bluuebunny/crossref_metadata_2025 huggingface dataset:
Carotid artery stenting prior to coronary artery bypass grafting in patients with carotid stenosis: Clinical outcomes
Authors: Mohammadian Reza , Tarighatnia Ali , Sharifipour Ehsan , Nourizadeh Eskandar , Parvizi Rezayat , Applegate Camille T. , Nader Nader D.
Published: March 2022

Objectives

Management of patients undergoing coronary artery bypass grafting (CABG) with obstructive disease of the carotid arteries is still a matter of debate. We compared the results of staged carotid artery stenting (CAS) before CABG in patients with carotid lesions.

Materials and Method

Patients with significant carotid artery disease who were deemed to simultaneously suffer from an obstructive coronary artery disease requiring CABG from 2008 to 2018 were screened and enrolled in this study. We performed a staged CAS in cases with ≥60% stenosis and neurological symptoms or asymptomatic patients with ≥80% carotid artery stenosis. Patients with bilateral carotid lesions received sequential CAS within three weeks. Six weeks after the CAS procedure, all patients underwent CABG.

Results

A total of 142 patients were included. Eighty-five of these had neurological symptoms, while the remaining 40% were asymptomatic. Thirty-one patients underwent sequential CAS for bilateral lesions. The cerebrovascular event (CVE) following CAS (3 patients) and CABG (3 patients) was 4.2%. There was only a single case of mortality in this cohort. Although it was not statistically significant, CVE after CABG was more frequent in patients with bilateral carotid disease.

Conclusions

Our results showed that staged CAS could be performed with minimal adverse outcomes in patients suffering from a simultaneous occlusive disease of carotids and coronary arteries before CABG. Bilateral CAS will further decrease cerebrovascular events and could be performed consequently or concomitantly.
Transcarotid artery revascularization (TCAR) stenting or angioplasty for intracranial carotid artery stenosis: Case series and novel application
Authors: Piper Keaton , Farooq Jeffrey , Yeung Elton , Flores-Milan Gabriel , Van Loveren Harry , Lau Tsz
Published: March 2022

Background

Carotid artery stenting is associated with a higher rate of stroke compared to carotid endarterectomy (CEA). This is likely due to procedural emboli resulting from plaque disruption. The transcarotid artery revascularization (TCAR) method aims to reduce the stroke rate by flow-reversal. TCAR, which has yet to be utilized for intracranial atherosclerotic disease (ICAD), may be particularly valuable given the lack of surgical treatment options for intracranial arterial stenosis.

Objective

Presented here are five cases of angioplasty or stenting that demonstrate the feasibility of TCAR for intracranial Internal Carotid Artery (ICA) stenosis treatment.

Methods

Five cases were reviewed retrospectively and summarized using PROCESS and CARE guidelines.

Results

All patients who underwent intervention between the petrous and ophthalmic segment of the ICA had no new neurologic deficit nor detected embolic stroke. One patient experienced an asymptomatic 5 mm hemorrhage on postoperative routine Computed Tomography (CT) head imaging.

Conclusions

This highlights a new method for treating intracranial ICA stenosis with a potentially reduced stroke risk. Given the historically higher stroke rates for cervical ICA stenting compared to carotid artery endarterectomy, this method may improve the previously higher stroke rates in endovascular carotid artery treatment, compared to CEA. Although this series is small, it illustrates a novel use for a rising technique that should be further evaluated in a larger study to validate its efficacy as a new treatment modality for surgically inaccessible intracranial disease.
Extent of mural thrombus is not associated with increased 5-year mortality following elective AAA repair
Authors: Siddiq Bilal , Dejong Matthew , Decicco Emily , Zielke Tara , D’Andrea Melissa , Aulivola Bernadette , Blecha Matthew
Published: March 2022

Background

Mural thrombus in abdominal aortic aneurysm (AAA) has been associated with increased rates of aneurysm growth as well as adverse cardiovascular events. The extent of mural thrombus in thoracoabdominal aortic aneurysms has recently been linked to 1-year mortality following endovascular repair and has been hypothesized as a marker for reduced cardiac reserve. This study investigates whether the extent of mural thrombus in infra-renal AAA is associated with 5-year mortality following elective repair.

Methods

Retrospective review of all patients undergoing elective infra-renal AAA repair at a single academic medical center between 2007 and 2016 was performed. The following variables at the time of surgery were investigated for association with 5-year mortality: age, sex, ethnicity, insurance status and co-morbidities, repair type, renal insufficiency, end-stage renal disease on dialysis, history of smoking, coronary artery disease, congestive heart failure, diabetes mellitus, hypertension, stroke, chronic obstructive pulmonary disease, body mass index category, AAA diameter, and ratio of aortic thrombus to total aneurysm diameter.

