bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulatory mechanisms to create healthier environments: planning appeals and hot food takeaways in England
Authors: O’Malley CL , Lake AA , Moore HJ , Gray N , Bradford C , Petrokofsky C , Papadaki A , Spence S , Lloyd S , Chang M , Townshend TG
Published: August 2023

Aims:

To explore existing regulatory mechanisms to restrict hot food takeaway (HFT) outlets through further understanding processes at local and national levels.

Methods:

The Planning Appeals Portal was utilised to identify recent HFT appeal cases across England between December 2016 and March 2020. Eight case study sites were identified using a purposive sampling technique and interviews carried out with 12 professionals involved in planning and health to explore perceptions of and including factors that may impact on the HFT appeal process. Additionally, documents applicable to each case were analysed and a survey completed by seven Local Authority (LA) health professionals. To confirm findings, interpretation meetings were conducted with participants and a wider group of planning and public health professionals, including a representative from the Planning Inspectorate.

Results:

Eight case study sites were identified, and 12 interviews conducted. Participants perceived that LAs would be better able to work on HFT appeal cases if professionals had a good understanding of the planning process/the application of local planning policy and supplementary planning documents; adequate time and capacity to deal with appeals cases; access to accurate, robust, and up to date information; support and commitment from elected members and senior management; good lines of communication with local groups/communities interested in the appeal; information and resources that are accessible and easy to interpret across professional groups.

Conclusions:

Communication across professional groups appeared to be a key factor in successfully defending decisions. Understanding the impact of takeaway outlets on health and communities in the long term was also important. To create a more robust appeals case and facilitate responsiveness, professionals involved in an appeal should know where to locate current records and statistical data. The enthusiasm of staff and support from senior management/elected officials will play a significant role in driving these agendas forward.
Evolving perspectives on the treatment of HR+/HER2+ metastatic breast cancer
Authors: Pegram Mark , Pietras Richard , Dang Chau T. , Murthy Rashmi , Bachelot Thomas , Janni Wolfgang , Sharma Priyanka , Hamilton Erika , Saura Cristina
Published: August 2023

Breast cancer (BC) with expression of the estrogen receptor (ER) and/or progesterone receptor (PR) protein and with overexpression/amplification of the human epidermal growth factor receptor 2 (HER2), termed hormone receptor-positive (HR+)/HER2+ BC, represents ∼10% of all BCs in the United States. HR+/HER2+ BC includes HER2+ BCs that are ER+, PR+, or both ER+ and PR+ (triple-positive BC). Although the current guideline-recommended treatment combination of anti-HER2 monoclonal antibodies plus chemotherapy is an effective first-line therapy for many patients with HER2+ advanced disease, intratumoral heterogeneity within the HR+/HER2+ subtype and differences between the HR+/HER2+ subtype and the HR−/HER2+ subtype suggest that other targeted combinations could be investigated in randomized clinical trials for patients with HR+/HER2+ BC. In addition, published data indicate that crosstalk between HRs and HER2 can lead to treatment resistance. Dual HR and HER2 pathway targeting has been shown to be a rational approach to effective and well-tolerated therapy for patients with tumors driven by HER2 and HR, as it may prevent development of resistance by blocking receptor pathway crosstalk. However, clinical trial data for such approaches are limited. Treatments to attenuate other signaling pathways involved in receptor crosstalk are also under investigation for inclusion in dual receptor targeting regimens. These include cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, based on the rationale that association of CDK4/6 with cyclin D1 may play a role in resistance to HER2-directed therapies, and others such as phosphatidylinositol-3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway inhibitors. Herein, we will review the scientific and clinical rationale for combined receptor blockade targeting HER2 and ER for patients with advanced-stage HR+/HER2+ disease.
Mealtime Insulin BOLUS Score More Strongly Predicts HbA1c Than the Self-Care Inventory in Youth With Type 1 Diabetes
Authors: Christie Jordan , Clements Mark A. , Williams David D. , Cernich Joseph , Patton Susana R.
Published: August 2023

Background:

To meet their glycated hemoglobin (HbA1c) goals, youth with type 1 diabetes (T1D) need to engage with their daily T1D treatment. The mealtime insulin Bolus score (BOLUS) is an objective measure of youth’s T1D engagement which we have previously shown to be superior to other objective engagement measures in predicting youth’s HbA1c. Here, to further assess the BOLUS score’s validity, we compared the strengths of the associations between youth’s HbA1c with their mean insulin BOLUS score and a valid, self-report measure of T1D engagement, the Self-Care Inventory (SCI).

Methods:

One-hundred and five youth with T1D self-reported their T1D engagement using the SCI. We also collected two weeks of insulin pump data and a concurrent HbA1c level. We scored youth’s SCI and calculated their mean insulin BOLUS score using standardized methods. For the analyses, we performed simple correlations, partial correlations, and multiple regression models.

Results:

Youth had a mean age of 15.03 ± 1.97 years, mean time since diagnosis of 8.11 ± 3.26 years, and a mean HbA1c of 8.78 ± 1.49%. The sample included n = 58 boys (55%) and n = 96 families (91%) self-identified as white. Simple correlations between youth’s age, HbA1c, SCI total score, and BOLUS score were all significant. Partial correlation and regression models revealed that youth’s insulin BOLUS score was more strongly associated with HbA1c than the SCI.

