bluuebunny/crossref_metadata_2025 huggingface dataset:
Sesamoid View Weightbearing Radiography vs Weightbearing Computed Tomography in the Measurement of Metatarsal Pronation Angle
Authors: Siebert Matthew J. , Steadman Jesse N. , Saltzman Charles L.
Published: February 2023

Background:

First metatarsal pronation angle (MPA) is increasingly relevant in the management of hallux valgus and is assessed on weightbearing computed tomography (WBCT) and sesamoid-view weightbearing radiography (WBR). The purpose of this study is to compare MPA measured by WBCT against WBR to determine if any systematic discrepancy in MPA measurement exists between the 2 modalities.

Methods:

A total of 40 patients with 55 feet were included for study. MPA was measured in all patients by 2 independent readers on both WBCT and WBR with an appropriate washout period between measurement modalities. Mean MPA by WBCT and WBR were analyzed; interobserver reliability was calculated with an intraclass correlation coefficient (ICC) value.

Results:

Mean MPA as measured by WBCT was 3.7 ± 7.9 degrees (95% CI, 1.6-5.9; range −11.7 to 20.5). Mean MPA measured on WBR was 3.6 ± 8.4 degrees, (95% CI, 1.4-5.8; range −12.6 to 21.4). There was no difference in MPA as measured by WBCT compared to WBR ( P = .529). Interobserver reliability was excellent with an ICC of 0.994 for WBCT and 0.986 for WBR.

Conclusion:

Measurement of first MPA by WBCT and WBR was not significantly different. In our cohort of patients with and without forefoot pathology, we found that either sesamoid view weightbearing radiographs or weightbearing CT can be used reliably to measure first MPA and will generate similar values.

Level of Evidence:

Level IV, case series.
Reducing the Bias of Norm Scores in Non-Representative Samples: Weighting as an Adjunct to Continuous Norming Methods
Authors: Gary Sebastian , Lenhard Alexandra , Lenhard Wolfgang , Herzberg David S.
Published: February 2023

We investigated whether the accuracy of normed test scores derived from non-demographically representative samples can be improved by combining continuous norming methods with compensatory weighting of test results. To this end, we introduce Raking, a method from social sciences, to psychometrics. In a simulated reference population, we modeled a latent cognitive ability with a typical developmental gradient, along with three demographic variables that were correlated to varying degrees with the latent ability. We simulated five additional populations representing patterns of non-representativeness that might be encountered in the real world. We subsequently drew smaller normative samples from each population and used an one-parameter logistic Item Response Theory (IRT) model to generate simulated test results for each individual. Using these simulated data, we applied norming techniques, both with and without compensatory weighting. Weighting reduced the bias of the norm scores when the degree of non-representativeness was moderate, with only a small risk of generating new biases.
Near and Far Transfer Effects of Computerized Progressive Attention Training (CPAT) Versus Mindfulness Based Stress Reduction (MBSR) Practice Among Adults With ADHD
Authors: Stern Pnina , Kolodny Tamar , Tsafrir Shlomit , Cohen Galit , Shalev Lilach
Published: February 2023

Objective:

The present study evaluated the near (attention) and far (reading, ADHD symptoms, learning, and quality of life) transfer effects of a Computerized Progressive Attention Training (CPAT) versus Mindfulness Based Stress Reduction (MBSR) practice among adults with ADHD compared to a passive group.

Method:

Fifty-four adults participated in a non-fully randomized controlled trial. Participants in the intervention groups completed eight 2-hr weekly training sessions. Outcomes were assessed before, immediately after, and 4 months post-intervention, using objective tools: attention tests, eye-tracker, and subjective questionnaires.

Results:

Both interventions showed near-transfer to various attention functions. The CPAT produced far-transfer effects to reading, ADHD symptoms, and learning while the MBSR improved the self-perceived quality of life. At follow-up, all improvements except for ADHD symptoms were preserved in the CPAT group. The MBSR group showed mixed preservations.

Conclusion:

Both interventions have beneficial effects, however only the CPAT group exhibited improvements compared to the passive group.
In-silico Structural Modeling of Human Immunodeficiency Virus Proteins
Authors: Elalouf Amir
Published: February 2023

Human immunodeficiency virus (HIV) is an infectious virus that depletes the CD4+ T lymphocytes of the immune system and causes a chronic life-treating disease—acquired immunodeficiency syndrome (AIDS). The HIV genome encodes different structural and accessory proteins involved in viral entry and life cycle. Determining the 3D structure of HIV proteins is essential for new target position finding, structure-based drug designing, and future planning for computational and laboratory experimentations. Hence, the study aims to predict the 3D structures of all the HIV structural and accessory proteins using computational homology modeling to understand better the structural basis of HIV proteins interacting with host cells and viral replication. The sequences of HIV capsid, matrix, nucleocapsid, p6, reverse transcriptase, invertase, protease, gp120, gp41, virus protein r, viral infectivity factor, virus protein unique, RNA splicing regulator, transactivator protein, negative regulating factor, and virus protein x proteins were retrieved from UniProt. The primary and secondary structures of HIV proteins were predicted by Expasy ProtParam and SOPMA web servers. For the homology modeling, the MODELLER predicted the 3D structures of HIV proteins using templates. Then, the modeled structures were validated by the Ramachandran plot, local and global quality estimation scores, QMEAN scores, and Z-scores. Most of the amino acid residues of HIV proteins were present in the most favored and generously allowed regions in the Ramachandran plots. The local and global quality scores and Z-scores of the HIV proteins confirmed the good quality of modeled structures. The 3D modeled structures of HIV proteins might help further investigate the possible treatment.
Thermal fatigue behavior of reinforced concrete column used as heater and energy storage
Authors: Özrahat Evrim , Dirikgil Tamer , Ünalan Sebahattin
Published: February 2023