Results

Amongst 427 patients undergoing infra-renal AAA repair during the study period, 232 met extensive inclusion criteria. Univariate analysis found mean age (76 vs 72, p < 0.01), age cohort over 72 years (OR = 1.9, p = 0.04), renal insufficiency (OR = 3.1, p < 0.01), ESRD (OR = 6.5, p < 0.01), AAA diameter 6 cm or greater (OR = 2.3, p < 0.01), and mean AAA diameter (61.36 vs 56.99 mm, p < 0.01) all predictive of 5-year mortality. Multivariate analysis revealed renal insufficiency ( p < 0.01) and AAA diameter 6 cm or greater ( p = 0.03) to be significantly associated with 5-year mortality. The extent of mural thrombus was identical between 5-year survivors and non-survivors. The mean inner to outer AAA diameter was 0.65 in the survivor cohort and 0.64 in the mortality cohort. Inner to outer ratio of < 0.5 was identified in 23% of 5-year survivors and 27% of the mortality group.

Conclusions

In our experience, the extent of mural thrombus in AAA does not influence long-term survival after elective repair. AAA repair may provide protection against circulating components of mural thrombus which have the potential to promote atherosclerotic-related adverse events. Patients with renal insufficiency and larger AAA have increased risk of mortality 5 years after elective repair.
Vascular surgical management of profunda femoris artery aneurysms: A single center experience
Authors: Elzawy George , Eisenberg Naomi , Jaberi Arash , Roche-Nagle Graham
Published: March 2022

Objective

Profunda femoris artery aneurysms (PFAAs), which comprise true profunda femoris artery aneurysms (TPFAAs) and profunda femoris artery pseudoaneuryms (PFA PSAs), are rare but clinically significant diseases of the peripheral arterial vasculature. Our aim is to describe our institution’s 15-year experience with PFAAs (TPFAAs and PFA PSAs) to provide insight into patient characteristics, diagnostic imaging modalities, and surgical interventions that contribute to clinically important outcomes in patients with PFAAs.

Methods

We conducted a retrospective study at our institution using our radiology database.

Results

We identified six patients with PFA PSAs and four patients with TPFAAs. The clinical presentation of PFA PSAs included a triad of thigh pain, bleeding, and unexplained anemia. There was variety in the aetiologies of PFA PSAs, arising from catheterizations, upper thigh fractures, anastomotic complications, or unknown causes. Most patients with PFA PSAs had hypertension and coronary artery disease, and half of our cohort had peripheral vascular disease. All patients were imaged with duplex ultrasonography (DUS) or computed tomography (CT), the latter being more accurate. All patients with PFA PSAs underwent endovascular treatment, including glue, thrombin, or coil embolization as well as stent-graft insertions. All TPFAAs presented to our center were small and incidentally discovered, explaining the conservative management of our TPFAAs. Two of the four TPFAAs were idiopathic in nature, while one was attributed to post-stenotic dilatation, and another was found in a patient with Ehlers Danlos Syndrome. There was an association between TPFAAs and multiple synchronous or asynchronous aneurysms.

Conclusion

Pseudoaneurysms of the PFA are mostly iatrogenic in nature and can present with the triad of thigh swelling, bleeding, and unexplained anemia. If the clinical picture is suggestive of a PFA PSA but DUS does not detect a pseudoaneurysm, CT may be added as a more accurate imaging modality. Endovascular embolization is used in smaller pseudoaneurysms and in poor surgical candidates. Multiple glue, coil, or thrombin injections may be required to fully thrombose the pseudoaneurysm sac. True aneurysms of the PFA are associated with synchronous/asynchronous aneurysms and small TPFAAs should be carefully monitored, as there is a risk of enlargement and rupture.
The effects of gender and country of origin on acculturation, psychological factors, lifestyle factors, and diabetes-related physiological outcomes among Mexican Americans: The Starr County diabetes prevention initiative
Authors: Brown Sharon A , Becker Heather A , García Alexandra A , Velasquez Mary M , Tanaka Hirofumi , Winter Mary A , Perkison William B , Brown Eric L , Aguilar David , Hanis Craig L
Published: March 2022

Objectives

Examine acculturation and psychological, lifestyle, and physiological factors based on gender and country of origin (U.S. vs. Mexico).

Methods

Baseline data from the Starr County diabetes prevention study ( N = 300) were analyzed – acculturation ( language), psychological factors ( depression), lifestyle factors ( sedentary behaviors), and diabetes-related physiological outcomes ( insulin resistance). MANOVA and linear regression were used to examine variable relationships based on gender and country of origin and identify predictors of depression and insulin resistance.

Results

Participants were: predominantly female (73%); 51 years of age, on average; born in Mexico (71%); and Spanish-speaking. Individuals spent 11 of their waking hours (range = 0–18 h) in sedentary activities. Compared to females, more males spoke English and reported fewer hours in sedentary activities. Compared to participants born in Mexico, those born in the U.S. were more likely to: speak English; report depressive symptoms; and exhibit elevated BMI and insulin resistance rates. Two distinct models significantly predicted depression (R2 = 14.5%) and insulin resistance (R2 = 26.8%), with acculturation-language entering into both models.