Conclusions:

Youths’ BOLUS score has better concurrent validity with HbA1c than the SCI. We should consider reporting the BOLUS score as an outcome metric in insulin pump data reports.
Fibrous hydrogels by electrospinning: Novel platforms for biomedical applications
Authors: Lee Ji Woo , Song Kwang Hoon
Published: August 2023

Hydrogels, hydrophilic and biocompatible polymeric networks, have been used for numerous biomedical applications because they have exhibited abilities to mimic features of extracellular matrix (ECM). In particular, the hydrogels engineered with electrospinning techniques have shown great performances in biomedical applications. Electrospinning techniques are to generate polymeric micro/nanofibers that can mimic geometries of natural ECM by drawing micro/nanofibers from polymer precursors with electrical forces, followed by structural stabilization of them. By exploiting the electrospinning techniques, the fibrous hydrogels have been fabricated and utilized as 2D/3D cell culture platforms, implantable scaffolds, and wound dressings. In addition, some hydrogels that respond to external stimuli have been used to develop biosensors. For comprehensive understanding, this review covers electrospinning processes, hydrogel precursors used for electrospinning, characteristics of fibrous hydrogels and specific biomedical applications of electrospun fibrous hydrogels and highlight their potential to promote use in biomedical applications.
Adalimumab-induced systemic lupus erythematosus: A case report and review of the literature
Authors: Landells Fiona M , Vender Ronald
Published: August 2023

Adalimumab is a tumor necrosis factor inhibitor that has been widely used since the early 2000s for the treatment of psoriasis and psoriatic arthritis. All tumor necrosis factor inhibitors have been identified as causative agents in drug induced lupus, particularly etanercept and infliximab. There have been few reported cases of systemic lupus erythematosus induced by adalimumab, many more are attributable to treatment with etanercept or infliximab. We present the case of a patient with long-standing psoriasis and psoriatic arthritis who was successfully treated with adalimumab, but developed anti-tumor necrosis factor-induced lupus.
A rare case of squamous cell carcinoma transformation in a mature cystic teratoma of the ovary
Authors: Sibarani Candra Novi Ricardo , Permata Hesty Duhita , Martiana Ellis Fasta , Tjandraprawira Kevin Dominique , Hadinata Caroline Viviana
Published: August 2023

Mature cystic teratoma of the ovary is the most common ovarian neoplasm (10%–20%). These tumors are generally benign but may undergo malignant transformation, 80% of which is squamous cell carcinoma, in postmenopausal women (1%–2%). Due to nonspecific findings, the preoperative diagnosis is challenging; most patients are detected at an advanced stage and have poor outcomes. A 40-year-old female, P2A0, complained of worsening lower abdominal pain and palpable abdominal mass. She had not been having menstrual periods for almost 4 months. For the last 3 months, she had asthenia, anorexia, and lost 10 kg. Abdominal examination was notable for an immobile, well-defined cystic mass measuring 12 × 8 × 8 cm with an irregular surface in the lower abdomen. Its overlying skin appeared reddish. A bimanual examination confirmed the adnexal origin of the cystic mass. Laboratory examination was notable for leukocytosis, thrombocytosis, increased neutrophil-to-lymphocyte ratio, and reduced absolute lymphocyte count. There was an increase in her cancer antigen 125. An abdominal ultrasonography examination showed bilateral mature cystic teratoma. A bilateral salpingo-oophorectomy was performed. A postoperative diagnosis of bilateral dermoid ovarian cysts was then established. The patient histopathology examination concluded squamous cell carcinoma (malignant transformation from benign cystic teratoma) in bilateral ovaries. The patient was referred to a gynecology oncology center for further examination and management. However, she missed the appointment for an unknown reason. The patient passed away 4 months after surgery. Clinicians should be aware of the possibility of malignant transformation of teratoma if a tumor has been present for a long time, its diameter is greater than 10 cm, there is a thickening of the cyst wall with papillary growth, there is an increase in tumor markers, and the patient is postmenopause. Malignant transformation of mature cystic teratoma remains a diagnostic and therapeutic puzzle and the prognosis is poor despite extensive initial surgery and optimal debulking.
A case report of metronidazole-induced encephalopathy in a bowel obstruction patient with MRI findings
Authors: Katwal Shailendra , Katuwal Sarad , Bhandari Sushmita
Published: August 2023

Metronidazole is a widely used antimicrobial agent in the treatment of anaerobic and protozoal infections. However, excessive and prolonged use of metronidazole can lead to encephalopathy. We present a case of a 69-year-old male with bowel obstruction who was treated with metronidazole for approximately 26 days and subsequently developed neurological signs and symptoms. The magnetic resonance imaging findings were consistent with the suspected diagnosis of metronidazole-induced encephalopathy. This case highlights the necessity for careful monitoring of patients receiving metronidazole to detect central nervous system toxicity, and emphasizes the role of magnetic resonance imaging in confirming the diagnosis.
Focused Jurisdictional Scan of Glomerulonephritis Medication Access in Canada: A Program Report
Authors: Naipaul Rohini , Marques Catherine , Ng Jenny , Barbour Sean , Lo Clifford , Hildebrand Ainslie M. , Siu Valerie , Prasad Bhanu , Laurin Louis-Philippe , Wazny Lori D. , Armstrong Sean , Tran Jaclyn , Sheffield Maneka , Jauhal Arenn , Hladunewich Michelle A.
Published: August 2023

