bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Management of Proximal Fifth Metatarsal Fractures in Elite Athletes: A Systematic Review
Authors: Goodloe J. Brett , Cregar William M. , Caughman Alexander , Bailey Evan P. , Barfield William R. , Gross Christopher E.
Published: September 2021

Background:

As a result of the high physical demand in sport, elite athletes are particularly prone to fifth metatarsal fractures. These injuries are typically managed surgically to avoid high rates of delayed union and allow for quicker return to play (RTP).

Purpose:

To review studies showing clinical and radiographic outcomes, RTP rates, and complication rates after different surgical treatment modalities for fifth metatarsal fractures exclusively in elite-level athletes.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic search was conducted within the PubMed, Scopus, and Cochrane databases from January 2000 to January 2020. Inclusion criteria consisted of clinical outcome studies after operative management of fifth metatarsal fractures in elite athletes. Exclusion criteria consisted of nonoperative management, high school or recreational-level athletic participation, nonclinical studies, expert opinions, and case series with <5 patients.

Results:

A total of 12 studies met inclusion and exclusion criteria, comprising 280 fifth metatarsal fractures treated surgically. Intramedullary screw fixation was the most common fixation construct (47.9%), and some form of intraoperative adjunctive treatment (calcaneal autograft, iliac crest bone graft, bone marrow aspirate concentrate, demineralized bone matrix) was used in 67% of cases. Radiographic union was achieved in 96.7% of fractures regardless of surgical construct used. The overall mean time to union was 9.19 weeks, with RTP at a mean of 11.15 weeks. The overall reported complication rate was 22.5%, with varying severity of complications. Refracture rates were comparable between the different surgical constructs used, and the overall refracture rate was 8.6%.

Conclusion:

Elite athletes appeared to have a high rate of union and reliably returned to the same level of competition after surgical management of fifth metatarsal fractures, irrespective of surgical construct used. Despite this, the overall complication rate was >20%. Specific recommendations for optimal surgical management could not be made based on the heterogeneity of the included studies.
Defending Freedom of Expression and Challenging the Press and Media Laws in Lebanon: The Case of the Lebanese Political TV Satire Shows
Authors: Asher Avner , Naor Dan , Mann Yossi
Published: September 2021

Lebanon is among the most developed Arab countries concerning freedom of expression, and its press and media are famous for their openness and critical approach toward domestic and Arab affairs. The openness and criticism notwithstanding, there are various restrictions, not always formal ones, on the freedom of expression in Lebanon. While much has been written about Lebanese freedom of expression and media, few researches have concentrated on Lebanese political TV satire. This article aims to examine the limits of freedom of expression in Lebanon, as reflected in the various political TV satire shows. The article examined five satire shows: Basmat Watan, La Youmal, Ma Fi Metlo, Chi.N.N. and Awal ‘Ala Akhir. For each show, the article referred to three controversial issues: the attitude toward politics and politicians; the attitude toward Hezbollah and its weapons; and the attitude toward Lebanese presidents, foreign heads of states and Syria. Focusing on the different Lebanese TV satire shows and these contentious subjects reveals how these shows challenge the press and media laws, break taboos and even, to a certain degree, habituate the Lebanese audience to engage with controversial issues.
Experiences of Nursing Students in the Care for Patients Diagnosed With COVID-19: A Qualitative Study
Authors: Nabavian Majedeh , Rahmani Narges , Alipour Hossein
Published: September 2021

The present study examined the experiences of nursing students in the care of patients diagnosed with coronavirus disease 2019 (COVID-19). This qualitative study was performed based on inductive qualitative content analysis in 2020. The samples were 10 nursing students who were selected purposively from the emergency and intensive care unit wards of hospitals affiliated with Mazandaran University of Medical Sciences in Iran. Data were collected through semistructured and individual interviews and analyzed simultaneously and continuously by Granheim and Landman inductive qualitative content analysis. Experiences of nursing students in the care for patients with COVID-19 include 3 main categories and 7 subcategories: (a) psychological stress (fear of ward and patients and mental conflict), (b) social isolation (rejection by the family and friends, isolation, and concealment of the workplace), and (c) coping strategies as an adaption strategy (a positive impact of spirituality and an effective role of increasing information). According to the findings of this study, the education system and university administrators can help reduce psychological stress and improve the quality of care in nursing students.
Abstraction, witnessing, and repair; or, how multimodal research can destabilize the coloniality of the gaze
Authors: Welcome Leniqueca A , Thomas Deborah A
Published: September 2021