Discussion

Significant gender and country-of-origin differences were found. Future research on diabetes prevention should examine other Hispanic subgroups and strategies for addressing individual differences, while employing cost-effective group interventions that incorporate these differences and reach more at-risk individuals.
The role of routine radial styloidectomy in proximal row carpectomy: a retrospective review of 120 patients
Authors: van Rijt Willem G. , Delnoy Robin E. , Bonhof-Jansen Elske E. D. J. , de Jong Tjeerd R.
Published: March 2022

Impingement between the radial styloid and the trapezium can occur after a proximal row carpectomy (PRC). We hypothesized that a PRC with primary radial styloidectomy reduces the risk of radial impingement, without affecting clinical or functional outcomes. In this retrospective cohort study, 120 patients were divided into two groups: PRC with or without primary radial styloidectomy. Patient-related outcome, strength and range of motion after proximal row carpectomy were measured in a subgroup. The occurrence of radial impingement was significantly lower in the group with primary radial styloidectomy versus those without ( p = 0.002). Five patients in the latter group were subsequently treated by a secondary radial styloidectomy, as compared with one patient who underwent primary radial styloidectomy ( p = 0.034). There were no significant differences in range of motion or patient-related outcome observed between the two groups. From our study, a radial styloidectomy is recommended as a routine part of the PRC procedure to prevent radial impingement without negatively impacting on function.

Level of evidence: IV
National language dilemma and its potential role in nation building: Academicians’ perception in Pakistan
Authors: Begum Tahira
Published: March 2022

Background: Pakistan inherits a multilingual heritage. Along with Urdu, 70 different languages are spoken. The 1973 Constitution officially recognizes Urdu as Pakistan's only national language. Purpose: Until today, the adoption and promotion of Urdu as a medium of educational instruction has remained a point of controversy. Existing research lacks the voice of academicians on the issue. Research Design: The present investigation focused on the voice of 100 university professors selected randomly. As part of the Ph.D. Data analysis: Research, data was gathered using a standardized Likert Summative Ranking Scale. Result: Data analysis revealed that there is a highly significant positive relationship ( p = 0.000) between the use of national language and nation-building. Conclusion: This means, academicians across Pakistani universities strongly believe in the use of national language in all lifestyles to realize the dreams of nation-building. It will help to achieve socio-cultural, developmental, strategic, academic, and identity goals amicably.
The distorted mirrors of humor
Authors: Neria Leticia
Published: March 2022

Research on humor has generated many different perspectives. Among them is a discussion of how humor acts to cause discomfort. Humor as a means of expression also appears in specific spaces and moments. The study of these spaces and moments, what is expressed through humor, the humorous mechanisms chosen by a collectivity, and who this collectivity may be, are broad-spectrum phenomenological issues that deserve further inquiry.
Obturator pyomyositis and labium majus cellulitis: A case report and literature review
Authors: Moriuchi Yuko , Fuchigami Tatsuo , Sugiyama Chihiro , Takahashi Satoko , Ohashi Yuko , Yonezawa Ryuta , Mizukoshi Waka , Morioka Ichiro
Published: March 2022

Pyomyositis is a rare, subacute, deep bacterial infection of the skeletal muscle. When treatment is delayed, pyomyositis causes abscess formation and progresses to sepsis; therefore, its early diagnosis is important. However, the clinical presentation and laboratory findings of pyomyositis are not specific; hence, diagnosis often takes time. We encountered the case of a girl with obturator pyomyositis and redness and swelling of the labium majus, which we considered as potentially important symptoms for distinguishing obturator pyomyositis from septic hip arthritis. An 8-year-old Japanese girl presented to our hospital with fever and right hip pain. On physical examination, she had redness and swelling of the right labium majus and a right limp. She was diagnosed with obturator pyomyositis and labium majus cellulitis with magnetic resonance imaging. Her clinical presentation markedly improved after starting antibiotic therapy with intravenous cefazolin for 2 weeks and oral cefaclor for 1 week. Improvement in the inflammation of the obturator muscle and labium majus was confirmed with follow-up magnetic resonance imaging. She recovered fully with no long-term sequelae. In conclusion, obturator pyomyositis rather than septic hip arthritis should be considered in children with a limp and hip and perineal pain, particularly girls with redness and swelling of the labium majus. In addition, imaging studies, including magnetic resonance imaging, should be performed for early diagnosis.
Utopia of abstraction: Digital organizations and the promise of sovereignty
Authors: Corballis Tim , Soar Max
Published: March 2022

Digital organizations form part of the new wave of blockchain technologies, following Bitcoin and related cryptocurrencies. “Utopia of Abstraction” offers an analysis of the utopian promise of digital organizations through a reading of one such project, Colony. We provide a critique of the ideology of Colony's white paper, supplemented by readings of pages from its website, as a member of a genre of texts that promote their products through seemingly neutral, technical descriptions. Colony's texts suggest an abstract, contextless and scaleless organizational solution—powered by smart contracts on a blockchain—that, according to its proponents, might be applied to any social situation, from small firm to state-level governance. For its users, this organization combines a promise of sovereignty removed from that of the state, as well as implied financial returns. Our reading of Colony echoes the critiques of scholars arguing that cyberlibertarianism is a dominant politic of blockchain technologies. Furthermore, drawing on critiques of code as law and the elision of the social in smart contracts, we argue that Colony's vision presents a model of technical organization that substitutes for the state in the context of waning popular sovereignty. We ultimately suggest an understanding of digital organizations reminiscent of the settler colonial situation: the assumption of an empty social space to be filled, and the promise of sovereignty and riches for those occupying it. Analysis of these logics is relevant as hype increases around non-fungible tokens, Web3, and the corporate metaverse as well as data practices more widely.
Teledentistry awareness, its usefulness, and challenges among dental professionals in Pakistan and Saudi Arabia
Authors: Chaudhary Farooq Ahmad , Ahmad Basaruddin , Javed Muhammad Qasim , Mustafa Saeed , Fazal Ayesha , Javaid Muhammad Mohsin , Siddiqui Ammar Ahmed , Alam Mohammad Khursheed , Ud Din Shahab
Published: March 2022