Purpose of Program:

Glomerulonephritis (GN) is a group of rare kidney diseases that is increasingly being managed with higher cost immunosuppressive (IS) agents in Canada. Ontario Health’s Ontario Renal Network (ORN) oversees the management and delivery of GN services in the province. Stakeholder surveys previously conducted by ORN identified that both clinicians and patients do not perceive access to GN medications as comprehensive or timely. The program conducted a focused jurisdictional scan among 7 provinces to inform ORN initiatives to improve access to GN medications. Specifically, the program examined clinician experience with GN access, public drug coverage criteria, and timelines for public coverage for select IS agents (ie, tacrolimus, cyclosporine, mycophenolate mofetil [MMF], mycophenolate sodium, rituximab, and eculizumab) used to manage GN in adults who live in Canada.

Methods:

For the selected IS agents, a focused jurisdictional scan on medication access was conducted by ORN in 2018 and updated in July 2022. Information was obtained by searching the gray literature and/or credible online sources for public funding policies and eligibility criteria. Findings were supplemented by personal communications with provincial drug programs and consulting GN clinical experts from 7 provinces (ie, Alberta, British Columbia, Saskatchewan, Manitoba, Ontario, Nova Scotia, and Quebec).

Key Findings:

Clinicians from different provinces prescribe IS agents similarly for GN indications, despite distinctions in public drug funding policies. While patients can obtain public funding for many IS agents, for GN, most provinces rely on case-by-case review processes. In addition, provinces can vary in their funding criteria and which IS agents are listed on the public formulary. For IS agents that require prior authorization or case-by-case review, timelines vary by province with decisions taking a few days to weeks. British Columbia, with a GN-specific drug formulary, had the most integrated and efficient system for patients and prescribers.

Limitations:

This scan primarily relied on publicly available information for drug coverage criteria and clinician experience with access in their province. Since this scan was conducted, public drug coverage criteria and/or application processes may have changed.

Implications:

While patients in most provinces have similar needs and nephrologists similar prescribing patterns, gaps still exist for publicly funded GN medications. Interprovincial differences in the drugs funded, funding criteria, and application process may affect timely and equitable access to GN medications across Canada. Given the rarity of GN, a pan-Canadian funding approach may be warranted to improve the current state.
Management of insufficiency fractures associated with long-term bisphosphonate therapy in a cat
Authors: Meneghetti Lauren M , Perry Karen L
Published: August 2023

Case summary

A 10-year-old spayed female domestic medium hair cat presented after sustaining atraumatic insufficiency fractures of the right calcaneus and the left tibia approximately 6 weeks apart. Chronic alendronate therapy had been ongoing for 9 years for the management of previously diagnosed idiopathic hypercalcemia. The right calcaneal fracture was managed non-operatively due to minimal functional impairment. The left tibial fracture was managed via open reduction and internal fixation with orthogonal plating. Alendronate therapy was discontinued at the time of the fracture repair with prednisolone being used to manage the hypercalcemia. Despite rapid clinical improvement, the tibial fracture had a protracted healing course, with clinical union only being achieved 22 weeks postoperatively. At 17 months postoperatively, the idiopathic hypercalcemia remained well controlled. Gait assessment, orthopedic examination and orthogonal radiographs performed at this time revealed resolution of left pelvic limb lameness, a normal orthopedic examination of the left pelvic limb and no evidence of implant-associated complications. Monitoring is ongoing but at the time of publication, no further fractures have occurred.

Relevance and novel information

As reported in humans, this case report gathers evidence of associations between bisphosphonate treatment and the occurrence of insufficiency fractures in cats, and provides evidence that stress reactions may precede their development. If bisphosphonate therapy is utilized in the long term, serial radiographic monitoring for signs of impending fracture may be warranted. Fracture repair can be successful in cats that have received long-term bisphosphonate therapy, but delayed healing should be anticipated and implant choices made accordingly.
Joint Prevalence of Influenza Preventive Behaviors Among Adults—United States, 2020
Authors: Webber Bryant J. , Wheaton Anne G. , Lu Peng-jun , Whitfield Geoffrey P.
Published: August 2023

Introduction/Objectives:

The Centers for Disease Control and Prevention recognizes routine vaccination, sufficient sleep, and adequate physical activity as behavioral approaches to reduce the incidence of influenza. We aimed to determine the joint national prevalence of these health behaviors among U.S. adults, which has not been reported.

Methods:

We used the 2020 National Health Interview Survey to assess prevalence of receiving influenza vaccination in the past 12 months, obtaining sufficient sleep, and achieving adequate physical activity among U.S. adults (n = 30,312). We calculated the joint prevalence overall and by sociodemographic and health-related variables.

