bluuebunny/crossref_metadata_2025 huggingface dataset:
How do aged-care staff feel about antimicrobial stewardship? A systematic review of staff attitudes in long-term residential aged-care
Authors: Singh Saniya , Degeling Chris , Fernandez Dominic , Montgomery Amy , Caputi Peter , Deane Frank P.
Published: June 2022

Background

Antimicrobial resistance (AMR) is a problem in residential aged care facilities (RACF). There is a gap in our understanding of how psychosocial barriers such as risk perceptions shape staff attitudes towards antimicrobial stewardship (AMS). We sought to ascertain the attitudinal domains that have been identified to be of importance to AMS in RACF and comment on how they have been measured empirically. Our aim was to consolidate what is known regarding staff attitudes and perceptions in order to inform future stewardship.

Method

We searched PsycINFO, PsycARTICLES, CINAHL Plus, MEDLINE, PubMed, Web of Science, Cochrane, and Scopus databases for primary studies of healthcare workers attitudes to AMS in RACF (1990-February 2021).

Results

14 Studies were included in the review, within which 10 domains were identified: attitudes towards antimicrobial prescribing; guidelines; educational interventions; self-confidence regarding clinical assessment and prescribing; awareness of AMR as a problem and stewardship as a priority; self-efficacy; perception of role; perception of risk; team culture and resident/family members expectations. 46 measures were developed across the 14 studies to measure the 10 domains. The variability in the attitudinal domains and how these domains were measured was large. Only 13% included psychometric data regarding reliability and/or internal consistency.

Conclusions

Attitudes are generally defined as having three evaluative bases: cognitive, behavioural, and affective. Findings from the current review suggest that the measures commonly used to capture healthcare staff attitudes to AMS do not sufficiently capture affect; particularly with respect to staff’s risk perceptions, perceptions of their role, and family members’ expectations. Given that affective processes have been postulated to influence medical decision making, these findings highlight the importance of understanding how staff, especially nurses feel about implementing AMS strategies and other peoples’ (e.g. residents and their families) perceptions of stewardship. It is expected that a more nuanced understanding of RACF nurses affective experiences when applying AMS, and their perceptions of the risks entailed, will help in reducing barriers to overprescribing antibiotics.
Reassessment of Neuronal Tau Distribution in Adult Human Brain and Implications for Tau Pathobiology
Authors: Paterno Giavanna , Bell Brach M. , Gorion Kimberly-Marie M. , Prokop Stefan , Giasson Benoit I.
Published: June 2022

Tau is a predominantly neuronal, soluble and natively unfolded protein that can bind and stabilize microtubules in the central nervous system. Tau has been extensively studied over several decades, especially in the context of neurodegenerative diseases where it can aberrantly aggregate to form a spectrum of pathological inclusions. The presence of tau inclusions in the form of neurofibrillary tangles, neuropil threads and dystrophic neurites within senile plaques are essential and defining features of Alzheimer’s disease. The current dogma favors the notion that tau is predominantly an axonal protein, and that in Alzheimer’s disease there is a redistribution of tau towards the neuronal soma that is associated with the formation of pathological inclusions such as neurofibrillary tangles and neuropil threads. Using novel as well as previously established highly specific tau antibodies, we demonstrate that contrary to this overwhelmingly accepted fact, as asserted in numerous articles and reviews, in adult human brain, tau is more abundant in cortical gray matter that is enriched in neuronal soma and dendrites compared to white matter that is predominantly rich in neuronal axons. Additionally, in Alzheimer’s disease tau pathology is significantly more abundant in the brain cortical gray matter of affected brain regions compared to the adjacent white matter regions. These findings have important implications for the biological function of tau as well as the mechanisms involved in the progressive spread of tau associated with the insidious nature of Alzheimer’s disease.
New insights into the deterioration of TiO2 based oil paints: the effects of illumination conditions and surface interactions
Authors: Schmitt Thomas , Rosi Francesca , Mosconi Edoardo , Shull Ken , Fantacci Simona , Miliani Costanza , Gray Kimberly
Published: June 2022

Titanium dioxide (TiO2) has been used in numerous paintings since its creation in the early 1920s. However, due to this relatively recent adoption by the art world, we have limited knowledge about the nature and risk of degradation in museum environments. This study expands on the existing understanding of TiO2 facilitated degradation of linseed oil, by examining the effect of visible light and crystallographic phase (either anatase or rutile) on the reactivity of TiO2. The present approach is based on a combination of experimental chemical characterization with computational calculation through Density Functional Theory (DFT) modeling of the TiO2-oil system. Attenuated Total Reflection Fourier Transform Infrared Spectroscopy (ATR-FT-IR) enabled the identification of characteristic degradation products during UV and visible light aging of both rutile and anatase based paints in comparison to BaSO4 and linseed oil controls. In addition, cratering and cracking of the paint surface in TiO2 based paints, aged under visible and UV–vis illumination, were observed through Scanning Electron Microscopy (SEM). Finally, Density Functional Theory (DFT) modeling of interactions between anatase TiO2 and oleic acid, a fatty acid component of linseed oil, to form a charge transfer complex explains one possible mechanism for the visible light activity observed in artificial aging. Visible light excitation of this complex sensitizes TiO2 by injecting an electron into the conduction band of TiO2 to generate reactive oxygen species and subsequent degradation of the oil binder by various mechanisms (e.g., formation of an oleic acid cation radical and other oxidation products).