The recent renewal of attention to abstraction within Black literary and visual studies, it seems to us, has to do with an interest in the various ways abstraction rejects ascribed categories, eschews narrow assumptions about “relevance,” and embraces experimentation during a moment when it is arguably most needed. Abstraction moves us simultaneously outside of representative realism, and it embraces research practices that often require the kind of intimacies that have long been the bread and butter of anthropology. As multimodal ethnographers, we have long made our ethical commitments to interlocutors through embodied participation and collective knowledge production. In this essay, we attend to questions of abstraction, witnessing, and refusal within our own filmic and photographic practices addressing state violence in the Caribbean. We are interested in the spatio-temporality of both witnessing and refusal and in the relationships between form and audience. We are interested in how forms of abstraction capture the ephemeral, performative, affective, non-linear, and unpredictable ways something that feels like sovereignty circulates and is transmitted from one to another, without contributing to a process of overexposure or a desire for transparency.
Metabolomic identification of α-ketoglutaric acid elevation in pediatric chronic graft-versus-host disease
Authors: Subburaj Divya , Ng Bernard , Kariminia Amina , Abdossamadi Sayeh , Lauener Madeline , Nemecek Eneida R. , Rozmus Jacob , Kharbanda Sandhya , Kitko Carrie L. , Lewis Victor A. , Schechter-Finklestein Tal , Jacobsohn David A. , Harris Andrew C. , Pulsipher Michael A. , Bittencourt Henrique , Choi Sung Won , Caywood Emi H. , Kasow Kimberly A. , Bhatia Monica , Oshrine Benjamin R. , Coulter Donald , Chewning Joseph H. , Joyce Michael , Pawlowska Anna B. , Megason Gail C. , Lawitschka Anita , Ostroumov Elena , Klein Geltink Ramon , Cuvelier Geoffrey D. E. , Schultz Kirk R.
Published: September 2021

Chronic graft-versus-host disease (cGVHD) is the most common cause for non-relapse mortality postallogeneic hematopoietic stem cell transplant (HSCT). However, there are no well-defined biomarkers for cGVHD or late acute GVHD (aGVHD). This study is a longitudinal evaluation of metabolomic patterns of cGVHD and late aGVHD in pediatric HSCT recipients. A quantitative analysis of plasma metabolites was performed on 222 evaluable pediatric subjects from the ABLE/PBMTC1202 study. We performed a risk-assignment analysis at day + 100 (D100) on subjects who later developed either cGVHD or late aGVHD after day 114 to non-cGVHD controls. A second analysis at diagnosis used fixed and mixed multiple regression to compare cGVHD at onset to time-matched non-cGVHD controls. A metabolomic biomarker was considered biologically relevant only if it met all 3 selection criteria: (1) P ≤ .05; (2) effect ratio of ≥1.3 or ≤0.75; and (3) receiver operator characteristic AUC ≥0.60. We found a consistent elevation in plasma α-ketoglutaric acid before (D100) and at the onset of cGVHD, not impacted by cGVHD severity, pubertal status, or previous aGVHD. In addition, late aGVHD had a unique metabolomic pattern at D100 compared with cGVHD. Additional metabolomic correlation patterns were seen with the clinical presentation of pulmonary, de novo, and progressive cGVHD. α-ketoglutaric acid emerged as the single most significant metabolite associated with cGVHD, both in the D100 risk-assignment and later diagnostic onset analysis. These distinctive metabolic patterns may lead to improved subclassification of cGVHD. Future validation of these exploratory results is needed. This trial was registered at www.clinicaltrials.gov as #NCT02067832.
Epidemiology and treatment patterns of idiopathic multicentric Castleman disease in the era of IL-6–directed therapy
Authors: Mukherjee Sudipto , Martin Rabecka , Sande Brenda , Paige Jeremy S. , Fajgenbaum David C.
Published: September 2021

The epidemiology of human herpesvirus-8–negative/idiopathic multicentric Castleman disease (iMCD) remains incompletely understood. Prior epidemiologic studies of CD and iMCD have been hampered by difficulties in accurate case ascertainment resulting from a lack of uniform diagnostic criteria and a disease-specific International Classification of Diseases (ICD) code. In this study, we provide reliable estimates of CD and iMCD in the United States using a novel claims-based algorithm that includes a CD-specific ICD (10th revision) diagnosis code (D47.Z2) supported by the presence of ≥2 claims codes corresponding to the minor criteria from the international evidence-based diagnostic criteria for iMCD. We additionally analyzed the treatment classes and patterns in the clinical course of patients with iMCD. Using an administrative claims database of 30.7 million individuals enrolled between 1 January 2017 and 31 December 2018, we identified 254 patients with iMCD, with an estimated annual incidence and prevalence of 3.4 (95% confidence interval [CI], 1.4-9.2) and 6.9 (95% CI, 3.7-13.3) cases per million, respectively. Among patients with iMCD, 39% received corticosteroid monotherapy, 33.1% received no iMCD-directed treatment, and 9.8% received interleukin-6 (IL-6)–targeted therapy with tocilizumab or siltuximab. Siltuximab, which is the only US Food and Drug Administration–approved treatment and established first-line treatment recommendation, was used in only 8.7% of patients with iMCD. This study provides the most up-to-date understanding of the iMCD disease burden in the United States and identifies a major unmet treatment need for IL-6–directed therapy in this vulnerable cohort.
Genetic profiles of subcutaneous panniculitis-like T-cell lymphoma and clinicopathological impact of HAVCR2 mutations
Authors: Koh Jiwon , Jang Insoon , Mun Seungchan , Lee Cheol , Cha Hee Jeong , Oh Young Ha , Kim Jin-Man , Han Jae Ho , Paik Jin Ho , Cho Junhun , Ko Young Hyeh , Park Chan-Sik , Go Heounjeong , Huh Jooryung , Kim Kwangsoo , Jeon Yoon Kyung
Published: September 2021