In this study, the damage effects of a new building heating system that activates the reinforced concrete columns (RC) which are the structural elements of the building by thermal cycles were investigated. The research was carried out experimentally on real-time data. The thermal fatigue effect that will occur after the structural RC is exposed to repeated thermal cycles was evaluated with the lateral cyclic loading test. The effect of the applied thermal cycles on the microstructure of the concrete was also tried to be observed. According to the data obtained in this study, in the preferred concrete type and geometry, the mechanical performance of the RC was not adversely affected at preferred operating temperatures and the number of applied thermal cycles. The results obtained are very promising in terms of the applicability of the new system as a preliminary study. In the proposed system, structural elements will be used as heater and energy storage throughout the life of the building. Therefore, it is essential to predict the exact thermal stress and strain values that the RC will be exposed to, and most importantly, the thermal fatigue life of the structural element under different parameters by future work.
The longitudinal relation between loneliness and perceived stress: A structural equation modelling analysis of 10,159 individuals
Authors: Laustsen Lisbeth M , Christiansen Julie , Maindal Helle T , Plana-Ripoll Oleguer , Lasgaard Mathias
Published: February 2023

Aims:

Prolonged loneliness and severe stress are increasingly recognised as public health concerns and considered risk factors for mental disorders, somatic illnesses and mortality. Loneliness and perceived stress also often co-occur; however, their longitudinal relation remains unclear. To the best of our knowledge, this is the first study aiming to investigate the longitudinal relation between loneliness and perceived stress independently of cross-sectional associations and time effects.

Methods:

Designed as a population-based cohort study with repeated measurements, the present study included individuals aged 16–80 years at baseline who participated in the Danish National Health Survey (‘How are you?’) in 2013 and 2017 ( N = 10,159; response rate = 50%). Structural equation modelling was used to examine associations between loneliness and perceived stress in the total sample and across age groups (i.e., 16–29, 30–64 and 65–80 years).

Results:

The models indicated bidirectional relations between loneliness and perceived stress. The standardized cross-lagged path from loneliness to perceived stress (β: 0.12, 95% confidence interval (CI) (0.08, 0.16), p < 0.001) and from perceived stress to loneliness (β: 0.12, 95% CI (0.07, 0.16), p < 0.001) both corresponded to small effect sizes in the total sample. Additionally, the results indicated strong cross-sectional associations, especially among adolescents and young adults (16–29 years), and high temporal stability, especially among the elderly (65–80 years).

Conclusions:

Loneliness and perceived stress mutually predict each other over time. The finding of both substantial bidirectional and cross-sectional associations demonstrates an interdependence between loneliness and perceived stress that may be relevant to consider in future interventions.
Beyond rights-based social protection for refugees
Authors: Zaman Tahir , Collyer Michael , Sabates-Wheeler Rachel , Szyp Carolina
Published: February 2023

The use of social protection measures has garnered increasing attention in recent years from academics and policymakers aspiring to unite the humanitarian origins and development ambitions of displacement governance regimes. Much of this attention has been focused on establishing and strengthening national systems of social protection provision. Analysis of policy approaches to social protection has become increasingly detailed, but typically does not extend beyond formal rights-based provision. This article seeks to address the paucity of literature on how refugees strategise around access to social assistance beyond Northern-mandated approaches. We review existing research on Syrian displacement in Lebanon to interrogate assumptions that refugees automatically seek institutionalised assistance. Drawing on postcolonial literature, we explore why modalities of social and humanitarian assistance offered through a rights-based approach represent only a partial mapping of the social protection that refugees avail themselves of. In doing so, we signal a move beyond the narrow and restrictive binary of formal/informal and attempt to consider the range of social protection opportunities from the perspective of refugees. Though unequal, we argue that both national systems of social protection provision and alternative approaches identified by displaced people are currently necessary, although a language of rights is only applicable to the former. Ultimately, greater coordination between the two is required. In conclusion, this article describes directions for future research aimed at a holistic understanding of how social protection is accessed in displacement and a more explicit interrogation of the impact of social protection measures in displacement settings.
(Why) Is Misinformation a Problem?
Authors: Adams Zoë , Osman Magda , Bechlivanidis Christos , Meder Björn
Published: February 2023

