bluuebunny/crossref_metadata_2025 huggingface dataset:
Infrastructures of dissensus: repartitioning the sensible and articulating the political through the occupation of Greece’s public broadcasting service
Authors: Karaliotas Lazaros
Published: January 2023

This article engages with contemporary debates around the politics of space and the spatiality of politics by exploring how the fabrication of emancipatory infrastructures shapes the articulation and reconfiguration of the (urban) political. Moving beyond the prevailing emphasis on urban uprisings, the article focuses on the occupation and self-management of Greece’s Public Broadcasting Service (ERT) in response to New Democracy’s government decision to dismantle it in June 2013. In this juncture, ERT workers and multiple movements and activists in solidarity occupied the Service’s buildings across the country and recuperated its infrastructures to broadcast TV and Radio programmes. ERT’s buildings became key political spaces and nodal political infrastructures in the struggle against austerity. Drawing on Jacques Rancière’s conceptualization of politics as a world-making activity, the article reads these occupations as the opening of new spatialities for politics through the fabrication of infrastructures of dissensus. In this, it foregrounds the spatial and infrastructural dimensions of urban politics, explores how such infrastructure spaces reconfigure the partition of the urban sensible and traces the challenges and limitations that emerge from their encounters with the police order.
Differentiating between counterexamples for supporting students’ algorithmic thinking
Authors: Tupouniua John G.
Published: January 2023

This study examines the use of counterexamples for supporting the development of students’ algorithmic thinking. Working from the premise that some counterexamples are more effective than others for the development of generalized algorithms, the study proposes distinctions between counterexamples in relation to the iterative refinement of student-invented algorithms. Furthermore, the study identifies some factors that may influence differences among counterexamples. Using task-based interviews, data were collected from 23 undergraduate students working in pairs ( n = 8) and individually ( n = 7) on three algorithmatizing tasks. From a thematic analysis of the data, two illustrative cases are presented to show how and why different counterexamples might bring about particular revisions in students’ algorithms. The two illustrative cases highlight two types of counterexamples— set-of-instructions-changing ( SoI-changing) and domain-of-validity-narrowing ( DoV-narrowing)—and their influencing factors. Implications of the findings are discussed with respect to existing literature, further research, and teaching.
Reducing the uncertainties in the NGA-West2 ground motion models by incorporating the frequency and amplitude of the fundamental peak of the horizontal-to-vertical spectral ratio of surface ground motions
Authors: Yazdi Mohammad , Anderson John G , Motamed Ramin
Published: January 2023

Ground motion models (GMMs) are developed empirically to predict ground motion intensity measures. The site effects in GMMs are usually addressed using time-averaged shear-wave velocity for the upper 30 m of the site (VS30) and shear-wave isosurface depth (i.e. Z1.0 and Z2.5). However, the former does not include the effect of layered soil structure on the site’s response, and the latter is generally inferred. Many studies have shown that site fundamental frequency can be used as an additional site proxy. Using horizontal-to-vertical spectral ratio (HVSR), one can estimate the site fundamental frequency in a fast and inexpensive way. In this article, a model is developed to incorporate site fundamental frequency and its corresponding amplification factor in the Next Generation Attenuation (NGA)-West2 GMMs to reduce the uncertainties. First, a subset of the NGA-West2 database consisting of 14,636 recordings from 298 events is selected after a two-step screening procedure and used to compute the horizontal-to-vertical response spectral ratio (HVSRPSA) of recorded surface ground motions. Second, automated methodologies previously developed by the authors are used to obtain maximum likelihood estimates of site fundamental frequency (fml), its corresponding amplitude (Aml), and associated uncertainties. Third, a mixed-effect maximum likelihood approach is implemented for residual analysis and site-term residual calculation. Finally, an HVSR-based model is developed for the NGA-West2 dataset considering the relationship between site-term residual and the HVSR-based proxies (i.e. fml and Aml). In this model, Aml is as important as fml in reducing the uncertainties. Results show that using a single HVSR-based model can consistently reduce the site-to-site variability ([Formula: see text]) for all NGA-West2 GMMs, which already include the effect of VS30, Z1.0, or Z2.5. Besides, the reduction in [Formula: see text] is period-dependent, with an average of 13% reduction. As a result of the reduction in [Formula: see text], total standard deviation ( σ) decreases by 3.5% on average.
Combination of automated sample preparation and micro-flow LC–MS for high-throughput plasma proteomics
Authors: Ye Xueting , Cui Xiaozhen , Zhang Luobin , Wu Qiong , Sui Xintong , He An , Zhang Xinyou , Xu Ruilian , Tian Ruijun
Published: January 2023

Background

Non-invasive detection of blood-based markers is a critical clinical need. Plasma has become the main sample type for clinical proteomics research because it is easy to obtain and contains measurable protein biomarkers that can reveal disease-related physiological and pathological changes. Many efforts have been made to improve the depth of its identification, while there is an increasing need to improve the throughput and reproducibility of plasma proteomics analysis in order to adapt to the clinical large-scale sample analysis.

Methods

We have developed and optimized a robust plasma analysis workflow that combines an automated sample preparation platform with a micro-flow LC–MS-based detection method. The stability and reproducibility of the workflow were systematically evaluated and the workflow was applied to a proof-of-concept plasma proteome study of 30 colon cancer patients from three age groups.