Recent studies identified germline mutations in HAVCR2 (encoding T-cell immunoglobulin mucin 3) as a genetic factor that predisposes to subcutaneous panniculitis-like T-cell lymphoma (SPTCL). However, the differences between HAVCR2-mutated (HAVCR2MUT) and HAVCR2 wild-type (HAVCR2WT) SPTCLs remain unclear. A nationwide cohort of 53 patients with SPTCL diagnosed at 8 Korean institutions was established. Whole-exome sequencing and RNA-sequencing were performed on 8 patients in the discovery set. In the validation set, targeted gene sequencing or direct sequencing of HAVCR2 was performed. Of 49 patients with available HAVCR2 status, 25 (51.0%) were HAVCR2Y82C. HAVCR2Y82C was associated with younger age (P = .001), development of hemophagocytic lymphohistiocytosis or hemophagocytic lymphohistiocytosis–like systemic illness (P < .001), and short relapse-free survival (RFS) (P = .023). Most mutated genes in SPTCLs were involved in immune responses, epigenetic modifications, and cell signaling. Mutations in UNC13D, PIAS3, and KMT2D were more frequent in HAVCR2WT SPTCLs. At the gene expression level, HAVCR2Y82C SPTCLs were enriched in genes involved in IL6-JAK-STAT3 signaling and in tumor necrosis factor-α signaling via NF-κB. CCR4 was significantly upregulated in HAVCR2WT SPTCLs both at the messenger RNA level and at the protein level. We established a risk stratification system for SPTCL by integrating clinical and histopathological features, including age and HAVCR2 mutation status. This risk stratification system was strongly associated with RFS (P = .031). In conclusion, the HAVCR2Y82C mutation was common in Korean patients with SPTCL and was associated with unique clinicopathological and genetic features. Combining clinicopathological parameters could aid in predicting prognosis for patients with SPTCL.
Integrative analyses of targeted metabolome and transcriptome of Isatidis Radix autotetraploids highlighted key polyploidization-responsive regulators
Authors: Zhang Zixuan , Tan Mingpu , Zhang Yingying , Jia Yue , Zhu Shuxian , Wang Jiang , Zhao Jiajing , Liao Yueyue , Xiang Zengxu
Published: September 2021

Background

Isatidis Radix, the root of Isatis indigotica Fort. (Chinese woad) can produce a variety of efficacious compound with medicinal properties. The tetraploid I. indigotica plants exhibit superior phenotypic traits, such as greater yield, higher bioactive compounds accumulation and enhanced stress tolerance. In this study, a comparative transcriptomic and metabolomic study on Isatidis Radix autotetraploid and its progenitor was performed.

Results

Through the targeted metabolic profiling, 283 metabolites were identified in Isatidis Radix, and 70 polyploidization-altered metabolites were obtained. Moreover, the production of lignans was significantly increased post polyploidization, which implied that polyploidization-modulated changes in lignan biosynthesis. Regarding the transcriptomic shift, 2065 differentially expressed genes (DEGs) were identified as being polyploidy-responsive genes, and the polyploidization-altered DEGs were enriched in phenylpropanoid biosynthesis and plant hormone signal transduction. The further integrative analysis of polyploidy-responsive metabolome and transcriptome showed that 1584 DEGs were highly correlated with the 70 polyploidization-altered metabolites, and the transcriptional factors TFs-lignans network highlighted 10 polyploidy-altered TFs and 17 fluctuated phenylpropanoid pathway compounds.

Conclusions

These results collectively indicated that polyploidization contributed to the high content of active compounds in autotetraploid roots, and the gene–lignan pathway network analysis highlighted polyploidy–responsive key functional genes and regulators.
Ruptured sinus of valsalva aneurysm presenting as syncope and hypotension: a case report
Authors: Zhuo Guang Ying , Zhang Pei Yong , Luo Li , Tang Qian , Xiang Tao
Published: September 2021

Background

Unruptured sinus of valsalva aneurysm (SOVA) are typically asymptomatic, and hence can be easily ignored. Ruptured sinus of valsalva aneurysm (RSOVA) usually protrude into the right atrium or ventricular. However, in this case, the RSOVA protruded into the space between the right atrium and the visceral pericardium leading to compression of the right proximal coronary artery. Very few such cases have been reported till date.

Case presentation

We describe a case of ruptured right SOVA in a 61-year-old man with syncope and persistent hypotension. At the beginning, considered the markedly elevated troponin, acute myocardial infarction was considered. However, emergency coronary angiography unexpectedly revealed a large external mass compressed right coronary artery (RCA) resulting in severe proximal stenosis. Then, aorta computed tomography angiography (CTA) and urgent surgery confirmed that the ruptured right SOVA led to external compression of the right proximal coronary artery. Finally, ruptured right SOVA repair and RCA reconstruction were successfully performed, and the patient was discharged with no residual symptoms.

Conclusions

It is very important to be vigilant about the existence of SOVA. RSOVA should be suspected in a patient presenting with acute hemodynamic compromise, and echocardiography should be immediately performed. Moreover, it is very important to achieve dynamic monitoring by using cardiac color ultrasound. Definitive diagnosis often requires cardiac catheterization, and an aortogram should be performed unless endocarditis is suspected.
Delayed coronary artery occlusion after transcatheter aortic valve replacement and chimney stenting: a case report
Authors: Li Hui , Zhang Wenduo , Xia Bo , Sun Fucheng , Yang Jiefu , Zhang Huiping
Published: September 2021

Background

Delayed coronary artery occlusion (CAO) is a rare but fatal complication after transcatheter aortic valve replacement, chimney stenting is the standard technique for established CAO or impending CAO.