Results and Conclusions:

The overall joint prevalence was 8.5% (95% CI, 8.0-9.0). Prevalence was lower among older persons (vs younger); Hispanic and non-Hispanic Black persons (vs non-Hispanic White); current and former smokers (vs never smokers); postpartum women (vs neither pregnant nor postpartum); and those with a history of coronary heart disease, hypertension, stroke, diabetes, and chronic obstructive pulmonary disease (vs not having those respective condition). In addition to recommending annual vaccination, primary care providers might encourage sufficient sleep and adequate physical activity—especially among patients who have increased risk for influenza complications and are less likely to achieve these behaviors.
Social Determinants and Health Disparities Pertaining to Diabetes in Appalachia
Authors: Borgemenke Samuel , Hughes Allyson S.
Published: August 2023

Context:

Diabetes poses a significant threat to public health in the United States, with an estimated total prevalence of 37.3 million individuals in 2019, of which 28.7 million were diagnosed and 8.5 million remained undiagnosed. The high prevalence of diabetes imposes a considerable economic burden on the U.S. healthcare system. Appalachian Ohio is disproportionately impacted with southeastern Ohio exhibiting a diabetes prevalence that exceeds the national average by more than twofold and a critical shortage of healthcare providers.

Objective:

To quantify the associations between diabetes prevalence and incidence in Ohio counties, considering various factors that impact health and quality-of-life outcomes.

Methods:

The data used in this study were obtained from the United States Diabetes Surveillance System (USDSS) on the 88 counties in Ohio. Pearson correlation tests were employed to investigate the relationship between diabetes (prevalence and incidence) and social determinants of health. A t-test and multivariate analysis of variance (MANOVA) test were performed to analyze the disparities in diabetes and social determinants between Appalachian and non-Appalachian counties.

Results:

The results of this study demonstrate notable disparities in diabetes prevalence between Appalachian and non-Appalachian counties ( P < .001, α = .05). Furthermore, the MANOVA test revealed significant differences between these 2 groups regarding social determinants of health ( P < .05).

Conclusion:

These findings suggest that Appalachian counties may face a disproportionate impact from health-related factors and experience limited access to healthcare services. The data highlight the need for focused efforts to address the specific challenges faced by Appalachian counties. Improving access to healthcare services in the Appalachian region is paramount to ensure equitable healthcare and enhance the overall health outcomes of affected communities.
Psoas Muscle Morphology as a Sarcopenia Marker to Predict Outcomes of Geriatric Trauma Patients: A Systematic Review and Meta-analysis
Authors: Wang Yang , Li Lei , Pan Qinmei , Zhong Ying , Zou Xinmei
Published: August 2023

Objective

To provide pooled evidence on the association between central sarcopenia and risk of mortality and/or complications among geriatric patients with moderate to severe trauma.

Methods

We conducted a systematic search in PubMed, EMBASE, and Scopus databases for relevant observational studies documenting the association of central sarcopenia with the risk of mortality and/or complications in geriatric patients with moderate to severe trauma. The studies reported computerized tomography (CT) based assessments of the psoas muscle cross-sectional area. We used a random effects model for the analysis and reported effect sizes as pooled odds ratios (ORs) or hazards ratios (HRs) along with 95% confidence intervals.

Results

We analyzed data from 13 studies and found an association between the presence of psoas muscle size reduction and the risk of in-hospital mortality (OR, 1.47; 95% CI, 1.13, 1.90). In addition, we found increased risk of mortality within 24 months of follow-up in patients with sarcopenia (HR, 2.40; 95% CI, 1.11-5.17). We found each unit increase in psoas muscle cross-sectional area to be significantly associated with reduced risk of mortality within 24 months of follow-up (HR, .92; 95% CI, .90-.95). Patients with sarcopenia also had an increased risk of complications (OR, 1.69; 95% CI, 1.08-2.63).

Conclusion

Central sarcopenia, assessed using psoas muscle morphology, among geriatric patients with moderate to severe trauma appears to be significantly associated with increased risks of mortality and complications.
Causes and Consequences of Corruption in Schools: The Role of Prevention and Control Promoted by Leaders’ Moral Impetus
Authors: Whang Nai-Ying
Published: August 2023

We explored the moderated mediating effect of the causes of corruption in schools on its consequences through prevention and control promoted by leaders’ moral impetus. We surveyed 81 Taiwanese elementary and secondary schools; 1,024 school principals, administrative staff, teachers, and parents completed valid questionnaires, which we analyzed using structural equation modeling. Corruption prevention and control promoted by leaders’ moral impetus partially mediated the relationship between the causes and consequences of corruption. Plundering (non-criminal form) increased and law-breaking behavior (criminal form) weakened the intensity of corruption prevention and control promoted by leaders’ moral impetus. Educational leaders should use moral leadership to decrease plundering and establish whistleblowing mechanisms on social media to support corruption prevention and control to hinder law-breaking behaviors.
Problemáticas: Multi-scalar, affective and performative politics of collective action among fishing cooperatives in Mexico
Authors: García Lozano Alejandro , Méndez-Medina Crisol , Basurto Xavier , Tercero Tovar María
Published: August 2023