In the last decade there has been a proliferation of research on misinformation. One important aspect of this work that receives less attention than it should is exactly why misinformation is a problem. To adequately address this question, we must first look to its speculated causes and effects. We examined different disciplines (computer science, economics, history, information science, journalism, law, media, politics, philosophy, psychology, sociology) that investigate misinformation. The consensus view points to advancements in information technology (e.g., the Internet, social media) as a main cause of the proliferation and increasing impact of misinformation, with a variety of illustrations of the effects. We critically analyzed both issues. As to the effects, misbehaviors are not yet reliably demonstrated empirically to be the outcome of misinformation; correlation as causation may have a hand in that perception. As to the cause, advancements in information technologies enable, as well as reveal, multitudes of interactions that represent significant deviations from ground truths through people’s new way of knowing (intersubjectivity). This, we argue, is illusionary when understood in light of historical epistemology. Both doubts we raise are used to consider the cost to established norms of liberal democracy that come from efforts to target the problem of misinformation.
How Professionals Cooperate through Conflicts: Networks and Social Face in the Workplace
Authors: Au Anson
Published: February 2023

Conflicts are everyday sources of professional disagreement in the workplace. This article advances the study of professional conflicts by examining the symbolic interactionist processes through which professionals in South Korea cooperatively work through conflicts. Through ethnographic fieldwork conducted at a large hospital in Seoul in 2018, it is demonstrated that clinical professionals retain their poise and cooperate their way through conflicts by adhering to predetermined script-like ‘lines’ of action that mandate the protection of a triadic conception of social face: their own social face, that of their colleagues, and that of their hospital. Locked in disagreement over the risk profile of procedures for clients, embattled clinicians and nurses reroute conversations about conflicts to stress a shared identity in a bid to prevent humiliation, maintain network reciprocity, and preserve social face – of their dissenting counterparts, themselves, and their hospital. Professionals exercise a discerning level of heterogeneity in their conflict avoidance to maintain harmonious relationships, foster a personal brand of trust with clientele, and ultimately safeguard professional unity in the hospital.
Turning Heads on the Dance Floor: Synchrony and Social Interaction Using a Silent Disco Paradigm
Authors: Bamford Joshua S. , Burger Birgitta , Toiviainen Petri
Published: February 2023

Music and dance appear to have a social bonding effect, which some have theorized is part of their ultimate evolutionary function. Prior research has also found a social bonding effect of synchronized movement, and it is possible that interpersonal synchrony could be considered the “active ingredient” in the social bonding consequences of music or dance activity. The present study aimed to separate the effects of synchrony from other factors associated with joint experience of dancing by using a “silent disco” manipulation, in which the timing of a musical stimulus was varied within a dyad in a freestyle dance setting. Three conditions were included: synchrony, tempo-shifted (in which the tempo was stretched by 5% for one participant), and phase-shifted (in which the beat was offset by 90 degrees for one participant). It was found that, when participants were listening to music in time with each other, they gave higher subjective ratings of their experience interacting with their partner. Participants also were observed looking towards each other more in the synchrony condition, compared with the non-synchrony conditions. From this, it appears that sharing time may contribute to the social effects of joint dancing, independent of any other effects associated with sharing space on the dancefloor. Avenues for further research, and possibilities using this “silent disco” paradigm, are discussed.
What Postoperative Nutritional Interventions Lead to Better Outcomes in Fragility Hip Fractures? A Systematic Review
Authors: Oberstar Jennifer S. , Bakker Caitlin J. , Sorich Megan , McCarthy Teresa
Published: February 2023

Background

Fragility hip fracture patients are often malnourished. Nutrition supplementation may help, but it is unclear if supplementation is impactful when considering outcomes. A systematic review of literature examining perioperative nutrition status for older adults experiencing a hip fracture was performed.

Methods

We searched Medline, CAB Abstracts and Embase (Ovid); Cochrane Library (Wiley); PubMed; Scopus; Global Index Medicus; Web of Science Core Collection; SPORTDiscus (EBSCO); and clinical trial registries ClinicalTrials.gov and WHO ICTRP from inception to April 2021, incorporating terminology related to nutritional interventions, fragility fractures, and postoperative outcomes. Two investigators reviewed citations for inclusion, extracted nutrition intervention criteria, and categorized hip fragility outcomes.

Results

Of 1792 citations, 90 articles underwent full-text screening, and 14 articles were included in the final sample. We identified nutritional interventions and 4 outcomes of interest. 8 studies (n = 649) demonstrated a mean difference of .78 days (CI .34-1.21) in length of stay (LOS) between the nutritional intervention and control groups. Rehabilitation ward stays were discussed in 2 studies demonstrating a non-statistically significant difference. 7 studies (n = 341) reported mortality rates; when pooled there was no statistically significant difference. 5 studies showed data for postoperative infections and 4 studies reported on postoperative urinary tract infections. Pooling of data found a statistically significant result (Relative Risk: .49 [.32, .75], P = .001) with low heterogeneity (I2 = 27%). 4 studies reported urinary tract infections (n = 140) in the intervention group and (n = 121) in the control group with a non-statistically significant result. Grip strength was only reported in two studies but pooling of the data was non-statistically significant.

Conclusions

This systematic review highlighted the lack of consensus regarding the type of nutrition interventions available and impact on outcomes of interest including mortality, length of stay, infections, and grip strength for fragility hip fractures in older adults.
Classification of Bone Bruises in Pediatric Patients With Anterior Cruciate Ligament Injuries
Authors: Wang Hong-De , Zhang Jiahao , Li Yuwan , Li Zong , Yan Wenqiang , Ao Yingfang
Published: February 2023

Background:

Bone bruises are frequently found on magnetic resonance imaging (MRI) after an anterior cruciate ligament (ACL) tear in pediatric patients.