Objectives

This study aims to describe the perception of dental professionals in Pakistan and Saudi Arabia (SA) towards the practice of teledentistry, its usefulness and challenges.

Methods

A cross-sectional study was carried out among 190 dentists from January 2021 to April 2021. The participants were included in the study using snowball sampling method. A 26-item adopted questionnaire was distributed using different social media channels. Chi-square test was used for analysis.

Results

Out of 190 participants, 46.3% were from Pakistan and 53.7% were from SA. The majority of participants in both countries agreed that teledentistry would enhance guidelines and advice (74.2%), improve peer-to-peer interaction (79.5%) and make patient's referrals more efficient (75.8%). For the usefulness, most participants agree that it is economical for the patients (61.1%), improves communication (74.7%), helps in educating the patients (86.3%), avoid unnecessary travel (76.8%), helps monitoring (71.6%), and benefits patients in remote areas (74.7%); however, more Pakistani participants perceived that time spent with the patient would increase compared to SA participants ( p < 0.001) and a higher proportion of SA participants believe that it helps in communication and monitoring of patients ( p < 0.001) than Pakistani participants. Regarding the challenges in the use of teledentistry, few participants think that it violates the patient's privacy (22.6%) or is difficult to use (14.7%) or have distrust towards the teledentistry equipment (24.2%).

Conclusion

The results indicated a high awareness and a positive attitude towards teledentistry, and its adaptation in their dental practice in both countries. However, limited infrastructure, set-up cost, and information technology (IT) literacy are the main challenges in integrating teledentistry which can be overcome by strategic government initiatives, policies, and programs.
Empathy Not Quarantined: Social Support via Social Media Helps Maintain Empathy During the COVID-19 Pandemic
Authors: Qin Xuebing , Yang Fan , Jiang Zhibin , Zhong Bu
Published: March 2022

The Covid pandemic had turned the world upside down, but not much is known about how people’s empathy toward others in difficult situations might be affected by the pandemic. Based on a nationally representative sample ( N = 943) from China, this study first let participants read three real scenarios and then measured: (1) how empathy toward others might be influenced by the perceived social support people obtained by using social media (i.e., WeChat); and (2) how different demographics such as age and gender as well as lockdown situations may affect preserving empathetic during the Covid outbreak. Results show that perceived social support via WeChat not only positively impacted empathy but also interacted with anxiety in influencing the degree to which participants could maintain empathy toward others. Those living in cities or towns with higher incomes were more empathetic to others. While anxiety does not necessarily decrease empathy, those who reported gaining more social support on social media showed more empathy toward others despite their elevated levels of anxiety. Age negatively predicted empathy, but gender and lockdown conditions did not impact empathy. This study contributes to the literature by identifying the critical role empathy plays in people’s affective response to others during a public health crisis.
Pollen Allergy Screening with Allergen-Specific and Total Immunoglobulin E Titers
Authors: Yokoi Hidenori , Matsumoto Yuma , Kawada Michitsugu , Sakurai Hiroyuki , Saito Koichiro
Published: March 2022

Background

Allergic rhinitis is a typical type I hypersensitivity reaction, commonly caused by inhalant allergens. Accurate identification of the causative antigen is important for rapid diagnosis and treatment initiation.

Objective

This study examined the efficiency of serum-based allergen-specific immunoglobulin E and total immunoglobulin E antibody titers in screening for pollen allergy. We also examined the effect of cross-reactive carbohydrate determinants on specific immunoglobulin E titers in screening for pollen allergy, one of the causes of false positivity in specific immunoglobulin E measurements.

Methods

A questionnaire was used to evaluate the symptoms of pollinosis among participants who underwent a medical examination. One hundred and thirty-two participants reported pollen allergy symptoms and 127 reported an absence of symptoms. Specific immunoglobulin E levels were measured using the AlaSTAT 3g Allergy method. Seventeen components, including four types of cross-reactive carbohydrate determinant-specific immunoglobulin E antibodies, were measured and evaluated comparatively.

Results

The sensitivity and specificity of the tests in predicting the presence or absence of pollen allergy were analyzed. The values of the areas under the curves for immunoglobulin E antibody levels against cedar, cypress, orchard grass, and ragweed pollen were 0.87, 0.82, 0.63, and 0.56, respectively. A cross-reactive carbohydrate determinant-related false-positive effect on the pollen specific immunoglobulin E titer was noted in pollen screening.