The world’s fisheries face complex and high-stakes governance problems that increasingly require mobilizing diverse collectives of governance actors. How fishers and fishing organizations understand and articulate governance problems has implications for how they engage with governance institutions and the kinds of collective action they enact. In Mexico, cooperatives are a major form of organization for small-scale fishers. Fishing cooperatives form regional organizations (federations), which in turn form national organizations (confederations). These are nested or multi-scalar organizations that represent fishers’ interests and negotiate with other governance actors. Drawing on longitudinal data from assemblies of a national organization (2016–2019) – which represents more than 30,000 fishers in Mexico organized in about 300 cooperatives – as well as regional meetings involving federations and cooperatives, this study examines how cooperativist fishers in Mexico articulate problems in the governance of fisheries and to what effect. More specifically, the paper builds on scholarship about the performativity of collective action to examine the strategic discursive and affective practices through which fishers engage with major governance problems and the implications for collective action. Through the politics of multi-level cooperative institutions, specific issues are prioritized as leaders of fishers’ organizations translate diverse local-regional concerns to advance the interests of the sector at the national level. Using examples of (1) conflicts surrounding environmental conservation in the Gulf of California and (2) legacies of privatization and the decline of cooperatives in shrimp fisheries, the analysis demonstrates how discourses and affects are incorporated into specific storylines and mobilized in political spaces. Cooperativist fishers become contingently aligned along these storylines, which shapes the translation of local-regional concerns into national priorities, giving rise to a multi-scalar performative politics of collective action.
Republication of “High-Speed Video Analysis of Syndesmosis Injuries in Soccer—Can It Predict Injury Mechanism and Return to Play? A Pilot Study”
Authors: Jain Neil , Murray David , Kemp Steve , Calder James
Published: August 2023

Background:

Ankle syndesmosis injuries in professional soccer may lead to an unpredictable and prolonged recovery. This injury has been investigated in anatomical and radiologic studies but the precise mechanism leading to syndesmosis injury is not well understood and remains debated. The 2 goals of this study were to (1) evaluate the relationship between the mechanism of syndesmosis injury as determined by high-speed video analysis and the injured structures identified by clinical and radiologic examination and to (2) investigate the relationship between mechanism of injury and time of return to play.

Methods:

This pilot study prospectively reviewed high-speed video analysis of 12 professional soccer players who sustained syndesmosis injuries. The mechanism of injury was compared with the clinical and MRI evaluation and the time taken to return to play.

Results:

Higher-grade syndesmosis injuries occurred during ankle external rotation with dorsiflexion. Supination-inversion injuries with a standard lateral ankle sprain (rupture of the anterior talofibular ligament) may extend proximally, causing a lower-grade syndesmosis injury. These may present with signs of a high ankle sprain but have a quicker return to sport than those following a dorsiflexion-external rotation injury (mean 26 days vs 91 days).

Conclusions:

Video analysis confirmed that at least 2 mechanisms may result in injury to the ankle syndesmosis. Those “simple” ankle sprains with signs of syndesmosis injury had a quicker return to play. This new finding may be used by club medical teams during their initial assessment and help predict the expected time away from soccer in players with suspected high ankle sprains.

Level of Evidence:

Level IV, retrospective cohort study.
Republication of “Ankle Fracture-Dislocations: A Review”
Authors: Lawson Kevin A. , Ayala Alfonso E. , Morin Matthew L. , Latt L. Daniel , Wild Jason R.
Published: August 2023

Ankle fractures are common musculoskeletal injuries that may result in tibiotalar joint dislocations. Ankle fracture-dislocations occur via similar mechanisms as ankle fractures, although the persistence or magnitude of the deforming force is sufficient to disrupt any remaining bony or soft-tissue stability. Ankle fracture-dislocations likely represent distinct clinical entities, as the pathology, management, and patient outcomes following these injuries differ from those seen in more common ankle fractures without dislocation. Ankle fracture-dislocations have higher rates of concomitant injury including open fractures, chondral lesions, and intra-articular loose bodies. Long-term outcomes in ankle fracture-dislocations are worse than ankle fractures without dislocation. Higher rates of posttraumatic osteoarthritis and chronic pain have also been reported. In this review, we discuss the current literature regarding the history, management, and outcomes of ankle-fracture dislocations and highlight the need for future study.
Republication of “Keeping It in the Fairway: Golf Handicap Following Total Ankle Arthroplasty”
Authors: Taylor Michel A. , Lachman James R. , Adams Samuel B. , Nunley James A. , DeOrio James K.
Published: August 2023

Background:

Total ankle arthroplasty (TAA) provides a surgical alternative to tibiotalar arthrodesis when treating end-stage ankle arthritis. TAA preserves range of motion at the tibiotalar joint leading to improved postoperative function. Many patients who undergo TAA wish to maintain a high level of activity, including participation in low-impact sports such as golf. There are several studies in the total hip and total knee arthroplasty literature that have looked at the effect of total joint arthroplasty on golf handicap. We hypothesized that similar to hip and knee arthroplasty research, TAA is likely to result in a postoperative increase in golf handicap.

