects Program criteria. There was no pattern of congenital malformations.

Discussion and conclusion:

No signal for adverse pregnancy outcomes or congenital malformations was observed in CZP-exposed pregnancies. Although the limitations of data collected through this methodology (including underreporting, missing information, and absence of a comparator group) should be considered, these data provide reassurance for women with CID who require CZP treatment during pregnancy, and their treating physicians.
An Examination of Affiliate and Network Television Channels’ Facebook Use for Addressing Audiences’ Critical Information Needs
Authors: Chadha Monica , Kwon K. Hazel , Tsai Jiun-Yi
Published: April 2022

Based on the principles of localism and Critical Information Needs (CIN), this study analyzed the news content posted on Facebook by three television news channels—one local ABC affiliate each in Phoenix, Arizona and Kearney, Nebraska, and ABC News network channel — to examine the extent to which these posts fulfilled the critical information needs of audiences via social media. Results showed the local channel in Phoenix posted more CIN content than both, national network ABC and the local television channel in Kearney. Audience engagement with CIN posts differed across communities, with some categories increasing engagement in Phoenix and the same categories decreasing engagement in Kearney. This finding highlights not all critical information posts lead to increased audience engagement on social media and it is important for television channels to pay attention to content format and user feedback to further increase audience engagement with critical information.
An etiology of ground - glass images during COVID-19: Pneumocystis jiroveci pneumonia
Authors: Yehouenou Tessi Romeo Thierry , Onka Behyamet , El Bakkari Asaad , Jerguigue Hounayda , Latib Rachida , Omor Youssef
Published: April 2022

Pneumocystis jiroveci pneumonia is a common pathology in HIV-infected but also in uninfected immunocompromised individuals. The pandemic coronavirus disease 2019 (COVID-2019) is a new type of coronavirus disease caused by SARS-COV-2, and the chest imaging is often used as complementary tool in patients’ evaluation. The imaging finding is similar with many pulmonary pathologies. Chest computed tomography scan is gold standard imaging and shows a central and diffuse distribution, ground- glass pattern with septal thickening with “crazy paving pattern.” We reported a case of 57-year-old man patient, followed in oncology for laryngeal cancer who presented of Pneumocystis jiroveci pneumonia during his follow-up. The diagnosis is confirmed by polymerase chain reaction with bronchoalveolar lavage fluid. Other immunochemical tests can be performed but are less specific. Both curative and preventive treatment in subjects at risk remains trimethoprim-sulfamethoxazole. Corticosteroid therapy may be associated depending on the case.
Sirenomelia: A case report
Authors: Tamene Ayanaw , Molla Mandefro
Published: April 2022

Sirenomelia also known as mermaid syndrome is a partial or complete fusion of lower extremities associated with visceral anomalies. It is a rare anomaly with a poor prognosis. Maternal age less than 20 years, maternal diabetes mellitus, and monozygotic twinning are some of the known risk factors. Diagnosis can be made via antenatal ultrasound or typical physical appearance after birth. A 2200 g baby was born from 18-year-old non-consanguineous mother via assisted breech delivery. The baby had fused lower limbs with 10 toes, absent external genitalia, and a single umbilical artery. It was small for gestational age. The baby was passed away after 30 min of birth. Young maternal age (18 years) was the identified risk factor for sirenomelia in this case. We recommend an early routine ultrasound anomaly scan in all pregnant women particularly for early detection and termination of pregnancy as the prognosis is poor. Avoiding teenager pregnancy and strict control of blood sugar in diabetic mothers can decrease this anomaly.
Human-centered design exploration with Kenyan health workers on proposed digital mental health screening and intervention training development: Thematic analysis of user preferences and needs
Authors: Kumar Manasi , Macharia Paul , Nyongesa Vincent , Kathono Joseph , Yator Obadia , Mwaniga Shillah , McKay Mary , Huang Keng Yen , Shidhaye Rahul , Njuguna Simon , Saxena Shekhar
Published: April 2022

Background

Health providers' perceived sense of knowledge, competency, and self-efficacy to support the needs of their patients contributes to optimal patient health outcomes. With regards to mental health service delivery in Kenya, this area needs further exploration. Guided by the e-health technology acceptance mode, the needs and preferences of health care providers around mental health training for clinical management and their ability to intervene in peripartum adolescent mental health care are explored. We probed how well-equipped service providers are, their engagement with technology to learn and offer services. The health care provider's technology use preferences were also explored.