Conclusion

Cedar pollen-specific immunoglobulin E titers showed sufficient accuracy for use in pollen allergy screening. The study of cross-reactive carbohydrate determinants suggested that subjects who tested positive for pollen often had false-positive results due to the impact of cross-reactive carbohydrate determinants.
Reflections on Peacebuilding Constructs in Seke District, Zimbabwe
Authors: Chivasa Norman
Published: March 2022

Since 2004, the formation of informal peace committees in Zimbabwe has signaled a change in the dynamics of local peace initiatives away from external elite top-down donor-driven interventions and toward a greater understanding of the potential of localized indigenous village and community informed solution-focused perspectives and initiatives. Despite the fact that non-governmental organizations (NGOs) aided in the facilitation, promotion, and enhancement of what was already in place, local peacebuilding efforts in Zimbabwe are not new, nor did they begin in 2004. Many Zimbabwean villages have had local peacebuilding initiatives such as customary courts for several decades prior to colonialism, but their notion of peacebuilding remain overlooked and under-appreciated. This study focuses on the peacebuilding constructs that have prompted ordinary people in the Seke district of Mashonaland East province, Zimbabwe, to create ward-level and village peace committees. The results of an action research method involving a 15-member ward peace committee (WPC) and 27 male and female respondents are discussed in this study. One of the main constructs was that peacebuilding is a collaborative mechanism (with no end-point) with the primary goal of preventing violence through conflict transformation rather than eradicating conflict. Peacebuilding was further interpreted as everyone’s occupation, regardless of social or political standing, since conflict knows no bounds. This study contends that elites can collaborate through a hybridized mechanism with local actors and informal institutions to promote community empowerment capacity for local peace and development initiatives in Zimbabwe.
Product Innovation and National Image of Chinese Products in the Eyes of Thai People
Authors: Luo Qiuxue , Suacamram Mayuree
Published: March 2022

This paper developed products from Guangxi, China, for customers in Bangkok, Thailand, and investigates the influence of country image and product innovation on purchasing eight products: a tea shop, flower tea, traditional Chinese dress, Chinese language lessons, an instant hotpot, Chinese noodles, jujube, and Chinese jewelry. The study followed four steps: (1) researching the demand of product development from documents and interviews with Chinese entrepreneurs; (2) developing a product concept and presenting it to two business experts; (3) selecting five products with the highest expert ratings and conducting a survey to collect data about the products from Thai customers; and (4) analyzing the level of buying decisions and influence of product country image and product innovation on each of the five products. Content analysis, path analysis, and multigroup techniques were used for data analysis. Results revealed that products with a high level of product innovation and buying decisions that introduced technology provided better value and that product innovation influenced buying decisions in all product categories. Product country image, however, only influenced buying decisions for Chinese jewelry and Chinese language lessons.

JEL Classification: M01, M03
When Self-Sacrificial Leaders Induce Employees’ Citizenship Behaviors? Uncovering the Nexus of Psychological Empowerment and Psychological Well-Being
Authors: Iqbal Kamran , Naveed Muhammad , Subhan Qazi Abdul , Fatima Tehreem , Alshahrani Saeed T.
Published: March 2022

The main objective of this study is to examine the effect of self-sacrificial leadership on organizational citizenship behavior within the health sector through a moderated mediation approach. The study has been conducted on nurses working in public hospitals in Sargodha, Pakistan, and data have been collected through a questionnaire survey method. In this study, psychological empowerment is used as a moderator, and psychological wellbeing is used as a mediator between self-sacrificial leadership on organizational citizenship behavior based on the fundamental premise of Conservation of Resource (COR) theory. The data have been analyzed through Partial Least Square Structural Equation Model (PLS-SEM) to examine the hypotheses. Empirical results demonstrated that psychological well-being plays a significant and positive mediating role in the relationship between self-sacrificial leadership and organizational citizenship behavior. The results further explain that nurses’ psychological empowerment moderates the mediating effect of psychological well-being between self-sacrificial leadership and organizational citizenship behavior. This study adds to a better understanding of the role of self-sacrificial leadership in encouraging organizational citizenship behavior.
Privacy Concern Behaviour on Social Media Sites: A Comparative Analysis of Urban and Rural Users
Authors: Bhandari Ravneet Singh , Bansal Ajay , Mathur Sanjeela , Nain Harikishni
Published: March 2022

Numerous researchers have examined various aspects of privacy concern and information-sharing behaviour for online social networking sites; few past researches stated that social media users' privacy concern behavior influenced by their demographic profile. This article attempts to analyse social networking users’ privacy concerns and information-sharing behaviours for urban and rural areas of India. It additionally investigates privacy concerns among users with distinctive levels of Internet addiction. It has been observed that are most of the respondents are susceptible to privacy infringement because of their online social media awareness. The examination finds that urban and rural users vary in their information-sharing practices and privacy adaption. Urbanites might be at more serious risk to privacy infringement and information sharing on account of their valuable data and their social media practices. Furthermore, social media users are dependent on the privacy alerts and settings available to them while sharing information on the various social media sites. Users with low social media awareness might be powerless against privacy infringement in the absence of such alerts from the site administrators. Potential implications of discoveries are given and advice for future research had been also discussed.
Adverse Neonatal Outcomes and Associated Risk Factors: A Case-Control Study
Authors: Workineh Yeneneh Ayalew , Workie Hailemariam Mekonnen
Published: March 2022

Background

Adverse neonatal outcomes have a significant effect on perinatal and neonatal survival and the risk of developmental disabilities and illnesses throughout future lives. Hence, the objective of this study was to identify adverse neonatal outcomes and associated risk factors.