Results

This workflow can analyze dozens of samples simultaneously with high reproducibility. Without protein depletion and prefractionation, more than 300 protein groups can be identified in a single analysis with micro-flow LC–MS system on a Orbitrap Exploris 240 mass spectrometer, including quantification of 35 FDA approved disease markers. The quantitative precision of the entire workflow was acceptable with median CV of 9%. The preliminary proteomic analysis of colon cancer plasma from different age groups could be well separated with identification of potential colon cancer-related biomarkers.

Conclusions

This workflow is suitable for the analysis of large-scale clinical plasma samples with its simple and time-saving operation, and the results demonstrate the feasibility of discovering significantly changed plasma proteins and distinguishing different patient groups.
Genome wide identification of GDSL gene family explores a novel GhirGDSL26 gene enhancing drought stress tolerance in cotton
Authors: Liu Jiajun , Liu Jiangna , Wang Heng , Khan Aziz , Xu Yanchao , Hou Yuqing , Wang Yuhong , Zhou Zhongli , Zheng Jie , Liu Fang , Cai Xiaoyan
Published: January 2023

Background

Current climate change scenarios are posing greater threats to the growth and development of plants. Thus, significant efforts are required that can mitigate the negative effects of drought on the cotton plant. GDSL esterase/lipases can offer an imperative role in plant development and stress tolerance. However, thesystematic and functional roles of the GDSL gene family, particularly in cotton under water deficit conditions have not yet been explored.

Results

In this study, 103, 103, 99, 198, 203, 239, 249, and 215 GDSL proteins were identified in eight cotton genomes i.e., Gossypium herbaceum (A1), Gossypium arboretum (A2), Gossypium raimondii (D5), Gossypium hirsutum (AD1), Gossypium barbadense (AD2), Gossypium tomentosum (AD3), Gossypium mustelinum (AD4), Gossypium darwinii (AD5), respectively. A total of 198 GDSL genes of Gossypium hirsutum were divided into eleven clades using phylogenetic analysis, and the number of GhirGDSL varied among different clades. The cis-elements analysis showed that GhirGDSL gene expression was mainly related to light, plant hormones, and variable tense environments. Combining the results of transcriptome and RT-qPCR, GhirGDSL26 (Gh_A01G1774), a highly up-regulated gene, was selected for further elucidating its tole in drought stress tolerance via estimating physiological and biochemical parameters. Heterologous expression of the GhirGDSL26 gene in Arabidopsis thaliana resulted in a higher germination and survival rates, longer root lengths, lower ion leakage and induced stress-responsive genes expression under drought stress. This further highlighted that overexpressed plants had a better drought tolerance as compared to the wildtype plants. Moreover, 3, 3’-diaminobenzidine (DAB) and Trypan staining results indicated reduced oxidative damage, less cell membrane damage, and lower ion leakage in overexpressed plants as compared to wild type. Silencing of GhirGDSL26 in cotton via VIGS resulting in a susceptible phenotype, higher MDA and H2O2 contents, lower SOD activity, and proline content.

Conclusion

Our results demonstrated that GhirGDSL26 plays a critical role in cotton drought stress tolerance. Current findings enrich our knowledge of GDSL genes in cotton and provide theoretical guidance and excellent gene resources for improving drought tolerance in cotton.
CT-based radiomics nomogram for differentiation of adrenal hyperplasia from lipid-poor adenoma: an exploratory study
Authors: Yuan Hongtao , Kang Bing , Sun Kui , Qin Songnan , Ji Congshan , Wang Ximing
Published: January 2023

Background

To establish and verify a radiomics nomogram for differentiating isolated micronodular adrenal hyperplasia (iMAD) from lipid-poor adenoma (LPA) based on computed tomography (CT)-extracted radiomic features.

Methods

A total of 148 patients with iMAD or LPA were divided into three cohorts: a training cohort (n = 72; 37 iMAD and 35 LPA), a validation cohort (n = 36; 22 iMAD and 14 LPA), and an external validation cohort (n = 40; 20 iMAD and 20 LPA). Radiomics features were extracted from contrast-enhanced and non-contrast CT images. The least absolute shrinkage and selection operator (LASSO) method was applied to develop a triphasic radiomics model and unenhanced radiomics model using reproducible radiomics features. A clinical model was constructed using certain laboratory variables and CT findings. Radiomics nomogram was established by selected radiomics signature and clinical factors. Nomogram performance was assessed by calibration curve, the areas under receiver operating characteristic curves (AUC), and decision curve analysis (DCA).

Results

Eleven and eight extracted features were finally selected to construct an unenhanced radiomics model and a triphasic radiomics model, respectively. There was no significant difference in AUC between the two models in the external validation cohort (0.838 vs. 0.843, p = 0.949). The radiomics nomogram inclusive of the unenhanced model, maximum diameter, and aldosterone showed the AUC of 0.951, 0.938, and 0.893 for the training, validation, and external validation cohorts, respectively. The nomogram showed good calibration, and the DCA demonstrated the superiority of the nomogram compared with the clinical factors model alone in terms of clinical usefulness.