Graphical Abstract
Deep-Eware: spatio-temporal social event detection using a hybrid learning model
Authors: Afyouni Imad , Khan Aamir , Aghbari Zaher Al
Published: June 2022

Event detection from social media aims at extracting specific or generic unusual happenings, such as, family reunions, earthquakes, and disease outbreaks, among others. This paper introduces a new perspective for the hybrid extraction and clustering of social events from big social data streams. We rely on a hybrid learning model, where supervised deep learning is used for feature extraction and topic classification, whereas unsupervised spatial clustering is employed to determine the event whereabouts. We present‘Deep-Eware’, a scalable and efficient event-aware big data platform that integrates data stream and geospatial processing tools for the hybrid extraction and dissemination of spatio-temporal events. We introduce a pure incremental approach for event discovery, by developing unsupervised machine learning and NLP algorithms and by computing events’ lifetime and spatial spanning. The system integrates a semantic keyword generation tool using KeyBERT for dataset preparation. Event classification is performed using CNN and bidirectional LSTM, while hierarchical density-based spatial clustering was used for location-inference of events. We conduct experiments over Twitter datasets to measure the effectiveness and efficiency of our system. The results demonstrate that this hybrid approach for spatio-temporal event extraction has a major advantage for real-time spatio-temporal event detection and tracking from social media. This leads to the development of unparalleled smart city applications, such as event-enriched trip planning, epidemic disease evolution, and proactive emergency management services.
Mental and physical health-related quality of life in patients with recurrent patellar dislocations—a generic and disease-specific quality of life questionnaire assessment
Authors: Balcarek Peter , Milinkovic Danko Dan , Zimmerer Alexander , Zimmermann Felix
Published: June 2022

Purpose

There is a paucity of quality of life (QoL) assessments in studies evaluating patients treated for recurrent lateral patellar dislocation (LPD). The primary aim of this study was to investigate whether mental well-being is impaired in patients with chronic (recurrent) LPD and, if so, to assess whether the mental health-related QoL dimension improves equivalently to the physical-related QoL dimension after successful surgical treatment.

Methods

Thirty-eight patients with recurrent LPD over a mean course of the disease of 4.7 ± 3.9 years (1—18 years) prior to surgery were included. Generic health-related QoL (HRQoL) (Short Form 36; SF-36) and disease-specific QoL (Banff Patella Instability Instrument 2.0; BPII 2.0) were assessed preoperatively and after a mean follow-up of 3.5 ± 0.8 years (2 – 5 years) postoperatively.

Results

Untreated LPD significantly impacted the physical dimension of patients’ generic HRQoL and their disease-specific QoL. When compared to age-equivalent normative data sets, the mental HRQoL dimension was not reduced prior to operative treatment but increased during the follow-up period. Surgical treatment normalized the physical dimension of patients’ generic HRQoL and significantly improved their disease-specific QoL. However, BPII 2.0 values remained reduced, albeit patellae were successfully stabilized.

Conclusion

The results of this study indicate that patients with recurrent LPD are generally in good mental health, although physical impairment is striking. Notwithstanding that surgery prevented further dislocations and normalized the generic HRQoL, the disease-specific QoL remained reduced as far as this can be interpreted without population-based data.

Level of evidence

Level IV; Retrospective case series.
Practical Blood Flow Restriction Training: New Methodological Directions for Practice and Research
Authors: Aniceto Rodrigo Ramalho , da Silva Leandro Leonardo
Published: June 2022

Most studies with blood flow restriction (BFR) training have been conducted using devices capable of regulating the restriction pressure, such as pneumatic cuffs. However, this may not be a viable option for the general population who exercise in gyms, squares and sports centers. Thinking about this logic, practical blood flow restriction (pBFR) training was created in 2009, suggesting the use of elastic knee wraps as an alternative to the traditional BFR, as it is low cost, affordable and practical. However, unlike traditional BFR training which seems to present a consensus regarding the prescription of BFR pressure based on arterial occlusion pressure (AOP), studies on pBFR training have used different techniques to apply the pressure/tension exerted by the elastic wrap. Therefore, this Current Opinion article aims to critically and chronologically examine the techniques used to prescribe the pressure exerted by the elastic wrap during pBFR training. In summary, several techniques were found to apply the elastic wrap during pBFR training, using the following as criteria: application by a single researcher; stretching of the elastic (absolute and relative overlap of the elastic); the perceived tightness scale; and relative overlap of the elastic based on the circumference of the limbs. Several studies have shown that limb circumference seems to be the greatest predictor of AOP. Therefore, we reinforce that applying the pressure exerted by the elastic for pBFR training based on the circumference of the limbs is an excellent, valid and safe technique.
Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs
Authors: Lo Cathy W. T. , Brodie Matthew A. , Tsang William W. N. , Lord Stephen R. , Yan Chun-Hoi , Wong Arnold Y. L.
Published: June 2022

Background

Total knee arthroplasty (TKA) is a common treatment for severe knee osteoarthritis. Medial-pivot TKA systems (MP-TKA) are theoretically better than posterior-stabilized TKA systems (PS-TKA) in improving static and dynamic balance of patients although it is difficult to objectively quantify these balance parameters in a clinical setting.