Purpose:

To establish a classification system for different bone bruise patterns to estimate the severity of a knee injury in pediatric patients with ACL tears.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A medical database was retrospectively reviewed to identify all cases of primary ACL tears in patients who were aged ≤17 years at the time of the injury and underwent MRI at our institution within 4 weeks of the injury between January 2011 and December 2020. A total of 188 patients were identified (67 male, 121 female; mean age, 15.1 ± 1.4 years). Bone bruises were classified according to their depth and location on MRI in the sagittal and coronal planes.

Results:

The new classification system identified 3 grades of depth: grade I, the bone bruise was located within the epiphysis but did not reach the epiphyseal plate (n = 54 [35.3%]); grade II, the bone bruise was within the epiphysis that reached the epiphyseal plate (n = 55 [35.9%]); and grade III, the bone bruise was in both the epiphysis and metaphysis (n = 44 [28.8%]). The bone bruise location was classified into 4 types: type a, the deepest bone bruise area was in the lateral tibial plateau (n = 66 [43.1%]); type b, the deepest bone bruise area was in the lateral femoral condyle, commonly occurring in the lateral one-third to two-thirds of the lateral femoral condyle (n = 22 [14.4%]); type c, the bone bruise area had a similar depth in both the lateral femoral condyle and lateral tibial plateau (n = 54 [35.3%]); and type d, the bone bruise area was in the lateral tibial plateau and lateral femoral condyle and extended to the fibular head (n = 11 [7.2%]). The prevalence of collateral ligament injuries increased from grade I to III. All patients with grade III type c bone bruises had meniscal lesions.

Conclusion:

This new classification system provides a basis for estimating associated lesions of the knee before surgery.
Autoantibodies to a Nodal Isoform of Neurofascin in Pediatric Chronic Inflammatory Demyelinating Polyneuropathy
Authors: Chauvet Eline , Blanchard Rohner Geraldine , Manel Véroniqu , Delmont Emilien , Boucraut Joseph , Garcia-Tarodo Stephanie
Published: February 2023

Pediatric chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated disorder of the peripheral nervous system with a number of diagnostic pitfalls. A subset of treatment-resistant CIDP adult patients have been found with antibodies against paranodal proteins. We report the first pediatric case in a 14 year-old adolescent with a severe CIDP phenotype in whom positive anti-neurofascin 155 antibodies were found in his serum. Resistant to conventional therapies, he showed dramatic improvement when treated with Rituximab with mild to moderate functional motor disability at 24 month follow-up. In pediatric CIDP patients that remain refractory to conventional treatments, the presence of antibodies to paranodal proteins warrants investigation as it can have potential therapeutic guidance.
Consonant Perception in Connected Syllables Spoken at a Conversational Syllabic Rate
Authors: Phatak Sandeep A. , Zion Danielle J. , Grant Ken W.
Published: February 2023

Closed-set consonant identification, measured using nonsense syllables, has been commonly used to investigate the encoding of speech cues in the human auditory system. Such tasks also evaluate the robustness of speech cues to masking from background noise and their impact on auditory-visual speech integration. However, extending the results of these studies to everyday speech communication has been a major challenge due to acoustic, phonological, lexical, contextual, and visual speech cue differences between consonants in isolated syllables and in conversational speech. In an attempt to isolate and address some of these differences, recognition of consonants spoken in multisyllabic nonsense phrases (e.g., aBaSHaGa spoken as /ɑbɑʃɑɡɑ/) produced at an approximately conversational syllabic rate was measured and compared with consonant recognition using Vowel-Consonant-Vowel bisyllables spoken in isolation. After accounting for differences in stimulus audibility using the Speech Intelligibility Index, consonants spoken in sequence at a conversational syllabic rate were found to be more difficult to recognize than those produced in isolated bisyllables. Specifically, place- and manner-of-articulation information was transmitted better in isolated nonsense syllables than for multisyllabic phrases. The contribution of visual speech cues to place-of-articulation information was also lower for consonants spoken in sequence at a conversational syllabic rate. These data imply that auditory-visual benefit based on models of feature complementarity from isolated syllable productions may over-estimate real-world benefit of integrating auditory and visual speech cues.
Magnitude of Cognitive Impairment Among Patients With Epilepsy at Health Institutions in Gurage Zone, Ethiopia
Authors: Wazema Deribachew Hailemariam , Assefa Zebene Makonnen , Shiferaw Bisrat Zeleke , Geleta Omega Tolessa , Haile Tariku Gebre
Published: February 2023

Introduction

Epilepsy is a widespread neurological disorder characterized by recurrent unprovoked seizures; it contributes to 1% of the global burden of diseases and can end in cognitive impairment.

Objective

To assess the magnitude and associated factors of cognitive impairment among patients with epilepsy.

Method

The study utilized an institution-based cross-sectional study design. All patients with epilepsy whose ages were above 18 years were the source population. The authors performed bivariate and multivariate logistic regression analyses. Finally, variables with a p-value <.05 were significantly associated.