Conclusions

A radiomics nomogram based on unenhanced CT images and clinical variables showed favorable performance for distinguishing iMAD from LPA. In addition, an efficient unenhanced model can help avoid extra contrast-enhanced scanning and radiation risk.
Clinical characteristics and prognosis of Glioblastoma patients with infratentorial recurrence
Authors: Kawauchi Daisuke , Ohno Makoto , Honda-Kitahara Mai , Miyakita Yasuji , Takahashi Masamichi , Yanagisawa Shunsuke , Tamura Yukie , Kikuchi Miyu , Ichimura Koichi , Narita Yoshitaka
Published: January 2023

Background

Glioblastoma (GBM) infrequently recurs in the infratentorial region. Such Infratentorial recurrence (ITR) has some clinically unique characteristics, such as presenting unspecific symptoms and providing patients a chance to receive additional radiotherapy. However, the clinical significances of ITR are not well studied.

Methods

We reviewed newly diagnosed isocitrate dehydrogenase (IDH)-wildtype GBM patients treated at our institution between October 2008 and December 2018. ITR was defined as any type of recurrence in GBM, including dissemination or distant recurrence, which primarily developed in the supratentorial region and recurred in the infratentorial region.

Results

Of 134 patients with newly diagnosed IDH-wildtype GBM, six (4.5%) were classified as having ITR. There was no significant difference in median duration from the first surgery to ITR development between patients with and without ITR (12.2 vs. 10.2 months, P = 0.65). The primary symptoms of ITR were gait disturbance (100%, n = 6), dizziness (50.0%, n = 3), nausea (33.3%, n = 2), and cerebellar mutism (16.7%, n = 1). In four cases (66.7%), symptoms were presented before ITR development. All patients received additional treatments for ITR. The median post-recurrence survival (PRS) of ITR patients was significantly shorter than that of general GBM patients (5.5 vs. 9.1 months, P = 0.023). However, chemoradiotherapy contributed to palliating symptoms such as nausea.

Conclusions

ITR is a severe recurrence type in GBM patients. Its symptoms are neurologically unspecific and can be overlooked or misdiagnosed as side effects of treatments. Carefully checking the infratentorial region, especially around the fourth ventricle, is essential during the GBM patient follow-up.
Hemolytic disease of the fetus and newborn: systematic literature review of the antenatal landscape
Authors: de Winter Derek P. , Kaminski Allysen , Tjoa May Lee , Oepkes Dick
Published: January 2023

Background

Prevention of pregnancy-related alloimmunization and the management of hemolytic disease of the fetus and newborn (HDFN) has significantly improved over the past decades. Considering improvements in HDFN care, the objectives of this systematic literature review were to assess the prenatal treatment landscape and outcomes of Rh(D)- and K-mediated HDFN in mothers and fetuses, to identify the burden of disease, to identify evidence gaps in the literature, and to provide recommendations for future research.

Methods

We performed a systematic search on MEDLINE, EMBASE and clinicaltrials.gov. Observational studies, trials, modelling studies, systematic reviews of cohort studies, and case reports and series of women and/or their fetus with HDFN caused by Rhesus (Rh)D or Kell alloimmunization. Extracted data included prevalence; treatment patterns; clinical outcomes; treatment efficacy; and mortality.

Results

We identified 2,541 articles. After excluding 2,482 articles and adding 1 article from screening systematic reviews, 60 articles were selected. Most abstracted data were from case reports and case series. Prevalence was 0.047% and 0.006% for Rh(D)- and K-mediated HDFN, respectively. Most commonly reported antenatal treatment was intrauterine transfusion (IUT; median frequency [interquartile range]: 13.0% [7.2–66.0]). Average gestational age at first IUT ranged between 25 and 27 weeks. weeks. This timing is early and carries risks, which were observed in outcomes associated with IUTs. The rate of hydrops fetalis among pregnancies with Rh(D)-mediated HDFN treated with IUT was 14.8% (range, 0–50%) and 39.2% in K-mediated HDFN. Overall mean ± SD fetal mortality rate that was found to be 19.8%±29.4% across 19 studies. Mean gestational age at birth ranged between 34 and 36 weeks.

Conclusion

These findings corroborate the rareness of HDFN and frequently needed intrauterine transfusion with inherent risks, and most births occur at a late preterm gestational age. We identified several evidence gaps providing opportunities for future studies.
Merkel cell carcinoma: a forty-year experience at the Peter MacCallum Cancer Centre
Authors: Wang Annie J. , McCann Brendan , Soon William C. L. , De Ieso Paolo B. , Bressel Mathias , Hui Andrew , Chua Margaret , Kok David L.
Published: January 2023

Background

Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine skin malignancy, with Australia having the highest reported incidence in the world. There is currently a lack of consensus regarding optimal management of this disease.

Methods

This was a retrospective audit conducted by reviewing existing medical records of MCC patients presenting to the Peter MacCallum Cancer Centre (PMCC) between 1980 and 2018. The primary endpoint was locoregional recurrence. The secondary endpoints were distant recurrence, disease-free survival (DFS) and overall survival (OS).

Results

A total of 533 patients were identified. Locoregional recurrence occurring at one, two and 5 years was 24, 31 and 32%, respectively. The estimated 5-year OS and DFS were 46% (95% Confidence Interval [CI] 41–51%) and 34% (95% CI 30–39%) respectively. Older age at diagnosis (hazard ratio [HR] per year = 1.07, 95% CI 1.06–1.07, p < 0.001), and larger primary tumour diameter (HR =1.16, 95% CI 1.03–1.31, p = 0.019) were associated with worse OS on multivariable analysis. Positive or negative histopathological margin status was not associated with OS or DFS differences in patients treated with post-operative radiotherapy.