Therefore, this pilot study aimed to evaluate the feasibility of using wearable devices in a clinical setting to examine whether people with MP-TKA have better postoperative outcomes than PS-TKA, and their balance control is more akin to age-matched asymptomatic controls.

Methods

The current cross-sectional pilot study recruited 57 participants with 2 different prosthesis designs (20 PS-TKA, 18 MP-TKA) and 19 asymptomatic controls. At 1-year post-TKA, pain, knee stiffness, and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Static balance, mobility, and gait stability of the participants were evaluated based on data collected from wearable motion sensors during the near tandem stance, timed-up-and-go, and 6-min walk tests.

Results

Compared to asymptomatic controls, both TKA groups reported significantly more pain and stiffness and demonstrated reduced functional mobility, increased stride-time-variability, and impaired balance. After Bonferroni adjustment, no significant differences in pain, balance, and mobility performance were observed between PS-TKA and MP-TKA participants 1 year after surgery. However, there was a trend for increased anteroposterior sway of the lumbar and head regions in the MP-TKA participants when undertaking the near tandem stance test. The wearable motion sensors were easy to use without any adverse effects.

Conclusions

It is feasible to use wearable motion sensors in a clinical setting to compare balance and mobility performance of patients with different TKA prothesis designs. Since this was a pilot study and no definite conclusions could be drawn, future clinical trials should determine the impacts of different TKA prosthesis designs on post-operative outcomes over a longer follow-up period.
A Middle East systematic review and meta-analysis of prevalence and antibiotic susceptibility pattern in MRSA Staphylococcus aureus isolated from patients with cystic fibrosis
Authors: Nikmanesh Yousef , Foolady Azarnaminy Afsaneh , Avishan Pourya , Taheri Mohammadreza , Sabeghi Paniz , Najibzadeh Ehsan , Khaledi Azad
Published: June 2022

Background

This study aimed to determine the prevalence and antibiotic resistance patterns in Staphylococcus aureus isolated from patients with cystic fibrosis in Middle Eastern countries.

Methods

A systematic search was conducted in the PubMed, Web of Science (ISI), and Scopus databases for studies presenting the prevalence of MRSA strains, antibiotic resistance pattern in S. aureus strains isolated from patients who suffered from cystic fibrosis in Middle Eastern countries from 1999 to 10 June 2020. The following terms were used; prevalence, antibiotic resistance, antimicrobial drug resistance, drug resistance, Staphylococcus aureus, S. aureus, Methicillin-resistant Staphylococcus aureus, MRSA, cystic fibrosis, CF, and the Middle East. The meta-analysis was performed using Comprehensive Meta-analysis software (Version 3.3.070).

Results

Patients’ age ranged from 1.6 to 18 years. Females were more than males. The prevalence of S. aureus was varied between 5.6 and 77.8%. The prevalence of S. aureus was varied between 5.6 and 77.8% in different countries. The combined prevalence of S. aureus in Middle East countries from 1999 to 2020 was reported by 40.9% (95% CI 29.6–53.1). The pooled prevalence of MRSA was reported at 18.6% (95% CI 1.1–82.6), Z = 0.9, I2 = 98.6, Q = 146.7. The highest combined resistance in S. aureus strains was reported to Penicillin G (94%), followed by Ciprofloxacin (54.9%).

Conclusion

Regarding a quite prevalence of S. aureus and an intermediate prevalence of MRSA in CF patients, preventive measures and health policies should be implemented in the Middle East area to prevent the spread of infections caused by MRSA strains in CF patients.
The impact of consecutive COVID-19 lockdowns in England on mental wellbeing in people with inflammatory arthritis
Authors: Caton Emma , Chaplin Hema , Carpenter Lewis , Sweeney Melissa , Tung Hsiu Yen , de Souza Savia , Galloway James , Nikiphorou Elena , Norton Sam
Published: June 2022

Background

During the first UK COVID-19 lockdown, studies identified over half of inflammatory arthritis (IA) patients in the UK reported a worsening of emotional distress. Given the prolonged nature of the pandemic, and the strict ‘shielding’ restrictions imposed on ‘extremely clinically vulnerable’ populations, it is likely that the implementation of the second lockdown period in England, during November 2020, may also have had a negative impact on the mental health of IA patients. The aim of this study was to qualitatively explore the impact of consecutive lockdown periods on mental wellbeing in people with IA.

Methods

Nine IA patients took part in semi-structured telephone interviews at both baseline (June/July 2020) and follow-up (November 2020). The interview schedule, which was developed and piloted with a Patient Research Partner, explored patient experiences and mental health impacts of the COVID-19 lockdown periods. Interviews were analysed using inductive thematic analysis.

Results

Five males and four females, with rheumatoid arthritis, psoriatic arthritis, or spondylarthritis, aged between 24–79 years (mean = 49.9, SD = 20.9) were included in the sample. Four main themes impacting on mental wellbeing were identified from the data: (1) Pandemic fatigue versus pandemic acclimatisation, (2) Social interaction and isolation, (3) Clarity of information, (4) Seasonal changes.