Case presentation

We describe a female patient who developed non-ST elevation myocardial infarction after receiving transcatheter aortic valve replacement and chimney stenting 4 months prior. An angiogram revealed delayed coronary artery occlusion with a deformed stent, which was never reported. This patient was subsequently treated with a new chimney stent.

Conclusions

For self-expanding valves, the coronary ostium is protected by chimney stenting, delayed coronary artery occlusion can occur and cause catastrophic complications.
Estimation of postpartum depression risk from electronic health records using machine learning
Authors: Amit Guy , Girshovitz Irena , Marcus Karni , Zhang Yiye , Pathak Jyotishman , Bar Vered , Akiva Pinchas
Published: September 2021

Background

Postpartum depression is a widespread disorder, adversely affecting the well-being of mothers and their newborns. We aim to utilize machine learning for predicting risk of postpartum depression (PPD) using primary care electronic health records (EHR) data, and to evaluate the potential value of EHR-based prediction in improving the accuracy of PPD screening and in early identification of women at risk.

Methods

We analyzed EHR data of 266,544 women from the UK who gave first live birth between 2000 and 2017. We extracted a multitude of socio-demographic and medical variables and constructed a machine learning model that predicts the risk of PPD during the year following childbirth. We evaluated the model’s performance using multiple validation methodologies and measured its accuracy as a stand-alone tool and as an adjunct to the standard questionnaire-based screening by Edinburgh postnatal depression scale (EPDS).

Results

The prevalence of PPD in the analyzed cohort was 13.4%. Combing EHR-based prediction with EPDS score increased the area under the receiver operator characteristics curve (AUC) from 0.805 to 0.844 and the sensitivity from 0.72 to 0.76, at specificity of 0.80. The AUC of the EHR-based prediction model alone varied from 0.72 to 0.74 and decreased by only 0.01–0.02 when applied as early as before the beginning of pregnancy.

Conclusions

PPD risk prediction using EHR data may provide a complementary quantitative and objective tool for PPD screening, allowing earlier (pre-pregnancy) and more accurate identification of women at risk, timely interventions and potentially improved outcomes for the mother and child.
Post-traumatic stress disorder among persons with HIV who engage in heavy alcohol consumption in southwestern Uganda
Authors: Kekibiina Allen , Adong Julian , Fatch Robin , Emenyonu Nneka I. , Marson Kara , Beesiga Brian , Lodi Sara , Muyindike Winnie R. , Kamya Moses , Chamie Gabriel , McDonell Michael G. , Hahn Judith A.
Published: September 2021

Background

We aimed to describe the prevalence of PTSD symptoms and its associated factors in persons living with HIV (PLWH) in Uganda who engage in heavy alcohol use.

Methods

We analyzed baseline data from the Drinkers Intervention to Prevent Tuberculosis study which enrolls PLWH with latent tuberculosis who engage in heavy alcohol consumption. Using the primary care Post Traumatic Stress Disorder (PTSD) screening scale from the DSM-5 (PC-PTSD-5), probable PTSD was defined as reporting ≥3 of 5 assessed symptoms. We conducted the Alcohol Use Disorders Identification Test-Consumption and assessed demographics, smoking, symptoms of depression, and spirituality/religiosity.

Results

Of 421 participants enrolled from 2018 through 2020, the majority (68.2%) were male, median age was 40 years (interquartile range [IQR]: 32–47), and median AUDIT-C score was 6 [IQR: 4–8]. Half (50.1%) of the participants reported ever experiencing a traumatic event, and 20.7% reported ≥3 symptoms of PTSD. The most commonly reported PTSD symptoms in the past 1 month in the entire sample were avoidance (28.3%), nightmares (27.3%), and being constantly on guard (21.6%). In multivariable logistic regression analyses, level of alcohol use was not associated with probable PTSD (adjusted odds ratio [AOR] for each AUDIT-C point: (1.02; 95% CI: 0.92–1.14; p = 0.69); however, lifetime smoking (AOR 1.89; 95% CI: 1.10–3.24) and reporting symptoms of depression (AOR 1.89; 95% CI: 1.04–3.44) were independently associated with probable PTSD.

Conclusions and recommendations

A history of traumatic events and probable PTSD were frequently reported among persons who engage in heavy drinking, living with HIV in Uganda. Level of alcohol use was not associated with probable PTSD in this sample of PLWH with heavy alcohol use, however other behavioral and mental health factors were associated with probable PTSD. These data highlight the high prevalence of PTSD in this group, and the need for screening and interventions for PTSD and mental health problems.
Prevalence and risk factors associated with asymptomatic malaria among school children: repeated cross-sectional surveys of school children in two ecological zones in Ghana
Authors: Mensah B. A. , Myers-Hansen J. L. , Obeng Amoako E. , Opoku M. , Abuaku B. K. , Ghansah A.
Published: September 2021

Background

Asymptomatic Plasmodium infections significantly drive malaria transmission and impact control and elimination strategies, but are largely uncharacterized. We investigated the prevalence and risk factors of asymptomatic malaria infections to inform malaria control strategies in Ghana.