Conclusions

In our study, about a third of patients developed locoregional recurrence, distal recurrence or both, and there appears to be no change over the last four decades. If treated with adjuvant radiotherapy, there is no difference in OS or DFS with positive surgical margins. Findings should influence future guidelines.
Effects of peripheral blood leukocyte count and tumor necrosis factor-alpha on early death in acute promyelocytic leukemia
Authors: Wen Jingjing , Xu Fang , Zhou Qiaolin , Shi Lin , Liu Yiping , Yue Jing , Zhang Ya , Liang Xiaogong
Published: January 2023

Background

Early death remains a major factor in survival in APL. We aimed to analyze the risk factors for differentiation syndrome and early death in acute promyelocytic leukemia (APL).

Methods

The clinical data of APL patients who were newly diagnosed at Mianyang Central Hospital from January 2013 to January 2022 were retrospectively analyzed.

Results

Eighty-six newly diagnosed APL patients (37 males and 49 females) were included in this study. The median age was 46 (17–75) years. Sixty-one patients (70.9%) had low/intermediate-risk APL, and 25 patients (29.1%) had high-risk APL. The incidence of differentiation syndrome (DS) was 62.4%. The multivariate analysis showed that a peak white blood cell (WBC) count ≥16 × 10^9/L was an independent risk factor (OR = 11.000, 95% CI: 2.830–42.756, P = 0.001) for DS in all APL patients, while a WBC count ≥10 × 10^9/L on Day 5 was an independent risk factor for DS in low-intermediate risk APL patients (OR = 9.114, 95% CI: 2.384–34.849, P = 0.001). There were 31 patients (36.5%) with mild DS and 22 patients (25.9%) with severe DS. The multivariate analysis showed that WBC count ≥23 × 10^9/L at chemotherapy was an independent risk factor for severe DS (OR = 10.500, 95% CI: 2.344–47.034, P = 0.002). The rate of early death (ED) was 24.4% (21/86). The multivariate analysis showed that male gender (OR = 7.578,95% CI:1.136–50.551, P = 0.036), HGB < 65 g/L (OR = 16.271,95% CI:2.012–131.594, P = 0.009) and WBC count ≥7 × 10^9/L on Day 3(OR = 23.359,95% CI:1.825–298.959, P = 0.015) were independent risk factors for ED. The WBC count at diagnosis, WBC count on Day 3 and WBC count on Day 5 had moderate positive correlations with tumor necrosis factor-α (TNF-α) at diagnosis, and the correlation coefficients were 0.648 (P = 0.012), 0.615 (P = 0.033), and 0.609 (P = 0.035), respectively. The WBC count had no correlation with IL-6.

Conclusion

During induction treatment, cytotoxic chemotherapy may need to be initiated to reduce the risk of DS for APL patients with a low-intermediate risk WBC count ≥10 × 10^9/L on Day 5 or for all patients with a peak WBC count ≥16 × 10^9/L. Patients with WBC > 7 × 10^9/L on Day 3 have a higher risk of ED. Leukocyte proliferation is associated with TNF-α rather than IL-6, and TNF-α may be a potential biomarker for predicting ED.
Neoadjuvant checkpoint blockade in combination with Chemotherapy in patients with tripe-negative breast cancer: exploratory analysis of real-world, multicenter data
Authors: Deng Heran , Wang Liying , Wang Na , Zhang Kejin , Zhao Yanxia , Qiu Pengfei , Qi Xiaowei , Zhang Danhua , Xu Fei , Liu Jieqiong
Published: January 2023

Purpose

Despite the poor prognosis of triple-negative breast cancer (TNBC), it has been demonstrated that neoadjuvant immunotherapy in combination with chemotherapy can improve the pathologic complete response (pCR) rate and/or long-term outcome of TNBC. However, there have been no real-world studies reporting on the effectiveness of neoadjuvant checkpoint inhibitors in early TNBC.

Methods

Between November 2019 and December 2021, 63 early TNBC patients treated with anti-PD-1 antibodies (pembrolizumab or camrelizumab) or anti-PD-L1 antibody (atezolizumab) in combination with chemotherapy at seven institutions were included. PCR1 defined as ypT0/Tis and ypN0 was the primary endpoint. Secondary endpoints included pCR2 defined as ypT0/Tis, overall response rate (ORR), disease-free survival (DFS), drug-related adverse events (AEs) and biomarkers.

Results

Among the patients in the current study, 34.9% of patients were able to achieve pCR1, and 47.6% of patients had achieved pCR2. The ORR was 82.5%. 33 patients with non-pCR2 tumors were found to have a median DFS of 20.7 months (95% CI 16.3 months-not reached). The DFS of patients with pCR2 and non-pCR2 after neoadjuvant therapy was significantly different (HR = 0.28, 95% CI 0.10–0.79; P = 0.038). The most common AEs were nausea (63.4%), fatigue (42.7%), leucopenia (30.0%) and elevated transaminase (11.7%).