Conclusion

The first two COVID-19 lockdown periods in England had an ongoing impact on the mental health of patients with IA. Healthcare professionals, in conjunction with government support, should ensure that adequate information and mental health resources are available to support IA patients during periods of ongoing restrictions, whilst also continuing to encourage behaviours which promote good mental health and wellbeing.
Endosymbiotic microbes from entomopathogenic nematode (EPNs) and their applications as biocontrol agents for agro-environmental sustainability
Authors: Tomar Preety , Thakur Neelam , Yadav Ajar Nath
Published: June 2022

Background

The biological diversity on planet earth is declining day by day, due to different factors such as excessive applications of pesticides. The utilization of chemical pesticides affected environment as well as microorganisms. The awareness among the peoples towards the hazards by the residual toxicity of chemical pesticides should be developed for agro-environmental sustainability.

Main body

Entomopathogenic nematodes (EPNs) are the bacto-helminth parasites which show classical mutualism with the genera Xenorhabdus and Photorhabdus. The nematodes along with its endosymbiotic bacteria have a biocontrol potential which could be used to reduce chemical pesticides. Applications of bioagents have been reported and resulted in considerable reduction in pathogens. Furthermore, these bioagents are biodegradable, eco-friendly and easy to apply for protection of crops against diverse pathogenic organism. The nematode-bacterium complexes are effective against huge range of bacteria, fungi, nematodes and insects that are harmful to the crops. Along with biocontrol potential, the endosymbionts produce diverse secondary metabolic compounds, exoenzymes and toxic compounds that show antibiotic, antimycotic, nematicidal, miticidal and anticancerous properties.

Conclusion

The present review deals with the diversity of endosymbiotic microbes from EPNs and their role in biocontrol for the agro-environmental sustainability.
Does the intramedullary femoral canal plug reduce blood loss during total knee arthroplasty?
Authors: Khanasuk Yutthana , Ngarmukos Srihatach , Tanavalee Aree
Published: June 2022

Introduction

The benefit of the femoral canal bone plug during total knee arthroplasty (TKA) in reducing blood loss has never been proven. The aim of this meta-analysis was to determine whether the femoral canal bone plug significantly reduces blood loss in primary TKA.

Method

All studies published before December 2021 were searched. The inclusion criteria were randomized controlled trials comparing blood loss between TKA with plugged and unplugged femoral intramedullary canal, respectively. The primary outcome was postoperative hemoglobin reduction.

Results

Five studies with a total of 717 patients (361 in the plugged group, 356 in the unplugged group) met the criteria for inclusion in the meta-analysis. The mean difference in hemoglobin level between the two groups was 0.92 g/dL, with significantly less hemoglobin reduction in the plugged group (95% confidence interval [CI] − 1.64 to − 0.21,p = 0.01). The patients in the plugged group also had a significantly lower risk of receiving a blood transfusion (risk ratio 0.58, 95% CI 0.47–0.73,p < 0.00001).

Conclusions

This meta-analysis demonstrates that using a femoral canal bone plug can significantly reduce blood loss and lower the risk ratio of blood transfusion in patients undergoing TKA.
A scoping review of the evaluation and effectiveness of technical assistance
Authors: Scott Victoria C. , Jillani Zara , Malpert Adele , Kolodny-Goetz Jenny , Wandersman Abraham
Published: June 2022

Background

Although the benefits of evidence-based practices (EBPs) for advancing community outcomes are well-recognized, challenges with the uptake of EBPs are considerable. Technical assistance (TA) is a core capacity building strategy that has been widely used to support EBP implementation and other community development and improvement efforts. Yet despite growing reliance on TA, no reviews have systematically examined the evaluation of TA across varying implementation contexts and capacity building aims. This study draws on two decades of peer-reviewed publications to summarize the evidence on the evaluation and effectiveness of TA.

Methods

Guided by Arksey and O’Malley’s six-stage methodological framework, we used a scoping review methodology to map research on TA evaluation. We included peer-reviewed articles published in English between 2000 and 2020. Our search involved five databases: Business Source Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), PsycInfo, and PubMed.

Results

A total of 125 evaluation research studies met the study criteria. Findings indicate that publications have increased over the last two decades, signaling a growth in the recognition and reporting of TA. Technical assistance is being implemented across diverse settings, often serving socially vulnerable and under-resourced populations. Most evaluation research studies involved summative evaluations, with TA outcomes mostly reported at the organizational level. Only 5% of the studies examined sustainability of TA outcomes. This review also demonstrates that there is a lack of consistent standards regarding the definition of TA and the level of reporting across relevant TA evaluation categories (e.g., cadence of contact, and directionality).

Conclusions

Advances in the science and practice of TA hinge on understanding what aspects of TA are effective and when, how, and for whom these aspects of TA are effective. Addressing these core questions requires (i) a standard definition for TA; (ii) more robust and rigorous evaluation research designs that involve comparison groups and assessment of direct, indirect, and longitudinal outcomes; (iii) increased use of reliable and objective TA measures; and (iv) development of reporting standards. We view this scoping review as a foundation for improving the state of the science and practice of evaluating TA.
An unusual presentation of diffuse sclerosing variant of papillary thyroid carcinoma
Authors: Houas Jihene , Ghammam Monia , Chouchane Lobna , Abdessaied Nihed , Omri Malika El , Bellakhdher Mouna , Abir Meherzi , Wassim Kermani , Abdelkefi Mohamed
Published: June 2022

Background

The diffuse sclerosing variant of papillary thyroid carcinoma is a rare pathologic entity. It is characterized by a tendency for rapid growth and a higher incidence of cervical lymph node and distant metastases.