Method

Guided by a human-centered design-focused qualitative inquiry we interviewed 20 specialists around their needs, perspectives, and preferences for digitized mental health screening and intervention. Mean age was 44.2 years, (range of 32–58 years), 25% (5) males and 75% (15) females. After a written consenting process, the online interviews (30−45 min) were conducted in April 2021, once personal information was de-identified interviews were transcribed and coded. Thematic analysis was used and we combined rapid appraisal of Google Jamboard online storyboards to do individual human-centered design personas alongside.

Results

Our participants were well-exposed to digital technologies. Prohibitive costs of data bundles, lack of funds for consistent online engagement, high workload, and instability of access to appropriate gadgets were found to be barriers to e-health training. Emerging opportunities were well-identified adolescent mental health service and intervention needs, willingness to take online courses offered on learning platforms, and wish for these to be disseminated through diverse social media. Other recommendations were the need to have a user-friendly interface such as data-light engaging and practical materials including animations, short, group-based learning.

Conclusion

Understanding contextual factors that influence perceived usefulness and ease of use of the remote/digital components would be critical for e-training development and its uptake.
Expecting parents’ use of digital sources in preparation for parenthood in a digitalised society – a systematic review
Authors: Bäckström Caroline , Carlén Kristina , Larsson Viveca , Mårtensson Lena Birgitta , Thorstensson Stina , Berglund Marina , Larsson Therese , Bouwmeester Björn , Wilhsson Marie , Larsson Margaretha
Published: April 2022

Background

In today's society, people are experiencing the rapid development of digitalisation. Expecting parents may have difficulties evaluating the information online; they are not always sure which sources of information are trustworthy, and this exacerbates their feelings of anxiety. More research is needed to broaden the knowledge about how their use of digital sources may influence their health.

Question

The focus of this study was to explore expecting parents’ use of digital sources and how this influences their health during pregnancy.

Methods

A systematic review covered the thematic analysis of 39 articles.

Findings

The analysis resulted in the following theme: The digitalised society involves both opportunities and challenges, and expecting parents express a need for a variety of digital sources to improve their health, and sub-themes: Digital sources could promote parents’ health and well-being in a digitalised society; Consuming digital health information facilitates understanding, different feelings and social connections; and A variety of digital sources may facilitate parental identification and adaption to parenthood.

Conclusion

Different digital sources in our digitalised society mean access to information and opportunities to extend social connections for expecting parents. This can promote their ability to understand and adapt to parenthood, as well as to improve their health and well-being and make the parental transition. However, professional support during face-to-face consultations cannot always be exchanged to digital sources. It is important to base digital sources devoted to expecting parents and digitalisation overall on multi-sectorial collaborations and coordination between different organisations and the digital sources they provide.
Intraoral Impalement Injury with Electric Toothbrush Head to the Infratemporal Fossa: A Case Report
Authors: Kobayashi Yoshikazu , Nakao Sachie , Okui Taro , Aizawa Takako , Satoh Koji
Published: April 2022

Study Design

Case Report.

Objective

To discuss the case of a 55-year-old man who complained of swelling and pain in the left cheek.

Methods

Computed tomographic images showed a shadow of retained electric toothbrush head in the left infratemporal fossa, heterotopic free air, and abscess formation in the masticatory space. Foreign body removal and surgical drainage were performed under general anesthesia.

Result

The patient was discharged 6 days postoperatively.

Conclusion

Computed tomography should invariably be performed on patients with intraoral impalement injury.