Method

Five cross-sectional surveys were conducted at the end of the peak transmission season (August–September) on 4892 school children aged between 6 and 14 years in two distinct ecological settings in Ghana between 2013 and 2017. The study sites were Begoro (forest ecology) and Cape Coast (coastal ecology). The children were screened for malaria parasites by microscopic examination of Giemsa-stained thin and thick blood films. Hemoglobin levels were measured using the Hemocue HB analyzer. In addition, height was measured and the height-for-age z-scores estimated from the reference population defined by WHO to determine children who were stunted. Proportions of categorical and means of continuous variables were compared using Chi-square test and Student’s t-test respectively, and multivariable logistic regression was done to assess risk factors associated with asymptomatic infections.

Results

The overall prevalence of asymptomatic malaria in the school children was higher in Begoro compared to Cape Coast (27% (95% CI: 17, 24%) vs. 24% (95% CI: 17, 24%), p value = 0.04). The study recorded three species of Plasmodium (Plasmodia falciparum, malariae, and ovale) in both sites. Plasmodium falciparum was the predominant species, accounting for about 85% of infections in both study sites. The asymptomatic school children were more likely to be anaemic (OR = 2.01, p value< 0.001) and stunted in growth (OR = 1.46, p value< 0.001). Males carried more asymptomatic infection than females (OR = 1.18, p value = 0.015). School children aged 12–14 years had more asymptomatic infections than those aged 6–8 years (OR = 1.28, p value = 0.005).

Conclusion

There is a considerable burden of asymptomatic malaria in the two regions of Ghana, which is associated with males, older children, anaemia, and stunted growth in children, and may have implications for malaria control and elimination strategies in Ghana.
The use of mono- and combination drug therapy in men and women with lower urinary tract symptoms (LUTS) in the UK: a retrospective observational study
Authors: Ali Mahmood , Landeira Margarita , Covernton Patrick J. O. , Choudhury Nurul , Jaggi Ashley , Fatoye Francis , van Maanen Rob
Published: September 2021

Background

Combination drug therapy for lower urinary tract symptoms (LUTS) is beneficial to selected patients and recommended by guidelines. Patterns of real-world LUTS drug use, especially combination drug therapy, have not been studied extensively. Moreover, further understanding of the recent landscape is required following the introduction of the beta-3-adrenoceptor agonist mirabegron in the UK in 2013 for overactive bladder (OAB). The objective was to describe mono- and combination drug therapy use for LUTS in patients in UK clinical practice.

Methods

This was a retrospective, descriptive, observational database study using UK Clinical Practice Research Datalink GOLD and linked databases. Men and women ≥ 18 years with a first prescription for any LUTS drug from 2014 to 2016 with ≥ 12 months continuous enrollment pre- and post-index date were included. Primary endpoints were mono- or combination drug therapy use for LUTS in male and female cohorts. Secondary endpoints were description of treatment prescribed, treatment persistence and patient demographics. Data were analyzed descriptively. Sub-cohorts were defined by drugs prescribed at index date.

Results

79,472 patients (61.3% male) were included, based on index treatments. Of all men, 82.5% received any benign prostatic obstruction (BPO) drug, 25.4% any OAB drug, and 7.9% any BPO drug plus any OAB drug. As either mono- or combination drug therapy, 77.1% received an alpha-blocker, 18.9% a 5-alpha reductase inhibitor, 23.9% an antimuscarinic agent, and 2.1% mirabegron. Of all women, 94.5% received any OAB drug, 6.0% duloxetine, and 0.5% any OAB drug plus duloxetine. As either mono- or combination drug therapy, 87.7% received an antimuscarinic, and 9.7% mirabegron. In men or women receiving OAB treatment, approximately 2.5% received combination drug therapy with an antimuscarinic agent and mirabegron. For OAB drug monotherapies, mirabegron had the highest persistence in both male and female cohorts.

Conclusions

This study provides a better understanding of the recent landscape of LUTS drug use in UK clinical practice. It highlights potential undertreatment of storage symptoms in men with LUTS and the low use of combination OAB treatments.
Pattern of dental needs and advice on Twitter during the COVID-19 pandemic in Saudi Arabia
Authors: Al-Khalifa Khalifa S. , Bakhurji Eman , Halawany Hassan S. , Alabdurubalnabi Esraa M. , Nasser Wejdan W. , Shetty Ashwin C. , Sadaf Shazia
Published: September 2021

Aim

To compare and evaluate the influence of the COVID-19 outbreak on tweets related to dental treatment needs and advice of Saudi Twitter users in 2020 by comparing them to the same time-period in 2019.

Methods

Eight independent searches based on dentistry related keywords: “teeth, mouth and gingiva” were carried out within the timeframe between the 23rd of March and the 21st of June for the years 2020 and 2019. Extracted tweets were analyzed by two calibrated examiners as tweets containing expressed dental needs and tweets for dental advice, while spam tweets were excluded. Descriptive analysis was performed to present the overview of the findings using SPSS. Bivariate analysis was performed with Pearson’s Chi Square, Fisher’s Exact test and Mann–Whitney U test. Statistical significance was set at p ≤ 0.05.

Results

A total of 595 tweets from the year 2019 and 714 tweets from the year 2020 were obtained. Overall, combined dental needs and advice tweets, retweets, likes, and replies were higher in 2020 compared to 2019. Dental needs tweets were higher in 2020 compared to 2019, while dental advice tweets were lower in 2020 compared to 2019. Statistically significant differences were found between 2020 and 2019 with regards to dental needs well as with dental advice (p < 0.05). In addition, statistically significant differences were found between 2019 and 2020 with presence of pain, urgency of the dental need and type of advisor (p < 0.05).