We report an unusual presentation of diffuse sclerosing variant of papillary thyroid carcinoma presented as a single thyroid mass of a small size.

Case presentation

We experienced a case of a diffuse sclerosing variant of papillary thyroid carcinoma in a 30-year-old woman. The preoperative findings on the cytology and ultrasound were suggestive of a malignant thyroid nodule. This case was confirmed by surgical excision. The management included surgery, radioiodine ablation, and suppressive levothyroxine therapy.

Conclusions

We would like to highlight that an early diagnosis associated with an appropriate management leads to a good prognosis.
A Comparison of Logistic Regression Against Machine Learning Algorithms for Gastric Cancer Risk Prediction Within Real-World Clinical Data Streams
Authors: Huang Robert J. , Kwon Nicole Sung-Eun , Tomizawa Yutaka , Choi Alyssa Y. , Hernandez-Boussard Tina , Hwang Joo Ha
Published: June 2022

PURPOSE

Noncardia gastric cancer (NCGC) is a leading cause of global cancer mortality, and is often diagnosed at advanced stages. Development of NCGC risk models within electronic health records (EHR) may allow for improved cancer prevention. There has been much recent interest in use of machine learning (ML) for cancer prediction, but few studies comparing ML with classical statistical models for NCGC risk prediction.

METHODS

We trained models using logistic regression (LR) and four commonly used ML algorithms to predict NCGC from age-/sex-matched controls in two EHR systems: Stanford University and the University of Washington (UW). The LR model contained well-established NCGC risk factors (intestinal metaplasia histology, prior Helicobacter pylori infection, race, ethnicity, nativity status, smoking history, anemia), whereas ML models agnostically selected variables from the EHR. Models were developed and internally validated in the Stanford data, and externally validated in the UW data. Hyperparameter tuning of models was achieved using cross-validation. Model performance was compared by accuracy, sensitivity, and specificity.

RESULTS

In internal validation, LR performed with comparable accuracy (0.732; 95% CI, 0.698 to 0.764), sensitivity (0.697; 95% CI, 0.647 to 0.744), and specificity (0.767; 95% CI, 0.720 to 0.809) to penalized lasso, support vector machine, K-nearest neighbor, and random forest models. In external validation, LR continued to demonstrate high accuracy, sensitivity, and specificity. Although K-nearest neighbor demonstrated higher accuracy and specificity, this was offset by significantly lower sensitivity. No ML model consistently outperformed LR across evaluation criteria.

CONCLUSION

Drawing data from two independent EHRs, we find LR on the basis of established risk factors demonstrated comparable performance to optimized ML algorithms. This study demonstrates that classical models built on robust, hand-chosen predictor variables may not be inferior to data-driven models for NCGC risk prediction.
Long-Term Follow-Up on Morbidity Among Women With a History of Gestational Diabetes Mellitus: A Systematic Review
Authors: Flachs Madsen Lana R , Gerdøe-Kristensen Stine , Lauenborg Jeannet , Damm Peter , Kesmodel Ulrik S , Lynge Elsebeth
Published: June 2022

Background

Gestational diabetes mellitus (GDM) complicates up to 10% of pregnancies and is a well-known risk factor for type 2 diabetes mellitus (T2DM) and cardiovascular disease. Little is known about possible long-term risks of other diseases.

Background

The aim was to review the literature for evidence of associations with morbidity other than T2DM and cardiovascular disease and with long-term mortality.

Methods

A systematic review based on searches in Medline, Embase, and Cochrane Library until March 31, 2021, using a broad range of keywords. We extracted study characteristics and results on associations between GDM and disease occurrence at least 10 years postpartum, excluding studies on women with diabetes prior to pregnancy or only diabetes prior to outcome. The results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Newcastle-Ottawa Scale was used to assess risk of bias.

Results

We screened 3084 titles, 81 articles were assessed full-text, and 15 included in the review. The strongest evidence for an association was for kidney diseases, particularly in Black women. We found indication of an association with liver disease, possibly restricted to women with T2DM postpartum. The association between GDM and breast cancer had been studied extensively, but in most cases based on self-reported diagnosis and with conflicting results. Only sparse and inconsistent results were found for other cancers. No study on thyroid diseases was found, and no study reported on short-term or long-term mortality in women with a history of GDM.

Conclusion

Given the frequency of GDM, there is a need for better evidence on possible long-term health consequences, in particular, studies based on comprehensive records of diagnosis of GDM and long-term health outcomes.
Thyroid Stimulating Hormone Levels Are Associated With Genetically Predicted Nonalcoholic Fatty Liver Disease
Authors: Fan Hong , Liu Zhenqiu , Zhang Xin , Wu Sheng , Shi Tingting , Zhang Pengyan , Xu Yiyun , Chen Xingdong , Zhang Tiejun
Published: June 2022

Context

Findings from observational studies indicate an association of thyroid hormone levels with the risk of nonalcoholic fatty liver disease (NAFLD); however, conflicting results remain and reverse causality may be a possibility.

Objective

This study aimed to evaluate the associations between NAFLD and both plasma thyroxine (T4) and thyroid stimulating hormone (TSH) at the phenotypic and genetic levels.