Conclusion

It is possible to achieve a meaningful pCR rate and DFS by combining neoadjuvant checkpoint blockade with chemotherapy in patients with high-risk TNBC. Compared to clinical trials, however, there was a slightly lower pCR rate in this multicentered real-world study.
The portrayal of electronic cigarettes in Indonesia: a content analysis of news media
Authors: Bigwanto Mouhamad , Arumsari Imas , Fauzi Ridhwan
Published: January 2023

Background

The news media play an essential role in shaping public opinion. Analyzing a specific issue reported in the news media provides insight and considerations for a government to form a policy. This study aimed to assess the portrayal of electronic cigarettes (e-cigarettes) in Indonesian news media, including the variety of arguments being presented and the actors behind them.

Methods

We used a paid service database from eBdesk to collect Indonesian news articles from 2020 to 2021 using the keywords ‘rokok elektronik’ (electronic cigarette), ‘rokok elektrik’ (electric cigarette), ‘e-rokok’ (e-cigarette), ‘vape’, and ‘vaping’. Content analysis of 551 full-text news articles was conducted to identify the concepts, topics, and frames of quoted arguments and to examine whether any frames were presented by different types of organizations and the origin of actors.

Results

News articles related to e-cigarettes were mostly published in the national newspaper and in the non-health section of the newspaper desk. A total of 891 arguments from 393 persons representing 212 institutions were identified. Twenty-eight concepts were further categorized into 12 topics. Health impact was the most frequently reported topic, followed by regulation, tax/price, and e-cigarettes as smoking cessation tools. Overall, the articles and arguments with positive tones toward e-cigarettes outnumbered negative articles and arguments. The industry, university, and research-based institutions were the most involved types of organizations in the news articles. There were more neutral frames toward e-cigarettes among government, even though the frame within the non-health government sector was reported to be more positive toward e-cigarettes.

Conclusions

Although health impact is the most reported topic, the actors involved in delivering arguments were mainly from the non-health sector, including when the news articles were published by the newspaper desk. The e-cigarette issue in Indonesia was mainly played by the non-health sector, which is more inclined toward economic interest than health.
Impact of a home-based nutritional intervention program on nutritional status of preschool children: a cluster randomized controlled trial
Authors: B Ansuya , Nayak Baby S. , B Unnikrishnan , N Ravishankar , N Shashidhara Y. , Mundkur Suneel C.
Published: January 2023

Background

Undernutrition in under-five children remains a worldwide health issue and is considered one of the leading causes of increased morbidity and mortality. This study aims to assess the impact of home-based nutritional intervention on the nutritional status of preschool children living in rural areas of South India.

Methods

A single-blinded cluster randomized controlled trial evaluated the impact of the intervention, with weight gain as the primary outcome. A cluster of 12 villages was randomized to intervention or control arms. A total of 253 underweight preschool children from 12 clusters (villages) were randomized to intervention (n = 127) and control arm (n = 126). The intervention was composed of a health-teaching program and a demonstration of nutritious food preparation in addition to the regular services provided at the Anganwadi centers. The control arm received only standard routine care provided in the Anganwadi centre. The anthropometric assessment was carried out at the baseline and every month for a year.

Result

A significant increase in the mean weight kilograms was noted in the intervention group (11.9 ± 0.98 to 13.78 ± 0.89) compared to the control group (11.8 ± 1.03 to 12.96 ± 0.88). In the intervention group, at the baseline, 41.5% were moderately malnourished (> − 2SD—3SD), which decreased to 24% at the end of the year. Similarly, severe malnutrition decreased from 8.69 to 3.16%, while 20.5% of malnourished children achieved normal nutritional status. In the control group, undernourished children demonstrated minimal changes in nutritional status. Analysis of repeated measures of ANOVA results between the intervention and control groups on weight measurements (F (1, 251) = 15.42, p .001) and height measurements (F (2, 1258) = 1.540, p .001) revealed statistical significance.

Conclusion

The nutritional status of preschool children is found to be improved by home-based intervention, which includes training mothers or caregivers in planning and preparing healthy nutritious diets, providing timely care, and gaining an understanding and knowledge of the nutritional status along with regular home-based diet preparation.

Trial registration

ctri@gov.in CTRI/2017/03/008273 [Registered on: 31/03/2017].
Laying the foundations for hepatitis C elimination: evaluating the development and contribution of community care pathways to diagnostic efforts
Authors: Robinson Emma , Byrne Christopher J. , Carberry James , Radley Andrew , Beer Lewis J. , Inglis Sarah K. , Tait Jan , Macpherson Iain , Goldberg David , Hutchinson Sharon J. , Hickman Matthew , Dillon John F.
Published: January 2023

Background

Hepatitis C Virus (HCV) is a public health threat which contributes substantially to the global burden of liver disease. There is much debate about effective approaches to scaling up diagnosis of HCV among risk groups. Tayside, a region in the East of Scotland, developed low-threshold community pathways for HCV to lay the foundations of an elimination strategy. In this retrospective study, we sought to: quantify the contribution of community pathways to increasing HCV diagnosis; understand if shifting diagnosis to community settings led to a higher proportion of individuals tested for HCV being actively infected; and describe functional characteristics of the care pathways.

Methods

Descriptive statistics were used to for analysis of routinely-collected HCV testing data from 1999 to 2017, and a review of the development of the care pathways was undertaken. Community-based testing was offered through general practices (GP); nurse outreach clinics; prisons; drug treatment services; needle and syringe provision (NSP) sites; community pharmacies; and mosques.