Result

The magnitude of cognitive impairment is 25.6%. Having no family history of epilepsy (AOR=0.12; 95% CI [0.02, 0.61]), polytherapy (AOR=5.14; 95% CI [1.12, 23.62]), and medication-related complaints (AOR=8.24; 95% CI [1.87, 36.38]) were strongly associated with cognitive impairment.

Conclusion

Significant numbers of patients were positive for cognitive impairment. Family history, polytherapy, and medication-related complaints were associated factors.
Core binding factor fusion downregulation of ADAR2 RNA editing contributes to AML leukemogenesis
Authors: Guo Mingrui , Chan Hon Man Tim , Zhou Qi-Ling , An Omer , Li Ying , Song Yangyang , Tan Zi Hui , Ng Hui En Vanessa , Peramangalam Philomina Sona , Tan Zhi Qing , Cao Xinang , Iwanaga Eisaku , Matsuoka Masao , Ooi Melissa G , Jen Wei Ying , Koh Liang Piu , Chan Esther , Tan Lip Kun , Goh Yufen , Wang Wilson , Koh Bryan T.H. , Chan Ming Chun , Fullwood Melissa J. , Chng Wee Joo , Osato Motomi , Pulikkan John Anto , Yang Henry , Chen Leilei , Tenen Daniel G.
Published: February 2023

Adenosine to inosine (A-to-I) RNA editing, which is catalyzed by adenosine deaminases acting on RNA (ADAR) family of enzymes ADAR1 and ADAR2, has been shown to contribute to multiple cancers. However, other than chronic myeloid leukemia (CML) blast crisis, relatively little is known about its role in other types of hematological malignancies. Here, we found that ADAR2, but not ADAR1 and ADAR3, was specifically downregulated in the core binding factor (CBF) AML with t(8;21) or inv(16) translocations. In t(8;21) AML, RUNX1-driven transcription of ADAR2 was repressed by the RUNX1-ETO AE9a fusion protein in a dominant negative manner. Further functional studies confirmed that ADAR2 could suppress leukemogenesis specifically in t(8;21) and inv16 AML cells dependent on its RNA editing capability. Expression of two exemplary ADAR2-regulated RNA editing targets COPA and COG3 inhibited clonogenic growth of human t(8;21) AML cells. Our findings support a hitherto unappreciated mechanism leading to ADAR2 dysregulation in CBF AML and highlight the functional relevance of loss of ADAR2-mediated RNA editing to CBF AML.
Research Progress on the Solder Joint Reliability of Electronics Using in Deep Space Exploration
Authors: Guan Qilong , Hang Chunjin , Li Shengli , Yu Dan , Ding Ying , Wang Xiuli , Tian Yanhong
Published: February 2023

The spacecraft for deep space exploration missions will face extreme environments, including cryogenic temperature, intense radiation, wide-range temperature variations and even the combination of conditions mentioned above. Harsh environments will lead to solder joints degradation or even failure, resulting in damage to onboard electronics. The research activities on high reliability solder joints using in extreme environments can not only reduce the use of onboard protection devices, but effectively improve the overall reliability of spacecraft, which is of great significance to the aviation industry. In this paper, we review the reliability research on SnPb solder alloys, Sn-based lead-free solder alloys and In-based solder alloys in extreme environments, and try to provide some suggestions for the follow-up studies, which focus on solder joint reliability under extreme environments.
Noninvasive direct bilirubin detection by spectral analysis of color images using a Mini-LED light source
Authors: Kuo Hsin-Ching , Ye Zhi-Ting , Tseng Shen Fu , Tsou Shang Xuan , Huang Shih Wei , Tsai Chun-Wei
Published: February 2023

Urine test paper is a standard, noninvasive detection method for direct bilirubin, but this method can only achieve qualitative analysis and cannot achieve quantitative analysis. This study used Mini-LEDs as the light source, and direct bilirubin was oxidized to biliverdin by an enzymatic method with ferric chloride (FeCl3) for labeling. Images were captured with a smartphone and evaluated for red (R), green (G), and blue (B) colors to analyze the linear relationship between the spectral change of the test paper image and the direct bilirubin concentration. This method achieved noninvasive detection of bilirubin. The experimental results demonstrated that Mini-LEDs can be used as the light source to analyze the grayscale value of the image RGB. For the direct bilirubin concentration range of 0.1–2 mg/dL, the green channel had the highest coefficient of determination coefficient (R2) of 0.9313 and a limit of detection of 0.56 mg/dL. With this method, direct bilirubin concentrations higher than 1.86 mg/dL can be quantitatively analyzed with the advantage of rapid and noninvasive detection.
Should multiple imputation be stratified by exposure group when estimating causal effects via outcome regression in observational studies?
Authors: Zhang Jiaxin , Dashti S Ghazaleh , Carlin John B. , Lee Katherine J. , Moreno-Betancur Margarita
Published: February 2023

Background

Despite recent advances in causal inference methods, outcome regression remains the most widely used approach for estimating causal effects in epidemiological studies with a single-point exposure and outcome. Missing data are common in these studies, and complete-case analysis (CCA) and multiple imputation (MI) are two frequently used methods for handling them. In randomised controlled trials (RCTs), it has been shown that MI should be conducted separately by treatment group. In observational studies, causal inference is now understood as the task of emulating an RCT, which raises the question of whether MI should be conducted by exposure group in such studies.