Methods

We included 14 797 participants, aged 20 to 74 years who had undergone abdominal ultrasonography during the Third National Health and Nutrition Examination Survey (NHANES III). Multivariable logistic regression analyses were used to examine the observational associations of TSH and T4 with NAFLD. Mediation analyses were performed to study whether the relationship between NAFLD and TSH levels was mediated via potential confounders. A bidirectional, two-sample Mendelian randomization (MR) analysis was used to determine the potential causal relationship.

Results

Multivariable logistic regression model suggested a “dose-response” relationship between TSH (Q4 vs Q1: OR = 1.29; 95% CI, 1.10-1.52; Ptrend = 0.001) and NAFLD. BMI and ALT partially mediated the association between TSH and NAFLD, while the proportion of the mediation effects of BMI and ALT were 39.1% and 22.3%, respectively. In MR analyses, the inverse-variance weighted method was selected as primary method and suggested a putative causal effect of NAFLD on serum TSH levels (OR = 1.022; 95% CI, 1.002-1.043). The result was further validated in the sensitivity analyses.

Conclusion

Circulating TSH levels were associated with the risk of NAFLD. MR analysis suggested a putative causal effect of NAFLD on TSH levels.
Effect of Selective Androgen Receptor Modulator on Cholesterol Efflux Capacity, Size, and Subspecies of HDL Particles
Authors: Guo Wen , Pencina Karol M , Furtado Jeremy D , Sacks Frank M , Vaisar Tomas , Cheng Ming , Sniderman Allan D , Page Stephanie T , Bhasin Shalender
Published: June 2022

Context

Selective androgen receptor modulators (SARMs), because of their preferential muscle vs prostate selectivity, are being developed for muscle-wasting conditions. Oral SARMs suppress high-density lipoprotein cholesterol (HDL-C) but their effects on functional capacity and atherogenic potential of HDL particles are unknown.

Objective

To determine the effects of an oral SARM (OPK-88004) on cholesterol efflux capacity, HDL particle number and size, apolipoprotein particle number and size and HDL subspecies

Methods

We measured cholesterol efflux capacity (CEC); HDL particle number and size; APOB; APOA1; and protein-defined HDL subspecies associated with coronary heart disease (CHD) risk in men, who had undergone prostatectomy for low-grade prostate cancer during 12-week treatment with placebo or 1, 5, or 15 mg of an oral SARM (OPK-88004).

Results

SARM significantly suppressed HDL-C (P < .001) but HDL particle size did not change significantly. SARM had minimal effect on CEC of HDL particles (change + 0.016, –0.036, +0.070, and –0.048%/µmol-HDL/L–1 at 0, 1, 5, and 15 mg SARM, P = .045). SARM treatment suppressed APOAI (P < .001) but not APOB (P = .077), and reduced APOA1 in HDL subspecies associated with increased (subspecies containing α2-macroglobulin, complement C3, or plasminogen) as well as decreased (subspecies containing APOC1 or APOE) CHD risk; relative proportions of APOA1 in these HDL subspecies did not change. SARM increased hepatic triacylglycerol lipase (HTGL) (P < .001).

Conclusion

SARM treatment suppressed HDL-C but had minimal effect on its size or cholesterol efflux function. SARM reduced APOA1 in HDL subspecies associated with increased as well as decreased CHD risk. SARM-induced increase in HTGL could contribute to HDL-C suppression. These data do not support the simplistic notion that SARM-associated suppression of HDL-C is necessarily proatherogenic; randomized trials are needed to determine SARM’s effects on cardiovascular events.
Decapod egg membranes: powerful barriers or regulatory structures?
Authors: Bas Claudia C. , Ituarte Romina B. , Kittlein Marcelo J.
Published: June 2022

Osmoregulatory abilities and mechanisms of adults and larvae of decapod crustaceans have been extensively investigated. However, how embryos carried by their mothers can deal with changing or extreme salinities is less understood. The egg membranes are believed to isolate embryos from a challenging environment, although osmoregulatory ability has been demonstrated in early developing embryos (naupliar stage) of two crabs. To establish whether embryos are isolated by their membranes and/or are able to osmoregulate, we measured the survival and volume change over 48 h of oocytes and embryos in different stages of three carideans (Betaeus lilianae, Palaemon macrodactylus and P. argentinus) and the brachyuran Neohelice granulata, subjected to different salinities. In addition, we recorded osmolality changes in homogenates of the same stages in P. argentinus and N. granulata after 2 h of exposure and mapped the presence of putative sites of ions exchange in the membrane of all species. High mortality, when it occurred, was associated with low salinity and mortality variation with the stage of development depended on the species. All species precipitated silver salts in or under the egg envelope, with a different pattern between carideans and the brachyuran. Changes in osmolality and egg volume after hypo- or hyper-osmotic salinity challenges indicate that eggs are not fully isolated by their membranes, and that some osmoregulatory mechanisms are in play to maintain developmental homeostasis. We suggest that egg membranes can participate in osmoregulation by selectively transporting ions to an intramembrane space, with differences between carideans and brachyurans.
The Impact of School Facility Investments on Students and Homeowners: Evidence from Los Angeles
Authors: Lafortune Julien , Schönholzer David
Published: June 2022