Method

Institutional based unmatched case-control study was conducted among 206 neonates. Neonates who had adverse outcomes were cases with their index mothers and those neonates who hadn’t had adverse outcomes were controls with their index mothers. Sociodemographic, potential neonatal risk factors, and clinical data were taken from the mothers and medical records. Data were entered into Epi Info v7 and analyzed using SPSS v23. Bivariate and multivariable logistic regression analyses were used to adjust for confounding factors of adverse neonatal outcomes. Frequencies, means, standard deviations, percentages, and cross-tabulations were used to summarize the descriptive statistics of the data.

Results

In this study, low birth weight (61.5%), preterm birth (57.7%), and low Apgar score at fifth minutes (53.9%) were the major identified adverse neonatal outcomes. Based on the multivariable logistic regression analysis, rural place of residence (AOR = 5.992 to 95% CI [1.011-35.809]), low monthly income (AOR = 4.364), middle monthly income (AOR = 4.364), and emergency cesarean section (AOR = 9.969) were the potential risk factors for adverse neonatal outcomes.

Conclusions

The adverse neonatal outcomes & the risk factors identified in this research have the potential to harm the health of the neonates. Thus, it needs emphasis to tackle the problems and save the life of the newborn through better and strengthened ANC follow-up, accesses to health care.
Diversifying the Professoriate
Authors: Hofstra Bas , McFarland Daniel A. , Smith Sanne , Jurgens David
Published: March 2022

The primary means of social and intellectual reproduction in the professoriate is through mentoring doctoral students who become faculty mentors and publish research. However, opportunities to transition into such roles are not equal, and underrepresented groups face challenges building and sustaining their representation in the professoriate. What are social resources enabling them to overcome these challenges? To study this, the authors analyze nearly all PhD recipients in the United States from 1980 to 2015 (~1.03 million) and follow their careers. Women and underrepresented minorities are less likely to transition into academia than men and whites, but their chances increase when they are paired with same-attribute advisors and when they have significant group representation in their departments. In contrast, men and white scholars receive no costs or benefits from different- or same-attribute advisors. These findings warrant inspection to see how such relations can be fostered in all mentors.
Primary heart involvement in systemic sclerosis, from conventional to innovative targeted therapeutic strategies
Authors: Ferlito Arianna , Campochiaro Corrado , Tomelleri Alessandro , Dagna Lorenzo , De Luca Giacomo
Published: March 2022

Primary heart involvement is frequent in systemic sclerosis, even though often sub-clinical, and includes cardiac abnormalities that are predominantly attributable to systemic sclerosis rather than other causes and/or complications. A timely diagnosis is crucial to promptly start the appropriate therapy and to prevent the potential life-threatening early and late complications. There is little evidence on how to best manage systemic sclerosis-primary heart involvement as no specific treatment recommendations for heart disease are available, and a shared treatment approach is still lacking. The objective of this review is to summarize the state of the art of current literature and the overall management strategies and therapeutic approaches for systemic sclerosis-primary heart involvement. Novel insights into pathogenic mechanisms of systemic sclerosis-primary heart involvement are presented to facilitate the comprehension of therapeutic targets and novel treatment strategies.
The absence of the autoimmune regulator gene (AIRE) impairs the three-dimensional structure of medullary thymic epithelial cell spheroids
Authors: Monteleone-Cassiano Ana Carolina , Dernowsek Janaina A. , Mascarenhas Romario S. , Assis Amanda Freire , Pitol Dimitrius , Santos Moreira Natalia Chermont , Sakamoto-Hojo Elza Tiemi , Issa João Paulo Mardegan , Donadi Eduardo A. , Passos Geraldo Aleixo
Published: March 2022

Background

Besides controlling the expression of peripheral tissue antigens, the autoimmune regulator (AIRE) gene also regulates the expression of adhesion genes in medullary thymic epithelial cells (mTECs), an essential process for mTEC-thymocyte interaction for triggering the negative selection in the thymus. For these processes to occur, it is necessary that the medulla compartment forms an adequate three-dimensional (3D) architecture, preserving the thymic medulla. Previous studies have shown that AIRE knockout (KO) mice have a small and disorganized thymic medulla; however, whether AIRE influences the mTEC-mTEC interaction in the maintenance of the 3D structure has been little explored. Considering that AIRE controls cell adhesion genes, we hypothesized that this gene affects 3D mTEC-mTEC interaction. To test this, we constructed an in vitro model system for mTEC spheroid formation, in which cells adhere to each other, establishing a 3D structure.