Methods

We addressed this question by evaluating the performance of seven methods for handling missing data when estimating causal effects with outcome regression. We conducted an extensive simulation study based on an illustrative case study from the Victorian Adolescent Health Cohort Study, assessing a range of scenarios, including seven outcome generation models with exposure-confounder interactions of differing strength.

Results

The simulation results showed that MI by exposure group led to the least bias when the size of the smallest exposure group was relatively large, followed by MI approaches that included the exposure-confounder interactions.

Conclusions

The findings from our simulation study, which was designed based on a real case study, suggest that current practice for the conduct of MI in causal inference may need to shift to stratifying by exposure group where feasible, or otherwise including exposure-confounder interactions in the imputation model.
Serological response to vaccination in post-acute sequelae of COVID
Authors: Joung Sandy , Weber Brittany , Wu Min , Liu Yunxian , Tang Amber B. , Driver Matthew , Sternbach Sarah , Wynter Timothy , Hoang Amy , Barajas Denisse , Kao Yu Hung , Khuu Briana , Bravo Michelle , Masoom Hibah , Tran Teresa , Sun Nancy , Botting Patrick G. , Claggett Brian L. , Prostko John C. , Frias Edwin C. , Stewart James L. , Robertson Jackie , Kwan Alan C. , Torossian Mariam , Pedraza Isabel , Sterling Carina , Goldzweig Caroline , Oft Jillian , Zabner Rachel , Fert-Bober Justyna , Ebinger Joseph E. , Sobhani Kimia , Cheng Susan , Le Catherine N.
Published: February 2023

Background

Individuals with post-acute sequelae of COVID (PASC) may have a persistence in immune activation that differentiates them from individuals who have recovered from COVID without clinical sequelae. To investigate how humoral immune activation may vary in this regard, we compared patterns of vaccine-provoked serological response in patients with PASC compared to individuals recovered from prior COVID without PASC.

Methods

We prospectively studied 245 adults clinically diagnosed with PASC and 86 adults successfully recovered from prior COVID. All participants had measures of humoral immunity to SARS-CoV-2 assayed before or after receiving their first-ever administration of COVID vaccination (either single-dose or two-dose regimen), including anti-spike (IgG-S and IgM-S) and anti-nucleocapsid (IgG-N) antibodies as well as IgG-S angiotensin-converting enzyme 2 (ACE2) binding levels. We used unadjusted and multivariable-adjusted regression analyses to examine the association of PASC compared to COVID-recovered status with post-vaccination measures of humoral immunity.

Results

Individuals with PASC mounted consistently higher post-vaccination IgG-S antibody levels when compared to COVID-recovered (median log IgG-S 3.98 versus 3.74, P < 0.001), with similar results seen for ACE2 binding levels (median 99.1 versus 98.2, P = 0.044). The post-vaccination IgM-S response in PASC was attenuated but persistently unchanged over time (P = 0.33), compared to in COVID recovery wherein the IgM-S response expectedly decreased over time (P = 0.002). Findings remained consistent when accounting for demographic and clinical variables including indices of index infection severity and comorbidity burden.

Conclusion

We found evidence of aberrant immune response distinguishing PASC from recovered COVID. This aberrancy is marked by excess IgG-S activation and ACE2 binding along with findings consistent with a delayed or dysfunctional immunoglobulin class switching, all of which is unmasked by vaccine provocation. These results suggest that measures of aberrant immune response may offer promise as tools for diagnosing and distinguishing PASC from non-PASC phenotypes, in addition to serving as potential targets for intervention.
Association between anemia and serum Klotho in middle-aged and older adults
Authors: An Chencheng , Chen Xiaoling , Zheng Donghui
Published: February 2023

Background

The role of Klotho as a multifunctional protein in anemia is unclear. This study aimed to determine the association between anemia and serum Klotho concentrations in middle-aged and elderly populations.

Methods

In this cross-sectional study, we used data collected from the National Health and Nutrition Examination Survey (NHANES) 2007-2016. A total of 13,357 individuals who received serum Klotho measurements, biochemical tests, and demographic surveys were analyzed. Multivariate linear regression models adjusting for covariates were used to investigate the associations between anemia and serum Klotho.

Results

Multivariable regression showed that serum Klotho correlates positively with hemoglobin and red blood cells and inversely with red cell distribution width. After adjusting for all covariates, compared with Q4, there was a significantly increased risk of anemia in serum Klotho quartiles 1 to 2 (OR=1.54, 95% CI:1.21-1.95, P=0.002; OR=1.30, 95% CI:1.02-1.64, P=0.042,respectively). Segmented regression showed that for every 100 pg/mL increase in serum Klotho <9.746 pg/mL, the risk of anemia was reduced by 10.9%, and this reduction was significant (P<0.001). Furthermore, stratified analyses yielded a stronger association between reduced anemia and high levels of Klotho in men and those with diabetes (P< 0.05 for interaction). However, this association was not found to be significantly altered by chronic kidney disease.