We study school facility investments using administrative records from Los Angeles. Exploiting quasi-random variation in the timing of new facility openings and using a residential assignment instrument, we find positive impacts on test scores, attendance, and house prices. Effects are not driven by changes in class size, peers, teachers, or principals, but some evidence points toward increased facility quality. We evaluate program efficiency using implied future earnings and housing capitalization. For each dollar spent, the program generated $1.62 in household value, with about 24 percent coming directly through test score gains and 76 percent from capitalization of non-test-score amenities. (JEL H75, H76, I21, I26, J31, R31, R53)
The Long-Run Evolution of Absolute Intergenerational Mobility
Authors: Berman Yonatan
Published: June 2022

This paper combines cross-sectional and longitudinal income data to present the evolution of absolute intergenerational income mobility in ten advanced economies in the twentieth century. Absolute mobility decreased during the second half of the twentieth century in all of these countries. Increasing income inequality and decreasing growth rates have both contributed to the decrease, yet growth is the dominant contributor in most countries. We show that detailed panel data are effectively unnecessary for estimating absolute mobility over the long run. (JEL D31, J62, N30)
The use of cyanoacrylate in the treatment of angiodysplasias: A safe and cheap alternative to coils
Authors: Pitrone Pietro , Stagno Alberto , Cattafi Antonino , Caloggero Simona , Silipigni Salvatore , Ascenti Velio , Catanzariti Francesca , Cinquegrani Antonella , Bottari Antonio
Published: June 2022

Gastrointestinal angiodysplasia (GIAD) represents one of the most frequent causes of recurrent lower gastrointestinal bleeding in the elder population. Clinical manifestations are highly variable, diagnosis is done with colonoscopy or CT and management consists of either endoscopic or, more conservatively, endovascular approach. Trans-arterial embolization (TAE) reduces blood flow into the lesion and may complicate with perforation, dissection, vasospasm and bowel ischaemia. To date, coils and Gelfoam represent the most employed embolizing agents, followed by PVA and onyx. We report the successful embolization of GIADs in four patients with n-butyl 2-cyanoacrylate (NBCA) and Lipiodol Ultra-Fluid (LUF): despite the reported higher risk of bowel infarction when compared with the other agents, no major complication or short-term recurrence occurred in our series.
Characterization of fungus ball CT-hyperdensities within maxillary and sphenoid sinuses
Authors: Alharbi Ahmed , Reville Nicolas , Molinier Sandrine , Bastier Pierre-Louis , de Gabory Ludovic
Published: June 2022

Objectives:

CT-scan hyperdensities (HD) are described in more than 60% of all paranasal sinus fungus ball (FB) cases. Two types can be distinguished according to their density: calcium and metal types. We aimed to establish the prevalence and density of the HD observed in sphenoid and maxillary sinus FB and their relation to dental factors.

Methods:

This retrospective study included 64 patients operated in a tertiary referral center for unilateral maxillary or sphenoid FB diagnosed by histology or mycology. Pre-operative CT scans were analyzed by three independent observers (two ENT and one radiologist).

Results:

There were 45 maxillary FB and 19 sphenoid FB. 63 FB showed HD. Metal-type HD were observed in 28 maxillary FB but not in sphenoid sinuses. Among maxillary FB, the prevalence of endodontic treatment was significantly more significant on the FB side than on the healthy side (p = 0.02). The prevalence of endodontic treatment on the pathological side was more significant in the metal-type group than in the group without metal-type HD (p = 0.01). Isolated calcium-type HD were evidenced in 17 maxillary FB and 18 sphenoid FB (p = 0.019).

Conclusion:

This study highlights the existence of two different types of HD in FBs of the paranasal sinuses with an association between metal-type HD and endodontic treatments.
Reflection of mentors and mentees at initiation of Faculty Mentorship Program at Aga Khan University: A perspective
Authors: Rehman Rehana , Khan Fauzia , Kayani Naila , Ali Tazeen Saeed
Published: June 2022

Objectives: To explore perception of mentors and mentees about ‘Mentorship Program at Aga Khan University Medical College (AKU-MC) from a structured feedback form

Methods: A retrospective study was conducted for evaluation of mentorship program at AKU-MC during the period from Jan 2019 to March, 2021. Responses on validated “Pre-intervention Probe Forms”, from forty-seven mentors and fourteen mentees inducted in the program were reviewed. Confidentiality and anonymity of data were deliberated. All replies to each question were entered in a separate worksheet to determine the frequency and percentage of answers. Responses conveying same message, but worded differently were then grouped.

Results: All the mentees (n=14) responded positively to the question on the “understanding of the mentoring program. The mentees (n=12, 86%) recognized the potential of the program to transfer knowledge and skills, (n=11, 79%) supported its role for achievement of goals, (n=7, 50%), acknowledged its role in faculty relationships. The mentors expressed their enthusiasm to help the mentee’s in their professional development. They (n=20, 43%) offered support to set career goals, (n=29, 62%) proposed transfer of knowledge, skills, and experiences to achieve goals, (n=15, 32%) decided to be “role models”. Some (n=10, 21%) forecasted improved communication skills, (n=14, 30%) boosted leadership capabilities, (n=13, 28%) expected improved work performance, (n=15, 32%) opinioned that networking and leadership qualities will impact the growth of the mentee to meet the university’s expectations.