Results

The comparisons between AIRE wild type (AIREWT) and AIRE KO (AIRE−/−) 3D mTEC spheroid formation showed that the absence of AIRE: i) disorganizes the 3D structure of mTEC spheroids, ii) increases the proportion of cells at the G0/G1 phase of the cell cycle, iii) increases the rate of mTEC apoptosis, iv) decreases the strength of mTEC-mTEC adhesion, v) promotes a differential regulation of mTEC classical surface markers, and vi) modulates genes encoding adhesion and other molecules.

Conclusions

Overall, the results show that AIRE influences the 3D structuring of mTECs when these cells begin the spheroid formation through controlling cell adhesion genes.
Increased normalized lactate load is associated with higher mortality in both sepsis and non-sepsis patients: an analysis of the MIMIC-IV database
Authors: Chen Han , Gong Shu-Rong , Yu Rong-Guo
Published: March 2022

Background

The present study aimed to evaluate the association between normalized lactate load, an index that incorporates the magnitude of change and the time interval of such evolution of lactate, and 28-day mortality in sepsis and non-sepsis patients. We also compared the accuracy of normalized lactate load in predicting mortality between these two populations.

Methods

Data were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database. We defined lactate load as the sum of the area under the lactate concentration curve; we also defined normalized lactate load as the lactate load divided by time. The performance of maximum lactate, mean lactate and normalized lactate load in predicting 28-day mortality in sepsis and non-sepsis patients were compared by receiver-operating characteristic curves analysis.

Results

A total of 21,333 patients were included (4219 sepsis and 17,114 non-sepsis patients). Non-survivors had significantly higher normalized lactate load than survivors in sepsis and non-sepsis patients. The maximum lactate, mean lactate, and normalized lactate load AUCs were significantly greater in sepsis patients than in non-sepsis patients. Normalized lactate load had the greatest AUCs in predicting 28-day mortality in both sepsis and non-sepsis patients. Sensitivity analysis showed that the AUC of normalized lactate load increased in non-sepsis patients when more lactate measurement was obtained, but it was not improved in sepsis patients.

Conclusions

Normalized lactate load has the strongest predictive power compared with maximum or mean lactate in both sepsis and non-sepsis patients. The accuracy of normalized lactate load in predicting mortality is better in sepsis patients than in non-sepsis patients.
Local infiltration analgesia versus peripheral nerve block anaesthesia in total knee arthroplasty: a pharmaco-economic comparison
Authors: Borck Michael , Wandrey Jan D. , Höft Moritz , Kastelik Joanna , Perka Carsten , Tafelski Sascha , Treskatsch Sascha
Published: March 2022

Background

A superior analgesic method in perioperative pain-management of patients receiving total knee arthroplasty is the subject of controversial debate. Although higher cost-efficiency is claimed for the local infiltration analgesia (LIA), there is a lack of data on its costs compared to peripheral nerve block anaesthesia (PNBA). The goal of this study was to investigate the differences in immediate perioperative costs between the LIA and PNBA in treatment of patients receiving total knee arthroplasty.

Methods

The comparison was conducted based on a randomized controlled clinical trial examining 40 patients with elective, primary total knee arthroplasty (TKA, 20 patients with LIA and 20 patients with PNBA). The analysis included surgical case costs, anaesthesiological case costs, material, costs of postoperative opioid requirements and catheter review visits for patients receiving PNBA.

Results

The overall mean costs for the LIA-group were 4328.72€ and 4368.12€ for the PNBA (p = 0.851). While there was no statistically significant difference in surgical case costs, the anaesthesiological costs were lower with the LIA procedure (1370.26€ vs. 1542.45€, p = 0.048). Material costs in the LIA group were 4.18€/patient and 94.64€/patient with the PNBA. Costs for postoperative opioid requirements showed no statistically significant difference between the two procedures.

Conclusions

There is no relevant difference in immediate perioperative costs between LIA and PNBA. Shorter induction times lead to lower anaesthesiological case costs with the LIA. Overall economic aspects seem to play a less important role for determining an adequate procedure for perioperative pain management.

Trial registration

The study was approved by the ethics-review-board of Charité Hospital Berlin (Ethikausschuss 4, Charité – Universitätsmedizin Berlin, on 16th February 2017) and registered with data safety authorities. Study patients provided written informed consent to participate in the trial. Study registry: ClinicalTrials.gov, NCT03114306.
Comparison of the outcomes between sorafenib and lenvatinib as the first-line systemic treatment for HBV-associated hepatocellular carcinoma: a propensity score matching analysis
Authors: Choi Na Ryung , Kim Ju Yeon , Hong Ji Hoon , Hur Moon Haeng , Cho Heejin , Park Min Kyung , Kim Jihye , Lee Yun Bin , Cho Eun Ju , Lee Jeong-Hoon , Yu Su Jong , Yoon Jung-Hwan , Kim Yoon Jun
Published: March 2022

Background/aim

In a randomized controlled trial, lenvatinib was non-inferior to sorafenib in overall survival (OS) of patients with unresectable hepatocellular carcinoma (uHCC). This study aimed to compare the effects of sorafenib and lenvatinib as first-line systemic therapy against uHCC with real-world data in chronic hepatitis B patients.