Methods:

After obtaining institutional review board approval, we retrospectively identified 60 patients (from 140 consecutive TAAs performed between August 2016 and February 2017) who had undergone TAA, played golf pre- and postoperatively, and had at least 1 year of postoperative follow-up. The average postoperative follow-up for the cohort was 28.1 months. Variables including preoperative and postoperative golf handicaps, swing laterality, age, gender, surgical laterality, implant used, and operating surgeon were recorded.

Results:

The average preoperative and postoperative handicaps were 19.7 and 17.9, respectively, which did not represent a statistically significant difference ( P = .07). Patients who played 3 or more rounds per week had better preoperative and postoperative handicaps compared to patients who played 2 rounds or less; however, the change in their handicap following TAA and the number of rounds played per week was not affected. There was no association between the change in handicap and the follow-up period, handedness of golf shot, surgical laterality, implant used, or the operating surgeon.

Conclusion:

Our findings showed that golf handicap was not negatively affected following TAA in this series.

Level of Evidence:

Level IV, case series.
Decrypting Skin Microbiome in Psoriasis: Current Status
Authors: Arya Preeti , Kaur Manpreet , Chosyang Stanzin , Kushwaha Neelam , Singh Balvinder
Published: August 2023

Background

Psoriasis is an autoimmune, chronic, inflammatory skin condition of multifactorial etiology. Recent studies in human skin microbiome research have revealed the dysbiosis in lesional skin of psoriatic patients, as well as have established the association of dysbiosis in the elicitation of inflammatory response of psoriatic skin.

Objective

The present review aimed to recapitulate the insights of psoriasis lesional skin microbiome studies published in the last 2 decades, and to determine the most important bacterial genera that can be deployed as psoriatic skin microbial signature for therapeutic intervention.

Methods

To achieve the stated objectives, full-text analysis of literature selected through systematic search of digital literature databases has been carried out following PRISMA guidelines.

Results

Literature analysis suggests differential abundance of specific bacterial genera in the lesional psoriatic skin (LPS) compared to normal skin (NS) of psoriasis patients and skin from healthy subjects. These bacterial genera collectively can be utilized as potential biomarker for constructing lesional psoriatic skin specific microbial signature, and to explore the role of bacterial species in maintaining the skin homeostasis. The analysis further revealed that multiple bacterial species instead of a single bacterial species is important for understanding the psoriasis etiogenesis. Furthermore, decreased microbiome stability and increased diversity might have role in the exacerbation of lesions on skin of psoriatic patients.

Conclusion

Considering the importance of human skin microbiome dysbiosis in psoriasis, research efforts should be carried out to develop new therapeutic measures in addition to current therapies by exploiting the human and host-skin-associated microbial genomic and metabolomic knowledge.
Households’ level considerations in the vulnerability to potential learning loss among school children in Ghana
Authors: Ansah Francis , Abreh Might Kojo , Agbevanu Wisdom Kwaku , Bosu Rosemary Seiwah , Jangu Alhassan Amina , Mills Clara Araba , Nyame Gloria
Published: August 2023

Generally, most children became vulnerable to potential learning loss during the COVID-19 pandemic. However, empirical evidence on households as vulnerability factor to children’s potential learning loss in Ghana does not exist to guide policy decisions and scholarly discourse. Through a national household survey underpinned by a disaster risk reduction framework, this paper examines the vulnerability of Ghanaian school children to perceived learning loss during the COVID-9 pandemic school closures. The findings of this study indicate that household efforts to mitigate the COVID-19 pandemic’s impact on the risk of potential learning loss among school children varied disproportionately across wealth quintiles and geographic locations. It is, however, revealing that about 29% of households in the richest wealth quintiles did not take deliberate actions to mitigate the risk of potential learning loss among their children. Against these revealing findings, we conclude that households’ decisions to support their children’s learning during the pandemic-induced school closures may not be based on economic reasons alone. Consistent with this finding, we recommend the exploration of additional factors and dynamics of understanding potential and perceived learning outcomes.
Comparative transcriptomic analysis of reproductive characteristics of reciprocal hybrid lineages derived from hybridization between Megalobrama amblycephala and Culter alburnus
Authors: Ding Xue , Zhang Yifei , Li Die , Xu Jia , Wu Chang , Cui Xiaojuan , Sun Yuandong
Published: August 2023

Background

Distant hybridization is an important breeding technique for creating new strains with superior traits by integrating two different genomes. Successful hybridization of Megalobrama amblycephala (Blunt snout bream, BSB, 2n = 48) and Culter alburnus (Topmouth culter, TC, 2n = 48) was achieved to establish hybrid lineages (BT and TB), which provide valuable materials for exploring the mechanisms of distant hybridization fertility. In this study, the gonadal tissue transcriptomes of BSB, TC, BT-F1, and TB-F1 were sequenced using Illumina high-throughput sequencing technology to analyze the reproductive characteristics of BT and TB.

Results

Differential gene expression analysis showed that the differentially expressed genes in BT vs BSB and BT vs TC were mainly enriched in signaling pathways not directly associated with meiosis. While, the differentially expressed genes of TB vs BSB and TB vs TC were mainly enriched in pathways related to meiosis, and most of them were down-regulated, indicating that meiosis is suppressed in TB. Under-dominance (UD) genes were enriched in pathways related to meiosis and DNA repair in TB. Over-dominance (OD) genes were enriched in MAPK signaling pathway, expression level dominance-BSB (ELD-B) genes were enriched in pathways related to steroid hormone synthesis and expression level dominance-TC (ELD-T) genes were not significantly enriched in any pathway in both BT and TB.