Conclusion: Both mentors and mentees recognized the importance of the faculty mentorship program at AKU-MC for professional guidance, development and improvement in work performance.

doi: https://doi.org/10.12669/pjms.38.6.5454

How to cite this:Rehman R, Khan F, Kayani N, Ali TS. Reflection of mentors and mentees at initiation of Faculty Mentorship Program at Aga Khan University: A perspective . Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5454

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The 12 Ds of geriatric medical-psychiatry: A new format for geriatric case presentation
Authors: Shulman Richard , Arora Reenu , Ali Amna , Versloot Judith
Published: June 2022

Background: We present a new format for geriatric case presentation called the 12 Ds of Geriatric Medical-Psychiatry that facilitates an integrated discussion of both the physical and mental health issues that pertain to any geriatric patient. The format can be used to replace or to complement traditional medical model case presentation and can also be used as a teaching aid to provide the parameters for a holistic view of the geriatric patient.

Methods: We developed the 12 Ds of Geriatric Medical-Psychiatry for case presentation by modifying the SBAR (situation, background, assessment, recommendations) with 12 clinical considerations that apply to any geriatric patient.

Following implementation of the 12 Ds of Geriatric Medical-Psychiatry case presentation in our integrated team of geriatric medicine and psychiatry healthcare providers, we successfully used the 12 Ds model to present more than 180 patients and found the model easy to use and well received by learners and colleagues.

Conclusion: The 12 Ds of Geriatric Medical-Psychiatry provides a comprehensive format to discuss the pertinent issues facing geriatric patients. When used in an SBAR format, it appears to be an efficient means for integrated case presentation and/or can be used as a tool for teaching and understanding a holistic view of complex geriatric cases.
Model-Free Bounds for Multi-Asset Options Using Option-Implied Information and Their Exact Computation
Authors: Neufeld Ariel , Papapantoleon Antonis , Xiang Qikun
Published: June 2022

We consider derivatives written on multiple underlyings in a one-period financial market, and we are interested in the computation of model-free upper and lower bounds for their arbitrage-free prices. We work in a completely realistic setting, in that we only assume the knowledge of traded prices for other single- and multi-asset derivatives and even allow for the presence of bid–ask spread in these prices. We provide a fundamental theorem of asset pricing for this market model, as well as a superhedging duality result, that allows to transform the abstract maximization problem over probability measures into a more tractable minimization problem over vectors, subject to certain constraints. Then, we recast this problem into a linear semi-infinite optimization problem and provide two algorithms for its solution. These algorithms provide upper and lower bounds for the prices that are ε-optimal, as well as a characterization of the optimal pricing measures. These algorithms are efficient and allow the computation of bounds in high-dimensional scenarios (e.g., when d = 60). Moreover, these algorithms can be used to detect arbitrage opportunities and identify the corresponding arbitrage strategies. Numerical experiments using both synthetic and real market data showcase the efficiency of these algorithms, and they also allow understanding of the reduction of model risk by including additional information in the form of known derivative prices.

This paper was accepted by Chung Piaw Teo, optimization.

Funding: This work was supported by the Nanyang Technological University [NAP Grant] and the Hellenic Foundation for Research and Innovation [Grant HFRI-FM17-2152].

Supplemental Material: The data files and online appendices are available at https://doi.org/10.1287/mnsc.2022.4456 .
A Transient Inflammatory Reaction with a B-Cell Lymphoid Infiltrate and Dysplastic Bone Marrow Changes Associated with the BNT162b2 COVID-19 Vaccine
Authors: Vronsky Daniella , Hershkowitz Shimrit , Hershko Alon , Eliakim-Raz Noa
Published: June 2022

COVID-19 vaccines were introduced soon after the COVID-19 pandemic emerged in 2020. Various side effects were reported worldwide, including several types of common systemic side effects such as fever and general fatigue. Reports of other rare manifestations also emerged. We report the case of an adult male with a rare systemic syndrome mimicking lymphoma after he had received the first dose of an mRNA-based COVID-19 vaccine. After nearly 6 months of investigation with suspicion for an infection or malignancy, all symptoms resolved, laboratory tests normalized, and imaging showed no sign of active disease.
Vaginal Malignant Melanoma: Case Report and Review of the Literature
Authors: Walz David , Cautha Sandhya , Gupta Sorab , Lombino Michael , Suhl Muhammad , Bello Jeismar , Smith Harriett
Published: June 2022

Introduction: Primary vaginal malignant melanomas are rare tumours with a limited number of cases published in the literature. They primarily affect post-menopausal women with a median age of 57–68 years and have a dismal prognosis. The 5-year survival rate, regardless of treatment, is approximately 5–25%. Case description: We present the case of an 87-year-old female who presented with haematuria and urinary incontinence. She was diagnosed with AJCC stage IIIC vaginal melanoma. Considering her age and the extent of malignancy, surgery was not a viable option and immunotherapy with nivolumab and ipilimumab was initiated as treatment. Discussion: The diagnosis of vaginal melanomas includes pathological analysis and immunohistochemistry (IHC) of the mass, imaging to determine extent, and genetic testing. Surgery is the preferred treatment in suitable cases. For metastatic or unresectable cases, immunotherapy or targeted therapy is the preferred first-line treatment. Due to the lack of an adequate number of cases to conduct randomized clinical trials, prognostic factors and treatment protocols for vaginal melanomas are not clearly defined. At present, the management of these tumours is largely based on retrospective studies and anecdotal evidence accompanied by significant knowledge gaps. Our case will be a valuable addition to the existing literature on vaginal melanomas that are managed non-surgically.