Conclusions

In summary, we indicated that low serum Klotho is associated with an increased likelihood of anemia using a nationally representative sample of middle-aged and older adults.
The expression of respiratory tract virus in pediatric glomerular disease: a retrospective study of 45 renal biopsy in China
Authors: Lin Li , Li Lu , Cao Yao , Peng Xin , Wu Yi , Yu Ping , Dong LiQun
Published: February 2023

Background

More attention has been put on the relationship between pediatric glomerular disease and respiratory tract virus infection. Children with glomerular illness, however, are uncommonly found to have biopsy-proven pathological evidence of viral infection. The purpose of this study is to determine whether and what kind of respiratory viruses are found in renal biopsy from glomerular disorders.

Methods

We used a multiplex PCR to identify a wide range of respiratory tract viruses in the renal biopsy samples (n = 45) from children with glomerular disorders and a specific PCR to verify their expression.

Results

These case series included 45 of 47 renal biopsy specimens, with 37.8% of male and 62.2% of female patients. Indications for a kidney biopsy were present in all of the individuals. In 80% of the samples, respiratory syncytial virus was discovered. Following that, the RSV subtypes in several pediatric renal disorders were found. There were 16 RSVA positives, 5 RSVB positives, and 15 RSVA/B positives, accounting for 44.4%, 13.9%, and 41.7%, respectively. Nephrotic syndrome samples made up 62.5% of RSVA positive specimens. The RSVA/B-positive was detected in all pathological histological types.

Conclusions

Patients with glomerular disease exhibit respiratory tract viral expression in the renal tissues, especially respiratory syncytial virus. This research offers new information on the detection of respiratory tract viruses in renal tissue, which may facilitate the identification and treatment of pediatric glomerular diseases.
Bioinformatics analysis and experimental validation of cuproptosis-related lncRNA LINC02154 in clear cell renal cell carcinoma
Authors: Shen Junlin , Wang Linhui , Bi Jianbin
Published: February 2023

Background

Clear cell renal cell carcinoma (ccRCC) is common in urinary system tumors. Cuproptosis is a non-apoptotic cell death pathway. Copper binds to fatty acylated mitochondrial proteins and activates various forms of cell death. LncRNA LINC02154 is significantly highly expressed in cells and tissues of many types of tumors, and the risk signature of LINC02154 in some tumors has been validated for effectiveness.

Methods

We constructed a risk prognostic signature by obtaining differentially expressed long noncoding RNAs (lncRNAs) associated with ccRCC outcomes and cuproptosis from The Cancer Genome Atlas (TCGA). We used TCGA to construct training and testing sets to analyze the risk signature and the impact of LINC02154, and we performed relevant survival analyses. Tumor mutational burdens were analyzed in different LINC02154 expression groups and risk score groups. We next analyzed the immune microenvironment of LINC20154. We performed LINC20154-related drug sensitivity analyses. We also investigated the cellular function of LINC02154 in the ACHN cell line and performed CCK-8 assay, EdU, wound-healing assay, and Transwell assay. The essential genes FDX1 and DLST of cuproptosis were detected by western blot.

Results

We demonstrated that LINC02154’s impact on outcomes was statistically significant. We also demonstrated the association of different ages, genders, stages, and grades with LINC02154 and risk models. The results showed a significant difference in tumor mutation burden between the groups, which was closely related to clinical prognosis. We found differences in immune cells among groups with different levels of LINC02154 expression and significant differences in immune function, immunotherapeutic positive markers, and critical steps of the immune cycle. The sensitivity analysis showed that differential expression of LINC02154 discriminated between sensitivity to axitinib, doxorubicin, gemcitabine, pazopanib, sorafenib, sunitinib, and temsirolimus. This difference was also present in the high-risk group and low-risk group. We demonstrated that the proliferation and migration of t ACHN cells in the LINC02154 knockdown group were inhibited. The western blot results showed that the knockdown of LINC02154 significantly affected the expression of FDX1 and DLST, critical genes of cuproptosis.

Conclusion

Finally, we demonstrated that LINC02154 and our constructed risk signature could predict outcomes and have potential clinical value.
“Community members have more impact on their neighbors than celebrities”: leveraging community partnerships to build COVID-19 vaccine confidence
Authors: Tjilos Maria , Tamlyn Autumn L. , Ragan Elizabeth J. , Assoumou Sabrina A. , Barnett Katherine Gergen , Martin Petrina , Perkins Rebecca B. , Linas Benjamin P. , Drainoni Mari-Lynn
Published: February 2023

Background

Vaccines are a strong public health tool to protect against severe disease, hospitalization, and death from COVID-19. Still, inequities in COVID-19 vaccination rates and health outcomes continue to exist among Black and Latino populations. Boston Medical Center (BMC) has played a significant role in vaccinating medically underserved populations, and organized a series of community-engaged conversations to better understand community concerns regarding the COVID-19 vaccine. This paper describes the themes which resulted from these community-engaged conversations and proposes next steps for healthcare leaders.