Conclusion

An obvious impact of the pandemic can be seen in the form of increased self-reported dental needs, pain and urgency among the public in Saudi Arabia. This study highlights the importance of social media, specifically Twitter, in expressing the public needs and utilizing it as a platform for education and advice.
Implementing welfare technology in palliative homecare for patients with cancer: a qualitative study of health-care professionals’ experiences
Authors: Oelschlägel Lina , Dihle Alfhild , Christensen Vivi L. , Heggdal Kristin , Moen Anne , Österlind Jane , Steindal Simen A.
Published: September 2021

Background

Introducing welfare technology in home-based palliative care has been suggested to be beneficial for improving access to health care at home and enhancing patients’ feelings of security and safety. However, little is known about the experiences of municipal health-care professionals using welfare technology in palliative home care. The aim of this study was to explore municipal health-care professionals’ experiences regarding the significant challenges, facilitators, and assessments associated with implementing a technological solution named “remote home care” in palliative home care for patients with cancer.

Methods

A qualitative, descriptive, exploratory design was used. Data were collected through focus-group interviews and individual semi-structured interviews with interdisciplinary health-care professionals who had experience using remote home care in clinical encounters with cancer patients who were in the palliative phase and living at home. Data were analyzed using qualitative content analysis.

Results

Three themes were identified: 1) shifting from objective measures to assessing priorities for patients, 2) lack of experience and personal distress regarding cancer inhibits professional care, and 3) prominent organizational challenges undermine the premise of remote home care.

Conclusion

The results showed that shifting from a disease-focused to a person-centered approach enables health-care professionals to assess patients’ personal priorities.

However, health-care professionals’ uncertainty and lack of knowledge and experience, along with organizational issues concerning information-sharing, represent great challenges that have the potential to inhibit professional care. The availability of networks through which difficult issues can be discussed was highlighted as being a fundamental resource for facilitating the provision of care.
The smell of lung disease: a review of the current status of electronic nose technology
Authors: van der Sar I. G. , Wijbenga N. , Nakshbandi G. , Aerts J. G. J. V. , Manintveld O. C. , Wijsenbeek M. S. , Hellemons M. E. , Moor C. C.
Published: September 2021

There is a need for timely, accurate diagnosis, and personalised management in lung diseases. Exhaled breath reflects inflammatory and metabolic processes in the human body, especially in the lungs. The analysis of exhaled breath using electronic nose (eNose) technology has gained increasing attention in the past years. This technique has great potential to be used in clinical practice as a real-time non-invasive diagnostic tool, and for monitoring disease course and therapeutic effects. To date, multiple eNoses have been developed and evaluated in clinical studies across a wide spectrum of lung diseases, mainly for diagnostic purposes. Heterogeneity in study design, analysis techniques, and differences between eNose devices currently hamper generalization and comparison of study results. Moreover, many pilot studies have been performed, while validation and implementation studies are scarce. These studies are needed before implementation in clinical practice can be realised. This review summarises the technical aspects of available eNose devices and the available evidence for clinical application of eNose technology in different lung diseases. Furthermore, recommendations for future research to pave the way for clinical implementation of eNose technology are provided.
RPL35A is a key promotor involved in the development and progression of gastric cancer
Authors: Wu Fang , Sun Dachuan , Liao Yuqian , Shang Kai , Lu Canrong
Published: September 2021

Background

RPL35A has been reported to work as a biomarker in tumor angiogenesis. However, little work has been performed on the expression level and functional importance of RPL35A in gastric cancer (GC).

Methods

The protein expression level of RPL35A was detected by immunohistochemical staining and western blot analysis. The Celigo cell counting assay was used to assess cell proliferation. Both the wound healing assay and the transwell assay were conducted to evaluate cell migration. Flow cytometric analysis was utilized to detect cell apoptosis and cell cycle. A mouse xenograft model was constructed for in vivo experiments.

Results

The results demonstrated that RPL35A expression was abundantly up-regulated in GC and positively related to tumor infiltrate. In addition, RPL35A knockdown could significantly suppress cell proliferation, migration, enhance apoptosis and arrest cell cycle. The in vivo study also verified the inhibitory effects of RPL35A knockdown on GC tumorigenesis.

Conclusions

The above mentioned results indicated that the knockdown of RPL35A might be a considerable therapeutic strategy for the treatment of gastric cancer.
Prognostic value of preoperative inflammatory markers in patients with hepatocellular carcinoma who underwent curative resection
Authors: Wu Wenlong , Wang Quancheng , Han Dandan , Li Jianhui , Nie Ye , Guo Dongnan , Yang Long , Tao Kaishan , Zhang Xuan , Dou Kefeng
Published: September 2021

Background

The prognosis of hepatocellular carcinoma (HCC) is not optimistic. Our study focused on present inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), aspartate aminotransferase-to-lymphocyte ratio (ALR) and fibrinogen-to-albumin ratio (FAR), and explored their optimal combination for the prognosis of HCC after resection.

Methods

A total of 347 HCC patients who underwent curative resection were enrolled. The optimal cutoff values of the inflammatory markers were calculated using receiver operating characteristic (ROC) curve analysis, and used to divide patients into two groups whose differences were compared by Kaplan–Meier analysis. Cox univariate and multivariate analyses were used to analyze the independent prognostic inflammatory markers. The χ2 test was chosen to determine the relationship between independent prognostic inflammatory markers and clinicopathological features. We created combined scoring models and evaluated them by Cox univariate and multivariate methods. The concordance index (C-index), Akaike information criterion (AIC) and likelihood ratio were calculated to compare the models. The selected optimal inflammatory markers and their combinations were tested in different stages of HCC by Kaplan–Meier analysis.