Conclusions

These results suggest that meiotic progression may not be affected in BT, whereas it is clearly inhibited in TB. Offspring of M. amblycephala maternal parent may have better genomic compatibility and fertility. Our study provides important information on the molecular mechanisms of breaking reproductive isolation in distantly hybridized fertile lineages.
Clinical characteristics and homology analysis of Staphylococcus aureus from would infection at a tertiary hospital in southern Zhejiang, China
Authors: Zhang Jiarong , Tu Jingjing , Chen Yongping , Jin Xiaoya
Published: August 2023

Objective

Staphylococcus aureus (S. aureus), especially Methicillin resistant S. aureus (MRSA), has been disseminated across communities and hospitals, associated with severe infections and organ failure. In order to understand the clinical epidemiological characteristics of S. aureus stains in the First Affiliated Hospital of Wenzhou Medical University in 2018, the prevalence and the drug resistance of S. aureus stains were investigated, for improving the clinical effective prevention and control of S. aureus infection.

Methods

A total of 105 S. aureus isolates were separated from wound infection of inpatients in the First Affiliated Hospital of Wenzhou Medical University in 2018, and the department distributions and drug resistance of the isolates were analyzed. The genotyping homology analysis was conducted through the random amplified polymorphic DNA typing (RAPD-PCR) coupled with NTSYS cluster analysis.

Results

Among the 105 strains of S. aureus, 31 isolates were MRSA. The prevalence of MRSA among inpatients in the Departments of Burn, Trauma, Orthopedics, Nephrology and Neurosurgery were 35.48%, 19.35%, 9.68%, 6.45%, and 29.03%, respectively. Among the 105 strains, 35.24% strains were the hospital-acquired infections (HAI) and 64.76% strains were community-acquired infections (CAI). DNA genotyping of the 105 S. aureus strains showed seventeen different groups, most of which were type I, type VII, type IX, and type VII, the others were scattered.

Conclusion

This study highlights the prevalence of S. aureus strains in the First Affiliated Hospital of Wenzhou Medical University in 2018. The emergence and mutation of the strains should be closely monitored for the prevention and control of the S. aureus infection and transmission in the nosocomial settings.
Novel combinations of variations in KCNQ1 were associated with patients with long QT syndrome or Jervell and Lange-Nielsen syndrome
Authors: Zhao Nongnong , Yu Zhengyang , Cai Zhejun , Chen Wenai , He Xiaopeng , Huo Zhaoxia , Lin Xiaoping
Published: August 2023

Objectives

Long QT syndrome (LQTS) is one of the primary causes of sudden cardiac death (SCD) in youth. Studies have identified mutations in ion channel genes as key players in the pathogenesis of LQTS. However, the specific etiology in individual families remains unknown.

Methods

Three unrelated Chinese pedigrees diagnosed with LQTS or Jervell and Lange-Nielsen syndrome (JLNS) were recruited clinically. Whole exome sequencing (WES) was performed and further validated by multiplex ligation-dependent probe amplification (MLPA) and Sanger sequencing.

Results

All of the probands in our study experienced syncope episodes and featured typically prolonged QTc-intervals. Two probands also presented with congenital hearing loss and iron-deficiency anemia and thus were diagnosed with JLNS. A total of five different variants in KCNQ1, encoding a subunit of the voltage-gated potassium channel, were identified in 3 probands. The heterozygous variants, KCNQ1 c.749T > C was responsible for LQTS in Case 1, transmitting in an autosomal dominant pattern. Two patterns of compound heterozygous variants were responsible for JLNS, including a large deletion causing loss of the exon 16 and missense variant c.1663 C > T in Case 2, and splicing variant c.605-2 A > G and frame-shift variant c.1265del in Case 3. To our knowledge, the compound heterozygous mutations containing a large deletion and missense variant were first reported in patients with JLNS.

Conclusion

Our study expanded the LQTS genetic spectrum, thus favoring disease screening and diagnosis, personalized treatment, and genetic consultation.
Ticagrelor plus aspirin in patients with minor ischemic stroke and transient ischemic attack: a network meta-analysis
Authors: Li Mingxia , Yang Qianru , Shi Jiankuan , Zhang Xiaolong , Lin Hong , Ge Fangfang
Published: August 2023

Background

Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel was recommended as the secondary prevention of minor ischemic stroke or transient ischaemic attack (TIA). However, genetic polymorphisms of CYP2C19 had been identified as the major cause of poor responsiveness to clopidogrel. Ticagrelor, unlike clopidogrel, did not depend on metabolic activation, but it remained unclear whether ticagrelor was superior to clopidogrel in ischemic stroke. We performed a network meta-analysis to compare the efficacy and safety of ticagrelor, clopidogrel, and aspirin in the minor ischemic stroke and TIA populations.