Results

Anti-HCV screening was undertaken on 109,430 samples, of which 5176 (4.7%) were reactive. Of all samples, 77,885 (71.2%) were taken in secondary care; 25,044 (22.9%) in GPs; 2970 (2.7%) in prisons; 2415 (2.2%) in drug services; 753 (0.7%) in NSPs; 193 (0.2%) pharmacies; and 170 (0.1%) in mosques. The highest prevalence of HCV infection among those tested was in NSP sites (26%), prisons (14%), and drug treatment centres (12%).

Conclusions

Decentralised care pathways, particularly in harm reduction and other drug service settings, were key to increasing diagnosis of HCV in the region, but primary and secondary care remain central to elimination efforts.
Constructing and validating an occupational job strain index based on five Norwegian nationwide surveys of living conditions on work environment
Authors: Le Giang Huong , Hermansen Åsmund , Dahl Espen
Published: January 2023

Background

It has been claimed that Nordic register data are a “goldmine” for research. However, one limitation is the lack of information on working conditions. Job exposure matrices (JEMs) are one solution to this problem. Thus, the three aims of this study were (i) to investigate the reliability of an occupation-based psychosocial JEM, i.e., a Job Strain Index (job strain or JSI abbreviated), (ii) to examine the construct and criterion-related validity of this measure of job strain (iii) and assesses the concurrent and the predictive validity of an occupation-based Job Strain Index for use in analyses of Norwegian register data.

Method

The study utilized five waves of the nationwide Norway Survey of Living Conditions in the Work Environment with a total sample of 43,977 individuals and register data with a total sample of 1,589,535 individuals. Job strain was composed of items belonging to the two dimensions of Karasek’s DC model, job demands and job control (1979). The reliability of the JSI and its dimensions and components were investigated by measuring the degree of agreement (Cohen’s kappa), sensitivity, specificity, and internal consistency (Cronbach’s alpha). Construct validity was assessed by confirmatory factor analysis, and criterion-related validity was measured by concurrent validity and predictive validity. The selected concurrent criteria were self-reported survey information on long-term sick absence, anxiety, depression, and sleeping difficulty. The predictive criteria were register information on receipt of disability benefits, mortality, and long-term sick leave.

Results

Agreement between individual and occupation-based job strain and components was fair to poor. The sensitivity and specificity of occupation-based job strain and its components varied from acceptable to low. The consistency of the items comprising job demand and job control was clearly acceptable. Regarding concurrent validity, significant associations between (both individual and occupational) job strain, and long-term sick leave and sleeping difficulty were observed for both genders. Occupation-based job strain indicated an elevated risk for anxiety and depression among men, but not among women. As for predictive reliability, significant associations between occupation-based job strain and all three health outcomes were observed for both men and women.

Conclusion

Our occupation-based JSI serves as a reliable and valid indicator of psychosocial job exposure that can be used in analyses of Norwegian register data where individual information on such conditions is missing.
Dorsal proximal interphalangeal joint tenderness is associated with prolonged postoperative pain after A1 pulley release for trigger fingers
Authors: Monteerarat Yuwarat , Misen Pimolpan , Laohaprasitiporn Panai , Wongsaengaroonsri Pattarawat , Lektrakul Nittaya , Vathana Torpon
Published: January 2023

Background

In some trigger finger patients, tenderness is found in the dorsal proximal interphalangeal (PIP) joint. The etiology and prevalence of this condition are unclear. Furthermore, surgical outcomes for trigger fingers with coexisting dorsal PIP tenderness have not been reported. This study (1) determined the prevalence and risk factors for PIP joint tenderness in trigger fingers and (2) compared postoperative outcomes for trigger fingers with and without joint tenderness.

Methods

This prospective cohort study was conducted between August 2018 and March 2020. We enrolled 190 patients diagnosed with single-digit trigger fingers undergoing open A1 pulley release. The incidence, demographic data, and surgical outcomes of patients with dorsal PIP tenderness were investigated. Factors associated with tenderness were analyzed, including patient occupation, finger involvement, trigger finger grading, duration of symptoms, previous corticosteroid injections, and presence of diabetes mellitus. A numeric pain scale, a patient-specific functional scale, and the range of motion were evaluated preoperatively and 1, 2, and 6 weeks after surgery, with telephone follow-ups at 3 and 6 months.

Results

Of 190 patients, 46.8% had tenderness of the dorsal PIP joint. Patients with joint tenderness had significantly more overall postoperative pain for up to 6 weeks and reported residual minor pain for up to 3 months. The functional scale and range of motion of the 2 groups did not differ during follow-up. The only risk factor observed was the occupation of the patients.

Conclusion

Dorsal PIP tenderness is more common in trigger fingers than previously thought. It is also associated with higher and prolonged levels of postoperative pain after A1 pulley release. Therefore, patients with pre-existing PIP tenderness should be informed about the possibility of sustaining residual minor pain for up to 3 months after surgery.

Level of Evidence

II
Efficacy of immediate postoperative intravenous iron supplementation after staged bilateral total knee arthroplasty
Authors: Lee Sung-Sahn , Lee Jeounghun , Moon Young-Wan
Published: January 2023

Background

Approximately 26% of patients undergoing major orthopedic elective procedures have preoperative anemia. This study aimed to investigate the effect of intravenous (IV) iron supplementation on the hemoglobin (Hb) level after staged bilateral total knee arthroplasty (TKA) in patients with or without preoperative anemia.