Results

The ALR and GPR were independent prognostic factors for disease-free survival (DFS); the ALR, PLR, and GPR were independent prognostic factors for overall survival (OS). The proposed GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively.

Conclusion

The preoperative GPR and ALR-GPR-PLR score models were independent predictors for DFS and OS, respectively, and performed well in stratifying patients with HCC. The higher the score in the model was, the worse the prognosis.
The prevalence and density of asymptomatic Plasmodium falciparum infections among children and adults in three communities of western Kenya
Authors: Salgado Christina , Ayodo George , Macklin Michael D. , Gould Meetha P. , Nallandhighal Srinivas , Odhiambo Eliud O. , Obala Andrew , O’Meara Wendy Prudhomme , John Chandy C. , Tran Tuan M.
Published: September 2021

Background

Further reductions in malaria incidence as more countries approach malaria elimination require the identification and treatment of asymptomatic individuals who carry mosquito-infective Plasmodium gametocytes that are responsible for furthering malaria transmission. Assessing the relationship between total parasitaemia and gametocytaemia in field surveys can provide insight as to whether detection of low-density, asymptomatic Plasmodium falciparum infections with sensitive molecular methods can adequately detect the majority of infected individuals who are potentially capable of onward transmission.

Methods

In a cross-sectional survey of 1354 healthy children and adults in three communities in western Kenya across a gradient of malaria transmission (Ajigo, Webuye, and Kapsisywa–Kipsamoite), asymptomatic P. falciparum infections were screened by rapid diagnostic tests, blood smear, and quantitative PCR of dried blood spots targeting the varATS gene in genomic DNA. A multiplex quantitative reverse-transcriptase PCR assay targeting female and male gametocyte genes (pfs25, pfs230p), a gene with a transcriptional pattern restricted to asexual blood stages (piesp2), and human GAPDH was also developed to determine total parasite and gametocyte densities among parasitaemic individuals.

Results

The prevalence of varATS-detectable asymptomatic infections was greatest in Ajigo (42%), followed by Webuye (10%). Only two infections were detected in Kapsisywa. No infections were detected in Kipsamoite. Across all communities, children aged 11–15 years account for the greatest proportion total and sub-microscopic asymptomatic infections. In younger age groups, the majority of infections were detectable by microscopy, while 68% of asymptomatically infected adults (> 21 years old) had sub-microscopic parasitaemia. Piesp2-derived parasite densities correlated poorly with microscopy-determined parasite densities in patent infections relative to varATS-based detection. In general, both male and female gametocytaemia increased with increasing varATS-derived total parasitaemia. A substantial proportion (41.7%) of individuals with potential for onward transmission had qPCR-estimated parasite densities below the limit of microscopic detection, but above the detectable limit of varATS qPCR.

Conclusions

This assessment of parasitaemia and gametocytaemia in three communities with different transmission intensities revealed evidence of a substantial sub-patent infectious reservoir among asymptomatic carriers of P. falciparum. Experimental studies are needed to definitively determine whether the low-density infections in communities such as Ajigo and Webuye contribute significantly to malaria transmission.
Malaria prevalence and associated risk factors in Dembiya district, North-western Ethiopia
Authors: Tarekegn Mihretu , Tekie Habte , Dugassa Sisay , Wolde-Hawariat Yitbarek
Published: September 2021

Background

Ethiopia embarked on combating malaria with an aim to eliminate malaria from low transmission districts by 2030. A continuous monitoring of malaria prevalence in areas under elimination settings is important to evaluate the status of malaria transmission and the effectiveness of the currently existing malaria intervention strategies. The aim of this study was to assess the prevalence of malaria and associated risk factors in selected areas of Dembiya district.

Methods

A cross-sectional parasitological and retrospective survey was conducted in the two localities of Dembiya District, selected based on their long standing history of implementing malaria prevention and elimination strategies. Thin and thick blood smears collected from 735 randomly selected individuals between October and December, 2018 were microscopically examined for malaria parasites. Six years (2012–2017) retrospective malaria data was collected from the medical records of the health centres. Structured questionnaires were prepared to collect information about the socio-economic data of the population. Logistic regression analysis was used to determine a key risk factor explaining the prevalence of malaria. The data were analysed using SPSS version 20 and p ≤ 0.05 were considered statistically significant.

Results

The 6-year retrospective malaria prevalence trend indicates an overall malaria prevalence of 22.4%, out of which Plasmodium falciparum was the dominant species. From a total of 735 slides examined for the presence of malaria parasites, 3.5% (n = 26) were positive for malaria parasites, in which P. falciparum was more prevalent (n = 17; 2.3%), Plasmodium vivax (n = 5; 0.7%), and mixed infections (n = 4; 0.5%). Males were 2.6 times more likely to be infected with malaria than females (AOR = 2.6; 95% CI 1.0, 6.4), and individuals with frequent outdoor activity were 16.4 times more vulnerable than individuals with limited outdoor activities (AOR = 16.4, 95% CI 1.8, 147.9). Furthermore, awareness about malaria transmission was significantly associated with the prevalence of malaria.