Methods

Databases of Cochrane Library, ClinicalTrials.gov, and PubMed were searched up to June 19, 2023. Randomized controlled trials (RCTs) assessing antiplatelet drugs for minor stroke or TIA were included. Statistical processing was conducted by using multivariate meta-analysis routines of STATA.

Results

Seven RCTs were included involving 41,745 participants. There was no significant difference between the two DAPTs in preventing stroke recurrence (OR, 1.16; 95% CI, 0.93-1.44), ischemic stroke recurrence (OR, 1.16; 95% CI, 0.93-1.45), and major hemorrhage (OR, 1.22; 95% CI, 0.62,2.39). Compared with aspirin alone, the two DAPT regimen reduced the risk of stroke recurrence (clopidogrel: OR, 0.69; 95% CI, 0.60-0.80, ticagrelor: OR, 0.66; 95% CI, 0.49-0.87) and ischemic stroke recurrence, but increased the incidence of major hemorrhage (clopidogrel: OR, 2.05; 95% CI, 1.22- 3.77; ticagrelor: OR, 2.55; 95% CI, 1.25-4.99). Despite being associated with a higher risk of any bleeding, ticagrelor did not impact the composite of vascular events or mortality. While ticagrelor and aspirin reduced the risk of ischemic stroke recurrence (OR, 0.77; 95% CI, 0.63- 0.92) without increasing the risk of major bleeding (OR 0.94; 95% CI 0.45–1.95) in the Asian population mainly Chinese.

Conclusions

DAPT was superior to aspirin in stroke prevention, but little difference existed between the two DAPT regimens. Asian population mainly Chinese may benefit from DAPT with aspirin and ticagrelor. But further head-to-head RCTs are needed to validate the study results.
Antenatal care utilization and its associated factors in Somalia: a cross-sectional study
Authors: Miikkulainen Alli , Abdirahman Mohamud Ibrahim , Aqazouz Majda , Abdullahi Suleiman Bishara , Sheikh Mohamud Omar , Ahmed Mohamed Abdifatah , Rossi Rodolfo
Published: August 2023

Background

WHO recommends attending minimum four ANC consultations during pregnancy to ensure early detection of complications. The objective of this study was to quantify ANC attendance and factors associated with it.

Methods

Participants were randomly selected using the WHO Cluster survey methodology in Southern and Central Somalia. A paper-print questionnaire was used to collect all data. Outcomes of interest were: access to at least one ANC consultation, completion of at least four ANC consultations, initiation of breastfeeding and place of delivery, while exposures included factors related to the latest pregnancy and demographic characteristics. Associations were assessed through logistic regression.

Results

Seven hundred ninety-two women answered the questionnaire; 85% attended at least one and 23% at least four ANC consultations, 95% started breastfeeding and 51% had an institutional delivery. Encouragement to attend ANC increased the odds of attending at least one consultation (aOR = 8.22, 95%CI 4.36–15.49), while negative attitude of husband or family decreased the odds (aOR = 0.33, 95%CI 0.16–0.69). Knowing there is a midwife increased the odds of at least four visits (aOR = 1.87, 95%CI 1.03–3.41). Attending at least four consultations increased the odds of delivering in a health structure (aOR = 1.50, 95%CI 1.01–2.24), and attending at least one consultation was associated with higher odds of initiating breastfeeding (aOR = 2.69, 95%CI 1.07–6.74).

Conclusions

Family has a strong influence in women’s ANC attendance, which increases the likelihood of institutional delivery and initiating breastfeeding. Women and families need to have access to information about benefits and availability of services; potential solutions can include health education and outreach interventions.
The role of fetal heart rate in first trimester sonograms in prediction of fetal sex: a systematic review and meta-analysis
Authors: Nouri Shadi , Kalantar Mohammad Hassan , Safi Fatemeh , Almasi-Hashiani Amir
Published: August 2023

Background

Early fetal sex determination is worthy of providing alertness about possible x-linked disorders, as well as predicting sex-related pregnancy complications and outcomes. Satisfying the curiosity of parents is another advantage. In this way, several studies have been performed which have shown conflicting results.

Aim

We planned a systematic review for identifying any plausible role of Fetal Heart Rate (FHR) for early predicting fetal sex during the first trimester of non-complicated pregnancies.

Methods

This is a meta-analysis in which PubMed and Scopus databases were searched using different related keywords to find similar articles up to December 2022. Then the articles were screened to find eligible articles and finally, the articles entered in the meta-analysis were analyzed using Stata software (Stata Corp, College Station, TX). Standardized mean difference (SMD) and their 95% confidence interval (CI) were estimated.

Results

A total of 223 articles were evaluated and five articles were included in the meta-analysis. The results showed that there is a significant heterogeneity between the articles (p = 0.012, I-squared = 69.0%). The results of meta-analysis with a random model showed that there is no significant difference between male and female genders in terms of mean FHR (SMD = 0.04, 95%CI = -0.09–0.16, Z = 0.59, p = 0.553).

Conclusion

This systematic review and meta-analysis showed that even though male fetuses show faster FHR but such sex-related difference is minimal. Therefore, first-trimester FHR is not a reliable predictive test for fetal sex determination. Further studies are recommended to achieve a more precise conclusion.

Trial registration

PROSPERO: CRD42023418291.