Methods

This retrospective single-center study involved 132 patients with HBV-related uHCC. Propensity score matching (PSM) was used to balance the baseline characteristics, including age, sex, serum alpha-fetoprotein levels, Child–Pugh class, tumor size, and tumor stage. The primary endpoint was overall survival (OS), and the secondary endpoints included progression-free survival (PFS), time to progression (TTP), and tumor response.

Results

After PSM, the final analysis included 44 patients treated with lenvatinib and 88 with sorafenib. The OS (7.0 vs 9.2 months, p = 0.070) and PFS (4.6 vs 2.4 months, p = 0.134) were comparable between the two drugs. Multivariable analysis showed that lenvatinib and sorafenib were not independent prognostic factors of OS (adjusted hazard ratio = 1.41, 95% confidence interval = 0.96–2.08, p = 0.077) after adjustment for baseline alpha-fetoprotein levels, total bilirubin levels, alanine aminotransferase level, performance status, tumor stage, and tumor size. However, the lenvatinib group had a significantly prolonged TTP (5.2 vs 2.5 months, p = 0.018) and a higher objective response rate (18.2% vs 4.5%, p = 0.020) and disease control rate (77.3% vs 47.7%, p = 0.001) than the sorafenib group.

Conclusions

Our study demonstrated that lenvatinib had a comparable OS and PFS but longer TTP and better tumor response compared to sorafenib in patients with HBV-related uHCC.
Relationship between modifiable lifestyle factors and chronic kidney disease: a bibliometric analysis of top-cited publications from 2011 to 2020
Authors: Yin Ting , Chen Yilong , Tang Lei , Yuan Huaihong , Zeng Xiaoxi , Fu Ping
Published: March 2022

Background

Chronic kidney disease (CKD) affects 8 to 16% of the world’s population and is one of the top ten important drivers of increasing disease burden. Apart from genetic predisposition, lifestyle factors greatly contribute to the incidence and progression of CKD. The current bibliometric analysis aims to characterize the current focus and emerging trends of the research about the impact of modifiable lifestyle factors on CKD.

Methods

We searched articles addressing the impact of modifiable lifestyle factors on the incidence and/or progression of CKD, published between 2011 and 2020, from the Science Citation Index Expanded (SCIE) database. An adjusted citation index, which considered both the original citation count and publication year, was derived for the selection of most-cited publications. Publishing trends, co-authorship network, keywords, and research hotspots were analyzed and visualized.

Results

Among the top 100 most influential articles, 32 were narrative reviews, 16 systematic reviews and/or meta-analysis, 44 clinical research, and 8 basic research. The United States occupied a dominant position in the perspective of article numbers and international partnerships, followed by European countries. The modifiable factors that drew the most and constant attention over the decade were diet or nutrition management reported in 63 papers, followed by obesity or body mass index (n = 27), and physical activity or exercises (n = 8). Alcohol consumption, fish oil, chain fatty-acids, and water-soluble vitamins were emerging hotspots identified in the recent most cited publications.

Conclusions

Based on the bibliometric analysis of the most influential articles, our study provides a comprehensive description of publishing trends and research focus over a decade in the field of lifestyle factors’ impact on CKD. Diet, obesity, and physical activity were factors receiving the most attention in this topic.
Maternal disease factors associated with neonatal jaundice: a case–control study
Authors: Yu Youngjae , Choi Jinwha , Lee Myeong Hoon , Kim KangHyun , Ryu Hyun Mee , Han Hyun Wook
Published: March 2022

Background

Neonatal jaundice is common, and despite the considerable medical costs associated with it, there are still few studies on the maternal factors associated with it. Identification of maternal factors associated with neonatal jaundice is very important in terms of prevention, screening and management of neonatal jaundice. The current study aimed to identify maternal disease factors associated with neonatal jaundice.

Methods

We compared the maternal disease diagnostic codes during pregnancy (study A) and 1 year before conception (study B) in mothers whose insurance claims data included newborns treated for neonatal jaundice before birth registration via the National Health Insurance Service–National Sample Cohort (control group). To decrease the effect of confounding variables, the neonatal jaundice and control groups were matched at a ratio of 1:10 via propensity score matching using covariates including age and income.

Results

The matched samples for studies A and B included 4,026 and 3,278 (jaundice group: 366 and 298) delivery cases, respectively. In both studies, the jaundice group had a higher proportion of patients who underwent cesarean section than the control group. In study A, other diseases of the digestive system had the highest odds ratio (OR) (K92; adjusted OR: 14.12, 95% confidence interval [CI]: 2.70–82.26). Meanwhile, gastritis and duodenitis had the lowest OR (K29; adjusted OR: 0.39, 95% CI: 0.22–0.69). In study B, salpingitis and oophoritis had the highest OR (N70; adjusted OR: 3.33, 95% CI: 1.59–6.94). Heartburn had the lowest OR (R12; adjusted OR: 0.29, 95% CI:0.12–0.71).

Conclusions

This study identified maternal disease factors correlated with neonatal jaundice during pregnancy and 1 year before conception. Maternal risk factors for neonatal jaundice included syphilis and leiomyoma during pregnancy, and salpingo-oophoritis before pregnancy. The protective factors included infection, inflammatory diseases, and dyspepsia.