Methods

We retrospectively analyzed 418 patients who underwent staged bilateral TKA (1 week interval). The iron group (n = 220) received IV iron isomaltoside immediately after each TKA. The no-iron group (n = 198) was recommended to receive transfusion if postoperative anemia was diagnosed between the first and second TKA. Preoperative anemia was present in 42 (21.2%) and 50 (22.7%) patients in the no-iron and iron groups, respectively. Demographic data, preoperative and postoperative Hb levels, Hb level change (preoperative minus postoperative 6-week Hb level), and blood drainage amount were compared between groups.

Results

The transfusion rate was lower in the iron group than in the no-iron group (96.5% vs. 58.6%, P < 0.001). Overall, the demographic data, preoperative and postoperative 6-week Hb levels, Hb level change, and blood drainage amount were not significantly different between the two groups. Among patients with preoperative anemia, the iron group showed lower Hb level change (0.6 ± 0.9 vs. 0.1 ± 1.1, P = 0.016).

Conclusion

Patients with preoperative anemia treated with IV iron showed lower Hb level change than did those without IV iron treatment. Despite the lower transfusion rate, the iron group showed similar postoperative 6-week Hb level and Hb level change to the no-iron group.
Development of an interprofessional task-based learning program in the field of occupational health: a content validity study
Authors: Keshmiri Fatemeh , Mehrparvar Amir Houshang
Published: January 2023

Objective

One of the duties of the educational system is to provide situations in which students learn the tasks corresponding to their future careers in an interprofessional team. This study was designed to develop an interprofessional task-based training program.

Methods

This was a curriculum development study conducted by content validity methodology in two stages: 1) ‘framework development’ which resulted in the creation of the framework items; and 2) ‘evaluation of the framework’ (judgment and quantification). The first stage consisted of task identification, generation of sub-tasks, and assimilation of items into a usable format. The second stage consisted of the judgment –quantification of the content validity of items and the framework. After that, the framework of the tasks of the occupational health team was finalized in the expert panel. After explaining the tasks, a matrix for task-expected roles in the occupational health team and a matrix for task-required skills to perform each task were developed. The next step determined the appropriate teaching and assessment methods for each task. Finally, an expert panel reviewed and approved the components of the interprofessional task-based training program.

Results

Integrating the interprofessional education strategy with task-based learning was considered innovative in occupational health team training. In the development stage, 48 items were extracted, and then 35 tasks were generated in the step of identification of tasks. In the second step, 174 sub-tasks were developed. The tasks and sub-tasks were categorized into seven areas. After the stage of evaluation of the framework, 33 tasks were categorized into seven main areas, including "assessment and identification of workplace hazards" (n = 10), "control of occupational hazards" (n = 4), "determining the appropriate job position for each person" (n = 3), "occupational health examinations" (n = 6), "management of occupational/work-related diseases" (n = 5), "inter-organizational and inter-disciplinary relations, and legal judgment" (n = 3) and "education and scholarship in occupational health services" (n = 2).

Conclusion

The results of the present study can be used in developing the use of the interprofessional strategy and task-based training as two appropriate strategies for the purposeful development of learners' abilities in the fields involved in providing occupational health services in their future careers.
Solutions for improved hospital-wide patient flows – a qualitative interview study of leading healthcare providers
Authors: Åhlin Philip , Almström Peter , Wänström Carl
Published: January 2023

Background

Hospital productivity is of great importance for patients and public health to achieve better availability and health outcomes. Previous research demonstrates that improvements can be reached by directing more attention to the flow of patients. There is a significant body of literature on how to improve patient flows, but these research projects rarely encompass complete hospitals. Therefore, through interviews with senior managers at the world’s leading hospitals, this study aims to identify effective solutions to enable swift patient flows across hospitals and develop a framework to guide improvements in hospital-wide patient flows.

Methods

This study drew on qualitative data from interviews with 33 senior managers at 18 of the world’s 25 leading hospitals, spread across nine countries. The interviews were conducted between June 2021 and November 2021 and transcribed verbatim. A thematic analysis followed, based on inductive reasoning to identify meaningful subjects and themes.

Results

We have identified 50 solutions to efficient hospital-wide patient flows. They describe the importance for hospitals to align the organization; build a coordination and transfer structure; ensure physical capacity capabilities; develop standards, checklists, and routines; invest in digital and analytical tools; improve the management of operations; optimize capacity utilization and occupancy rates; and seek external solutions and policy changes. This study also presents a patient flow improvement framework to be used by healthcare managers, commissioners, and decision-makers when designing strategies to improve the delivery of healthcare services to meet the needs of patients.

Conclusions

Hospitals must invest in new capabilities and technologies, implement new working methods, and build a patient flow-focused culture. It is also important to strategically look at the patient’s whole trajectory of care as one unified flow that must be aligned and integrated between and across all actors, internally and externally. Hospitals need to both proactively and reactively optimize their capacity use around the patient flow to provide care for as many patients as possible and to spread the burden evenly across the organization.
A pyroptosis-related gene signature provides an alternative for predicting the prognosis of patients with hepatocellular carcinoma
Authors: Lin Dezhao , Chen Zhuoyan , Zeng Yuan , Ding Yinrong , Zhao Luying , Xu Qian , Yu Fujun , Song Xian , Zhu Xiaohong
Published: January 2023

Background

Hepatocellular Carcinoma (HCC) is a common malignant neoplasm with limited treatment options and poor outcomes. Thus, there is an urgent need to find sensitive biomarkers for HCC.