Methods

We accessed nine publicly available recordings of the community-engaged conversations which were held between March 2021 and September 2021 and ranged from 8 to 122 attendees. Six conversations prioritized specific groups: the Haitian-Creole community, the Cape Verdean community, the Latino community, the Black Christian Faith community, guardians who care for children living with disabilities, and individuals affected by systemic lupus erythematosus. Remaining conversations targeted the general public of the Greater Boston Area. We employed a Consolidated Framework for Implementation Research-driven codebook to code our data. Our analysis utilized a modified version of qualitative rapid analysis methods.

Results

Five main themes emerged from these community-engaged conversations: (1) Structural factors are important barriers to COVID-19 vaccination; (2) Mistrust exists due to the negative impact of systemic oppression and perceived motivation of the government; (3) There is a desire to learn more about biological and clinical characteristics of the COVID-19 vaccine as well as the practical implications of being vaccinated; (4) Community leaders emphasize community engagement for delivering COVID-19 information and education and; (5) Community leaders believe that the COVID-19 vaccine is a solution to address the pandemic.

Conclusion

This study illustrates a need for community-engaged COVID-19 vaccine messaging which reflects the nuances of the COVID-19 vaccine and pandemic without oversimplifying information. In highlighting common concerns of the Greater Boston Area which contribute to a lack of confidence in the COVID-19 vaccine, we underscore important considerations for public health and healthcare leadership in the development of initiatives which work to advance health equity.
Complex organisational factors influence multidisciplinary care for patients with hip fractures: a qualitative study of barriers and facilitators to service delivery
Authors: Fox F , Drew S , Gregson CL , Patel R , Chesser TJS , Johansen A , Javaid MK , Griffin XL , Gooberman-Hill R
Published: February 2023

Background

Hip fractures are devastating injuries, with high health and social care costs. Despite national standards and guidelines, substantial variation persists in hospital delivery of hip fracture care and patient outcomes. This qualitative study aimed to identify organisational processes that can be targeted to reduce variation in service provision and improve patient care.

Methods

Interviews were conducted with 40 staff delivering hip fracture care in four UK hospitals. Twenty-three anonymised British Orthopaedic Association reports addressing under-performing hip fracture services were analysed. Following Thematic Analysis of both data sources, themes were transposed onto domains both along and across the hip fracture care pathway.

Results

Effective pre-operative care required early alert of patient admission and the availability of staff in emergency departments to undertake assessments, investigations and administer analgesia. Coordinated decision-making between medical and surgical teams regarding surgery was key, with strategies to ensure flexible but efficient trauma lists. Orthogeriatric services were central to effective service delivery, with collaborative working and supervision of junior doctors, specialist nurses and therapists. Information sharing via multidisciplinary meetings was facilitated by joined up information and technology systems. Service provision was improved by embedding hip fracture pathway documents in induction and training and ensuring their consistent use by the whole team. Hospital executive leadership was important in prioritising hip fracture care and advocating service improvement. Nominated specialty leads, who jointly owned the pathway and met regularly, actively steered services and regularly monitored performance, investigating lapses and consistently feeding back to the multidisciplinary team.

Conclusion

Findings highlight the importance of representation from all teams and departments involved in the multidisciplinary care pathway, to deliver integrated hip fracture care. Complex, potentially modifiable, barriers and facilitators to care delivery were identified, informing recommendations to improve effective hip fracture care delivery, and assist hospital services when re-designing and implementing service improvements.
Comparison of the preoperative diagnostic accuracy of BIPSS versus MRI for Cushing disease: a single-centre experience
Authors: Mao Jian-Nan , Yan Hui-Ying , Chen Jie-Yu , Yan Chao-Long , Li Ping , Jin Wei , Hang Chun-Hua
Published: February 2023

Background

Cushing disease (CD) arises due to a pituitary corticotroph adenoma, which is the most common cause of Cushing syndrome (CS). Bilateral inferior petrosal sinus sampling (BIPSS) is a safe method for differentiating CD from ectopic adrenocorticotropic hormone (ACTH)-dependent CS. Enhanced high-resolution magnetic resonance imaging (MRI) can localize tiny pituitary lesions. The aim of this study was to compare the preoperative diagnostic accuracy of BIPSS versus MRI for CD in CS patients. We performed a retrospective study of patients who underwent BIPSS and MRI between 2017 and 2021. Low- and high-dose dexamethasone suppression tests were performed. Blood samples were collected simultaneously from the right and left catheter and femoral vein before and after desmopressin stimulation. MRI images were obtained, and endoscopic endonasal transsphenoidal surgery (EETS) was performed in confirmed CD patients. Dominant sides of ACTH secretion during BIPSS and MRI were compared with surgical findings.

Results

Twenty-nine patients underwent BIPSS and MRI. CD was diagnosed in 28 patients, 27 of whom received EETS. Localizations of microadenomas by MRI and BIPSS agreed with the EETS findings in 96% and 93% of the cases, respectively. BIPSS and EETS were successfully performed on all patients.

Conclusion

BIPSS was the most accurate method (gold standard) for establishing a preoperative diagnosis of pituitary-dependent CD and was more sensitive than MRI in diagnosing microadenoma. High-resolution MRI with enhancement had an advantage over BIPSS in microadenoma lateralization diagnostics. The combined use of MRI and BIPSS could improve the preoperative diagnosis accuracy in ACTH-dependent CS patients.