Conclusions

Malaria is still a public health problem in Dembiya district irrespective of the past and existing vector control interventions. Therefore, the authorities should work on designing alternative intervention strategies targeting outdoor malaria transmission and improving community awareness about malaria transmission and control methods in the study area. For this, continuous monitoring of vectors’ susceptibility, density, and behaviour is very important in such areas.
The basic characteristics of extracellular vesicles and their potential application in bone sarcomas
Authors: Li Shenglong
Published: September 2021

Bone sarcomas are rare cancers accompanied by metastatic disease, mainly including osteosarcoma, Ewing sarcoma and chondrosarcoma. Extracellular vesicles (EVs) are membrane vesicles released by cells in the extracellular matrix, which carry important signal molecules, can stably and widely present in various body fluids, such as plasma, saliva and scalp fluid, spinal cord, breast milk, and urine liquid. EVs can transport almost all types of biologically active molecules (DNA, mRNA, microRNA (miRNA), proteins, metabolites, and even pharmacological compounds). In this review, we summarized the basic biological characteristics of EVs and focused on their application in bone sarcomas. EVs can be use as biomarker vehicles for diagnosis and prognosis in bone sarcomas. The role of EVs in bone sarcoma has been analyzed point-by-point. In the microenvironment of bone sarcoma, bone sarcoma cells, mesenchymal stem cells, immune cells, fibroblasts, osteoclasts, osteoblasts, and endothelial cells coexist and interact with each other. EVs play an important role in the communication between cells. Based on multiple functions in bone sarcoma, this review provides new ideas for the discovery of new therapeutic targets and new diagnostic analysis.
Underlying factors related to HIV/AIDS prevention: investigating the willingness to take pre-exposure prophylaxis among men-who-have-sex-with-men in Germany
Authors: Pazzini Michele , Ignácz Zsófia S. , Tuppat Julia
Published: September 2021

Background

This study investigates the willingness of men-who-have-sex-with-men (MSM) to use HIV pre-exposure prophylaxis (PrEP). Research in the HIV/AIDS field typically relies on clinical and epidemiological studies, thereby often excluding social dimensions of the illness as well as factors explaining its prevention. The current study analyzes HIV-prevention through an interdisciplinary theoretical approach. It aims to comprehensively understand the mechanisms associated with the willingness to take PrEP among MSM in terms of psychological, social, behavioral, cultural, and demographic factors.

Methods

We analyze data from the survey “Gay Men and AIDS” conducted in Germany in 2013 prior to market approval for PrEP. Analyses were performed using the statistical software SPSS 25.0, while results were visualized using the R programming language.

Results

We find that perceived risk of infection, social norms (anticipated HIV-stigma), practices (e.g. regular condomless sex), and socio-demographic factors (young age, being single) all have a positive effect on the willingness to take PrEP, while education reveals a negative, and income no effect.

Conclusions

Results indicate that beyond well-established socio-psychological mechanisms of health behavior, social factors play a crucial role in understanding the willingness of PrEP uptake. This study enriches existing health behavior theories with sociological concepts such as social norms and social practices.
Enhanced disease progression due to persistent HPV-16/58 infections in Korean women: a systematic review and the Korea HPV cohort study
Authors: Seong Jaehyun , Ryou Sangmi , Lee JeongGyu , Yoo Myeongsu , Hur Sooyoung , Choi Byeong-Sun ,   The Korea HPV Cohort Study
Published: September 2021

Background

Persistent human papillomavirus (HPV) infection is a key factor for the development and progression of cervical cancer. We sought to identify the type-specific HPV prevalence by cervical cytology and assess disease progression risk based on high-risk persistent HPV infection in South Korea.

Methods

To investigate the HPV prevalence by Pap results, we searched seven literature databases without any language or date restrictions until July 17, 2019. To estimate the risk of disease progression by HPV type, we used the Korea HPV Cohort study data. The search included the terms “HPV” and “Genotype” and “Korea.” Studies on Korean women, type-specific HPV distribution by cytological findings, and detailed methodological description of the detection assay were included. We assessed the risk of disease progression according to the high-risk HPV type related to the nonavalent vaccine and associated persistent infections in 686 HPV-positive women with atypical squamous cells of uncertain significance or low-grade squamous intraepithelial lesions from the Korea HPV Cohort Study. Type-specific HPV prevalence was the proportion of women positive for a specific HPV genotype among all HPV-positive women tested for that genotype in the systematic review.

Results

We included 23 studies in our review. HPV-16 was the most prevalent, followed by HPV-58, -53, -70, -18, and -68. In women with high-grade squamous intraepithelial lesions, including cancer, HPV-16, -18, and -58 were the most prevalent. In the longitudinal cohort study, the adjusted hazard ratio of disease progression from atypical squamous cells of uncertain significance to high-grade squamous intraepithelial lesions was significantly higher among those with persistent HPV-58 (increase in risk: 3.54–5.84) and HPV-16 (2.64–5.04) infections.

Conclusions

While HPV-16 was the most prevalent, persistent infections of HPV-16/58 increased the risk of disease progression to high-grade squamous intraepithelial lesions. Therefore, persistent infections of HPV-16 and -58 are critical risk factors for cervical disease progression in Korea. Our results suggest that equal attention should be paid to HPV-58 and -16 infections and provide important evidence to assist in planning the National Immunization Program in Korea.