Methods

Gene expression and clinicopathological information were obtained from public databases, based on which a pyroptosis-related gene signature was constructed by the least absolute shrinkage and selection operator Cox regression. The applicability of the signature was evaluated via Kaplan–Meier curve and time-dependent ROC curve. TIMER, QUANTISEQ, MCPCOUNTER, EPIC, CIBERSORT, ssGSEA, and ESTIMATE were employed to assess the immune status. Comparisons between groups were analyzed with Wilcoxon test. Pearson and Spearman correlation analyses were adopted for linear correlation analysis. Genetic knockdown was conducted using siRNA transfection and the mRNA expression levels of interest genes were measured using quantitative reverse transcription PCR. Finally, protein levels in 10 paired tumor tissues and adjacent non-tumor tissues from HCC patients were measured using immunohistochemistry.

Results

A pyroptosis-related gene signature was established successfully to calculate independent prognostic risk scores. It was found that survival outcomes varied significantly between different risk groups. In addition, an attenuated antitumor immune response was found in the high-risk group. Meanwhile, multiple immune checkpoints were up-regulated in high-risk score patients. Cell cycle-related genes, angiogenesis-related genes and tumor drug resistance genes were also markedly elevated. Knockdown of prognostic genes in the signature significantly inhibited the expression of immune checkpoint genes and angiogenesis-related genes. Besides, each prognostic gene was expressed at a higher level in HCC tissues than in adjacent normal tissues.

Conclusions

We successfully established a novel pyroptosis-related gene signature which could help predict the overall survival and assess the immune status of HCC patients.
Eating habit of adding salt to foods and incident sleep apnea: a prospective cohort study
Authors: Li Tingting , Song Lin , Li Guang , Li Fengping , Wang Xiaoge , Chen Liangkai , Rong Shuang , Zhang Li
Published: January 2023

Background

Previous studies have revealed that sodium-restricted diet intervention significantly decreased apnea frequency among patients with sleep apnea. However, the longitudinal association between the habit of adding salt to foods and sleep apnea in general populations is uncertain.

Methods

The UK Biobank cohort study includes more than 500,000 participants aged 40 to 69 across the United Kingdom from 2006 to 2010. The frequency of adding salt to foods was collected through a touch screen questionnaire. Incident sleep apnea was ascertained by hospital inpatient records, death registries, primary care, and self-reported diagnosis. The association between the habit of adding salt to foods and incident sleep apnea was estimated using Cox proportional hazard regression models.

Results

Among the 488,196 participants (mean age 56.5 years; 55.0% female) in this study. During a median follow-up of 12.3 years, 6394 sleep apnea events occurred. Compared to participants who never/rarely added salt to foods, those who sometimes, usually, and always added salt to foods had an 11% (hazard ratio [HR] 1.11, 95% confidence interval [CI]: 1.04 to 1.17), 15% (HR 1.15, 95% CI: 1.07 to 1.24), and 24% (HR 1.24, 95% CI: 1.12 to 1.37) higher risk for incident sleep apnea, respectively.

Conclusions

In this large prospective study, the habit of adding salt to foods was associated with a higher risk of incident sleep apnea. The findings support the benefits of a salt reduction program in preventing sleep apnea.
Safety and therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria at Shecha health centre, Arba Minch, Ethiopia
Authors: Gubae Kale , Mohammed Hussein , Sime Heven , Hailgiorgis Henok , Mare Anteneh Kassahun , Gidey Bokretsion , Haile Mebrahtom , Assefa Gudissa , Bekele Worku , Tasew Geremew , Abay Solomon Mequanente , Assefa Ashenafi
Published: January 2023

Background

In 2004, Ethiopia adopted artemether-lumefantrine (AL, Coartem®) as first-line treatment for the management of uncomplicated Plasmodium falciparum malaria. Continuous monitoring of AL therapeutic efficacy is crucial in Ethiopia, as per the World Health Organization (WHO) recommendation. This study aimed to assess the therapeutic efficacy of AL in the treatment of uncomplicated P. falciparum infection.

Methods

A 28 day onearm, prospective evaluation of the clinical and parasitological response to AL was conducted at Shecha Health Centre, Arba Minch town, Southern Ethiopia. Patients were treated with six-dose regimen of AL over three days and monitored for 28 days with clinical and laboratory assessments. Participant recruitment and outcome classification was done in accordance with the 2009 WHO methods for surveillance of anti-malarial drug efficacy guidelines.

Results

A total of 88 study participants were enrolled and 69 of them completed the study with adequate clinical and parasitological response. Two late parasitological failures were observed, of which one was classified as a recrudescence by polymerase chain reaction (PCR). The PCRcorrected cure rate was 98.6% (95% CI 92.3–100). AL demonstrated a rapid parasite and fever clearance with no parasitaemia on day 2 and febrile cases on day 3. Gametocyte clearance was complete by day three. No serious adverse events were reported during the 28 days follow-up.

Conclusion

The study demonstrated high therapeutic efficacy and good safety profile of AL. This suggests the continuation of AL as the first-line drug for the treatment of uncomplicated P. falciparum malaria in Ethiopia. Periodic therapeutic efficacy studies and monitoring of markers of resistance are recommended for early detection of resistant parasites.